This study intended to investigate the volume of respiration according to the postoperative time and positions among the upper abdominal surgery patients. Tidal volume and vital capacity were measured in three positions-supine, left lateral and sitting position-at preoperatively, 12 hours postoperatively and 36 hours postoperatively. Thirteen male and seven female patients who were admitted an smoking habit were excluded from the study. The study was conducted from March 15 to June 30, 1985 in Seoul National University Hospital. Tidal volume and vital capacity were measured by Wright spirometer in various positions at preoperatively, 12 hours postoperatively and 36 hours postoperatively. The results were as following : 1) Vital capacity was significantly decreased at 12 hours preoperatively and 36 hours postoperatively than preoperatively. Vital capacity was not significantly different in Various positions, but sitting position revealed better than left lateral and supine position. Tidal volume was not significantly different in each position. 2) Male patients showed significantly higher than female patients in tidal volume and vital capacity. Vital Capacity was not significantly different by sex in each position, but vital capacity was higher in sitting position than in lateral and supine position. 3) There was not significantly different in tidal volume and vital capacity according to the type of incision and position, vital capacity was higher in sitting position than in left lateral and supine position.

This study was attempted to investigate the main factors affecting health perception of the patients following cardiac valve replacement surgery. Data were collected from Sept. 1 to Oct. 31, 1984 through administration of questionnaire developed for this study by the researcher. The subject was 95 patients who received follow up care following cardiac valve replacement surgery at S.N.U.H. The data were analyzed by T-test, oneway ANOVA, pearson correlation and multiple regression according to dependent variables. The results were as follows. (1) Average self-health perception of those patients were 4.62, (maximum;7 minimum;1) and they showed on affirmative response for their health condition. (2) There was significant difference in health perception according to sex difference. Men had higher health perception than women. (t=2.83, p=0.006) (3) There was significant difference in health perception according to occupation. Those who had occupation showed higher health perception those who had no occupation. (t=3.25, p=0.002) (4) The longer post-operative period elapsed, the higher health perception was, and there was significant difference in health perception. (gamma=-0.2958, p=0.002) (5) The higher age was, the lower health perception was, and there was a significant difference in health perception. (gamma=-0.2485, p=0.008) (6) The fewer subjective psychosomatic symptoms were, the higher health perception was, and there was a significant difference in health perception. (gamma=-0.4988, p=0.0000) (7) The more active daily activities were, the higher health perception was, and there was a significant difference in health perception. (gamma=0.6359, p=0.0000) (8) The main factors predicting health perception are like these. Daily activities (42.7%), highest variable. Psychosomatic symptoms (7.29%) Elapsed period after cardiac valve replacement (1,89%) Existence of occupation (1.87%) Sex (1.78%) Age (0.8%)

The purpose of this study was to compare educational needs following open heart surgery assessed by nurses & patients themselves. Data were collected from Nov. 1983 to Jan. 1984 through administration of questionnaire developed for this study by the researcher. The subjects were 45 patients who experienced open heart surgery and 29 nurses who taking care of these patients in chest surgery ward at Seoul National University Hospital. The Data were analyzed by T-test and One Way ANOVA according to dependent variables. The result were as follows 1. There are significant difference between educational needs, assessed by nurses and patients themselves. (p<0.05) The nurses reported higher score of educational needs than patients. 2. In comparison of content area of educational needs, there was significant difference according to respiratory care, pain, chest tube care and operation including heart function between two groups. But, there was no significant difference in diet, activity, complication, emotional care and medication between two groups. 3. The priorities in content area of educational needs rated by nurses and patients were similar.

The study investigated the effects of nursing information given verbally and a booklet on the knowledge, physical symptoms, anxiety and daily activities of patients recovering from open heart surgery from just before discharge to six weeks after discharge. The convenience sample was of patients who had undergone open heart surgery in Seoul National University Hospital. The first 25 patients who agreed to participate in the study became the control group. They did not receive the intentional information but the usual nursing care. The next 28 patients became the experimental group who received a booklet about their post-discharge care which was discussed with them by the researcher before discharge. This study used a non equivalent group non-synchronized quasiexperimental design. The tool included a 30 items knowledge scale, a 9 item physical symptom scale, Spieberger's state anxiety scale, and a 28 items daily activity scale. The instruments were applied before discharge and at two and six weeks after discharge. For data analysis, frequency, t-test, Pearson's Correlational Coefficient and Cronbach's alpha were used. The results were as follows : 1. Information given through the booklet was effective in increasing the knowledge of patients recovering from open heart surgery. The experimental group's knowledge was higher at 2 weeks after discharge than prior to discharge(P<0.05). 2. There was no significant difference in physical symptoms between the two groups at two and six weeks after discharge. 3. Information given through the booklet was effective in decreasing the State Anxiety two weeks after discharge(P<0.001) but at six weeks after discharge, there was no significant difference in anxiety between the control and the experimental groups. 4. There was no significant difference in daily activity between the two groups at two and six weeks after discharge. 5. There was a negative correlation between knowledge at discharge and at 2 weeks and anxiety at 2 weeks after discharge. There was a positive correlation between knowledge at discharge and daily activity at 2 weeks after discharge. There was a negative correlation between knowledge at 2 weeks and Physical symptom at 6 weeks after discharge.

The purpose of this study was to identify factors related to daily activities of post myocardial infarction patients. Data were collected from Aug. 1 to Aug. 31, 1988 through an interview schedule lasting for about 30~60 minutes by the investigators. Tools for this study were a daily activities scale and a subjective physical symptom scale developed by the researchers, and Zung's self rating depression scale. The subjects were 45 men 18 women post myocardial infarction patients who were receiving follow up care at SNU Hospital. The data were analyzed by percentage, mean, t-test, ANOVA, the Pearson moment Correlation Coefficient test, and Cronbach's a reliability test. The results were as follows. (1) Reliability of the daily activities scale was 0.91 by Cronbach's a. In the daily activities scale, items about transfer, exercise, and job related activities were most highly rated as meaningful to the post myocardial infarction patients, (2) The average daily activities score of these patients was 3.30 (maximum point; 4) all scores were high except for exercise and job related activities. (3) There was a significant difference in daily activities according to sex ; men had a higher daily activities score than women (T=2.32, P<0.05). (4) There was a significant difference in daily act ivities according to job status. Subjects having a job had a higher daily activities score. (5) The lower the depression score, the higher the daily activities score(lambda= -0.5748, P<0.05). (6) The lower the subjective physical symptoms score, the higher the daily activities score (lambda=-0.6015, P< 0.05).

The purpose of this study was to identify the factors which influence the effectiveness of nursing organization in the hospital. The data were collected by employing Delphi technique in a series of three rounds from June 15, 1985 to January 31, 1986. In each round the responses to questionnaires were analyzed and the results were communicated back to the subjects. Finally consensed among subjects in identification of the 48 items which influence the effectiveness of nursing organization in the hospitial. The 48 items were reduced to C factors and named, planning, organization and problem-solving, staffing-and staff developing, supporting, evaluating-contr-oiling and leading, and the number of items included for each factor were 14,14,8,5,3,2 and respectively. Among the 48 items, 2 items were not loaded on forementioned 6 factors because factor loading was below 0.3.

PURPOSE: It was identified that how many homebound bedridden elderlies and their primary caregivers were depressed, and which factors affected the bedridden elderly's depression. METHOD: The subjects were 191 homebound bedridden elderlies and their primary caregivers. The affecting factors were classified into two categories: bedridden elderly and their primary caregiver related factors. Then bedridden elderly's factors were classified demographic and disease-related factors again. The stepwise regression was used to identify significant factors. RESULT: The prevalence of bedridden elderly's and caregiver's depression was 77.8% and 67.0%, respectively. And the model explained 33.3% of variance of bedridden elderly's depression. Cognitively-impaired female elderlies who had depressed caregivers were found to be more depressed. And caregivers who perceived burden were identified to be more depressed. CONCLUSION: It is recommended that the health professionals need to identify bedridden elderlies and caregivers at risk of depression. Especially elderlies who is in poor cognition, those who are female, and those whose caregivers were depressed might be considered carefully in all counseling or follow-up. Also the primary caregivers must be helped to access already available formal and informal support.

PURPOSE: This study aims to identify the ADL and IADL of bed-ridden elderly. Also it is used to show fuctional status, and to investigate the content and the level of nursing services provided. METHOD: The subjects were 191 elderly who received visiting nurse service through public health centers in the Seoul Metopolitan and Chungnam Province. Data collection was conducted by public health center nurses during four months in 2000. Result: As for daily living activities, 100% of subjects had at least one difficulty in ADL and IADL. Among them, only 0.5% had moderate disabilities and 99.5% had severe disabilities by HFS, 27.9% were in a semi bed-ridden state and 72.1% were completely bed-ridden by JABC. The major service provided was a visiting nurse service which was preferable to the social welfare service. In the visiting nurse service, there was no significant difference according to the elderlys' functional status. In addition there was no standadization about the qualification of the visiting nurse, and single entry point for the nursing service. CONCLUSION: The researchers urgently suggest that a community based comprehensive service model has to be developed to respond to the needs of the elderly in Korea.

PURPOSE: The purpose of this study was to investigate the effects of biofeedback exercise training on muscle activity and activities of daily livings (ADL) in hemiplegic patients. An experimental group consisting of 17 people, was given biofeedback exercise training for 30- 60 minutes per week for 5 weeks, while a control group consisting of 18 people, was given normal exercise with quasi-experimental design. RESULT: The results of the study show that biofeedback exercise is effective for improving muscle activity in hemiplegic patients, especially in the hemiplegic limbs. However, this study found no significant differences in ADL and IADL between the experimental and the control groups. It implies that ADL and IADL may not be improved for a short period of time, such as 5 weeks, for people with more than five years of hemiplegia. The study suggests that the effect of biofeedback exercise on ADL and IADL should be determined in hemiplegic patients in acute stage.

A phenomenological study was conducted to investigate the experiences of mothers pregnant via in vitro fertilization (IVF). Sample of nine mothers participated. Ten theme clusters emerged when the formulated meanings were organized into categories. During the infertility period, the participants were subject to self- depreciation, envy, anxiety, and depression. It changed their priorities in life from a job-oriented life to one where having a baby was the most important thing. After trying numerous alternative therapies, IVF became their last hope in having a baby. Since the success rate for IVF is low (only 20-30%), the participants for the treatment were overwhelmed with uncertainty, and it led to further anxiety, depression and despair. Success of pregnancy gave them extreme satisfaction, but they became very cautious in their day-to-day life because of their fear of abortion and early delivery. Some were even worried about the side effect of IVF during the pregnancy. Finally, the delivery of the baby gave them relief from the obligation of having a baby. Women did not have any difficulties in rearing a "test tube baby" except in the case of twins. Most women had no ethical difficulty in having a baby by IVF. However they did not wish this information to be revealed to other people. They again turned to IVF to have a son(s) when the resultory child(s) was a daughter(s). This is because of the strong preference for sons in Korean society.

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.

This study is based on grounded theory methodology by Strauss & Corbin(1998). Ten hospitalized subjects were interviewed for data collection. In the process of data analysis, 'acceptance' is found to be the causal condition, while 'health professionals' skillfulness', 'ward environment', 'history of hospitalization', and 'general conditions' were identified as context, 'felling of relief' as the core phenomenon, 'self-efficacy', 'support of others', and 'life style' as the intermediate situation, 'passive reaction', 'alternative reaction' and 'active reaction' as the strategy and 'stabilization', 'satisfaction', 'hope' and 'carrying out' as consequences. 'Feeling of relief' is found to go through the three stages of recognition-generation-maintenance after the five different patterns. 1) In case the health professionals are skillful, the ward environment is favorable, the general conditions of the patients improved and as a result the feeling of relief is strong, during the first hospitalization, the self-efficacy of the subjects tends to be strong. They proceed toward the goal set for themselves with a renewed hope and active or alternative reaction toward the feeling of relief. 2) The subjects tend to proceed toward the goal set for themselves with a renewed hope and active and alternative reaction toward the feeling of relief in case health professionals are skillful, the ward environment is favorable the general conditions of the subjects improved, self-efficacy is strong, and lifestyle is autonomous, during the second hospitalization even though support of others is merely superficial. 3) The subjects tend to stabilize, and satisfy themselves with the given situation with passive and alternative reaction to the feeling of relief in case health professionals are skillful and the ward environment is favorable but the general conditions worsened and accordingly the feeling of relief, is weak and life style is dependent during the second hospitalization although the subjects' self-efficacy is strong and support of others is specific. 4) The subjects tend to stabilize and satisfy themselves with the given situation with passive and alternative reaction to the feeling of relief in case health professionals are unskillful the ward environment is unfavorable, the general conditions improved, support of others is specific but life style is dependent and self-efficacy is weak during the first hospitalization. 5) The subjects tend to stabilize and satisfy themselves with the given situation in case health professionals are unskillful the ward environment is unfavorable but the general conditions improved support of others is specific and as a result self-efficacy is strong but life style is dependent.

The purpose of this study was to describe the perceived burden of the stroke patient's caregiver and related factors to analyze relationships between perceived burden and social supports. A convenient sample of 225 caregivers who take care for a stroke patient at home participated in this study. Caregiver's perceived burden was measured by the objective and subjective burden scale developed by Montgomery (1985). Related factors of burden were studied in terms of the patient's instrumental activties of daily living, cognitive function, caregiver's demographic variables and caregiver's illness intrusiveness. The results were as follows: (1) The mean of objective burden score was 4.5, and subjective burden score was 3.1. These scores show that caregivers perceive moderate level of burden. (2) Caregivers' objective burden was significantly related to caregivers's illness intrusiveness (r=.62), patient's IADL (r=-.33), and patient's cognitive function (r=-.15). The subjective burden was related to the caregiver's illness intrusiveness (r=.29), the patient's IADL (r=.24), and the caregiver's age(r=.23). (3) The percentage of stroke caregivers who perceived physical support was 49.1%. The percentage of those who perceived emotional support was 61.0%, and those who perceived financial support totaled 37.6%. (4) Caregivers who received any type of social supports perceived lower subjective burden, and caregivers who received physical or psychological support perceived lower objective burden. These results emphasized the necessity of a rehabilitation programs for stroke patients and support program for family caregivers.

THE NECESSITY AND PURPOSE OF THE STUDY: Recently the number of patients with chronic diseases and the aged patients is increasing steadily. Furthermore, due to the expansion of health insurance system, the number of patients hospitalized in the general hospital is increasing at a surprising speed. However, hospitals urge the early discharge of the patients for the efficiencies of hospital administration, and therefore, the number of patients who must be taken care of in their home is also increasing. Homecare nursing is one of the health care service for the patients at home who require continual attention and care, and now increasing attentions are given to it as one of the professional nursing fields. However, it was almost impossible to find a study on the actual experiences of the homecare nurses written by their own language in Korea, that it also posed a great difficulty in understanding their diverse experience. Considering these situation, this study will help understanding of them, and provide the fundamental data on their experiences for making policies to develop homecare nursing.
METHODS
OF RESEARCH: Phenomenological research method was employed to analyze the lived experiences of homecare nurses fundamentally. DATA COLLECTION: Data were collected from August 1998 to December 1998 from ten homecare nurses who worked for patients under the homecare nursing setting as model cases designated by Seoul Nurses Association and who agreed to the purpose of this study after listening to and understanding the explanation completely. The in-depth interview was carried at the time which was convenient both for the researcher and participants for one or two hours, and recovered with the approval participants. The first interview covered diverse and broad areas like the situation of homecare nursing, and their feelings and thoughts over it, and in the second and third interviews, more specific questions are asked. DATA ANALYSIS: For the phenomenological analysis, contents analysis was employed. The data collected from the participants were analyzed into the following procedures according to Van Manen 's phenomenological analysis. 1) Reserve the preconception of the researcher by restricting it inside parenthesis. 2) Make a thorough observation of the lived experiences by insight process. 3) Analyze the contents (Find out the repetitive factors) 4) Interpret the essence found. 5) State the meaning of the interpretation.
RESULTS
AND DISCUSSION: 1. Fear and expectation for the first visit. (unfamiliarity, awkwardness, anxiety, shivering) 2. Mingle with the family (feeling friendly with the family, becoming like a family member) 3. Being proud of her own know-how (learning the know-how, organizing alternatives, building up confidence) 4. Pity for the poor. (criticizing the current government, feeling ashamed, feeling anger) 5. Difficulty of constructing cooperative system with physicians (strenuousness, frustration) 6. Helplessness due to the lack of support system (difficulty to get supplies, annoyance, embarrassment by institutional restraints) 7. Anxiousness for heavy traffic and parking (annoyance, hastiness) 8. Ethical conflicts (pity for the patients and family, skepticism about lengthening life maintenance) 9. Burden for the possible accident (pressure, anxiety, conflict, physical exhaustion) 10. Establishment of identity as a professional (fulfillment, worth, joy) 11. Being distressed at other's ignorance

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.