This study is a descriptive study to provide basic data related to types of uniforms worn by nurses. Nurses, other medical center personnel, patients and their famillies were asked for their opinion on changing nurses' uniforms and how the image of nurses is related to the type of uniform worn by the nurses. The data for this study were collected during the period from Feb. 25, 1993 to Mar. 26, 1993 at Y-University Medical Center from 132 nurses, 137 other medical center personnel, 117 patients and their families. The instruments used for this study were the Nurses' Image Scale(NIS) developed by Bown (1986), and an instrument to measure opinions of uniform and cap using photographs of nurses' uniforms that was developed by the researcher through a literture review. Data were analyzd using the SPPS/PC package, Statistics used for analysis were frequencies, percentages, paired t-test, and oneway ANOVA. The results of this study are summarized as follows; 1. Of the nurses, 84.3%, along with, 51.5% of the medical center personnel, 39.1% of the patients and their families agreed to a change in the color of nurses uniforms. 2. Similarly, 87.4% of the nurses, 27.7% of the medical center personnel, 19.3% of the patients and their families were in favor of nurses not wearing cape. 3. Only 11.8% of nurses answered that a white uniform was important to the professional image of nursing. Only 2.4% of the nurses answered that a cap was very important to the professional image of nursing. 4. Only 1.6% of the nurses answered that a white uniform and cap were important to show the role of nurses in the twenty first century. 5. About 1/3, 36.5%, of the medical center personnel, the patient and their families answered that changing the color of the nurses' uniform will make a change in the image of nurses. 6. A White uniform and cap were seen as being important in distinguishing nurses from other medical personnel in the hospital by 76.5% of the medical personnel, the patients and their families. 7. Nurses gave high marks to the idea of no cap regardless of the color of the uniform which would still portray the symbol of the nurses' role, identity and would differentiate the role from other jobs. The patients and their families gave high marks to a white uniform with cap. 8. Generally, nurses, medical center personnel and patients and their families thought that a colored uniform with cap presented a good image of nurses. 9. There was a significant difference in the response among the three groups (F=24.65, P<.001) to the figure in a white uniform with a cap, and the patients and their families thought it was the best portrayal of the image of nurses. There was a significant difference among the three groups (F=9.03, P<.001) to the figure in a white uniform with no cap and the nurses indicated that it was the best portrayed of the image of nurses. There was no significant difference among the three groups to the figure in a colored uniform with cap. There was a significant difference(F= 17.50, P<. 001) to the figure in a colored uniform with no cap, and the nurses indicated that it was the best portrayal of the image of nurses. In summary, the nurses wanted to change the color of uniform and not to wear a cap. But many of the medical center personnel, patients and their families indicated they did not agree with this idea. Therefore, changing the type of uniform worn by nurses should be done only after consideration has been given to the relation of the change to the professional role of nurses and the image of nurses held people in general. Suggestions arising from this study are as follows: 1. The relation between the role of nurses and their uniform was surveyed, and these results can be used as data when considering a change in uniforms. 2. A change in uniforms should be tried based on the norm established about uniforms. 3. The nurses did not want to wear a cap, but before a decision is definitely made it is necessary to study the philosophy related to the symbol of the cap because the figure of a nurse with a cap portrayed a positive image of the nurses. If the cap is kept, the symbol of the cap should be redefined. 4. In this study, only the image related to the uniform was examined, but in future studies it will be necessary to examine the practicality of various types of uniforms.
This study was done to verify validity of nursing diagnoses related to difficulty in respiratory function. First, content validity was examined by an expert group considering the etiology and the signs/symptoms of three nursing diagnoses-ineffective airway clearance, ineffective breathing pattern, impaired gas exchange. Second, clinical validity was examined by comparing the frequencies of the etiologies and signs/symptoms of the three nursing diagnoses in clinical case studies with the results of the content validity. This study was a descriptive study. The sample consisted of 23 experts (professors, head nurses and clinical instructors) who had had a variety of experiences using nursing diagnoses in clinical practice, and 102 case reports done by senior student nurses of the college of nursing of Y-university. These reports were part of their clinical practice in the ICU. The instrument used for this study was a checklist for etiologies and signs and symptoms based on the literature, Doenges and Moorhouse (1988), Kim, McFarland, McLane (1991), Lee Won Hee et al. (1987), KimCho Ja et al. (1988). The data was collected over four month period from May 1992 to Aug. 1992. Data were analyzed using frequencies done with the SPSS/PC+ package. The results of this study are summarized as follows: 1. General Characteristics of the Expert Group: A bachelor degree was held by 43.5% and a master or doctoral degree by 56.5% of the expert group. The average age of the expert group was 35.3 years. Their average clinical experience was 9.3 years and their average experience in clinical practice was 5.9 years. The general characteristics of the patients showed that there were more women than men, that the age range was from 1 to over 80. Most of their medical diagnoses were diagnoses related to the respiratory, system, circulation or neurologic system, and 50% or more of them had a ventilator with intubation or a tracheostomy. The number of cases for each nursing diagnoses was: -Ineffective airway clearance, 92 cases. -Ineffective breathing pattern, 18 cases. -Impaired gas exchange, 22 cases. 2. The opinion of the expert group as to the classification of the etiology, and signs and symptoms of the three nursing diagnoses was as follows: -In 31.8% of the cases the classification of etiology was clear. -In 22.7%, the classification of signs and symptoms was clear -In 17.4%, the classification of nursing interventions was clear. 3. In the expert group 80% or more agreed to 'dyspnea' as a common sign and symptom of the three nursing diagnoses. The distinguishing signs and symptoms of (Ineffective airway clearance) were 'sputum', 'cough', 'abnormal respiratory sounds: rales'. The distinguishing sings and symptoms of (Ineffective breathing pattern) were 'tachypnea', 'use of accessory muscle of respiration', 'orthop-nea' and for (Impaired gas exchange) it was 'abnormal arterial blood gas'. 4. The distribution of etiology, and signs and symptoms of the three nursing diagnoses was as follows: -There was a high frequency of 'increased secretion from the bronchus and trachea' in both the expert group and the cade reports as the etiology of ineffective airway clearance. -For the etiologies for ineffective breathing pattern, 'ain', 'anxiety', 'fear', 'obstructions of the trachea and bronchus' had a high ratio in the expert group and 'decreased expansion of lung' in the case reports. -For the etiologies for impaired gas exchanges, 'altered oxygen-carrying capacity of the blood' and 'excess accumulation of interstitial fluid in lung' had a high ratio in the expert group and 'altered oxygen supply' in the case reports. -For signs and symptoms for ineffective airway clearance, 'dyspnea', 'altered amount and character of sputum' were included by 100% of the expert group. 'Abnormal respiratory, sound (rale, rhonchi)' were included by a high ratio of the expert group. -For the signs and symptoms for ineffective breathing pattern, 'dyspnea', 'shortness of breath' were included by 100% of the expert group. In the case reports, 'dyspnea' and 'tachypnea' were reported as signs and symptoms. -For the sign and symptoms for impaired gas exchange, 'hypoxia' and 'cyanosis' had a high ratio in the expert group. In the case report, 'hypercap-nia', 'hypoxia' and 'inability to remove secretions' were reported as signs and symptoms. In summary, the similarity of the etiologies and signs and symptoms of the three nursing diagnoses related to difficulty in respiratory function makes it difficult to distinguish among them. But the clinical validity of three nursing diagnoses was established through this study, and at last one sign and symptom was defined for each diagnosis.
The study was conducted to identify predictors of mammography screening for rural Korean women according to ‘Stage of Change’ from the Transtheoretical Model which, along with the Health Belief Model, formed the theoretical basis for this study.
A cross-sectional descriptive design was utilized. Through convenience sampling 432 women were selected from 2 rural areas. Data were collected by survey. Health beliefs constructs were measured with Champion's HBM Scale-Korea version. Mammography participation was measured using the Stage of Mammography Adoption Scale developed by Rakowski, et al. (1992).
The most frequent stage of mammography adoption was ‘contemplation’ (40.5%). Predictors of stage of mammography adoption included ‘mammogram recommended by health professional’ (beta=0.59, t=16.12, p=.000), ‘perceived benefits’ (beta=0.09, t=2.21, p=.050), ‘perceived susceptibility’ (beta=0.09, t=1.98, p=.050), and ‘perceived barriers’ (beta= 0.07, t= -2.05, p=.041). ‘Mammogram recommended by health professional’ demonstrated the greatest association with having a mammogram.
Health professionals play key roles in improving mammography participation and should recognize the importance of their role in cancer prevention and be more actively involved in education and counseling on prevention of breast cancer.
The purpose of this study was to develop a socioculturally-appropriate psychosocial intervention program for Korean patients with breast cancer and test its effects on stress, anxiety, depression, and coping strategies.
One group pretest and posttest design was used to test the effects of the intervention. A post-intervention interview was conducted to refine the nature of the intervention. A convenience sample of 10 breast cancer survivors was recruited from the outpatients clinics. Psychosocial intervention was developed to provide the health education, stress management, coping skill training and support weekly(90min) for 6 weeks.
There was a significant decrease in stress scores following the intervention(Z= -2.388, p=0.017). However, no significant changes were noted in the use of problem-focused and emotion-focused coping strategies, nor in the changes of anxiety and depression levels. Content analysis of interview data revealed six clusters; changes in perception, changes in problem solving approaches, changes in anger management, changes in life pattern, social support and reduction of perceived stress.
Based on quantitative and qualitative data, we recommend the refinements of the intervention in the following areas for future studies: 1) duration, activities, and progression of psychosocial intervention; 2) research design and sample size; and 3) measurements.
The purpose of this study was to identify experiences of nurses who served as preceptors in clinical education for senior student nurses in a college of medicine in Wonju city.
Data was collected from 20 preceptors instructing senior student nurses in 2001 using a self-completion questionnaire. To analyze data, content analysis was done using an analysis scheme developed by the investigators.
The analysis scheme consisted of 7 categories and 25 subcategories. 135 significant statements were analyzed and categorized. Preceptors indicated that they were role models, socialization facilitators and educators while instructing students in the clinical practicum. In performing the preceptors' role, preceptors reported that their most important change was self-enhancement,and positive experience was a constructive work atmosphere. The most important factor facilitating the preceptors' role performance was support from head nurses, and the most discouraging factor was work loads.
This study suggests that interventions for encouragement and socialization of preceptors should be developed to promote clinical education for senior student nurses.
The purpose of this study was to validate Quality of Life Index-Cancer (Q.L.I.-C) developed by Ferrans (1990) among Korean cancer patients.
This study design was exploratory factor analysis methodology. Q.L.I.-C was translated into Korean and reverse-translated into English. The subjects were 357 Korean patients with various cancers. Data were collected by questionnaires from May to August, 2000 and was analyzed by descriptive statistics, Principal Component Analysis for construct validity and Cronbach's alpha coefficient for reliability.
The range of factor loadings was .446~.841. The explained variance from the 5 extracted factors was 63.7% of the total variance. The first factor ‘family’ was 35.5%, and ‘health & physical functioning’, ‘psychological’, ‘spiritual’, and ‘economic’ factors were 11.5%, 6.9%, 5.6%, and 4.2% respectively. Because of cultural difference between Americans and Koreans, certain items such as sexuality, job status, and education were deleted from the extraction of factors in this study. The Cronbach's alpha coefficient was .9253 among the 28 items.
Q.L.I.-C could be applied in measuring quality of life of Korean cancer patients. It also recommend to do further studiesfor validation of Q.L.I.-C American and Korean versions relating to cultural differences.
The study was done to identify the relationship of treatment side effects, family support, and quality of life in patients with cancer, and factors influencing quality of life.
A convenience sample of 106 patients who were receiving cancer treatment at W hospital were interviewed using the Side Effects scale by Hur, Family Support scale by Kang, and QOL scale by Ro.
Results indicate that women experienced more severe side effects than men. There was a negative relationship between side effects and quality of life, and a positive relationship between family support and quality of life. The most bothersome side effects were changes in taste and appetite, followed by general weakness and fatigue. Side effects such as loss of hair, nausea, dizziness, numbness, pins and needles in fingers and toes, and dry mouth were also experienced. General weakness and family support were analysed as to whether they were factors influencing quality of life.
The results revealed that relieving general weakness should be given high priority in nursing interventions for patients undergoing cancer treatment. In addition, nursing programs should be developed that can reinforce family support.
This study was undertaken to develop and test a mastery learning program of nursing skills for undergraduate nursing students.
In this methodological study, first, the preliminary draft of a mastery learning program to provide training for nursing skills was developed based on Bloom's framework for mastery learning. Second, to test the developed program, a single-blinded, nonequivalent control group non-synchronized study was conducted on 50 senior nursing students in a University selected by convenient sampling. Thirteen students were assigned to a control group; 13, 12, and 13 of them were assigned to intravenous therapy, transfusion, and patient transfer groups, respectively. The achievement levels and performance scores of the selected nursing skills were measured before and after the completion of the program in all the groups. Lastly, the final program was confirmed based on the results of the program testing.
Intravenous therapy, transfusion, and patient transfer were selected as essential nursing skills for the program based on the priorities rated by clinical instructors and staff nurses. The achievement levels of selected nursing skills were determined by Angoff scores. After participating in the program, the proportion of passers and performance scores of the nursing skills in the experimental groups were significantly higher than those in the control group. The final program was confirmed which included a diagnostic test, enrichment activities for the passers and three repetitions of corrective activities and formative assessments for non-passers.
The results suggest that a mastery learning program for undergraduate students can lead to better improvement and performance of essential nursing skills.
This study was done to examine the difference in cancer screening with mammography and Papanicolaou smear according to Body Mass Index (BMI).
The participants in this study were 5,912 women ages 40 to 69 yr, selected from the Korean Genomic Regional Cohort in Kangwon province. Mammography and Papanicolaou smear were assessed by questionnaire and body weight (kg) and height (m) measured to calculate BMI.
The distribution of BMI was as follows: low weight (1.5%), normal weight (31.1%), over weight (24.6%), mildly obese (36.4%) and severely obese (6.3%). After adjusting for age, education and monthly income, compared with normal weight women, overweight women (odds ratio [OR]=1.283, 95% confidence interval [CI]=1.089-1.513) and mildly obese women (OR=1.214, 95% CI=1.048-1.406) were less likely to have had mammography. In contrast to mammography, cancer screening with Papanicolaou smear was not significantly different by BMI.
Obese women in rural areas are less likely to screen for breast cancer by using mammography than non obese women. To ensure regular screening for breast cancer, health care providers need to give scrupulous care to obese women and remove barriers originated from obesity. Also, educational and clinical implications are considered to increase the Papanicolaou smear rate.
The purpose of this study was to examine stress, coping, and immune response effects of a psychosocial intervention program based on the PNI model and Stress-Appraisal-Coping for Korean patients with breast cancer.
A nonequivalent control group pretest-posttest design was used. The participants who had survived breast cancer and lived in Wonju city and the surrounding area were assigned to an intervention group (N=21) or a control group(N=18).We conducted a 12-week intervention, 2 hours a day weekly, and measured the variables at baseline, six and twelve weeks later. Dependent variables are: stress, anxiety-depression and anger, and immune response.
Patients in the psychosocial intervention program reported significantly less stress perception (U=31.500, p=.023), more problem solving ability and less problem avoidance in coping (U=20.500, p= .013; U=29.500, p=.040), and less anxiety-depression (U=22.000, p=.023). No difference, however, was found in anger and immune responses between the two groups. Intervention effects were evident at week 6 and 12 for anxiety-depression, and at week 6 for problem avoidance in coping, the same time that NK cell counts and the T8 decreased.
These results suggested positive effects of a psychosocial intervention program. However, the results are inconclusive due to the small sample.