The purpose of this study was to investigate the preoperative anriety of surgical patients and to observe the effects of an experimental nursing process on the incidence of vomiting, the number of analgesice used and the voiding ability of surgical patients within a 48 hour postoperative period and also the number of postoperative days in the hospital. This study was based on a sample of 51 patients who were schoduled for abdominal surgery. They were assigned alternately to experimental and control groups. Patients assigned to the-experimental group were given nursing care by the writer, using an experimental mursing process. This is a process directed toward helping the patient obtain a suitable psychological state for surgery. This process was performed by use of the following steps: 1. The nurse approached the patient with interest and concern, and observed the patient's behavior to deternine the presence of anxiety. 2. The nurse explored further to find out what was causing the anxiety and what was peeded too relieve it. 3. The nurse listened carefully to the patient. 4. Teh nurse gave an opportunity for expression of individuality. 5. The nurse showed friendliness and reassured the patient. 6. The nurse gave instruction about deep beating, turing and coughing and gave an explanation of routine preoperative preparation which decreased the unknown and so decreased the patient's anxiety. The findings of this study are as follows: 1. The investigation of preoperative anxiety through observing and ineerviewing rewealed patients were qoncerned about the following: a. Length of stay in the hospotal 69.7%(31 cases) b. Condition unimproved or worse 58.8%(30 cases) c. Postoperative pain and discomfort 56.8%(29 cases) 2. The resalts of the study regarding the four hypothesis were as follows: a. Preoperative psychological care did not reduce the number of analysics needed during the 48 hour period following surgery. b. Preoperative psycholegical care did not reduce the Postoperative incidence of vomiting c. Preoperative psychological care had noinfluence on voiding ability following surgery. d. Preoperative psychological care significantly reduced the number of postoperative days in the hospital. The experimental nursing process proved to be successful in decreasing the length of postoperative hospitalization(improving rate of healing). This study has demonstrated further that the relief of anxiety (emotional distress) is part of the nurses' professional role. In order to be sure psychological care is given it is important to make a nursing care plan which includes a plan for the psychological care needed by the patient. As this care is given it can be checked off by each nurse just as medication and treatments are checked after they are given.

This study is a descriptive study to provide basic data related to types of uniforms worn by nurses. Nurses, other medical center personnel, patients and their famillies were asked for their opinion on changing nurses' uniforms and how the image of nurses is related to the type of uniform worn by the nurses. The data for this study were collected during the period from Feb. 25, 1993 to Mar. 26, 1993 at Y-University Medical Center from 132 nurses, 137 other medical center personnel, 117 patients and their families. The instruments used for this study were the Nurses' Image Scale(NIS) developed by Bown (1986), and an instrument to measure opinions of uniform and cap using photographs of nurses' uniforms that was developed by the researcher through a literture review. Data were analyzd using the SPPS/PC package, Statistics used for analysis were frequencies, percentages, paired t-test, and oneway ANOVA. The results of this study are summarized as follows; 1. Of the nurses, 84.3%, along with, 51.5% of the medical center personnel, 39.1% of the patients and their families agreed to a change in the color of nurses uniforms. 2. Similarly, 87.4% of the nurses, 27.7% of the medical center personnel, 19.3% of the patients and their families were in favor of nurses not wearing cape. 3. Only 11.8% of nurses answered that a white uniform was important to the professional image of nursing. Only 2.4% of the nurses answered that a cap was very important to the professional image of nursing. 4. Only 1.6% of the nurses answered that a white uniform and cap were important to show the role of nurses in the twenty first century. 5. About 1/3, 36.5%, of the medical center personnel, the patient and their families answered that changing the color of the nurses' uniform will make a change in the image of nurses. 6. A White uniform and cap were seen as being important in distinguishing nurses from other medical personnel in the hospital by 76.5% of the medical personnel, the patients and their families. 7. Nurses gave high marks to the idea of no cap regardless of the color of the uniform which would still portray the symbol of the nurses' role, identity and would differentiate the role from other jobs. The patients and their families gave high marks to a white uniform with cap. 8. Generally, nurses, medical center personnel and patients and their families thought that a colored uniform with cap presented a good image of nurses. 9. There was a significant difference in the response among the three groups (F=24.65, P<.001) to the figure in a white uniform with a cap, and the patients and their families thought it was the best portrayal of the image of nurses. There was a significant difference among the three groups (F=9.03, P<.001) to the figure in a white uniform with no cap and the nurses indicated that it was the best portrayed of the image of nurses. There was no significant difference among the three groups to the figure in a colored uniform with cap. There was a significant difference(F= 17.50, P<. 001) to the figure in a colored uniform with no cap, and the nurses indicated that it was the best portrayal of the image of nurses. In summary, the nurses wanted to change the color of uniform and not to wear a cap. But many of the medical center personnel, patients and their families indicated they did not agree with this idea. Therefore, changing the type of uniform worn by nurses should be done only after consideration has been given to the relation of the change to the professional role of nurses and the image of nurses held people in general. Suggestions arising from this study are as follows: 1. The relation between the role of nurses and their uniform was surveyed, and these results can be used as data when considering a change in uniforms. 2. A change in uniforms should be tried based on the norm established about uniforms. 3. The nurses did not want to wear a cap, but before a decision is definitely made it is necessary to study the philosophy related to the symbol of the cap because the figure of a nurse with a cap portrayed a positive image of the nurses. If the cap is kept, the symbol of the cap should be redefined. 4. In this study, only the image related to the uniform was examined, but in future studies it will be necessary to examine the practicality of various types of uniforms.

This study was done to verify validity of nursing diagnoses related to difficulty in respiratory function. First, content validity was examined by an expert group considering the etiology and the signs/symptoms of three nursing diagnoses-ineffective airway clearance, ineffective breathing pattern, impaired gas exchange. Second, clinical validity was examined by comparing the frequencies of the etiologies and signs/symptoms of the three nursing diagnoses in clinical case studies with the results of the content validity. This study was a descriptive study. The sample consisted of 23 experts (professors, head nurses and clinical instructors) who had had a variety of experiences using nursing diagnoses in clinical practice, and 102 case reports done by senior student nurses of the college of nursing of Y-university. These reports were part of their clinical practice in the ICU. The instrument used for this study was a checklist for etiologies and signs and symptoms based on the literature, Doenges and Moorhouse (1988), Kim, McFarland, McLane (1991), Lee Won Hee et al. (1987), KimCho Ja et al. (1988). The data was collected over four month period from May 1992 to Aug. 1992. Data were analyzed using frequencies done with the SPSS/PC+ package. The results of this study are summarized as follows: 1. General Characteristics of the Expert Group: A bachelor degree was held by 43.5% and a master or doctoral degree by 56.5% of the expert group. The average age of the expert group was 35.3 years. Their average clinical experience was 9.3 years and their average experience in clinical practice was 5.9 years. The general characteristics of the patients showed that there were more women than men, that the age range was from 1 to over 80. Most of their medical diagnoses were diagnoses related to the respiratory, system, circulation or neurologic system, and 50% or more of them had a ventilator with intubation or a tracheostomy. The number of cases for each nursing diagnoses was: -Ineffective airway clearance, 92 cases. -Ineffective breathing pattern, 18 cases. -Impaired gas exchange, 22 cases. 2. The opinion of the expert group as to the classification of the etiology, and signs and symptoms of the three nursing diagnoses was as follows: -In 31.8% of the cases the classification of etiology was clear. -In 22.7%, the classification of signs and symptoms was clear -In 17.4%, the classification of nursing interventions was clear. 3. In the expert group 80% or more agreed to 'dyspnea' as a common sign and symptom of the three nursing diagnoses. The distinguishing signs and symptoms of (Ineffective airway clearance) were 'sputum', 'cough', 'abnormal respiratory sounds: rales'. The distinguishing sings and symptoms of (Ineffective breathing pattern) were 'tachypnea', 'use of accessory muscle of respiration', 'orthop-nea' and for (Impaired gas exchange) it was 'abnormal arterial blood gas'. 4. The distribution of etiology, and signs and symptoms of the three nursing diagnoses was as follows: -There was a high frequency of 'increased secretion from the bronchus and trachea' in both the expert group and the cade reports as the etiology of ineffective airway clearance. -For the etiologies for ineffective breathing pattern, 'ain', 'anxiety', 'fear', 'obstructions of the trachea and bronchus' had a high ratio in the expert group and 'decreased expansion of lung' in the case reports. -For the etiologies for impaired gas exchanges, 'altered oxygen-carrying capacity of the blood' and 'excess accumulation of interstitial fluid in lung' had a high ratio in the expert group and 'altered oxygen supply' in the case reports. -For signs and symptoms for ineffective airway clearance, 'dyspnea', 'altered amount and character of sputum' were included by 100% of the expert group. 'Abnormal respiratory, sound (rale, rhonchi)' were included by a high ratio of the expert group. -For the signs and symptoms for ineffective breathing pattern, 'dyspnea', 'shortness of breath' were included by 100% of the expert group. In the case reports, 'dyspnea' and 'tachypnea' were reported as signs and symptoms. -For the sign and symptoms for impaired gas exchange, 'hypoxia' and 'cyanosis' had a high ratio in the expert group. In the case report, 'hypercap-nia', 'hypoxia' and 'inability to remove secretions' were reported as signs and symptoms. In summary, the similarity of the etiologies and signs and symptoms of the three nursing diagnoses related to difficulty in respiratory function makes it difficult to distinguish among them. But the clinical validity of three nursing diagnoses was established through this study, and at last one sign and symptom was defined for each diagnosis.

Computerization has been applied in most areas of health care in recent years. But computerized standardized nursing care plans have not yet been adequately developed even though they can significantly contribute to an improvement in the quality of nursing care. Therefore, this study was done to develop computerized nursing care plans. For this purpose, the study had the following objectives: 1) to develop a computerized program for standardized nursing care plans which include defining characteristics, relating factors, expected outcomes and nursing interventions 2) to test applicability of the computerized programs to the actual clinical situation of the clinical nurse. Application of the system development life cycle by davis was used as the study methodology. There are five stages in this method; strategy planning development, system analysis, system design, system practice and system evaluation. The first four steps in this methodology were used in this project. Two clinical nurses were selected to apply this computerized program in the clinical situation. The results of the study are as follows; 1) Ten standardized nursing care plans including defining characteristics, relating factors, expected outcomes and nursing interventions which had been proven to have validity in the clinical setting were computerized using the Foxbase Program. 2) These programs were applied to the actual clinical situation by two clinical nurses working at Severance Hospital. For further study, continuous revision should be done by the users. Evaluation related to the utilization of the program should also be done.

Older people, because of the psychological and physiological changes related to the aging process are more vulnerable to experiencing powerlessness than any other age group. This self destructive cycle of depression in older people related to the experience of continued and long term powerlessness can lead even to death. The purpose of this study was to measure powerlessness and resources to increase power in older people, and to measure the effectiveness of a psychological rehabilitation program for reducing powerlessness. The research methodology used was two step process. In the first step, a survey was done of perceived powerlessness and power resources comparing four groups of elderly people ; those living at home, those in hospital, those living in nursing homes and those attending educational programs for the elderly. The total sample size was 236. In the second step, a psychological rehabilitation program was carried out, pre and post measurements were taken related to this program. The sample consisted of 29 residents in a nursing home. The results of the study are as follows : 1. Powerlessness was classified as cognitive, emotional, activity and learning. The lowest score for powerlessness was in the area of activity, that is the people in the sample felt more power concerning their activities. The highest score was in the area of cognition were they felt they had less power. 2. When the different groups of elderly were compared, it was found that the residents of the nursing home had the highest score in perceived powerlessness and the group who perceived powerlessness and the group who were living at home had the lowest score. 3. Among the general characteristics, the factors influencing the powerlessness score were age, sex, level of education, financial resources and health status. In the interaction effects among these factors, it was found that level of education and health status were factors influencing perceived powerlessness. The elderly with lower education and poorer health status had the higher scores for perceived powerlessness. 4. The power resources could be classified into the following areas : physical strength, emotional strength, positive self-image, energy, knowledge, motivation and belief system. Be-life system was given the highest score among the power resources and energy, knowledge and motivation were given low scores. 5. The group participating in an educational program for the elderly had the highest score for power resources while the group made up of residents of a nursing home had the lowest score as well as the highest score for perceived powerlessness. 6. The factors influencing the power resource scores were sex, level of education, financial resources and health status. In the analysis of the interaction effect among the factors, it was found that sex, level of education and financial resources were the factors that influenced the power resource score, that is women, those with a low level of education and those with poor financial resources reported a lower level of power resources. 7. There was a negative correlation between perceived powerlessness and power resources in the elderly in this study. Since power resources explained 49% of the variance for powerlessness, it can be concluded that the power resources can be used to reduce powerlessness. 8. The psychological rehabilitation program was carried out with the nursing home residents over a period of five weeks. No statistically significant difference was found in the scores on powerlessness between the pre and post test, but there was a slight decrease in the raw scores on the post test for emotional, activity and learning powerlessness. There was a statistically significant increase in the power resource scores for emotional strength, positive self-image, energy, knowledge and motivation in the post test as compared to the pre test. In conclusion, the study indicates that a psychological rehabilitation program for the elderly could be effective in increasing power resources and this in turn could lead to a decrease in perceived powerlessness.

This study was to investigated the factors influencing the decisions of nurses to resign. The purpose was to contribute information useful for the effective management of nurse staffing resources. The specific objectives were as follows : 1. To investigate the level of job satisfaction of nurses who resign. 2. To analyze the relationship of job expectations and the decisions to resign. 3. To investigate the major reason for nurses' resignations. 4. To identify the relationship of the general characteristics of the nurses and the factors influencing their decisions to resign. 5. To analyze the relationship of the intention to resign and the factors influencing the decisions to resign. The sample consisted of 90 nurses who worked at Y hospital in Seoul from march. 1987 to Feb. 1988 and who had resigned. The instruments used for this study were slavitt et al's index of Work Satisfaction Scale and job expectations scale developed by the researcher. Analysis of data was using frequency, t-test and ANOVA. The results of study were as follows ; 1. There was no difference in the job satisfaction level of nurses who resigned compared with nurses in active service but the subcategory interaction score was lower and the subcategory salary score was higher than for nurses in active service. 2. Low job expectation scores influenced the decision to resign. 3. The major reason of resigning were personal problems such as marriage, childbirth, and relocation of family. 4. The length of employment and the number of different service areas of the nurses who resigned were associated with the job satisfaction level. 5. The nurses who had have an intention to resign while in active service had lower scores for job satisfaction and the job expectation score was a greater influence on the decision to resign. In conclusion, the factors influencing the decisions of nurse to resign were job satisfaction, job expectations and intention to resign while still in active service.

Circadian rhythm is entrained in the 24-hour time interval by periodic factors in the environment, known as zeitgeber. But most rotating work schedules are outside the range of the entertainment of the pacemaker timing the human circadian sleep-wake cycle. It has been postulated that physiological and emotional disturbances occur in most human functions when the circadian rhythm is disturbed. So application of circadian principles to the design of shift schedules can aid in maintaining the temporal integrity of the circadian system and thereby minimize for the shift worker any detrimental consequences of circadian disruption. The study was quasi-experimental study to test the effect of shift intervals for the clinical nurse on the circadian rhythm. Twenty nurses newly employed in general units of two hospitals were selected as an experimental group and twelve college nursing students as a control group. Both groups were selected according to an established criteria using a purposive sampling technique. Ten subjects were assigned to weekly shift group and another ten to a biweekly shift group engaged in a semi-continuous shift schedule(sunday off) with a backward direction, that is, morning-evening-night shift. The control group worked a morning shift for 42 days. Oral temperature rhythm, waking time, sleep-wake cycle, fatigue, and mental performance were measured during the experimental period. The data collection period was from April 30, 1990 to June 10, 1990. MANOVA, paired t-test, ANOVA, and Student Newman Keuls method were used for statistical analysis. The results are summarized as follows. 1. Phase delay in the acrophase of temperature rhythm was shown according to the backward rotating shift. A complete adaptation to work on the night shift was achieved between the sixth and ninth day of the night shift. 2. There was no difference in either waking time or sleep-wake cycle according to the duration of the working day for every shift group. Significant difference was found in the waking time and the sleep-wake cycle for subjects on the morning, evening, and night shift in both of the shift groups(weekly shift group : lambda=0.121, p<0.01, lambda=0.112, p<0.01, biweekly shift group : lambda=0.116, p<0.01, lambda=0.084, p<0.01). 3. There was no difference in fatigue between the first working day and the last working day for the control group and for the biweekly shift group. In the weekly shift group, physical fatigue was significantly different for the first day and the sixth day of the night shift(t=-2.28, p<0.05). Physical fatigue and total fatigue on the first day of the night shift showed a significant difference among the control group, the weekly shift group, and the biweekly shift group(F=5.79, p<0.01, F=4.56, p<0.05). There was a significant difference between the shift groups and the control group(p<0.05). Physical fatigue, neuro-sensory fatigue and total fatigue on the last day of the night shift showed a significant difference among the control group, the weekly shift group, and the biweekly shift group(F=12.65, p<0.01, F=7.77, p<0.01, F=9.68, p<0.01). There was a significant difference between the shift groups and the control group(p<0.05). 4. No difference in mental performance was seen between the first day and the last day of work in each case. An arithmetic test on the first day of the night shift revealed a significant difference among the control group, the weekly shift group, and the biweekly shift group(F=3.79, p<0.05). There was a significant difference between the shift groups and the control group(p<0.05). The digital symbol substitution test and the arithmetic test on the last day of the night shift showed a significant difference among the control group, the weekly shift group, and the biweekly shift group(F=3.68, p<0.05, F=5.55, p<0.01), and both showed a significant difference between the shift groups and the control group(p<0.05). Accordingly, this study showed that during night duty, the waking time, sleep-wake cycle, and fatigue increased and mental performance decreased compared with morning and evening duty. It was also found that the weekly shift group had a higher fatigue score on the sixth day of night duty as compared to the first day, but the waking time, sleep-wake cycle, and mental performance revealed no difference for the duration of the night duty or between shift groups, and complete adaptation of temperature rhythm was achieved between the sixth and ninth day of night duty. It is possible to conclude from these results that for intermediate circadian type in a healthy young woman, a biweekly shift system is more compatible with the circadian timing system than weekly shift system.

A central issue in the development of nursing practice is to describe the phenomenon with which nursing is concerned. To identify the health problems which can be diagnosed and managed by the nurse is the first step to organize and managed by the nurse is the first step to organize and ensure the development of nursing science. Therefore the academic world has been discussing the application of the nursing diagnosis in nursing practice as a means of improving quality of care. The objectives of this study were to develop a standardized nursing care plan for ten selected nursing diagnoses to from a database for computerized nursing service. The research approach used in the study was (1) the selection of the ten nursing diagnoses which occur most frequently on medical-surgical wards, (2) the development of standardized nursing care plan for the ten selected nursing diagnoses, (3) application of the plan to hospitalized patients and evaluation of the content validity by the nurses, and (4) evaluation of the clinical effects after the use of the standardized nursing care plans. The subjects were 56 nurses and 395 hospitalized patients on two medical and two surgical unit. The results of this study were as follows ; 1) The ten selected nursing diagnoses for the development of the standardized nursing care plans were "PAIN, SLEEP DISTURBANCE, ALTERED HEALTH MAINTENANCE, ALTERATION IN NUTRITION, ANXIETY, CONSTIPATION, ALTERED PATTERNS OF URINARY ELIMINATION, DISTURBANCE IN BODY IMAGE, POTENTIAL FOR ACTIVITY INTOLERANCE AND ACTIVITY INTOLERANCE". 2) The developed standardized nursing care plans included the nursing diagnosis, definition, defining characteristics, etiologic or related factors that contribute to be condition, recording pattern desired out-comes and nursing orders(nursing interventions). 3. The plan was used with hospitalized patients on medical-surgical wards to test for content validity. The patient's satisfaction with the nursing care and nurses' job satisfaction were investigated to evaluate the clinical effects after the use of the standardized nursing care plans. A comparison of patient satisfaction with nursing care before and after the introduction of the standardized nursing care plans showed a statistically significant higher level of satisfaction with the standardized care plans. There was no difference in the level of job satisfaction expressed by the nursing staff before and after the standardized nursing care plans were introduced. However, when opinions about the use of the standardized nursing care plans were examined it was found that there was a positive effect on clarity in defining the nursing problems, determining nursing cost, more feasible goal setting, effective and systematic nursing records and indications for nursing research. The results of this study suggest that in order to increase the use of nursing diagnoses in the clinical area, it would be effective to select some wards as a pilot project, give the nurses training in the use of nursing diagnosis and develop and use the standardized nursing care plans. In addition to the ten diagnosis used in this study it sis recommended that continual development of nursing diagnoses be done using diagnoses that are appropriate to Korea and testing them for validity through standardized care plans.

The purpose of this study was to investigate factors influencing role adaptation in newly employed nurses and the consistency between role expectations before employment and after one year of employment. The results of this study may contribute to strategy development towards positive role adaptation in newly employed nurses. The data used in this study were colleted from 111 nurses, the sample was drawn from all newly employed professional nurses working at Y Medical Center in 1987. The data were collected longitudinally in the 2nd ?3rd weeks, the 3rd month and the 12th month after employment. The results of this study were as follows : 1. The degree of change the importance of factors influencing role adaptation and the length of time after employment were investigated. The result showed that the degree of change was the greatest within the first 3 months after emloyment. Important factors related to role adaptation were working conditions, the environment of the assigned ward and the work load. These factors always displayed high scores without any great change over time. New employees put more importance on practical factors which were obtained through experience in their jobs rather than on ideal factors which they had considered more important while in school. 2. Consistency between role expectation before employment and after 12 month of employment was investigated. The highest consintency item was the expectation about the variety of patients, and the highest inconsistency was the expectation about their own welfare. An average score of 69.07 points was achieved from a maximum of 225 points for the 25 items, showing that expectations tor role development before employment were not fully satisfied. In conclusion the administraor should assess the initial expectation at the time of employment of new nurses and she / he should make clear to the new nurses that these expectations may not be realistic. In this way the administrator can provide more satisfactory conditions towards the expectations of the new nurses and help them towards positive role adaptation and reduction of role conflict. Newly employed nurses have high and unrealistic expectations about socialization to the profession from their nursing educational program. It is suggested that a transitional training program should be planned and carried out for newly employed nurses.

This study was undertaken at Yonsei University Medical Center to identify the crisis responses and nursing problems of patients who had been diagnosed with cancer, and changing patterns of grieving over time periods, and to analyse the effectiveness of follow up care through home visiting nursing. This study was carried out in three stages. The 1st study data were collected from a total of 205 patients who had been diagnosed with cancer from Sept. 1 to Dec. 31.1987 using a cross-sectional method. The 2nd study data were collected three times from 30 patients with cancer at 4 weeks intervals from March 1 to June 31.1988 using a longitudinal method. The 3rd study data were collected from two different groups from March 1 to June 31, 1988. One was an experimental group who was visited by nurses and the other one was a control group not visited by nurses. The subjects of the 3rd study consisted of 60 patients with cancer and a Quasi-experimental research design was used. The results were as follows : 1. The patients did not experience one stage at a time among the five stages of grieing, denial, anger, bargaining, depression and acceptance, as identified by Kubler Ross. They experienced a combination of stages, especially of the bargaining and the depression stages. This stages did not change with the passing of time. 2. The patients expressed more physical and socioeconomical problems than emotional problems. And they used more problem coping methods than emotional coping methods. 3. Follow up care through home visiting nursing positively influenced the patient's quality of life, especially their pyhsical well-being and symptom control. The patients responsed positively to the home visiting nursing, stating that it was helpful to them. It was concluded that the development of a home visiting nursing program is needed for the effective home care of patients with cancer.

Infection has assumed increased importance as a cause of death among thermally injured individuals. Decreased treatment effectiveness and an increase in mortality are the hallmarks of nosocomial infection. Infection control is a monumental task that must be achieved to reduce mortalities. This was a retrospective study to survey the epi-demiological features of nosocomial infections in a burn unit and to identify the possibilities for infection control. During the past 6 year 2 month period from July, 1981 to August, 1987, 306 burn patients were treated in the burn unit of university hospital. Among of these, 290 eases were the subjects of this study.The data were collected from the patients' recor-ds after discharge. All data collected were analyzed using percent, x2-test, t-test with SPSS program. The results of this study are summarized as follows: 1) Infection rate was 40%. According to site, there were 67 cases of wound infection, 60 cases of post-operative skin graft infection, 20 cases of septicemia and 20 cases of donor site infection. As far as the burn size was concerned, the infection rate for patients whose burn size ranged 61 to 70%, was shown to be 100%, followed by the infection rate of 93.8%, for patients whose burn size ranged from 41~50%. As far as the period of time over which the infection developed, 5 to 7 days showed the highest frequency. Further infection was the main cause of deaths and complications. 2) Based upon the results obained by comparing the general characteristics, between a hospital infection-group and non-hospital infection group, there was a significant defference according to age, the time of the year when the accident happened, the place of accident or length of hospital-admission. And according to the result obtained by comparing the general characteristics of the burn, there was a significant difference according to burn size, burn depth, burn type, and burn site. And also based upon the result obtained by comparing the two groups according to method of treatment, there was a significant difference according to the use of antibiotics and to the type of wound- treatment, and for the 8 different binds of treatment related to infection, there was a significant difference for all. In conclusion, age, length of hospital-admission, burn size, burn type, burn site, burn depth, type of woundtreatment and the 8 different binds of treatment, which are related to burns, were shown to be the factors which affect the infection rate in burn patients.

Nursing service, as the largest user of labor reso-urces, has become concerned about appropriate allocation of staffing resources. Therefore, this project was designed to measure quantitatively the direct nursing care provided to patients and to develop a new patient classification system based on the direct nursing care activities. The initial step in the development of the classification instrument was to identify the content of direct nursing activities. The frequency with which these activities were carried out, the total time spent in carrying them out and the average time for one performance of each of the nursing activities was calculated. The next step was to select the items for the cia ssification instrument taking into account these direct nursing activities. A list of 40 items was prepared. These items were then classified into 8 major categories; personal hygiene, moving & exercise, nutrition & elimination, observation, medication, treatment, collecting specimens and other care activities for severity ill patients. Each item was assigned a value unit based on the average time required by the nursing staff to complete the specific item. The third step was to determine the practicality of the items and value units, so an attempt was made to establish content validity for these items and units by obtaing a consensus from 8 head nurses, representing eight different departments. The 4th step was to conducted a pilot study to establish the score range for the classification boundaries. For this purpose an instrument was designed using the list of items and value units and a prepared classification criteria as a guideline to validate the patient classification. A judgment group consisting of 52 supervisory nurses and head nurses were asked to select the proper patient to fit each classification criteria and to fill out the instrument for each patient. The total value unit and the frequency for each classification group was calculated. According to the frequency distribution, the score range for the classification group was determined as follows: 0~15 for group I, 16~30 for group II, 31~50 for group III, and above 51 for group IV.Finally a patient classification form was developed.

The Purpose of this study was to study what effect providing the patient with preparatory concrete information had on the state anxiety depending on coping styles of patients undergoing cardiac catheterization. State Anxiety scores for 32 patients who had cardiac catheterization were examined after information was provided about the test using and audio tape. The state anxiety of patients who had a high trait anxiety level was compared to that of those who had a low trait anxiety level. The state anxiety of those who had a monitor type were compared to those of patients who had blunter type. The Trait and State Anxiety Scale of Spielberger Miller's Behavioral Style Scale, and Krantz's Health Opinion Survey and Visual Analog Scale(I, II) were used. Findings were as follows : 1. Among the demographic characteristics, gender difference of the patients was significantly different for the trait anxiety level. Female patients had higher trait anxiety level than male patients. 2. Analysis of state anxiety scores indicated that the mean score of the state anxiety prior to the test was higher than mean score of the state anxiety examined after the test. The difference was statistically significant. 3. Among the patients, 14 patients (43.7%) used monitor type, while 18 patients(56.3%) used blunter type. The means of preference for information measured on the Krantz' subscale was 2. 45. 4. The study results indicate that the state anxiety level of those who a low trait anxiety level was lower than that of those who had a high trait anxiety level. 5. State anxiety levels depending upon the kind of coping style which patients used during the test were not significantly different. This study did not identify the influence of preparatory concrete information on the state anxiety depending on coping styles, and there fore a quasi-experimental study using a large sample according to different types of information, and the amount of information, coping styles is recommended.

Cardiac catheterization is a diagnostic procedure which is intrusive and anxiety provoking. Patient education and information offer have been suggested as effective nursing interventions to reduce patients' anxiety and stress. Main objectives of this study are : 1) to develop concrete objectives information for patients undergoing cardiac catheterization ; 2) to analyze the types of information included in the newly developed concrete objective information. The subjects of this study are 11 patients who were admitted to the CCU of a general hospital in Seoul. The subjects were provided with preparatory information about cardiac catheterization by using interview and a booklet. After the procedure, the subjects were asked to describe additional information which they suggest to be added into the booklet and the physical sensations felt during the procedure. The results of the study are summarized as follows : Most subjects were satisfied with the preparatory information that was provided by interview and the booklet before the procedure. But patients suggested several problems related to the content of the booklet. First, they reported difficulty to differentiate the terms-coronary angio gram and cardiac catheterization. Also, some patients expressed that they feared after reading the information about the incision of inguinal area. Subjects responded that the information about the direct process of the test did not reduce their anxiety and the information was not detail enough. Next, most subjects would want to know about the monitor and the sound from monitor. They said that they could not hear instructions from doctor of nurse during the procedure due to tension. Considering above response results, the need for more effective way to provide information, like visual and auditory information through video tape for giving information is suggested. Sensations related to the procedure were the smell coming from sterilization of inguinal area, stinging pain in groin when the doctor inserts a needle into artery, and the sensation of pressure and moving of vessels surrounding neck when the catheter was inserted and visualized on fluoroscopy. Besides, subject reported hot sensation and burning feeling in face and chest area, and nausea when dye is injected by hand. In the analysis of information content, there was 79% agreement on the actual units of analysis that were coded. In the analysis of type of information, procedural information was 60.4%. Concrete objective information was 28.1%, and other information was 11.5%. Agreement of the coders in categorizing the units of information was determined by using Cohen's kappa which corrects for chance agreement. Cohen's kappa was .84.

For the purpose of integrating nursing diagnosis into the nursing curriculum, a descriptive survey re search was done using the inductive method with questionnaires and a literature review. Research subjects included nurse educators, textbooks of adult nursing published in Korea, and the course outline for adult nursing used in one college of nursing. The Results show that there was common agreement on 39 nursing diagnosis which should be included in the adult nursing curriculum, textbooks of adult nursing, and patient care on the medical-surgical units. The two existing nursing diagnosis classification systems (NANDA and Gordon's Human Response Patterns) show different basic frameworks and difficulties were discovered in integration of nursing diagnosis into the curriculum. To develop a conceptual framework for a nursing diagnosis classification system, diagnosis were classified into three categories; health promotion, high risk problem, and actual problem on the basis of the framework used in adult nursing textbooks and Gordon's 11 Functional Health Patterns. Subconcepts for actual problems were classified as; activity and rest, nutrition and elimination, perception and coordination, stress and coping. Progress in this study supports further development of a conceptual framework of nursing based on a nursing diagnosis classification system, from which improvement in nursing education and clinical practice can be expected.

PURPOSE: This study was to identify priority areas of nursing research in Korea. METHOD: A data analysis was done for the PhD subjects (n=133) who responded at the national level two-rounds delphi survey. Subjects were asked to assign a score from 1 to 7 for 29 nursing research areas regarding 3 aspects: the degree of nurses research leadership; the degree of contribution to nursing professions; and the degree of contribution to health and welfare of patients/clients. RESULT: For the overall three aspects, research area on clinical nursing practice was identified as the first priority, followed by nursing education, home health nursing, nursing research, and chronic disease. For nursing research leadership, research area on clinical nursing practice, nursing education, home health nursing, nursing research, and nursing diagnosis were identified. Concerning contribution to the nursing profession, the first priority was nursing education, followed by clinical nursing practice, nursing research, nursing policy, and home health nursing. Concerning contribution to the health/welfare of patients, clinical nursing practice, home health care, geriatric nursing, chronic disease, and symptom management were ranked as top 5 research priorities. CONCLUSION: The findings of this national survey will assist in building insights into the research needs of nurses practicing in Korea.

PURPOSE: The purpose of this study was to identify factors that influence the functional status of chronic lung disease patients. METHOD: A descriptive, correlational study design was used. The study was conducted at the outpatient respiratory clinic of the large university hospital in Korea. A convenience sample of 128 chronic lung patients (age = 64.2 yrs; 106 COPD, 17 bronchiectasis, 5 DILD) with mean FEV1 64.4 % predicted. Functional status was measured with SIP. Physical variables (FEV1% predicted, dyspnea, fatigue, pulmonary symptom distress), psychological variables (mood, stress), and situational variable (sleep quality) were examined. Dyspnea was measured by the BDI, fatigue was measured with the MFI. Mood was measured with the modified Korean version of POMS. Sleep quality was measured with the Pittsburgh Sleep Quality Index. Potential independent variables for the regression were age, gender, years since diagnosis, FEV1% predicted, dyspnea, fatigue, pulmonary symptom distress, stress, and sleep quality. RESULT: In general, functional status was relatively good. In regression analysis, functional status were significantly influenced by dyspnea, mood, age and fatigue. These variables explained 70 % of the variances in functional status. CONCLUSION: The results suggest that psychophysiologic symptom management should be a focus to enhance the functional status in this group.

PURPOSE: This study is a fact-finding research to understand the status of visiting nursing services operated by health centers in Korea and it aims to provide basic information for policy development on operation and management of visiting nursing services in health centers. METHOD: This study investigates the results of visiting nursing services in 242 health centers from Jan. 10 through Dec. 30, 2000, where 3,106 visiting nurses were employed by the public work program. RESULT: In 2000, 129,401 new household as service recipients was identified and that was 0.9% of Koreas total households (15,137,000), and 5.8% of low income households (2,242,000). The highest high risk group was dementia patients(aver. 55.2/1,000 person). Average number of households visited by visiting nurse were 4.5 households per day and the first-visited houses per visiting nurse were 1.1 households per day. The re-visiting rate was 71.3%. Total 4,059,130 service items were provided and assessment ranked the highest with 33.7%. The satisfaction level of clients on the nurses was an average of 3.17 points in the scale of 4 and the nursing service was a 2.60 points in a scale of 3. CONCLUSION: Visiting nursing service should continue to provide comprehensive healthcare services in cost-effective ways while cooperating with others.

With the dynamically changing environment of society, managing change is the vital element of organizations's survival and growth. Health care organizations have expended enormous resources to restructure patient care delivery. Despite the growing literature describing these organizational innovations, there is a paucity of credible data that reflects systematic measurement and evaluation of such changes. This study examined the nurses' psychological response toward the work process redesign, newly introduced by the nursing department in a acute care hospital. The aim of the study was to figure out how nurses's general perception of change and perceived attributes of change affected their acceptance of change during the organizational transition. This was descriptive-correlational. The sample for the study included 50 head nurses and 135 staff nurses. Data was analyzed using SPSS PC+, version 10.0. The major findings of the study were as follows: First, the mean score of the perception of change was 71.2 (SD=13.8) with the range of 0-100, which means nurses generally perceived change positively. There were significant differences in perception of change by gender and education level. Head nurses perceived change more positively than staff nurses. The higher education level showed the more positive view of change. Second, among the perceived attributes of change, trialability had the highest mean score, which means nurses perceived the change more positively if it is testable on a limited basis. Relative advantage was perceived the most negatively. Finally, factors influencing the acceptability of the work-process redesign were perceived comparability, complexity, relative advantage, and observability, which accounted for 43.7% of the variance in the acceptability of change.This study evaluated the preliminary effects of the nursing process for reengineering, focusing on nurses' acceptability towards change. The usefulness of this research study was to determine the factors influencing acceptance of organizational members during transitional periods of change and to suggest effective strategies for increasing adoption as well as for decreasing resistance to change.

This study was performed to identify the physiological and psychological variables related to successful weaning from a mechanical ventilator. The subjects of this study were 22 patients who received mechanical ventilation therapy for more than 3 days in intensive care units. Before the weaning trial, baseline data for following physiologic variables were obtained: spontaneous respiration rate, blood pressure, pulse rate, PaO2, PaCO2, PEEP, static compliance, minute ventilation, tidal volume, rapid shallow breathing index(f/VT), SaO2, PaO2/FiO2 and mean arterial pressure. During spontaneous breathing, physiologic and psychologic variables such as vital signs, ABG, perspiration, chest retraction, paradoxical respiration, dyspnea, anxiety, confidence and efficacy were measured. Successful weaning was defined as sustaining spontaneous respiration over 24 hours after extubation. Weaning failure was defined as the development of more than one of following signs: (1) hypoxemia, (2) CO2 retention or (3) perspiration, tachypnea, chest retraction, tachycardia, arrhythmia, hypotension or hypertension. Subjects (N=18) who successfully weaned from mechanical ventilator were compared with subjects (N=4) who failed. The results are as follows; Eighteen percents of the subjects failed during the weaning trial. Most subjects in the failed group were mechanically ventilated for long-time. This result shows that the success of weaning is more difficult in long-term ventilation patients. In the baseline data that was measured before weaning trial, the mean score of PaO2 in the successfully weaned group was 121mmHg. This is significantly higher than the mean score of PaO2 in the failed group(95mmHg). However, the scores of pH, tidal volume, f/VT, pulse rates, blood pressure, mean airway pressure, SaO2, and PaCO2 were similar between the two groups. Specially the scores of f/VT index as a predominant predictor for successful weaning were not significant (f/VT=44.4) and (f/VT=47). During spontaneous breathing, the scores of dyspnea and anxiety level in the successfully weaned group were less than those of the failed group. On the contrary, the scores of confidence and efficacy in the successful group were greater than those of the failed group. In conclusion, the baseline data that were measured before weaning trial were similar between the both groups, therefore future studies are needed to focus on searching other variables besides physiological parameters related to weaning outcome.

Many patients of acute myocardial infarction showed delay time before seeking treatment although they needed immediate thrombolytic therapy once they perceived their symptoms. The objectives of this study were to identify the relationship between clinical symptoms and the delay, and to find the time spent before seeking the treatment. This study was a retrospective research. The delay time for the treatment consisted of the length of delay from symptom onset to patients' decision (T1), from patients' decision making to finding transportation (T2), and from taking transportation to the first hospital arrival(T3). The subjects were 89 patients who were admitted in the ICU and Cardiac Ward at Chonnam University Hospital with the first attack of acute myocardial infarction. The data was collected for three months from March 1st to May 31st of 1998 through questionnaires and reviewing patients' charts: The chart information was suppled by two nurses working at the ICU and Cardiac Ward. The data was analyzed by using frequency, mean and ANOVA through the SAS program. The results of study summarized as follows: 1. Sixty two patients (69.7%) were male and twenty seven patients (30.3%) were female, the ratio of male to female was 2.3 : 1. 2. In daily life, the 70.8% of the patients felt chest pain and discomfort fatigue in 67.4%, dyspnea in 57.3%, and pain in arm, neck, and jaw in 52.8%. During the attack, 97.8% of the patients felt chest pain and discomfort dyspnea in 82.1%, pain in arm, neck, jaw in 67.4% and perspiration in 51.7%. 3. The length of time a patient spent seeking time for treatment (T1+T2+T3) was 94.6 minutes, in which the time for patients' decision making for treatment (T1) was 70.3 minutes, time for finding transportation (T2) was 8.2 minutes, and time for the transportation of the patient to the first hospital (T3) was 16.1 minutes. Time for patients' decision making to go to a hospital(T1) was 74.2% of the total time sought for treatment.

The main purposes of this study were to determine the interval between the onset of symptoms of myocardial infarction and treatment-seeking time and identify the factors related to the interval time. This study used a retrospective design, The sample consisted of 45 patients aged over 30 who were diagnosed with an acute myocardial infarction at two large university affiliated medical center from September 1, 1997 to June 30, 1998. Data was collected by using questionnaires, which included demographic data, premonitory clinical signs and symptoms of myocardial infarction, and a measure of the severity of the signs and symptoms. Also semi-structured interviews and chart reviews were used to obtain information related to treatment seeking time. The results of this study are summarized as follows: 1. The most frequent premonitory clinical symptom was chest pain(92.9%), the second, was perspiration(81.0%), and the next were nausea(40.5%) and dyspnea(38.1%). Thirty two patients reported having more than four premonitory signs and symptoms. Patients described the characteristics of chest pain as "something very heavy pressing down "(26.2%), "felt like my chest would burst"(24.4%), or "sharp pain"(16.7%). Over 95% of the sample reported having chest pain. 2. Twenty two (52.4%) patients reported to have "very severe" premonitory pain. 3. The mean time interval between the onset of signs and symptoms and the arrival at the medical center was 6.39+/-0.80 hours in 42 samples, the mean time from the onset to arrival at a local hospital was 3.27+/-.39 hours and for transfer from a local hospital to the medical center was 4.75+/-.87 hours in patients who had arrived at medical center via local hospital. 4. The severity of premonitory signs and symptoms did not differ significantly according to existence of premonitory signs and symptoms. 5. There was no significant relationship between treatment-seeking time and age, gender, marital status, economic status, occupation, or residence. But education had significant relationship(r=-0.51, p=0.01). Analysis of difference of the time interval according to the premonitory signs and symptoms showed that the time was shorter in patients who experienced nausea or dysnea(U=115.50, p=0.01, U=132.00, p=0.04), however the severity of premonitory signs and symptoms did not have statistical significance.

The purpose of this study was to classify, from collected home health care records data, nursing diagnoses according to the NANDA system and nursing interventions according to the NIC system, and to link nursing interventions to nursing diagnoses. For this study, 101 home health care records of clients seen between September, 1994 and November, 1996 at Yonsei Medical Center, Seoul, were analyzed. The results of this study are summarized as follows: 1. The most frequent nursing diagnoses were 'Risk for infection' and 'Altered nutrition : Less than body requirements', then 'Impaired skin integrity' and 'Ineffective airway clearance' in the Exchange patterns of NANDA nine human response patterns. 2. The most frequent nursing interventions were the interventions in the Physiological : Complex domain, there were 690(50.7%) interventions among a total 1347 interventions. This results corresponds to Yom, Young Hee(1995)'s research, both Korean and U.S. nurses used the interventions in the Physiological : Complex domain most often on a daily basis. And respiratory nursing interventions were most frequent because 32.7% of the subjects were respiratory patients. 3. The next step was to link the nursing interventions to nursing diagnoses. The most frequent nursing diagnosis was 'Risk for infection' and 19 interventions for 'Risk for infection' were used 267 times. Then 14 interventions for 'Impaired skin integrity' were used 258 times, 12 interventions for 'Ineffective airway clearance' were used 193 times, 12 interventions for 'Altered nutrition : Less than body requirements' were used 122 times, 10 interventions for 'Activity intolerance' were used 75 times, and 11 interventions for 'Knowledge deficit' were used 52 times. 4. The use of standardized classification in the areas of nursing diagnoses and nursing interventions facilitates clinical decision making and prompt nursing activity, and so enhances the effectiveness of nursing care.