• 임상간호연구
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• 제28권3호
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• pp.277-288
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• 2022

Purpose: This study was conducted to evaluate the effects of the insulin therapy adherence program (INSTA GRAM) for patients with type 2 diabetes mellitus. Methods: This study examined a total of 63 patients with type 2 diabetes for whom the initiation of insulin therapy is being considered or within 6 months of undergoing insulin therapy. INSTAGRAM is a stage-specific intervention consisting of strategies for motivating patients to initiate and maintain insulin therapy using the transtheoretical model on the stages of change, the process of change, and self-efficacy. The participants were randomly assigned to either the INSTAGRAM group (experimental group, n=32) or the standard diabetes education group (control group, n=31). The INSTAGRAM group received 6 sessions over 8 weeks(face-to-face education was conducted in the first and last sessions, and telephone coaching was conducted from the second to fifth sessions). The outcomes were measured by psychological insulin resistance, self-efficacy, and glycosylated hemoglobin (HbA1c). Results: Psychological insulin resistance (p<.001), self-efficacy (p<.001), and HbA1c (p=.024) of the participants in the INSTAGRAM group significantly improved compared to those in the control group. Conclusion: INSTAGRAM is effective in overcoming psychological insulin resistance and improving self-efficacy and HbA1c. Therefore, the INSTAGRAM can be recommended as a nursing intervention for type 2 diabetic patients who delay the initiation of insulin therapy.

• Journal of Preventive Medicine and Public Health
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• 제56권3호
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• pp.238-247
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• 2023

Objectives: Low adherence to antiretroviral (ARV) therapy in pregnant women with human immunodeficiency virus (HIV) increases the risk of virus transmission from mother to newborn. Increasing mothers' knowledge and motivation to access treatment has been identified as a critical factor in prevention. Therefore, this research aimed to explore barriers and enablers in accessing HIV care and treatment services. Methods: This research was the first phase of a mixed-method analysis conducted in Kupang, a remote city in East Nusa Tenggara Province, Indonesia. Samples were taken by purposive sampling of 17 people interviewed, consisting of 6 mothers with HIV, 5 peer facilitators, and 6 health workers. Data were collected through semi-structured interviews, focus group discussions, observations, and document review. Inductive thematic analysis was also performed. The existing data were grouped into several themes, then relationships and linkages were drawn from each group of informants. Results: Barriers to accessing care and treatment were lack of knowledge about the benefits of ARV; stigma from within and the surrounding environment; difficulty in accessing services due to distance, time, and cost; completeness of administration; drugs' side effects; and the quality of health workers and HIV services. Conclusions: There was a need for a structured and integrated model of peer support to improve ARV uptake and treatment in pregnant women with HIV. This research identified needs including mini-counseling sessions designed to address psychosocial barriers as an integrated approach to support antenatal care that can effectively assist HIV-positive pregnant women in improving treatment adherence.

• 모자간호학회지
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• 제2권1호
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• pp.70-86
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• 1992

What is the meaning of menopause experienced by urban Korean women? Nurses need an under standing of menopause as it is experienced by women themselves. Nursing needs to build knowledge of womens' health experiences. This phenomenological study examined what menopause means to modern Korean woman to build a structure of knowledge useful for practice to enhance the quality of life of women throughout this experience. Traditional definition of menopause according to physiological changes, as illness and more recently as psychosociocultural phenomena were examined along with the folk lore information generally available in the society A review of the research and scientific literature was done from the perspectives of four models including the medical model of menopause as disease, the psychosocial model as positive and negative behavioral responses to menopause, a feminist model of menopause as a time of rebirth and a nursing model of the changing patterns of meaning, rythms and transformation women experience through menopause. Van Kaam's method was used to analyse data audio-recorded during interviews by the investigator with 65 women, 40 to 60 years of agey whose confidentility was assured. Interpretation of the data was enhanced luther by consultation with professional colleugues and with informants. Four rhythmical patterns of process emerged : from suffering to comfort, from oppression to freedom from being a good wife and wise mother to becoming a woman and from a hard life to an abundant life. The detailed common elements making up each of the four patterns and definitions of each pattern were presented. Each pattern was discussed critically from the point of view of medical, psychosociocultural, womens' and nursing models. The structural definition of the synthesis of the four process patterns was stated as : in spite of suffering the middle-aged urban Korean woman find she is able to help herself to feel comfortable and to realize release as she moves from oppression to liberation and freedom from being a good wife and wise mother she experiences rebirth as a woman : she begins to live a profitable and valuable life : her life becomes one of transformed abundant living. The definition transcends the medical and phychosociocultural model to embody a nursing model. The analysis was critiqued by using Parse' Human Becomming theory of nursing because the emerging themes were process patterns. Parse' theory provides and explanation of the experience of menopause consistant with the data which enhances nursing understanding of womens' experience of menopause. Parse' practice methodology provide guidance for promoting womens' quality of life throughout the experience of menopause. Feminist analysis contributes valuable critique to nursing research, richly expanding the perspective from traditional approaches to promote understanding of the meaning of womens' health experiences.

• 대한통합의학회지
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• 제12권3호
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• pp.163-178
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• 2024

Purpose : This study aimed to evaluate the effectiveness of an integrative medical service model applied to breast cancer patients and their caregivers, exploring its feasibility and challenges within the context of South Korean healthcare system. Methods : A case study approach was chosen to assess the integrative medical service model's efficacy, involving one breast cancer patient and her primary caregiver from W University Hospital. The patient had completed reconstructive surgery and chemotherapy and was undergoing radiotherapy. The model included standard treatments alongside psychological counseling, aromatherapy, axillary rehabilitation exercise, make-up program, art therapy, laughter therapy, horticultural therapy, and yoga programs, and meditation programs delivered over eight weeks. Quantitative and qualitative data were collected through surveys, psychological tests, and feedback assessments. Results : The integrative medical service model demonstrated notable improvements in the quality of life for both breast cancer patients and their caregivers. Participants reported enhanced emotional well-being, reduced stress levels, and improved coping mechanisms throughout the treatment journey. Qualitative feedback highlighted the positive impact of holistic interventions in alleviating psychological distress and fostering resilience. Quantitative data corroborated these findings, showing statistically significant improvements in various psychosocial parameters assessed. Conclusions : Our findings underscore the benefits of integrative medical service model with standard medical treatments in the care of breast cancer patients and their caregivers. The holistic approach not only addresses physical symptoms but also enhances overall well-being and quality of life. However, the implementation of such models faces challenges within the South Korean healthcare system, including fragmented service networks and financial constraints. Addressing these structural barriers is crucial for the widespread adoption and sustainability of integrative care models in oncology practice. Future research should focus on larger-scale studies to further validate these findings and inform policy decisions aimed at optimizing cancer care delivery.

• 근관절건강학회지
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• 제4권2호
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• pp.197-220
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• 1997

The lack of a comprehensive theory describing the mechanism of adaptation scientifically has been one of the limiting factors for the development of nursing intervention of patients with chronic illness. Since Roy's theory provides the general conceptual framework depicting adaptation process with structural stimuli and control mechanism, it is appropriate to understand the process of adaptation. But in Roy's theory, the propositions about cognator and regulator as control mechanisms are not clearly defined. For this reason, most of the previous researches applying the Roy's theory have disregarded the study of cognator and regulator. For the patients with chronic illness such as rheumatoid arthritis, it was reported that adaptation states were different for the same stimuli due to the difference of the control mechanism. Moreover in nursing it is important to identify the control mechanism which can be and must be intervened by nurses. It was the Lazarus and Folkman's theory that proposed the control mechanism. They suggested that individual differences in the reaction against the perceived stress are due to the difference in appraisal and coping. Therefore, the synthesis of Roy's and Lazarus and Folkman's propositions might help to clearly understand the mechanism of adaptation. From this point, a theoretical framework has been developed and tested. The subjects were the 297 patients who had been diagnosed rheumatoid arthritis and attended the outpatient clinic. A hypothetical prediction model of adaptation was tested by the covariance structure analysis with PC-LISREL 7.13. As a result, the overall fit was good($x^2$=78.83, p=0.00 ; GFI=0.96 : AGFI=0.90 ; RMR=0.04) for the hypothetical model. In the final model added GA(5, 1), the overall fit was increased ($x^2$=57.82, p=0.003 ; GFI=0.97 ; AGFI=0.93 : RMR=0.036). Except the fact that illness symptoms affected physical adaptation directly, it was supported that focal and contextual stimuli affected physical and psychosocial adaptation through appraisal and coping. Therefore, it was asserted that the synthesis of two theory's propositions was appropriate. So this model would be useful for the theoretical framework in the nursing practice. And this study synthesizing and testing the theory might contribute to establish nursing's scientific base.

• 한국응용과학기술학회지
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• 제41권2호
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• pp.472-483
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• 2024

본 연구에서는 건강신념모델(HBM) 구조를 통해 자외선차단제 사용에 대한 국내 인구의 태도를 평가하였으며, 자외선차단제 사용에 영향을 미치는 심리적 요인을 조사하였다. 이를 위해 2023년 11월 1일부터 2024년 1월 1일까지 온라인 설문조사를 실시하여 총 303명의 자료를 수집하였다. 수집된 데이터는 SPSS v. 25.0 program을 이용하여 Cronbach's 𝛼, 빈도분석, 기술통계분석, 상관관계분석, 독립표본 t-test, One way ANOVA, Scheffe's test, 그리고 다중회귀분석이 실시되었다. 연구 결과 자외선차단제 사용에 대한 평균 점수는 5점 만점에 3.26±1.384로 나타났으며 건강신념모델 변수와 자외선차단제 사용 간에는 서로 유의한 상관관계가 있는 것으로 나타났다(p<.01). 성별, 연령, 피부색에도 각 변수들 간에 차이가 있었으며 그중 여성, 연장자, 밝은 피부색을 가진 집단에서 자외선 보호에 적극적인 성향을 보였다. 다중회귀분석 결과 건강신념모델의 하위요인별 자기효능감(𝛽=.629, p<.001), 인지된 취약성(𝛽=.139, p<.001)이 자외선차단제 사용에 통계적으로 유의미한 정(+)의 영향을 미치는 것으로 나타났고, 인지된 장벽(𝛽=-.261, p<.001)은 자외선차단제 사용에 통계적으로 유의미한 부(-)의 영향을 미치는 것으로 나타났다. 이러한 결과는 자외선 차단에 영향을 미치는 심리사회적 요인들을 제공함으로써, 자외선차단제 사용을 촉진하기 위한 교육 프로그램을 개발하고 시행하는 데 중요한 이론적 시사점을 제공할 수 있다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권19호
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• pp.8483-8488
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• 2014

Background: Breast cancer is the most common cancer and the second most common cause of cancer-induced mortalities in Iranian women, following gastric carcinoma. The survival of these patients depends on several factors, which are very important to identify in order to understand the natural history of the disease. Materials and Methods: In this retrospective study, 313 consecutive women with pathologically-proven diagnosis of breast cancer who had been treated during a seven-year period (January 2006 until March 2014) at Towhid hospital, Sanandaj city, Kurdistan province of Iran, were recruited. The Kaplan-Meier method was used for data analysis, and finally those factors that showed significant association on univariate analysis were entered in a Cox regression model. Results: the mean age of patients was $46.10{\pm}10.81$ years. Based on Kaplan-Meier method median of survival time was 81 months and 5 year survival rate was $75%{\pm}0.43$. Tumor metastasis (HR=9.06, p=0.0001), relapse (HR=3.20, p=0.001), clinical stage of cancer (HR=2.30, p=0.03) and place of metastasis (p=0.0001) had significant associations with the survival rate variation. Patients with tumor metastasis had the lowest five-year survival rate (37%)and among them patients who had brain metastasis were in the worst condition (5 year survival rate= $11%{\pm}0.10$). Conclusions: Our findings support the observation that those women with higher stages of breast malignancies (especially with metastatic cancer) have less chance of surviving the disease. Furthermore, screening programs and early detection of breast cancer may help to increase the survival of those women who are at risk of breast cancer.

• 대한간호학회지
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• 제50권3호
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• pp.487-500
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• 2020

Purpose: This study aimed to evaluate the validity and reliability of the Korean version of Menopause-Specific Quality of Life (MENQOL). Methods: The MENQOL was translated into Korean according to algorithm of linguistic validation process. A total of 308 menopausal women were recruited and assessed using the Korean version of MENQOL (MENQOL-K), the World Health Organization Quality of Life Brief Version (WHOQOL-BREF), and Center for Epidemiological Studies Depression Scale (CES-D-K). In estimating reliability, internal consistency reliability coefficients were calculated. Validity was evaluated through criterion validity and construct validity with confirmatory factor analyses using SPSS 23.0 and AMOS 25.0 software. Results: In item analyses, the "increased facial hair" symptom was excluded because of the low contribution of MENQOL-K. The confirmatory factor analysis supported good fit and reliable scores for MENQOL-K model, and the four-factor structure was validated (χ²=553.28, p<.001, NC=1.84, RMSEA=.05, AGIF=.85, AIC=765.28). The MENQOL-K consists of 28 items in 4 domains, including vasomotor (3 items), psychosocial (7 items), physical (15 items), and sexual subscales (3 items). There was an acceptable criterion validity with moderately significant correlation between MENQOL-K and WHOQOL-BREF. The Cronbach's α for the 4 subsacles ranged from .80 to .93. Conclusion: The MENQOL-K is a valid and reliable scale to measure condition-specific quality of life for perimenopausal and postmenopausal women. It can be used to assess the impact of menopausal symptoms on the quality of life of Korean women in clinical trials.

• 정신신체의학
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• 제2권1호
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• pp.3-9
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• 1994

암의 원인, 과정 및 예후와 심리적 특성 또는 행동변인들(behavioral variables) 사이에 연관성이 있는지, 있다면 어떻게 영향을 미치는지 아직 결정적인 증거는 제시되지 않고 있다. 이에 대해서는 동질(homogeneous)집단을 대상으로 치밀하게 고안된 전향적 (well-designed, prospective) 연구계획을 통하여 장기간의 추적조사가 필요할 것으로 생각된다. 또한 암환자에서 나타나는 정신과적 문제에 신속하게 대처하기 위하여 종양전문의와 정신과 의사간의 긴밀한 자문체계가 수립되어야 할 것이다. 정신종양학 분야에서 정신과 의사의 역할과 연구의 촛점은 다음과 같이 될 수 있다. 1. 암 예방: 원인적 측면에서 암의 발생과 연관되는 것으로 알려진 정신사회적, 요인들을 감소 또는 제거시키는 역할(예를 들면 스트레스, 흡연, 주정중독 등). 2. 암 치료: 1) 암의 각종 치료에서 환자의 순응(compliance)을 강화시켜 주는 역할. 2) 암환자에서 병발한 정신장애의 치료. 3) 암환자의 동통이나 오심 등의 치료. 4) 암환자의 삶의 질(quality of life)에 대한 지각을 향상시키도록 도와주는 역할. 3. 암 연구: 1) 암의 발생 또는 암환자의 생존에 영향을 미치는 정신사회적 요인들의 조사. 2) 심리반응 또는 정신사회적 요인들과 면역반응사이의 연관성 조사. 3) 암환자에서의 정신치료와 인지-행동치료의 효과규명. 4) 화학요법제 또는 방사선치료가 정신병리와 인지기능에 미치는 영향 조사 등.

• 대한물리의학회지
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• 제15권2호
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• pp.109-120
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• 2020

PURPOSE: This study was conducted to verify the effects of a functional correction of the pain of patients with chronic low back pain(CLBP), and to examine the effect of dysfunctional factors on health-related quality of life. METHODS: A preliminary survey was first conducted on 90 patients with CLBP after functional orthodontic treatment. Some revised questionnaires were also prepared. The survey was distributed for approximately eight weeks, and 215 copies were used as the final analysis data, except for questionnaires that were inadequate, error or non-response. RESULTS: Path analysis using the structural equation model of CLBP patients showed a positive correlation between all the path coefficients and the potential factors. The multidimensional relationship between pain and dysfunction after orthognathic treatment was confirmed using three subdivisions of the pain variables as independent variables and the dysfunctional variables as the dependent variables. Multiple regression analysis was performed to examine the effects of pain on the dysfunction. To identify the multidimensional relationship between dysfunction and the health-related quality of life, eight sub-factors of dysfunctional variables were set as the independent variables, and multiple regression was analyses were performed with the dependent variables of the health-related quality of life. CONCLUSION: This study examined the structural and influence relationships of the functional correction with pain, dysfunction, and health-related quality of life. The results, suggest that a functional orthodontic treatment can be used as a positive program for the health-related quality of life. In addition, this study is meaningful in that it provieds useful information for intervention such as psychosocial change of patients.