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Volume 29(6); December 1999
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Original Articles
Assessment of Appetite and Nutritional Status in Cancer Patients Undergoing Radiation Therapy: A Prospective Study
Hyang Sook So
Journal of Korean Academy of Nursing 1999;29(6):1179-1191.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1999.29.6.1179
AbstractAbstract PDF

This study was conducted to identify appetite and nutritional status of 48 cancer patients who have been irradiated over 150 cm2 on chest or pelvic area over the three-month period. The data were gathered 3 phases, Each from initiation to completion of radiotherapy through the questionnaires of anorexia, the anthropometric and biochemical measures were used such as weight, TSF, MAC, MAMC, serum albumin and hemoglobin, TLC. Using SAS program, data were analyzed by percentage, Mean+/-SD, and two-way repeated measures ANOVA. The results were summarized as follows: 1. Eighty five percent(85%) of the subjects were aged from fifties to sixties. Cancers in the chest area occurred in 100% of men, 56% of the all subjects. The other 44% were pelvic cancer and 71% of the pelvic cancer occurred in women. 2. There were no significant differences in the appetite scores by all groups(characteristics). Changes of the appetite score over time were statistically significant by age, sex, cancer areas staging, treatment modality, and radiation dosage (F=4.0, p=.022; t=6.09, p=.003; t=4.90, p=.009; F=3.28, p=.042; t=5.04, p=.0084; t=4.76, p=.011). The appetite score on the 2nd phase (4 weeks after initiating radiotherapy) decreased from the 1st phase (initiating irradiation), and then increased on the 3rd phase (completing irradiation). 3. There were no significant differences in the body weight and MAMC by all characteristics, and no changes in the body weight and MAMC over time. However there were significant differences of TSF, MAC, level of hemoglobin, level of albumin, and TLC by all characteristics during the three phases. TSF of the men and the chest cancer were lower than those of the women and the pelvic cancer (t=73.20, p=.0001; t=22.91, p=.0001). And there was significant difference by cancer staging(F=3.19, p=.050). But there was no change in TSF over time. MAC of the men and the chest cancer were lower than those of the women and the pelvic cancer each(t=9.23, p=.004; t=17.85, p=.0001). But no change in MAC over time. Levels of hemoglobin had significant differences by age, sex and cancer areas; levels of hemoglobin of older than the fifties, men, and chest area were higher than those on the others(F=3.82, p=.029; t=21.75, p=.0001; t=8.71, p=.005). Levels of albumin were significant differences by sex and cancer areas; levels of albumin on women, and pelvic area were higher than those on the others(t=6.34, p=.015; t=15.23, p=.0003). While the levels of hemoglobin were changed over time, levels of albumin were not changed and within normal limit. TLC of the men was higher than women(t=5.05, p=.029). Changes in the level of hemoglobin over time were statistically significant according to sex, cancer areas, and radiation dosage(t=3.49, p=.035; t=3.36, p=.039; t=4.04, p=.021).

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Development of Structural Equation Model for Causal Relationships Among the Risk Factors of Arteriosclerosis
Hyun Soo Oh, Wha Sook Seo
Journal of Korean Academy of Nursing 1999;29(6):1192-1207.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1999.29.6.1192
AbstractAbstract PDF

The purpose of this study was to clarify the dynamic relationships among risk factors of arteriosclerosis and to develop and examine a model which could explain this relationship clearly. Data were collected from medical records of 400 male clients who visited a university hospital located in Inchon for physical examinations, from May 1996 to December 1996. Data were analyzed using the LISREL (Linear Structural Relationship) 8 program. To test the fitness of the hypothesized model, chi-square, RMSR (root mean square residual), GFI (goodness of fit index), CN (critical number) and Q-plot were used. Most of the fitness measurements, except the chi-square showed that the hypothesized model complimented the real data. According to the results, there were trends that obesity and hyperlipidemia were prevalent in heavier smokers, higher alcohol intakers, and groups who excercised less. Also, hypertension was more prevalent in older age, higher alcohol intaker, and higher serum lipid level groups. In contrast to the hypothesis, alcohol intake did not significantly affect serum lipid levels. This might be due to the serum lipid measurements (total cholesterol and trigryceride) used in this study to estimate hyperlipidemia. The direct effect of smoking on hypertension was not significant. However, the total effect of smoking on the hypertension was significant since indirect effects of smoking on hypertension, such as obesity and hyperlipidemia, were significant. The total effect of obesity on hypertension was significant since the indirect effect of obesity on hypertension via hyperlipidemia was significant, although the direct effect of smoking on hypertension was not significant. The degree of explaining hyperlipidemia with smoking, exercise, and obesity was high (60%), however, the degree of explaining obesity with age, smoking, alcohol intake, and exercise was very low (7%). On the basis of these results, high risk factors of arteriosclerosis such as hypertension, hyperlipidemia, or obesity are either directly or indirectly correlated each other. Therefore, it is difficult to predict outcomes for increasing or decreasing the risk factors by simply modulating a factor. Smoking, alcohol, and exercise both directly and indirectly affected major risk factors of arteriosclerosis. Therefore, correcting these variables is required to decrease risk factors. Finally, the relationship among other risk factors which have been known to be related with arteriosclerosis (diet, stress or hereditary) should be clarified in further studies.

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A Comparison of Phenomenological Research Methodology: Focused on Giorgi, Colaizzi, Van Kaam Methods
Boon Han Kim, Keum Ja Kim, In Sook Park, Keum Jae Lee, Jin Kyung Kim, Jeong Ju Hong, Mi Whang Lee, Young Hee Kim, In Young Yoo, Hee Young Lee
Journal of Korean Academy of Nursing 1999;29(6):1208-1220.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1999.29.6.1208
AbstractAbstract PDF

The purpose of this study was to describe the differences in three phenomenological research methods used to understand the experience of families of patients with cancer and so provide as guideline to novices first attempting qualitative research. The subjects were 3 family members - spouse, daughter, daughter-in-law -of cancer patients at S-hospital. Unstructured deep interviews were carried out and taped for further analyzed. Interviews were analyzed using three phenomenological methods ; Giorgi's, Colazzi's, and Van Kaam's. The results are as follows: The experience of family the analyzed using Giorgi's method showed different characteristics according to the family members' role. According to Colaizzi's method, they experienced burden, a willingness to care, role conflict, thanks to family and significant others, and ambivalence about treatment. Using Van Kaam's methodology, two categories were identified ; change of family function and burden. Themes in change of family function were positive attitude(9), role conflict(6), negative attitude(5), active attitude(2), and passive attitude(2) ; Themes in burden were emotional burden, physical burden, and economic burden. The result from using Giorgi's method were centered or individual characteristics and these results constituteds situational structured description and a general structured description. From Colaizzi's method the focus was on the common experience of all fo the subjects. In Van Kaam's method, subthemes (13), themes(8), and categories(2) were identified. So researchers should choose the qualitative method according to their research goals and methodological characteristics.

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The Concept of Hwa-Byung in Nursing
Soon Yong Khim
Journal of Korean Academy of Nursing 1999;29(6):1221-1232.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1999.29.6.1221
AbstractAbstract PDF

The purpose of this study was to study how nurses interpreted the meaning of Hwa-Byung. It was carried through a review of literature, and the result is expected to explore ways that nursing intervention can promote the understanding of Hwa-Byung. The literature review focused on cultural psychology and psychiatrists' views toward Hwa-Byung. After that, it was reconfirmed concept of Hwa-Byung in nursing devived from historical analysis of the examples of Hwa-Byung from a true record of the Cho-Sun Dynasty(CD ROM, 1997). Characteristics of patients with Hwa-Byung include 'Hwa', an aspect of somatization, and self-diagnosing. It also could find that Hwa-Byung is characterized as 'Hwa', 'somatization' and 'self-diagnosis(subjectiveness)' according to a true record of the Cho-Sun Dynasty(CD ROM, 1997). The conceptual definition of 'Hwa', 'somatization' and 'self-diagnosing (subjectiveness)' are as follows. The core concept of Hwa-Byung, 'Hwa,' has the property of 'fire', and equals the feeling of injustice. Hwa-Byung means congestion of 'Hwa'. Therefore Hwa-Byung is the accumulation of being mistreated and mortified. The feeling of mistreatment comes from subjective experiences, which cannot be in harmony with the values, beliefs and rights of the patients. The situations that they have to endure again and again, though they are the sufferers, connote suppressed aggression and powerlessness endured over time. Suppressed aggression subordinated hostility, hatred and revengeful thoughts; powerlessness subordinates frustration, resignation, and fatalism. Somatization is another form of expressing 'Hwa' through physical symptoms. The somatization of clients with Hwa-Byung plays a role in expressing non-verbalized and suppressed emotions within themselves. The clients who experiences Hwa-Byung think that they know the cause of their illness and self-diagnose their problem as Hwa-Byung. Therefore, the feeling of unfairness which is the premise of Hwa-Byung infers 'subjectiveness' In conclusion, nursing's concept of Hwa-Byung is the accumulation of feelings of being mistreated and mortified. Hwa-Byung is the internalized 'Hwa' from enduring again and again. The feeling of being mistreated comes from subjective judgements about unfairness that cannot be harmonized with the clients' values, beliefs and rights. Those who can express their 'Hwa' only through their bodies imply suppressed aggression and powerlessness.

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The Lives of Daughters-in-Law Who Care for Parents with Dementia
Hyun Sook Kang, Keum Ja Go, Won Ock Kim, Eun Sim Kim, Soon Yong Khim, Hyun Li Kim, Soon Ok Shin, Sang Eun Oh, Jeong Sook Won, Chun Yu Li, Min Jung, Nam Hee Choe
Journal of Korean Academy of Nursing 1999;29(6):1233-1243.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1999.29.6.1233
AbstractAbstract PDF

This study was done to investigate the lives of the daughters- in- law caring for parents with dementia and participate in their lives through having quality time with them. Data were collected by depth interviews and interpreted through the hermeneutic circle as follows. These daughters-in-law have conflict between social custom and subjective self. They had ambivalence toward their demented partents-in- law and were fighting a battle between rationality and emotions in their mind. These daughters-in law and mothers-in- law did not get along and the parents' dementia aggravated the relationships. They were alienated from their family by the parents with dementia. The indifference of their family especially their husbands, made these subjects live in misery. They cared for the demented mother-in-law with hatred. Even though they had this yoke, there daughters- in-law were not able to throw off the shackles of convention.

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An Ethnographic Research on the Phenomenon of A Dan-Jeon Breathing Training Center
Eun Zoo Park, Sung Sook Jun
Journal of Korean Academy of Nursing 1999;29(6):1244-1253.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1999.29.6.1244
AbstractAbstract PDF

The purpose of this study was to explore and describe the experience of Dan-Jeon breathing training and of Qi as a essential substance in forming human body. The sample consists of 7 participants who are Dan-Jeon Breathing training in a Training center, Pusan, Korea. They were asked open-ended questions in order for them to talk about their experiences. With permission of the subjects, the interviews were recorded and transcribed. 1. The purpose of Dan-Jeon Breathing The interview data was organized by themes into 4 categories: hope for health recovery, a concern about Dan-Jeon Breathing, seeking meaning of life, change of lifestyle. 2. The experience of Qi during Dan-Jeon Breathing training The interview data was organized by themes into 3 categories: an autonomic movement of body, spiritual experience, conviction of existence of Qi. 3. The change after Dan-Jeon Breathing training The interview data was organized by themes into 7 categories: physical health promotion, emotional relaxation, promoting brain function, positive attitude about life, love to others, investigation for self, improvement on Qi feeling.

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The Effects of Exercise Program on Fatigue, Perceived Health State, Exercise-related Affect, Perceived benefits, and Self-Efficacy: From the samples of female college students
Eun Sook Choi, Mi Ra Lee
Journal of Korean Academy of Nursing 1999;29(6):1254-1262.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1999.29.6.1254
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The purpose of this study was to examine the effects of 6-wk low intensity exercise program on fatigue, perceived health state, exercise-related affect, perceived benefits, and exercise self-efficacy for female college student's. The subjects of the study consisted of thirty-four female college students. The research subjects were assigned to experimental and control group. The experimental group participated in 13-17 and 30-60 minute sesseions of exercise program over 6 weeks. Data analysis was done by t-test with SAS program. The results of this study are as follows. 1) The first hypothesis, "The fatigue of experimental group will be lower than control group", was supported. 2) The second hypothesis, "The perceived health state of experimental group will be higher than control group", was not supported. 3) The third hypothesis, "The exercise-related affect of experimental group will be higher than control group", was not supported. 4) The fourth hypothesis, "The benefits of exercise of experimental group will be higher than control group", was not supported. 5) The fifth hypothesis, "The self-efficacy for exercise of experimental group will be higher than control group", was supported.

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A Study of Women's Menopausal Experiences
Mi Young Kim, Soo Jeong Choi, Seung Ae Yang
Journal of Korean Academy of Nursing 1999;29(6):1263-1272.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1999.29.6.1263
AbstractAbstract PDF

This study was alone to identify the meaning and the essence of the menopause experience by means of the Colaizzi's phenomenological method. The participants were eight women, 48-60 years old, who were experiencing perimenopause or postmenopause. They were selected using a theoretical sampling technique. Data were collected through in-depth interviews from April 6 to May 20, 1999. The interviews took from 40 to 90 minutes. Interviews were tape- recorded and analyzed using the constant comparative method. Significant statements from data were extracted. From these formulated meanings, 18 themes, 8 clusters of themes and 3 catagories were constructed. Final descriptions were found to be valid through the interviewee validation process. Essential themes of the menopausal experience which emerged were "coming of change", "inclined to deny the in mind", and "adapted life". Menopause, as coming of change was the turning point in the women's life cycle acompaning changes, in body and mind and marital life changes. Especially, the unpredictable menopausal changes were an opportunity to hide the fact of menopause and not to talk with anybody. Such a phenomenon reflected on the psychological attributes of menopausal woman such as an inclination to deny in the mind. Their experiences of menopause as adapted life were generally regarded as signalling the end of fertility and were interpreted as a natural developmental process that indicates a life transition. In conclusion, participants depicted the menopause as a natural stage in the life cycle. In order to help women have a positive life change and self accomplishment, nurses need to understand the essential themes of the menopausal experience. Thus, the importance of an open approach in eliciting the phenomena of menopause cannot be overemphasized. In conclusion, the results of this study suggest that exercise program is one of the effective interventions to improve the self-efficacy and also to lower the fatigue in the sample of female college students.

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The Effect of Dance Therapy on Pulmonary and Cognitive Function in the Elderly
Young Ran Lee, Sook Ja Yu
Journal of Korean Academy of Nursing 1999;29(6):1273-1283.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1999.29.6.1273
AbstractAbstract PDF

This study was done to explore the effects of dance therapy on pulmonary and cognitive functions in the elderly. The design of this study was a non-equivalent pre-post test experiment. The subjects consisted of elderly persons living in a facility located in Kyoungi-Do. Fifty eight subjects had normal cognition, sensory function and resting blood pressure. They underwent tests of pulmonary and cognitive function as baseline data before dance therapy, and at 6th week and at the end of 12nd week after following dance therapy. Twenty seven elderly persons were assigned to the experimental group and participated with the dance therapy. This therapy was based on the Marian Chace's dance therapy and Korean traditional dance with music. The dance therapy consisted of 50 minutes session, 3 times a week for 12 weeks. One session consisted of warming-up, expression, catharsis, sharing and closing stage. the intensity of the dance therapy was at the 40% of age-adjusted maximum heart rates. Data were analyzed with mean, standard deviation, Chi-square test, unpaired t-test, repeated measures ANOVA, and Bonferroni multiple regression using SAS program. The results were as follows: 1. Pulmonary function(forced expiratory volumn at one second and forced vital capacity) of the experimental subjects significantly increased over time more than that of the control subjects. 2. The experimental group had significantly higher score for pulmonary function than the control group at the 12nd week after dance therapy. 3. Cognitive function of the experimental subjects significantly increased over time more than that of the control subjects. 4. The experimental group had significantly higher score for cognitive function than the control group at the 6th week and 12nd week after dance therapy. The findings showed the dance therapy could be effective in improving the pulmonary and cognitive function of the elderly.

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Effect of Aromatherapy on Skin Xerosis and Pruritus in Patients Undergoing Maintenance Hemodialysis
Hyae Chung Ha
Journal of Korean Academy of Nursing 1999;29(6):1284-1293.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1999.29.6.1284
AbstractAbstract PDF

This study was designed to investigate the effect of aromatherapy on skin xerosis and pruritus in patients undergoing maintenance hemodialysis. Twenty one subjects of this study were selected from St. Paul's Hosipital in Seoul. All the subjects were received the mineral oil massage at the arm without fistular three timesper week for 4 weeks. After 2 weeks period of wash-out, the subjects were received the aromatherapy of lavender and tea tree essence oil in the same way. This study was carried out from March 20 to June 13, 1998. Pruritus score, skin pH and stratum corneum hydration were measured before and after each treatment. But, biochemical parameters were measured before the treatment of the mineral oil massage, after the treatment of the mineral oil massage and the aromatherapy. Data of this study were analyzed by paired t-test, repeated measures ANOVA, Bonferroni multiple comparisons and Pearson correlation coefficient. The results were as follows: 1. Pruritus score was significantly decreased after the aromatherapy, while no significant change after the treatment of the mineral oil massage. Therefore, there was a significant difference in the priritus score between the two treatments. 2. Stratum corneum hydration was significantly increased after the aromatherapy, while no significant change after the treatment of the mineral oil massage. Therefore, there was a significant difference in the stratum corneum hydration between the two treatments. 3. Skin pH was significantly increased after the treatment of the mineral oil massage, while no significant change after the aromatherapy. Therefore, there was no significant difference in the skin pH between the two treatments. 4. After the aromatherapy, the serum calcium was significantly increased. Whereas the serum parathyroid hormone intact was significantly decreased compared with the treatment of the mineral oil massage. But the level of the serum Ca and PTH-intact were within the normal range. 5. Stratum corneum hydration was decreased corresponding to the duration of hemodialysis, while pruritus score and skin pH showed no change corresponding to the duration of hemodialysis and the age of the subjects. The correlation of pruritus score on skin pH, stratum corneum hydration and biochemical parameters was not significant. In conclusion, this findings indicate that aromatherapy may be effective in decreasing skin xerosis and pruritus score in uremic pruritus patients undergoing maintenance hemodialysis.

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A Study of Tool Development for Powerlessness of Elderly and the Degree of Elderly's Powerlessness
Seung Eun Chung
Journal of Korean Academy of Nursing 1999;29(6):1294-1303.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1999.29.6.1294
AbstractAbstract PDF

The purpose of this study was to develop a tool to assess the powerlessness and to measure the powerlessness of elderly. From the result of pre-test, twenty seven items were finally selected to survey the elderly's powerlessness. The questionnaires on the elderly's powerlessness were drafted so that such tool may be evaluated in accordance with the four point Likert Scale. The number of subjects is 1,150 with ages of 60 years or more and who live in a large city, a small and middle-sized city and a rural area. The subjects of the test and retest were 85 elderlies. Collected data were analyzed by utilizing SAS program with Cronbach's alpa and Pearson's correlation, factor analysis method and known group techniques, descriptive statics, t-test and ANOVA. The results from this study were summarized below: 1. When the factor analysis method was applied for validity, the tool for powerlessness of elderly was separated into 5 factors: loss of self-confidence to deal with physical, emotional, social aspects of life; expulsion by others from meaningful human relate; perception that life is meaningless and time passes quickly; falling behind young people; being rejected by other people, having no influence on others. An application of the known group technique showed a significant difference with the result of the degree of elderly's powerlessness tools developed by the two groups, with illness and without. 2. In testing reliability, it was found that coefficient of test-retest was .9435(P<.0001) when the test-retest method was used as a test of stability, and that the alpha coefficient of internal consistency was .9141 over all items within the tool of elderly's powerlessness. 3. In powerlessness of elderly, total mean is 2.8493. And in factor of powerlessness, the highest factor is falling behind young people (M=3.1713), the lowest factor is loss of self- confidence to deal with physical, emotional, social aspects of life(M=2.6080). 4. The results from the test for the degree of powerlessness, according to the subject's demographic variables, showed that there were significant differences between age, sex, marital status, educational level, religion, possession of house, job, monthly pocket money, health status, illness and a place of residence.

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Theoretical Bases and Technical Application of Breathing Therapy in Stress Management
Pyoung Sook Lee
Journal of Korean Academy of Nursing 1999;29(6):1304-1313.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1999.29.6.1304
AbstractAbstract PDF

Breathing is essential for life and at the same time takes a role as a antidote for stress. In the Orient, it was recognized early that respiration, mind, and body have a relation that is inseparable and therefore proper breathing is so important. However, since the mechanism of therapeutic effect by breathing have not been verified, the treatment has been continued till recent years. From that which originated in the Orient, several techniques in the west have been developed to regulate breathing, and have been applying to the clinical situation and to studies, however scientific studies are still lacking. Recently, relaxed breathing has been used as an efficient strategy for breathing therapy as it has an effect on reducing physiological tension and arousal, and, therefore can be used as a basic technique to control or manage stress. In this study, in order to provide basic information and guidelines for clinical application, which will aid in the application of the theoretical basics of breathing therapy and its technique, a review of the literative was conducted. The findings are as follows: 1. Since proper breathing not only has, physically, the important function in supplying oxygen to the body but also gives a good emotional, or pleasant state of mind, it is the first step in controlling physical and mental health. 2. The basic types of breathing can be classified into two types; 'diaphragmatic breathing(relaxed breathing)' and 'chest breathing(stress breathing)'. In yoga type breathing, there are four kinds of breathing, 'upper breathing', 'mid breathing', 'down breathing', and 'complete breathing'. 3. The theoretical explanation of the positive thera peutic effect of breathing therapy techniques exemplifies good brain function, sufficient air flow through the nasal passages, diaphragmatic movement, light vagal stimulation, CO2 changes and cognitive diversion but in most studies, the hypothesis of CO2 is supported. 4. The technique of breathing is designated with many names according to the muscles and techniques used for breathing, and for control of stress, diaphragmatic breathing(relaxed breathing) is explained as a basic technique best used to manage of stress. 5. The relaxed-breathing includes slow diaphragmatic breathing, breath meditation, nasal breathing, yogic abdominal breathing, Benson's relaxed response, and quiet response.

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Effects of Group Art Therapy Program on Self-Esteem and Mental Health Status in Chronic Schizophrenic Inpatients
Kil Soo Chung
Journal of Korean Academy of Nursing 1999;29(6):1314-1323.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1999.29.6.1314
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The purpose of the study was to determine the effects of the 8-week, 15-session group art therapy program on self-esteem and mental health status in chronic schizophrenic inpatients. The sample consisted of two groups of chronic schizophrenic inpatients: 10 patients with an average of total disease duration of 8.90 years who participated in a 8-week group art therapy program, and 8 comparison subjects with an average of total disease duration of 8.25 years who did not participate in the program. A pretest-posttest quasiexperimental design was used to assess self-esteem and mental health status at the beginning and at the end of the 8-week, 15-session group art therapy program. The time points for obtaining data were matched for both groups. The effectiveness of the 8-week group art therapy program was assessed by Rosenberg's Self-esteem Scale(Rosenberg, 1965) and SCL-90- R(Derogatis et al., 1973). SPSSWIN 8.0 was utilized for data entry and analysis employing Mann-Whitney U test. The findings of the study indicated the followings: (a) No significant differences were found between two groups in self-esteem and (b) The experimental group showed significantly lower scores in obsessive-compulsive symptom dimension and interpersonal sensitivity symptom dimension on the SCL-90-R than the comparison group after participating in the group art therapy program. In conclusion, the findings showed the possibility of applying group art therapy as an effective nursing intervention for patients with lack of verbal communication skills and social interaction to improve their interpersonal relationship.

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A Study on the Educational Needs of Patients with Kidney Transplants and their Family Members after Discharge from Hospital
Jae Hyun Ahn, Nam Cho Kim
Journal of Korean Academy of Nursing 1999;29(6):1324-1335.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1999.29.6.1324
AbstractAbstract PDF

The purpose of this study was to explore the educational needs of patients with, kidney transplants and their family members to develop a rehabilitational and educational program. Data were collected from January 29, 1999 to April 20, 1999 with interviews using a structured questionnaire. There were 184 subjects in this study. of them, 107 were patients who had kidney transplants and had visited at the out-patient department of three general hospitals located in Seoul and 77 were family members. The questionnaire used for this study was developed by the investigator through a literature review and from data collected from 11 professional personnel and three kidney transplant patients and their families. The data were analyzed using the SAS program with t-test, ANOVA, Scheff test, Pearson correlation coefficient. 1) In the patient group, total mean score for educational needs was 154.61 and the item mean score was 3.96. For the family group, total mean score for educational needs was 168.84 and the item mean score was 4.15. So in the family group, educational needs were scored higher than by the patient group. With regard to domains, both patient and family groups had as the highest educational needs, the domain of physical health and the top ten items in the educational needs were also in the domain of physical health. 2) In the patient group, women and the divorce/ bereavement group had higher educational needs in the domain of nutritional management, those who had been admitted longer than four weeks from their kidney transplant had higher educational needs in the domain of physical health and those who were less than 4 years from their transplant had higher educational needs in the domain of follow-up care. In the family group, those who were Catholics and had high school education had higher educational needs in the domain of nutritional management. 3) In the patient group, academic background was positively correlated(r=.208, p=.031) to educational needs.

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Neglecting and Ignoring Menopause Within A Gendered Multiple Transitional Context: Low Income Korean Immigrant Women
Eun Ok Im
Journal of Korean Academy of Nursing 1999;29(6):1336-1354.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1999.29.6.1336
AbstractAbstract PDF

Researchers have rarely explored menopausal experience in the context of the totality of women's lives, subsequently making the picture of menopause incomplete, discrete and fragmented. Respecting the totality of women's lives, this study addressed how a vulnerable group of women-low income Korean immigrant women-experience menopause within a context of multiple transitions. This is a cross- sectional study using methodological triangulation. A sample of 119 first-generation Korean immigrant women aged 40 to 60 years, who were in low-income jobs, was recruited using convenience sampling methods. From the total sample, 21 peri- or post- menopausal women were recruited for in-depth interviews following the collection of the survey data. Questionnaires, short interviews, and in- depth interviews were used to collect data. The quantitative data were analyzed using descriptive and inferential statistics. Thematic analysis was used to interpret interview data. The findings indicate that menopause was given the lowest priority amidst women's multiple and demanding roles within a gendered multiple transitional (immigration, work and menopause) context. The lack of language clarity to describe women's experience, cultural background, inadequate knowledge, and lack of social supports made menopause hidden, invisible, and inaudible. Conclusions and implications for nursing practice are guided by the goal of understanding women's experiences and meanings of menopause and supporting women through reflecting these experiences into their health care.

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Effects of the Nursing Intervention on Mother-Infant Interaction
Mi Ye Kim
Journal of Korean Academy of Nursing 1999;29(6):1355-1364.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1999.29.6.1355
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Mother and infant relationship has a great influence on child's developments. In this study, nursing intervention to increase maternal sensitivity to the infant's cues was applied to 25 primiparas (Experimental Group). Mother and infant interacations of these primiparas were compared with those of 25 primiparas (Control Group) who did not receive the nursing intervention. Fifty primiparas and infants were recruited from a university hospital, a general hospital, and an OBGY clinic located in Taegu city. Mother and infant interactions were assessed at 6 weeks after birth using videotapes. Feeding situations were videotaped and two trained observers analyzed the tapes. Data were collected from March 23rd to July 27th of 1998. Mother and infant interactions during feeding were assessed by the response rating scale which was modified by the author based on NCAST feeding scale (Barnard, 1978a) and AMIS scale (Price, 1983). The validity of the modified rating scale was verified by faculty members and researchers who previously had research experience in the area. Cronbach's Alpha of the modified scale for this study was .90. The data was analyzed by SAS program, using wilcoxon rank sums test, chi square test, Fisher's exact test, and ANOVA. Findings were as follows: 1. Mothers in the experimental group were more likely to have higher scores in mother and infant interactions during feeding than mothers in the control group. 2. Mothers in the experimental group showed better sensitivity to infant's signals or cues, provided growth fostering, and had higher responsibility to the infant's distress than mothers in the control group. 3. Infants in the experimental group showed higher clarity of cues and responsibility to the mother's behaviors than infants in the control group. 4. Mothers and infants in the experimental group showed higher synchronic responses than mothers and infants in the control group. In conclusion, this study has shown that the applied nursing intervention promoted mother and infant interaction among primiparas. Therefore, this study suggests that the nursing interventions to increase maternal sensitivity to the infant's cues should be broadly applied to primiparas, which can be beneficial to the social, affective, and cognitive developments of their children.

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Development of a Tool to Measure Suffering in Patients with Cancer
Kyoung Ah Kang
Journal of Korean Academy of Nursing 1999;29(6):1365-1378.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1999.29.6.1365
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This study is a methodological research study to develop an instrument to measure in patients with cancer and to test the validity and reliability of the instrument. The research procedure was as follows: 1) The first step was to develop conceptual framework based on a comprehensive review of the literature and in-depth interviews with patients with cancer. This conceptual framework was organized in to three dimensions (the intrapersonal dimension, the significant-other and context related dimension, the transcendental dimension). Initially 59 items were adopted. 2) These items were analyzed through the index of content validity(CVI) and 53 items were selected which met more than 80% on the CVI. 3) The pretest was carried out with 87 patients with cancer. After the pretest results were analyzed by item analysis, 44 items were selected. A second test of content validity was conducted and 6 items were eliminated considering the 80% CVI. 4) To test for reliability and validity, data collection was done during the period from January 25, 1999, to February 26, 1999. The subjects for the test were 160 patients with cancer and 185 healthy persons. This study utilized Cronbach's alpha in analyzing the reliability of the collected data and applied factor analysis, item analysis and multitrait-multimethod method to analyze validity. The findings are as follows: 1) The Cronbach's alpha coefficient for internal consistency was .92 for the total 38 items and .79, .82, .85, for the three dimensions in that order. 2) The item analysis was based on the corrected item to total correlation coefficient( .30 or more) and information about the alpha estimate if this item was dropped from the scale. 3) As a result of the initial factor analysis using principal component analysis and varimax rotation, one item was deleted because of factor complexity (indiscriminate factor loadings). In the secondary factor analysis, 7 factors with eigenvalue of more than 1.0 were extracted and these factors explained 56 percents of the total variance. The seven factors were labeled as 'family relationship', 'emotional condition', 'physical discomfort', 'meaning and goal of life', 'contextual stimuli', 'change of body image', 'guilt feelings'. 4) The convergence effect between this instrument and the life satisfaction scale was identified and there was significant positive correlation(r= .52, p= .00). The discriminant validity between this instrument and the depression scale(CES-D) was tested and there was significant negative correlation(r= -.50, p= .00). The instrument for accessing the suffering of patients with cancer developed in this study was identified as a tool with a high degree of reliability and validity. In this sense, this tool can be effectively utilized for assessment in caring for patients with cancer.

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The Study of Loneliness in Infertile Women
Kyoung Jin Bae, Seung Ok Ro, Jung A Kim
Journal of Korean Academy of Nursing 1999;29(6):1379-1391.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1999.29.6.1379
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The purpose of this study was to investigate loneliness in infertile women and determine how loneliness related to personal characteristics, cause of infertility, family composition, and family conflicts. It also provides basic data for nursing strategies concerning infertile women. A total of 182 subjects were selected at an infertile clinic in Seoul, Korea. Data were collected from May 2 to June 21, 1997 by questionaire. It consisted of questions concerning general characteristics, items relating to infertility, and the Loneliness Scale. The UCLA Loneliness scale was used(more specifically, the Korean version of the Revised UCLA Scale by Kim Ok Soo.). The data were analyzed by using SPSS/PC computer program. The result are as follows: 1. The mean age of infertile women was 32.4 years old, and the mean age of souses was 34.8 yerars old. 30.2% of women had a marital duration of 3-5 years, and 25.8% had a marital duration of 5-10 years. 23.1% reported the main etiology of infertility as unexplained, 18.1% reported ovulation disturbances, and 26.4% reported complex causes. 3.8% of the couples had sexual relationship difficulty 83% lived in nuclear families, while 17% lived in large families. 2. The mean loneliness scores of infertile women was 35.53(SD=8.66). The total loneliness score of this study was 80. 3. There were significant differences in loneliness scores according to ages(F=6.893, p=.001), education background(t=4.418, p=.000), and the educational background of husband(t=2.339, p=.020). 4. Loneliness scores related to family situations were significantly different according to several male nephews in husbands' family(F=2.822, p=.027). 5. Loneliness scores related to conflicts were significantly different according to husbands and their family(F=11.465, p=.000). Nurses should acknowlege the fact that some infertile women may experience loneliness. In conclusion, nurses can provide infertile women with information about ways to decrease loneliness and create support groups for themselves, assisting infertile women to adjust to the experience of infertility through positive methods.

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A Study of Eating in Obese High School Girls during Stressful Situations
Kim, Sook Young
Journal of Korean Academy of Nursing 1999;29(6):1392-1402.   Published online December 31, 1998
AbstractAbstract
This study was carried out to find out stress-eating relationship in obese high school girls and to investigate the factors related to stress-induced eating. The conceptual framework used in this study was individual difference model. The research method was methodological triangulation. The data of the study were collected from purposively sampled 309 normal high school girls and 314 obese high school girls in S city. 15 volunteers, obese high school girls, enrolled in this qualitative research. Quantitative data was collected from May 6 to June 10, 1997 through questionnaires about stress and stress-related eating changes and from June 23 to August 26, 1997, qualitative data was collected. The results of the study were as follows: 1. Obese high school girls were unaffected by stress(t=-1.84, p=0.0662). 2. Through quantitative analysis, obese people divided into two groups in their response to stress. One group was composed of stress- eater. The other group was composed of non- stress eater. 3. Disinhibition(t=-3.1275, p=0.0019), cognitive restrain (t=-3.1597, p=0.0017), hunger(t=-3.5878, p=0.0004) were significantly different between stress-eaters and non-stress eaters. 4. According to the interview, 5 subjects of obese girls were stress eaters, and 10 subjects were non-stress eaters. Through qualitative research, the related factors of eating were eating attitude & behavior, stimuli situations on eating, and personality. In stress-eater group, they constantly went on a diet, however, they were prompted to eat when an uneasy feeling such as anxiety, depression, annoyance developed. Their personality were entirely optimistic. Whereas non-stress eater group had no interest in diet and didn't appear to have psychological factors to stimulate eating in stressful situations. Their personality was not only optimistic but also keenly characteristic. 5. To compare obese-normal high school girls on the effect of stress in eating. Normal weigh high school girls decreased their eating when stressed(t= -13.62, p=0.0001). In conclusion, this study suggests that there are two different groups in obese high school girls in regards to eating responses on stressful situations. As a result of these finding, clinical and school nurses can detect the stress-eaters who need stress management intervention, and can apply appropriate management program according to the individual needs.
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The Development of Korean Nursing Alternative
Kyong Rim Shin
Journal of Korean Academy of Nursing 1999;29(6):1403-1418.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1999.29.6.1403
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Nursing is a discipline that helps to understand human being, to mitigate pains in life by promoting and recovering health, and to study the basic principles in sustaining and preserving life. To understand man and thus to nurse, it is essential to take the way of life of the specific person, his/her ideas, and natural environment into consideration. This means, the temperament, geography, environment and society peculiar to Korea have formed its own culture distinguished from those of other people. Thoughts and philosophy develop as a products of the specific culture and society. Therefore, accurate understanding of the concepts of nursing in the traditional thoughts and philosophy is indispensible to define Korean nursing. Modern Korean nursing at first rooted in the westernized nursing and western nursing intervention has been applied ever since its introduction in the late 19th century under the paradigm of western natural science. However, Koreans in the past made use of alternative therapy which put its emphasis on the organic and holistic view of life as well as a means for traditional medicine and nursing. This alternative therapy has been largely ignored since the introduction of western medical science, and was considered something used only by the aged or the uneducated. Moreover, Health concerned practices and customary traditional therapy have been discarded in the clinical medicine as "unscientific" or "unsystematic". As described above, it is true that Korean nursing has developed in the quantitative aspect only adhering to western nursing intervention. Now it is the time to stop to hold ourself and to look back our past. To find and develop the originality of Korean nursing to cope with the globalization, it is necessary to rediscover nursing (alternative) therapy in Korean culture ignored so far. For this purpose, this study examines the oriental philosophy to explore alternative nursing theory now under development. Also it aims to present ways to apply alternative therapy to nursing education, research and clinical practices and ultimately to show the desirable direction of the nursing to go in the future. Yangsaeng theory of Taoism and Yin-yang, Oh-hang(five elements) and khi theory in Dongeuibogam which gave enormous influences on Korean medical culture and treatment together with Sahsang(four temperaments) emphasized in Dongeuisusebowon will be examined as conceptual framework. Concepts of nursing are categorized into views on each the universe, the human being and nursing. Views on human being is classified into subcategories of body, life, health, and disease. Also it emphasizes the necessity of including alternative therapy in nursing intervention. Views on the universe is classified into yin-yang, khi, and temperament. Nursing will be available anywhere and easily accessible with this new nursing intervention. Trying to give a new thoughts to all those traditional concepts and alternative therapy, this article suggests the necessity of developing original Korean nursing theory and nursing intervention.

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A Critical Review and Visim of Family Caregiving Research on the Demented Elderly's in Republic of Korea
Jin Sun Kim
Journal of Korean Academy of Nursing 1999;29(6):1419-1433.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1999.29.6.1419
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Little is known about the impact of family caregiving for the demented elderly in Korea. The purpose of this study was to identify the current state of development of family caregiving research for the demented elderly in Korea and to identify correlates of caregiver or health problems and burdens within the socio-political contexts of Korea. A critical review of 17 family caregivers was carried out. The review revealed that various caregiving impacts and correlates of caregiver burden or health problems have been studied in relation to demented elderly family caregiving. Family caregiving for the demented elderly is a very complex phenomenon and various factors were related to caregiver burden, or their emotional and physical health. Findings from studies reviewed have shown inconsistent, inconclusive, and contradictory results. Furthermore, several conceptual and methodological problems were identified in the studies reviewed: restricted conceptualization, unrepresentative study samples, inadequate sample size, inappropriate study design, absence of comparison groups, inappropriate psychometric properties, and uncontrolled confounding factors. More research, as well as directions for further research, is recommended to identify family caregiving the impact of for the demented elderly, and to clarify the factors that explain results.

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A Study on the Influence of Job Characteristics Perceived by Nurses on Their Job Satisfaction and Organizational Commitment: Focusing on Moderating Effect of Individual Personality Characteristics
Myoung Sook Kim, Young Bae Park
Journal of Korean Academy of Nursing 1999;29(6):1434-1444.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1999.29.6.1434
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The purpose of this study was to investigate the influence of job characteristics on the nurses' the moderating effect of locus of control on the job satisfaction and organizational commitment and relationship between job characteristics and attitude. The sample for this study consisted of 594 nurses from 8 university hospitals. Factor analysis, Cronbach's alpha analysis, multiple regression analysis and hierarchical multiple regression analysis were used for the statistical methods. The results of this study were found that (1) autonomy among 5 core job characteristics showed positive influence on job satisfaction, (2) task significance and autonomy among 5 core job characteristics had positive influence on organizational commitment, (3) the internals of locus of control moderated the effect of job characteristics on nurses' job satisfaction, and (4) internals and externals of locus of control moderated the effect of job characteristics on nurses' organizational commitment.

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Effects of A Sensory Stimulation Program on Growth and Behavioral Development of Infants
Jeong Sun Kim
Journal of Korean Academy of Nursing 1999;29(6):1445-1454.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1999.29.6.1445
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This study was designed to investigate the effects of a sensory stimulation program on the growth (weight, height, head circumference, and chest circumference), behavioral development, behavioral states, and the heart rate of the infants. A total of 23 infants of 2 weeks old were divided into sensory stimualtion group (11 infants) and control group (12 infants). The infants of sensory stimulation group had received sensory stimulation for 6 weeks. Sensory stimulation program was composed of tactile and kinesthetic stimulation. We assessed growth, behavioral state and heart rate every week and behavioral development every 2 weeks. The results were as follows: 1. Body weight in sensory stimulation group, from two weeks after the sensory stimulation program, was significantly increased more than control group, but there was no significant difference in height, head circumference, and chest circumference between the two groups. 2. Behavioral developmental score of sensory stimulation group was significantly higher than that of control group from two weeks after the sensory stimulation program. Developmental states of sensory stimulation group showed more 'high average developmental state' than the control group from 4 weeks after sensory stimulation program. 3. Behavioral states of sensory stimulation group after the sensory stimulation program, the 'sleeping state' was significantly increased more than control group. The 'awakening state' and the state of fuss or crying were significantly less than those of the control group. 4. The heart rate of the sensory stimulation group after the sensory stimulation was significantly lower than the control group. These results indicate that the sensory stimulation program decreases heart rate and improves the sleeping state to be effective on promoting the growth and development of the infants. In view of these experiments, we suggest sensory stimulation program might be considered as a nursing intervention for growth and development of the infants not only in clinical settings but also at homes and in the communities.

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Objectives and Contents of Basic Medical Sciences in Nursing Education
Myoung Ae Choe, Gi Soo Shin
Journal of Korean Academy of Nursing 1999;29(6):1455-1468.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1999.29.6.1455
AbstractAbstract PDF

The purpose of this study was to investigate the objectives and contents of basic medical sciences at department of nursing in college of nursing, and junior college of nursing, thus ultimately providing the basic data to standardize the curriculum of the basic medical sciences in nursing education. Seventy eight professors who were in charge of teaching basic medical sciences to at 22 colleges of nursing/department of nursing, and 20 junior colleges of nursing responded to the questionnaires that consisted of the questions regarding objectives and contents, of basic medical sciences. Based on the description of objectives, the description related to nursing, nurse, nursing science was cathegorized as on objective applicable to nursing science, the description related to medicine or clinical medicine as medical model, the description without description related to medicine was cathegorized as knowledge acquisition. The number of schools corresponding to each category were summerized in descending order. The objectives of basic medical sciences were categorized by concepts and number of schools corresponding to the categorized concept. The findings of the study are as follows: 1. The subjects of basic medical science identified were physiology, anatomy, biochemistry, pathology, microbiology, and pharmacology in most colleges of nursing and junior colleges. Two colleges of nursing/department of nursing (9.1%) and 19 junior colleges of nursing(95%) did not offer biochemistry, 1 college of nursing /department of nursing(5%) did not offer pathology & pharmacology. 2 junior colleges of nursing (10%) did not offer pharmacology, 1 junior college of nursing(5%) did not offer pathology. The other 1 junior college of nursing did not offer microbiology. 2. Objectives of physiology were to acquire knowledge and understanding on human function in both 6 (50%) colleges and 5 junior colleges. Objectives of anatomy were to acquire knowledge on human structure in both 4 (57%) colleges and 2 (50%) junior colleges; knowledge applicable to nursing sciences in both 3 (42.8%) colleges and 2 (50%) junior colleges. Objectives of biochemistry was to obtain knowledge and understanding on biochemistry, and understanding of basic concepts about biochemistry. Objectives of pathology were to obtain knowledge and understanding on pathology in both 4 (57.1%) colleges and 5(62.5%) junior colleges. Objectives of microbiology were to acquire knowledge and understanding on microbiology in both 5(83.8%) colleges and 6(85.7%) junior colleges. Objectives of pharmacology were to acquire knowledge on pharmacology in both 7(100%) colleges and 8(100%) junior colleges. 3. Contents of physiology in 19 (100%) schools were membrane transport, digestion, circulation, nervous system and respiration. In 16(84.2%) were kidney and muscle, that in 13(68.4%) were endocrine physiology. In 11(57.9%) were introduction and that in 9(47.4%) were structure and function of cells. Contents of anatomy in 11(100%) schools were skeletal system, muscle system, digestive system, circulatory system, concepts regarding human structure. In 10(90.9%) schools were endocrine system and nervous system, and in 5(45.5%) schools were blood, urinary system and cell. Contents of biochemistry in 6(100%) schools were history of biochemistry, body regulating factor, bioenergy, health and nutrition, nutrition of cell, energy production system. In 5(83.3%) schools were metabolism of protein and carbohydrate and enzyme, and in 3(50%) schools were metabolism of energy and fat. Contents of microbiology in 13(100%) schools were environment and influenc of bacteria, virus, G(-) rods, purulent cocci, G(+) rods. In 10 (76.9%) were immunity, diphtheria, enterobacteria, and in 9(69.2%) were spirochete, rickettsia and clamydia, and that in 6(46.2%) were sterilization and disinfection. Contents of pathology in 14(100%) schools were cell injury and adaptation, inflammation, respiratory diseases, circulatory diseases. In 10(71.4%) were neurological disorders, in 8(57.1%) were immunity and disease, and in 7 (50%) were tumor and progressive changes. Contents of pharmacology in 15(100%) were cardivascular drugs, introduction to pharmacology, hypnotics, analgesics, local anesthetics, an ticonvulsants. In 12(80%) were drugs activity on sympathetic and parasympathetic nervous system, and in 11(73%) were sulfa drugs, antibiotics, drug abuse and addiction.

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Journal of Korean Academy of Nursing 1999;29(6):1469-1473.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1999.29.6.1469
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No abstract available.

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