This study was performed to evaluate the effect of 7-week comprehensive health promotion program for RA patients (CHPPRA) on changes in pain and depression. In addition, it was also examined that this effect was generated by changes in patients' health promoting strategies (positive self-image, positive thinking, problem solving, communication, pain management, stress management, exercise, and knowledge about RA) learned through CHPPRA. Twenty-eight out-patients of RA clinic in a university hospital participated for this study. The results are as followers. Changes in exercise, self-concept, positive thinking, problem solving, depression, and pain management were significant predictors to explain relieving pain level. Since all of these variables had positive standardized beta weights (betas), it can be interpreted that increasing level of these health promoting strategies may induce pain improvement. Changes in positive thinking, communication skill, exercise, self-concept, pain management, and knowledge about the disease were significant predictors to explain positive change in depression. Since all of the significant variables except the change in knowledge about the disease had positive standardized beta weights (betas), it can be interpreted that increasing level of these health promoting strategies may induce improving depression level. However, our results showed that the higher level of the knowledge about the disease was, the worse depression was.

The theory of unpleasant symptoms is a middle-range theory proposed by Lenz and her colleagues (1997). Analysis and evaluation of this theory was performed using Fawcett (1999) and Fawcett and Downs's (1992) guidelines. Results of the theory analysis and evaluation suggest that the theory of unpleasant symptoms has theoretical and social significance and parsimony. However, a lack of internal consistency was evident. For empirical adequacy of the theory, it is recommended that research be conducted examining the complexities of the interaction effects, reciprocal relationships, and medication effects among physiological, psychologic, and situational factors, symptoms, and performance. The knowledge derived from the research findings should be used in practice for patients experiencing symptoms.

This study was conducted to determine the prevalence rate of adverse reactions to latex gloves. The study compared allergic reactions to ordinary latex gloves with four types of hypoallergenic gloves among operating room nurses at a teaching hospital in Seoul, Korea. Data were collected from 63 operating room nurses by a questionnaire and direct observation of a skin prick test. Among respondents, 25 nurses with adverse reactions to latex gloves were selected for the skin prick and exposure tests with five latex gloves (1 ordinary glove, and 4 hypoallergenic gloves) using a repeated measures design of counterbalancing method. Study Results are as follows: (1) The response rate of the questionnaire was 96.8%, and the prick test was performed in 61 out of 63 nurses. (2) Common symptoms of allergic reactions to latex gloves were rash (49.2%), skin itching (44.3%), dizziness (31.1%), and eye itching (26.2%). (3) The prevalence rate of adverse reactions was 80.3%, and that of latex allergy was 9.8%. (4) Atopic subjects had more latex allergy than the non-atopics. (5) There was no difference in the incidence rate of latex allergy among the five gloves by the skin prick test. But with the skin exposure test, ordinary latex gloves had a higher incidence rate of latex allergy than the hypoallergenic gloves (p<0.0001).

Twenty-three research studies regarding nurses or nursing students intention to care for HIV disease patients were reviewed. Studies on this issue were sporadic and not systematic. A majority of the studies were limited to one institution at one point in time. Convenience sampling was prevalent. Only 5 studies used random sampling (Jemmott III et al., 1992; Kelly et al., 1988; Planter & Foster, 1993; Scherer et al., 1989; Van Servellen et al., 1988). Consequently the findings of most studies can not be generalized to the population at large. In addition, between 1985 and 1994, the emphasis on descriptive studies continued even though correlational and experimental studies were being conducted. The development of the body of knowledge on this issue is still in a primitive stage. Correlational or comparative studies reviewed rarely had a theoretical basis for the study questions. Only two studies were found that cited a theoretical basis (Laschinger & Goldenberg, 1993; Goldenberg & Laschinger, 1991). A variety of attitude instruments were developed by investigators and used in their own studies. The constructs of the instruments were quite varied. For example, some studies identified fear as the attitude to be measured, while others measured opinion or intention as the attitude. None of the studies reviewed reported content, construct or convergent validity of the instruments. Reliability data for most instruments used in the studies were either not reported or low. Such a lack of information limits the interpretation of the findings. Study findings were inconclusive. Some descriptive studies indicated that nurses or nursing students were willing to care for HIV disease patients, while others revealed they were not willing to do so. Three correlational studies examining the relationship between attitude and intention obtained inconsistent findings. Findings from one study (Jemmott et al., 1992) indicated a positive relationship, while others found no relationship between them (Cole & Slocumb, 1994; Jemmott et al., 1992). Descriptive studies identified that families or friends stigmatization were the important factors. Only two correlational studies on this issue were found, but study findings were inconsistent (Laschinger & Goldenberg, 1993; Glodenberg & Laschinger, 1991). Studies focusing on nursing students intentions or attitude were limited. Only 7 of the 23 research reviewed were conducted using nursing students (Lawrence & Lawrence, 1989; Lester & Beard, 1988; Mueller et al., 1992; Oerman & Gignac, 1991; Jemmott et al., 1992; Jemmott III et al., 1992; Wiely et al., 1988). This review leads to the conclusion that there is a need for study of this issue with nursing students as the target population. Studies with questions based upon a theoretical framework provide a basis for linking findings. In addition, reliable instruments and sophisticated statistical analysis are also needed when studying this topic.

Recovery in substance abuse has been simplistically measured; a more comprehensive understanding of recovery outcomes is needed. This study therefore explored recovery outcomes of Korean adolescents with substance abuse by qualitative research. The recovery was found to occur in several domains; they included reconciliation with the self, hope for the future, reconciliation with family, self-liberation, socialization, conventional norm pursuit, and a struggle for realistic independence. An understanding of the recovery process and recovery outcomes may provide guidance for clinical interventions with substance abuse adolescents.

BACKGROUND: The phenomenon of nursing turnover has been explained by organizational commitment, job satisfaction, or intent to stay in previous studies; yet the combined contribution of these factors to nurse turnover has not been examined. OBJECTIVES: The purpose of this study was to develop and test a turnover model which included professionalism, job-related variables, job satisfaction, organizational commitment, and intent to stay.
METHOD
A total of 424 registered nurses in a university hospital completed a self-administered questionnaire including Professionalism Scale, Job Diagnostic Survey, Nurse Assessment Survey, and intention to stay. Nurses were classified as to whether they remained in or had left the organization 18 months after the survey. Multiple regression and logistic regression analyses were conducted to test the model.
RESULTS
Overall job satisfaction and intent to stay were the most important determinants of nursing turnover. Organizational commitment positively affected intent to stay and indirectly decreased turnover through intent to stay. Satisfaction with coworkers and supervisor were the most important factors in explaining overall job satisfaction. Satisfaction with pay, autonomy, and feedback from job also positively affected overall job satisfaction.
CONCLUSION
Using the results of the tested model nurse managers and administrators could predict turnover by monitoring its determinants, and ultimately reduce the turnover rate through early intervention.

Due to great concern about quality of care in nursing home, legislative in the US mandated development of LTC MDS. MDS, a standardized assessment database for nursing home residents, provides comprehensive, holistic assessment data for nurses and make it possible to identify nursing needs of residents. The purpose of this study is to assess the health status of nursing home residents in Missouri, America, and to stimulate international comparative research assessing the health status of the elderly. This study presented the age-specific prevalence of diseases, sex differences, and the relative prevalence of chronic diseases among nursing home residents using the Minimum Data Set in Missouri. In addition, the possibility of racial and regional differences in chronic diseases and its relationship to demographic factors were analyzed. The prevalence of diseases was, in general, higher in female elderly then males and increased with age in both sexes. The average number of diseases in the elderly, among 31 chronic diseases, was 3.43 in women and 3.25 in men. The most prevalent 5 diseases were hypertension (29.1%), congestive heart failure (26.1%), dementia (23.6%), arthritis (20.6%), and diabetes mellitus (17.7%). Sixty-eight percent of nursing home residents had at least one of the heart/circulation related diseases and 58. 4% had neurology related diseases. In conclusion, the usefulness and implication of LTC MDS to nursing can't be overemphasized. Korean nurses should prepare themselves for using it for nursing research and to answer nursing questions.

When people have experienced a personally life-threatening event, individuals try to find the meaning of suffering. In order to provide nurses with information about how meaning is individually experienced, nurses should assess the degree of suffering and the patient's perceptions of the meaning of suffering. The purpose of this study is to assess the reliability and validity of the Korean version of the MIST (the Meaning of Suffering Test) instrument originally developed by Starck (1983). The MIST consists of PART I and II. In this study, the validity and reliability of MIST I is tested except MIST II consisting of 17 open questions. The translation involved four steps: translation into Korean, checking agreement, translation into English, and arriving at a consensus. Then the Korean version of the MIST, PART I was tested with a sample of 160 patients with cancer who have experienced suffering. The Cronbach's alpha coefficient for internal consistency was .92 for the total 20 items and .91, .89, and .88 for the three dimensions in that order. As a result of the factor analysis using principal component analysis and varimax rotation, three factors with eigenvalue of more than 1.0 were extracted and these factors explained 93.6 percent of the total variance. The items clustered together in this study were almost identical with initial scale and subscales reported by Starck. The instrument for accessing patients' perceptions of the meaning of suffering 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.

The labor participation rate of women are increasing, especially for married and 30 and over aged women in Korea. The employment of married women occurs dual-role problems. But recent empirical evidences suggest that employment yields a net gain of benefits over costs with respect to both physical and mental health for women as well as men. Previous researches suggested that the quality of the role or role satisfaction, not the occupancy of the role, is one of the predictors of psychological health. The purpose of this study is to investigate influencing factors on quality of job role for Korean women with children and husband. Data were collected from 323 mothers of students at 3 kindergartens, 2 elementary schools, 3 middle schools, 4 high schools in metropolitan area, during 1998.8 - 1998.12. they were dual-earner couples, and were employed over one year. Response rate is 62.3%. Quality of role was measured using Role Quality Scale developed by Park, June & Kim(1999). This instrument is based on Role Rewards and Concerns Scale of Barnett et al.(1993) for quality of job role. Quality of job role is made of 27 items and the subfactors are interpersonal relationship, job stress, pride, payment, and autonomy. Scales have good internal consistency(Cronbach ??= 0.86). The findings of this study show that personal income, occupation, husband's attitude for wife's employment, and the perceived equity for labor division between couples are significant variables for quality of job role. But age, education, career years, working hours per week are not significant. 24.83% of the variance in quality of job role were accounted for by these variables.

This research was performed to compare life satisfaction of the elderly in institutions and homes. The scores of life satisfaction were collected from 74 elders in 5 institutions and 71 elders at their homes in Daegu and Gyungbuk province during October 1st to December 1st, 1999. The results were summarized as follows: 1. The elders in institutions revealed lower scores in life satisfaction than the elders at homes, but not statistically significant. 2. In institutions, the general characteristics which affected life satisfaction was health status and monthly income. For elderly at home, the general characteristics which affected life satisfaction scores were educational level and health status. According to the result of this research, the health-care and economic support must be considered as main factors in the nursing strategy for the elders. The results should be considered carefully when applied to the entire older population because it was conducted on a segment of the elderly population in Korea. And various social activities and nursing programs for the aged are required.

The purpose of this study is to identify and classify the different types of cancer patients who use alternative therapies, to understand their subjective frameworks in using such alternative therapies. The results of this study provided the subjective information on five types of attitudes towards alternative therapies and described characteristics of five types from 30 cancer patients. The "Dependent to Others" (the first type) decided to use alternative therapy because they were influenced by the experiences of others and invocations of the family (especially spouse) or close relatives. In general, they did not believe that it will cure the diseases but generally thought it was not harmful and it may be better than doing nothing. There were a group of patients who chose to use alternative therapy with vague hope and belief. These patients decided to try alternative methods with their own convictions and confidences because they have personally seen or heard about some people who had been cured miraculously. This group of patients was grouped as "Belief in Effects (second type)." Although, there is a very little chance for miracles, "Expecting for Effects (third type)" believed alternative therapy will strengthen immune systems, help with feces and urine, change physical constitutions, slow down the progression of cancerous cell, have no side-effects, and expects to have practical effects and uses. The fourth group of patients thought foods in alternative therapies were same as general foods, therefore, it was easy to take, did not expect miracles to happen but considered the alternative therapy as supplementary treatments. This "Supplementary for Effects (fourth type)" patients thought it was their duty to do everything possible. The last type was "Expecting for Miraculous Effects (fifth type)." The patients in this group were devastated and thought of alternative treatments as the last hope for miracles. They thought it would relieve their physical pains, reduce the chance of side effects from chemical treatments, help them for comfortable and painless death, and considered it as the last possible option with expecting for miracles. The result of this study has implications to provide practical and concrete guidelines for caring and nursing cancer patients using alternative therapies. It will be used as a tool to work on independent for nursing intervention. Furthermore, the result of study will provide practical guidelines to help develop better tools and nursing intervention strategies to nurse cancer patients.

The propose of this study is to give a theoretical basis for better home health service by looking at the subjective structure the collaboration between the home health nurse and doctor and at how collaboration can be improved. There are at least three types of recognition that can help the collaboration. The first type is to put more weight on the relationship between doctors and home health care nurses. This means that doctors and home health care nurses should make an effort to improve, their collaboration. The second type is to put more weight on the reward for doctors' participation. Reward will help collaboration. The third type is to put more weight on organization support. Organization support will bring about trust between doctors and home health care nurses The following conclusion were reached: 1) Trust should exist between doctors and home health care nurses. 2)Doctors should maintain an equal relationship with home health care nurses and accept them as professionals. 3) Appropriate reward should be given to doctors for their participation. 4)Home health care nurses should reinforce their skills through education, training, and professionalization. 5) Home health care nurses should cooperate with doctors by building a system that centers on patients. 6) Collaboration between doctors and home health care nurses is important because it is useful to recognize patients and their families in a broader light. 7) Doctors and home health care nurses need to be more concerned about patients. 8)More active support of hospital administrators and systems is needed to enhance collaboration between doctors and home health care nurses. 9) The present legal system for collaboration between doctors and home health care nurses can be a factor. The nine nursing strategies above will help doctors and home health care nurses build more positive relations and get closer to their patient, more effective home healthcare will get closer to people who want quality medical service.

Stress urinary incontinence is most common type in urinary incontinence. Most women had been suffering with stress urinary incontinence for more than a year in the community without seeking medical help. Under the assumption that stress urinary incontinence will be treated or improved by keeping PFM exercise with his/her continence confidence, this study was conducted. This study examined Continence self-efficacy effect on PFM exercise adherence. Subject were in 48 women aged 20 to 75 years with stress urinary incontinence and were recommended by their doctor to attempt PFM exercise as one treatment method.. Data were collected by self-administered report using Continence Self-Efficacy Scale, PFM exercise adherence check sheet. Telephone support was used as a method of CEIP to increase Continence self-efficacy. Continence self-efficacy score was higher in the intervention group than in control group (T=-3.23, P<.01), PFM exercise adherence was better in the intervention group than in control group (T=-4.03, P<.001). Through this research, it was also found that there were three types in attitude toward treatment; those who want to be treated completely, those who want to be relieved, and those who think urine loss is no problem. It can be concluded that to increase Continence self-efficacy was useful to the PFM exercise adherence of women with stress urinary incontinence.

BACKGROUND: The purpose of this study was to describe breastfeeding policies and practices among hospitals in South Korea and the degree to which the hospitals are implementing the WHO/UNICEF Baby Friendly Hospital Initiative.
METHODS
A cross-sectional survey of 34 hospitals was used to collect data. Quantitative and qualitative information and insights into current breastfeeding policies and practices were derived from responses of maternal and child health personnel at each hospital. One questionnaire per hospital was completed with personnel from all sections of maternity services, labor and delivery, nursery, and postpartum, contributing information needed to create a composite picture of the hospital's breastfeeding policies and practices.
RESULTS
Most hospitals were classified as either high or moderately high implementers on four of the Ten Steps: printed information distributed to breastfeeding mothers, oral breastfeeding instruction given to mothers, infant supplementation, and infant feeding schedules. The remaining steps, including key practices like staff instruction, breastfeeding initiation, rooming-in, and hospital postpartum support are being partially implemented by the majority of hospitals in this study.
CONCLUSIONS
Areas identified as needing the greatest attention by hospitals were health care staff training, breastfeeding initiation, supplementation, rooming-in, breastfeeding policy, and postpartum support for the breastfeeding mother.

The purpose of this study was to investigate the waist to hip ratio, body fat, BMI(Body Mass Index), weight, serum lipids and to examine the correlation between waist to hip ratio, body fat, BMI(Body Mass Index), weight and serum lipids in obese college women. The subject were 52 college women with a score above 25 on the BMI, between March and May of 2000 at G Women's University. Data has been analyzed by SPSS/PC using frequency, percentage, mean, standard deviation, and Pearson Correlation Coefficient. The result of this study are as follows : 1. The mean of body weight and height of the subjects were 72.38kg, 160.23cm. 2. The mean of waist to hip ratio was 0.88, body fat was 38.88%, BMI(Body Mass Index) was 28.15, the level of total cholesterol was 174.88mg/dl, triglyceride was 104.29mg/dl, HDL-cholesterol was 50.83mg/dl, LDL-cholesterol was 104.23mg/dl. 3.Waist to hip ratio was more significantly correlated to triglyceride(r=.34, P<.05) and BMI(Body Mass Index) was more significantly correlated to triglyceride(r=.30, P<.05).