Health-Oriented Tourists and Sustainable Domestic Tourism
Abstract
:1. Introduction
2. Literature Review
2.1. Definition of Health: Psychological, Physical, and Social Domains
2.2. The Impacts of Travel on Health
2.3. Health and Wellness Tourism
3. Methodology
3.1. The Survey Process
3.2. Health-Contributing Items in the Questionnaire
4. Results
4.1. Demographic Characteristics of Participants
4.2. The Frequency of Health-Contributing Travel Items
4.3. The Psychological Health-Contributing Travel Experience
4.4. The Physical Health-Contributing Travel Experience
4.5. Social Health-Contributing Travel Experiences
5. Discussion
6. Conclusions
6.1. Theoretic Contribution
6.2. Practical Implications
6.3. Limitations and Further Research
Author Contributions
Funding
Conflicts of Interest
References
- Dolnicar, S.; Yanamandram, V.; Cliff, K. The contribution of vacations to quality of life. Ann. Tour. Res. 2012, 39, 59–83. [Google Scholar] [CrossRef] [Green Version]
- Han, J.-S.; Lee, T.J.; Ryu, K. The promotion of health tourism products for domestic tourists. Int. J. Tour. Res. 2018, 20, 137–146. [Google Scholar] [CrossRef]
- Hoheb, C. Wellness Tourism. In The Sage International Encyclopedia of Travel & Tourism; Lowry, L.L., Ed.; Sage: Thousand Oaks, CA, USA, 2017; pp. 1433–1436. [Google Scholar]
- Cho, H.; Lee, T.J. Stakeholders in the medical trade: The case of South Korea’s networks with China and the United States. Int. J. Tour. Res. 2020. [Google Scholar] [CrossRef]
- Cooper, M.; Vafadari, K.; Hieda, M. Current Trends and Emerging Issues in Medical Tourism; IGI Global Press: Hershey, PA, USA, 2015. [Google Scholar]
- McCabe, S.; Johnson, S. The happiness factor in tourism: Subjective well-being and social tourism. Annal. Tour. Res. 2013, 41, 42–65. [Google Scholar] [CrossRef]
- Yoo, I.Y.; Lee, T.J.; Lee, C.K. Effect of health and wellness values on festival visit motivation. Asia Pac. J. Tour. Res. 2015, 20, 152–170. [Google Scholar] [CrossRef]
- Chen, K.H.; Chang, F.H.; Tung, K.X. Measuring wellness-related lifestyles for local tourists in Taiwan. Tour. Anal. 2014, 19, 369–376. [Google Scholar] [CrossRef]
- Choi, K.; Meng, B.; Lee, T.J. An investigation into the segmentation of Japanese traditional “Ryokan” hotels using selection attributes. J. Vacat. Mark. 2018, 24, 324–339. [Google Scholar] [CrossRef]
- Choi, K.; Lee, T.J.; Kim, H.K. Strategic marketing development of hospitals participating in medical tourism: A case of South Korea. Tour. Anal. 2015, 20, 129–136. [Google Scholar] [CrossRef]
- Yu, J.; Lee, T.J.; Noh, H. Characteristics of a medical tourism industry: The case of South Korea. J. Travel Tour. Market. 2011, 28, 856–872. [Google Scholar] [CrossRef]
- Kim, S.S.; Lee, J.; Jung, J. Assessment of medical tourism development in Korea for the achievement of competitive advantages. Asia Pac. J. Tour. Res. 2013, 18, 421–445. [Google Scholar] [CrossRef]
- Lin, C.H. Determinants of revisit intention to a hot springs destination: Evidence from Taiwan. Asia Pac. J. Tour. Res. 2013, 18, 183–204. [Google Scholar] [CrossRef]
- Chang, L. The relationship between nature-based tourism and autonomic nervous system function among older adults. J. Travel Med. 2014, 21, 159–162. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Erfurt-Cooper, P.; Cooper, M. Health & Wellness Spa Tourism, Aspects of Tourism Series; Channel View Press: London, UK, 2009. [Google Scholar]
- Gilbert, D.; Abdullah, J. Holiday taking and the sense of well-being. Ann. Tour. Res. 2004, 31, 103–157. [Google Scholar] [CrossRef]
- Hjalagera, A.M.; Flagestad, A. Innovations in well-being tourism in the Nordic countries. Curr. Issues Tour. 2012, 15, 725–740. [Google Scholar] [CrossRef]
- Lee, C.F.; Ou, W.M.; Huang, H.I. A study of destination attractiveness through domestic visitors’ perspectives: The case of Taiwan’s hot springs tourism sector. Asia Pac. J. Tour. Res. 2009, 14, 17–38. [Google Scholar] [CrossRef]
- Orsega-Smith, E.; Mowen, A.J.; Payne, L.L.; Godbey, G. The interaction of stress and park use on psycho-physiological health in older adults. J. Leis. Res. 2004, 36, 232–256. [Google Scholar] [CrossRef]
- Hieda, M. The Psychology of Medical Tourism. In Current Issues and Emerging Trends in Medical Tourism; Cooper, M., Vafadari, K., Hieda, M., Eds.; IGI Global: New York, NY, USA, 2015; pp. 44–57. [Google Scholar]
- Kim, H.J.; Lee, T.J.; Ko, T.G. A comparative study of health tourism seekers and non-seekers’ satisfaction and subjective well-being evaluation: The case of Japanese and Korean tourists. J. Travel Tour. Market. 2016, 33, 742–756. [Google Scholar] [CrossRef]
- Walker, T.; Lee, T.J. Visitor and resident perceptions of the slow city movement: The case of Japan. Int. J. Tour. Sci. 2019, 19, 112–127. [Google Scholar] [CrossRef]
- Güzel, O.; Sahin, I.; Ryan, C. Push-motivation-based emotional arousal: A research study in a coastal destination. J. Destin. Market. Manag. 2020, 16, 100428. [Google Scholar] [CrossRef]
- Strauss-Blasche, G.; Reithofer, B.; Schobersberger, W.; Ekmekcioglu, C.; Wolfgang, M. Effect of vacation on health: Moderating factors of vacation outcome. J. Travel Med. 2005, 12, 94–101. [Google Scholar] [CrossRef] [Green Version]
- Sopha, C.; Jittithavorn, C.; Lee, T.J. Cooperation in health and wellness tourism connectivity between Thailand and Malaysia. Int. J. Tour. Sci. 2019, 19, 248–257. [Google Scholar] [CrossRef]
- Smith, M.; Puczko, L. Health and Wellness Tourism; Butterworth-Heinemann: London, UK, 2010. [Google Scholar]
- Voigt, C.; Brown, G.; Howat, G. Wellness tourists: In search of transformation. Tour. Rev. 2011, 66, 16–30. [Google Scholar] [CrossRef]
- Finnicum, P.; Zeiger, J.B. Tourism and wellness: A natural alliance in a nature state. Parks Recreat. 1996, 31, 84–95. [Google Scholar]
- Bookman, M.Z.; Bookman, K.R. Medical Tourism in Developing Countries; Palgrave Macmillan: New York, NY, USA, 2007. [Google Scholar]
- Laesser, C. Health travel motivation and activities: Insights from a mature market—Switzerland. Tour. Rev. 2011, 66, 83–89. [Google Scholar] [CrossRef]
- Lim, Y.J.; Kim, H.K.; Lee, T.J. Visitor motivational factors and level of satisfaction in wellness tourism: Comparison between first-time visitors and repeat visitors. Asia Pac. J. Tour. Res. 2016, 21, 137–156. [Google Scholar] [CrossRef]
- Brannon, L.; Feist, J. Health Psychology: An Introduction to Behavior and Health, 5th ed.; Thomson: London, UK, 2004. [Google Scholar]
- Sanderson, C.A. Health Psychology; John Wiley & Sons: Hoboken, NJ, USA, 2004. [Google Scholar]
- McGinnis, J.M.; Foege, W.H. Actual causes of death in the United States. J. Am. Med. Assoc. 1993, 270, 2207–2212. [Google Scholar] [CrossRef]
- World Health Organization. Executive Board, 101st Session, Geneva, 19–27 January 1998: Summary Records; World Health Organization: Geneva, Switzerland, 1998. [Google Scholar]
- Wellness Tourism Worldwide. 4WR: Wellness for Whom, Where and What? Wellness Tourism 2020 Full Report; Xellum: Budapest, Hungary, 2011. [Google Scholar]
- Moon, S.; Choi, M. Health Administration, 4th ed.; Bomungak: Seoul, Korea, 2011. [Google Scholar]
- Naidoo, J.; Wills, J. Foundations for Health Promotion, 3rd ed.; Elsevier Health Sciences: London, UK, 2009. [Google Scholar]
- Hills, P.; Argyle, M. The Oxford Happiness Questionnaire: A compact scale for the measurements of psychological well-being. Personal. Individ. Differ. 2002, 33, 1073–1082. [Google Scholar] [CrossRef]
- Lee, K.H.; Lee, T.J. Opportunities and issues in the health tourism industry: Deep sea water development in Taiwan. Tour. Anal. 2015, 20, 419–424. [Google Scholar] [CrossRef]
- Bradburn, N.M. The Structure of Psychological Well-Being; Aldine: Chicago, IL, USA, 1969. [Google Scholar]
- Lawton, M.P. The dimension of moral. In Research Planning and Action for the Elderly: The Power and Potential of Social Science; Kent, D.P., Kasternbaum, R., Sherwood, S., Eds.; Behavioral Publications: New York, NY, USA, 1972; pp. 144–165. [Google Scholar]
- Goldberg, D.P. The Detection of Psychiatric Illness by Questionnaire; Oxford University Press: London, UK, 1972. [Google Scholar]
- Fazio, A.F. A concurrent validational study of the NCHS General Well-being Schedule. Vital Health Stat. 1977, 73, 1–53. [Google Scholar]
- Veit, C.T.; Ware, J.E., Jr. The structure of psychological distress and well-being in general populations. J. Consult. Clin. Psychol. 1983, 51, 730–742. [Google Scholar] [CrossRef]
- Keyes, C.L.M. Mental illness and/or mental health? Investigating axioms of the complete state model of health. J. Consult. Clin. Psychol. 2005, 73, 539–548. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Ryff, C.D.; Singer, B. Psychological well-being: Meaning, measurement, and implications for psychotherapy research. Psychother. Psychosom. 1996, 65, 14–23. [Google Scholar] [CrossRef] [PubMed]
- Macmillan, A.M. The health opinion survey: Technique for estimating prevalence of psychoneurotic and related types of disorder in communities. Psychol. Rep. 1957, 3, 325–329. [Google Scholar] [CrossRef]
- Ware, J.E.; Kosinski, M. Interpreting SF-36 summary health measures: A response. Qual. Life Res. 2001, 10, 405–413. [Google Scholar] [CrossRef]
- Pfeffer, R.I.; Kurosaki, T.T.; Harrah, C.H., Jr.; Chance, J.M.; Filos, S. Measurement of functional activities in older adults in the community. J. Gerontol. 1982, 37, 323–329. [Google Scholar] [CrossRef] [PubMed]
- Sarason, I.G.; Levine, H.M.; Basham, R.B.; Sarason, B.R. Assessing social support: The social support questionnaire. J. Personal. Soc. Psychol. 1983, 44, 127–139. [Google Scholar] [CrossRef]
- Chou, K. Assessing Chinese adolescents’ social support: The multidimensional scale of perceived social support. Personal. Individ. Differ. 2000, 28, 299–307. [Google Scholar] [CrossRef]
- McFarlane, A.H.; Neale, K.A.; Norman, G.R.; Roy, R.G.; Streiner, D.L. Methodological issues in developing a scale to measure social support. Schizophr. Bull. 1981, 7, 90–100. [Google Scholar] [CrossRef] [Green Version]
- Billings, A.G.; Moos, R.H. Social support and functioning among community and clinical groups: A panel model. J. Behav. Med. 1982, 5, 296–311. [Google Scholar] [CrossRef]
- Gianfredi, V.; Albano, L.; Basnyat, B.; Ferrara, P. Does age have an impact on acute mountain sickness? A systematic review. J. Travel Med. 2020. [Google Scholar] [CrossRef]
- Jo, S. The study of tourist stress on overseas traveling. J. Glob. Acad. Market. Sci. 2006, 16, 27–43. [Google Scholar]
- Swarbrooke, J.; Horner, S. Consumer Behavior in Tourism; Butterworth-Heinemann: Oxford, UK, 2007. [Google Scholar]
- Gan, L.L.; Frederick, J.R. Medical tourism facilitators: Patterns of service differentiation. J. Vacat. Market. 2011, 17, 165–183. [Google Scholar] [CrossRef]
- Rodrigues, A.; Kastenholz, E.; Rodrigues, A. Hiking as a wellness activity: An exploratory study of hiking tourists in Portugal applied to a rural tourism project. J. Vacat. Market. 2010, 16, 331–343. [Google Scholar] [CrossRef]
- Rest in Korea. 2013. Available online: http://www.restinkorea.com/default_eng.asp (accessed on 10 July 2013).
- Veal, A.J. Research Methods for Leisure and Tourism: A Practical Guide, 3rd ed.; Pearson Education: Edinburgh Gate, UK, 2006. [Google Scholar]
- Austin, D.R. Therapeutic Recreation: Processes and Techniques, 6th ed.; Sagamore: Champaign, IL, USA, 2009. [Google Scholar]
- Fredrickson, B.L.; Losada, M.F. Positive affect and the complex dynamics of human flourishing. Am. Psychol. 2005, 60, 678–686. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Fredrickson, B.L.; Mancuso, R.A.; Branigan, C.; Tugade, M. The undoing effect of positive emotions. Motiv. Emot. 2000, 24, 237–258. [Google Scholar] [CrossRef] [PubMed]
Element | |
---|---|
Psychological health |
|
Physical health |
|
Social health |
|
Measuring point | Scale | |
---|---|---|
Good mood (excitement, interested, calm, contentment, happiness, the experience of the best), or not feeling bad (boredom, not happy, soreness, loneliness, restlessness). | The Affect Balance Scale [41], The Philadelphia Geriatric Center Morale Scale [42], The General Health Questionnaire [43], The General Well-Being Schedule [44], The Rand Mental Health Inventory [45], Oxford Happiness Questionnaire [39], The Mental Health Continuum-Short Form (MHC-SF) [46]. | |
Psycho-logical health | Life satisfaction, satisfaction with every lived day, and current status. | The Philadelphia Geriatric Center Morale Scale [42], The General Health Questionnaire [43], The Rand Mental Health Inventory [45], Psychological Well-Being Scale [47], Oxford Happiness Questionnaire [39]. |
Self-control (stress management skills, emotion regulation skills, thoughts, feelings, feelings of control). | The General Health Questionnaire [43], The General Well-Being Schedule [44], The Rand Mental Health Inventory [45], Psychological Well-Being Scale [47], Oxford Happiness Questionnaire [39]. | |
Confidence, belief in self, self-esteem. | The General Health Questionnaire [43], Psychological Well-Being Scale [47], Oxford Happiness Questionnaire [39]. | |
Appetite, gastrointestinal functioning, quality of sleeps, fatigue, cold sweat. | Health Opinion Survey [48], The SF-36 Health Measures [49]. | |
Physical health | Activities, body movement. | The Functional Activities Questionnaire [50], The SF-36 Health Measures [49]. |
Activities and energy. | The General Well-Being Schedule [44], The SF-36 Health Measures [49]. | |
Healthy feeling. | Health Opinion Survey [48], The SF-36 Health Measures [49]. | |
Social support: having person(s) who talk to each other and are happy to be with others. | The Social Support Questionnaire [51], Multidimensional Scale of Social Support [52]. | |
Social health | Intimacy, trust, respect, and self-expression in social relationships. | The Social Relationship Scale [53], The Family Relationship Index [54], Multidimensional Scale of Social Support [52], Psychological Well-Being Scale [47], Oxford Happiness Questionnaire [39]. |
Intimacy and exchange with family, neighbors, and participation in group activities. | Multidimensional Scale of Social Support [52]. |
Time | Schedule |
---|---|
07:00 | Departure from Seoul. |
10:30~11:40 | Visit to a historical heritage site where local historic celebrity family lived in the 16th Century. |
11:40~13:00 | Lunch with traditional healthy meal with organic food distinctively provided in the local Gangneung area. |
13:00~14:30 | Therapeutic walk in the pine forest. Experience of traditional health tea ceremony and learning about etiquette and how to make the healthy herbal tea. |
14:30~16:30 | Coffee tasting (well-known in the Gangneung countrywide) experience and roasting. Therapeutic walk in the forest along the ocean beach next to black pine forest. Wishing a happy New Year while enjoying pine forest, and the beach in the East Sea (4 km stretch). |
16:30 | Departure from Gangneung to return to Seoul. |
Time | Schedule |
---|---|
07:00 | Departure from Seoul. |
10:30~12:00 | Mountain-hike 300 m above sea level, walk passing through natural arboretum. Wishing a happy New Year watching mountain and the East Sea. |
12:00~13:00 | Lunch with healthy vegetarian ‘Buddhist temple food’ (macrobiotic food). |
13:00~15:00 | Visit to local health tourism sites and local culture exhibition hall. Coffee roasting experience at one of the most famous coffee shops in Korea. Relaxing with a cup of herbal tea while watching the beautiful winter scenery of the East Sea. |
15:00~16:30 | Visiting a famous film-induced tourism site in the local area (location of a popular TV drama). Visit to Sandglass Park and a local museum. |
16:30 | Departure from Gangneung to return to Seoul. |
GYEONGPO (GP) (n = 435) | Jeongdongjin (JDJ) (n = 427) | Total (n = 862) | |||||
---|---|---|---|---|---|---|---|
Number | Ratio | Number | Ratio | Number | Ratio | ||
Gender | Male | 89 | 20% | 116 | 27% | 205 | 24% |
Female | 346 | 80% | 311 | 73% | 657 | 76% | |
Age | 18 to 20 | 20 | 5% | 17 | 4% | 37 | 4% |
21 to 30 | 21 | 5% | 24 | 6% | 45 | 5% | |
31 to 40 | 36 | 8% | 23 | 5% | 59 | 7% | |
41 to 50 | 72 | 17% | 70 | 16% | 142 | 16% | |
51 to 60 | 183 | 42% | 177 | 41% | 360 | 42% | |
61 or older | 103 | 24% | 116 | 27% | 219 | 25% | |
Companion | Family | 222 | 51% | 242 | 57% | 464 | 54% |
Friend | 150 | 34% | 129 | 30% | 279 | 32% | |
Partner | 12 | 3% | 14 | 3% | 26 | 3% | |
Colleague | 31 | 7% | 23 | 5% | 54 | 6% | |
Others | 20 | 5% | 19 | 4% | 39 | 5% | |
Area of residence | Seoul City | 289 | 66% | 281 | 66% | 570 | 66% |
Gyeonggi Province | 102 | 23% | 115 | 27% | 217 | 25% | |
Incheon City | 41 | 9% | 28 | 7% | 69 | 8% | |
Others | 3 | 1% | 3 | 1% | 6 | 1% | |
Occupation | Office worker | 105 | 24% | 108 | 25% | 213 | 25% |
Self-employed | 28 | 6% | 42 | 10% | 70 | 8% | |
Service / Sales | 32 | 7% | 22 | 5% | 54 | 6% | |
Student | 31 | 7% | 23 | 5% | 54 | 6% | |
Housewife | 200 | 46% | 194 | 45% | 394 | 46% | |
Others | 39 | 9% | 38 | 9% | 77 | 9% |
GP * (n = 435) | JDJ ** (n = 427) | Total (n = 862) | ||||
---|---|---|---|---|---|---|
Number | Ratio | Number | Ratio | Number | Ratio | |
Psychological health | ||||||
1. Experience of good feeling. | 291 | 67% | 303 | 71% | 595 | 69% |
2. Accepting myself as I am. | 104 | 24% | 115 | 27% | 220 | 25% |
3. Seeing myself in a positive way. | 117 | 27% | 98 | 23% | 216 | 25% |
4. Getting out of bad feelings. | 113 | 26% | 98 | 23% | 211 | 25% |
5. Gaining the strength to control myself. | 87 | 20% | 85 | 20% | 172 | 20% |
6. Regaining confidence. | 74 | 17% | 90 | 21% | 164 | 19% |
7. Improving self-esteem. | 74 | 17% | 77 | 18% | 151 | 17% |
8. Enhancing self-belief. | 78 | 18% | 64 | 15% | 142 | 17% |
9. Thinking that I’m great. | 70 | 16% | 64 | 15% | 134 | 16% |
10. Gaining power to solve problems. | 48 | 11% | 43 | 10% | 91 | 11% |
11. Others. | 26 | 6% | 30 | 7% | 56 | 6% |
Physical health | ||||||
1. Eating organic or healthy foods. | 331 | 76% | 273 | 64% | 604 | 70% |
2. Feeling natural energy being charged in my body. | 200 | 46% | 205 | 48% | 405 | 47% |
3. Awakening five senses with natural encounter. | 183 | 42% | 201 | 47% | 383 | 44% |
4. Making more activities than usual. | 174 | 40% | 201 | 47% | 375 | 43% |
5. Feeling healthier while traveling. | 178 | 41% | 162 | 38% | 341 | 40% |
6.Increased appetite and better digestion. | 117 | 27% | 107 | 25% | 224 | 26% |
7. Relaxing tense body. | 100 | 23% | 77 | 18% | 177 | 21% |
8. Reflecting my body and recognizing what is important. | 91 | 21% | 81 | 19% | 172 | 20% |
9. Others. | 13 | 3% | 9 | 2% | 22 | 3% |
Social health | ||||||
1. Improving relationship with people traveling together. | 222 | 51% | 222 | 52% | 444 | 51% |
2. Understanding and respecting those who travel together more. | 170 | 39% | 162 | 38% | 332 | 39% |
3. Having more opportunities to talk to people traveling together. | 170 | 39% | 158 | 37% | 328 | 38% |
4. Deepening trust with people traveling together. | 135 | 31% | 124 | 29% | 259 | 30% |
5. Having the opportunity to express my new self. | 83 | 19% | 94 | 22% | 177 | 20% |
6. Having the opportunity to get to know a variety of people. | 74 | 17% | 56 | 13% | 129 | 15% |
7. Expressing myself sociably while traveling. | 48 | 11% | 34 | 8% | 82 | 10% |
8. Others. | 13 | 3% | 21 | 5% | 34 | 4% |
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Lee, T.J.; Han, J.-S.; Ko, T.-G. Health-Oriented Tourists and Sustainable Domestic Tourism. Sustainability 2020, 12, 4988. https://doi.org/10.3390/su12124988
Lee TJ, Han J-S, Ko T-G. Health-Oriented Tourists and Sustainable Domestic Tourism. Sustainability. 2020; 12(12):4988. https://doi.org/10.3390/su12124988
Chicago/Turabian StyleLee, Timothy J., Ji-Sook Han, and Tae-Gyou Ko. 2020. "Health-Oriented Tourists and Sustainable Domestic Tourism" Sustainability 12, no. 12: 4988. https://doi.org/10.3390/su12124988
APA StyleLee, T. J., Han, J.-S., & Ko, T.-G. (2020). Health-Oriented Tourists and Sustainable Domestic Tourism. Sustainability, 12(12), 4988. https://doi.org/10.3390/su12124988