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Oral Health and Related Factors for the Elderly (Structural Equation Modeling을 통한 노인(老人)의 구강건강(口腔健康) 관련요인(關聯要因) 분석(分析))

  • Seung, Jeung-Hee
    • Journal of dental hygiene science
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    • v.4 no.3
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    • pp.91-95
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    • 2004
  • This study aims to analyze realities of oral health and related factors, and establish Structural Equation Modeling. The subjects of study were 9,340 elderly over age 65 who took the health examination(the first) for the local insured which National Health Insurance Corporation carried out in the survey area mentioned below from January 2002 to December 2002. The areas surveyed were 4 big cities including Seongbuk-ku, Seoul, 5 medium cities including Wonjusi, Gangwon-do, and 5 Counties including Yeong deok County, Kyeongbuk. Considering location and the scale of population, firstly, big unit areas(metropolitan city, province) were selected according to convenience, secondly, low unit areas(city, county, district) were selected randomly. The subjects were the elderly who took all tests including an oral examination and filled in the questionnaire. Major results from analysis are as follows: 1. Review of Composition Conception Validity As a result of analyzing composition conception validity of SEM including posture test, urine test, blood test, habits of eating, drinking and smoking, oral symptoms, and oral health status, using fit index such as GFI, CFI, TLI, and RMSEA, all were within fit range and composition conception validity was recognized. 2. As a result of analyzing SEM to find the relationship between each factor and oral health status, it was confirmed that all factors except urine test affected oral health status and the synthetic SEM to explain it could be established. In result, we could verify that the elderly of rural areas who had lesser experience of visiting a clinic and oral prophylaxis had a higher rate of caries, missing teeth, and denture need, and drinking and smoking negatively affected the rate of caries, periodontal, and missing teeth. Also, periodontal diseases were observed from 43.2% of the total elderly and much from the lower age. Most of oral disease can be prevented by right oral health behavior. Therefore through oral health professionals from each district public health center of the nation, oral health education for the elderly about right eating habits and oral health care should be carried out systematically and policy change to increase access to dental service is required lest that visiting a dental clinic should be impossible or oral health behaviors such as oral prophylaxis and denture wearing should be neglected by economic, geographical barriers. Also, to establish SEM to explain the relationship between oral health status and systemic health, more accurate test methods and effective index development should be preceded. Because items developed by National Health Insurance Corporation applied to this study without alteration, structuring a model had the uppermost limit. Continual study seems to be needed.

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A Study on Curriculum Development For Community Health Practitioners (보건진료원 직무교육 교과과정 개선을 위한 일 연구)

  • 조원정;이경자
    • Journal of Korean Academy of Nursing
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    • v.22 no.2
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    • pp.207-226
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    • 1992
  • This study was designed to develop a conceptual framework for the curriculum and develop the details of the learning content for the education of Community Health Practitioners (CHPs). Since education programs for CHPs started 10 years ago, concepts related to CHP services have changed because of changes in society. The objectives of the study were as follows : 1) to analyse the usefulness of the present education program for CHPs, 2) to analyse the Job performance and self -confidence of the CHPs, 3) to identify the health needs of the clients served by the CHPs and the community problems related to health. 4) to develop a conceptual framework for the curriculum, for the education of CHPs, 5) to develops details for the learning content of the education program for CHPs. Phase I of the study was conducted by questionnaires to 150 CHPs who have worked in remote rural areas for more than 2 years. Among them, 147 responded. Data was collected from August 16, to August 25, 1990. In order to identify the health needs of the community people, research within the last five years was reviewed and analyzed. The data on 1, 842 communities gathered by the WHO Nursing Collaborations Center of the College of Nursing, Yonsei University was utilized to identify community problems related to health and the self - confidence in job performance of the CHPs. Psase II of the study consisted of a workshop with 13 professionals including Community Health Practitioners to evaluate the existing education program and a conceptual framework of the curriculum for the job education of CHPs. The results of the study are Summariged below : 1. The only 26 among 45 content items of the education program related to job skills was used by 80% of the responding CHPs. The knowledge of $\ulcorner$Networking community organization$\lrcorner$ was used by only 53.7% of the respondents. Educational content about $\ulcorner$Mental disease$\lrcorner$ was used by less than 50% of CHPs because of a knowledge deficit. 2. The CHPs reported that their activities concentrated on clinical services during the last six months. The survey showed that they seemed to neglect the activities for health promotion and disease prevention. Thus, $\ulcorner$Education for community loaders$\lrcorner$(15.9%), $\ulcorner$Activity for eavironmental health$\lrcorner$(16.3%) and $\ulcorner$Social work for needey people$\lrcorner$(23.3%) were done by less than 30% of CHPs. 3. More than 90% of CHPs reported being self - confident for the activities of $\ulcorner$Health education and counselling$\lrcorner$, $\ulcorner$Medicine prescription$\lrcorner$ and $\ulcorner$Immunization$\lrcorner$. But 50% of CHPs reported that they were not have self - confident in $\ulcorner$Management of water and environmental health$\lrcorner$ and only 25.6% of CHPs could insert an IUD independently. 4. It was identified that respiratory diseases and the gastrointestinal diseases were most common problems for the community people, followed by musculoskeletal and skin problems. 5. The community problems were classified into eight categories : physical environmental problems, environmental hygiene, health problems, health behavior, social problem, lack of resources, financial problem and the problems of the cultural and value system. 6. The conceptual framework consisted of the target population and their health status, nursing process working site and primary health care services such as health promotion, disease prevention, treatment and rehabilitation. 7. The contents of curriculum of education program for CHPs were formulated from the results of this study.

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Clinical Competency of Dental Hygiene Students to Manage Disabled Patients in Some Areas (일부 지역 치위생학과 학생들의 장애인 환자 관리에 대한 역량)

  • Hwang, Hyeon-Jeong;Kim, Ah-Hyeon;Kim, Jeong-Hee;Seo, Bo-Ryeon;Lee, Da-Hye;Hwang, Soo-Jeong
    • Journal of dental hygiene science
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    • v.18 no.6
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    • pp.349-356
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    • 2018
  • The demand for medical care and welfare for patients with disabilities is expanding, and healthcare professionals are also increasingly interested in the need for medical care for patients with disabilities. The purpose of this study was to evaluate the competency of disabled patients' management and the education experience of dental hygiene students, who are the main players of oral health care for disabled patients. A total of 196 students in the dental hygiene department and 3rd and 4th grade students were surveyed using questionnaires. As a result, most of the students had a positive awareness of disabled patients; 84.7% answered with the need to train dental hygienists in specializing in handicapped patients, 76.5% were willing to attend seminars related to disabled patients after graduation, and 71.4% of the students provided dental treatment for patients with disabilities in curriculum and comparative curriculum. The students who provided treatment for disabled patients showed that their competence in most areas of knowledge of disabled patients, oral health education, and oral disease prevention was highly evaluated as significant. The competence of respondents who answered that the theoretical education was sufficient was significantly higher. Based on this, institutional support for the education of dentistry for disabled patients is needed, and sufficient theoretical education and practical training should be offered to foster personnel capable of contributing to the improvement in the oral health of patients with disabilities. In addition, in-depth discussions on the training of dental hygienists specialized in handicapped patients should be conducted.

Approach Toward Integrated Curriculum for Dental Hygienist (치과위생사 통합교육과정을 위한 접근)

  • Hwang, Mi-Yeong
    • Journal of Korean society of Dental Hygiene
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    • v.3 no.1
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    • pp.59-72
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    • 2003
  • The purpose of this study was to examine what the role of denial hygienist was. The subjects were 751 dental hygienists from dental clinics, dental hospitals, general hospitals, public dental clinics and their branches throughout the nation. After a survey was conducted, the collected data were analyzed with SPSS WIN 10.0, and variance analysis and post-analysis were implemented. And Forgarty's 8th integrated model, out of 10 ones, was selected to delve into the practical role of dental hygienist in detail. The findings of this study were as follows: 1. The three age groups had a significantly different opinion on the significance of individual subjects. The dental hygienists of thirty six and over found the basic and preventive public dental care courses most important, and the 31~35 age group placed most stock in education and research. Overall, the post-analysis results showed that prevention and clinical courses were considered most vital, followed by education and fundamental courses. 2. There was a significant gap between four groups from the different work places in their view of the weight of the individual subjects. According to the post-analysis, the dental hygienists from the general hospitals, public dental clinics and their branches gave more weight to fundamental, education and research areas. Those who were with the dental clinics, dental hospitals and general hospitals put higher value on clinical course than the dental hygienists from the public dental clinics and their branches. 3. Two groups with a different career also had a different outlook on the importance of the individual subjects. The post-analysis results illustrated that the dental hygienists who had worked for three years or more put higher stress on the fundamental course than those with a less career, and the dental hygienists with a five-year or higher career attached more importance to the education and research field than those with a smaller career. 4. There was a significant difference between the three age groups in their clinical role. The post-analysis results indicated thai the younger dental hygienists were more of assistants than of professionals, as they chiefly took X-ray photograph, handled treatment materials or performed treatment-related works. Overall, handling treatment materials was most common. 5. The three groups from the different work places significantly varied in their clinical role. According to the post-analysis, those from the dental clinics and dental hospitals took more x-ray photographs, handled more treatment materials and performed more relevant works, compared to those from the general hospitals, public dental clinics and their branches. 6. The two groups with a different career differed significantly in their clinical role. The post-analysis results suggested that the dental hygienists with a less career played an assistant role more, which handled treatment materials or carried out other relevant works. 7. The fundamental courses (I) and (II), preventive class (I) and (II) and its practice course were regarded as integrated subjects that they should take 10 offer preventive treatment, which was one of the dental hygienist missions. What's needed to act as dental-care educators was the basic courses (I) and (II), dental hygiene education and its practice. Finally, integrated clinical courses (I) and (II) and clinical practice were viewed as necessary for their role performance as dental treatment collaborators.

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Concept Development of Service Marketing Promotion in Nursing (간호서비스 마케팅에 관한 연구;'촉진(Promotion)' 개념 개발)

  • Kang, Yoon-Sook
    • Journal of Korean Academy of Nursing Administration
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    • v.5 no.1
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    • pp.63-76
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    • 1999
  • The main objective of this study was to develop a concept of service marketing promotion in nursing that is derived from the concepts of service marketing theory. This research was a descriptive study, at the factor isolation level. The principle of concept derivation suggested by Walker and Avant (1988) and the Hybrid model suggested by Schwarz-Barcott and Kim (1993) were employed as the research method. The data were collected from December, 1997 to April. 1998 at a large general hospital located in Seoul. The procedures of this study were as follows: First. at the theoretical phase: the meaning, attributes, and definition of service marketing promotion were identified through an extensive review of the literature. Second, at the empirical phase: fieldwork was done to identify the promotional activities and events in nursing. Top nurse managers from 4 units (Director of Nursing, Head nurses of inpatient nursing unit, outpatient nursing unit. and home care nursing unit) were interviewed and the content of the interview was analyzed to identify the meaning and attributes of promotion in nursing. Other methods such as brochures and other audio-visual materials which were relevant to nursing promotion were used to supplement the interviews. Finally, the results of the theoretical and empirical analyses were intergrated to develop a concept of service marketing in nursing practice. A final definition of service marketing promotion in nursing was identified as follows. 1. Promotion as a marketing function in nursing service is concerned with communication to target markets on all information related to nursing service in order to satisfy the objectives of both a nursing service organization and the target markets. 2. The goals of nursing service promotion include: 1) increasing visibility of nursing services and delivering the information on nursing services, 2) affirming the value of nursing services, so it can contribute to formulation of reimbursement policy for nursing services. 3) advancing the general image of the nursing profession and nursing services. 4) achieving and attaining a desirable positioning for nurses among health care professionals. and 5) creating and stimulating the demand for nursing services. 3. In order to obtain these goals it is necessary to provide information on nursing services, to persuade target markets. to remind them about nursing services. and to establish a collaborative relationship with related departments. 4. The tools used to carry out the above functions of promotion in nursing are the providing nursing services, public relations and publicity. QA of nursing, advertising, and sales promotion. 5. The target markets of nursing service include the nursing customer markets. the internal markets, the influence markets. the recruitment markets. the supplier markets. and the nursing referral markets. In conclusion, the concept of promotion in other service marketing areas can be applied to the promotion of nursing service marketing. The promotion of nursing service is more than just effective communication in nursing service. it is the effective use of the concepts of service marketing promotion. Promotion of nursing service will contribute to create and expand nursing services.

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Development of Cyber Counseling Program for Hospice (호스피스 사이버 상담을 위한 프로그램 개발)

  • Lee, Won-Hee;Oh, Eui-Geum;Kim, Cho-Ja;Kang, Kyu-Sook;Kang, Se-Won
    • Journal of Hospice and Palliative Care
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    • v.8 no.2
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    • pp.209-215
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    • 2005
  • Purpose: The purpose of this study is to enhance the quality of life for the terminal patients and their family by providing counseling service through a hospice counseling homepage, thus activating hospice service and contributing to our national health. Methods: The study was methodologically conducted to assess the homepage developed and to professionally verify the counseling flow. Results: The cyber hospice homepage was developed between January 2004 and August 2004, whereby its counseling service was operated. The homepage included introduction, news (announcement), on-line lectures, community site for hospice clients, hospice counseling, and related links. As a result of assessing the site and of verifying the reliability of counseling service, the counseling flow was unanimously approved by the professionals. Conclusion: The cyber counseling for hospice was conducted to enhance the quality of life for the terminal patients and their family and to activate hospice service. It is required to train professional hospice cyber counselors and to establish systematic promotional strategies for activation of the cyber counseling site.

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Exploring Job Stress, Job Satisfaction, and Turnover Intention of Nurses in the Comprehensive Nursing Service (상급종합병원의 간호·간병통합서비스 병동에 근무하는 간호사의 직무스트레스, 직무만족 및 이직의도)

  • Kwak, Sook Hee;Hyun, Sookyung
    • The Journal of the Convergence on Culture Technology
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    • v.5 no.2
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    • pp.23-30
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    • 2019
  • The purpose of this study was to examine job stress, job satisfaction, and turnover intention of the nurses who work at the comprehensive nursing service units in two academic medical institutions that provide healthcare service at the tertiary care level in Korea. A descriptive study was conducted with the nurses by using self-reported questionnaires. We used descriptive statistics to summarize the data and Mann-Whitney U test for group comparison. The mean scores of job stress, job satisfaction, and turnover intention were $89.17{\pm}12.56$, $107.25{\pm}6.85$, $37.19{\pm}4.86$, respectively. Nurses with religion showed more job stress than those without. Nurses with their age below 30 years old had significantly less job satisfaction than those older than 30 years old. Monthly income was significantly associated with turnover intention in our data. The top three sub-category of the job stress were conflict with physicians, patients and their caregivers, and conflicts with others; and those of the job satisfaction were pay and promotion and task requirement. Job stress, job satisfaction, and turnover intention were significantly correlated. In order to reduce turnover intention of nursing professionals in the comprehensive nursing service, job stress related to issues on relationships with patients, their family, health care providers need to be taken into consideration. Policy and administrative support are needed to improve their work environment.

A Study on The Nursing Needs of Users and their Service Status at Short-Stay Centers for The Elderly (단기노인보호소 이용자의 간호요구도 및 서비스 실태연구)

  • Shin Kyoung Hi;Rhee Seon Ja
    • Journal of Korean Public Health Nursing
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    • v.16 no.2
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    • pp.354-377
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    • 2002
  • Aging population is a global trend and Korea is no exception. Due to the progress of the medical and scientific sectors, increase in the average lifetime incurred increase in the number of elderly people. Meanwhile, the family function of supporting the elderly has become a major issue in a society due to the changes in the society's structure and increased entry of the women into the workforce. As a means to substitute the protection of the elderly who are not protected at their respective homes and to replace the tending needs, weekly protection centers and short-stay centers for the elderly were established and operated in Seoul since 1992. However, structured and satisfactory services are not yet to be provided, thus this research intends to understand the current situation at the short-stay centers for the elderly, to identify users' characteristics and to conduct study on nursing need for the health reasons so that the results of the research can be utilized as basic data for the development of nursing care program. Towards this end, this research targeted 142 elderly people who were undergoing treatment at the 11 short-stay centers for the elderly out of total of 13 located in Seoul that were willing to cooperate. The research was conducted from April to May 2002, with the measurement tool developed by Rhee, Seon-ja (2001) to measure the level of nursing need. Then data was collected and analyzed using SPSS program. The results are as follows. The general characteristics of users of the short-stay centers for the elderly were: 123 females $(86.6\%)$, 19 males $(13.4\%)$ and 72 elderly were over the age of 80 $(50.7\%)$. Among these, 24$(16.9\%)$ were living by themselves. Among the illnesses that the subjects were inflicted with were: dementia $(54.2\%)$, stroke $(54.1\%)$ and high blood pressure $(50.7\%)$, in the respective order. Despite the fact that they were diagnosed with illnesses, $47.2\%$ responded that they do not undergo special treatment due to financial reasons. When the level of needs for nursing care among the elderly who use the short-stay centers is divided into informational. physical. and emotional need levels and scored between zero to two, the level of emotional need is the highest with 1.80, followed by physical (1.45) and informational (1.44) need levels. As for the realities of services at the centers and improvement areas, restriction on term was cited as the greatest inconvenience with $38.7\%$, followed by lack of budget (24 respondents, $16.9\%$). Wishful services were financial assistance $(46.5\%)$, medical and nursing services $(40.1\%)$, meal provision service $(8.5\%)$ and counseling service $(4.9\%)$, in the respective order. Based on the above mentioned results, the research identified the need to develop nursing program for the patients of dementia that can be applied onto the short-stay centers and the need to develop volunteer service, backed by societal support. Also, placement of specialized cadre of professionals is needed so that medical and nursing service functions can be provided in a complementary manner.

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A Plan for Activating Elderly Sports to Promote Health in the COVID-19 Era (코로나19 시대 건강증진을 위한 노인체육 활성화 방안)

  • Cho, Kyoung-Hwan
    • Journal of Korea Entertainment Industry Association
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    • v.14 no.7
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    • pp.141-160
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    • 2020
  • The purpose of this study was to devise a specific plan for activating sports to promote health in old age against the prolonged COVID-19 pandemic. Through literature review, it also analyzed the association between health status and COVID-19 in old age, suggested health promotion policies and projects for elderly people, and presented a plan for activating sport to promote health in old age against COVID-19 era. First, it is necessary to revise the relevant laws, including the Sport Promotion Act and the Elderly Welfare Act, partially or entirely, make developmental and convergent legislations for elderly health and sports, and establish an institutional device as needed. Second, it is necessary to build an integrated digital platform for the elderly and make a supporting system that links facilities, programs, information, and job creation as part of a New Deal program in the field of sports on the basis of the Korean New Deal. Third, it is necessary to train elderly welfare professionals. Efforts should be made to establish more departments related to elderly sports in universities and make it compulsory to place elderly sports instructors at elderly leisure and welfare facilities. Fourth, it is necessary to develop contents related to health in old age. This means performing diverse movements by manipulating them through a virtual reality (VR) simulation. Fifth, it is necessary to make a greater investment in research and development related to elderly sports and relevant fields. This means the need to conduct constant research on healthy and active aging in a systematic and practical way through multidisciplinary cooperation. Sixth, it is necessary to establish and operate an elderly management agency (elderly health agency) under the influence of the Office of the Prime Minister. This means the need to secure independence in implementing the functions related to health promotion in old age and make comprehensive operation, which involves all the issues of health promotion in old age, daily function maintenance and rehabilitation, social adjustment, and long-term care, by establishing an elderly management agency in an effort to give lifelong health management to the elderly and cope with the untact, New Normal age.

A Model for Health Promoting Behaviors in Late-middle Aged Woman (중년후기 여성의 건강증진행위 모형구축)

  • Park, Chai-Soon
    • Women's Health Nursing
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    • v.2 no.2
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    • pp.298-331
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    • 1996
  • Recent improvements in living standard and development in medical care led to an increased interest in life expectancy and personal health, and also led to a more demand for higher quality of life. Thus, the problem of women's health draw a fresh interest nowadays. Since late-middle aged women experience various physical and socio-psychological changes and tend to have chronic illnesses, these women have to take initiatives for their health control by realizing their own responsibility. The basic elements for a healthy life of these women are understanding of their physical and psychological changes and acceptance of these changes. Health promoting behaviors of an individual or a group are actions toward increasing the level of well-being and self-actualization, and are affected by various variables. In Pender's health promoting model, variables are categorized into cognitive factors(individual perceptions), modifying factors, and variables affecting the likelihood for actions, and the model assumes the health promoting behaviors are affected by cognitive factors which are again affected by demographic factors. Since Pender's model was proposed based on a tool broad conceptual frame, many studies done afterwards have included only a limited number of variables of Pender's model. Furthermore, Pender's model did not precisely explain the possibilities of direct and indirect paths effects. The objectives of this study are to evaluate Pender's model and thus propose a model that explains health promoting behaviors among late-middle aged women in order to facilitate nursing intervention for this group of population. The hypothetical model was developed based on the Pender's health promoting model and the findings from past studies on women's health. Data were collected by self-reported questionnaires from 417 women living in Seoul, between July and November 1994. Questionnaires were developed based on instruments of Walker and others' health promotion lifestyle profile, Wallston and others' multidimensional health locus of control, Maoz's menopausal symptom check list and Speake and others' health self-rating scale. IN addition, items measuring self-efficacy were made by the present author based on past studies. In a pretest, the questionnaire items were reliable with Cronbach's alpha ranging from .786 to .934. The models for health promoting behaviors were tested by using structural equation modelling technique with LISREL 7.20. The results were summarized as follows : 1. The overall fit of the hypothetical model to the data was good (chi-square=4.42, df=5, p=.490, GFI=.995, AGFI=.962, RMSR=.024). 2. Paths of the model were modified by considering both its theoretical implication and statistical significance of the parameter estimates. Compared to the hypothetical model, the revised model has become parsimonious and had a better fit to the data (chi-square =4.55, df=6, p=.602, GFI=.995, AGFI=.967, RMSR=.024). 3. The results of statistical testing were as follows : 1) Family function internal health locus of control, self-efficacy, and education level exerted significant effects on health promoting behaviors(${\gamma}_{43}$=.272, T=3.714; ${\beta}_[41}$=.211, T=2.797; ${\beta}_{42}$=.199, T=2.717; ${\gamma}_{41}$=.136, T=1.986). The effect of economic status, physical menopausal symptoms, and perceived health status on health promoting behavior were insignificant(${\gamma}_{42}$=.095, T=1.456; ${\gamma}_{44}$=.101, T=1.143; ${\gamma}_{43}$=.082, T=.967). 2) Family function had a significance direct effect on internal health locus of control (${\gamma}_{13}$=.307, T=3.784). The direct effect of education level on internal health locus of control was insignificant(${\gamma}_{11}$=-.006, T=-.081). 3) The directs effects of family functions & internal health locus of control on self-efficacy were significant(${\gamma}_{23}$=.208, T=2.607; ${\beta}_{21}$=.191, T=2.2693). But education level and economic status did not exert a significant effect on self-efficacy(${\gamma}_{21}$=.137, T=1.814; ${\beta}_{22}$=.137, T=1.814; ${\gamma}_{22}$=.112, T=1.499). 4) Education level had a direct and positive effect on perceived health status, but physical menopausal symptoms had a negative effect on perceived health status and these effects were all significant(${\gamma}_{31}$=.171, T=2.496; ${\gamma}_{34}$=.524, T=-7.120). Internal health locus and self-efficacy had an insignificant direct effect on perceived health status(${\beta}_{31}$=.028, T=.363; ${\beta}_{32}$=.041, T=.557). 5) All predictive variables of health promoting behaviors explained 51.8% of the total variance in the model. The above findings show that health promoting behaviors are explained by personal, environmental and perceptual factors : family function, internal health locus of control, self-efficacy, and education level had stronger effects on health promoting behaviors than predictors in the model. A significant effect of family function on health promoting behaviors reflects an important role of the Korean late-middle aged women in family relationships. Therefore, health professionals first need to have a proper evaluation of family function in order to reflect the family function style into nursing interventions and development of strategies. These interventions and strategies will enhance internal health locus of control and self-efficacy for promoting health behaviors. Possible strategies include management of health promoting programs, use of a health information booklets, and individual health counseling, which will enhance internal health locus of control and self-efficacy of the late-middle aged women by making them aware of health responsibilities and value for oneself. In this study, an insignificant effect of physical menopausal symptoms and perceived health status on health promoting behaviors implies that they are not motive factors for health promoting behaviors. Further analytic researches are required to clarify the influence of physical menopausal symptoms and perceived health status on health promoting behaviors with-middle aged women.

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