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Volume 36(7); December 2006
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Original Articles
Effects of Aerobic Exercise Using a Flex-band on Physical Functions & Body Image in Women Undergoing Radiation Therapy after a Mastectomy
Hyang Sook So, In Sook Kim, Jung Han Yoon, Oh Jang Park
Journal of Korean Academy of Nursing 2006;36(7):1111-1122.   Published online December 31, 2006
DOI: https://doi.org/10.4040/jkan.2006.36.7.1111
AbstractAbstract PDF
Purpose

This study examined the effects of aerobic exercise using a flex band on the improvement of physical functions & body image in breast cancer women undergoing radiation therapy after a mastectomy.

Method

Women with breast cancer(n = 26) were assigned to an experimental group(EG, n = 15) and control group(CG, n = 11). The E.G. participated in an aerobic exercise program with a 60% to 80% intensity of maximal heart rate for 25 minutes during the main exercise, 3 times per week, for 6 weeks. The EG did not exercise regularly for 3 months before participating in this program. The CG received no exercise treatment during the research period. Data were analyzed using the χ2-test and Mann-Whitney U test by the SPSS version 11.0 program at a 5% significant level.

Result

Group analysis revealed that the EGwomen had significantly more improved cardiopulmonary functions, ROM of the affected shoulder joint, and body image compared to the CG.

Conclusion

Aerobic exercise using a flex band may be an effective rehabilitative measure for mastectomy women with respect to cardio-pulmonary functions, ROM, & body image. Further studies are recommended to study early rehabilitation programs within 10 days post-operatively.

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The Effects of the Inhalation Method Using Essential Oils on Blood Pressure and Stress Responses of Clients with Essential Hypertension
Jin Hee Hwang
Journal of Korean Academy of Nursing 2006;36(7):1123-1134.   Published online December 31, 2006
DOI: https://doi.org/10.4040/jkan.2006.36.7.1123
AbstractAbstract PDF
Purpose

The purpose of this study was to identify the effects of aromatherapy on blood pressure and stress responses of clients with essential hypertension.

Method

There were fifty-two subjects divided into an essential oil group, placebo group, and control group by random assignment. The application of aromatherapy was the inhalation method of blending oils with lavender, ylangylang, and bergamot once daily for 4 weeks. To evaluate the effects of aromatherapy, blood pressure and pulse were measured two times a week and serum cortisol levels, catecholamine levels, subjective stress, and state anxiety were measured before and after treatment in the three groups. Data was analyzed by repeated measures of ANOVA, one-way ANOVA, and χ2-test using the SPSS 10.0 program.

Results

The blood pressure, pulse, subjective stress, state anxiety, and serum cortisol levels among the three groups were significantly statistically different. The differences of catecholamine among the three groups were not significant statistically.

Conclusion

The results suggest that the inhalation method using essential oils can be considered an effective nursing intervention that reduces psychological stress responses and serum cortisol levels, as well as the blood pressure of clients with essential hypertension.

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Effects of a Structured Drug Education Program on Knowledge and Medication Compliance for Hemodialysis Patients
Hyang Sook So, Ae Yeong Kim, Eun A Kim, Su Mi Kim
Journal of Korean Academy of Nursing 2006;36(7):1135-1144.   Published online December 31, 2006
DOI: https://doi.org/10.4040/jkan.2006.36.7.1135
AbstractAbstract PDF
Purpose

The purpose of this study was to analysis the effects of a structured drug education program on knowledge and medication compliance for hemodialysis patients.

Method

Hemodialysis patients were recruited from a kidney center, at a university hospital located in G city, Korea. Thirty subjects in the control group received no intervention and 30 subjects in the experimental group received a structured drug education program.

Result

There were significant increases in medication knowledge and medication compliance in the experimental group compared to the control group.

Conclusion

According to the above results, this education program for hemodialysis patients increased knowledge and medication compliance. These findings suggest that a structured drug education program can be used as an efficient nursing intervention for hemodialysis patients.

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Comparison of Quality of Life between Kidney Transplant and Hemodialysis Patients
Sook Hee Oh, Eun Kwang Yoo
Journal of Korean Academy of Nursing 2006;36(7):1145-1153.   Published online December 31, 2006
DOI: https://doi.org/10.4040/jkan.2006.36.7.1145
AbstractAbstract PDF
Purpose

The purpose of this study was to discover kidney transplant and hemodialysis patients' quality of life(QOL) and provide basic data to improve their QOL.

Method

One hundred two hemodialysis patients and 106 kidney transplant patients were given a self-administered questionnaire from Mar. 6 to Mar. 31, 2006. The instrument consisted of demographic variables, therapeutic-related characteristics and QOL. Collected data was processed using the SPSS 12.0 statistical program for real numbers, percentages, ANCOVA, t-test, ANOVA, Stepwise multiple regression and the Scheffe test.

Results

Kidney transplantpatients' QOL was higher than hemodialysis patients. The demographic variables which showed a significant difference in overall QOL were religion, children and monthly income for kidney transplantpatients and educational background for hemodialysis patients. The therapeutic-related variable which showed a significant difference in overall QOL was the patients' perceived health condition for both groups. The influencing factor on overall QOL for both groups was the health condition perceived by themselves. The total variance of the variable for QOL was 42% for kidney transplant patients and 19% for hemodialysis patients.

Conclusion

This study revealed that kidney transplant patients have a higher QOL and how patients perceive their health is the strongest influencing factor for QOL. However, there is a large difference between the demand and supply of kidney donors. To solve this problem the standards for donation should be reviewed and revised.

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Development of E-Mail Education for Hyperlipidemia Health Check-up and Application Effects
Sang Sook Han, Sun Hee Kim
Journal of Korean Academy of Nursing 2006;36(7):1154-1163.   Published online December 31, 2006
DOI: https://doi.org/10.4040/jkan.2006.36.7.1154
AbstractAbstract PDF
Purpose

This study was to monitor the effects of forming desirable eating and exercise habits and change the blood lipid levels by developing and applying E-Mail educational programs for a hyperlipidemia health check-up.

Method

The research design used a nonequivalent control group pre-post test. Ninety-nine subjects (Exp.=50, Cont.=49) were selected randomly and the male subjects agreed to a hyperlipidemia health check-up at a comprehensive medical screening center. This study verified validity and reliability through factor analysis on a life habit measurement tool. The data was analyzed with SPSS win 12.0 using an χ2-test,t-test, ANOVA and ANCOVA.

Result

Eatingand exercise habit scores of the experimental group which were educated through E-Mails changed considerably more than that of the control group which was not educated. Total-cholesterol and LDLcholesterol in the experimental group was considerably lower than that in the control group, but HDL-cholesterol increased considerably. Triglycerides, however, didn't show change.

Conclusion

An E-Mail educational program may be applied as a hyperlipidemia health check-up nursing intervention strategy.

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The Effects of a PMS Nutritional Education Program for College Students
Hae Won Kim
Journal of Korean Academy of Nursing 2006;36(7):1164-1174.   Published online December 31, 2006
DOI: https://doi.org/10.4040/jkan.2006.36.7.1164
AbstractAbstract PDF
Purpose

This study was conducted to identify the effects of a PMS nutritional education program for college nursing students.

Method

Subjects consisted of nursing students(experimental group: 29, control group: 27). The experimental group participated in a PMS nutritional education program for 8 weeks (including group and individual involvement). Data was collected before and after the education, and measurement tools were premenstrual symptoms, PMS knowledge, and self health behavior.

Results

After the intervention, the experimental group showed a significant increase in PMS knowledge(Z=6.32, p=.000) and self health behavior(t=3.00, p=.004) compared to the control group. After the intervention the experimental group showed a significant increase in PMS knowledge(Z=-4.64, p=.000) and self health behavior(t=-3.04, p=.005) than before the intervention.

Conclusions

These results suggest that the short term effects of a PMS nutritional education program for nursing students was proven useful and the program should be applied to PMS nutrition education for PMS clients as well as health professionals.

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Effects of Education on Knowledge and Practice of Caregivers of the Stroke Patient
Jae Sun Choi, Young Mi Seo, In Soo Kwon
Journal of Korean Academy of Nursing 2006;36(7):1175-1182.   Published online December 31, 2006
DOI: https://doi.org/10.4040/jkan.2006.36.7.1175
AbstractAbstract PDF
Purpose

This study was conducted to evaluate the effects of stroke patient care education on the knowledge and practice of caregivers of stroke patients.

Method

Data was collected from December 15, 2004 to March 30, 2005. The research design was a non-equivalent control group non-synchronized design. The subjects were forty primary caregivers of stroke patients who were hospitalized in a neurology unit of a university hospital. Forty caregivers, twenty in the experimental group and twenty in the control group were assigned. The experimental group participated 2 times in an education class given by the researcher. Data analysis included -test, and t-test using the SPSS program.

Result

Knowledge(t=5..87, p=o.oo) and practice(t=5.53, p=0.00) of the experimental group were significantly different from the control group.

Conclusion

The stroke patient care education developed in this studyshows a significant promotion of knowledge and practice of caregivers. Thus this program can be recommanded as an intervention model for stroke patients and caregivers.

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A Preliminary Survey of Nurses' Understanding of Delirium and Their Need for Delirium Education: In a University Hospital
Young Sook Park, Keum Soon Kim, Kyung Ja Song, Jiyeon Kang
Journal of Korean Academy of Nursing 2006;36(7):1183-1192.   Published online December 31, 2006
DOI: https://doi.org/10.4040/jkan.2006.36.7.1183
AbstractAbstract PDF
Purpose

The purpose of this survey was to investigate clinical nurses' understanding of delirium and their educational need of delirious patient care.

Method

A survey questionnaire regarding nurses' general perception and understanding of delirium, experience with delirious patients and educational need was developed and conducted with 179 clinical nurses in a university hospital in Seoul. Data was analyzed using descriptive statistics.

Results

Nurses thought that delirium was one of the most important nursing problems and they considered it to be more treatable than to be preventable. However, the majority of nurses were not confident in caring for delirious patients. Nurses reported that delirium happened most often after surgery, and that possible contributing factors could be changes in physical environment and anxiety/stress, as well as medication and long-term isolation. Thirteen nursing interventions were identified but half of the nurses utilized only one or two of the thirteen. The most frequently used intervention was reorienting the patient followed by medication and emotional support, presenting family, and close observation. 99.5% of nurses addressed the importance of professional education on delirium care, especially in the area of intervention and management.

Conclusion

The results support the strong need for development of a multi-component educational program on delirium care.

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Current Status of Costs and Utilizations of Hospital Based Home Health Nursing Care in Korea
Hosihn Ryu
Journal of Korean Academy of Nursing 2006;36(7):1193-1203.   Published online December 31, 2006
DOI: https://doi.org/10.4040/jkan.2006.36.7.1193
AbstractAbstract PDF
Purpose

The purpose of this study was to describe the current status of utilization and costs of home health nursing care by the levels of medical institutes in Korea.

Method

A secondary analysis of existing data was used from the national electronic data information(EDI) of 148 home health agencies for 6 months from May to Oct 2005 in total.

Result

The 148 agencies had multiple services in cerebral infaction, essential hypertension, sequela of cerebrovascular disease, type 2 diabetes mellitus, etc.. The highest 10 rankings of 76 categories of home health nursing services were composed of 96.4% of the total services, such as simple treatment, inflammatory treatment, urethra & bladder irrigation, inserting indwelling catheter etc., in that order. The highest 20 rankings of 226 categories of home examination services were composed of 77.0% of the total home examination services. In addition, the average cost of home health care per visit was 46,088 Won (≒48 $, 1 $=960 Won). The costs ranged from 74,523 Won (≒78 $, loss of chronic kidney function, N18) to 32,270 Won (≒34 $, other cerebrovascular diseases, I67).

Conclusion

Results suggest that client characteristics of hospital based HHNC are not different from community based HHNC or visiting nursing services for elderly. The national results will contribute to baseline data used to establish a policy for the home health nursing care system and education.

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Status of Nosocomial Urinary Tract Infections in the ICU: Molecular Epidemiology of Imipenem Resistant P. aeruginosa
Seong Mi Yu, Seong Sook Jeon, In Soon Kang, Hye Gyung An
Journal of Korean Academy of Nursing 2006;36(7):1204-1214.   Published online December 31, 2006
DOI: https://doi.org/10.4040/jkan.2006.36.7.1204
AbstractAbstract PDF
Purpose

This retrospective study was done to evaluate the status of nosocomial urinary tract infections and to determine the risk factors andtransmission route of causal IRPA through molecular epidemiology.

Method

Two hundred ninety-nine of 423 patients admitted to the internal medicine and surgery ICU at a university hospital incity B had a positiveurine culture. Twelve of the 299 patients who had a urinary tract infection had IRPA strains. The data was collected from November 1, 2004 to January 31, 2005. The following results were obtained after the data was analyzed using percentile and UPGMA.

Result

The rate of nosocomial urinary tract infections in the ICU was 10.8%. Therewere 16.8 cases of infection based on the period of hospitalization. There were 16.9 cases of infection based on the use of a foley catheter. The rate of nosocomial urinary tract infection in the ICU and urinary tract infections related to IRPA were higher in patients with the following characteristics: men, old age, admission through the emergency room, longer than seven days admission, severity of admitting causes, disturbance of consciousness, hydration less than 300cc in 24hours, a long course of antibiotics, a long period of foley catheterization and perineal care. Most of the microorganisms that caused the urinary tract infection were gram negative bacilli, among which P. aeruginosa was found in 70 patients (18.5%) and IRPA in 12 (4.0%). Among the 12 IRPA strains that were tested with PFGE, eight showed a dice coefficient higher than 80%, suggesting a genetic relationship. They were related with the period of hospitalization in the same ICU. These patients all received direct care for a urinary tract infection.

Conclusion

Through these results, IRPA can be consideredas a contributing factors to urinary tract infections thus, active preventative measures are needed by the medical staff.

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Experiences of Being Tied with Drugs in the Elderly Women in Community
Jeong Sun Kim
Journal of Korean Academy of Nursing 2006;36(7):1215-1223.   Published online December 31, 2006
DOI: https://doi.org/10.4040/jkan.2006.36.7.1215
AbstractAbstract PDF
Purpose

This study was done to understand elderly women within a community who have used lots of drugs.

Method

Data was collected through in-depth interviews with four elderly women from April 2001 to February 2002. Data was analyzed by Giorgi's phenomenological method(2000).

Results

The components in common with drug usage of elderly women were as follows: ‘Awareness of the limitation of physical strength and uncertainty of life’, ‘Dread of a crisis situation occurring’, ‘Attachment and dependency on drugs’, ‘Expectation of a comfortable life and death’, ‘Prevention of family burden’, and ‘Pursuit of psychological comfort’. The general structure of experiences was as follows: causal factors were ‘Awareness of uncertainty and limitation’, ‘dread of a crisis situation occurring’ the results factor was ‘Attachment and dependency on drugs’ and the facilitating factors were ‘Expectation of a comfortable life and death’, ‘Prevention of family burden’, and ‘Pursuit of psychological comfort’. The causal relation was cyclic. This structure showed a realistic adaptation pattern.

Conclusion

This study contributed to provide fundamental data for nursing interventions for health promotion and promoting quality of life in elderly women by increasing understanding of the experiences of drugs use.

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Comprehensive Predictors of Fatigue for Cancer Patients
Young Min Seo, Hyun Soo Oh, Wha Sook Seo, Hwa Soon Kim
Journal of Korean Academy of Nursing 2006;36(7):1224-1231.   Published online December 31, 2006
DOI: https://doi.org/10.4040/jkan.2006.36.7.1224
AbstractAbstract PDF
Purpose

This study was conducted to identify comprehensive predictors of fatigue in cancer patients.

Methods

One hundred ten cancer patients visiting in-patient or out-patient clinics of a university hospital located in Incheon participated in this study.

Results

The hematologic indicators (WBC and Hemoglobin) were significant for explaining fatigue. The psychological factors of fatigue were statistically significant. Both anxiety and depression, included as psychological factors, were significant in explaining fatigue in cancer patients. The influence of physical factors on fatigue was also statistically significant. Among the variables included as physical factors, pain, nausea/vomiting/anorexia, and sleep disturbance were significant whereas, dyspnea was not significant. The influence of the daily activity factor on fatigue was statistically significant. Among the variables included as daily activity factors, regular exercise or not and the usual activity level were significant in explaining fatigue of cancer patients, while the level of rest was not statistically significant.

Conclusion

From the study results fatigue of cancer patients appeared to be influenced by multidimensional factors, such as physiological, physical, psychological, and activity related factors.

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Effects of Isometric Contraction Training by Electrostimulation on Type I and II Hindlimb Muscles in Cerebral Ischemia Model Rats
Yoon Kyong Lee, Myoung Ae Choe, Gyeong Ju An
Journal of Korean Academy of Nursing 2006;36(7):1232-1241.   Published online December 31, 2006
DOI: https://doi.org/10.4040/jkan.2006.36.7.1232
AbstractAbstract PDF
Purpose

The purpose of this study was to examine the effects of cerebral ischemia on Type I(soleus) and Type II(plantaris, gastrocnemius) muscles, and to determine the effects of isometric contraction training by electrostimulation on Type I andII muscles in cerebral ischemia model rats.

Method

Twenty-five male Sprague-Dawley rats were randomly divided into four groups: ST(stroke), STES(stroke+electrostimulation), SH(sham) and SHES (sham+electrostimulation). The ST and STES groups received a transient right middle cerebral artery occlusion operation. The SH and SHES groups received a sham operation. The STES and SHES groups had daily isometric contraction training by electrostimulation(100Hz, 45mA, 7.5V) on hindlimb muscles for 7days.

Result

Plantaris and gastrocenmius muscle weight, myofibrillar protein contents of soleus and gastrocnemius, and the muscle fiber cross-sectional area of gastrocnemius in the ST group significantly decreased compared with the SH group. Soleus, plantaris, gastrocnemius muscle weight, myofibrillar protein contents of soleus and gastrocnemius, and the Type I muscle fiber cross-sectional area of soleus and the Type II muscle fiber cross-sectional area of gastrocnemius in the STES group significantly increased compared with the ST group.

Conclusion

Hindlimb muscle atrophy occurs after acute stroke and isometric contraction training by electrostimulation during early stages of a stroke attenuates muscle atrophy of Type I and Type II muscles.

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The Attitudes of Nurses Toward Transsexuals
Eun Nam Lee, Ji Min Seo, Hyeon Ok Ju, Young Sun Song, Dong Mei Lee, Bok Nam Lee, Sun Mi Shin, Yeon Hee Ju, Ok Hee Choi, Yeong Hee Heo
Journal of Korean Academy of Nursing 2006;36(7):1242-1252.   Published online December 31, 2006
DOI: https://doi.org/10.4040/jkan.2006.36.7.1242
AbstractAbstract PDF
Purpose

The purpose of this study was to identify the attitude of nurses toward transsexuals.

Method

The Q-methodology which provides a method of analyzing the subjectivity of each item was used. Twenty-nine nurses classified the 50 selected Q-statements into a normal distribution using a 9 point scale. The collected data was analyzed using the Quanl PC program.

Result

Four types of attitudes toward transsexuals were identified. The first type (humanitarian acceptance) showed an attitude of respecting transsexuals as human beings and understanding and accepting their desires and difficulties. The second type (superficial understanding) understood the psychological conflicts and suffering of transsexuals but could not accept them as members of families or society. The third type (insufficient understanding) did not feel a sense of rejection toward transsexuals but showed a lack of understanding of their desires and difficulties. The fourth type (rejection) failed to understand the desires and difficulties of transsexuals and showed a sense of rejection toward them, in addition to regarding them as sexually immoral people.

Conclusion

The results of the study indicate that different approaches of educational programs based on the four types of attitudes toward transsexuals are recommended.

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A Conversation Analysis of Communication between Patients with Dementia and Their Professional Nurses
Myungsun Yi, Bong Sook Yih
Journal of Korean Academy of Nursing 2006;36(7):1253-1264.   Published online December 31, 2006
DOI: https://doi.org/10.4040/jkan.2006.36.7.1253
AbstractAbstract PDF
Purpose

The purpose of this study was to understand conversations and to identify typical conversational problems between nurses and patients with dementia.

Method

A conversation analysis method was used. The data was collected in a geriatric institutional setting, using a videotape recorder, and transcribed. The transcribed data was analyzed in terms of expressions, contents, and relationships to identify communicative problems and their resolutions.

Results

Among a total of 532 episodes, 440(82.7%) were identified as nurse-involved episodes. In addition, 66 of the 440 episodes were selected based on the significance of the conversation. The communicative problems between nurses and patients in terms of expressions were identified as “directive and authoritative expressions”, “emotional and competitive expressions”, “evasive and on-looking expressions”, and “excessive use of title only”, such as calling them granny or grandpa without proper names. In terms of content and relationships, “lack of themes in psychosocial areas” and “nurse-led relations” were identified respectively as communicative problems.

Conclusion

The results of this study will provide substantial guidelines for nurses in caring for elderly patients with dementia by deeply understanding linguistic structures and problems of everyday conversations between nurses and patients with dementia.

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Evaluation of a Virtual Class on Lifelong Health Care for Women
Jeong Sook Park, Jin Hyang Yang
Journal of Korean Academy of Nursing 2006;36(7):1265-1273.   Published online December 31, 2006
DOI: https://doi.org/10.4040/jkan.2006.36.7.1265
AbstractAbstract PDF
Purpose

This study was to evaluate a virtual class, ‘lifelong health care for women’, for female university students.

Method

The research design was one group pre-post design. A pretest and posttest were conducted to measure CMI, perceived health status, health promoting lifestyle, and knowledge related to women's health. The subjects of this study were 74 female students in 3 universities, and they were provided with the virtual class by K university consortium for 16 weeks. Data was analyzed by descriptive and paired t-test.

Results

There were statistically significant differences in CMI (t=3.367, p=.001), perceived health status (t=-2.788, p=.007), and knowledge related to women's health (t=-10,432, p=.000) between the pretest and posttest. However, there was not a statistically significant difference in a health promoting lifestyle (t=-1.431, p=.157) between the pretest and posttest.

Conclusion

These results suggest that a virtual class on lifelong health care for women is aneffective method in decreasing health problems, and improving perceived health status and knowledge related to women's health by female university students.

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