A descriptive study was conducted to describe the content of nursing interventions and incoming telephone calls from the parents whose child was discharged to home or who has planned immunization during the period from March 15, 1995 to November 30, 1995. Detailed notes on 145 telephone calls and 243 nursing interventions were recorded by head nurses on pediatiric nursing units were entered to data collection and content analysis. The results of the study are as follows: 1. Six analysis categories for the records on incoming telephone calls were identified judgement-dependence, dependent-coping, self-initiated coping, support, adjustment and intermediation need. 2. Five analytic categories for the records on tel-tphone interventions were identified: guidance, mediation, facilitating self -care abilities, support, instrumental use. 3. Problems related to physical signs and symptoms, medication, immunization, and vital signs were most often cited as concerns by parents and caregivers. 4. Instruction, suggention, provision knowledge and information, reassurance related to physical problems, medication, immunization and clinic visits were most often used as an nursing interventions by head nurses on pediatric nursing units. In spite of the fact that the telephone calls were initiated by the parents, dependency of parents during the telephone calls was remarkable. The dependency of parents on judgement and decision making of the pediatric nurses should be unhderstood in terms of the psychosocial content as well as cultural characteristics. Therefore, it is suppested that telephone interventions focus on facilitating the self-care ability of the parents whose children have chronic conditions. The results of this study will be useful as an essential reference in providing effective for children and their families after discharged from the hospital. The results can also be used as reliable data for ex tended pediatric nursing service in the health care delivery system as well as for the development of telephone intervention service program in responding to the current health care environment.

This study was done to develop a Maternal Identity Scale for Pregnant Women and to test the validity and reliability of the scale. A convenience sample of 161 pregnant women were asked to complete the MISP questionnaire which consisted of 45 item, this was done from December 20, 1995 to January 15, 1996. The research procedure were as follows. The first step was to identify a conceptual definition of maternal identity using Rubin(1984)'s maternal identity and maternal experience during pregnancy. The second step was to operationalize the maternal identity, that is, perception of image possible of selves as mother, maternal role play by imagination, and the experiences of various emotional responses which are embedded in the mother-fetus dyad. The third step was item development which resulted in 45 items as appropriate measurement of maternal identity are except for the perception of image possible of selves as mother. The result findings were as follows: 1) Four factors for MISP(finally 40 items) were extracted through the principal component analysis and varimax rotation, and these contributed 49.3% of the variance in the total score. All 40 items in the scale loaded above .43 on one of 4 factors. 2) Each factor was named: factor 1 was named maternal role imagery and has 10 items, factor 2 was named happiness and has 11 items, factor 3 was named maternal fetal interaction and has 10 items, and the last factor 4 was named negative emotion and has 9 items. 3) Cronbach's -alpha coefficient for internal consistsncy was .92 for the total 40 items and .89, . 90, .86, .78 for the four subscales in that order. Recommendations are suggested below: 1) The developed MISP be used to assess maternal readiness in pregnancy. 2) Replication study be done to test validity and relaibility. 3) For the overall measure of Maternal Identity in Pregnancy, scale for the perception of image possible of selves as mother, and cognitive domain be reorganized for the maternal identity in pregnancy. 4) It is necessary to identify variables that influences maternal pregnancy. 5) It is necessary to identify that maternal identity in pregnancy is a reliable index of motherhood, to do correlation studies on maternal identity and major maternal variables in maternal transition period, to reoperationalize the maternal identity in postpartum, and finally to designate a longitudinal study of the maternal identity changes or stabilities.

The Study of the Development of Efficacy Expectation Promoting Program and it's Effect for Cervical Spinal Cord Injury Patients. This study was conducted to develop on Efficacy Expectation Promoting Program (EEPP) based on the Self-Efficacy Theory of Bandura for Cervical Spinal Cord Injury Patient(CSCIP), and invesgated it's effects. The research process of this study was done in three phases. The first phase was an analysis of the patient's life experience. The second phase was to develop an Efficacy Expectation Promoting VTR Tape Program(EEPP) that reflected the life experience of the CSCIPs. EEPP was composed Performance Accomplishment and Vicarious Experience with a home visitation program based on Verbal Persuation, which are all induction modes of efficacy expectation of Bandura. The third phase was an experimental stage. The experimental design was an AB Single Experimental Design. Research subjects were three CSCIPs(cer-vical area 5-7). The data was collected from 24th June to 22th Oct, 1995. The result of the experimentation showed great increase self-efficacy score, subject self-care score, all competence of daily living score, and social activities. In conclusion, it was found that an EEPP is an effective home nursing intervention technique for rehabilitation of CSCIPs.

In an attempt to investigate the effect of a muscle strengthening exercise program on muscle strength, pain, depression, self-efficacy and quality of life of patients with knee osteoarthritis, a pre-experiment, one group pre-test and post-test design, was planned. Muscle strengthening exercise was carried out from May 22 through August 14, 1995 at isokinetic exercise room in rehabilitation department of University Hospital in Taejon. The subjects were seven female clients conveniently sampled from University Hospital located in Taejon, between 39 and 61 years of age, who had a osteoarthritis in knee. Muscle strengthening exercise program was composed of three sessions per week, one isokinetic exercise at angular velocity of 60degrees and 180degrees with Cybex isokinetic dynamometer and two resistance home exercise sessions with elastic band. Data were analyzed with frequency, percentage of change, Friedman test, Duncan test using SAS program. Results were obtained as follows: 1) Flexion and extension muscle strength at angular velocity of 60degrees and 180degrees were increased after 12weeks' exercise than those of before experiment. But exept flexion muscle strength at angular velocity of 180degrees (F=3.34, P=0.0261), there was no statistically significant difference among muscle strengths, which is measured every 3 weeks. 2) Pain was decreased after 6weeks' exercise than that of before experiment, and after 12weeks' exercise than that of 6weeks' exercise. There was statistically significant difference(F=4.28, P= 0.0396). 3) Depression was increased after 6weeks' exercise than that of before experiment, and after 12weeks' execise than that of 6weeks' exercise. There was no statistically significant difference between before experiment and after 6weeks' exercise. But, there was statistically significant difference between after 6weeks' exercise and 12weeks' exercise (F=9.38, P=0.0035). 4) Self-efficacy was decreased after 6weeks' exercise than that of before exercise. But, it was increased after 12weeks' exercise than that of before exercise and after 6weeks' exercise. But there was no statistically significant difference (F=1.46, P=0.2706). 5) Quality of life was increased after Gweeks' exercise than that of before exercise, and after 6weeks' exercise than that of 12weeks' exercise. But there was no statistically significant differ-ence(F=1.06, P=0.3816). Thus, the significant of muscle strengthening exercise for the improvement of muscle strength, pain, depression, is verified. But, this study was a preexperiment with small size subjects. So, controlled experimental study is necessary to determine the effect of this muscle strengthening exercise program on muscle strength, pain, depression, self-efficacy, and quality of life of patients with knee osteoarthritis.

Advanced countries such as the USA and Japan are eagerly seeking ways to improve health and welfare of the elderly. One of the services is home health care service using the telephone. Various types of services using the telephone have been developed, improved and are being utilized ranging from the basic consulting to emergency response systems in the area of health care for the elderly. A demonstration project was launched to study the feasibility of a consulting system and telemedicine for the elderly using the public phone system in Korea. For this project, a gathering site for the elderly was selected and those who visited this place were interviewed to find out what kinds of services they wanted and what kind of system they needed to provide the required services. Based on the users' requests and the surrounding environment, a telephone consulting facility was established at the Research Institute of Nursing Science at Seoul National University and consulting personnel was recruited, trained and posted at the center. An Application program for home health care nurses to use when they visited the patients at their homes was developed. This system operates on a notebook Computer and allows nurses to communicate with a doctor at a local hospital through a modem and telecommunication line. These systems were implemented for three months and problems which developed during operation of the systems were identified and progressively modified. Through system evaluation, it was found that a consulting system using phone service will be an invaluable system for the welfare of the elderly in the future. But in order to meet the elderly's need, more services than mere consultation are needed. That is, communication with physicians and hospitals are needed. Thus, when there is any need for physicians' attention, physicians or hospitals should be contacted directly. Similarly for telemedicine, when the home health care nurse visits elderly patients she can assess the patient's problem and provide nursing care, access a physician or hospital to refer her patient to or consult directly using the telecommunication the system. The above mentioned system is a basic form of futuristic telemedicine for the elderly and those who have chronic disease problems. This kind of system will be of great value when it is used on the national information super-high ways in the future. In order to get to that stage, of course, this project needs great improvement in the technical, academic, and legal aspects.

The surgical hand scrub(SHS) is the single most important procedure in the prevention of postoperative wound infections and yet it remains the most violated of all infection control procedures. The purpose of this study was to gain an overview of SHS habits in operative theatre personnel and to determine knowledge and attitudes to identify whether there is a need for improvement. The subjects for this study included 79 doctors and 94 nurses working in the operative theatres of four hospitals in Incheon City and Kyungki Province. Related data were collected from July 25 to August 10, 1995 by the author. The data were analyzed using descriptive statistics and Chi-squre test. The results of the study are summarized as follows: 1. Nurses felt that they conducted SHS for a longer period of time than doctors did(X=20.1, P= .005). 2. Nurses and doctors had some knowledge of slipping rings off fingers and the length of nails, but they lacked knowledge on the duration of SHS, handwashing after an operation and on manicure. 3. There were many reasons given for insufficient SHS included: 1) because they were so busy (38%). 2) brushes were too harsh(19.7%). 3) operations were very simple(18.7%). 4) surgical latex gloves provide functional barrier(11.6%). 5) SHSs were troublesome(7.4%) 6) there were no clocks near the sinks(2.5%) and 7) the operative patients were administered antibiotics after operartion(2.1%). 4. Most of nurses and doctors considered SHS to be important in prevention against post operative infections. 5. Nurses were found to do a thorough SHS, but residents were found to neglect SHS. 6. Considering prevention against postoperative infections, most nurses and doctors considered aseptic techniques, environment-sanitary management and SHS more important than the use of antibiotics, the resistance of patients or the method of operation. 7. Half of the nurses and doctors(54.3%) considered surgical latex gloves to function well as a barrier. 8. Half of the nurses(56.4%) and doctors(51.9%) learned SHS as part of the curriculum in their school education and the rest (nurses: 95.7%, doctors: 74.7%) learned SHS as part of their In Service Education. In conclusion, these findings suggest a need to develop an educational program on surgical hand scrub and hospital infection control for surgical personnels, to install clocks near the hand scrub sinks, to consider a violation report for negligent surgical hand scrubs, and to develop a soft brush for hand scrubs in order to increase performance of the surgical hand scrub.

Needle stick injury, in which blood-borne pathogens including Human Immuno-Deficiency virus and hepatitis B virus are transmitted, is one of the major occupational hazards that health professionals face everyday. In order to provide basic data for the development of educational programs for health professionals aimed at preventing and effectively managing needle stick injuries, a retrospective descriptive study was carried out. The subjects of the study were 630 health professionals, 499 nurses and 131 physicians, from two university hospitals in Seoul, Korea. Data on episodes of needle stick experiences; over the past is months September 1994 through August 1995, were collected between September 1 and 7, 1995. A Questionaire developed by the researcher was used. The frequencies and the percentile score for episodes of needle stick injuries were calculated using the PC-SAS program. The differences and similarities in reference to the structure, career, and specialty variables were analysed by X2-tests. Results are as follows: 1. Of the sample, 521 (82.7%) reported a needle stick injury, 33.4% reported 3 or more episodes of needle stick injuries. 2. The needle stick injuries occured in the following processes; process of percutaneous venepuncture for intra-venous injection and infusion(55.3%), medical examination and treatment(48.9%), percutaneous venepuncture for blood sampling (46. 3%) and intra-muscular injection (42.2%). 3. The study showed that needle stick injuries occured before(19%), during(25%), and after (56%) client treatment. The major causes of needle stick injuries were perceived to be hastiness (82.2%) and carelessness (48.3%). Of these injuries, 91.8% occured in emergency situations. 4. Follow of care for the injury consisted of; treating the injured site immediately using disinfectants (89.7%), reviewing the clinical records of the patient involved (84.2%), immunological investigation for the status of anti-bodies(ll.l%) and self-medication of antibiotics (10.7%). Only 16.3% of the total episodes were founded to have been reported to the administrative unit. 5. The length of clinical experience of the nurses, clinical specialty and length of clinical experience in physicians were found to have influenced the episodes of needle stick injuries; nurses with less than 1 year and with more than 6 years of clinical experiences had significantly lower levels (X2=25.04, P=.00), surgeons had significantly higher levels(X2=9.89, P=.02) compared to that of internists and interns, higher(X2=4.54, P= .03) than residents.

No abstract available.

It has been noted that a genetic alteration of cells influenced by unhealthy lifestyle in addition to a series of other carcinogens increases the incidence of various neoplasmic diseases. Therefore the importance of a lifestyle that minimizes such an impact on health should be emphasized. Since stomach cancer, the most common neoplasmic disease in Korea, is related to personal lifestyle and as there is a possibility of its recurrence, patients with stomach cancer need to lead a healthy lifestyle. Also the quality of life which patients experience is negatively affected by the side effects of treatments and the possibility of recurrence. Therefore an effective nursing intervention to enhance quality of life and encourage healthy lifestyle is needed. The purpose of this study is to provide a basis for nursing intervention strategies to promote health and thus enhance quality of life. A hypothetical model for this purpose was constructed based on Pender's Health Promotion Model and Becker's Health Belief Model, with the inclusion of some influential factors such as hope for quality of life and health promoting behavior. The aims of study were to: 1) evaluate the effectiveness of patient's cognitive-perceptual factors on health promoting behaviors and quality of life; 2) examine the causal relationships among perceived benefit, perceived barrier, perceived susceptibility and severity, internal locus of control, perceived health status, hope, health concept, self efficacy, self esteem, health promoting behaviors and quality of life; 3) build and test a global hypothetical model. The subjects for this study were 164 patients who were being treated for stomach cancer were approached in the outpatient clinic on a University Hospital. The data from the completed questionnaires were analyzed using Linear Structural Relationships (LISREL). The results of research are as follows: 1) Hypothetical model and the modified model showed a good fit to the empirical data, revealing considerable explanational power for health promoting behaviors(54.9%) and quality of life(87.6%) 2) Self efficacy and hope had significant effects on health promoting behaviors. Of these, hope was affected indirectly through self efficacy and self esteem. 3) Perceived health status, hope and self esteem had significant direct effect on the quality of life. Of these variables, perceived health status was the most essential factor affecting general satisfaction in life. 4) Self-efficacy, as a mediating variable, was positively affected by perceived benifit and hope. 5) Self-esteem, as a mediating variable, was positively affected by perceived health status and hope. 6) Hope was the main variable affecting self efficacy, self esteem, health promoting behaviors and quality of life. The derived model in this study could effectively be used as a reference model for further study and could suggests a direction for nursing practices.

It is important to find indicators of quality nursing care to establish the excellence of nursing practice and for the development of nursing as a profession. Caring is one of the indicators which can represent professional nursing care. The purpose of this study was to develop a measurement tool of caring that could be used as an instrument for the evaluation of quality of nursing care. The Target population for the developed tool of caring is the adult patient. The mearsurement tool of caring was developed through the following steps. (1) A list of caring behaviors was made using qualitative researches on caring that has been done in Korea. (2) Caring behaviors in nurses were selected using the list of caring behaviors developed from Watson's 10 factors of caring, (3) Items for the measurement tool of caring were developed using the caring behaviors of nurses (4) Content validity of the developed items was evaluated by an expert panel. (5) The mearsurement tool of caring was developed after a pilot study (6) Internal consistency, and construct validity of the developed tool were verified. (7) The mearsurement tool of caring with the items verified for the internal consistency and construct validity was confirmed. As a result of the study, a mearsurement tool of caring, composed of 27 items with 3 factors, was developed. The Reliability coefficient of the tool was . 9578. The tool is a 5 point Likert scale. The factors of the tool and the number of items for each factor are, 1) accessibility and availablility, 15 items; 2) emotional support and giving information, 8 items; 3) providing a protective environment, 4 items.

This study is a phenomenological study done to promote understanding of the dying process in patients with terminal cancer who were in an independent hospice center. The purpose of study was to explore and understand indepth information on the dying process in order to provide data for holistic hospice care in nursing and to give insights in to practical applications in the nursing care. In ?depth interviewing was done from may, through November, 1995 with 11 patient with cancer who were being cared for at K Hospice Care Center. Experiences in the dying process were discussed as they expressed feelings about death including (a) feeling of isolation because family members try to hide the diagnosis of cancer, (b) hopelessness, (c) guilt, anger, and hostility, (d) suffering from pain, (e) fear of death. However, subjects did not deny death itself and were developing peace of mind and acceptance of death through religion.

Smoking is considered to be one of the important risk factors associated with various health problems. Thirty seven million people in America quit smoking in the past decade, with 90% quitting on their own(Americal Heart Association, 1986). According to McAlister(1975), 70% of smokers reported that they adopted a self-help smoking cessation approach rather than a formal treatment program. In our country, although, auccessful exsmokers have used, are not available, concerns about smoking cessation have increased, recently, due to changes in social and political attitudes to health promotion. This study was conducted to help smokers who had made a decision to adopt a self-helf smoking cessation approach instead of depending on a formal treatment program. It provided a structurd way for sucessful smoking cessation by identifying change mechanism factors which have been commonly used by smokers. The subjects selected for this study were 155 university students between 20 and 29. Years of age the results from the analysis of the collected data showed that seven factors in the self-help change processes significant, and they are named, Stimulus Control, Self-Determination, Information Management, Reinforcement Management, Helpful Relationships, Dramatic Relief and Cognitive Restructuring. All of the factors except Self-Determination represent the same change mechanisms which are proposed by Prochaska et al. (1988). Self-Determination uniformly includes items belonging to various change processes. Therefore, it might be an transitional factor including strategies related to both cognitive and behavioral dimensions. In spite of this, noted that one item which gives meaning of Self-Determination shows the highest factor loading, it is named Self-Determination.

The purpose of this study was to investigate the fluid balance of the patients who were either on soft fluid diet or total parenteral nutrition. We studied 19 patients with neurologic disorders and 22 patients with oromaxillary surgery who were admitted to either D university hospital in Choognam or S general hospital in Seoul between May and November 1995. The mean age lor the patients who had oromaxillary surgery was 24 years and their average hospital stay was 9 days. The mean age of the patients with neurologic disorders was 54 years and they were bedridden for average of 71 days. For the maxillary bone surgery patients we did not limit the range of their activities in the ward during data collection period. The patients with neurological disorders were bedridden and did not move around the ward. They were all either on soft fluid diet, or total parenteral nutrition. The findings of this study are as follows; 1) The difference of the triceps skinfold thickness between the baseline and the final measurement was 0.4cm for neurologic patient group and 0.5cm for oromaxillary surgery patient group. The difference was not statistically significant in each group. 2) In the oromaxillary surgery patient group, the daily intake of fluid in the form of pure water, other beverages, fluid diet as well as IV fluid was 4581ml while urine output was 2979ml. The difference between fluid intake and output was statistically significant, indicating that fluid intake was far more than urine output. In neurologic patient group, the daily intake of fluid including water from fluid diet and IV fluid was 2701ml whereas urine output was 2253ml and they were statistically significant. 3) For a more accurate assessment we adjusted the fluid balance based on weight changes during data collection period. In the oromaxillary surgery patient group, the difference between fluid intake and output was 1238ml after weight changes being adjusted. The difference was statistically significant, suggesting fluid overload in this patient group. In neurologic patient group, the difference between fluid intake and output considering weight changes was 124ml. The difference was not statistically significant, suggesting that the fluid intake and output was well balanced in this patient group.

Most efforts to improve tuberculosis treatment adherence target the patient and his or her behavior. This study examined the effects of behavioral modification training for these patients. Based on Bandura's behavioral principles of modeling, intervention strategies using a video program were devised to elicit specific patient target behaviors considered to improve patients' adher ence to tuberculosis treatment regimens. A random assignment, two-group (experimental group and control group) research design including 81 subjects was used. The main outcomes measured were pill taking measured with the Medication Event Monitaring System(MEMS) Medication Cap, patients' self-efficacy, and their knowledge of tuberculosis. The findings are as follows: 1) There was a significant difference between the experimental group and the control group in patients' feelings of self-efficacy. That is, the patients who received the behavior modification program showed greater feeling of self-efficacy to initiate and change their behavior for the tuberculosis treatment regimen than the patients who did not receive the program(t=3.51, p=0. 01). 2) There was a significant difference between the experimental group and the control group in patients' knowledge of tuberculosis. That is, the patients who received the behavior modification program showed higher level of knowledge of tuberculosis than the patients who did not receive the program(t=2.15, p=0.03). 3) There was a significant difference between the experimental group and the control group in patients' adherence to tuberculosis treatment regimens. That is, the patients who received the behavior modification program showed greater adherence to the treatment regimens than the patients who did not receive the program(t=5.11, P=0.00). The study findings provided useful insights into nursing practice, particularly in planning intervention strategies aimed at enhancing patients' adherence in tuberculosis that may also be relevant to other chronic diseases with patient adherence problems.

This study was done to analyze the trends of research on coping in Korea, to suggest future direction, for research on coping, and ultimately to contribute to an increase in explanation of adaptation. This article reviewed 79 nursing research papers on coping done since 1978 by examining them according to the period of publication or presentation, research design, type of subjects, measurement instruments, research for a degree or not, range of reliability, and association of coping and related variables. The results are as follows: The number of studies on coping increased rapidly from the mid -1980's and decreased slowly from the mid 1990's. The maority of the studies were surveys, comparative studies, or correlational studies. The subects of the 46 studies were healthy people, while those in the remaining studies were patients with a variety of illnesses. Thirth-eight studies on coping were done for master's thesis, three for dissertion, and 38 were not degrees. The Bell and Jalowiec coping scales have not been used since the early 1990's. In contrast, Lazarus and Folkman's W.C.C.L. has been used increasingly since that time. The reliabilities of the coping scale were reported in 37 cases and the Cronbach's alpha coefficients were .71 to .86. All subjects reported using more problem-oriented coping than emotion-oriented coping in short-term or emotion -oriented coping and healthy groups did more long-term coping. It was difficult to describe consistently the relationship between stress and coping according to the type of coping scale or research subjects, but generally moderate relationships were found. This was due to instrumental problems and no consideration of situational context. The subject group who used more short-term coping and less long-term coping reported poorer mental status, and higher scores in burnout and state anxiey than others. That is, the relationship between stress and adaptation increased the power of explanation with intervening the mediating effect of coping. The association of locus of control, mastery, social support, and self-concept with coping showed positive relationships; those of uncertainty and severity in illness with coping showed negati-verelationships; those of state anxiety and depression with short-term coping were positive, and those of self-esteem with long -term coping or problem -oriented coping were negative. There were significant differences in the scores of types of coping according to religion, level of education, and socio-economic status. That is, Presbyterians and Catholics, those with higher education levels and higher socio-economic status used more long-term or problem-oriented coping. On the basis of the above findings the following recommendations are made: 1. There is a need to test the mediating effect of coping variable in order to clarify the concept. 2. Longitudinal studies are needed to determine the patterns of change in coping strategies when stressful events are encountered. 3. It's necessary to develop a reliable and variable measurement tool for coping. 4. There is a need to identify subscales of coping to increase explanation of variance 5. It's necessary to consider personal, situational, and antecedent variables: the characteristics of subject populations, the natures of illness and treatment situations. 6. The power of explanation of studies designed to identify the stress-adaptation process should be increased using the combination model of process-oriented coping and cognitive-structural model.