The purpose of this study was to examine the effect of supportive nursing one stress reaction of breast cancer patients undergoing chemotherapy. The nonequivalent control group pre-test/post-test design was used for this experimental study. The subjects were 32 patients who were receiving chemotherapy after mastectomies at K hospital in Taegu from June, 1994 to June 1995. Among 32 subjects, 16 were placed in the experimental group and 16 in the control group. The experimental and control groups were tested for general characteristics, trait anxiety, health locus of control, family support, state anxiety, hopelessness, physical stress, and anxiety behavior. Collected data was analyzed by means of a chisquare test and a t-test for the comparative analysis of the general characteristics and homogeneity of subjects. ANOVA, and MANOVA were used for testing the hypothesis. Reliability of the tools were analyzed using the Pearson Correlation coefficient. The results of this study were as follows : 1. The hypothesis ; The stress reaction of the experimental group which took supportive nursing was lower than the stress reaction of the control group ; this was supported statistically. The main variable influenced in stress reaction was hopelessness. Supportive nursing for breast cancer patients, who are receiving chemotherapy, was especially effective in the reduction of hopelessness compared to state anxiety, physical stress, and anxiety behavior. 2. An analysis of the difference on stress reaction, according to the frequency of supportive nursing between the control and experimental group showed the level of hopelessness of the experimental group was lower than the control group after four supportive meeting sessions. But there was no statistical difference in state anxiety, physical stress, and anxiety behavior. In conclusion, this study supported utilization of supportive care as well as demonstrating the effectiveness of the System-Developmental Stress Model developed by Chrisman and Riehl-Sisca.

The majority of studies on breastfeeding consists of descriptive correlational studies identifying the incidence and correlates of breastfeeding. The theory of planned behavior has been shown to yield great predictive power for behavioral goals over which individuals have only limited control such as improving school grades and weight loss. The purpose of this study was to test the "theory of planned behavior" in the prediction of breastfeeding of mothers who delivered vaginally. One hundred mothers who delivered vaginally in one general hospital in Seoul and one general hospital and three private hospitals in Taejeon participated in this study. The instruments used for data collection in this study were developed by the researchers following the guidelines suggested by Ajzen and Fishbein(1980) and Ajzen and Madden(1986). The instruments included measurement of attitude, subjective norm, perceived behavioral control and intention. The collected data were analyzed using descriptive statistics, Pearson product moment correlation, hierachical multiple regression and logistic regression. The results are as follows : 1. Intention to breastfeed correlated significantly with attitude, subjective norm and perceived behavioral control. Both attitude and subjective norm did not make a significant contribution to the prediction of intention, but the addition of perceived behavioral control to the regression equation greatly improved the model's predictive power, increasing the R(2) from .05 to .52. 2. Intention to breastfeed alone had a significant predictive effect on actual breastfeeding, resulting in a regression coefficient of .16(x2=8.60, p<.01), but when perceived behavioral control was added to the equation, intention was not a significant predictive variable and only perceived behavioral control showed significant predictive power on actual breastfeeding, resulting in a regression coefficient of .12(x2=4.68, p<.05). In sum, breastfeeding behavior lent only partial support to the second version of the theory of planned to the second version of the theory of planned behavior, and because perceived behavioral control had a strong effect on intention to breastfeed and actual breastfeeding, it would be desirable to develop nursing intervention programs which focus on strengthening the perceived behavioral control for the promotion of breastfeeding.

The purpose of this study was to understand the subjective breastfeeding experience of primiparous women to identify how breastfeeding was started and to explore the process of breastfeeding. The Grounded theory methodology was used. Data was collected from 6 primiparous women who had breastfeed their infants for at least over 8 weeks, recently breastfeeding or having breatfeed their infants within the last 6 months. With the permission of the subjects, the interviews were recorded and transcribed. The data were analysed in the framework of grounded theory method as mapped out by Strauss and Corbin(1990). 105 concepts and 21 subcategories were of data analysis. In the process of data analysis, "Identity as a mother" was found to be the core phenomenon. The 21 sub-categories were as follows : natural food, neighbour inducement, self purpose, good feeling, tenderness, breast pain, change of breast shape, physical discomfort, loss of physical energy, confirmation of adhesion, one body through coupling, tie, capacity, role performance, mental comfort, healthy mother, healthy infant, confidence of breast milk, feeling of satisfaction. The sub-categories were again grouped into 14 categories including infant nutritious food, formation of breastfeeding opportunity, feeling of satisfaction, injury of the breast, physical suffering, awareness of mothering, formation of maternal affection, connecting, coupling, acceptance, effort, emotional stability, mother and child health and feeling of achievement.

BACKGROUND: Pediatric societies throughout the world recommend breastfeeding as the optimal form of infant nutrition. This recommendation is based on extensive epidemiologic research that documents the health, developmental, psychological, social, economic, and environmental benefits to infants, mothers, families, and society. The purpose of this study was to examine breastfeeding information and emotional support received by mothers prenatally, hospital breastfeeding practices, and the relationship between information and support received and breastfeeding initiation and planned feeding method post discharge from the hospital.
METHODS
A 36-item questionnaire was distributed during the Spring 2000 to mothers who delivered babies at maternity centers in Seoul, South Korea. A sample of 52 mothers was surveyed at the time of hospital discharge. The questionnaire was developed based on the literature and reviewed by experts including internationally board certified lactation consultants, a nutritionist, and perinatal nurses. The survey instrument consists of five components: sociodemographic information, breastfeeding information received by mothers prenatally, emotional support regarding the mothers' infant feeding choice, breastfeeding initiation and supplementation, and hospital breastfeeding practices.
RESULTS
Fifty-two breastfeeding mothers at three hospitals completed the survey. The majority of the mothers were 26 to 35 years of age, college graduates, married, had uncomplicated vaginal or planned cesarean deliveries, and primiparas. Forty-nine mothers responded that they decided to breastfeed during their pregnancy. Mothers reported that the information they received during pregnancy was provided primarily by their mothers, or friends and other relatives. The majority of mothers reported that others influenced their infant-feeding decision. Forty mothers reported receiving emotional support for their infant feeding choice during their pregnancy with mothers or mothers-in-law and friends providing the greatest support.
DISCUSSION
Women obtain information prenatally about breastfeeding from many sources-family, friends, written materials, prenatal classes, and health care professionals. There are benefits and drawbacks to information received from multiple sources. Additionally, research has shown that a woman's infant-feeding decision is affected by the type of professional and social support the mother receives. Postpartum professional support for new breastfeeding mothers encompasses multiple dimensions ranging from a follow-up telephone call from the hospital nursing staff to referral to a community resource. Prenatal breastfeeding education on a community-wide basis can provide essential information for future mothers, families, and community support networks. Additional research needs to be done exploring the impact of prenatal, postpartum, and post-discharge support for women on breastfeeding initiation and duration rates.

PURPOSE: The purpose of this study was to determine the effects of exercise program on cardiopulmonary functions and shoulder joint functioning in breast cancer patients who under- went radiation therapy after surgery. METHOD: Subjects in the experimental group(N=12) participated in an exercise program for eight weeks. The Exercise program consisted of shoulder stretching, arm weight training, and walking on treadmill. Maximal oxygen uptake(o2max), maximal running time, shoulder joint range of motion, and shoulder functional assessment were determined before and after the exercise program. Baseline sociodemographic and medical data were compared between experimental group and control group using the Fisher's exact test and Mann- Whitney U test. For effects of the exercise program, repeated measures ANOVA were used. RESULT: 1) Following the exercise program for eight weeks, both o2 max and maximal running time tended to increase in experimental group comparing with the control group. 2) Shoulder abduction, extension and flexion of the operated upper extremity in the experimental group comparing with control significantly increased after the exercise program(p<0.05). 3) Shoulder flexion of the normal upper extremity in the experimental group comparing with control significantly increased after the exercise program(p<0.05). CONCLUSION: The
results
suggest that the exercise program for breast cancer patients undergoing radiation therapy after breast surgery can improve shoulder functions and increase cardiopulmonary functions, which are maximal oxygen uptake and maximal running time.

The purpose of this quasi-experimental study was to explore the effect of aromatherapy massage on the mood, the milk ejection reflex, and the immunoglobulin A of the breast milk of mothers who gave birth through a Cesarean section delivery. Twenty mothers who had Cesarean section were selected as an experimental group, and twenty-two were in the control group. Lavander and Rosemary oil mixed with Jojova carrier oil was used to massage the back, both axillar and breasts. Aromatherapy massage was done once a day for 20 minutes by the researcher. Each session consisted of 4 minutes for warm-up, 14 minutes for massage and 2 minutes for closure. The levels of IgA within the breast milk was analyzed by an immunoturbidimeter assay (Cobas INTEGRA, Roche, Swiss) before and after aromatherapy massage. Mood and milk ejection reflex were measured by self-reports at the same time. The data were analyzed using SPSS 7.5 and the hypotheses were tested by ANCOVA and the Pearson coefficient correlation. The results were as follows: 1) Score of mood increased significantly after the use of aromatherapy massage. 2) Score of milk ejection reflex increased significantly after the use of aromatherapy massage. 3) Level of IgA of breast milk did not change significantly after the use of aromatherapy massage. 4) After the use of aromatherapy massage, there wasn't any correlation among mood, milk ejection reflex, and level of IgA of breast milk. In conclusion, the results suggest that aromatherapy massage is an effective nursing intervention to enhance the mood and the milk ejection reflex and to increase the rate of breastfeeding in the breastfeeding mothers under stresses like a Cesarean section.

The purpose of the present study is to identify the mediation effect of hope between fatigue and psychosocial adjustment in women with breast cancer. The framework for this study was guided by concepts and propositions derived from the theoretical and empirical literature on fatigue, hope and adjustment. The design of this study is a descriptive correlation study using a cross-sectional design. One hundred and twenty two outpatients with early breast cancer, receiving post-surgical radiation therapy or chemotherapy, were selected from three major medical centers in Seoul, Korea. A packet including PABCF (Psychosoical Adjustment to Breast Cancer Factor), revised RPFS (Revised Piper Fatigue Scale), HHI (Herth Hope Index), and self-addressed return envelope was given to the participants at seven to eight weeks post surgery. The questionnaires were to be completed at home and returned to the researcher by mail. The obtained data were analyzed using three regression equations guided by Baron and Kenny (1986); first, hope was regressed on fatigue; second, psychosocial adjustment was regressed on fatigue; and third, psychosocial adjustment was regressed on fatigue and hope, simultaneously. In the first equation, fatigue explained 4% of the variance in hope. In the second equation, fatigue explained 47% of the variance in psychosocial adjustment. In the last equation, hope and fatigue significantly explained the variance in psychosocial adjustment. Therefore, all conditions for the test of mediation effect of hope were satisfied. For the test of the mediation effect, the beta coefficients of fatigue on psychosocial adjustment on the second and third regression equations were compared. The beta coefficients were decreased from .69 (p < .001) on the second regression equation to .63 (p < .001) on the third regression equation. Thus, the hypothesis of this study was supported. As a result of this study, the negative Influence of fatigue on psychosocial adjustment is dampened through the mediator effect of hope in women with breast cancer. Therefore, when planning care for the adverse effect of fatigue on psychosocial adjustment, oncology nurses should consider hope as a mediator between fatigue and psychosocial adjustment to breast cancer.

To determine whether personal history of lactation in premenopausal women influence bone mineral density, a cross-sectional study was conducted. One hundred eighty-four premenopausal women were selected from women who had been checked for bone mineral density by dual energy x-ray absortiometry in lumbar spine, femoral neck, Ward's triangle, and trochanteric site at general hospitals in Seoul and Pusan. They completed a questionnaire including life style factors and reproductive history. In the data analysis, Pearson correlation coefficients were used to test any association between individual variables and bone mineral density and a statistical comparisons between long term lactation(>24 months) and short term lactation(<24 months) were made by one way analysis of covariance. The results were summarized as follows: 1) There was no significant difference in the bone mineral density of the lumbar vertebrae in premenopausal women between the long term lactation group(>24months) and the short term lactation group(<24months). 2) There was no significant difference in the bone mineral density of the femur neck, Ward's triangle, and trochanteric site in premenopausal women between the long term lactation group (>24months) and the short term lactation group (<24months). Considering these results, we suggest prospective studies that measure bone mineral density before and after, in addition to those during lactation. We also suggest the further study with premenopausal women less than 35 who have achieved peak adult bone mass.

The Purpose of this study was to explore the meaning of breastfeeding using a phenomenological research methodology. The sample consisted of 9 primiparous mothers who had breastfed their babies at least for 3 consecutive months. Data were collected from January 10 to February 28, 1998 through interviewing. The research question was "What was the meaning of breastfeeding to breastfeeding mothers?" Responses to non-structured open-ended question was audio-recorded during the interview. Data were analyzed using the phenomenological method of Colazzi. From the protocols, significant statements about meaning of breastfeeding were clustered into 8 themes. Mothers perceived meaning of breastfeeding as feeling of unification through tie, expression of love, gift, nutritional supplement, duty as a mother, nurturing, mystery, and identity. From the results of this study, breastfeeding mothers perceived breastfeeding positively, so nurses need to encourage mothers to breastfeed her baby and develop program which can promote successful breastfeeding.

Breast self-examination is the most effective and easiest way for women to increase the responsible consciousness about their health. The purpose of this study was to test the variables impacted to promote breast self-examination practice. The research design used in this study was a nonequivalent control group of a non-synchronized design. The sample that was assembled consisted of 124 women. A purposive sample consisted of 124 omen. Each subject was given to assessed on the following the demographic data relate to the breast self-examination, knowledge of self-examination, accuracy, in performing self-examination, self-efficacy about breast cancer and breast self-examination, and the number of subjects who found a mass. The result of this study may be summarized as follows : 1. To examine the theoretical model fit to the data, chi square test statistics and goodness of fit index were identified(x2=2.30, df=2, GFI=0.99, AGFI=0.94 RMSR=0.02, NFI=0.99, NNFI=0.99, Critical Number=439). 2. The direct effects of education of breast self- examination were knowledge, self-efficacy, accuracy, number finding a mass. But the indirect effect of education in breast self-examination was frequency of breast self-examination. 3. Knowledge, as direct paths to the breast self-examination practices, was removed in the theoretical model. The parsimonious best fit model included self-efficacy, accuracy, the number finding mass, frequency of breast self-examination practices. 4. The final model produced a chi-square=5.58(p=0.35) with df=5, and GFI=0.99 AGFI=0.94, NFI=0.03, NFI=0.99, NNFI=0.99, CN=339 indicating very a good fit. Based on the result of this study, education of breast self-examination is very effective for increasing the competency of the breast self-examination through the knowledge and self-efficacy. Resources to promote self-examination may be helpful to increase the frequency of self-examination because self-efficacy is a direct effort on it. These findings suggest the need t develop nursing strategy to promote the self- efficacy of breast self-examination.

By using Q-methodology, this study examines the attitudes of pregnant womens' husbands toward breastfeeding. Also, the research provides basic data necessary to develop a strategy for recommending breastfeeding. A total of 112 items for the Q-population were collected from related literature and interviews with the general public, specialists, pregnant women and the general public, specialists, pregnant women and their husbands. Finally, 38 statements were selected. Twenty one husbands of pregnant women classified these statements on each card on a 1 to 9 point scale(forced normal distribution) and wrote the reasons for both the most supported and the mos resisted statements. The materials collected were analyzed by using pc QUANL program. The analysis drew down following fact that even though the attitudes of the husbands of pregnant were very similar, they could be classified to three types according to the motivation and recognition the degree of choosing breastfeeding. Type 1 is the mother's duty supporter, who insists that breastfeeding is completely natural and the proper duty of the mother. Type 2 is the emotional value supporter, who thinks that breastfeeding emotionally affects both the baby and the mother in a positive way. Type 3 is the conditional choice supporter, who chooses the most proper suckling way of feeding according to given conditions.