The main purposes of the study were to develop and test a model which explains the dynamic relationship among factors reported as affecting to the quality of life of individuals with rheumatoid arthritis and to examine the relationship between self-help response and quality of life. Data for the study were collected from March 1996 to December 1996 from 153 female patients who regularly visited a clinic for people with rheumatism. The Patients were introduced to the investigators by nurses who worked at that clinic, and then the investigator interviewed the patients for 30 to 40 minutes to collect the data. Instruments used in the study were modified self-report questionnaires from the ones which were already developed in previous studies of from related literature. Data analysis were performed using LISREL(Lineal Structural Relations) 8 Program to test whether the proposed hypothesized model fit the collected data. To test fitablity of the hypothesized model both a general fit measure and a detailed fit measure were used. Based on the test results from the various fit measures, the hypothesized model was found to be well suited to the real data. As characteristics related to illness becomes severe, the feasibility for uncertainty about the illness tend to increase, but, the direct effects from the illness characteristics(such as level of physical symptoms, sense of social-psychologic change, limitations of action) as they are related to the other intrinsic variables(self-efficacy or self-help behavior and quality of life), were found to be not significant. It was found that uncertainty had a direct effect on self-efficacy but did not have a direct effect on self-help behavior or quality of life. Also, it is noted that self-efficacy had a positive effect on self-help behavior and quality of life and there was a bilateral relationship between self-efficacy and self-help behavior. Lastly, the hypothesis proposed from the theoretical model in this study was supported basis of the results that self-help behavior provides both direct and positive effects to quality of life. Particularity, since a bilateral relationship was also found between self-help behavior and quality of life in the modified model, as self-help behavior increased, so did quality of life. And, reversely, as quality of life increased, so did self-help behavior. In conclusion, the results of this study suggest that focusing on both acquirement and reinforcement of adjustment factors or self-help behavior is more efficient than focusing on the characteristics of illness in establishing the strategies for improving quality of life of individuals with rheumatoid arthritis.

Postpartum depression is one of the most serious problems in maternal health because it affects not only the mother but also her family. Postpartum depression disturbs the maternal-infant interaction and attachment. However, most postpartum depression patients ignore this problem and do not seek treatment. Many clinicians and researchers realize there is a need to develop a postpartum depression scale. Thus, this study has been designed to development of a postpartum depression scale. Data were collected through a survey over a period of three months. Subjects who participated in the study were 167 Korean mothers in their postpartum period. The author used a convenience sampling method. The analysis of the data was done with SPSS PC+ for descriptive statistics, item analysis and factor analysis. Initially 62 items were generated from the interview data of eight postpartum depression patients and from a literature review. This preliminary scale was analyzed for reliability and validity. The results of this analysis are as follows. 1. Initially 62 items were analyzed through the index of Content Validity(CVI)and 48 items were selected. 2. Seven factors were extracted through the principal component analysis, and these contributed 61% of the variance in the total score. Finally 46 items in the scale loaded .41~.84 on one of seven factors. 3. Each factor was labeled. Factor 1 was labeled 'emotional phenomena-emotional upset' and included 13 items, factor 2 was labeled 'cognitive phenomena-self concept disturbance' and included seven items, factor 3 was labeled 'relationship to baby-negative feeling' and included six items, factor 4 was labeled 'relationship to baby-overload' and included eight items, factor 5 was labeled 'negative maternal identity' and included five items, factor 6 was labeled 'biophysiological phenomena-disturbance of physical functioning' and included four items, and factor 7 was labeled 'interpersonal relationship phenomena-blamed others' and included three items. 4. Cronbach Coefficient Alpha for internal consistency was .95 for the total 46 items. Finally, the author suggests that this scale could be adequately applied in assessing the postpartum depression of mothers during the postpartum period. The results of this study can contribute to designing an appropriate postpartum depression prevention strategy.

Rheumatoid Arthritis(RA), a chronic and systemic inflammatory disorder, is characterized by joint pain, swelling and stiffness. Patients with RA suffer from joint pain and overall pain. The painful and disabling consequences of RA are accompanied by a variety of affective, cognitive, and behavioral changes. The purpose of this paper was to explore and describe the life experiences of RA patients by eliciting verbal description of their experiences. Participants were nine persons who were diagnosed with RA, and had if for more than six months. They were asked open ended and descriptive questions in order for them to talk about their experiences in their own terms. Interviews were tape recorded and transcribed verbatim. The transcripts were analyzed by Colaizzi method. From the protocols, 213 significant statements about life experience were organized into 83 formulating meanings which were then grouped into five theme clusters. The major themes that emerged from the analysis were 'Emotional Disturbances', 'Trying to Adapt to the Progress of Treatment', ' Change of Role Performances', 'Experiences related to Family'. The result of this study showed that RA patients and families need nursing care based on a deep understanding of their lived experiences in everyday life. Nurses and other health workers must develop rehabilitation programs that focus on the pain control, functional independence and psychosocial factors.

The purpose of this study is to explore types of postpartum depression and to understand the nature and structure of the postpartum depression by using Q-methodological approach. As a way of research, 55 statements concerning postpartum depression were selected through individual interviews with postpartum mothers and literature review. 30 women were chosen as a subject group for the study, with opinions shown in 55 statements divided into 9 scales by forced distribution. PC QUANL Program was used for analysis and Q-factors were analyzed by using principal component analysis. As a result, postpartum depression experience was classified into 5 types. There are "Role -Strain Type", "Unattributional Depression Type", "Psychosomatic Symptoms Type", "Self-Compassion Type", and "Role-Crisis Type". Type I was named "Role-Strain Type", referring to the strain generally experienced by mothers with regard to the new role as a mother and as a social member. Type II was named "Unattributional Depression Type", referring to the symptom experienced by people who were in a state of vanity and a sense of loss. They often break into tears for no specific reasons. In case of Type III, people in a state of "Psychosomatic Symptoms Type" develop physical symptoms after suffering from inherent emotional conflict. Type IV was named "Self-Compassion Type" refers to the symptom shown by those who feel pity for their children and for themselves. And they show inability to cope with the reality properly. Type V was named "Role-Crisis Type", which is experienced by people who have a burden and a severe fear of their own job and their children in their mind, also showing serious conflict with maternal role. Futhermore, it was carried out to examine structure of postpartum depression in terms of degree of depression and adjustment ability. Type I showed mild degree of depression and relatively good adjustment ability. Type II showed broad range of degree in depression and moderate adjustment ability. Type III showed moderate depression and relatively low adjustment ability. Type IV revealed relatively serious degree of depression and the lowest adjustment ability. Type V revealed very serious degree of depression and the lowest adjustment ability. As a result, considering the structure of postpartum depression, Type I is considered to be a normal depression sympton which most mothers generally experience, followed by Type II, Type III, Type IV and Type V, each of which show increasingly worse degree of depression and lower adjustment ability. In conclusion, it seems to be it is necessary to understand distinct symptoms of postpartum depression and to examine the characteristics and structure of those types, so that it could lead to more individual nursing approach.

In an attempt to investigate the effect of a muscle strengthening exercise program on muscle strength, pain, depression, self-efficacy and quality of life of patients with knee osteoarthritis, a pre-experiment, one group pre-test and post-test design, was planned. Muscle strengthening exercise was carried out from May 22 through August 14, 1995 at isokinetic exercise room in rehabilitation department of University Hospital in Taejon. The subjects were seven female clients conveniently sampled from University Hospital located in Taejon, between 39 and 61 years of age, who had a osteoarthritis in knee. Muscle strengthening exercise program was composed of three sessions per week, one isokinetic exercise at angular velocity of 60degrees and 180degrees with Cybex isokinetic dynamometer and two resistance home exercise sessions with elastic band. Data were analyzed with frequency, percentage of change, Friedman test, Duncan test using SAS program. Results were obtained as follows: 1) Flexion and extension muscle strength at angular velocity of 60degrees and 180degrees were increased after 12weeks' exercise than those of before experiment. But exept flexion muscle strength at angular velocity of 180degrees (F=3.34, P=0.0261), there was no statistically significant difference among muscle strengths, which is measured every 3 weeks. 2) Pain was decreased after 6weeks' exercise than that of before experiment, and after 12weeks' exercise than that of 6weeks' exercise. There was statistically significant difference(F=4.28, P= 0.0396). 3) Depression was increased after 6weeks' exercise than that of before experiment, and after 12weeks' execise than that of 6weeks' exercise. There was no statistically significant difference between before experiment and after 6weeks' exercise. But, there was statistically significant difference between after 6weeks' exercise and 12weeks' exercise (F=9.38, P=0.0035). 4) Self-efficacy was decreased after 6weeks' exercise than that of before exercise. But, it was increased after 12weeks' exercise than that of before exercise and after 6weeks' exercise. But there was no statistically significant difference (F=1.46, P=0.2706). 5) Quality of life was increased after Gweeks' exercise than that of before exercise, and after 6weeks' exercise than that of 12weeks' exercise. But there was no statistically significant differ-ence(F=1.06, P=0.3816). Thus, the significant of muscle strengthening exercise for the improvement of muscle strength, pain, depression, is verified. But, this study was a preexperiment with small size subjects. So, controlled experimental study is necessary to determine the effect of this muscle strengthening exercise program on muscle strength, pain, depression, self-efficacy, and quality of life of patients with knee osteoarthritis.

Neural networks have recently attracted considerable attention in the field of classification and other areas. The purpose of this study was to demonstrate an experiment using back-propagation neural network model applied to nursing diagnosis. The network's structure has three layers; one input layer for representing signs and symptoms and one output layer for nursing diagnosis as well as one hidden layer. The first prototype of a nursing diagnosis systern for patients with stomach cancer was developed with 254 nodes for the input layer and 20 nodes for the output layer of 20 nursing diagnoses, by utilizing learning data set collected from 118 patients with stomach cancer. It showed a hitting ratio of .93 when the model was developed with 20,000 times of learning, 6 nodes of hidden layer, 0.5 of momentum and 0.5 of learning coefficient. The system was primarily designed to be an aid in the clinical reasoning process. It was intended to simplify the use of nursing diagnoses for clinical practitioners. In order to validate the developed model, a set of test data from 20 patients with stomach cancer was applied to the diagnosis system. The data for 17 patients were concurrent with the result produced from the nursing diagnosis system which shows the hitting ratio of 85%. Future research is needed to develop a system with more nursing diagnoses and an evaluation process, and to expand the system to be applicable to other groups of patients.

The Purpose of this study was to build a substan tive theory about the experience of postpartum depression. The qualitative research method used was grounded theory. The interviewees were eight mothers who had experienced postpartum depression. The data were collected through in-depth interviews with audiotape recording done by the investigator over a period of twelve months. The data were analyzed simultaniously by a constant comparative method in which new data were continuously coded into categories and properties according to Strauss and Corbin's methodology. Analysis the grounded data resulted in 28 concepts being identified. Eight categories emerged from the analysis. The categories were regret, loss of freedom, isolation of oneself, heartache, loss, emotional upset, avoidance, recovery. These substantive categories are consistant with preious research results. Causal conditions included: regret, loss of freedom. Phenomena: heartache, loss, emotional upset. Context: isolation oneself. Intervention condition: avoidance. Action/interaction strategies: desire for recovery. Consequences: recovery. These categories were synthesized into the core concept-The process of filling the empty loss of self The process of the experienced postpartum depression was (1) change after delivery, (2) searching for a reason for depression, (3) effort to recover from postpartum depression, (4) recovery from postpartum depression and return to previous life. The process of recovery from postpartum depression was proceeded by (1) support from others, especially husband, (2) resolution of stressful life events, (3) reconstructing of life goals and resolution strategies, (4) acceptance of depression and seeking psychiatric treatment. Seven hypotheses were derived from the analysis. (1) Mothers who experienced stressful life event and economic problem are more depressive. (2) Mothers who have conflict with parents are more depressive. (3) The more somatic symptoms, the more depression. (4) Social support faciliates recovery from postpartum depression. (5) Mothers who have lower self-esteem are more depressive. (6) Mother's role overload disturbs recovery from postpartum depression. (7) Ideal maternal identity faciliates recovery from postpartum depression. Through this substantive theory, nurses can understand the importance of postpartum depression management.

PURPOSE: The purpose of this study was to identify the change and difference and relationship of postpartum depression and physical image. METHOD: The subjects consisted of 86 postpartum women at one general hospital in Seoul. The data was collected from September to November 2001. The instrument used for this study were SRD (Self-Rating Depression Scale) and Norris' Body Image Scale to evaluate depression and body image. The collected data was analyzed with frequency, mean, t-test, paired t-test, ANOVA and Pearson's correlation coefficient. RESULT: The result of this study were as follows: 1.The mean score of D2 was significantly higher than D1(p=.003). There was no difference significantly B1 and B2(p=310). 2. There was significant correlation between the two, D1-D2(r=.381, p<.01), B1-B2(r=.364, p<.01), D1-B1(r=.579, p<.01), D2-B2(r= .567, p<.01). (D1: depression of postpartum 1-3days, D2: depression of postpartum 6-8weeks, B1: body image of postpartum 1-3days, B2: body image of postpartum 6-8weeks) CONCLUSION: There was very high postpartum depression in postpartum women, but body image was positive. Also, there was correlated to postpartum depression and body image. Thus it is necessary to implement nursing intervention focused on to decrease the postpartum depression and to enhance the body image of the postpartum women.