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Volume 27(1); March 1997
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Original Articles
Analysis of Factors related to the Utilization of a Community Health Posts Information System
Chung Yul Lee, Suk Myung Bang
Journal of Nurses Academic Society 1997;27(1):7-12.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.1.7
AbstractAbstract PDF

A computerized Community Health Posts information system was developed in 1991 by Yonsei University, College of nursing and disseminated to more than four hundred Community Health Posts. The content of was published in the journal, The Korean nurses in 1995, volume 34, number 4. Successful adoption to the computer program is related to many factors, such as personal factors and environmental factors. For the computer program to succeed it must be significantly related to the users and therefore it is necessary to analyze these related factors. This study describes the status of the utilization of computer programs in Community Health posts and analyzed the factors related to utilization of the computer program. Of the 801 community health practitioners, 656 responded and data were analyzed using SPSS computer programs. Respondents were from six provinces and about 85% had been working as CHPs for more than five years and 84.1% had graduated from a community college. Of these 656, 42.1% had a computer and about 60% had funding aid from the community or government. The percentage using the community health post's computer program was 22.3%. Community health practitioners were most often using the following content of the computer program ; treatment activities (65.5%), medication management (53.5%), counselling and education (46.4%), bookkeeping (39.5%), chronic disease management (28%), and insurance billing (15.9%). The factors which were significantly related to the computer utility were degree of support from province, years of working, and age. The Community health practitioners who had more support from the province, who had fewer working years, and were younger used the computer program more frequently.

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An Exploration of the Life Experiences of Patients with Chronic Pain: Women with Rheumatoid Arthritis
Hea Kyung Hur
Journal of Nurses Academic Society 1997;27(1):13-25.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.1.13
AbstractAbstract PDF

Rheumatoid Arthritis(RA), a chronic and systemic inflammatory disorder, is characterized by joint pain, swelling and stiffness. Patients with RA suffer from joint pain and overall pain. The painful and disabling consequences of RA are accompanied by a variety of affective, cognitive, and behavioral changes. The purpose of this paper was to explore and describe the life experiences of RA patients by eliciting verbal description of their experiences. Participants were nine persons who were diagnosed with RA, and had if for more than six months. They were asked open ended and descriptive questions in order for them to talk about their experiences in their own terms. Interviews were tape recorded and transcribed verbatim. The transcripts were analyzed by Colaizzi method. From the protocols, 213 significant statements about life experience were organized into 83 formulating meanings which were then grouped into five theme clusters. The major themes that emerged from the analysis were 'Emotional Disturbances', 'Trying to Adapt to the Progress of Treatment', ' Change of Role Performances', 'Experiences related to Family'. The result of this study showed that RA patients and families need nursing care based on a deep understanding of their lived experiences in everyday life. Nurses and other health workers must develop rehabilitation programs that focus on the pain control, functional independence and psychosocial factors.

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Sex Knowledge and Need for Sex Education among University Students
Young Whee Lee, Mi Ra Park, Mi Sook Song, Jin Hee Too, Soon Nam Choi, Yoo Mi Han, Yoon Jung Hwang
Journal of Nurses Academic Society 1997;27(1):26-35.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.1.26
AbstractAbstract PDF

This study was done to examine knowledge about. and need for sex education among university students in Korea. This Study design was descriptive survey design. The data were collected from 540 university students from June 10 to June 30, 1996, using questionnaires developed by the authors. The results are as follows : Those who had sex education had higher scores in sex knowledge than those had not had sex education. The average score for sex knowledge was 71.9 of a maximum score of 100. Knowledge of sexually transmitted disease was scored highest of 79.8, and knowledge of the anatomy and physiology of the reproductive system was scored lowest at 60.9. The subjects who answered 'yes' about the necessity of sex education numbered 529(98%) and the most important reason given for needing sex education was to cope well with physical and psychological developments. Regarding the content of sex education, a choice of relevant contraceptive methods was given the highest rating. Anatomy and physiology of reproductive system was the least chaser subject as the first priority among five topics. Yet, sex education for university students should include anatomy and physiology of the reproductive system, considering the low level of knowledge on this topic in the subjects of this study and its importance as a part of sex education.

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Degree of Cognitive function, Self-esteem and Depression of the Elderly by Aging
Sung, Ki Wol
Journal of Nurses Academic Society 1997;27(1):36-48.   Published online December 18, 1997
DOI: https://doi.org/10.4040/jnas.1997.27.1.36
AbstractAbstract PDF
Abstract

This survey was performed to evaluate and compare cognitive function, self— esteem and depre– ssion in the elderly related to aging. The data were collected from 200 elders in eight homes for the elderly in Taegu. Data collection was done from June 1 to 31, 1996. The scale used to measure cognitive function was the MMSE - Κ (Mini - Mental State Examination—Korea), Self—esteem was measmed using Rosenberg's self-esteem scale and depression using SDS (Self—rating Depression Scale). A comparison of cognitive functionôself- esteem and depression by aging were summarised as follows :

1. There were significant differences on the cognitive function score in the elderly according to age group(F=24.81 P<.01).

2. There were significant differences on the self— esteem scorc in the elderly accoidiug Ιυ age group(F=3.84 P<.5).

3. There were significant differences on the depression score in the elderly according to age group (F-5,90, P<.1).

4. The general characteristics which affected the cognitive function scores of the elders were sex (F=8.45, PC.5) educational level(F-8.86, P< .5) spousing(F=34.59, P<.01), and the perception of health(F-4.63, PC.5).

5. The general characteristic which affected the self-esteem scores of the eiders was the perception of health(F-3.81, P<.5).

6. The general characteristic which affected the depression scores was the educational level (F=3.96 P<.5).

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Changes in Nutritional Status of General Medical Patients During Hospitalization
Young Hee Yang, S Mi Choi-Kwon, Eun Kyung Kim
Journal of Nurses Academic Society 1997;27(1):49-60.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.1.49
AbstractAbstract PDF

The purpose of this study was to determine the incidence of malnutrition among patients on admission to hospital, to monitor changes in their nutritional status during hospitalization, and to determine the factors which might affect changes in nutritional status. The subjects for the study were patients who were admitted to general medicine for more than one week. Patients suffering from cardiovascular, renal disease, or dehydration were excluded. Nutritional assessment of the patients was performed on admission and nutritional status was reassessed one week and two weeks after admission. The nutritional assessment tool consisted of subjective history taking and anthropometric measurements. Biochemical measurements were performed only on admission. For anthropometric assessment ; patients' body weight, subcutaneous skinfolds thickness, % of body fat, body mass index, and lean body mass were measured using caliper or Bio impedance Analyzer. Factors which might influence current nutritional status, like dietary intake, anorexia, nausea, vomiting, diarrhea, sleep disturbance, and number of day of NPO for diagnostic examinations were analyzed. The results are as follows : 1. Of the 59 patients who were studied, 61% were male and 39% female. The nutritional status of all of the 59 subjects was reassessed one week after admission, but it was only done for 22 subjects at two weeks. 2. The anthropometric measurements, including weight, body mass index, lean body mass, body fat, and skin fold thickness, were all significantly decreased at one week after admission compared to the values at admission. On the other hand, two weeks after admission, only body weight and abdominal skinfolds thickness were decreased. 3. The subjects reported anorexia for an average of two days, sleep disturbance for two days, and no food intake due to diagnostic test for one day. In the second week of hospitalization almost none of the patients complained of gastrointestinal symptoms or sleep disturbance except anorexia Food consumption which was measured based on rice intake was 60% of the food served during the first week of hospitalization, and 66% during the second week of hospitalization. 4. There was no correlation between the subjective nutritional assessment and anthropometric assessment. 5. There was no statistical significance in anthropometric measurements among the patients with various diseases whereas sleep disturbance and no food intake due to various diagnostic test was prominent in patients with gastrointestinal diseases.

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A Producing Process for Korean Nursing Knowledge and Discourse on Analytic Prospects
Bong Sook Kwon, Hyoung Sook Park
Journal of Nurses Academic Society 1997;27(1):61-70.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.1.61
AbstractAbstract PDF

The purpose of this study was to identify the producing process for Korean nursing knowledge as applied by Foucault's discourse analytic method. By Foucault's discourse analytic method, the problem is not what is knowledge but sort of knowledge is made up through specific level of practice. A Korean body of nursing knowledge had been discussed since 1980. At the end of 19th century, missionaries transplanted western nursing knowledge and method to Korea. Western nursing knowledge and methods have been developed continuously with both merits and demerits to Korean society. Recently our world has be come a global community via advances in transportation and correspondence. Although each person is different in skin color and shape, there is a clear line between Oriental people and Western people. Nursing science is only one in our world, but western humanistic nursing practice based on western world view and human life has limits. It is natural that the Koreans as Oriental people have a systemic nursing science to reveal the specific experiential and concrete body of nursing knowledge rooted in the Korean world view and human life. Nursing science is to understand human being, to promote health, to promote health, to restore health, to alleviate suffering and to search for principles needed throughout all of human life. In Korea, now is the quickening period to shape a Korean body of nursing knowledge because of shortage of nursing language in matters of intellectual recognition, and unfamiliar practical nursing field where there is no familiarity in the system of nursing research methodology. In reviewing articles from the Journal of the Nurses' Academic Society on Korean body of nursing knowledge, it was found that there are two common features. The first, human body and mind are inseparable that is one unit in this world and health is keeping a harmonious relationship between human body and mind. The second, Korean nursing practice is based on human nature and family ties. Accordingly discourse analysis had a good future prospect to produce a Korean body of nursing knowledge for analytic research on body and mind monism and family centered care based on human nature and family ties.

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Exploratory Study on Developing Model for Smoking Cessation Process
Hyun Soo Oh, Young Ran Kim
Journal of Nurses Academic Society 1997;27(1):71-82.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.1.71
AbstractAbstract PDF

In this paper, the study model, which presents the patterns of how the changing mechanisms are adopted to the changing stages of smoking cessation, was developed modifying the integrative model of Prochaska et al.(1983) with including seven changing mechanisms which were identified by Oh and Kim(1996). Then the developed study model was exploratively tested with 155 University student between 20 and 29 years of age subjects. According to the study results, among the five mechanisms, which are significant in explaining the differences between stages, DUNCAN post-comparison showed that the least applied ones were Stimulus Control, Self Determinism, Cognitive Restructuring in the precompletion stage, and Reinforcement and Dramatic Relief, in the relapsed stage. In the contemplation stage, it was observed that Dramatic Relief is used most frequently and that the other two mechanisms, Information Management and Cognitive Restructuring, showed different results from those inferred in the study hypothesis. In the case of Information Management, it was excluded from the analysis it was not included in explaining significant difference among changing stages, but Cognitive Reconstruction turns out to be a more frequently used mechanism in the action stage rather than in the contemplation stage. Helping Relationship was also excluded in the post-comparison analysis since it was not included in explaining significant difference among changing stages and Reinforcement was a more frequently used mechanisms in the contemplation stage. Stimulus Control turns out to be the connecting mechanism which was most frequently used in both the contemplation and action stages. Self Determination was most frequently used in the action stage rather than in both the contemplation stage and action stage, differing from the presumption of the model. Lastly, subjects in the relapsed stage were utilizing Stimulus Control and Self Determination at the same level as subjects in the precontemplation stage, and the utilization of both Reinformcement and Dramatic Relief was lower than that of the precontemplation stage, that is at the lowest level. Only Cognitive Restructuring was used of the same level as the contemplation stage. The relapsed stage in this study did not represent the preparation for action stage as presumed in the model of Prochaska et. al.(1983) but did show a pattern similar to the initial stage of smoking cessation, However, since this interpretation about the relapser was based on only a small number of relapsers(n=5), this conclusion may not be reliable.

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A Study on the Content of Fundamentals of Nursing in Korea: Focused on Nursing Professors and Clinical Educators
Ku Sook Kang, Eun Sook Kong
Journal of Nurses Academic Society 1997;27(1):83-95.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.1.83
AbstractAbstract PDF

This study analyzed the necessity of detailed items of fundamentals of nursing in college by soliciting answers from clinical nursing educators in hospitals and nursing professors. The questionnaires consisted of four parts. The first part included questions about the general demographic characteristics of respondents, the second part, questions about the general necessity of fundamentals of nursing, the third part, questions about the necessity of 26 items in fundamentals of nursing in knowledge education and about the necessity of 81 items in fundamentals of nursing in practice education, the fourth part solicited free description of ideas about the problems education in fundamentals of nursing in Korea. Thirty professors from universities, 30 professors from community, and 30 clinical nursing educators were randomly sampled and the questionnaires were sent by mail. Seventy people returned completed questionnaires. Ninety three percent evaluated fundamentals of nursing as necessary for nursing not only in knowledge education but also in practice education. They also generally agreed on what items are necessary for fundamentals of nursing. However, opinions about some items were split between nursing scholars and clinical nursing educators. Clinical educators wanted fundamentals of nursing to be more practical and to incorporate recent developments and changes in clinical settings. They described several problems in fundamentals of nursing. One was some the content of fundamentals of nursing overlaps with other subjects, especially with adult nursing. Some respondents also thought that fundamentals of nursing included too many topics. These problems make it difficult for students, scholars, and nurses identify what fundamentals of nursing is. This causes an identity problem in fundamentals of nursing. Some disparity between clinical nursing and knowledge education in fundamentals of nursing was also reported. This was also related to problems lack of clinical experience in teachers of fundamentals of nursing. Some respondents suggested requiring clinical experience for professors of establishing a system of clinical professorship. problems of teaching material were also pointed out. Fundamental nursing skills and knowledge in teaching materials are often old or not appropriate for the Korean nursing situation. The respondents urged the development of teaching materials appropriate for Korean nursing. In order to solve these problems, the authors suggest forming an ad hoc committee which can reformulate and standardize education in fundamentals of nursing in Korea.

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Effect of Endurance Exercise Prior to Occurrence of Muscle Atrophy on the Mass, Myofibrillar Protein Content and Fiber Crossectional Area of Atrophied Hindlimb Muscles of Rats
Myoung Ae Choe
Journal of Nurses Academic Society 1997;27(1):96-108.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.1.96
AbstractAbstract PDF

The purpose of this study was to determine the effect of endurance training prior to occurrence of muscle atrophy on the mass, myofibrillar protein content and fiber crossectional area of atrophied hindlimb muscles of rats. Adult female Wistar rats were trained prior to occurrence of muscle atrophy induced by hindlimb suspension. Training began on the lst day for 10min/day at 15m/min on a 0% grade, training exercise increased daily in time and intensity so that by the 4th week rats were running 60min/day, at 34m/min on a 13.5% grade. Wet weight and relative weight of soleus, plantaris and gastrocnemius muscle decreased significantly after seven days of hindlimb suspension. Wet weight and relative weight of soleus tended to increase and that of plantaris and gastrocnemius tended to decrease in the exercise group as compared to the control group. Myofibrillar protein content of soleus and gastrocnemius tended to in crease and that of plantaris tended to decrease in the endurance trained group as compared to the control group. Fiber crossectional area of Type I, II fiber in soleus and plantaris muscle tended to increase in the exercise group as compared to the control group. Wet weight and relative weight of soleus, plantaris and gastrocnemius decreased significantly, myofibrillar protein content of soleus, plantaris and gastrocnemius increased in hindlimb suspended rats following endurance training as compared to the control group. There was no change in fiber type percentage and crossectional area of type I and II fiber in soleus muscle and that of type I and II fiber in plantaris muscle decreased in the hindlimb suspended rats following endurance training as compared to the control group. Wet weight and relative weight of soleus and plantaris tended to increase, that of gastrocnemius increased significantly, myofibrillar protein content of soleus and plantaris muscle increased significantly and that of gastrocnemius tended to increase in the hindlimb suspended rats following endurance training as compared to sedentary rats following endurance training. Crossectional area of type I fiber of soleus muscle tended to increase, that of type I fiber of plantaris muscle increased significantly and that of type II fiber tended to increase in hindlimb suspended rats following endurance training as compared to sedentary rats following endurance training. The results suggest that endurance training prior to occurrence of muscle atrophy can attenuate the decrease of mass, myofibrillar protein content and fiber crossectional area induced by hindlimb suspension.

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The Effect of the Structured Education on the Early Rehabilitation Knowledge and Activity Performance of the C.V.A. Patients
Hei Jin Lee, Hyang Yun Rhee
Journal of Nurses Academic Society 1997;27(1):109-119.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.1.109
AbstractAbstract PDF

This study had been attempted to set up the strategies of the nursing which can promote the activity performance for early rehabilitation for the patients by examining the effect of the structured patient education on the early rehabilitation knowledge and activity performance of the C.V.A. patients. The study method had been done by investigating the experiment group and control group in advance through the question papers and interview and observation on 65 patients who had been hospitalized at oriental medicine hospital of K Medical Center form July 1st 1995 to the end of Sep, 1995. The analysis of the collected material had been done for the homogeneity test in which general characters of experiment group and control group had been tested by x2 and the homogeneity test of ADL by t-test. To test the hypothesis the t-test had been given for the difference of the early rehabilitation knowledge and activity performance between the two groups and the correlation between early rehabilitation knowledge and activity performance had been tested by Pearson's Correlation Coefficient. The result of the test of the hypothesis is as the below. 1. The 1st hypothesis "The experiment group which had received the structured education should be higher in the early rehabilitation knowledge than the control group" was supported(t=4.45, p=.000). 2. The 2nd hypothesis "The experiment group which received the structured education should be higher in the early rehabilitation activity performance than the control group" was supported(t=2.11, p=.036). 3. The 3rd hypothesis "The higher the early rehabilitation knowledge of the patient the higher the activity performance degree" was rejected(r=.1546, p=.219). In conclusion, the patients who received the structured showed the increase in the degree of early rehabilitation knowledge and activity performance so, it had been judged that education had been prerequisite in increasing the knowledge and activity performance of early rehabilitation.

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The Effect of Structured Patient Education on Knowledge and Behavior about Selfcare in Hemodialysis Patients
Young Ran Jeong
Journal of Nurses Academic Society 1997;27(1):120-127.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.1.120
AbstractAbstract PDF

The purpose of this study was to identify the effect of structured patient education on knowledge and behavior about selfcare in hemodialysis patients, and to find the strategy to promote their selfcare behavior. In conclusion, structured patient education in hemodialysis patients was improved the level of knowledge and behavior about selfcare. But there was a little relationship between the knowledge and behavior about selfcare. That is ; structured patient education is the effective nursing intervention to improve their selfcare knowledge and behavior, but further research is needed to find the factor to increase selfcare behavior in hemodialysis patients.

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The Loss Experience in Women with Hysterectomy
Mi Hae Sung
Journal of Nurses Academic Society 1997;27(1):128-140.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.1.128
AbstractAbstract PDF

When women are removed with their matrix which is a emotionally significant organ of symbol in psychologically adapting themselves to mother and woman, that is threatened and injured with woman role decisively. This study tried to find the efficient nursing intervention method to maintain and promote their health, to cope with health problem, and to inquire into the loss experience of women with hysterectomy by using the phenomenological method. The analysis of the data was made through the phenomenological analytic method suggested by Giorgi. The result of the study was as follows: The factors which have influence on the loss experience of the subjects are an offer of information, support system, age, occupation, economic situation, family history, character, season, the existence of ovary and religion. The loss experience of matrix was expressed in lingual, reactions to the loss of function, sex, body change and husband, in behavioral behaviors in emotion and body. The loss of matrix of the subjects was relived by religion, perineorrhapy, exercise, reading, watching video and diet. The subjects each showed ways of reaction of fatalism, giving-up, coping on the loss experience of matrix. In conclusion, since we ascertained that the nursing in the process of recovery decide the quality of life, though women with hysterectomy undergo various loss experience and adapt to it in the end, it is necessary to give them enough information and educate husband, having on important effect on the loss experience, to be a good supporter. And technically skilled nurses of consultant are thought to be able to contrive better qualitative life of women with hysterectomy as an important bridge between the subjects and their required information, since the nurses have their well-formed position of relationship of confidence through continuous contact with patients and their family.

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A Study for the Development of Korean Nursing Theory: A Humanistic Approach based on Shinhyung, Naekyungpyun in Dongeuibogam
Kyung Rim Shin
Journal of Nurses Academic Society 1997;27(1):141-155.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.1.141
AbstractAbstract PDF

The universe had its order of yang and yin ; all creation are continuously generated, grow and die, which is the results of the harmonious operation by yang and yin. Among all creation, the human is one of the samjae(three bases of the world, which are heaven, earth, and man) and he is from the combined sukhi(a superior khi) of yang and yin. And human life itself is basically a condensed jonghyul(life blood) and at the same time it is only a transient joining of sadae(the four elements of earth, air, fire and water). Yang and yin, the two axes of the world, therefore, are the most crucial and fundamental concept to explain the generation and extinction of all creation, to understand people in time and space, to find out the reality of human life as an organism, and at last, to observe the state of human health. If so, what is the most essential idea in yang and yin? It is taegeuk(chungkhi) or tao(of one yang and one yin). If the property of heaven and earth is kongon, taegeuk is a khi and tao a principle. And it can be sid that a human body is merely a union of hyung and khi, that human life is an essence of sambo, jeongkhishin, that human health is a harmonized coordination of yang and yin because it is from the combined sukhi of yang and yin because it is from the combined sukhi of yang and yin. Hyung, a vessel for smbo, jeongkhishin, is at the bottom and shin is on the top ; the personality and the disposition of individuals differ according to their working. Thus, on the basis of the above discussion, the following can be offered as some suggestions for Korean Nursing Theory. Though human beings are part of Nature, they are the most eminent microcosm among all creation. So, as a subject for nursing, a person should be understood with khijok kyoryu rather than with logical thinking, then mutual trust between the patient and the nurse can be established. The health of a person on the harmony of yang and yin. To be healthy, a person should consider harmonization with Nature(including his surroundings) as well as a balanced human relationships in society. Moreover, it is crucial for each person to obtain hoshim as a method of mind control rather than to only treat the symptoms of disease.

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Determinants of Health Promoting Lifestyle of College Students
Mi Ra Lee
Journal of Nurses Academic Society 1997;27(1):156-168.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.1.156
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This study was undertaken in order to examine the relationship of self-efficacy, control, perceived health status, self-esteem, social support, and demographic characteristics to health promoting lifestyle of college students, and to determine factors affecting health promoting lifestyle of college students. The subjects were 92 students of one university in Taejon. The instruments used for this study were a survey of general characteristics, health promoting lifestyle(44 items), self-efficacy (28 items), self-esteem(10 items), control(8 items), perceived health status( 1 item), and social support(12 items) Analysis of data was done by use of mean, percentage, t-test, ANOVA, Pearson correlation coefficient and stepwise regression with SAS program. The results of this study are as follows. 1) The average item score for the health promoting lifestyles was low at 2.30. n the sub-categories, the highest degree of performance was interpersonal support(2.90), and the lowest degree was exercise(1.67). 2) Male students showed a significant higher score in exercise subscale than female students. Students who had more income had higher scores in self actualization subscale. Students who's family had experienced severe disease had higher scores in health responsibility and interpersonal support subscale. Students who had experienced exercise had higher scores interpersonal support, and stress management subscale. 3) Significant correlation between perceived health status and self-efficacy, perceived health status and self-esteem, control and self-efficacy, control and self-esteem, control and social support, self-esteem and self-efficacy was found. 4) Self-efficacy and control revealed significant correlations with total health promoting lifestyle and all subscales of health promoting lifestyle except self actualization. A significant correlation between perceived health status and self actualization subscale was found. Self-esteem revealed significant correlations only with self actualization and interpersonal support subscale. 5) Significant correlations were found between most of the subscales of total health promoting lifestyle. 6) Self-efficacy was the highest factor predicting health promoting lifestyles of college students (30.55%). Self-efficacy and control accounted for 36.55% in health promoting lifestyle of college students.

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A Study on the Relationship between Nurses' Relative Power and Interpersonal Conflicts
Myung Ok Lee
Journal of Nurses Academic Society 1997;27(1):169-177.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.1.169
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This study aims at empirically clarifying the relationship between power and the interpersonal conflict, including nurses' understanding of their relative power, the causes of interpersonal conflicts with the nurses, and strategies to resolve conflicts in order to understand how nurses' relative power affect their conflicts. For the empirical survey, the population was defined as all the nurses working at a medical organization in Seoul, Korea. 1083 nurses were selected as the sample for the questionnaire survey and statistical analyses. For the sampling, 32 medical organizations were selected by a stratified random method and sub-samples were arbitrarily drawn from each organization to obtain the final sample of 1083 nurses who responded to the questionnaire designed by the researcher. According to the result of the study, most nurses experience conflict more than once a month, and 70.4% of the respondents answered that interpersonal conflicts were directly or indirectly caused by power relations, which indicates that they perceive power relations as the main cause of interpersonal conflicts. Nurses experienced the most conflicts with interns and residents(29.7%), then patients and their families(24.3%), higher-positioned nurses(12.3%), nurse colleagues(7.7%), lower-positioned nurses(6.5%), and staff doctors(5.1%). If we classify these into three groups, the frequency of the conflicts, from most frequent to least, is in the order of doctors, nurses, and patients. In terms of relative power, nurses perceive that they have greater power than patients than patients and their families, lower-positioned nurses, and nurse colleagues. In contrast, nurses perceive that they have less power than interns and residents, higher-positioned nurses, and staff doctors. Among these groups, nurses perceive that they have the most power over patients and the least over staff doctors. These results indicate that nurses tend to experience more conflicts with members of groups that are stronger than themselves in terms of relative power. Nurses use positive strategies such as the compromise strategy(32.3%) or the collaboration strategy(20.3%) to manage conflicts, more than other strategies. However, they use avoidance or competition strategy more at the earlier stage, compromise strategy more in the mid stage, and collaboration strategy more at the later stage of the interpersonal conflict. In relation to power, nurses use the collaboration strategy or the compromise strategy more when their perceived power is greater than or equal to their counterpart's and they use the avoidance strategy or the accommodation strategy if their power is less. In terms of source of power, nurses' perceived relative power is greater in the order of referent power, expert power, reward power, legitimate power, and coercive power, where referent power is perceived as having the greatest power and coercive power is least. Most nurses(69.3%) used their power to resolve a conflict, with positive outcomes. Expert power was used most frequently. Overall, this study strongly indicates that the enhancement of power of nurses to have equal power relations with doctors would heighten the success of conflict resolution, since power is the main cause of conflicts. Specifically, nurses experience most conflicts with doctors against whom they perceive the greatest gap in power, and the choice of a conflict management strategy depend upon their power relations.

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A Study on the Disturbing Factors Which Work against Therapeutic Atmosphere and Environment on Hospital Wards as Perceived by Patients and Nurses
Young Hae Kim, Myoung Eun Han
Journal of Nurses Academic Society 1997;27(1):178-188.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.1.178
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As a descriptive survey, this study was attempted to get basic data necessary to recognize the factors that disturb the therapeutic atmosphere of hospital wards as perceived by nurses and hospitalized patients, to identify differences between the perceptions of the nurses and of patients. The subjects, 159 patients in Pusan National Hospital and 68 nurses working there were sampled between March 18 and April 13, 1996. The tool used to measure the disturbing factors was an amended form of the one developed by Kim, Mae Ja(1983). The differences between each subject's score for each factor were analyzed using means and SD, and the highest 3 items above the mean score for each factor were collected and compared. The results are described below : 1. Subject's perception of main disturbing factors : patients reported that the main factors were 'loss of role and economic trouble', 'the prognosis of disease', 'the change of daily life' but nurses replied that the main factors were 'the prognosis of disease', 'the communication trouble with the medical team and interpersonal relationships'. 'The change of daily life' was not a perceived factor by nurses, but ranked third by patients. 2. Subject's perception degree of each disturbing factor : (1) among the items related to interpersonal relationship, the patient group reported that the worst disturbance was due to severely ill patients in the same room' but the nurse group regarded 'greed to monopolize wheelchairs or other supplies' as the worst disturbance. (2) among the items related to physical factors, the patient group regarded 'limitations to wash their body, physical pain and limitations in physical activity' as the worst disturbance, but the nurse group regarded 'physical pain', and 'limitations to activity or change of appearance' as the worst disturbance. (3) among the items related to the change of daily activity, the patient group regarded 'the boredom of hospitalization or in favorable diet' as the worst disturbance, but the nurse group regarded 'too much noise or unclean room' as the worst disturbance. (4) among the items related to the communication trouble with medical team, the patient group regarded 'the ignorance of their disease due to poor information, the inability to understand the language of the medical team or the difficulty in seeing physician in time' as the worst disturbance, but the nurse group regarded 'the inability to trust physicians and physician's poor attention to patients' as the worst disturbance.

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The Effectiveness of Nursing Organization(I)
Young Joo Park, Sook Ja Lee, Jin Kyu Lee, Sung Ok Jang
Journal of Nurses Academic Society 1997;27(1):189-200.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.1.189
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This study was designed to test relationship between effectiveness of nursing organizations and structural and managerial variables of nursing organizations that are described in the Robbins Organizational theory model. The data were collected through self reported questionnaires from 605 nurses working in, and 782 patients hospitalized in, five tertiary hospitals in seoul. Results showed that according to MANOVA there was a significant difference in nurses job satisfaction and patient satisfaction among the five hospitals. According to cluster analysis of the structural and managerial variables of nursing organizations, the five hospitals were divided into two clusters and there was no significant difference in nurses job satisfaction or patient satisfaction between the two clusters. According to canonical correlation analysis the formalization and centralization of structural variables were shown to be predicting variables for nurses job satisfaction, and the managing job design and managing change of managerial variables were shown to be predicting variables for nurses job satisfaction.

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Effect of the Education on AIDS for Korean Healthe Care Workers
Soon Bok Chang, C W Lee
Journal of Nurses Academic Society 1997;27(1):201-211.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.1.201
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This study was an evaluation study of AIDS education program. The purpose of this study was to clarify the education effects on AIDS for health care workers to develop abetter next education program. This study was done by self reporting with a 67 items of structured questionnaire by 431 health care workers included doctors, nurses, laboratory technicians, and health educators. Data were collected at the time of completion of each AIDS education with the help of education program manager. Both the AIDS related knowledge score and the acceptance attitudes score were significantly higher in the male group, in the medical institution employer group, in the group who have met the HIV infected person, who has known the HIV positive person, and the group of laboratory technician, but the AIDS prevention intention score was statistically higher in the group of female and laboratory technician group. The post education scores of AIDS related knowledge, acceptance attitudes, and preventive intention were statistically higher than those of the preeducation. The most increased item among AIDS prevention intention list was 'I will provide the meeting between the HIV infected persons and the public(+21.9%)'. But even the decreased item among AIDS prevention intention list was 'I will advice to female not to have extra marital sexual contact to avoid AIDS(-3.1%)'. It could be concluded that the health care workers were ignorant of vertical transmission of AIDS, they were afraid of disclosing the infection status, and have less AIDS prevention intention. Therefore is needed to take an assessment process before each new education strategy to increase AIDS related the effect of the education on AIDS.

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The Hope of the Stroke Patients
Lee Sun Kim
Journal of Nurses Academic Society 1997;27(1):212-227.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.1.212
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Cerebrovascular diseases in Korea is an important health problem since mortality and morbidity have been increased rapidly. It marked the 2nd cause of specific death rates in 1993. The stroke causes physical function disorder due to hemiparalysis and emotional disorder, and stroke patients experience helplessness, powerlessness, sense of alienation and loss of hope. These feelings make the rehabilitation difficult because they lose the will of life. The subjects of the study were seven citizens who live in Pusan, are over 50 year old and belong to low income-level. The data were collected from Jan. to Sep. 1195. The researcher as a caregiver and volunteer made confidence of them and asked for their agreement on the purpose of the study. The subjects expressed their experience as openheartedly as possible. The analysis of the data was made through the phenomenological analytic method suggested by Giorgi, which is as follows ; as an unit of description which include the subject' expressions and the researcher's observation, it is examined the theme that express the hope experience with the subject's language(underlining), and the focal meanings are identified. The focal meaning is the crystalization of the theme, which is written in the language of the researcher. After integrating the focal meaning ant make the situated structural description as the meaning of the hope experience identified on each subject's point. After integrating the situated structural description and make the general structural description as the meaning of the hope experience identified on total subject's point the systemizing of the structure of the hope experienced phenomena and the flowing of the consciousness was researched. The conclusions of this study was as follows : The ten sources of hope which the subjects experienced were sorted as under : <mutual relations to others : spouse, children, relatives, fellow believer, health professioner, associate patient group>, <spiritual dependence>, <recovery of physical function>, <rumination of the past life>, <expectation of hte future>, <economic power>, <beledf>, <ability>, <spontaneous participation>, and <recovery of roles>. Their hope was spoken out by the following two kinds of linguistics. First, the hope was expressed in the affirmative expression as follows : <to be dependable>, <to make efforts>, <to keep under control>, <to desire>, <to be pleasant>, <to be peaceful>, <to be grateful>, <to ve help>, self-confidence, Courage>, <to be happy>, <to satisfy oneself>, <to share with others>, <to understand>, and <to be affected, be impressed> Second, the hope was expressed in the negative expression as under : <to be destressed>, <to be uneasy>, <to be sorry, be unsatisfied> <despair>, <to abandon>, <to be fearful>, <to be suffer>, < to bear a burden> <to be confused>, <to be solitary>, <chest trouble>, <to feel heavy> <grief>, <to be daunted>, <to get angry>, <to be uncomfortable>, <to have something regretable> and <to feel guilty>. And their hope was expressed by the following four behavioral expressions : <physical sphere>, <psychological sphere>, <social support sphere> and <spiritual sphere>. The reaction patterns of their experience appeared in the following 4 coping method : <conquest type>, <dependence type>, <adaptation type> and <fate type>. Finally, in the hope structure the sense of certainty don't always coexict with the sense of uncertainty. When the stroke patients try to search for the best quality of life, the senses of certainty and uncertainty make a continual cyclic system in the hope structure.

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Transformational and Transactional Leadership Styles of The Nurse Administrators and Job Satisfaction, Organizational Commitment in Nursing Service
Hyun Tae Park
Journal of Nurses Academic Society 1997;27(1):228-241.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.1.228
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Today's healthcare environment is changing driven by demographic, environmental, social, political and technological forces. These rapidly changing healthcare environment and increasingly professional nursing practice indicate that identifying leadership characteristic of nursing leaders and executives is a vital importance in today's time and also mandate innovative leadership for nursing service. Therefore, the purpose of this study is to examined the transformational, transactional leadership styles of the Nurse Administrators. Also described are the relationships between these leadership style and the job satisfaction, the organizational commitment of their subordinates. The sample consisted of sixteen mid-level nurse administrators, fifty head nurses and one hundred and fifty-three staff nurses of 4 public and private University Hospitals and 1 General Hospital. Data for this study was collected from Sep. 20 to Oct. 5by Questionnaire(Bass' MLQ, Job Satisfaction scale developed by Poter et al(1978). Organizational Commitment scale by Poter at al(1070). The data was analyzed by frequency, percentage, one-way ANOVA, Pearson's Correlation Coefficient with SPSS PC+ program. Major findings are as follows : Appropriate one-way ANOVA tests revealed that the difference for transformation and transactional leadership styles of nurse executives, mid-level nurse administrators, head nurses as perceived by their immediate subordinates were statistically significant(P<.05). The scores of transformational and contingent reward behaviors were declined of the mid-level nurse administrators, nurse executives. The transactional scores of nurse administrators were lower than transformational ones, which is desirable findings. The result of the highest transformational leader by their subordinates, and second was the mid-level nurse administrators. The nurse executives received the lowest transformational leadership scores from their subordinates. These results were opposit to the previous studies. And significant positive correlations were founded between transformational leadership including charisma, intellectual stimulation, individual consideration and contingent reward of nurse administrators and the job satisfaction, the organizational commitment of their subordinates. From the data, it can be concluded that transformational leadership style of nurse administrators promotes the job stratification, the organizational commitment of their staff nurses. Therefore leader looks for potential motives in subordinates, seeks to satisfy higher need, and engages the full person of the subordinate resulting in a relationship of mutual stimulation and elevation.

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J Korean Acad Nurs : Journal of Korean Academy of Nursing
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