A curriculum development model is presented to examine the processes necessary to develop new programs or evaluate existing programs within the philosophy of outcomes-based education in nursing, especially in the context of accreditation. The philosophy of outcomes-based education is to produce individuals who can demonstrate the evidence of competencies in designated areas of education. For nursing education, this means competencies in performing the role of professional nursing as defined by the profession and social needs at the beginning level upon completing a nursing program.

A curriculum development model has been developed analytically based on the literature and experiences.

A 10-step process framework incorporating the tenets of outcomes-based nursing education is illustrated.

This curriculum development framework can be applied in developing new educational programs in nursing or to evaluate and revise existing programs in anticipation of the accreditation process that is moving with a full force in such countries as Korea.

The current study was done to identify individual- and group-level factors associated with health care service utilization among Korean medical aid beneficiaries by applying multilevel modeling.

Secondary data analysis was performed using data on health care service reimbursement and medical aid case management progress from 15,948 beneficiaries, and data from 229 regions were included in the analysis.

Results of multilevel analysis showed an estimated intraclass correlation coefficient (ICC) of 18.1%, indicating that the group level accounted for 18.1% of the total variance in health care service utilization, and that beneficiaries within the region are more likely to share common features with regard to health care service utilization. At the individual level, existence of disability and types of medical aid beneficiaries showed a significant association, while, at the group level, social deprivation index, and the number of beneficiaries and case managers within the region showed a significant association with health care service utilization.

The significant influence of group level variables in health care service utilization found in this study indicate a need for group level approaches, such as policy change and/ or promotion of community awareness.

This study was done to develop a video discharge education program focusing on mother-infant interaction to facilitate the development of maternal role confidence for mothers of premature infants.

The process of the program was based on the Network-based Instructional System Design suggested by Jung (1999). For the content of the program, needs and concerns of mothers of premature infants found on web sites and existing literature were analyzed. Based on this content, the scenario and the video were developed. Nurses and mothers of premature infants participated in the process of testing the content validity, scenario development, and evaluation of final video production. The final video has two parts and lasts 21 minutes. The first part focuses on mother-premature infant interaction and the second part focuses on health management of infants.

Eleven mothers of premature infants participated in the evaluation of the appropriateness of the video as a teaching method and for educational content. They reported that the content on mother-infant interaction, maternal sensitivity, and maternal role confidence was especially beneficial.

The findings indicate that video program is effective for education on maternal-premature infant interaction and the use of video in practical settings is strongly recommended.

To investigate the effect of progressive resistance training (PRT) on body composition, physical fitness, quality of life, lipid and nutritional profile of patients on hemodialysis (HD).

A non equivalent comparison group pretest and posttest design study was used with 40 participants who were randomly assigned to the exercise group (20 participants) and the comparison group (20 participants). The exercise group received PRT for 30 minutes per session, 3 sessions a week, for 12 weeks, while the comparison group received usual care. The PRT consisted of upper and lower body exercises using elastic bands and sandbags. Outcome measures evaluated were: body composition, physical fitness, quality of life, and lipid profile.

Skeletal muscle mass, grip, leg muscle strength, and quality of life all improved significantly in the exercise group. Body fat rate, total cholesterol and triglyceride rate decreased significantly in the exercise group.

These results suggest that PRT improves body composition, physical fitness, quality of life, and lipid profile of patients on HD. PRT using elastic bands and sandbags can be utilized as part of a regular care plan for these patients.

This study was conducted to develop a gambling addictive behavior scale for adolescents.

The process involved construction of a conceptual framework, initial item search, verification of content validity, selection of secondary items, and extraction of final items. The participants were 299 adolescents from two middle schools and four high schools. Item analysis, factor analysis, criterion validity, internal consistency, and ROC curve were used to analyze the data.

For the final scale, 25 items were selected, and categorized into 4 factors which accounted for 54.9% of the total variance. The factors were labeled as loss of control, life dysfunction from gambling addiction, gambling experience, and social dysfunction from problem gambling. The scores for the scale were significantly correlated with addictive personality, irrational gambling belief, and adolescent's gambling addictive behavior. Cronbach’s alpha coefficient for the 25 items was .94. Scale scores identified adolescents as being in a problem gambling group, a non-problem gambling group, and a non-gambling group by the ROC curve.

The above findings indicate that the gambling addictive behavior scale has good validity and reliability and can be used with adolescents in Korea.

The purpose of this study was to evaluate a self-care program for elders with osteoarthritis managed by primary health care workers, Community Health Practitioners (CHPs), in rural Korea.

The self-care program, consisting of 7 areas, was evaluated with a randomized experimental study for patients over age 60 with osteoarthritis in which 150 participants in the experimental group and 140 in the control group were compared. The self-care program was implemented for six weeks, 2 hours per week, at community health posts by CHPs. Data were collected using an interview questionnaire given by the CHPs and laboratory tests before and after the intervention for both groups. Propensity score matching analysis was done to test effectiveness after controlling for confounding variables.

The intervention group showed a significant decrease in the number of painful joints (p<.001) and a significant increase in self-care ability (p<.05) compared to the control group.

Study results indicate that training and utilizing primary health care workers in rural areas is valuable in increasing the generalization and continuity of intervention programs. As arthritis should be managed life-long, CHP directed self-care programs are useful interventions for rural elders with arthritis to learn self-care management.

The purpose of this study was to translate the Spiritual Perspective Scale (SPS) and Self-transcendence Scale (STS) into Korean and test the psychometric properties of the instruments with Korean elders.

A cross-sectional survey design was used to implement the three stages of the study. Stage I consisted of translating and reviewing the scales by six experts. In Stage II, equivalence was tested by comparing the responses between the Korean and English versions among 71 bilingual adults. Stage III established the psychometric properties of the Korean versions SPS-K and STS-K among 154 Korean elders.

Cronbach's alpha of the SPS-K and the STS-K .97, and .85 respectively with Korean elders. Factor analysis showed that the SPS-K had one factor; the STS-K had four factors with one factor clearly representing self-transcendence as theorized. Both scales showed good reliability and validity for the translated Korean versions. However, continued study of the construct validity of the STS-K is needed.

Study findings indicate that the SPS-K and the STS-K could be useful for nurses and geriatric researchers to assess a broadly defined spirituality, and to conduct research on spirituality and health among Korean elders. Use of these scales within a theory-based study may contribute to further knowledge about the role of spirituality in the health and well-being of Korean people facing health crises.

The purpose of this study was to evaluate the effects of a school-based intervention program for middle school adolescent girls with depression.

The study was a pretest–posttest repeated-measure design with a nonequivalent control group. Fifty eight students with depressive symptoms were recruited from two middle schools in Seoul, Korea. The data were collected from the intervention (n= 30) and the comparison group (n= 28). The research instrument was Reynolds Adolescent Depression Scale.

The intervention group greatly improved from baseline to 10 weeks and then saw a slight positive change between 10 and 13 weeks.

The results of this research show that depression intervention programs are effective for young female adolescents. Thus the investigation has important school-based treatment implications, and should be integrated into school curriculums by school health nurses for early intervention of depressive symptoms in middle school adolescent girls.

The purpose of this study was to verify prevalence rates of atopic dermatitis (AD) in middle school students in Korea and to define AD and associated factors.

This study was conducted using secondary analysis of raw data from the ‘The 6th Korean National Adolescent Health Behavior Survey, 2010’ conducted by the Korea Centers for Disease Control. The participants were 37,570 students. General characteristics and health behavior-related characteristics were analyzed using descriptive statistics, χ²-test and logistic regression analysis.

Results are as follows. 1. There were 8,494 middle school students (22.6%), who had been diagnosed with AD during the last 12 months. 2. Factors associated with AD in middle school students were gender (p< .001), grade level (p= .001), father’s education (p< .001), mother’s education (p= .032), regular dietary habits (breakfasts, p= .025; lunches; p= .003), stress (p< .001), recognition of subjective awareness of one’s health conditions (p< .001), hand washing before meals at school (p= .013), and cessation education for both smoking (p= .002) and alcohol (p= .031).

Results of the study indicate that in order to alleviate AD symptoms in these students, there is a need to develop nursing interventions and education programs taking into consideration these variables and verifying the effects of interventions and programs.

The purpose of this study was to identify the characteristics of anger expression in middle-aged Korean women by categorizing their patterns of expression while considering the complexity and multidimensionality of anger, and by investigating the characteristics relative to the patterns.

The research design was a descriptive design using Q methodology, which is a method of measuring subjectivity. A convenience sample of 42 participants aged 40–60 years and living in the community in Korea was recruited. The PC-QUANL software program (a factor analysis program for the Q technique) was used to analyze the Q-sort data.

Four factors were extracted that described different expressions of anger among middle-aged Korean women; these factors explained 50.1% of the total variance. The frames of reference of the four factors were a) direct diversion, b) silent masking with remaining anger, c) self digestion, and d) controlling anger with objectification.

In this study has identified patterns and characteristics of anger expression among middle-aged Korean women were identified, which will aid the development of effective anger-management programs for controlling anger in this population. In future studies, it would be helpful to investigate how the patterns of anger expression established herein are associated with specific health problems such as cardiovascular disorder and cancer.

This study was done to evaluate effectiveness of home healthcare services (HHCS) specialized for elders who received spinal surgeries.

A non-equivalent control group pre-post test quasi-experimental study was performed. HHCS was developed based on the Rice model of dynamic self-determination for self-care. For data collection, a control group (n=23) and an experimental group (n=23) were selected by matching age, BMI, pain, general characteristics and type of spine surgery. Measurement tools to evaluate uncertainty and knowledge were developed by the authors. The Numeric Rating Scale (NRS) and Japanese Orthopedic Association Back Pain Evaluation Questionnaire (JOABPEQ) were used to evaluate pain levels. Muscular strength in the legs was measured using a digital muscle tester and tape ruler. Questionnaires were used to evaluate disability in performing ADL and psychological distress levels.

The experimental group showed significant decrease in uncertainty (p=.028), increased knowledge (p=.038), and partially decreased pain (p=.003-.331). Partial muscle strength increased significantly (p=.021-.644). Disability in performing ADL and psychological distress in the experimental group decreased significantly compared to control group (p=.002, p=.004).

Results indicate HHCS is an efficient home care nursing program for these elders. Further experimental studies with larger samples are required to confirm effects of HHCS.

To examine geographical imbalances by analyzing new graduate nurses' migration patterns among regions where they grew up, attended nursing school, and had their first employment and to identify factors related to working in non-metropolitan areas.

The sample consisted of 507 new graduates working in hospitals as full-time registered nurses in South Korea. Migration patterns were categorized into 5 patterns based on sequential transitions of "geographic origin-nursing school-hospital." Multiple logistic regression analysis was conducted to identify factors associated with working in non-metropolitan hospitals.

Nurses who grew up, graduated, and worked in the same region accounted for the greatest proportion (54%). Sixty-five percent had their first employment in the region where they graduated. Nurses tended to move from poor to rich regions and from non-metropolitan to metropolitan areas. Working in non-metropolitan hospitals was related to older age, the father having completed less than 4 years of college education, non-metropolitan origin, non-capital city school graduation, and a diploma (vs. baccalaureate) degree.

Admitting students with rural backgrounds, increasing rural nursing school admission capacities, and providing service-requiring scholarships, particularly for students from low-income families, are recommended to address geographical imbalances.

This study was done to analyze the job of clinical research coordinators (CRCs).

Through the "developing a curriculum (DACUM)" workshop, the definition of CRCs' role was described and CRCs' duties and tasks were identified. Finally, the developed duties and tasks were validated for importance, difficulty, and frequency.

A CRC is defined as the one who coordinates and performs tasks related to clinical research/trials among investigators, participants, and sponsors according to the Good Clinical Practice at institutions conducting clinical trials. Twelve duties and 78 tasks were identified on the DACUM chart which represented the importance, difficulty, and frequency of tasks represented as A, B, and C respectively. Based on determinant coefficient (DC) of the task, the highest ranked task was confirming the eligibility of participants for research (DC=8.03) and the lowest was inventory management for clinical study materials (3.95).

In this study, the job of a CRC was analyzed through the DACUM process and it was found that CRCs were doing various duties and tasks. Based on these results, it is suggested that it is necessary to develop CRC education programs considering the career ladder of CRCs.

From the holistic environmental perspective, individual and environmental influences on low-income children's questionable development were identified and examined as to differences in the influences according to the child's developmental stage of infancy (age 0-35 months) or early childhood (age 36-71 months).

This study was a cross-sectional comparative design using negative binominal regression analysis to identify predictors of questionable development separately for each developmental stage. The sample was comprised of 952 children (357 in infancy and 495 in early childhood) from low-income families in South Korea. Predictors included individual factors: child's age and gender; proximal environmental influences: family factors (family health conditions, primary caregiver, child-caregiver relationship, depression in primary caregiver) and institution factors (daycare enrollment, days per week in daycare); and distal environmental influences: income/resources factors (family income, personal resources and social resources); and community factors (perceived child-rearing environment). The outcome variable was questionable development.

Significant contributors to questionable development in the infancy group were age, family health conditions, and personal resources; in the early childhood group, significant contributors were gender, family health conditions, grandparent as a primary caregiver, child-caregiver relationships, daycare enrollment, and personal resources.

Factors influencing children's questionable development may vary by developmental stage. It is important to consider differences in individual and environmental influences when developing targeted interventions to ensure that children attain their optimal developmental goals at each developmental stage. Understanding this may lead nursing professionals to design more effective preventive interventions for low-income children.

The purpose of this study was to identify the effects of mothers' involvement in a dental health program for their elementary school children.

This study was a non-equivalent control group pre-post test design in which knowledge and behaviors related to dental health, perceived benefits and barriers, self-efficacy and plaque control scores were compared between the experimental group (n=26) for whom the dental health program included the direct involvement of the mothers, and the control group (n=24) for whom knowledge related to dental health was provided through brochures.

Scores for the experimental group in which the mothers were involved in the dental health program were significantly higher for knowledge, behaviors in dental health, self-efficacy and plaque control compared to the control group.

Results of this study suggest that mothers involvement in the dental health program is effective in reinforcing dental health enhancing behavior in elementary school children.

Meager research has been carried out to determine the effectiveness of the token economy among patients behaving violently in mental hospitals. The purpose of this study was to examine the effectiveness of the Short-Term Token Economy (STTE) on violent behavior among chronic psychiatric in-patients.

A nonequivalent control group design method was utilized. Participants in an experimental group (n=22) and control group (n=22) took part in this study from January to April, 2008. Observation on aggressive behavior among male in-patients in one hospital as a baseline was made during the week before the behavior modification program and measurement of aggressive behavior was done using the Overt Aggression Scale (OAS), which includes verbal attacks, property damage and physical attacks.

The aggressive behavior scores of the experimental group decreased, those of the control group, scores showed an increase after the eight-week behavior modification program utilizing STTE.

The results of the study indicate that STTE is effective in reducing the incidence of aggressive behavior among male in-patients in psychiatric hospitals. The outcome of this study should be helpful in reducing the use of coercive measures or psychoactive medication in controlling the violent behavior among in-patients in hospitals.

The purpose of this study was to examine the effects of a face-to-face self-management educational program on knowledge, self-care practice and kidney function in patients with chronic kidney disease (CKD) before kidney replacement therapy.

This study employed a nonequivalent control group, non-synchronized design. Data were collected from 61 patients with CKD visiting an outpatient department of nephrology in a university hospital in Seoul, South Korea. The experimental group (n=31) took the pre-test, then after 3 weeks, face-to-face education and individualized consultation (1st intervention), after a week of self-practice, the 1st post-test, followed by re-enforcement education and consultation (2nd intervention), and 4 weeks later, the 2nd post-test. The control group (n=30) took the pre-test and post-tests at 4 and 8 weeks.

Scores for knowledge of CKD and self-care practice over time improved significantly in the experimental group compared to the control group. Kidney function did not improve significantly in the experimental group.

Health care providers can identify various and individualized needs, and provide effective education and consultation through face to face self-management for patients with chronic irreversible illnesses. Nurses can coordinate for these program by designing and providing systematic and effective education.

The purpose of this study was to develop and evaluate psychometric properties of the instrument, Resuscitation Self-Efficacy Scale for nurses.

This was a methodological study for instrument development and psychometric testing. The initial item pool derived from literature review and experts resulted in 30 items linked to resuscitation self-efficacy. A convenience sample of 509 Korean nurses from eleven academic teaching hospitals participated in a survey to examine psychometric properties of the scale. To examine construct validity, exploratory factor analysis and known-group comparison were used. Cronbach's coefficient alpha was used to determine the scale's internal consistency reliability.

The final scale included 17 items with four-component structure termed 'Recognition', 'Debriefing and recording', 'Responding and rescuing', and 'Reporting'. These four factors accounted for 57.5% of the variance. Each subscale and the total scale demonstrated satisfactory internal consistency: .82; .88; .87; .83; and .91 respectively. Experienced nurses reported significantly higher self-efficacy mean scores in both total and subscales compared to new graduate nurses.

The Resuscitation Self-Efficacy Scale for nurses yields reliable and valid results in appraising the level of resuscitation self-efficacy for Korean nurses. Further study is needed to test and refine the scale.

This study aimed to identify relationships between compassion fatigue, burnout, and turnover intention in Korean hospital nurses.

In total, 142 hospital nurses were surveyed as part of data collection. Data related to compassion fatigue, burnout, and turnover intention were collected using a questionnaire between May 2011 and September 2011. The data analysis was performed using PASW 19.0 program, which included one-way ANOVA, independent t-tests, Pearson's correlation coefficient, and hierarchical regression analysis.

This study detected a positive correlation between compassion fatigue and burnout(r=.37, p<.001), and turnover intention(r=.55, p<.001). Compassion fatigue accounted for 29.6% of the variance for turnover intention among Korean hospital nurses.

The results indicate that it is necessary to reduce compassion fatigue, and turnover intention among Korean hospital nurses.

The purpose of this study was to investigate the contribution of actual cardiovascular disease (CVD) risk, as well as, individual, psychosocial, and work-related factors as predictors of CVD risk perception among Korean blue-collar workers.

The participants were 238 Korean blue-collar workers who worked in small companies. Data were collected through a survey; anthropometric and blood pressure measures; and blood sampling for lipid levels.

Blue-collar workers had high actual CVD risk and low CVD risk perception. The significant predictors of risk perception included perceived health status, alcohol consumption, knowledge of CVD risk, actual CVD risk, decision latitude, and shift work. The model explained 26% of the variance in CVD risk perception.

The result suggests when occupational health nurses are giving routine health examination in small companies, they can enhance CVD risk perception in blue-collar workers by providing essential information about CVD risk factors and personal counseling on the individual worker's CVD risk status.