Every year the number of the elderly increases in Korea thanks to the improvement of social and economical levels and the development of medicine. However, many problems such as insufficent care and the isolation of the elderly have been commonplace. This trend exists not only because of increased lifespan but also the changing social structure of the nuclear family. Accordingly, inspite of the development of medicine, geriatric diseases including circulatory diseases are increasing in proportion of elderly population, as well as the severity. Therefore, it is important to emphasize that health care programs provide the best possible health care and functional capacities in terms of healthy elderly lifestyles. Especially, the phenomena of aging and geriatric diseases taking place with the elderly naturally are affected by lifestyle and the drastic changes in exercise patterns. This study aims to improve geriatric health by introducing a rhythmic movement program for the elderly to estabilish a health-promoting self-care system and by developing quality of life, perceived health status, their physical and physiological functions and emotional state. The theoretical framework used in this dissertation is derived from the Health-Promoting Self-Care System Model (Simmons, 1990), which integrates the Self-Care Deficit Nursing Theory (Orem, 1985), the interaction model of Client Health Behavior (Cox, 1982) and the Health Promotion Model (Pender, 1987). As a quasi-experimental design, the nonequivalent control group pretest-posttest design is utilized for this study. The subjects of this study consist of 64 people, over 65 years old who live in 2 nursing homes for the aged located in S city , Kyong-gi province and volunteered for this study from July, 12, 1999 to September, 17, 1999. They are divided into two groups: 33 in the experimental group and 31 in the control group. The experimental group particpated in the Rhythmic Movement Program at the nursing home, which was comprised of 45 minutes a session, 5 sessions a week during 9 weeks. In order to measure the results of the Rhythmic Movement Program, aspects of perceived health status, balance, flexibility, grip strength, leg strength, heart rate, blood pressure, depression, anxiety and the quality of life were measured before and after participating in the Rhythimic Movement Program for the experimental group after 9 weeks, as well as the control group. The collected data were processed by SPSS PC+ and analyzed by the X2 test, t-test, ANCOVA and the Pearson Correlation Coefficient. The results of this study are as follows: 1. The perceived health status conditions in the experimental group show statistically significant improvement when compared to the control group (F=17.51, p=.000). 2. The physical and physiological functions, that is, balance (F=17.51, p=.000), flexibility (F=8.01, p=.006), grip strength (F=3.21, p=.018) and leg strength (F=25.78, p=.000) in the experimental group are higher than the control group. The vital signs, that is, the number of heart rate (F=.022, p=.884), systolic pressure (F=1.73 p=.193), and diastolic pressure (F=2.74, p=.103) in the experimental group compared to the control group decreased, but doesn't show statistically significant differences. Immune responses (F=5.13, p=.003) showed statistically significant increases in the experimental group when compared to the control group. 3. The emotional state are improved, that is, degree of depression (F=11.56, p=.001) and degree of anxiety (F=9.14, p=.004) in the experimental group showed statistically significant decreases. 4. The quality of life in the experimental group (F=3.03, p=.037) showed statistically significant differences compared to the control group. 5. The observations of the relationships among the perceived health status, emotional state , the quality of life, the relationships between the perceived health status, the degree of depression (r=-.653, p=.000) and the degree of anxiety (r=-.786, p=.000) were in contrary propotions, while the relationships between the perceived health status and the quality of life (r=.234, p=.008) were in direct propotion. In conclusion, the Rhythmic Movement Program used in this study for geriatric nursing care is simple and safe for application to the elderly and shows significant effects by implementing 5 sessions a week for 9 weeks. The Rhythmic Movement Program improves the quality of life, maintains as well as improves the physical and physiological fuctions and emotional state, therefore this program is strongly recommended for positive applications for independant geriatric nursing health care.

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The purpose of this study was to test the effectiveness of self-management relaxation training through biofeedback and progressive muscle relaxation methods. The effectiveness of the experimental methods was tested by measuring the degree of symptoms of stress(SOS), the McNair's profile of Mood STates(POMS), the levels of ephinephrine, norepinephrine, pulse rate, blood pressure and natural killer cells. The subjects of this study were sixty six nursing students divided into four groups two groups were the biofeedback and progressive muscle relaxation groups, the other two groups served as control groups. One was a group of sophomores with no experience at all, the other a junior group without self-management or relaxation training. This study was condicted for eight weeks of clinical practice from April, 26th 1998 to June, 20th 1998. Biofeedback training was done with software developed by J&J company(1-410 form for abdominal respiration training). Progressive muscle relaxation training was done with an audiotape recorded according to Jacobson's Theory. The data were analyzed with frequencies, means, and analysis of cobariance using the SPSS program and the significance level of statistics was 5%. The results of the study are : 1) The importance of clinical practice stress reduction is shown in that the level of symptoms of stress in the experimental groups in clinical practice was higher than in the group receiving only a lecture. 2) The relaxation training methods of biofeeback and progressive muscle relaxation were effective in reducing the symptoms of stress under the clinical practice stress conditions. 3) The effectiveness of the biofeedback training relaxation method to reduce symptoms of stress was higher than that of progressive muscle relaxation. 4) The relaxation training methods of biofeedback and progressive muscle relaxation were effective in reducing stressful mood states. 5) The relaxation training methods of bioffedback and progressive muscle relaxation were not effective in reducing epinephrine and norepinephrine levels. 6) The relaxation training methods of biofeedback and progressive muscle relaxation were effective in increasing the number of natural killer cells. 7) The relaxation training methods of biofeedback and progressive muscle relaxation were effective in decreasing high systolic and diastolic values of blood pressure and high pulse rates. In summary, the relaxation methods of biofeedback and progressive muscle relaxation in reducing clinical practice stress were effective in lowering the level of symptoms of stress and the profile of stressful mood states. They were also effective in lowering high blood pressure and pulse rates. The relaxation methods were effective in increasing the number of natural killer cells as part of the immune function. However, relaxation methods were not effective symptoms of stress was more effective than the progressive muscle relaxation method.

This study was designed to investigate the effect of a hand massage program on anxiety and immune function in patients during cataract surgery. The hand massage program, in this study, consisted of hand massage and hand-holding. The subjects were sixty-three patients, thirty for the experimental and thirty-three for the control group, who were admitted at Kang Nam St. Mary's Hospital for cataract surgery. This study was carried out from December 10, 1997 to February 26, 1998. The level of anxiety as measured by the Visual Analogue Scale, systolic blood pressure, diastolic blood pressure, and pulse rate were measured before, after hand massage, and after hand-holding. Epinephrine, norepinephrine, cortisol, blood sugar levels, neutrophil, lymphocyte, and natural killer cell percentages also were measured before hand massage and five minutes before the end of the operation. Data were analyzed by t-test, ANCOVA, repeated measure ANOVA, and Bonferroni multiple comparisons. The results were as follows : 1) After hand massage, psychological anxiety levels decreased significantly compare with before hand massage in the experimental group, not in the control group. After hand holding, there were significant decrease in both groups. 2) There were no significant differences on systolic blood pressure, diastorlc blood pressure, and pulse rates in both groups. 3) The hand massage program decreased epinephrine, norepinephrine, and cortisol significantly in the experimental group and increased epinephrine, norepinephrine, and cortisol in the control group. 4) There were no differences in blood sugar levels, neutrophil and lymphocyte percentages in white blood cells after the hand massage program. However, natural killer cells in lymphocytes were significantly increased in the experimental group. These findings indicate that a hand massage program could be a effective nursing intervention in decreasing the psychological and physiological anxiety levels and improving immune function in clients having cataract surgery under local anesthesia.

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The purpose of this study was to examine the effect of slow stroke back massage(SSBM) on anxiety and immune response in patients undergoing open heart surgery and to compare the effect of 5-minutes with 10-minutes SSBM. Among the sixty-four patient subjects, twenty-one were one experimental group receiving massage for 10-minutes, twenty for the other experimental group receiving massage for 5-minutes and twenty-three for the control group. Subjects were admitted at Hospitals in Inchon and Puchon for open heart surgery. This study was carried out from October 10, 1997 to May 10, 1998. The levels of anxiety were measured by the Visual Analogue Scale(VAS), Trait anxiety scale, systolic and diastolic blood pressure, pulse rate, blood cortisol and the levels of immune response were measured by the blood T-lymphocyte and Natural killer cell. Study measurements were taken before and after SSBM on the 1st pst operative day. Data were analyzed using x2test, oneway ANOVA, paired t-test, t-test and Pearson product moment correlation. The results were summarized as follows: 1. After SSBM, VAS anxiety level, systolic and diastolic blood pressure and pulse rate of the experimental group were decreased significantly than those measurements before the SSBM. After SSBM, significant difference in the VAS anxiety level, systolic blood pressure and pulse rate between the experimental and control groups were found. 2. After SSBM, the blood cortisol of the experimental and control groups were increased significantly compared with before SSBM. But the significant difference in blood cortisol between the two groups was not found. 3. After SSBM, the blood T-lymphocyte percentages of the experimental and control groups were decease significantly and blood Natural killer cell percentages of the two groups were increased compared with before SSBM. But significant difference in blood T-lymphocyte and Natural killer cell percentages between the two groups was not found. 4. Significant difference in VAS anxiety level, systolic and diastolic blood pressure, pulse rate, blood cortisol, blood T-lymphocyte and Natural killer cell percentages between SSBM for 5 minutes and SSBM for 10 minutes were not found. Based upon the results, this study concludes that the slow stroke back massage for 5 minutes is a useful intervention that decreases anxiety and produces relaxation in patients undergoing open heart surgery.

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