The purpose of this descriptive study was to identify the homecare needs of patients with cancer and to provide a basis of interventions. One hundred and two patients at one general hospital in Gyeongnam responded to a questionnaire developed on the basis of care needs perceived by nurse caring for hospitalized patients with cancer. The questionnaire was a Likert type 5 point scale with 56 items on five need categories ; 1) informational 2) physical care 3) emotional care 4) socioeconomic care and 5) special care needs. Internal consistency of this questionnaire was Cronbach's alpha=.9101 for total items. The data was collected from March 1st to May 31th, 1998, by tow graduate nurses. In the data analysis, mean & standard deviation were calculated to identify the degree of care need of each item, and the t-test & ANOVA were done to determine the effects of patients' demographic background on their care needs. The findings are summarized as follows ; 1) The mean score of total of need items was 3.048. Of the four need categories the highest score was informational at 3.4, followed by emotional care, 3.063, physical care, 2.623, and socioeconomic care, 2.599. 2) In the informational and category there were four subcategories with 19 items. Medication and pain control had the highest score, 3.755 ; second was diet and exercise, 3.613 ; third was disease and treatment process, 3.337 ; and last was personal hygiene and infection prevention at 2.687. 3) In the physical care need category there was nine items, IV infusion for nutrition and management of treatment complication was above 3.2 points and the remaining items were in the 2.847-2.070 score ranges. 4) In the emotional care need category there were seven items. The highest need was in support for relationships with health personnel, 3.673. The need for support of religions beliefs and support fir having a religion were low at about 2 points. 5) In the socioeconomic care need category there were six items. Support for medical insurance expansion and financial support were above 3 points. Legal support and support for caring of children were low in the care needs. 6) In the special care need category the there were 15 items. Informational need about immunization and informational need about effects of disease on growth and development were high, above 4.1 points. Need for decubitus care and prevention, sitz bath and incontinence care were low, below 2 points. 7) There were significant differences in degree of care need according to admission rate, education level, marital status, religion and caregiver's religion. In conclusion, homecare needs perceived by hospitalized patient's with cancer was moderate, but informational need was higher than direct care needs, leading to the conclusion that the provision of sufficient information to patients with cancer at discharge is needed. Nursing interventions should be developed considering the patient's background.
Most people experience fatigue at some point in their lives, and they say the word 'fatigue' in their ordinary conversational speech. The ordinary word is used as a military or engineering term and has been studied in various different disciplines such as ergonomics, physiology, psychology, medicine, and nursing. In spite of its widespread uses, however, fatigue has not been well defined. The terms of fatigue is thus often used with different meanings and is applied in diverse contests that had led to a confusion of ideas. In people with cancer, fatigue is reported as a major distress. Despite the importance of fatigue in cancer patients, the phenomena of fatigue is poorly understood. Therefore, the purpose of the present study is to analyze the concept of fatigue in people with cancer. The process for the concept analysis was guided by Walker and Avant's conceptual analysis methodology. The identified attributes of fatigue in the present study were subjective feeling, lack of energy, sustenance, and multi-dimensions. The antecedents were cancer treatment and economic status. The consequences were decreased daily, vocational, leisure, and social activities, uncertainty, and difficulties in adjustment. Symptoms(pain, anorexia, and insomnia) and emotional disturbance were not clear whether they are antecedents or consequences. However, they are related with cancer related fatigue. Even though still in the beginning stage, instruments measuring cancer related fatigue have been developed by some nursing investigators.
The purpose of this study was to investigate the relationship between the burdent on families who live with an elderly person suffering from senile dementia, and the degree of their depression. There were 400 participants in this study, staying in the Seoul and Kyonggi areas from August, 1, 1997 to February 28, 1998. Among the group, 100 participants took care of their patients at home, and another 300 participants left 100 patients at a day-care center, 100 sanatorium for senile dementia(asylum for helpless elderly people), 100 an infirmary for elderly people. Eventually 242 subjects out of the 400 were selected for the data analysis. The Zarit(1980) tool was employed to measure the degree of burden and Zung's(1965) "Self-Rating Depression Scale" was employed for the data analysis. The data was analyzed, and the percentage, t-test, ANOVA, and Pearson's Correlation Coefficient were calculated. The results are as follows. 1. The average degree of burden that care-giving families felt was 49.13, which is somewhat high. 2. The average degree of depression that-giving families felt was 51.95, which is relatively high. 3. The degree of burden was directly affected by the relation with the patient(F=2.48, P<.05), and the socio-economic status of the family(F=5.17, P<.05). It's also affected by the patient's educational status(F=2.17, P<.05). 4. The degree of depression of the family was significantly dependent on sex(t=-2.05, P<.05), age(F=2.99, P<.05), the relationship with the patient(F=3.65, P<.01), socio-economic status(F=7.74, P<.001), occupation(t=2.82, P<.01), health status(F=4.42, P<.01), and the place of residence(F=4.30, P<.01). The patient characteristics was significantly dependent on his/her educational status(F=3.85, P<.01), the period of suffering from senile dementia(F=2.47, P<.05), and smoking habit(F=6.17, P<.001). 5. The relationship between the degree of burden and that of depression reads r=0.43, which is statistically positive correlation in the high significant level. Upon analyzing the entire summation, most care-giver for elderly patients suffering from senile dementia lack time in caring for themselves. They also experience chronic fatigue and mental discomfort caused by the isolation from society, curtailment of certain activities, a sense of responsibility of certain activities, a sense of responsibility for their patients, and limits of their endurance in taking care of their patients over time. In conclusion, this study emphasizes the necessity for the following propositions : 1. In order to measure the degree of burden that Korean care-giving families undergo, a new tool must be developed on the basis of Korean culture. 2. An educational program based on the demands that care-giving families undergo must e developed, and its clinical effect also has to be examined.
This study was conducted to identify the attributes constituting Korean social support and to validate the results of the previous study 'Search for the meaning of social support in Korean Society.' The informants were 41 Korean middle-aged women in three cities : Seoul, Dagjun and Daeku. The data were collected through indepth interviews using the interview guide from Jun. 1994 to Jun. 1995. The interview guide was developed in the simulated situations of 'Stroke attack' which expected to be in need of social support. The women were asked to answer what they felt and the appropriated terms representing the situations. Data analysis were conducted by content analysis. consequently, the Koran social support pyramid was modified as follows ; Support is the apex of the pyramid. The four sides of the pyramid are made up of 'Jung'(Bound by ties of affection, regard or shared common experience, Connectedness), Do-oom(both emotional and material help), Mi-dum(Faith or belief in) and Sa-Rang(Love). The base of the pyramid is 'yun'(the basic network of relationships in Korean culture) that connote the meaning of Eunhae(Benevolence), Euimu(duty, responsibility) and Dori(obligation).
The purpose of this study was to generated a grounded theory of how families with kidney donor or recipient copel with kidney transplantations. Interview data from twelve familes involved in didney transplants was analyzed using the grounded theory method. Data analysis revealed that "protecting the family" was the main theme that represented family member experiences. In order to maintain family function and to protect the family from breaking up, family members had to adjust the family structure from the traditional style of a husband-centered family, to one that was patient health-centered. the process of this adjustment was a very long and difficult one, taking several years from the recognition of the kidney disease to the kidney transplants. Family members, especially spouses, employed nine different strategies to deal with various problems and conflicts which occurred during the process : 1) paying attention to the patient's illness and complications ; 2) accepting the patients's illness as the family's illness as well ; 3) managing the patient's illness and complications that occurred ; 4) being thrifty ; 5) supporting the kidney donor ; 6) accepting and replacing the lost roles of the patient ; 7) keeping composure and encouraging the patient ; 8) sustaining the patient's independence ; 9) self-restraining sexual desires.
The purposes of this research were to identify nursing interventions performed by Korean nurses and to compare the interventions performed by nurses working in the oriental medicine hospitals and with those performed by nurses working in the general hospitals. The samples consisted of 144 Korean nurses working in three hospitals, 70 nurses working in the oriental medicine hospitals and 74 nurses working in the general hospitals. The Nursing Interventions Classification(NIC) Use Questionnaire developed by the Iowa Intervention Project team was translated to Korean and verified using the method of back-translation. The questionnaire consists of 433 intervention labels and definition. Thirteen interventions were used at least daily by nurses working in the oriental medicine hospitals, while twenty-one interventions were used at least daily by nurses working in the general hospitals. the most frequently used interventions by nurses working in the oriental medicine hospitals were Documentation, shift Report vital signs Monitoring, Pressure Ulcer Prevention, Positioning, Fall Prevention, Exercise Promotion, Intravenous(IV) Therapy, Pressure Ulcer care, and Bed Rest Care in that crder. For nurses working in the general hospitals the most frequent intervention was Analgesic Administration, followed by the interventions of Medication Administration : Parenteral and Intravenous Therapy(IV) Therapy, Documentation, Intravenous(IV) Insertion, shift Report, Fall Prevention, vital Signs Monitoring, Medication Adnninistraction : and , fluid Monitoring, and Medication Management in that order. The interventions performed least often by nurses working in the oriental medicine hospitals were Hemodialysis Therapy and Bleeding Reduction : Antepartum Uterus, while the interventions performed least often by nurses working in the general hospital were Rape Trauma Treatment and Contact Lens Care. The nurses working in the oriental medicine hospitals performed the interventions in the Physiological : Complex domain significantly more often than the nurses working in the general hospitals, while the nurses working in the general hospitals performed the intervention in the Behavior domain significantly more often than the nurses working in the oriental medicine hospitals. This study suggests that further study will be needed to developed and validate more interventions sensitive to Korean culture.
This is a descriptive study on quality of life(QOL) and related factors of ostomates to provide a basic data for development of nursing interventions. The subjects were 110 ostomates who were members of the Daegu or Daejon branches of the Korean Ostomy Association. Data collection was performed between March 1st and April 6th, 1998. Measurements of QOL, self-care, family support, self-esteem, and hope were used as the study tools. Data were analyzed with the SAS program by using t-test, ANOVA, Pearson correlation and stepwise multiple regression. The results are as follows : 1) The score on the QOL scale ranged from 97 to 226 with a mean of 164.53(+/-28.29). 2) The score of QOL on the general and ostomate-related characteristic showed significant differences according to monthly income, monthly participation in ostomate meetings, combined treatments after operation, types of evacuation management, problems of ostomy, help in caring for the ostomy, length of time since ostomate surgery, and presence or absence of readmission after discharge. 3) There were significant positive correlations between quality in life and other factors ; self-esteem(r=0.7107, P<0.001), hope(r=0.6584, P<0.001) family support(r=0.6191, P<0.001), perception of health condition(r=0.6017, P<0.001), and self-care(r=0.2286, P<0.05). 4) The variables that affected the quality of life of the subjects were self-esteem, level of family support, perception of health condition, monthly participation in ostomate meetings, combined treatments after operation, monthly income, level of hope, and age in that order. The variance of quality of life was R2=77.20 percent by calculating the sum of those variables. In conclusion, it is necessary for nursing intervention to promote self-esteem, family support, and hope in the care of ostomates in order to improve QOL.
This study was condicted to construct a hypothetical model of depression in Korean adolescent women and validate the fit of the model to the empiricla data. The data were collected from 345 high school girls in Seoul, from May 1 to June 30, 1998. The instruments were the Body Mass Index, Physical Satisfaction Scale, Family Adaptatibility and Cohesion Evaluation Scale III, Family Satisfaction Scale, CES-D and School Adaptation Scale. The data were analyzed using descriptive statistics with the pc-SAS program. The Linear Structural Relationship(LISREL) modeling process was used to find the best fit model which would predict the causal relationships among the variables. The overall fit of the hypothetical model to the data was moderate [X2=69.6(df=17, p=.000), GFI=0.95, AGFI=0.90, RMR=0.087, NNFI=0.86, NFI=0.90]. The predictable variables, especially menstrual symptoms, physical symptoms and family function, had a significant direct effect on depression, but school life adaptation did not have a significant direct effect. These variables explained 18.1% of the total variance.
This study tried to the answer to the question : "How does the human communication happen between clinical nurse and patient?" To answer that, a micro-ethnographic research method was used and I performed field work at the orthopedic ward in one Korean metropolitan city. After analysis of interview data, observational data and field notes, I could understand that clinical nurse-patient communication performed for clinical decision making, providing patient education and emotional support. Prepared nurse communicate with patient more effectively, eventually can establish more trust relationship with patient. Conclusively I discussed about the way of nurse's skill acquisition, need of collaborative conference with doctor and nurse, and curriculum development to promote nurses's understanding of human.
The purpose of this study was to test the effectiveness of self-management relaxation training through biofeedback and progressive muscle relaxation methods. The effectiveness of the experimental methods was tested by measuring the degree of symptoms of stress(SOS), the McNair's profile of Mood STates(POMS), the levels of ephinephrine, norepinephrine, pulse rate, blood pressure and natural killer cells. The subjects of this study were sixty six nursing students divided into four groups two groups were the biofeedback and progressive muscle relaxation groups, the other two groups served as control groups. One was a group of sophomores with no experience at all, the other a junior group without self-management or relaxation training. This study was condicted for eight weeks of clinical practice from April, 26th 1998 to June, 20th 1998. Biofeedback training was done with software developed by J&J company(1-410 form for abdominal respiration training). Progressive muscle relaxation training was done with an audiotape recorded according to Jacobson's Theory. The data were analyzed with frequencies, means, and analysis of cobariance using the SPSS program and the significance level of statistics was 5%. The results of the study are : 1) The importance of clinical practice stress reduction is shown in that the level of symptoms of stress in the experimental groups in clinical practice was higher than in the group receiving only a lecture. 2) The relaxation training methods of biofeeback and progressive muscle relaxation were effective in reducing the symptoms of stress under the clinical practice stress conditions. 3) The effectiveness of the biofeedback training relaxation method to reduce symptoms of stress was higher than that of progressive muscle relaxation. 4) The relaxation training methods of biofeedback and progressive muscle relaxation were effective in reducing stressful mood states. 5) The relaxation training methods of bioffedback and progressive muscle relaxation were not effective in reducing epinephrine and norepinephrine levels. 6) The relaxation training methods of biofeedback and progressive muscle relaxation were effective in increasing the number of natural killer cells. 7) The relaxation training methods of biofeedback and progressive muscle relaxation were effective in decreasing high systolic and diastolic values of blood pressure and high pulse rates. In summary, the relaxation methods of biofeedback and progressive muscle relaxation in reducing clinical practice stress were effective in lowering the level of symptoms of stress and the profile of stressful mood states. They were also effective in lowering high blood pressure and pulse rates. The relaxation methods were effective in increasing the number of natural killer cells as part of the immune function. However, relaxation methods were not effective symptoms of stress was more effective than the progressive muscle relaxation method.