The agitation of dementia patient is a factor which aggravates the care-givers' burdon, and it is needed to develop intervention methods. Hall and Buckwalter hypothesized that an increase in agitation behavior occur when persons experience high levels of stress. This study was conducted to explore the efficacy of hand massage in producing relaxation and decreasing agitation behaviors in persons with dementia. Hand massage was administered once a day in afternoon for 8days to 24 patients and 4days to 23 patients. There was no difference in result between the two groups. Significant differences were found in systolic blood pressure, pulse rate, emotional state from pre to post -intervention with the use of hand massage. The change of systolic blood pressure was 26% explained by ADL, MMSE-K and institutionalized period. The most significant variable was institutionalized period. The change of diastolic blood pressure was 11% explained by ADL, and it was significant. But no decrease in agitation behavior was observed and no increase in functional capacity.

This Meta-Analysis of 18 studies was conducted to determine the magnitude of th relationship between health promotion behavior and each of explanatory variables. The studies were measured using Health Promoting Life Style(HPLP) developed by Walker and others based on Pender's definiton of health promoting behavior. The sample was collected by searching for The Journal of Korean Academy Nursing Society, The Journal of Korean Women's Health Nursing Academic Society,The Journal of Korean Academic Society of Adult Nursing, Journal of Korean Community Nursing, The Journal of Fundamentals of Nursing, The Journal of Korean Nursing Administration Academic Society, The Korean Journal of Child Health Nursing, The Journal of Korean Psychiatric Academic Society, the dissertations for mater degree or doctoral dissertations for the period from 1980 to 1998. The explanatory variables measured more than 2 times in studies were self-efficacy, perceived health status, self-esteem, internal, powerful- others and chance dimensions of health locus of control, perceived benefits, hardiness, wellbeing and clinical demensions of health concepts, and quality of life(life satisfaction). Effect sizes were calculated by unweighted mean r, weighted mean r by sample size and weighted mean r by quality index score after homogeneity test. The mean r effect size indicator range of each predictor variable were as follows; quality of life (0.50- 0.52), self-efficacy(0.46-0.47), hardiness (0.42-0.44), self-esteem(0.41-0.43), health locus of control- internal(0.32-0.34), health locus of control- powerful others (0.25-0.31), perceived health status(0.18-0.19) and clinical dimensions of health concepts (0.16-0.17).

Parents are primary care taker for the children and have an important role for the assessment and managent of children's pain following surgery. The purpose of the present study was to examine the validity and clinical utilization of the Postoperative Pain Measure for Parents (PPMP) developed by Chambers et al. Subjects were 52 children aged 4-12 years admitted for tonsillectomy and other minor surgery and their mothers. Faces Pain Scale, State Anxiety, and Postoperative Pain Measure for Parents were used. The data were collected by two research assistant on the operation day and 1st day after surgery at hospital during the period of July 20 to August 28, 1998. The results are as follows: 1. Eta correlation coefficient between 15 items of PPMP and child rated pain were calculated. Correlation coefficients were more than .2 for both day. 2. Internal consistency for PPMP were .82 and .83. 3. The scores of the PPMP were 10.73 (SD=3.71) and 9.27(SD=4.07) on the operation day and 1st day after surgery and there was no significant difference between two days(p=.056) On the other hand, there was a significant difference on the child rated pain by Faces Pain Scale between operation day and 1st day after surgery(p=.001). 4. The correlation(Spearman Rho) between PPMP and child rated pain were .40(p=.003) and .56(p=.000). The score of the PPMP and the children's state anxiety were highly correlated on the operation day and 1st day after surgery (.60, .52, p=.000). 5. Partial correlation between PPMP and child rated pain except state anxiety were .18(p=.23) and .48(p=.001) on the opration day and 1st day after surgery. 6. Using a cut-off score 10 out of 15, the measure showed excellent sensitivity (>80%) and moderate specificity (46.15%, 60% ). This study provides preliminary evidence for the use of the PPMP as a valid pain assessment tool with children between the ages of 4-12 years following surgery. It is suggested to explore the validity with a different subjects with other surgery and to examine the validity for infant and younger children.

The purpose of the present study is to identify the mediation effect of hope between fatigue and psychosocial adjustment in women with breast cancer. The framework for this study was guided by concepts and propositions derived from the theoretical and empirical literature on fatigue, hope and adjustment. The design of this study is a descriptive correlation study using a cross-sectional design. One hundred and twenty two outpatients with early breast cancer, receiving post-surgical radiation therapy or chemotherapy, were selected from three major medical centers in Seoul, Korea. A packet including PABCF (Psychosoical Adjustment to Breast Cancer Factor), revised RPFS (Revised Piper Fatigue Scale), HHI (Herth Hope Index), and self-addressed return envelope was given to the participants at seven to eight weeks post surgery. The questionnaires were to be completed at home and returned to the researcher by mail. The obtained data were analyzed using three regression equations guided by Baron and Kenny (1986); first, hope was regressed on fatigue; second, psychosocial adjustment was regressed on fatigue; and third, psychosocial adjustment was regressed on fatigue and hope, simultaneously. In the first equation, fatigue explained 4% of the variance in hope. In the second equation, fatigue explained 47% of the variance in psychosocial adjustment. In the last equation, hope and fatigue significantly explained the variance in psychosocial adjustment. Therefore, all conditions for the test of mediation effect of hope were satisfied. For the test of the mediation effect, the beta coefficients of fatigue on psychosocial adjustment on the second and third regression equations were compared. The beta coefficients were decreased from .69 (p < .001) on the second regression equation to .63 (p < .001) on the third regression equation. Thus, the hypothesis of this study was supported. As a result of this study, the negative Influence of fatigue on psychosocial adjustment is dampened through the mediator effect of hope in women with breast cancer. Therefore, when planning care for the adverse effect of fatigue on psychosocial adjustment, oncology nurses should consider hope as a mediator between fatigue and psychosocial adjustment to breast cancer.

The purpose of this study was to assess the perceived exercise self-efficacy and exercise benefits/barriers of Korean adults with chronic diseases, and the relationship between the two variables. For the study, 249 Korean adults with chronic diseases with ages ranging from 18 to 79 years were recruited from hospitals or health centers in five Korean cities and surrounding rural areas. The research instruments were the scales that researchers psychometrically verified the Exercise Self-Efficacy Scale, developed by Bandura (1997), and the Exercise Benefits/ Barriers Scale, developed by Sechrist, Walker, and Pender(1987). Results of descriptive analysis showed that Korean adults with chronic diseases perceived relatively low exercise self-efficacy and relatively high exercise benefits/ barriers. Exercise self-efficacy was significantly correlated with gender, education, regular exercise, and exercise benefits/barriers was significantly correlated with gender, regular exercise. Pearson correlation coefficient showed the significant relationship between the two variables. Further researches, which are a study to evaluate a causal structure for Pender's Health Promotion Model and an intervention study to increase physical activity of chronic patients, are recommended.

The purpose of this study was to investigate the factors influencing health perception in the elderly, to provide the basic data for health behavior program and nursing intervention. The subjects of this study were 240 elderly person over the age 60, living in Seoul and Kangnung. They were conveniently sampled for this study and the data was collected from June 1999 to September 1999. The instruments for this study were the Health Perception Questionaire developed by Ware(1979), the OARS Functional Assessment Questionaire (Duke University 1978), and Multidimensional Health Locus of Control by Wallston, Wallston, and De Vills(1978). The data were analyzed by using SPSS Win computer Program. The results are as follows; 1. The total mean score of the health perception was 52.02(S.D=+/-7.07) in a range of 33 to 69, and the mean score of the functional status was 27.02 (SD=+/-2.75) in a range of zero to 28 and the mean score of the health locus of control was 65.66(S.D=+/-8.68) in a range of 43 to 90. And The mean scores on the HLOC subscales were HLOC-I: 23.73+/-4.56 (range: 6-30), HLOC-P: 23.07+/-4.74 (range: 6-30), HLOC-C: 18.55+/-4.03 (range: 11-30). 2. There was a significant positive correlation between health perception and functional status(r=.216, p=.001), and health perception and the health locus of control(HLOC) were not correlated at the level of statistical significance. However, the HLOC-I and health perception were correlated positively(r=.328, p=.000), and the HLOC-P were correlated negatively (r=-.129, p=.046). 3. There was a significant difference statistically in the degree of health perception according to the age(F=3.351, p=.002), spouse(t=2.232, p=.021), education level(F=7.373, p=.001), disease(t=3.639, p=.000), group activity (t=2.458, p=.015). drink(t=2.327, p=.021). 4. Stepwise multiple regression analysis revealed that the most powerful predictor of health perception was internal health locus of control. A combination of HOLC-I, functional status, HLOC-P, group activity explained 17.9% of the variance for health perception in the elderly. In conclusion, the results of this study show that internal health locus of control factor is very important in explaining the health perception for the elderly. Therefore, it will be considered internal health locus of control factor in nursing intervention and program in order to enforce the health behavior for elderly people.

The sample of this study consisted of 140 informal caregivers who provided care to the older adults(over 60 years of age) in Great Cleveland, USA. Self-rated questionnaires were utilized to collect information. The purpose of the study was to identify coping strategies most frequently utilized by informal caregivers of older adults and to examine predictors of the caregivers' health responses to the caregiving situation applying Lazarus and Folkman stress model(1984). Stepwise multiple regression was used to identify significant predictors among caregivers' demographic-socio-economic factors, older adult's dependency of activities of daily living(ADLs), caregiver's appraisal to the caregiving situation, and coping strategies. Informal caregivers (N=140) included in the study utilized help-seeking and problem-solving coping strategies more than self-blame and minimization of threat coping strategies. Caregivers' responses to the caregiving situation were observed by caregivers' perceived physical health, depression and life satisfaction. For perceived physical health, threat appraisal, older adult's dependency on ADLs, existential growth coping strategy, and monthly income accounted for 25% of the variance. Caregivers who appraised the caregiving situation as more threatening, reported higher dependency on ADLs, used more existential growth coping strategy, and had higher monthly income reported better physical health. For depression, threat appraisal, stress appraisal, existential growth coping strategy, self-blame coping strategy, and monthly income accounted for 48% of the variance. Caregivers who used more existential growth coping and less self-blame coping, appraised the situation as less threatening, less stressful, and had higher monthly income reported less depression. For life satisfaction, self-blame coping, existential growth coping, monthly income, stress appraisal accounted for 49% of the variance. Caregivers who used more existential growth coping, less self-blame coping, less stress appraisal, lower monthly income reported better life satisfaction. In conclusion, informal caregivers in this study utilized positive coping strategies such as problem-focused, existential growth, help-seeking, rather than negative coping strategies including self-blame. When they utilized positive coping strategies more often, caregivers experienced higher perceived physical health, higher life satisfaction and lower depression. Therefore, nursing intervention which utilized positive coping strategies is needed to enhance informal caregivers to have positive health responses to the caregiving demands.

The purpose of this study was to investigate the educational needs of a mother when nurturing children from neonates to the schoolage. A total of 657 subjects responded to the survey about the level of educational needs when nurturing children. The subjects of the study constituted of 401 mothers who visited the health center for immunization and 256 mothers who visited the pediatric outpatient department or whose children were hospitalized in pediatrics. This instrument had 64 items about nurturing children from neonates to the schoolage and one item had a score range of one to four. In data analysis, SPSSWIN 9.0 program was utilized for descriptive statistics. The results were as follows. 1) Mothers who had the neonates represented the highest educational needs about parental-neonates attachments with 3.47 of mean score compared to neonatal convulsion(3.44), management of common colds(3.44), nutrition(3.44), fever control (3.42). 2) Mothers who had infancy represented the highest educational needs about management of common colds with 3.34 of mean score compared to psychosocial developments (3.23), management of foreign bodies (3.22), feeding the food(3.19), playing with the infant(3.16). 3) Mothers who had toddlers represented the highest educational needs about psychosocial developments with 3.35 of mean score compared to discipline for children(3.34), management of teeth (3.29), management of common colds (3.21), management of accidents(3.20). 4) Mothers who had the a child in preschool represented the highest educational needs about psychosocial developments with 3.53 of mean score compared to management of accidents(3.23), discipline for children (3.00). 5) Mothers who had the child in secondary school represented the highest educational needs about psychosocial developments with 3.42 of mean score compared to management of teeth(3.13), management of accidents (3.05).

This study was to provide understanding for the juvenile problem of drug brought about by industrialization, and the importance people that we should take a role in helping to resolve the problem. The purpose of this study lies in approaching the effective methods to prevent Korean adolescents from being involved in drug by examining the factors of their experience. The method of this study is designed to grasp the adolescents' drug experience, its meaning, its structure and the nursing intervention ways. By applying a phenomenological approach which is based on a qualitative research method, the researchers hoped to reveal key data in each group. It has been carried on from October 1998 until September 1999 with sample of 5 adolescent inmates in K mental hospital located in Seoul. The data were collected by sereous personal deep interviews and observations. Collected data were analyzed according to the phenomenological method suggested by Giorgi. The results of this study are as follows: First, pleasure seeking: curiosity, joy, and fun; Second, affiliation: formation of clique with the same age; Third, escape from reality: loneliness, emptiness, heroic mind, self- confidence, self-absorption, and comfort; Forth, feeble- mindedness: anxiety, fear, and temptation; Fifth, psychological unadaptation: wandering, forfeiture, and incompetence; Sixth, physical counteraction: headache, vomiting, loss of memory, loss of appetite and loss of sensibility; Seventh, psychological confusion: illusion, auditory hallucination and dream; Eighth, recovery of self-consciousness: repentance, desire and awareness This study results in the following suggestions of the nursing intervention 1. To cultivate a wholesome game culture for the adolescents. 2. To make up the group activities so that the adolescents can establish their sense of identity through a variety of group counseling program. 3. To foster the capability to cope with the change in the process of social accommodation. 4. To enforce the social life skill for the adolescents. 5. To practice the systematic education about drug use. 6. To develop the social education programs. 7. To help the adolescents build up their sense of identity by applying the adolescent cure programs. Above all, it is necessary that school and community as well as home should establish the educational environment paying special concern and consideration to the adolescents.

The purpose of this study was to suggest directions for developing a Health Promotion Program for the elderly in Korea for the future. For this, twenty previously developed & implemented health promotion programs were reviewed and analyzed in terms of target population of the program, components of the program, measurement variables for effects of program, the effects of the program. The results were as follows. 1. Most of the target populations were older adults living independently in the community. 2. Components of the program were health education, health assessment and counseling and exercise program. - Health education was done in most of programs. The topics of health education that were often included in the programs were life style changes, medical knowledge, independent living, the concept of health promotion and changes related to aging. - In health assessment and counseling, health professionals discovered their health problems through health assessment or health risk appraisal. Then they developed health recommendations on each health problem and encouraged the elderly to implement the recommendations. 3. Variables measuring the direct effects of the program were health behavior, knowledge, attitude, skill, use of medical/health reference book. Variables measuring the indirect effects, biometric outcome, health status, functional status, medical service utilization, medical cost and wellbeing. 4. The analysis showed that health education was effective for changing health behaviors, improving knowledge, skill and attitude in the elderly. Those results were suggested to be used as guidelines for developing a health promotion program for the elderly in Korea for the future.

This study was done to compare the difference of obesity index(waist-hip ratio, body fat, body mass index, relative body weight), blood pressure and serum lipids in abdominal obesity and non abdominal in both men and women. Abdominal and non abdominal obesity was divided into waist-hip ratio above 0.85 in women and 0.95 in men. The subjects were 412 adults (age range 40-59), who had regular health examinations between 1996 to 1997 at the S-Hospital in Seoul. The data were analyzed using ANCOVA (for adjusted for age) and Pearson correlation coefficient. The results were as follows: 1. 39.9% of men and 42.5% of women had abdominal obesity. The average age group of abdominal obesity was 50.8 which is older than the non abdominal obesity group(48.0). 2. After they were adjusted for age, the group of men who have abdominal obesity had higher levels in body fat, body mass index, relative body weight, blood pressure, total cholesterol, LDL- cholesterol and triglyceride than the group of non abdominal obesity group. The group of women with abdominal obesity had higer levels in body fat, body mass index, relative body weight , blood pressure and triglyceride than the group of non abdominal obesity. 3. In the group of non abdominal obesity, the waist-hip ratio was significantly correlated to body fat, body mass index, relative body weight, blood pressure and serum lipids the group of abdominal obesity in men and women.

The purpose of this study was to examine the comparative between depression and stress related to life events among women in the menopausal stage. Menopausal stages were divided into two groups: Pre and post- menopausal stages. The degree of depression and stress related to life events between pre and post menopausal women were compared to each other. Women, aged between 41 and 59 years, answered self-reported questionnaires which included Zung's depression scale and life events scale modified by Lee (1984). Findings were as follows; 1) The mean score of premenopausal women who experienced depression was 39.66, and for post-menopausal women the score was 41.45. There was no significant differences in depression levels between pre and post menopausal group.s (t=-1.55, p=.122). 2) Menopausal women experienced low levels of stress related to life events. There were no significant differences between pre and post menopausal groups(t=.527, p>.05). Both pre and post menopausal groups were highly concerned about education issues of their children and disharmony between couples. 3) There was a significant relationship between depression and stress related to life events among post-menopausal groups (r=.22, p<.01). Based on the findings of this study, the menopausal depression was associated with stress related to life events, especially among post-menopausal women. Feelings of lost fertility and feminine attributies result in menopausal depression, which is significantly correlated with women's negative perception of their life events. Therefore, nursing intervention needs to develop to help reduce the levels of depression and overcome their negative perception of the menopausal experience. Nurses should develop nursing strategies to help menopausal women to have positive perceptions and enhance quality of life by assisting their adaptability to physiological and psychological changes related to menopause.

The purpose of this study is to evaluate the effects of Chu-ma therapy and to suggest that the therapy is an effective nursing intervention tool to reduce blood pressure. The research design employed was the non-synchronized research method with non- equivalent control group. A total of 30 people with essential hypertension, who were from forty to sixty five years old, participated in the study. The Chu-ma therapy was administered by every day for ten or fifteen minutes for eight weeks from 19, April to 13, June in 1999. In order to evaluate the effects of Chu-ma therapy, blood pressure of the two groups were measured once a week, and physiological parameters (epinephrine, norepinephrine, total cholesterol, HDL-cholesterol, triglycerides) were measured before and after the treatment. Collected data was analyzed by SAS package. The results of this study can be summarized as follows: 1) There were significant decrease in systolic blood pressure and diastolic blood pressure in the experimental group. 2) There were no significant changes in epinephrine, norepinephrine of the two groups. 3) There were significant decrease in total cholesterol and triglycerides, and HDL- cholesterol increased significantly in the experimental group. 4) The effect of Chu-ma therapy on the measured time on the blood pressure in experimental group was as follows: Both of systolic and diastolic blood pressures were significantly decreased after 5weeks. The result proved that Chu-ma therapy is an effective nursing intervention tool for clients with essential hypertenion. However further research is still necessary to compare the effect with the different periods and number of times for Chu-ma therapy.

This study was designed to develop a program for unemployed matriarchs and show if the program affected their view on the meaning in life. The subjects were women registered in an occupational training program for unemployed matriarchs, which is being practiced in the 'Working Women Center' located in Busan. The researchers selected 44 persons from the group who agreed to our program. This study was done from the 10th of March, 1999 to the 9th of October. The researchers used the measurement tools, The Purpose in Life, Self-esteem, Hope and Meaning in Life which was composed of 63 items developed by them. Their Cronbach's alpha were .88, .79, .76 and .95. The researchers analyzed the data with frequency, percentage, Mean, S.D, Wilcoxon signed ranks test which were deduced from SPSS 10.0 WIN program. The results of this study were as follows: 1) The program is composed of 'becoming intimate', 'open-minded', 'exploration on self', 'relax of repressed emotion', 'self- acceptance', 'establishing the life-goal', 'enrichment of human relationship' and closing. It took 20 hours for this program to come into practice. 2) According to the analysis of the general traits of all subjects, average age was 39.36. High school graduates were 86%, college graduates were 14% and divorce were 57%, bereavement were 18%, and the rest were 25%. 3) The result of 1st progam showed self-esteem during the program was high. 4) The result of 2nd progam showed self-esteem during the program was high. 5) The result of 3rd progam showed the sum scores of meaning in life, creative meaning, and attitudinal meaning during the program was high. 6) The result of 4th progam showed the sum scores of meaning in life and creative meaning during the program was high. On the viewpoint of above results, we convinced that 'a program for unemployed matriarch is effective to establish a stronger meaning in life. Therefore, it is demanded that support for unemployed matriarchs should not only be economic help such as technical training and help of living expenses, but also psychological, professional and systematic support.

This study was performed to identify the physiological and psychological variables related to successful weaning from a mechanical ventilator. The subjects of this study were 22 patients who received mechanical ventilation therapy for more than 3 days in intensive care units. Before the weaning trial, baseline data for following physiologic variables were obtained: spontaneous respiration rate, blood pressure, pulse rate, PaO2, PaCO2, PEEP, static compliance, minute ventilation, tidal volume, rapid shallow breathing index(f/VT), SaO2, PaO2/FiO2 and mean arterial pressure. During spontaneous breathing, physiologic and psychologic variables such as vital signs, ABG, perspiration, chest retraction, paradoxical respiration, dyspnea, anxiety, confidence and efficacy were measured. Successful weaning was defined as sustaining spontaneous respiration over 24 hours after extubation. Weaning failure was defined as the development of more than one of following signs: (1) hypoxemia, (2) CO2 retention or (3) perspiration, tachypnea, chest retraction, tachycardia, arrhythmia, hypotension or hypertension. Subjects (N=18) who successfully weaned from mechanical ventilator were compared with subjects (N=4) who failed. The results are as follows; Eighteen percents of the subjects failed during the weaning trial. Most subjects in the failed group were mechanically ventilated for long-time. This result shows that the success of weaning is more difficult in long-term ventilation patients. In the baseline data that was measured before weaning trial, the mean score of PaO2 in the successfully weaned group was 121mmHg. This is significantly higher than the mean score of PaO2 in the failed group(95mmHg). However, the scores of pH, tidal volume, f/VT, pulse rates, blood pressure, mean airway pressure, SaO2, and PaCO2 were similar between the two groups. Specially the scores of f/VT index as a predominant predictor for successful weaning were not significant (f/VT=44.4) and (f/VT=47). During spontaneous breathing, the scores of dyspnea and anxiety level in the successfully weaned group were less than those of the failed group. On the contrary, the scores of confidence and efficacy in the successful group were greater than those of the failed group. In conclusion, the baseline data that were measured before weaning trial were similar between the both groups, therefore future studies are needed to focus on searching other variables besides physiological parameters related to weaning outcome.

The purpose of this study was to provide basic information for developing a nursing intervention that helps patients learn how to acquire coping to reduce post operation uncertainty and anxiety by investigating the level of uncertainty and anxiety experienced by mastectomy patients. The subjects were 134 patients selected from St. Mary's Kangnam and St. Mary's hospital, and the data collection period was from October to December of 1998. Uncertainty was measured by using Mishel Uncertainty in Illness Scale (MUIS), anxiety measured by using State-Trait Anxiety Inventory(STAI), and coping by using a questionnaire developed by Kim & Yoo (1996). Data were analyzed with SAS program by t-test, ANOVA, Duncan's multiple range test, Pearson correlation coefficients, and stepwise multiple regression. The results were as follows: 1. The mean uncertainty score was 57.6. The results of the correlation between the compliance of medical regimen and demographic characteristics were as follows ; Those who monthly income over 2,010,000 won had lower than above 1,000,000 won, and those with the experience of chemotherapy had higher than those without, and the patient who has 7~12 months(1 yr.) post operation period had higher than the one below 6months, 25~36 months(3 yrs.), 37~60 months(5 yrs.), and over 61 months. 2. The mean anxiety score was 45.9. Anxiety tended to be increased slightly in subjects with low educational background, poor monthly income, experience of chemotherapy, and 7~12 months(1 yr.) post operation period, but there was no significant difference by general characteristics. 3. The mean value of the coping score was 100.7. The study revealed higher score in problem-focused coping than emotion-focused coping. In regard to coping by demographic characteristics were as follows ; those who had monthly income over 2,010,000 won had higher level of coping than those whose monthly income was between 1,010,000 and 2,000,000 won. In terms of problem- focused coping, those who had 25~36 months of post operation period showed significantly lower level of coping than those below 6 months or 37~60 months(5 yrs.) or over 61 months of post operation period. Regarding the emotion-focused coping, those with the christianity had significantly lower level of coping than those without it. Also, those whose monthly income over 2,010,000 won had significantly higher coping level than those with income of between 1,010,000 and 2,000,000 won. 4. A positive relationship was found between uncertainty and anxiety. Patients who experienced more uncertainty also showed more anxiety. Problem-focused coping was inversely related to uncertainty and anxiety. 5. The major variable that affected uncertainty was anxiety, explaining 63.3% of the uncertainty. In addition to this, it would explain 66.4% in total when experience of chemotherapy was added.

The purpose of this study was to construct model of sexual adjustment in people with spinal cord injury and to determine factors that relate to sexual adjustment using methodological triangulation. A total of 134 persons who were registered members of spinal cord injury organization and admitted rehabilitation unit in the hospital were included in the study. Participants answered questionnaire concerning importance of life events, sexual concern, sexual adjustment. Qualitative data were collected through semi-structured indepth interviews from 10 individuals with spinal cord injury who were previously included in the quantitative study. Constant compatative method was used to analyze the data. The results were as follows: 1) With respect to eleven other areas of life, sex life ranked the sixth and economic status ranked the highest in terms of importance. However social life ranked the lowest among the 11areas. 2) Among seven topics related to sexuality were methods and techniques to achieve sexual satisfaction, and helping a partner cope emotionally with limitation on sexual dysfunction was the second greastest. 3) The mean score for sexual adjustment was 19.47 which can be considered. 4) A process on how individuals with spinal cord injury adjust to their changed sexual life immerged from the qualitative data. It includs 4 stages: 'stage of loss' 'stage of endeavoring' 'stage of effort' and 'stage of adjustment'. Categories showing context for the action/interaction strategies were 'steadiness' and 'rediscovery as a sexual being'. There were three factors which may stimulate the adjustment process while the others may interrupt it. Those factors included personal matters, family matters and social matters. The individuals may follow each stage step by step but may go back to the previous step depending on the outcomes of their adjustment. 5) There were three factors which may stimulate the adjustment process while the others may interrupt it. Those factors included personal matters, family matters and social matters.

The purpose of this study was to develop and evaluate an internet based program for nursing informatics. The course subject, Nursing Informatics, was made by a computerized instructional module using the internet. The program was developed after taking into consideration the level of competence and knowledge in the subjects. It was based on 10 steps of the CAI module developed by Alessi and Trollip. The subjects consisted of 76 junior nursing students taking a Nursing Informatics course. Two sets of questionnaires were used for this study. First, a questionnaire was administered to 76 students to collect general information on their experience while using computers and the internet. Secondly, another questionnaire was administrated to 76 students after they took the course. They were asked to evaluate the program in terms of easiness of use, precision of contents, freshness of contents, motivation in learning, effectiveness of learning, enhancement of communication, precision of screen, and interest in the contents. IDs and passwords were given to the students. The students were asked to write their IDs and passwords when they connected to Nursing Informatics (http://hallym.ac.kr/~yhyom/inform.html). They were led the menu page which was categorized into 8 icons (i. e., syllabus, lecture notes, quick test, Q & A board, assignment, on-line test, related web sites and mailing lists) after confirming their IDs and passwords. The students' responses were very positive. This program was a very useful in increasing the effectiveness of learning and motivation in the students. Suggest to be use for other nursing courses.

As cost pressures have escalated, policy makers, politicians, health care providers and families have tried to devise ways to reduce health care costs. While originally developed to enhance patient control and to provide better care at the end of life, hospice care has recently received significant attention as a mean of reducing health care costs. As a program providing care for patients who are dying at their homes, hospice has expanded slowly since the opening of the first hospice in Korea in 1963. Therefore, a variety of services that responds to the needs and concerns of many dying people and their families is limited The purpose of this study was to determine the potential cost savings at the end of life among patients who used home hospice compared with the patients who received institutional care in Korea. This study used a retrospective, descriptive design. The sample for this study included 46 patients who died of lung cancer: 25 patients who received home hospice care and 21 patients who received institutional care. Data on patient characteristics, kinds and frequencies of provided treatment and nursing services, and hospice and hospital charges during the last month before death were collected. Cost of care was measured by the average cost per patient per day in the last month of life. The results of the study indicated that there were significant differences in average cost of care between home hospice sample and institutional care sample (t=9.956, p<.001; home hospice sample: M=18,102 won, institutional care sample: M=317,578 won). The cost of the home hospice sample was approximately 6% of the cost of institutional care. The majority of the home hospice nursing services were education (35.7%) and supportive counseling (25.2%), followed by medication management (13.6%), assessment (12.1%), basic nursing (7.2%), treatment (5.5%) and others. In institutional care sample, basic nursing and treatment were more emphasized than education or supportive counseling among the nursing services provided. The results of this study showed the potential for hospice to reduce costs and implications for policymakers and clinicians to incorporate hospice program into the formal health care delivery system in Korea.

The purpose of this study was to develop, through the integration of instructional theory, a Courseware and to investigate the effectiveness of a web-based computer assisted instruction(WBI) program for preventing drug abuse, a serious problem for youth problem. During the first stage of this study done "Drug Abuse Prevention" Courseware was developed based on, Gagn & Brigg's instructional design theory, Keller's ARCS theory and the CAI model of Hannafin & Peck. For the second stage, the courseware was used to provide education for students adolescents in drug abuse prevention. This study used an quasi-experimental, one-group pretest-posttest design with a convenience sample of 36 male high school students who were at one high school located in Seoul. Data were collected using self-reported questionnaires which included a learning achievement tool, the Keller's IMMS (Instructional Material Motivation Survey), on attitudes to drug use, and on responses to the WBI instruction. Prior to the experiment, the "drug abuse prevention" learning method and the procedures of the study were explained to the students, and then the learning achievement of the subjects was measured as a pretest. The students were then given 2 weeks WBI utilizing the courseware. A post-test which included the pre-test learning achievement questionnaire and a survey of learning motivation and attitudes toward drug were given two weeks after the education was completed. The data analysis was done using SPSS/PC. Paired t-test was used to analyze the differences between the pre-test and post-test scores for learning achievement. The results of the analysis are as follows: There were significant differences in learning achievement between the pre-test and post-test(t=-18.62, p=0.000). The hypothesis, that learning achievement will be higher, after the class has used the courseware, than before was supported. The scores for learning motivation and attitudes toward drugs were also higher than the results of existing studies. In conclusion, this study suggests that WBI is an effective learning method in the prevention of drug abuse for adolescents as it can be used for self-learning and repeated learning as assisted instruction. Recommendation would be given that further research needs to be develped in the courseware by cognitive learning style and by multimedia courseware and virtual reality system.

The purpose of this study is to develop self-efficacy promotion program and to test its effects on self-efficacy, self-care, physiologic index of hemodialysis patients after applying this program to them. Preliminary study was carried out to identify the levels and types of self-care, self-efficacy of hemodialysis patients. To develop self-efficacy promoting program, several discussions with nursing professors and nurse specialists on hemodialysis patients were made after in-depth literature review on the area. Through these processes, the self-efficacy promoting program including 20 minutes long videotape and other counciling documents were completed. This videotape consisted of specific self-care techniques for hemodialysis patients including management of fistula, measurement of blood presure and body weight, special diets, medications, exercise and rest, management of physical problems and social adjustment. Two group equivalent pre and post test quasai-experimental research design was used in this study. The total subjects were 34 hemodialysis patients who received hemodialysis three time per week at 1 university hospital. Seventeen experimental group subjects were matched with control group subjects in sex and age. Data were analysed with the SPSS window program. Homogeniety between experimental and control group pretest data was tested by 2 and t-test. There were no significanct differences in general characteristics, illness history, specific self-efficacy and self-care between the two groups. The differences of general self-efficacy of two groups were tested with the Repeated Measure ANCOVA because of significant differences of pretest data of general self efficacy between two groups. The differences of self-efficacy and self-care of two groups were tested with Repeated Measure ANOVA and the differences of physiologic indecies including blood potassium level and blood phosphorus level and interdialytic weight gain were tested by t-test. The results were as follows: 1. There was no significant difference in general self-efficacy between the two groups over four different time, and no interaction by groups and by time. 2. There was significant difference in specific self-efficacy between the two groups over four different time, and interaction by groups and by time. 3. There was significant difference in self-care between the two groups over four different time, and interaction by groups and by time. 4. There were no significant differences of blood potassium level and blood phosphorus level, but there was significant difference of interdialytic weight gain between the two groups. From the results above, it can be concluded that the self-efficacy promotion program for hemodialysis patients was effective to improve degree of specific self-efficacy and self-care and to decrease interdialytic weight gain. Considering results, the followings are recommended: 1) Repeated studies are needed for another hemodialysis patients. 2) This program can be used for improving degree of self-efficacy and self-care of hemodialysis patients by nurse practitioner and nurse educator.

The purpose of this study was to develop and to evaluate the Computerized Nursing Diagnosis/ Intervention System for Nutritional and Eliminative Problems for clinical application. Each stage was processed based on the System Development Life Cycle. At the Strategy Planning Stage, valid nursing diagnoses and interventions were chosen. At the System Analysis Stage, a nursing diagnosis and intervention flowchart was drawn up. At the System Design Stage, a system was developed based on the flowchart and named the Nursing Diagnosis/Intervention System. The Nursing Diagnosis/Intervention System consisted of the Patient's Basic Information, Patient's Nursing Process, Nursing Process, and Code Registration. Each element in flowchart was coded and made into a database. The System was used and evaluated. A total of 30 cases were collected. After the application, the nurses evaluated the System using a 5 point Likert scale. Every item was scored at three points or more and 13 out of 17 items were scored at four points or more, thus the Nursing Diagnosis/Intervention System that was developed in this study was regarded as a useful one.