Recently, the rate of cesarean section in Korea has been increasing. The results of several previous studies in foreign countries on the emotional responses of cesarean section mothers showed that they might experience difficulties in the mother-infant interaction due to fatigue, lack of early mother-infant interaction, disappointments, anger, feelings of loss of control, and other factors. Human behavior is said to be determined by one's self concept, and self concept is influenced by both internal and external environmental factors. A scale to measure the self concept of cesarean section mothers was needed in order to identify those who might have difficulties in the mother-infant interactions in future. The purpose of this study were to develop a measuring scale, and to test its reliability and validity. The process of this study was as follows. A structured interview was done with 50 cesarean section and vaginal delivery mothers to fine their state of emotional reaction after giving birth to their babies. Based on the results of the interviews, a 50 items Likert scale was developed. The self concept of 268 cesarean section and vaginal delivery mothers who were hospitalized at six hospital in seoul were measured, during the period between Feb. 1 and April 30. Reviewing the discriminating power of each item by means of crosstabulation, ten items were selected for the final scale. The reliability and validity of this ten item scale were tested by Cronbach's alpha and t-test, using spss pc+package. The results of this study and recommendation are as follows. 1. The ten selected items were as follows. I feel pains in my breast.(-) I have a good appetite now.(+) I feel pains in my flank.(-) I feel fine now.(+) My body seems to have returned to its prepregnant state.(+) Thinking of the delivery process, I feel sorry.(-) I want to hold my baby in my arms.(+) I want to keep my own life, even if I became a mother. (-) I want to delegate the care of the baby to my mother/mother in law.(-) I think baby is my alter ege.(+) 2. The reliability of this scale was tested by Cronbach's alpha, and the coefficient of this scale was 0.8066. 3. The construct validity of this scale was tested by means of known group methods. The value of self concept for cesarean section mother was significantly lower than for vaginal delivery mothers(t=-5.51, df=226, p=0.007). 4. The criterion validity of this scale was tested indirectly. Though this scale could discriminate the section and vaginal delivery mothers, the five items on the personal self concept scale didn't show any difference between cesarean section and vaginal delivery mothers. Therefore, the study indicate that those who shows lower values in the personal self concept measurement, that is, lower than 12.03 points, could be regard as "risk mothers". 5. Further studies using this scale to clarify the influencing factors on negative self concept are strongly recommended.

This study was to determined the trend of child rearing attitude, to investigate how variables affect the child rearing attitudes, and to suggest directions for developing much needed parental effective training programer or counselling for autistic child in community. The subjects were seventy six mother's of autistic children who attending to 13 treatment institutions in Korea. The data were collected from 1, March to 30, May, 1985. Maternal Behavior Research Instrument exploited by Schaefer, used as a tool in this study. The research findings obtained were as follows : 1. Mothers, in general, had affective, restrictive attitudes, and were found to be affective, yet did not give a positive evaluation of children's behavior and used fear control extensively, thus made their children dependent. 2. There were no significantly differences in child rearing attitude by children's sex and age. 3. There were no significantly differences in child rearing attitudes by mother's age, education level and religion. 4. There was no significantly differences in child rearing attitudes by father's occupation.

One of the important tasks for new parents, especially mothers, is to establish warm, mutually affirming interpersonal relationships with the new baby in the family, with the purpose of promoting the healthy development of the child and the wellbeing of the whole family. Nurses assess the quality of the behavioral characteristics of the maternal-infant interaction. This study examined the relationships between primiparas perceptions of their delivery experience and their maternal infant interaction. It compared to delivery experience of mothers having a normal vaginal delivery with those having a cesarean section. The purpose was to explore the relationships between the mother's perceptions of her delivery experience with her maternal infant interaction. The aim was to contribute to the development of theoretical understanding in which to vase care toward promoting the quality of maternal-infant interaction. Data were collected directly by the investigator and a trained associate from Dec. 1, 1987 to March 8, 1988. Subjects were a random sample of 62 mothers, 32 who had a normal vaginal delivery and 30 who had a non-elective cesarean section(but without other perinatal complications) at three general hospitals in Seoul. Instruments used were the Stainton Parent-infant Interaction Scale(1981). The first observations were made in the delivery room(for vaginally delivered mothers only), followed by day 1, day 2, day 3 and 2 weeks, 4 weeks, 6 weeks and 8 weeks after birth, for a total of 7-8 contacts(Cesarean section mothers were observed on days 4 and 5 but the data not used for analysis). Observations in the hospital were made during the hour prior to scheduled feedings. The infant was placed beside the mother. Later contacts were made at home. Data analysis was done by computer using as SPSS program and indulged X2 test, paired t-test, t-test, and Pearson Correlation coefficient ; the results were as follows. 1. Mothers who had a normal vaginal delivery tended to perceive the delivery experience more positively than cesarean section mothers(p=0.002). the finding supported the hypothesis I that perception of delivery would vary according to the method of delivery. Mothers' perceptions of birth were classified into three dimensions, labor, delivery and the baby. There was a significantly different and positive perception by the vaginally delivered mothers to the delivery experience(p=0.000) but no differences for labor or the baby according to the delivery method(p=0.096, p=0.389). 2. Mothers who had a normal vaginal delivery had higher average maternal-infant interaction scores(p=0.029) than mothers who had a cesarean section. There were similar higher scores for the 1st day(p=0.042), 2nd day(p=0.009), and the 3rd day(p=0.006) after delivery but not for later times. The findings supported the hypothesis II that there would be differences in maternal-infant interaction for mothers having vaginal and cesarean section deliveries. However these differences decreased section deliveries. However these differences decreased over time ; by eight weeks the scores for vaginal delivery mothers averaged 8.1 and for cesarean section mothers, 7.9. 3. The more highly positive the perception of the delivery experience, the higher the maternal-infant interaction score for all subjects(F=0.3206, P=0.006). The findings supported the hypothesis III that there would be correlations between perceptions of delivery and maternal-infant interaction. The maternal infant interaction was highest when the perception of the baby and delivery was positive(r=0.4363, p=0.000, r=0.2881, p=0.012). No correlations between perception of labor and maternal-infant interaction were found(p=0.062). 4. The daily maternal-infant interaction score for the initial contact after birth to 8 weeks postpartum had the lowest average score 5.20 and the highest 7.98(in a range of 0-10). This subjects group of mothers needed nursing intervention to promote their maternal-infant interaction. The daily scores for the maternal-infant over the period of eight weeks. However, there were significantly different increases in maternal-infant interaction only from the first to second day(p=0.000) and from the fourth to sixth weeks after birth(p=0.000). 5. When the eight items of maternal-infant interaction were evaluated separately, "Expresses feelings about her role as mother" had the highest average score, 1.64(in a range of 0-3) and "Speaks to baby" the lowest, 0.9. All items, with the possible exception of "Expresses feelings about her role as mother", suggested the subjects' need of nursing intervention to promote maternal-infant interaction. 6. There were positive correlations between certain general characteristics, namely, both a higher economic status(p=0.002) and breast feeding(p=0.202) and maternal-infant interaction. There were positive correlations between a mother's confidence in her role as a mother and the perception of the birth experience(p=0.004). For mothers who had a cesarean section, a positive perception of the birth experience was related to the duration of her marriage(p=0.010), a wanted pregnancy(p=0.030) and her confidence in her role as a mother(p=0.000). Perceptions of birth for mothers who had a normal vaginal delivery were positive than those for mothers who had a cesarean section. The level of maternal-infant interaction for mothers delivered vaginally was higher than for cesarean section mother. The relationship between perception of birth and maternal-infant interaction was confirmed. Cesarean section has an impact on the mother's perceived experience of birth which, in turn, is positively related to maternal-infant in turn, is positively related to maternal-infant interaction. Nursing intervention to enhance maternal-infant interaction should begin in prenatal classes with an exploration of the potential impact of cesarean section on the perceptions of the birth experience and continue throughout the perinatal and post-natal periods to promote the mother's ability to control with this crisis experience and to mobilize social support. Nursing should help transform a relatively negatively perceived experiences into accepted, positively perceived and self affirming experience which enhances the maternal-infant interaction.

In order to determine the effect of individual patient teaching through home visiting on compliance with sick role behavior and the blood sugar level in diabetic patients, to determine if the effectiveness of the education was still present four years later and to inquire as to the effective time for a repeat education program this study was done through two quasi-experimental researchers. The subjects consisted of 52 diabetic patients. The results of the study may be summarized as follows ; 1. Hypothesis I, in which the compliance with sick role behavior, the knowledge on diabetes and the health belief of the experimental group who received a diabetic education, was supported by both studies in 1984 and 1988, confirming the effect on diabetic patients of the individualized education through home visiting ; In the 1984 study : Compliance(t=-11.7, p<0.001) Knowledge(t=-5.41, p<0.001) Health belief(t=-4.74, p<0.001) In the 1988 study : Compliance(t=-4.85, p<0.001) Knowledge(t=-2.85, p<0.01) Health belief(t=-2.99, p<0.005) 2. The Hypothesis II, the blood sugar level of the experimental group will be lower than that of the control, was rejected in both studies, 1984 and 1988. 3. The Hypothesis III, the compliance, knowledge and health belief of the experimental group who received the education program in 1984 will not last till 1988, was supported in part, in compliance and health belief, but not in knowledge. In conclusion those who received the education program twice with an interval of 2 weeks, 4 years ago still knowledge of diabetes but compliance and health belief had disappeared.

The purpose of this study was to investigate the correlation of discomfort, self-esteem, personality and life-satisfaction in persons with rheumatoid arthritis and to provide basic data to help them attain a better quality of life. From Jan. 27 to Feb. 24, 1988, 53 patients, registered at a rheumatic clinic at one general hospital in Seoul, were accepted as subjects for this study. The instruments used for this study were a discomfort scale and life-satisfaction scale developed by the researcher, Rosenberg's Self-esteem Scale and Wallston and Wallston's Multidimensional Health Locus of Control(MEILC) Scale. The reliability of the scales were tested by Cronsbach's alpha. The collected data were analyzed by the SAS program using unpaired t-test, ANOVA, and Pearson's Correlation Coefficients. The results were as follows : 1. There was a significant difference in the subjects perceived discomfort level(t=-3.49, p=0.0010) between the onset of the disease(14.87+/-9.02) and the present(19.87+/-8.44). 2. There was a significant correlation between the MHLC-internal score and the MHLC-chance score(r=-0.4366, p=0.0011). 3. The findings related to the demographic variables regarding the MHLC scores were as follows : 1) Regarding sex, there was a significant difference for the MHLC-internal score(t=4.2572, df=15.2, p=0.0007) between male(32.13+/-2.47) and female(27.56+/-2.85) was lower(t=3.1539, df=21.8, p=0.0047) than for female(19.47+/-6.29). 2) Regarding educational background, the MHLC-chance score for the below-high school group(20.52+/-5.81) was higher(t=2.5450, df=51.0, p=0.0140) than the college graduate group(16.41+/-5.76). 4. The average Self-esteem score was 26.87(S.D.=5.29) and there was a significant correlation between the Self-esteem score and the MHLC-chance score(r=0.3122, p=0.0026). 5. It was found that the subjects' Discomfort score(r=-0.3788, p=0.0051) and the Life-satisfaction score(r=-0.3570, p=0.0087). It was also found that subjects' Self-esteem score was correlated with the Life-satisfaction score(r=0.4474, p=0.0008).

The purpose of this study is to assess if ENG biofeedback training with progressive muscle relaxation training is effective in reducing the EMG level in patients with tension headaches. This study which lasted from 23 October to 30 December 1989, was conducted on 10 females who were diagnosed as patients with tension headaches and selected from among volunteers at C. University in Seoul. The process of the study was as follows : First, before the treatment, the baseline was measured for two weeks and the level of EMG was measured five times in five minutes. And then EMG biofeedback training was used to six weeks, 12 sessions in all, and progressive muscle relaxation was done at home by audio tape over eight weeks. Each session was composed of a 5-minutes baseline, two 5-minutes EMG biofeedback training periods and a 5-minutes self-control stage. Each stage was followed by a five minutes rest period. So each session took a total of 40 minutes. The EMG level was measured by EMG biofeedback(Autogenic-Cyborg: M 130 EMG module). The results were as follows: 1. The average age of the subjects was 44.1 years and the average history of headache was 10.6 years(range : 6 months-20 years). 2.The level of EMG was lowest between the third and the fourth week of the raining except in Cases I and IV. 3. The patients began to show a nonconciliatory attitude at the first session of the fifth week of the training.

For a man to maintain attention, he needs to keep a certain level of arousal. An inordinate increase or decrease in the level of arousal eventually has a negative influence on attention. Precedent research has shown that the degree of attention changes when an experience of stress is related to anxiety resulting in a rise in arousal. This research was done to examine this hypothesis by looking at the 27 female students, 14 of whom had failed in the annual examination. The results of the investigation are as follows ; The stress of failure in the examination was seen to raise the level of physiological arousal. Although pulse and electromyography showed no significant change, further inquiries should be made based on other types of methodology. In spite of the rise of arousal, the performance of selective task was degraded. This suggests those students failed to give moderate attention to given information for that kind of task. But the exact reason of that failure was not identified : that is it was difficult decide whether they gave too much attention to the anxiety brought about by stress. Performance of integral tasks, however, did not show any degradation. Judging from these results, stress seems to exert significant influence on attention in the selection of the appropriate information among the various potions given. This offers an important hint in relation to the health care situation where nursing information is offered. Clients who receive nursing information in stressful situations may have difficulty in separating and selecting this helpful information from other options which they have acquired through their life experience. The content and terminology of nursing information may be strange and unintelligible to clients, although they are quite familiar and distinct to nurses. So, it is desirable for nurses to give, in addition and at the same time when nursing information is given, some certain related information as devices for selection, instead of merely giving nursing informations as such. So far it is not clear whether the concept of information processing theory can be suitably applied to nursing. However, it is obvious, according to this research, that the quality of attention is disturbed in the stress situation. This is why further inquiries should be made into attention in practical nursing situation.

The study was conceived in relation to a concern over the growing gap between the needs of chronic patients and the availability of care from the current health care system in Korea. Patients with agonizing chronic pain, discomfort, despair and disability are left with helplessly unprepared families with little help from the acute care oriented health care system after discharge from hospital. There is a great need for the development of an alternative means of quality care that is economically feasible and culturally adaptable to our society. Thus, the study was designed to demonstrate the effectiveness of home health care as an alternative to bridge the existing gap between the patients' needs and the current practice of health care. The study specifically purports to test the effects of home care on health expenditure, readmission, job retention, compliance to health care regime, general conditions, complications, and self-care knowledge and practices. The study was guided by the operations research method advocated by the Primary Health Care Operations Research Institute(PRICOR) which constitutes 3 stages of research : namely, problems analysis solution development, and solution validation. The first step in the operations research was field preparation to develop the necessary consensus and cooperation. This was done through the formation of a consulting body at the hospital and a steering committee among the researchers. For the stage of problem analysis, the Annual Report of Seoul National University Hospital and the patients records for last 5 years were reviewed and selective patient interviews were conducted to find out the magnitude of chronic health problems and areas of unmect health care needs to finally decide on the kinds of health problems to study. On the basis of problem analysis, the solution development stage was devoted to home care program development as a solution alternative. Assessment tools, teaching guidelines and care protocols were developed and tested for their validity. The final stage was the stage of experimentation and evaluation. Patients with liver diseases, hemiplegic and diabetic conditions were selected as study samples. Discharge evaluation, follow up home care, measurement and evaluation were carried out according to the protocols of care and measurement plan for each patient for the period of 6 months after discharge. The study was carried out for the period from Jan. 1987 to Dec. 1989. The following are the results of the study presented according to the hypothesis set forth for the study : 1. Total expenditures for the period of study were not reduced for the experimental group, however, since the cost per hospital visit is about 4 times as great as the cost per home visit, the effect of cost saving by home care will become a reality as home care replaces part of the hospital visits. 2. The effect on the rate of readmission and job retention was found to be statistically nonsignificant though the number of readmission was less among the experimental group receiving home care. 3. The effect on compliance to the health care regime was found to be statistically significant at the 5% level for hepatopathic and diabetic patients. 4. Education on diet, rest and exercise, and medication through home care had an effect on improved liver function test scores, prevention of complications and self-care knowledge in hepatopathic patients at a statistically significant level. 5. In hemiplegic patient, home care had an effect on increased grasping power at a significant level. However, there was no significant difference between the experimental and control groups in the level of compliance, prevention of complications or in self-care practices. 6. In diabetic patients, there was no difference between the experimental and control groups in scores of laboratory tests, appearance of complications, and self-care practices. The above findings indicate that a home care program instituted for such short term as 6 months period could not totally demonstrate its effectiveness at a statistically significant level by quantitative analysis however, what was shown in part in this analysis, and in the continuous consultation sought by those who had been in the experimental group, is that home health care has a great potential in retarding or preventing pathological progress, facilitating rehabilitative and productive life, and improving quality of life by adding comfort, confidence and strength to patients and their families. For the further studies of this kind with chronic patients it is recommended that a sample of newly diagnosed patients be followed up for a longer period of time with more frequent observations to demonstrate a more clear-cut picture of the effectiveness of home care.

The purpose of this study is to identify whether ethical values of Korean nursed are deontological utilitarian . Nurse's ethical value questionnaire was developed from review of literature and interview of nurses in the clinical settings. Content validity was tested from three nursing faculties and staffs. Ethical problems are categorized into four areas : 1) human life area 2) nurse-patient relationship area 3) nurse-nursing task relationship area 4) nurse-colleague relationship area The data were obtained from the 404 nurses in the clinical settings from Feb. to Mar. in 1990 by ethical value questionnaire. The analysis of data was done by Pearson's correlation coefficient, t-test, anova. 1. The ethical values of human life slightly took up the position of utilitarian. 2. The ethical values of nurse-patient relationships slightly took up deontological position. 3. The ethical values of nurse-nursing task relationships slightly took up deontological position. 4. The ethical values of nurse-colleague relationships greatly took up deontological position. 5. The ethics of nurses related to demographic characteristics of religion, attitude of nursing, ethical standards, education level and post. Those who have religion took up more deontological position than those who have not. Those who have positive attitude of nursing and firm ethical standards took up more deontological position than those who have not. Those who have higher education level and post took up more deontological position than those who have not.