The purpose of this study was to identify patients' perceptions of health professionals' unkind behavior and the effects of this unkind behavior using a phenomenological research methodology. Understanding of this phenomena should enlighten nurses to interaction and relationship problems between patient and health professionals and thus lead to further research toward enhancing these interaction and relationships. The subjects were 40 adult patients hospitalized in a university hospital in Seoul. They were form 20 to 65 years old and hospitalized at IM, GS, OS, NS, OB/GY ward. Their hospital days were from 4 to 72. Data were collected from July 29 to August 9, 1991 and from January 6 to 17, 1992. The research questions were "What behavior on the part of health of health professionals you perceive as unkind and what effect does such behavior have in you?". Responses to the non-structured open-ended questions were audio-recorded during the interviews done by two nurses researchers. Data were analyzed using the phenomenological method of Colazzi. The validity was enhanced by confirmation of the analysis by two nursing clinical researchers, and professor of psychology, and philosophy, all knowledgable of phenomenological research. From the protocols, 146 significant statements about unkind behavior were organized into 38 formulating meanings which then grouped into six clusters of themes. Perceived health professional' unkind behavior as being cold, insincere, unconcerned, disregardful, lacking in technical skill, and failing to provide a therapeutic environment. From the protocols, 65 significant statements about the influence of such behavior on patient care were organized into 18 formulating meanings which were then grouped into four clusters of themes. Patients perceived these unkind behavior influencing then emotionally, physically and having negative effects on their compliance with medical and nursing care. The study points to the need for health professionals to understand how their may be perceived by their patients as unkind behavior. Patients perceptions of health professionals' unkind behavior may suggest the opposite desire, that professionals have excellent medical knowledge and skill and that they be sincere, concerned, respectful and warm emotionally toward their patients.

Recent research reported that postpartum mothers showed different responses according to the type of delivery, and though most mothers preferred vaginal delivery to cesarean section, the numbers of negative comments about the delivery experience were higher in a vaginal delivery group than in a cesarean section group. This study set out to understand the meaning of vaginal delivery as perceived by mother who delivered their babies vaginally and how the mothers felt about their delivery experience. The subjects of this study were 17 primiparous mothers right after vaginal delivery in one university affiliated hospital. Data were collected from March to April, 1992 through interviews lasting 20~30 minutes using open ended questions about the delivery experience. The data were analyzed by Giorgi's phenomenological analysis method and categorized according to similarity of content. The meaning of the vaginal delivery was grouped in to four categories and the reason for vaginal in to three. One category of the meaning of vaginal delivery was pain, consisting of the subcategorics too painful, want to be rid of the pain, unbearable pain and bearable pain. Another category was a sense of accomplishment containing the subgroups wonderful, good and being finished, The third category was the feeling of becoming a mother. The fourth category was that of not having any sense yet of the experience. The reasons for preference for vaginal delivery to a cesarean section were categorized in to the instinctive thinking that vaginal delivery was the natural method, a shortened period of recovery and lower incidence of complications and s stronger feeling of maternal identity.

No abstract available.

Head Injuries due to traffic accidents are now the leading cause of death and long term disability in males between 30-50 years. Many patients with head injuries experience mild dysfunction of cognition without major neurosurgical problems, and this may interfere with successful rehabilitation. However, not many studies have been done to investigate the cognitive functioning following mild head injuries. The purpose of this study was to obtain injured patient's demographic data including medical, neuropsychological and social data, and to investigate the cause of injury and alcohol use at the time of injury. This study focused on the recovery of cognitive function in patients with head injuries and used the Mini Mental State Examination(MMSE) score and its correlation with demographic and social data. Data on 77 patients with minor head injuries who were admitted to the department of Neurosurgery in C and E hospital in Dae Jun from September 1991 to February 1992 were analyzed. The findings of this study are as follows ; 1) Out of the 77 cases reviewed in this study, 62 were male, 15 were female. 2) A higher incidence of injury was observed between 7:00 PM and 12:00 PM. 3) The most common cause of head injury in traffic accidents was pedestrian accidents, and the next most frequent cause was most motorcycle accidents. 4) Thirteen of the 77 cases in this study were under the influence of alcohol at the time of injury, and they were all male. 5) The MMSE scores one month after injury and at discharge were significantly lower in patients with head injuries that included skull fractures than in patients without skull fractures, suggesting lower cognitive function in patients with skull fractures. 6) The level of consciousness at admission and three days after admission measured by the GCS for drivers under the influence of alcohol was lower than for sober drivers. The MMSE score was also lower for drunken drivers. 7) The MMSE score one month after the injury had a reciprocal relationship with the age of the patient. 8) The MMSE score one month after the injury had at discharge were highly correlated with the duration of unconsciousness. 9) The MMSE score one month after injury and at discharge were highly correlated with the GCS scores at admission, three days after admission, and one week after admission.

This study was designed to develop and test a structural model for maternal adaptation and family stress in families with mentally handicapped children. A hypothetical model was constructed on the basis of the family stress theory developed by McCubbin etc. The model included 6 theoretical concepts and 11 paths. For the purpose of the model testing, empirical data were collected from May to August, 1992. The subjects of the study constituted 190 mothers of children in five special schools and one private institute in Seoul and Choong Nam. An SPSS PC+ and PC-LISREL 7.13 computer programs were used for descriptive and covariance structure analysis. The results of the study were as follows. (1) The hypothetical model showed itself a good fit to the empirical [Chi-square=18.35 (df=7, P=0.005), Goodness of Fit Index=0.991, Adjusted Goodness of Fit Index=0.959, Root Mean Square Residual=0.042), Non Normed Fit Index=0.90, Normed Fit Index=0.93]. (2) The results of Hypothesis testing indicated : 1) Social support(gamma11=.238, T=2.352), Family functioning(gamma12=.729, T=5.957) and Family life event stress(gamma13=.125) had direct effects on situational definition. 2) Life event stress(gamma23=.319, T=3.872) had direct effects on the effect of the handicapped child on the family. Family functioning(gamma22=-.245) and situational definition(beta21=-.335, T=3.227) had direct effects on the effect of the handicapped child on the family. 3)Situational definition(beta31=-.273, T=3.493), family life event stress(gamma33=.124, T=2.169) and the effect of the handicapped child on the family(beta32=.264, T=-3.227) showed the direct effect on the maternal adaptation. The model was supported by the empirical data. Thus it was suggested that model could be applied to family nursing care with the families with the mentally handicapped. The construction and testing of the comprehensive model seem to be the first trial in Korea.

The purpose of this research was to understand the structure of the lived experience of parents of a child terminally ill with cancer. The research question was "What is the structure of the experience of parents of a child terminally ill with cancer?" The sample consisted of 17 parents of children admitted to the cancer units of two university hospitals in Seoul. The unstructured interviews were carried out from October 10, 1991 through January 10, 1992. They were audio-recorded and analyzed using Van Kaam's method. Parents ascribed the cause of the cancer to the mother's emotional imbalance during pregnancy, the mother's stress, failure to observe religious rites, food, the parent's sin, misfortune and pollution. The theme clusters were tension, fear and depression experienced during pregnancy, stress that children suffer from abusive parents, failure to observe religious activities, bad luck, and sins committed during a previous life. When the child suffered a recurrence of cancer, the parents experienced negative emotions, nervousness, sorrow, depression and death. The theme clusters were feelings of despair, helplessness, regret, guilt, insecurity, emptiness and apathy. The long struggle with cancer resulted in the loss of economic security, loss of psychological and physical well being, and social withdrawal. The theme clusters were the economic burden of medical cost, giving up treatment, debt, limited medical insurance coverage and blood transfusion. The loss of psychological well being included stress, lack of support systems, inability to carry out responsibilities, lack of trust of the medical team, family breakdown, inappropriate expression of emotion and not disclosing the diagnosis to the child. Physically the parents suffered fatigue, insomnia, loss of appetite, loss of weight, dizzness, headache, psychosomatic symptoms, and increased consumption of liquor and cigarettes. Social withdrawal was manifested by taking time off from work to look after the child, decrease of outside social activities and feelings of isolation. Influences on family life were spousal conflicts, negative response of siblings, separation of the family members and economic hardship. The theme clusters were blaming a spouse for the cause of the illness and disagreements, maladjustment, loneliness, hostility and depression of siblings. The high price of medical care over the long period was a major factor influencing the life of the family. Positive experiences during the child's long illness were the strengthening of support systems and religious beliefs and financial help from social organizations. The support of one's spouse primarily helped to overcome the stress of the long illness. In addition, support was received from parents of other children with cancer and from nurses and religious leaders. The nurse, by providing empathetic support, should be a person with whom parents can express their feelings and share their experiences.

Older people, because of the psychological and physiological changes related to the aging process are more vulnerable to experiencing powerlessness than any other age group. This self destructive cycle of depression in older people related to the experience of continued and long term powerlessness can lead even to death. The purpose of this study was to measure powerlessness and resources to increase power in older people, and to measure the effectiveness of a psychological rehabilitation program for reducing powerlessness. The research methodology used was two step process. In the first step, a survey was done of perceived powerlessness and power resources comparing four groups of elderly people ; those living at home, those in hospital, those living in nursing homes and those attending educational programs for the elderly. The total sample size was 236. In the second step, a psychological rehabilitation program was carried out, pre and post measurements were taken related to this program. The sample consisted of 29 residents in a nursing home. The results of the study are as follows : 1. Powerlessness was classified as cognitive, emotional, activity and learning. The lowest score for powerlessness was in the area of activity, that is the people in the sample felt more power concerning their activities. The highest score was in the area of cognition were they felt they had less power. 2. When the different groups of elderly were compared, it was found that the residents of the nursing home had the highest score in perceived powerlessness and the group who perceived powerlessness and the group who were living at home had the lowest score. 3. Among the general characteristics, the factors influencing the powerlessness score were age, sex, level of education, financial resources and health status. In the interaction effects among these factors, it was found that level of education and health status were factors influencing perceived powerlessness. The elderly with lower education and poorer health status had the higher scores for perceived powerlessness. 4. The power resources could be classified into the following areas : physical strength, emotional strength, positive self-image, energy, knowledge, motivation and belief system. Be-life system was given the highest score among the power resources and energy, knowledge and motivation were given low scores. 5. The group participating in an educational program for the elderly had the highest score for power resources while the group made up of residents of a nursing home had the lowest score as well as the highest score for perceived powerlessness. 6. The factors influencing the power resource scores were sex, level of education, financial resources and health status. In the analysis of the interaction effect among the factors, it was found that sex, level of education and financial resources were the factors that influenced the power resource score, that is women, those with a low level of education and those with poor financial resources reported a lower level of power resources. 7. There was a negative correlation between perceived powerlessness and power resources in the elderly in this study. Since power resources explained 49% of the variance for powerlessness, it can be concluded that the power resources can be used to reduce powerlessness. 8. The psychological rehabilitation program was carried out with the nursing home residents over a period of five weeks. No statistically significant difference was found in the scores on powerlessness between the pre and post test, but there was a slight decrease in the raw scores on the post test for emotional, activity and learning powerlessness. There was a statistically significant increase in the power resource scores for emotional strength, positive self-image, energy, knowledge and motivation in the post test as compared to the pre test. In conclusion, the study indicates that a psychological rehabilitation program for the elderly could be effective in increasing power resources and this in turn could lead to a decrease in perceived powerlessness.

The purpose of this study was to identify the commonalities of various nursing interventions and effective intervention methods in each intervention through analysis and synthesis of many accumulated research papers. The study analyzed the effects of various nursing interventions on anxiety and/or stress. For this purpose, 64 experimental studies with randomized or nonequivalent control group pre-test-posttest design were selected were selected from journals of medical and nursing schools, the Korean Nurse, the Korean Nurses' Academic Society Journal, the Central Journal of Medicine, the New Medical Journal, the Nurse Monthly, and from theses and dissertations conducted from 1970 to 1991. The selected studies were classified according to three characteristics : 1) the research sample, 2) types and methods of nursing interventions, and 3) statistical tests. The following analysis was done : 1) Confirmation of the accuracy of data drawn from each study by paired review, 2) Estimation of the homogenity of pre-test scores of the dependent variable between control and experimental groups warranted the effect size of post-scores, 3) If the homogenity of pre-test scores did not warrant, the change scores from pre-test to post-test were used to estimate the effect size, 4) Use of the effect size of each study among homogenious studies was tested for each intervention method, such as relaxation, information, and touch and/or support. Finally, for the studies not showing homogenity, and ANOVA test was used to identify patterns for each intervention. Some findings are summarized as follow: The effect sizes for relaxation and information were greater than those for touch and / or supportive technique. Studies using random assignment had greater effect sizes than nonrandomized sample studies using the same intervention. For healthy people, group education was more effective than individual teaching. However, for patients, relaxation and touch and / or supportive techniques given on individual basis were more effective than when given in a group situation. Measuring anxiety and stress by biological indicators was less effective than by self-report. Budzynski's relaxation method was the most effective. The more frequently the techniques applied, the larger the effect size. On the bases of these findings, the following recommendations were made : 1. A combination of information, relaxation, and touch-supportive techniques should be sued for greater effect in reducing the level of anxiety and / or stress. 2. Information is the first choice of intervention to reduce the level of anxiety and/or stress of health people ; other intervention may be added depending on the conditions of the subjects.

Recent improvements in the standard of living, national income and medical care, and a decline in the infant death rate which have occurred related to economic growth and modernization, have led to a longer average life-span and a higher ratio of elderly people in the total population, Therefore, not only in the field of nursing science, issues concerning the elderly have been given increasing interest. A great deal of effort has been spent on increasing the quality of life for elderly people. The study was conducted to analyze the correlation between social support and quality of life. The sample consisted of III subjects residing at home and 107 subjects residing in institutions all of whom were over 65 years of age. The data collection period was from October 23, 1990 to January 26, 1991. Social support was measured using the Norbeck social Support Questionnaire developed by Norbeck, translated by Oh, Ka Sil and quality of life was measured using the QOL scale developed by No, You Ja. Data were analyzed using percentages, t-test, Pearson Correlation Coefficient and ANOVA. The results of this study are as follows : 1. There was a statistically significant difference in the level of social support between the two groups(t=-8.83, P<.001). The elderly at home reported a much higher level of social support. 2. There was a statistically significant difference in the level of QOL between the two groups(t=-5.77, P<.001). The elderly at home reported a much more positive quality of life. 3. There was a positive correlation between social support and QOL for the elderly at home and it was statistically significant(r=.32, P<.001). 4. There was a positive collection between social support and QOL for the elderly in institutions and it was also statistically significant (r=.19, P<.05). 5. The relationship between the general characteristics of the elderly at home and the variables of social support and of QOL were as follows ; 1) according to sex(t=10.57, P<.01) and the number of offspring(F=6.19, P<.01), there was a statistically significant difference in social support. 2) according to amount of Pocket money, there was a statistically significant difference in QOL(F=2.98, P<.05). 6. The relationship between the general characteristics of the elderly institutions and the two variables were as follows ; 1) according the sex(t=6.24, P<.05), the number of offspring(F=6.16, P<.001) and religion(F=2.58, P<.05), there was a statistically significant difference in social support. 2) according the religion, there was a statistically significant difference in QOL(F=2.90, P<.05). In conclusion, it can be said that social support is an important variable related to QOL in the elderly and that social support levels are higher for the elderly residing at home. Therefore, more specific and objective approaches and efforts are needed to effectively use resources to maintain the elderly at home and to enhance social support available to the elderly in institutions and thereby increase QOL regardless of residence.

This study examined the relationship between the experience of stressful life events and somatic symptoms of urban women. Data were collected by interviewing 200 women from June to July 1, 1991. Viable data work obtained from 162 of the women. Modified version of a stressful life events measurement toll developed P.S. Lee (1984) and the Somatic Discomfort Inventory by Wittenborn were used to measure the variables. Data were processed by an S.P.S.S. program and analyzed. statistically for percentage, T-test, ANOVA and Pearson Correlation coefficient. Result of the Study are as follows : 1) The group total mean score of stressful life events was 92.66+/-10.41. The higher scores in the "Test and school" of the Extrapersonal factor, in the "Health problems" of the Intrapersonal factor and "Conflict and differences within the family" of the Interpersonal factor, factors, which a suggested by Neuman's model. 2) The group total mean score for somatic symptoms was 100.41+/-9.74. The higher scores were for the factors of "Fatigue (1.94)", "Menopause(1.74)", "Muscular system (1.67)" and "Sleeping (1.67)" 3) The mean scores of stressful life events were higher in the 40~60 age group, for middle school graduates(P<.05), career women and those in nuclear families(P>.05). 4) The mean scores of somatic symptoms were higher in the 45~60 age group, for middle school graduates, non career women and women with 5 or more children(P<0.05). 5) There was a positive correlation between the scores of stressful life events and somatic symptoms(r=.585 P<.05). The higher the level of stressful life events the higher the score of somatic symptoms, the results were consistent with the Extrapersonal, Intrapersonal and Interpersonal stress factors of Neuman's Health Care Systems This research assessed the stressful life events of women, who play the most important role in the family for illness prevention and health promotion and suggested the importance of programs in the Primary Health Services to build basic coping resources.

This study investigated a process to estimate the need for nursing staff on the basis of a patient classification system and the required care needs and activities. The investigation was carried out in the following four steps. Step 1. Patients were classified according to the amount of nursing care need on each shift as class I(mildly ill), class II (moderately ill), class III (acutely ill), and class IV (critically ill). Step 2. Measurement of the direct nursing care hours needed for each patient class, and measurement of indirect nursing care hours and personal time of the nursing staff. Step 3. Calculation of the total nursing workload in a nursing nuit. Step 4. Estimation of the nursing staff needed. The investigation was carried out from July 17th to 30th, during 24hours over other day. The subjects were the patients and the nursing staff on two units of Seoul National University Hospital, Korea. Some of the results from the investigation are as follows : 1) Distribution of patient classification On the neuro surgical(N.S.), the distribution was class I, 22 patients, class II, 27 patients, class III, 26 patients, and class IV, 25 patients, For the orthopedic surgical unit (O.S.), it was class I, 43 patients, class II, 43 patients, class III, patients, and class IV, 3 patients. 2) Direct nursing care hours per day On the N.S. unit, 3.2 hours of direct nursing care were needed for class I, 3.9 hours for class II, 5.1 hours of class III, and 6.2 hours for class IV patients, while 2.0 hours for class I, 2.5 hours for class II, 3.5 hours for class III, 5.0 hours class IV patients were needed on the O.S. units. 3) Analysis of direct nursing care activities Activities were classified into assessment and observation(47%), medication(38.7%), communication(5.1%), exercise(2.4%), elimination and irrigation(1.3%), treatment(1.1%), hygiene(0.8%), nutrition(0.8%), and hot and cold compress(0.1%). 4) Average hours of indirect nursing care per day. On the N.S. unit 4.2 hours, and on the O.S. unit, 3.5 hours of RN indirect care was needed. 5) The average personal time used by the of nursing staff was 17 minutes for both RNs and nursing assistants in the N.S. unit, and 32 minutes for both RNs and nursing assistants in the O.S. unit. 6) Estimation of nursing staff needed on two specialized units of a university hospital For the N.S. nursing unit of 43 beds, 31 nursing staff would be indicated. For the O.S. nursing unit of the same number of beds, 19 nursing staff would be indicted.

This study was designed to investigate the problems facecl by adolescents who have nephrotic syndrome and who have struggled with their disease over a long time. Information obtained from this study can be utilized as basic data in planning nursing care for these adolescents. The subjects in this study were 13 adolescents who were being treated in the pediatric OPD of one general hospital in Seoul. The treatment period ranged from 2to 15 years. The tool for this study was constructed after asking patients with nephrotic syndrome about their problems using anunstructured questionnaire. problem items which were observed during nursing cared in the pediatric unit. were also included. Ten problem items were constructed on the basis of Moonlcy's problem check list and two additional items related to diet and physical activity were added to the list. The results of this study can be summarized as follows ; adolescents with Nephrotic Syndrome. 1) have a vague knowledge about their illness and have distorted concepts. 2) feel social isolation within their peer group because of their changed appearance, limited physical activity and special diet regimen. 3) have problem in heterosexual relationship because of short height in boys and changes in body proportions in girls. 4) think that their personality has changed due to illness. In mose cases (8) changes were in a negative direction but in two cases they were positive. 5) have problems with scholastic achievement due to physical weakness and school absence. 6) who are in late adolescence are more realistic and plan for their future taking into consideration their prognosis much more so than do patients who are in early adolescence. 7) have problems in their peer relationships. 8) have limitation their enjoyment of leisure time. 9) have some conflict with their siblings. 10) think religion is significant and it has and influence on their life.

This study identified correlations between perceived family support and hopelessness in patients admitted to Neuro-surgical Intensive Care Units. The purpose was to enhance theoretical understanding of the relationships of these two variables. The subjects of this study were 51 patients admitted to N-ICU, at three general hospitals in Seoul. Data were collected by researcher in structured interviews from Aug. 12 to Oct. 13, 1992. The research tools were parts of the Moos Family Environment Scale and the Beck hopelessness Scale. The general characteristic data were analyzed for frequency and percentage ; the hypothesis was tested by the pearson product Moment Correlation coefficient. After normality tests by using Kolmogorov-Sminorvtest, and T-test, ANOVA, and Mann-Whitney U test, Kruskal-Wallis test were used on the Family support and the Hopelessness about general characteristics. The results of the above analysis were as follows; 1) The average family support score for the group was 63.61 (tool average 51) and item average was 3.74(tool item average 3) ; the family support score of this sample was higher than average. The average family cohesion score of family support was 35.25 (tool average 27) and item average was 3.91 (tool item average 3). The average family expression score of family support was 28.35 (tool average 24) and item average was 3.57 (tool average 3). In this sample, perceived family expression was lower than family cohesion. 2) The average hopelessness score was 45.99 (tool average 60) and item average was 2.29 9tool item average 3) ; the hopelessness score of this sample was low in comparison to the average. 3) The hypothesis in this study was supported. The main hypothesis that the higher the perceived family support level, the lower the level of the hopelessness, was supported(r=-.3688 p=.004). The sub-hypothesis that the higher the perceived family expression level, the lower the level of hopelessness, was supported(r=-.3068 p=0.014). 4) General characteristics of the objects related to family support were 'economic status'(p=.025) and 'helping person'(p=.044); the higher the economic status, the greater the family support. When the patient identified the helping person as a spouse, family support was rated more highly. The only general characteristic related to family cohesion was 'helping person'(p=.041). No general characteristics were related to family expression. 5) The one general characteristic related to hopelessness was 'education'(p=.002) ; the higher their education, the lower their hopelessness. For these ICU patients, were related perceived family support and hopelessness, and family expression level was low in comparison to family cohesion level. The perceived family support of these seriously ill patients in situational crisis may have influenced the patient's emotional reaction of hopelessness. This study concluded that nurses in the ICU confirm the family support of the patient, and involve the family as the most intimate support systems in the care of the patient to help reduce the patient's hopelessness.

This study identified the impact of childhood cancer on the Korea family. The purpose was to contribute knowledge for family nursing and pediatric hospice care practice with sick children and their families. This descriptive study was conducted during a 6 month period with children who were being treated for cancer at six university hospitals in Seoul. the data were gathered from members of 68 families ; 24(Group A), with a child newly diagnosed with cancer ; 27(Group B), with a child under treatment and without complications, and 17 (Group C), with a child in relapse. Medical records., structured questionnaires and interviews were used for data collection. The questionnaires and interview schedules had been used previously in Martinson's research in the USA and China. The findings, conclusions, and suggestions are as follows. 1. The impact of childhood cancer on the family. Members of the family experienced fear, helplessness, guilty feelings, and anger at the time of the initial diagnosis and at relapse. Mothers complained of headache, anorexia and poor appetite, weight loss, sleep disturbance, and bad dreams. Many of the fathers either lost or changed jobs, and all working mothers stopped working. half the parents reported changes in their marital relationships such as frequent quarrels but also stronger unity. Family members perceived cancer as the most frightening disease. Change in their world view was expressed as living on faith understanding suffering, determining to live a better life, wanting to live an upright life and valuing health as the most important. Religious activities are found most helpful through this difficult experience. Financial debt due to the treatment and care of the sick child, burdened 22 families. The above mentioned impact was most evident in Group B(those presently undergoing treatment) and Group C(those in relapse). Findings indicate that nursing care should embrace the family of a child who is being treated for cancer. 2. Characteristics of the child with cancer The majority of the children in this sample had a diagnosis of leukemia. Their mean age was 6.8 and the ratio of boys to girls was 1.12 ; 1. The mean hospitalization frequency was 13.5 times and the mean duration of illness was 16.8 months. Most of the children perceived cancer as the most frightening disease ; 32.7% of the children described their sickness as serious. Children in Group C were hospitalized more frequently, stayed in hospital for longer periods, and expressed their sickness as quite serious more often than the other two groups. These findings indicate how much comprehensive pediatric hospice nursing care services are needed along with relevant research and nursing education. 3. Characteristics of the families. The mean age of the father was 39.5 and the mother, 36.5 ; they are in their most productive life period. Mothers especially expressed feelings of financial uneasiness and powerlessness about giving up their jobs, and guilty feelings for not providing enough care and concern to other children due to taking care of the sick one. The burden of caring for the sick child can bring negative changes in family dynamics which they think provoke potential health problems in members of the family. These findings suggest a need for nursing support and counselling resources. Findings also suggest the need for ethical inquiry about such questions as who should give information to the child in regard to diagnosis and prognosis, when, and how. Other suggestions included : 1) Quality health care for childhood cancer such as home care and pediatric hospice programs should be established. 2) Special and practical consideration fro long-term patients should be made in the present insurance coverage. The reimbursement period for long-term patients should be lengthened. 3) Further in-depth qualitative studies are needed. 4) Education programs including guided practice experience for pediatric hospice care practitioners are needed.