Hyera Yoo

Self‐efficacy associated with self‐management behaviours and health status of South Koreans with chronic diseases

Although prior research in Western societies has revealed an association between self-efficacy and both self-management behaviours and better health status, little is known about the applicability of this association in Korean populations. We examined the differences in self-management behaviours and health status among three groups according to the level of self-efficacy (high, moderate and low). We used a descriptive and correlational design, and administrated a questionnaire to 322 Korean patients with diabetes mellitus, hypertension or arthritis at three ambulatory clinics in a university medical centre. We performed the Pearson chi-square test to test for differences in proportions, and the Kruskall-Wallis and Mann-Whitney U-tests for non-parametric measures. The level of self-efficacy was associated with self-management behaviours (P < 0.05) and with better health status indices (P < 0.001) except fatigue (P < 0.277). The mean age (Mean ± standard deviation, 53.71 ± 12.60), the percentage of high level of education (62.4%) and the level of employment (51.4%) were significantly higher in high self-efficacy group than in low self-efficacy group or moderate self-efficacy group. Further study of the potential factors affecting any relationship between self-efficacy and fatigue is recommended. Self-efficacy-enhancing interventions can be beneficial for Korean chronic patients to improve their self-management behaviours and health status.

Impact of Critical Thinking Disposition, General Self-Efficacy, and Leadership on Clinical Competence in Nursing Students

PURPOSE The purpose of this study was to evaluate the relationships among critical thinking disposition, general self-efficacy, leadership and clinical competence, and identify the factors influencing clinical competence in nursing students. METHODS In this descriptive study, 153 nursing students (from 2nd to 4th school year) of a university in South Korea were enrolled in December 2010. The instruments for this study were the Korean versions of the Critical Thinking Disposition Scale, General Self-Efficacy Scale, Leadership Inventory, and Clinical Competence Scale. Data were analyzed by descriptive statistics, t-test, MANOVA, Pearson correlation, and multiple linear regression with PASW 18.0 software. RESULTS The mean scores (ranging from 1 to 5) in nursing students for critical thinking disposition, general self-efficacy, leadership, and clinical competence were 3.44, 3.51, 3.55, and 3.42, respectively. Positive correlations were found for clinical competence with critical thinking disposition, general self-efficacy, and leadership. The strongest predictor of clinical competence was leadership. In addition, leadership, nursing school year, and subjective academic achievement accounted for 34.5% of variance in clinical competence. CONCLUSION This study revealed that developing leadership, critical thinking disposition, and self-efficacy in undergraduate nursing education is important to improve clinical competence of nursing students.

Self-management programs based on the social cognitive theory for Koreans with chronic disease: A systematic review

Abstract Self-management programs based on social cognitive theory are useful to improve health care outcomes for patients with chronic diseases in Western culture. The purpose of this review is to identify and synthesize published research on the theory to enhance self-efficacy in disease management and examine its applicability to Korean culture regarding the learning strategies used. Ultimately, it was to identify the optimal use of these learning strategies to improve the self-efficacy of Korean patients in self-management of their hypertension and diabetic mellitus. The authors searched the Korean and international research databases from January 2000 to September 2009. Twenty studies were selected and reviewed. The most frequently used learning strategies of social cognitive theory was skill mastery by practice and feedback (N = 13), followedby social or verbal persuasion by group members (N = 7) and, however, observation learning and reinterpretation of symptoms by debriefing or discussion were not used any of the studies. Eight studies used only one strategy to enhance selfefficacy and six used two. A lack of consistency regarding the content and clinical efficacy of the self-efficacy theory-based self-management programs is found among the reviewed studies on enhancing self-efficacy in Koreans with hypertension and diabetes mellitus. Further research on the effectiveness of these theory-based self-management programs for patients with chronic diseases in Korea and other countries is recommended.

Similarities and Differences of Self-Care Behaviors Between Korean Americans and Caucasian Americans With Heart Failure

Purpose: To compare the differences of self-care behaviors between Korean Americans with heart failure (HF) and Caucasian Americans with HF. Method: Ninety (N = 90) participants (45 Korean Americans and 45 Caucasian Americans) were recruited for this study. A two-group, comparative, descriptive design using the Revised Heart Failure Self-Care Behavior Scale was used to assess self-care behaviors. Results: Self-care behavior was not significantly different between the two groups (p > .05). However, culture-specific self-care behaviors were evident between two racial groups. Discussion: Implementation of culturally congruent education programs could be useful in preventing and managing HF. Further studies comparing self-care behaviors should be conducted in diverse racial populations.

Psychometric testing of the Chronic Disease Self-Efficacy Scale-Korean Version (CDSES-K).

Purpose: To examine the validity and reliability of the Chronic Disease Self-Efficacy Scale–Korean Version (CDSES-K) in 380 Korean adults with three chronic diseases: arthritis, diabetes, and hypertension. Methods: The Korean translated CDSES-K was back-translated to ensure translation equivalency. A methodological research design was used with exploratory factor analysis for validity and Cronbach’s alpha coefficients for reliability. Results: The factor analysis identified eight CDSES-K factors explaining 72.5% of the total variance. The internal consistency reliability for the total instrument was high with Cronbach’s alpha of .93. Conclusion: The results support the cross-cultural applicability of the concepts underlying the CDSES-K and the self-efficacy transcends across cultures. Implications: The CDSES-K can be used not only to assess self-efficacy in Koreans with chronic diseases but also to examine the potential function of self-efficacy in improvement of self-management behaviors and enhanced health status of people with chronic diseases in a variety of clinical settings.

Psychometric Evaluation of the Korean Version of the Adapted Illness Intrusiveness Rating Scale

PURPOSE To examine the psychometric properties of the Korean version of the adapted Illness Intrusive-ness Rating Scale (a-IIRS). The a-IIRS is a modified version of the original IIRS that measures illness-disruptions to daily life in patients with diverse diagnoses. While the psychometric properties of the original IIRS have been validated, no study has been conducted to validate the Korean version of a-IIRS. METHODS After translation and back-translation processes, the Korean version of a-IIRS was developed. A pilot test was conducted with 10 patients with chronic diseases. A convenience sample of 380 patients with diabetes, hypertension, and/or arthritis was used. Exploratory and confirmatory factor analyses, known-group technique, hypothesized relationships, internal consistency, and item analysis were tested. RESULTS Three factors were extracted from principal components analysis with varimax rotation: Relationships and Personal Development, Instrumental Life, and Intimacy. Confirmatory factor analysis corroborated the good fit of the three-factor model. Illness intrusiveness was significantly different among the study subjects categorized into three groups according to different health status: poor, fair and good. The instrument was positively correlated with the scales of fatigue and depression. The tool demonstrated high internal consistency with adequate item-total correlations. CONCLUSIONS The findings are consistent with previous study results on IIRS and support the reliability and validity of the Korean version of a-IIRS. The instrument is culturally relevant for Korean patients with chronic diseases. Health care professionals need to consider illness intrusiveness when caring for patients with chronic diseases and promote their quality of life.