This paper was done to verify the use of the Profile of Mood States (POMS) which was developed by McNair, Lorr, and Droppleman(1992) with modifi cations so that it is appropriate for Korean elders. Through the modified tool, it is possible to examine the mood of Korean elders and to contribute to the welfare of elders. The subjects were 370 elderly persons over 60 years old and the data for 319 persons(86%) were analyzed. The research tool was the POMS translated by Yun(1993) and corrected by the researcher. Data were collected between February 12 and April 9 in 1996 and analyzed using the SAS package. The result are as follows: 1. Items with low Cronbach coefficient alpha which means low correlation with total items were removed. The items were removed; friendly, tense, considerate, relaxed, sympathetic, resentful, good-natured, rebellious, trusting, carefree. 2. Overlapped or ambiguous items were discussed by colleagues and elders through verification of content-validity and were removed. Five items were removed in tense-anxiety, seven, in depression -dejection, three, in vigor-activity, three, in fatigue-inertia, two, in confusion-bewilderment, five, in friendliness, and six, in anger? hostility. Thirty four items remainined; angry, clear-headed, lively, confused, sorry, shaky, listless, peeved, sad, active, blue, hopeless, spiteful, uneasy, unable to concentrate, fatigued, helpful, nervous, lonely, cheerful, bitter, exhausted, anxious, ready to fight, sluggish, helpless, alert, deceived, efficient, worthless, forgetful, terrified, vigorous, and uncertain about things. 3. Factor analysis was done in order to confirm con struct validity and three factors were obtained from the result. The first factor, 'anxiety-depression' included 21 items, the second factor, 'vigor' included eight items, and the third factor, 'anger' included five items. Cronbach coefficient alpha for the 34 items was .95. Based on the result, the following is suggested: 1. a contribute to elder's welfare can be made by examining Korean elder's mood in life. 2. there is a need to develop tools appropriate to Korean culture which can be used to examine elders' mood. 3. The modified POMS tool needs to be reverified with appropriate age groups and settings.

This study was done to provide an understanding of nursing in relation to the existential philosophy of the West and Buddhistic philosophy. It examined how human beings and death are interpreted and understood in existential philosophy as well as in Buddhistic philosophy. Then the study suggested that nursing should focus on helping the sufferer to find meaning and a sense of responsibility in his or her existence. When people have the opportunity to realize certain important but painful truths about their existence, they develop internal strength and control of their lives. Just as people learn to face their being, so can they come to terms with their non-being. According to the causal process in Buddhism, Human Being is not always annihilation of self. Therefore, birth, aging, disease and death go through the process of natural change and it is the appearance of human existence which is inherent in the health of every human being. To promote our health we must gain an insight about this phenomenon. This study viewed nurses' clients as (good friend) rather than (patient) which focuses on a disease-oriented concept. The concept of (good friend) views nurses' clients as active participants to create their life and as responsible persons in a constantly changing life. The study also examined the concept of recovery which means to come back to the previous healthy state and it suggested that the concept of recovery should be changed to (good change), because in existential philosophy, human beings are viewed as never going back to the past but moving on to the future by creating their existence. This study also suggested that nursing should help (good friend) enlighten their existence to be free from pain and death and to get control over their existence.

The problem of care of patients and families with Alzheimer's disease has become a conscious raising social policy issue in Korea. The government of the Republic of Korea has become cognizant of the situation and has begun searching for ways to remedy it. Thus, there is a need for a comprehensive understanding of the situation in which patients and their families are struggling and the enormous problems of care. With a realization of the urgent need, this study was done to investigate the situation and the care needs of families with patients with Alzheimer's Disease, and to compare the effectiveness of services utilized by the families in terms of cost and effects on patient's conditions and on family live. The Subjects for the study were 29 families with hospitalized patients, 25 families utilizing hospital outpatient clinics, 14 families utilizing day care facilities, and 16 families with homebound patients. A total of 84 families were interviewed by four trained interviewers using structured and semistructured questionnaires. The data produced from these interviews included: the patient's stage of Alzheimer's disease, patient's bizarre behavior, hours spent on patient care per day, family burden and quality of life, direct and indirect costs encountered in the care of patients, and the families' evaluation of the effectiveness of the services received. The data were analyzed to determine the relationships between family charactersistics, patient's conditions and services utilization. The effectiveness of each of the service entities was assessed through families evaluation and hoped for service and comparisons were made between services in terms of the cost-effectiveness ratios. After initial comparison of cost-effectiveness ratios, further analysis was done to compare between groups for incremental effectiveness for each incremental unit of cost to determine the most cost-effective service entities. The findings of the study are as fellows: 1. The choice of living arrangement and the types of services are a function of the stage of Alzheimer's condition and the economic status of the family. 2. Comparision of the cost of care showed that most expenses were encountered in by families with hospitalization, families using outpatient services, and families using day care services in that order. The least expense was involved in the care of homebound patients. The economic burden felt by families was in the same order as expenses. 3. The average number of hours spent on daily patient care was 9.9 hours for the outpatient clinic users, 9.7 hours for homebound patients, and 5.4 hours for day care users. 4. There were significant differences in the patient's conditions(CDRL), bizarre behaviors and the families's burden by living arrangement and/or types of service. However, no significant difference was found between groups in the family's quality of life. 5. The families rated the services of day care center as most effective for the care of the patients and families, except for a few families who had experienced some improvement in the patient's conditions. The outpatient clinic users expressed psychological comforts mainly in that the patient was being taken care of. For those hospitalized patients, families expressed the comfort of being relieved of the burden of care and that the patient is being professionally cared for. Form the analysis of the costs, hours of patient care, patient's bizarre behaviors, family's quality of life and burdens, and family's evaluation of services, it is concluded that up to the mid stage of Alzheimer's condition, the utilization of day care center services is found to be the most cost-effective, and toward the end stage of the Alzheimer's disease, it is hoped that there will be a establishment of long term or short term in-patient facilities for the protection of patients and preservation of the integrity of families for less cost. Thus, it was concluded that the family centered system of care is the most effective for Korea with systematic support systems developed for the care of patients and their families according to the needs of families as the patient's condition deteriorates.

This study was a survey done for the purpose of constructing a nursing theory according to Korean culture and to identify the traditional Korean view of humans and the expectations of the sick role, and to confirm changes from the traditional view of humans and expectations of the sick role according to general characteristics of the population. The subjects were all adults over 18 years old. 517 who lived in six large cities and 191 who lived in five rural communities. Data collection was done from November 19th, 1994 to January 19th, 1995 using a tool to measure the traditional view of humans and expectations of the sick role which was developed by the investigator through a literature review. Collected data were analyzed using frequency, percent, Cronbach alpha, t -test, F- test and Scheffe post hoc contrasts, with the SAS program. Thr results of this study are summerized as follows; 1. The Traditional view of human score for all subject was 49.92, which shows that Korean traditional view of human is moderate. High scored items were "human need to live by making harmony with nature, not by overcoming the nature" (3.44), "Filial duty to parents and elders is important"(3.31), "Think of family more than a individual"(2.96). 2. The differences in the traditional view of humans between residential districts showed that the residents of Chungbuk(56.00), Kyungbuk(55.26), Chonbuk(51.32), Taegu(50.59) had a more traditional view of humans than those in Pusan(45. 42)and Seoul(47.27). 3. The differences in the traditional view of humans according to general characteristics showed that rural community residents, males, older people, people with lower levels of education, married and house-resident groups had a significantly higher traditional view of humans than urban residents, females, younger people, people with a higher levels of education, single and apartment-resident groups. There were differences according to religion and job. Buddhism had a higher traditional view of humans than those of atheism, Christianity and Catholicism and physical workers, a significantly highers score, than technicians and professional workers. 4. Daily expected task performance during illnesses was lowest for patients with stroke(2.16) and psy-chosis (2.40), in which case almost no daily general tasks were expected, followed by arthritis 4. 06, peptic ulcer 4.79, headache 4.99 and cough 5. 58. The amount of expected role exemption during illnesses was also highest for stroke(2.25), followed by psychosis(2.08), arthritis(1.64). peptic ulcer(1.29), headache(1.16) and cough(1.09). The amount of daily task performance in the acute stage(3.05) was significantly lower than that of convalescent stage(4.95). 5. Total expectation of role exemption according to general characteristics showed that there was no significant differences in urban/rural community, marriage, level of education and religion. By sex, women showed higher expectation of role exemption during illnesses than men. By age, the 31-40 year old group showed lower expectation of role exemption than the 41-50 year old group or over the 61 year old group.

This study was done to compare the effects of managing obesity using a behavior modification program and an aerobic exercise in adolescent girls. Thirty three subjects were selected from one girls' middle school located in Seoul. Seventeen girls participated in the behavior modification program by joining 60 ?90 minute group sessions weekly. The aerobic exercise program was given to 16 girls three times per week for 60 minutes each. These iter-ventions continued for eight weeks from October 17 to December 10,1995. The data were obtained before and after the interventions by measuring degree of obesity, body weight, blood pressure, serum lipid, %body fat, and waist to hip ratio (WHR). Data ware analysed by using paired t-test. The results are as follows. 1. Subjects in both the behavior modification and the aerobic exercise groups showed significant decresc in the degree of obesity, body weight, di-astolic blood pressure, total cholesterol, low density lipoprotein, %body fat and fat mass after the 8-week interventions. 2. Systolic bood pressure, high density lipoprotein cholesterol and waist to hip ratio were significantly decreased after the 8-week intervention in the behavior modification program group while triglyceride was significantly decreased after the 8-week intervention in the aerobic exercise program group. These findings indicate that both behavior modification and aerobic exercise programs are good strategies for managing obesity among adolescent girls.

The purpose of this study was to examine the stressors and coping strategies of school-age children and to explore the relatioship between stressful life events and health symptoms and the effects of coping and trait anxiety which is theoretically considered to mediate the relationship between stress and health symptom. The study subjcets consisted of 639 elementary school children in the fourth to sixth grade living in Seoul. Of the 639 subjects, 348 were boys and 291 were girls. The mean age was 11.35(SD=.86). The Feel Bad Scale (FBS), Schoolager's Coping Strategy Inventory (SCSI), Spielberger's Trait Anxiety Scale for Children(STAIC), and Health Symptom Questionnaire(HSQ) were adapted for this study. A pilot study was undertaken to ascertain the reliability and validity of the instruments. The Cronbach alphas of FBS, SCSI, STAIC and HSQ were from. 81 to .92. The Researcher and a research assistant visited the school and data were collected in the class using the questionnaire method after an explanation of the purpose and procedures was given to the children. Data collection was done during the period between Nov. 25 to Dec. 19,1995. Using the SAS statistical program, percentages, t-test, ANOVA, correlation analysis, and multiple regression were used for data analysis. The result are as follows: 1. The mean score for the FBS was 204.79(range: 48-472) and there was a significant difference according to grade. The most severe stressors perceived by children were parental divorce and death or illness of family members. The most frequently experienced stressful life events were conflict with siblings and being home alone. 2. The mean score for the SCSI was 57.36(range: 9-118) and there was a significant difference according to grade. The most frequently used, and perceived as helpful, coping strategies were distraction and cognitive activities. 3. The mean score for the HSQ were 20.7(range: 0-8l) and there were significant differences according to grade and sex. The percentage of the children answering that they perceived their health state as not good was 3.9%. 4. The mean score for the STAIC was 33.76 and there were significant differences according to grade and sex. 5. There was a significant relationship between stressful life events and health symptoms(r=.53, p<.01). Also, Stressful life events were postively related with coping strategies(r=.39, p<.01). Trait anxiety was highly correlated with health symptoms(r=.72, p<.01). 6. To examine the multivariate effects of the variables to health symptoms, multiple regression was performed. Stressful life events, coping, trait anxiety, and health concerns were identified as significant variables. Explanation of the health symptoms by these variables was 56. 78%. The study revealed that stressful life events correlated with health symptoms in School-age children and coping and trait anxiety had mediating effects on this relationship. The implication for nursing is that there is a need to develop supportive interventions for high risk population to decrease health problems due to stress. Also, it is recommended that a study be conducted to explore protective factors for the prevention of health problems in children.

The average smoking rate for Adults' in our country is 40.6%: It is 74.2% for men and 5.0% for women. Particularly, the smoking rate for men is reported higher than that of men in U. S. A. or Japan. Since the first report on the association between smoking and cancer appeared, 370 thousand smokers have succeeded in smoking cessation and over 90% of them have responded that they depended on a self-help smoking cessation approach. Despite this positive evidence about self-help approaches for smoking cessation, most studies on smoking cessation have focused on evaluation of formal treatment programs that are provided by clinics. Reports on the smoking cessation process used by smokers in our country could not be found. However, it is believed that the situation in our country would be quite similar to that in U.S.A. as far as approaches to successful smoking cessation are concerned. This study was conducted to classify the smoking stage to which they smoker belong and which changing mechanisms could be included at each changing stage (precontemplation stage, comtem-plation stage, action stage) with a sample of 155 college students between 20 and 29 years old. And it also identified which variables related both to smoking pattern and to health, which ones were significantly discriminating in the changing stages. From the results of the data analysis it was found that Self-Determination is the most influential variable as one of the changning mechanisms which can discriminate three changing stages. And as the next significant mechanisms were Reinforcement, Dramatic Relief, Cognitive Restructuring, Helping Relationship, and Information Management in that order. Among variables related to the smoking pattern, years of regular smoking, whether smoking is continued or not even when they are sick, the number of attempts to stop smoking, number of cigarettes smoked per day, and whether they have smoked over 100 cigarettes up to now, but not the time of the first cigarette after waking-up, were the significant factors to descriminate changing stages. It was confirmed that among variables related to health that, perceived control for health, confidence of health maintence ability, and self confidence in smoking cessation, were significant variables in determinating changing stages. The most influential variables among them was self-confidence in smoking cessation. Conclusively, it was shown that smoking cessation is the process of attempting to change smoking habits through the various changing processes. Also it can be shown that a few factors smoking habit, self-confidence of smoking cessation, and belief in self control of his/her health, were influential in discriminating the changing stages of the smoking habit.

Regular long term dance movement could be one of ways to induce improvement of psychophysiological variables, resulting in improvement of quality of life. However, there have been few studies to evaluate the effect of dance movement training on both physiological and psychological variables in the elderly. This study was focused to determine the effect of Korean traditional dance movement training on psychophysiological variables-body weight, body fat, lean body mass, muscle strength, muscle endurance, flexibility, agility, resting heart rate and blood pressure, depression and life satisfaction-in Korean elderly women. Thirty four subjects, aged between 65 and 75years who have normal cognition, sensory function, cerebellum function, cardiovascular function, participated in this study. Seventeen experimental group subjects were selected from E-elderly university in Kyung Gi province, and Seventeen control group subjects were selected from N -welfare facility in Seoul City. Seventeen experimental group subjects participated for 12weeks dance movement program. Korean traditional dance movement program was developed on the basis of Korean traditional dance and music by the author. The program consisted of approximately 50minutes of dance, 3times a week for 12weeks. During 50minutes workout, there were 15minutes of warm-up dancing, 25minutes of conditioning dance and 10minutes of cool-down dancing. The intensity for the conditioning phase was at between 60% and 65% of age-adjusted maximum heart rates. The body weight, body fat, lean body mass, muscle strength(grip strength, leg strength), muscle endurance, flexibility, agility, resting heart rate and blood pressure, depression and life satisfaction were measured prior to and following the experimental treatment. The participants in dance movement were interviewed focusing on subjective feeling following 12 week's regular dance movement. Data were analyzed with mean, standard deviation, percentage of change, X2-test, t-test, and ANCOVA test using SPSS PC+ program. Subjec tive feeling was categorized into cognitopsy-chological and physiological responses. Results were obtained as follows: 1) The body weight(F=15.52, p=.000), body fat (F=18.33, p=.000) and lean body mass(F=7.28, p=.011) of the experimental group were significantly lower than those Of the control group following the dance movement training. 2) The leg strength (F=30.96, p=.000), muscle endurance (F=9.06, p=.005), agility(F=44.92, 000), flexibility(F=6.84, p=.014) of the experimental group were significantly higher than those of the control group following the dance movement training. There was no significant difference of grip strength (F=. 43, p=.515) between experimental and control groups. 3) The heart rate(F=26.96, p=.000), systolic (F=10.40, p=.000) and diastolic(F=3.99, p= .005) blood pressure at rest of the experimental group were significantly lower than those of the control group following the dance movement training. 4) No significant difference of score of depression (F=3.49, p=.071) was observed between experimental and control groups. 5) Score of life satisfaction of experimental group was remarkably higher than that of control group following 12weeks of dance movement training (p<0.05). 6) Thematic responses about the dance movement following the training were positive. "I feel good" was the most frequent among cognitopsychol-ogical responses and "I feel lightness of body" was the most frequent among physiological responses. The results suggest that Korean traditional dance movement training can improve psychophysiological variables of Korean elderly.

This study was designed and undertaken to identify the degree of burden and depression in family caregivers of patients with stroke and to determine whether burden was directly related to depression. The data were collected from October 23th to November 20th, 1995. The subjects in this study were 80 caregivers, that is, one family member and 80 patients with stroke who were hospitalized in one oriental medicine hospital located in Taejon City. The questionnaires consisted of questions regarding burden(13 item, 6 point scale) and depression(20 item, 4 point scale). Data were analyzed using percentages, means, t-test, ANOVA and Peason-correlation coefficients, done with the SAS program. The results of this study are as follows; 1. The score for family caregiver's burden was higher than the mid level for the 13 items. 2. The score for of family caregiver's depression was relatively low. 3. The relationship between burden and depression showed a significant inverse correlation. 4. In the relationships between total burden and general characteristics of the family caregivers; there were no significant differences. But, in the relationship between objective burden and general characteristics of the family caregivers; age and education had statistically significant differences. That is, the 40's group felt more objective burden than any other age group and the high education group more than the illiterate group. 5. In the relationship between depression and general characteristics of the family caregivers; sex, education and monthly income had statistically significant differences. That is, female caregivers felt more depression than males, and the lower the level of education and the lower the monthly income, the higher the degree of depression. 6. In the relationships between burden and general charateristics of the stroke patients, only subjective burden according to the patients' sex was significantly different. That is, caregivers felt more subjective burden when caring for male patients than for female patients. 7. In the relationships between depression and general charateristics of the stroke patients, only the patients' economic status showed a statistically significant difference. That is, caregivers felt more depression in case of patients' low economic status.

This study was done to analyze research trends and to suggest future perspectives for nursing research on fatigue. The author reviewed 31 Korean and foreign research papers which have been published in the literature since 1970. An analysis of the study focused on the type of research subjects, type of study design, measurement instrument, and its correlated parameters. The results of the study are summarized as follows: First, within all of the studies analayzed, 14 studies were publised in Korea and 17 were published abroad. The number of studies done abroad have been increasing rapidly since 1991. Second, an analysis of the research design of the studies showed, eight studies each, Korean and foreign used survey design. Two Korean studies and seven foreign studies used a correlational design. Four comparative studies were done in Korea, but only two experimetal studies were performed abroad. Therefore, it was found that the trend of the study design used is survey design and there are more correlational studies done abroad than in Korea. Third, the type of the study subjects; 11 Korean and three foreign studies dealt with healthy people. In addition, three Korean and 14 foreign studies investigated patients with various illnesses. It was found that patients with various illnesses were studied more frequently in foreign studies than in Korean studies. Fourth, the measurement tool used in the Korean studies; 13 studies used a testible tool to assess patients' subjective symtoms or complaints of fatigue. The most commonly used tool used in 10 studies, was the Fatigue Self-Perception Scale, which was designed by the Labor and Health Institute of Japan. The Visual Analogue Scale was used in two studies, and Piper Fatigue Scale, addtional with physiologic parameters, was used in one study. In the foreign studies, subjective measurement tools were used in 16 studies. A combination of a subjective measurement tool with objective parameters was used in ten studies. For the subjective measurement tool used in the foreign studies, a specific measurement tool developed by the researcher which was used in seven studies. Either Rhoten Fatigue Scale or the Visual Analog Scale were used in three studies. Additionally, in order to identify the relationship between fatigue and psychological factors, The Profile of Mood State was used in three studies. Beck Depression Inventory was used in two studies. The Self Rated Depression Scale, developed by Zung, was used in one study and other measurement tools were used to measure various psychological parameters. Rhoten Fatigue Checklist was also used to observe behavior patterns. Lastly, nine studies identified correlations between fatigue and other parameters. A significant correlation was found between fatigue and psychological factors such as depression, and pain. As a result of the above findings, it can be said that research trends on fatigue are increasing internationally. The selected study designs are survey studies both in Korea and abroad. There are more correlational studies abroad than in Korea. In addition, subjective measurement tools and objective parameters are used variously and combined with each other. And, there is a significant correlation between fatigue and psychological factors such as depression, and pain. More survey and correlational studies need to be done to identify the relationship of fatigue in patients with various condition or diagnoses and to suggest a scientific basis for nursing interventions with fatigue. Also, a tool to assess patient's subjective, objective, and behavioral aspects on fatigue needs to be developed.

The main purpose of this study was getting related to the pain charactristic data of elderly. It contains past and present health status, daily living activity level, pain frequency, causes, pain area, pain intensity, pain worse causes, and pain releave causes, pain management methods. The subject were 79 elderly whose age were over 65 years old. They were lived in their home environment. Half of them were resident of middle range city at province and the others were Seoul city. The data was collected from Dec. 1st. 1995 to Jan. 30th. 1996. Interviews were held with semi-structured questionaire after pilot study by researchers. Pain measurement tool were used graphic rating scale and Abstract of Korean Pain Language Scale. To analize the subject's general characteristics, past and present health status, daily living activity level, characteristics about pain, pain management methods statistical SPSS for win frequency were employed. The findings were as follows; 1. There were 33(41.8%) male and 46(58.2%) female Below 69 year old were 20(25.3%), 70-79 year old were 42 (53.2%), over 80 year old were 17(21.5%), mean age was 74(from 65 to 89). 2. Buddhist were 24(30.4%), Christian were 29(36. 7%), the other religious status or nun religians were 26(32.9%). 3. Past good health status were 63(79.7%), not so good status were 6(7.6%). Present good health status were 19 (24.1%), moderated health status were 6(7.6%), not so good status were 14(17.7%). 4. Daily living activity limitation were 39(49.4%), nonlimitation of activity were 5(6.3%). 5. Walking limitation were 3(3.8%), nonlimitation walking were 52(65.8%). 6. Insomnia was 23(29.1%), no difficult were 38(48. 1%). 7. Chronic pain complaints were 64(81%), diseases causes of pain were 25(31.6%), bad health behavior causes of pain were 27(34.2%). 8. Most pain area were back 30(29.4%), leg 17(16. 7%), knee 16(15.7%), arm 13(12.7%), teeth, chest and head were each 5(4.9%), loin, trunk were each 4(3.9%), the other areas were 3(3%). 9. Pain intensity was 3.49(mean) by Korean Language Scale, 6.59(mean) by graphic rating scale. Sensitive pain was 3.5(47.9%), affective pain was 3(20.8%) It was high pain level and sensitive pain. 10. Most pain worse causes moving was 35(44.3%), pain relieving causes rest was 29(36.7%). 11. Pain management method were medication 40 (42.1%), physiotherapy 23(24.2%), hospital 12 (12.6%), the others 7(7.4%), none 13(13.7%). The conclusion; Present health status of eldery was not so good. Almost half of them have some diseases. Most common diseases of eldery were arthristis, respitatory and heart problems. Fourty nine percent of elderly had limitation of daily living activities. Eighty one percent of eldely had chronic pain. Most of them was back pain (30%). Pain intensity was high (score over 3.5). The worsening pain causes was moving and releiving causes was rest. Pain management method were pain medication, physiotherapy. Therefore, Nursing care plan for the elderly have to focus on pain because majority of elderly have chronic high level of pain related to the arthritis.

The purpose of this study was to identify the effects of music therapy on anxiety in neurotic patients. The subjects of the study were 41 patients that had been diagnosed as having anxiety disorder, neurotic depression, or somatization disorder and were admitted to one general hospital in Seoul. The 41 research subjects were assigned to an experimental (22 clients) and a control (19clients) group. Data were gathered from September. 25, 1995 to December. 15, 1995 using a questionnaire and physiological measurement tool. Data were analyzed with the SAS package using frequency, t-test, paired t-test and Pearson correlation coefficients. The results of this study are as follows; 1. There were significant differences between two groups on systolic and diastolic blood pressure, and pulse rate after treatment. In the experimental group, Systolic and diastolic blood pressure, and pulse rate decreased significantly after Music Therapy. 2. There were no significant differences between the two groups on the pre and post psychological anxiety score. But, after music therapy, experimental group had a lower psychological anxiety score than the control group. From these results, it is concluded that the music therapy can be effective in decreasing anxiety in neurotic patients.

The purpose of this study was to discover practical health problems which hemodialysis clients experienced so as to present basic data for development of a health assessment tool. The research subjects were 70 clients receiving hemodialysis in Seoul and Inchon from Mar. 1996 to Sep. 1996. Data were collected by researcher's informal indepth interview and nurses' open ended question. Content analysis was applied to collect similar contents and common experiences in order to derivate concepts and categories for better understanding of hemodialysis clients' experiences. As a result, 9 categories derivated to identify the health problems of clients receiving hemodialysis were as follows: 1) They experienced 'the decreased digestive function' which contained the changed appetite, nausea, vomiting, constipation and diarrhea. 2) They experienced 'the decreased respiratory and circulatory function' which contained dyspnea, changed blood pressure, tingling sensation and the fear of aggrevated vascular condition. 3) They experienced 'the aggrevated oral condition' which contained dry mouth and destruction of teeth and their soft tissue. 4) They experienced 'the decreased sensory function' which contained visual disturbances, sensation difficulty, and hearing loss. 5) They experienced 'the aggrevated skin condition' which contained dark brown skin color, dry skin (and hyperpigmentatic freckle, seborrheric kera-tosis, scale), itching sense, and alopethia. 6) They experienced 'the decreased urinary reproductive function' which contained anuria or oliguria, dysmenorrhea, sterility and decreased libido. 7) They experienced 'the restricted activity' which contained decreased activity, muscle cramp and stiffness of joint. 8) They experienced 'the changed mental status' which contained memory disturbance, decreased cognition, disorientation, neurosis and psychosis. 9) They experienced 'the aggrevated general condition' which contained kyphosis, weight loss, fatigue, sleep disturbance, bleeding tendency, inflammation, generalized edema and foul Oder of uremia.

The purpose of this study is to explore types of postpartum depression and to understand the nature and structure of the postpartum depression by using Q-methodological approach. As a way of research, 55 statements concerning postpartum depression were selected through individual interviews with postpartum mothers and literature review. 30 women were chosen as a subject group for the study, with opinions shown in 55 statements divided into 9 scales by forced distribution. PC QUANL Program was used for analysis and Q-factors were analyzed by using principal component analysis. As a result, postpartum depression experience was classified into 5 types. There are "Role -Strain Type", "Unattributional Depression Type", "Psychosomatic Symptoms Type", "Self-Compassion Type", and "Role-Crisis Type". Type I was named "Role-Strain Type", referring to the strain generally experienced by mothers with regard to the new role as a mother and as a social member. Type II was named "Unattributional Depression Type", referring to the symptom experienced by people who were in a state of vanity and a sense of loss. They often break into tears for no specific reasons. In case of Type III, people in a state of "Psychosomatic Symptoms Type" develop physical symptoms after suffering from inherent emotional conflict. Type IV was named "Self-Compassion Type" refers to the symptom shown by those who feel pity for their children and for themselves. And they show inability to cope with the reality properly. Type V was named "Role-Crisis Type", which is experienced by people who have a burden and a severe fear of their own job and their children in their mind, also showing serious conflict with maternal role. Futhermore, it was carried out to examine structure of postpartum depression in terms of degree of depression and adjustment ability. Type I showed mild degree of depression and relatively good adjustment ability. Type II showed broad range of degree in depression and moderate adjustment ability. Type III showed moderate depression and relatively low adjustment ability. Type IV revealed relatively serious degree of depression and the lowest adjustment ability. Type V revealed very serious degree of depression and the lowest adjustment ability. As a result, considering the structure of postpartum depression, Type I is considered to be a normal depression sympton which most mothers generally experience, followed by Type II, Type III, Type IV and Type V, each of which show increasingly worse degree of depression and lower adjustment ability. In conclusion, it seems to be it is necessary to understand distinct symptoms of postpartum depression and to examine the characteristics and structure of those types, so that it could lead to more individual nursing approach.

The purpose of this study was to identify the degree to which nursing diagnoses accepted by NANDA are used and to identify problems in application of nursing diagnoses in clinical practice. With the expanding potential fur computerization of nursing diagnosis, the survey also included data on the present status of hospital computerization and willingness to use computerized nursing diagnoses. The data collection was done from July 1 to August 3, 1996 using structured questionnaires. The questionnaires were mailed to 1,126 head nurses working in 44 hospitals with on occupacy of over 500 beds located in Korea, of these, 883 were returned from 40 hospitals. Among the 883 questionnaires, 867 were used for the analysis. The results of the analysis are as follows 1. Among 109 nursing diagnoses, pain, constipation, diarrhea, hyperthermia, high risk for infection, sleep pattern disturbance, and anxiety, chronic pain, altered urinary elimination, and altered nutrition: less than body requirements were the ten most frequently used diagnoses. 2. The primary problem in the use of nursing diagnoses was lack of time and personnel. Others were lack of knowledge and motivation, absence of protocols and absence of the appropriate methods to apply nursing diagnoses. 3. Among the 40 hospitals, 27 hospitals used a computerized system and expressed willingness to utilize the computerized system of nursing diagnoses that is planned for the future.

The purpose of this study was to contribute to the development of clinical instruction by students' ratings of teaching effectiveness in clinical nursing education. The subjects were comprised of graduating class 618 students from 24 nursing colleges in the nation. The instruments used in this study were "general characteristics and status of clinical nursing education" developed by the researcher and "Instrument to Measure Effectiveness of Clinical Instructors " by Reeve (1994). The 50 questions used in the questionaire were categorized into 13 components subject to factor analysis. The 13 components were interpersonal relationships, communication skills, role model, resource for students, favorable to students, encouraging to think for selves, teaching methods, evaluation, finding assignments for objectives, organization of subject matter, professional competence, knowledge of subject matter and working with agency personnel. The results of this study are as follows 1. Status of clinical nursing educaion: 1) Clinical nursing education were led by nursing professors(44.9%), a team of both nuring professor and head nurse(6.8%), instructors from specific hospital(15.1%), instuctos for a specific subject(14.6%), and head nurse (6.8%). For 3-year program students, 34.6% of the clinical nursing education were led by instructors from specific hospital and 51.4% of the education by nursing professors for Bachelor's program. 2) The contents for clinical education comprised of Conference being the most frequent of 34.5%; a combination of Nursing skills, Orientation, Conference etc. 22.0%; Nursing process 21.7%; Orientation 13.5%; Inspection (making rounds) 6.4%, and Nursing skills of 2% being the least frequent. 3) Students' preference of clinical teachers from the highest to the lowest were instructors for a specific subject being the most desired(44.9%) followed by nursing professor, head nurse, a team of both nursing professor and head nurse, and instructors from specific hospital being the least desired. 4) Students felt that the qualification for clinical teachers should be at least a master's degree holder and 5 or more years of clinical experience. The reason they felt was because knowledge and experience are imperative for professional education. 2. Clinical teaching effectiveness: The total points for teaching effectiveness was 147.97(mean of 2.95 +/- 0.98) where the total score is considered to be an average rating. 3. Teaching effectiveness as status of clinical nursing education: 1) The score ratings for the clinical instructors from the highest to the lowest were as follows; instructors for a specific subject, instructors from specific hospitals, a team of both nursing professors and head nurses, nursing professors, head nurses, which resulted in significunt differ-ence(F=4.53, P<0.001). 2) The rating scores based on the teaching program from the highest to the lowest were as follws; nursing skills, nursing process, a combination of nursing skills, orientation, conference etc., conferences, orientation, inspection, which resulted in significunt difference(F-10.97, P<0.001). 4. Based on 13 categorized components from the questionaires, questions related to communication skills scored the highest points of 3.20 where inquiries regarding resource for students scored the lowest points of 2.38. 5. Among the 13 categorial components from the questionaire, Interpersonal relationship, Communication skills, Resource for students, Encouraging to think for selves, Evaluation, Teaching method, Finding assignment for objectives, Organization of subject matter, Professional competence, and Working with agency personnel, instructors for a specific subject scored the highest points and head nurse scored the lowest, which resulted in significant diference. Favorable for students, instructors for a specific subject scored highest points and nursing professor scored the lowest, which resulted in significant deference (F=5.39, P<0.001). Role model and Professional competence, instructors for a specific subject scored the highest points and head nurse scored the lowest, with minimum variation(F-1.29, p>0.05:F=1.64,P>0.05). 6. Based on 13 categorial components as a whole, the highest points scored among the 5 groups of clinical teachers was instructors for a specific subject and the lowest, by head nurse(F=1.94, P<0. 001). A team of both nursing professor and head nurse attained higher score in clinical education than their independent education.

The purpose of this study was to call attention to the mental, physical and occupational hazards of the anticancer-drug-handling nurses by examining the possible urinary mutagenicity and measuring physical symptoms and stress level of the nurses exposed to anticancer drugs. The experimental group of the urinary mutagenicity assay was 14 nurses handling anticancer drugs at the medical wards of a hospital located in J city; the control group was 12 psychiatric nurses of the same hospital. The test material was the nurses' 24hrs urine, which was concentrated by XAD-2 column chromatography. Tester strains were TA98( +/- S9 mix), TA100( +/- S9 mix), TA1535( +/- S9 mix) and TA1537( +/- S9 mix); Salmonella mammalian-microsomal test (Ames test) was employed for the urinary mutagenicity assay. The physical symptoms of which the nurses experienced were investigated through self-reports on open-questionnaires. The stress levels of the experimental group were measured by a stress measuring instrument developed by this author. Reliability of this instrument was found to be adequate (Cronbach's Alpha=0.9079). To ascertain the urinary mutagenicity of the experimental group, the mean and the standard deviation of the colonies of Tester strains appearing on the minimal plates were taken and compared differences between two groups. T-test was employed for the significance test of two groups. The physical symptoms were compared between the two groups through the analysis of the nurse' self-reports. The mean and standard deviation of the stress levels of the experimental group were also calculated and were examined through t-test. The results were summarized as follows: 1. The experimental group revealed significantly higher urinary mutagenicity both in the activation method test and the non-activation method test of the tester strains TA98, TA100 and TA1535. In the case of TA1537, two groups showed no difference in the non-activation method test, but the activation method revealed difference. 2. The physical symptoms were also much more frequently reported in the experimental group. 79. 3% of the experimental group reported more than 1 kind of physical symptoms. On the other hand, 33.2% of the control group complained of 1 kind of physical symptom. The items with high symptom frequency were 'headache', 'itching sensation', 'corneal congestion', 'skin allergy'. 3. The mean score of stress in the experimental group was 2.41(range 1-4). The experimental group showed the stress level above 2.0 in the 14 of 15 items in all. The highest stress level were recorded in the following items in the order quoted, 'I fear that anticancer drug may touch any part of body while handling it.', 'I feel concerned there is no protective countermeasure against anticancer drug handling.', 'I am afraid the anticancer drug handling may produce a fetal loss in the future'.