완성08-A01-김인홍.PDF

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1 :,,,,,, * **. 1., %, (Body Ma ss In dex :BMI) 27 (St en a la n d & Ma r gdis, 1982 )., 9 5 (Minist ry on H ea lt h a n d Welfar e, 1996 ) BMI 27.3, % 3.6 %. (Bosello, Am ellini & Za mb oni, 1997 ),, LDL H DL (Kissebat h & Kr a k ower, 1994 ). (h yp erlipidem ia ) (Sk elt on & Sk elt on, ). 32 % (Lee, 1994 ), J on es, Hu nt, Br ow n, & N or ga n (198 6 ), 1 17,, BMI , 0.93, BMI , 0,1 1 (J oon gan gllbo, 2002 ),.. * 2002 **

2 3 2 6,., (Lu st ig, 199 1)., % % (393 ) (Mar t in & Hu nt er, )., (Ch u n g, ; Wood, H a sk ell, Klein & Leis, 1976 ), H DL- C, TC. TG, LDL- C, TC/ H DL- C, (Seal, H a gb er g, Hwley, Eh sam i, & H ollost y, 1984 ; Ryu, 1997 ; Wood, ). Gr u ber (1986 ),.,. (Zem a n, 199 1).,,., 1), (, BMI). 2 ), [ (t ot al ch olest er ol :TC), (t riglyceride :TG), (high densit y lipopro-t ein- ch olest er ol :HDL- C), (low den sit y lipopr ot ein - ch olest er ol :LDL- C), %TC/ H DL- C]. 3 ),.. 1. K (BMI) 30 % 12, 12, , 11, 12, (n on equ ivalent cont r ol gr ou p pr et est - post est design ) , 1),, 30, 4,

3 %. (h ear t r at e ch eck er : P ola Syst em ). (% = - / - ), %. 5-10, ) E pst ein, Va losk, Win g & McCu r ley (1990 ), Wa dden (199 3 ),, (self- m onit erin g),,,,. (st im u lu s cont r ol ),, ( :,, TV, ) <Ta ble 1>. 4. <T a b le 1> ,,,,, :? -,,,. 1 2?

4 ) (BMI) 0.1cm, 0.1k g 3 [BMI = (k g)/ (m ) 2 ]. 2 ) (TC) (TG) (Au t o- a n a lyzer Hit a ch i 7 150, Hit a ch i Lt d. Tok yo, J a pa n ), (H DL- C) H DL (LDL- C) F riedewa ld, Levy & F r edrick son (197 2 ) [LDL = TC- (H DL + TG/ 5) ]. %TC/ H DL- C. 3 ) Rosenber g Self- E st eem Inven t ory Rosen ber g Sca le (196 5) 10, Lik ert t yp e Cr on ba ch ' s = 0,7 6. SP SS 8.0/ P C +. 1) K- S (Kolmogorove- Smirmov). 2 ),,,,, (on e- wa y AN OVA ). 3 ),,, pa ir ed t - t est. 4 ) (AN COVA), Mu lt iple Ra n ge Test (SN K- Test ).. 1.,,,,, (BMI), (TC), (TG ), (H DL- C), (LDL- C), % / (% TC/ H DL- C), <Table 2 > <T a b le 2 > T e s t f o r h e m o g e n e ity o f g e n e ra l c h a ract e rist ics a m o ng g ro u p s (n = 3 5) It em s E G E + BG CG F - va lu e Age (yr s ) H eigh t (cm ) ) Weigh t (k g) BMI (k g/ m 2 ) TC ( / ) TG ( / ) H DL- C ( / ) LDL- C ( / ) % TC/ H DL- C (% ) Self- est eem EG : Exericse Grou p E + BG : Exer cise & Beh a vior Modifica t ion Gr ou p CG : Cont r ol Gr ou p

5 <T a b le 3 > Ch a ng e o f w e ig ht a n d BMI a m o ng g ro u p s (n = 3 5) It em s Weigh t BMI *** p < Gr ou ps period of exp er im en t a l 0week 12w eek s DM t - va lu e F - va lu e SN K- t est EG *** E :C, E + BG *** *** E + B :C CG EG *** E + BG *** *** E :C CG , (p< ), , (p <0.00 1) , (p >0.0 5). (F = , p < )., <Ta ble 3 > /, / (p<0.00 1), /, / (p<0.00 1) /, / (p >0.0 5 ). (F = , p< ). <Ta ble 3 >. 3. Tot a l Ch olest er ol /, / (p<0.0 1), /, / (p<0.0 1) /, / (p >0.0 5). (F = , p <0.00 1). <T a b le 4 > Ch a ng es of b lo o d lip id s a m o n g g ro u ps (n = 3 5) It em s Gr ou ps p er iod of experim ent al 0 w eek 12 w eek DM t - va lu e F -v alu e SN K- t est TC EG ** E :C, E + BG ** *** E + B :C CG EG * TG E + BG *** CG H DL- C EG ** E :C, E + BG *** *** E + B :C CG * LDL- C EG * E :C, E + BG *** 9.7 1*** E + B :C CG EG ** %TC/ H DL- C E + BG *** *** E :C CG ** p <0.0 1 *** p <

6 3 2 6, <Ta ble 4 >. Triglycerid es /, / (p<0.0 5 ), /, / (p< ) /, / (p >0.0 5 ). (F = 1.50, p >0.0 5 ) <Table 4 >. H DL- Ch olest er ol /, / (p<0.00 1), /, / (p< ) /, / (p<0.0 5). (F = , p < )., <Ta ble 4 >. LDL- Ch olest er ol /, / (p< ) /, / (p< ) /, / (p >0.0 5 ). (F = 9.7 1, p<0.00 1)., <Ta ble 4 >. % Tot a l Ch olest er ol/ H DL- Ch olest er ol %, 3.93 % (p<0.0 1), 4.59 %, % (p< ) %, 4.5 1% (p >0.0 5). (F = , p< ). <Ta ble 4 > , (p <0.00 1), 34.07, (p< ) , (p >0.0 5). (F = 6.8 1, p<0.00 1). <Table 5>.. 12,,. 5.67k g, 5k g, BMI 2k g/ m 2, 2k g/ m 2 (p < ),., <T a b le 4 > Ch a ng es of S e lf- es t e e m a m o n g g ro u p s (n = 35 ) It em Self- est eem *** p < Gr ou p s experim ent a l of period 0 week 12 w eek DM t -v alu e F -v alu e SN K- t est E G *** E + BG *** 6.8 1*** E + B :C CG

7 , BMI., Wood, H a sk ell, Klein & Leis (19 76 ). Wilm or e & Cost ill (19 88 ) 6-8, Sh in (1992 ) 12 Cir cu it t r a in nin g 4.58k g, %. (F or eyt & Goodrick, ), BMI , 12 6k g Va n sa nt et a l (19 99 ) Ch u n g (199 8 ) k g, BMI 3.3k g/ m 2, 2.9 %, 8 2.5k g (Ch a u n g, ). Va n sa nt et al (199 9 ) k g, 3.36k g Ryu (199 7 ) 12., (Zem a n, 199 1), F or eyt & Goodrick (19 93 ) 19. TC (4 7 m g/ dl p<0.0 1, 9.33m g/ dl p <0.0 1), TG (12.8 9m g/ dl p<0.0 5, 6.00m g/ dl p < ), LDL- C (39.98m g/ dl p <0.0 5, m g/ dl p < ), %TC/ H DL- C (1.06 % p<0.0 1, 0.19 % P <0.00 1), H DL- C (12.8 9m g/ dl p<0.0 5, m g/ dl p <0.00 1). H DL- C (2.38m g/ dl, p<0.0 5) TC, H DL- C, LDL- C,, %TC/ H DL- C.,. LDL- C H DL- C LDL- C H DL- C,. TC LDL- C, H DL- C. %TC/ H DL- C 5.0, 4.0,, TC H DL- C %TC/ H DL- C (Wood et a l., 1976 ). Com m it t ee in st it u t ion of h yp er lipd em ia Gu idelin es (199 6 ), TC 2 00m g/ dl, TG 2 00m g/ dl, H DL- C 3 5m g/, LDL- C 130m g/. TC, LDL- C, %TC/ H DL- C, H DL- C,

8 H DL- C, TC, TG, %TC/ H DL- C. Sea l, H a gb er g, Hwley, Eh sam i & H ollost y (19 84 ) H DL- C, TC/ H DL- C, TC. LDL- C, TG, Br own ell (1982 ) TC. TC, TG LP L (lipopr ot ein lipa se ) TG,. H DL- C. TC/ H DL- C H DL- C. Va n sa n t et a l (19 99 ) 12 TC, TG, LDL- C, H DL- C Ch u n g (1998 ) TC, TG, LDL- C, %TC/ H DL- C H DL- C. TC, TG, LDL- C, %TC/ H DL- C H DL- C (Ryu, ; Wa d den, ). TC HMG- CoA r edu ca t a se (Wa dden, ).. (p<.00 1).. 8 Ch au n g (19 97 ). Gru b er (198 6 ) Collin gw ood (1972 ) ,., (Kr a m er et a l, )., - - (Br ow n ell & Kr am er, 1989 ).,,.,

9 ,, BMI 30 % 3 5 ( 12, 11, 12 ) 4, 30, 50 % 12, 1 12,,,, k g, 5k g, BMI 2k g/ m 2, 2k g/ m 2 (p<0.00 1),.,, BMI...,,..,.. 1). 2 ). 2. Re f e re n ce s TC (4 7 m g/ dl, p<0.0 1, 9.33m g/ dl, p <0.0 1), TG (12.89m g/ dl, p<0.0 5, 6.00m g/ dl, p < ), LDL- C (3 9.98m g/ dl, p<0.0 5, m g/ dl, p <0.00 1), %TC/ H DL- C (1.06 %, p <0.0 1, 0.19 %, P <0.00 1), H DL- C (12.89m g/ dl, p<0.0 5, 4.33 m g/ dl, p<0.00 1). H DL- C (2.38m g/ dl, p<0.0 5), TC, H DL- C, LDL- C,, %TC/ H DL- C. 3. (p <.00 1) Bosello, O., Am ellini, F., & Za mb oni, M. (199 7 ). Th e b en efit s of m odest weigh t loss in t ype diab et es, int j ob es 2 1 :s 10- s 13. Br onw n ell, K. D. (1982 ).Obesit y : u n der st a n din g a n d t r ea t in g a seriou s, pr evalent, a n d r efr a ct ory disor der. J. Conu su lt. Clin. Psy ch ol., 50, Br own ell, K. D., & Kr am er, F. M. (198 9 ). Beh a vior a l m a n a gem ent of ob esit y. M ed. clin. N ort h A m erica, 73 (1), Ch a u n g, S. K. (199 5). Effect s of beh av ior m odificat ion on t h e care of ob esit y in obese adolescent girls. U npu blish ed d oct oral dissert at ion. Th e Cat h olic U niver sit y. Ch u n g, J. S. (199 8 ). T h e Effect s of Ex ercise an d Diet com bin ed w it h B eh av ior M odificat ion Program on B ody com p osit ion, Blood Lipid s L ev el an d aerobic Cap acity in Ob ese M iddle -aged w om en. U n pu blish ed

10 3 2 6 doct or a l dissert at ion. t h e H a n Ya n g U n iver sit y. Collin gw ood, J. R. (197 2 ). Th e effect s of ph ysica l t r ainin g u pon beh a vior a n d self at t it u des. J ou rn al of Clinical Psy ch ology, 28, Comm it t ee in st it u t ion of h yperlipemia Gu idelines (1996 ). Gu idelines of hy p erlipim ia, Or ien t al m edicin e P u blish in g Com p a ny, Seou l. E pst ein, L. H., Valosk i, A., Win g, R. R., & McCu rley, J. (199 0 ). Ten year s follow- u p for b eh a vior a l, fam ily-b a sed t r eat m ent for obese ch ildr en s. J.A.M.A., 264, F or eyt J. P., Goodrick G K. (1993 ). Eviden ce for su ccess of beh avior m odificat ion in loss a n d cont r ol. A n n als of Int ern al M edicin e. 19 (7-2 ), F riedewa ld, W. T., Levy, R. L., & Fr edrick son, D. S. (1972). Est im at ion of t h e con cent r at ion of low- d en sit y lipopr ot ein ch olest er ol in pla sm a, wit h ou t u se of t h e pr epa r at ive u lt r a cent rifu ge. Clin. Ch rm ist ry., 18, Gru b er, J. J. (198 6 ). P h ysical a ct ivit y a n d self- est eem developm ent in ch ildr en : A m et a -analy sis. A m erican A cadem y of Phy sical Edu cat ion Pap ers, 19, U p gr a de t h e n a t ion a l h ea lt h - Th e obesit y is disea se. (200 0, Mar ch 5 ). J oon gan gllbo, p J on es, P. R. M., H u nt, M. J., Br own, T. P., & N or ga n, N. G. (1986 ). Wa ist - h ip cir cu m - fer en ce r a t io a n d it s r ela t ion t o a ge a n d over weigh t in Brit ish m en, Hu m an N u t r Clin N u t r, 4 0 C, Kissenb ah, A. H., & Kr ak ower, G. R. (19 94 ). Region a l a dip osit y a n d m or bidit y, p hy siol R ev, 74, Kr a m er, W. J., F leck, R., Callist er, M., Sh ealy, G. A., Du dley, C. M., Ma r esh. L., Mar ch it elli, C., Cru t h ir ds, T., & H alk el, J. E. (19 89 ). Tr a inin g r espon ses of pla sm a - en d or ph in, a dr en ocort ico- t r opin, a n d cort isol. M d e. S ci. S p ort s Ex erc., 2 1 (2 ), Lee, J. Y. (1994 ). Ca r e of m en op au se. T h e Korean S ociety of M en op au se. Lu st in g, A. (19 9 1). Weigh t Loss pr ogr a m s. F a ilin g t o m eet et h ica l st a n dar d? J.A m. Dit e. A ssoc., 9 1, Ma rt in, L. F., & Hu nt er, S. M. (199 5). Sever e obesit y : expen sive t o societ y, fru st r at in g t o t r ea t, bu t im port a nt t o confr ont. S ou t h M ed J 8 Lu st in g A (199 1) :Weigh t Loss pr ogr am s. F a ilin g t o m eet et h ica l st a n dar d? J.A m. Dit e. A ssoc., 9 1, , Min ist ry on H ea lt h a n d Welfa r e (199 7 ). '9 5 R esu lt of p u blic nu t rit ion su rv ey Rosen ber g, M. (196 5). S ociety an d t h e A d olescent S elf -Im age. Pr in cet on, N J : Prin cet on U niver sit y P r ess. Ryu, R. K. (1997 ). A S t u dy on t h e b eh av ioral m odificat ion for j u v en nile ob ese m an agem ent an d applicat ion of aerobic ex ercise program. U n pu blish ed doct or a l dissert a t ion, Th e Myon g J i U niver sit y. Seal, D. R., H a gber g, J. M., Hu r ley, B. F., Eh sa m i, A. A., H olloszy, J. O. (1984b ). Effect s of en du r a n ce t r a nin g on glu cose t oler a n ce a n d pla sm a lipid level in old er m en a n d w om en. J. A m. M ed. A ssoc., 2 52, Sh in, H. J. (19 92 ). T h e S t u dy of Ob esit y in m iddle sch ool st u dent t o a ev alu at ion of n eeds. U n pu blish ed d oct or a l dissert a t ion. Kor ea Sport U niver sit y. Sk elt on, N. K., & Sk elt on, W. P. (1992 ). Medical im plica t ion of ob esit y. p ost grad m ed 92, St en a la n d, S. H., Ma r golis, S. (19 82 ). Sim plifyin g t h e ca lcu lat in g of b ody m a ss in dex for qu ick r efer en ce. J. A m. diet. A ssoc., 90 (6 ), 8 56 Va n sa nt, G., Hu len s, M., Va n der Bor gh t, W., Dem yt t en a er e, K., Lysen s, R., & Mu ls, E

11 A. (1999 ). m u lt i- disciplin ar y a p pr oa ch t o t h e t r ea t m en t of ob esit y. Int J Obes 23 (Su p pl 1), Wa d den, T. A. (199 3 ). T h e t ret m en t of ob esit y : A n ov erv iew. in obesity t h eory an d t h erapy. 2n d ed. N ew York : Raven Pr ess. Wilm or e, J. H., Cost ill, D. L. (1988 ). Tr a inin g for spor t a n d a ct ivit y. Iowa Pu b. : Wm. c. Br own Wood, D. D., H a sk ell, W., Klein, H., & Leis, S. (1976 ). Th e dist ribu t ion of pla sm a lip opr ot ein in middle- a ged ru n n er s. M et ab olism. 2 5 (11), Zem a n, F. J. (199 1). Clinical N u t rit ion & Diet et ics. McMilla n Pu bl Com p, NY, Ab s t r a c t - Th e Effe ct s of Ex er cis e Th er a p y a n d Ex er cis e- Beh avior Mod ifica t ion Th er a p y on Ob e s it y, Bloo d Lip id s, a n d Self- e s t eem of t h e Ob es e Mid d le- a ge d Wom en * Kim, In -Hon g * P u r p o s e : To exa m in e t h e effect of t h e exer cise t h er a py, a n d exer cise- beh avior m odifica t ion t h er a py on obesit y, blood lipids a n d self- est eem of t h e obese m iddle- a ged wom en. Me t h o d : A t ot a l of 3 5 m iddle- a ged wom en (BMI : over 30 ) wer e select ed for t h is r esea r ch. Walk in g at a 50 % int en sit y w a s a dm inist er ed 4 da ys a w eek for 12 week s, wh ile t h e b eh a vior m odifica t ion t h er a py p er for m ed for 60 ~ 9 0 m inu t es per w eek for 12 week s. Re s u l t : Body weigh t a n d BMI h a s significa nt ly r edu ced in t h e ca se of EG a n d E BG. Th e r esu lt of com pa rin g b ody weigh t b et ween gr ou ps sh owed significa nt differ en ce b et ween E G a n d CG, a n d E BG a n d CG wh er ea s BMI sh owed significa nt differ en ce b et ween E G a n d CG only. TC, TG, LDL- C, %TC/ H DL- C h a ve sh ow n sign ifica n t decr ea se in E G a n d E- BG, wh ile H DL- C displayed significa nt in cr ea se in E G a n d E BG. An d H DL- C sh ow ed significa nt decr ea se in CG. As for com par ison b et ween gr ou ps, significa nt differ en ce w a s n ot ed in E G a n d CG, a n d E BG a n d CG a t TC, H DL- C, LDL- C, a n d in E G a n d CG a t %TC/ H DL- C. Self- est eem displayed significa nt in cr ea se in EG a n d E BG ; h owever, t h er e wa s n o significa nt differ ent in CG. As for com pa rison bet w een gr ou ps, t h er e w a s significa nt differ en ce n ot ed in E BG a n d CG only. Co n c lu s i o n : Th e r esu lt s sh owed t h a t t h e exer cise t h er a py a n d t h e exer cise- beh avior m odifica t ion t h er a py wer e effect ive in ch a n gin g ob esit y, blood lipids a n d self- est eem of t h e ob ese m id dle- a ged w om en. Ke y w o rd s : Exer cise t h er a py, Beh a vior m odifica t ion t h er a py, Ob esit y, Blood lipids, Self- est eem * This work wa s supp ort ed by t h e Don ggu k Un iver sit y Resear ch F u n d in ** Departm ent of Nur sing, College of Medicin e, Dongguk Univer sity

완성09E02박은숙.PDF

완성09E02박은숙.PDF : * 1 ) 2 ) 3 ) 4 ) 1 ) 5 ) 6 ). 1.,., (cont ent - ba sed cu rricu la ) (pr ocess- b a sed cu rricu la ),,,,,., -, (Ben -Zu r, Ya gil & Spit zer, 1999 ; H egge, 19 9 5 ; Oer m a n n, 19 94 : Spit ser,