The most effective modality for cold application and the length of the application have not been determined despite many studies about the use of cold. A quasi-experimental study was conducted to examine the most effective modality among three methods of cold application, the most effective length of time for the application and the continuing effect after each type of cold application. Thirty adult patients admitted to medical and neurnsurgical unit and with high fever (above 38.2 degrees C) were assigned randomly to each of three cold application methods: (a) ice bag; (b) cold compress; and (c) tepid water sponge bath. Each method was applied to the whole anterior surface except the face and neck with the patient in the supine position. Rectal temperatures and skin temperatures (mid chest, upper arm,thigh and leg) were measured before each application and every 10 minutes during each application for a period of 60 minutes. They were also measured every 10 minutes for 30 minutes after each cold application was finished. The experiments were carried out from Dec. 22. 1992 through Feb. 26,1993. The data were analyzed using means, ANCOVA, Sheffe test and Pearson's Correlation Coefficient. The results of this study are as follows: 1. There were no significant differences among the three cold application methods in the reduction of body temperature. 2. Among the ice bag, cold compress and tepid water sponge bath groups, the ice bag proved to be the most effective method for lowering skin temperature while the cold compress was least effective. 3. Both rectal and skin temperature continued to decrease during the 60 minutes of cold application, but the hunting phenomena was not observed at any of the cold application sites. 4. There were no significant correlations between mean rectal and skin temperatures. 5. Skin temperatures according to the cold application sites decreased to a range of 3.46 degrees C to 5.20 degrees C (mid chest), a range of 4.48 degrees C 4.96 degrees C (upper arm), a range of 3.86 degrees C to 5.05 degrees C (thigh), and a range of 5. 42 degrees C -7.12 degrees C(leg). 6. In continuing effect after the cold applications were finished, rectal temperatures according to ice bag, cold compress and tepid sponge bath decreased to 0.29 degrees C, 0.23 degrees C and 0.09 degrees C respectively,while the mean skin temperatures increased to 2.39 degrees C, 2.04 degrees C aud 2.22 degrees C respectively. In this experiment the ice bag was the most-effective modality for lowering skin temperature, whenever cold is applied for systemic effect, the continuing effect of cold should be considered. The determination of the most effective length of time for cold application needs further study.

This study evaluated the effect of diabetic group teaching programs in one university hoapital in Seoul to predict when re-education would be needed. This study examined the patients' knowledge at four points (before, directly after, three months and six months after the teaching program) and self-care performance related to diabetes twice (three months and six months after the teaching program). The subjects of the study were 34 admitted diabetic patients who participated in four-day teaching programs. Data were gathered from January to October, 1992 by means of an instrument developed from two diabetic knowledge tests which were equivalent in item differentiation and item discrimination coefficients. Collected data were analyzed by paired t-test, Pearson correlation, t and F tests. The results of study were as follows. 1. The analysis of the effect of the diabetic group teaching program and the duration of the effect of teaching. 1) The first hypothesis, that the diabetes knowledge score directly after the teaching program would be higher than before, was rejected (t=-1.40 ;p=.172). 2) The second hypothesis, that the diabetes knowledge score directly after teaching would be higher than three months later, was rejected(t=-4.27; p=.000). 3) The third hypothesis, that the diabetes knowledge score three months after teaching would be higher than six months later, was supported(t=2.43; p=.020). 2. The relation of knowledge and self-care performance 1) The forth hypothesis, that the level of self-care performance related to diabetes three months later would be higher than six months later, was rejected(t=1.49; p=.146). 2) The fifth hypothesis, that the higher the diabetes knowledge, the higher the level of self-care performance, was rejected(r=.2086: P=.118). 3. The relation of diabetes knowledge and self-care performance according to demographic variables and structural variables of diabetes. 1) Diabetic knowledge scores varied according to the educational levels of the clients directly after the teaching. Three months after the teaching program higher educational levels and higher economic status were related to higher diabetic knowledge scores and men had higher knowledge scores than women. 2) Self care performance scores of men were higher than those of women at three months and six months after the teaching program. 3) Before the diabetes teaching, the diabetic knowledge scores of subjects who had a dia-betic patient in the family were higher than those who did not have patient in their family. Six months after the teaching, the diabetic knowledge scores of subjects who read the distributed books about diabetes were higher than those who did not read them. 4) No significance differences were found between self-care performance and structural variables of dialetes. The results of this study indicated that the levels of diabetes knowlege and self-care performance incease of three months after the teaching program but decrease of six months. Reeducation would be needed between three and six months. The investigator thinks that a study of the content and teaching methodology is needed to increase the education effect. The subjects want to hear patient histories of diabetic management. Group discussion would be helped after the teaching sessions.

Inpatients are mostly occupied in bed with restric ted activity, nearly all patient populations are at risk for the occurrence of skeletal muscle atrophy due to decreased level of activity. Restriction of mobility is far greater in pediatric patients compared with adult patients since almost all the activities of daily living is performed by parents or caregivers. It could be assumed that pediatric patients are more vulnerable to skeletal muscle atrophy than adult patients, however, there have been no attempts to reduce the atrophy of developing muscle. Therefore it is important to determine the effect of exercise in developing muscle during decreased activity. The purpose of this study was to determine the effect of periodic weight support during hindlimb suspension on the mass and cross-sectional area of Type I. and II fibers in developing soleus (Type I) muscle. To examine the effectiveness of periodic weight support activity in maintaining mass and fiber size, the hindlimb of young female Wistar rats was sus-pended(HS) and half of these rats walked on a treadmill for 45min/day(15min every 4h) at 5m/min at a 15 grade (HS-WS). After 7days of hindlimb suspension, soleus wet weight was 28. 57% smaller and relative soleus weight was 28. 21% smaller in comparison with con trol rats (p<0.05) Soleus wet weight and relative soleus weight increased by 67.72% and 71.43% each with periodic weight support activity during hindlimb suspension (p(0.01. p<0.005), moreover soleus wet weight and relative soleus weight of the HS-WS rats were greater than those of the control group. No change was observed in fiber type percentage of the developing soleus muscle after 1 week of hindlimb suspension plus weight support activity. Type I and II fiber cross-sectional areas of the developing soleus muscle were 50.45% and 43.39% lower in the HS group than in the control group (p<0.0001), type I and II fiber cross-sectional areas of the developing soleus were 24.49% and 29.93% greater in the HS-WS group than in the HS rats (p<0.0001), whereas Type 1 and II fiber cross-sectional areas of HS-WS group were less than those of the control group. The results suggest that periodic weight support activity can ameliorate developing soleus muscle atrophy induced by hindlimb suspension, even in type II fibers that would not have been expected to be recruited by this type of neuromuscular demand. Clinical experimental study is needed to determine the effect of periodic weight bearing exercise on developing atrophied leg muscle based on these results.

This study was designed to develop and test a model of the theoretical structure of factors influencing womens' attitudes toward menstruation, specifically, premenstrual discomfort or pain, negative affect, disability and role acceptance. The conceptual framework wa3 built through are view of the literature. For the purpose of testing the model, data were collected from April to June, 1992 with the use of Menstrual Distress Questionnaire, Menstrual Attitude Questionnaire, Sex Role Acceptance Scale. Data analysis was done with the SPSS PC+ for descriptive statistics and PC-LISREL 7.13 for covariance structure. The study subjects consisted of 320 women college students in 2 three-year nursing junior colleges and 1 department of nursing of a college of medicine. The mean age of the subjects was 19, the mean age at menarch was 13.7, the mean menstrual cycle was 29.7 days and the mean menstrual duration was 5.3 days. The amount of menstrual discharge was moderate and the menstrual cycle variability was within 3 days. The score for pain, negative affect and disability were higher during the perimenstrual period than intermenstrual period. The fit of the hypothetical model with the six paths and the empirical data was high [X2(df=4) =. 57 (P=.966), GFI=.999, AGFI=.997, RMR=.008]. The hypotheses were supported on acceptable level of significance. 1) The higher the pain and negative affect, the stronger the disability. 2) The higher the pain, negative affect and disability, the more negative the attitudes toward menstruation. 3) The lower the women's role acceptance, the more negative the attitudes toward menstruation. The model was supported by the empirical data, and thus these results may help nurses and nursing scientists to understand and support these phenomena of womens' health experience.

The purpose of this study was to identify effective methods to minimize increases in intracranial pressure(IICP) during endotracheal suction by means of comparing two methods of hyperventi-lation and oxygen supply before and after endotracheal suction. In order to evaluate the effects of these two methods, the ICP during suctioning and the sustained time of I ICP were measured. For hyperventilation, ambu-bagging was done 10 times for 30 seconds with a tidal volume of 800-900ml. For oxygen supply, 100 percent oxygen was supplied for 2 minutes before and after suction. The subjects for this study were 12 neurosurgical patients who had had a subarachnoid bolt inserted for ICP monitoring and they were all on mechanical ventilatory support in a surgical intensive care unit of Seoul National University Hospital from July 1, 1991 to March 31, 1992. In each patient hyperventilation was performed five times and oxygen supply was given five times and intracranial pressures were measured immediately before and every 30 seconds for 15 minutes after suction. For case assignments counterbalancing and repeated measure designs were combined. And so the total number of experiments were sixty for each group. The effects of hyperventilation and oxygen supply on the IICP and the sustained time of IICP after suction were analyzed by t-test. The results of study were as follows 1. There was a significant difference between the two groups in the increased ICP during suction (t=2.49, p=.014). 2. The sustained time of IICP after suctioning in the oxygen supply group was shorter than that in the hyperventilation group(t=2.35, p=.020) In summary, the Increase in the ICP during suction was lower and the time for the ICP to return to the presuction level was shorter in the oxygen supply group as compared to the hyperventilation group. Therefore, oxygen supply can be recommended before and after endotracheal suction.

This descriptive correlational research was conducted to compare the relationship between self-esteem, performance of antenatal care and health promotion lifestyles for unmarried and married pregnant women. The sample consisted of 94 married women attending one general hospital and residing in Seoul and 82 unmarried women from two social institutes for unmarried women. The tool used for this study was a structured questionnaire which was developed and revised by the researcher. The tool consisted of 12 items related to demographic characteristics, 10 items on self-esteem measurement, 20 items on performance of antenatal care and 37 items on health promotion lifestyle profile. The data collected from the interviews were analyzing using the SPSS, yielding frequencies, percentiles, means, standard deviations, t-test, ANOVA, Pearson's Product Moment Correlation. The results of this study are as follows: 1) The demographic variables for the two groups were heterogenous except for religion. 2) The results of the comparison between the two groups were significantly different for self-esteem, married women(mean 20.41, standard deviation 3. 94) had higher scores on self-esteem than unmarried women(mean 24.02, standard deviation 4.11), (t=-5.91, p.001) 3) There was a stastically significant difference between the two groups on the health promotion lifestyle profile. The married women had higher scores on the health promotion lifestyle profile (t=7.22, p<.001) 4) The 3corc for married women on performance of antenatal care has higher than the score for unmarried women (t=8.83, p<.001) 5) With regard to the relationship between health promotion lifestyle and performance of antenatal care and self-esteem, the correlation coefficient between self-esteem and health promotion lifestyle for married women was .45, between performance of antenatal care and health promotion lifestyle, .54, between self-esteem and performance of antenatal care, .32. For the unmarried women, between self-esteem and health promotion lifestyle, .39, between performance of antenatal care and health promotion lifestyle, .67, between self-esteem and performance of antenatal care, .30. 6) There was a statistically significant different between the two groups on all subconcepts of the health promotion lifestyle profile (p<.001). 7) Comparison of the order of the scores between the two groups for the married women showed that the highest score was for nutrition, then self-actualization, interpersonal support, health responsibility, stress management and exercise in that order. For the unmarried women, the highest score was for self-actualization followed by nutrition, interpersonal support, stress management, health responsibility, and exercise in that order. The score in the exercise domain was lowest in both groups. In conclusion, on the basis of the results of this study, resources and protection facilities for unmarried pregnant women could be improved through government policies and health care policies that would allow unmarried women to utilize significant social support resources and actualize health promotion lifestyles. Nursing should offer interventions to increase psychosocial adjustment and support tp improve the quality of life for unmarried pregnant women and further to promote improved growth and development of the infants.

The purpose of this study was to develop a typology of stress in Nurses through the use of a Q methodology. The research was done between June, 1 and November 30,1992 Fifty nurse working in a hospital were interviewed to solicit statements on their opinions about concepts factors and coping methods related to stress. The statements which were collected were classi fied and categorized to a find list 48 statements. Each of the statements was written dr a seperate card and 30 nurses were a shed to sort the co according the degree of agreement along with quasinormal distribution. The results of the sorting by each subject were coded and analyzed using the Quanal PC progam. As a result of the analysis, four types were identified; Type I was classified and named as neccessary for living Type II was named as stimulues to be avoided Type III was named as situation to be consumption. Type IV was named as self-limited problem which can be solve The correlation among each types was relatively high, but the characteristics of each type are unique and distinct. throughout this study, it was indentified that the type of Nurse's stress would be formed.

This study was carried out to compare perceptions about nursing activities in oriental medical hospital settings. Data were collected from 47 patients hospitalized in an oriental medical hospital, and 41 nurses and 47 oriental medical doctors working in four oriental medical hospitals from July 10th to Sept. 20th, 1991. The findings of this study are as follows; 1. There were significant differences in the perceptions about physical nursing activities between patients (M=44.07) and nurses (M=48.44) (t=-3.09, P =0.003), and between nurses and oriental medical doctors (M=41.47) (t=-5,20, P=0.000). 2. There were no differences in perceptions about psychological and emotional nursing activities between patients (M=27.64) and nurses (M=28.52) (t=-1.02, P=0.310), but there were differences between nurses and oriental medical doctors (M=24. 31)(t=-5.31, P=0.000). 3. There were differences in perceptions about observation, recording and implemention of medical care activities between patients (M=53.65) and nurses (M=57.08) (t=-2.15, P=0.034), but there were no differences between nurses and oriental medical doctors (M=57.28) (t=.014, P=0.892). 4. There were no differences in perceptions about nursing management activities between patients (M=24.88) and nurses (M=26.42) (t=-1.91, P=0. 059), but there were differences between nurses and oriental medical doctors (M=24.25) (t=-3.24, P=0. 002).

Koreans are one of the fastest growing immigrant groups in America. Stress responses and stressors among this large cultural minority has been rarely been studied by nursing researeliers. Adjusting to life in foreign country produces a great deal of stress. Differences in culture, language, expectations and social behavior can lead to misunderstandings between health care providers and clients. These misunderstandings are not well accounted for in health assessment. This study investigated the relationship between life events or/and daily activities as a stressor and the symptoms of stress among a sample of Korean immigrants in America. The symptoms of stress scale (SOS) was used to identify stress responses and open ended questions were used to identify life events and daily activities considered by the respondents to be stressful. A simple random sample of 283 subjects was selected from the Directory of the Korean Society of Chicago, New York, Los Angeles, Philadelphia and Seattle. Demographically, the subjects ranged in age from 20 to 69 years, and the percentage of women and men was approximately 50% each. Almost ninety percent of the subjects were highly educated, 17% owners of business, 19% white collar professionals, 14% employed in sales or as skilled/unskilled labor, 27% as housewives and students and 3% had no occupation. The total group SOS mean was 0.8042; the SOS men for man was 0.7371, and for women was 0.8713. The stress response of this subject group was high, -the stress response of women higher than that for men. In an earlier study (June, 1992) with another sample, the total mean SOS score was similar to this one. The main stressful life events or/and daily activities were, in order, economic problems (N?7), interpersonal problems (N=68), children care problems (N=258), health problems (N=49), communication problems (N=42), family problems (N=38), worry about future career (N=36), and religious problems (N=25). There was a significant difference in the SOS means between the group that expressed life events or/and daily activities to be stressful and the group that did not. Interpersonal relationships and economic and family problems were stressors for those who complained about peripheral manifestations, cardiopulmonary symptoms, central-neurological symptoms, gastro intestinal symptoms, muscle tension, habitual patterns, depression, anxiety, emotional irritability and cognitive disorganization. In summary, interpersonal relationships and economic and family problems influenced stress response manifestations. Income, the number of people in the family, the year of immigration, the level of edu cation, and marital status were related to physiologi cal and psychosocial stress responses.