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Original Articles
Psychosocial Adjustment after Kidney Transplantation
Myungsun Yi
Journal of Korean Academy of Nursing 1998;28(2):291-302.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1998.28.2.291
AbstractAbstract PDF

The purpose of this phenomenological study was to understand and describe the essence and the structure of lived experience of people with kidney transplantation. Initially, nine individual interviews were conducted to gather data regarding their subjective experiences. And two focus group interviews were utilized to validate or discard the themes that were emerged from the analysis using Colaizzi's method. Among 17 participants, 13 had living related kidney donations, one living unrelated, and the remaining two cadavor donations. About 130 significant statements were extracted and these were clustered into 11 themes. All participants felt anxiety and fear toward the rejection of transplantation and the complication of immunosuppressive drugs. Although they were initially satisfied with their life after kidney transplantation most of them lost a self-confidence and experienced loneliness, depression, and despair. Most of the participants also felt guilty for not being able to accomplish their appropriate roles in the family. They also had financial difficulties and social restrictions. However, they overcame these psychosocial distress by exercising, working and sharing love with others. They also could overcome it by living a religious life and by working to help others with kidney transplantations. Most of them felt gratitude toward the donor and did not have a psychological rejection toward the kidney transplanted. The results of the study might help nurses who work with people with kidney transplantations in establishing and implementing an effective nursing intervention by understanding their lived experience.

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Conversation Analysis for Improving Nursing Communication
Myungsun Yi
Journal of Korean Academy of Nursing 2007;37(5):772-780.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2007.37.5.772
AbstractAbstract PDF
Purpose

Nursing communication has become more important than ever before because quality of nursing services largely depends on the quality of communication in a very competitive health care environment. This article was to introduce ways to improve nursing communication using conversation analysis.

Methods

This was a review study on conversation analysis, critically examining previous studies in nursing communication and interpersonal relationships.

Results

This study provided theoretical backgrounds and basic assumptions of conversation analysis which was influenced by ethnomethodology, phenomenology, and sociolinguistic. In addition, the characteristics and analysis methods of conversation analysis were illustrated in detail. Lastly, how conversation analysis could help improve communication was shown, by examining researches using conversation analysis not only for ordinary conversations but also for extraordinary or difficult conversations such as conversations between patients with dementia and their professional nurses.

Conclusion

Conversation analysis can help in improving nursing communication by providing various structures and patterns as well as prototypes of conversation, and by suggesting specific problems and problem-solving strategies in communication.

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Illness Experience of People with Chronic Hepatitis B in Korea
Myungsun Yi, Eun Ok Choi, Seung Woon Paik, Keum Soon Kim, Sangman Kwak, Hwa Jin Lee
Journal of Korean Academy of Nursing 2007;37(5):665-675.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2007.37.5.665
AbstractAbstract PDF
Purpose

The purpose of this study was to explore the experiences of people with chronic hepatitis B (CHB) in Korea. The specific aim was to identify major problems that people with CHB face and strategies that they are dealing with.

Methods

A grounded theory method was utilized. The data were collected by individual in-depth interviews from 12 CHB patients from one of the major hospitals in Korea.

Results

After constant comparative analysis, a core category emerged as “illness management with self-reliance and will.” Seven major strategies that were identified in dealing with the illness were maintaining receptive and positive attitudes; restraining excessive work and greed; searching for information; controlling illness information; adhering to practices for not spreading the viral disease; abstaining from alcohol and smoking and maintaining healthy eating habits; nd using alternative therapies. The outcomes that result from employing these strategies were identified as burden, depression and helplessness, stress for maintaining compliance, and dispirited interpersonal relationships.

Conclusion

The results of this study suggest that most people with CHB in Korea have problems in psychosocial area. Thus health professionals need to provide not only informational support but also emotional one to improve quality of life of the people with CHB.

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Subjective and Objective Caregiver Burden in Parkinson's Disease
Keum Soon Kim, Bog Ja Kim, Kyung Hee Kim, Myoung Ae Choe, Myungsun Yi, Yang Sook Hah, Sun Ju Chung, So Hi Kwon
Journal of Korean Academy of Nursing 2007;37(2):242-248.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2007.37.2.242
AbstractAbstract PDF
Purpose

Parkinson's disease (PD) is a common neurodegenerative disorder characterized by motor disabilities and increasing dependence on others for daily life activities with consequent impact on patients' and caregivers' quality of life. The aim of this study was to elucidate the burden on primary caregivers of patients with PD, and identify related factors.

Methods

A cross-sectional descriptive study. Seventy-six primary caregivers of PD patients in a neurology outpatient clinic, Seoul, Korea completed structured questionnaires, of which 68 were analyzed. The structured self-report questionnaire included (1) demographic information on the caregivers, (2) information regarding the disease characteristics of the patients, and (3) the subjective and objective caregiver burdens as assessed on Montgomery, Gonyea, & Hooyman's scale.

Results

The mean age of the caregivers was 54.56 years, and spouses represented the largest proportion(47.0%). Caregivers of PD patients experienced high levels of burden (mean scores on the subjective and objective burdens were 45.22 and 34.90, respectively), which were comparable to the caregiver burdens in stroke, and higher than the caregiver burdens in general chronic disease. Older caregivers and spousal caregivers experienced significantly higher burdens (p=.004 and p=.019, respectively). A greater motor disability and higher modified Hoehn and Yahr grade were related to higher caregiver burden (p=.001 and p=.018, respectively).

Conclusion

Caring for PD patients is associated with a high level of caregiver burden. Therefore, healthcare professionals should identify the burden of caregivers who look after PD patients and develop comprehensive management strategies both for patients and their caregivers.

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Feminism in Nursing Science in Korea
Myungsun Yi
Journal of Korean Academy of Nursing 2005;35(5):914-923.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2005.35.5.914
AbstractAbstract PDF
Purpose

Although feminism has been actively discussed and applied to nursing in Western societies since the 1980s, it is little known among Korean scholars as well as Korean nurses. This article explores the use of feminist perspectives in nursing science in other developed countries and suggests how feminism could be applied to nursing science in Korea.

Method

The literature related to nursing and feminism were reviewed in terms of nursing practice, education, and research.

Result

This article describes what feminism is and how feminism and nursing have evolved historically over time in other countries, especially in Western societies. In addition, it discusses how it can be applied to nursing practice, education, and research in Korea.

Conclusion

Accepting feminist perspective in Korean nursing could benefit in empowering nurses by valuing nursing, by raising self-esteem of nurses, and by raising the consciousness of socio-political realities. Eventually it could benefit in changing and developing nursing science in Korea.

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Experience of Gastric Cancer Survivors and their Spouses in Korea: Secondary Analysis
Myungsun Yi, David Kahn
Journal of Korean Academy of Nursing 2004;34(4):625-635.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2004.34.4.625
AbstractAbstract PDF
Purpose

The purpose of this study was to explore the experiences of gastric cancer couples in Korea and to generate a substantive theory integrating the experiences of gastric cancer survivors and their spouses as a whole. The specific aims of this study were to explore major problems gastric cancer couples faced and how they resolved these problems, focusing on inter-relational dynamics within the couples and on similarities and differences between the couples.

Methods

This was a secondary analysis study using grounded theory techniques. The study used the data of 11 married couples which was collected from in-depth interviews from two primary studies. The unit of analysis was dyads of gastric cancer survivors and their spouses.

Results

The basic social psychological process that emerged from the analysis was “taking charge of their health.” Major categories involved in this process were identified as 1) adjusting to new diets, 2) reinforcing physical strength, 3) seeking information, 4) strengthening Ki, 5) lowering life-expectations, and 6) going their separate ways. These six categories represent major strategies in overcoming critical problems that occurred in day-to-day experiences. In terms of the process, the first five categories characterize the earlier stage of the process of “taking charge of their health,” while “going their separate ways” indicates the later stage and also the beginning of their separate ways: “pursuing spiritual life” for the survivors, and “preparing for the future” for the spouses.

Conclusions

The results of this study will help design family care for the people with gastric cancer by providing in-depth understanding and insight on the lives of gastric cancer couples.

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Feminism and Qualitative Nursing Research
Myungsun Yi, Bong Sook Yih
Journal of Korean Academy of Nursing 2004;34(3):565-575.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2004.34.3.565
AbstractAbstract PDF
Purpose

The purpose of this article was to describe feminism and to propose the integration of a feminist method into qualitative nursing methodology in order to expand the body of nursing knowledge.

Method

The world view of feminism including philosophy, epistemology and methodology was outlined, and a feminist grounded theory and feminist ethnography were suggested as a way of strengthening nursing research methodology using literature review.

Result

Four different philosophical perspectives of feminism, that is, liberal feminism, radical feminism, Marxist feminism, and social feminism were described. Also epistemological perspectives including feminist empiricism, feminist standpoint, and postmodern feminism, were explained and were related to the methodology and methods of feminism. To enhance the strengths of nursing research within the feminist perspectives, feminist grounded theory and feminist ethnography were exemplified in the paradigm of qualitative nursing research.

Conclusion

This paper suggested that incorporation of feminist approaches within nursing is a valuable attempt to expand the body of nursing knowledge and to enhance the quality of nursing care services by rectifying male-oriented knowledge and by empowering women in the care of other people as well as themselves.

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Nurses' Experience of Caring for Dying Patients in Hospitals
Myungsun Yi
Journal of Korean Academy of Nursing 2003;33(5):553-561.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2003.33.5.553
AbstractAbstract PDF
Purpose

To develop a substantive theory that represents hospital nurses' experience on caring for dying patients.

Method

Grounded theory method guided the data collection and analysis. A purposeful sample of 15 hospital nurses participated during the period of 2001-2002. The data were collected by semi-structured individual interviews. All interviews were audio taped and transcribed verbatim. Constant comparative analysis was employed to analyze the data.

Result

“Putting oneself into shape while being faithful to feelings and emotions” emerged as the basic social-psychological process. Three different phases were identified: being faithful to own feelings and behaviors; putting oneself into shape; and mourning death. The first phase includes the categories of “establishing trust relationships” and “sympathizing with dying patients and their family members.” The second phase consists of “controlling feelings,” “adjusting ethical conflicts,” and “providing best patient-care,” and “helping family accept the death.” And the third phase consists of “overcoming sadness” and “releasing other negative feelings.”

Conclusion

The result of this study will help health professionals develop efficient support programs that support nurses caring for dying patients in hospitals. Further study needs to be done to verify findings.

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Hermeneutic Phenomenological Study on Caring Experience of the Mothers of Children with Epilepsy
Woo Joung Joung, Myungsun Yi
J Korean Acad Nurs 2017;47(1):71-85.   Published online February 28, 2017
DOI: https://doi.org/10.4040/jkan.2017.47.1.71
AbstractAbstract PDF
Purpose

The purpose of this study was to develop a deeper understanding of the experience of mothers caring for children with epilepsy.

Methods

Data were collected through individual in-depth interviews and observation from 12 mothers of children with epilepsy. Data were collected from December, 2014 to February, 2015 and analyzed using van Manen's hermeneutic phenomenological methodology to identify essential themes of their experience.

Results

The essential themes that fit into the context of the 4-existential grounds of time, body, other people, and space were: Lived time-ongoing influence of the past, living in insecure present, fearful future with no answer; Lived body-bonded body, burned out state; Lived other-burden but also support, shrunken down; Lived space-narrowed range of activity, widened horizon.

Conclusion

The findings in this study show in-depth understanding of the hardships of mothers who are caring for children with epilepsy. The beauty and greatness of these mothers are revealed through the analysis of various phenomenological materials such as literary and artistic work reflecting socio-cultural context, as well as vivid care experiences of mothers of children with epilepsy. This will be helpful in increasing understanding of the nature of caregivers' experience for medical professionals dealing with patients and caregivers. Also it helps to improve the understanding of the disease among the general public, followed by a more warming and caring attitude towards patients and family members. Finally, it will enhance psychological well-being and overall quality of life of the epileptic children and their families.

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The Lived Experience of Patients with Heart Transplantation: A Phenomenological Study
Younghui Hwang, Myungsun Yi
J Korean Acad Nurs 2017;47(1):110-120.   Published online February 28, 2017
DOI: https://doi.org/10.4040/jkan.2017.47.1.110
AbstractAbstract PDF
Purpose

The purpose of this study was to describe the lived experience of patients with heart transplantation in Korea.

Methods

Individual indepth interviews and a focus group interview were used to collect the data from nine patients who had heart transplantations in 2015. All interviews were audio-taped and verbatim transcripts were made for the analysis. Data were analyzed using Colaizzi's phenomenological method.

Results

Among the nine participants, eight were men. Mean age was 57.30 years. Six theme clusters emerged from the analysis. ‘Joy of rebirth obtained by good luck’ describes the pleasure and expectation of new life after narrow survival. ‘Suffering from adverse drug effects’ illustrates various psychosocial difficulties, such as low self-esteem, helplessness, alienation, and burnout, arising from the side effects of medications. ‘Body and mind of being bewildered’ illustrates disintegrated health and haunting fear of death. ‘Alienation disconnected with society’ describes isolated feeling of existence due to misunderstandings from society. ‘Suffering overcome with gratitude and responsibility’ includes overcoming experience through various social supports and suitable jobs. Finally, ‘acceptance of suffering accompanied with new heart’ illustrate changed perspective of life itself.

Conclusion

The findings in this study provide deep understanding and insights of the lived experience of heart related illness for these patients and should help in the development of tailored-interventions for patients with heart transplantation.

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Hermeneutic Phenomenological Study on Caring Experience of Spouses of Elderly People with Dementia at Home
Hye-Young Jang, Myungsun Yi
J Korean Acad Nurs 2017;47(3):367-379.   Published online January 15, 2017
DOI: https://doi.org/10.4040/jkan.2017.47.3.367
AbstractAbstract PDF
Abstract Purpose

This study aimed to understand and describe the caring experiences of spouses of elderly people with dementia.

Methods

The hermeneutic phenomenological method was used and participants were 12 spouses aged 65 and over who were taking care of their husbands or wives with dementia at home. Data were collected from individual in-depth interviews on participants’ actual caring experiences. Additionally, novels, movies, and memoirs on elderly couples with partner who had dementia were included as data for the analysis. The qualitative data analysis software program was used to manage and process the collected qualitative data. Data were analyzed using hermeneutic phenomenological analysis based on four fundamental existentials including lived body, lived space, lived time, and lived others.

Results

Five essential themes emerged from the analysis: 1) body moving like an old machine, 2) swamp of despair filling with hope, 3) sweet time after bitterness, 4) disappointed elderly couple in the empty nest, and 5) unappreciation vs. empathetic feelings. These essential themes were comprehensively summarized as “the road leading to the maturation of life with dedication and hope while bearing the weight of caring based on the couple's relationship.”

Conclusion

The findings indicate that the nature of the caring experience of spouses of elderly individuals with dementia is filled with many dynamic and paradoxical dimensions. Thus, results of the study would help with developing interventions tailored specifically for elderly spouse caregivers to support their role adaptation and ultimately improving their quality of life.

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Decision Making Experience on Breast Reconstruction for Women with Breast Cancer
Myungsun Yi, Woo Joung Joung, Eun Young Park, Eun Jin Kwon, Haejin Kim, Ji Young Seo
J Korean Acad Nurs 2016;46(6):894-904.   Published online December 30, 2016
DOI: https://doi.org/10.4040/jkan.2016.46.6.894
AbstractAbstract PDF
Purpose

The purpose of this study was to explore decision making experiences of Korean women with breast cancer who underwent breast reconstruction with/after a mastectomy.

Methods

Data were collected during 2015-2016 through individual in-depth interviews with 10 women who had both mastectomy and breast reconstruction, and analyzed using phenomenological method to identify essential themes on experiences of making a decision to have breast reconstruction.

Results

Five theme clusters emerged. First, “expected loss of sexuality and discovery of autonomy” illustrates various aims of breast reconstruction. Second, “holding tight to the reputation of doctors amid uncertainty” specifies the importance of a trust relationship with their physician despite a lack of information. Third, “family members to step back in position” describes support or opposition from family members in the decision making process. Fourth, “bewilderment due to the paradox of appearance-oriented views” illustrates paradoxical environment, resulting in confusion and anger. Lastly, “decision to be made quickly with limited time to oneself” describes the crazy whirling process of decision making.

Conclusion

Findings highlight aims, worries, barriers, and facilitators that women with breast cancer experience when making a decision about breast reconstruction. Deciding on breast reconstruction was not only a burden for women in a state of shock with a diagnosis of breast cancer, but also an opportunity to decide to integrate their body, femininity, and self which might be wounded from a mastectomy. These findings will help oncology professionals provide effective educational counselling before the operation to promote higher satisfaction after the operation.

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Factors Influencing Quality of Life during Chemotherapy for Colorectal Cancer Patients in South Korea
Yongae Baek, Myungsun Yi
J Korean Acad Nurs 2015;45(4):604-612.   Published online August 31, 2015
DOI: https://doi.org/10.4040/jkan.2015.45.4.604
AbstractAbstract PDF
Purpose

The purpose of this study was to investigate the levels of physical symptoms, anxiety, depression, and quality of life (QOL) during chemotherapy for colorectal cancer patients in South Korea and to identify factors influencing their QOL.

Methods

Data were collected from 144 colorectal cancer patients receiving chemotherapy during 2012 at one general hospital located in Seoul. Physical symptoms were measured by the M. D. Anderson Symptom Inventory-Gastrointestinal Cancer Module, and anxiety and depression were measured by the Hospital Anxiety Depression Scale. QOL was measured by the Functional Assessment of Cancer Therapy-Colorectal. Data were analyzed using descriptive statistics, t-test, one-way ANOVA, Scheffé post hoc test, Pearson correlation and stepwise multiple regression.

Results

Mean age of the participants was 56.6 and most of them were not employed. In terms of cancer stage, 38.2% were in stage 3, followed by stage 4 (34.7%). The most frequent symptom was lack of appetite, followed by sleep disturbance and fatigue. The mean score for anxiety was 5.40 with a prevalence of 23% and that of depression 8.85 with a prevalence of 64.6%. The mean score for quality of life was 81.93 out of 136 and 75.3% of the variance in QOL was explained by depression, symptoms, anxiety, treatment place, and occupational status. Depression was the strongest predictive factor.

Conclusion

Oncology professionals need to pay special attention to relieving depression as well as physical symptoms to improve QOL during chemotherapy for colorectal cancer patients.

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Structural Equation Modeling on Quality of Life in Older Adults with Osteoarthritis
Jihyun Oh, Myungsun Yi
J Korean Acad Nurs 2014;44(1):75-85.   Published online February 28, 2014
DOI: https://doi.org/10.4040/jkan.2014.44.1.75
AbstractAbstract PDF
Purpose

The aim of this study was to explore how individual factors, physiologic factors, symptoms, environmental factors, functional status and health perception predict the quality of life (QOL) for older adults with osteoarthritis and to provide guidelines for interventions and strategies to improve QOL in these patients. The conceptual model was based on the Wilson and Cleary's Model.

Methods

Data were analyzed using SPSS WIN 20.0 and AMOS 19.0 program.

Results

The proposed model was a good fit for the data based on the model fit indices. Based on the constructed model, individual factors, social support, functional status and health perception were founded to have direct effects on QOL. Symptom had a indirect effect on QOL. Social support had a significant effect on QOL, and this model explained 63.6% of the variance in QOL.

Conclusion

The results of this study suggest that nursing strategies to increase QOL in this population should contain social support to promote QOL and manage functional limitations and health perception.

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Factors Influencing Quality of Life in Patients with Breast Cancer on Hormone Therapy
Eunkyung Hwang, Myungsun Yi
J Korean Acad Nurs 2014;44(1):108-117.   Published online February 28, 2014
DOI: https://doi.org/10.4040/jkan.2014.44.1.108
AbstractAbstract PDF
Purpose

The purpose of the study was to identify degrees of pain, menopause symptoms, and quality of life, and to identify factors influencing quality of life of patients with breast cancer who were on hormone therapy.

Methods

A cross-sectional survey design was utilized. Data were collected using questionnaires from 110 patients with breast cancer who had been on hormone therapy for 3 months or more and were being treated at a university hospital in Seoul. Data were analyzed using χ2-test, t-test, ANOVA, Pearson correlation coefficient and multiple linear regression.

Results

Mean age of the participants was 53.56 (SD=6.67) and 54 (51.4%) had stage 0 or I at the time of diagnosis. Most of the participants reported having pain and menopause symptoms (88.2% and 95.5% respectively). The mean score for quality of life was 87.84±21.17. Pain, menopause symptoms and quality of life had strong correlations with each other (p<.005). Quality of life was explained by menopause symptoms (β= -.71), economic status (β=.20) and occupation (β=.16).

Conclusion

The results of the study suggest that menopause symptoms should be incorporated into oncologic nursing care to improve quality of life of patients with breast cancer on hormone therapy.

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Overcoming Experiences of Family Members Caring for Elderly Patients with Dementia at Home
Mi Ra Sung, Myungsun Yi, Dong Young Lee, Hye Young Jang
J Korean Acad Nurs 2013;43(3):389-398.   Published online June 28, 2013
DOI: https://doi.org/10.4040/jkan.2013.43.3.389
AbstractAbstract PDF
Purpose

The purpose of the study was to understand and describe the overcoming experiences of family members caring for elderly patients with dementia at home.

Methods

Data came from autobiographies on the overcoming experiences of caregiving from 31 participants, who had submitted the autobiographies to a public contest held by the Seoul Metropolitan Center for Dementia in 2012. Data were analyzed using qualitative content analysis.

Results

Four overcoming stages emerged from the analysis: confronting stage; challenging stage; integrating stage; and transcendental stage, representing transformation of experiences from frustration and suffering to happiness and new hope in life. The confronting stage illustrates severe negative feelings and exhaustion occurring after the diagnosis of dementia. The challenging stage signifies major driving forces in taking good care of their patients. It includes tender loving memories about the patients as well as family and social supports. The integrating stage shows genuine empathy for the patients' situation and the happiness of 'here and now', while the transcendental stage represents new hope in the future.

Conclusion

Health professionals need to support caregivers to find true meaning of caring and happiness in everyday life, while providing specific information on dementia care and relieving various negative feelings.

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Health Knowledge, Health Promoting Behavior and Factors Influencing Health Promoting Behavior of North Korean Defectors in South Korea
Myoung-Ae Choe, Myungsun Yi, Jung-An Choi, Gisoo Shin
J Korean Acad Nurs 2012;42(5):622-631.   Published online October 31, 2012
DOI: https://doi.org/10.4040/jkan.2012.42.5.622
AbstractAbstract PDF
Purpose

The purpose of this study was to identify health knowledge, health promoting behavior and factors influencing health promoting behavior of North Korean defectors in South Korea.

Methods

Participants in this study were 410 North Korean defectors, over 20 years of age residing in Seoul. They were recruited by snowball sampling. Data were collected from April to June, 2010. Health knowledge, health promoting behavior, self-efficacy, perceived barriers to health promoting behavior and social support were measured by structured questionnaires, and perceived physical and mental health status were measured by one item with 10-point numeric rating scale. The data were analyzed using t-test, ANOVA, and multiple regression.

Results

Health knowledge, health promoting behavior, and perceived barriers to health promoting behavior were moderate while self-efficacy and social support were high. Factors influencing health promoting behavior of the participants were found to be self-efficacy, social support and perceived barrier to health promoting behavior.

Conclusion

The results of this study indicate that nursing intervention programs enhancing self-efficacy, social support and reducing perceived barriers to health promoting behavior need to be developed for North Korean defectors in South Korea.

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Phenomenology on the Lived Experience of Korean Women with Spinal Cord Injuries
Hye Min Hwang, Myungsun Yi, Eun Young Park, Eun Jin Kwon
J Korean Acad Nurs 2012;42(4):508-516.   Published online August 31, 2012
DOI: https://doi.org/10.4040/jkan.2012.42.4.508
AbstractAbstract PDF
Purpose

The purpose of the study was to understand and explain the essences and structures of the experience of Korean women who have had a spinal cord injury.

Methods

The data were collected in 2010 through individual in-depth interviews using open-ended questions. A total of 9 women with spinal cord injuries participated in the study. Each interview lasted about 2 hours. Verbatim transcripts were analyzed using phenomenological analysis.

Results

Five theme clusters emerged from the analysis using Colaizzi's method: frozen mind with rigid body; shame due to restrictions of physical function and dependency; struggle to go back to the previous normal body; disabilities that are noticeable in everyday family life; rebirth by discarding the obsessions of the past. These theme clusters illustrate that although most participants faced very strange and unbearable situations in most aspects of life after the injury, they were empowered finally by finding their hope and by giving new meanings to the current existence.

Conclusion

This study provides deep understanding of women with spinal cord injuries who are relatively alienated from society. Based on the results of the study, health professionals could develop effective nursing interventions to improve quality of life of these women.

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Nurses' Experience of Career Ladder Programs in a General Hospital
Kwang-Ok Park, Myungsun Yi
J Korean Acad Nurs 2011;41(5):581-592.   Published online October 31, 2011
DOI: https://doi.org/10.4040/jkan.2011.41.5.581
AbstractAbstract PDF
Purpose

The purpose of this study was to identify and describe nurses' experience of a career ladder program (CLP) in a general hospital in Korea.

Methods

The data were collected from 15 nurses who participated in the CLP. Each nurse completed individual in-depth interviews, for which the main interview question was "How do you describe your experience of CLP?". All interview data were transcribed and were analyzed using the grounded theory method.

Results

The core category of the experience of CLP was identified as "challenging to rebirth as an expert". The participants used five action/interaction strategies such as "taking some time for introspection", "appreciating the essence of nursing", "making use of feedback positively", "throwing away doubts about their own capabilities", "exerting themselves with confidence". The consequence of the process of adjusting to CLP was "positioning a differentiated expert."

Conclusion

The results of this study show that participants recognized CLP as a powerful resource which leads them to professional growth and development. Thus, CLP could be utilized as a clinical career-promoting program and ultimately as a program for providing high-quality nursing services.

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Hospital Workers' Experience with Hospital Evaluation Program: A Focus Group Study
Myungsun Yi, Ji Hyeon Oh, Hye Min Hwang, Eun Jin Kwon, Jeong-hee Lee, Eun Young Park
J Korean Acad Nurs 2011;41(4):568-579.   Published online August 31, 2011
DOI: https://doi.org/10.4040/jkan.2011.41.4.568
AbstractAbstract PDF
Purpose

The purpose of the study was to understand and describe the hospital workers' experience related to the hospital evaluation program implemented in Korea between 2004 and 2009.

Methods

During 2010, data were collected using focus group interviews. Four focus group interviews were held with a total of 28 hospital workers participating. All interviews were recorded and transcribed as they were spoken, and data were analyzed using qualitative content analysis.

Results

Nine themes emerged from the analysis: 1) Positive change in the necessity of the evaluation; 2) Improvement in the hospital system, facilities, and human resources; 3) Unity through cooperation among departments; 4) Nursing work overload; 5) Lack of physicians' awareness and responsibilities; 6) Unfair and unrealistic evaluation items; 7) Lack of credibility of the outcome; 8) Shifting responsibility for negative outcomes to the workers; 9) Lack of pragmatic utility.

Conclusion

The results of the study demonstrate that the hospital evaluation program played a key role in improving some work environments and communication among departments. At the same time, they show various negative themes resulting from the context of very authoritarian hospital systems and a connection-oriented society in Korea.

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Psychosocial Adjustment of Low-Income Koreans with Cancer
Myungsun Yi, Eun Young Park, Dal Sook Kim, Young Sook Tae, Bok Yae Chung, Hyang Sook So
J Korean Acad Nurs 2011;41(2):225-235.   Published online April 30, 2011
DOI: https://doi.org/10.4040/jkan.2011.41.2.225
AbstractAbstract PDF
Purpose

To describe psychosocial adjustment of low-income Koreans who have cancer.

Methods

Data were collected during 2008 using individual in-depth interviews with 18 Korean people with cancer. The income status of the participants was low, 11 were recipients of the National Basic Livelihood Protection program. Mean age was 58.3 yr and 11 were female. Five participants had stomach cancer, five, colorectal cancer, and four, breast cancer. Data were analyzed using grounded theory methodology.

Results

The core category emerged as 'bearing up alone with double suffering'. 'Poverty and cancer: A double suffering' emerged as a causal condition. The adjustment process consisted of three stages: 'forming a treatment will to live' ,'practicing for the cure',and 'restructuring self and repaying favors'. Each stage indicated action-interaction strategies which were employed to bear up alone with double suffering during the illness process. Self-reflection, parental responsibility, and support from the public sector played important roles in overcoming the double suffering. Two types of consequences were identified: Transcended life and strained life suppressed by poverty and cancer.

Conclusion

The results provide insights into the psychosocial adjustment process for low income Korean with cancer and can be used in developing and implementing efficient home-care services for these people.

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The Life Stories of Elderly Korean Women with Urinary Incontinence: A Narrative Study Approach
Bong-Sook Yih, Myungsun Yi
J Korean Acad Nurs 2009;39(2):237-248.   Published online April 28, 2009
DOI: https://doi.org/10.4040/jkan.2009.39.2.237
AbstractAbstract PDF
Purpose

The purpose of this study was to investigate the experience of urinary incontinence (UI) for elderly Korean women using a narrative approach.

Methods

The data were collected using individual in-depth interviews with 15 community-dwelling elderly women who had UI for at least 1 yr. The narratives of the life stories of these women were analyzed from the actor's perspective, motivation and purpose of actions, and action toward goal achievement. Also the narratives on UI were analyzed according to cognition, behavior, and evaluation of UI.

Results

Three major types of the life stories emerged from the analysis. First, the conquest narrative type reflects active characteristics of narrators within the circumstances of the sociocultural context. Second, the patience narrative is characterized as having flexibility between self determination for goal achievement and the boundary of the sociocultural context. Lastly, the compliance narrative reflected characteristics of narrators who easily adapt their way of life to circumstances. In terms of UI, the narrators in all three types lacked awareness of UI as an illness condition. Three different reasons are specifically identified according to the narrative types.

Conclusion

The results of this study indicate that the concept and the illness behaviors related to UI in elderly Korean women with UI were closely related to the way of women's lives within the sociocultural and historical context.

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Analysis of Conversation between Elderly Patients with Dementia and Nurses: Focusing on Structure and Sequential Patterns
Myungsun Yi
J Korean Acad Nurs 2009;39(2):166-176.   Published online April 28, 2009
DOI: https://doi.org/10.4040/jkan.2009.39.2.166
AbstractAbstract PDF
Purpose

The purpose of the study was to identify functional structure and patterns of dialogue sequence in conversations between elderly patients with dementia and nurses in a long-term care facility.

Methods

Conversation analysis was used to analyze the data which were collected using video-camera to capture non-verbal as well as verbal behaviors. Data collection was done during February 2005.

Results

Introduction, assessment, intervention, and closing phases were identified as functional structure. Essential parts of the conversation were the assessment and intervention phases. In the assessment phase three sequential patterns of nurse-initiated dialogue and four sequential patterns of patient-initiated dialogue were identified. Also four sequential patterns were identified in nurse-initiated and three in patient-initiated dialogues in the intervention phase. In general, "ask question", "advise", and "directive" were the most frequently used utterance by nurses in nurse-initiated dialogue, indicating nurses' domination of the conversation. At the same time, "ask back", "refute", "escape", or "false promise" were used often by nurses to discourage patients from talking when patients were raising questions or demanding.

Conclusion

It is important for nurses to encourage patient-initiated dialogue to counterbalance nurse-dominated conversation which results from imbalance between nurses and patients in terms of knowledge and task in health-care institutions for elders.

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Hospital Nurses' Experience of Do-Not-Resuscitate in Korea
Myungsun Yi, Sang Eun Oh, Eun Ok Choi, In Gak Kwon, Sungbok Kwon, Kyung-mi Cho, Youngah Kang, Jeonghui Ok
Journal of Korean Academy of Nursing 2008;38(2):298-309.   Published online April 30, 2008
DOI: https://doi.org/10.4040/jkan.2008.38.2.298
AbstractAbstract PDF
Purpose

The purpose of the study was to describe the experiences of do-not-resuscitate (DNR) among nurses.

Methods

Data were collected by in-depth interviews with 8 nurses in 8 different hospitals. Conventional qualitative content analysis was used to analyze the data.

Results

Eight major themes emerged from the analysis: DNR decision-making bypassing the patient, inefficiency in the decision-making process of DNR, negative connotation of DNR, predominance of verbal DNR over written DNR, doubts and confusion about DNR, least amount of intervention in the decision for DNR change of focus in the care of the patient after a DNR order, and care burden of patients with DNR. Decision-making of DNR occurred between physicians and family members, not the patients themselves. Often high medical expenses were involved in choosing DNR, thus if choosing DNR it was implied the family members and health professionals as well did not try their best to help the patient. Verbal DNR permission was more popular in clinical settings. Most nurses felt guilty and depressed about the dying/death of patients with DNR.

Conclusion

Clearer guidelines on DNR, which reflect a family-oriented culture, need to be established to reduce confusion and to promote involvement in the decision-making process of DNR among nurses.

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A Study on Exercise Behavior, Exercise Environment and Social Support of Middle-Aged Women
Myoung-Ae Choe, Yang Sook Hah, Keum Soon Kim, Myungsun Yi, Jung-An Choi
Journal of Korean Academy of Nursing 2008;38(1):101-110.   Published online February 28, 2008
DOI: https://doi.org/10.4040/jkan.2008.38.1.101
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Purpose

The purpose of this study was to identify exercise environments and social support associated with exercise behaviors in middle-aged women

Methods

Subjects were 207 women aged between 41 and 59 yr in an urban community. The research instruments utilized in this study were exercise stages, exercise environments, exercise partners and social support scale. Subjects were given a self-report questionnaire. Data was analyzed using the SPSS Win program.

Results

The subjects were in the stages of precontemplation (3.4%), contemplation (25.1%), preparation (40.6%), action (5.8%), and maintenance (25.1%). Subjects who engaged in regular exercise were 30.9%. The mean score of the exercise environment was 6.34. The mean score of social support was 21.28, and 65.7% of subjects had exercise partners. The score of the exercise environment was significantly associated with the exercise stage (p=.01). The number of exercise partners of regular exercise groups was significantly greater than that of non-regular exercise groups (p=.00). The score of social support of regular exercise groups was significantly greater than that of non-regular exercise groups (p=.00). The score of social support was significantly associated with the exercise stage (p=.00).

Conclusion

Exercise environments and social support need to be considered in planning exercise programs to improve exercise behavior among middle-aged women.

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A Conversation Analysis of Communication between Patients with Dementia and Their Professional Nurses
Myungsun Yi, Bong Sook Yih
Journal of Korean Academy of Nursing 2006;36(7):1253-1264.   Published online December 31, 2006
DOI: https://doi.org/10.4040/jkan.2006.36.7.1253
AbstractAbstract PDF
Purpose

The purpose of this study was to understand conversations and to identify typical conversational problems between nurses and patients with dementia.

Method

A conversation analysis method was used. The data was collected in a geriatric institutional setting, using a videotape recorder, and transcribed. The transcribed data was analyzed in terms of expressions, contents, and relationships to identify communicative problems and their resolutions.

Results

Among a total of 532 episodes, 440(82.7%) were identified as nurse-involved episodes. In addition, 66 of the 440 episodes were selected based on the significance of the conversation. The communicative problems between nurses and patients in terms of expressions were identified as “directive and authoritative expressions”, “emotional and competitive expressions”, “evasive and on-looking expressions”, and “excessive use of title only”, such as calling them granny or grandpa without proper names. In terms of content and relationships, “lack of themes in psychosocial areas” and “nurse-led relations” were identified respectively as communicative problems.

Conclusion

The results of this study will provide substantial guidelines for nurses in caring for elderly patients with dementia by deeply understanding linguistic structures and problems of everyday conversations between nurses and patients with dementia.

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Adjustment of Middle-aged People with Hemiplegia after a Stroke
Hwa Jin Lee, Myungsun Yi
Journal of Korean Academy of Nursing 2006;36(5):792-802.   Published online August 28, 2006
DOI: https://doi.org/10.4040/jkan.2006.36.5.792
AbstractAbstract PDF
Purpose

The purpose of this study was to understand the adjustment process of middle-aged people in Korea with hemiplegia after a stroke.

Method

For this study, the grounded theory method was utilized.

Results

After constant comparative analysis, the core category emerged as ‘rebuilding the body which was ruined’. In addition, the causal conditions were ‘restriction of physical function’, and ‘loss of roles’. The adjustment process consisted of the ‘facing reality phase’, ‘overcoming depression phase’, ‘overcoming physical limits phase’ and ‘reestablishing roles phase’. The main strategies in the facing reality phase were ‘holding on to a glimmer of hope’, ‘getting away from the harsh reality’ and ‘facing up to the reality’. The main strategies in the overcoming depression phase were ‘soothing oneself’, ‘Self-introspection’ and ‘restoring self-esteem’. In addition, the main strategies in the self-initiative overcoming physical limits phase was ‘discovering personal strategies and striving to recover’. The main strategies in the reestablishing roles phase were ‘reestablishing a parents’ role’, ‘reestablishing a spouse's role’ and ‘reestablishing social roles’.

Conclusion

In conclusion, even though many middle aged stroke patients remained in the depression phase, most of them who overcame depression strived to conquer physical limits on their own initiative.

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A Review Study on the Strategies for Concept Analysis
Myungsun Yi, So Woo Lee, Kum Ja Kim, Myo Gyeong Kim, Ji Hyun Kim, Kyung Hee Lee, Inok Lee, Jung Sook Lee, Jeong Hee Hong
Journal of Korean Academy of Nursing 2006;36(3):493-502.   Published online June 30, 2006
DOI: https://doi.org/10.4040/jkan.2006.36.3.493
AbstractAbstract PDF
Purpose

Concept analysis is an essential part of theory development in nursing. Thus, many strategies or methods of concept analysis have been suggested in nursing literature. However, in Korea, only limited strategies were utilized, without much consideration on a wide range of strategies in choosing a method that coincides with the characteristics of each concept to analyze. The purpose of this article was to propose various strategies for concept analysis.

Method

A literature review method was used.

Result

Ten methods of concept analysis were identified in the literature, and they were evaluated for advantages and limitations. In addition to the method by Walker and Avant and a hybrid model, more advanced strategies, such as triangulation method, critical analysis and the feminist approach were introduced and described in detail. The examples used in each concept analysis method were presented in table to provide the extent of utilization of each method.

Conclusion

This article provides a wide range of strategies in identifying, clarifying, or elaborating a concept. It might help in choosing a method that best fits the concept to analyze, thus enhancing quality of concept analysis research.

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Mothers' Experience of Caregiving for Their Children with Schizophrenia
Myungsun Yi, Myoung Ae Choe, Yang Sook Hah, Keum Soon Kim, Bong Sook Yih, Jahun Kim
Journal of Korean Academy of Nursing 2006;36(1):45-54.   Published online February 28, 2006
DOI: https://doi.org/10.4040/jkan.2006.36.1.45
AbstractAbstract PDF
Purpose

The purpose of this study was to explore Korean mothers' experiences of caregiving for their adult children with schizophrenia.

Method

A iterative descriptive qualitative research design was used to understand and explain the caregiving experience from the perspective of mothers. The data were collected by individual in-depth interviews and one focus group interview from 11 mothers. The ages of the participants ranged from 50 to 60 years old and the ages of their sick children ranged from late 20s to early 40s.

Results

Three major themes were identified from qualitative thematic analysis: (a) “emotional debris from the disease,” (b) “the disease that makes mothers dumb” (c) “space of rational reason.”

Conclusions

This study would provide health care professionals insights in establishing intervention for mothers by deeply understanding the process of recognition and acceptance of their children with schizophrenia.

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J Korean Acad Nurs : Journal of Korean Academy of Nursing
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