In this study, the effects of laughter therapy on levels of depression, quality of life, resilience and immune responses in breast cancer survivors were examined.

A quasi-experimental nonequivalent control group, pretest-posttest design was used. Participants (n=37) included breast cancer survivors who finished chemotheraphy and radiation therapy: 16 in the experiment group and 21 in the control group. Data were collected from August to November 2009. The experimental group participated in laughter therapy eight times, twice a week for 60 min per session. Questionnaires were used to me-asure pretest and posttest levels of depression, quality of life and resilience. A blood test was used to analyze changes in Total T cell, T helper, T suppressor, Th/Ts ratio, Total B cell, T cell/B cell ratio and NK cell for immune responses.

The results showed that laughter therapy was effective in increasing the quality of life and resilience in breast cancer survivors. but depression and immune responses did not differ significantly between the groups.

The results of the study indicate that laughter therapy may be an effective nursing intervention to improve quality of life and resilience in breast cancer survivors.

The purpose of this study was to examine the effects of laughter therapy on postpartum fatigue and stress respon-ses of postpartum women.

The research design was a nonequivalent control group non-synchronized design. The participants were 67 postpartum women who agreed to participate in this study, selected by convenience sampling: (experiment group-33 and control group-34). The data were collected from August 5 to September 30, 2010. The experimental group received laughter therapy from a laughter therapy expert for 60 min, twice a week for 2 weeks, a total of 4 sessions. To evaluate the effects of laughter therapy, postpartum fatigue by self-report questionnaire and cortisol concentration in breast milk were measured. The data were analyzed using the SPSS WIN 13.0 Program.

The first hypothesis that "the degree of postpartum fatigue in the experimental group participating in laughter therapy would be lower than that of the control group" was accepted. These findings indicate that laughter therapy has a positive effect on decreasing postpartum fatigue.

The finding provides evidence for use of complementary and alternative nursing in Sanhujori facilities and obstetric units to reduce postpartum women's fatigue.

The purpose of this study was to develop a resource-based relative value scale (RBRVS) and its conversion factor for advanced nursing practices carried out by critical care nurse practitioners (CCNP) in intensive care units.

The methodology was developed by calculating CCNP's RBRVS for 32 advanced nursing services based on CCNP's workload and time spent in the context of national health insurance. A cost analysis was performed to estimate the conversion factor of CCNP's RBRVS. The share of CCNP's contribution to fee-for-service in intensive care units was also analyzed.

Calculation of the RBRVS of 32 advanced nursing practices showed a range of points from 100.0 to 1,181.4 and an average of 296.1 points. The relevant conversion factor for advanced nursing practices in CCNP were estimated at 37.3-48.4 won. The contribution rate of CCNP's advanced nursing practices in the relative value scale of the national health insurance was estimated at 0.1-31.3%.

Measuring the economic value of advanced nursing services will be a basis for esta-blishing a reimbursement system for CCNP's practices and thus encourage a social demand for advanced nurse practitioners.

The study was done to develop a dignified dying scale for Korean adults.

The process included construction of a conceptual framework, generation of initial items, verification of content validity, selection of secondary items, preliminary study, and extraction of final items. The participants were 428 adults who lived in one of 3 Korean metropolitan cities: Seoul, Daegu, and Busan. Item analysis, factor analysis, criterion related validity, and internal consistency were used to analyze the data. Data collection was done from March to June 2010.

Thirty items were selected for the final scale, and categorized into 5 factors explaining 54.5% of the total variance. The factors were labeled as maintaining emotional comfort (10 items), arranging social relationship (9 items), avoiding suffering (3 items), maintaining autonomous decision making (4 items), and role preservation (4 items). The scores for the scale were significantly correlated with personal meanings of death scale. Cronbach's alpha coefficient for the 30 items was .92.

The above findings indicate that the dignified dying scale has a good validity and reliability when used with Korean adults.

To develop and test the validity and reliability of the Korean version of PES-NWI measuring nursing work environments in hospitals.

The Korean version of the PES-NWI was developed through forward-backward translation techniques, and revision based on feedback from focus groups. An internal consistency reliability and construct validity using confirmatory factor analysis were conducted using SPSS WIN (16.0) and AMOS (18.0). Survey data were collected from 733 nurses who worked in three acute care hospitals in Seoul, South Korea.

The Korean version of PES-NWI showed reliable internal consistency with a Cronbach's alpha for the total scale of .93. Factor loadings of the 29 items on the five subscales ranged from .28 to .85. The five subscales model was validated by confirmatory factor analysis (RMR<.05, CFI>.9).

The findings of this study demonstrate that the Korean version of PES-NWI has satisfactory construct validity and reliability to measure nursing work environments of hospitals in Korea.

The aim of this study was to assess the suitability and readability of printed educational materials for patients with hypertension in Korea.

A total of 33 written educational materials related to hypertension were collected from public health centers, hospitals, and internet web site. Among them, we analyzed 19 materials which fit the inclusion criteria: leaflets (n=9), booklets (n=3), and guide book (n=7). Two trained nurses evaluate the materials using suitability assessment tool (SAM; Doak, Doak, & Root, 1996a) and graded lexical items for teaching Korean (Kim, 2003).

Overall, 14 (73.7%) of 19 materials scored adequate, and 5 (26.3%) scored inadequate. On the average, the education materials contained 36.1% to 50.5% of 1st grade reading level words and 12.9% to 21.6% of 4th grade level and over.

The reading level of the materials was higher than a 6th grade reading level. It is proposed that the written educational materials should be developed by health professionals according to suitability and quality by taking the target group's literacy capacity into consideration.

The purpose of this study was to compare the quality of sleep with the serum lipid profile in patients who have restless legs syndrome (RLS).

The data were obtained from 116 patients with RLS through questionnaires and blood sampling.

The results of this study showed correlations between lower quality of sleep and serum lipid profile (LDL Cholesterol) in patients with RLS (r=.19, p=.040). There were correlations for scores of quality of sleep from the, Pittsburgh Sleep Quality Index (PSQI) sub-region between lower subjective sleep quality and serum lipid profile (LDL Cholesterol) (r=.20, p=.026), between fewer hours of sleep duration and serum lipid profile (Total Cholesterol) (r=-.21, p=.024), and, between higher daytime dysfunction and serum lipid profile (LDL Cholesterol) (r=.42, p<.001) of patients with RLS.

Patients with RLS have sleep disorders with lower quality of sleep and changes in the serum lipid profile for total cholesterol and LDL cholesterol. That is, patients with RLS have lower quality of sleep and dyslipidemia compared to persons without RLS. Further research is needed to monitor serum the lipid profile in early stage symptoms of midlife adult patients with RLS and especially older women.

The purpose of this cross-sectional study was to examine the relationship between characteristics of severe ALS patient-caregiver couples and health related quality of life (HRQoL) in family caregivers.

The participants in this study were 89 pairs of ALS patients using ventilators and a family caregiver. The characteristics of the ALS patients and caregivers, Korean-Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised, Zarit Burden Interview and SF-36 were measured in this study. The data were collected from August 2008 to April 2009. Descriptive statistics, Pearson correlation coefficients, and canonical correlation were used for data analysis.

The physical component summary and mental component summary of the HRQoL score for family caregivers were 147.49±31.63 and 129.09±35.83, respectively. HRQoL for caregivers was related to characteristics of the ALS patient-caregiver couples, such as patient's gender, caregiver's age, gender, marital status, daily time spent in caregiving and burden with one significant canonical variable. The significant variate showed that the lower the age, the time spent in caregiving and the burden of caregivers, the higher the HRQoL of caregivers.

The support systems for caregivers considering caregiver characteristics such as demographics and burden should be implemented to improve the HRQoL of caregivers.

In this study the fitness of a path model for the relationship among biological risk disposition, sociocultural risk factors, self-control, parent-adolescent communication, and risk behavior in adolescents was examined.

The participants were 387 adolescents. The data were analyzed with the PASW 18.0 and AMOS 18.0 programs.

Sociocultural risk factors, self-control, and parent-adolescent communication showed a direct effect on risk behavior for adolescents, while biological risk disposition and sociocultural risk factor showed an indirect effect on risk behavior for adolescents. The modified path model of adolescents' risk behavior was showed a good fit with the model (χ²/df=2.37, GFI=.95, AGFI=.92, RMSEA=.06 [.05<RMSEA<.07], NNFI=.95, CFI=.97).

These results suggest that adolescents' risk behavior can be decreased by reducing biological risk disposition and sociocultural risk factor, and increasing parent-adolescent communication and self-control. Thus there is a need to design intervention programs that emphasizes reducing biological risk disposition and sociocultural risk factor and increasing parent-adolescent communication and self-control in order to decrease adolescents' risk behavior.

The purpose of this study was to develop and validate a hospice·palliative care performance measure which would cover more than just physical symptoms or quality of life.

Through an intensive literature review, the author chose questions that measured aspects of physical, emotional, spiritual, social, or practical domains pertinent to hospice·palliative care for inclusion in the scale. Content validation of the questions was established by 15 hospice·palliative care professionals. A preliminary Hospice Palliative Care Performance Scale (HPCPS) of 20 questions was administered to 134 pairs of terminal cancer patients from 5 hospice palliative care units and their main family caregiver. A validation study was conducted to evaluate construct validity and internal consistency.

Factor analysis showed 14 significant questions in five subscales; Physical, Emotional, Spiritual, Social, and Patient' rights. There were no significant differences between the ratings by patients and family members except for three out of the 14 questions. The measure demonstrated construct validity, and Cronbach's α of the subscales ranged from .73 to .79.

The HPCOS demonstrated acceptable validity and reliability. It can be used to assess effectiveness of hospice·palliative care for terminal cancer patients in practice and research.

This study was done to identify some natural meaning through the dosage experience of psychoactive drugs in women patients with schizophrenia.

The Hermeneutic phenomenology written by van Manen was used. The period for data collection was from November 2009 to January 2010. This study took place in mental health hospitals and mental health centers in two cities in North Jeolla Province. Nine patients with schizophrenia participated. Data collection was done through individual in-depth interview.

The seven natural subjects demonstrated by participants from this study were 'Pills forcibly taken like veiled threats', 'A terrible side effect, a side effect rooted slowly', 'Shame which cannot be hidden as a woman', 'A bad medicine took away from motherhood', 'The fate of a wife who can't be equal', 'A struggle for the complete recovery without promise', and 'Participants want the future without medicine'.

The results of this study indicate that the urgent need to develop a safe and believable psychoactive drug for woman patients considering the time of menstruation, pregnancy, childbirth, and child raising.

This study was done to assess the educational needs that should be considered in developing curriculum for staff in charge of public health services in public hospitals.

The participants in this study were staff in charge of public health services in 130 public hospitals. The Borich's Needs Assessment Model which analyzed the relation of 'required competence level' and 'present competence level', was utilized. Data were collected from October to November 2007 using a structure self-report questionnaire. The return rate was 66.9%. The Cronbach's alpha score was 0.959.

The mean scores for 'required competence level', 'present competence level' and Borich's need were 4.02, 3.44, and 2.30 respectively. According to public health service items, 'strategies to recognize the present condition and analyze problems' had the highest score for Borich's need, but 'establishment of annual or monthly objectives' had the lowest score for Borich's need.

Education was found to be very important for staff carrying out public health services. Ultimately the results of this study may be utilized to develop education program for staff carrying out public health services in public hospitals.

This study was to identify the current status of vaccination against the pandemic (H1N1) 2009 virus among university students from the fields of nursing and allied health from a local community and verify factors influencing vaccination.

The study included 227 students in the fields of nursing and allied health from a provincial university. Data were obtained from these participants between May 31 and June 11, 2010 by using self-report questionnaires.

The rate of vaccination against the pandemic (H1N1) 2009 virus for these participants was 14.5%. No difference was observed in this regard between majors and school year. Factors that influence vaccination against this virus included previous vaccination against seasonal influenza and participants' attitudes toward general vaccination.

The results suggest that for effective pandemic (H1N1) 2009 vaccination of university students from the fields of nursing and allied health, students who have not been vaccinated should be intensively managed. Developing a vaccination program that encourages a positive attitude toward vaccination is recommended.

The aim of this study was to clarify the actual condition of elders with dementia who were registered in the Seoul Dementia Management Project.

Data were collected from 5,312 elderly patients with dementia. Demographic included characteristics, comorbidity, and healthy lifestyle habits; data from the Seoul Dementia Management Project.

First, demographic characteristics were as follows; mean age at the time of definite diagnosis was 78.0 yr. There were slightly more women (69.3%), and 4.55 yr was the average length of education with 41.4% being illiterate or uneducated patients. Second, there were several comorbidities including hypertension (61.7%), diabetes mellitus (31.8%), hypercholesterolemia (10.2%), heart disease (11.1%), obesity (4.2%), and stroke (21.4%). Third, alcoholic history was found in 11.8% of the patients, and smoking in 9.8%. Regular exercise was done by only 29.1% of the patients with dementia. Finally, significant differences between men and women were found for the following; age, education, medical security, hypertension, diabetes mellitus, stroke, alcoholic consumption, smoking, and regular exercise.

Authors expect that the present data will be used for establishment of dementia associated projects and policies.

The study was designed to determine the discriminating ability of a Bayesian network (BN) for predicting risk for pressure ulcers.

Analysis was done using a retrospective cohort, nursing records representing 21,114 hospital days, 3,348 patients at risk for ulcers, admitted to the intensive care unit of a tertiary teaching hospital between January 2004 and January 2007. A BN model and two logistic regression (LR) versions, model-I and -II, were compared, varying the nature, number and quality of input variables. Classification competence and case coverage of the models were tested and compared using a threefold cross validation method.

Average incidence of ulcers was 6.12%. Of the two LR models, model-I demonstrated better indexes of statistical model fits. The BN model had a sensitivity of 81.95%, specificity of 75.63%, positive and negative predictive values of 35.62% and 96.22% respectively. The area under the receiver operating characteristic (AUROC) was 85.01% implying moderate to good overall performance, which was similar to LR model-I. However, regarding case coverage, the BN model was 100% compared to 15.88% of LR.

Discriminating ability of the BN model was found to be acceptable and case coverage proved to be excellent for clinical use.