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Volume 20(3); December 1990
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Original Article
Comparative Stduy on Head Nurses' Role Perception to own Role and Staff Nurses' Role Expectation to their Head Nurse Between University Hospitals and General Hospitals
Sook Hyun Lee
Journal of Nurses Academic Society 1990;20(3):281-299.   Published online March 31, 2017
DOI: https://doi.org/10.4040/jnas.1990.20.3.281
AbstractAbstract PDF

The organization of nursing department Significantly effects the hospital management. Especially, The head nurse in one of the most important position because head nurse is a first-line manager in the hospital level, a middle manager in nursing service organizations level and the top manager in each nursing unit level. This study was attempted to show the ideal model and rule compare head nurses' role perception with staff nurses' role expectation according to two types of hospital. The survey was conducted among 94 head nurses and 233 staff nurses who are working at 5 different University Hospitals over 600 beds and 93 head nurses and 218 staff nurses Who are working at 12 different General Hospitals between 100~300 beds in Seoul. The data was collected in a period from 8th September to 13th October in 1989 and the instrument used for this study was based on Han's one and referred back to many literary sources and revised. The collected data was analysed by computer using S.P.S.S. program as a Mean, Percentage, Cronbach's alpha, Chi-Square, t-test and ANOVA. 1. The study was compared to the difference of the two subject group's general characteristics according to a type of hospital. As a result, there were significant differences in age, educational background and career. 2. This Study was compared to the difference of the two subject group's role perception and role expectation about each question according to a type of hospital. The result of this comparisons as follows : First, These were the most important issue between both groups : "Head nurse has to know about her staff's events and problems and then help them to solve that promptly" Second, These were the least important issue between both groups : "Head nurse has an interview with patient's family and visitors", "Head nurse is interested in her staff's privacy". 3. This study was compared to the differences of each role areas according to a type of hospital. As a result, there were no significant differences both two subject groups except nursing manager role in staff nurses' group(t=-2.893, df=449.0 p=0.004). 4. This study was tested to the difference of the two subject groups according to general characteristics. As a result, All of that there were no significant differences.

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Clinical Trial
A Randomized Controlled Trial To Motivate Worksite Fecal Occult Blood Testing
Chung Yul Lee
Journal of Nurses Academic Society 1990;20(3):300-306.   Published online March 31, 2017
DOI: https://doi.org/10.4040/jnas.1990.20.3.300
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Colorectal cancer is second only to lung cancer as a cause of death due to cancer in the united States. Studies have shown that fecal occult blood(FOB) tests are effective in detecting colorectal cancer in its early stages. To motivate worksite FOB testing, a randomized controlled trial was conducted. Employees 40 years or older from three federal agencies in Washington State were randomized to a control group(n=139) which received a letter stating the availability of the FOB test at the worksite clinic or to an intervention group(n=139) which received the letter about facts on colorectal cancer and a Colorectal Cancer Risk Appraisal. The Colorectal Cancer Risk Appraisal included a feedback on an individual's risk of developing colorectal cancer compared to his/her peers in terms of 'normal', 'moderate', or 'high' risk status. After 3 months, a follow-up questionnaire was sent to all participants to measure the effectiveness of the intervention. In the analysis of the three major outcomes, two possible confounding factors(dietary fat and family history of colorectal cancer) were controlled by logistic regression. Based on a review of the worksite clinic records, the intervention group had 4.3% higher compliance rate with the FOB test during the follow-up period compared to the control group(p=.10). The largest effect of the intervention was on the employees' intention to get a FOB test within the next year(62.6% in the intervention group vs. 36.2% in the control group, OR=3.18, p<.001). In the final Multivariate logistic model, the employees who were more likely to intend to get a FOB test within the next year were in the intervention group ; were at 'moderate' or 'high' risk of colorectal cancer ; knew more about the availability of the FOB test at the worksite clinic ; and had a FOB test during the last tree years.

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Original Articles
A Study of the Heath Status of Korean Elderly
Young Hee Choi, Moon Sil Kim, Young Soon Byon, Jong Soon Won
Journal of Nurses Academic Society 1990;20(3):307-323.   Published online March 31, 2017
DOI: https://doi.org/10.4040/jnas.1990.20.3.307
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This Study was done to design and test an instrument to measure the health status of the elderly including physical, psychological and social dimensions. Data collection was done from July 18 to August 17, 1990. Subjects were 412 older persons in Korea. A convenience sample was used but the place of residence was stratified into large, medium and small city and rural areas. Participants located in Sudaemun-Gu, Mapo-Gu, and Kangnam-Gu, Seoul were interviewed by brained nursing students, and those in chungju, Jonju, Chuncheon, and Jinju by professors of nursing colleges. Rural residents were interviewed by community health practioners working in Kungsang-Buk-Do, Kyngsang-Nam-Do, Jonal Buk-Do, and Kyung Ki-Do. The tool developed for this study was a structured questionnaire based on previous literature and then tested for reliability and validity. This tool contained 20 physical health status items, 17 mental-emotional health status items and 38 social health status items. Physical health status items clustered in to six factors such as personal hygiene, activity, home management, digestive, sexual, sensory, and climination functions. Metal-emotional health status items clustered into two factors, mental health and emotional health. Social health status items clustered into seven factors, grandparent, parent, spouse, friend, kinships, group member and religious role functions. Data analysis included percentage, average, S.D., t-test and ANOVA. The results of the analysis were as follows : 1. The tool measuring the health status of the elderly and developed for this research had a relatively high reliability indicated by a cronbach=0.97793. 2. Average score of the subjects physical health status was 4,054 in a 5 point likert scale, mental-emotional health status was 3.803 social health status was 2.939 and the average was 3.521. The social status of the subjects was the lowest and the next was mental-emotional health status ; physical health status was the highest. 3. Educational background, perceived health status, the amount of pocket money were related to physical and mental-emotional health status and family structure was related mental-emotional physical and social health status. Occupation was related to physical and mental-emotional status. Area of residence was related to mental-emotional and social status. Source of living in the expenses was related to physical and mental-emotional health status marital status to mental-emotional and social health status, and the number living in the home physical health status and religion to social health status. The following conclusions were derived from the above results : 1. The health status of Korean was relatively sound but social health status was the most vulnerable. The Social activity for Korean elderly is needed to improve social health. 2. Education background, perceived health status and the amount of pocket money must be considered in the health assessment criteria of the elderly. Family structure, marital status, occupation, residence variables and sources of living expense must also be considered as significant. 3. A health education program based on the education background of the elderly, and provision of an occupational socio-economic welfare policy will be useful in order to increase social health status of Korean elderly.

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The Effect of Supportive Nursing Care on Depression, Mood and Satisfaction in Military Patients with Low Back Pain
Jeong Ah Kim
Journal of Nurses Academic Society 1990;20(3):324-340.   Published online March 31, 2017
DOI: https://doi.org/10.4040/jnas.1990.20.3.324
AbstractAbstract PDF

Support has always been considered an important nursing concept. However, there is no agreement among nurse researchers as to a conceptual definition of supportive nursing or meaningful supportive behaviors. Clarification of the concept, supportive behaviors. Clarification of the concept, support in nursing, is necessary to promote communication among nurses on nursing behaviors that are effective in providing support and on understanding the relevant properties and characteristics of the concept, supportive nursing care. The objectives of the study were ; 1. to analyze the concept, support in nursing, in order to provide a definition of supportive nursing care and 2. to operationalize the definition of supportive nursing care and use it as an experimental nursing intervention for patients with low back pain. The first part of the study used to concept analysis approach developed by Walker and Avant(1983) to define to concept of supportive nursing care. The properties of supportive nursing care, defined by this analysis, included perception of supportive need, reciprocal interaction(Transaction), listening, providing empathy and information related to health, and confirmation of the patient's verbal and non-verbal response. The second part, the experimental part of the study, was done using King's(1970) Interpersonal Theory for Nursing. The concept, supportive nursing care, as defined in the concept analysis was operationalized and used as the experimental intervention. The experiment tested the effectiveness of the independent variable, supportive nursing care on the dependent variables, depression, mood and patient satisfaction, in the patients with low back pain in army hospitals. The instruments used to measure the dependent variables were Zung's(1965) Self-Rating Depression Scale, Ryman and Colleagues'(1974) Mood Questionnaire and LaMonica and Colleagues'(1986) Patient satisfaction Scale. The experimental design used for this study was a Solomon 4 group experimental design. This design has the strength of allowing for observation of the main effects of supportive nursing care and pretesting, and for observation of the interaction effects of pretesting and supportive nursing care. The design includes one experimental group and three control groups. The Subjects of this study were 150 young male patients with low back pain on Neuro-Surgical Wards in three general army hospitals. There were 35 in the experimental group, 39 in the pre-posttest control group, 36 in the treatment-posttest control group and 40 in the posttest only control group. Supportive nursing care, as operationalized by the researcher according to the concept analysis, was given to the patients in the experimental group and the treatment-posttest control group, individually for 30 minute sessions, every other day for 5 days. Data collection was done using a questionnaire. The data were collected in a pretest on week before the supportive nursing care sessions, a posttest immediately after the sessions and follow-up test one week later. Hypotheses testing was done using 2x2 factorial analysis of variance and Meta analysis(Stouffer's Z method). The results of this study are summarized as follows ; 1. Hypothesis I, "There will be a difference on depression level between the patients with low back pain who receive supportive nursing care and those who do not receive supportive nursing care", was supported(F=8.49, p<.05). 2. Hypothesis II, "There will be a difference on mood level between the patients with low back pain who receive supportive nursing care and those who do not receive supportive nursing care", was supported(Z meta=2.17, p<.05) 3. Hypothesis III, "There will be a difference on satisfaction level between the patient with low back pain who receive supportive nursing care and those who do not receive supportive nursing care", was supported(F=13.67, p<.05). 4. ANOVA, done to examine the interaction effect of history and maturation, showed no significant difference on the dependent variables between the observations of the pretest scores of the experimental group, the pretest scores of the pre-posttest control group and the posttest score of the posttest only control group. 5. To test for continuing effect of supportive nursing care, paired t-test was done to compare the scores for the dependent variables at the posttest and at the one week later follow-up test. No significant difference on the scores for the dependent variables was found between the posttest scores and the follows-up test scores for the groups that received supportive nursing care, the experimental group and the treatment-posttest control group. In conclusion, it was found that in the case of young soldiers with low back pain in army hospitals, their depression level was decreased, their mood state was changed positively and their satisfaction level was increased by receiving supportive nursing care. Further, the effectiveness of the supportive nursing care lasted for at least one week in this study. The significance of this study to nursing is in the analysis of the concept of supportive nursing care and the demonstration of the effectiveness of supportive nursing care as an intervention within the limits of the study.

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Predictors of Sick Role Behavior on Patients Receiving Radiotherapy for Cancer
Kang Mi Ja Kim
Journal of Nurses Academic Society 1990;20(3):341-356.   Published online March 31, 2017
DOI: https://doi.org/10.4040/jnas.1990.20.3.341
AbstractAbstract PDF

Cancer is still a threat to human beings. The incidence and mortality rate of cancer have been gradually increasing as the life span has been lengthened. Radiotherapy is one of the most commonly used treatments for cancer. This study explored the influence of social support and stress on sick role behavior of patients receiving radiotherapy for cancer. The subjects for this study were 60 patients undergoing radiotherapy for cancer, selected from the radiotherapy treatment unit of the out patient departments of two major medical centers in Jeonju. Data were collected from February 1 to 28, 1990 by a Likert Scale Questionnaire and an interview schedule designed by the investigator. Data analysis included percentages, mean and standard deviation, to or F-test, Pearson Correlation Coefficient and stepwise multiple regression. Results included the following : 1. Support came primarily from sons and daughters(90.1%) ; the type of support was primarily emotional support from friends(60.0%) ; information support came from health personnel(81.7%) ; and material support was sons and daughters(40.0%) ; satisfaction with support was highest for the spouse(4.02+/-.52). 2. Among the patient's demographic status was occupation the was the only socioeconomic characteristic influencing sick role behavior(F=2.91, p=.029). 3. Directly perceived support was positively correlated with sick role behavior(r=.2374, p=.034). 4. Stepwise multiple regression was used to determine the predictors of sick role behavior. Directly perceived support was the most significant predictor accounting for the highest contribution to sick role behavior(5.6%). Directly perceived support, socioeconomic status, perceived stress and indirectly perceived support variables together, accounted for only 6.8% of sick role behavior.

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Factors Influencing Sexual Satisfaction in Women who have had a Hysterectiomy : A comparative group study
Soon Bok Chang
Journal of Nurses Academic Society 1990;20(3):357-367.   Published online March 31, 2017
DOI: https://doi.org/10.4040/jnas.1990.20.3.357
AbstractAbstract PDF

The descriptive study was done to identify factors influencing sexual satisfaction in women who had a hysterectomy and to compare these with women who had not a hysterectomy. The purpose was to contribute theoretical understanding on which to base nursing care planning. One group of subjects were 156 women who had a hysterectomy, between one and 18 months post surgery, living with their spouse, having no complications, and menstruating before surgery. The other group of subjects were 282 healthy women who were living with their husbands and menstruating. The study tool consisted of 108 items including item concerning personal characteristics, characteristics related to the hysterectomy, husband's support , body image, emotions, attitude toward the sexual relationship, knowledge of sexuality, sexual behavior, and sexual satisfaction. Sexual satisfaction was measured by a tool based on Derogatis Sexual Function Inventory. The range of the internal level of the study tool was from .5208 to .9462. Data collection was done during the period from June 20 to Aug.20, 1989. The same questionnaire was used of data collection for both groups, but a mail survey method was used for the women who had a hysterectomy, and an interview method was used for the women who had not had a hysterectomy. Data analysis was done using frequency, ratio, mean and S.D. for the characteristics of the subjects and level of sexual satisfaction. t-test or ANOVA was used for the differences between the groups with regard to the general and hysterectomy related characteristics. The relationship between the score for sex life related factors and the level of sexual satisfaction was analyzed using the Pearson Correlation, and the influencing factors on sexual satisfaction were analyzed by stepwise multiple regression. The results of this study were as follows ; 1. Mean age and income level were the only general characteristics for the two groups that were significantly different. The mean age, and income level of the group who had a hysterectomy were 45 years, and 1,151,000 won respectively, and for those who had not had a hysterectomy, 41 years and 999,000 won. 2. There was no statistical difference of the sexual satisfaction score between the two groups. 3. There was differences in the factors influencing sexual satisfaction between the two groups. Factors influencing sexual satisfaction for the group who had a hysterectomy were husband's support(R=.5793, P=.000) and the women's Knowledge of sexuality (R=.6670, P=.000) (total variance : 33.56). On the other hand, emotional status (R=.4294, P=.000) sexual behavior(R=.5793, P=.000), husband's support(R=.5274, P=.000) and attitude towards sexual relations (R=.5412, P=.000) (total variance : 54.12) were the had a hysterectomy. Since husband's support and sexuality knowledge were identified as factors influencing sexual satisfaction of women who have had a hysterectomy, it can be concluded that, before a woman who had a hysterectomy is discharged from hospital, nurses should include strategies in the nursing care plan that will promote husband's support and the women's knowledge of sexuality.

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A Study on the Development of Standardized Nursing Care Plans for Computerized Nursing Service
Cho Ja Kim, Choon Young Chun, Young Sin Lim, Jee Won Park
Journal of Nurses Academic Society 1990;20(3):368-380.   Published online March 31, 2017
DOI: https://doi.org/10.4040/jnas.1990.20.3.368
AbstractAbstract PDF

A central issue in the development of nursing practice is to describe the phenomenon with which nursing is concerned. To identify the health problems which can be diagnosed and managed by the nurse is the first step to organize and managed by the nurse is the first step to organize and ensure the development of nursing science. Therefore the academic world has been discussing the application of the nursing diagnosis in nursing practice as a means of improving quality of care. The objectives of this study were to develop a standardized nursing care plan for ten selected nursing diagnoses to from a database for computerized nursing service. The research approach used in the study was (1) the selection of the ten nursing diagnoses which occur most frequently on medical-surgical wards, (2) the development of standardized nursing care plan for the ten selected nursing diagnoses, (3) application of the plan to hospitalized patients and evaluation of the content validity by the nurses, and (4) evaluation of the clinical effects after the use of the standardized nursing care plans. The subjects were 56 nurses and 395 hospitalized patients on two medical and two surgical unit. The results of this study were as follows ; 1) The ten selected nursing diagnoses for the development of the standardized nursing care plans were "PAIN, SLEEP DISTURBANCE, ALTERED HEALTH MAINTENANCE, ALTERATION IN NUTRITION, ANXIETY, CONSTIPATION, ALTERED PATTERNS OF URINARY ELIMINATION, DISTURBANCE IN BODY IMAGE, POTENTIAL FOR ACTIVITY INTOLERANCE AND ACTIVITY INTOLERANCE". 2) The developed standardized nursing care plans included the nursing diagnosis, definition, defining characteristics, etiologic or related factors that contribute to be condition, recording pattern desired out-comes and nursing orders(nursing interventions). 3. The plan was used with hospitalized patients on medical-surgical wards to test for content validity. The patient's satisfaction with the nursing care and nurses' job satisfaction were investigated to evaluate the clinical effects after the use of the standardized nursing care plans. A comparison of patient satisfaction with nursing care before and after the introduction of the standardized nursing care plans showed a statistically significant higher level of satisfaction with the standardized care plans. There was no difference in the level of job satisfaction expressed by the nursing staff before and after the standardized nursing care plans were introduced. However, when opinions about the use of the standardized nursing care plans were examined it was found that there was a positive effect on clarity in defining the nursing problems, determining nursing cost, more feasible goal setting, effective and systematic nursing records and indications for nursing research. The results of this study suggest that in order to increase the use of nursing diagnoses in the clinical area, it would be effective to select some wards as a pilot project, give the nurses training in the use of nursing diagnosis and develop and use the standardized nursing care plans. In addition to the ten diagnosis used in this study it sis recommended that continual development of nursing diagnoses be done using diagnoses that are appropriate to Korea and testing them for validity through standardized care plans.

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Patient's Preferances for Nurse's Nonverbal Expressions of Warmth During Nursing Rounds and Administration of Oral Medication
Hyung Sun Kim, Moon Sil Kim
Journal of Nurses Academic Society 1990;20(3):381-398.   Published online March 31, 2017
DOI: https://doi.org/10.4040/jnas.1990.20.3.381
AbstractAbstract PDF

Nursing involves deep human interpersonal relationships between nurses and patients. But in modem Korea, the nurse-patient relationship tends to be ritualistic and mechanistic. Patients usually express the hope that nurses be more tender and kind. Patients expect nurses to express their warmth especially through nonverbal behaviour. This study was conducted to identify patients' preferences for nurse's nonverbal expressions of warmth. Through the confirmation of these preferences, nurses may learn how to enhance their interpersonal relationships with patients. Subjects for the study were 73 patients who had been admitted to a university teaching hospital for at least three days and agreed to be interviewed by the investigator. The interactions were studied nonverbal expressions of warmth during nursing rounds and administration of oral medication. The interview schedule was expecially designed by the investigator to measure the nurse's posture, the distance between the nurse and the patient, the nurse's eye contact, facial expression hand, motion and head nodding. Data analysis included frequencies, percentages and X2-test. The results of this study may be summarized as follows : 1. Patient's preferences for nurse's nonverbal expressions of warmth during nursing rounds. Preferred nurse's posture was sitting(50.7%) or standing(49.3%) opposite the patient was close to the bed(93.2%), less than 1m. Preferred eye contact was directed to the patient's eyes or their affected part(41.1%). Preferred facial expression was a smile(97.3%). Preferred hand motions were light gestures(41.1%). Patients preferred head nodding which approved their own opinions(69.9%). 2. Patient's preferences for nurse's nonverbal expressions of warmth during administration of oral medication. Preferred nurse's posture was standing and waiting to confirm that medication had been taken(58.9%). Preferred distance from the patient was at arm's length, 0.5-1m (64.4%). Patients preferred direct eye contact(58.9%) and a smile(94.5%). Patients preferred that the nurse put the medicine directly the patient's hand(64.4%). Whether the nurse nodded her head or not was not considered important. 3. The relation of general characteristics and patient's preferences for nurse's nonverbal expressions of warmth during nursing rounds administration of oral medication. During nursing rounds, the age of subjects(p=0.010) and the standard of education (p=0.026) related to the distance between the nurse and the patient. The sick hospital ward related to the eye contact(p=0.017) and facial expression(p=0.010). During administration of oral medication, the age of subjects(p=0.044) and days of hospital treatment(p=0.043) and the sick hospital ward(p=0.0004) related to the facial expression. From this study, nurses can learn what kind nonverbal expressions of warmth are preferred by patients during rounds and administration and thus will enhance nurse-patient interpersonal relationships.

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Quality of life of Middle-Aged Persons Who have cancer
Yoon Book Hahn, You Ja Ro, Num Cho Kim, Hee Seung Kim
Journal of Nurses Academic Society 1990;20(3):399-413.   Published online March 31, 2017
DOI: https://doi.org/10.4040/jnas.1990.20.3.399
AbstractAbstract PDF

This descriptive study was under taken to explore relationships among the quality of life, health locus of control and perceived state of health persons with cancer to contribute theoretical understanding about these phenomenon of interest to the quality of nursing care. The subjects of this were 200 persons with cancer(100-in patients and 100-out patients), both male and female, between 30 and 59 years of age. Data were obtained using a convenience sample technique from two university in seoul from August, 1989, to June, 1990. The instruments used for this study were the Quality of life scale developed by Ro, You-Ja and the Health Locus of Control scale developed by Wallston & Wallston. Data were analyzed using a SAS program for ANOVA, t-test, Schefffe test, Pearson Correlation Coefficients and Stepwise multiple regression. The results were as follows : 1. The scores on the quality of life scale ranged from 95 to 191 with as mean of 147.85(range 47 to 235). The Mean scores(range 1-5) on the different dimensions were family relationships 3.50, relationships with neighbours 3.48m self-esteem 3.17, physical state and function 2.99, economic life 2.93 and emotional life 2.91. 2. Significantly higher scores on the quality of life and demographic characteristics were as follows : the quality of life for women(t=2.80, p=.006), for those without complications(t=2.54, p=.013), and for those who perceived their illness as mild(F=4.85, p=.009). Higher scores on quality of life were correlated with the following : 1) emotional state and the age group 50-59(F=3.43, p=.34). 2) economic life and higher income(F=6.72, p=.002), those without complications(t=2.68, p=.00), and those who perceived their illness as mild(F=3.11, p=.05). 3) self-esteem and marriage(F=3.64, p=.028), those without complications(t=2.18, p=.03), and those who perceived their illness as mild(F=7.72, p=.000). 4) physical state and function and the age group 30-39(F=4.65, p=.010), those without complications(t=2.00, p=.05), and those who perceived their illness as mild(F=3.38, p=.04). 5) family relationship and those who live with their spouse(t=2.82, p=.005). 3. There was a significant positive correlation between the subjects perceptions of their current state of health and the quality of life score(r=.4364, p=.0001). 4. There was no relationship between Locus of control and quality of life in this sample. 5. Stepwise multiple regression analysis showed that : 1) the perception of current health status was the main predictor and accounted for 20.11% of the total variance. 2) sex and educational level accounted for an additional 21.71% of the total variance. 6. The quality of life and the perception of their current health status of these patients with cancer were generally lower than those of healthy adults as noted in previous studies. In conclusion, the quality of life for these cancer patients was generally low especially in regard to their emotional state. The current perceived state of health, sex, complications and perceived degree of illness were important variables relating to quality of life.

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Stressful Life Events, Health Symptoms, Social Support and Coping in Early Adolescents
Ka Sil Oh, Jung Suk Han
Journal of Nurses Academic Society 1990;20(3):414-429.   Published online March 31, 2017
DOI: https://doi.org/10.4040/jnas.1990.20.3.414
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Numerous research reports have substantiated the role of stressful life events in relation to the onset of health changes. The relationship tends to hold across different age groups. Theoretically, adolescence has been considered a developmental crisis period of great stress, impoverished coping skills and high vulnerability to biological, social and psychological demands. The research problem addressed by this study was to examine the relationships between stressful life events and health symptom patterns, and the effect of two variables, coping and social support, theoretically considered to mediate the relationship between stress and health symptoms in adolescents. The following five hypotheses were tested in this research : 1. Health symptoms are positively related to stressful life events in adolescents, 2. Health symptoms are negatively related to coping in adolescents, 3. Health symptoms are negatively related to social support in adolescents, 4. When coping is controlled, the relationship between health symptoms and stressful life events will decrease, and 5. When social support is controlled, the relationship between health symptoms and stressful life events will increase. The study subjects consisted of 1090 high school students of the metropolitan city of Seoul. The following sampling procedure was used : 1. Of the 169 high schools in nine school administrative districts in the city, a proportional sample of ten schools was selected. 2. One class from each of the freshman and sophomore was randomly selected and all the students who were in the sampled class were used as the study sample. The study was limited to freshman and sophomore adolescents, aged 15 to 18(mean=16.6). Of the 1090 subjects 688(63%) were boys and 402(37%) were girls. An Adolescent Inventory of Stressful Life Events, a Health Symptom Questionnaire and an Adolescent Coping Inventory were adapted for this study. The Norbeck Social Support Questionnaire was utilized to collect the data on perceived social support. Five high school teachers in the areas of school health and counselling reviewed the items of each questionnaire for content validity. A pilot study was undertaken to ascertain reliability. Fifty three high school students responded to the questionnaires and gave their opinions on the items. For stressful life events, health symptoms, coping, and social support, the Cronbach's alpha's on the study were .70, .94, .77, and .76 respectively. Research assistants attended all the sampled classes with the school proctor to explain the purpose and procedures of the study to the students. The questionnaires along with a ballpoint pen were distributed to the students who were asked to complete each item. The research assistants left the ballpoint pen with the students as a gift for their cooperation. An average of 50 minutes was required to complete the questionnaires. Using as SPSS, the first, three hypotheses were tested using Gamma, a measure of association for ordinal variables. Partial gamma was used to test the fourth and fifth hypotheses. Patterns of elaboration described by Babbie was selected to interpret the relationship of the three variable analyses. The significance of gamma was determined by Chisquare at a .05 level of significance. There was a positive relationship between health symptoms and stressful life events (Gamma=.35, p=.000). Thus the first hypothesis was supported. Unexpectedly, coping was positively related with health symptoms(Gamma=.13, p=.000). That is, the higher the coping levels, the greater number of health problems. The third hypothesis, the higher the level of social support, the fewer the health symptoms, was not accepted in this adolescent study group. When coping was controlled, under the condition of low coping the association between health symptoms and stressful life events increased significantly to a partial gamma of .39, and under the condition of high coping it was .30. According to the elaboration model, when one partial relationship is the same or greater than the original and the other is smaller, the control variable should be considered to be specifying the conditions. When social support was controlled the relationship between stressful life events and health symptoms increased under the condition of low social support, but with high social support, the relationship decreased. Both partial gamma were statistically significant at .05 level(.43 and .26 relatively). It can be interpreted that stressful life events are strongly and positively related to health symptoms under the condition of low social support, however this relationship can not be expected with high social support. Thus, the last two hypotheses were conditionally sustained. In this study, the relationships between stressful life events and health symptoms, and the specified me diating roles of coping and social support were found to have statistical interaction. This finding supports the theoretical position of this study. It suggests that stressful life events would create high susceptibility to biological, social and psychological health symptoms and coping and social support buffering the relationship between stressful life events and health symptom. The findings of this study have implications for nursing practice. When adolescents are confronted with non-developmental life events that are perceived as stressful, nurses should recognize the evidence of the stress-buffering effect of coping and social support on health symptoms and utilize to diverse sources of social support that are readily available to adolescents.

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Study of Folk Caring in Korea for Cultural Nursing
Seoung Hee Ko, Myoung Ok Cho, Young Hee Choi, Sin Pyeo Kang
Journal of Nurses Academic Society 1990;20(3):430-458.   Published online March 31, 2017
DOI: https://doi.org/10.4040/jnas.1990.20.3.430
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Care is a central concept of nursing. Nursing would not exist without caring. Care and quality of life are closely related. Human behavior is a manifestation of culture. We can say that caring and nursing care are expression of culture. The nurse must understand the relationship of culture with care for ensure quality nursing care. But knowledge of cultural factors in nursing is not well developed. Time and in-depth study are needed to find meaningful relationships between culture and care. Nurses recognized the importance of culturally appropriate nursing There are two care systems in culturally based nursing. The folk care system and the professional nursing care system. The folk care system existed long before the professional nursing care system was introduced into this culture. If the discrepancy between these two care systems is great, the client may receive inappropriate nursing care. Culture and subcultures are diverse and dynamic in nature. Nurses need to know the caring behaviors, patterns, and their meaning in their own culture. In Korea we have taken some first step to study cultural nursing phenomena. It is not our intent necessarily to return to the past and develop a nationalistic of nursing, but to identify the core of traditional caring and relate that to professional nursing care. Our Assumptions are as follows : 1) Care is essential for human growth, well being and survival. 2) There are diverse and universal forma, expressions, patterns, and processes of human care that exist transculturally. 3) The behaviors and functions of caring differ according to the social structure of each culture. 4) Cultures have folk and professional care values, beliefs, and practices. To promote the quality of nursing care we must understand the folk care value, beliefs, and practices. We undertook this study to understand caring in our traditional culture. The Goals of this study were as follows : 1) To identify patterns in caring behavior, 2) To identify the structural components of caring, and 3) To understand the meaning and some principles of caring. We failed several questions in this study. Who is the care-giver? Who is the care-recipient? Was the woman the major care-giver at any time? What are the patterns in caring behavior? What are the principles underlying the caring process? We used an interdisciplinary team approach, composed of representatives from nursing and anthropology, to contribute in-depth understanding of caring through a sociocultural perspective. A Field study was conducted in Ro-Bong, a small agricultural kinship village. The subjects were nine women and one man aged bo or more years of age. Data were collected from January 15 to 21, 1990 through open-ended in-depth interviews and observations. The interview focused on caring behaviors surrounding birth, aging, death and child rearing. We analysed these data for meaning, pattern and principles of caring. In this report we describe caring behaviors surrounding childbirth. The care-givers were primarily mothers-in-low, other women in the family older than the mother-to-be, older neighbor woman, husbands, and mothers of the mother-to-be. The care receivers were the mother-to-be the baby, and the immediate family as a component of kinship. Emerging caring behavior included praying, helping proscribing, giving moral advice(Deug-Dam), showing concern, instructing, protecting, making preparations, showing consideration, touching, trusting, encouraging, giving emotional comfort, being with, worrying about, being patient, preventing problems, showing by an example, looking after bringing up, taking care of postnatal health, strong theming the health condition, entering into another's feelings(empathizing), and sharing food, joy and sorrow. The emerging caring component were affection, touching, nurturing, teaching, praying, comforting, encouraging, sharing, empathizing, self-discipline, protecting, preparing, helping and compassion. Emerging principles of caring were solidarity, hierarchical relationships, sex-role distinction. Caring during birth expresses the valve of life and reflects the valued traditional beliefs that human birth is given by god and a unique unifying family event reaching back to include the ancestors and forward to later generations. In addition, We found positive and rational foundations for traditional caring behaviors surrounding birth, these should not be stigmatized as national or superstitious. The nurse appropriately adopts the rational and positive nature of traditional caring behaviors to promote the quality of nursing care.

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J Korean Acad Nurs : Journal of Korean Academy of Nursing
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