The main purpose of th study was to evaluate he validity of Korean Pain Measurement Tool composed of pain terms. The specific purposes of this study were 1. to examine whether pain intensities of pain terms are congruent with those classified in three previous studies. 2. to evaluate the relative intensity of each term by panel of judges. 3. to explore the difference of ranks of pain terms according to the sex, education, and ages. One hundred and sixty normal individuals were selected by 2x2x4 sampling design. Sex (male, female), education (high school, college), and age (20s, 30s, 40s, 50s) were matched. Each individual was asked to rate the ranks of 3~8 pain terms in each subclass. The data measured by ordinal scale were transformed to the interval scale to compare with the pain intensities gained from the previous study. The pain ranks different from previous results were finally rearranged or cancelled through the consultation of 4 panel of judges and sunmed up to 91 pain terms in the scale. As a result, the ranks of pain terms within each of eleven subclasses among the twenty subclasses completely were congruent with the previous pain ranks, while the ranks of nine subclasses were different from the previous pain ranks. In addition, there was significant relation between sex and pain ranks in skin punctuate pressure pain and cavity pressure. (sp : x2=5.18 phi=0.26; cp : x2=5.83 phi=0. 24) In conclusion, seven terms from subclasses of inflammatory repeated pain, traction pressure pain, fatigue-related pain, fear-related pain, dull pain, and pulsation-related pain were cancelled. The ranks of four terms in subclasses of incisive pressure pain and constrictive pressure pain were tentatively rearranged. Ranks of two terms in the tract pain were left as shown in the third study. As a result, six terms must be studied repeatedly for obtaining exact scores from ratio scale.

The main purpose of this study is to develop a ratio scale measuring level of pain using Korean pain terms. The specific purposes of this study are to identify the degree of pain of each pain term in each subclass; to classify each subclass in terms of dimensions of pain; and to analyze factors of the Korean pain ratio scale clustering together. One hundred and fifty eight pain terms which were originally identified as representative terms and their synonyms were used for data collection. Fifty eight nursing professors and sixty one medical doctors who have contacted with patients having pain were asked to rate the weight of each pain term on a visual analogue scale. Subclasses in which ranks of pain terms were same as findings in two previous studies were 1) thermal pain 2) cavity pressure, 3) single stimulating pain, 4) radiation pain. and 5) chemical pain. Subclasses in which ranks of pain terms were confused were 1) incisive pressure, and 2) cold pain. Subclasses in which one new pain term was added were 1) inflammatory-repeated pain, 2) punctuate pressure, 3) constrictive pressure, 4) fatigue-related pressure, and 5) suffering-related pain. Subclasses in which two new pain terms were added were 1) traction pressure, 2) peripheral nerve pain, 3) dull pain, 4) pulsation-related pain, 5) digestion-related pain. Subclass in which 3 new pain terms were included was fear-related pain. Rating scores of 5 words in 4 subclasses were significantly different between the normal group and the extreme group of subjects in terms of subjective rating. Only one word among 5 words was that newly added to the scale. Rating scores of 12 words in 9 subclasses were significantly different between doctor group and nursing professor group. Among these 12 words, only 3 were those newly added to the scale. In comparison of these 12 words, mean scores of the nursing professors were always 7 to 16 points higher than those of the medical doctors. In the analysis of judgement of subjects in terms of dimensions of pain terms, subclasses of dull pain, cavity pressure, tract pain and cold pain were suggested to be included in the miscellaneous dimension. As a result of factor analysis of the ratings given to 96 pain words using principal components analysis without iteration and with varimax rotation limiting the number of factors to 4, factors of severe pain(factor I) mild-moderate pain(factor II), causative pain(factor III) and temperature-related pain(factor IV) were extracted with the factor loading above 0.388. When the pain words were rearranged on the bases of factor loading above 0.368, number of factors decreased to only first two factors. Maximum score of pain word in factor II was 46.17 and the minimum score of the factor 1 was 45.36. Further studies are needed to identify the validity, reliability, sensitivity and practicability of this ratio scale using patients having various sources of pain.

The main purpose of this study is to observe patterns of pain of surgical patients following surgery. The postoperative pain was checked with the interval of every 2 hours from 6 hours to 80 hours after surgery. Graphic rating scale from unidimensional concept of pain and sensory intensity scale and unpleasantness scale from two dimensional concept of pain were used for pain measurement. Thirty two patients were participated in this study in which 22 were undergone upper abdominal surgery, 7 thyroid or neck surgery and 3 other surgeries. The findings obtained from this study were as follows: 1) In all cases of using 3 different pain measurement tools, postoperative pain was markedly decreased since 36 hours after surgery. In case of patient's less cooperation, either sensory intensity scale or graphic rating scale may be chosen for the measurement of pain. 2) Pain amounts measured by sensory intensity scale were highly correlated with those measured by unpleasantness scale in all situations except several situations having few cases included. Unpleasantness scale may be separately used for the measurement of affective response due to pain. 3) Almost 90% of total amount of analgesics used for relief of pain were used within 36 hours after surgery. 4) Mean frequency of analgesics used by every patient during 80 hours following surgery was 0.84.

The main purpose of this study is to systematically classify words indicating pain in terms of their ranks in each subclass. This study is a part of developing a Korean Pain Measurement Tool. This study did not include exploration of each word's dimension such as sensory or affective. Eighty three Korean words tentatively classified in 19 subclasses in previous study were used for this study. At least three to six words were included in each subclass and the words were randomly placed in which each subject indicates their rank of pain degree. One hundred and fifty nursing students and one hundred clinical nurses were requested to indicate the rank of each word. One hundred and sixteen students and eighty three nurses completed the ratings for analysis. The data were collected from June 1983 to July 1983. The data using ordinal scale were analyzed by Friedman ANOVA to test significant difference between rank means. All of pain words indicated significant rank mean difference in all of 19 subclasses. Some of the words were either cancelled or replaced by other words, or rearranged for their ranks. Subclasses of which words were cancelled were 1) Simple stimulating pain, 2) Punctuate pressure, 3) peripheral nerve pain, 4) radiation pain, 5) punishment-related pain, and 6) suffering-related pain. Subclasses of which words were replaced or rearranged were 1) incisive pressure, 2) constrictive pressure, 3) dull pain, 4) tract pain, 5) digestion-related pain and 6) fear-related pain. Four subclasses such as traction pressure, thermal, cavity pressure, and fatigue-related pain indicated significant differences among rank means in each subclasses and showed no visible overlaps of the ranks among means. Further research is needed using high level measurement of pain degree of each word and more sophisticated analysis of the pain degrees. Three pain words which would be related to chemical stimulation were newly explored and included as a new subclass. Through this study, the total number of subclasses increases from 19 to 20 and the total number of Korean words in the scale decreases from 83 to 80.

The purposes of this study were to(a) develop theoretical modifications of the extended gate control theory of pain using Fishbein's model and(b) test the efficacy of these modifications. Attitude, social subjective norm, personal subjective norm, habit and state anxiety were operat-ionalized to represent internal stimuli for the cognitive-evaluative and motivational-affective dimensions of the theory. Pain expression was operationalized as sensory and affective responses to pain, and pain endurance. Sixty-two female nurses from 20 to 50 years of age participated. A semantic differential scale measured attitude and motivations to comply; a Likerty-type scale measured personal and social norms and habit. Spielberger's STAI measured state anxiety. Pain was produced using a modified submaximum effort tourniquet technique. Pain expression was measured using ratio scales of sensory intensity and unpleasantness developed by Gracely and his associates. Pain endurance was measured by subtracting time of pain threshold from pain tolerance. The first hypothesis examining whether pain endurance would be more significantly related to the affective response than to the sensory response was not rejected. Four remaining hypotheses, testing the ability of the five variables to predict the sensory and affective responses were not rejected. However, the habit of pain expression and the attitude toward pain expression contributed to the prediction of both sensory and affective responses to pain. The interaction between the cognitive-evaluative and the sensory-discriminative dimensions and the interaction between the cognitive-evaluative and motivational-affective dimensions were partially supported by the data from these two variables. The interaction between the motivational-affective and the sensory-discriminative dimensions was also supported by the relationship of sensory "to affective responses. The variables which did not significantly predict pain expression appeared to have potential for prediction. Revision and testing of the tools for better reliability, validity, and clinical usuability are needed. The study contributed to theory building. The identification of variables which predict pain behavior must occur before effective nursing interventicuis can be developed.

The purposes of this study were to determine the relevant nursing needs of patients following discharge; to identify the degree of their nursing needs; to identify types and status of discharge order and information given to patients; and to determine their specific nursing needs according to their diagnosis. In addition, opinions toward home care services provided by hospitals or by public health nurses and appointment plans with their physicians were also asked in order to determine the necessity of follow-up care for the patient after discharge. Nine hundred and eighty eight subjects were collected among patients being discharged from one national university hospital and four city hospitals. Data were collected from June, 1979 to December, 1979 using questionnaires and interviews. On the bases of these data the following findings were observed; 1) Almost 40 percents of total subjects discharged from the hospital with some or great degree of nursing needs in general. The most problematic nursing needs were needs for comfort which include needs for releaving pain, for sound sleep and rest, because these needs can only be met by professional help. More than 50% of total subjects have this problem. 2) Needs for mental health, general metabolism, general hygiene and activities and safety were observed in more than 20 percent of subjects. 3) Discharge orders on diet and oral medication were recorded in patients' charts in 70% of all cases. However, more than fifty percents of patients have not been told these information from docters or nurses. Even though some of them might have had appointment plans with their physicians, they would not keep the appointments unless they completely understood the necessity of the follow-up care. If they have not had any appointment or would not visit the outpatient chinic, there is no method of caring them and prerenting funther discomfort or complications. Even in injection, skin care, dressing and bath, only one thirds of the subjects having recorded discharge orders understood what they need after discharge. The rest of cases have not known what to do for their further care. 4) More than 80 percents and 70 percents of total subjects agreed to a system of home care services provided by hospitals or public health nurses respectively. That is, regardless of sources of medical expenses, most of patients wanted to be taken care of at home following discharge. 5) While more than half of the patients having benefit of medical insurance or paying fully by themselves had appointment plans with their physicians, only one thirds of the patients fully or partially paid by government had appointment plans with their physicians. These results explain that the appointment plan is directly associated with their economic power. This indicates that the home care services are more needed to the people with lower economical status. 6) Those who have been in the hospital more than 24 days wanted to have home care services more than those who had less hospital days. They also had more appointment plans than other groups. 7) More than 70 percents of the subjects who had been in a university hospital and approximately 30 percents of the subjects in the city hospitals had appointment plans with their physicians. 8) Those who had the cerebrovascular disease, cancer or hypertension demanded more nursing needs such as needs for comfort, for general metabolism and for mental health. 9) Factors which were associated with the degree of patients' nursing needs were age, duration of hospitalization, opinion toward home care services given by public health nurses, hospital appointments and types of hospital. That is, the older they were and the longer the periods of hospitalization were, the higher were their nursing needs. The more they had nursing needs, the more they wanted to have nursing services and had appointment plans. It can be concluded that there is a great demand for a positive and systematic home care services to the people who have been discharged from hospitals following critical care. This program is definitely demanded for the low income groups of people with less education with the financial assistance of the government or other funding agencies.

Regardless of a patient's diagnosis, the care of his skin has been a primary concern of nurses throughout the years. Nurses has washed, dried, and rubbed the skin and have changed his position so as to keep the patient's skin in good condition and to protect him from pressure sores. However, we still find many 'patients suffering from the pressure sores which may take many mothers or years of treatment and cost a lot to be repaired. In view of expensive cost for treatment of the sores and low ratios of nursing staff per patient for intensive nursing care, prophylaxis of the bed sores with sufficient aids is extremely important both for patients and for nurses. Therefore, the unique purpose of this study was to determine whether sponge is good enough to treat and prevent the pressure sore as compared with gel pad and sheepskin. Sixty patients in the age range of 15 through 45 who were in unconscious status or have difficulty of mobility were chosen between January and March of 1974 at Seoul National University Hospital. They were randomly assigned to each treatment and observed on every 4th day with regard to level of consciousness, status of mobility, moisture or dryness of the bed, general skin condition, intake of nutrition, vital signs and intevals of position change in comparison with the changes of skin over the bony prominences. The study results were reviewed in a statistical method analysis of variance-to obtain the following findings; 1. There was no significantly different changes of skin over the sacrum or the trochanter in each group using gel pad, sheepskin or sponge. It means that we may substitute sponge for 2. There was no significant difference among mean changes of patient's skin in relation to sheepskin, gel pad and sponge. 3. There was no significant changes of patient's skin in relation to level of consciousness, status of mobility, intake of nutrition, general skin condition, temperature, blood pressure or interval of position change. 4. There were no meaningful interactions between each treatment and level of consciousness, moisture or dryness of the bed, intake of nutrition, general skin condition, temperature or blood pressure. 5. Sheepskin and gel pad had significantly better influence on patients with limited-mobility than on patients with immobility, and sponge on patients with immobility on than patients with limited mobility. 6. Sheepskin and sponge had meaningfully batter influence on patients changing position at below 2-hour interval, gel pad at 2-4-hour interval, sheepskin at 4-6-hour interval, and three of them at above 6-hour interval.

There is an urgent need to improve the tool predicting success or failure of academic achievement of nursing in Korea so as to identify as early as possible those students who should receive special instruction and to improve screening- procedures for admission of nursing. The main purpose of this study is to identify the correlation between the grade point averages of courses learned and their psychological test characteristics in a baccalaureate nursing program. All 240 students, except freshmen, enrolled in Nursing Department of Seoul National University in the spring semester, 1972, participated in this study. All of the subjects completed the psychometric tests such as interest test, per- sonality test and test of self-concept. Total grade point averages, grade point averages of general education subjects, of supporting science courses and of pr- ofessional education subjects were used as performance criteria of the students. Through the calculation of product-moment correlation coefficients between the test scores and four grade point averages of each class and of total subjects, the following findings and recommendations were obtained. 1. There was so much variation in characteristics of interest test correlated with academic achievement of nursing students in each class. 2. Since the school objectives, curriculum and teaching strategies may affect predictive efficiency of characteristics of students' interest test, interest test must be utilized in a homogeneous group in order to predict school achivement. 3. Characteristics of interest test positively correlated at significant level with total grade point averages of all subjects were scientific interest-biological, scie- ntific interest-physical, and humanitarian interest. Scientific interest-physical was the only characteristic positively correlated at significant level with total grade point averages and grade point averages of professional courses. 4. There were various patterns in characteristics of personality test correlated with school achievement of nursing students by class pattern and personality maturation as they progress toward higher classes. 5. A characteristic of personality test, responsibility, is in high positive corre- lation with academic achievement in the upper division of classes. 6. Responsibility was the sole personality factor positively correlated at signif- icant level with total grade point averages and grade point averages of nursing courses in the total number of students. 7. There were very different correlation coefficients between characteristics of self-concept test and academic achievement according to the type of each class and type of courses they learned. 8. Characteristics of self-concept test positively correlated at significant level with total grade point averages and grade point averages of nursing courses of all students were physical self and row variability. Those who have positive concept on their own physical status and who are dificient in self-concept were higher in total grade point averages and grade point averages of professional courses than other students. 9. Scores of professional courses offered in freshmen and sophomore classes were in positive correlation with limited number of characteristics of psychological tests. In pursuit of a tool predicting successful academic achievement of nursing students, their G.P.A. during the junior and senior year of nursing will serve as the more reasonable criteria. 10. Junior students of this school were in higher positive correlation with many psychological factors than other classes.

The purpose of this study is to observe the administering of analgesice and sedatives to cases of surgery, the influence of the patients' situavional variables on the use of these drugs. and the required number of recovery days in relation to the patients' situational variables and general conditions. Fifty patients in the age range of 15 through 65 who had undergone general surgery at Seoul National University Hopital, Woo Sok University Hospital and Koryo Hospital between May and August of 1971 were chosen for this study. They were observed with regard to the frequency of pestoperative rses of analgesics and sedatives and the requied period of recovery in comparison with the situational vaiables of patients such as sex, age, marjtal status, the type and duration of anesthesia, experience of previous operation, history of cther diseases, preopcrative period of hospitalizaton; and the general conditions of patients such as sleep, stomach condition, bowel condition, urination, interest in surroundings, strength and energy, self-assistance and appetite. The study results were reviewed in a statistical method to obtain the following findings: 1. There was a significant decrease in the crequency of analgesic uses according to the number of days passed after operation. 2. The mean postoperative recovery days were 5.31 days and more than half of the patients have never used analgesics until recovery. 3. There was a significant decrease in the frequency of sedative uses according to the number of days passed after operation. 4. The rank-order correlation between the frequency of analgesic use and that of sedative use following surgery observed in relation to the number of postoperative days was a low and negative one. 5. All of the patients except one have used sedatives only once a day for the whole recovery period. 6. The longer they stayed in the hospital before surgery, the less have they used analgesics after surgery. 7. There were significant differences in use of analgesics after surgery by agegroups; the 24--44 age group used more analgesics than the 15-24 and 45-65 age groups. 8. There were no significant differences in use of analgesics after surgery by all situational variables except the number of days of hospitalization and age. 9. The longer they stayed in the hospital before surgery, the earlier have they recovered from the surgery. 10. There were no significant differences in the number of required recovery days by all situational variables except the length of preoperative hospitalization. 11. There were no significant differences in the number of required postoperative recorvery days by the general conditions of patients.

No abstract available.

This article reviewed and analyzed 39 studies on self efficacy theory applied to health related behavior. The following analysis was done: 1) study subjects 2) measurement tools 3) analysis according to the type of research design(intervention research, explanatory research). Some findings are summarized as follows: The study subjects were both healthy people in various developmental stages and patients with various illnesses. The health related behaviors examined in the studies were also various including exercise, smoking cessation, self care behaviors, etc. The measurement of self efficacy was done with specific tools in most studies. In the tools, activities that measured the health behavior domain were listed according to increasing difficulty or contexual arrangement or in combination of both of them. The analysis of 17 intervention research studies showed that generally the intervention program increased the self efficacy level of subjects and then the increased strongly self efficacy influenced behavioral changes. Most studies used more than one intervention method for increasing the self efficacy level. These were derived from sources of self efficacy suggested by Bandura. The analysis of 21 explanatory research studies showed that self efficacy strongly influenced behavior change and persistence. The major independent variable to affect the self efficacy was performance accomplishment in the past. Self efficacy explained more of the variance in health related behavior when it was applied with the variables in the health belief model, health promotion model, and reasoned action theory. On the basis of the above findings, the following suggestions are made: 1. For a desirable research design, self efficacy should be the intervening variable. That is, desirable designs would include intervention-self efficacy-behavior in intervention research studies and antecedent-self efficacy-behavior in explanatory research studies. 2. More prospective, longitudinal studies are needed to test the effect of self efficacy on persistence in health related behavior. 3. Studies comparing the effects of intervention methods are needed for each health related behavior, subject group, and context. 4. It is necessary to develop a reliable, valid measurement tool for self efficacy for each health related behavior. 5. Studies to differenciate the effect of self efficacy from that of outcome expectation on the health related behavior are necessary. 6. The antecedents of self efficacy should he investigated further.

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 Purposes of this study were : 1) to evaluate validity of a pain rating scale using the level of correlation between the Korean Pain Rating Scale(KPRS), Short-From KPRS(SKPRS) and the Graphic Rating Scale(GRS). 2) to identify sensitivity of the scale using pain behavior of patients with chronic pain Of the 2025 patients with chronic pain who visited the orthopedic and neurosurgical out-patients departments of 11 university hospital in various districts of Korea, 520 subjects wee selected through convenient sampling and responded to the questionnaires by mail. The results of the study can be summarized as follows ; 1. The mean pain score measured by the KPRS was 444.85 : the mean sensory score was 209.47, the mean affective score, 147.63 and the mean miscellaneus score. 87.85. The mean pain score measured by the GRS was 20.11 : the mean sensory intensity score, 10.54. and the mean distress score, 9.57. 2. The average number of hours of rest during the day was 3.3, the average score of discomfort in carrying out ADL was 99, the average frequency of pain relieving practices was 3.0 the average number of pain sites was 3.6. 3. The most sensitive scale to differentiate each group was the GRS, the KPRS and SKPRS were less sensitive than the GRS. 4. The intercorrelation between the KPRS total score and the GRS score(.500) as well as that of the SKPRS score were highly correlated(.652), but intercorrelation between the SKPRS score and the GRS score(.172) was not high. Based on the above results, it was found that the SKPRS must be studied further to obtain validity.

The study was conceived in relation to a concern over the growing gap between the needs of chronic patients and the availability of care from the current health care system in Korea. Patients with agonizing chronic pain, discomfort, despair and disability are left with helplessly unprepared families with little help from the acute care oriented health care system after discharge from hospital. There is a great need for the development of an alternative means of quality care that is economically feasible and culturally adaptable to our society. Thus, the study was designed to demonstrate the effectiveness of home health care as an alternative to bridge the existing gap between the patients' needs and the current practice of health care. The study specifically purports to test the effects of home care on health expenditure, readmission, job retention, compliance to health care regime, general conditions, complications, and self-care knowledge and practices. The study was guided by the operations research method advocated by the Primary Health Care Operations Research Institute(PRICOR) which constitutes 3 stages of research : namely, problems analysis solution development, and solution validation. The first step in the operations research was field preparation to develop the necessary consensus and cooperation. This was done through the formation of a consulting body at the hospital and a steering committee among the researchers. For the stage of problem analysis, the Annual Report of Seoul National University Hospital and the patients records for last 5 years were reviewed and selective patient interviews were conducted to find out the magnitude of chronic health problems and areas of unmect health care needs to finally decide on the kinds of health problems to study. On the basis of problem analysis, the solution development stage was devoted to home care program development as a solution alternative. Assessment tools, teaching guidelines and care protocols were developed and tested for their validity. The final stage was the stage of experimentation and evaluation. Patients with liver diseases, hemiplegic and diabetic conditions were selected as study samples. Discharge evaluation, follow up home care, measurement and evaluation were carried out according to the protocols of care and measurement plan for each patient for the period of 6 months after discharge. The study was carried out for the period from Jan. 1987 to Dec. 1989. The following are the results of the study presented according to the hypothesis set forth for the study : 1. Total expenditures for the period of study were not reduced for the experimental group, however, since the cost per hospital visit is about 4 times as great as the cost per home visit, the effect of cost saving by home care will become a reality as home care replaces part of the hospital visits. 2. The effect on the rate of readmission and job retention was found to be statistically nonsignificant though the number of readmission was less among the experimental group receiving home care. 3. The effect on compliance to the health care regime was found to be statistically significant at the 5% level for hepatopathic and diabetic patients. 4. Education on diet, rest and exercise, and medication through home care had an effect on improved liver function test scores, prevention of complications and self-care knowledge in hepatopathic patients at a statistically significant level. 5. In hemiplegic patient, home care had an effect on increased grasping power at a significant level. However, there was no significant difference between the experimental and control groups in the level of compliance, prevention of complications or in self-care practices. 6. In diabetic patients, there was no difference between the experimental and control groups in scores of laboratory tests, appearance of complications, and self-care practices. The above findings indicate that a home care program instituted for such short term as 6 months period could not totally demonstrate its effectiveness at a statistically significant level by quantitative analysis however, what was shown in part in this analysis, and in the continuous consultation sought by those who had been in the experimental group, is that home health care has a great potential in retarding or preventing pathological progress, facilitating rehabilitative and productive life, and improving quality of life by adding comfort, confidence and strength to patients and their families. For the further studies of this kind with chronic patients it is recommended that a sample of newly diagnosed patients be followed up for a longer period of time with more frequent observations to demonstrate a more clear-cut picture of the effectiveness of home care.

The purpose of this study was to identify the accu racy rates (hit ratio) which mean the degree of con cordance between pain rating scale differences over time & subjective comparisons. Subjective comparisons mean the responses to the question "how does the pain you are now experiencing compare with the one at the time of the assessment yesterday?". Answers to this question were translated into 'greater', 'same', or 'less'. KPRS(Korean Pain Rating Scale) was developed through 4 consecutive studies to assess pain extensively & accurately by Lee etc. VAS (Visual Analogue Scale) was reported as valid & veliable measure for the intensity of pain by many researchers. Thirty hospitalized patients with complaints of Headache were partispated in this study during the period from May 1 to July 31, 1987. In conclusion, the accuracy rates of KPRS and VAS were 60%, 67%, respectively.

The purposes of this study were ; 1) to assess the level of pain and to identity the varieties and the degree of pain-related behavior, 2) to measure the level of correlation between the level of pain and the degree of pain?related behavior, 3) to test the correlation between the Korean Pain Rating Scale (KPRS) and Graphic Rating Scale(GRS), and 4) to gather data relevant to the Socio-demqgraphic status of the subjects. The level of pain was measured by KPRS and GRS developed by the researchers. The KPRS consists of three dimensions ; the sensory, the affective and the miscel laneous and the GRS of two separate scales ; the intensity scale and the unpleasantness scale. Of the 2,025 who had visited orthopedic and neurosur-gical out-patients department of 11 university hospitals in various districts of Korea with the episode of joint pain, 405 subjects were self-selected by responding to the data gathering tools and questionaires mailed. The results are summaried as follows; 1. Maale(217, 53.6%) exceeded female patients( 188, 46. 4%) in number and the onset of joint pain was more prevalent in the age groups of the 20s and the 30s. 160(39.5%) had been hospitalized for the treatment of, and 87 (21.5%) had retired because of the joint pain. 2. Mean pain score measured by KPRS was 128.31 (ran ge; 0 1.344.8); mean sensory score was 43.23(range: 0-645.88%), mean affective score was 46.09(range; 0 356.72), and mean miscellaneous score was 39.99 (range; 0-341.68). Mean pain scores measured by GRS were; sensory intensity score; 109l(range: 0-200) and distress score; 99.1 (range: 0 200). 3. The prevalent sites of joint pain revealed to be the right knee joint(203: 50.1%), left knee joint(181(44. 7%), left ilium ( 147,36.3%). lumbar regir,n(106: 26. 2%), hip joint(92: 22.7%) and the ankle(84; 20.7%). 4. The average sleep hour was 6.8hours per day and the average rest hour during the day hours was 3.3hours (range 0-20). 5. The average duration of suffering from bint pain was 49.1 months. 6. Most of the subjects(298; 73.6%) used some sorts.

Most patients having leukemia suffer severely from emotional turmoil due to the generalized perception that cancer will be fatal. The conventional chemotherapy results in side effects such as severe bone marrow depression which interfere with self-care management, vital for improvement in their condition. Bandura's theory of the self-efficacy suggests that self-efficacy can be enforced by performance attainments, vicarious experiences, verbal persuasion and the release of emotional arousal. Self-efficacy can be enforced by a program of vicarious experiences and verbal persuasion, while the emotional arousal can be relieved through a hope promotion program. If once self-efficacy increases, the patient's self-care behaviors and the quality of life will also increase. The purpose of this study was to empirically test the effects of a program, to promote self-efficacy and hope, on self-care behaviors and quality of life in patients having leukemia. In this study, three types of approaches to enhance self-efficacy and hope were used : 1) a 20-minute long slide/tape for vagarious experiences ; 2) a 10-minute long telephone call coaching for verbal persuasion ; and 3)two booklets for information about the symptoms of leukemia and treatment modalities and hope promotion. Thirsty one patients were recruited in the experimental group and 29 in the control group with a nonequivalent pretest-posttest design. The subjects were patients with leukemia undergoing chemotherapy. Sherer and Maddux's self-efficacy scale, Nowotny's hope scale, and Padilla's quality of life scale were employed with some modifications. A self-care behavior scale was developed by the researchers. Statistical analyses including paired t-test, Chi-square, ANCOVA and ANOVA, were used. The results are as follows : The levels of self-efficacy, self-care behavior and quality of life were higher in the experimental group than in the control group after four weeks of intervention(F=28.71, P=.0001 ; F=63.35, P=.0001 ; F=16.57, P=.0001). After ten weeks of intervention, all of the dependent variables(self-efficacy, self-care behavior, hope and quality of life) in the experimental group were higher than in the control group(F=74.12, P=.0001 ; F=108.34, P=.0001 ; F=13.11, P=.001 ; F=43.52, P=.0001). In conclusion, self-care behavior and quality of life increased mainly through an increase an increase in self-efficacy, while increases in hope took more time and effort.

Resourcefulness was analyzed by Walker and Avant's method to make a theoretical framework for nursing. Also, the appropriate Korean terminology was identified. "Resourcefulness" means the ability to use internal and external resources to eliminate or to control stress. 'Resourcefulness' is chosen to be the most appropriate term to reflect the concept of resourcefulness. Upon the concept analysis availability, controllability, confidence, and self-instruction were identified as the defining characteristics of resourcefulness. Contrary to other work, "availability" means the ability to use the social resources as well as the internal cognitive-behavioral resources. "Controllability" means the ability to delay or control immediate gratification of one's needs or to divert one's own mood in order to solve problem. "Confidence" is the self-efficacy belief in one's control ability. "Self-instruction" is the cognitive ability to instruct oneself positively. Resourcefulness is learned by active experience, vicarious experience, and formal or informal instruction or a need for change. As a result of the use of resourcefulness, the target behavior performed immediately and ultimately improve the quality of life or adaptation. Therefore, it is necessary to develop the instrument including the defining attributes identified in this study. Also, it is necessary to simultaneously analyze the related concepts of self-efficacy, self-control, and self-regulation for appropriate use.

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

PURPOSE: The purpose of this study was to develop an instrument to measure family resilience for Korean families with a chronically ill child, and to test the validity and reliability of the instrument. METHOD: The items of instruments used based on the researchers' previous study of concept analysis of Korean family resilience. Nineteen item scales were developed with five domains. In order to test reliability and validity of the scale, data were collected from 231 families, who had a child with a chronic illness. Data was collected between August and September of 2001 in a 3rd level University Hospital in Seoul, Korea. RESULT: The results were as follows: As a result of the item analysis, 19 items were selected from the total of 37 items, excluding items with low correlation with the total scale. Five factors were evolved by factor analysis, which explained 56.4% of the total variance. The first factor 'Family strength' explained 28.5%, 2nd factor 'Family maturity' 8.7%, 3rd factor 'The ability to use of external resources' 7.0%, 4th factor 'Control' 6.6%, 5th factor 'The driving force for finance' 5.7%. The attributes in these factors were different with those identified by concept analysis of the family resilience in Korean families from the previous study. Cronbach's alphacoefficient of this scale was .8039 and Guttman spilt- half coefficient was .8184. CONCLUSION: The study support the reliability and validity of the scale. Because the main concept of family resilience was family strength, there were distinct differences in dimensions of family functioning scales.

PURPOSE: The purpose of this study was to test the relationship between health status and bathing. METHOD: The population of this study consisted of females, above age 20 in urban areas in order to control the effects of extraneous variables, resident areas, gender, and age. Four hundred and twenty-eight (428) women were interviewed with a structured questionnaire. Medical Outcomes Study Short Form (SF)-36 Health Survey assessed individual health status. Bathing behavior and attitudes toward bath have been measured with questionnaires designed by the authors. RESULT: The most popular bathing type was shower (46.8%). The preferred type of bath was related to health status. A common purpose of the tub-bath was relieving fatigue and hygiene, but the other purposes were different on the subjects health status. Persons with low health status took frequently tub-baths for health. Attitudes toward bath were related to health status. Women with low scores in physical health recognized more physical effects of bath than psychological effects or hygenic effects. CONCLUSION: Bathing included physical and psychological dimensions and was related to health status.

PURPOSE: The purpose of this study was to develop the instrument to measure family functioning for Korean family with a chronic ill child, and to test the validity and reliability of the instrument. METHOD: The items of instrument were consisted based on researchers' previous study of concept analysis of the Korean family functioning. Twenty six item scale was developed with six domains. In order to test reliability and validity of the scale, data were collected from the 231 families, who have a child with a chronic illness. Data was collected between August and September in 2001 in a General Hospital in Seoul, Korea. RESULT: The results were as follows:As a result of the item analysis, 24 items were selected from the total of 26 items, excluding items with low correlation with total scale. Six factors were evolved by factor analysis. Six factors explained 61.4% of the total variance. The first factor 'Affective bonding' explained 15.4%, 2nd factor 'External relationship' 11.8%, 3rd factor 'Family norm' 10.5%, 4th factor 'Role and responsibilities' 8.3%, 5th factor ' Communication' 7.9%, and the 6th factor 'Financial resource' explained 7.3%. Cronbach's alpha coefficient of this scale was .87 and Guttman spilt- half coefficient was .84. CONCLUSION: The study support the reliability and validity of the scale. There were distinct differences in dimensions of family functioning scales developed in the U. S.

PURPOSE: The exercise status in patients with rheumatoid arthritis, associations between exercise behavior and personal factors, and associations between exercise behavior and exercise-specific cognitions and their effects were assessed. METHOD: Four hundred thirty nine outpatients with rheumatoid arthritis were studied. The exercise status was measured by a single item. The intensity was multiplied by the frequency and duration of each exercise. The product of these intensity values for all exercises was defined as exercise behavior. Based on the Pender's revised health promotion model, exercise benefit, barrier, self-efficacy, enjoyment and social support were chosen as exercise specific cognitions and affect variables. Path analysis was used to identify the predictors of exercise behavior. Results: Compared to the duration before being diagnosed, the number of subjects who exercised regularly increased after being diagnosed. However over half of the subjects refrain from any sort of exercise and the type of exercise is very limited. Among the variables, exercise barrier, self-efficacy, and social support were found to be significant predictors of exercise behavior, and only previous exercise experience was found to be significant predictors of all behavior specific cognitions and affect variables. CONCLUSION: These findings suggest that studies should explore exercise behaviors and strategies to emphasize the cognitive-motivational messages to promote exercise behaviors.

The main objectives of this study were to analyze the concept of hope, so to provide basic data to develop a valid instrument to measure hope, and to develop hope enhancing nursing intervention a program for cancer patients. The hybrid model approach was applied in three phases, the theoretical phase, the empirical phase, and the analytic phase. The study was developed on universal attributes explaining generalized hope and specific hope, which were revealed in a comprehensive review of the literature. In the empirical phase, eight cancer patients undergoing chemotherapy were interviewed to reveal causes, motivation, and their resource of hope according to The Hope Assessment Guide (Farren, Herth, & Popovich, 1995). In the analytical phase, the results of the two previous stages of the study were compared. The results were as follows: In the theoretical phase, six dimensions of hope emerged; affective, cognitive, behavioral, affiliative, temporal and contextual dimension. The antecedent of hope was loss, crisis, uncertainity, and stress. The consequences were renewal, development of new methods, safety, peace and transcendental competence. In the empirical phase, these six dimensions emerged as theoretical phases were verified and specified as these descriptive terms: feeling, intention, expectation, activity, relation, future- orientation, reality and goal-setting. The antecedent factor of hope was occurrence or recurrence of cancer. The consequence of hope was ability to cope with real condition, feeling of safety and comfort, peace, development of new strategy and recovery of disease. The major content of hope in this phase was related to specific hope, but it was also influenced on by general hope. In the analytic phase, general and specific hope was renamed as trait and state hope. All attributes emerged at the empirical phases, and also emerged at the theoretical phase. However, cognitive and contextual dimensions were revised and specified. In conclusion, the concept of hope is divided into trait hope and state hope, and state hope is an anticipatory expectation that occurs at the time of a stressful stimulus, such as being diagnosed with cancer. Hope is a multidimensional dynamic energized mental state which has the dimensions of affective, cognitive, behavioral, affiliative, temporal and contextual. There should be further studies to develope the state and trait hope scale according to definition and attributes of hope investigated in this study. In addition, considering results of the empirical phase, the family is very a important factor as a resource of hope, so it is necessary to consider family in implementing a nursing intervention program to enhance hope.

The purpose of this research was to uncover the expertise of ICU nursing in Korea, and to describe nurses' practice based on the degree of skill acquisition. A total of 18 ICU nurses participated in the study. The data was collected through individual in-depth interviews and it was managed using the NUDIST 4.0 software program. The data was analyzed using interpretive phenomenology suggested by Benner. Four properties of expertise of ICU nursing were identified. These are 1) concern and love toward patients; 2) knowledge; 3) skill, and 4) abilities in interpersonal relationships. And the characterisitcs of four levels of skill acquisition, that is advanced beginner, competent, proficient, and expert, were described with exemplars. The results of this study might help nurse researchers clarify and elaborate on the concept of expertise in ICU nursing, and enable them to understand how the process of skill acquisition occurs in the ICU setting. They might also help nurse managers establish educational goals for ICU nursing for student or novice nurses.

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

The main objectives of this study were to investigate the concept of family function from the perspective of the contemporary Korean family, and to construct model of change of family function whit chronic illness. The hybrid model approach was applied in which three phases(theoretical phase, empirical phase, and analytic phase) of concept development were explored for family functioning. The study was conducted from 1997 to 1998. In empirical phase, two groups of purposive samples were drawn : normal family group composed of six families without ill family member, and ill family group composed of seven families of which wives have rheumatoid arthritis. Only families with child(or children)in primary or secondary schools were included in the study. The results were as follows: In theoretical phase, six dimensions of family concept were emerged : affective, structural, control, cognitive, financial, and reproductive dimension. In order to analyze the Korean normal family function in middle class with middle-age women, financial and reproductive dimension were not included. In empirical phase, five dimensions(affective, structural, control, cognitive, and external relationship) were fond from the normal family data. External relationship dimension is very important factor as a resource of the support, especially when their parents or siblings had no help or support to them. In the affective dimension, Korean family emphasized harmony and balance rather than affective expression harmony and balance rather than affective expression between couples and between parents and children. They also showed common goals of the families to solve their problems to control the family members. The priority of the goals was getting into the higher education of their children or helping their unhealthy parents or family members. Six dimension(affective, structural, control, cognitive, external relationship, and financial) of family functions were emerged from the ill family data. From the analysis of ill family data, types of restructuring house chore after wives illness were developed : (a) negociated, (b) accomodated, and (c) isolated, enduring types. Although the dimensions of family functioning identified in this study are similar to the conceptualizations that exist in the western literature, there where distinct differences in the nature of major themes and subconcepts under these family function dimensions.

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.