Circadian rhythm is entrained in the 24-hour time interval by periodic factors in the environment, known as zeitgeber. But most rotating work schedules are outside the range of the entertainment of the pacemaker timing the human circadian sleep-wake cycle. It has been postulated that physiological and emotional disturbances occur in most human functions when the circadian rhythm is disturbed. So application of circadian principles to the design of shift schedules can aid in maintaining the temporal integrity of the circadian system and thereby minimize for the shift worker any detrimental consequences of circadian disruption. The study was quasi-experimental study to test the effect of shift intervals for the clinical nurse on the circadian rhythm. Twenty nurses newly employed in general units of two hospitals were selected as an experimental group and twelve college nursing students as a control group. Both groups were selected according to an established criteria using a purposive sampling technique. Ten subjects were assigned to weekly shift group and another ten to a biweekly shift group engaged in a semi-continuous shift schedule(sunday off) with a backward direction, that is, morning-evening-night shift. The control group worked a morning shift for 42 days. Oral temperature rhythm, waking time, sleep-wake cycle, fatigue, and mental performance were measured during the experimental period. The data collection period was from April 30, 1990 to June 10, 1990. MANOVA, paired t-test, ANOVA, and Student Newman Keuls method were used for statistical analysis. The results are summarized as follows. 1. Phase delay in the acrophase of temperature rhythm was shown according to the backward rotating shift. A complete adaptation to work on the night shift was achieved between the sixth and ninth day of the night shift. 2. There was no difference in either waking time or sleep-wake cycle according to the duration of the working day for every shift group. Significant difference was found in the waking time and the sleep-wake cycle for subjects on the morning, evening, and night shift in both of the shift groups(weekly shift group : lambda=0.121, p<0.01, lambda=0.112, p<0.01, biweekly shift group : lambda=0.116, p<0.01, lambda=0.084, p<0.01). 3. There was no difference in fatigue between the first working day and the last working day for the control group and for the biweekly shift group. In the weekly shift group, physical fatigue was significantly different for the first day and the sixth day of the night shift(t=-2.28, p<0.05). Physical fatigue and total fatigue on the first day of the night shift showed a significant difference among the control group, the weekly shift group, and the biweekly shift group(F=5.79, p<0.01, F=4.56, p<0.05). There was a significant difference between the shift groups and the control group(p<0.05). Physical fatigue, neuro-sensory fatigue and total fatigue on the last day of the night shift showed a significant difference among the control group, the weekly shift group, and the biweekly shift group(F=12.65, p<0.01, F=7.77, p<0.01, F=9.68, p<0.01). There was a significant difference between the shift groups and the control group(p<0.05). 4. No difference in mental performance was seen between the first day and the last day of work in each case. An arithmetic test on the first day of the night shift revealed a significant difference among the control group, the weekly shift group, and the biweekly shift group(F=3.79, p<0.05). There was a significant difference between the shift groups and the control group(p<0.05). The digital symbol substitution test and the arithmetic test on the last day of the night shift showed a significant difference among the control group, the weekly shift group, and the biweekly shift group(F=3.68, p<0.05, F=5.55, p<0.01), and both showed a significant difference between the shift groups and the control group(p<0.05). Accordingly, this study showed that during night duty, the waking time, sleep-wake cycle, and fatigue increased and mental performance decreased compared with morning and evening duty. It was also found that the weekly shift group had a higher fatigue score on the sixth day of night duty as compared to the first day, but the waking time, sleep-wake cycle, and mental performance revealed no difference for the duration of the night duty or between shift groups, and complete adaptation of temperature rhythm was achieved between the sixth and ninth day of night duty. It is possible to conclude from these results that for intermediate circadian type in a healthy young woman, a biweekly shift system is more compatible with the circadian timing system than weekly shift system.

The intent of this longitudinal descriptive correlational study is to investigate the change of the mother-infant interactions over the periods of one month, three months and six months of the infant's age. This study is also intended to explore the interrelationships among three major factors-the perception of pregnancy, the mother-infant interaction and the maternal attitude. The samples participated are 36 pairs of mother and infant from two university hospitals in Seoul. A data collection was made, from October in 1988 to September in 1989, for each subject at five periods of time ; prenatal period(after 36 weeks in pregnancy), postpartum two or three days, one month, three months and six months of infant's age. The research tools used in this investigation are Mother-Infant Play Interaction Scale (MIPIS), Prenatal Self-Evaluation Questionnaire and Cohler's Maternal Attitude Scale. Some of the findings are as follows ; 1. There is a significant increase in the mother-infant interaction from one month to three months and six months of infant's age. The highest score of the mother-infant interaction during three periods is at the time of three months. 2. The primipara's mother-infant interaction is not affected by the demographic characteristics, such as age, education and vocation of mother, types of delivery, or sex of infant. 3. Among seven categories of the perception of pregnancy, the most positively perceived categories by primiparas are acceptance of pregnancy and identification of a motherhood role ; whereas the negative ones are preparation for labor, concern for well-being of self and baby, and fear of pain, helplessness and loss of control in order of negativity. 4. There is no significant relationship between the perception of pregnancy and the mother-infant interactions. 5. There is no significant change in the maternal attitude over the period of one month, three months, and six months of infant's age. 6. There is no significant relationship between the maternal attitude and the mother-infant interactions. 7. The significant relationships are found between the perception of pregnancy and maternal attitude, especially in the categories of concern for well-being of self and baby, acceptance of pregnancy, identification of a motherhood role, fear of pain, helplessness and loss of control, and relationship with husband. In conclusion it is confirmed that primipara's mother-infant interactions change over time period, and that perception of pregnancy and the maternal attitude do not affect the mother-infant interactions despite a significant relationship between those two variables. The implications of this investigation include a suggestion that nurses need to teach and demonstrate to mothers how to care for and interact with their infants, with a view to improving the mother-infant interactions which can be obtained through the improvement of maternal sensitivity to their infants.

A written association test has been conducted to establish the concept, the meaning and the process of hope. The test consists of the major question : List of three words related to "hope". The question was given to 55 nurses(rehabilitation / cancer / internal medicine care wards units) and 61 patients. A total of 289 words have been collected, and the collection was analyzed with categorization by the value or meaning of listed words. The analysis yields three major categories, namely, components of hope, metaphors/symbols, and synonyms. The three major categories may be further partitioned into subcategories. The results are significant to define the nature of the hope and process of the hope. These understanding will facilitate the development of effective methods of nursing or chronic or cancer patients disabled.

Nursing, a profession, continues its efforts foulard professionalization. Attention to efficiency and effectiveness of its organizational system must be balances with that of maintaining quality of care. The wise use of personnel is of particular concern. The structure of nursing's administrative organization is very important, because most nursing services are delivered through an organization. Professional bureaucracy is recommended for the structure and managerial strategy of nursing's administrative organization, Specifically, considerable decision-making in their work should be transferred to the staff nurses who province professional nursing services in direct interaction with the public. The co-ordinative parameters of the system should be based on professional nursing knowledge. The premise required by this commitment would be built on the identification of nursing knowledge and intellectual and behavioral standard of nursing practice.

Correlations among body weight and sociodemographic factors, including life-style were tested as social determinants of health in a sample of 5,201 adults in Korea. The aim of this study was to determine the extent to which sociodemographic variables and life-style associated health behaviors explain body weight distribution. A second aim was to explain the relation of body weight and health status to stress the importance of body weight as an early risk indicator of health status. The canonical correlation between the weight distribution(underweight and overweight) and the independent variables was 0.29, 17% of the total variance was explained. Perceived health level represented the highest contribution(canonical coefficient 0.82) to body weight. Sociodemographic factors such as sex, economic status, and life-style factors such as smoking, exercise, regular meals and sleep showed comparatively high contributions to body weight. The relevance of body weight for health status including the rate of chronic disease and the rate of medical utilization was significant. Especially, underweight was clarified as being more important than overweight to morbidity level and medical utilization. These findings suggest that perceived body weight is an important indicator status and is thus a valuable variable to be considered for nursing intervention and health education related to the promotion of health.

The purpose of this study is to verify the effect of lateral position and chest percussion on gas exchange in the decreased level of conscious patients. The Subjects for this study were 21 patients' admitted in ICU of CNUH from Dec 18th, 1989 to Aug 4th, 1990. The Data was analyzed by paired t-test. The results of this study as follows ; 1) In comparison of supine position, good-lung dependent position and good-lung dependent with chest percussion, the difference of PaO was statistically significant(p<0.05). 2) In comparison of supine, good-lung dependent position and good-lung dependent with chest percussion, the difference of A-a Do was statistically significant(p<0.05). In conclusion, the use of good-lung dependent position and chest percussion was effective nursing intervention on decreased level of conscious patients in ICU.

The problem addressed by this study were to explore the effect of hardiness on psychosocial adjustment of persons with a colostomy and to identify factors which influence that psychosocial adjustment. The purpose was to suggest a theoretical base for the planning of supportive nursing interventions to increase the level of adjustment. Among members of the Korea Ostomy Association, 34 subjects who had undergone colostomy from March, 1990 to March, 1991 were selected as the sample. Data were collected from April 8 to May 8, 1991 using a mailed questionnaire. The instruments used for this study were the Health-Related Hardiness Scale(Pollock, 1984) and the Psychosocial Adjustment to Illness Scale(Derogatis, 1975). ANOVA, Pearson correlation coefficient and Stepswise Multiple Regression were used for data analysis. The results of the study are summarized as follows. 1. Hardiness was significantly related to psychosocial adjustment(p=0.009). That is, the higher the hardiness, the higher the level of psychosocial adjustment. 2. Among the demographic variables, only economic level was significantly related to the level of psychosocial adjustment(p=0.005). 3. The important factors influencing the level of psychosocial adjustment of persons with a colostomy were economic level, commitment, challenge(subconcepts of hardiness). Therefore, in order to increase the level of the psychosocial adjustment, it might be helpful to provide them with hardiness training to strengthen their commitment and their challenge.

Pain is a subjective and multidemensional concept. Therefore the patient's expression of pain have been referred to the best believable indicator of pain condition but the support data obtained from the patient considered cultural deference is a deficient condition in determined on the precise nursing diagnosis. The purpose of this research was to understand multiple pain reponses in cultural difference and sensitivity, to encourage communication between medical teams, and to provide the foundation data of on data of precise nursing assessment for the patient in pain. The research problem was to grasp pain express pattern of Korean peptic ulcer patients. The subjects were 20 peptic ulcer patients in medical unit or OPD of two university hospitals in Seoul. Data were collected from September 7th to 22nd, 1990 by intensive interviews. Interviews were done by the researcher and all were tape-recorded. The Data analysis was done by Phenomenological method from Van Kaam. Validity assured by confirmation of the internal consistency of the statements and category by nursing college in educational and clinicians in medical care. From the emic data, 96 descriptive statements were organized in 18 theme cluster. The results of study were summarized as follows. 1. Pain Express Pattern cluster of Peptic Ulcer Patients were "pain as clogging", "shallow pain", "pain as pressing", "nauseating pain", "pain as smarting", "pain as pulling", "pain as pricking", "pain as bursting", "wrenching pain", "excising pain", "uncontrollable pain for mind and body", "awakening pain", "pain as hollowing" and the other cluster. As above mentioned, Pain Express Pattern of Peptic Ulcer Patient appeared diversely in verbal and they were propered to Korean culture. Therefore they will provide for the foundation data of precise nursing assessment.