Computerization has been applied in most areas of health care in recent years. But computerized standardized nursing care plans have not yet been adequately developed even though they can significantly contribute to an improvement in the quality of nursing care. Therefore, this study was done to develop computerized nursing care plans. For this purpose, the study had the following objectives: 1) to develop a computerized program for standardized nursing care plans which include defining characteristics, relating factors, expected outcomes and nursing interventions 2) to test applicability of the computerized programs to the actual clinical situation of the clinical nurse. Application of the system development life cycle by davis was used as the study methodology. There are five stages in this method; strategy planning development, system analysis, system design, system practice and system evaluation. The first four steps in this methodology were used in this project. Two clinical nurses were selected to apply this computerized program in the clinical situation. The results of the study are as follows; 1) Ten standardized nursing care plans including defining characteristics, relating factors, expected outcomes and nursing interventions which had been proven to have validity in the clinical setting were computerized using the Foxbase Program. 2) These programs were applied to the actual clinical situation by two clinical nurses working at Severance Hospital. For further study, continuous revision should be done by the users. Evaluation related to the utilization of the program should also be done.
Older people, because of the psychological and physiological changes related to the aging process are more vulnerable to experiencing powerlessness than any other age group. This self destructive cycle of depression in older people related to the experience of continued and long term powerlessness can lead even to death. The purpose of this study was to measure powerlessness and resources to increase power in older people, and to measure the effectiveness of a psychological rehabilitation program for reducing powerlessness. The research methodology used was two step process. In the first step, a survey was done of perceived powerlessness and power resources comparing four groups of elderly people ; those living at home, those in hospital, those living in nursing homes and those attending educational programs for the elderly. The total sample size was 236. In the second step, a psychological rehabilitation program was carried out, pre and post measurements were taken related to this program. The sample consisted of 29 residents in a nursing home. The results of the study are as follows : 1. Powerlessness was classified as cognitive, emotional, activity and learning. The lowest score for powerlessness was in the area of activity, that is the people in the sample felt more power concerning their activities. The highest score was in the area of cognition were they felt they had less power. 2. When the different groups of elderly were compared, it was found that the residents of the nursing home had the highest score in perceived powerlessness and the group who perceived powerlessness and the group who were living at home had the lowest score. 3. Among the general characteristics, the factors influencing the powerlessness score were age, sex, level of education, financial resources and health status. In the interaction effects among these factors, it was found that level of education and health status were factors influencing perceived powerlessness. The elderly with lower education and poorer health status had the higher scores for perceived powerlessness. 4. The power resources could be classified into the following areas : physical strength, emotional strength, positive self-image, energy, knowledge, motivation and belief system. Be-life system was given the highest score among the power resources and energy, knowledge and motivation were given low scores. 5. The group participating in an educational program for the elderly had the highest score for power resources while the group made up of residents of a nursing home had the lowest score as well as the highest score for perceived powerlessness. 6. The factors influencing the power resource scores were sex, level of education, financial resources and health status. In the analysis of the interaction effect among the factors, it was found that sex, level of education and financial resources were the factors that influenced the power resource score, that is women, those with a low level of education and those with poor financial resources reported a lower level of power resources. 7. There was a negative correlation between perceived powerlessness and power resources in the elderly in this study. Since power resources explained 49% of the variance for powerlessness, it can be concluded that the power resources can be used to reduce powerlessness. 8. The psychological rehabilitation program was carried out with the nursing home residents over a period of five weeks. No statistically significant difference was found in the scores on powerlessness between the pre and post test, but there was a slight decrease in the raw scores on the post test for emotional, activity and learning powerlessness. There was a statistically significant increase in the power resource scores for emotional strength, positive self-image, energy, knowledge and motivation in the post test as compared to the pre test. In conclusion, the study indicates that a psychological rehabilitation program for the elderly could be effective in increasing power resources and this in turn could lead to a decrease in perceived powerlessness.
This study was to investigated the factors influencing the decisions of nurses to resign. The purpose was to contribute information useful for the effective management of nurse staffing resources. The specific objectives were as follows : 1. To investigate the level of job satisfaction of nurses who resign. 2. To analyze the relationship of job expectations and the decisions to resign. 3. To investigate the major reason for nurses' resignations. 4. To identify the relationship of the general characteristics of the nurses and the factors influencing their decisions to resign. 5. To analyze the relationship of the intention to resign and the factors influencing the decisions to resign. The sample consisted of 90 nurses who worked at Y hospital in Seoul from march. 1987 to Feb. 1988 and who had resigned. The instruments used for this study were slavitt et al's index of Work Satisfaction Scale and job expectations scale developed by the researcher. Analysis of data was using frequency, t-test and ANOVA. The results of study were as follows ; 1. There was no difference in the job satisfaction level of nurses who resigned compared with nurses in active service but the subcategory interaction score was lower and the subcategory salary score was higher than for nurses in active service. 2. Low job expectation scores influenced the decision to resign. 3. The major reason of resigning were personal problems such as marriage, childbirth, and relocation of family. 4. The length of employment and the number of different service areas of the nurses who resigned were associated with the job satisfaction level. 5. The nurses who had have an intention to resign while in active service had lower scores for job satisfaction and the job expectation score was a greater influence on the decision to resign. In conclusion, the factors influencing the decisions of nurse to resign were job satisfaction, job expectations and intention to resign while still in active service.
A central issue in the development of nursing practice is to describe the phenomenon with which nursing is concerned. To identify the health problems which can be diagnosed and managed by the nurse is the first step to organize and managed by the nurse is the first step to organize and ensure the development of nursing science. Therefore the academic world has been discussing the application of the nursing diagnosis in nursing practice as a means of improving quality of care. The objectives of this study were to develop a standardized nursing care plan for ten selected nursing diagnoses to from a database for computerized nursing service. The research approach used in the study was (1) the selection of the ten nursing diagnoses which occur most frequently on medical-surgical wards, (2) the development of standardized nursing care plan for the ten selected nursing diagnoses, (3) application of the plan to hospitalized patients and evaluation of the content validity by the nurses, and (4) evaluation of the clinical effects after the use of the standardized nursing care plans. The subjects were 56 nurses and 395 hospitalized patients on two medical and two surgical unit. The results of this study were as follows ; 1) The ten selected nursing diagnoses for the development of the standardized nursing care plans were "PAIN, SLEEP DISTURBANCE, ALTERED HEALTH MAINTENANCE, ALTERATION IN NUTRITION, ANXIETY, CONSTIPATION, ALTERED PATTERNS OF URINARY ELIMINATION, DISTURBANCE IN BODY IMAGE, POTENTIAL FOR ACTIVITY INTOLERANCE AND ACTIVITY INTOLERANCE". 2) The developed standardized nursing care plans included the nursing diagnosis, definition, defining characteristics, etiologic or related factors that contribute to be condition, recording pattern desired out-comes and nursing orders(nursing interventions). 3. The plan was used with hospitalized patients on medical-surgical wards to test for content validity. The patient's satisfaction with the nursing care and nurses' job satisfaction were investigated to evaluate the clinical effects after the use of the standardized nursing care plans. A comparison of patient satisfaction with nursing care before and after the introduction of the standardized nursing care plans showed a statistically significant higher level of satisfaction with the standardized care plans. There was no difference in the level of job satisfaction expressed by the nursing staff before and after the standardized nursing care plans were introduced. However, when opinions about the use of the standardized nursing care plans were examined it was found that there was a positive effect on clarity in defining the nursing problems, determining nursing cost, more feasible goal setting, effective and systematic nursing records and indications for nursing research. The results of this study suggest that in order to increase the use of nursing diagnoses in the clinical area, it would be effective to select some wards as a pilot project, give the nurses training in the use of nursing diagnosis and develop and use the standardized nursing care plans. In addition to the ten diagnosis used in this study it sis recommended that continual development of nursing diagnoses be done using diagnoses that are appropriate to Korea and testing them for validity through standardized care plans.
The purpose of this study was to investigate factors influencing role adaptation in newly employed nurses and the consistency between role expectations before employment and after one year of employment. The results of this study may contribute to strategy development towards positive role adaptation in newly employed nurses. The data used in this study were colleted from 111 nurses, the sample was drawn from all newly employed professional nurses working at Y Medical Center in 1987. The data were collected longitudinally in the 2nd ?3rd weeks, the 3rd month and the 12th month after employment. The results of this study were as follows : 1. The degree of change the importance of factors influencing role adaptation and the length of time after employment were investigated. The result showed that the degree of change was the greatest within the first 3 months after emloyment. Important factors related to role adaptation were working conditions, the environment of the assigned ward and the work load. These factors always displayed high scores without any great change over time. New employees put more importance on practical factors which were obtained through experience in their jobs rather than on ideal factors which they had considered more important while in school. 2. Consistency between role expectation before employment and after 12 month of employment was investigated. The highest consintency item was the expectation about the variety of patients, and the highest inconsistency was the expectation about their own welfare. An average score of 69.07 points was achieved from a maximum of 225 points for the 25 items, showing that expectations tor role development before employment were not fully satisfied. In conclusion the administraor should assess the initial expectation at the time of employment of new nurses and she / he should make clear to the new nurses that these expectations may not be realistic. In this way the administrator can provide more satisfactory conditions towards the expectations of the new nurses and help them towards positive role adaptation and reduction of role conflict. Newly employed nurses have high and unrealistic expectations about socialization to the profession from their nursing educational program. It is suggested that a transitional training program should be planned and carried out for newly employed nurses.
This study was undertaken at Yonsei University Medical Center to identify the crisis responses and nursing problems of patients who had been diagnosed with cancer, and changing patterns of grieving over time periods, and to analyse the effectiveness of follow up care through home visiting nursing. This study was carried out in three stages. The 1st study data were collected from a total of 205 patients who had been diagnosed with cancer from Sept. 1 to Dec. 31.1987 using a cross-sectional method. The 2nd study data were collected three times from 30 patients with cancer at 4 weeks intervals from March 1 to June 31.1988 using a longitudinal method. The 3rd study data were collected from two different groups from March 1 to June 31, 1988. One was an experimental group who was visited by nurses and the other one was a control group not visited by nurses. The subjects of the 3rd study consisted of 60 patients with cancer and a Quasi-experimental research design was used. The results were as follows : 1. The patients did not experience one stage at a time among the five stages of grieing, denial, anger, bargaining, depression and acceptance, as identified by Kubler Ross. They experienced a combination of stages, especially of the bargaining and the depression stages. This stages did not change with the passing of time. 2. The patients expressed more physical and socioeconomical problems than emotional problems. And they used more problem coping methods than emotional coping methods. 3. Follow up care through home visiting nursing positively influenced the patient's quality of life, especially their pyhsical well-being and symptom control. The patients responsed positively to the home visiting nursing, stating that it was helpful to them. It was concluded that the development of a home visiting nursing program is needed for the effective home care of patients with cancer.
Herzberg and his associates concluded from their findings that job satisfaction consisted on two independent dimension; the first dimension was related to job satisfaction, the second to job dissatisfaction. According to the Herzberg theory, the satisfiers are related to the nature of the work itself and the rewards that flow directly from the performance of that work. The dissatisfaction factors are associated with the individual' s relation to the context or environment in which he works. The purpose of this study was to investigate selected factors which result in job satisfaction / dissatisfaction of nurses employed in general hospital. In a study of this nature, it is important that the population be as homogenous as possible in order to reduce the effects of the different environments and backgrounds on job satisfaction. A job satisfaction questionnaire developed by Slabitt et els. was used for this study. It contains 45 statements and utilizes a Likert type scale of 5. Participants were asked to select response which were congruent with their perceptions of the item. It was decided to conduct the study in one general hospital in Seoul. A sample of 505 clinical nurses were selected to participate in this study. The results of this study were as follows; 1. The overall mean score for the 45 five-point scales of job satisfaction items was 2.945, showing that the subjects of this study were neither satisfied nor dissatisfied. 2. To identify the specific job related factors that result in Job satisfaction / dissatisfaction, the 45 items of job satisfaction were divided into 6 areas and the mean scores and % of agreement were compared. The specific job related factor that resulted in job satisfaction was the job status and those that resulted in job dissatisfaction were salaries, task requirements and organization requirements. But the areas of autuuuiuy and interaction did not belong to either side of the specific job related factors. 3. To identify the relationship between the job satisfaction and the subject's general characteristic, data was analyzed using the t-test and the Pearson correlation coefficient. It was found that the relationship between the job satisfaction and the request for rotation and intention to remain on the job were statistically significant at .05 level, but the relationship between the job satisfaction and age, work experience, and educational background were nor statistically' significant at the .05 level.
Nursing service, as the largest user of labor reso-urces, has become concerned about appropriate allocation of staffing resources. Therefore, this project was designed to measure quantitatively the direct nursing care provided to patients and to develop a new patient classification system based on the direct nursing care activities. The initial step in the development of the classification instrument was to identify the content of direct nursing activities. The frequency with which these activities were carried out, the total time spent in carrying them out and the average time for one performance of each of the nursing activities was calculated. The next step was to select the items for the cia ssification instrument taking into account these direct nursing activities. A list of 40 items was prepared. These items were then classified into 8 major categories; personal hygiene, moving & exercise, nutrition & elimination, observation, medication, treatment, collecting specimens and other care activities for severity ill patients. Each item was assigned a value unit based on the average time required by the nursing staff to complete the specific item. The third step was to determine the practicality of the items and value units, so an attempt was made to establish content validity for these items and units by obtaing a consensus from 8 head nurses, representing eight different departments. The 4th step was to conducted a pilot study to establish the score range for the classification boundaries. For this purpose an instrument was designed using the list of items and value units and a prepared classification criteria as a guideline to validate the patient classification. A judgment group consisting of 52 supervisory nurses and head nurses were asked to select the proper patient to fit each classification criteria and to fill out the instrument for each patient. The total value unit and the frequency for each classification group was calculated. According to the frequency distribution, the score range for the classification group was determined as follows: 0~15 for group I, 16~30 for group II, 31~50 for group III, and above 51 for group IV.Finally a patient classification form was developed.
Nowadays, most big hospitals have a computer system to manage their administration. For maximum effectiveness in managing the computer system, an analysis of the variables affecting its implementation is necessary from the beginning. This study was done to analyze the variables influencing the operation of a hospital information system (HIS). The theoretical base for this study considered the combined effects of user expectations of computerization, and computer-anxiety. The relationship between variables in the theoretical base were analyzed and the individual characteristics influencing each variable were also analyzed. This study was done in two steps. First, 344 nurses were given an initial questionnaire developed to evaluate the reliability of the items. Based on the results, a second revised questionnaire was administered to 88 nurses who had been working in the areas where HIS was applied. The results of the first and second steps of the study are as follows: 1. The initial study was done with nurses who were trained on the computer system briefly before HIS was implemented. The individual characteristics influencing computer anxiety and expectation regarding computer system usage in that initial study included, length of career, type of degree or certification, previous experiences with a computer, training on a computer, desire for computer training, and level of acceptance of a computerized work environment. But in the second study with nurses working in areas of the hospital where HIS was introduced, the work site was the only influencing characteristics. Therefore, in applying a computer system, overcoming work-environment barriers will be more important than any individual characteristics. 2. The computer anxiety of the nurses in both groups, before and after the computer system application, was below the average level but the expectation of the effects of computerization was above average. The nurses using the computer program showed an above average level of satisfaction with the computer system itself, and with its effect on their efficiency. Therefore, the ability of nurses operating HIS will be positively predictive. 3. For the variables included in the theoretical framework of the study, all of the correlational coefficients were statistically significant in the analysis of variation correlation. Therefore, the theoretical base of the study, "expectation in conjunction with computer anxiety" can be considered an model which can be evaluated. According to our analysis, the higher the level of nurses' motivation to use the computer system and the lower the anxiety about computer usage, the higher the possibility of computer system acceptance by nurses. The results of this study showed that in applying a computer system in the hospital, the main characteristic influencing acceptance was where the individual worked rather than personal characteristics such as length of career, type of degree or certification, and previous experiences with a computer. Therefore, it is suggested that the first step in uncovering and eliminating hindrance factors in application of a computer system should be an analysis of working conditions in relation to the functional content of the computer system. The suitability of the theoretical model based on the hypothesis applied in this study should be further tested.
PURPOSE: This descriptive study was designed to find out the relationship between moral self concept and ethical sensitivity of nurse managers.
METHODS
Study data were collected from Aug 6, 2001 to Aug 24, 2001. Study subjects were 283 nurse managers working in university hospitals. Moral self concept was measured with questionnaire developed by Chung (1965) and ethical sensitivity was measured with the questionnaire developed by the researchers.
RESULTS
1. The score for degree of nurse managers' moral self concept was shown to be an average of 3.06 out of 4.00, which is relatively high. The score for degree of nurse managers' ethical sensitivity was shown to be an average of 2.84 out of 4.00 2. Analysis of correlation between moral self concept and ethical sensitivity showed a statistically significant positive correlation (r= .34, p=.00). 3. In general characteristics, a variable that caused significant difference in moral self concept was the total period of experience as a nurse (F=3.52, p=.02). A variable that caused significant difference in ethical sensitivity was the current working department (F=3.91, p=.01). 4. Nurse administrator's moral self concept was significantly related to ethical sensitivity (r= .34, p= .00).
CONCLUSION
It is important to intensify individual moral self concept in order to improve ethical sensitivity of nurse managers. Also, it is recommended that investigate variables affected moral self concept and develop a nursing education program to promote moral self concept in nurse administrators.
PURPOSE: The objective of this research is to provide the indoor environment management education program for the asthma patients and their families and then analyze the effectiveness in education preventing allergic asthma.
METHODS
A pre-post single group quasi-experimental design was used to provide an education program about correct indoor environment management to a total of 58 households (29 patient households and 29 normal households). The performance rate of correct indoor environment management procedure, amount of house dust mite antigen, allergy subjective symptoms score and knowledge score about indoor environment management were compared before and after the education to test the effectiveness of the education.
RESULTS
Home-visit education in this research had effects in improving subject households' performance rate of indoor environment management procedures, reducing the amount of house dust mite antigen - an important inducing factor of allergy, and reducing perceived subjective symptoms of allergy.
PURPOSE: The purposes of this study was to evaluate an occupational health promotion program for the prevention of cardiovascular disease. METHOD: This study employed a quasi-experimental non-equivalent pre and post test to evaluate the program. The subjects of this study were 48 employees selected by convenience sampling who were suspected of having hypertension and hyperlipidemia in routine physical examinations and who were working in A University Hospital in Suwon. 25 subjects were assigned to the experimental group and 23 to the control group. Data collection was done using questionnaries before and after the subjects used the program. RESULTS: The results of this study showed that systolic blood pressure, ALT, gamma-GTP in the experimental group was lower than that of the control group. There were significant differences between two groups in the percentage of 'irregularity of diet' and in health behavior compliance. There were significant differences between the two groups in the number of complaints of symptoms after using the program. CONCLUSION: This study shows that there were no obvious differences between the two groups in all areas, but this program had a positive effect on health behavior changes. It is expected that employees' lifestyles can be changed through continuous health promotion programs.
This study was aimed at exploring the current status of graduate programs for an advanced practice nurse(APN) to recommend future directions of APN education.
A total of 142 students enrolled in seven APN specialty programs, 67 professors who were involved in APN education, and nine nurse administrators participated in the study. Data was collected by questionnaires and focus group interviews.
The current definition of APN was found not to be specific enough to represent expected roles of APN in regards to knowledge, attitudes, roles, and skills. Standard curricula employed regardless of the area of APN specialty, lack of qualified clinical practice settings, as well as prepared instructors were found to be problematic.
The following needs to be addressed: 1. redefining of APN roles, 2. tailoring specialty areas of APN, 3. consolidating educational programs, and 4. ensuring APN role models and faculty. Suggesting a CNS role in Korean APN, areas of APN should be rearranged toclarify their roles and educational programs need to be further developed to meet the expectations and quality of APNs. It is necessary to ensure APN's employment in the health care system by laws and policies to perform advanced nursing roles.
In this longitudinal study, we examined the moral judgment level and its related factors, such as individual characteristics. The result of this study will provide baseline data to establish policy of ethics education for college students and healthcare professionals.
We enrolled 37 nursing students and 20 medical students as the subjects in a university in Suwon, Korea. We conducted a questionnaire on the subjects using Korean version of Defining Issues Test(DIT) to analyze the subjects' moral judgment level. Collected data was coded using ASCII document and scored using Fortran program for computer. Then the data was statistically analyzed by SPSS Version 10.0.
Nursing students' moral development score at each stage were consistently higher at stage 5A across 4-years rather than other stages. On the other hand, medical students' moral development score were consistently higher at stage 4 than other stages. There was no significant difference in the change P(%) score at each academic year in both groups. In the perspective of the subjects' general characteristics, P(%) score showed no significant in both groups.
Based on the results of this study, further studies will examine the correlation between curriculum and moral judgment development in detail. Moreover, we suggest that the current ethics education should be developed and evaluated in more realistic manner.
The purpose of this study was to develop a stress measurement scale for Korean nursing students.
Sixty preliminary items were selected by classifying 229 basic items extracted via literature review and Q-sorting method. In order to verify the reliability and validity of the preliminary instrument, data were collected from 617 nursing students in 2 colleges of nursing in Korea.
As a result of the item analysis, 58 items were selected. They consisted of 2 types of stress which were college-based stress (38 items) and clinical-based stress (20 items). Ten factors in college-based stress and four factors in clinical-based stress were extracted by factor analysis, and each had a total variance of 63.01%, and 64.93%. Cronbach's Alpha of those 58 items were .937 in college-based stress and .922 in clinical-based stress, which was high.
This paper is meaningful in a way that it has developed a tool capable of measuring stress for nursing students, which reflects the characteristics of our country. It is recommended for further study to re-verify the relevance and stability of this measurement.
This study was done to describe the research trend of Complementary and Alternative Medicine(CAM) in Korea and internationally.
A Systematic review of CAM related literature published from 2000 to 2005 was done. A comprehensive search by using 34 CAM modalities as search terms to identify all articles dealing with CAM was undertaken from 4 databases: PubMed, RICHIS, KoreaMed, and Riss4U. A Total of 588 abstracts and 223 original articles were reviewed by two independent reviewers using systematic analysis guidelines. Data regarding the types of study design, characteristics of subjects and researchers, and classification of CAM modalities was recorded. The outcome measures of CAM were identified.
CAM research has been rapidly increasing worldwide in the last decade. In Korea, nursing(53.5%) followed by medicine(42.7%) occupied the majority of CAM research in comparison to medicine(42.9%) and disciplines in CAM(25.0%), like homeopathy, internationally. Prevailing research designs in Korea were experimental and quasi-experimental, however, randomized clinical trials were found. Internationally, survey research was dominant, with the exception of randomized clinical trials that were mostly an experimental design.
The findings suggest that a robust research design in CAM research is needed to accumulate strong scientific evidence and to adopt nursing interventions from CAM modalities.