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Volume 36(3); June 2006
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Original Articles
A Study on Health Perception and Health Promoting Behavior in Chronic Back Pain Patients
Hyoung Sook Park, Young Sook Kang, Kyung Yeon Park
Journal of Korean Academy of Nursing 2006;36(3):439-448.   Published online June 30, 2006
DOI: https://doi.org/10.4040/jkan.2006.36.3.439
AbstractAbstract PDF
Purpose

The purpose of this study was to show a relationship between health perception and health promoting behaviors in chronic low back pain patients.

Method

The subjects for this study were 213 persons who the visited hospital with low back pain-related problems.

Results

The higher the levelof the health perception in chronic back pain patients was the higher the rate of the practice of health promoting behaviors (r=0.393, p<.001). The health perception T score was 50.00±10.00. As for health promoting behaviors, the T score was 49.99±10.00. The subscale of the highest mean score was interpersonal support (2.96±0.64) and the subscale of the lowest mean score was exercise (2.13±0.99).

Conclusion

This study showed that chronic low back pain patients had a lower level of perception of their health, and their practice to improve their health was not enough. Therefore, nurses should educate and encourage chronic low back pain patients in proper exercises and correct posture to strengthen and maintain lumbar extension muscle power.

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Health Perception, Body Image, Sexual Function and Depression in Menopausal Women according to Menopausal Stages
Jung Hee Kim, Hyun Sook Moon
Journal of Korean Academy of Nursing 2006;36(3):449-456.   Published online June 30, 2006
DOI: https://doi.org/10.4040/jkan.2006.36.3.449
AbstractAbstract PDF
Purpose

The purpose of this study was to investigate the influences of health perception, body image and sexual function on depression according to the menopausal stage in Korean middle aged women.

Methods

Subjects were 182 perimenopausal and postmenopausal women who had not received hormonal replacement therapy. A five-item General HealthShort Form (SF-36) Health Survey Questionnaire (Ware & Sherbourne, 1992) was used to measure health perception. Body image was measured Semantic Differential scale, CES-D was used to measure the level of depression, and sexual function was measured by FSFI.

Results

The subjects rated their health as ‘moderate’, their body image as ‘moderate, and level of depression as ‘high’. However, there were no significant differences in health perception, body image, and depression between perimenopasual and postmenopausal women. Postmenopausal women experienced lower levels of sexual function than perimenopausal women in sexual arousal, lubrication, orgasm, satisfaction, and pain. In stepwise regression analysis, 21.7% of variance in depression was shown to be perceived health and body image in postmenopausal women. However, in perimenopausal women, perceived health and sexual function explained 34.5% of variance in depression.

Conclusion

These findings indicate that nurses must consider the menopasusal stage when counseling their patients.

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The Impacts of a Community Health Practitioner's Ego State, and Interpersonal Attitude on Depression
Sook Lee
Journal of Korean Academy of Nursing 2006;36(3):457-467.   Published online June 30, 2006
DOI: https://doi.org/10.4040/jkan.2006.36.3.457
AbstractAbstract PDF
Purpose

Community health practitioners (CHP) in Korea have a responsibility for delivering primary health care to remote or isolated communities. The aim of this paper is to analyze CHPs' level of depression and impacts of their Ego state and interpersonal attitude in transactional analysis on depression. This paper gives fundamental data for developing a the program for mental health promotion of CHPs.

Method

The subjects of this study consisted of 459 Korean CHP who were conveniently selected from the target population. The data was collected through interviews using self-administered questionnaires, including the Korean Ego gram and life position inventory and depression scale.

Results

The CHP's Ego gram showed the N type with the top point of NP. The type of interpersonal attitude was I'M OK - YOU'RE OK (I+U++). The level of depression was 35.4, normal range. There was a significant difference in depression according to the duration of the career. There was a significant negative correlation among NP, A, FC ego states, interpersonal OK and depression, and a significant positive correlation between interpersonal Not-OK and depression. The NP, A, FC ego states and interpersonal Not-OK were significant predictors (47.1%) of depression.

Conclusion

This study showed that a program for CHPs to should include increasing the function of ego states and positive interpersonal attitude.

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A Concept Analysis of Assertiveness
Hyoung Sook Park, Young Ok Yang
Journal of Korean Academy of Nursing 2006;36(3):468-474.   Published online June 30, 2006
DOI: https://doi.org/10.4040/jkan.2006.36.3.468
AbstractAbstract PDF
Purpose

The purpose of this study was to analyze and clarify the meaning of the concept, assertiveness.

Method

This study used Walker and Avant's process of concept analysis.

Results

1. Attributes of assertiveness were defined as 1) Self-esteem 2) Comprehension to others 3) Clarification of the subject 4) Verbal communication 5) Non-verbal communication 2. The antecedents of assertiveness consist of these facts 1) The occurrence of a conflict situation 2) The occurrence of will to stick to one's opinions 3. There are consequences occuring as a result of assertiveness 1) Positive self-confidence 2) Increased comprehension or consideration to others 3) Expand of mutual respect 4) Maintenance of continuously cooperative relationship with each other 5) Output of acceptable results to each other.

Conclusion

Assertiveness is a core human behavior and is key to interpersonal relationships. Using the components of the concept of assertiveness, many conflicts in a nursing situation can be effectively prevented.

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A Study of Factors That Influence the Promotion of Healthy Behavior in the Elderly According to Types of Residency
Eun Young Jeon, Kwuy Bun Kim
Journal of Korean Academy of Nursing 2006;36(3):475-483.   Published online June 30, 2006
DOI: https://doi.org/10.4040/jkan.2006.36.3.475
AbstractAbstract PDF
Purpose

The goal of this study was to investigate the factors influencing health promoting behaviors in elderly individuals according to types of residency.

Method

This was a descriptive study. The subjects were comprised of 243 elderly aged 65 years or over living in 3 large cities. The instruments used for this study were a health promoting lifestyle, perceived health status, geriatric depression short form scale-Korea, social support scale, and self-efficacy. The data was analyzed using SPSS Win 12.0.

Result

Powerful predictors of a health promoting lifestyle were depression, self-efficacy, and perceived health status for the elderly living at home. In the cases of the elderly living in institutions, a powerful predictor of a health promoting lifestyle was identified as social support.

Conclusion

For the operation of long-term care insurance, a service for home care programs is needed for the elderly living at home in order to reduce depression and to increase self-efficacy and perceived health status. In addition, social support provided by health-care professionals should be developed to promote a healthy lifestyle for the elderly living in institutional environments.

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Effects of a Rehabilitation Nursing Program on Muscle Strength, Flexibility, Self efficacy and Health Related Quality of Life in Disabilities
Hea Young Lee
Journal of Korean Academy of Nursing 2006;36(3):484-492.   Published online June 30, 2006
DOI: https://doi.org/10.4040/jkan.2006.36.3.484
AbstractAbstract PDF
Purpose

The purpose of this study was to investigate the effects of a rehabilitation nursing program(RNP) for persons with disabilities.

Method

a quasi-experimental pretest and post test study was used to examine the changes of patient's muscle strength, flexibility, self efficacy and health related quality of life at the completion of an 8-week education and physical exercise with a Thera-Band and Exercise Ball course. The subjects consisted of 40 adults who were disabled. Twenty-two experimental and 18 control subjects completed pre and post-test measures. Outcome variables were flexibility, hand grip, elbow flexor and extensor, knee flexor and extensor, self efficacy and quality of life. Independent t-test and ANCOVA were used to examine group differences by using SPSS 12.0

Result

Mean comparisons of the change scores revealed that the experimental group increased significantly in knee extremity flexor(p=0.035), extensor(p=0.039), flexibility(p=0.008), self efficacy(p=0.000), and quality of life(p=0.000). No significant group differences were found in each patient's hand grip, elbow flexor and extensor.

Conclusion

RNP can improve lower extremity flexibility, muscle strength, self efficacy and health related quality of life in people with disabilities. The intervention to tailor exercise and education to the unique needs of the disability was suggested for further study.

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A Review Study on the Strategies for Concept Analysis
Myungsun Yi, So Woo Lee, Kum Ja Kim, Myo Gyeong Kim, Ji Hyun Kim, Kyung Hee Lee, Inok Lee, Jung Sook Lee, Jeong Hee Hong
Journal of Korean Academy of Nursing 2006;36(3):493-502.   Published online June 30, 2006
DOI: https://doi.org/10.4040/jkan.2006.36.3.493
AbstractAbstract PDF
Purpose

Concept analysis is an essential part of theory development in nursing. Thus, many strategies or methods of concept analysis have been suggested in nursing literature. However, in Korea, only limited strategies were utilized, without much consideration on a wide range of strategies in choosing a method that coincides with the characteristics of each concept to analyze. The purpose of this article was to propose various strategies for concept analysis.

Method

A literature review method was used.

Result

Ten methods of concept analysis were identified in the literature, and they were evaluated for advantages and limitations. In addition to the method by Walker and Avant and a hybrid model, more advanced strategies, such as triangulation method, critical analysis and the feminist approach were introduced and described in detail. The examples used in each concept analysis method were presented in table to provide the extent of utilization of each method.

Conclusion

This article provides a wide range of strategies in identifying, clarifying, or elaborating a concept. It might help in choosing a method that best fits the concept to analyze, thus enhancing quality of concept analysis research.

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Test on the Cost and Development on the Payment System of Home Health Care Nursing
Hosihn Ryu, Keysun Jung, Jiyoung Lim
Journal of Korean Academy of Nursing 2006;36(3):503-513.   Published online June 30, 2006
DOI: https://doi.org/10.4040/jkan.2006.36.3.503
AbstractAbstract PDF
Purpose

This study focused on analysing costs per home health care nursing visit based on home health care nursing activities in medical institutes.

Method

The data was collected in three stages. First, the cost elements of home health care nursing services were collected and 31 home care nurses participated. Second, the workload and caseload of home care nursing activities were measured by the Easley-Storfjell Instrument(1997). Third, the opinions on improving the home health care nursing reimbursement system were collected by a nation-wide mailing survey from a total of 125 home care agencies.

Result

The cost of home health care nursing per visit was calculated as 50,626 won. This was composed of a basic visiting fee of 35,090₩(≒35$) and travel fee of 15,536₩(≒15$). The major problems of the home care nursing payment system were the low level of the cost per visit, no distinction between first visit and revisits, and the limitations in health insurance coverage for home health care nursing services.

Conclusion

This study's results will contribute as a baseline for establishing policies for improvement of the home health care nursing cost and for applying a community-based visiting nursing service cost.

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Effects of a Tilting Training Program on Lower Extremities Function, Depression, and Self-efficacy among Stroke Inpatients
Nam Sook Seo, Mi Sook Han, Jeong Soon Lee
Journal of Korean Academy of Nursing 2006;36(3):514-522.   Published online June 30, 2006
DOI: https://doi.org/10.4040/jkan.2006.36.3.514
AbstractAbstract PDF
Purpose

The purpose of this study was to identify effects of a tilting training program on lower extremities function, depression, and self-efficacy among stroke inpatients.

Method

The subjects were 60 stroke patients hospitalized in an oriental medical hospital; 31 in the experimental group and 29 in the control group. A nonequivalent control group pretest-posttest design was used. The tilting training program consisted of 3 sessions and was implemented for 30 minutes daily during 3 weeks. Data was collected from Feb to July 2003, and analyzed by percentage, Fisher's exact probability, χ2-test, and t-test using the SPSS/Win 10.0 computerized program.

Result

After treatment with the tilting training program, the experimental group was significantly increased in the mean score for function of lower extremities (t=2.72, p=.009) compared to the control group, especially for keeping standing balance (t=2.78, p=.007) and standing by oneself (t=3.32, p=.002). However, in the mean scores of depression and self-efficacy, there were no significant differences between the two groups.

Conclusion

The tilting training program was effective for increasing the function of lower extremities and to improve walking ability earlier among stroke inpatients. Therefore, the tilting training program is applicable to increase the balance level in standing and walking ability at the early rehabilitation stage for stroke patients.

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The Effects of the Ulmus Root-bark Dressing in Tissue Regeneration of Induced Pressure Ulcers in Rats
Yeon Kyung Na, Hae Sook Hong
Journal of Korean Academy of Nursing 2006;36(3):523-531.   Published online June 30, 2006
DOI: https://doi.org/10.4040/jkan.2006.36.3.523
AbstractAbstract PDF
Purpose

The purpose of this study was to examine the effects of the ulmus root-bark dressing on tissue regeneration in experimentally-induced pressure ulcers in rats.

Method

A randomized pretest/post-test control group time-series study design was used. Thirty-three male Sprague-Dawley rats were used in this study. The rats were anesthetized with 100mg/kg of ketamine. Pressure ulcers were induced at 140mmHg for three hours using a personally-designed pressing apparatus. For four weeks, the ulmus root-bark dressing was applied every other day in the experimental group (n=18) and a wet gauze dressing in the control group (n=15). For data analysis, the statistical program SPSS WIN 12 was used. The wounds were examined by light microscopy and electron microscopy.

Result

There were significant statistical differences in the size of the pressure ulcers as time went by(p=0.006). It should be noted that there were no significant statistical differences in the number of capillaries. Using light microscopy the inflammatory infiltration and neovascularization in the dermis in the experimental group emerged densely in the early stages, but recovered rapidly at the latter stages. In addition, the reepithelization of the epidermis occurred earlier than in the control group. By electron microscopy, the cell organelles of the capillary endothelial cells and the basal lamina of capillaries in the experimental group showed a more rapid maturation during the latter stages, compared with the control group.

Conclusion

According to this study, it can be concluded that the ulmus root-bark dressing is effective regarding the healing of pressure ulcers.

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Effects of on Education Program for Nurses on the Use of Restraints
Jeong Min Yeo, Myong Hwa Park
Journal of Korean Academy of Nursing 2006;36(3):532-541.   Published online June 30, 2006
DOI: https://doi.org/10.4040/jkan.2006.36.3.532
AbstractAbstract PDF
Purpose

This study was conducted to verify the effects of an education program of restraints use on nurses' knowledge, attitude and nursing performance related to restraints use.

Method

A quasi experimental study with a pre and post non-equivalent design was used. The subjects were nurses who met the selection criteria and worked in intensive care units of two university hospitals located at K-city, Gyeongbuk. Twenty nurses in A hospital were designated as the experimental group and 20 nurses in B hospital as the control group.

Result

The first hypothesis which assumed that the experimental group would have higher scores of knowledge than the control group was supported(F=62.66, p=0.000). The second hypothesis which assumed that the experimental group would have lower scores of attitude toward using restraints than the control group was supported(F=23.77, p=0.000). The third hypothesis which assumed that the experimental group would have higher scores of nursing performance than the control group was supported(F=3.28, p=0.032).

Conclusion

An education program for nurses' on the use of restraints needs to be introduced to decrease inappropriate use of restraints.

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The Effects of a Recovery Education Program on Rehabilitation Motivation, Symptoms, and Function for Schizophrenic Patients
Yi Young Kim, Hyun Sook Park, Kyung Min Park
Journal of Korean Academy of Nursing 2006;36(3):542-550.   Published online June 30, 2006
DOI: https://doi.org/10.4040/jkan.2006.36.3.542
AbstractAbstract PDF
Purpose

This study investigated the effects of a recovery education program on rehabilitation motivation, symptoms, and function for schizophrenic patients.

Method

The study employed a quasi-experimental design. Participants for the study were 27 patients with schizophrenia, 14 in the experimental group and the other 13 in the control group. Data were analyzed by using the SPSS/WIN 11.5 program with Fisher's exact test, t-test, and Repeated measures ANOVA.

Results

After a 7 week intervention, participants in the recovery education program group reported increased rehabilitation motivation and function scores, which was significantly different from those in the control group.

Conclusion

A recovery education program was effective improving rehabilitation motivation and function for schizophrenic patients. Therefore, this program is recommended as a rehabilitation strategy for schizophrenic patients.

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Effects of Biophysical Index, Knowledge, and Self Management Compliance of Patients with Primary Hypertension by a Self Management Compliance Promotion Program
Bok Seon Jeong, Hui Gyeong Gang, Mi Yeol Gwak, Eun Suk Kim, Hyeon Yeong Kim, Eun Suk Bak, Gye Yong Song, Hyang Su Sin, Bok Hui Yun, Eun Gyeong Lee, Jeong Sun Im, Sun Ok Pi, Eun Yeong Jeong, Sang Ju Choe, Mi Yang Jeon
Journal of Korean Academy of Nursing 2006;36(3):551-560.   Published online June 30, 2006
DOI: https://doi.org/10.4040/jkan.2006.36.3.551
AbstractAbstract PDF
Purpose

This study was to develop and prove the effects of aself management compliance promotion program for primary hypertension patients who reside in rural communities.

Method

The content of the self management compliance promotion program developed by this study was as follows: A leader trains patients as a group or individually, in walking, education and green tea therapy from the first to twelfth week. From the thirteenth to twenty fourth week, the patients should perform walking and green tea therapy by themselves. One hundred twenty subjects volunteered to participate in the study, who were among those registered as hypertension patients in the 14 community health clinics located in Chungcheongbuk-do.

Result

Systolic blood pressure, total cholesterol, low-density lipoprotein cholesterol, triglyceride, step width, and degree of obesity decreased significantly. High-density lipoprotein cholesterol, step length, knowledge of hypertension, and self management compliance significantly increased.

Conclusion

A self management compliance promotion program for primary hypertensive patients enhances biophysical index and knowledge on hypertension, thus ultimately suggesting a nursing intervention for promoting self management compliance.

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Comparison of Influential Variables for Smoking Temptation between Adolescent and Adult Smokers
Sung Ok Chang, Eun Ju Kim, Gyeong Ae Seomun, Su Jeong Lee, Chang Seung Park
Journal of Korean Academy of Nursing 2006;36(3):561-570.   Published online June 30, 2006
DOI: https://doi.org/10.4040/jkan.2006.36.3.561
AbstractAbstract PDF
Purpose

This study attempted to identify influential variables on smoking temptation between groups: adolescent smokers and adult smokers.

Method

A survey was conducted with 376 adolescent smokers in 4 high schools and 451 adult smokers in community settings in South Korea. Univariate statistics and regression were used for data analysis.

Result

The most powerful predictor of smoking temptation for adolescent smokers was nicotine dependency. On the other hand, the most powerful predictor of smoking temptation for adult smokers was self-efficacy for smoking abstinence. In the high smoking temptation group, depression and nicotine dependency were the predictors for smoking temptation for adolescent smokers and nicotine dependency and pros for smoking were the predictors for smoking temptation for adult smokers. In the low smoking temptation group, cons for smoking and process of change for smoking abstinence were the predictors on smoking temptation for adolescent smokers and self-efficacy for smoking abstention and pros for smoking were the predictors on smoking temptation for adult smokers.

Conclusion

There were different influential variables on smoking temptation according to age groups and level of smoking temptation. Smoking-cessation interventions should be tailored to the level of smoking temptation of the individual smokers.

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Comparison of Effects among Tai-Chi Exercise, Aquatic Exercise, and a Self-help Program for Patients with Knee Osteoarthritis
Hea Young Lee
Journal of Korean Academy of Nursing 2006;36(3):571-580.   Published online June 30, 2006
DOI: https://doi.org/10.4040/jkan.2006.36.3.571
AbstractAbstract PDF
Purpose

This study was to compare the effects among Tai-Chi exercise, aquatic Exercise, and a self-help program for knee osteoarthritis patients on symptoms of arthritis, muscle strength, balance, and difficulty of performing activities.

Method

There were 50 final subjects50. A non-equivalent pretest-posttest design was used. The collected data was analyzed using SPSS for Window. One-way ANOVA and Scheffe's multiple comparison test were used 8weeks after each program.

Result

There were significant differences in joint pain(p=.000), stiffness (p=.001), knee extensor peak torque(p=.006), knee flexor(p=.002), and difficult of performing activity (p=.000), but there was no significant difference in balance(p=.648). The Tai-Chi group was significantly different from the self-help group for knee extensor peak torque, knee flexor and stiffness on Scheffe's multiple comparison tests. In addition, the Tai Chi group or aquatic group were significantly different from the self-help group for difficulty of performing activities(p<0.05).

Conclusion

There are significant differences in the effects of the nursing intervention among the three groups. The Tai Chi group and aquatic group were significantly different from the self-help group. However, it seems that Tai-chi exercise may be more suitable than aquatic exercise in osteoarthritis exercise programs. Further studies with a longitudinal study are necessary to confirm the longer exercise period.

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