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Volume 27(3); September 1997
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Original Articles
A Study of Primiparous Womens' Breastfeeding Experience
Shin Jeong Kim, Sook Ja Yang
Journal of Nurses Academic Society 1997;27(3):477-488.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.3.477
AbstractAbstract PDF

The purpose of this study was to understand the subjective breastfeeding experience of primiparous women to identify how breastfeeding was started and to explore the process of breastfeeding. The Grounded theory methodology was used. Data was collected from 6 primiparous women who had breastfeed their infants for at least over 8 weeks, recently breastfeeding or having breatfeed their infants within the last 6 months. With the permission of the subjects, the interviews were recorded and transcribed. The data were analysed in the framework of grounded theory method as mapped out by Strauss and Corbin(1990). 105 concepts and 21 subcategories were of data analysis. In the process of data analysis, "Identity as a mother" was found to be the core phenomenon. The 21 sub-categories were as follows : natural food, neighbour inducement, self purpose, good feeling, tenderness, breast pain, change of breast shape, physical discomfort, loss of physical energy, confirmation of adhesion, one body through coupling, tie, capacity, role performance, mental comfort, healthy mother, healthy infant, confidence of breast milk, feeling of satisfaction. The sub-categories were again grouped into 14 categories including infant nutritious food, formation of breastfeeding opportunity, feeling of satisfaction, injury of the breast, physical suffering, awareness of mothering, formation of maternal affection, connecting, coupling, acceptance, effort, emotional stability, mother and child health and feeling of achievement.

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Changes in Fatigue and the Quality of Life of Cancer Patients Receiving Radiotherapy
Eun Sook Lee, Jucia Jo
Journal of Nurses Academic Society 1997;27(3):489-502.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.3.489
AbstractAbstract PDF

Quality of life(QOL) and fatigue in cancer patients receiving the radiotherapy was assessed. The subjects were 46 cancer patients who daily attended the radiotherapy department. Assessment was done on four occasions ; the first assessment was done on the treatment simulation visit, the second one was four week after treatment started, the third one at the completion of treatment and the last assessment was done between six and eight week following treatment. The results are as follows : The fatigue scores of the patients at each stage of assessment ranged from 5.49 points to 7.67 points and highest score was recorded at the third assessment hat is, at the completion of treatment. The fatigue points showed an increase from the 1st. to 3rd. stage. However, at the 4th. stage, fatigue points decreased to the level at the first stage, fatigue points decreased to the level at the first stage of assessment. QOL were assessed in three areas namely, physical, emotional and social/functional. The QOL scores in the physical area showed the highest score, followed by social/functional and emotional areas. The QOL scores decreased gradually to the third. stage of assessment thereafter recovered to the level of the first. stage. Correlation between QOL and fatigue scores during the treatment indicated that the level of QOL decreased as the level of fatigue increased. In particular, fatigue persisted after completion of the treatment and showed a significantly negative correlation with QOL. The present study strongly suggests that a strategy to restore the emotional well being level of the patient should be devised in order to improve QOL and reduce fatigue of patients receiving radiotherapy.

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Effect of Head Elevation and Position on Intracranial Pressure(ICP) in the neurosurgical Patient with a Cerebral Aneurysm
Hye Ja Park, Kyung Ok Choi, Byung Ok Lee, Eun Ju Jung, Yang Sook Yoo
Journal of Nurses Academic Society 1997;27(3):503-509.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.3.503
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This study was undertaken to identify optimal head elevation and position in the care of the neurosurgical patient with a cerebral aneurysm. The effects of 0degree, 15degrees and 30degrees head elevation and three positions(supine, side lying position opposite to the operation site, and side lying position on the same side as the operation site) on ICP was studied in fourteen neurosurgical patients with cerebral aneurysms. The results are as follows : 1. The mean intracranial pressure was significantly lower when the patient's head was elevated at 30degrees as compared to 0degree and 15degrees. 2. The mean intracranial pressure was significantly lower when the patient was positioned in the supine as compared to side lying positioned in the supine as compared to side lying position opposite to the operation site and side lying position on the same side as the operation site. The data indicate the head elevation to 30degrees and the supine position reduce ICP in neurosurgical patients with cerebral aneurysm.

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Effect of Regular Exercise During Dexamethasone Injection on the Body Weight, Weight of Hindlimb Muscle and Adrenal Gland in Young Rats
Myoung Ae Choe, Jung Ae Choi, Gi Soo Shin
Journal of Nurses Academic Society 1997;27(3):510-519.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.3.510
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The purpose of this study was to determine the effect of regular exercise during dexamethasone injection on the body weight, weight of hindlimb muscles and adrenal gland in young rats. 80-100g Wistar rats were divided into control, exercise, dexamethasone injection(dexa), and exercise during dexamethasone injection(D+E) group. The dexa group received daily subcutaneous injection of dexamethasone at a dose of 5mg/kg body weight for 10 days. The exercise group ran on a treadmill for 60min/ day(20 minutes every 4 hour at 10m/ min and a 10degrees grade. The control group received daily subcutaneous injection of normal saline at a dose of 5mg/kg body weight for 10 days. The D+E group ran on a treadmill for 60min/day(20 minutes every 4hour) at 10m/min and a 10degrees grade. Body weight of both control and exercise group increased significantly until 10 days, the of both dexa and D+E group decreased significantly, resulting in 79.47 and 78.75% decrease respectively compared to the first day of experiment. Body weight and muscle weight of the soleus, plantaris and gastrocnemius decreased significantly with dexamethasone injection. Relative weight of the dexa group decreased significantly compared to that of the control group. Body weight and muscle weight of the soleus and plantaris of the D+E group showed a tendency to increase, and muscle weight of the gastrocnemius increased significantly compared to the dexa group. The Relative weight of the plantaris was comparable to the control group and that of the soleus and gastrocnemius tended to increase, in the exercise group. Body weight and muscle weight of the soleus and plantaris of the D+E group showed a tendency to increase, and muscle weight of the gastrocnemius increased significantly compared to the dexa group, The Relative weight of the soleus and gastrocnemius tended to increased and that of the plantaris of the D+E group increased significantly compared to the dexa group. Body weight, muscle weight and relative weight of the soleus, plantaris and gastrocnemius of the D+E group increased significantly compared to the dexa group Adrenal gland weight of the dexa and D+E group tended to increase, and that of the exercise group increased significantly. From these results. it can be suggested that regular exercise during dexamethasone injection might attenuate the decrease of body weight and hindllimb muscle weight induced by the dexamethasone injection.

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Biological Monitoring on the Absorption of Antineoplastic Drugs in Nursing Personnel
Bong Im Kim
Journal of Nurses Academic Society 1997;27(3):520-530.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.3.520
AbstractAbstract PDF

Antineoplastic agents may exhibit effects not only in patients therapeutically exposed, but also in health workers who prepare and administer these drugs. This study was done to clarify whether nurses who handle anticancer drugs show signs of drug absorption. The experimental group was 14 nurses handling anticancer drugs at three medical wards of a hospital in J city ; the control group was 12 psychiatric nurses at the same hospital. The test materials were the nurses' 24hr urine specimens, which were concentrated by XAD-2column chromatograpy. Tester strains were TA98(+/-S9mix), TA100(+/-S9mix), TA135(+/-S9mix)and TA1537(+/-S9mix) ; the salmonella mammalian microsomal test(Ames test) was used for the urinary mutagenicity assay. The results are summarized as follow : 1. In qualitative analysis of the results, both experimental group and control group showed 15.4% urine toxicity. 2. The experimental group revealed significantly higher urinary mutagenicity both in the activation method test and non-activation method test of the tester strains TA98, TA100 and TA1535. In the case of TA1537, the two groups showed no difference in the non-activation method test, but the activation method revealed a difference. 3. In urinary mutagenicity of the experimental group by ward career, there was a significant difference between the group with more than 20 months experience and the group with less than 20 months on the tester strains TA98, TA100, and two groups by the tester strain TA1537. No Significant difference was found between two groups by the tester strain TA1535.

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An Attempt of Reinterprtation on History of Nursing and Health Care Using Post-structural Method
Nam Sun Kim
Journal of Nurses Academic Society 1997;27(3):531-540.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.3.531
AbstractAbstract PDF

The purpose of this study is to reinterpretate the history of nursing and health care from the viewpoint of post-structuralism. It has been emphasized that the development of modern health care has been due to the progressive efforts of medicine and to medical discoveries. Medicine has dominated the history of health care rather than nursing or other health professions. The present study adopts the post-structural method by Foucault, which tries to unite language and knowledge. Foucault examines "the institutionalization of knowledge and the power exerted thereby, with special reference to the devices of social regulation and their function over the madness, the disease, the crime, and the sexuality." The concept of power in Foucault's writing is that it is exerted spontaneously in verbal behaviors of individuals through knowledge of everyday life such as definition of body or mind, sexuality and relation ship of family. Therefore as to the problem of power, this study tries to understand the meaning of the health care history through an analysis of the formation of medical discourse. In order to have authority in a power relation, the medical professional asserts that medical discourse in the most scientific knowledge. The authority of medical professionals can be reinforced by the fact that male medical professionals outnumber female. Devaluation of nursing care is reinforced by the medicine which has the legitimate through use of the political skills.

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The Study on Health Promoting Lifestyle of the Elderly
Young Shin Song, Mi Ra Lee, Eun Kyong Ahn
Journal of Nurses Academic Society 1997;27(3):541-549.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.3.541
AbstractAbstract PDF

This study was done to describe health promoting lifestyle and determine affecting factors in elderly based on the Heath Promotion Model by Pender. Cognitive-perceptual factors that were included in this study were self-efficacy and hardiness. Modifying factors were demographic characteristics(sex, age, partner, previous illness, education level, income and religion). The specific purpose of this study was to examine the relationships of self-efficacy, hardiness and the demographic chasteristics to health promoting lifestyle and to determine causal factors affecting the elderly. The subjects were a volunteer sample of 98 elderly in one city in? The instruments for this study were Health Promoting Lifestyle Profile(47items, 4scale), Health Related Hardiness Scale(22items, 6scale), general Self-Efficacy Scale((13items, 5scale). Frequency, percentage, t-test, ANOVA, Pearson's correlation coefficient and Stepwise Multiple regression technique with SAS program were used to analyze the data. The Results of the study are follows ; 1) The average item score for the health promoting lifestyle was 2.63, the highest score on the subscales was interpersonal support(M=3.3), followed by self-actualization(M=2.9), nutrition (M=2.8), stress management(M=2.7), health responsibility(m=2.1) with the lowest being exercise(M=2.0). 2) A significant difference between education level, income, religion and health promoting lifestyle were found. 3) All of the subscales on health promoting lifestyle were positively related to total hardiness(r=0.330, p<0.001). The hardiness subscale of control was positively related to self-actualization(r=0.276, p<0.01), and commitment was positively related to self-actualization(r=0.315, p<0.001), exercise/nutrition(r=0.245, p<0.01), interpersonal support(r=0.278, p<0.01), stress management(r=0.250, p<0.01). Challenge was positively related to self-actualization(r=0.315, p<0.001), exercise/nutrition((r=0.245, p<0.01). There was no significant correlation between self-efficacy and all of the subscales of health promoting lifestyle. Self-efficacy showed a significant correlation only with control(r=0.469, p<0.001), committment(r=0.507, p<0.001), Challenge(r=0.489, p<0.001). 4) Committment, self-efficacy and income explained 25.01% of the variance for the total health promoting lifestyle. The results of this study show that commitment, self efficacy and income predicted the health promoting lifestyle of the elderly. So health promoting programs that increase committment and self-efficacy should be developed to promote a healthy lifestyle of the elderly, especially those who have low income.

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Need Assessment for Home Nursing of Stroke patients
Hyun Sook Kang
Journal of Nurses Academic Society 1997;27(3):550-562.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.3.550
AbstractAbstract PDF

Since patients with strokes occupy a high priority among patients for home nursing, the development of guidelines for such nursing is required and the need of these patients should be reflected in the guidelines. Therefore, this study was done to identify the content and levels of home nursing for patients with strokes and to utilize the data in developing the most effective home nursing guidelines for these patients. The level of A.D.L. and the ability to control upper extremities were measured, and through a questionnaire. the needs for home nursing and related variables were also evaluated. The subjects for the study were 121 patients, 58 inpatients and 63 home care patients who had a Stroke. Data collection was done from September 1996 to January 1997. The collected data were analyzed utilizing SPSS/PC, and the results are as follows : 1. Home nursing need of inpatients The priority order of home nursing need for inpatients was : "Training in emergency treatments and how to cope with a stroke"(2.28+1.06), next "Explanation of diets as limited or recommended", and last, "Nursing care for sleeping problems". 2. Home nursing need home of patients The priority order of home nursing needs for home patients was ; "Care for the paralyzed side"(2.89+.34), next, "Maintenance of right posture and how to change position"(2.87+.34), and last, "Counseling on sex". 3. Comparison of the levels of home nursing needs between inpatients and home patients The results of analyses of home nursing needs according to causes were grouped into seven categories ; and t-tests of the seven categories showed significant differences between the two groups in all categories, that is, the level of home nursing needs were significantly higher for home patients than inpatients in all categories of home nursing. 4. Level of home nursing needs by characteristic The variables that have affected the level of home nursing needs for these patients were sex, profession, level of education, accompanying diseases, paralyzed position, A.D.L. levels and ability levels in coordinating upper extremities. There variables, displayed a reverse correlation with the level of home nursing needs, and the degree of correlation was high. In conclusion, the above results, show there were differences in the priority order of home nursing needs between inpatients and home patients : but the content of home nursing needs wanted by these patients was similar. Meanwhile, the levels of demand for home nursing was exceptionally higher on the part of home patients than inpatients, Although it is realized that nursing guidelines for home nursing needs in all items need to be developed, there is also a necessity to guidelines in accordance with priority orders, and with consideration of the factors that affect the level of home nursing needs.

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Characteristics of Individuals Seeking Comprehensive Health Check-ups
Mi Hae Sung
Journal of Nurses Academic Society 1997;27(3):563-576.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.3.563
AbstractAbstract PDF

This study was carried out to identify basic data for more efficient operation of comprehensive health check-up centers in the national health care system. The researcher reviewed and analyzed the main symptoms of the subjects according to sex, age, occupation and positive rate in the screening tests of a comprehensive health check-up, performed at one comprehensive health check-up center in located in a hospital. The subjects were 512 persons who had a check-up at the comprehensive health check-up, center in K university hospital in Seoul from October 2, 1996 to March 30, 1997. A questionnaire developed by the researcher to obtain subject's general characteristics, main symptoms, medical examination, diagnosed disease was used as the tool for the study. The researcher analyzed the data with SPSS PC+ program : the distribution of the subject's general characteristics and main symptoms was described with percentages and the difference between main symptoms and screening tests analyzed with X2-test, t-test, ANOVA. The result of this study are as follows : 1. For the distribution of diagnosis in males, liver disease was most frequent and hypertension was second : in females, hypertension and liver disease were not common in that order. 2. The most common complaints were indigestion in the digestive system, sputum in the respiratory system, irregular heart beat in the cardiovascular system, frequent urine in the urinary system, vertigo in the hematologic system. 3. The main symptoms according to sex were for females, a statistically significant higher rate of complaints in the digestive system, cardiovascular system, urinary system, hematologic system, musculoskeletal, mental and nervous system as compared to males. 4. The main symptoms according to age were that in the second decade there ware higher rate of complaints in the digestive system, and cardiovascular system than in the older age group : and in the fifth decade more in the musculoskeletal system. 5. The main symptoms according to occupation were that farmers and fishers had a higher rate of complaints in the mental and nervous system as compared to other occupation groups : and office workers, in gynecology. 6. The main symptoms according to diagnosis, were symptoms of the digestive system, frequent in liver disease : symptoms of the cardiovascular system in allergic disease. 7. The screening tests which showed the highest rates were UGI/FGS, PFT : In males a higher rate of abnormality was seen in abdominal ultrasonography and in, females, in mammography. 8. In screening tests according to sex, males showed a higher positive rate for chest X-rays, and LFT, and females, in mammography, pap smear, CBC. 9. In screening tests according to age, higher positive rates of obesity, high blood pressure, chest X-ray, mammography, pap smear, FBS, CBC, urine test were seen in the fifth decade : PFT and abdominal ultrasonography in the third decade. The subjects who wanted comprehensive health check-up were not asymptomatic but had an illness with several symptoms. It is found that the most frequent diagnosed diseases were hypertension and liver disease. So proper observations must be done for them. Comprehensive health check-ups should be changed to a comprehensive examination including treatment beyond examination for those subjects with positive results.

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The Perceived Discomfort of Plateletpheresis Donors
Sang Dol Kim
Journal of Nurses Academic Society 1997;27(3):577-587.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.3.577
AbstractAbstract PDF

PURPOSE: To collect and interpret basic data involving the discomfort level of platelet donors and to see which nursing interventions would help make plateletpheresis more comfortable. METHODS: Using " the Platelet Donor's Discomfort Scale" developed by the researcher herself and reviewed by an expert panel, the severity of discomfort as well as factors contributing to the development of this discomfort were analyzed. This scale contained 59 items and each item was scored by the 4-point Likert manner. Between March 1, 1996 and May 31, 1996, 500 platelet donors(16 years of age and older) were enrolled in this study. The Statistical methods used were factor analysis, t-test, and ANOVA. The results were as follows : 1. The mean of the platelet donor's discomfort scale was 130, range 69-207, possible score ranging from 59-236. 2. The platelet donor's discomfort scale had psychological, environmental, physical, and time-related factors. The time-related factor was the highest positive correlation with the development of the discomfort. 3. In looking at the psychological and environmental factors of the discomfort scores, the 16-20 age group had significantly higher rating than those of the 26-30 age group. The students' group had higher scores than the soldier's group, and those who used the V-50, MCS-3P, or the PCS Plus machines had higher scores than those who used the COBE Spectra machine(P<.05, respectively) 4. In relation to the physical factor of the discomfort score, the youngest group felt significantly more discomfort, the student's group had a higher score than the soldier's group had a higher score than the soldier's group, and those who used the V-50, MCS-3P, or the PCS Plus machines had higher scores than those who used the COBE Spectra machine(P<0.05, respectively). 5. The time related factor of the discomfort score had the highest scores in every variable, how ever, statistically significant differences were no found between any of the variables(P>.05). CONCLUSION: Based on the above results, it can be oserved that the time-related factor was the most important factor influencing discomfort. The age and job of the donor, as well as the type of machine used, were significant variables in predicting the level of discomfort, regardless of psychological, environmental, and physical factors. This data could be used to determine nursing interventions that would relieve some of the discomfort of patients, as well as donors, undergoing plateletpheresis. Furthermore, consideration of the donor's time, introduction of a platelet donor pool system, publicity and education about platelet donation are required.

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A Study on the Development of a Postrartum Depression Scale
Jeung Iee Bai
Journal of Nurses Academic Society 1997;27(3):588-600.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.3.588
AbstractAbstract PDF

Postpartum depression is one of the most serious problems in maternal health because it affects not only the mother but also her family. Postpartum depression disturbs the maternal-infant interaction and attachment. However, most postpartum depression patients ignore this problem and do not seek treatment. Many clinicians and researchers realize there is a need to develop a postpartum depression scale. Thus, this study has been designed to development of a postpartum depression scale. Data were collected through a survey over a period of three months. Subjects who participated in the study were 167 Korean mothers in their postpartum period. The author used a convenience sampling method. The analysis of the data was done with SPSS PC+ for descriptive statistics, item analysis and factor analysis. Initially 62 items were generated from the interview data of eight postpartum depression patients and from a literature review. This preliminary scale was analyzed for reliability and validity. The results of this analysis are as follows. 1. Initially 62 items were analyzed through the index of Content Validity(CVI)and 48 items were selected. 2. Seven factors were extracted through the principal component analysis, and these contributed 61% of the variance in the total score. Finally 46 items in the scale loaded .41~.84 on one of seven factors. 3. Each factor was labeled. Factor 1 was labeled 'emotional phenomena-emotional upset' and included 13 items, factor 2 was labeled 'cognitive phenomena-self concept disturbance' and included seven items, factor 3 was labeled 'relationship to baby-negative feeling' and included six items, factor 4 was labeled 'relationship to baby-overload' and included eight items, factor 5 was labeled 'negative maternal identity' and included five items, factor 6 was labeled 'biophysiological phenomena-disturbance of physical functioning' and included four items, and factor 7 was labeled 'interpersonal relationship phenomena-blamed others' and included three items. 4. Cronbach Coefficient Alpha for internal consistency was .95 for the total 46 items. Finally, the author suggests that this scale could be adequately applied in assessing the postpartum depression of mothers during the postpartum period. The results of this study can contribute to designing an appropriate postpartum depression prevention strategy.

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Development of Health Behavior Assessment Tool of the Korean Elders
Young Hee Choi, Soon Yi Kim
Journal of Nurses Academic Society 1997;27(3):601-613.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.3.601
AbstractAbstract PDF

This project was conducted using a survey method and through interviewing with four persons aged 60 years and over. An interview with an open-ended questionnaire was also used for elderly persons, families, oriental medicine doctor and nurses. topic-related literature review was also done. In total, 382 statements were derived. For content validity, nursing professionals were involved in this study. From that 48 items are developed. The subjects were 340 elderly persons over 60 years old. Data were collected during February and March 1997 and analyzed using the SPSS package The result are as follows. 1. Items with low Cronbach Coefficient alpha which means low correlation with total items were removed. 2. Factor analysis was done in order to confirm construct validity and eight factors were obtained from the results. The first factor, 'positive cognition of the aging process', the second factor, 'relationship network' the third factor, 'maintenance of physical functioning, the fourth factor', 'maintenance of peaceful mind' the fifth factor, 'keeping up with daily tasks' the sixth factor, 'continuous adequate body movement' the seventh factor, 'involvement of religion in the elderly person's life and the eight factor', 'appropriate resting'. Cronbach Coefficient alpha for the 33 items was .9127 Based on the result, the following is suggested 1. It is anticipated that the fundamental health of elderly person could be promoted by assessing healthy behaviors of elderly person with this assessment tool. 2. Further studies could be derived from this research. 3. Validity of this assessment tool should be further tested with and a larger sample of elderly person including in-patient elderly persons as well as nursing home residents.

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A Structural Model for Quality of Life in Individuals with Rheumatoid Arthritis
Hyun Soo Oh, Young Ran Kim
Journal of Nurses Academic Society 1997;27(3):614-626.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.3.614
AbstractAbstract PDF

The main purposes of the study were to develop and test a model which explains the dynamic relationship among factors reported as affecting to the quality of life of individuals with rheumatoid arthritis and to examine the relationship between self-help response and quality of life. Data for the study were collected from March 1996 to December 1996 from 153 female patients who regularly visited a clinic for people with rheumatism. The Patients were introduced to the investigators by nurses who worked at that clinic, and then the investigator interviewed the patients for 30 to 40 minutes to collect the data. Instruments used in the study were modified self-report questionnaires from the ones which were already developed in previous studies of from related literature. Data analysis were performed using LISREL(Lineal Structural Relations) 8 Program to test whether the proposed hypothesized model fit the collected data. To test fitablity of the hypothesized model both a general fit measure and a detailed fit measure were used. Based on the test results from the various fit measures, the hypothesized model was found to be well suited to the real data. As characteristics related to illness becomes severe, the feasibility for uncertainty about the illness tend to increase, but, the direct effects from the illness characteristics(such as level of physical symptoms, sense of social-psychologic change, limitations of action) as they are related to the other intrinsic variables(self-efficacy or self-help behavior and quality of life), were found to be not significant. It was found that uncertainty had a direct effect on self-efficacy but did not have a direct effect on self-help behavior or quality of life. Also, it is noted that self-efficacy had a positive effect on self-help behavior and quality of life and there was a bilateral relationship between self-efficacy and self-help behavior. Lastly, the hypothesis proposed from the theoretical model in this study was supported basis of the results that self-help behavior provides both direct and positive effects to quality of life. Particularity, since a bilateral relationship was also found between self-help behavior and quality of life in the modified model, as self-help behavior increased, so did quality of life. And, reversely, as quality of life increased, so did self-help behavior. In conclusion, the results of this study suggest that focusing on both acquirement and reinforcement of adjustment factors or self-help behavior is more efficient than focusing on the characteristics of illness in establishing the strategies for improving quality of life of individuals with rheumatoid arthritis.

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Effects of a Program to Promote Self-Efficacy and Hope on the Self: Care Behaviors and the Quality of Life in Patients with Leukemia
Pok Ja Oh, Eun Ok Lee, Young Sook Tae, Dong Choon Um
Journal of Nurses Academic Society 1997;27(3):627-638.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.3.627
AbstractAbstract PDF

Most patients having leukemia suffer severely from emotional turmoil due to the generalized perception that cancer will be fatal. The conventional chemotherapy results in side effects such as severe bone marrow depression which interfere with self-care management, vital for improvement in their condition. Bandura's theory of the self-efficacy suggests that self-efficacy can be enforced by performance attainments, vicarious experiences, verbal persuasion and the release of emotional arousal. Self-efficacy can be enforced by a program of vicarious experiences and verbal persuasion, while the emotional arousal can be relieved through a hope promotion program. If once self-efficacy increases, the patient's self-care behaviors and the quality of life will also increase. The purpose of this study was to empirically test the effects of a program, to promote self-efficacy and hope, on self-care behaviors and quality of life in patients having leukemia. In this study, three types of approaches to enhance self-efficacy and hope were used : 1) a 20-minute long slide/tape for vagarious experiences ; 2) a 10-minute long telephone call coaching for verbal persuasion ; and 3)two booklets for information about the symptoms of leukemia and treatment modalities and hope promotion. Thirsty one patients were recruited in the experimental group and 29 in the control group with a nonequivalent pretest-posttest design. The subjects were patients with leukemia undergoing chemotherapy. Sherer and Maddux's self-efficacy scale, Nowotny's hope scale, and Padilla's quality of life scale were employed with some modifications. A self-care behavior scale was developed by the researchers. Statistical analyses including paired t-test, Chi-square, ANCOVA and ANOVA, were used. The results are as follows : The levels of self-efficacy, self-care behavior and quality of life were higher in the experimental group than in the control group after four weeks of intervention(F=28.71, P=.0001 ; F=63.35, P=.0001 ; F=16.57, P=.0001). After ten weeks of intervention, all of the dependent variables(self-efficacy, self-care behavior, hope and quality of life) in the experimental group were higher than in the control group(F=74.12, P=.0001 ; F=108.34, P=.0001 ; F=13.11, P=.001 ; F=43.52, P=.0001). In conclusion, self-care behavior and quality of life increased mainly through an increase an increase in self-efficacy, while increases in hope took more time and effort.

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An Effect of Self: Care Education and Level of Resourcefulness on Active Coping in Patients with Chemotherapy
Soon Rim Suh
Journal of Nurses Academic Society 1997;27(3):639-647.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.3.639
AbstractAbstract PDF

The purpose of this study was to identify how internal and external coping resources influenced active coping in the process of stress-coping. The model was established theoretically by comparing and integrating the following theories : Stress-Coping, Self-Care, and Resourcefulness. The subjects consisted of sixty eight patients undergoing chemotherapy(experimental group 34, control group 34) at two general hospitals from January to July, 1995, The results were as follows : After self-care education, the active coping score of the experimental group was significantly higher than that of the control group. The active coping score of the high resourcefulness group was significantly higher than that of the low resourcefulness group. The interaction effect between self-care education and resourcfulness was not significant statistically. Specifically as to such scores of seeking social support, problem-oriented strategy and self care behavior, there were significantly higher in the experimental group and high resourcefulness group than in each of the other groups. Considering them both, self-care education and resourcefulness are effective nursing strategies to promote active coping including self-care. Consequently, the synthesis and testing of theories of stress-coping, self-care, and resoucefulness in this study are mostly proven to enhance the explanation and prediction of the change of active coping including self-care. Therefore the result of this study will contribute in the development of practice theory of nursing. A further study is necessary to reevaluate the interaction effect between self-care education and resourcefulness and to identify the difference between resourcefulness and self-efficacy.

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The Effect of Preparatory Information on the State Anxiety Depending on Coping Styles of Patients Undergoing Cardiac Catheterization
Cho Ja Kim, Gi Yon Kim
Journal of Nurses Academic Society 1997;27(3):648-659.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.3.648
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The Purpose of this study was to study what effect providing the patient with preparatory concrete information had on the state anxiety depending on coping styles of patients undergoing cardiac catheterization. State Anxiety scores for 32 patients who had cardiac catheterization were examined after information was provided about the test using and audio tape. The state anxiety of patients who had a high trait anxiety level was compared to that of those who had a low trait anxiety level. The state anxiety of those who had a monitor type were compared to those of patients who had blunter type. The Trait and State Anxiety Scale of Spielberger Miller's Behavioral Style Scale, and Krantz's Health Opinion Survey and Visual Analog Scale(I, II) were used. Findings were as follows : 1. Among the demographic characteristics, gender difference of the patients was significantly different for the trait anxiety level. Female patients had higher trait anxiety level than male patients. 2. Analysis of state anxiety scores indicated that the mean score of the state anxiety prior to the test was higher than mean score of the state anxiety examined after the test. The difference was statistically significant. 3. Among the patients, 14 patients (43.7%) used monitor type, while 18 patients(56.3%) used blunter type. The means of preference for information measured on the Krantz' subscale was 2. 45. 4. The study results indicate that the state anxiety level of those who a low trait anxiety level was lower than that of those who had a high trait anxiety level. 5. State anxiety levels depending upon the kind of coping style which patients used during the test were not significantly different. This study did not identify the influence of preparatory concrete information on the state anxiety depending on coping styles, and there fore a quasi-experimental study using a large sample according to different types of information, and the amount of information, coping styles is recommended.

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Attitudes, Subjective Norms, and Beliefs of Korean Nursing Students as Predictors of Intentions to care for HIV Disease Patients: a Test of Theory of Reasoned Action
Hye Ra Yoo
Journal of Nurses Academic Society 1997;27(3):660-672.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.3.660
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No abstract available.

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A Study on Self-esteem, Coping Type and the Quality of Life in Mothers of Handicapped Children
Mi Kyung Sim
Journal of Nurses Academic Society 1997;27(3):673-682.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.3.673
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The purpose of this study was to examine the relationship between self-esteem and quality of life(QOL) and between coping type and quality of life (QOL) in mothers of handicapped children and further to identify the level of self-esteem and quality of life of the subjects. The subjects of this study were the 51 mothers of handicapped children who were registered in two special schools in Taejon. The data were collected using a questionnaire and the period of the data collection was from April 18th to May 26th, 1997. The instruments for this study were Resenberg's self-esteem scale, Folkman and Lazarus's Ways of Coping Checklist(WCC) and the quality of life scale designed by Ro, You Ja. The results were analyzed using SPSS/PC+. Data analysis included the descriptive correlational statistics of ANOVA, Pearson Correlational Coefficient, and t-test. The results are as follows : 1. The level of self-esteem showed a mean score 34.51 and the level of QOL, a mean score 137.55. An Active type of coping was used more often than a passive one. 2. The level of self-esteem differed according to monthly income and was significantly higher in mothers of children with acquired handicaps than those of children with congenital handicaps. The level of QOL differed according to monthly income. 3. There was positive correlation between health status and self-esteem(r=.355, p<.05), and between health status and QOL(r=.367, p<.01). 4. Test for hypothesis ; Hypothesis 1, "The higher the level of self-esteem in mothers of handicapped children, the higher their level of quality of life will be." was supported(r=.755, p<.001). Hypothesis 2, "The QOL level for the active coping group as compared to the passive coping group will be higher." was not supported.

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Incidence and Correlates of Urinary Incontinence in Women
Hae Sang Yoon, You Za Ro
Journal of Nurses Academic Society 1997;27(3):683-693.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.3.683
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Urinary incontinence is defined as the involuntary and inappropriate loss of urine to failure to emit normal responses as the bladder fills, or inability to reach the bathroom in sufficient time. This study was undertaken to estimate the incidence of urinary incontinence and to determine the correlates of urinary incontinence among women. Subjects of this survey consisted of 408 women, 26 to 83 years old in Incheon. The results of this study are follows. 1. Of the subjects 50.7% reported urine loss once or twice per year and 28.5% reported incontinence on a regular basis at least once per month. 2. 40.5% of women reported small volume accidents of only 1 to 2drops, 31.4% ; 1t-spoon, 16.9% ; 1T-spoon, while 10.1% of women couldn't estimate the volume of urine loss. 3. The volume of urine loss was great enough to require a change of garment(undergarments or outer garments) in 73%. But only 3.8% of those used some type of pads. 4. 56.5% of incontinent women didn't talk about their urinary incontinence with other persons because they felt that urinary incontinence was shameful(38.4%), was not a disease(31.6%), was incurable in spite of treatment(27.4%) and was fearful of being uncured(2.6%). 5. Only 15.5% of urinary incontinent women had sought treatment. 6. The incidence of urinary incontinence was significantly higher in women who had more pariety and uterine-ovarian disease, older age, worrying about where toilets were when they visited new places or voiding anxiety, nocturia and frequency, but was significantly lower in women who had coffee intake. The incidence of urinary incontinence was not related to smoking and enuresis. The results indicate that urinary incontinence is common among young and middle-aged women. That few seek treatment for urinary incontinence suggests a need for more information about women's attitudes toward urinary incontinence and more attention to this problem by health care providers.

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Glucose Tolerance and Insulin Secretion patterns by Body Mass Index(BMI) in Offspring of Parents with Non-Insulin Dependent Diabetes Mellitus
Young Im Moon, Hye Ja Park, Young Ae Chang
Journal of Nurses Academic Society 1997;27(3):694-704.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.3.694
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This study was designed to assess the body fat distribution, and also to investigate the effects of body fat on glucose tolerance and on insulin secretion pattern by body mass in offspring of parents with NIDDM. The subjects consisted of twenty parents with NIDDM who had been admitted to the Department of Internal Medicine or had been seen in the outpatient clinic at Kangnam St. Mary's Hospital, Catholic University between February to March, 1995. Twenty offspring were randomly selected from forty six offspring of twenty healthy people without a family history of diabetes mellitus were matched by sex, age and body mass index(BMI). The results are as follows : 1. mean fasting serum glucose and insulin levels and insulin/glucose ratio were significantly greater in offspring than in the control subjects with BMI>or=25kg/m2 in the offspring and in the BMI<25kg/m2(P<0.05). 2. The total glucose area and insulin area were significantly greater in both the offsping and the control subjects with BMI>or=25kg/m2 than in both the offspring and the control subjects with BMI<25kg/m2(P<0.05). 3. Upper body skinfold thickness, Waist hip ratio(WHR), serum levels of total cholesterol and triglyceride(TG), total dietary calorie intake and protein intake in both the offspring and the control subjects with BMI>or=25kg/m2 were greater than those with BMI<25kg/m2(P<0.05). On the other hand, HDL-cholesterol in both the offspring and the control subjects with BMI 25kg/m2 was lower than those with BMI<25kg/m2(P<0.05). 4. The major variables influencing the total glucose area were subscapular skinfolds thickness and WHR and the major variables influencing the total insulin area were suprailiac skinfolds thickness, WHR, TG and free fatty acid. In the light of the results, glucose intolerance and insulin resistance were affected by body mass index, Upper body fat, WHR, and lipids(TG, Free fatty acid), it is implied that these are influencing factors on total glucose area and total insulin area. The identification of these factors might provide a useful tool to identify individuals at high risk of diabetes mellitus. Therefore, various nursing intervention programs to reduce obesity could be given to both the offspring of parents with NIDDM and to the obese healthy controls before diabetes mellitus develops.

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Validity Testing Study for Related Factors and Charateristics of Nursing Diagnosis
Young Hee Choi, Hyang Yeon Lee, Hea Sook Kim, So Sun Kim, Kwang Ok Park, Hyeoun Ae Park, Hyoun Kyoung Park
Journal of Nurses Academic Society 1997;27(3):705-714.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.3.705
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This study was conducted to test validity of related factors and characteristics of 98 Nursing Diagnosis identified in a previous study by the Korean Nurses Association. Data for this study was collected from 892 nurses in eight teaching hospitals located in Seoul using a cross sectional survey method. Each participating hospital was asked to produce at least 10 cases for every nursing diagnosis. There were 7,422 responses out of a possible 7,840. Out of the 7,422 responses 26 were discarded due to incompleteness. Data were analyzed using SAS. The result of the study shows that most of the related factors and characteristics for each of the 98 nursing diagnosis were ranked at more than 3.5 point out of 5 point Likert scale in terms of significance. Through this study the related factors and characteristics of the 98 nursing diagnosis identificance. Through this study the related factors and characteristics of the 98 nursing diagnosis identified through literature review were validated by experts in nursing diagnosis. These validated related factors and characteristics will be utilized for computerization of the nursing diagnosis process.

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J Korean Acad Nurs : Journal of Korean Academy of Nursing
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