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REFERENCE LINKING PLATFORM OF KOREA S&T JOURNALS
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Journal of muscle and joint health
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Korean Society of Muscle and Joint Health
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Volume & Issues
Volume 8, Issue 2 - Nov 2001
Volume 8, Issue 1 - Apr 2001
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A Structural Model for Aquatic Exercise Adherence of Patients with Arthritis
Kang, Hyun-Sook ;
Journal of muscle and joint health, volume 8, issue 1, 2001, Pages 5~26
Many studies have reported that regular aquatic exercise can lead to improvement of health for patients suffering from arthritis. In spite of these benefits, the adherence rate has shown as few as 26% of patients with arthritis who had completed the aquatic exercise education program. Moreover, when patients with arthritis begin an aquatic exercise, 47% withdraw within the first 6 month. No study has been found that constructs model to explain aquatic exercise adherence of patients with arthritis. The purpose of this study were to identify the factors influencing exercise adherence and to construct and test a structural model to explain aquatic exercise adherence of patients with arthritis. Hypothesized model was constructed on the basis of Bandura's social cognitive theory and literature review. Exogenous latent variables included in this model are group cohesion and barrier, endogenous latent variables are self-efficacy, outcome expectancy and self-evaluation. Empirical data used was collected through individual interviews with the structural questionnaire on 249 patients with arthritis who had completed the 6-week aquatic exercise education program of Korean Rheumatology Health Professionals Academy. The interviews were performed from September 6, 1999 through October 8, 1999. A model tested by the covariance structural analysis with LISREL 8.12a program and by descriptive statistics and correlation with SAS 6.12 program. The results are summarized as follows: First, hypothesized model showed a good fit to the empirical data. In the modified model added one new path showed a much better fit. Second, group cohesion had a direct, indirect positive effects, self-efficacy and self evaluation had a direct positive effects on exercise adherence. Barrier had a direct, indirect negative effects on exercise adherence. Outcome expectancy had a direct negative effect, indirect positive effects through self-evaluation on exercise adherence, but total effects was not significant. Total effect size of the variables were group cohesion, self-efficacy, barrier and self evaluation in order. All variables accounted for 54% of the total variance of exercise adherence in the model. In conclusion, this model confirmed to be proper in explaining of aquatic exercise adherence. Group cohesion, self-efficacy, outcome expectancy, self-evaluation, barrier contributed to the aquatic exercise adherence of patients with arthritis. The results of this study suggested that improvement of group cohesion, self-efficacy and self-evaluation, motivation of outcome expectancy through self-evaluation, and reduction of the barrier should be included in the strategy of nursing intervention for the aquatic exercise adherence of patients with arthritis.
Prediction Model of Fatigue in Women with Rheumatoid Arthritis
Lee, Kyung-Sook ; Lee, Eun-Ok ;
Journal of muscle and joint health, volume 8, issue 1, 2001, Pages 27~50
Rheumatoid arthritis is a chronic systemic autoimmune disease. Although the joints are the major loci of the disease activity, fatigue is a common extraarticular symptom that exists in all gradations of rheumatoid arthritis. Fatigue is defined as a subjective sense of generalized tiredness or exhaustion and has multiple dimensions. Therefore fatigue is a common and frequent problem for those with rheumatoid arthritis. In fact, 88-100% of individuals with rheumatoid arthritis experience fatigue. Especially the degree of fatigue is higher in women than men with rheumatoid arthritis. Despite the importance of fatigue among the patients with rheumatoid arthritis, the mechanism that leads to fatigue in rheumatoid arthritis is not completely understood. This study was intended to test and validate a model to predict fatigue in women with rheumatoid arthritis. Especially it was intended to identify the direct and indirect effects of the variables of pain, disability, depression, sleep disturbance, morning stiffness, and symptom duration to fatigue. Data were collected by questionnaires including Multidimensional Assesment of Fatigue(Tack, 1991), numeric scale of pain, graphic scale of joints, Ritchie Articular Index, Korean Health Assessment Questionnaire(Bae, et al., 1998), Inventory of Function Status(Tulman, et al., 1991), Center for Epidemiologic Studies-Depression, and Korean Sleep Scale(Oh, et al 1998). The sample consisted of 345 women with a mean duration of rheumatoid arthritis for 10.06 years and a mean age of 49.64 years. SPSS win and Win LISREL were used for the data analysis. Structural equation modeling revealed the overall fit of the model. Pain predicted fatigue directly and indirectly through disability, depression, and sleep disturbance. Disability, sleep disturbance predicted fatigue only directly, while depression only indirectly through disability and sleep disturbance. Also morning stiffness and symptom duration predicted fatigue through disability and depression. All predictors accounted for 65% of the variance of fatigue. Depression, pain, and disability predicted sleep disturbance. Depression had reciprocal relationship with disability and they both were predicted by pain directly and indirectly. In summary, pain, depression, disability, sleep disturbance, morning stiffness, and symptom duration contributed to the fatigue of patients with rheumatoid arthritis. The best predictor of fatigue was pain. This finding indicates that the modification of pain, depression, disability, sleep disturbance, morning stiffness could be nursing intervention for relief or prevention of fatigue.
A Predictors of Exercise Participation in Rheumatoid Arthritis Patients
Lim, Nan-Young ; Yi, Yeo-Jin ;
Journal of muscle and joint health, volume 8, issue 1, 2001, Pages 51~64
The purposes of this study were to examine and to predict the affecting factors on exercise participation of Rheumatoid arthritis Patients. The subjects were 161 adult out-patients who visited the hospital for rheumatic disease in H-university. Data were composed of self-reported questionnaire. The conceptual model of this study consisted of that personal characters(age, marriage, education, income), situational characters(pain intensity, fatigue, IADL, depression), behavioral characters(formerly exercise behavior, life-style), and cognitive-perceptional characters(perceived health status, perceived benefit, perceived barrier, perceived self-efficacy) affected directly to exercise participation. Logistic regression analysis was applied for testing model of this study. The results were as follows : 1. Personal characters(education), situational characters(pain intensity), behavioral characters(formerly exercise behavior, life-style), and cognitive characters(perceived barrier, perceived self-efficacy) were significant difference between current exercise participants(127subjects) and non-exercise participants(34). 2. Personal characters(income), situational characters(pain intensity), behavioral characters(life-style), and cognitive-perceptional characters(perceived barrier, perceived self-efficacy) were correlated to exercise participation. 3. Formerly exercise behavior, perceived barrier, and perceived self-efficacy were significant predictor of exercise participation. The logistic equation predicted overall 81.94% of this study subjects 161.
A Study of Correlation among the Knowledge of the Disease, Health Promoting Behaviors and the Quality of Life in the Female Patients with Osteoporosis
Lee, Hye-Young ;
Journal of muscle and joint health, volume 8, issue 1, 2001, Pages 65~85
Osteoporosis is the disease that is the most controversial issue with the aging tendency in 1990. It is an important issue in dealing with the health management for women in middle life. This study is designed to determine the relationships among the level of the knowledge of osteoporosis, the health promoting behaviors and the quality of life. The test has conducted a questionnaire survey of women with osteoporosis. This is a study that focused an interrelation of above issues and its purpose is to gain a foundation of a nursing intervention that can help to improve the qualify of life of an osteoporosis patients. The method of collecting data is collecting a questionnaire survey, individual interviews and records and the collected 123 questionnaire surveys are utilized for an data analysis. Questionnaire surveys are conducted in K and S Universities infirmaries and K general hospital in Seoul and C and J general hospital in near Seoul area from Sep. 27th to Nov. 4th, 2000. The instruments of this study were as follows: Yoon's used the revised and supplemented instrument to test the level of the knowledge of osteoporosis and she referred to the substance of Cassells & Knotz. Lee's revised and supplemented the instrument called Health Promoting Life style Profile that were invented by Walker, Sechrist & Pender and she used it to test the health promoting behaviors with the questionnaires added by this researcher. They are not related to the quality of life but relevant to the patients. Ro's tested the quality of life with the instrument that was invented by herself. The results of this study were as follows. 1. The general characteristics of this study subjects showed that the age of the patients was concentrated from 50 to 59. The periods after menopause was mainly from 6 to 10 years. Subjective symptoms that patients usually complain were musculoskelectal symptoms. 2. The results of measuring the level of the knowledge of osteoporosis, the health promoting behaviors and the quality of life were following. The level of the knowledge was the score 19.83 and it was above middle score out of the score 27 as full marks. In the result of the health promoting behaviors test, the score average was 2.58 with 4 point rating scale and it was about middle score. The quality of life test showed that average score was 2.92 with 5 point rating scale and it indicated that the quality was also around middle score. 3. The statistical test in the activities for promoting health according to the general characteristics of the patients showed that only monthly income has statistically significant difference(F-4.761, p=.004). The same test for the qualify of life indicated that the quality of life was higher from 1 to 5 years after menopause but it was not meaningful statistically. 4. In the correlation among the level of knowledge of osteoporosis, the health promoting behaviors and the qualify of life of the patients, showed a relationship between the health promoting behaviors and the qualify of life. The higher the health promoting behaviors, it was also higher the quality of life. But it was statistically significant with significant positive correlation.
Prevalence of Musculoskeletal Symptom in Rural Farmers
Oh, Hae-Ok ; Kam, Sin ; Han, Chang-Hyun ; Hwang, Byung-Deog ; Mun, Hyo-Jung ; Cha, Byung-Jun ; Park, Sang-Yeon ;
Journal of muscle and joint health, volume 8, issue 1, 2001, Pages 86~108
This study was performed to examine the annual experience rate of musculoskeletal symptom and its related factors in rural farmers. Six-hundred and sixty one rural farmers were investigated by questionnaire survey through interview from July 1 to July 31 in 2000. The results were as follows; The rural farmers who had experienced musculoskeletal symptom during recent 1 year was 82.7% in male, 92.1% in female. The annual experience rate of musculoskeletal symptom by part of the body in male were turned out as back; 42.3% leg and knee; 36.4%, shoulder; 21.4%, arm and hand; 12.7%, elbow; 7.7%, hip; 6.8% neck; 6.4%, ankle and foot; 6.4% in order. The annual experience rate of musculoskeletal symptom by part of the body in female were turned out as back; 59.4%, leg and knee; 48.5%, shoulder; 20.2%, arm and hand; 13.8%, hip; 10.7%, neck; 6.8%, ankle and foot; 6.3%, elbow; 5.0% in order. The annual experience rate of musculoskeletal symptom, back pain, and pain on leg and knee were significantly higher in female. In male, the experience rate of musculoskeletal symptom was different significantly according to educational level, family size, economic status, status of smoking, duration of farming, type of major agricultural affairs. By the multiple logistic regression analysis for experience of musculoskeletal symptom, family size and economic status were the significant variables. It was higher in male with no or one family living together and low economic status. In female, the experience rate of musculoskeletal symptom was different significantly according to body mass index, perceived health status, type of agricultural affairs. By the multiple logistic regression analysis for experience of musculoskeletal symptom, body mass index, perceived health status, and type of major agricultural affairs were the significant variables. It was higher as female farmer's body mass index was increasing and when female farmer's perceived health status was not healthier, and it was lower when female farmer did livestock farming as major agricultural affair. The experience rate of musculoskeletal symptom was higher in the busy season for farmers and treatment methods for musculoskeletal symptom were physical therapy, medication, herb medical treatment, etc. In conclusion, because most of farmers experience musculoskeletal symptom, continuous systematic study on musculoskeletal symptom of farmers and active effort to prevent and manage musculoskeletal symptom of farmers are necessary.
The Effects of Follow-Up with Peer Group Meetings after Self-Help Program for Arthritis Patients
Lee, In-Ok ; Suh, Moon-Ja ; Lee, Kyung-Sook ;
Journal of muscle and joint health, volume 8, issue 1, 2001, Pages 109~121
The purpose of this study was to find out the long-term effects of the self-help program through the follow-up with peer group meetings of arthritis patients. In order to fulfil the purposes, the follow-up program with peer group meetings was developed by researchers with consisting of monthly health contract, group discussion, group counseling, recreation, and exercise. This program was carried out 2-3 hours once in a month for 5 months (1999-2000) and evaluated in a nonequivalent control group pretest-posttest quasi-experimental design. The subjects were 34 patients of experimental group and 24 of control group. The measurement tools of this study are pain rating scale(Lee & Song), KHAQ(Bae), rating scale of fatigue, and goniometer. The results of this study revealed no significant differences on number of pain site, fatigue, physical functioning, flexibility of the shoulder joints, and level of the extension of the knee joints between experimental group and control group. Whileas pain reaction of the control group was significantly high. However, the peers expressed very much their satisfaction and appreciations with the follow-up program with Peer group meetings. Actually, they wanted to have this peer group meeting continuously. This results suggested that the follow-up program with peer group meeting could be recommended as good nursing intervention to help the arthritis patients after having the Self Help Program in the community setting.
Prediction Model of Exercise Behaviors in Patients with Arthritis (by Pender's revised Health Promotion Model)
Lim, Nan-Young ; Suh, Gil-Hee ;
Journal of muscle and joint health, volume 8, issue 1, 2001, Pages 122~140
The aims of this study were to understand and to predict the determinent factors affecting the exercise behaviors and physical fitness by testing the Pender's revised health promotion model, and to help the patients with rheumatoid arthritis and osteoarthritis perform the continous exercise program, and to help them maximize the physical effect such as muscle strength, endurance, and functional status and mental effects including self efficacy and quality of life, and improve the physical and mental well being, and to provide a basis for the nursing intervention strategies. Of the selected variables in this study, the endogenous variables included the physical fitness, exercise score, exercise participation, perceived benefits of action, perceived barriers of action to exercise, activity-related affect(depression) and perceived self-efficacy, interpersonal influences(family support), situational factors(duration of arthritis, fatigue) and the exogenous variables included personal sociocultural factor(education level), personal biologic factor(body mass index), personal psychologic factor(perceived health status) and prior related behavior factors(previous participation in exercise, life-style). We analyzed the clinical records of 208 patients with rheumatoid arthritis and degenerative arthritis who visited the outpatient clinics at H university hospital in Seoul. Data were composed of self reported qustionnaire and good of fitness score which were obtained by padalling the ergometer of bicycle for 9 minutes. SPSS Win 8.0 and Window LISREL 8.12a were used for statistical analysis. Of 75 hypothetical paths that influence on physical fitness, exercise participation, exercise score, perceived benefits of action, perceived barriers of action to exercise, activity-related affect(depression) and perceived self-efficacy, interpersonal influences(family support), situational factors(duration of arthritis, fatigue), 40 were supported. The physical fitness was directly influenced by life-style, perceived health status, education level, family support, fatigue, which explained 12% of physical fitness. The exercise participation were directly influenced by life-style, education level, past exercise behavior, perceived benefits of action, perceived barriers of action, depression and duration of arthritis, which explained 47% of exercise participation. Exercise score were directly affected by perceived self efficacy. BMI, life-style, past exercise behavior, perceived benefits of action, family support, perceived health status. perceived barriers of action, and fatigue, which explained 70%. Perceived benefits of action was directly influenced by BMI, life-style, which explained 39%. Perceived barriers of action were directly influeced by past exercise behavior, perceived health status, which explained 7%. Perceived self efficacy were directly influeced by level of education, perceived health status, life-style, which explained 57%. Depression were directly influeced by past exercise behavior, BMI, life-style, which explained 27%. Family support were directly influeced by life-style, perceived health status, which explained 29%. Fatigue were directly influeced by BMI, life-style, perceived health status. which explained 41%. Duration of arthritis were directly influeced by life-style, past exercise behavior, BMI, which explained 6%. In conclusion, important variables for physical fitness were life-style, and variable affecting exercise participation were life-style. Perceived self-efficacy of exercise was a significant predictor of exercise score. BMI, Life-style, perceived benefits of action, family support, past exercise behavior showed direct effects on perceived self-efficacy. Therefore, disease related factor should be minimized for physical performance and well being in nursing intervention for patients with rheumatoid arthritis, and plans to promote and continue exercise should be seeked to reduce disability. In addition, Exercise program should be planned and performed by the exact evaluation of exercise according to the ability of the patients and the contents to improve the importance of exercise and self efficacy in self control program, dedicated educational program should be involved. This study suggest that the methods to reduce the disease related factors, the importance of daily life-style, recognition of benefit of exercise, and educational program to promote self efficacy should be considered in the exercise behavior promotion and nursing intervention for continous performance. The significance of this study is also thought to provide patients with chronic arthritis the specific data for maximal physical and mental well being through exercise, chronic therapeutic procedure, daily adaptation and confrontation in nursing intervention.