PURPOSE: The purpose of this study was to develop on east-west nursing intervention program. This study was conducted to identify the effectiveness of using facial meridian points for massage nursing intervention on the recovery of facial paralysis for 46 patients (22 for experimental group). All had suffered from strokes, and were also admitted to the division of oriental medicine in K University Hospital.
METHOD
Data was collected from February 1st to December 31st of 2000. This study used a quasi experimental, non-equivalent control group pre-test and post-test design. The recovery of facial paralysis was measured by the difference between left and right facial length, observation and self report on a seven point scale, and facial discomfort by a facial scale after 6-7 facial massages in a two week period. Data was analyzed using the SPSS package program with x2 and t test.
RESULT
The result of this study are as follows; The experimental group who received the facial meridian massage showed higher scores in recovery of facial paralysis (t=2.72, p=.009), and a smaller difference between left and right facial strength than those in control group (t=2.26, p= .29). The discomfort of the facial area in the experimental and control group showed no significant differences.
CONCLUSION
These findings indicate that a facial meridian points massage could be an effective nursing intervention to the recovery of facial paralysis. This study contributes in developing an east-west nursing intervention with the oriental meridian theory and western massage therapy.

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• The Effects of Abdominal Meridian Massage on Abdominal Distention, Pain, and Recovery of Bowel Motility after Sedated Colonoscopy
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• Effects of Meridian Acupressure in Joktaeyang Bangkwang Kyeong on the Physical Health State, Depression, and Life Satisfaction of Korean Older Adult Women Living Alone
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  Journal of Gerontological Nursing.2016; 42(2): 28.     CrossRef
• Effects of a Facial Muscle Exercise Program including Facial Massage for Patients with Facial Palsy
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• Effect of Acupressure Massage on Temperatures of Acupoints, Severity of Facial Paralysis, Subjective Symptoms, and Depression in Bell's Palsy Patients
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The purpose of the study was to identify the effect of structured patients education had on prevention of osteoporosis, with fracture and the resulting of life style changes in patients. In this study, a non equivalent control group pre and a post test design was employed. Data were collected through an interview process using questionnaires from April to December of 1999. The subjects, consisting of 59 patients with fractures and over 40 years of age, were diagnosed in K University Hospital. This study tested the patients knowledge at three times. The times were before the program 2 weeks into the program, and 6 months after education program. Life style change related to prevention of osteoporosis was shown twice (before and 6 months after the education program) in the experimental group, and control group went without it. The instruments used for this study were developed by literature review according to a reliability test. Data was analyzed using X2 test and t test to determine similarities between the experimental and control groups. The hypothesis was tested using repeated measures of ANOVA, t-test and Pearson correlation coefficients. The results of the study were summarized as follows: 1. The first hypothesis was accepted: a higher level of knowledge about osteoporosis was found in experimental groups who received education than to the control group during the period (F=19.82, p=.0001). 2. The second hypothesis was accepted: a higher level of life style changes about osteoporosis on experimental group were recorded than as compared to control group (t=3.55, p=.001). 3. The third hypothesis was accepted: the higher the knowledge about osteoporosis the higher the level of performance of life style changes about prevention of osteoporosis (r=.600, p=.0001). In conclusion, structured patient education in patient with fractures improved the level of knowledge about osteoporosis and more likely undergo of life style changes 6 months after the education program. Also reeducation would be needed 6 months after program ends. That is structured patient education in pamphlet form would be very effective in nursing intervention that may to result in life style changes. Therefore further research is needed to reinforce the education material and to generalize the education effect.

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  Bong Hae Ma, Chai-Soon Park, Hee Chong Baek
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  Yunmi Kim, Jung Hwan Kim, Dong Sook Cho
  Journal of Korean Academy of Nursing.2015; 45(2): 293.     CrossRef
• Study of the Level of Osteoporosis Awareness among Women Dwelling in Urban Area
  Miyoung Chung, Kyunghye Hwang, Euysoon Choi
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The purpose of this study was to develop a curriculum for the oriental clinical nurse specialist program based on the understanding of Korean human beings so as to develop nursing as a profession and promote the client's health. The design of this study was based on literature review and nominal group study. The research was managed by East-West Nursing Research Institute of nursing science college at Kyung Hee University. The research team was composed of 17 professors of nursing departments of oriental medical colleges. We obtained opinions from Oriental Nurses Association, Oriental Nursing Research Association, and professors in oriental medical college. We reviewed articles, curriculums of other clinical nurse specialist programs, medical laws and the curriculum development plan for the oriental clinical nurse specialist program from Korean Nurses Association. We discussed a curriculum thoroughly in numerous meetings. We developed a following curriculum: 1. Educational philosophy was founded on the oriental human view which was based on Chun-In union theory. It was founded on the oriental health view which recognized health being in harmony with nature and the balance of body function with the harmony of Yin-Yang in the five elements. In addition, it was founded on oriental nursing view to promote these health states. 2. Educational goals were to train oriental clinical nurse specialists, oriental nursing educators and oriental nursing researchers who developed knowledge of oriental nursing theory, nursing practice and created a leadership. 3. Curriculum consisted of 48 credits, of which 36 credits are based on lectures and laboratory classes and 12 credits are based on clinical practice. 36 credits consisted of 5 general subject credits and 31 core subject credits. General subjects consisted of nursing theory, nursing research, law and ethics. Students who had earned master's degrees are not required to take the general subjects. Core subjects consisted of 11 subjects such as advanced physical examination and laboratory, oriental nursing theory, original text of oriental nursing, oriental medical nursing, oriental pediatric nursing, oriental gynecologic nursing, oriental gerontologic nursing, oriental pharmacology, oriental constitutional nursing, advanced nursing of channels and acupuncture points and laboratory and oriental rehabilitation nursing and laboratory. In addition, clinical practice in a hospital ward, out patient department, herb prepation room, department of physical therapy and health promotion center in oriental medical hospitals for 12 weeks. To admit this program, students should complete prerequisites of introduction to oriental nursing and nursing of channels and acupuncture points. 4. Course contents of each subjects were developed to include the course's goal and objectives and specific items. 5. Evaluation involved lecture, laboratory and in field practice. We applied various evaluation systems and methods that were based on both knowledge and skills of the students to ensure full credibility and validity.

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Many patients of acute myocardial infarction showed delay time before seeking treatment although they needed immediate thrombolytic therapy once they perceived their symptoms. The objectives of this study were to identify the relationship between clinical symptoms and the delay, and to find the time spent before seeking the treatment. This study was a retrospective research. The delay time for the treatment consisted of the length of delay from symptom onset to patients' decision (T1), from patients' decision making to finding transportation (T2), and from taking transportation to the first hospital arrival(T3). The subjects were 89 patients who were admitted in the ICU and Cardiac Ward at Chonnam University Hospital with the first attack of acute myocardial infarction. The data was collected for three months from March 1st to May 31st of 1998 through questionnaires and reviewing patients' charts: The chart information was suppled by two nurses working at the ICU and Cardiac Ward. The data was analyzed by using frequency, mean and ANOVA through the SAS program. The results of study summarized as follows: 1. Sixty two patients (69.7%) were male and twenty seven patients (30.3%) were female, the ratio of male to female was 2.3 : 1. 2. In daily life, the 70.8% of the patients felt chest pain and discomfort fatigue in 67.4%, dyspnea in 57.3%, and pain in arm, neck, and jaw in 52.8%. During the attack, 97.8% of the patients felt chest pain and discomfort dyspnea in 82.1%, pain in arm, neck, jaw in 67.4% and perspiration in 51.7%. 3. The length of time a patient spent seeking time for treatment (T1+T2+T3) was 94.6 minutes, in which the time for patients' decision making for treatment (T1) was 70.3 minutes, time for finding transportation (T2) was 8.2 minutes, and time for the transportation of the patient to the first hospital (T3) was 16.1 minutes. Time for patients' decision making to go to a hospital(T1) was 74.2% of the total time sought for treatment.

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• Decision Tree Model of the Treatment-Seeking Behaviors Among Korean Cancer Patients
  Hyo-Sook Oh, Hyeoun-Ae Park
  Cancer Nursing.2004; 27(4): 259.     CrossRef

Diabetes mellitus, a universal and prevalent chronic disease, is projected to be one of the most formidable worldwide health problems in the 21st century. For those living with diabetes, there is a need for self-care skills to manage a complex medical regimen. Self-efficacy which refers to one's belief in his/her capability to monitor and perform the daily activities required to manage diabletes has found to be related to self-care. The concept of self-efficacy comes from social cognitive theory which maintains that cognitive mechanism mediate the performance of behavior. The literature cities several research studies which show a strong relationship between self-efficacy and self-care behavior. Meta-analysis is a technique that enables systematic review and quantitative integration of the results from multiple primary studies that are relevant to a particular research question. Therefore, this study was done using meta-analysis to quantitatively integrate the results of independent research studies to obtain numerical estimates of the overall effect of a self-efficacy with diabetic patient on self-care behaviors. The research proceeded in three stages : 1) literature search and retrieval of studies in which self-efficacy was related to self-care, 2) coding, and 3) calculation of mean effect size and data analysis. Seventeen studies which met the research criteria included study population of adults with diabetes, measures of self-care and measures of self-efficacy as a predictive variable. Computation of effect size was done on DSTAT which is a statistical computer program specifically designed for meta-analysis. To determine the effect of self-efficacy on self-care practice homogeneity tests were conducted. Pooled effect size estimates, to determine the best subvariable for composite variables, metabolic control variables and component of self-efficacy and self-care, indicated that the effect of self-efficacy composite on self-care composite was moderate to large. The weighted mean effect size of self-efficacy composite and self-care composite were +.76 and the confidence interval was from +.66 to +.86 with the number of subjects being 1,545. The total for this meta-analysis result showed that the weighted mean effect sizes ranged from +.70 to +1.81 which indicates a large effect. But since reliabilities of the instruments in the primary studies were studies were low or not stated, caution must be applied in unconditionally accepting the results from these effect sizes. Meta-analysis is a useful took for clarifying the status of knowledge development and guiding decision making about future research and this study confirmed that there is a relationship between self-efficacy and self-care in patients with diabetes. It, thus, provides support for nurses to promote self-efficacy in their patients. While most of the studies included in this meta-analysis used social cognitive theory as a framework for the study, some studies use Fishbein and Ajzen's attitude model as a model for active self-care. Future research is needed to more fully define the concept of self-care and to determine what it is that makes patients feel competent in their self-care activities. The results of this study showed that self-efficacy can promote self-care. Future research is needed with experimental design to determine nursing interventions that will increase self-efficacy.

The purpose of this study was to examine the effect of slow stroke back massage(SSBM) on anxiety and immune response in patients undergoing open heart surgery and to compare the effect of 5-minutes with 10-minutes SSBM. Among the sixty-four patient subjects, twenty-one were one experimental group receiving massage for 10-minutes, twenty for the other experimental group receiving massage for 5-minutes and twenty-three for the control group. Subjects were admitted at Hospitals in Inchon and Puchon for open heart surgery. This study was carried out from October 10, 1997 to May 10, 1998. The levels of anxiety were measured by the Visual Analogue Scale(VAS), Trait anxiety scale, systolic and diastolic blood pressure, pulse rate, blood cortisol and the levels of immune response were measured by the blood T-lymphocyte and Natural killer cell. Study measurements were taken before and after SSBM on the 1st pst operative day. Data were analyzed using x2test, oneway ANOVA, paired t-test, t-test and Pearson product moment correlation. The results were summarized as follows: 1. After SSBM, VAS anxiety level, systolic and diastolic blood pressure and pulse rate of the experimental group were decreased significantly than those measurements before the SSBM. After SSBM, significant difference in the VAS anxiety level, systolic blood pressure and pulse rate between the experimental and control groups were found. 2. After SSBM, the blood cortisol of the experimental and control groups were increased significantly compared with before SSBM. But the significant difference in blood cortisol between the two groups was not found. 3. After SSBM, the blood T-lymphocyte percentages of the experimental and control groups were decease significantly and blood Natural killer cell percentages of the two groups were increased compared with before SSBM. But significant difference in blood T-lymphocyte and Natural killer cell percentages between the two groups was not found. 4. Significant difference in VAS anxiety level, systolic and diastolic blood pressure, pulse rate, blood cortisol, blood T-lymphocyte and Natural killer cell percentages between SSBM for 5 minutes and SSBM for 10 minutes were not found. Based upon the results, this study concludes that the slow stroke back massage for 5 minutes is a useful intervention that decreases anxiety and produces relaxation in patients undergoing open heart surgery.

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The purpose of this study was to develop the computerized nursing diagnoses system for clinical application and activation of nursing diagnosis based on validity verification. In addition, our research team also performed system tests in clinical situations, to identify ways to improve the program and make it more practical. Nursing Diagnoses System will increase nurses' knowledge and experience of the application of nursing diagnoses in clinical situations and development of nursing interventions by nurses as well as the effectiveness of hospital computerized systems. We expect this system can contribute to an improvement in the quality of nursing care. Also we will continuously evaluate and revise the system related to the utilization of the program.

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This study was conducted to test validity of related factors and characteristics of 98 Nursing Diagnosis identified in a previous study by the Korean Nurses Association. Data for this study was collected from 892 nurses in eight teaching hospitals located in Seoul using a cross sectional survey method. Each participating hospital was asked to produce at least 10 cases for every nursing diagnosis. There were 7,422 responses out of a possible 7,840. Out of the 7,422 responses 26 were discarded due to incompleteness. Data were analyzed using SAS. The result of the study shows that most of the related factors and characteristics for each of the 98 nursing diagnosis were ranked at more than 3.5 point out of 5 point Likert scale in terms of significance. Through this study the related factors and characteristics of the 98 nursing diagnosis identificance. Through this study the related factors and characteristics of the 98 nursing diagnosis identified through literature review were validated by experts in nursing diagnosis. These validated related factors and characteristics will be utilized for computerization of the nursing diagnosis process.

Various accidents and injuries are currently occuring in Korea at increasingly high rates. Good quality emergency care service is urgently needed to cope with these various forms of accidents and injuries. In order to develop a sound emergency care system, there need to be a plan to educate and train professionals specifically in emergency care. One solution for the on going problem would be to educate and train emergency clinical nurse specialists. This study on a strategy for curriculum development for emergency clinical nurse specialist was based on the following five content areas, developed from literature related to the curriculum of emergency nursing and emergency care situation: 1. Nurses working in the emergency rooms of three university hospitals were analyzed for six days to identify categories of nursing activities. 2. Two hundreds and eleven nurses working in the emergency rooms of 12 university hospitals were surveyed to identify needs for educational content that should be included in a curriculum for the clinical nurse specialist. 3. Examination of the environment in which emergency management was provided. 4. Identification of characteristics of patients in the emergency room. 5. The role of emergency clinical nurse specialist was identified through literature, recent data, and research materials. The following curriculum was formulated using the above mentioned process. 1. The philosophy of education for emergency clinical nurse specialist was established through a realistic philosophical framework. In this frame, client, environment, health, nursing, and learning have been defined. 2. The purpose of education is framed on individual development, social structure, nursing process and responsibility along with the role and function of the emergency clinical nurse specialist. 3. The central theme was based on human, environment, health and nursing. 4. The elements of structure in the curriculum content were divided to include two major threads, i.e., vertical and horizontal: The vertical thread to consist of the client, life cycle, education, research, leadership and consultation, and the horizontal thread to consist of level of nursing (prevention to rehabilitation), and health to illness based on the health care system developed by Betty Neuman system model. 5. Behavioral objectives for education were structured according to the emergency clinical nurse specialist role and function as a master degree prepared in various emergency settings. 6. The content of the curriculum consisted of three core courses(9 credits), five major courses(15 credits), six elective courses(12 credits) and six prerequisite courses (12 credits). Thus 48credits are required. Recommendations: 1. To promote the quality of the emergency care system, the number of emergency professionals, has to be expanded. Further the role and function of the emergency clinical nurse specialist needs to be specified in both the medical law and the Nursing Practice Act. 2. In order to upgrade the qualification of emergency clinical nurse specialists, the course should be given as part of the graduate program. 3. Certification should be issued through the Korean Nurses Association.

The job related activities of sixty nine nurses, working in the emergency rooms of three university hospitals, were analyzed for six days according to preestablished checklist of nursing activities; the frequency of these activities and the amount of time spent in each specific nursing activity. The established checklist was monitored every five minutes for the duration of the duty autu, thus producing 414 items of data. The data were not gathered on consecutive days but over the period of one month from May 6, 1994 to June 5, 1994. The following conclusions are derived from analy sis of the data: 1. Twelve categories of nursing activities were obtained: The primary activity was communic ation related to the patient and all information pertaining to the patient. Other activities included maintaining the patient's record, observation and assessment of the patient, cooperation with other medical personnel, management of equipment and drugs, procedure and treatment, specimen collection, consultation and education for the patient, including drug management and personal hygiene and any other relevant education to the patient's condition. 2. The average frequency of categorized nursing activity can be classified as follows: communication related to patient was the highest at 17.6 times. The next was maintaining the patient's record at 17.3 times. The observation and assessment occurred 16.9 times. Consultation and education for patients and family, 8 times, medication, 5.7 times, and procedures and treatments, 6 times. 3. The average time required for each activity was as follows: 230.1 minutes for maintaining the patient's record, 204.9 minutes for communication related to the patient, 199.2 minutes for observation and assessment, 71.2 minutes for medication, 66 minutes for consultation and education of the patient and family, and 51.8 minutes for procedures and treatment. 4. The most demanding nursing activity in the emergency room for the nurse was answering questions from the patient's family, maintaining communication between the medical staff, maintaining and reviewing the patient's charts, writing prescriptions and monitoring I. V. infusion rates. 5. The most time consuming nursing activities for the emergency room nurse include maintaining and following the patient's charts, communication between the medical staff, answering questions from the patient's family, observation of the patient and relaying all of the appropriate patient information to the incoming nurses during a shift change. 6. The F-test was administered to measure the required time for the categorized nursing activities according to day, evening, and night-shift nurses. There were significant differences(p<.05) in specimen collection, observation and assessment, cooperation between medical staffs, personal hygiene, communication related to patient, education and research. Posterior multiple comparison test showed that specimen collection, cooperation between medical staffs and personal hygiene were mostly done by the evening-shift nurses. Also most observations and assessments were done by the night-shift nurses. Education and communication to patients were done by day-shift nurses. Thus there were significant difference between shifts for the main nursing activities. So there should considev a reallocation of the duty of nurses on each shift. 7. The F-test also indicated that there wes a similarity in time duration for procedures and treatments and for cooperation between medical staff and nurses in all three hospitals. However, the remaining categories of nursing activities also showed a significant differnce between the three hospitals. This indicated that there were differences in each emergency room that influence time for each categorized nursing activities and this should be given more consideration. Recommendations: 1. A seasonal difference should be considered in the activities of nurses in the emergency room and a comparative analysis should be carried out to determine seasonal differentiation. 2. A study on more objectively measurable nursing activities should be administered as well as one determining the subjective responds towards nursing activities in the emergency room.

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This study evaluated the effect of diabetic group teaching programs in one university hoapital in Seoul to predict when re-education would be needed. This study examined the patients' knowledge at four points (before, directly after, three months and six months after the teaching program) and self-care performance related to diabetes twice (three months and six months after the teaching program). The subjects of the study were 34 admitted diabetic patients who participated in four-day teaching programs. Data were gathered from January to October, 1992 by means of an instrument developed from two diabetic knowledge tests which were equivalent in item differentiation and item discrimination coefficients. Collected data were analyzed by paired t-test, Pearson correlation, t and F tests. The results of study were as follows. 1. The analysis of the effect of the diabetic group teaching program and the duration of the effect of teaching. 1) The first hypothesis, that the diabetes knowledge score directly after the teaching program would be higher than before, was rejected (t=-1.40 ;p=.172). 2) The second hypothesis, that the diabetes knowledge score directly after teaching would be higher than three months later, was rejected(t=-4.27; p=.000). 3) The third hypothesis, that the diabetes knowledge score three months after teaching would be higher than six months later, was supported(t=2.43; p=.020). 2. The relation of knowledge and self-care performance 1) The forth hypothesis, that the level of self-care performance related to diabetes three months later would be higher than six months later, was rejected(t=1.49; p=.146). 2) The fifth hypothesis, that the higher the diabetes knowledge, the higher the level of self-care performance, was rejected(r=.2086: P=.118). 3. The relation of diabetes knowledge and self-care performance according to demographic variables and structural variables of diabetes. 1) Diabetic knowledge scores varied according to the educational levels of the clients directly after the teaching. Three months after the teaching program higher educational levels and higher economic status were related to higher diabetic knowledge scores and men had higher knowledge scores than women. 2) Self care performance scores of men were higher than those of women at three months and six months after the teaching program. 3) Before the diabetes teaching, the diabetic knowledge scores of subjects who had a dia-betic patient in the family were higher than those who did not have patient in their family. Six months after the teaching, the diabetic knowledge scores of subjects who read the distributed books about diabetes were higher than those who did not read them. 4) No significance differences were found between self-care performance and structural variables of dialetes. The results of this study indicated that the levels of diabetes knowlege and self-care performance incease of three months after the teaching program but decrease of six months. Reeducation would be needed between three and six months. The investigator thinks that a study of the content and teaching methodology is needed to increase the education effect. The subjects want to hear patient histories of diabetic management. Group discussion would be helped after the teaching sessions.

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