BACKGROUND: Korea and the People's Republic of China received their nursing traditions from European and the American missionaries in the late 1800's. However, the stages of nursing education development and its standards are not same among countries. Korea, People's Republic of China and the United States have gone through various internal socio-political, hierarchical changes which impact development of its nursing education systems in the past. PURPOSE AND METHODS: In this paper the authors have endeavored to review undergraduate nursing education systems in Korea, China and the United States in consideration with their unique historical social and political background of its development. Result: Korea has two nursing education systems: associate and baccalaureate. China developed three types of nursing education systems: certificate, associate and baccalaureate. The United States, one of the countries, which nurtured the modern nursing education, has four types of nursing education systems: certificate, associate, diploma and baccalaureate. Furthermore, the authors have discussed on several core and common issues to be considered for future directions on nursing education systems for three countries.

PURPOSE OF THE STUDY: Atrial fibrillation is the most common sustained cardiac rhythm disturbance encountered in clinical practice. In contrast to its high prevalence and the associated high number of hospital admissions, there is a paucity of published studies that have evaluated the perspective of patients with atrial fibrillation or patients' perceptions or responses to diagnosis, treatment, or prognosis of atrial fibrillation in health care literature and clinical studies. This study aimed to explore uncertainty in diagnosis, treatment, and prognosis of atrial fibrillation.
METHODS
This study employed a descriptive cross-sectional survey design using a face-to-face interview method to explore uncertainty. Patients with atrial fibrillation confirmed by 12-lead ECG were interviewed. Uncertainty was measured by the Mishel Uncertainty in Illness Scale-Community Form (MUIS-C), and the data collected were analyzed by the Statistical Package for Social Science software program.
RESULTS
A total of 81 subjects were included in this study and their mean score of uncertainty was 62.60 with the standard deviation of 10.81. Uncertainty in patients with atrial fibrillation was higher than that reported in other disease populations such as bowel resection surgery, breast cancer, myocardial infarction, and so forth. However, it was lower than the level of uncertainty in patients with cardiac arrest and HIV disease.
CONCLUSION
From the findings of the present study, it was demonstrated that uncertainty existed in patients with atrial fibrillation, and this was considered to be part of patients' responses to atrial fibrillation. In terms of nursing practice and nursing research, uncertainty was explored and described as one of the most relevant phenomena in patients newly diagnosed with atrial fibrillation.

With the demanding level of care needed for people with dementia, more Korean families are institutionalizing their relatives with dementia. This presents particular concerns for the Korean culture that values family responsibility for elder care. The purpose of this study was to describe Korean family members' perceptions of stress and satisfaction with care, the caregiving role, the family-staff relations. A purposive sample of 94 family members in 10 long-term care dementia care facilities in Korea participated in the study. Family Perceptions of Care Tool and Family Perceptions of Caregiving Role developed by Maas and Buckwalter (1990) were used to investigate Korean family caregivers' perceptions of care. Findings from the study can be summarized as follows: a) family caregivers showed the lowest satisfaction level for staff management effectiveness, especially for facility's resources available for care, and (b) family caregivers showed the highest stress from staff members' control on caregiving, feeling the same responsibilities after placement, and guilt over their placement. The results contribute to the understanding of Korean family caregivers' perceptions of caregiving and the care relationship after institutionalizing their elderly persons with dementia.

PURPOSE: The purpose of this research is to identify factors influencing anticipatory nausea and vomiting in cancer patients.
METHODS
The conceptual framework was derived from Roy's Adaptation Model. The subjects for this study were 66 adult patients with various types of cancers, who were scheduled for a third cycle of chemotherapy or above.
RESULTS
47% of the patients experienced anticipatory nausea and vomiting.
CONCLUSION
The study identified two factors, psychological symptoms (p=.002) and severity of post-chemotherapy nausea and vomiting(p=.004), which are directly related to anticipatory nausea and vomiting. These two factors accounted for 39.5% of the anticipatory nausea and vomiting. Identified environmental cues were awareness of hospital setting, sensory stimuli, and experience of chemotherapy which induced nausea and vomiting. Strategies for relieving anticipatory nausea and vomiting taken by cancer patients were religion, reminiscence, distracting imagery, positive thinking, relaxation and physical exercise.

BACKGROUND: Blood pressure measurement are used by medical purposes. Most clinical staffs assume that its values are accurate and reliable irrespective of the measured position. In order to measure blood pressure exactly the cuffed upper arm and the heart should be kept at the same level. However, sometimes the blood pressure must be taken with the patient lying on his/her side. In this lateral position it is difficult to set the cuff at the heart's level. PURPOSE: This study aims at applying exact measurements of blood pressure to practical use. Blood pressure measurements taken from the four extremities (right arm, left arm, right leg and left leg) in the lateral position are compared to those taken in the right arm in the supine position.
METHODS
Thirty-one female and Thirty-two male subjects were sampled among fit students and the data were collected from May 7th, 2001 through June 7th, 2001. To begin with, the blood pressure of right arm in the supine position was measured. Then the blood pressure was measured again after 3 minutes in the subject's right lateral position.
RESULTS
The blood pressure in the left arm in the right lateral position was lower than the right arm's blood pressure in the supine position (systolic difference=15.57 mmHg, diastolic difference=10.86 mmHg).
DISCUSSION
Hydrostatic effects are the most likely cause of the drop in blood pressure of left arm in right lateral position. When blood pressure is measured in the left arm in the right lateral position, the position and site should be noted as well as the pressure may be 10mmHg or more lower than the precise blood pressure.

Sleep disturbance is a typical health problem of the elderly. The purpose of this study was to explore the extent of sleep disturbance of Korean elderly, and to identify the influencing and predicting factors. A total of 15216 subjects were interviewed. To measure the quality of sleep, "The Korean Sleep" Scale was used, and as influencing factors on sleep, physical health, emotional and social activity variables were included. In this study, the percentage of a change of sleep pattern was 59.2%, and it was higher in elderly women and in above 80 yrs. But only 10.4% of subjects regarded a change of sleep pattern as a problem, and it was higher in elderly women. Total sleeping time was shorter in female and it was shortest in 65-69yrs. The higher age, the presence of Ds, the longer sickdays, the lower level of ADL and IADL, the more depressive, the more tedious during the daytime, and the less frequent engagement in exercise, the lower quality of sleep measured by KSS. Predicting variables of quality of sleep included depression, boredness during the daytime, sex, the presence of Ds, IADL, the frequency of exercise during a week, and age. These seven variables explained 13% of total quality of sleep. The extent of change of sleep pattern in the elderly is very high. Continuous efforts to increase quality of sleep of the elderly by intervening in factors influencing quality of sleep are needed.

PURPOSE OF THE STUDY: A retrospective and descriptive survey was conducted to investigate the level of anxiety that patients experience in early stage of AMI and to examine whether anxiety independently predict inhospital complications. SIGNIFICANCE OF THE STUDY: AMI is a major cause of death and disability. Anxiety may contribute to developing complications and mortality. However, the association between anxiety and complications has not been examined.
RESULTS
Data were analyzed for 424 AMI patients enrolled for MICA (Myocardial Infarotion Complication and Anxiety) project. The mean score of the state anxiety inventory (SAI) measured within 72 hours after admission for the whole sample was 39.14 (+/-12.77) and ranged from 18 to 80. Overall, 161 patients (38.0%) experienced at least one episode of in-hospital complication (i.e. VT, VF, reinfarction, recurrent ischemia or cardiac death). Incidence of in-hospital complications was higher in the high anxiety group than in the low anxiety group (45.4% vs. 31.2%). There were significant differences in the incidence of recurrent ischemia between groups with low level of anxiety and high level of anxiety (27.5% vs. 18.9%). According to the Ward criterion from the logistic regression, anxiety reliably predicted the occurrence of in-hospital complications. Anxiety (odds ratio = 1.75, 95% CI 1.01-3.01, p= 0.04) significantly contributed to the model. Patients who were in the high anxiety group were 1.8 times more likely to have in-hospital complications than those who were in the low anxiety group.
CONCLUSION
AND SUGGESTION: This finding confirms that patients experience significant level of anxiety early after AMI, and this anxiety, after controlling other risk factors for the complications, is a reliable predictor of in-hospital complications.

To determine bowel patterns and the prevalence of defecation difficulty in young university students, we administered a self-reported questionnaire to 1,617 college students about their bowel habits and eating patterns and obtained the following: 83.7% showed defecation frequency between 2 times per day and 3 times per week, and 33.4% reported difficulty in defecation. Among the subjects with defecation difficulty, 69% complained of constipation and 31% of diarrhea. It was also shown that the prevalence of self-reported defecation difficulty varied by sex. Women were more likely to have defecation difficulty than men (OR=2.5; 95% CI: 2.005-3.149). There were also differences between men and women in respect to the bowel habits (frequency, regularity, thickness, volume, form and time required) and food preferences. Men reported a higher frequency of defecation than women (p<.001). The dietary fiber intake volume of the subjects with defecation difficulty was smaller than subjects without the problem (OR=0.83, CI; 0.706-0.978). Moreover, those whose favorite food was meat were more likely to have defecation difficulty than those preferred vegetables (OR=1.39; 95% CI: 1.058-1.820). Irregular defecation was reported in 44.5% of the students, especially non-residents of Cheolla province (OR=1.2; 95% CI: 1.007-1.480). Non-residents ate dietary fiber significantly less than residents and there were some differences in diet habits and also in bowel habits.

PURPOSE: The objective of this research is to provide the indoor environment management education program for the asthma patients and their families and then analyze the effectiveness in education preventing allergic asthma.
METHODS
A pre-post single group quasi-experimental design was used to provide an education program about correct indoor environment management to a total of 58 households (29 patient households and 29 normal households). The performance rate of correct indoor environment management procedure, amount of house dust mite antigen, allergy subjective symptoms score and knowledge score about indoor environment management were compared before and after the education to test the effectiveness of the education.
RESULTS
Home-visit education in this research had effects in improving subject households' performance rate of indoor environment management procedures, reducing the amount of house dust mite antigen - an important inducing factor of allergy, and reducing perceived subjective symptoms of allergy.

This cross-sectional design was to identify the age at menopause of Korean women using a national sample, and to examine relationships between age at menopause and the anthropometric, sociodemographic, biological and life style behavioral factors. Two thousand eight hundred seven naturally postmenopausal women aged between 41-65 years were recruited by self-selection from 7 metropolitans and 6 provinces in Korea from Dec. 20, 1998 to April 30, 1999. The age at menopause of Korean women was 49.2 years (mean) and 50.0 years (median). The range of age at menopause was 33.0 to 61.0 years. The significant influencing factors on age at menopause were body mass index, mother's and sister's age at menopause, alcohol use, physical activity, coffee preference, and residential area. The menopausal age of Korean women has slightly increased compared to a previous study.

PURPOSE: The purpose of this study is to grasp the conflicts that nurses are facing in their practice and to develop some nursing intervention on these conflicts of nurses. The subjects of this study are the nurses working at K hospital in Seoul. The data were taken from Jan. to May in 2001. It took me and half or two hours for each interview and six interviews were done for each subject. The data were analysed by Giorgi technique and conclusions are given as followings; 1. The unreasonable international relationship is derived from misunderstanding between peer groups in nursing, the lack of leadership, the relative property, irresponsible job done, under expectation and some unreasonable behaviors. 2. The changing portrait of oneself is view through the changed fram of mind, unreasonable fret and the changing appearance. 3. The limitations originated from lack of vision, lack of knowledge, lack of professionalism, lack of confidence and one's worry about one's job. 4. The poor working environments are such as lack of man power, lack of commodities, worn out facilities, irregular transferring of job, night work, overwork, good for nothing continuing education program and errors in the administration. 5. The conflicts between nurse's role in the hospital and a nurse as a homemaker are the lack of opportunity to educate their offsprings, multiple roles, and not cooperating husband who has to chip in his role as a partner. The nutshell of our study is that the working environment should be improved such that nurses can work with joy in their heart. Also the practical educational programs should be provided by hospital administration such that nurses can work in the hospital with pride in their heart

The purpose of this study was to develop an instrument to measure meaning in life based on Frankl's theory of logotherapy. Data were collected from August to October, 1999 by means of questionnaires developed by researchers. The subjects were 351 adults living in Busan and Kyoung Nam province. The study was conducted as follows: 1) A conceptual framework was identified based on the extensive review of relevant literatures and interviews with adults and professionals in psychology, philosophy, theology, and nursing. 2) The 76 items, 4-points scale were developed. 3) The scale was tested on 351 adults to assess the reliability and validity, and factor analysis was done. 4) 63 items were established based on this testing and ten factors were extracted. These factors were labeled as self-awareness and self-acceptance, futuristic aspiration, valuelessness, purpose in life, contentedness with life, role awareness, experience of love, love in family, commitment, self- transcendence. Cronbach's alpha of the 63 items was .950. Comparative studies to assess construct validity and repetitive studies to heighten generalizability are needed. This tool can be utilized to measure Korean's meaning in life.

PURPOSE: The object of this study was to explore and describe the experience of women living with lymphedema within a socio-medical context in Korea.
METHODS
Research data was collected through interviews and participant observation with 9 informants between February 2000 and July 2002. Data was examined using Spradley's taxonomy analyzing techniques.
RESULTS
5 themes were identified; 'overwhelming and despair over the ailment condition', 'distrust and abandonment of conventional medicine' 'shaming of losing maternity and femineity', 'returning to the permanent safe shelter', and 'struggling for reconstruction of one's self'. The 'chaotic' state of knowledge and health care system for lymphedmea patient affected the experiences of informants.
CONCLUSIONS
This result will be a basic understanding of psychosocial impact of lymphedema for the women and to develop the comprehensive nursing program including counseling program.

INTRODUCTION: Consumerism is prevailing value in Korean society, while there has been little concern about it especially in Korean nursing society even though there has been an increasing emphasis on patients' participation in decisions concerning health care and nursing as an ideal in the literature. OBJECTIVES AND METHODS: The study with survey method was carried out to examine the nature of collaboration between patient and nurse in nursing practice in Korea through a replication of the studies carried out in US, Norway, Finland, an Japan (Kim et al., 1993) and to revise and test Kim's explanatory model of collaborative decision making in nursing practice from the Korean perspectives. RESULTS & CONCLUSIONS: Both patients and nurses as groups exhibited pro-consumerist attitudes regarding collaboration in health care, while there were significant differences in attitudes and perceptions of patients and nurses. These findings are similar to those of Kim et al.' s study carried out in US, Norway, Finland, and Japan. Nurses as a group compared to patients held stronger health-care consumerist attitudes and beliefs in general. However, the Korean nurses seem to hold a weaker attitude for challenging professional authority. And the Korean patients compared to the nurses seem to hold stronger belief in the patient's right to information, as found in US, Finland, and Japan. Regarding the nurse patient collaborative attitude in decision making, it revealed that one third or more of the patients as a group believe in the patients' right to be informed of decisions that nurses make for their patients, while another one third or more of them believe in the patients' right for advisory role and joint role in nursing care decision making. This result for the patients is very similar as those found in US, Norway, Finland, and Japan. However, the attitude for the nurses held stronger agreement with patients' to be informed of decision making that nurses make than the patients' right for advisory and joint role. The nurses have weaker belief in patients' self determination on their care than the patients. The results of path analyses confirmed the explanatory models that tested two explanatory models examining the factors contributing to the differences in the attitudes of patients and nurses. The path model for nurses identified nurses' lengths of experience as the important factor explaining attitudes regarding challenging professional authority and the patient's rights for information. The path model for patients identified the level of education as the most significant factor that explains patients' attitudes regarding the rejection of general authority, challenging professional authority, and the patient's right for participation in decision making.

SIGNIFICANCE OF THE STUDY: Acute myocardial infarction (AMI) is a major cause of death in Korea. Delay in seeking treatment may cause unnecessary exacerbation of the disease and early mortality from AMI. Patients' recognition of symptoms of an AMI and response to those symptoms may influence the delay time. Bystanders' role in patients' seeking treatment after AMI has not been studied in previous research. Understanding reasons for delay in seeking treatment is important in developing interventions for reducing these delays and increasing survival rate from AMI. PURPOSE OF THE STUDY: A retrospective survey was conducted with 144 AMI patients to: (1) investigate time from symptom onset to arrival at the first hospital for treatment of AMI; (2) describe patient's and bystander's response to the patient's symptoms; (3)examine whether patient's and bystander's responses affect delay time.
RESULTS
The mean of overall pre-hospital delay time was 13.64 (21.86) hours and it consisted of patients' delay of 13.64 (22.32) hours and transportation time of 24.86 (19.41) minutes. People living in rural area delayed longer than people living in urban area. Pre-hospital delay time was associated with the bystander: patients delayed longer when they were with their spouse, family and friends than when with colleagues at work. Calling 119 saved transportation time, but did not reduce overall pre-hospital delay time.
CONCLUSION
AND SUGGESTIONS: Patients delay longer than the time window for a successful reperfusion therapy when they experience symptoms of AMI; and calling 119 does not diminish this delay. Bystanders' adequate response to the patients' symptom may reduce the delay time in seeking treatment. Findings from this study may suggest that health education and public campaigns are needed to increase people's recognition of symptoms of an AMI and to promote adequate response from bystanders to the AMI symptoms. In addition, public campaigns urging car operators to yield to the emergency vehicle are needed in order to reduce transportation time.

PURPOSE: This descriptive study was designed to find out the relationship between moral self concept and ethical sensitivity of nurse managers.
METHODS
Study data were collected from Aug 6, 2001 to Aug 24, 2001. Study subjects were 283 nurse managers working in university hospitals. Moral self concept was measured with questionnaire developed by Chung (1965) and ethical sensitivity was measured with the questionnaire developed by the researchers.
RESULTS
1. The score for degree of nurse managers' moral self concept was shown to be an average of 3.06 out of 4.00, which is relatively high. The score for degree of nurse managers' ethical sensitivity was shown to be an average of 2.84 out of 4.00 2. Analysis of correlation between moral self concept and ethical sensitivity showed a statistically significant positive correlation (r= .34, p=.00). 3. In general characteristics, a variable that caused significant difference in moral self concept was the total period of experience as a nurse (F=3.52, p=.02). A variable that caused significant difference in ethical sensitivity was the current working department (F=3.91, p=.01). 4. Nurse administrator's moral self concept was significantly related to ethical sensitivity (r= .34, p= .00).
CONCLUSION
It is important to intensify individual moral self concept in order to improve ethical sensitivity of nurse managers. Also, it is recommended that investigate variables affected moral self concept and develop a nursing education program to promote moral self concept in nurse administrators.