정보-동기-행동기술 모델을 기반으로 한 학령기 아동의 건강증진행위에 영향을 미치는 요인

임보라 성신여자대학교 일반대학원 2023 국내석사

Based on the Information-Motivation-Behavioral Skills Model(IMB model), this is a descriptive research study to identify the factors influencing health promotion behavior among school-age children's health literacy, attitude toward health behavior, social support, and self-efficacy. The subjects of the study were selected by convenience sampling from 209 fifth and sixth graders of elementary schools located in S city. Data were collected from March 13, 2023, to March 31, 2023, using a self-written questionnaire. The research tool consisted of questions that measured general characteristics, health literacy, attitude toward health behavior, social support, self-efficacy, and health promotion behavior. The collected data were analyzed by frequency analysis, descriptive statistics, independent t-test, one-way ANOVA, Scheffé post-hoc test, Pearson's Correlation Coefficient, and Multiple Regression Analysis according to the purpose of the study and the characteristics of the variables. The results of this study are as follows. First, the gender of the subjects was 104 (49.8%) for men and 105 (50.2%) for women, 77 (36.8%) for fifth grade and 132 (63.2%) for sixth grade. As for subjective health status, 96 students (45.9%) were ‘healthy’, and academic performance was ‘good’ with 109 students (52.2%). As for the experience of hospitalization, 120 students (57.4%) answered ‘no’ and 89 students (42.6%) answered ‘yes’. As for health-related information, 65 students (31.1%) received the most information from ‘friends and family’, and 84 students (40.2%) expressed interest in health as ‘normal’. Regarding school health education experience, 111 students (53.1%) answered ‘no’ and 98 students (46.9%) answered ‘yes’, and the subjective family economic status was ‘middle’ with 129 students (61.7%). Second, the average score of health literacy was 29.35±4.22 points out of 42 points. The average score of attitude toward health behavior was 19.62±3.36 points out of 25 points. The average score of social support was 97.18±13.02 points out of 120 points. The average score of self-efficacy was 35.87±7.34 points out of 50 points. The average score of health promotion behavior was 113.07±14.09 points out of 145 points. Third, in the difference in health promotion behavior according to general characteristics, there was a statistically significant difference according to grade (t=2.546, p=.012), subjective health status (F=8.731, p<.001), academic performance (F=5.918, p=.003), interest in health (F=12.960, p<.001), school health education experience (t=2.848, p=.005) and subjective family economic status (F=18.844, p<.001). Fourth, health promotion behavior showed a significant positive correlation with social support (r=.696, p<.001), attitude toward health behavior (r=.622, p<.001), self-efficacy (r=.561, p<.001), health literacy (r=.330, p<.001). Fifth, as a result of confirming the factors influencing the health promotion behaviors of school-age children, health literacy, attitude toward health behavior, social support, self-efficacy, and interest in health were found. Social support (β=.419, p<.001) appeared to have the greatest influence on health promotion behavior. Next, attitude toward health behavior (β=.267, p<.001), self-efficacy (β=.134, p=.021), health literacy (β=.109, p=.025), and interest in health (β=.102, p=.043). The explanatory power of this model was 60.4% (F=32.677, p<.001). In view of the above results, it is necessary to develop and apply health education and health promotion programs that consider health literacy, attitude toward health behavior, social support, self-efficacy and interest in health in order to promote the practice of school-age children's health promotion behavior. Keywords: IMB model, Health Promotion Behavior, Health Literacy, Attitude toward Health Behavior, Social Support, Self-efficacy, School-Aged Children 본 연구는 정보-동기-행동기술 모델(Information-Motivation-Behavioral Skills Model, IMB model)을 기반으로 학령기 아동의 건강정보이해능력, 건강행위에 대한 태도, 사회적 지지, 자기효능감이 건강증진행위에 영향을 미치는 요인을 확인하기 위한 서술적 조사연구이다. 연구 대상은 S시에 소재한 초등학교 5, 6학년 학생 209명을 편의표집하여 선정하였다. 자가기입식 설문지를 사용하여 2023년 3월 13일부터 2023년 3월 31일까지 자료를 수집하였다. 연구도구는 일반적 특성, 건강정보이해능력, 건강행위에 대한 태도, 사회적 지지, 자기효능감, 건강증진행위의 정도를 측정하는 문항으로 이루어졌다. 수집한 자료는 연구 목적 및 변수의 특성에 따라 빈도분석, 기술통계, independent t-test, one-way ANOVA, Scheffé post hoc test, Pearson`s Correlation Coefficient, Multiple Regression Analysis로 분석하였다. 본 연구 결과는 다음과 같다. 첫째, 대상자의 성별은 남자가 104명(49.8%), 여자가 105명(50.2%)이었고, 학년은 5학년 77명(36.8%), 6학년 132명(63.2%)으로 나타났다. 주관적 건강상태는 ‘건강하다’가 96명(45.9%)으로 가장 많았고, 학업성적은 ‘좋은 편이다’가 109명(52.2%)으로 가장 많았다. 병원입원경험은 ‘없다’가 120명(57.4%), ‘있다’가 89명(42.6%)이었다. 건강과 관련된 정보는 주로 ‘친구, 가족 등 주변 사람들’에게서 얻는 경우가 65명(31.1%)으로 가장 많았고, 건강에 대한 관심도는 ‘보통이다’가 84명(40.2%)으로 가장 많이 나타났다. 학교 보건교육 경험 유무는 ‘없다’가 111명(53.1%), ‘있다’가 98명(46.9%)이었고, 주관적 가정 경제상태는 ‘중’이 129명(61.7%)으로 가장 많았다. 둘째, 건강정보이해능력의 평균은 42점 만점을 기준으로, 29.35±4.22점이었다. 건강행위에 대한 태도의 평균은 25점 만점을 기준으로, 19.62±3.36점이었다. 사회적 지지의 평균은 120점 만점을 기준으로, 97.18±13.02점이었다. 자기효능감의 평균은 50점 만점을 기준으로, 35.87±7.34점이었다. 건강증진행위의 평균은 145점 만점을 기준으로, 113.07±14.09점이었다. 셋째, 일반적 특성에 따른 건강증진행위는 학년(t=2.546, p=.012), 주관적 건강상태(F=8.731, p<.001), 학업성적(F=5.918, p=.003), 건강에 대한 관심도(F=12.960, p<.001), 학교 보건교육 경험 유무(t=2.848, p=.005), 주관적 가정 경제상태(F=18.844, p<.001)에 따라 통계적으로 유의한 차이가 있는 것으로 나타났다. 넷째, 건강증진행위는 사회적 지지(r=.696, p<.001), 건강행위에 대한 태도(r=.622, p<.001), 자기효능감(r=.561, p<.001), 건강정보이해능력(r=.330, p<.001) 순으로 유의한 양의 상관관계가 나타났다. 다섯째, 학령기 아동의 건강증진행위에 가장 큰 영향을 미치는 요인은 사회적 지지(β=.419, p<.001)로 나타났다. 다음으로, 건강행위에 대한 태도(β=.267, p<.001), 자기효능감(β=.134, p=.021), 건강정보이해능력(β=.109, p=.025), 건강에 대한 관심도(β=.102, p=.043)의 순서로 건강증진행위에 영향을 미치는 것으로 나타났다. 이 모델의 설명력은 60.4%로 나타났다(F=32.677, p<.001). 이상의 결과에 비추어 볼 때, 학령기 아동을 대상으로 건강증진행위의 실천을 촉진하기 위해서는 건강정보이해능력, 건강행위에 대한 태도, 사회적 지지, 자기효능감, 건강에 대한 관심도를 고려한 보건교육과 건강증진프로그램의 개발 및 적용이 필요하다.

PRECEDE-PROCEED 모형을 적용한 건강증진교육프로그램 개발 및 효과

김영진 계명대학교 대학원 2019 국내박사

본 연구는 의무경찰의 건강증진교육프로그램을 개발하고 적용하여 그 효과를 검정하기 위한 목적으로 실시되었다. 연구설계는 비동등성 대조군 전후설계로 실험군 25명, 대조군 26명이었다. 연구대상은 D지방경찰청 소속 의무경찰로 하였으며, 자료수집기간은 2018년 7월10일부터 9월 9일까지 이루어졌다. 본 연구에서 실험군은 건강증진교육프로그램을 5주 동안 7회 적용하였다. 자료분석은 SPSS/WIN 21.0 프로그램을 이용하였으며, 일반적 특성 및 건강관련 특성의 동질성 검증을 위해 χ2과 독립표본 t-검정을 실시하였고, 종속변수에 대한 동질성 검증을 독립표본 t-검정으로 실시하였다. 가설검증은 반복측정 분산분석(Repeated Measures ANOVA), 신뢰도 검정은 Cronbach’ alpha 계수로 분석하였다. 연구결과는 다음과 같다. 1) 제1가설: ‘시간 경과에 따른 실험군과 대조군은 자기효능감에 차이가 있을 것이다’를 검증한 결과, 시간 경과에 따른 자기효능감의 전반적인 변화 추이는 집단 간에 유의한 차이가 없었다(F=2.24, p=.122). 따라서 제1가설은 기각되었다. 2) 제2가설: ‘시간 경과에 따른 실험군과 대조군은 건강지식에 차이가 있을 것이다’를 검증한 결과, 시간 경과에 따른 건강지식의 변화가 집단 간에는 유의한 차이가 있었다(F=21.03, p<.001). 따라서 제2가설은 지지되었다. 3) 제3가설: ‘시간 경과에 따른 실험군과 대조군은 사회적 지지에 차이가 있을 것이다’를 검증한 결과, 시간 경과에 따른 사회적 지지의 변화가 집단 간에는 유의한 차이가 없었다(F=0.50, p=.570). 따라서 제3가설은 기각되었다. 4) 제4가설: ‘시간 경과에 따른 실험군과 대조군은 거래적 리더십에 차이가 있을 것이다’를 검증한 결과, 시간 경과에 따른 거래적 리더십의 변화가 집단 간에는 유의한 차이가 있었다(F=20.96, p<.001). 따라서 제4가설은 지지되었다. 5) 제5가설: ‘시간 경과에 따른 실험군과 대조군은 자원이용가능성에 차이가 있을 것이다’를 검증한 결과, 시간 경과에 따른 자원이용가능성의 변화가 집단 간에는 유의한 차이가 없었다(F=1.98, p=.143). 따라서 제5가설은 기각되었다. 6) 제6가설: ‘시간 경과에 따른 실험군과 대조군은 건강증진행위에 차이가 있을 것이다’를 검증한 결과, 시간 경과에 따른 건강증진행위의 변화가 집단 간에는 유의한 차이가 있었다(F=7.63, p<.001). 따라서 제6가설은 지지되었다. 7) 제7가설: ‘시간 경과에 따른 실험군과 대조군은 부대적응에 차이가 있을 것이다’를 검증한 결과, 시간 경과에 따른 부대적응의 변화가 집단 간에는 유의한 차이가 없었다(F=2.70, p=.072). 따라서 제7가설은 기각되었다. 8) 제8가설: ‘시간 경과에 따른 실험군과 대조군은 객관적 스트레스에 차이가 있을 것이다’를 검증한 결과, 시간 경과에 따른 객관적 스트레스의 변화는 집단 간에 자율신경활성도(F=29.24, p<.001), 스트레스저항도(F=31.22, p<.001), 스트레스지수(F=22.42, p<.001), 피로도(F=12.87, p<.001)에 유의한 차이가 있었다. 따라서 제8가설은 지지 되었다. 9) 제9가설: ‘시간 경과에 따른 실험군과 대조군은 삶의 질에 차이가 있을 것이다’를 검증한 결과, 시간 경과에 따른 삶의 질의 변화가 집단 간에는 유의한 차이가 있었다(F=3.49, p=.042). 따라서 제 9가설은 지지되었다. 본 연구결과는 대상자들의 전반적인 삶의 질을 향상시키고 유병률을 줄이기 위한 전략을 개발하는 데 매우 중요한 의미가 있다. 의무경찰의 건강문제의 심각성이 증대됨에 따라 적절한 전략을 계획하고 실천하는 것이 필요하며, 건강지식의 부족이나 오해, 건강 문제에 대한 우려는 건강에 대한 부정적인 행위로 이어질 수도 있다. 이상의 결과, 의무경찰의 건강증진교육프로그램은 대상자의 삶의 질을 향상시키는데 효과적인 중재로 검증되었으며, 의무경찰에 유용하게 활용될 수 있을 것이다. The purpose of this study was to develop and examine the effect of the Health Promotion Education Program for the Auxiliary Police based on the PRECEDE–PROCEED Model. This study was conducted using a nonequivalent control group pretest-posttest design. There were 25 participants in the experimental group and 26 participants in the control group. The data were collected from July 10, 2018 to September 9, 2018 for Auxiliary Police officer in D provincial Police Agency. In this study, the experimental group completed 7 sessions of health promotion programs for 5 weeks. Data were analyzed using the SPSS/WIN 21.0 Program. To verify the identity of the general characteristics and health-related characteristics, x2 and independent samples t-test were performed. The independent samples t-test was performed to verify the homogeneity of the dependent variables. Hypothesis were tested using Repeated Measures ANOVA and reliability test was performed through Cronbach' alpha coefficient. The results of this study were as follows: 1) The first hypothesis: “The experimental group and the control group will differ over time in terms of self-efficacy over time” was rejected. There was no significant differences between the groups over time in terms of self-efficacy (F=2.24, p=.122). 2) The second hypothesis: “The experimental group and the control group will differ over time in terms of health knowledge” was supported. There was significant differences between the groups over time in terms of health knowledge (F=21.03, p<.001). 3) The third hypothesis: “The experimental group and the control group will differ over time in terms of social support" was rejected. There was no significant differences between the groups over time in terms of social support (F=0.50, p=.570). 4) The fourth hypothesis: “The experimental group and the control group will differ over time in terms of transactional leadership." was supported. There was significant differences between the groups over time in terms of transactional leadership (F=20.96, p<.001). 5) The fifth hypothesis: “The experimental group and the control group will differ over time in terms of availability of resources " was rejected. There was no significant differences over time between the groups availability of resources (F=1.98, p=.143). 6) The sixth hypothesis: “The experimental group and the control group will differ over time in terms of Health promotion behavior" was supported. There was significant differences over time between the groups in terms of health promotion behavior (F=7.63, p<.001). 7) The seventh hypothesis: “The experimental group and the control group will differ over time in terms of military life adjustment" was rejected. There was no significant differences over time between the groups in terms of military life adjustment (F=2.70, p=.072). 8) The eighth hypothesis: “The experimental group and the control group will differ over time in terms of objective stress" was supported. There was significant difference over time in terms of the autonomic nervous activity (F=29.24, p<.001), stress resistance (F=31.22, p<.001), stress index (F=22.42, p<.001), and fatigue (F=12.87, p<.001). 9) The ninth hypothesis, “The experimental group and the control group will differ over time in terms of quality of life" was supported. There was significant difference over time in terms of quality of life (F=3.49, p=.042). The results may be crucial to develop strategy in order to decrease the disease prevalence as well as increase the participants’ overall quality of life. As the health problems in the auxiliary police is increasing in nationwide, it is necessary to plan and practice proper strategies for the auxiliary police. The insufficient knowledge or misconceptions about the health promotion, and the concerns of health problems as an auxiliary police officer may lead to inappropriate health seeking behaviors towards. As a result, the Health Promotion Education Program for the auxiliary police was proved to be an effective intervention in order to improve the quality of life. Therefore, the program may be a useful intervention for the auxiliary police.

중국 고령층의 온라인 건강정보 이용 동기가 건강증진 행동에 미치는 영향에 관한 연구 : 이용과 충족이론 및 확장된 기술수용모형을 중심으로

한뢰 영남대학교 대학원 2021 국내박사

With China's rapid aging society and the development of information and communication technology, the elderly are increasingly concerned about health.Older people are trying to deal with the economic problems, social isolation and physical frailty that they inevitably face as they grow older in their life cycles.If older people take an interest in and make an effort to address their personal health issues, they can benefit from health management.Recently, the Internet has begun to play an important role in providing health information to the elderly. Based on this research background, this study wanted to examine the motivation of the elderly to use online health information.How does the information provided by the Internet meets the health information needs of the elderly?What are the mediating factors between the elderly's motivation to use online health information and their satisfaction?In addition,How does the motivation of the elderly to use online health information really has an effect on the health promotion behavior of the elderly?Therefore, this study focused on the use and gratification theory and technology acceptance model to explore the impact of online health information use motivation on health promotion behavior among Chinese elderly people. This study was conducted with 550 Chinese elderly people over 60 years old as the objects. This survey is conducted online and the questionnaires are issued by WeChat. In the collected 550 questionnaires, 48 questionnaires with dishonest answers were eliminated, and 500 were finally selected for analysis.Firstly, SPSS26 statistical software was used to verify the reliability and validity of the samples. Secondly, frequency analysis was performed to confirm general characteristics. Descriptive statistical analysis was performed to understand the individual characteristics of respondents, and correlation analysis is also carried out. Confirmatory factor analysis and structural equation analysis were carried out using AMOS.26 . First, perceived usefulness and ease of use, health literacy has a significant impact on health information satisfaction. Second, this study examines the impact of motivations for the use of online health information in older adults on perceived usefulness, and the results show that the motivation to pursue happiness has the greatest impact. Third, this study verifies the impact of motivations for the use of online health information among older adults on perceived ease of use and the results show that motivations for information pursuit have the greatest impact on perceived ease of use. Forth, this study verifies the impact of motivations for the use of online health information on health literacy among older adults. Similarly, motivations for information pursuit have the greatest impact on health literacy. Fifth, by analyzing the relationship between self-identity motivation, happiness motivation, social motivation, information pursuit motivation and health information satisfaction, we found that perceived usefulness and perceived ease of use, as well as health literacy played a mediating role.Health literacy variables, in particular, had the greatest influence on the relationship between the four motivations and health information satisfaction.Therefore, health literacy can be validated as an extended variable in the technology acceptance model. This study empirically analyzed the impact of online health information use motivation on health promotion behavior of Chinese elderly people, and found that the Internet should provide short and useful health information, which can help the information satisfaction of elderly people with impaired vision or memory or cognitive ability.We should also build a simple, easy and easy-to-use Internet environment to improve the access of the elderly to health information.In addition, older people should develop the ability to know where and how to obtain necessary health information.

해군 장병의 건강증진행위 실천 관련 요인 및 건강증진 프로그램 요구도

정인희 연세대학교 일반대학원 2024 국내석사

건강증진모델을 적용한 중학생의 사고 예방행위 예측 모형

김선수 경상국립대학교 대학원 2021 국내박사

본 연구의 목적은 중학생의 사고 예방행위에 영향을 미치는 요인을 조사하는 것이다. 이러한 요인들은 선행연구와 Pender(1996)의 건강증진모델을 기반으로 하였고, 가설 모형을 구축하여 모델의 적합성을 검증하여 구조방정식 모델을 구축하였다. 본 연구의 자료수집은 경상남도 진주시에 위치한 남자중학교와 의령군에 위치한 여자중학교의 중학생 279명을 대상으로 설문지를 이용하여 자기기입 방식으로 설문을 실시하였다. 자료 분석은 SPSS/WIN 25.0과 AMOS 18.0을 이용하여 가설 모형의 적합성을 확인하고 사고 예방행위에 영향을 미치는 변수의 직·간접 효과를 조사하였다. 결과는 다음과 같다. 1) 수정모형의 적합도 검정을 실시한 결과, 카이제곱값(=151.096, p<.001)은 적합하지 않게 나왔으나 정규화된 /df는 2.325로 권장수준을 만족하였다. 절대적합지수인 RMR(.023), RMSEA(.069), GFI(.934), AGFI(.878)는 권장수준을 만족하였고, 증분적합지수인 NFI(.900), TLI(.902), CFI(.939)도 권장수준을 만족하는 것으로 나타났다. 따라서 22개의 가설 중 13개의 가설을 뒷받침하여 최종모형으로 선정되었다. 2) 최종모형에서 자아존중감(γ=-.28, p=.049), 자기조절능력(β=.86, p=.002)이 사고 예방행위로 가는 경로는 유의하였으며, 사고경험(γ=-.09, p=.138), 안전교육경험(γ=-.04, p=.537), 충동적 성격(γ=.05, p=.504), 사회적 지지(β=.06, p=.576), 사고 예방 자기효능감(β=.18, p=.135)의 경로는 유의하지 않았다. 변인들에 의한 설명력은 72%였다. 3) 사고 예방행위에 영향을 주는 변인은 충동적 성격(γ=-.18, p=.005), 자아존중감(γ=-.28, p=.049), 사회적 지지(β=.46, p=.009), 사고예방 자기효능감(β=.48, p=.007), 자기조절능력(β=.86, p=.002)이었다. 자기조절능력은 직접적으로 사고 예방행위에 가장 큰 정적영향(β=.86, p=.002)요인이었으며 다음으로 자아존중감(γ=-.28, p=.049)으로 부적 영향을 미치는 요인이었다. 충동적 성격(γ=-.23, p=.010), 사회적 지지,(β=.40, p=.007) 사고예방 자기효능감(β=.30, p=.009)은 사고 예방행위에 간접적으로 영향을 미치는 요인이었다. 이를 토대로 본 연구는 중학생의 사고 예방행위 증진을 위한 이론적 근거를 제공할 수 있으며, 중학생의 사고 예방행위를 증진시키기 위해 충동적 성격을 완화시키고, 자아존중감, 사회적 지지, 사고예방 자기효능감, 자기조절능력을 증진시킬 수 있는 간호중재 전략이 필요하다는 것을 제안한다. The purpose of this study was to investigate factors affecting accident prevention behavior of middle school students. These factors were based on the previous studies and health promotion model by Pender (1996) and to analyze structural equation model by building a hypothetical model and verifying the fit of the model. The data collection of this study was conducted on 279 middle school students in men's middle school located in J city, and women's middle school located in U gun using a questionnaire. Data analysis was performed using SPSS/WIN 25.0 and AMOS 18.0 program to verify the fit of the hypothetical model and to identify the direct and indirect effect of variables on the accident prevention behavior of middle school students. The results are as follows: 1) For the fit of a hypothetic model, χ²=151.096(p<.001) was found to be inadequate but χ²/df(2.325) was found to be adequate. The absolute fitted indices RMR (.023), RMSEA (.069), GFI (.934), and AGFI (.878) met the recommended levels, while the incremental fitted indices NFI (.900), TLI (.902), and CFI (.939) also met the recommended levels. Therefore, the model was selected as the final model that supports 13 hypotheses out of 22 hypotheses. 2) In the final model, self-esteem(γ=-.28, p=.049), self-regulation ability (β=.86, p=.002) had a significant effect on the accident prevention behavior of middle school students. However, accident experience (γ=-.09, p=.138), safety education experience (γ=-.04, p=.537), Impulsive personality(γ=.05, p=.504), Social Support (β=.06, p=.576), Self-efficacy for accident prevention (β=.18, p=.135) did not have a significant effect. The Explanatory power of these variables was 72%. 3) The Impulsive personality (γ=-.18, p=.005), self-esteem (γ=-.28, p=.049), Social Support (β=.46, p=.009), Self-efficacy for accident prevention (β=.48, p=.007) and self-regulation ability (β=.86, p=.002) had a significant effect on the accident prevention behavior of middle school students. Self-regulation ability and self-esteem had a significant direct effect on the accident prevention behavior of middle school students. The Impulsive personality, social support, and self-efficacy for accident prevention had a significant indirect effect indirect on the accident prevention behavior of middle school students. The Accident prevention behavior predicting model of middle school students constructed through this study is recommended to be used as a model to predict and explain accident prevention behavior of middle school students. In addition, based on this model, it is required to develop a nursing intervention program considering the impulsive personality, self-esteem, social support, self-efficacy for accident prevention, self-regulation ability. While accident experience and safety education experience did not have a significant effect on the accident prevention behavior in this study. Further study needs to identify the influence between accident experience and safety education experience.

Lifestyle Behaviors that Contribute to Wellness of Healthy 30–40 Year Olds

Crouch, Jason Ashford University ProQuest Dissertations & Theses 2020 해외박사(DDOD)

The identified topic looked at what it takes for individuals to be healthy and well. Discussed in detail were the definitions and significance of health behaviors, and the numerous lifestyle factors relevant to the models and theories of health and wellness. The over-arching research question was how does wellness through the lens of the biopsychosocial model of health determine how lifestyle behaviors of 30-to-40 year olds influence their health? The project’s intent was to explore a group of healthy individuals to discover, through the lens of the biopsychosocial model, the lifestyle elements and behaviors that contributed to health at an individual level. The research approach was conducted using a qualitative descriptive single case study. This approach offered the possibility to explore complex topics within lifestyle behaviors through the lens of the biopsychosocial model. Examining the fundamental lifestyle behaviors of an individual allowed for a better understanding of what is required to maintain or improve health and well-being. Behavior is an essential concept for one to maintain and enhance his or her mental and physical health. Because health and wellness differ considerably from one individual to the next, a personalized approach needs to be considered when focusing on lifestyle behaviors. A practicable implication for this study is to help understand the significant behavioral factors and elements that lead to wellness. The biopsychosocial model takes a dynamic approach that includes the combination of body, mind, and environmental influences that affect one’s health and wellness. The findings from the study provide valuable information to approach the person as a whole, rather than focus on solitary influences. Results from this study can help provide insight into designing comprehensive lifestyle programs. Progressive thinking and practical methods of research and application are necessary to promote wellness, develop new or improved health promotion programs, and increase awareness through health education.

건강증진모형을 이용한 구강건강행위 관련 요인 분석

이호연 연세대학교 보건대학원 2001 국내석사

본 연구는 구강건강행위와 이에 영향을 미치는 요인을 분석하여 대학생들의 효과적인 구강건강증진프로그램을 개발하고 구강보건교육과정 개발의 방향을 설정하는데 필요한 기초자료를 제공하고자 시도된 연구이다. 본 연구의 대상자는 서울, 경기, 및 강원도에 위치한 3개 대학의 3년제 치과계열(치기공과, 치위생과)과 2년제 일반계열의 학생을 대상으로 하였다. 2000년10월 20일부터 10월 31일까지 자기기입식 설문조사 방법 12일간 자료를 수집하였으며 수집된 자료 중 불충분한 자료를 제외하고 429부를 분석하였다. 자료분석은 SAS 통계프로그램을 이용하여 백분율, 산술평균, T-test, ANOVA, χ²-test, 요인분석, 상관계수, 다중회귀분석 등의 통계방법을 사용하였다. 본 연구의 주요 결과는 다음과 같다. 첫째, 학생들의 구강건강행위의 실천 정도는 치과계열에서 전체 평균 29.8점(총점50점)이었고 실천 정도가 가장 높은 것은 올바른 잇솔질(5점 척도 평균 3.9점)이었고 일반계열은 전체 평균 26.6점(총점 50점)으로 실천정도가 가장 높은 것은 술, 담배 절제(5점 척도 평균 3.8점)였다. 요인분석에 의해 구강건강행위는 요인 1 주기적인 구강검진, 스케일링 및 치실 사용과 요인 2 식후 잇솔질, 올바른 잇솔질 및 술, 담배 절제, 요인 3 불소 함유 세치제 및 용액 사용과 요인 4 식습관 (설탕 섭취 제한, 충분한 영양섭취) 4가지로 구분되었다. 둘째, 구강건강행위와 인지-지각요인과의 상관관계를 본 결과 구강건강 행위 요인1에 유의한 상관관계를 보인 변수는 구강건강중요성, 구강건강지식, 구강건강관심도, 자기효능감, 구강건강상태, 구강건강장애이고 구강건강 행위 요인2와 유의한 상관관계를 보인 변수는 구강건강중요성 구강건강지식, 구강건강관심도, 자기효능감, 구강건강상태, 구강건강혜택, 구강건강통 제위로 나타났고 구강건강행위 요인3과 유의한 상관관계를 보인 변수는 구강건강중요성, 구강건강지식, 구강건강관심도, 자기효능감, 구강건강혜택, 구강건강통제위로 나타났다. 구강건강행위 요인4에서는 유의한 상관관계를 보인 변수가 없었다. 셋째, 구강건강행위에 영향을 미치는 주요요인을 규명하기 위해 다중회귀 분석한 결과 구강건강행위 요인1에서 영향을 미치는 변수는 구강보건교육, 최근 1년내 구강건강검진, 치과예방처치와 구강건강행위장애와 구강건강행위혜택 변수가 영향을 미쳤고, 구강건강행위 요인2에 영향을 미치는 변수는 성별과 구강건강 관심도, 구강건강통제위, 인지된 구강건강상태가 영향을 주는 변수였다. 구강건강행위 요인3에 영향을 주는 변수는 구강건강관심도와 자기효능감이였고, 구강건강행위 요인4에 영향을 미치는 변수는 지역과 구강건강의 중요성이 영향을 주는 변수로 나타났다. 결론적으로 구강건강행위를 측정하는 변수가 객관적이고 정확한 연구도구로 개발되어져야 할 것이며 대학생들의 구강건강행위를 유도하기 위한 구강건강교육 프로그램에 대한 연구가 앞으로도 진행되어져야 할 것이다. This study attempts to provide basic information that is necessary to establish the direction of oral health education process and to develop effective oral health promoting programs for college students by analyzing the modifying factors that may affect their oral health behaviors and their cognitive and perceptive factors. Data for this study are collected by the questionnaire method from college students who attend colleges located in Seoul, Kyunggi and Kangwon province for the period between October 20, 2000 and October 31, 2000. The respondents were chosen from Dental department and Non-Dental department. After omitting the responses with insufficient information, 429 valid responses are used for this analysis. To analyze the data, the following statistical methods are used by the SAS(Statistical Analysis System) program: percentile, arithmetic average, t-test, ANOVA, Chi-square test, factor analysis, correlation coefficient and multiple regression. The results of this study are as follows. First, in dental Department the overall average score for oral health behaviors questions is 29.8(The total score of 50) and in Non-Dental Department the overall average score for oral health behaviors questions is 26.6(The total score of 50). The highest score is the correct teeth-brushing with the average score of 3.9 on a scale of 1-5 in Dental Department while the highest score is the self-restraint of liquor and cigarettes with the average score of 3.8 on a scale of 1-5 in Non-Dental Department. Second, from the Pearson correlation coefficient analysis between oral health behaviors and perception-awareness factors, variables which appear significant correlation coefficient by the first oral health behavior factors are the importance of oral health, the knowledge of oral health, the concern about oral health, self-efficiency, oral health status and the barriers to oral health behaviors. Variables which appear significant correlation coefficient by the second oral health behavior factors are the importance of oral health, the knowledge of oral health, the concern about oral health, self-efficiency, oral health status, the benefits of oral health behaviors and the control of oral health. Variables which appear significant correlation coefficient by the third oral health behavior factors are the importance of oral health, the knowledge of oral health, the concern about oral health, self-efficiency, the benefits of oral health behaviors and the control of oral health. Variable which appear significant correlation coefficient by the fourth oral health behavior factors is nothing. Third, multiple regression is used to determine major factors affecting oral health behaviors. Variables which influence the first oral health behavior factors are the oral health education, the oral health examination within one year, the preventing treatment of oral disease, the barriers to oral health behaviors and the benefits of oral health behaviors. Variables which influence the second oral health behavior factors are the sex, the concern about oral health, oral health status and the control of oral health. Variables which influence the third oral health behavior factors are the concern about oral health and self-efficiency. Variables which influence the fourth oral health behavior factors are a region and the importance of oral health. Finally variables which measure oral health behaviors should be developed by objective and accurate study methods. Study on oral health education program is continually progressed for the oral health behaviors of college students.

경로당 고령 여성의 운동프로그램 개발 및 효과 검증-Pender의 건강증진모형 적용

이경임 경상대학교 대학원 2016 국내박사

This study aimed to investigate the effects of an exercise program developed for old-old aged women using a senior citizen hall on the basis of Pender's health promotion model. A non-equivalent control group pretest-posttest design was used. A total of 40 elderly women using a senior citizen hall participated in the study, and they were divided the experimental group (20) and the control group (20). Data were collected from July 23 to October 20, 2015. The exercise program developed in this study was conducted three times per week over 12 consecutive weeks for 60 minutes per day. The exercise program combines flexibility exercise, rhythmic aerobic exercise and muscle strength exercise with the goal of improving perceived benefits and barriers to exercise, exercise self-efficacy and exercise social support. Data were collected from pre-program and post-program assessments. In the pre-program assessment, participants' general characteristics, perceived benefit and barriers to exercise, exercise self-efficacy, exercise social support, exercise behavior and physical fitness were assessed, and only program-related factors were assessed after the exercise programs. Data were analyzed using a t-test, Mann-Whitney U test and Wilcoxon Signed Ranks test with SPSS/WIN 18.0. The results of this study are as follows: 1) Hypothesis 1: The experimental and control groups perceive exercise behavior-related factors differently. This hypothesis was rejected because there was no significant difference between the experimental and control groups with respect to the perceived benefits of exercise (U=-0.69, p=.493). However, there were significant differences between the two groups in perceived barriers to exercise (U=-4.82, p<.001) and exercise self-efficacy (U=-4.38, p<.001). Thus hypothesis 1 was partially accepted in the experiment. 2) Hypothesis 2: The experiment and control groups perceive different levels of exercise social support. This hypothesis was accepted because the experiment group showed a significantly higher score for exercise social support than the control group (U=-5.46, p<.001). 3) Hypothesis 3: The experiment and control groups have different levels of exercise behavior. This hypothesis was accepted because the experiment group showed a significantly higher score for exercise behavior than the control group (U=-5.44, p<.001). 4) Hypothesis 4: The experiment and control groups have different levels of physical fitness. This hypothesis was accepted because the experiment group showed significantly higher scores for the right hand grip (t=2.75, p=.009), the left hand grip (U=-2.59, p=.009), the right upper body flexibility (U=-3.02, p=.002), the left upper body flexibility (U=-2.08, p=.038), the lower limb flexibility (t=3.95, p=.001). 5) Hypothesis 5: The experiment and control groups have different levels of perceived health status. This hypothesis was accepted as the experiment group showed a significantly higher score for perceived health status than the control group (t=3.29, p=.002). 6) Hypothesis 6: The experiment and control groups have different levels of depression. This hypothesis was accepted because the experiment group showed a significantly lower score for depression than the control group (U=-4.87, p<.001). In conclusion, the exercise program intervention turned out to be effective in reinforcing exercise behavior as it help increase exercise self-efficacy and exercise social support but reduce barriers to exercise in old-old aged women using a senior citizen hall. As a result, they showed improvement in physical fitness and perceived health status and a decrease in depression. Therefore, this study proposes the use of the exercise program for old-old aged women using senior citizen halls.

외국인 근로자의 신체활동에 영향을 미치는 요인 : 건강증진모형 기반으로

조정의 경상대학교 대학원 2020 국내박사

본 연구의 목적은 Pender의 HPM을 토대로 외국인 근로자의 문화적응, 지각된 운동유익성, 지각된 운동장애성, 운동 자기효능감, 운동정서, 운동 사회적지지, 신체활동의 정도와 관계 및 외국인 근로자의 신체활동에 영향을 미치는 요인을 규명하기 위함이다. 연구대상자는 경남 G시에 소재한 조선소에 근무하는 만 19세 이상 60세 이하의 외국인 근로자들을 대상으로 하였다. 본 연구에 자발적으로 참여하기로 동의한 250명을 대상으로 2019년 5월 설문조사를 시행하였다. 설문지 분석결과 응답이 불성실한 자료 34부을 제외한 216부를 대상으로 통계 분석하였다. 수집된 자료는 SPSS 23.0 program을 이용하여 각 변수의 실수와 백분율, 평균과 표준편차를 산출하였다. 대상자의 일반적 특성 및 근로환경에 따른 신체활동 차이는 chi-square test 과 One-way ANOVA를 실시하였으며, 사후 검정은 Scheffe' test를 이용하였다. 대상자의 문화적응, 지각된 운동유익성, 지각된 운동장애성, 운동 자기효능감, 운동정서, 운동 사회적지지, 신체활동의 상관관계는 Pearson's correlation coefficient와 Spearman's rank Correlation coefficient로 분석하였다. 대상자의 신체활동에 영향을 미치는 요인을 알아보기 위해 다변량 순서형 로지스틱 회귀분석을 하였다 1) 대상자의 신체활동 관련 특성 운동경험은 ‘있다’ 161명(74.5%)이었다. 신체활동의 비활동(1단계)은 9.3%, 최소한의 신체활동(2단계) 53.2%, 건강증진형 활동(3단계) 37.5%이었다. 2) 대상자의 문화적응, 지각된 운동유익성, 지각된 운동장애성, 운동 자기효능 감, 운동정서, 운동 사회적지지 정도 문화적응의 점수는(범위 1-5점) 통합 3.49±0.72점, 분리 3.17±0.62점, 동화 2.64±0.67점, 주변화 2.28±0.85점으로 통합이 가장 점수가 높았다. 지각된 운동유익성은 2.95±0.34점(범위 1-4점)이었다. 지각된 운동장애성은 2.20±0.41점(범위 1-4점)이었다. 운동 자기효능감은 4.16±1.88점(범위 0-10점)이었다. 운동정서는 5.23±1.38점(범위 1-7점)이었다. 운동 사회적지지는 2.10±0.57점(범위 1-4점)이었다. 3) 대상자의 일반적 특성 및 직무관련 특성에 따른 신체활동의 차이 대상자의 일반적 특성 및 직무관련 특성에 따른 신체활동 정도는 체류기간(F=3.25, p=.041), 진단질환여부(=7.58, p=.023), 이전운동행위(=10.32, p=.006)에서 유의한 차이가 있었다. 연구대상자의 신체활동에 따라 차이를 보이는 변인은 문화적응의 통합(F=6.21, p=.002), 지각된 운동유익성(F=4.38, p=.014), 운동 자기효능감(F=4.11, p=.018), 운동 사회적지지(F=7.56, p<.001)이었다. 4) 대상자의 문화적응, 지각된 운동유익성, 지각된 운동장애성, 운동 자기효능감, 운동정서, 운동 사회적지지, 신체활동의 관계 연구대상자의 신체활동은 문화적응의 통합(r=.24, p<.001), 지각된 운동유익성(r=.16, p=.021), 운동 자기효능감(r=.20, p=.004), 운동정서(r=.14, p=.047), 운동 사회적지지(r=.24, p<.001)와 정적상관이 있었다. 5) 신체활동에 영향을 주는 변인들의 영향력 분석 다변량 순서형 로지스틱 회귀분석 결과 모형1에는 이전운동행위, 문화적응의 통합을 투입하였으며, 모형2에는 모형1에 추가로 지각된 운동유익성과 운동 자기효능감을 투입하였다. 모형3에는 모형2에 추가로 운동 사회적지지를 투입하였다. 모형1에 투입된 이전운동행위(β=.55, p=.006)과 문화적응의 통합(β=.41, p=.022)는 유의한 영향을 미치는 것으로 나타났다. 모형1에 의해 설명되는 Cox & Snell's R2은 8.8% 이었다(=24.30, p<.001). 모형2에 추가로 투입된 지각된 운동유익성(β=.68, p=.016), 운동 자기효능감(β=.14, p=.007)이 유의하였다. 모형2의 총 설명력은 14.8% 이었다(=34.49, p<.001). 모형3에 추가로 투입된 운동 사회적지지(β=46, p=.009)는 유의하였다. 모형3의 총 설명력은 17.5% 이었다(=41.42, p<.001). 이상의 연구결과를 통해 외국인 근로자의 문화적응의 통합, 지각된 운동유익성, 운동 자기효능감, 운동 사회적지지는 신체활동에 유의한 영향을 미치는 것으로 나타났다. 외국인 근로자의 문화적응의 통합과 지각된 운동유익성, 운동 자기효능감, 운동 사회적지지를 높여 신체활동을 증가시킬 수 있는 간호중재 개발이 필요하다. The purpose of this study was to investigate the degrees of acculturation, perceived exercise benefits, perceived exercise barriers, exercise self-efficacy, activity-related affect, exercise social support and physical activities of foreign workers and their correlations, and then to identify influencing factors on physical activities of foreign workers. The subjects of the study were foreign workers aged 18 to 60 who were employed at a shipyard in the city of G in Gyeongnam. A questionnaire was distributed to 250 participants. After collecting data, 34 cases were dismissed for lack of sincerity and finally a total of 216 cases were statistically analyzed. With the obtained data, the value, percentage, average and standard deviation of each variable were calculated using SPSS 23.0program. The chi-square test and one-way ANOVA were conducted to find the difference in physical activities according to the subject's general characteristics and job-related characteristics. For the significant results of one-way ANOVA, post-hoc test was conducted using the Scheffé test. Moreover, the Pearson's correlation coefficient and Spearman's rank correlation coefficient was used to analyze the correlation between the subject's acculturation, perceived exercise benefits, perceived exercise barriers, exercise self-efficacy, exercise social support and physical activity. For identifying influencing factors affecting physical activity of foreign workers, the multivariate ordinal logistic regression analysis was utilized. 1) Physical activity-related characteristics of subjects   For prior experience in exercise, a total of 161 subjects(74.5%) answered ‘Yes.’ Inactive (stage 1) was 9.3%, minimum physical activity (stage 2) was 53.2% and health promotional type of exercise (stage 3) was 37.5%. 2) Degree of subject's acculturation, perceived exercise benefits, perceived exercise barriers, exercise self-efficacy, activity-related affect and exercise social support   The scores for acculturation (range 1-5) were biculturalism 3.49±0.72, segregation 3.17±0.62, assimilation 2.64±0.67 and marginalization 2.28±0.85. Of subscale scores, biculturalism showed the highest score. The score was 2.95±0.34(range 1-4) for perceived exercise benefits, 2.20±0.41(range 1-4) for perceived exercise barriers, 4.16±1.88(range 0-10) for exercise self-efficacy, 5.23±1.38(range 1-7) for activity-related affect, and 2.10±0.57(range 1-4) for exercise social support. 3) Differences in physical activity according to the subject's general characteristics and job-related characteristics For differences between physical activity and subject's general characteristics and job-related characteristics, there were significant differences between physical activity and general characteristics such as period of stay (F=3.25, p=.041), diagnosed disease (=7.58, p=.023), prior experiences in exercise (=10.32, p=.006). Moreover, there were significant differences between physical activity and biculturalism (F=6.21, p=.002), perceived exercise benefits (F=4.38, p=.014), exercise self-efficacy (F=4.11, p=.018) and exercise social support (F=7.56, p<.001). 4) Correlations between acculturation, perceived exercise benefits, perceived exercise barriers, exercise self-efficacy, activity-related affect, exercise social support and physical activity The physical activity showed positive correlations with biculturalism (r=.24, p<.001), perceived exercise benefits (r=.16, p=.021), exercise self-efficacy (r=.20, p=.004), activity-related affect(r=.14, p=.047), exercise social support (r=.24, p<.001). 5) Factors influencing on physical activity As a result of the multivariate ordinal logistic regression analysis, the biculturalism and prior experiences in exercise were placed in model 1 and for model 2, perceived exercise benefits and exercise self-efficacy were added to model 1. In model 3, exercise social support was inserted to model 2. The results showed that the biculturalism of acculturation (β=.41, p=.022) and prior exercise experiences (β=.55, p=.006) inserted in model 1 were significantly influential.  Cox & Snell's R2 explained by model 1, was 8.8%(=24.30, p<.001). The perceived exercise benefits (β=.68, p=.016) and the exercise self-efficacy (β=.14, p=.007) that were additionally inserted to model 2 were significant. The explanatory power of model 2 was 14.8%(=34.49, p<.001). And exercise social support (β=46, p=.009), which was added to model 3, was significant. The total explanatory power of model 3 was 17.5%(=41.42, p<.001). In conclusion, our results have demonstrated that the significant variables affecting on physical activity of foreing workers are biculturalism, perceived exercise benefits, perceived exercise barriers, exercise self-efficacy and exercise social support. Based on these results, there is a need to develop a customized program to increase physical activities of foreign workers by enhancing biculturalism, perceived exercise benefits, exercise self-efficacy and exercise social support.

치아우식발생 고위험 한국 청년의 구강건강증진 모형개발

이병진 서울대학교 대학원 2007 국내박사