The main purpose of this study was to identify the effects of integrated stress management program on the stress symptoms of psychophysiological patients, especially patients with peptic ulcer. The study employed a quasi -experimental design using two different experiential groups. The samples in the integrated stress management program participated in autogenic training with biofeedback, discussions on effective coping method, cognitive, behavioral, and emotional management. They were also provided with an educational booklet on stress management and an tape on progressive muscle relaxation. Exch session lasted one hour and the program consisted of seven sessions over four weeks. The other group was only given an tape on progressive muscle relaxation. The data were collected from May 20 to september 25, 1996 A total 47 patients from ore university hospital located in Seoul participated, experiment group 1 (integrated stress management training) had 23 subjects and experiment group 2(progressive muscle relaxation training) had 24 subjects. The effects of these programs were measured by the stress symptom scale developed by Kogan(1991) which was translated by Lee(1892) and the healing status of the ulcer evaluated by a physician The data were analyzed using Chi-square test, t-test, ANOVA, repeated measure ANOVA. The result are as follows : 1. The integrated stress management group reported a significantly lower stress symptom score than the group given the progressive muscle relaxation only. 2. The integrated stress management group showed a significantly improved ulcer status as compared to the group given a progressive muscle relaxation only. In conclusion, it was found that the integrated stress management program was more effective in decreasing self-reported stress and physiological symptoms among patients with peptic ulcer as compared to the progressive muscle relaxation group. Based on this finding, the following suggestions can be made. 1. It is necessary to broaden the scope of nursing Practice for psychophysiological patients so nurses can include stress management as part of Patient care. 2. It is necessary to develop stress management Program for other patients whose symptoms are know to be related to stress. 3. It is necessary to replicated this study with a larger sample in different settings.

This study was designed to test relationship between effectiveness of nursing organizations and structural and managerial variables of nursing organizations that are described in the Robbins Organizational theory model. The data were collected through self reported questionnaires from 605 nurses working in, and 782 patients hospitalized in, five tertiary hospitals in seoul. Results showed that according to MANOVA there was a significant difference in nurses job satisfaction and patient satisfaction among the five hospitals. According to cluster analysis of the structural and managerial variables of nursing organizations, the five hospitals were divided into two clusters and there was no significant difference in nurses job satisfaction or patient satisfaction between the two clusters. According to canonical correlation analysis the formalization and centralization of structural variables were shown to be predicting variables for nurses job satisfaction, and the managing job design and managing change of managerial variables were shown to be predicting variables for nurses job satisfaction.

No Abstract available.

The purpose of this study was to identify the level of grief experience, family hardiness and family resource for management after bereavement of a family member. The subjects of this study were 100 family members who had lost a family member from cancer within the past two years. The data was analyzed using the SPSS program for descriptive statistics, t-test, ANOVA, Duncan test, and Pearson correlation. The results were as follows. 1. The mean score for the level of grief was 2.84 +/- 0.66. The mean score for the a family hardiness was 3.08 +/- 0.39. The mean score for the level of family resource management was 2.70 +/- 0.35. 2. The level of grief experience differed according to respondent's age was F=2.95, p=.02, and type of bereavement was t=2.01, p=.04. 3. The level of family hardiness was not significantly different according to respondent's and familial characteristics. 4. The level of family resource management differed according to monthly income of the family (F=3.98, p=.01). 5. There were negative correlations between grief experience and family hardiness (r= -.551, p<.001), grief experience and family resource for management (r=-.351, p<.001). Family hardiness was positively related with family resource for management (r=.709, p<.001). In conclusion, family hardiness and family resource management were identified as important variables that contributed to reduce the grief experience. Therefore, it is important to develop nursing intervention that enhances family hardiness and family resource for management for bereaved family.

Breathing is essential for life and at the same time takes a role as a antidote for stress. In the Orient, it was recognized early that respiration, mind, and body have a relation that is inseparable and therefore proper breathing is so important. However, since the mechanism of therapeutic effect by breathing have not been verified, the treatment has been continued till recent years. From that which originated in the Orient, several techniques in the west have been developed to regulate breathing, and have been applying to the clinical situation and to studies, however scientific studies are still lacking. Recently, relaxed breathing has been used as an efficient strategy for breathing therapy as it has an effect on reducing physiological tension and arousal, and, therefore can be used as a basic technique to control or manage stress. In this study, in order to provide basic information and guidelines for clinical application, which will aid in the application of the theoretical basics of breathing therapy and its technique, a review of the literative was conducted. The findings are as follows: 1. Since proper breathing not only has, physically, the important function in supplying oxygen to the body but also gives a good emotional, or pleasant state of mind, it is the first step in controlling physical and mental health. 2. The basic types of breathing can be classified into two types; 'diaphragmatic breathing(relaxed breathing)' and 'chest breathing(stress breathing)'. In yoga type breathing, there are four kinds of breathing, 'upper breathing', 'mid breathing', 'down breathing', and 'complete breathing'. 3. The theoretical explanation of the positive thera peutic effect of breathing therapy techniques exemplifies good brain function, sufficient air flow through the nasal passages, diaphragmatic movement, light vagal stimulation, CO2 changes and cognitive diversion but in most studies, the hypothesis of CO2 is supported. 4. The technique of breathing is designated with many names according to the muscles and techniques used for breathing, and for control of stress, diaphragmatic breathing(relaxed breathing) is explained as a basic technique best used to manage of stress. 5. The relaxed-breathing includes slow diaphragmatic breathing, breath meditation, nasal breathing, yogic abdominal breathing, Benson's relaxed response, and quiet response.

In the last few years, psychiatric nurse practitioners have shown a growing an interest in community psychosocial rehabiliation, caring for chronic psychiatric patients as case manager in South Korea. The purpose of this study was to evaluate the effectiveness of a community psychiatric rehabilitation nursing program on self-care actively and quality of life and to suggest this program as an effective nursing intervention in a group of chronic home-based psychiatric patients in a poor town. A nonequivalent control group, pretest-posttest design was used . Of the twenty women that started the program, sixteen finished it. The data were analyzed by the Wilcoxon Rank Sum Test. The program included the process of case management which consisted of four phases: the first was an active case finding and pre-test, the second was home visiting and contracted by phone, the third was group activity therapy of 12 sessions, and the fourth phase was terminal and post-test. The effects of the program were assessed by quality of life and self-care activity. The quality of life and the self-care activity, especially, area of nutrition, elimination, dressing, leisure activity, and follow-up clinic visiting showed greater improvement than those of the control group. The results of this study suggest that this program was effective in improving the quality of life of chronic home-based psychiatric patients.

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.

The purpose of this study was to test the effects of a epilepsy education program as a nursing intervention for patients with epilepsy. A quasi treatment research (non equivalent control group pretest-posttest design) was used in this study. The subjects were 40 epilepsy patients visiting an outpatient department of a general hospital in Daegu city(treatment group : 20 patients, control group : 20 patients). The study was carried out from June, 19998 to September, 1998. Data was collected before the education program(pretest), immediately after(posttest 1) and 4 weeks later(posttest 2) and were analyzed with repeated measures ANOVA, t-test, Chi-square test and Pearson correlation coefficient. The results are as follows : There was a significant difference in epilepsy self efficacy between two groups(F=26.27, p=.000). There was a significant difference according to pretest, posttest 1 and posttest 2(F=111.20, p=.000), and interaction effect between treatment and time(F=109.42, p=.000). There was a significant difference in epilepsy self management between two groups(F=78.02, p=.000). There was a significant difference according to pretest, posttest 1 and posttest 2 test(F=94.02, p=.000), and interaction effect between treatment and time(F=88.14, p=.000). There was a significant correlation(r=.76, p=.000) between epilepsy self efficacy and epilepsy self management. These results suggest that a epilepsy education program is effective in promoting self efficacy and self management of the patient with epilepsy. Thus this program can be recommended as an effective nursing intervention for the epilepsy patients.

Postpartu depression is one of the most serious problems in maternal health because it affects not only the mother but also her family. Postpartum depression disturbs maternal-infant interaction and attachment. However, most postpartum depression patients ignore this problem and do not seek treatment. Thus this study in conducted to development of a Home-Based Multimedia Tutoring System for postpartum depression management. With this computerized system, mothers in the postpartum periods can check the level of postpartum depression using a personal computer. This system will go through each mother's data and screen those who have abnormal values. In addition this system includes intervention programs-education for nutrition, hygiene care, sleep, postpartum exercise, methods of relaxation, deep breathing, visualization, music therapy and family therapy-to relieve postpartum depression. Using this system, a mother who has a minor level of depression can manage it by herself. Computer language used in this study were html 3.2 OS used was Microsoftware Ni Server 4.0, the graphic tool was Adobe Photoshop 4.0, and the Webpage tool was Notepade. The results of this study are show at internet "URL : Http://203.241.225.42/". Finally, the author suggests that this system could be adequately applied to assessing postpartum depression and as a intervention strategy for mothers during the postpartum period. Further this study contributes to designing an appropriate postpartum depression prevention strategy.

The two objectives of this study were 1) to develop an educational program based on the Self-Efficacy Theory(SET) of Bandura, and 2) to investigate the effects of the educational program on the management of menopause. The investigation process of this study was done in two phases. The first phase was to development an educational program through video tape. A telephone coaching program served as a follow-up to the educational video program and provided encouragement and support to the subjects. The second phase was the experimental stage. This experimentation was conducted to determine whether an educational program based on theory of Bandura would increase self-efficacy and management of menopause. RESULTS: The developed video consisted of 2 parts. Part one discussed symptoms and management of menopause. Part two reflected the vicarious step-by-step success of middle-aged women's of menopause through the effective use of the 5 factors mentioned above. Telephone coaching program served as a followed to the educational video program and provided encouragement and support to the subjects. Total length of video is 32 minutes. Hypothesis stated in phase two were supported by the following result. Experimental group increased general-self-efficacy scores. Experimental group increased concrete-self-efficacy scores. Experimental group increased objective and subjective management of menopause scale.

The various and serious types of disaster occur everyday and everywhere on the earth. There is no doubt that it is very timely to discuss about the effectiveness and preparedness of disaster. The purpose of this study is to develop a curriculum on the disaster management through reviewing disaster concepts and the disaster management system. For the empirical relevance of the study, researchers participated in a couple or more disaster training program, reviewed references, and consulted to the experts working on action parts in the area. As a result, the 'Integrated Disaster Management System Model(IDMSM)' was designed, in which four dimensions were explained. Then the 'Disaster Curriculum Model(DCM)' was explored with its theoretical framework based on the system model. The developed curriculum is composed of four levels ; the introductory course, the fundamental course, the advanced course, and the expert course. From this DCM, basically the course-outlines of two subjects in the introductory course, 18 subjects in the fundamental course(5 of direct services, 13 of indirect services) were developed. Also each course-outline was explored by its course objective, learning objectives, contents, and its length. Finally to make the most of the results, suggestions are proposed. The governmental considerations on the policy should support the systematic and integrated educational program to practice, appointing [Disaster School] or [Disaster Training Center] of relevance and accountabilities. The further study should explore the higher levels of the DCM through interdisciplinary efforts, and develop the text materials. The further study should explore the higher levels of the DCM through interdisciplinary efforts, and develop the text materials.

The purpose of this study was to develop a critical pathway for case management for patients who have received Coronary Artery Bypass Graft(CABG) because of Ischemic Heart Disease(IHD) which is a factor of rising medical expenses. For this study, a conceptual framework was developed through a review of the literature including six critical pathways which are currently being used in USA. In order to identify the overall service contents required by these patients and to draw up a preliminary critical pathway, 30 cases of medical records of patients who had CABG because of IHD between January, 1995 to June, 1996 at the Cardiovascular Center of Yonsei Medical Center in Seoul were analyzed. An expert validity test was done for the preliminary critical pathway and clinical validity test was also done using seven IHD patients with CABG between November 11 and 23, 1996. After these processes, the final critical pathway was developed. The results of this study are summarized as follows : 1. The vertical axis of the critical pathway includes the following eight items, nutrition medications, consultations, activity, assessments, treatments, education discharge planning and the horizontal axis includes the time from the start of hospitalization to discharge. 2. Analysis of the 30 medical records indicated that the average length of stay was 20.2 days with the average length of stay from hospitalization day to operation day being 6.2 days, and the average length of stay from operation day to discharge day was 13.9 days. Analysis of the service contents showed that the horizontal axis of the preliminary critical pathway was set from hospitalization to the 14th post operation day and the vertical axis was set to include eight items, the contents which ought to have occurred, according to the time frames of the horizontal axis. 3. As a result of the experts validity, it was found the among the total of 571 items, there was over 83% agreement for 482 items, less than 83% for 89 items, which were then deleted and a revision of the critical pathway was done. 4. A clinical validity test was done using seven, IHD patients with CABG. During the process, three patients were deleted because they were out of the criteria the investigator set. Finally, four patients were used. The result of study indicated that only one patient was discharged on the tenth post operation day. which was one day later than the expected day. Three patients were discharged later than the expected day from three days to nine days. All the cases progressed on schedule until the operation day and the first post operation day. but from the second post operation days, there were differences between the critical pathway and the actual practice. The differences came from tests, assessments, and treatments. 5. On the basis of the results of the clinical validity test, the following revisions in the final critical pathway were made : the transfer from ICU to step down ward would be the second post operation day, and the transfer to a general ward, the fifth post operation day, for patients who complained of lack of sleep from the fifth post operation day to discharge, a sleeping pill would be prescribed, skin observations would be performed routinely from immediately after the operation until the third post operation day, and would continue if there was a sign of skin injury on the fourth post operation day, and assessment of chest pain would be done from the third post operation day, and the "stairs climbing" item, expected to be done on the ninth post operation day would be deleted. In conclusion, this critical pathway is partially applicable to the care of patients with CABG but there are some parts needed to be further investigated.

PURPOSE: This study was done to develop and examine the effects of a self-management program (SMP) on physical, psychological functions, and symptoms in patients with Parkinson's disease(PD). METHODS: In a two-group pre-and post-test design, a total of 40 patients were assigned to the experimental group(21) or the control group (19). The experimental group received eight weekly 2-hour sessions for 10-15 literate adults of all ages, while the control group did not receive any intervention. RESULTS: The experimental group showed significant improvements in muscle strength, balance, self-efficacy, depression, quality of life(QL), quality of sleep, and discomfort of constipation. It also reduced the number of participants using assistive walking devices. There were no significant changes in fear of falling and duration of sleep. CONCLUSION: The eight week SMP in patients with PD was found to be significantly effective in enhancing muscle strength, balance, self-efficacy, QL, and quality of sleep. It also decreased depression, discomfort of constipation, and assistive walking devices. These results suggest that a SMP can have effects on physical, psychological functions and symptoms in patients with PD. Further research with a larger sample and for a longer follow up period is needed to expand our understanding of the effects of a SMP for patients with PD.