Recently, there has been an increasing interchange between South Korea and North Korea. Accordingly, there has been active research to understand the society and culture of North Korea, it has been attempted to have comparative study about nursing education to increase understanding between South and North Korea. In the current educational system, 12 years of education is required for entering a nursing college or university in South Korea, but there are only 10 years for entering nursing college in North Korea. After finishing undergraduate studies one can enter graduate school for a masters degree and or a doctoral degree, but there is a longitudinal relation to medical education in North Korea. Regarding the number of nursing educational institutions, there are 50 BSN programs & 61 Diploma programs in South Korea and 11 Diploma programs in North Korea. In regards to curriculum, South Korea has diverse subjects for general education for freshmen, then is subjects to basic specialities sophomore year, and speciality subject and clinical practices from junior year corresponding to the student's intentions. North Korea has minor subjects for general education and basic specialities in freshmen, speciality subjects sophomore year, speciality subjects and clinical practice in the junior year that may not correspond with the student's intentions. The most outstanding difference in the curriculum is North Korea has various subjects for oriental medicine with clinical application. North Korea also does not teach computer science and English is at a very low level. In clinical practice, South Korea has various settings for clinical practice including community health institutions under the nursing professor or clinical instructor. However, North Korea has limited settings for clinical practice (general hospitals) under a doctor's instruction. Also both South and North Korea have a similar licensing system. Therefore, there must be many more studies regarding North Korea, especially in nursing and nursing education in order to decrease differences and confusion between the Koreas and to prepare for a future unification.

The purpose of this study was to determine the meaning of the pain and experiences of elderly women with osteoarthritis, by adopting Colaizzi's phenomenological method. The participants were 7 elderly women over the age of 65. They were selected using a theoretical sampling technique. The Data was collected by in-depth and open-ended interviews from Dec. 1. 1999. to Feb, 28. 2000. The length of the interviews varied from 120 minutes to 180 minutes. Data was recorded and analyzed by a constant comparative
method
. From the data, significant statements were extracted and then organized into 48 themes, which resulted in 15 clusters of themes and 6 categories. The final descriptions turned out to be valid through the interviewee' validation process. Essential themes of the pain experiences emerged : "physical discomfortness(disturbances)", "negative state of mind", "influence of the death", "positive change in life", "Cause of pain perceived", and "change of their personal relationships". From these results, it was found that elderly women need nursing care based on a deep understanding of pain, and a reflection on their past is imperative to overcome their given situations. In conclusion, it is suggested that the care givers provide more support to solve the problems experienced by the elderly. Thus the researchers expect to provide understanding of older people and give basic data of holistic care for them.

The purpose of the study was to identify the effect of structured patients education had on prevention of osteoporosis, with fracture and the resulting of life style changes in patients. In this study, a non equivalent control group pre and a post test design was employed. Data were collected through an interview process using questionnaires from April to December of 1999. The subjects, consisting of 59 patients with fractures and over 40 years of age, were diagnosed in K University Hospital. This study tested the patients knowledge at three times. The times were before the program 2 weeks into the program, and 6 months after education program. Life style change related to prevention of osteoporosis was shown twice (before and 6 months after the education program) in the experimental group, and control group went without it. The instruments used for this study were developed by literature review according to a reliability test. Data was analyzed using X2 test and t test to determine similarities between the experimental and control groups. The hypothesis was tested using repeated measures of ANOVA, t-test and Pearson correlation coefficients. The results of the study were summarized as follows: 1. The first hypothesis was accepted: a higher level of knowledge about osteoporosis was found in experimental groups who received education than to the control group during the period (F=19.82, p=.0001). 2. The second hypothesis was accepted: a higher level of life style changes about osteoporosis on experimental group were recorded than as compared to control group (t=3.55, p=.001). 3. The third hypothesis was accepted: the higher the knowledge about osteoporosis the higher the level of performance of life style changes about prevention of osteoporosis (r=.600, p=.0001). In conclusion, structured patient education in patient with fractures improved the level of knowledge about osteoporosis and more likely undergo of life style changes 6 months after the education program. Also reeducation would be needed 6 months after program ends. That is structured patient education in pamphlet form would be very effective in nursing intervention that may to result in life style changes. Therefore further research is needed to reinforce the education material and to generalize the education effect.

The purpose of this study was to investigate the impact of depression, discomfort, spirituality, physical care, and opioid use on pain with terminally ill cancer patients residing in hospice units. The convenient sample of this study consisted of 41 terminally ill cancer patients at three hospice units in university affiliated hospitals. Patients were interviewed with structured questionnaires three times at predetermined intervals: admission to the hospice unit (Time 1), one week later (Time 2), and two weeks later (Time 3). The data was collected from January 1998 to January 1999 and was analyzed using ANOVA, Pearson correlation coefficient, and multivariate multiple regression. The results of this study were as follows: 1. The mean age of the participants was approximately 55 years old. In terms of diagnosis, lung cancer showed the highest frequency (19.5%), followed by stomach cancer and rectal cancer (17.1%). The motive of seeking hospice unit admission was control (72. 2%), followed by spiritual care (50%), and symptom relief (38.9%). 2. Regarding the type of pain felt, the highest pain frequency the participants experienced was deep pain (55%), followed by multiple pain (25%), intestinal pain (10%), then superficial (5%) and neurogenic pain (5%). For the level of pain measured by VAS, there was no significant difference among the three time points; Time 1 (5.04 +/-2.21), Time 2 (4.82+/-2.58) and Time 3(4.73+/-2.51). 3. There was significant change seen in spirituality and physical care in each time interval. Namely, the longer the length of admission at the hospice unit, the higher the importance of spirituality (p=0.0001) and the more the physical care the participants received (p=0.01). The opioid use at the three time points showed the following frequencies : Time 1 (75.6%), Time 2 (85.4%) and Time 3 (75.6%). 4. Regarding factors influencing pain, the pain level was significantly affected by the depression level (p <0.01) and the opioid use (p <0.1). These results were the most significant at the two time points (Time 1 and Time 2). At Time 3 (two weeks later), the pain level was significantly affected by the depression level (p <0.05) and the amount of physical care the participants received (p <0.1). In conclusion, the terminally ill cancer patients had moderate pain, were generally depressed, and were treated with opioid analgesics. As approaching death, the patients received more physical care due to increased physical symptoms experienced and they had a higher perception of the importance of spirituality. Thus, health care professionals need to provide continuous care for each of them to die comfortably physically, psycho- logically, and spiritually.

This study was conducted by analyzing all 33 articles based on the LISREL, published from January 1991 to March 1999 in Korea. The analyses consisted of the publication date of articles, principal dependent variables, subjects of the research, adequacy of sampling, adequacy of research purposes and
results
, accordance between theoretical model and hypothetical model, fit measures, theoretical base of model modification, and adequacy of conclusion. The results were as follows : The thesis of 33 articles in total were outnumbered as 25 (75.8%) to 8 (24.2%) research articles. As for a sex classification of the subjects, 45.5% of the research were conducted around a female group of subjects, while 54.5% were done for both sex, The range of the sample size was 105 to 803, and the average was 259 subjects. A single theoretical variable was measured for each measurement variable, any difference between variables was hardly found in 8 articles (24.2%), and 19 articles (57.6%) did not consider any measurement error. To analyze if the representative has been considered while collecting the data, most data were collected by a convenient sampling. Seven articles (21.2%) were seen with a sign of a representative. Questionnaires were used in a majority (31 articles) of the data collecting process. Only 2 articles (6.1%) were measured with a physiologic index simultaneously. 14 articles (42.2%) were centered on theory development, 10 articles on theory synthesis, and 9 articles on theory test. The research purposes and results were consistent in 25 articles (75.5%) and 8 articles (24.2%) were inconsistent. The quality of life and health promotion behavior were the concepts most frequently studied as a dependent variable, and 7 articles centered on them. In applied theories a health promotion model was used on 4 articles (12.1%), while role theory and stress-coping models were in 3 articles respectively. The articles were analyzed to see if the hypothetical model was elaborated and tested by the theoretical model. Twenty-five articles proved to be rationale for the inconsistencies. Also, 56.5% proposed hypotheses were supported among the subject articles, and 30 articles (90.0%) suggested a revised model. Path coefficient (17 articles) and theoretical adequacy (17 articles) were the standards mostly used. In conclusion, the principal factors were obtained from the research are to be considered as the principes of LISREL application. First, a model has to be established on a theoretical base rather than empirical results dependent on the data. The results are also required to be globally interpreted. Secondly, at least 200 samples are necessary to satisfy the need. Third, more than 3 measurement variables are to be adjusted to a single theoretical variable; the measurement errors must be suggested as well. Finally, normal distribution characteristics of the data and the estimation method need to be reported. Based on the research result, the follows are suggested; Systematic criteria on the LISREL application and procedure need to be developed Agreement form is required to report the results of research using the LISREL

When people undergo stressful situations such as a cancer diagnosis, they ask, "why me?" The causal attributions people make about cancer influence what kind of coping strategies are chosen. Weiner (1979) suggested three dimensions of causal attributions: focus of causality, stability, and controllability. The purpose of the present study was to test the relation between causal attributions and self-efficacy in patients with cancer. The subjects were 194 patients who had been diagnosed cancer one year ago and attended an outpatient clinic. 1. Each mean score of causal attribution dimensions (focus of control, stability, controllability) that each patient made about cancer was 2.47, 2.73, 2.86, 3.35, and 3.28. The mean score of self-efficacy was 71.03. 2. There was a significant negative correlation between self efficacy and controllability. Particularly, there was a significant negative relationship between self efficacy and external controllability. Based upon these results, it is recommended that the developing nursing interventions to change causal attribution and self-efficacy is necessary. A number of theoretical relationships and empirical finding are confirmed by this data, and future proposals in research is suggested.

The purpose of this study was to investigate the effects of coping mechanisms on uncertainty and depression. The subjects were 71 cancer patients selected from Junbook National University Hospital, and the data collection period was from June 21 to October 19 of 2000. Uncertainty was measured by using Mishel's Uncertainty Scale, problem- focused coping, and emotional-focused coping. The data was collected by a questionnaire developed by Lee (1984), and then depression measured by using Beck's depression scale. Data was analyzed with SPSS/WIN 7.5 program by Pearson Correlation Coefficients, and Path analysis. The results were as follows : 1. The mean uncertainty score was 59.17, the mean problem-focused coping score was 48.78, the mean emotional-focused coping score was 42.52. 2. The mean depression score was 15.77. 3. Uncertainty in illness was significantly related to depression (p=0.003) and emotional-focused coping (p=0.028), but uncertainty was not associated with coping mechanisms. 4. When analyzed multiple regression between uncertainty, problem-focused coping, emotional- focused coping, and depression, more specifically emotional-focused coping showed a stronger association with depression than problem-focused coping. 5. Depression was highly correlated with economic status (p=0.015), educational background (p=0.005), duration of disease (p=0.045). 6. Problem-focused coping and emotional-focused coping appeared to function as moderators instead mediators on the relation between uncertainty and depression. In addition, as a whole, uncertainty showed a significant moderating effect on depression, while problem-focused coping did on depression. Finally, limitation of present findings were discussed and implications for future studies are suggested.

It is known that a pulmonary rehabilitation program improves dyspnea and exercise tolerence in patients with chronic obstructive pulmonary disease. However, it is also known that although it does not improve pulmonary function. This study was performed to evaluate the effect of a 4 week pulmonary rehabilitation on pulmonary function, gas exchange, and exercise tolerance in patients with chronic obstructive pulmonary disease. The pulmonary rehabilitation programs included breathing exercises, such as pursed-lip breathing and diaphragmatic breathing, upper-limb exercises, and inspiratory muscle training. These activities were performed for 4 weeks in twenty one patients with chronic obstructive pulmonary disease. Pre and post-rehabilitation pulmonary function and exercise capacities were compared after the 4 week period. Results are as follows: 1) Before the rehabilitation, the predicted value of FVC and FEV1 of the patients were 70.3+/-16.7% and 41.1+/-11.9% respectively. These pulmonary functions did not change after pulmonary rehabilitation. 2) Aloility of walking a 6 minute distance (325.29+/-122.24 vs 363.03+/-120.01 p=.01) and dyspnea (p=.00) were significantly improved after rehabilitation. Thus showing that pulmonary rehabilitation for 4 weeks can improve exercise performance and dyspnea in patients with chronic obstructive pulmonary disease.

Many women in the world have suffered from anemia produced by menstruation, pregnancy and delivery. In the theory of oriental medicine, a sour taste is believed to have a tonic effect on the blood. Thus this paper is to investigate the effect of sour tastes on the improvement in anemia-induced female mice, using citric acid and Fructus schizandrae. The method used in this experiment was the change of RBC, WBC, Hemoglobin, Hematocrit, Fe, and TIBC in the blood of female mice who were fed citric acid and Fructus schizandrae. The results obtained were as follows ; 1. Compared with the control group (anemia-induced group without treatment), the mean number of RBC in the blood of mice was significantly increased only in evaluating the change of sample group fed Fructus schizandrae 500mg/kg. 2. Compared with the control group (anemia-induced group without treatment), the mean number of WBC in the blood of mice was not significantly larger in both sample groups fed citric acid and Fructus schizandrae. 3. Compared with the control group (anemia-induced group without treatment), the mean number of Hemoglobin in the blood of mice was significantly larger only in evaluating the change of the sample group fed Fructus schizandrae. 4. Compared with the control group (anemia-induced group without treatment), the mean percentage of Hematocrit in blood of mice was significantly increased only in evaluating the change of sample group fed Fructus schizandrae 500mg/kg and sample group fed Fructus schizandrae 250mg/kg for 3days. 5. Compared with control group (anemia- induced group without treatment), the mean volume of Fe in serum of mice was significantly increased only in evaluating the change of sample group fed Fructus schizandrae 500mg/kg. 6. Compared with control group (anemia-induced group without treatment), the mean TIBC in serum of mice was significantly increased only in evaluating the change of sample group fed Fructus schizandrae 500mg/kg and sample group fed Fructus schizandrae 250mg/kg for 7days. According to these results, a sour taste is presumed to have a general tonic effect on anemia, but more study must be taken on the effects of citric acid in improving female anemia.

Rapid progress in modern medical technology has made it possible to sustain life and/or delay death using 'heroic' treatments. The availability of life-sustaining treatment brings several issues in end-of-life care such as 'dying with dignity' and an radical increase in health care costs. The use of Advance Directives(AD) have been widely heralded by health care providers, gerontologists, and advocacy groups as means of protecting patients' right to accept or refuse life-sustaining treatment in end-of-life care. The use of AD can not only improve patients' autonomy and quality of life but also bring efficiency in distributing health care resources. The proportion of older persons in Korean population has been increasing. Those 65 years of age or over were about 7 percent of the population. Death and dying is not limited to older persons, but it is more prevalent among them. In conjunction with an aging population and the increasing prevalence of death, the issues of death and dying will become crucial in near future in terms of 'dying with dignity', 'autonomy', and 'self-control'. This paper attempts to explode and establish the concept of advance directives (AD) based on literature review. Data sources are computer searches with the MEDLINE database. Due to the lack of prior study on AD for a Korean cases, studies abroad are reviewed. This paper suggests the need for future study on the possibility of the use of AD in Korea.

The purpose of the study was to find out the level of knowledge, attitude, subjective norm, social interaction, and behavioral intention of nursing students regarding AIDS. It also identified factors that predict behavioral intentions and to provide care for patients with AIDS using Theory of Reasoned Action. The subjects consisted of 117 nursing students at three universities. Data was collected with self reporting in a questionnaire of with 67 items. Data was analyzed by an SPSS pc+ program. The results were as follows; 1. The mean age of the subjects was 20.98 years. The mean score for HIV/AIDS knowledge was 24.444 out of 32. Mostly Korean students were quite knowle- dgeable about the basic facts and symptoms of AIDS but confused about the made of transmission such as public toilets, preven- tion methods, and especially infection control. 2. This study found that social interaction, attitudes and subjective norms of Korean nursing students explained the intention to care for AIDS patients. The students who had a more positive attitude toward caring for AIDS patients and those who perceived more support from their significant others for caring the AIDS patients reported a more positive intention to care for AIDS patients. 3. In stepwise multiple regression analysis, 47.58% of the variance in AIDS patient care intention was accounted for by social interaction (33.41%), attitude (9.1%), and subjective norm (5.0 %). According to the finding of this study, and social interaction are the most significant predictors of intentions. Therefore it can be suggested that a HIV/AIDS prevention program should focus on transmission modes and prevention methods, especially in infection control. AIDS education efforts aimed at nursing students should place greater emphasis on correcting these kinds of misconceptions. Nursing intenvention for reducing fear of contagion, improving perception of social interaction, fostering positive attitudes and increasing intention to care for AIDS patients should be provided for nursing students. They also recommended that nursing students be adequately prepared to care for AIDS patients because of the increasing probability that they will encounter AIDS patients. Therefore it is important that education about HIV/AIDS should be incorporated within current undergraduate curriculum.

Major purposes of this study were to investigate the administration patterns of analgesics and sedatives in SICU and to identify the factors influencing the use of prn analgesics and sedatives by ICU nurses. The sample of this descriptive study was 50 adult patients in SICU and 53 ICU nurses. Patient's medical records were reviewed to investigate names, doses, the routes of administration, the interval of administration, and the type of prescription of sedatives and analgesics administered. Study medications were narcotics, hypnotics, and antipsychotics. To identify the factors influencing the use of prn analgesics and sedatives, 53 ICU nurses checked 9 items, and rank them from first to fifth. The selection of items was based on the previous studies and the experience of the investigator. The
results
of the study are as follows: 1. The mean age of the subjects was 53 years, 24 patients out of 50 subjects had received mechanical ventilation therapy. Most of the patients received neurosurgeries and abdominal surgeries. 2. For 4 days, 13 total study medications and combination of these were administered to the patients. Commonly prescribed drugs were Ketoprofen and Midazolam. Twenty six to fourty two percent of the patients did not receive any drugs for at least one day during the four days. 3. On the average, the study drugs were administerd 1.4 to 2.6 times per day during 4 days. 4. More than 50 percent of the prescription was as-needed (prn) except those of the POD 3. Fourteen percent of the patients did not have any prescription for sedation and pain control after surgery. 5. Examination of the frequency of sedatives and analgesics bolus administration revealed that a greater number of doses were given during daytime (from 7 am. to 7 pm.) than nighttime (from 7 pm. to 7 am.). The difference was significant at Alpha, .05. 6. First factor that most influenced nurses to administer sedatives and analgesics for intubated patients was the evaluation of patient's vital signs (51%). For non- intubated patients, the factors that nurses considered important were the patients' complaints of pain (64%) and evaluations of patients' vital signs (23%). In conclusion, the results of this study indicate that patients in SICU might not receive enough analgesics and sedatives to feel completely free from pain during the post operational period. Future study should be focused on the evaluation of the adequacy of current practice for pain and anxiety control in terms of the SICU patient's response.

This was a descriptive study clarifying the factors affecting family caregivers' sense of well-being. This study was conducted with 131 caregivers using structured self-reporting questionnaires and directly interviewing adult patients who had been under treatment in two general hospitals. The hospitals were located in M city from Aug. 10, 2000 until Sep. 2, 2000. The collected data were analyzed using SAS PC+ program, and the data were tested using descriptive statistics, t-tests, ANOVA, Pearson's Correlation Coefficient, and Stepwise Multiple Regression. The results of this study are as follows; 1) The variables affecting the caregivers' sense of burden were age (F=3.76, p=.0063), education level (F=4.67, p=.0015), monthly income (F=2.49, p=.0466), amount of assistance provided (F=4.19, p=.0037), and the relationship with patient before disease (F=9.49, p=.0001). 2) The variables affecting caregivers' sense of well-being were age (F=9.54, p=.0001), residing with patient (t=11.38, p=.0010), the period of caregiving (F=10.52, p= .0001), education level (F= 2.79, p=.0290), monthly income (F=3.04, p=.0196), and relationship with patient before disease (F= 10.51, p=.0001). Also, all of the variables which showed statistical significance. 3) In viewing the relationship between activities of daily living (ADL) and the senses of burden and well-being, a negative relation- ship between activities of daily living (ADL) and a sense of burden was found (r=-.640, p=.000). However, the relationship between activities of daily living (ADL) and a sense of well-being had a positive correlation (r= .232, p=.008). Also the relationship between the sense of burden and the sense of well-being was revealed to have a negative correlation (r=-.614, p=.000). 4) A sense of burden was the most important indicator to the well-being of the caregivers who took care of stroke patients (R2 =.36). In addition to this, living with the patient (45%), activities of daily living (51%), relationship with patient before disease (53%), and the family's monthly income accounted for 56% of the sense of well-being of the caregivers.

The purpose of this study was to describe decision making model of 180 public health nurses in Korea and their knowledge structure for decision making. The differences of decision making models by nurse's knowledge structure were also tested. Research concepts were measured using the instrument based on systemic and interpretive decision making approaches that were developed by Lauri & Salantera (1995). The results were as follows. 1. The public health nurses turned to, most commonly, a mixed practical-theoretical knowledge structure (45.9%), followed by practical knowledge (32%) and theoretical knowledge (22.1%). 2. The six different decision making models were identified. These were named for decision making theories and nursing process. These were client-oriented decision making, rule-oriented systemic decision making, wholistic and intuitive decision making, decision making depending on subjective view and experience, systemic decision making for defining problems, and hypotheticodeductive decision making for defining problems. 3. The public nurses who had practical and practical-theoretical knowledge structure and community health practitioner (CHP) retold that decision making depends on subjective view and experience. Also the public health nurses who had 5~19 years clinical experience represented hypothetico-deductive decision making for defining problems.

The purpose of this study was to investigate the factors influencing social adaptation of chronic mental illness. The subjects of this study were 190 patients, over the age of 20 with chronic mental illness diagnosed by a physician, and living in Seoul, Korea during May, 2000 to December 2000. The instruments for this study were the social adaptation scale by Wallace (1979), the self-esteem scale by Rogenberg (1965), social support scale by ParkJiWon (1985), coping behavior scale by Shirley Zeitlin (1978), self efficacy scale by Sherer et. al (1982), and Rand mental health inventory(1979). The data were analyzed using descriptive statistics, pearson correlation coefficients, and stepwise multiple regression. The results of this study are as follows: 1. The level of social adaptation showed moderate (M=3.43). 2. The social adaptation showed significant positive correlation with self-esteem (r=0.39, p=0.00), self-efficacy (r=0.31, p=0.00), social support (r=0.47, p=0.00), self-productive coping (r=0.14, p=0.05), self-flexible coping (r=0.22, p=0.00), environment-active coping (r=0.21, p=0.00), and environment-flexible coping (r=0.14, p=0.04). The social adaptation showed significant negative correlation with anxiety (r=-0.16, p=0.02), and emotional problems (r=-0.18, p=-0.00). 3. The stepwise multiple regression analysis revealed that the most powerful predictor of social adaptation was social support (21%). A combination of social support, depression, behavioral controllability, self-efficacy, and environmental coping behavior accounted for 39% of the variance in social adaptation in chronic mental illness. From the results of this study, it is suggested to develop and apply a social adaptation training program for chronic mental illness.