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This study was conducted to identify the effects of a planned exercise program based on Bandura's self efficacy model on metabolism, and the exercise compliance in type 2 diabetes mellitus patients. The study design was a nonequivalent pre-test post-test control design. Thirty four type 2 diabetes mellitus patients, who received follow-up care regularly through the diabetic out-patient clinic, were randomly sampled for this study. Twenty patients were assigned to the experimental group and fourteen patients were assigned to the control group. In the experimental group, a planned exercise program is composed of an individualized exercise prescription for 12 weeks, an individual education, and even a telephone coach program. In the case of the control group, they were instructed to continue with their usual schedules. The data collection period was from March 1999 to February 2000 Data were analyzed using SPSS/WINDOW 10.0program. The results were as follows. 1. In the experimental group, the level of fasting blood sugar has significantly decreased from 188.20 mg/dl to 155.55 mg/dl after planned exercise program (F= 16.86, p=.000). For lipid metabolism, body fat per cutaneous decreased from 27.16% to 26.57% after planned exercise program. The score of self efficacy has increased from 64.20 to 66.65 after planned exercise program and it was statistically significant (F=4.850, p=.040) The functional vital capacity has increased from 3.28 liter to 3.37 liter and it was statistically significant(F=7.300, p=.020). 2. In an after effect of a planned exercise program, 35 percent of the subjects who participated in a planned exercise program continued to exercise for another six months. In conclusion, the planned exercise program can improve cardiopulmonary function, glucose, and lipid metabolism. This program was show a positive effect on the self efficacy and exercise compliance.

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This study examined all the research published in Journal of Korean Academy of Nursing (JKAN) for last 30 years, from its beginning year to year 1999, based on an objective frame of evaluation. The purpose of this study is to reflect the trend of nursing research in Korea to date, and to provide an optimal direction for future research. The total number of 959 studies were analyzed with the following results. 1. Since 1990s, the number of non-degree based research has been larger than that of degree-based research compared to 1970s and 1980s. Both collaborative and funded research has been particularly increased in a gradual rate. 2. Research on nurses or nursing students has decreased while research on more diverse populations such as patients, patient families, or community-dwelling healthy clients has increased. 3. While essential nursing concepts such as human, nursing, and health have been consistently dealt as main research topics, research related to the concept of environ- ment has been insufficiently conducted. 4. It was remarkable that the quality of nursing research has been improved due to the acknowledgement of the importance of the empirical research method within the nursing community. 5. Qualitative research has appeared in the journal since the late 1990s, but it is still regarded to be in its novice stage. 6. Although the utilization of research findings for expanding the nursing body of knowledge has been wide in diverse specialties, most studies are limited to focus on concept development or evolution yet. also, in some of these research finding are utilization already considerably as to develop nursing interventions. Based on these findings, conclusions are extended to the following discussions: For the last 30 years, nursing research in Korea has shown an acute methodological development in both quantity and quality. However, there has been a lack of research on theory development although it is one of the ultimate goals in nursing. Further research should be empirical enough to be utilized in an actual nursing care context, and thus to be basis of developing culturally competent nursing theories in Korea.

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Circadian rhythm is entrained in the 24-hour time interval by periodic factors in the environment, known as zeitgeber. But most rotating work schedules are outside the range of the entertainment of the pacemaker timing the human circadian sleep-wake cycle. It has been postulated that physiological and emotional disturbances occur in most human functions when the circadian rhythm is disturbed. So application of circadian principles to the design of shift schedules can aid in maintaining the temporal integrity of the circadian system and thereby minimize for the shift worker any detrimental consequences of circadian disruption. The study was quasi-experimental study to test the effect of shift intervals for the clinical nurse on the circadian rhythm. Twenty nurses newly employed in general units of two hospitals were selected as an experimental group and twelve college nursing students as a control group. Both groups were selected according to an established criteria using a purposive sampling technique. Ten subjects were assigned to weekly shift group and another ten to a biweekly shift group engaged in a semi-continuous shift schedule(sunday off) with a backward direction, that is, morning-evening-night shift. The control group worked a morning shift for 42 days. Oral temperature rhythm, waking time, sleep-wake cycle, fatigue, and mental performance were measured during the experimental period. The data collection period was from April 30, 1990 to June 10, 1990. MANOVA, paired t-test, ANOVA, and Student Newman Keuls method were used for statistical analysis. The results are summarized as follows. 1. Phase delay in the acrophase of temperature rhythm was shown according to the backward rotating shift. A complete adaptation to work on the night shift was achieved between the sixth and ninth day of the night shift. 2. There was no difference in either waking time or sleep-wake cycle according to the duration of the working day for every shift group. Significant difference was found in the waking time and the sleep-wake cycle for subjects on the morning, evening, and night shift in both of the shift groups(weekly shift group : lambda=0.121, p<0.01, lambda=0.112, p<0.01, biweekly shift group : lambda=0.116, p<0.01, lambda=0.084, p<0.01). 3. There was no difference in fatigue between the first working day and the last working day for the control group and for the biweekly shift group. In the weekly shift group, physical fatigue was significantly different for the first day and the sixth day of the night shift(t=-2.28, p<0.05). Physical fatigue and total fatigue on the first day of the night shift showed a significant difference among the control group, the weekly shift group, and the biweekly shift group(F=5.79, p<0.01, F=4.56, p<0.05). There was a significant difference between the shift groups and the control group(p<0.05). Physical fatigue, neuro-sensory fatigue and total fatigue on the last day of the night shift showed a significant difference among the control group, the weekly shift group, and the biweekly shift group(F=12.65, p<0.01, F=7.77, p<0.01, F=9.68, p<0.01). There was a significant difference between the shift groups and the control group(p<0.05). 4. No difference in mental performance was seen between the first day and the last day of work in each case. An arithmetic test on the first day of the night shift revealed a significant difference among the control group, the weekly shift group, and the biweekly shift group(F=3.79, p<0.05). There was a significant difference between the shift groups and the control group(p<0.05). The digital symbol substitution test and the arithmetic test on the last day of the night shift showed a significant difference among the control group, the weekly shift group, and the biweekly shift group(F=3.68, p<0.05, F=5.55, p<0.01), and both showed a significant difference between the shift groups and the control group(p<0.05). Accordingly, this study showed that during night duty, the waking time, sleep-wake cycle, and fatigue increased and mental performance decreased compared with morning and evening duty. It was also found that the weekly shift group had a higher fatigue score on the sixth day of night duty as compared to the first day, but the waking time, sleep-wake cycle, and mental performance revealed no difference for the duration of the night duty or between shift groups, and complete adaptation of temperature rhythm was achieved between the sixth and ninth day of night duty. It is possible to conclude from these results that for intermediate circadian type in a healthy young woman, a biweekly shift system is more compatible with the circadian timing system than weekly shift system.

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• Sleep quality among shift-work nurses: A systematic review and meta-analysis
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It has been well documented that animals exposed to cold show increased activity of thyroid gland. The calorigenic action of thyroid hormone has been demonstrated by a variety of in vivo and in vitro studies. According to Edelman et al, the thyroid thermogenesis is due to activation of energy consuming processes, especially the active sodium transport by the hormone in target tissues. If SO, the increase in thyroid activity during cold exposure should induce increased capacity of sodium transport in target tissue and the change in tissue metabolism should be precisely correlated with the change in Na+-K+-ATPase activity of the tissue. This possibility was tested in the present study: in one series, changes in oxygen consumption and Na+- K+-ATPase activity of liver preparations were measured in rats as a function of thyroid status, in order to establish the effect of thyroid hormone on the tissue respiration and enzyme system; in another series, the effect of cold stimulus on the serum thyroid hormone level, hepatic tissue oxygen consumption and Na+-K+-ATPase activity in rats. The results obtained are as follows:1. The Na+-dependent oxygen consumption of liver slices, the oxygen consumption of liver mitochondria and the Na+-K+-ATPase activity of liver preparations were significantly inhibited in hypothyroidism and activated in hyperthyroidisrn. Kinetic analysis indicated that the Vmax. of Na+-K+-ATPase was decreased in hypothyroidism and increased in hyperthyroidisrn. 2. In cold exposed rats, the serum triiodothyronine (T3) level increased rapidly during the initial one day of cold exposure, then declined slowly to the control level after two weeks. The serum thyroxine (T4) level decreased gradually throughout the cold exposure. Accordin'gly the T3/T4 ratio increased. The mitochondrial oxygen consumption and the Na+-dependent oxygen consumption of liver slices increased during the first two days and then remained unchanged thereafter. The activity of the Na+-K+-ATPase in liver preparations increased during cold exposure with a time course similar to that of oxygen consumption. Kinetic analysis indicated that the Vmax. of Na+-K+-ATPase increased. 3. Once the animal was adapted to cold, induction of hypothyroidism did not significantly alter the hepatic oxygen consumption and Na+-K+-ATPase activity. These results indicate that: 1) thyroid hormone increases capacities of mitochondrial respiration and active sodium transport in target tissues such as liver; 2) the increased T3 level during the initial period of cold exposure facilitates biosynthesis of Na+-K+-ATPase and mitochondrial enzymes for oxidative phosphorylation, leading to enhanced production and utilization of ATP, hence heat production.