BACKGROUND: The present study was to apply the Health Belief Model (HBM) to identify factors associated with an assertive behavior of asking smokers not to smoke among college students in Korea when they were exposed to secondhand smoke. METHODS: Data were collected from college students (n=2,061, 66.5% females) at two universities in Seoul and Gyeonggi-do. A main outcome measure was the assertive behavior. HBM factors including perceived susceptibility to illness, perceived severity of illness, perceived barrier to the assertive behavior, and cues to action were self-administrated. RESULTS: The mean of the assertive behavior (range 1-5 points) was 2.20 points with 39.1% never being assertive and 4.2% always being assertive. Based on results of a multiple logistic regression analysis, high levels of perceived severity (odds ratio, OR 2.04, 95% confidence interval, CI 1.40-2.97) and perceived barrier (OR 1.72, 95% CI 1.41-2.08) were significantly associated with the assertive behavior, while perceived susceptibility and cues to action were not. CONCLUSIONS: Perceived severity and perceived barrier of the HBM model were significant factors associated with the assertive behavior among college students. Modifying these factors may lead to enhancing the assertive behavior of asking smokers not to smoke when college students were exposed to secondhand smoke.
Assertiveness ; Cues ; Humans ; Korea ; Logistic Models ; Models, Theoretical ; Outcome Assessment (Health Care) ; Smoke ; Tobacco Smoke Pollution

BACKGROUND: We aimed to examine the effects of an experiential learning activities-focused smoking prevention (ELSP) program on the basis of the Attitude-Social Influence-Efficacy (ASE) model in elementary school students. METHODS: A non-equivalent control group pre-test and post-test design was conducted with 84 participants who were in the fifth grade of two elementary schools in Seongnam city, South Korea. The two schools were allocated into either the ELSP (n=42) or control (n=42) group. The ELSP group completed five ELSP classes, while the control group completed five traditional lecture-based classes during the 5 weeks. Both groups were examined before and after 5 weeks, using ASE measures of smoking attitude, social influence, self-efficacy for the refusal of smoking temptation, and intention not to smoke. Data were collected from August to September 2017. RESULTS: The ELSP group had significant changes in the scores of smoking attitude (t=4.75, P<0.001) and social influences (t=3.73, P<0.001), compared to those in the control group. However, the ELSP group had non-significant changes in the scores of self-efficacy for the refusal of smoking temptation and intention not to smoke, compared to those in the control group. CONCLUSIONS The ELSP program may be effective in improving smoking attitude and perceived social influence of smoking among those in upper grades of elementary schools. However, the duration and intensity of the ELSP program must be revised to effectively enhance smoking refusal self-efficacy and non-smoking intentions.

PURPOSE: This study evaluated the accuracy of electronic devices compared with mercury sphygmomanometer. Of 132 outpatients with electronic devices, 77 who possessed oscillometric cuff devices participated in this study. METHOD: When the blood pressure was measured, all electronic devices were connected by means of a Y-connector to a mercury sphygmomanometer. Using the simultaneous same arm approach, each comparison was carried out three times at 2-minute intervals. RESULTS: Compared with the mercury sphygmomanometer, the electronic devices underestimated systolic and diastolic blood pressure, respectively by 4.0 +/- 5.8mmHg and 2.5 +/- 6.7mmHg, which satisfies the standard error range of the American Association for the Advancement of Medical Instrumentation. According to the British Hypertension Society criteria, these differences achieved C grade for both systolic and diastolic pressure. For the graphical analysis, the differences had a tendency to fulfill the permitted error limits in both diastolic and systolic blood pressure. Moreover, the purchase duration was not correlated with the accuracy of electronic devices. CONCLUSION: These results indicate that difference in blood pressure between electronic devices and mercury sphygmo- manometer is within the standard error. Therefore, electronic blood pressure measuring devices may be useful for therapeutic self-management of hypertension.
Arm ; Blood Pressure* ; Humans ; Hypertension ; Outpatients ; Self Care ; Sphygmomanometers

BACKGROUND: We aimed to examine the effects of an experiential learning activities-focused smoking prevention (ELSP) program on the basis of the Attitude-Social Influence-Efficacy (ASE) model in elementary school students. METHODS: A non-equivalent control group pre-test and post-test design was conducted with 84 participants who were in the fifth grade of two elementary schools in Seongnam city, South Korea. The two schools were allocated into either the ELSP (n=42) or control (n=42) group. The ELSP group completed five ELSP classes, while the control group completed five traditional lecture-based classes during the 5 weeks. Both groups were examined before and after 5 weeks, using ASE measures of smoking attitude, social influence, self-efficacy for the refusal of smoking temptation, and intention not to smoke. Data were collected from August to September 2017. RESULTS: The ELSP group had significant changes in the scores of smoking attitude (t=4.75, P<0.001) and social influences (t=3.73, P<0.001), compared to those in the control group. However, the ELSP group had non-significant changes in the scores of self-efficacy for the refusal of smoking temptation and intention not to smoke, compared to those in the control group. CONCLUSIONS: The ELSP program may be effective in improving smoking attitude and perceived social influence of smoking among those in upper grades of elementary schools. However, the duration and intensity of the ELSP program must be revised to effectively enhance smoking refusal self-efficacy and non-smoking intentions.
Gyeonggi-do ; Humans ; Intention ; Korea ; Peer Influence ; Problem-Based Learning ; Smoke ; Smoking

PURPOSE: The purpose of this study was to examine the association between health behaviors and health-related quality of life (HRQOL) among vulnerable children in a community. METHODS: Using data from 'The Obesity Prevention Framework for Vulnerable Children', a secondary analysis was conducted for 165 children (ages 8~12 years) and their parents who were recruited from 16 K-gu Community Child Centers in Seoul. Six types of health behaviors related to eating and activity were assessed. Each behavior was categorized into the non-recommended vs. recommended levels. The scores of the recommended levels of the six health behaviors were summed up for the composite score of health behaviors. HRQOL was measured by KIDSCREEN-52. RESULTS: The groups with a non-recommended level of fast food intake and sedentary behavior had a significantly lower total score of KIDSCREEN-52 than those with a recommended level. Moreover, the lower composite score of health behaviors was significantly associated with the lower total score of KIDSCREEN-52. CONCLUSION: Among the vulnerable children, the six recommended health behaviors and their composite score were in significant positive associations with the HRQOL levels. Therefore, nursing strategies for enhancing the recommended levels of health behaviors are needed for vulnerable children.
Child* ; Eating ; Fast Foods ; Health Behavior* ; Humans ; Nursing ; Obesity ; Parents ; Quality of Life* ; Seoul ; Vulnerable Populations ; Child Health

BACKGROUND: There is little evidence on the prevalence of secondhand smoke (SHS) exposure among cancer patients. We aimed to investigate its prevalence, and to identify gender differences in factors associated with SHS exposure among cancer patients. METHODS: Participants were 304 patients who have been treated via either inpatient or outpatient clinics in the National Cancer Center. SHS exposure was defined as an individual's experience of SHS exposure during the past month. Gender-stratified analysis was performed by using a logistic regression analysis with potential covariates. RESULTS: SHS exposure was prevalent in 69.5% of the total participants, specifically in 57.1% of men and 62.7% of women; however, it did not differ significantly by gender. The prevalence of SHS exposure at home was significantly greater in women (20.7%) than in men (4.4%) (P=0.048). Among men, age < or =50 years (Adjusted odds ratio [OR]=3.11; confidence interval [CI]=1.05-9.24), employed status (Adjusted OR=3.15; CI=1.38-7.19), and having family smokers (Adjusted OR=0.32; CI=0.12-0.82) were significantly associated with SHS exposure. Among women, employment status (Adjusted OR=2.67; CI=1.40-5.10), good self-rated health (Adjusted OR=2.35; CI=1.20-4.61), and having family smokers (Adjusted OR=2.03; CI=1.05-3.91) were significantly associated with SHS exposure. CONCLUSIONS: Cancer patients were exposed to SHS by 69.5% during the past month. Among cancer patients, factors associated with SHS exposure differed by gender. Therefore, gender-specific strategies for preventing SHS exposure are needed for cancer patients.
Ambulatory Care Facilities ; Employment ; Female ; Humans ; Inpatients ; Logistic Models ; Male ; Odds Ratio ; Prevalence ; Tobacco Smoke Pollution*

BACKGROUND: Abdominal obesity as measured by waist-to-height ratio (WHtR) may have stronger and inverse associations with cardiovascular (CV) health than overall obesity as measured by body mass index (BMI). However, there was some challenges for controversies. We aimed to examine the associations of WHtR and BMI with CV health among Korean children using data of the 2010-2012 Korea National Health and Nutrition Examination Survey. METHODS: A cross-sectional study was conducted with the sample of 2,363 children by analyzing by gender and two-age groups (10-12 and 13-18 years). Overall obesity was categorized into 3 groups by BMI percentile: non-overweight (<85), overweight (≥85), and obesity groups (≥95). Abdominal obesity was categorized into 2 groups by WHtR: normal (<0.5) and abdominal obesity groups (≥0.5). The CV health score was defined as a z-score by calculating the sum of 7 CV factors. RESULTS: The overweight/obesity groups had significantly lower CV health scores than the normal group (P<0.05) in boys and girls aged either 10-12 years or 13-18 years after adjusting for covariates. The abdominal obesity group also showed significantly lower CV health scores than the normal group (P<0.05) in all the groups; this significant association remained significant in boys aged 13-18 years even after further adjusting for BMI category (P<0.01). CONCLUSIONS: Among boys aged 13-18 years, abdominal obesity as measured by WHtR was significantly and inversely associated with CV health, independent of BMI category. Therefore, it should be considered to assess the level of abdominal obesity as a measure of CV health in late adolescent boys.
Adolescent ; Body Mass Index ; Cardiovascular Diseases ; Child ; Cross-Sectional Studies ; Female ; Humans ; Korea* ; Nutrition Surveys* ; Obesity ; Obesity, Abdominal ; Overweight ; Pediatric Obesity* ; Risk Factors

PURPOSE: Loneliness may be a typical psychological consideration in chronically ill patients, linking with low life satisfaction. We aimed to determine if loneliness would be independently associated with life satisfaction in pneumoconiosis patients hospitalized in long-term care facilities. METHODS: We recruited 164 patients from 3 pneumoconiosis-specialized hospitals in M and S cities, South Korea, and measured loneliness and life satisfaction by using the University of California Los Angeles loneliness and life satisfaction index-Z scales. The Multiple regression analysis was performed to examine an independent association between loneliness and life satisfaction after adjustment for age, the levels of dyspnea and bronchitisemphysema symptom, length of institutionalization, marital status, previous coal work experience, perceived socioeconomic status, and presence of caregivers. RESULTS: The mean of loneliness was 46.4. We found a significant association between loneliness and life satisfaction (standardized beta=-0.16, p=0.049), independent of all the covariates. Conclusions: Loneliness was an independent associate of life satisfaction in patients with pneumoconiosis who were institutionalized in long-term care facilities. Thus, a nursing intervention strategy for relieving loneliness is needed to increase life satisfaction in these patients.
California ; Caregivers ; Chronic Disease ; Coal ; Dyspnea ; Humans ; Institutionalization ; Loneliness ; Long-Term Care ; Los Angeles ; Marital Status ; Pneumoconiosis ; Republic of Korea ; Social Class ; Weights and Measures

PURPOSE: The present study was to apply the Attitudes-Social influence-Efficacy (ASE) model in order to identify factors associated with the assertive behavior of non-smoking college students when they are exposed to secondhand smokes in Korea. METHODS: Data were collected from non-smoking college students (N=1,656, 76.6% female) at two universities in Seoul and Gyeonggi-do. The main outcome measure was the assertive behavior. ASE factors such as attitudes toward being assertive, social influences, and self-efficacy as well as socio-demographic, health- related, and smoking-related factors were self-administrated. RESULTS: The mean of the assertive behavior (range 1~5 points) was 2.23; 37.6% was not at all assertive, while 4.3% was always assertive. Higher assertiveness was significantly correlated with a higher level of positive attitude, social influence and self-efficacy (p<.05 for all). Stepwise multiple regression analyses showed that the social influence was the strongest factor associated with the assertive behavior (beta=0.430, p<.001, R2=.246), followed by self-efficacy, motive to assertiveness, having any family member who had diseases, and male gender. These factors explained the assertive behavior by 39.7%. CONCLUSION: The ASE model may explain the assertive behavior of non-smoking college students under secondhand smoke exposure. Social influence and self-efficacy were significant factors associated with their assertive behavior.
Assertiveness ; Gyeonggi-do ; Humans ; Korea ; Male ; Outcome Assessment (Health Care) ; Seoul ; Social Behavior ; Tobacco Smoke Pollution*

Background: The purpose of this study was to determine whether metabolic syndrome (MetS) and MetS management behaviors would be significantly associated with health-related quality of life (HRQOL) among patients with liver transplantation. Methods: Ninety-four patients who underwent liver transplantation were recruited at an outpatient clinic from a university hospital in Seoul. MetS was defined according to the National Cholesterol Education Program-Adult Treatment Panel III. MetS management behaviors were measured by using the Evaluation Tool of a Lifestyle Habit for MetS Modification. HRQOL was measured by using the Medical Outcomes Study Short-Form Health Survey-36 II and analyzed by categorizing physical and mental quality of life (QOL). Results: The means of physical and mental QOLs were 82.3 and 82.8 scores, respectively. MetS prevalence was 72.3% and a mean of MetS management behaviors was 97.0. MetS prevalence was not significantly associated with either physical or mental QOLs. A total score of the MetS management behaviors was significantly associated with physical (β=0.42, P=0.008) and mental QOLs (β=0.44, P=0.001). Of the MetS management behaviors, diet control and drinking & smoking control were significantly associated with physical QOL (P<0.05 for all). Physical activity, diet control, and drinking & smoking control were significantly associated with mental QOL (P<0.05 for all). Conclusions MetS prevalence may not associate with HRQOL directly but MetS management behaviors may associate with HRQOL among patients with liver transplantation. Therefore, nursing strategies for promoting MetS management behaviors should be enhanced to improve their HRQOL levels in outpatient clinics and community settings.