Purpose
This study involved a meta-synthesis of qualitative research concerning the experiences of women with infertility and infertility treatments. Based on an analysis of emotional changes and adaptation processes, it aimed to propose an interaction model encompassing expectation, loss, and resilience and clarify the conceptual meaning of each component.
Methods
Thomas and Harden’s five-step qualitative meta-synthesis methodology was employed. A total of 22 studies published between 2014 and 2024 were comprehensively analyzed and synthesized. The findings were integrated into a model representing the experiences of women undergoing infertility and infertility treatments.
Results
The meta-synthesis identified six key themes: changes in identity and inner growth; strengthening resilience through the roles of spouses, family, and peers; strategies for recovery and growth; support systems amidst economic and social burdens; life in the tension of waiting and hope; and the reconfiguration of couple and family relationships. Based on these themes, a dynamic interaction model, named the Model of Psychological Changes and Resilience (PCR Model), was developed to illustrate the interrelationships among expectation, loss, and resilience. The conceptual implications of these relationships were also explicated.
Conclusion
The cyclical interplay between expectation and loss among women experiencing infertility is intensified by social ideologies and cultural contexts, while resilience is strengthened through overcoming distress and finding meaning in life. Further quantitative research is necessary to validate these relationships in clinical settings by obtaining empirical data that apply this model.

Purpose
This study was conducted to develop a conceptual framework for understanding non-adherence to self-management among patients with Chronic Obstructive Pulmonary Disease (COPD). This was accomplished through a literature review, in-depth interviews with patients, and a survey of healthcare professionals featuring semi-structured open-ended questions.
Methods
First, a systematic literature review was conducted across five databases. Next, 25 patients with COPD participated in detailed interviews that included seven semi-structured questions. Subsequently, 15 healthcare professionals completed a survey about factor categories and specific factors associated with non-adherence to COPD self-management. Categories and factors identified at least once across these three methods were documented. Finally, two researchers conducted preliminary mapping of the relationships between factor categories and individual factors, which was assessed for face validity by a third researcher. All processes were conducted from March 28, 2022, and January 30, 2023.
Results
The research revealed eight factor categories and 53 individual factors associated with non-adherence to COPD self-management. The categories encompassed personal, socioeconomic, disease-related, functional, treatment- related, health system-related, and environmental characteristics. The literature review, patient interviews, and survey of healthcare professionals yielded 35, 19, and 44 factors, respectively. Twelve factors were identified using all three sources. All processes were conducted from March 28, 2022, and January 30, 2023.
Conclusion
In this study, quantitative and qualitative methods were employed to develop a conceptual framework for non-adherence to COPD self-management. The findings indicate that effective self-management of this condition requires not only patient effort but also adaptations to complex treatment regimens, societal perceptions, and workplace environments.

Citations

• Development of a deep learning model to predict smoking status in patients with chronic obstructive pulmonary disease: A secondary analysis of cross-sectional national survey
  Sudarshan Pant, Hyung Jeong Yang, Sehyun Cho, EuiJeong Ryu, Ja Yun Choi
  DIGITAL HEALTH.2025;[Epub]     CrossRef
• Factors Associated with Non-Adherence to Self-Management Among Patients with Chronic Obstructive Pulmonary Disease: A Survey Using the Delphi Technique and Analytic Hierarchy Process
  Ja Yun Choi, Eui Jeong Ryu
  International Journal of Chronic Obstructive Pulmonary Disease.2024; Volume 19: 1247.     CrossRef

Purpose
This scoping review aimed to identify the current state of the application of theories in research related to advance care planning and to analyze the types and characteristics of the theories applied. Methods: Using the scoping review methodology presented by Arksey & O'Malley, the articles published from 2010 to 2022 were searched by combining the terms "advance care planning," "theory," and "model" in five electronic databases; PubMed, CINAHL, EMBASE, KMBASE, and KISS. Results: Thirty-two studies were identified. Theory-based research has been actively conducted since 2019, with a total of 25 theories applied. Psychological theories were the most prevalent, accounting for 75.0% of the applications, followed by sociological theories (12.5%), public health theories (6.3%), and one nursing theory (3.1%). Theories were utilized to create a framework for data analysis, establish a philosophical underpinning, develop intervention frameworks, and derive new tools. Conclusion: Various theories have been applied to research on advance care planning, yet the application of nursing theory has been limited. To optimize end-of-life care and advance care planning from a nursing perspective, further research incorporating nursing theory is essential.

Purpose
After Transarterial Chemoembolization (TACE), patients may experience Post-Embolization Syndrome (PES), which is characterized by abdominal pain, fever, and nausea/vomiting. Various risk factors, including demographic, clinical, laboratory, and radiological data, have been reported. This study aimed to identify sex-specific risk predictors of PES following TACE.
Methods
This retrospective study included 1,495 patients who underwent TACE and were discharged from January 1, 2014 to December 31, 2021. The demographic, clinical, laboratory, and radiological characteristics of the patients undergoing TACE were analyzed. Descriptive statistics, the χ² test, the independent t-test (or Mann-Whitney U test), Spearman correlation analysis, and logistic regression were used.
Results
The incidence of PES was higher in female (43.9%) than in male (37.3%). Multivariate logistic regression analysis Alanine aminotransaminase (ALT) levels as the only independent predictor of PES in female patients (Exp [B]=1.01, 95% Confidence Interval [CI]=1.00~1.01). The risk factors of PES in male patients were a tumor >5 cm in diameter (Exp [B]=2.51, 95% CI=1.46~4.32), the amount of lipiodol (Exp [B]=1.27, 95% CI=1.01~1.60), C-Reactive Protein (CRP) levels (Exp [B]=1.11, 95% CI=1.02~1.21), ALT level (Exp [B]=1.00, 95% CI=1.00-1.01), lymphocyte levels (Exp [B]=0.98, 95% CI=0.96~0.99), and right posterior section (S6-S7) (Exp [B]=0.71, 95% CI=0.55-0.92).
Conclusion
Oncology nurses should be aware of sex-specific differences in PES risk and monitor clinical, laboratory, and radiological data to evaluate PES in female and male after TACE. The results of this study will serve as basic data for establishing a clinical decision-supporting system.

Purpose
Cancer survivors face a high risk of developing secondary cancers; thus, they should consider their primary cancer experiences as signals to adopt secondary cancer-preventive behaviors. This study examined the mediating effect of perceived threat in the relationship between cue to action and such behaviors and identified the gender effect as a moderator in breast and colorectal cancer survivors. Methods: A total of 505 cancer survivors (253 with breast cancer and 252 with colorectal cancer) participated in this study. These participants were involved in cancer-related physical activities at the outpatient oncology clinic of a tertiary teaching hospital in Korea. Participants completed structured, self-administered questionnaires, and a PROCESS macro was utilized to analyze the mediating effect of perceived threat. Results: Cue to action positively affected perceived threat (B=0.38, p <.001). Additionally, both cue to action (B=0.20, p=.047) and perceived threat (B=1.28, p<.001) positively influenced secondary cancer-preventive behaviors. In the relationship between cue to action and these behaviors, perceived threat explained 30.0% of the variance. Gender was supported as a moderator in the relationship between cue to action and perceived threat. A bootstrap analysis confirmed the mediating effect of perceived threat. Conclusion: Perceived threat can help cancer survivors understand the risk and seriousness of secondary cancer, thereby strengthening the relationship between cue to action and secondary cancer-preventive behaviors. Healthcare providers should provide accurate information as a cue to cancer survivors, enabling them to recognize the risk of secondary cancer.

Citations

• Factors impacting breast cancer survivors' performance of annual follow-up mammograms: A nationally representative study.
  Safa Elkefi, Alicia K. Matthews
  Patient Education and Counseling.2025; 130: 108428.     CrossRef
• Chinese undergraduates' mental health help-seeking behavior: the health belief model
  Haojing Wang, Zhuowen Feng, Zitong Zheng, Jiachen Yang
  Frontiers in Psychology.2024;[Epub]     CrossRef

Purpose
This study aimed to identify variables influencing the sexual adjustment of patients who underwent radical prostatectomy in order to establish a structural model and intervention strategy for improving patients’ sexual adjustment.
Methods
Participants were 179 patients who received follow-up care after undergoing radical prostatectomy at two university hospitals in South Korea. Data were collected from July to November, 2017 using structured questionnaires. The exogenous variables were urinary symptoms and age, and the endogenous variables were sexual function, self-esteem, depression, couple intimacy, and sexual adjustment. The collected data were analyzed using SPSS 21.0 and AMOS 21.0.
Results
The goodness-of-fit measures of the final hypothetical model were satisfactory, as follows: χ² /df=2.68, GFI=.91, CFI=.90, RMSEA=.09, SRMR=.07. Sexual function, self-esteem, and couple intimacy had direct and total effects on sexual adjustment in patients who underwent radical prostatectomy, and age had only an indirect effect. These variables explained 66.5% of sexual adjustment among patients. Urinary symptoms and depression did not show any significant effects, however.
Conclusion
To improve sexual adjustment in patients who underwent radical prostatectomy, it is imperative to establish active and effective nursing interventions to strengthen their sexual function, self-esteem, and couple intimacy, considering their age.

Purpose
This study was conducted to investigate selected constructs of the Transtheoretical Model (TTM) of behavior change regarding smoking behavior among Asian students in Korea.
Methods
A convenience sample of 240 Chinese and Vietnamese smokers studying in colleges, graduate schools, and language programs across the country completed the Chinese and Vietnamese versions of the short form questionnaire from October 2020 to January 2021, through an online survey. The collected data were analyzed using the SPSS/WIN 25.0 program using descriptive statistics, one-way ANOVA, independent t-test, and logistic regression.
Results
Analyses showed that 72.1% of participants were in contemplation and preparation stage. There were significant differences in the process of change, decisional balance, and self-efficacy depending on the stages of change in smoking cessation. Factors influencing smoking cessation intention were consciousness raising (Odds Radio [OR]=1.22, 95% Confidence Interval [CI]=1.00~1.15, p=.047), self-reevaluation (OR=1.40, 95% CI=1.15~1.70, p=.001), cons of smoking (OR=1.18, 95% CI=1.00~1.39, p=.045), and self-efficacy (OR=1.08, 95% CI=1.00~1.15, p=039).
Conclusion
The results provide support on the advantages of including the concepts of consciousness raising, self-reevaluation, negative aspects of smoking (cons), and self-efficacy in intervention program development for smoking cessation.

Citations

• Comparison of the Predictors of Smoking Cessation Plans between Adolescent Conventional Cigarette Smokers and E-Cigarette Smokers Using the Transtheoretical Model
  Min-Hee Park, Bomi An
  Children.2024; 11(5): 598.     CrossRef
• Factors Predicting Chinese Students' Intention to Quit Smoking: Decision Tree Analysis
  Shinae Jung, Sung Rae Shin
  Korean Journal of Adult Nursing.2022; 34(6): 545.     CrossRef

PURPOSE
This study aimed to identify the factors explaining the performance of health behaviors among adults with metabolic syndrome based on the theory of planned behavior.
METHODS
A total of 218 adults with metabolic syndrome were recruited for the study from September to December, 2017. Data were analyzed using SPSS/WIN 22.0 and AMOS 24.0.
RESULTS
The hypothetical model appeared to fit the data with χ²/df=2.65, SRMR (Standardized Root Mean Residual)=.07, PNFI (Parsimonious Normed Fit Index)=.67. Attitude toward health behavior, subjective norm and perceived behavioral control explained 32.3% of variance in intention toward health behavior. Perceived behavioral control showed significant direct effects and mediating effect through intention on health behavior (γ=.57, t=5.85). Family support also had significant direct effects on health behavior (γ=.38, t=4.75). Attitude toward health behavior, subjective norm, perceived behavioral control, and family support were the significant factors explaining 56.3% of variance in the performance of health behaviors among patients with metabolic syndrome.
CONCLUSION
Health promotion programs for behavioral modification in this population should focus on these factors to lead to better health outcomes. Further studies are warranted to test the health promotion strategies based on theory of planned behavior for long-term change toward a healthy lifestyle among individuals with metabolic syndrome.

Citations

• Factors Affecting Radiation Protective Behaviors in Perioperative Nurses Applying the Theory of Planned Behavior: Path Analysis
  Se Young Jang, Hee Sun Kim, Seok Hee Jeong, Young Man Kim
  Journal of Korean Academy of Nursing.2023; 53(2): 222.     CrossRef
• Factors Associated with Prevention of Metabolic Syndrome Among Middle-Aged Postmenopausal Korean Women: A Study Based on the Information, Motivation, Behavioral Skills (IMB) Model
  Yoonjung Kim, Sooyeon Park
  Patient Preference and Adherence.2023; Volume 17: 2279.     CrossRef
• Predictors of Health Promotion Behaviors Among Working Adults at Risk for Metabolic Syndrome
  Sungwon Park, Min Kyeong Jang, Chang Gi Park, Oi Saeng Hong
  Nursing Research.2022; 71(4): 275.     CrossRef
• Development and Evaluation of an Integrated Health Management Program for Psychiatric Patients with Metabolic Syndrome
  Yun Bock Kwak, Ji Young Kim
  Journal of Korean Academy of Nursing.2022; 52(3): 261.     CrossRef
• An Analysis and Evaluation of the Theory of Planned Behavior Using Fawcett and DeSanto-Madeya's Framework
  Sungwon Park, Hyewon Shin
  Advances in Nursing Science.2021; 44(4): E141.     CrossRef

PURPOSE
The purpose of this study was to construct and test a predictive model for physical activity adherence for secondary prevention among patients with coronary artery disease.
METHODS
Two hundred and eighty-two patients with coronary artery disease were recruited at cardiology outpatient clinics in four general hospitals and the data collection was conducted from September 1 to October 19, 2015.
RESULTS
The model fit indices for the final hypothetical model satisfied the recommended levels: χ2/dF=0.77, adjusted goodness of fit index=.98, comparative fit index=1.00, normal fit index=1.00, incremental fit index=1.00, standardized root mean residual=.01, root mean square error of approximation=.03. Autonomy support (β=.50), competence (β=.27), and autonomous motivation (β=.31) had significant direct effects on physical activity adherence for secondary prevention among patients with coronary artery disease. This variable explained 35.1% of the variance in physical activity adherence.
CONCLUSION
This study showed that autonomy support from healthcare providers plays a key role in promoting physical activity adherence for secondary prevention among patients with coronary artery disease. The findings suggest that developing intervention programs to increase feelings of competence and autonomous motivation through autonomy support from healthcare providers are needed to promote physical activity adherence for secondary prevention among patients with coronary artery disease.

Citations

• Self‐care behaviours and their determinants in people affected by coronary heart disease
  Roberta Di Matteo, Tatiana Bolgeo, Alberto Dal Molin, Barbara Bassola, Maura Lusignani, Antonio Maconi, Laura Rasero, Ercole Vellone, Paolo Iovino
  Journal of Clinical Nursing.2025; 34(5): 1713.     CrossRef
• Prognostic factors of adherence to home-based exercise therapy in patients with chronic diseases: A systematic review and meta-analysis
  Ellen Ricke, Arie Dijkstra, Eric W. Bakker
  Frontiers in Sports and Active Living.2023;[Epub]     CrossRef
• Association between Social Support and Physical Activity in Patients with Coronary Artery Disease: Multiple Mediating Roles of Self-Efficacy and Autonomous Motivation
  Nam-Sin Han, Mi-Hwa Won
  Healthcare.2022; 10(3): 425.     CrossRef
• Concept Analysis of the Empowerment of Patients With Coronary Artery Disease Using a Hybrid Model
  Jiyoung Kim, Nayeon Shin
  Advances in Nursing Science.2022; 45(1): E31.     CrossRef
• Lifestyle and Quality of Life in Patients with Coronary Artery Disease: A Propensity-Matched Comparison with a Healthy Control Group
  Seong Hui Choi, Seon Young Hwang
  Korean Journal of Adult Nursing.2020; 32(2): 199.     CrossRef

PURPOSE
The aim of the study was to create a structural model based on Wilson and Cleary's Conceptual Model of Patient Outcomes. Secondly, the intention was to identify variables influencing the health-related quality of life (HRQoL) as reported by patients with thyroid cancer.
METHODS
A total of 201 patients with thyroid cancer were recruited from an outpatient clinic. Data were collected from June to November, 2015, using a structured questionnaire. The questionnaire included the Quality of Life-Thyroid Scale, Thyroid Stimulating Hormone (TSH), Medical Outcome Study Social Support Survey, MD Anderson Symptom Inventory-Thyroid, the Brief Illness Perception Questionnaire, and general characteristics of patients. The data were analyzed using the SPSS/WIN 21.0, AMOS 21.0, and SmartPLS 3.2.3 programs.
RESULTS
The fitness of the hypothetical model with the Wilson and Cleary model was satisfactory, showing that the coefficients of determination (R2) were between .101 and .692 and the predictive relevance (Q2) were between .124 and .320. The model explained 69.2% of the HRQoL. Symptom experience, functional status, disease perception, and social support directly and indirectly affected HRQoL. Age and TSH had an indirect influence on the HRQoL with the mediation effect of reported symptom experience.
CONCLUSION
To improve the quality of life for patients with thyroid cancer, comprehensive nursing interventions need to be developed and applied. Decreasing the reported symptoms, changing the perception of the disease, improving functional status, and increasing social support may contribute to a higher quality of life among patients with thyroid cancer.

Citations

• Can the Correlation of Periodontopathies with Gastrointestinal Diseases Be Used as Indicators in Severe Colorectal Diseases?
  Lavinia Rat, Andrada Moldovan, Daniela Trifan, Loredana Matiș, Gelu Murvai, Lavinia Maris, Timea Ghitea, Marius Maghiar
  Biomedicines.2023; 11(2): 402.     CrossRef
• A Structural Model of Quality of Life in Patients after Colorectal Cancer Surgery
  Jeong Won Yeom, Yeon Ok Suh
  International Journal of Environmental Research and Public Health.2022; 19(5): 2564.     CrossRef
• Analysis of the Effect of Nursing Intervention for Thyroid Diseases Based on Family Nursing Methods
  Xin Chen, Osamah Ibrahim Khalaf
  Computational and Mathematical Methods in Medicine.2022; 2022: 1.     CrossRef
• Influence of Sleep Quality, Coffee Consumption, and Perceived Stress on the Incidence of Thyroid Cancer in Healthy Korean Adults
  Myoyoun Kim, Seon Young Hwang
  Korean Journal of Adult Nursing.2021; 33(2): 125.     CrossRef
• Mediating Effect of Stress on the Relationship between Illness Perception and Sleep in Patients at Risk of Metabolic Syndrome
  Hyun-E Yeom, Jee-Won Shin
  Korean Journal of Adult Nursing.2019; 31(4): 449.     CrossRef

PURPOSE
The purpose of this study was to identify the factors associated with compliance with standard precautions among hemodialysis unit nurses.
METHODS
A cross-sectional study design was used. One hundred ninety six nurses were recruited from 18 hemodialysis units in South Korea. Data were analyzed using SPSS/WIN 23.0 to provide descriptive statistics to describe the characteristics of the sample and variables. A hierarchical linear model was used to analyze effects of individual and hospital characteristics on nurses' compliance with standard precautions.
RESULTS
The majority of the sample was female (98%) and reported receiving in-service education on infection control (80%). The participants' average year of work experience in hemodialysis units was 7 years and the average nurse-patient ratio was 7:1. At the individual level, the perception of patients' severity, the length of work experience in hemodialysis unit, and the safety climate on infection prevention practices were significantly associated with nurse's compliance with standard precautions. At the hospital level, clinics showed a lower compliance with standard precautions than general hospital or university hospital.
CONCLUSION
In order to enhance compliance with standard precautions among hemodialysis unit nurses, it is imperative to warrant safety climate on infection prevention practice at clinics and develop infection control educational program for nurses with less work experience in hemodialysis units.

Citations

• Factors Influencing Emergency Department Nurses’ Compliance with Standard Precautions Using Multilevel Analysis
  Su Jung Kim, Eun Ju Lee
  International Journal of Environmental Research and Public Health.2021; 18(11): 6149.     CrossRef
• Factors influencing the adherence of nurses to standard precautions in South Korea hospital settings
  Eunja Oh, Jeong Sil Choi
  American Journal of Infection Control.2019; 47(11): 1346.     CrossRef

PURPOSE
The objective of this study was to identify the relationships between family function and successful aging of vulnerable elderly using the circumplex model.
METHODS
The participants were the elderly (N=401) who were over 65 years old living in H city under the National Livelihood Security Act. Family Adaptability and Cohesion Evaluation Scale III and Successful Aging Instrument were used.
RESULTS
The family function perceived by the study subjects was average 43.20 +/- 16.62 out of maximum 100 points. According to the analysis on family types suggested by circumplex model, there were 183 people for balance family (45.6%) and 218 people (54.4%) for extreme family. The total points on successful aging were 1.67 +/- 0.37 out of 3 points. When the difference in points on the Successful Aging instrument were analyzed according to the scores on the Family Adaptability and Cohesion Scale those points of the balanced family were statistically significant (t=2.087, p=.038).
CONCLUSION
In case of the balanced family type, the level of perceiving successful aging was relatively higher. For the improvement of family function, it is advised that the successful aging perception among vulnerable elderly can be uplifted through a program that enables effective communication with other family members.

PURPOSE
The aim of this study was to construct leisure physical activity model of middle-aged women in urban area. METHODS: Data were gathered by self-report questionnaire from 211 women aged between 41 and 59 years in urban community. The data were analyzed using the SPSS/WIN 10.0 program and the model was constructed using the LISREL 8.54 program. RESULTS: Variables that have direct effects on leisure physical activity were health state, past leisure physical activity, social support, self-efficacy, and affect. Perceived leisure state and behavioral leisure attitude also influenced leisure physical activity in an indirect way. Perceived leisure state had a direct effect on self-efficacy. Behavioral leisure attitude, past leisure physical activity, and experience of exercise effect had significantly direct effects on affect CONCLUSION: It will provide basic information for developing strategies of programs to enhance leisure physical activity of middle-aged women in urban area.

PURPOSE
The purpose of this study was to explore the utilization of the Transtheoretical Model(TTM) for Korean nursing studies on health behaviors and identify the strategies for improvement of further studies.
METHODS
From a main and seven branch journals on the Korean Society of Nursing Science, a total of 26 studies, which had been conducted based upon the TTM, were selected. The selected studies were analyzed from the September of 2006 to the February of 2007 by the criteria; name of journal, year of publication, health behavior, population, sampling, sample size, research design, instrument (translation process, reliability and validity), and statistical analysis.
RESULTS
TTM on the Korean nursing studies was mainly applied for smoking cessation or exercise with elderly or middle aged women. The research findings could not be generalized with the limitation of the use of non representative samples. The most frequently used research design was a cross-sectional survey. Some studies had a lack of reliable and valid instruments, so that the internal validity of the study findings may be threatened. Statistically related problems increased type I error and decreased power.
CONCLUSION
Korean nursing studies based on TTM can be the beginning stage in quality and quantity.

PURPOSE
This study was to predict the stage of exercise behavior change in undergraduate students and to identify the factors affecting exercise behavior change by using the trans theoretical Model.
METHOD
The subjects were 193 undergraduate students at K and D university in D city. Data were collected by questionnaire surveys using convenience sampling and analyzed by SPSS 12.0 program.
RESULTS
77.7% of 193 nursing students do not exercise or they exercise irregularly. Exercise self-efficacy score and exercise benefits score were decreased with advancing exercise stage, on the other hand exercise barriers score and the process of exercise behavior change score were increased. In addition to this, the results revealed that stage of exercise behavior was significantly correlated with the process of exercise behavior change, exercise benefits, exercise barriers and exercise self-efficacy.
CONCLUSION
These results suggested that the process of exercise behavior change, exercise decisional balance and exercise self-efficacy can be potential affecting factors for the stages of behavior change in university students. Therefore, these findings give useful information for educating nurse to construct nursing service programs focused on the stage of behavior change.

PURPOSE
Behavioral symptoms in dementia (BSD) are one of the most disturbing behaviors to caregivers and a major reason for nursing home placement. Behavioral symptoms are often treated with psychotropic drugs (PD), however, the effect of such drugs for the frail elderly dementia patient is not certain because of their critical adverse effects. Theoretical model applicable to nursing practice for BSD in nursing homes, which is essential in guiding and evaluating such interventions, is absent. This article presents the process of developing a theoretical model of BSD in nursing homes.
METHOD
Using Walker and Avants' theory synthesis method, three behavior models and two system models were incorporated into the proposed model to provide the theoretical and analytical explanation of the relationships between PD usage, its determinants, and BSD.
RESULTS
Resident variables and nursing home variables related to the two focal concepts (i.e., PD usage and BSD) were identified. Resident variables include demographical characteristics such as age and gender, and dementia-compromised functions such as cognitive and functional impairment. Nursing home variables include facility characteristics such as ownership type and size, and physical and psychosocial environment.
CONCLUSION
The proposed model suggests that fulfillment of resident unmet needs through improvement of physical and psychosocial environment may produce better health outcomes of nursing home residents with BSD. Assessment and intervening environmental triggers of such behaviors are also suggested to be prior to the PD usage.

PURPOSE
The purpose of this study was to propose a theoretical model of hope commonly held by the cancer patients just after surgery, under the assumptions that hope of those patients is not only realistic and disease oriented but in dialectical circulation.
METHOD
A theoretical model was generated through 4 steps: exploring a hope structure by synthesizing the relevant hope structures expressed in Kim and Tae's studies, in-depth literature review, examining the meanings of the concepts consisted of the structure in use and their causal relations in logical adequacy, proposing a theoretical structure through synthesizing the causal relations, and diagramming the structure.
RESULTS
The proposed theoretical model involves concepts such as Cancer Related Uncertainty (CRU), Efforts to Find out the Possibility of Cure or Recovery (EFPCR), and Hopefulness or Hopelessness. The 'EFPCR' is stipulated as 'Behaviors Related to Looking for Evidences or Cues (BRLEC)' and 'Formation of Cognitive Schema (FCS)'. In the model, Hopefulness is directly influenced by 'CRU in low', which is affected by 'FCS in good' from the result of EFPCR started with 'CRU in increase' while 'CRU with increase' from the result from EFPCR has direct effect on Hopelessness.
CONCLUSION
The theoretical model would be used to enhancing hope of the cancer patients in post-operation.

PURPOSE
The purpose of this study was to evaluate and compare the predictive ability of three mortality scoring systems; Acute Physiology and Chronic Health Evaluation(APACHE) III, Simplified Acute Physiology Score(SAPS) II, and Mortality Probability Model(MPM) II in discriminating in-hospital mortality for intensive care unit(ICU) patients with spontaneous intracerebral hemorrhage. METHODS: Eighty-nine patients admitted to the ICU at a university hospital in Daejeon Korea were recruited for this study. Medical records of the subject were reviewed by a researcher from January 1, 2003 to March 31, 2004, retrospectively. Data were analyzed using SAS 8.1. General characteristic of the subjects were analyzed for frequency and percentage. RESULTS: The results of this study were summarized as follows. The values of the Hosmer-Lemeshow's goodness-of-fit test for the APACHE III, the SAPS II and the MPM II were chi-square H=4.3849 p=0.7345, chi-square H= 15.4491 p=0.0307, and chi-square H=0.3356 p=0.8455, respectively. Thus, The calibration of the MPM II found to be the best scoring system, followed by APACHE III. For ROC curve analysis, the areas under the curves of APACHE III, SAPS II, and MPM II were 0.934, 0.918 and 0.813, respectively. Thus, the discrimination of three scoring systems were satisfactory. For two-by-two decision matrices with a decision criterion of 0.5, the correct classification of three scoring systems were good. CONCLUSION: Both the APACHE III and the MPM II had an excellent power of mortality prediction and discrimination for spontaneous intracerebral hemorrhage patients in ICU.

PURPOSE
This study was performed to examine predictors of allied health science students' exercise behavior using Pender's Health Promotion Model. METHOD: The subjects were 203 university students majoring in nursing, emergency medical service, and exercise prescription. The hypothetical model was based on the HPM(Pender, 1996). Exogenous variables of the model were exercise habit and role belief. Endogenous variables were exercise-related affect, exercise self-efficacy, exercise barrier, exercise intention, and exercise behavior. The data were analyzed by SAS PC program and LISREL 8.12 program. RESULT: The degree of exercise behavior was low(mean 1.86, range 1~4). The overall fit of the model to the data was acceptable. Exercise habit, exercise self-efficacy and exercise-related affect were significant predictors of exercise intention and exercise behavior. CONCLUSION: This study shows the necessity of the program to increase the level of exercise participation of university students majoring in allied health science. The model constructed in this study is applicable to explain exercise behavior of university students majoring in allied health science, and suggests that we should focus on exercise habit, exercise self- efficacy and exercise-related affect to increase the level of exercise behavior of this group.

PURPOSE
The study was performed to investigate the predictors associated transition with each stage of exercise behavior based to the Transtheoretical Model, and to provide basic data for exercise behavior programs for middle aged women.
Methods
The subjects consisted of 434 women residing in B city by convenience sampling. The collected data were analyzed with multiple logistic regression using SPSS/WIN program. RESULTS: The predictors of transition from precontemplation to contemplation were consciousness raising(OR=2.095, 95% CI: 1.305-3.363), Reinforcement management(OR= 1.903, 95% CI: 1.107-3.271), Stimulus control (OR=2.176, 95% CI:1.239-3.820), Menstrual status (OR=5.327, 95% CI: 1.110-25.562). The predictors of transition from contemplation to preparation were Helping relationship(OR= 1.671, 95% CI: 1.065-2.662), Pros(OR=2.500, 95% CI: 1.254-4.982), Perceived Health status (OR=.178, 95% CI: .041-.770). The predictor of transition from preparation to action was Stimulus control(OR=1.918, 95% CI: 1.103- 3.336). The predictors of transition from action to maintenance were Consciousness raising(OR= 1.939, 95% CI: 1.031-3.647), Dramatic relief (OR=2.249, 95% CI: 1.025-4.931). CONCLUSIONS: Adequate examination on the factors, which can predict the transitional stages of change exercise behaviors among middle aged women, which is presented in this study. The results of this study will become the pillar of exercise intervention program planning and application.

PURPOSE
Many studies have shown that regular exercise produces positive effects on health. The purpose of this study was to examine the differences of health-related quality of life by stage of exercise and the interaction effect of age, sex and stage of exercise. METHOD: A total of 1266 participants were interviewed with structured questionnaire. Stage of exercise was assessed with a single item and respondents were classified with respect to exercise intention and behavior. Health-related quality of life was measured with SF-36 Health Survey Questionnaire. RESULT: Health-related QOL were found to be different by stage of exercise. The subjects who were reached maintenance stage showed significantly higher scores on physical functioning, bodily pain, general health perception, mental health, role limitation due to emotional problems, social functioning, and vitality than those in preparation, contemplation, and precontemplation stage. In addition a significant interaction effect between stage of exercise and age was found on physical functioning, bodily pain, general health perception, mental health, and vitality. CONCLUSION: Perceived health-related QOL varies with stage of exercise. This finding suggests that health is related to both intention and behavior of exercise. Therefore it is important to consider cognitive-motivational and behavioral stage of change for developing exercise programs.

PUPPOSE: This research is a descriptive study to explore "patient respect" in nursing. Respect was analyzed as a concept in the domain of the patient. The Hybrid Model suggested by Schwartz-Barcott and Kim was used in this study.
METHOD
For the theoretical phase, nursing and other literature were reviewed to analyze attributes and develop a working definition of the concept, respect. For the fieldwork phase, four subjects in two general hospitals in Seoul participated. With the participants' permission, the data was collected between January and April, 2002, through in-depth interview and participant observation. The data analysis progressed at the same time as the fieldwork. Data analysis proceeded according to the analysis method of Strauss and Corbin.
RESULT
The final attributes of patient respect are suggested by consideration, recognition, cordial treatment, concern, honesty, acceptance. The final definition of patient respect as a concept in the domain the of patient is suggested by "Patient respect is that the patient is recognized as an individual with worth and is accepted, and considered to be that kind of an individual person. In addition, the patient is recognized to be an independent person and is treated with concern and honesty." CONCLUSION: The results of the analyses is helpful in integrating into a comprehensive description of the concept, Patient Respect.

The purpose of this study was to test the fitness and explainable power of TPB-SE model to the behavior of breast self examination and it was to examine effectiveness of education for Intention and behavior of breast self examination. The subjects were 122 womens under baby sitting teachers' training programs at "S"college on Po Hang city, Kyung Pook province from May 10, 1998 through October 17, 1998. Among 122 subjects, 61 were placed in experimental group and 61 in control group. The experimental group was treated by researcher who administered booklet, slide and breast model. Collected data were analyzed through x2-test, t-test, MANOVA, ANCOVA, Pearson correlation coefficient via SPSS/PC and applied LISREL 8.0 programs to test TPB-SE model. The result of this study was summarized as follows: 1. TPB-SE model with additions of self efficacy from TPB fits well for predictive factors of behavior of breast self examination and it also fits well for data (GFI=.91, R2=.45). 2. Behavior score of breast self examination in the experimental group with already educated with breast self examination was significantly higher than that of control group (Wilks's value=.711, p=000). Through the results of this study, TPB-SE model with additions of self efficacy from TPB fits well for predictive factors of behavior of breast self examination and the education of breast self examination was effective to improving intention and behavior of breast self examination. I herewith reached final conclusions that the behavior of breast self examination should be regarded as one of health behavior for all women and the health education to women for breast self examination will be important job role for all nurses. In addition to above, the intervention through effective education designed for improving attitude, subjective norm, perceived control, self efficacy and intentions will be necessary step for any improvement of women' health behavior.

This study was conducted to examine if the revised HPM was appropriate to explain smoking quitting behavior. A convenience sample of 400 college students enrolled in the universities located in Seoul and Kyunggi-Inchon province was selected. According to the study results, smoking-specific cognitions and affect included in the study could significantly explain commitment to a plan to quit smoking which was one of the behavioral outcomes in the revised HPM. The study result showed that among predictors, smoking-related affect, perceived benefit of quitting smoking, and perceived self-efficacy significantly explained commitment to a plan to quit smoking, but perceived barriers and interpersonal influences did not. The model for smoking quitting behavior formulated with smoking-specific cognitions and affect was statistically significant and the model explained 48 percent of variance in smoking quitting behavior. More specifically, it was shown that among smoking-specific cognitions and affect, only smoking-related affect, interpersonal influences, and perceived self-efficacy were the significant predictors to explain smoking quitting behavior. Smoking-related affect was the most important variable to explain smoking quitting behavior, followed by perceived self-efficacy. However, the influence of commitment to a plan to quit smoking on smoking quitting behavior was not statistically significant. Lastly, the model for smoking quitting behavior formulated with individual characteristics and experiences could explain 13 percent of the variance in behavior to quit smoking. Although the model is statistically significant, only the number of quitting attempts had significant and direct influence on behavior to quit smoking, while the remaining variables did not.

The main purpose of this study was to characterize and classify families of KT recipients and to identify family adaptability and cohesion, as family function, by the Circumplex model. A Cross-sectional survey approach was employed for this research project. The data was collected by the questionnaire method in 3 general hospitals in Seoul and Kyonggi-do, Korea. The Family Adaptability and Cohesion Evaluation Scales III was used. By Convenient sampling, a total of 190 subjects (Male 117, Female 73) with an average age of 39.7 years (range: 18-62 yrs.) participated. The mean age at transplantation was 36.8 yrs. (SD: 9.4 yrs.). On an average, the patients had received transplants 39.9 months previously. The data was analyzed by percentage of frequency, t-test, and one-way ANOVA by the SPSS program. The results were as follows: 1. The mean family adaptability score was 30.26(SD: 6.6, range: 12-49) and the mean family cohesion score was 34.96(SD: 6.5, range: 15-48). 2. All of 16 distinct types of family system were identified. Among them, 'Flexibly connected types' (32 families, 16.8%) were the most common and 'chaotically disengaged types' (2 families, 1.1%) were the least common. 3. Dividing the 16 unit typology into 3 basic groups of types, 'Balanced types' composed 88 families (46.3%), 'Mid-range types' composed 76 families (40.0%), and 'extreme types' composed 26 families (13.7%). 4. The family adaptation differed according to age, education level, marital status, the diagnostic age of CRF, and level of recipient's perception of the family's importance. The family cohesion differed according to age, employment status, number of kid, and level of recipient's perception of the family's importance. In conclusion, by providing nursing intervention designed to increase family adaptability and cohesion, considering the socio-demographic factors of recipient and family, nurses may improve the recipient's family function and health, and also the recipient's health and quality of life.

The purpose of this study was : 1) to develop and test a theoretical model examining relationships among social support( and social network size ), illness demands, marital adjustment, family coping, and an outcome measure of family functioning in response to a mother's breast cancer in the early postdiagnostic phase ; 2) to investigate the sources of functional social support : and 3) to assess characteristics of social support networks for Korean families with breast cancer. This study used a cross-sectional, correlational design with a causal modeling methodology to test the specified relationships in the recursive theoretical model. the convenience sample of this study consisted of 82 married Korean couples with recently diagnosed breast cancer in the child-rearing mother. Six standardized questionnaires were used to measure the theoretical concepts : social support (ISSB), social network(ASSIS), illness demands(DOII), marital adjustment(DAS), family coping(F-COPES), and family functioning(FACESII). The theoretical model was tested on the aggregated couples' data( family data ) and on mothers and fathers data. Path analysis results from the mothers and the fathers revealed different patterns. A core set of predictive variables were identified with three data sets showing consistent effects on family functioning level-marital adjustment and family coping, marital adjustment and family functioning, and family coping and family functioning. Namely, the level of family functioning was directly and positively affected by family coping behavior and the level of marital adjustment ; the level of marital adjustment had a direct positive effect on family coping behavior. In two reduced models from couples' and mothers' data, three sets of predicted relationships were supported, social support and marital adjustment, and s and marital adjustment. The level of social support received had a direct positive effect on both the level of marital adjustment and family coping behavior, and the experienced illness demands had a direct negative effect on the level of marital adjustment. Few significant gender differences were found in terms of 1) actual and perceived network sizes, need for support, and satisfaction with the support received for each type of functional social support, 20 total network size encompassing all types of functional social support, as well as, 3) the amount of functional social support received. These findings may prove useful for health care professionals working with Korean families with breast cancer or other chronic illness.