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Volume 34(8); December 2004
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Original Articles
A Comparison of Smoking Control Strategies in Korea and the United States
Chung Yul Lee, Ok Kyung Ham, Yoon Mi Hong
Journal of Korean Academy of Nursing 2004;34(8):1379-1387.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2004.34.8.1379
AbstractAbstract PDF

The purpose of this study was to compare smoking control strategies between Korea and the United States. Korea and other developing countries may learn from the experience of the United States in dealing with the growing epidemic of cigarettes. In particular, smoking control objectives, structures, laws and regulations, funds, programs and activities, research, and surveillance systems were compared. The comparison was conducted at the federal, states/provincial, and county levels of the two countries. The data were collected through various governmental websites, contact with people directly, and a literature review. Based on the comparison, seven recommendations for smoking control strategies were made primarily for Korea.

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Prevalence and Determining Factors related to Depression Among Adult Women in Korea
Kyung Rim Shin, Chol Shin, Sun Young Park, Hye Ryeon Yi
Journal of Korean Academy of Nursing 2004;34(8):1388-1394.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2004.34.8.1388
AbstractAbstract PDF
Purpose

Korean women are likely to experience symptoms of depression, possibly due to socially fixed limitations on the roles that Korean women are expected to perform. Also if a Korean woman experinces negative relationship problem or stress in her family, she would feel responsible, which will worsen her depression. Nonetheless, much of the research on depression among Korean women has focused on menopausal women. This study aims to understand the depression of Korean women to provide fundamental data to develop nursing intervention method for promoting women's health.

Methods

The present investigation assessed the prevalence and correlates of depression in a large sample of Korean women, aged 18 or older, from the general population. With a probability sample of 3312 women drawn from two areas in Korea, a survey, which contains the Center for Epidemiological Studies Depression Scale (CES-D) and background, was completed.

Results

According to CES-D classification criteria, 36.5% of the women in the sample displayed either no depression or mild depression, 55.6% exhibited moderate depression, and 7.8% manifested severe depression. Significant bivariate relationships were observed between depression and each measured background variable except alcohol use. Logistic regression analysis indicated that the strongest combination of predictors of depression included income, menopausal, and marital status.

Conclusion

The data support the premise that Korean women disproportionately experience elevated levels of depression. Consistent with the theory, depression may be related to social pressures to conform to the traditional roles. The study suggests the need for further research, primary prevention activities, and increased access to treatment.

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Perimenstrual Symptoms of Korean Women Living in the USA: Applicability of the WDHD(Women's daily health diary)on Prospective Report
Hae Won Kim
Journal of Korean Academy of Nursing 2004;34(8):1395-1401.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2004.34.8.1395
AbstractAbstract
Purpose

To compare perimenstrual (premenstrual, menstrual, postmenstrual) symptoms by concurrent reporting using the Women's Daily Health Diary (WDHD) and by retrospective reporting using the Moos Menstrual Distress Questionnaire (MMDQ).

Methods

A prospective and retrospective study was conducted among 31 Korean women, aged 27 to 48 yrs, living in the USA.

Results

On the prospective report using the WDHD, the most severe complaints were fatigue or tiredness (1.48 +/−.98), sensation of weight gain (.88+/−98), increased appetite (.79+/−.96) in premenstrual phase, fatigue or tiredness (1.34+/−.85), backaches (1.06+/+.79), and bloating or swelling of the abdomen (.93+/−.86) during the menstrual phase. On the retrospective report using the MMDQ, the most severe complaints during the premenstrual phase were fatigue (2.2 6+/−1.65), irritability (2.06+/−1.48), and backaches (1.97+/−1.68) and during the menstrual phase backaches (2.35+/−1.62), fatigue (2.29+/−1.75), and cramps (2.23+/−1.80). According to both measurements of PMS symptomology during the premenstrual and menstrual phases, the most frequently reported symptom was fatigue or tiredness. Highly rated symptoms on the MMDQ and on the WDHD were found to be similar.

Conclusion

The WDHD was found to be suitable for daily prospective PMS assessment, which will be necessary for the screening and management of women with severe PMS.

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Case Reports
Self-Care in Elders with Dementia: A Concept Analysis
Hye A Yeom
Journal of Korean Academy of Nursing 2004;34(8):1402-1408.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2004.34.8.1402
AbstractAbstract
Purpose

The purpose of this study was to analyze the concept of self-care in elders with dementia through a review of nursing literature and to provide more understanding of the definition and perspectives of the concept of self-care notion in elders with dementia.

Methods

The technique developed by Walker and Avant was used as a guide in analyzing the concept of selfcare.

Results

Attributes of self-care in dementia may include a single or group of actions needed for sustaining life, a personal effort to maintain functional independence while minimizing other's assistance, an outcome behavior from the person's interaction with inter-personal and/or contextual environment, and a functional ability that may decline in parallel to cognitive impairment. Antecedents of self-care in dementia may include at least presence of a certain degree of cognitive appraisal for the self-care needs, self-willingness for the selfcare action, spatial and visual orientation, cultural pre-conception of the self-care behavior, presence of environmental context/equipment available for self-care, and sufficient time available. The consequences may include sustaining of life, feel of satisfaction, achieving independence, extended life expectancy, increased self-confidence, decreased caregiver distress and/or burden, savings in health care costs.

Discussion

Defining attributes and antecedents and consequences of self-care in dementia identified in this study provided empirical ground of a middle-range theory of self-care for a clinical population with dementia and generated possible hypotheses to be tested in future studies.

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Original Articles
Effect of Taegyo-focused Prenatal Education on Maternal-fetal Attachment and Self-efficacy Related to Childbirth
SoonBok Chang, Somi Park, ChaeWeon Chung
Journal of Korean Academy of Nursing 2004;34(8):1409-1415.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2004.34.8.1409
AbstractAbstract PDF
Purpose

To examine the effect of Taegyo-focused prenatal classes on maternal-fetal attachment and self-efficacy related to childbirth.

Methods

Over 4 weeks, 49 women, 20 to 36 weeks of gestation participated in a prenatal program led by the nurse who developed it. In addition to Lamaze content it included; understanding ability of fetus to respond, sharing motivation, purpose of pregnancy, and preconceptions of experiencing childbirth, training in maternal-fetal interaction, writing letters and making a declaration of love to unborn baby. Using a pre-experimental design, data were collected by self-report, before and after program, using Cranley's Maternal-Fetal Attachment Scale (1981), and Shin's (1997) Labor Self-Efficacy Measurement.

Results and Conclusion

Paired t-test showed significant changes in scores of maternal-fetal attachment (t=6.91. p<.001) and self-efficacy related to childbirth (t=10.19, p<.001). Taegyo opens the possibility of integrating Western ideas with Korean traditional health behavior. Incorporation of Taegyo into existing prenatal classes is recommended.

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The Role Adaptation Process of Head Nurses in the General Hospitals
Sung Rye Kang
Journal of Korean Academy of Nursing 2004;34(8):1416-1426.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2004.34.8.1416
AbstractAbstract PDF
Purpose

The purpose of this study is to identify the role adaptation process experienced by head nurses.

Methods

Data were collected from 10 head nurses with in-depth interviews about their actual experiences. All the interviews were recorded and transcribed. The collected data were analyzed by the grounded theory methodology of Strauss and Corbin.

Results

The core category was identified as “weighing and balancing,” and the role adaptation process was divided into six stages by time sequence: inquiring, approaching to others, bringing people into their fold, working with conviction, avoiding conflicts, and settling.

Conclusion

The results of this study yield useful information for top mangers of nursing to identify, by stages, the demands of the head nurses in their role adaptation process. The findings of this study contributes to developing programs that facilitates the head nurses' role adaptation.

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The Development and Evaluation of an Incontinence Intervention Program for the Elderly Women at Elderly Welfare Center
Jeungim Kim
Journal of Korean Academy of Nursing 2004;34(8):1427-1433.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2004.34.8.1427
AbstractAbstract PDF
Purpose

The elderly with UI experienced urine leakage for a long time. The prevalence of UI has increased and it makes costly. Particularly, the elderly were reluctant to visit a hospital or a clinic for the reasons of modesty and poverty. To solve this problem, incontinence intervention programs should be provided at the elderly welfare center. The purpose of this research was to develop Incontinence Intervention Program for the Elderly Women (IIPE) and evaluate in its effect.

Methods

The study design was quasi-experimental with pre and post-test. The study was performed for ten weeks at one elderly welfare center, Seoul, Korea. The subjects were gathered through an official announcement and informed consent was obtained. IIPE, in this study, was consisted of diagnosis, education, exercise and evaluation. The study variables were PFM exercise adherence, pelvic muscle strength, Continence selfefficacy, geriatric depression and incontinence stress. The effects of the IIPE on PFM exercise adherence, pelvic muscle strength, Continence self-efficacy, geriatric depression and incontinence stress were also evaluated.

Results

The mean age of the subjects was 75.2 years. The average attendance was 6.2 times. The IIPE improved PFM exercise adherence, intra-vaginal contraction power and CSE significantly. But it was not significant in incontinence stress and geriatric depression. Other important results were that the two-finger test and urine stream interruption were more useful for elderly women with rigid vaginas in teaching and evaluating.

Conclusion

The Findings suggest that IIPE is effective to the community-residing elderly. Further investigation is needed on a long-term basis with control group.

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A Q-methodological Study on Nursing Students' Attitudes toward Nursing Ethics
Eun Ja Yeun, Young Mi Kwon, Hung Kyu Kim
Journal of Korean Academy of Nursing 2004;34(8):1434-1442.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2004.34.8.1434
AbstractAbstract PDF
Purpose

Professional nursing ethics is a living, dynamic set of standards for nurses'professional moral behavior. Furthermore, in daily clinical nursing training, nursing students are constantly confronted with decisionmaking that is moral in nature. The aim of this study was to identify the perceived ethical attitudes in the clinical training process of senior nursing students using Q-methodology to offer basic strategies for nursing ethics education and thereby improve patients'care.

Methods

Q-methodology provides a scientific method for identifying perception structures that exist within certain individuals or groups. Thirty-seven participants in a university rated 38 selected Q-statements on a scale of 1-9. The collected data were analyzed using pc-QUNAL software.

Results

Principal component analysis identified 3 types of ethical attitudes in nursing students in Korea. The categories were labeled Sacred-life, Science-realistic and Humane-life. Sacred-life individuals think that a life belongs to an absolute power (God), not a man, and a human life is a high and noble thing. Science-realistic individuals disagreed that allowing an induced abortion or embryo (human) duplication is unethical behavior that provokes a trend, which takes the value of a life lightly; most of them took a utilitarian position with respect to ethical decisions. Humane-life individuals exhibit a tendency toward human-centered thought with respect to ethical attitudes.

Conclusion

This study will be of interest to educators of students of nursing and hospital nursing administrators. Also, the findings may provide the basis for the development of more appropriate strategies to improve nursing ethics education programs.

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Predictors of Tobacco-Control Activities of Community Health Practitioners: Report from a National Survey
Kim, Jin Sun , Song, Mee Suk , Oh, Hyun Ei
Journal of Korean Academy of Nursing 2004;34(8):1443-1450.   Published online December 31, 2003
AbstractAbstract PDF
The involvement of health-care professionals in tobacco-control activities is essential to prevent smoking-related morbidity and mortality. The purposes of this predictive correlational study were to examine tobacco-control activities and to identify the predictors of such activities of community health practitioners (CHPs). Of the 1,813 members of the Korean Association of CHP, 1,247 participated in this study. A mailed survey was conducted to collect data. The majority of CHPs supported tobacco-control policies and recognized tobacco-control activities as an important role for them. Only 44.3% of CHPs were confident in their knowledge and skills regarding tobacco-control activities, and only 30.8% had received professional tobacco-control education. While the majority of the CHPs "asked, advised, and assessed"their clients, only a small number "assisted or arranged". The tobacco-control activities of CHPs were predicted by their attitude toward it, age, experience of tobacco-control education, educational level, and general perception of the risk of smoking; these variables accounted 13.5% of variance in the tobacco-control activities of CHPs. These findings provide the basis for developing a continuing education program for CHPs. CHPs should be encouraged to integrate tobacco-control activities into their routine practice, and CHP education programs should be adjusted to increase the time spent on the tobacco-control intervention techniques.
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A Study on Aggressive Behavior Among Nursing Home Residents with Cognitive Impairment
Heeyoung Oh, Miran Eom, Yunjung Kwon
Journal of Korean Academy of Nursing 2004;34(8):1451-1459.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2004.34.8.1451
AbstractAbstract PDF
Purpose

With a sample of cognitively impaired nursing home residents and nursing staff, the following were examined 1) the proportion and nature of aggressive behavior, 2) the frequency and types of aggressive behavior, 3) the difference between the residents who demonstrate aggressive behavior and those who do not demonstrate aggressive behavior (age, mental status, functional status, and pain, length of nursing home stay), and 4) nursing staff responses to aggressive behavior by residents.

Methods

A cross-sectional descriptive study design was used. Data were collected from cognitively impaired nursing home residents (N=205) and nursing staff (N=60) at two nursing homes using Ryden Aggression Scale I and II, Mini-Mental State Exam, Modified Barthel Index, Verbal Descriptor Scale, and aggressive behavior management questionnaire. Data were analyzed using descriptive statistics including t-test.

Results

About 62.9% residents were found to be aggressive and 38.5% were both physically and verbally aggressive. Pushing, making threatening gestures, hitting, slapping, cursing/obscene/vulgar languages, making verbal threats were occurred frequently. Aggressive residents were significantly older, had more cognitive impairment, had more pain, and stayed longer in the nursing home when compared with non-aggressive residents. Considerable proportion of nursing staff responded to aggressive behaviors inadequately.

Conclusion

Aggressive behavior among cognitively impaired nursing home residents is prevalent thus needs to be prevented and reduced. Along with environmental modification, educational programs for nursing staff and family caregivers need to be developed and implemented so that they can have extensive knowledge and skills to manage aggressive behaviors.

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Predictors of the Utilization of Oral Health Services by Children of Low-income Families in the United States: Beliefs, Cost, or Provider?
Young Ok Rhee Kim, Sharon Telleen
Journal of Korean Academy of Nursing 2004;34(8):1460-1467.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2004.34.8.1460
AbstractAbstract PDF
Purpose

This study examined the predictive factors enabling access to children's oral health care at the level of financial barriers, beliefs, and the provider.

Methods

In-depth interviews were conducted with 320 immigrant mothers of low-income families regarding their use of oral health services for children aged four to eight years old. Access to oral health care was measured with frequency of planned dental visits, continuity of care, and age at first visit to dentist.

Results

The mother took her child to the dentist at a younger age if she received referrals to a dentist from pediatrician. Regular dental visits were significantly related to household income, provider availability on weekends, and insurance coverage. The extended clinic hours in the evenings, and the belief in the importance of the child's regular dentist visits increased the likelihood of continuing care. The mothers perceiving a cost burden for the child's dental care were also less likely to return to the dentist.

Conclusion

The available care delivery system, coordinated medical care, and health beliefs were among important predictors of the health service use. The study findings suggest need for culturally competent dental health interventions to enhance access to oral health care among particularly vulnerable populations such as low-income children in Korean communities.

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The Effects of a Home-Visiting Discharge Education on Maternal Self-esteem, Maternal Attachment, Postpartum Depression and Family Function in the Mothers of NICU Infants
Young Mee Ahn, Mi Ran Kim
Journal of Korean Academy of Nursing 2004;34(8):1468-1476.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2004.34.8.1468
AbstractAbstract PDF
Purpose

A quasi-experimental study was performed to investigate the effects of a home visiting discharge education program on the maternal self-esteem, attachment, postpartum depression and family function in 35 mothers of neonatal intensive care unit (NICU) infants.

Methods

Twenty-three mothers in the intervention group received the home visiting discharge education while 12 mothers in the control group received the routine, hospital discharge education. Baseline data was collected in both groups one day after delivery. The intervention group received the home visiting discharge education while the control group did the routine hospital-based discharge education. The questionnaire including the data on maternal self-esteem, attachment, postpartum depression and family function were collected within 1week after the discharge by mail.

Results

The scores of maternal self-esteem, and attachment were significantly increased, and the postpartum depression and the family function score were decreased after the home visiting discharge education in intervention group. There were no changes in these variables before and after the routine hospital-based discharge education in control group.

Conclusion

These results support the beneficial effects of home visiting discharge education on the maternal role adaptation and family function of the mothers of NICU infants.

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Commercial Sex Workers'Condom Use Behavior in Korea
Surin Shin, Hee Sun Kang, Soon Bok Chang
Journal of Korean Academy of Nursing 2004;34(8):1477-1482.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2004.34.8.1477
AbstractAbstract PDF
Purpose

With the continuous spread of the AIDS virus and other sexually transmitted diseases (STDs) throughout Asia, it has become imperative for HIV/AIDS prevention outreach programs to stress the need for using prophylactics as one form of protection. This is particularly true for commercial sex workers. This pilot study was conducted to investigate the rate of condom use among the commercial sex workers in Korea and reasons why they frequently do not wear condoms during sexual intercourse.

Methods

Fifty female commercial sex workers who worked in the Yong San area were recruited while outreach was performed and forty eight responses were analyzed due to two incomplete questionnaires. The data were collected on June 28, 2004 as part of an outreach program for condom use promotion.

Results

The subjects ranged in age from 21 to 45 years. Nearly half of the subjects (47.9%) did not consistently use condoms. The major reason for not using protection was clients'reluctances for using condoms. When condoms were used, the subjects preferred lubricant-rich and less painful condom during intercourse.

Conclusion

Due to the inconsistent use of condoms, it is clear that many commercial sex workers and clients are susceptible to sexually transmitted diseases. Therefore, it is important to not only educate commercial sex workers, but also to educate their pimps and clientele about the importance of condom use. In general, it is recommended that practical strategies and a policy for condom use promotion be developed.

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Risk Factors for Falls among the Community-Dwelling Elderly in Korea
Kyeong Yae Sohng, Jung Soon Moon, Hae Hiang Song, Kwang Soo Lee, Young Sook Kim
Journal of Korean Academy of Nursing 2004;34(8):1483-1490.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2004.34.8.1483
AbstractAbstract PDF

Community-based centres were surveyed to determine the frequency of and risk factors for falls among elderly Koreans. We examined fall-related risk factors, including physiological and physical health, psychosocial functions, self-reported physical capacity and activity, vision, and the use of medication, among 351 elderly people aged 65 years or older, with ambulatory. Forty-two per cent of elderly Korean subjects reported at least one episode of falling in the previous 12 months, 38% of whom had consequences that required either the attention of a physician or hospitalization.

Factors significantly associated with an increased risk of falling were a restricted activity during the previous five years (adjusted OR 1.3), use of alternative therapy (adjusted OR 2.7), low knee flexor and extensor-muscle strength (adjusted OR 1.21 and 1.20), and poor balance with closed eyes (adjusted OR 8.32).

We conclude that falls among older persons living in the community are common in Korea and that indicator of bad health and frailty or variables directly related to neuromuscular impairment are significant predictors of the risk of falling.

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Rearing Behavior and Rearing Stress of Fathers with Children of Preschool and School Age
Ja Hyung Lee, Hye Young Kim, Young Ae Park
Journal of Korean Academy of Nursing 2004;34(8):1491-1498.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2004.34.8.1491
AbstractAbstract PDF
Purpose

This study was conducted to compare the paternal rearing behavior and rearing stress level between fathers with a preschooler and fathers with school children so that it can be utilized as a basic source for developing parental rearing education programs.

Methods

A descriptive comparative method was conducted to identify the paternal rearing behavior and paternal rearing stress. Respondents were 361 fathers who had either preschoolers (n=189) or children of elementary age (n=172).

Results

Comparing the two group's means, the rearing activity score and rearing stress there were significant differences. In the school children's group's father, ‘ outdoor activity’ and ‘ guidance on discipline activity’ were significantly higher than the other group. In the preschool children's fathers group, ‘ play interaction activity’ was statistically significant higher than the other, and the child-part mean score of paternal rearing stress was significantly higher than the other group. The correlation between paternal rearing behavior and paternal rearing stress, indicates that more paternal rearing behavior means less paternal rearing stress.

Conclusion

These results of this study will help design more effective rearing programs for fathers that have either preschool children or school children by providing the basic data for paternal rearing behaviors and paternal rearing stress.

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Attitudes toward the Elderly among Nursing Students in Korea
Jung Hee Kim, Gwi Ryung Son, Donna L. Algase
Journal of Korean Academy of Nursing 2004;34(8):1499-1508.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2004.34.8.1499
AbstractAbstract PDF
Purpose

The primary purpose of this study was to reexamine underlying dimensions of attitudes toward the elderly held by undergraduate nursing students. A secondary purpose was to investigate characteristics of nursing students associated with attitudes toward elders.

Methods

A survey was performed using self-report questionnaire completed by nursing students from a total of 10 nursing schools or departments each selected randomly from one province of Korea. Students' responses (N=366) were analyzed using factor analysis, correlation coefficients, t-test, and ANOVA.

Results

Three attitudinal dimensions explaining 35.29% of the variance were extracted: vitality, generosity and flexibility. From a neutral point of 4.0 in the range of 1 to 7, only generosity (4.47) was evaluated positively, whereas vitality (3.31) and flexibility (2.91) were evaluated negatively. The mean scores of the vitality and generosity dimensions were significantly different by students' level of communication with the elderly, experience living with the elderly, and interest in elders or in issues related to elders. Interest in elders/elder issues was the only characteristic affecting significant mean score difference in flexibility.

Conclusion

Educational process should increase students' exposure to healthy elderly to modify negative attitudes toward the elderly among nursing students.

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