The effects of the mouth care using cool sterile normal saline on oral stomatitis were investigated in 59 patients on chemotherapy. The subjects were divided into two groups, one was experimental group(N=31) in which the subjects were provided mouth care 4 times a day (after meals, before bedtime)with cool normal saline, the other was the control group(N=28). The Oral Assessment Guide (OAG) which it includes eight items(voice, swallowing, lips, tongue, salivation, oral mucous membrane, gingiva and teeth) was used to assess oral status six times (once in the prechemotherapy period, and on the third, 5th, 7th, 10th and 14th day postchemotherapy). The means of the total scores at each time were analyzed by repeated ANOVA. The results are as follows: 1. The incidence of stomatitis was higher in the control group than in experimental group. The incidence of third grade stomatitis characterized by bleeding, sore, infection and severe pain was 3.3% in the experimental group, and while 21.4% in the control group(p=0.01). 2. The number of stomatitis sites which were occurred in the experimental group were significantly lower than in the control group(p=0.046). 3. The grade of stomatitis (mean of total score) for patients in the control group was significantly higher than for patients in the experimental group (p=0.005). 4. In the control group, voice change increased in the period between the seventh and tenth day after chemotherapy (p=0.04). 5. In the control group, swallowing difficulty was most severe in the period between seventh and tenth day (p=0.05), and decreased by the fourteenth day(p=0.01). 6. Changes in the lips gradually increased after chemotherapy in the control group(p=0.0025), while they were significantly lower in the experimental group(p=0.0002). 7. The increment of tongue changes started on the third day after chemotherapy reached a peak on the tenth day and decreased by the fourteenth day in both groups(p=0.0016). 8. Driness of the mouth reached a peak on the seventh day after chemotherapy in the control group (p=0.05). 9. The degree of oral mucositis was significantly higher in the control group than in the experimental group (p=0.02). In the control group, the mucosal change started three days after chemotherapy and reached a peak on the tenth day(p=0.03). 10. Changes in the gingia were significantly higher in the control group(p=0.03). In control group, the degree of gingivitis reached a peak on the tenth day. In conclusion, mouth care with normal saline four times a day could reduce the incidence and grade of stomatitis. Stomatitis was shown to begin on the third day after chemotherapy, reach a peak on the tenth day and be reduced by fourteenth day.

This study was done to analysis data on breastfeeding mothers. This study was conducted using data from telephone counseling in one metropolitan area. The subjects who had received consultation about breastfeeding were 100 breastfeeding mothers. The period of consultation was from Mar. 9,1994 to August 23,1994. Consultants were referred from UNICEF, hospitals, TV, newspapers or magazines. Analysis of the problem patterns resulted in 11 classifications. These were physio-anatomical factors(11 cases), psychological factors(15 cases), breastfeeding methods(21 cases), breastfeeding intervals and frequency(19 cases), disease in the breastfeeding mothers(13 cases), disease in the babies(12 cases), lack of support(4 cases), food and drugs while breastfeeding(5 cases), weaning(11 cases), others(27 cases). The highest frequency was for breastfeeding methods(21 cases). When the contents of the counselling were analyzed for the 100 cases, 36 problem patterns were identified. Patterns with over 10 responses were diarrhea, insufficient milk supply, sore and cracked nipples, weaning, inverted nipples and jaundice. The age of infants when mothers were telephoned was as below: 1 week(28 cases), 2 weeks(12 cases), 3-4 weeks(18 cases), 5-8 weeks(7 cases), 9 weeks - 3 months (4 cases), 4 months - 6 months (12 cases), over 6 months(2 cases), and the number of pregnant women was 12. The nursing diagnosis were classified according to problem patterns and each diagnosis was assigned an appropriate problem pattern. The total number of nursing diagnoses was 22. When clients are referred for counselling nurses need guidelines about problems, possible causes and nursing. In this study, the example of guidelines for sore nipples is suggested. The recommendations based on the telephone counseling results are as follows: Prenatal education about the advantages of breastfeeding and breast care, and home visits after delivery for counseling related to breastfeeding. During the hospital stay, nursing intervention such as education on breastfeeding methods using slides, audio -visual tapes, pamphlets are needed as well as an initial trial of breastfeeding. Further research is indicated on the perceived lack of breast milk and on the effectiveness of nursing interventions to promote breastfeeding.

This study aimed at analyzing the trend of research on pain in Korea, suggesting direction future pain research, and contributing to the use of pain interventions in nursing practice. Research studies on pain were selected from journals of medical and nursing schools, the Korean Nurse, the Korean Nurses' Academic Society Journal, the Central Journal of Medicine, the New Medical Journal, and from theses and dissertations, which were conducted between 1970 and 1994. The total number of the studies was 93. These studies were analyzed for 1) time of publication or presentation, 2) thesis for a degree or nondegree, 3) research design, 4) characteristics of subjects used in each study, 5) measurement tool, 6) types of correlated variables, 7) Korean terms for pain, 8) types of nursing interventions, and 9) results of studies. The findings of the analysis can be summerized as follows: 1) The number of studies related to pain has increased rapidly since the early 1980's. The number of experimental research studies related to pain has increased chronologically, but the number of survey research studies related to pain was highest from 1981 to 1985, after that it decreased slowly. 2) The subjects in 19 studies were healthy people and, in 73 studies, patients with various illnesses. Thirty two studies were conducted with surgical patients. 3) Sixty one pain research studies were done for a thesis for a degree and 32 were nondegree research studies. 4) As measurement tools for pain, self-report pain scales were used in 54 studies and more than two tools were used in 28 studies. In the experimental studies, the trend was to use more than two tools. And in the nonexperimental studies, the trend was to use self-report pain scales only. 5) There were 11 correlational studies. In these studies, the trend was to study anxiety, depression and variables such as intravenous infusion as related to pain. 6) In the thirty six experimental studies, the effects of 16 types of nursing interventions were tested. Teaching and information, and relaxation technique were the most popular interventions for pain. 7) In eighteen methodological studies, the majority were studies testing the validity and reliability of Dr. Lee's Korean Pain Rating Questionnaire. The following suggestions are made based on the above findings: 1) The patterns of these studies related to pain in Korea need to be compared with trends in other countries. 2) Meta-analysis should be done to analyze and integrate the results of various studies. 3) This analysis of pain research is needed to identify the present trend of pain research and to suggest the direction of future pain research, so these patterns of studies should be done in 5 to 10 year intervals. 4) More replicated pain research is needed to prove the effect of nursing interventions and more qualitative reserch on pain is needed to identify indepth the meaning of pain. 5) Pain researchers should make an effort to apply research result in various clinical settings and try to carry out team research with clinical nurses or with other multidiscipinary researchers.

This study investigated the effects of education program conducted through individual home visit by CHPs, which was developed by the operational research technique for families of dementia patients. (Yeo Shin Hong et al, 1994) The study was conducted in the form of a primary experimental design with 43 people as subjects, including dementia patients and family member in several Myon areas of Chungcheong Namdo between June 10 and August 20, 1994. The data was collected by questionnaires through the home visit by the CHPs. The results of study are as follows. 1. There is no difference in the quality of life between before and after the education program. 2. Role stress 'before the education program' was significantly different than 'after the education program'. 3. There was no difference in the feeling of burden between before and after the education program. 4. There was a significant difference in the abnormal behaviors of patients between before and after the education program. 5. The knowledge of dementia by the patient's family increased significantly after the educaion program, compared to that of 'before the education program'. 6. There was a significant difference in the attitude of family members toward the education program on dementia between before and after the education program. 7. The results of analysis on the coefficient relationship of various variables showed that the age of patients and family members have a significant correlation with role stress(p=.01). 8. In the subjective evaluation of family members on changes in actual nursing actions and the improvement of knowledge and technique in terms of daily living, (including abnormal behavior of patients, adjustment of environment for patients, activity programs for patients, communication technique with patients, ensuring the safety of patients, clothing, meals and elimination, 60-65% of family members responded that their knowledge had increased. As for improvement in techniques for each item, the technique for communication with patients showed the greatest improvement while the action program method for patients showed the least change. As for the nursing service provided to patients, most respondents showed a positive change. The specific items for which more than 80% respondents answered positively were as follows: recognizing the demand of patients, getting patients to do simple house works, talking softly and gently, removing dangerous things, preparing comfortable clothes that are easy to put on and take off, and limiting water consumption at night. As a result of study, the following suggestions can be made. The purpose of the study was to examine the effect of an education program developed and applied for dementia patients and family members in the community. This needs to be compared with a similar study conducted in the urban setting. In addition, a community service program (ex: nursing horn and shelter) including the applicaion of the education program should be developed and the study done to investigate its effect.

When children are admitted to hospital, they have to adapt to new and unfamiliar stimuli. Children may respond with fear to stimuli such as pain or unfamiliar experiences. One goal of nursing is to help hospitalized children to adapt effectively to their hospital experience. Accordingly, nurses need to assess childrens' fears of their hospital experience to contribute to the planning of care to alleviate these fears. The problem addressed by this study was to identify and measure hospital-related fears (hereafter called HRF) in hospitalized school-aged children. The study was conceptualized with Roy's model. A descriptive qualitative approach was used first, followed by a quantitative approach. This study was conducted from November 30, 1989 to January 12, 1991. The sample consisted of 395 hospitalized school-aged children selected through an allocated sampling technique in nine general hospitals. The HRF questionnaire (three point likert scale) was developed by a delphi technique. The data were analyzed by an SAS program. Factor analysis was used for the examination of component factors. Differences in the HRF related to demographic variables were examined by t-test, analysis of variance and the Scheffe test. The crude scores of the HRF scale were transformed into T-scores to calculate the standard scores. The results included the following: 1. Forty-four items were derived from 188 statements identifying the childrens' hospital-related fears. These items clustered into 14 factors, fear of injections, operations, bodily harm, others' pain, medical rounds, physical examinations, medical staff, disease process, blood and X-rays, drugs and cochroaches, tests, harsh discipline from parents or staff, being absent from school, and separation from family. The 14 factors was classified into four categories, 'pain', 'the unfamiliar', 'the unknown' and 'separation'. 2. The reliability of the HRF instruments was .92 (Cronbach's alpha). In the factor analysis, Cronbach's alpha coefficients for the 14 factors ranged from .84 to .86 and Cronbach's alpha coefficients for the four categories ranged from .70 to .84. Pearson correlation coefficient scores for relationships among the 14 factors ranged from .11 to .50, and among the four categories, from .44 to .63, indicating their relative independence. 3. The total group HRF score ranged from 45 to 130 in a possible range of 44 to 132, with a mean of 74.51. The fears identified by the children were, in order, injections, harsh discipline by parents or staff, bodily harm, operations, medical staff, disease process, and medical rounds; the least feared was others' pain. The fear item with the highest mean score was surgery and the lowest was examination by a doctor. HRF scores were higher for girls than for boys, and for grade 1 students than for grade 6 students. HRF scores were lower for children whose fathers were over 40 than for those whose fathers were in the 30 to 39 age group, and whose mothers were over 35 than for those whose mothers were in the 20 to 34 age group. HRF scores were lower when the mother rather than any other person stayed with the child. The expressed fear of pain, the unfamiliar, the unknown and of separation directs nurses' concern to the threat felt by hospitalized children to their concept of self. This study contributes to the assessment of fears of hospitalized children and of stimuli impinging on those fears. Accordingly, nursing practice will be directed to the alleviation of pain, pre-admission orientation to the hospital setting and routines, initiation of information about procedures and experiences and arrangments for mothers to stay with their children. Recommendations were made for further research in different settings and for development and testing of the instrument.

The critical problem of nurse scheduling in the hospital is determining the day-to-day shift assignments for each nurse for the specified period in a way that satisfies the given requirements of the hospital. As nurse scheduling involves many factors and requirements, manual scheduling requires much time and effort to produce an adequate schedule. A PC-based decision support system, developed in Turbo-C++, for nurse scheduling was introduced. The system is composed of 4 sub-systems: 1) Entering basic information for each nursing unit; 2) Generation of an appropriate initial schedule and revised schedule for a given period, maximally satisfying each nurse's duty requests; 3) Provision of variety of statistical information, and 4) Help messages for each modular function. Icons and a mouse are used for easier graphic user interface and reducing the need for typing efforts. This system can help nurses develop quick and easy schedule generation and allow more time for the patient care.

The Fluid and electrolytes balance in the body is of critical importance in maintaining good health. When the fluid and electrolyte imbalance is present, patients are in great danger. They must be assessed immediately by a nurse so that appropriate treatment can be started as soon as possible. Patients' fluid intake and output records contain highly important information for the diagnosis and treatment of fluid imbalance, but, these records are often inaccurate and the method of recording the fluid intake is not universial for every hospital. Because they are few quantitative measurements of a patient's hydration, the need to improve the accuracy of fluid intake records is very important. However, very few studies have been done to investigate the accuracy of measurements of patients' fluid intake and output. The purpose of this study was to investigate the methods used for calculation of fluid intake which is most similar to fluid output in normal adults and hospitalized patients. This study focused on three different calculation methods for fluid intake and compared these to fluid output and developed suggestions as to the ideal way to record fluid intake. Data for 43 hospitalized patients and 37 normal adults were analyzed. The findings of this study are as follows; 1) In normal adults, the daily intake of water which enteres by the oral route was 2415ml(the first method of calculation). The daily intake of water in the form of pure water or some other beverage was 1365ml(the third method of calculation). The daily intake of water including fresh fruits and vegetables, rice, porridges, and Me urn which have water content more than 80% were 2186ml (the second method of calculation). 2) The urine output of the normal adults was 1350ml. This apprroximates the amount of fluid an adult takes in the form of pure water. 3) In patient group, the total intake of water was 2550ml(the first method of calculation). The intake of water in the form of pure water or as some other beverage and IV fluid was 1661ml (the third method of calculation). The daily intake of water including foods which have high water content was 2356ml (the second method of calculation). 4) The urine output of the patient's group was 1728ml. This approximates the amount of fluid an adult takes in the form of pure water. 5) Investigation of the method of calculation of the patient fluid intake showed that among the 31 hospitals studied, only eight use the third method of calculation which reflects the most close value to urine output. From the results obtained in this study, it was indicated that the amount of fluid taken in the form of pure water reflects the most close value to urine output. Therefore, it can be suggested that the third method of calculation which includes water intake only in the form of pure water or beverage should be used as patients' fluid intake record.

Post-operative wound infections have been the serious problems in nursing care in the operating room and appear to be strongly related to the infection occurring during the operation. The purpose of this study is to identify the level of contamination in saline used in the operation and also examine the correlation between the contaminated saline and the length of the operation, and unclean atmospheric factor. Subjects for this study include 13 cases of operation performed at the operative theatre of a hospital in Seoul area. Test samples and related data were collected from this medical facility between Oct. 6 through Dec. 10, 1994 by the auther and a nurse who worked in the operating room. For the study, multiple batches of saline sample were collected at the various time intervals during the operation and filtered through the membrane filters. Viable microorganisms retained on the filters were cultured on the appropriate culture media and the levels of existing cells in saline were enumerated according to Koch's method. In the analyses of the data, Pearson's correlation coefficient was obtained for the examination of relationship between the length of operation and numbers of microorganisms existing in saline and for the comparison of the differences in numbers if microrganisms in saline sample collected at the various operative stages, e. g. pre-incision, excision and skin suturing stages, ANOVA and Scheffe Tests were performed. The results of this study are summarized as follows. 1) The lenth of the operation and numbers of microorganisms in the saline used in the operation appeared to be significantly correlated (r =0.5467, P<0.001). 2) In case of saline exposed to air, but not used in the operation, the length of exposure to the air and the numbers of microorganisms present in saline also showed an apparent correlation(r=0.5087, P<0. 001). 3) The frequencies of occurrence of microorganisms in saline used in the operation and in saline exposed only to the air in the given time showed significant differences(t=3.73, p=.0000). 4) In case of saline used in the operation, there is significant differences in its numbers of contained microorganisms between the operative stages; pre-incision, excision, and skin suture(F=17.7500, p=.0000). 5) In case of saline exposed only to the air in the given time, there is significant differences in its numbers of contained microorganisms between the operative stages; pre -incision, excision, and skin suture (F=6.3807, p=. 00031).

This study was done to analyze the relationship between task stress and morale in psychiatric nursing assistants. The subjects were 118 psychiatric nursing assistants selected from the National Mental Hospital in Seoul and 18 non-medical mental institutions. The data were collected from October 22 to November 12, 1994. The instruments used for this study were modified PNOSS(Psychiatric Nurse Occupational Stress Scale) which was developed by Bai and modified the Morale scale which was developed by Oh. The confidence varification of these instruments were computed and Cronbach alpha=.9255, .9260. Data were analyzed by t-test, ANOVA on 5% significant level and Pearson correlation coefficient. The results of the study are as follows; 1. The average work stress scores of subjects were 2.83. Among the work stress factors; the conflict with nurse was identified as the most stress factor. There was significant relationship between the degree of work stress and the variables of psychiatric Nursing Assistants such as the marital status, educational level, religion, job satisfaction, working place, predicted period of work. 2. Average total morale scores for the subjects was 3.08. There was a significant relationship between the degree of morale and variables of psychiatric nursing assistants such as working place, certification as a nursing assistant, job satisfaction, opportunity for practical education and predicted period of work. 3. There was a significant relationship between the degree of morale and work stress factors such as administration problem, work overload.

Cardiac cathererization has become a routine diagnostic procedure indicated for evaluation of a wide varity of cardiac conditions. Patients are admitted to the coronary care unit after cardiac catheterization. These conscious patients report feeling uncomfortable in the CCU, but no studies have been done on the effects of bed rest, sand bags on the femoral puncture site and restricted mobility for 4 to 12 hours or longer postprocedure. The main objective of this thesis is to provide basic data to nursing on interventions which decrease the uncomfortableness experienced by patients in the CCU following cardiac catheterization. In this phenomenological study, the various discomforts felt by the patients were collected and classified. The study subjects were a convenience sample of 29 patients who were admitted to the CCU of a general hospital in Inchon following cardiac catheterization. They were conscious, so they were able to communicate without difficulty. The data were collected over an 86 days period from July 21, to October 14, 1994. The subjects were interviewed using unstructured open questions and the interviews were tape recorded with the patient's permission. The data were analyzed using the Van Kaams phenomenological method. Reliability and validity were examined by two professor of nursing science, one head nurse, one staff nurse and one cardiologist. The results of the study are summarized as follows: 1. The 129 descriptive statements by the postcardiac catheterization patients of discomfort were organized into 19 themes. 2. The 19 themes were divided into 3 categories; physical, psychological, and environmental aspects. 3. The problems concerning the physical aspect were the discomfort of restriction of movement, dysuria, medical devices, pain in the puncture site, symptom is related to the procedure of cardiac catheterization, headache and dizziness, leg pain and tingling sensation, and chest pain. The problems concerning the psychological aspect were regret resulting from dependency, economic burden, dissatisfaction with medical personnel, dissatisfaction with medical service system, anxiety about the result of the procedure, concern about the prognosis, loneliness, and concern over treatment procedure. The problems concerning the environmental aspect were influence from neighboring patients, noise, and maladaptation to environmental change. The necessity for holistic care which satisfies physical, psychological, and environmental need must be emphasized in order to solve these discomforts.

The objective of this study was to develop a scale to measure stress in infertile couples and to test its reliability and validity. Prior to item generation, a basic decision was made to conceptualize stress in infertile couples as including two dimensions and four subdimensions. The dimensions were, intrapersonal stress including cognitive and affective stress, and interpersonal stress including marital and social stress. Initially 95 items were generated from the interview data of 31 primary or secondary infertile women and from a literature review. These items were analyzed through the Index of Content Validity(CVI) and 69 items were selected which met 70% or more of the CVI. This preliminary Infertility Stress Scale were analyzed for reliability and construct validity. Item analysis and factor analysis were applied for construct validity. Forty items were selected through item analysis. This procedure was based on the inter-item correlation matrix, a corrected average inter-item correlation coefficient (.30~.70), a corrected item to total correlation coefficient(.03 or more) and information about the alpha estimate if this item was dropped from the scale. The result of the initial factor analysis including varimax rotation produced eight factors. Five items deleted because of factor complexity (indiscriminate facter loadings). The secondary factor analysis including varimax rotation produced seven factors that coincided with the conceptual framework posed for the scale developed. The seven factors were labeled as 'meaning of children', 'worthiness', 'tenacious thinking', 'marital satisfaction', 'sexual satisfaction', 'familial adjustment' and 'social adjustment'. The alpha coefficient relating to internal consistency was .93 for reliability. The results of this study suggest that the measurement derived from the Infertility Stress Scale is useful in assessing the stress of infertile couples.

No abstract available.

Pain management of postoperative patients or patients suffering from terminal cancer became one of the most important task of nurses in recent years. This study analyzed basic knowledge of 175 student nurses in Taegu on the pain assessment and management. The questionnaires included five areas: Assessment, pharmacological actions, medication, classification of opioids, and psychological dependence of analgesics. The results indicated that nursing students, in general, lacked knowledge on pain management: Correct responses on pain assessment varied between 9.7 and 100%; classification of opioids was in ranges of 61.7 to 95.4%: Pharmacological actions was 16.6 to 80%; and medication was 14.9 to 85.7%. Less than 12.6% of students correctly identified the frequency of psychological dependence. These results suggested that the need of reinforcement on the pain management in formal nursing education.

The research questions of this study were: Will the level of sexual satisfaction of women who have had a hysterectomy 4 months before be decreased compare to the level of sexsual satisfaction before the hysterectomy?, Will the level of perceived spouse support of women who have had a hysterectomy 4 months before be decreased compare to the level before the hysterectomy?, and What is the relationship between sexual satisfaction and spouse support? This is a perspective descriptive correlational study. The number of subjects was 44. The subjects were limited to Korean women who had an abdominal or vaginal hysterectomy for non-malignant diseases, were married (living with their husbands), mentally healthy, and premenopause at the time of operation. The instrument was consisted of 4 items of demographic characteristics, 13 items of spouse support, and 10 items of sexual satisfaction. The instrument of sexual satisfaction was a component of the Derogatis Sexual Function Inventory. Data analysis was done by paired t-test to see the differences between the pre- post scores of sexual satisfaction and spouse support. The Pearson Correlation Coefficiency was calculated to see the relationship between the scores of sexual satisfaction and spouse spport of pre-post hysterectomy. Results were summerized as follow: The mean age of the subjects was 43.5 years; 72. 1% of the subjects were above middle school graduates: their mean income level was 1,453,000 Korean won and 86.4% of the subjects have had bilateral oophrectomy. 1. The scores of sexual satisfaction of women at 4 months after hysterectomy was decreased significantly compare to the score before hysterectomy (paired t=. 274, p=.009). 2. The scores of spouse support of the women at 4 months after hysterectomy was not decreased significantly compare to the score before hys-terectomy(paired t=.19, p=.847). 3. The scores of sexual satisfaction and spouse support before hysterectomy was significantly related(r=.5186, p=.000). 4. The scores of sexual satisfaction and spouse support at 4 months after hysterectomy was significantly related (r=.4110, p=.005) It can be concluded that the sexual satistaction level could be decreased 4 months after the hysterectomy, but the spouse support level may not be decreased at 4 months after hysterectomy. Further studies have to be done to identify the factors related to the decrease of sexual satisfaction and spouse support after hysterectomy.