The purpose of this study was to examine the relationship between self-esteem and quality of life(QOL) and between coping type and quality of life (QOL) in mothers of handicapped children and further to identify the level of self-esteem and quality of life of the subjects. The subjects of this study were the 51 mothers of handicapped children who were registered in two special schools in Taejon. The data were collected using a questionnaire and the period of the data collection was from April 18th to May 26th, 1997. The instruments for this study were Resenberg's self-esteem scale, Folkman and Lazarus's Ways of Coping Checklist(WCC) and the quality of life scale designed by Ro, You Ja. The results were analyzed using SPSS/PC+. Data analysis included the descriptive correlational statistics of ANOVA, Pearson Correlational Coefficient, and t-test. The results are as follows : 1. The level of self-esteem showed a mean score 34.51 and the level of QOL, a mean score 137.55. An Active type of coping was used more often than a passive one. 2. The level of self-esteem differed according to monthly income and was significantly higher in mothers of children with acquired handicaps than those of children with congenital handicaps. The level of QOL differed according to monthly income. 3. There was positive correlation between health status and self-esteem(r=.355, p<.05), and between health status and QOL(r=.367, p<.01). 4. Test for hypothesis ; Hypothesis 1, "The higher the level of self-esteem in mothers of handicapped children, the higher their level of quality of life will be." was supported(r=.755, p<.001). Hypothesis 2, "The QOL level for the active coping group as compared to the passive coping group will be higher." was not supported.

The purpose of this study was to identify how internal and external coping resources influenced active coping in the process of stress-coping. The model was established theoretically by comparing and integrating the following theories : Stress-Coping, Self-Care, and Resourcefulness. The subjects consisted of sixty eight patients undergoing chemotherapy(experimental group 34, control group 34) at two general hospitals from January to July, 1995, The results were as follows : After self-care education, the active coping score of the experimental group was significantly higher than that of the control group. The active coping score of the high resourcefulness group was significantly higher than that of the low resourcefulness group. The interaction effect between self-care education and resourcfulness was not significant statistically. Specifically as to such scores of seeking social support, problem-oriented strategy and self care behavior, there were significantly higher in the experimental group and high resourcefulness group than in each of the other groups. Considering them both, self-care education and resourcefulness are effective nursing strategies to promote active coping including self-care. Consequently, the synthesis and testing of theories of stress-coping, self-care, and resoucefulness in this study are mostly proven to enhance the explanation and prediction of the change of active coping including self-care. Therefore the result of this study will contribute in the development of practice theory of nursing. A further study is necessary to reevaluate the interaction effect between self-care education and resourcefulness and to identify the difference between resourcefulness and self-efficacy.

This study examined the effects of group social support on the reduction of burden and increase in well-being of mothers of developmentally delayed children. The research used a one group pre-post experimental design. The independent variable in the experiment was group social support. Two series of 4-weekly meetings for group social support were conducted by the researcher with the intention of developing a self-help group. The dependent variables were burden and well-being. Well-being was operationalized as physical symptoms and quality of life. Thirty mothers of developmentally delayed infants from the rehabilitation center of a medical center participated in the study. Data were collected by interview and a self-administered questionnaire. The mean age of the subjects was 29.9 years. Changes of the dependent variables between pre and post tests were compared using the t-test. Even though there was a slight improvement in the scores for the dependent variables, they were not statistically significant. The items, "I resent my baby", "I feel angry about my interactions with my baby", "I feel guilty in my relationship with my baby" showed a significant decrease in burden score and were statistically significant. Symptoms of loneliness, constipation, anxiety, restlessness were less and feeling of happiness was greater after participation in the group social support, than on the pretest. The mothers showed emotional instability and frustrations during the group sessions but their reactions in general were positive. Emotional support, stress management and information provided were identified as the most valuable content of the sessions. However, participation was not active due to the mother's denial, delayed acceptance and/or avoidance of their infants' problems. It can be seen that group social support for the mothers with developmentally delayed children should be provided after infancy when the mothers have time to accept their children's conditions and are ready to receive support. The use of comprehensive instruments which measure burden in both families and mothers needs to be developed for future research.

Stomatitis is a common toxicity associated with the administration of certain cancer chemoth-erapeutic agents used in the treatment of malignant tumors. It represents one of the most distressing side effects of cancer chemotherapy and can interfere with the patient's ability to eat, be the cause of much pain and discomfort, and require the use of potent analgesics. The situation also creates favorable conditions for local infection which may lead to septicemia. Several authors have identified the need to estabilish protocols for the control and treatment of the oral discomfort associated with oral mucositis as a result of chemotherapy. Thus this study attempted to development of oral care protocol for chemotherapy patients. The effects of the mouth care using sterile normal saline, nystatine solution on oral stomatitis were investigated in 30 patients on chemotherapy. The subject were devided into three groups; control group: not gargling experimental group A: normal saline gargling (4 times a day) experimental group B: nystatine solution gar-gling(4 times a day) The Oral Assessment Guide (OAG) was used to assess oral status three times (once in the prechemotherapy period, on 5th, 10th day of post chemotherapy) Oral culture was used to assess oral infection on 5th day of postchemotherapy. Data was analyzed on SAS program which used repeated ANOVA, t-test, X2 test. The results are as follows; 1. The incidence of stomatitis was higher in the control group and experimental group A than in experimental group B. (X2=0.002 P=0.001) 2. The grade of stomatitis (mean of total score) for patients in the experimental group B were significantly lower than in the experimental group A (F=1.96 P=0.0024). 3. In incidence of tougue change, control group, experimental group B were significantly higher than experimental group B(F=6.84 P=0.0039). 4. In control group and experimental group A, oral infection due to pathogenic bacteria were identified. In conclusion, mouth care with nystatine solution four times a day could reduce the incidence of stomatitis and secondary oral infection due to stomatitis. Thus active mouth care protocol which used to nystatine solution gargling need to prevention of stomatitis in chemotherapy patients.

PURPOSE: This study is attempts to clarify the effect of infant massage for the promotion of primipara's mother-infant interaction METHOD: The term for collecting data for experimental group ranged from April 25, 2001 to June 5, 2001. The infants for this group were sampled among normal mother-infant from one postpartum care center located in J city. The term for collecting data for control group ranged from June 10, 2001 to August 3, 2001. The infants for this group were sampled among normal mothers infant from 1 general hospital, 1 university hospital and 1 postpartum care center located in J city. The experiment was implemented giving primipara education about massage based on protocol for infant massage provided by Johnson and Johnson Korea and they received 10 days of education, 10 minutes a day (from 10 to 11 a.m) In the post test, we videotaped both the control group and the experimental group visiting their homes 4 weeks after delivery to observe mother-infant play interaction. Data analysis was done using SAS and the homogeneity between general properties owned by both control group and experimental group and mother's perception scale for children was verified through x2-test. Mother-infant play interaction with both control group and experimental group was analyzed through t-test in the experiment. And analysis of mother-infant interaction points based on general properties was made using ANOVA and t-test. RESULT: Hypothesis that mother-infant play interaction with primipara who gave her infant a massage will be more active than that of the primipara who didn't was verified (t=-4.27, p=.0001). And the points in each item, points in each item were estimated as follows. Mother behavioral items (t=-4.96, p=.0001), infant behavioral item (t=-0.36, p=.71), mother-infant interaction reciprocity (t=-2.64, p=.01). CONCLUSION: An infant massage program can contribute to promoting the Mother-Infant Play Interaction positively.

PURPOSE: This study aimed to identify the change patterns of fatigue and quality of life during consecutive chemotherapies and to determine the relationship of these two variables. METHOD: Stomach cancer patients receiving chemotherapy were recruited from a university hospital in Seoul. Each chemotherapy, subjects were asked to respond to the questionnaires regarding their fatigue and quality of life. The number of subjects who completed 4 cycles and over was 11. Fatigue was measured with Lee's tool(1999). Quality of life was measured with a tool revised by the author based on Padilla et al(1983). RESULT: Most patients were in 1st stage(5 patients) or 3rd stage(5 patients). Fatigue was revealed at its highest level in the 3rd or 4th chemotherapy and at its lowest level in the 1st or 6th chemotherapy. A quality of life appeared at its highest level in the 5th or 6th chemotherapy and the lowest level in 3rd or 4th chemotherapy. CONCLUSION: Among 6 cycles of chemotherapy, in 3-4th chemotherapy the fatigue was the highest and the quality of life were the lowest. Many patients decided to stop treatment at the same period. Therefore we can recognize cancer patients receiving chemo- therapy are in the highest risk at the time of the 3-4 th chemotherapy.

PURPOSE: The purpose of this study was to determine the changing patterns of nausea, vomiting, anorexia and calorie intake. To examine the influence of those variables on the nutritional status of the cancer patients receiving chemotherapy.
METHOD
To assess nutritional status, anthropometry and blood test were performed on 94 stomach cancer patients receiving postoperational chemotherapy on the daily basis. NVA and calorie intake were measured during chemotherapy.
RESULT
93% of subjects had low level of hemoglobin and 45.7% was below the lymphocyte count. 57% of subjects lost 10% of usual weight. The value of anthropometry was reduced but the difference between pre- and post-chemotherapy did not reach any statistical significance. 27% of subjects was grouped into the malnutritional state. During chemotherapy, the higher the degree of NVA, the less calorie intake. The significant predictors for nutritional status were nausea and calorie intake.
CONCLUSION
The chemotherapy affected the food intake of cancer patients through NVA. Though the influence of chemotherapy on anthropopmetry was not significant in this research, nausea and food intake were the most affecting factors for nutrition of cancer patients. Therefore we need to assess nutritional status and support for cancer patients receiving chemotherapy and to develop an intervention for improvement of symptoms and food intake.

PURPOSE: This study was conducted to evaluate the effectiveness of the maternal role education program for primiparas in mother-infant interaction, childrearing environ- ment, and infant development. METHOD: A Non-equivalent control group time-series design was used. For the intervention group, programmed parenting education focusing on mother-infant interaction, home environment for infant development, and parent counseling and support was provided via home visits or telephone for twelve months.
RESULT
Significant differences were found in the mother-infant interaction feeding scale at one and three months, but no differences were found in the teaching scale at six and twelve months between the intervention and control groups. Also, the difference in childrearing environment (HOME) between the two groups was significant at three, six, twelve months. In addition, the intervention group showed higher GQ in the Griffiths mental development scale at three and six months. In multiple regression analysis, 22.6% to 43.6% of infant development was explained by HOME, mother-infant interaction, and previous development. CONCLUSION: The maternal role education program proved to be effective in promoting mother-infant interaction, organizing the childrearing environment, and fostering infant development.

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.

This study was conducted to evaluate the effects of the program for the autistic children which was designed to promote mother-child attachment. The subjects of this study were consisted of 11 pairs of mother and child( 7 for participant group:PG, 4 for non-participant group: NPG), who were diagnosed as Pervasive Developmental Disorder. The intervention was consisted with play activity centered mother-child interaction, educational activity for mothers, lecture, video-feedback, and supports. The main data were collected by video-taping and analyzed by Wilcoxon Rank Sign Test, and Content Analysis. The results obtained were as follows, 1. Before the program, there were no significant group differences on the children's and the mother's characteristics. After the program, total score on the attachment of PG was higher than that of NPG, but not significant. Only proximity-seeking behaviors and contact-maintaining behaviors were higher significantly(p<.05). Then the characteristics on contact- maintaining behaviors of PG were lasting longer and reciprocal than those of NPG. 2. After the program, the score on mother's nurturing behavior of PG was significantly more increased. The mother's behaviors to her child of PG became more child- centered, positively responsive, expressive supportively. But there were pretty big individual difference. It can be concluded that Mother-child Attachment Promotion Program is effective. Thus it can be recommended to be a early intervention model for autistic children.

The purpose of this study was to investigate the educational needs of a mother when nurturing children from neonates to the schoolage. A total of 657 subjects responded to the survey about the level of educational needs when nurturing children. The subjects of the study constituted of 401 mothers who visited the health center for immunization and 256 mothers who visited the pediatric outpatient department or whose children were hospitalized in pediatrics. This instrument had 64 items about nurturing children from neonates to the schoolage and one item had a score range of one to four. In data analysis, SPSSWIN 9.0 program was utilized for descriptive statistics. The results were as follows. 1) Mothers who had the neonates represented the highest educational needs about parental-neonates attachments with 3.47 of mean score compared to neonatal convulsion(3.44), management of common colds(3.44), nutrition(3.44), fever control (3.42). 2) Mothers who had infancy represented the highest educational needs about management of common colds with 3.34 of mean score compared to psychosocial developments (3.23), management of foreign bodies (3.22), feeding the food(3.19), playing with the infant(3.16). 3) Mothers who had toddlers represented the highest educational needs about psychosocial developments with 3.35 of mean score compared to discipline for children(3.34), management of teeth (3.29), management of common colds (3.21), management of accidents(3.20). 4) Mothers who had the a child in preschool represented the highest educational needs about psychosocial developments with 3.53 of mean score compared to management of accidents(3.23), discipline for children (3.00). 5) Mothers who had the child in secondary school represented the highest educational needs about psychosocial developments with 3.42 of mean score compared to management of teeth(3.13), management of accidents (3.05).

Malnutrition is a common problem in cancer patients. In addition anticancer drugs used in chemotherapy as a major therapeutic mode are famous as the side effect like nausea, vomiting, which lead the patients to malnourished state. This study was to determine the relationship of anorexia, nausea, vomiting and oral intake and identify the influence these side effects on the nutritional status in patients receiving chemotherapy. To assess the nutritional status, anthropometry such as weight, height, body mass index(BMI), body fat proportion, and triceps skinfold thickness, and biochemistry test such as hemoglobin and lymphocyte were measured at the pre- and post- chemotherapy and the readmission time, all three times. During chemotherapy, anorexia, nausea, and vomiting using a VAS or 5-point scale and 24 hour oral intake using a food record were measured daily. Forty-nine patients knowing their diagnosis and receiving chemotherapy were recruited from an oncological ward in a general hospital for 5 months and they were reduced 31 at readmission time for a next chemotherapy. The results were as follows. Most subjects (93.6%) were in the 4th stage of cancer and 57.1% of subjects were in the first or the second chemotherapy. In most subjects(82.6%), their weight was decreased 10.7% than as usual. The degree of anorexia, nausea, and vomiting was significantly higher and the amount of oral intake was significantly less during the chemotherapy than at the pre-chemotherapy. Weight, BMI, triceps skinfold were reduced more at the post- chemotherapy than the pre-chemotherapy and were recovered the nearly same but less level at the readmission time. Body fat proportion was increased at the post chemotherapy and then decreased at the readmission phase. Hemoglobin and the number of lymphocyte were below normal at the pre-chemotherapy and more reduced at the readmission time. Anorexia, nausea, and vomiting were related positively and oral intake was negatively related with nausea and vomiting. The nutritional status at the post- chemotherapy and the readmission time was explained 20% over by the side effect like anorexia, nausea, vomiting and oral intake during the chemotherapy. The significant nutrition predictors at the post- chemotherapy were vomiting and the significant predictors at the readmission time were anorexia, vomiting, and oral intake. These results indicated the patients receiving chemotherapy were continued to deteriorate the nutritional status. Therefore nurse should have knowledge how much the nutritional status can be affected and assess the nutritional status periodically and try to find out the intervention for side effects from the series of chemotherapies.

Mother and infant relationship has a great influence on child's developments. In this study, nursing intervention to increase maternal sensitivity to the infant's cues was applied to 25 primiparas (Experimental Group). Mother and infant interacations of these primiparas were compared with those of 25 primiparas (Control Group) who did not receive the nursing intervention. Fifty primiparas and infants were recruited from a university hospital, a general hospital, and an OBGY clinic located in Taegu city. Mother and infant interactions were assessed at 6 weeks after birth using videotapes. Feeding situations were videotaped and two trained observers analyzed the tapes. Data were collected from March 23rd to July 27th of 1998. Mother and infant interactions during feeding were assessed by the response rating scale which was modified by the author based on NCAST feeding scale (Barnard, 1978a) and AMIS scale (Price, 1983). The validity of the modified rating scale was verified by faculty members and researchers who previously had research experience in the area. Cronbach's Alpha of the modified scale for this study was .90. The data was analyzed by SAS program, using wilcoxon rank sums test, chi square test, Fisher's exact test, and ANOVA. Findings were as follows: 1. Mothers in the experimental group were more likely to have higher scores in mother and infant interactions during feeding than mothers in the control group. 2. Mothers in the experimental group showed better sensitivity to infant's signals or cues, provided growth fostering, and had higher responsibility to the infant's distress than mothers in the control group. 3. Infants in the experimental group showed higher clarity of cues and responsibility to the mother's behaviors than infants in the control group. 4. Mothers and infants in the experimental group showed higher synchronic responses than mothers and infants in the control group. In conclusion, this study has shown that the applied nursing intervention promoted mother and infant interaction among primiparas. Therefore, this study suggests that the nursing interventions to increase maternal sensitivity to the infant's cues should be broadly applied to primiparas, which can be beneficial to the social, affective, and cognitive developments of their children.

Accidents are the leading cause of death in children worldwide. The purpose of this study is to use basic data of safety education, counseling, and information available regarding accident prevention to examine the degree of mother's accident prevention practices for their children. Data were collected from June to October, 1998 from 587 mothers including 2 University hospitals located in Seoul and KyoungKi-Do. By using the 30 item questionnaire, which was created by researchers through literature review, the degree of mothers' accident prevention practices for their children was measured. The degree of accident prevention practices of mothers shown ranged 70-118 and averaged 3.19. Compared to the composit area average score, drug keeping had the highest score of 3.57. The next highest scores and traffic safety(3.41), and super vision of child(3.30). Prevention against burning was the lowest point at 2.58. With the respect to the demographic characteristics, there were statistically significant differences in the mothers' education(F=4.291, p=.014), type of residence(F=3.979, p=.008), and child developmental age(F=5.275, p=.001). The degree of accident prevention practices of mothers were relatively high. But the area which showed the low degree of accident prevention practices, required nurses' active education, counseling, social interest and support, and mass media participation.

The purpose of this study was to evaluate maternal perception of the newborn, confidence and gratification of mothering role, and contribute to maternal nursing and neonatal nursing. The questionnaire, maternal perception of the newborn(I) was completed by 47 mothers at three hospitals in the Kyoung-In area during the first to third day after birth. the questionnaire, maternal perception of the newborn(II), confidence and gratification of mothering role were completed at fourth to sixth week after birth. the data were analyzed by a SPSS program. The results were as follows; 1) The means of perception of the newborn(I) and (II) were 2.28+/-4.81 and 3.83+/-4.84. The means of confidence and gratification of mothering role were 40.38+/-5.51 and 39.30+/-6.70. 2) Half of the mothers(48.9%) rated their newborn as better than average newborn at first to third day after birth, and 74.5% of mothers did at fourth to sixth week after birth. 3) The score of maternal perception of the newborn(I) was significantly correlated with the score of confidence and gratification of mothering role. The score of maternal perception of the newborn(II) was correlated with the score of confidence and gratification of mothering role. The score of confidence and gratification of mothering role was related. 4) Maternal gratification of mothering role was significantly different by maternal perception of the newborn(I), and maternal confidence was different by maternal perception of the newborn(II). 5) Mothers who had religions and who wanted the pregnancy had higher perception of the new-born(I) than those who did not. Mothers whose newborn(II) than those whose newborns were girls. Mothers who wanted the pregnancy had higher confidence of mothering role than those who did not. Mothers who planed cow's milk had lower gratification of mothering role than those who did not. The above findings indicate that mothers who have a different level of perception of the newborn, confidence and gratification of mothering role. Therefore, it is important maternal perception of the newborn, confidence and gratification of mothering role were precisely evaluated, and nursing intervention for improving perception of the newborn should be provided of for mothers.

This study is to define the caring experience of mothers with insulin-dependent diabetes mellitus children, by finding core category, contextual factors, intervening factors, and the patterns of caring, and to develop a practice theory on it. Research method followed grounded theory methodology by Strauss and Corbin. Subjects were six mothers, whose children have had insulin-dependent diabetes mellitus for 4 months to 14 years by the interview time. They were selected by theoretical sampling. Data were collected from September, 1995 to January, 1996. Interview were done by long interview took 50 minutes to 2 hours. Content of interview was recorded and transcribed later. Based on the results of previous interview, content of next interview was planned until data reached to the saturation point. Results were as follows : One hundred and forty concepts were found. These concepts were grouped into thirty-three categories, and then to ten categories. Mothers with diabetic child were revealed to face "being overwhelmed by burden". Overwhelming by burden is found to be progressed through the cycle production-coping-decrease or in crease process. Mothers showed four patterns of adaptation in caring the diabetic children. 1) If mothers felt large amount of overwhelming by burden because of difficulty of caring and unsympathizing but they had sufficient support, no condition of the child, and their coping mechanism was positive, most of them overcome with strong will, but some fell into burnout. 2) If mothers felt large amount of overwhelming by burden because of difficulty of caring, unsympathizing, insufficient support, serious condition of the child, and their coping mechanism was negative, they fell into burnout by coping with feeling. 3) In mothers felt small amount of overwhelming by burden because of little difficulty of caring and sympathizing, sufficient support, no serious condition of the child, but their coping was negative, most of them fell into burnout by coping with feeling, but some overcome. 4) If mothers felt small amount of overwhelming by burden because of little difficulty of caring and unsympathizing, sufficient support, no serious condition of the child, and their coping was positive, they overcome with strong will. On the basis of the above result, in order to help mothers take good care of their children, nursing assesment and intervention on life readjustment, and getting support should be required. Especially, through understanding mothers' personalities, individual support consistent with each of them should be required. Therefore education, counseling, mutual support and exchange of information will have to be accomplished.

PURPOSE: This qualitative study aimed to identify the common, lived experiences of grandmothers who cared for their grandchildren as the primary caregivers. METHODS: This study was based on the phenomenological method described by Colaizzi (1978). RESULTS: Seven theme clusters emerged from the data as follows: "grandmother caregivers accept the parenting role of the incessant responsibilities and the distrust of non-kin caregivers.", "grandmother caregivers have a double maternal roles; an instrument-oriented maternal role to their own child and relationship-oriented maternal role to their grandchild.", "grandmother caregivers are partially authorized to make decisions in the matters of their grandchild.", "grandmother caregivers suffer a deterioration in their health by an acceleration of the aging process.", "caregiving causes grandmother caregivers to feel a sense of social isolation, and persue various coping strategies to control this feeling.", "grandmother caregivers have a greater feeling of self-esteem, but they often conflict with their adult children if they don't feel appreciated by them.", "grandmother caregivers have limited social support and their health issues are often overlooked in the family context." CONCLUSION: The results of this study can guide nurses and health care workers to understand the experiences of grandmother caregivers and to implement individualized nursing interventions suited for them.