A number of nursing researchers have used the concept of health locus of control over the past decade in Korea. This article reviewed 92 nursing research papers on health locus of control conducted since 1982, and examined type of subjects, design, measurement instruments, the scores of each di men9ion of the HLOC, and significant variables. Most of the research were correlational in design, used an 18-item 6-point score instrument and studied the relationship between HLOC, health related variables, and cognitive-emotional variables, The health related variables included health behavior, health management, preventive health behavior, compliance to treatment regimen and self care behavior. The cognitive-emotional variables included depression, anxiety, stress and self-esteem. Some consistent findings are beginning to emerge. The concept of internal HLOC was positively correlated with the health related variables. But few studies found any significant correlation between powerful others HliOC and health related variables. In the case of chance HLOC, few studies reported a significant relationship. Many of the articles reported significant relationships between internal HLOC and cognitive-emotional variables, but few reported a significant relationship between powerful others or chance HLOC and cognitive-emotional variables. All experimental studies but one found that only internal HLOC was significantly changed following experimental manipulation. When the different groups of subjects such as normal persons, chronic patients, acute patients were compared in terms of mean scores, it was found that the HLOC appeared to change depending on the status of the patients. Recommendations for future research include modification of the instrument to increase the reliability and validity, study about the pattern of response suggested by Wallston and Wallston(1982) and further experimental study on changing the belief of subjects to internal HLOC.
The purpose of this study was to identify the commonalities of various nursing interventions and effective intervention methods in each intervention through analysis and synthesis of many accumulated research papers. The study analyzed the effects of various nursing interventions on anxiety and/or stress. For this purpose, 64 experimental studies with randomized or nonequivalent control group pre-test-posttest design were selected were selected from journals of medical and nursing schools, the Korean Nurse, the Korean Nurses' Academic Society Journal, the Central Journal of Medicine, the New Medical Journal, the Nurse Monthly, and from theses and dissertations conducted from 1970 to 1991. The selected studies were classified according to three characteristics : 1) the research sample, 2) types and methods of nursing interventions, and 3) statistical tests. The following analysis was done : 1) Confirmation of the accuracy of data drawn from each study by paired review, 2) Estimation of the homogenity of pre-test scores of the dependent variable between control and experimental groups warranted the effect size of post-scores, 3) If the homogenity of pre-test scores did not warrant, the change scores from pre-test to post-test were used to estimate the effect size, 4) Use of the effect size of each study among homogenious studies was tested for each intervention method, such as relaxation, information, and touch and/or support. Finally, for the studies not showing homogenity, and ANOVA test was used to identify patterns for each intervention. Some findings are summarized as follow: The effect sizes for relaxation and information were greater than those for touch and / or supportive technique. Studies using random assignment had greater effect sizes than nonrandomized sample studies using the same intervention. For healthy people, group education was more effective than individual teaching. However, for patients, relaxation and touch and / or supportive techniques given on individual basis were more effective than when given in a group situation. Measuring anxiety and stress by biological indicators was less effective than by self-report. Budzynski's relaxation method was the most effective. The more frequently the techniques applied, the larger the effect size. On the bases of these findings, the following recommendations were made : 1. A combination of information, relaxation, and touch-supportive techniques should be sued for greater effect in reducing the level of anxiety and / or stress. 2. Information is the first choice of intervention to reduce the level of anxiety and/or stress of health people ; other intervention may be added depending on the conditions of the subjects.
The purposes of this study were 1) to identify patterns and trends of studies of anxiety and stress and 2) to provide direction on which to base further research. Research studies of anxiety and stress were selected from journals of medical and nursing schools, the Korean Nurse, the Korean Nurses' Academic Society Journal, the Central Journal of Medicine, the New Medical Journal, Monthly Nurse, and from theses and dissertations, which had been conducted for the 20 years from 1970 to 1990. The total population of the studies numbered 463. Seven studies were excluded from the analysis because of duplication, so that 252 studies of anxiety and 204 of stress were analyzed. These studies were analyzed for 1) time of publication or presentation, 2) research design, 3) characteristics of subjects used in each study, 4) types of correlated variables, and 5) types of nursing interventions. Findings obtained in the study were as follows : 1. The number of studies related to anxiety and stress has increased rapidly since the early 1980's. 2. The studies were primarily descriptive throughout the 20 years. However, correlational studies, comparative studies and experimental studies slowly increased. 3. Anxiety studies tend to be conducted more on patients and stress studies with normal subjects in non-experimental research. However, experimental studies were conducted more with patients than with normal subjects. 4. In correlational studies, the trend was to study physical conditions in relation to anxiety, and coping and adaptation in relation to stress. 5. In experimental studies, teaching and information therapy and relaxation were the most popular interventions for anxiety, and supportive care for stress. On the bases of these findings, the following recommendations were made : 1. These patterns of studies related to anxiety and stress in Korea need to be compared with studies conducted in other countries. 2. More attention is needed in terms of research design, reliability and validity of tools, and results of statistical analysis. 3. Meta-analysis should be done to analyze and integrate the results of various studies. 4. For theory testing and identification of useful intervention methods, experimental studies with the same protocols must be conducted rather than more descriptive studies.
The purpose of this study was to analyze womens' health problems using Green & Kreuter's 1991 PRECEDE model and to develop a model for a womens' health care center located in the community. The subjects were recruited from Wonju City. 1. The results showed that 23% of the sample population felt there was a need for a womens' health care center. The mean number of health problems was 3.1. The prevalence rate, was 44.4%, and the rate for an artificial abortion, was 36.4%. Also 30.5% did not have a health examination in the past year. Women using the hospital for medical care accounted for 45% of the sample, while 40% used the drugstore. The average score on the HPLP was 2.41, and this was influenced by self-efficacy, family support, sexual role, and health locus of control. There are a few educational programs in the city provided by the Wonju Health Center and by community health nurse practitioners. 2. The nursing center, as defined in North America, is a nurse-anchored system of primary health care delivery or neighborhood health center. Centers offer various services ranging from primary care to the more traditional such as education, health promotion, wellness screening, and coordination of services by advanced practice nurses. For examples in Sweden MCH centers provide total services for childbearing women and their families, sexual counseling and education for adolescents, and screening by midwives for cervical cancer. 3. The developed model combines purpose, target population, organization, and services, and is related to health resources. The purpose is primary health care and promotion of the quality of life. The target population can be grouped according to the life cycle, (premarriaged age group, the childbearing/child rearing age group, and middle aged and elderly women) and focuses on self-help. The organization of the center includes an advisory committee to plan and evaluate, and a health services team that will be multidisciplinary to provide health care, counseling education, and research. The model development suggested that a variety of women's health care centers are needed to insure adequate management of women's health. Follow-up research using PROCEED is needed to analyze health outcomes. Also a health nursing specialist system is required to develop health promotion, and improve the quality of life of women.
Promoting women's health lifestyles are important due to their connection to family health. The purpose of this study was to analyse women's health lifestyles(HLP) and their effects on women's life-cycle, so in order to develop a program in a women's health care center. The subjects included were 1080 women over 18 years old living in Wonju city, and were selected by stratified and purposive sampling. The data were collected through a questionnaire and interview. The Cronbach alpha, %, mean, ANOVA, Pearson's correlation, and regression in SPSS PC Win. package was used to analyze the data. The sample was sepernted into three groups premarital group 20.2%(premarital women between 18 and 40 years old), delivery and children rearing group 49.9%(marital women between 18 and 40 years old), over middle agedelderly group 29.9%(women over 41 years old). Significant difference were found in the HPL according to group. Also, relating variables, such as self-efficacy, family functions, health locus of control and gender role perception that were considered relating variables to HPL significantly differed among the tree groups. HLP significantly correlated with self-efficacy, family functions, HLOC and gender role perception in all participants and at all groups. The regression analysis of HPL was interpreted 40.6% with relating variables, self-efficacy, health attention, family functions, and internal locus of control, health perception, power other locus of control and chance locus of control in all participant. Self-efficacy, family functions, health attention were considered important variables in premarital group, self-efficacy, family functions, internal locus of control, health attention, health perception and power of control were important in delivery-rearing group. Self-efficacy, health attention, internal locus of control, family functions and health perception were important in middle aged-elderly group. As a result, we found the differences HPL scores and relating variables according to life-cycle groups. Therefore, we should prepare health promoting education programs for women according to women's life cycles. Also we suggest that women's health care centers based on communities was needed for proper management of women's health.
In this study, we attempted to investigate the needs and problems of the terminal cancer patients and their family caregivers to provide them with nursing information to improve their quality of life and prepare for a peaceful death. Data was collected from August 1, 1995 to July 31, 1996 at the internal medicine unit of S hospital in Seoul area with the two groups of participants who were family members of terminal cancer patients seventy four of them were in-patients and 34 were out-patients who were discharged from the same hospital for home care. The research tool used in this study has been developed by selecting the questionnaires from various references, modifying them for our purpose and refining then based on the results of preliminary study. While general background information about the patients was obtained by reviewing their medical records, all other information was collected by interviewing the primary family caregivers of the patients using the questionnaire. The data collected were analyzed with the SPSS PC+ program. The results of this study are summarized as follows; 1) Most frequently complained symptoms of the terminal cancer patients were in the order of pain(87%), weakness(86.1%), anorexia(83.3%) and fatigue(80.6%). 2) Main therapies for the terminal cancer patients were pain control(58.3%), hyperalimentation(47.2%) and antibiotics(21.3%). 3) Special medical devices that terminal cancer patients used most were oxygen device(11.1%), and feeding tube(5.6%). Other devices were used by less than 5% of the patents. 4) The mobility of 70.4% of the patients was worse than ECOG 3 level, they had to stay in bed more than 50% of a day. 5) Patients wanted their medical staffs to help relieve pain(45.4%), various physical symptoms(29.6%), and problems associated with their emotion(11.1%). 6) 16.7% of the family caregivers hoped for full recovery of the patients, refusing to admit the status of the patients. also, 37% wished for the extension of the patient's life at least for 6 months. 7) Only 38.9% of the family members was preparing for the patient's funeral. 8) 45.4% of family caregivers prefer hospital as the place for the patient's death, 39.8% their own home, and 14.8% undetermined. 9) caregivers of the patients were mostly close family members, i.e., spouse(62%), and sons and daughters or daughter-in-laws(21.3%). 10) 43.5% of the family caregivers were aware of hospice care. 46.8% of them learned about the hospice care from the mass media, 27.7% from health professionals, and the rest from books and other sources. 11) Caregivers were asked about the most difficult problems they encounter in home care, 41 of them pointed out the lack of health professionals they can contact, counsel and get help from in case of emergency, 17 identified the difficulty of finding appropriate transportation to hospital, and 13 stated the difficulty of admission in hospital as needed. 12) 93.6% of family caregivers demanded 24-hour hot line, 80% the visiting nurses and doctors, and 69.4% the volunteer's help. The above results indicate that terminal patients and their family caregivers demand help from qualified health professionals whenever necessary. Hospice care system led by well-trained medical and nursing staffs is one of the viable answers for such demands.