No abstract available.

No abstract available.

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.

This study was done to develop a Maternal Identity Scale for Pregnant Women and to test the validity and reliability of the scale. A convenience sample of 161 pregnant women were asked to complete the MISP questionnaire which consisted of 45 item, this was done from December 20, 1995 to January 15, 1996. The research procedure were as follows. The first step was to identify a conceptual definition of maternal identity using Rubin(1984)'s maternal identity and maternal experience during pregnancy. The second step was to operationalize the maternal identity, that is, perception of image possible of selves as mother, maternal role play by imagination, and the experiences of various emotional responses which are embedded in the mother-fetus dyad. The third step was item development which resulted in 45 items as appropriate measurement of maternal identity are except for the perception of image possible of selves as mother. The result findings were as follows: 1) Four factors for MISP(finally 40 items) were extracted through the principal component analysis and varimax rotation, and these contributed 49.3% of the variance in the total score. All 40 items in the scale loaded above .43 on one of 4 factors. 2) Each factor was named: factor 1 was named maternal role imagery and has 10 items, factor 2 was named happiness and has 11 items, factor 3 was named maternal fetal interaction and has 10 items, and the last factor 4 was named negative emotion and has 9 items. 3) Cronbach's -alpha coefficient for internal consistsncy was .92 for the total 40 items and .89, . 90, .86, .78 for the four subscales in that order. Recommendations are suggested below: 1) The developed MISP be used to assess maternal readiness in pregnancy. 2) Replication study be done to test validity and relaibility. 3) For the overall measure of Maternal Identity in Pregnancy, scale for the perception of image possible of selves as mother, and cognitive domain be reorganized for the maternal identity in pregnancy. 4) It is necessary to identify variables that influences maternal pregnancy. 5) It is necessary to identify that maternal identity in pregnancy is a reliable index of motherhood, to do correlation studies on maternal identity and major maternal variables in maternal transition period, to reoperationalize the maternal identity in postpartum, and finally to designate a longitudinal study of the maternal identity changes or stabilities.

PURPOSE: This research study explores the job stress, job satisfaction, and health of women who works in the professional work place and identify the influence of the job stress and job satisfaction on the mental health status focused on the social and psychological structure of the workplace. METHOD: 535 participants of registered nurses and teachers from 10 General Hospitals and 15 Middle and High School located in Seoul, Korea were completed the modified version of the short form Work-family stress inventory of questionnaire as used for job stress and mental health problems and perceived overall health status and job satisfaction. RESULT: Job stress was significantly correlated with job satisfaction, overall health, and mental health. There were also significant group differences in job stress and job satisfaction between nurses and teachers. Multiple regression only moderately supported the effect of job stress and job satisfaction on the mental health of professional working women. Also marital status demonstrated a significant factor of group differences in job stress, work-family stress, job satisfaction, and mental health problem. CONCLUSION: These results suggest that job stress in the work place has profound impact on job satisfaction and health of women who work in the professional job. This study also identified major sources and types of work-related stress on women's health which should be considered in a management for health promotion.

The purpose of this study was to develop the framework of community-based home care nursing delivery system, and to demonstrate and evaluate the efficiency of it. The study was carned out over a period of 3years from September 1996 to August 1999. The researchers developed Standards for operations, this was all aimed toward a home care recording system, and an assessment intervention algorithm for various diseases quality control and standardization. In the center, 185 patients enrolled, and of the enrollments cerebrovascular disorder and cancer were the most prevailment diseases. Also, a home care nursing activity classification was developed in six domains. Those domains were assessment, medication, treatment, education and consultation, emotional care, and referral or follow-up care. Ten sub-domains were divided according to the systematic needs. Among these nursing activities, treatment, assessment, and education and consultation were frequently performed. In sub-domain classification, skin integrity, respiration, circulation, and immobility related care were provided most frequently. The cost of home care nursing per visit was also suggested. The cost include direct and indirect nursing care, management, and transportation cost. Also, the researchers tried to overcome the limitations of hospital-based home care to provide more accessible, efficient, safe, and stable home care nursing. Therefore, clients were referred from other patients, families, public health care centers, industries, and even hospitals. As a result of this study, several limitations of operation were found. First, it was difficult to manage and communicate with doctor in the emergency situations. Second, there was too much time spent for transportation. This was because they are only five nurses, who cover all of the areas of Seoul and nearby cities. Third, preparation for special care of home care nurses was lacking. Fourth, criteria for the termination of care and the frequency of home visits were ambiguous. Finally, interconnection with home care machinery company was so yely needed. New paragraphs' strategies for solving these problems were suggested. This study will be the basis of community-based home care nursing, and the computerized information delivery system for home care nursing in Korea.

Management of perimenstrual discomfort could be an effective strategy for women's health promotion. This study was designed to develop and test the nursing intervention program for the reduction of the perimenstrual discomfort. The data were collected from a group of 76 female university students(34 in the intervention group, 42 in the control group) during November 20, 1997 and March 10, 1998. Measurements were taken concerning perimenstrual discomfort, self care behavior, and perimenstrual discomfort from both groups, at pre and post intervention. Intervention program involves education, support, counselling, and relaxation training, via individual and group levels over a twelve- week period. Listed are the summarized results: 1. The intervention group had more knowledge concerning perimenstrual discomfort(t=2.290, p=.025), self care behavior(t=3.198, p=.000), and lower perimenstrual discomfort score(t=-4.446, p=.000) than the control group at post intervention. 2. The intervention group showed an enhancement on the knowledge on perimenstural discomfort(t=2.35, p=.025), and decreased the perimenstrual discomfort score(t=-7.36, p=.000). However change of self care behavior was not significant during the intervention. According to this study a developed nursing intervention program is effective for reduction of the perimenstrual discomfort. For a future research, it is necessary that experiments concerning menstruation, and a correlational study of perimensturual discomfort and stress will be performed.

This study was performed to compare the transcultural differences on perimenstrual discomforts, menstrual attitudes and sex role acceptance between Korean and American college students. The subjects, 2557 nursing students were selected from 13 universities all around Korea, and 4 universities in the eastern, western, and middle areas of the United States. The data were collected using the MDQ(Menstrual Distress Questionnaire by Moos), the MAQ(Menstrual Attitude Questionnaire) and the Sex Role Acceptance Scale, the subjects answered the MDQ for three points(premenstrual, menstrual, intermenstrual based on their recollections) between July, 1996 and April, 1997. The findings are as follows : 1. There were significant differences in the age of menarche, duration of menstruation, and menstrual cycle between the Koreans and the Americans. 2. As for sex role acceptance, Americans more frequently denied the traditional female role than did Koreans. 3. There were significant differences between the two groups on five categories of menstrual attitude(menstruation is a phenomena that weakens women physically and psychologically, menstruation is a bothersome phenomena. menstruation is a natural phenomena, and menstruation is a phenomena that does not influence women's behaviors non is expected to). 4, For the menstrual discomfort scores, there were significant differences between the two groups on all six categories of the MDQ(pain, attention deficit, behavioral changes, ANS response, water retention, and negative emotion) for the three points(premenstrual, menstrual, intermenstrual period). 5. The most common complaints for the Korean women were pain during the perimenstrual period and fatigue during the intermenstrual period. In contrast, for the Americans the most common complaint was negative emotions during the perimenstrual period, but less pain than the Koreans, and a similarity to Koreans during the intermenstrual period. 6. Regularity of the menstrual cycle was positively correlated with age of menarche, menstrual cycle, and duration of menstruation. 7. For the interrelationship between of Perimenstrual discomforts, menstrual attitudes, and sex role acceptance, there were significant correlations for both group as follows : First, the MA category "menstruation is a bothering phenomena" was negatively correlated with sex role acceptance, second, the MA category "menstruation is a phenomena that weakens the women physically and psychologically" was positively correlated with the MA category "menstruation onset is a predictable phenomena." For the further research, it is recommended that efficient nursing intervention programs for perimenstrual discomforts, be developed and qualitative re search to demonstrate the cultural differences as the feminism view point be done.