Objectives The purpose of this study was to investigate the role of self-esteem as a moderator of the factors influencing suicidality among middle-schoolers.
Methods Moderated multiple regression analysis was applied to assess the influence of happiness, depression, and hostility on suicidality and to determine the degree to which self-esteem served as a moderator of those relationships. Data were collected from 268 students at a middle school in Busan, Korea, using a self-administered structured questionnaire.
Results Happiness, depression, and hostility had significant direct effects on suicidality. Self-esteem showed no direct effect, but had a significant moderating effect on the relationship between hostility and suicidal behavior.
Conclusions These results suggest that various interventions, such as counseling programs, should be designed to alleviate hostility and depression and to enhance happiness and self-esteem among early adolescents.
Summary
Korean summary
본 연구는 중학생의 자살성향에 영향을 주는 주요 요인을 식별하고, 자아존중감의 조절효과를 확인하여 청소년 자살예방 방안 모색을 위한 실마리를 제공하고자 하였다. 실증자료의 분석 결과 자살성향에 행복, 우울, 적대감이 유의한 직접효과, 그리고 조절변수인 자아존중감이 적대감과 상호작용하여 유의한 조절효과를 보였다(p<0.05). 청소년 자살 예방의 실효성을 높이기 위해서는 행복감의 증진, 우울과 적대감의 완화 등 원인변수에 대한 개입과 동시에 조절변수인 자아존중감을 향상시키기 위한 가정과 학교의 체계적인 노력이 필요함을 시사한다.
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OBJECTIVE The purpose of this study was to examine the therapeutic compliance and its related factors in the rural hypertensives. METHOD: A questionnaire survey and blood pressure measurement were performed to 3,876 residents of a rural area, and 660 hypertensives were selected as subjects of study. The study employed a hypothetical model which was composed of constructs from the health belief model and KAP model. The analysis techniques employed included contingency table analysis and structural equation modeling. RESULT: The proportion of those who were compliant to the treatment of hypertension was 44.2% of subjects. As the result of structural equation modeling, when patients had more favorable attitude toward treatment, higher perceived benefit, or lower perceived barriers to treatment, the therapeutic compliance was significantly higher(T>2.0). When patients had more knowledge about hypertension, or higher perceived severity of hypertension, the attitude toward the treatment of hypertension was more favorable significantly(T>2.0). And when patients had the support for treatment from family or neighbor, the attitude toward treatment was more favorable(T>2.0). When patients had experience of health education, they had more knowledge, higher perceived susceptibility of complication, perceived severity for hypertension, and perceived benefit of treatment, compare to patients without health education(T>2.0). CONCLUSION: In consideration of above findings, in order to improve the therapeutic compliance in the rural hypertensives, it would be necessary to change attitude, perception, knowledge about hypertension and its treatment, by various methods such as effective health education and programs for maintaining the supportive environment for hypertension treatment.
Hee Sook Oh, Byung Yeol Chun, Sin Kam, Min Hae Yeh, Yun Sik Kang, Keon Yeop Kim, Young Sook Lee, Ki Soo Park, Jae Hee Son, Sang Won Lee, Moon Young Ahn
OBJECTIVES This study was performed to identify the risk factors related to the development of hypertension in a rural area. METHOD: Total of 3,573 subjects in Chung-Song County were interviewed and examined in 1996. The study cohort comprised 2,580 hypertension-free subjects aged above 20. One-year follow up was completed for 1,781 subjects(69.0%) in 1997. General characteristics(age, gender, education level, economic status, marital status), the family history of hypertension, diet, alcohol, smoking, coffee, stress, past history of oral contraceptive and menopausal status in female, height, weight, waist and hip circumference, baseline blood pressure, and serum total cholesterol were considered as risk factors. RESULTS: Multivariate analysis using logistic regression model indicated that age(RR=1.50, 95% CI; 1.15-1.96), the family history of hypertension(RR=2.11, 95% CI; 1.04-4.26), waist-hip ratio(WHR) (RR=2.09, 95% CI; 1.15-3.79), and baseline systolic blood pressure(130-139/<120mmHg)(RR=3.34, 95% CI; 1.47-7.60) were significant risk factors associated with the development of hypertension above the borderline level in male. In female, age(RR=1.06, 95% CI; 1.03-1.09), change in menopausal status(no--> yes/no-->no) (RR=3.32, 95% CI; 1.01-10.87), baseline systolic blood pressure(120-129/<120mmHg: RR=2.00, 95% CI; 1.02-3.90)(130-139/<120mmHg: RR=2.64, 95% CI; 1.34-5.20) and baseline diastolic blood pressure(85-89/<80mmHg)(RR=4.09, 95% CI; 1.86-8.96) were identified as risk factors. CONCLUSIONS: Age and high normal blood pressure were significant risk factors for the development of hypertension above the borderline level. In addition, the family history of hypertension and WHR in men, and the change of menopausal status in women might be significant risk factors in Korea.
OBJECTIVES The purpose of this study was to examine the factors related to children's health behavior. METHODS: A self-administered questionnaire survey was carried out for 431 (boys; 227, girls; 204) children, 6th grade students, in Taegu from December 14 to 18 in 1998. This study employed health promotion model as a hypothetical model. Collected data were analysed through the chi-square test, ANOVA, and path analysis. RESULTS: By univariate analysis, in case of boys, health practice was related to perceived self efficacy, perceived health status, perceived benefits of health-promoting behaviors, and perceived barriers, and in girls, health practice was related to perceived self efficacy, perceived benefits of health-promoting behaviors, perceived barriers, and cues to action. By path analysis, in case of boys, the better economic status, the younger mothers' age, the higher score of family cohesion and adaptability, healthier, the more perceived benefits, and the less perceived barriers were, the more health behaviors were practiced. Girls did the more health practice, in case of living with parents only, the higher score of family cohesion and adaptability, the more perceived self-efficacy, the less perceived barriers, and the more cues to action. Family cohesion had the most important effect on health practice of primary school students. CONCLUSIONS: In order to promote health behavior of primary school students, a good family environment as well as health education might be very important. That is, we have to try together in home and as well as in school.
OBJECTIVES This study was performed to determine the relationships among Health concern, health practice and health status of the disabled. METHODS: A self-administered questionnaire survey was carried out for 1,662 disabled persons in Taegu city from April to July, 1997. RESULTS: Health concern had a significant and positive relationship with health practice(p<0.05) and health practice also had a significant and positive relationship with self-rated health status(p<0.05) in men and women. To determine the structural model of the Health concern, health practice, health status and sociodemographic variables, the covariance structural analysis was used. In men, age, economic status, medical security type, educational level and type of disability had significant direct effects on Health concern(T>2.0). Educational level and type of disability had significant direct effects on health practice(T>2.0). And Economic status, medical security type and job status had significant direct effects on health status(T>2.0). In women, economic status and educational level had significant direct effects on Health concern(T>2.0). However there was no variable which had a significant direct effect on health practice. Job status had a significant direct effect on health status(T>2.0). In men and women, health practice was significantly increased with increasing Health concern and the more health practice, the higher health status(T>2.0). CONCLUSIONS: It is recommended that the institutional approach which improve the economic status of the disabled with understanding their behavior and attitude should be established to increase health status, in addition, the health policy for encouraging the disabled, such as health education, consulting and health promotion program, should be done.
In order to investigate the factors influencing QOL and life satisfaction of the physically disabled, the author interviewed, by using structuralized questionnaire, 440 individuals among the physically disabled who were participated in Health Examination from April to July, 1997. The questionnaire consisted of the general characteristics(sex, age, marital status, family number, etc), the Reintegration to Normal Living Index(RNLI) to assess QOL, and the single item of five-likert scale to evaluate life satisfaction. The means of RNLI were 16.2+/-4.8 in total score, 12.2+/-3.4 in daily functioning and 4.0+/-2.1 in perception of self. The respondents were less reintegrated toward social activities and relationships than impairments or disabilities. While the satisfied group was 47.3%, the dissatisfied group was 52.7%. As the results of multiple regression and logistic regression analysis, the significant predictors of QOL were age, education, job, grade of disability and subjective health status. The life satisfaction were related to economic status, job and subjective health status. To improve QOL and life satisfaction of the physically disabled, it is important that we improve their basic socioeconomic status by getting a job through rehabilitation education and induce them to have positive self-assessment by extending the opportunity of social participation.
To investigate determinants of health care utilization of the physically, disabled over 20 years old in age living in Taegu city, a self-administered questionnaire survey was carried out for 337 disabled persons with chronic illness from April to July, 1997. Health care utilization rate was 81.9%(69.l% for hospital or clinic and 12.8% for pharmacy). Marital status, job, health concern, and response to illness showed statistically, significant relationship with health care utilization(p<0.05). By, path analysis, job, economic status, medical security type and response to illness had a significant direct effect on health care utilization(p<0.05), however, health concern and regular source of care had an indirect effect. The reasons of no health utilization were due to economic problem(31.l%), no symptom(18.0%), inconvenience to seek care or no accompanying persons to be helped(14.8%), unseriousness of the severity of the illness(14.8%), too busy to be treated or no free time(8.2%), hopeless prognosis to be treated(6.6%) in order. In conclusion, it is recommended that the program for expanding medicaid, improving socioeconomic status by getting a job and health education to increase the health Concern toward physically disabled should be implemented to increase health care utilization rate.
OBJECTIVES To develop a tool for multidimensional measurement of the quality of life, which was psychometrically sound, short, and easy to administer for patients with hypertension. METHODS: A sample of 1, 115 hypertensive patients aged 20 or above in Cheong-Song County was studied from June 1997 to October 1998. In the development of the instrumental stage, the authors first conceptualized the quality of life. Item generation, item reduction, and questionnaire formatting were followed. Item-level (item descriptive, missing%, item internal consistency, item discriminant validity) analysis, scale-level (scale descriptive, floor and ceiling effect) analysis, and other tests (Cronbach's alpha, inter-dimension correlations, factor analysis, clinical validity) were performed to evaluate the validity and reliability of the new measurement scale. After 1 year, responsiveness and confirmatory factor analysis were performed. RESULTS: The results of both item-level and scale-level analyses were acceptable. An acceptable degree of internal consistency was observed for each of the dimensions (Cronbach's alpha was 0.60 or higher). Inter-dimension correlations were below 0.50 and the factor analysis result was the same as the intended dimension structure. Correlation coefficients between perceived health status, stress and dimensions were proven to be acceptable. The result of comparing dimensional score means among ADL and MMSE-K groups above 60 years was statistically significant (p< 0.05). The result of confirmatory factor analysis concluded that the dimensional structure model was well fitted. However, the result of responsiveness test using sensitivity and specificity was unsatisfactory. CONCLUSIONS: The newly developed measurement scale is psychometrically reliable and valid instrument for measuring quality of life in hypertensive patients.