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Original Article

Attitude Styles toward Holistic Health in Male Baby Boomers using Q-methodology

Hyun-Ok Jung, MSN, RN1, Eun-Jeong Shin, MSN, RN1, Kyung-Ran Park, Ph.D., RN2, Kwang-Za Yu, Ph.D., RN3, Hee-Sook Kim, Ph.D., RN4
Korean Journal of Adult Nursing 2016;28(5):501-513.
Published online: October 31, 2016

1PhD Student, College of Nursing, Kyungpook National University, Daegu

2Assistant Professor, Department of Nursing, Taegu Science University, Daegu

3Assistant Professor, Department of Nursing, Gyeonnam Provincial Geochang Colleage, Geochang

4Professor, College of Nursing ․ The Research Institute of Nursing Science, Kyungpook National University, Daegu, Korea

Corresponding author: Kim, Hee-Sook College of Nursing, Kyungpook National University, 680 Gukchaebosang-ro, Jung-gu, Daegu 41944, Korea. Tel: +82-53-420-4927, Fax: +82-53-422-4926, E-mail: hskim4114@nate.com
• Received: June 8, 2016   • Accepted: October 26, 2016

Copyright © 2016 Korean Society of Adult Nursing

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Purpose
    The purpose of this study was to identify attitudes of male baby boomer toward holistic health using Q-methodology.
  • Methods
    Q-methodology is analysed through the subjectivity of each type of attitudes. Thirty-five q-statements were selected from a total of 145 statements. These statements were categorized into six areas (Physical, psychological, spiritual, work and leisure, love and friendship, culture). The recruited P-sample consisted of thirty-four male baby boomers from one town and two cities. The 35 selected Q-statements from each of 35 participants were classified into the shape of a normal distribution using a 9-point scale. The collected data were analysed using the PQMethod Program 2.11.
  • Results
    Four types of male baby boomer attitudes towards holistic health were identified. The first is a relationship oriented-marital relationship oriented type, the second type is an economic oriented-job seeking type, the third type is a nature friendly oriented-independent living type, and the fourth type is health oriented-physical health seeking type.
  • Conclusion
    The results of this study indicated that different approaches to holistic health promotion program could be developed based on the four types of holistic health attitudes among baby boom generation males in Korea.
  • Key Words: Baby boom; Male; Holistic health; Attitudes; Health care for the elderly
Table 1.
Eigen Values, Total Variance, and Correlation among Types (N=28)
Variables Categories Relationship oriented Economic oriented Natural harmony oriented Health oriented
Eigen value   9.20 13.64 7.77 9.97
Total variance Variance (%) 19 12 13 9
Cumulative (%) 19 31 44 53
Correlation among types Relationship oriented 1.000      
Economic oriented .224 1.000    
Natural harmony oriented .508 .126 1.000  
Health oriented .378 .326 .449 1.000
Table 2.
General Characteristics and Factor Weights by Types (N=28)
Type ID Factor weights Age (year) Education Level Marital status Occupation Satisfaction of occupation Monthly income (10,000 won) Religion Children Psychological coping education
Type 1 (n=10) 1 0.7174 56 Graduates school Married Profession Satisfied ≥600 No Yes Want
2 0.6580 57 Graduates school Married Self-employment Average ≥200 Yes Yes Want
3 0.7070 60 Graduates school Married Office worker Very satisfied ≥600 Yes Yes Want
5 0.7014 54 Graduates school Married Profession Satisfied ≥500 Yes Yes Want
7 0.6633 55 Graduates school Married Service Average ≥200 None Yes Want
8 0.6553 57 Graduates school Married Self-employment Average ≥400 None Yes Unwilling
13 0.5619 58 Graduates school Married Profession Average ≥500 Yes Yes Want
25 0.6097 55 High school Married Production worker Satisfied ≥600 None Yes Unwilling
27 0.6093 56 University Married Public official Satisfied ≥400 Yes Yes Unwilling
31 0.4685 59 University Married Engineer Satisfied ≥200 None Yes Want
Type 2 (n=5) 6 0.5274 54 University Married Public official Very satisfied ≥200 Yes Yes Want
11 0.5814 53 University Married Self-employment Average ≥200 None Yes Ambivalent
16 0.9373 55 University Divorce Production worker Very dissatisfied ＜200 None Yes Ambivalent
17 0.9373 57 University Married Production worker Satisfied ≥400 Yes Yes Want
24 0.5119 52 High schoo1 Married Production worker Average ＜600 None Yes Ambivalent
Type 3 (n=7) 10 0.6885 59 Graduates school Married Inoccupation Average ＜200 Yes Yes Ambivalent
15 0.6370 58 High school Married Office worker Satisfied ≥300 Yes Yes Want
18 0.5559 52 University Married Profession Satisfied ≥400 Yes Yes Want
21 0.5263 60 High school Married Office worker Satisfied ＜200 Yes Yes Want
30 0.4779 60 High school Married Engineer Average ≥200 None Yes Unwilling
32 0.6227 57 High school Married Inoccupation Average ≥200 None Yes Ambivalent
34 0.4536 59 High school Married Production worker Satisfied ≥400 Yes Yes Unwilling
Type 4 (n=6) 4 0.7096 55 University Married Profession Average ≥600 None Yes Ambivalent
9 0.5568 55 University Married Self-employment Satisfied ≥300 None Yes Want
20 0.6207 59 University Married Profession Average ≥300 Yes Yes Ambivalent
23 0.6960 52 High school Married Production worker Satisfied ＜600 Yes Yes Want
26 0.5046 57 High school Married Production worker Satisfied ＜400 None Yes Unwilling
28 0.5065 56 High school Married Public official Dissatisfied ≥400 None Yes Want
Table 3.
Factor Q-Sort Values and Z-Scores for Each Statement (N=28)
Q-Statement Factor Q-sort value/Z-score
Type 1 Type 2 Type 3 Type 4
1. Working in later years is one key to maintaining holistic health. 2 1.01 3 1.45 0 -0.05 -1 -0.37
2. I want to live life my way for the sake of holistic health. 1 0.55 2 1.02 3 1.08 3 1.48
3. For holistic health, it is essential to reflect on past years rather than to take on new challenges from the present. -2 -0.82 3 1.28 -1 -0.83 0 -0.04
4. A balance between work and leisure life helps with staying healthy. 3 1.55 1 0.53 -1 -0.14 2 0.75
5. A job guaranteed till retirement age is preferred to work with short retirement age, despite of high salary. -1 -0.78 0 0.02 2 1.03 0 0.22
6. It is better to live life as long as it lasts, without worrying too much about health. -2 -0.60 -4 -1.85 -4 -2.03 -2 -1.14
7. Living in a quiet private residence helps maintaining holistic health better than living in a city apartment. -1 -0.56 1 0.40 0 -0.08 3 1.44
8. Exercising is mandatory for holistic health. 4 1.63 2 0.82 2 0.95 4 1.75
9. Regular consumption of dietary supplements helps with staying healthy. -1 -0.77 -1 -0.37 1 0.36 1 0.27
10. It is good for the health to stop drinking alcohol and smoking cigarettes. 0 -0.36 -2 -0.93 3 1.33 -1 -0.35
11. The health of my spouse is an important element in maintaining my own wellness. 3 1.11 2 1.01 1 0.44 4 1.87
12. The sense of responsibility to support the family makes it hard to feel comfortable. -3 -1.03 3 1.34 -2 -1.10 0 -0.24
13. Regular meet ups with old friends at reunions makes one happy. 0 -0.37 2 0.90 -2 -0.92 -3 -1.25
14. The traditional culture of South Korea makes people more comfortable than the modern culture. -1 -0.56 -4 -1.86 -1 -0.48 -2 -1.08
15. A happy life is already determined at birth. -4 -2.33 -3 -1.47 -3 -1.12 -4 -2.06
16. Being grateful for everything brings good fortune. 3 1.45 -2 -0.80 2 0.92 2 0.59
17. It is positive to maintain romantic feelings for the other sex, whether for a spouse or someone else. 1 0.63 -2 -0.91 0 0.17 1 0.49
18. A prolonged period of senescence is terrifying. -3 -1.28 4 1.63 -3 -1.38 0 -0.23
19. It is more important to have respect from one's family than from others. 0 0.13 0 -0.02 1 0.61 1 0.53
20. Holistic health can be achieved by confronting and accepting any difficulty. 1 0.46 -2 -0.99 -1 -0.23 -1 -0.38
21. Holistic health can be achieved by having insight into my self-identity. 2 0.94 -3 -1.32 0 -0.04 -2 -0.43
22. It is hard to embrace the constant changes in various social phenomena. -2 -0.85 -1 -0.55 -3 -1.16 -3 -1.33
23. I am sad because it feels like my presence is becoming less significant. -3 -1.16 -1 -0.48 -2 -0.90 0 -0.11
24. I would like the younger generation to recognize our contribution to industrialization. -2 -0.82 1 0.44 0 0.00 3 1.33
25. It would be convenient if the government could build a system capable of generating a stable source of income. -4 -1.50 0 -0.08 -2 -0.83 -1 -0.27
26. Developing the ability to stay well when left alone is required for holistic health. 1 0.60 1 0.53 4 1.64 0 0.03
27. It is possible to gain considerable self-esteem by talent donation or volunteering, even without low or no income. 0 0.14 0 0.02 -1 -0.46 2 1.07
28. One cannot be happy without fulfillment of sexual desire. -1 -0.53 -3 -1.53 0 0.01 0 0.05
29. It is better to have the right to choose to embrace death over life extension when diagnosed with an untreatable disease. 0 -0.34 -1 -0.37 0 -0.03 2 1.17
30. Amicable communication with the spouse is important for holistic health. 4 1.97 0 0.12 1 0.61 1 0.26
31. Some kind of religion is required to maintain a happy life. 0 0.00 -1 -0.53 2 1.05 -3 -1.61
32. Physical and mental health can be acquired by being harmonious with nature. 2 0.85 0 0.11 4 1.82 1 0.28
33. Having professional knowledge or skills is an important condition for a happy life. 0 0.03 0 0.01 1 0.23 -2 -0.58
34. Financial capability is an important element of holistic health. 1 0.78 4 1.86 3 1.56 -1 -0.26
35. Since everybody dies, it is essential to know about well-dying. 2 0.81 1 0.58 -4 -2.05 -4 -1.83
Table 4.
Distinguishing Statements for Each Type† (N=28)
Type Item Q-Statement Factor Q-sort value Z-score
Type 1 30 Amicable communication with the spouse is important for holistic health. 4 1.97**
4 A balance between work and leisure life helps with staying healthy. 3 1.55**
16 Being grateful for everything brings good fortune. 3 1.45*
24 I would like the younger generation to recognize our contribution to industrialization. -2 -0.82**
25 It would be convenient if the government could build a system capable of generating a stable source of income. -4 -1.50**
Type 2 18 A prolonged period of senescence is terrifying. 4 1.63**
12 The sense of responsibility to support the family makes it hard to feel comfortable. 3 1.34**
3 For holistic health, it is essential to reflect on past years rather than to take on new challenges from the present. 3 1.28**
21 True holistic health can be achieved by having insight into my self-identity. -3 -1.32**
28 One cannot be happy without fulfillment of sexual desire. -3 -1.53**
14 The traditional culture of South Korea makes people more comfortable than the modern culture. -4 -1.86**
Type 3 32 Physical and mental health can be acquired by being together with nature. 4 1.82**
26 Developing the ability to stay well when left alone is required for holistic health. 4 1.64**
10 It is good for the health to stop drinking alcohol and smoking cigarettes. 3 1.33**
4 A balance between work and leisure life helps with staying healthy. -1 -0.14*
25 It would be convenient if the government could build a system capable of generating a stable source of income. -2 -0.83*
Type 4 11 The health of my spouse is an important element in maintaining my own holistic health. 4 1.87**
7 Living in a quiet private residence helps maintaining holistic health better than living in a city apartment. 3 1.44**
24 I would like the younger generation to recognize our contribution to industrialization 3 1.33**
33 Having professional knowledge or skills is an important condition for a happy life. -2 -0.58*
14 The traditional culture of South Korea makes people more comfortable than the modern culture. -2 -1.08*
31 Some kind of religion is required to maintain a happy life. -3 -1.61**

†Statements of each type are factor Q-Sort values and Z-Score greater or less than others;

*p＜.05

**p＜.01.

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      Attitude Styles toward Holistic Health in Male Baby Boomers using Q-methodology
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      DOI: https://doi.org/10.7475/kjan.2016.28.5.501
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      Attitude Styles toward Holistic Health in Male Baby Boomers using Q-methodology
      Korean J Adult Nurs. 2016;28(5):501-513.   Published online October 31, 2016
      DOI: https://doi.org/10.7475/kjan.2016.28.5.501
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      Attitude Styles toward Holistic Health in Male Baby Boomers using Q-methodology
      Attitude Styles toward Holistic Health in Male Baby Boomers using Q-methodology

      Eigen Values, Total Variance, and Correlation among Types (N=28)

      Variables Categories Relationship oriented Economic oriented Natural harmony oriented Health oriented
      Eigen value   9.20 13.64 7.77 9.97
      Total variance Variance (%) 19 12 13 9
      Cumulative (%) 19 31 44 53
      Correlation among types Relationship oriented 1.000      
      Economic oriented .224 1.000    
      Natural harmony oriented .508 .126 1.000  
      Health oriented .378 .326 .449 1.000

      General Characteristics and Factor Weights by Types (N=28)

      Type ID Factor weights Age (year) Education Level Marital status Occupation Satisfaction of occupation Monthly income (10,000 won) Religion Children Psychological coping education
      Type 1 (n=10) 1 0.7174 56 Graduates school Married Profession Satisfied ≥600 No Yes Want
      2 0.6580 57 Graduates school Married Self-employment Average ≥200 Yes Yes Want
      3 0.7070 60 Graduates school Married Office worker Very satisfied ≥600 Yes Yes Want
      5 0.7014 54 Graduates school Married Profession Satisfied ≥500 Yes Yes Want
      7 0.6633 55 Graduates school Married Service Average ≥200 None Yes Want
      8 0.6553 57 Graduates school Married Self-employment Average ≥400 None Yes Unwilling
      13 0.5619 58 Graduates school Married Profession Average ≥500 Yes Yes Want
      25 0.6097 55 High school Married Production worker Satisfied ≥600 None Yes Unwilling
      27 0.6093 56 University Married Public official Satisfied ≥400 Yes Yes Unwilling
      31 0.4685 59 University Married Engineer Satisfied ≥200 None Yes Want
      Type 2 (n=5) 6 0.5274 54 University Married Public official Very satisfied ≥200 Yes Yes Want
      11 0.5814 53 University Married Self-employment Average ≥200 None Yes Ambivalent
      16 0.9373 55 University Divorce Production worker Very dissatisfied ＜200 None Yes Ambivalent
      17 0.9373 57 University Married Production worker Satisfied ≥400 Yes Yes Want
      24 0.5119 52 High schoo1 Married Production worker Average ＜600 None Yes Ambivalent
      Type 3 (n=7) 10 0.6885 59 Graduates school Married Inoccupation Average ＜200 Yes Yes Ambivalent
      15 0.6370 58 High school Married Office worker Satisfied ≥300 Yes Yes Want
      18 0.5559 52 University Married Profession Satisfied ≥400 Yes Yes Want
      21 0.5263 60 High school Married Office worker Satisfied ＜200 Yes Yes Want
      30 0.4779 60 High school Married Engineer Average ≥200 None Yes Unwilling
      32 0.6227 57 High school Married Inoccupation Average ≥200 None Yes Ambivalent
      34 0.4536 59 High school Married Production worker Satisfied ≥400 Yes Yes Unwilling
      Type 4 (n=6) 4 0.7096 55 University Married Profession Average ≥600 None Yes Ambivalent
      9 0.5568 55 University Married Self-employment Satisfied ≥300 None Yes Want
      20 0.6207 59 University Married Profession Average ≥300 Yes Yes Ambivalent
      23 0.6960 52 High school Married Production worker Satisfied ＜600 Yes Yes Want
      26 0.5046 57 High school Married Production worker Satisfied ＜400 None Yes Unwilling
      28 0.5065 56 High school Married Public official Dissatisfied ≥400 None Yes Want

      Factor Q-Sort Values and Z-Scores for Each Statement (N=28)

      Q-Statement Factor Q-sort value/Z-score
      Type 1 Type 2 Type 3 Type 4
      1. Working in later years is one key to maintaining holistic health. 2 1.01 3 1.45 0 -0.05 -1 -0.37
      2. I want to live life my way for the sake of holistic health. 1 0.55 2 1.02 3 1.08 3 1.48
      3. For holistic health, it is essential to reflect on past years rather than to take on new challenges from the present. -2 -0.82 3 1.28 -1 -0.83 0 -0.04
      4. A balance between work and leisure life helps with staying healthy. 3 1.55 1 0.53 -1 -0.14 2 0.75
      5. A job guaranteed till retirement age is preferred to work with short retirement age, despite of high salary. -1 -0.78 0 0.02 2 1.03 0 0.22
      6. It is better to live life as long as it lasts, without worrying too much about health. -2 -0.60 -4 -1.85 -4 -2.03 -2 -1.14
      7. Living in a quiet private residence helps maintaining holistic health better than living in a city apartment. -1 -0.56 1 0.40 0 -0.08 3 1.44
      8. Exercising is mandatory for holistic health. 4 1.63 2 0.82 2 0.95 4 1.75
      9. Regular consumption of dietary supplements helps with staying healthy. -1 -0.77 -1 -0.37 1 0.36 1 0.27
      10. It is good for the health to stop drinking alcohol and smoking cigarettes. 0 -0.36 -2 -0.93 3 1.33 -1 -0.35
      11. The health of my spouse is an important element in maintaining my own wellness. 3 1.11 2 1.01 1 0.44 4 1.87
      12. The sense of responsibility to support the family makes it hard to feel comfortable. -3 -1.03 3 1.34 -2 -1.10 0 -0.24
      13. Regular meet ups with old friends at reunions makes one happy. 0 -0.37 2 0.90 -2 -0.92 -3 -1.25
      14. The traditional culture of South Korea makes people more comfortable than the modern culture. -1 -0.56 -4 -1.86 -1 -0.48 -2 -1.08
      15. A happy life is already determined at birth. -4 -2.33 -3 -1.47 -3 -1.12 -4 -2.06
      16. Being grateful for everything brings good fortune. 3 1.45 -2 -0.80 2 0.92 2 0.59
      17. It is positive to maintain romantic feelings for the other sex, whether for a spouse or someone else. 1 0.63 -2 -0.91 0 0.17 1 0.49
      18. A prolonged period of senescence is terrifying. -3 -1.28 4 1.63 -3 -1.38 0 -0.23
      19. It is more important to have respect from one's family than from others. 0 0.13 0 -0.02 1 0.61 1 0.53
      20. Holistic health can be achieved by confronting and accepting any difficulty. 1 0.46 -2 -0.99 -1 -0.23 -1 -0.38
      21. Holistic health can be achieved by having insight into my self-identity. 2 0.94 -3 -1.32 0 -0.04 -2 -0.43
      22. It is hard to embrace the constant changes in various social phenomena. -2 -0.85 -1 -0.55 -3 -1.16 -3 -1.33
      23. I am sad because it feels like my presence is becoming less significant. -3 -1.16 -1 -0.48 -2 -0.90 0 -0.11
      24. I would like the younger generation to recognize our contribution to industrialization. -2 -0.82 1 0.44 0 0.00 3 1.33
      25. It would be convenient if the government could build a system capable of generating a stable source of income. -4 -1.50 0 -0.08 -2 -0.83 -1 -0.27
      26. Developing the ability to stay well when left alone is required for holistic health. 1 0.60 1 0.53 4 1.64 0 0.03
      27. It is possible to gain considerable self-esteem by talent donation or volunteering, even without low or no income. 0 0.14 0 0.02 -1 -0.46 2 1.07
      28. One cannot be happy without fulfillment of sexual desire. -1 -0.53 -3 -1.53 0 0.01 0 0.05
      29. It is better to have the right to choose to embrace death over life extension when diagnosed with an untreatable disease. 0 -0.34 -1 -0.37 0 -0.03 2 1.17
      30. Amicable communication with the spouse is important for holistic health. 4 1.97 0 0.12 1 0.61 1 0.26
      31. Some kind of religion is required to maintain a happy life. 0 0.00 -1 -0.53 2 1.05 -3 -1.61
      32. Physical and mental health can be acquired by being harmonious with nature. 2 0.85 0 0.11 4 1.82 1 0.28
      33. Having professional knowledge or skills is an important condition for a happy life. 0 0.03 0 0.01 1 0.23 -2 -0.58
      34. Financial capability is an important element of holistic health. 1 0.78 4 1.86 3 1.56 -1 -0.26
      35. Since everybody dies, it is essential to know about well-dying. 2 0.81 1 0.58 -4 -2.05 -4 -1.83

      Distinguishing Statements for Each Type† (N=28)

      Type Item Q-Statement Factor Q-sort value Z-score
      Type 1 30 Amicable communication with the spouse is important for holistic health. 4 1.97**
      4 A balance between work and leisure life helps with staying healthy. 3 1.55**
      16 Being grateful for everything brings good fortune. 3 1.45*
      24 I would like the younger generation to recognize our contribution to industrialization. -2 -0.82**
      25 It would be convenient if the government could build a system capable of generating a stable source of income. -4 -1.50**
      Type 2 18 A prolonged period of senescence is terrifying. 4 1.63**
      12 The sense of responsibility to support the family makes it hard to feel comfortable. 3 1.34**
      3 For holistic health, it is essential to reflect on past years rather than to take on new challenges from the present. 3 1.28**
      21 True holistic health can be achieved by having insight into my self-identity. -3 -1.32**
      28 One cannot be happy without fulfillment of sexual desire. -3 -1.53**
      14 The traditional culture of South Korea makes people more comfortable than the modern culture. -4 -1.86**
      Type 3 32 Physical and mental health can be acquired by being together with nature. 4 1.82**
      26 Developing the ability to stay well when left alone is required for holistic health. 4 1.64**
      10 It is good for the health to stop drinking alcohol and smoking cigarettes. 3 1.33**
      4 A balance between work and leisure life helps with staying healthy. -1 -0.14*
      25 It would be convenient if the government could build a system capable of generating a stable source of income. -2 -0.83*
      Type 4 11 The health of my spouse is an important element in maintaining my own holistic health. 4 1.87**
      7 Living in a quiet private residence helps maintaining holistic health better than living in a city apartment. 3 1.44**
      24 I would like the younger generation to recognize our contribution to industrialization 3 1.33**
      33 Having professional knowledge or skills is an important condition for a happy life. -2 -0.58*
      14 The traditional culture of South Korea makes people more comfortable than the modern culture. -2 -1.08*
      31 Some kind of religion is required to maintain a happy life. -3 -1.61**

      †Statements of each type are factor Q-Sort values and Z-Score greater or less than others;

      *p＜.05

      **p＜.01.
      Table 1. Eigen Values, Total Variance, and Correlation among Types (N=28)

      Table 2. General Characteristics and Factor Weights by Types (N=28)

      Table 3. Factor Q-Sort Values and Z-Scores for Each Statement (N=28)

      Table 4. Distinguishing Statements for Each Type† (N=28)

      Statements of each type are factor Q-Sort values and Z-Score greater or less than others;

      p＜.05

      p＜.01.

      Table 1.

      Table 2.

      Table 3.

      Table 4.

      Korean J Adult Nurs : Korean Journal of Adult Nursing

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