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
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 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
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 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.