The purpose of this study was to examine the relationship between self-esteem and quality of life(QOL) and between coping type and quality of life (QOL) in mothers of handicapped children and further to identify the level of self-esteem and quality of life of the subjects. The subjects of this study were the 51 mothers of handicapped children who were registered in two special schools in Taejon. The data were collected using a questionnaire and the period of the data collection was from April 18th to May 26th, 1997. The instruments for this study were Resenberg's self-esteem scale, Folkman and Lazarus's Ways of Coping Checklist(WCC) and the quality of life scale designed by Ro, You Ja. The results were analyzed using SPSS/PC+. Data analysis included the descriptive correlational statistics of ANOVA, Pearson Correlational Coefficient, and t-test. The results are as follows : 1. The level of self-esteem showed a mean score 34.51 and the level of QOL, a mean score 137.55. An Active type of coping was used more often than a passive one. 2. The level of self-esteem differed according to monthly income and was significantly higher in mothers of children with acquired handicaps than those of children with congenital handicaps. The level of QOL differed according to monthly income. 3. There was positive correlation between health status and self-esteem(r=.355, p<.05), and between health status and QOL(r=.367, p<.01). 4. Test for hypothesis ; Hypothesis 1, "The higher the level of self-esteem in mothers of handicapped children, the higher their level of quality of life will be." was supported(r=.755, p<.001). Hypothesis 2, "The QOL level for the active coping group as compared to the passive coping group will be higher." was not supported.

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.

The purpose of this study was to identify how internal and external coping resources influenced active coping in the process of stress-coping. The model was established theoretically by comparing and integrating the following theories : Stress-Coping, Self-Care, and Resourcefulness. The subjects consisted of sixty eight patients undergoing chemotherapy(experimental group 34, control group 34) at two general hospitals from January to July, 1995, The results were as follows : After self-care education, the active coping score of the experimental group was significantly higher than that of the control group. The active coping score of the high resourcefulness group was significantly higher than that of the low resourcefulness group. The interaction effect between self-care education and resourcfulness was not significant statistically. Specifically as to such scores of seeking social support, problem-oriented strategy and self care behavior, there were significantly higher in the experimental group and high resourcefulness group than in each of the other groups. Considering them both, self-care education and resourcefulness are effective nursing strategies to promote active coping including self-care. Consequently, the synthesis and testing of theories of stress-coping, self-care, and resoucefulness in this study are mostly proven to enhance the explanation and prediction of the change of active coping including self-care. Therefore the result of this study will contribute in the development of practice theory of nursing. A further study is necessary to reevaluate the interaction effect between self-care education and resourcefulness and to identify the difference between resourcefulness and self-efficacy.

The purpose of this study was to examine the stressors and coping strategies of school-age children and to explore the relatioship between stressful life events and health symptoms and the effects of coping and trait anxiety which is theoretically considered to mediate the relationship between stress and health symptom. The study subjcets consisted of 639 elementary school children in the fourth to sixth grade living in Seoul. Of the 639 subjects, 348 were boys and 291 were girls. The mean age was 11.35(SD=.86). The Feel Bad Scale (FBS), Schoolager's Coping Strategy Inventory (SCSI), Spielberger's Trait Anxiety Scale for Children(STAIC), and Health Symptom Questionnaire(HSQ) were adapted for this study. A pilot study was undertaken to ascertain the reliability and validity of the instruments. The Cronbach alphas of FBS, SCSI, STAIC and HSQ were from. 81 to .92. The Researcher and a research assistant visited the school and data were collected in the class using the questionnaire method after an explanation of the purpose and procedures was given to the children. Data collection was done during the period between Nov. 25 to Dec. 19,1995. Using the SAS statistical program, percentages, t-test, ANOVA, correlation analysis, and multiple regression were used for data analysis. The result are as follows: 1. The mean score for the FBS was 204.79(range: 48-472) and there was a significant difference according to grade. The most severe stressors perceived by children were parental divorce and death or illness of family members. The most frequently experienced stressful life events were conflict with siblings and being home alone. 2. The mean score for the SCSI was 57.36(range: 9-118) and there was a significant difference according to grade. The most frequently used, and perceived as helpful, coping strategies were distraction and cognitive activities. 3. The mean score for the HSQ were 20.7(range: 0-8l) and there were significant differences according to grade and sex. The percentage of the children answering that they perceived their health state as not good was 3.9%. 4. The mean score for the STAIC was 33.76 and there were significant differences according to grade and sex. 5. There was a significant relationship between stressful life events and health symptoms(r=.53, p<.01). Also, Stressful life events were postively related with coping strategies(r=.39, p<.01). Trait anxiety was highly correlated with health symptoms(r=.72, p<.01). 6. To examine the multivariate effects of the variables to health symptoms, multiple regression was performed. Stressful life events, coping, trait anxiety, and health concerns were identified as significant variables. Explanation of the health symptoms by these variables was 56. 78%. The study revealed that stressful life events correlated with health symptoms in School-age children and coping and trait anxiety had mediating effects on this relationship. The implication for nursing is that there is a need to develop supportive interventions for high risk population to decrease health problems due to stress. Also, it is recommended that a study be conducted to explore protective factors for the prevention of health problems in children.

The purpose of this study was to contribute to family nursing in the areas of reducing stress and improving coping for parents of mentally retarded children. Data were collected through self-report questionnaires during a period of 2 months between November 1994 and January 1995 in the Kyoung-in area. The subjects consist of 176 parents (88 mothers and 88 fathers) of mentally retarded children attending schools for the handicapped. The levels of general stress and of parental role stress were measured with the General stress scale and the Parental role stress scale, respectively. The coping scale developed by Folkman and Lazarus was adopted to measure the level of coping, and the patterns of adaptation scale developed by Damrosch and Perry was adopted to measure the patterns of adaptation. The data were analyzed by a SAS program using Fisher's exact test, paired t-test, and oneway ANOVA. The results are as follows: 1. The level of general stress was significantly higher in mothers than in fathers. Mothers experienced a significantly greater level of parental role stress than fathers did. No significant difference in the level of coping was observed between mothers and fathers. There were differences in maternal and paternal patterns of adaptation. 2. The adaptation pattern of fathers was different according to their level of general stress, parental role stress and coping. The adaptation pattern of mothers was not different according to their level of general stress and parental role stress, but was according to their level of coping. 3. General stress experienced by fathers was different according to education, health status and support from their spouses. Satisfaction with family life, satisfaction with spouse and the support from spouse influenced coping used by fathers. Their level of parental role stress was not associated with any of their general characteristics. 4. In mothers, the level of general stress was different according to their health status, the level of parental role stress was related to satisfaction with family life and satisfaction with spouse. Their level of coping was associated with the support from spouse. The above findings indicate that mothers did not have more coping strategies than fathers did, despite the results which showed that mothers experienced greater stress than fathers did. Especially, the adaptation pattern of mothers was different according to their level of coping. Hence, nursing interventions directed at managing stress and improving coping should be used with mothers who use adaptation pattern 1. In particular, fathers should actively participate in parenting, and support their spouses.

PURPOSE: This study was conducted to identify and compare the stressors and coping behaviors of high school students who experienced suicidal ideation vs those who do not. METHOD: The data were collected from 1,441 high school students living in the middle region of Korea. Researchers collected the data using Adolescent Stress Inventory and Adolescent Coping questionnare from February to May of 1999. Data were analyzed using X2, T-test. RESULT: A significant proportion (31.9%) of subjects had thought about suicide during the past 6 months, 297 girls (35.3%) and 163 boys (27.2%). Major stressors of subjects who experienced suicidal ideation were academic problems, conflicts between family members, and changes in sleeping or eating patterns. Conflicts with family members contributed to have suicidal ideation. There was no significant difference in helpful coping behaviors between the two groups. The group who experienced suicidal ideation had lower scores and fewer coping behaviors. Boys perceived more stressors and had fewer helpful coping behaviors than girls. CONCLUSION: It is necessary to develope school-based suicide prevention programs. Our findings suggest that the program should focus on problems related to studying and conflicts within the family.

PURPOSE: To find the experience about clients with hypertension and to help them to care for themselves in the community.
METHOD
All data was collected from August 1999 to October 1999, through in-depth interviews, observation, and telephone interview with 7 participants who have been diagnosed with hypertension for 1 to 10 years. According to Strauss and Corbin's Methodology, the data was continuously coded into concepts and categories, and then new data was analyzed simultaneously by a constant comparative method.
RESULTS
There are 171 concepts, and then they were grouped into 34 the lower categories and 15 to the upper categories. The course of the coping of fear in hypertensive client consisted of 6 processes. The awareness of seriousness was context, and the fear was core phenomenon about the coping experience. We also found that hypertensive clients have 3 patterns, depending on the awareness degree of seriousness and the fear about hypertension.
CONCLUSION
Our nurses should recognize the importance of effective management and seriousness about hypertension, offer clients the importance of family support and the information of etiology, symptoms and signs of hypertension, and provide the correct information on hypertensive medication. We should be able to guide their fear about hypertension to positive self-management, so that they may manage their disease thoroughly and effectively.

The purpose of this study was to investigate the effects of coping mechanisms on uncertainty and depression. The subjects were 71 cancer patients selected from Junbook National University Hospital, and the data collection period was from June 21 to October 19 of 2000. Uncertainty was measured by using Mishel's Uncertainty Scale, problem- focused coping, and emotional-focused coping. The data was collected by a questionnaire developed by Lee (1984), and then depression measured by using Beck's depression scale. Data was analyzed with SPSS/WIN 7.5 program by Pearson Correlation Coefficients, and Path analysis. The results were as follows : 1. The mean uncertainty score was 59.17, the mean problem-focused coping score was 48.78, the mean emotional-focused coping score was 42.52. 2. The mean depression score was 15.77. 3. Uncertainty in illness was significantly related to depression (p=0.003) and emotional-focused coping (p=0.028), but uncertainty was not associated with coping mechanisms. 4. When analyzed multiple regression between uncertainty, problem-focused coping, emotional- focused coping, and depression, more specifically emotional-focused coping showed a stronger association with depression than problem-focused coping. 5. Depression was highly correlated with economic status (p=0.015), educational background (p=0.005), duration of disease (p=0.045). 6. Problem-focused coping and emotional-focused coping appeared to function as moderators instead mediators on the relation between uncertainty and depression. In addition, as a whole, uncertainty showed a significant moderating effect on depression, while problem-focused coping did on depression. Finally, limitation of present findings were discussed and implications for future studies are suggested.

The sample of this study consisted of 140 informal caregivers who provided care to the older adults(over 60 years of age) in Great Cleveland, USA. Self-rated questionnaires were utilized to collect information. The purpose of the study was to identify coping strategies most frequently utilized by informal caregivers of older adults and to examine predictors of the caregivers' health responses to the caregiving situation applying Lazarus and Folkman stress model(1984). Stepwise multiple regression was used to identify significant predictors among caregivers' demographic-socio-economic factors, older adult's dependency of activities of daily living(ADLs), caregiver's appraisal to the caregiving situation, and coping strategies. Informal caregivers (N=140) included in the study utilized help-seeking and problem-solving coping strategies more than self-blame and minimization of threat coping strategies. Caregivers' responses to the caregiving situation were observed by caregivers' perceived physical health, depression and life satisfaction. For perceived physical health, threat appraisal, older adult's dependency on ADLs, existential growth coping strategy, and monthly income accounted for 25% of the variance. Caregivers who appraised the caregiving situation as more threatening, reported higher dependency on ADLs, used more existential growth coping strategy, and had higher monthly income reported better physical health. For depression, threat appraisal, stress appraisal, existential growth coping strategy, self-blame coping strategy, and monthly income accounted for 48% of the variance. Caregivers who used more existential growth coping and less self-blame coping, appraised the situation as less threatening, less stressful, and had higher monthly income reported less depression. For life satisfaction, self-blame coping, existential growth coping, monthly income, stress appraisal accounted for 49% of the variance. Caregivers who used more existential growth coping, less self-blame coping, less stress appraisal, lower monthly income reported better life satisfaction. In conclusion, informal caregivers in this study utilized positive coping strategies such as problem-focused, existential growth, help-seeking, rather than negative coping strategies including self-blame. When they utilized positive coping strategies more often, caregivers experienced higher perceived physical health, higher life satisfaction and lower depression. Therefore, nursing intervention which utilized positive coping strategies is needed to enhance informal caregivers to have positive health responses to the caregiving demands.

The purpose of this study was to provide basic information for developing a nursing intervention that helps patients learn how to acquire coping to reduce post operation uncertainty and anxiety by investigating the level of uncertainty and anxiety experienced by mastectomy patients. The subjects were 134 patients selected from St. Mary's Kangnam and St. Mary's hospital, and the data collection period was from October to December of 1998. Uncertainty was measured by using Mishel Uncertainty in Illness Scale (MUIS), anxiety measured by using State-Trait Anxiety Inventory(STAI), and coping by using a questionnaire developed by Kim & Yoo (1996). Data were analyzed with SAS program by t-test, ANOVA, Duncan's multiple range test, Pearson correlation coefficients, and stepwise multiple regression. The results were as follows: 1. The mean uncertainty score was 57.6. The results of the correlation between the compliance of medical regimen and demographic characteristics were as follows ; Those who monthly income over 2,010,000 won had lower than above 1,000,000 won, and those with the experience of chemotherapy had higher than those without, and the patient who has 7~12 months(1 yr.) post operation period had higher than the one below 6months, 25~36 months(3 yrs.), 37~60 months(5 yrs.), and over 61 months. 2. The mean anxiety score was 45.9. Anxiety tended to be increased slightly in subjects with low educational background, poor monthly income, experience of chemotherapy, and 7~12 months(1 yr.) post operation period, but there was no significant difference by general characteristics. 3. The mean value of the coping score was 100.7. The study revealed higher score in problem-focused coping than emotion-focused coping. In regard to coping by demographic characteristics were as follows ; those who had monthly income over 2,010,000 won had higher level of coping than those whose monthly income was between 1,010,000 and 2,000,000 won. In terms of problem- focused coping, those who had 25~36 months of post operation period showed significantly lower level of coping than those below 6 months or 37~60 months(5 yrs.) or over 61 months of post operation period. Regarding the emotion-focused coping, those with the christianity had significantly lower level of coping than those without it. Also, those whose monthly income over 2,010,000 won had significantly higher coping level than those with income of between 1,010,000 and 2,000,000 won. 4. A positive relationship was found between uncertainty and anxiety. Patients who experienced more uncertainty also showed more anxiety. Problem-focused coping was inversely related to uncertainty and anxiety. 5. The major variable that affected uncertainty was anxiety, explaining 63.3% of the uncertainty. In addition to this, it would explain 66.4% in total when experience of chemotherapy was added.

The purse fo this study was to examine the predictors of burnout among informal caregivers of older adults. One hundred thirty seven caregivers of who had provided care to older adults over 60 years of age for more than one month were included in the study. Most of the caregivers where white (91%) and female (78%). mean ages of the caregivers were 64 years and 78% of them were married. Seventy percent of the older adults suffered from Alzheimer and related disease. In this study, caregivers and related disease. In this study, caregivers reported that they experience burnout once a month. The scores of emotional exhaustion and reduced personal accomplishment of the caregivers were in the moderate burnout rang. To examine the predictors of burnout, discriminant analysis was used. Caregivers were divided by two groups based on the sum of score (cutpoint=6) on three dimensions of burnout after each dimension was categorized into high(3), moderate(2), and low(1). Nine predictors were include in the analysis: Caregiver's age, employment status, Instrumental Activities of Daily Living (IADL) of the older adult, presence of dementia of the older adult, caregiver's empathy toward the older adult(emotional and cognitive), and 3 coping strategies (negative, problem-focused, cognitive reconstructioning). Catefgivers who reported high burnout showed higher cognitive empathy toward the adults than those who showed low burnout. Caregivers who experienced high burnout used negative coping more often, and cognitive reconstructioning coping and problem focused coping less often than their counterparts. Wilks' Lambda was .78 indicating that their differences between the two groups were signigicant. Cognitive empathy and cognitive reconstructioning coping showed high standardized canonical discriminant function coefficients over .40. Discriminant function with 9 predictors correctly classified 71% of the sample. In conclusion, informal caregivers also experienced certain level of burnout. Cognitive empathy and coping strategies predicted burnout experience of the caregivers. Based on this study, nursing intervention to the informal caregovers to improve their cognitive empathy toward the older adults and to modify their coping strategies in way to reduce burnout experience can be applied. Further research to develop effective nursing interventions for the purpose of reducing burnout experience by modifying predictors was suggested.

Cancer has been considered a life-threatening disease and coping patterns could have a string impact the physical and psychological health of patients and their family. The purpose of this study was to identify the change of coping patterns according to the phases of illness in the patients with cancer and their family caregivers and to compare the coping patterns of patients with those of their caregivers. The phases of illness consisted of 1st(initial) stage, 2nd(metastatic or recurred) stage and 3rd(terminal) stage based on literature. The coping methods were measured using the modified Ways of Coping Questionnaire by Lazarus and Folkman(1984). Seventy-nine patients(35 in stage 1,31 in stage 2, and 13 in stage 3) and ninety-two caregivers(38 in stage 1,30 in stage 2 and 24) agreed to participate from two general hospitals in Seoul and Choongnam. No significant changes were found in the coping patterns according to the phases of illness in both groups. Patients in stage 2 and caregivers in stages 2 and 3 problem-focused coping methods were significantly used more than emotion-focused coping methods. Patients in stage 1 significantly used two coping strategies that were cognitive reconstruction and emotion expression more than caregivers. Patents in stage 2 significantly used emotion-focused coping methods including minimizing threat, blame, and emotion expression excepting wishful thinking more than caregivers. We need more research to identify the relationship between the coping methods and their efficiencies through long-term observation and attempt to develop the nursing interventions that could have an improvement on positive coping methods and provide guidance on the problems the patients experience.

This was designed to identify the relationship of perceived stress, ways of coping, and stress response in student nurses. The subjects of this study were 320 student nurses from two universities and three junior colleges located in Seoul. The data were collected from November 28 to December 10, 1997 by a questionnaire survey method. The instruments for this study were the perceived stress scale developed by Levenstein(1993), ways of coping scale developed by Lazarus and Folkman(1984), and the stress response scale developed by Choi(1991). The data were analyzed by SAS program, using descriptive statistics, Pearson correlation coefficient, and ANOVA. The results are summarized as follows : 1. The mean score for the level of perceived stress was 2.55. 2. The mean score for the level of problem oriented coping was 1.61 and the mean score for the level of emotional oriented coping was 1.37. 3. The mean score for the level of stress response was 3.74. Stress was classified into nine factors and the order of scoring for the most frequent was; assignments(3.98), as a nurse(3.97), interpersonal relationship(3.88). 4. The relationship between perceived stress and stress response revealed a positive significant correlation(r=0.23, p=0.0001). 5. The relationship between emotional oriented coping and stress response revealed a positive significant correlation(r=0.22, p=0.0001). 6. The relationship between perceived stress and emotional oriented coping revealed a positive significant correlations(r=0.13, p=0.020). In conclusion, this study revealed that the level of perceived stress and ways of coping were important factors influencing the stress response of student nurses. Therefore, in consideration of perceived stress, ways of coping should be included in the development of a stress management program for student nurses. Further research with an expanded area and subjects is recommended.