This study adopts the phenomenological approach in order to explore the experience of urinary felt by the small island women and to find the meaning and structure of their experience, for the further understanding of them. This study succeeded in detecting five topics and three basic structure from eight participants, and followings are the comprehensive statement of them. The five topics include neglect of care after childbirth, unavoidable life in the tidal flat, shame which cannot be expressed even to their husbands, endless anxiety toward the expected future, and sad(dilemmatic) lived experience. The basic structure is that small island women who have urinary incontinence are apt to regard their disease as a natural destiny of women who fail to get adequate care after childbirth, and something to be endured to live in the seashore. They think of urinary incontinence as something so shameful that they cannot reveal it even to their husband and family. They believe that it even changes their personality since they must always stay alert in order to cope with the situation; for example, when it takes place unexpectedly, like too often to go to toilet, to change the underwears, to wake up in the middle of the night to go to toilet, to try not to laugh loudly, or to have showers. In addition, they accept it as a natural process of aging and incurable disease, and they consider themselves already ruined on the way of becoming uglier. They show dilemmatic abandonment: give it up unwillingly but at the same time think it is natural for others too. The unique experience of small island women with urinary incontinence implied in those statement are inseparable with the specific conditions for survival in the island. Unlike other diseases, it is considered the result of traditionally poor care after childbirth. However this misunderstanding that it is a natural phenomena for all the women who experience childbirth and aging and thereby incurable leads to an undesirable attitude toward urinary incontinence. According to the analysis, environmental conditions specific for small islands make the women there have distinct and unique experience concerned with urinary incontinence. Consequently, the future nursing plan for urinary incontinence in the small island area must be made and enforced with the consideration of these specific phenomenological meanings. Modern Korean nursing has basically been centered to hospital or urban areas. Besides, nursing intervention has long depended upon the research of western countries. This research, however, shows how greatly the regional and cultural characteristics influence the understanding of a certain disease, and is expected to make more specific and in-depth nursing approach enable for those who have urinary incontinence in small islands.

Citations

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For producing large numbers of professional nurses who could manage 21th century's human health, it is necessary to review the direction of registered nursed' national examination which evaluates the nursing education and is granted a licence. For adapting to social expectation of the nurse, we have to nurture the nurses' problem solving capability in clinical setting. Seven divisions of Korean Academy of Nursing suggested clinical competency according to their categories. This paper was presented in the workshop for setting up direction of registered nurses' national examination. We expect that this paper would be more refine and confirm through reviewing subdivisions' learning objectives and discussing clinical minimum level of competence contents with clinical leaders.

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