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Volume 38(5); October 2008
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Original Articles
A Structural Equation Model on Sexual Function in Women with Gynecologic Cancer
Nami Chun
J Korean Acad Nurs 2008;38(5):639-648.   Published online October 30, 2008
DOI: https://doi.org/10.4040/jkan.2008.38.5.639
AbstractAbstract PDF
Purpose

This study was designed to construct and test a structural equation model on sexual function in women with gynecologic cancer.

Methods

The model was constructed and tested under the hypotheses that women's physical changes in sexual function after gynecologic cancer treatment did not automatically lead to sexual dysfunctions. Women's psychosocial factors were considered to be mediating variables. Two hundred twelve women with cervical, ovarian, and endometrial cancer were recruited and asked to complete a survey on their physical factors, psychosocial factors and sexual function. Data was analyzed using SPSS WIN 12.0 and Amos WIN 5.0.

Results

Predictors of sexual function in the final model were sexual attitude affected by physical distress and couple's age, sexual information affected by physical distress and couple's age, depression affected by physical distress, and marital intimacy affected by physical distress. Tumor stage and time since last treatment directly affected women's sexual function without any mediating psychosocial variables. However, body image did not affect women's sexual function.

Conclusion

Nursing professionals should develop a tailored educational program integrating both physical and psychosocial aspects, and apply it to women and their spouses in order to promote sexual function in women with gynecologic cancer.

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Factors Influencing Quality of Life in Patients with Gastrointestinal Neoplasms
Eun Ok Lee, Aeyong Eom, Rhayun Song, Young Ran Chae, Paul Lam
J Korean Acad Nurs 2008;38(5):649-655.   Published online October 30, 2008
DOI: https://doi.org/10.4040/jkan.2008.38.5.649
AbstractAbstract PDF
Purpose

The purpose of this study was to identify the factors influencing quality of life after analyzing the relationship between depression, health promotion and quality of life in patients with gastrointestinal neoplasms.

Methods

The subjects of this study were 63 people who underwent treatments from 2 general hospitals in Seoul and Daejeon and had no recurrence in stages I & II of gastrointestinal neoplasms. Data was collected from March 1 to April 30, 2006. A questionnaire consisting of Center for Epidemiologic Studies Depression (CES-D), Health Promoting Lifestyle Profile II (HPLP II) and Functional Assessment of Cancer Therapy-Colorectal (FACT-C) was given. The collected data was analyzed with the SPSS program which was used for descriptive statistics, Pearson correlation coefficients and hierarchical multiple regression.

Results

The major findings of this study were as follows: 1) There was a significant relationship between depression (r=-.639, p=.000), health promotion (r=.407, p=.001) and quality of life. 2) Significant factors were depression (F=-4.091, p=.000) and health promotion (F=2.375, p=.021) that explained 46% of quality of life (F=10.022, p=.000).

Conclusion

Cancer patients experienced extreme depression which led to a negative effect on quality of life. Health promotion was an important variable to the quality of life and it gave the patients motivation for having a will and belief for better health.

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Development of Nursing Key Performance Indicators for an Intensive Care Unit by using a Balanced Scorecard
Yun Jeong Choi, Ji Young Lim, Young Whee Lee, Hwa Soon Kim
J Korean Acad Nurs 2008;38(5):656-666.   Published online October 12, 2008
DOI: https://doi.org/10.4040/jkan.2008.38.5.656
AbstractAbstract PDF
Abstract Purpose

The purpose of this study was to develop visions of nursing service, nursing strategies and key performance indicators (KPIs) for an intensive care unit (ICU) based on a Balanced Scorecard (BSC).

Methods

This study was undertaken by using methodological research. The development process consisted of four phases; the first phase was to develop the vision of nursing in ICUs. The second phase was to develop strategies according to 4 perspectives of a BSC. The third phase was to develop KPIs according to the 4 perspectives of BSC and the final phase was to combine the nursing visions, strategies and KPIs of ICUs.

Results

Two main visions of nursing service for ICUs were established. These were ‘realization of harmonized professional nursing with human respect’ and ‘recovery of health through specialized nursing’ respectively. In order to reach the aim of developing nursing visions, thirteen practical strategies and nineteen KPIs were developed by four perspectives of the BSC.

Conclusion

The results will be used as objective fundamental data to attain business outcomes for the achievement of nursing visions and strategies of ICUs.

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The Relationship between Lifetime Sports Activity Measured with MET and Peak Strain Score and Bone Measurement in College-aged Women
Eun-Nam Lee, Eun Jung Choi
J Korean Acad Nurs 2008;38(5):667-675.   Published online October 30, 2008
DOI: https://doi.org/10.4040/jkan.2008.38.5.667
AbstractAbstract PDF
Purpose

The aim of this study was to compare the relation between differently measured sports activities (metabolic equivalent [MET] and peak strain score) and distal radius bone mineral density in college-aged women.

Methods

Lifetime sports activity was scored in two different ways: 1) a sports activity score by multiplying the intensity (METs) and duration and 2) a sports activity score by adding up physical strain scores based on the ground reaction force of each sports activities. Bone mineral density was measured using dual energy x-ray densitometry (DTX-200) in the distal radius site.

Results

In stepwise multiple regression analysis, body weight and sports activities during the college period were significant positive predictors for distal radius bone mineral density. The explained variance of sports activity measured with a peak strain score (8.8%) for distal radius bone mineral density was higher than one measured with the MET score (3.3%).

Conclusion

It can be concluded that sports activity scores based on MET and peak strain scores during college are very important for determining the bone mineral density in the distal radius site in women under 30.

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Falls Risk Factors of Inpatients
Eun-Kyung Kim, Jae Chang Lee, Mi-Ran Eom
J Korean Acad Nurs 2008;38(5):676-684.   Published online October 30, 2008
DOI: https://doi.org/10.4040/jkan.2008.38.5.676
AbstractAbstract PDF
Purpose

The purpose of this study was to identify the risk factors for falls and to suggest data for developing a program for preventing falls.

Methods

This was a case-control study in five university hospitals and a general hospital. In total, 216 patients over the age of 18 yr admitted from January 1 to December 31, 2007 participated. One hundred eight patients with experience of falling were matched by gender, age level, diagnosis, and length of stay with 108 patents with no experience of falling admitted on the same unit. A quality assurance coordinator nurse in each hospital examined 35 fall risk factors developed by researchers.

Results

In acute hospitals, history of falls, orientation ability, dizziness or vertigo, general weakness, urination problems, transfer/mobility difficulty, walking dependency, impatience, benzodiazepines, diuretics, and vasodilators showed significance on adjusted-odds ratios for fall. Logistic regression analysis was performed to elucidate the factors that influence falls. The probability of falls was increased by dizziness/vertigo, general weakness, and impatience/agitation.

Conclusion

This finding can be used as a useful resource in developing nursing intervention programs to predict and prevent the falls of inpatients.

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Comparative Study on the Sleep Patterns, Satisfaction of Sleep, and Sleep Enhancement Behaviors between Hospitalized and Non-hospitalized Elderly
Kwuy Bun Kim, Jung Sook Yun, Sohyune R Sok
J Korean Acad Nurs 2008;38(5):685-693.   Published online October 30, 2008
DOI: https://doi.org/10.4040/jkan.2008.38.5.685
AbstractAbstract PDF
Purpose

This study was to compare and analyze sleep patterns, satisfaction of sleep, and sleep enhancement behaviors between hospitalized and non-hospitalized elderly.

Methods

Subjects were 201 older adults, who were hospitalized patients or living in U-city, Gyung-gi province. Data was collected from June 10 to August 25, 2007, and was analyzed by the SAS program.

Results

1) Non-hospitalized elderly had better sleep patterns than hospitalized elderly patients. 2) There was a strong positive correlation between sleep patterns and satisfaction of sleep in both groups. 3) In hospitalized elderly, there were significant differences in sleep patterns and satisfaction of sleep by month. 4) In non-hospitalized elderly, there was a significant difference in sleep patterns by presence or absence of spouses. There was a significant difference in satisfaction of sleep by those living with others. There were significant differences in sleep enhancement behaviors by age, religion, length of time, and sponsors.

Conclusion

To relieve sleep disturbances of elderly, comprehension of sleep of the aged by nursing care givers should be obtained. Also, improving environments and elder's self-esteem with religious consideration and preparation of financial conditions are needed to promote the sleep of hospitalized and non-hospitalized elderly.

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Quality of Life in Low Income Korean Aged
Hye-Ryoung Kim, Kasil Oh, Kyong-Ok Oh, Sun-Ock Lee, Sook-Ja Lee, Jeong-Ah Kim, Hoa-Yun Jun, Jung-Hee Kang
J Korean Acad Nurs 2008;38(5):694-703.   Published online October 30, 2008
DOI: https://doi.org/10.4040/jkan.2008.38.5.694
AbstractAbstract PDF
Purpose

The purpose of this study was to identify the quality of life and its predictors in low income Korean aged.

Methods

This was a predictive correlational study. An accessible sample from the population of people who were 65 and over and were supported by the basic livelihood security system was 1,040. Quota sampling with strata of state division in the nation was chosen. Quality of life and its predictors in the subjects were measured.

Results

The mean quality of life in the subjects was 47.0±10.7. Predictors of this study significantly explained 54.3% of the total variance of quality of life. Depression was the most significant predictor of quality of life. Health problems, district, social support, leisure activity, and health behavior had effects on quality of life.

Conclusion

This finding indicates that quality of life in lower income Korean aged is different from other populations by economic status. Demographics, health status and social status were predictors of quality of life in the aged with a small income.

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The Effects of Psychosocial Rehabilitation Programs on the Levels of Self-Efficacy for Mentally Disabled Persons
Hyun Sook Park, Sung-Woo Bae, Yi Young Kim
J Korean Acad Nurs 2008;38(5):704-711.   Published online October 30, 2008
DOI: https://doi.org/10.4040/jkan.2008.38.5.704
AbstractAbstract PDF
Purpose

This study investigated the effects of psychosocial rehabilitation programs provided by a psychosocial rehabilitation center on the levels of self-efficacy for mentally disabled persons. We followed the study subjects for 2 yr in order to examine whether the psychosocial rehabilitation programs had a positive impact on their levels of self-efficacy.

Methods

There were 18 subjects in the experimental group and they received all the psychosocial rehabilitation services available at the psychosocial rehabilitation center for 2 yr. In the comparison group, there were 17 participants who voluntarily refused to participate in the psychosocial rehabilitation programs.

Results

The results indicated that the psychosocial rehabilitation programs were effective in increasing the levels of the self-efficacy total score and specific self-efficacy score.

Conclusion

The overall study results indicated that psychosocial rehabilitation programs provided by a psychosocial rehabilitation center had a positive impact on increasing the levels of self-efficacy for mentally disabled persons.

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Factors Associated with Social Isolation in Older Adults using Senior Welfare Centers
Yeon-Hwan Park, Hee Sun Kang
J Korean Acad Nurs 2008;38(5):712-719.   Published online October 30, 2008
DOI: https://doi.org/10.4040/jkan.2008.38.5.712
AbstractAbstract PDF
Purpose

The purpose of this study was to investigate the factors associated with social isolation in older adults using a senior welfare center.

Methods

This study was a cross-sectional survey. Data was collected from June to August 2006 using a questionnaire. A total of 248 older adults responded.

Results

About one third (34.9%) of participants responded they felt socially isolated. There were statistically significant differences in living, religion, family and belongingness social support, loneliness, depression, family function, perceived health status, and number of chronic illnesses between socially isolated and non isolated groups. However, factors influencing social isolation were family function (OR=0.954, CI=0.926-0.982), loneliness (OR=1.042, CI=1.002-1.083), depression (OR=1.041, CI=1.002-1.081), and number of chronic illness (OR=1.657, CI=1.153-2.382).

Conclusion

We found that some older adults were feeling socially isolated even though the senior welfare center was a good place to meet people. The findings of this study indicated that older adults suffering from social isolation need special attention and may benefit from interventions which promote health and social interactions. Further studies are needed to develop and evaluate an intervention program for this population.

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The Effects of Preemptive Analgesia of Morphine and Ketorolac on Postoperative Pain, Cortisol, O2 Saturation and Heart Rate
Yun Ju Seo, Haesang Yoon
J Korean Acad Nurs 2008;38(5):720-729.   Published online October 30, 2008
DOI: https://doi.org/10.4040/jkan.2008.38.5.720
AbstractAbstract PDF
Purpose

This study investigated the preemptive analgesic effects of Morphine and Ketorolac on postoperative pain, cortisol, O2 saturation and heart rate for the first 24 hr after abdominal surgery.

Methods

Data collection was performed from April 1 to September 30, 2006. Forty patients undergoing a gastrectomy under general anesthesia were randomly allocated to the experimental or control group. The experimental group (20 patients) was administered Morphine and Ketorolac approximately 1 hr prior to skin incision, but the control group (20 patients) was administered Morphine and Ketorolac at peritoneum closure through a patient-controlled analgesia (PCA) pump. Postoperative pain, blood pressure, heart rate, cortisol, O2 saturation, frequency of the PCA button pressed and doses of additional analgesics were observed through post operative 24 hr. Collected data was analyzed using t-test, χ2 test, repeated measures ANOVA, and Bonferroni methods.

Results

Postoperative pain, cortisol, the frequency of PCA button pressed, and dose of additional analgesics of the experimental group were significantly lower than the control group. There were no statistical differences in blood pressure, heart rate and O2 saturation between the experimental group and control group.

Conclusions

We concluded that administration of morphine and ketorolac at 1 hr prior to skin incision resulted in decreasing postoperative pain, but it didn't affect blood pressure, heart rate or O2 saturation for 24 hr after abdominal surgery.

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The Mediating Effect of Depression in the Relationship between Muscle Strength of Extremities and Falls among Community-Dwelling Elderly
Hyoung-Sook Park, Kyung-Yeon Park
J Korean Acad Nurs 2008;38(5):730-738.   Published online October 12, 2008
DOI: https://doi.org/10.4040/jkan.2008.38.5.730
AbstractAbstract PDF
Abstract Purpose

The purpose of this study was to identify the mediating effect of depression in the relationship between muscle strength of extremities and falls among community-dwelling elderly.

Methods

Two hundred forty-seven participants were recruited from a public health center, a hall for the aged and a school for the aged in B city. Face-to-face interviews were conducted using questionnaires from May to September of 2007. Data was analyzed with descriptive statistics, Pearson correlation, and multiple regression using the SPSS WIN 14.0 program.

Results

There was a significantly negative relationship between muscle strength of lower extremities and falls, muscle strength of left upper extremity and falls, and muscle strength of right upper extremity and falls. Depression positively correlated with falls. Depression showed mediating effects between muscle strength of extremities and falls. Weakness of muscle strength of extremities increased depression and the increased depression increased the frequencies of falls.

Conclusion

For the effective management and prevention of community-dwelling older adults’ falls, exercise programs including depression-decreasing strategies should be established. These exercise programs can decrease depression which is the mediator role between the degrees of muscle strength of extremities and falls.

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The Life of Elderly Women Living Alone
Chunmi Kim, Moon Hee Ko, Moon Jeong Kim, Joohyun Kim, Hee Ja Kim, Jin Ha Moon, Kyoung Seon Baek, Haeng-Mi Son, SangEun Oh, YoungAe Lee, Jung-Sook Choi
J Korean Acad Nurs 2008;38(5):739-747.   Published online October 12, 2008
DOI: https://doi.org/10.4040/jkan.2008.38.5.739
AbstractAbstract PDF
Abstract Purpose

This study aimed to uncover the fundamental nature of living alone in female elderly.

Methods

The phenomenological research approach developed by van Manen was adopted.

Results

The theme was ‘taking a firm stand alone on the edges of life’. The composition elements of living alone experienced by elderly women were as follows: 1) Corporeality: participants perceived their bodies by their health status. Unhealthy participants were suffering with diseases and dependant on other persons, while healthy participants were free from family responsibility and kept on moving. 2) Spatiality: participants felt both freedom and loneliness while they stayed home. 3) Relationality: participants felt pity and yearning for their bereaved husband and sometimes talked to his picture. According to their children’s filial piety, participants were pleased or displeased. However, they incessantly devoted themselves to their children. 4) Temporality: participants considered the rest of their life as extra-time which was proceeding to death, and tried to keep themselves busy before they died.

Conclusion

A nurse should understand the multifarious aspects of elderly women’s life, and then intervene to consolidate their strengths for self-supporting the final years of life.

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Menstrual Attitudes and Maternal Child Rearing Attitudes in Middle School Female Students
Kyoung Ja Hong, Hae Won Kim, Hye Young Ahn
J Korean Acad Nurs 2008;38(5):748-757.   Published online October 30, 2008
DOI: https://doi.org/10.4040/jkan.2008.38.5.748
AbstractAbstract PDF
Purpose

This correlational study was performed to identify the impacts of maternal child rearing attitudes on the menstrual attitudes and the determinants of positive menstrual attitudes in female middle school students.

Methods

With convenience sampling, 198 middle school female students were recruited living in one major city and its surrounding areas in Korea. Data was collected using a self administered questionnaire including menstrual attitudes and maternal child rearing attitudes from April 1 to July 15, 2008.

Results

Among the Maternal child rearing attitudes, affectionate, achievement oriented and rational attitudes had positive correlations to a positive menstrual attitude, and an autonomous attitude had a negative correlation to a negative menstrual attitude. As determinants of positive menstrual attitudes, feeling of menarche, mother's response at first menstruation, and rational maternal child rearing attitudes were delineated and their explained variance for a positive menstrual attitude was 18.5%. There was no difference on menstrual attitudes by K clustering in terms of maternal child rearing attitudes.

Conclusion

These results support the critical role of the mother. Especially desirable maternal child rearing attitudes in relation to a positive menstrual attitude would be affectionate, achievement oriented and rational for early adolescent girls. In further studies, considerations are needed for menstruation related education and research for early adolescents and active involvement of the mother & daughter together.

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Meaning of Life in Wives of Alcoholics: Autobiographical Method
Sunhee Cho
J Korean Acad Nurs 2008;38(5):758-767.   Published online October 30, 2008
DOI: https://doi.org/10.4040/jkan.2008.38.5.758
AbstractAbstract PDF
Purpose

The purpose of this study was to explore and describe life-stories and meanings of life in wives of alcoholics by analyzing their autobiographies.

Methods

Autobiographies were collected from 20 participants who produced their own autobiographies in the logotherapeutic autobiography program at community alcohol counseling centers in Korea. The data were coded to identify themes of agency and communion using the manual coding system developed by McAdams, and analyzed by the existential approach.

Results

There were 214 coded episodes in twenty autobiographies. There were 128 agency themes and 86 communion themes. The most common themes were Love/Friendship. Five themes emerged from the autobiographical episodes on the existential perspective: 1) overcoming the suffering, 2) meaningful people and relationships, 3) spiritual maturation, 4) caring and helping, and 5) finding a meaning of life.

Conclusion

These results showed that the wives of alcoholics who participated in the logotherapeutic autobiography program found the meaning of life through their suffering. Furthermore, a study on existential nursing interventions for people who have meaninglessness in life needs to be done.

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Re-employment Experience of Nurses Who Have Left the Profession
Young Soon Byeon, Miyoung Kim
J Korean Acad Nurs 2008;38(5):768-778.   Published online October 30, 2008
DOI: https://doi.org/10.4040/jkan.2008.38.5.768
AbstractAbstract PDF
Purpose

The purpose of this study was to explore the re-employment process of inactivated nurses returning to the nursing field and to develop a grounded theory about their re-employment experiences.

Methods

Data was collected through a face-to-face interview and telephone interviews from 10 nurses. The ground theory methodology of Strauss and Corbin (1998) was used for theoretical sampling in accordance with their unemployment period and reason for leaving prior to reemployment; whereas works of data collection and analysis were performed concurrently.

Results

The core category was discovered to be 'identifying a career path by striking a balance between the practical and the ideal'. This series of processes was categorized into five stages: 'trying to get a job again', 'tolerating difficulties as a beginner', 'trying their best to remain a nurse', 'trying to get another job', and 'staying in the profession till the end'.

Conclusion

The results of this study suggest an understanding and profound insight on the issue of a nursing shortage.

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