The study was carried out to measure the degree of work stress among clinical nurses, and to identify factors influencing the work stress. Data was collected from 215 staff nurses working in the Seoul National University Hospital from the end of February to first of march, 1984. The results and suggestion of study were: 1. Nurses perception of work stress. 1) Mean score of total work stress of nurses was 4.467, when maximum score was 6. High degree of work stress is evident among nurses. 2) The highest rank of stress factor was interpersonal relationship with physicians, night duty, heavy work load, inadequate working condition and payment were other stress factors. 2. Relationships between situational variables and degree of stress. There was significant correlation-ship between nurse's total work stress score and educational levels (r=0.153, P=0.032)

The purpose of this study is to propose the baseline data for developing the stress measurement tool for staff nurses working in the hospital. Two hundred and fifteen staff nurses in Seoul National University Hospital were participated during the period from Feb. 28 to Mar. 10, 1984. Though the pretest and literature review a questionnaire was constructed with 63 stressors which were experienced by the nurses in the hospital. Subjects were given instruction to rate 1~6 likert type scale according to the level of stress experienced by each stressor described. Reliability of the tool was tested by Cronbach's Alpha, and the result was alpha=0.94871. Factor analysis was applied to organize 63 items together As the result, 15 factors were obtained and these factors explained 66.3% of variance. The 15 factors were: 1) Work overload 2) Role conflict as a profession 3) Lack of professional knowledge and skill 4) Interpersonal problem 5) Conflict in nurse-doctor relationship 6) Work conflict with doctors 7) Emotional burden due to the limitation of medicine 8) Poor treatment 9) Unsatisfactory relationship with supervisor 10) Low reward 11) Unsatisfactory relationship with subordinate 12) Poor physical environment of unit 13) Responsibility for extra affairs 14) Unfamiliar situation 15) Night duty.

This study was done to investigate the changes in the quality of life(QOL) of patients who received radiation therapy after surgery for breast cancer. For this purpose, 35 patients were interviewed using a questionnaire. They were followed over 8 month period from the beginning of radiation therapy. Changes in the QOL, side effect of the RT(radiation therapy), depression were measured. The results can be summarized as follows: 1. The mean score of the side effect of RT increased significantly over the period of RT. When the RT was completed, the QOL score was the lowest, and the depression score was the highest, but the changes of these scores were not statistically significant. 2. When the 6-week RT was finished, the QOL was significantly correlated with QOL of the beginning of RT, depression at RT completion and age. At three months after the completion of RT, the QOL was significantly correlated with QOL of the beginning of RT, depression and side effect of RT at three months after the completion of RT. At six months after the completion of RT, the QOL was significantly negatively correlated with age. 3. In the stepwise multiple regression analysis, the major influencing variables on the QOL were vairous according to the time lapse after the RT. The QOL at the completion of RT was predicted by the QOL at the beginning of RT, depression at the completion of RT and age. The QOL at three months after the completion of RT was predicted by the QOL at the beginning of RT and side effect of RT and depression at three months after the completion of RT. The QOL at six months after the completion of RT was predicted by age. This study suggests that continuous nursing care be required for improving the QOL of breast cancer patients not only during the RT period but also for a long term after the completion of RT.

The purpose of this study was to identify effective methods to minimize increases in intracranial pressure(IICP) during endotracheal suction by means of comparing two methods of hyperventi-lation and oxygen supply before and after endotracheal suction. In order to evaluate the effects of these two methods, the ICP during suctioning and the sustained time of I ICP were measured. For hyperventilation, ambu-bagging was done 10 times for 30 seconds with a tidal volume of 800-900ml. For oxygen supply, 100 percent oxygen was supplied for 2 minutes before and after suction. The subjects for this study were 12 neurosurgical patients who had had a subarachnoid bolt inserted for ICP monitoring and they were all on mechanical ventilatory support in a surgical intensive care unit of Seoul National University Hospital from July 1, 1991 to March 31, 1992. In each patient hyperventilation was performed five times and oxygen supply was given five times and intracranial pressures were measured immediately before and every 30 seconds for 15 minutes after suction. For case assignments counterbalancing and repeated measure designs were combined. And so the total number of experiments were sixty for each group. The effects of hyperventilation and oxygen supply on the IICP and the sustained time of IICP after suction were analyzed by t-test. The results of study were as follows 1. There was a significant difference between the two groups in the increased ICP during suction (t=2.49, p=.014). 2. The sustained time of IICP after suctioning in the oxygen supply group was shorter than that in the hyperventilation group(t=2.35, p=.020) In summary, the Increase in the ICP during suction was lower and the time for the ICP to return to the presuction level was shorter in the oxygen supply group as compared to the hyperventilation group. Therefore, oxygen supply can be recommended before and after endotracheal suction.

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.

No abstract available.

PURPOSE: The purpose of study is to develop a home nursing care project model suitable for Korea's heath care system and policy directions for expansion and establishment of home nursing care. METHOD: The first, status of home nursing care program in medical institution and public health center was evaluated respectively in view of structure, process and performance. And then, issues of the program were analyzed in view of accessibility, safety, and sufficient supply. The second, demand projection of home nursing care according to income level and technical level of service that is needed to the subject was tried. In addition, the level of supply for home nursing care at present was estimated. The third, home nursing care program in advanced countries (Japan and U.S.A.) was examined. RESULT AND CONCLUSION: Community-based home nursing care program is developed into public-operation model and private-operation model from above the sub-subject result. Functional network for referral system among related institutions is built up to meet various needs, regardless of accessibility to distance and economy. And prior settlements and policy directions for expansion and establishment of home nursing care are suggested.

PURPOSE: The purpose of this study was to examine the level of intention to quit smoking and to identify factors influencing intention to quit among patients with coronary heart disease. Method: The subjects consisted of 80 male patients with coronary heart disease (angina pectoris, myocardial infarction) at three hospitals in Seoul. The data were collected with self reporting in a structured questionnaire. Stepwise multiple regression was used to identify predictors of intention to quit. Included variables were attitudes toward smoking cessation, subjective norms, perceived behavioral control, usefulness of smoking cessation, and previous attempts to quit. RESULT: 1. The mean score for intention to quit was 11.1(+/-6.1) which was lower than median score of the scale. 2. There were significant correlations between the all predictive variables and the intention to quit(r=.24-.48, p<.05). 3. usefulness of smoking cessation, perceived behavioral control, and previous attempts to quit explained 34.6% of the variance for intention to quit. CONCLUSION: usefulness of smoking cessation, perceived behavioral control, and previous attempts to quit were identified as important variables in explaining the intention to quit smoking among patients with coronary heart disease. Thus, it is necessary to try to enhance this factors for increasing intention to quit among patients with coronary heart disease.

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.

The purpose of this study was to examine the correlation between self-efficacy and self-care of hemodialysis patients. The subjects consisted of 140 hemodialysis patients who underwent hemodialysis at 2 university hospital. The data were collected by used the self-efficacy tool developed by Kim Ju Hyune(1995) and the self-care tool developed by literature review and indepth open openended questions to 10 patients. Also, the questionnaire in cluded phusiologic data which collected through review of the patients' charts. The statistical analysis was used the SPSS program for frequency, mean, t-test, ANOVA and Pearson correlation. The results were as follows: 1. The mean score for general self-efficacy of hemodialysis patients was 3.103(1-4point) and there were significant differences according to perceived health. The mean score for specific self-efficacy of hemodialysis patients was 3.113 (1-4point) and there were significant differences according to perceived health, side effects and complications which related hemodialysis. 2. The mean score for self-care of hemodialysis patients was 3.822(1-5point) and there were significant differences according to marital status and economic level. 3. The relationship between general self-efficacy and self-care was a positive correlation(P=.000). The relationship between specific self-efficacy and self-care was a positive correlation(P=.000). In conclusion, this study revealed the level of self-efficacy and self-care, and the positive correlation between self-efficacy and self-care on hemodialysis patients. Therefore, intervention is needer to promote self-efficacy for self-care of hemodialysis patients. Considering the vulnerable self-care area same as checking blood pressure and weight, fluid restriction, social adjustment, exercise and rest, further studies should develop self-efficacy promoting programs for self-care of hemodialysis patients.