• Nutrition Research and Practice
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• v.13 no.5
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• pp.415-424
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• 2019

BACKGROUND/OBJECTIVES: Existing evidence on lifestyle modification programs for weight loss is limited by the high attrition rate of such programs. Identifying predictors of adherence to a lifestyle modification program could result in program improvement. However, little is known about behavior-specific adherence and its psychological predictors. This study aimed to examine the psychological predictors of adherence after one-month participation in a community-based lifestyle modification program among Chinese overweight and obese adults in Hong Kong. SUBJECTS/METHODS: A total of 205 Chinese overweight and obese adults aged $38.9{\pm}10.5years$ completed the study. Data were collected at baseline and after one month using self-reported questionnaires, which assessed knowledge (self-developed scale), motivation (Treatment Self-Regulation Questionnaire), stage of change (Stage of Exercise Scale) and self-efficacy (Self-Rated Abilities for Health Practices Scale). At one month, a 4-day dietary recall and the International Physical Activity Questionnaire-Short Form were used to assess dietary and physical activity (PA) adherence. Food and PA diaries were examined to indicate self-monitoring. Program attendance was tracked between baseline and one-month follow-up. RESULTS: After one month, participants reported high dietary adherence, attendance, and adherence to self-monitoring but low PA adherence. Multiple regression analyses suggested that diet self-efficacy (baseline) and nutrition knowledge (one-month change) were independent predictors of dietary adherence score at one month, whereas autonomous PA motivation (baseline) and PA self-efficacy (both baseline and one-month change) were independent predictors of PA adherence score at one month. No significant psychological predictor was identified for attendance or self-monitoring. CONCLUSIONS: The results suggest that the effect of psychological factors on adherence differs between diet and PA adherence outcomes. To promote adherence, practitioners should assess self-efficacy, knowledge, and motivation at the beginning of a weight-loss program and explore behavior-specific strategies to improve knowledge and self-efficacy. The results of this study have direct implications for program improvements.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.2 no.2
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• pp.155-168
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• 1995

Many arthritis patients experience physical and psychological impairment. The influence psychological factors on physical functioning beyond disease & demographic factors has been investigated. Unlike others studied the relationship between just two variables (i. e., depression & helplessness or self-efficacy & depression), the relationships among several variables such as depression, helplessness and self-efficacy were examined altogether. Foully-two patients were examined to identify the relationship between the variables. It was found that ADL is significantly negatively related to depression and helplessness, and positively related to self-efficacy. And ADL was more strongly correlated with self-efficacy and helplessness than depression. Contrary to ADL, pain was significantly negatively related to self-efficacy, and positively related to depression and helplessness. Then stepwise regression analysis was performed to identify the variables to predict ADL. It revealed that helplessness was the only significant predictor of ADL. Finally, it is suggested that the inclusion of the method to increase self-efficacy & to decrease helplessness in any nursing intervention is very important.

• Journal of Korean Academy of Nursing
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• v.50 no.1
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• pp.52-65
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• 2020

Purpose: To examine the effects of a smartphone application-based exercise program on self-efficacy expectations (SEE) and outcome expectations regarding exercise (OEE), physical fitness, activity level, physiological indices, and health-related quality of life in a sample of hemodialysis patients. Methods: A quasi-experimental control group pre-test post-test design was used. Subjects were recruited from two university hospitals in G city. The subjects were assigned randomly by coin toss: 33 participants to the experimental group and 30 to the control group. A literature review and the self-efficacy theory were used to develop the smartphone program. Experts designed and verified the program to be userfriendly and in consideration of user interaction. Data were collected through a self-report pre-test post-test questionnaire and online medical records. Results: In the experimental group, the levels of physical fitness and physical activity were significantly improved post-test, but the scores on health-related quality of life and the physical indices did not improve. In the experimental group, the SEE and OEE post-test scores were also significantly higher than the pre-test scores, but the control group's scores did not change. Conclusion: The smartphone application-based exercise program based on self-efficacy theory significantly improved the level of physical fitness and activity, SEE, and OEE for hemodialysis patients. The use of this application-based exercise program for hemodialysis patients might be an effective nursing intervention tool for improving SEE, OEE, level of physical fitness, and physical activity.

• Research in Community and Public Health Nursing
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• v.19 no.4
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• pp.704-714
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• 2008

Purpose: This study explored the feasibility of a 12 week self-efficacy based exercise intervention for overweight and obese college students. Method: A repeated measure, 4-group randomized controlled design was used. Students were recruited from two universities. in Seoul. Korea using: (1) flyers either on the campus bulletin boards or in campus restrooms: (2) advertisement on campus e-board: and (3) self-referral. Inclusion criteria were: (1) Korean college students aged 18 to 29: (2) BMI >23: (3) viscerally obese: and (4) accessible to a phone and a computer. Participants completed three self-reported questionnaires: socio-demographic questionnaire (at the baseline), Exercise Self-Efficacy Scale (at the baseline and $12^{th}$ week), and Physical Fitness sub-subscale (at the baseline and $12^{th}$ week). Additionally. physiological data (height, weight, blood pressure) were collected at the baseline and $12^{th}$ week. Descriptive statistics and a two-way mixed ANOVA were performed using SPSS12.0. Results: No significant group difference was observed. However. students with increased exercise self-efficacy during the program showed better physical fitness in the $12^{th}$ week. When students' physical fitness was enhanced. the physiological factors were improved. Conclusions: Self-efficacy based exercise intervention may be applicable and acceptable to the college students. It is necessary to conduct a replicated study with a larger sample and an elongated intervention period.

• Journal of muscle and joint health
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• v.5 no.1
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• pp.39-56
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• 1998

This study was an quasi-experimental study, done to identify factors Influencing the reduction of symptoms in patients with fibromyalgia. The primary purpose of the study was to develop a Self-Help Program suitable for patients with fibromyalgia in Korea. The secondary purpose was to identify the effects of a Self-Help Program which included stretching exercise. This study was carried out between Feb. 24 and July 8, 1997 and patients in the study Included out patient diagnosed with fibromyalgia based on the criteria developed by the American College of Rheumatology(1990) and H, University which is a tertiary patient care clinic for Rheumatism. The experimental group included 38 patients who were residents of Seoul or Kyungi province, and a control group of 38 patients who were residents of other areas. The control patients were matched to the experimental group patients and they were selected considering the number of tender points on the Fibromyalgia Impact Questionnaire score and a score of self-efficacy. The experimental group participated in a Self-Help Program based on the American Arthritis Foundation(1995) guidelines. The program participants participated in a small group which consisted of 12-15 members attending the program once a week, for 6 weeks with each program lasted two to two and a half hours. The stretching exercise was carried out in each patient's home every day following the video tape exercise provided by the researcher, and the researcher provided encouragement and concern to the patients by calling them once a week. The number times the exercise was performed was divided by the number of participants to calculate the percentage of performance and determine the amount of exercise. Self-efficacy was measured by the Self-Efficacy Scale developed by Lorig et al. (1989) for arthritis patients. The degree of pain was converted to scores based on the Visual Analog Scale, the number of tender points was converted to scores based on the criteria of the ACR(1990) and of Yunus. Depression was measured by CES-D and physical disability, sleep disturbance, fatigue, and anxiety of patients with fibromyalgia were measured by the Fibromyalgia Impact Questionnaire. The level of the exercise performance was converted to scores using the number of times the exercise was performed following the video tape prepared by Association of Rheumatology Health Professionals. Data were analyzed by SPSS windows and the results ire described below. 1. The experimental group which participated in the Self-Help Program showed higher efficacy scores than the control group when both groups were analyzed for depression and the number of tender points as common variables(F=9.146, p=.003). 2. The experimental group which participated in the Self-Help Program showed lower scores than the control group, for pain, the number of tender points, depression, physical disability, fatigue, sleep disturbance and anxiety. These symptoms of fibromyalgia can all be seen to have subsided(F=9.483, p=.003 : F=32.680, p=.001 ; F=11.104, p=.001, F=5.344 : p=.024, F=7.630 : P=.007, F=15.6512, p=.003 : F= 7.5412, p=.008). 3. In the experimental group, the self-efficacy score for the first three weeks showed a positive correlation with the exercise-performance score for four to six weeks (r=.387, p=.043). 4. In the experimental group, the relationship between the level of exercise-performance and the reduction of symptoms showed a significant correlation only to physical disability(r= -.500, p=.001). 5. In the experimental group, the relationship between the self-efficacy score and pain, the number of tender points, depression, physical disability, fatigue, sleep disturbance and anxiety score showed inverse correlations and thus, a reduction of symptoms occured when the self-efficacy score increased(r=-.325, p=.004 ; r= -.253, p=.027, r=-.452, p=.001 : r=-.434, p=.001 ; r=-.316, p=.005 ; r=-.460, p=.001 ; r=-.397, p=.014). Therefore, self-efficacy improved following the Self-Help Program including the stretching exercise. It was also found that physical symptoms (pain, number of tender points, level physical disability) and psychological symptoms (depression, fatigue, sleep disturbance, anxiety) were reduced. Moreover, It was found that the higher the self-efficacy, the the higher the degree of achievement of goals set for the stretching exercises. In addition, the level of exercise-performance influenced the level of physical disability, one of the symptoms of fibromyalgia. Accordingly, the conclusions from this study are that exercise-performance and the reduction of symptoms is achieved through promotion of self-efficacy. Therefore, it is proposed that are the Self-Help Program including stretching exercises is an appropriate nursing intervention for the reduction of symptoms of fibromyalgia.

• Journal of muscle and joint health
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• v.4 no.2
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• pp.262-276
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• 1997

The purposes of this study are 1) to modify a self-help program for patients having fibromyalgia, 2) to revise instruments to measure the self-efficacy and impact of fibromyalgia; and 3) to test the effects of the program in terms of self-efficacy, physical activities, and clinical symptoms. The subjects of this study were persons diagnosed as fibromyalgia at a university hospital. For the first two purposes, six patients were selected. Twenty three subjects for the third purpose were selected and assigned to experimental and control group on the base of their residence. Thirteen were assigned to the experimental group, while 10 to the control group. Instruments selected for revision were self-efficacy scale and fibromyalgia impact profile. On the basis of the text developed by Arthritis Foundation, a program for patients with fibromyalgia was tentatively developed. Instruments for measurement of self-efficacy and impact of fibromyalgia were revised to show high reliabilities. Results obtained by utilization of the program were as follows : 1) There were no increase of self-efficacy and physical activities. 2) There were no improvement of the number of tender points and pain. 3) There were improvement of depression, fatigue and sleep impairment. These findings indicate the needs for modification of the program with emphasis of exercise for relaxation of tender points, increases of enactive action and vicarious learning.

• Journal of muscle and joint health
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• v.8 no.1
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• pp.122-140
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• 2001

The aims of this study were to understand and to predict the determinent factors affecting the exercise behaviors and physical fitness by testing the Pender's revised health promotion model, and to help the patients with rheumatoid arthritis and osteoarthritis perform the continous exercise program, and to help them maximize the physical effect such as muscle strength, endurance, and functional status and mental effects including self efficacy and quality of life, and improve the physical and mental well being, and to provide a basis for the nursing intervention strategies. Of the selected variables in this study, the endogenous variables included the physical fitness, exercise score, exercise participation, perceived benefits of action, perceived barriers of action to exercise, activity-related affect(depression) and perceived self-efficacy, interpersonal influences(family support), situational factors(duration of arthritis, fatigue) and the exogenous variables included personal sociocultural factor(education level), personal biologic factor(body mass index), personal psychologic factor(perceived health status) and prior related behavior factors(previous participation in exercise, life-style). We analyzed the clinical records of 208 patients with rheumatoid arthritis and degenerative arthritis who visited the outpatient clinics at H university hospital in Seoul. Data were composed of self reported qustionnaire and good of fitness score which were obtained by padalling the ergometer of bicycle for 9 minutes. SPSS Win 8.0 and Window LISREL 8.12a were used for statistical analysis. Of 75 hypothetical paths that influence on physical fitness, exercise participation, exercise score, perceived benefits of action, perceived barriers of action to exercise, activity-related affect(depression) and perceived self-efficacy, interpersonal influences(family support), situational factors(duration of arthritis, fatigue), 40 were supported. The physical fitness was directly influenced by life-style, perceived health status, education level, family support, fatigue, which explained 12% of physical fitness. The exercise participation were directly influenced by life-style, education level, past exercise behavior, perceived benefits of action, perceived barriers of action, depression and duration of arthritis, which explained 47% of exercise participation. Exercise score were directly affected by perceived self efficacy. BMI, life-style, past exercise behavior, perceived benefits of action, family support, perceived health status. perceived barriers of action, and fatigue, which explained 70%. Perceived benefits of action was directly influenced by BMI, life-style, which explained 39%. Perceived barriers of action were directly influeced by past exercise behavior, perceived health status, which explained 7%. Perceived self efficacy were directly influeced by level of education, perceived health status, life-style, which explained 57%. Depression were directly influeced by past exercise behavior, BMI, life-style, which explained 27%. Family support were directly influeced by life-style, perceived health status, which explained 29%. Fatigue were directly influeced by BMI, life-style, perceived health status. which explained 41%. Duration of arthritis were directly influeced by life-style, past exercise behavior, BMI, which explained 6%. In conclusion, important variables for physical fitness were life-style, and variable affecting exercise participation were life-style. Perceived self-efficacy of exercise was a significant predictor of exercise score. BMI, Life-style, perceived benefits of action, family support, past exercise behavior showed direct effects on perceived self-efficacy. Therefore, disease related factor should be minimized for physical performance and well being in nursing intervention for patients with rheumatoid arthritis, and plans to promote and continue exercise should be seeked to reduce disability. In addition, Exercise program should be planned and performed by the exact evaluation of exercise according to the ability of the patients and the contents to improve the importance of exercise and self efficacy in self control program, dedicated educational program should be involved. This study suggest that the methods to reduce the disease related factors, the importance of daily life-style, recognition of benefit of exercise, and educational program to promote self efficacy should be considered in the exercise behavior promotion and nursing intervention for continous performance. The significance of this study is also thought to provide patients with chronic arthritis the specific data for maximal physical and mental well being through exercise, chronic therapeutic procedure, daily adaptation and confrontation in nursing intervention.

• Journal of Digital Convergence
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• v.19 no.3
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• pp.415-423
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• 2021

The purpose of this study was to report the changes in underwater anxiety, physical self-efficacy, and water safety consciousness in elementary school students through participation in survival swimming education, and the relationship between variables. For this purpose, 300 out of 312 elementary school students who participated in survival swimming education in Busan were used as valid samples. The collected data were analyzed through exploratory factor analysis, reliability analysis, correspondence sample t-test, and multiple regression analysis using the SPSS 25.0 statistical program, and the results are as follows. First, the underwater anxiety of elementary school students before and after participating in survival swimming education decreased, and the physical self-efficacy and water safety awareness increased. Second, underwater anxiety of elementary school students who participated in survival swimming education partially negatively affected physical self-efficacy and water safety consciousness, and physical self-efficacy partially positively affected water safety consciousness. Based on these results, the effectiveness of survival swimming education could be confirmed, and the direction of qualitative expansion of the program could be reconsidered.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.3
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• pp.408-417
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• 2017

The objective of this study is to examine the structural relations between physical self-efficacy, depression, and ego-integrity among the elderly (60 years and older) currently participating in leisure sports. In addition, since the variables affecting ego integrity are presented in a multidimensional manner, it is very important to examine the cause and effect of the variables from an integrated perspective. To achieve this objective, 427 senior citizens attending the leisure sports program of a seniors center were assigned as the research subjects. For the structural equation modeling performed in the study, confirmatory factor analysis and reliability analysis were conducted for each variable, and direct, indirect, and total effects were estimated. The model fit is based on TLI, CFI, and RMSEA, and both the fit of the measurement model and the fit of the research model satisfy the criterion. The results of the analysis are as follows. First, in the results of verifying the validity and reliability of the questionnaire, all the variables of physical self-efficacy, depression, and ego-integrity were suitable. Second, the perceived physical ability had positive effects on depression, current life satisfaction, wise life, and attitude toward life, whereas the physical self-expression confidence had positive effects on current life satisfaction and attitude toward life, but negative effects on acceptance of the past life. Lastly, depression had negative effects on current life satisfaction. The results showed that the elderly identified the integrated relationship of physical self - efficacy, depression, and self-integration.

• Journal of muscle and joint health
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• v.10 no.1
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• pp.19-31
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• 2003

Purpose : The purpose of this study was to examine the effect of the self- efficacy, group cohesion and family support on adherence of aquatic exercise in arthritis patients. Method : The Subjects were 30 patients with arthritis who had participated in the 6-week aquatic exercise programs of Korean Rheumatology Health Professionals Society. All subjects were interviewed from November to December, 2001(1st) and Feburary, 2002(2nd) using a structured questionnaire which was composed of 42 items. SPSS Win 10.0 was used for data analysis. Results : Ten out of thirty were adherer who were keeping aquatic exercise for three months since they completed 6-week aquatic exercise program. The major reasons of adherence were affectional reasons and general condition improvement on the first month. The reasons of 3-month adherence were improvement of arthritis symptoms, affectional improvement, expectations, general condition improvement and group activity. The major reasons of drop out were environment factors and physical factors. The environmental reason were time shortage, economic problem and long distance. And the physical factor were cold, pain and other health problem. The scores of self-efficacy were decreased from 528.00 to 476.00 within 3 months after compeleting aquatic exercise program and that was statistically significant(p=.029). But there were no statistically differences in group cohesion and family support. There was a significant positive correlation between exercise adherence and self-efficacy. Factors influencing the exercise adherence was self-efficacy which accounted for 23% of the variance in the exercise adherence. Conclusion : In conclusion, self-efficacy is a significant variable in the exercise adherence and changes within 3 month after completing aquatic exercise program. The results of this study suggested that the strategy for maintaining self-efficacy should be developed.