사무직 남성의 건강증진행위 예측모형

Abstract

This study was conducted with a covariance structural analysis and test Pender's HPM model to define the factors related to health promotion behaviors of male office workers. The following measurement tools were used after some modification in this study : Seyeonok's HPLP scale, Sherer & Maddux's self-efficacy scale, Moonjeongsun's Perceived Benefit & Perceived Obstacle scale, Semoonja's Social support scale, Speake, Cowart & Pellet's Perceived Health Status scale, Joeunsuk's Job Stress scale, and Yunsunyeong & Kimjeonghee's Previous Health Related Behaviors scale. Measurement tools were used after ascertain the reliability and validity The Data in this study were gathered by using questionnaire from 260 male office workers who live in the areas of Seoul, Gyeonggi, Kangwon, Choongchungdo from September 6th to September 26th in 2004. However, 252 subjects among these were used for the study analysis. 1. Application of Pender's Health Promotion Model Pender's HPM model was applied to define the factors related to health promotion behaviors of male office workers. Previous Health Related Behaviors, Job Stress, and Perceived Health Status were included in Individual characteristics and experiences. Also Perceived Benefit, Perceived Obstacle, Self-Esteem, Self-Efficacy and Social Support were included in Behavior-specific cognitions and affect, while Health Promotion Behaviors were included in Behavior outcome. 2. Testing of the model This study identified 9 variables that may effect the health promotion behaviors of male office workers. Previous Health Related Behaviors, Job Stress, and Perceived Health Status were included in Exogenous Variables, while Perceived Benefit, Perceived Barrier, Self-Esteem, Self-Efficacy, Social Support, Health Promotion Behaviors were included in Endogenous Variables. Each variable was identified as a prediction factor of the health promotion behaviour, and tested as an identified variable from the Previous studies. The present study constructed a hypothetical model with 26 paths, but only 13 hypotheses were supported. Through model modification, 21paths were established after inserting 8paths and eliminating 5paths. Finally, a modified model with 17 paths was perceived as the prediction model on Health Promotion Behaviors. Effect Analysis of the modified model The hypothesis "perceived benefit(β_(13)) will be high when the previous health related behaviour(γ_(11)=2.319, t=-3.557) and Perceived Health Status(γ_(13)= 2.964, t=-2.126) are high" were supported as direct effect and total effect. The hypothesis "perceived barrier values(β_(23)) will be low when the perceived health status(γ_(23)= -5.662, t=2.125) is high" was supported as direct effect and total effect. The hypothesis "self-esteem(β_(35)) will be high when the social support level(β_(35)=11.335, t=3.120) and Perceived Health Status(γ_(33)=6.776, t=2.581) are high, while Job Stress(γ_(32)=-6.449, t=2.321) is Low" were supported as direct effect and total effect. The hypothesis "self efficacy(β_(43)) level will be high when the Social support(β_(45)=0.340, t=-4.653) and self esteem levels(β_(43)=0.235, t=3.021) is high, while Job stress(γ_(42)=-2.290, t=-2.522) is Low" was supported as direct effect and total effect. The hypothesis "social support(γ_(52)) level will be high when the job stress level(γ_(52)=-0.107, t=1.963) is low" was supported as direct effect and total effect. The hypothesis "health promotion behavior(γ_(61)) level will be high when the self esteem(β_(63)=3.920, t=4.918), perceived benefit(β_(61)=1.650,t=3.019), self-efficacy(β_(64)=0.918, t=2.710), perceived health status (γ_(63)=1.081, t=4.017) and previous health related behaviour(γ_(61)=1.224, t=2.219) are high, while perceived barrier(β_(62)=-0.299,t=1.990) & Job stress(γ_(62)=-0.332, t=2.312) are low" were supported as direct effect and total effect. The result of this study for the modified model indicated that perceived self-esteem had the most significant direct effect on health promotion behaviors, and perceived benefit, previous health related behaviour were important factors having influences on them. All predictive variables of health promoting behaviors explained 72% of the total variance in the modified model. Therefore, to establish a more effective intervention program, it may be helpful using predictive variables that were identified as effective factors on health promotion behavior from this study.;본 연구는 사무직 남성의 건강증진행위에 영향을 미치는 요인을 확인하기 위하여 Pender의 건강증진모형을 적용하고 검증하는 공변량 구조분석 연구이다. 연구도구는 서연옥(1995)의 건강증진행위척도, 전병재(1974)의 자아존중감척도, Sherer & Maddux(1982)의 자기효능감 척도, 문정순(1990)의 지각된 유익성과 지각된 장애성 척도, 서문자(1988)의 사회적 지지 척도, Speake, Cowart, Pellet(1989)의 지각된 건강상태 척도, 조은숙(1990)의 직무스트레스 척도, 윤순녕과 김정희(1999)의 과거 건강관련행위 척도를 신뢰도와 타당도 확인후 사용하였다 자료수집은 2004년 9월 6일부터 9월 26일까지 이루어졌고, 연구대상자는 편의추출로 서울, 경기, 강원, 충청도, 경상도에 위치한 대기업 사무직 종사자 252명이었다. 수집된 자료는 SAS프로그램과 Lisrel 8.13프로그램을 이용하여 분석하였다. 1. Pender의 건강증진모형 적용 사무직 남성의 건강증진행위에 영향을 주는 요인을 확인하기 위해 Pender의 건강증진모형을 적용하였는데, 개인적 특성과 경험에는 과거 건강관련행위, 직무스트레스, 지각된 건강상태, 행위와 관련된 인지와 감정에는 지각된 유익성, 지각된 장애성, 자아존중감, 자기효능감, 사회적지지, 행위결과에는 건강증진행위가 선정되었다. 2. 모형검증 모형검증에 포함된 이론변수는 9개로 외생변수는 과거 건강관련행위, 직무스트레스, 지각된 건강상태가 선정되었고, 내생변수는 지각된 유익성, 지각된 장애성, 자아존중감, 자기효능감, 사회적 지지, 건강증진행위가 포함되었다. 이들 변수들을 이용한 가설경로 총 26개중 13개의 경로가 지지되었다. 모형수정을 위해 경로 5개를 삭제하고, 8개의 경로가 추가된 총 21개의 경로중 17개의 경로가 지지되었다. 수정모형의 효과분석 지각된 유익성은 과거 건강관련행위(γ_(11)=2.319, t=-3.557), 지각된 건강상태(γ_(13)= 2.964, t=-2.126)가, 지각된 장애성에는 지각된 건강상태(γ_(23)= -5.662, t=2.125)가, 자아존중감은 지각된 건강상태(γ_(33)=6.776, t=2.581), 사회적 지지(β_(35)=11.335, t=3.120), 직무 스트레스(γ_(32)=-6.449, t=2.321)가 직접효과와 총효과가 있었다. 자기효능감은 직무 스트레스(γ_(42)=-2.290, t=-2.522), 자아존중감(β_(43)=0.235, t=3.021), 사회적 지지(β_(45)=0.340, t=-4.653)가 사회적 지지는 직무스트레스(γ(52)=-0.854, t=5.956)가 직접효과와 총효과가 있었다. 건강증진행위에는 자아존중감(β_(63)=3.920, t=4.918), 지각된장애성(β_(62)=-0.299,t=1.990), 지각된유익성(β_(61)=1.650,t=3.019), 자기효능감(β_(64)=0.918, t=2.710), 지각된 건강상태(γ_(63)=1.081, t=4.017), 과거 건강행위(γ_(61)=1.224, t=2.219), 직무스트레스(γ_(62)2=-0.332, t=2.312)가 직접효과와 총효과가 있었다. 수정모형에서 건강증진행위에 가장 많은 영향을 미치는 변수는 자아존중감, 지각된 유익성, 과거 건강관련행위 순으로 통계적으로 유의하였고, 변수들의 건강증진행위 설명력은 72%였다. 본 연구에서 구축된 사무직 남성의 건강증진행위 예측모형은 간명하면서도 포괄적인 모형이라 할 수 있다. 따라서 본 연구에서 건강증진행위에 영향요인으로 나타난 예측변수들을 활용한 건강증진프로그램을 개발한다면 더욱 효과적인 중재프로그램이 개발될 것으로 사료된다.