A 2023 Daejeon survey, and how reduction was measured

Kim Jeong-won’s 2023 master’s thesis at Daejeon University looks at midlife women’s behavior to reduce exposure to endocrine-disrupting chemicals, using the information-motivation-behavioral skills model. Midlife is placed as a turn when aging begins in earnest, and midlife women often carry a family’s first care and can lose the chance to look after themselves; the thesis notes a higher incidence of chronic illness than in men and a lower rate of practiced health behavior, a point left as it is placed.

After IRB approval, women aged 40 to 64 were recruited from the top ten women’s community cafés in Korea; of 269 online responses, 250 were analyzed. The 2009 Kim Mi-ra and Kim Hyo-jeong scale, 23 items, is scored so that a lower score means more active reduction. Knowledge, a modified 2015 motivation scale, Sherer’s 1982 self-efficacy scale, and Zimet’s 1988 social-support scale were also used, with the reliabilities the 2023 thesis records.

What the 2023 results found, and a nursing reading

In that sample the mean age was about 49, and the mean reduction-behavior score sat at a mid-level of practice. The strongest influence was self-efficacy (beta minus 0.450, p less than .001); because of how the 2009 scale is scored, higher self-efficacy went with more practiced reduction. Subjective health called “bad,” having a religion, and regular exercise also went with more practice, as the 2023 coefficients place them.

The report’s nursing reading is to put self-efficacy first in counseling, with small doable goals and clear feedback, and not to stop at information: regular exercise sessions at a hospital or a local public-health center, with teaching about endocrine disruptors in the same setting, are suggested. This page stays with the 2023 sample and coefficients, and does not add later official exposure or illness figures. The same Korean report, at fuller length, is on CampusDown.

Sources

1. This page reads a practice-application report on Kim Jeong-won’s 2023 master’s thesis at the general graduate school of Daejeon University, in Daejeon, titled Factors Influencing Midlife Women’s Behavior to Reduce Exposure to Endocrine-Disrupting Chemicals. The writer, studying nursing, chose the work in a time when talk of a “hundred-year life” feels close at hand, and midlife women’s health is treated as more than a private matter: it is an important element in keeping a family’s and a society’s health. Midlife is an important turn from the first half of life to the second, and a time when physical aging begins in earnest. Midlife women carry out many tasks at home and in society, and the chance that their own health care will be neglected is high, which is why they are seen as a group that needs still more attention. The writer had long been interested, as a nursing student, in the relation between the endocrine system and health behavior. Endocrine-disrupting chemicals, also called environmental hormones, interfere with normal hormone action in the body, and the question of their effect on midlife women’s reproductive health and on health more generally is not only an environmental question but a good nursing subject. The thesis analyzes factors that influence midlife women’s behavior to reduce such exposure, and it is also a relatively recent paper. Class work on the harm of these chemicals made the writer feel that the subject could have implications for actual nursing practice, not only for academic interest: offering patients and families concrete ways to reduce exposure, through nursing intervention, would have a real advantage in protecting health. The study applied the information-motivation-behavioral skills (IMB) model to midlife women’s reduction behavior, and it also offered a chance to think about how the research could be used in nursing practice and what limits might arise in that use. The study set out to analyze the factors that influence midlife women’s behavior to reduce exposure to endocrine-disrupting chemicals. The main keywords were midlife women, endocrine-disrupting chemicals, reduction behavior, and the IMB model, and the aim was to look for a way of keeping midlife women’s health and raising the quality of life. Midlife is an important turning point, a time when, along with physical aging, psychological change also appears in earnest. Women in this period often hold the first responsibility for caring for a family, and they easily lose the chance to care for their own health. For this reason, the incidence of chronic illness is higher than in men, and the rate of practiced health behavior is lower, as the thesis places that comparison, without a later official rate. The problem is treated as important because it goes beyond a midlife woman’s own health to the health of a family and, further, of society as a whole. Recently, endocrine-disrupting chemicals (EDCs) have drawn notice as a new threat to midlife women’s health. They are substances easily met in daily life, in the environment, in food, and in household goods, and when absorbed into the body they are known to be able to interfere with hormone function and to lead to reproductive abnormalities, cancer, disorders of neural development, and so on. Midlife women are placed in an environment in which they are easily exposed, through cosmetics, plastic containers, disposables, and the like, and because of hormone changes before and after menopause they may be more affected. Existing research, the thesis says, had the limit of not clearly identifying practical factors that could promote reduction behavior. This study therefore set out to use the IMB model. The IMB model was used to study three main elements needed to form a health behavior — information, motivation, and behavioral skill — and it can be used as an effective tool to induce reduction behavior by raising midlife women’s knowledge of endocrine-disrupting chemicals, strengthening motivation and self-efficacy, and improving practical behavioral skill. The purpose was to analyze how knowledge of endocrine-disrupting chemicals, motivation for reduction behavior, self-efficacy, and social support affect reduction behavior, and to prepare an effective way of reducing exposure. Data were collected by an online survey. The subjects were midlife women aged 40 or older and 64 or younger, recruited from the top ten women’s community cafés in Korea. Those who could understand a Korean-language questionnaire were included, and participants were recruited after prior consent; selection was limited to people who had voluntarily agreed to take part. After IRB approval, the online questionnaire was provided through a Google survey link. It was composed of items asking about general characteristics, health-related characteristics, knowledge related to endocrine-disrupting chemicals, motivation, self-efficacy, social support, and reduction behavior. A total of 269 survey responses were collected, and after 19 insincere responses were excluded, data from 250 forms were used in the final analysis. The data were managed on the basis of IRB approval, and participants’ personal information and anonymity were carefully protected. Completing the survey took about 15 to 20 minutes, and participants were given a mobile gift certificate as compensation. The instrument for reduction behavior was the tool developed by Kim Mi-ra and Kim Hyo-jeong (2009), a Likert scale of 23 items in all. A lower score means that reduction behavior is more active. Reliability was very high, with Cronbach’s alpha of .90. The knowledge instrument was composed of 24 items asking about knowledge of household goods, food containers, related illness, and so on; a higher score means a higher level of related knowledge, and reliability was Kuder-Richardson 20 of .92. The motivation instrument modified the eco-behavior scale of Kim Su-ji and others (2015) to measure personal motivation and social motivation separately, eight items in all, with Cronbach’s alpha of .89. The self-efficacy instrument used the perceived self-efficacy scale of Sherer and others (1982) to measure self-efficacy for reduction behavior, 17 items, with Cronbach’s alpha of .85. The social-support instrument was based on the social-support scale of Zimet and others (1988), measuring family, friends, and special support, 12 items, with Cronbach’s alpha confirmed at .83. The report notes that verified instruments were used to raise reliability, that anonymity and ethical questions were carefully considered in the survey, that IRB approval established the appropriateness and ethical basis of the design, and that voluntary participation was sought in the collection of data. According to the 2023 results, the mean age of the midlife women was 49.37 plus or minus 5.34 years. A majority of the subjects held a university degree or higher (66.4 percent), and 72.0 percent had an occupation. Respondents with no religion were more numerous, at 61.2 percent, and in type of living together the most common case, at 44.8 percent, was living with a spouse and children. Family monthly income of 5 million won or more was 66.4 percent, which the thesis takes as showing economic stability. In health-related characteristics, 59.2 percent of the subjects were exercising regularly, and the most common answer for subjective health, at 53.2 percent, was “average.” Those who had experienced a reproductive-system illness were 62.4 percent, and those with past or current experience of hormone treatment reached 71.2 percent. The mean score for reduction behavior was 61.70 plus or minus 16.69, showing a mid-level rate of practice. The mean knowledge score was 13.25 plus or minus 6.67, motivation for reduction behavior 41.12 plus or minus 10.49, self-efficacy 57.66 plus or minus 10.66, and social support 43.50 plus or minus 8.66. Whether the subject practiced regular exercise, and subjective health, showed a significant difference in reduction behavior. Whether one had a religion, monthly income, and whether one had heard of endocrine-disrupting chemicals also appeared as variables affecting the rate of practiced behavior. The factor with the greatest influence on reduction behavior was confirmed to be self-efficacy (beta equals minus 0.450, p less than .001). Subjects with high self-efficacy tended to practice reduction behavior better. In addition, when subjective health was answered as “bad” (beta equals minus 0.178, p equals .001), when the person had a religion (beta equals minus 0.172, p equals .002), and when the person exercised regularly (beta equals minus 0.141, p equals .008), the rate of practiced reduction behavior was also high. Because a lower score on the 2009 scale means more active reduction, the negative coefficients are in the direction of more practiced reduction, which is also how the report reads the findings. The study presented self-efficacy as important in reduction behavior, and also presented the need for a subjective sense of health and for regular exercise. It therefore suggested that, in order to promote midlife women’s health behavior, a strengthening of self-efficacy and a practical strategy for a change in behavior are needed. According to the research, self-efficacy was the strongest factor deciding reduction behavior, and the higher the self-efficacy, the higher the rate of practiced behavior. This suggests that a nurse, in education or counseling with a subject, should consider first a strategy for raising self-efficacy. To raise it, it would be effective to offer concrete, practicable guidance for action and to give positive feedback on a change in behavior. It is important to help a subject recognize the risk of endocrine-disrupting chemicals and to practice, in real life, concrete actions that can reduce exposure. The study also found that regular exercise and subjective health had a significant effect on reduction behavior. When a health-promotion program is designed in nursing practice, this shows the need for a comprehensive approach that does not stop at health education, but can improve the subject’s physical activity and daily habits at the same time. For a subject whose subjective health is poor, exercise is important, and psychological support is needed so that the person can look at their own health more positively. This could not only promote a change in behavior but also raise the overall quality of life. If these results are used in nursing practice, it would be important to design a nursing intervention that raises each patient’s self-efficacy in order to promote reduction behavior. As one example, a method that, in counseling with a patient, establishes a concrete plan of action and sets small goals so that the person can feel a sense of accomplishment may be effective. It is also necessary to offer practical feedback so that the patient can feel, through their own change in behavior, a positive change. In addition, by offering educational materials or success cases related to exposure, one could help a patient become confident of the effect of their change in behavior on health, and strengthen motivation. The writer also thinks it necessary, in nursing practice, to design a program that encourages regular exercise. Exercise, this study confirmed, is closely tied not only to keeping physical health but also to reduction behavior. If a hospital or a local public-health center were to run exercise sessions for midlife women on a regular basis, and in that setting also teach about endocrine-disrupting chemicals, a change in behavior could be induced more effectively. Feedback should be given continuously, and the program improved, so that patients taking part in an exercise program can experience not only physical health but also emotional stability and a change in behavior. As a nurse, such a practical approach could help patients toward a real and lasting change in behavior, beyond the mere provision of information. The writer learned that solving midlife women’s exposure problem need not depend only on a change in an individual’s behavior, but can be done more effectively through a nurse’s active intervention and support, and confirmed in a concrete way the effect of self-efficacy on the rate of practiced behavior, seeing the need for a tailored strategy to strengthen self-efficacy in the nursing field. The main content of the study was to analyze the factors that influence midlife women’s reduction behavior, and to see how self-efficacy, subjective health, and daily habits affect that behavior. The results found that the higher the self-efficacy, the higher the rate of practiced reduction, and that subjective health and whether regular exercise was practiced acted as important variables. This page stays with the 2023 sample, means, percentages, and coefficients as the thesis places them, and does not add later official exposure figures or later official illness tallies.

Last updated: 14 November 2026