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Factors Affecting the Intention to Use Smartmonitor-Based Mobile Health in Middle-Aged in Patients Applying the Technology Acceptance Model II
Ol Eum Joo, Yi Kyung Ha
J Korean Acad Nurs 2024;54(4):620-632.   Published online November 13, 2024
DOI: https://doi.org/10.4040/jkan.24091
AbstractAbstract PDFePub
Purpose

This study aimed to identify factors that influence the intention to use smart monitor-based mobile health (SBM) technology among middle-aged inpatients, based on the technology acceptance model II (TAM II).

Methods

A total of 222 participants were surveyed. Data were analyzed using SPSS Statistics 23.0 and IBM SPSS Amos 23. Seven exogenous variables–social influence (SI), personal self-efficacy, (PSE), environmental self-efficacy (ESE), health literacy, health concerns, resistance to innovative technology (RIT), accessibility (AC)– and three endogenous variables–perceived ease of use (PEOU), perceived usability (PU), and intention to use (ITU)–were investigated.

Results

The hypothesized path model demonstrated a good fit for the data. SI (β = .13, p = .042), PU (β = .46, p < .001), and PEOU (β = .16, p = .008) had significant direct effects on the ITU, which explained 39.5% of the variance. Additionally, SI (β = .27, p < .001), ESE (β = .16, p = .010), RIT (β = - .12, p = .026), AC (β = .28, p < .001), and PEOU (β = .20, p = .001) indirectly affected ITU through PU, which explained 50.7% of the variance. Furthermore, PSE (β = .38, p < .001) indirectly influenced ITU via PEOU, which explained 38.4% of the variance.

Conclusion

This study demonstrates that the TAM II can be used to effectively predict ITU in SBMs among middle-aged inpatients. To expand the intention to use SBMs, it is necessary to develop SBMs that include content and programs that promote PU, SI, and PEOU.

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The Effects of a Self-Efficacy Theory-Based Exercise Program for Patients Undergoing with Total Knee Arthroplasty
Kyung-Hye Park, Hee-Young Kang
J Korean Acad Nurs 2024;54(4):547-562.   Published online October 22, 2024
DOI: https://doi.org/10.4040/jkan.24027
AbstractAbstract PDFSupplementary MaterialePub
Purpose

This study was performed to develop a self-efficacy theory-based exercise program for total knee arthroplasty (TKA) and to test the program’s efficacy in ameliorating knee pain and restoring function as measured by lower extremity muscle strength, 3 meter walking time, Korean Western Ontario McMaster Index (WOMAC), exercise self-efficacy, and length of hospital stay for TKA patients.

Methods

This quasi-experimental study incorporating a non-equivalent control group and pretest-posttest non-synchronized design non-synchronous design was applied to assess self-efficacy reinforcement strategies based on self-efficacy theory. The exercise program consisted of the following steps: TKA, education to prevent postoperative complications, and muscle strength exercises. Respective exercise and control groups included 29 and 27 participants. The experimental group received eight sessions of the program from three weeks before TKA to four weeks after TKA. Collected data were analyzed using the chi-square test, Mann–Whitney U test, and ranked ANCOVA and t-tests using IBM SPSS Statistics 23.

Results

Experimental group showed significant improvement in lower extremity muscle strength (F = 8.63, p = .005), 3 meter walking time (z = - 5.02, p < .001), WOMAC index (z = - 2.22, p = .027), self-efficacy for exercise (z = - 3.29, p = .001), and length of hospital stay (t = - 2.11, p = .040) compared to the control group. No significant differences in knee pain and range of motion were observed.

Conclusion

These findings indicate that a self-efficacy theory-based exercise program can be an effective exercise strategy that patients undergoing TKA can easily follow at home without assistance. It is thus recommended as an exercise intervention for TKA patients.

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Psychometric Properties of the Fall Risk Perception Questionnaire-Short Version for Inpatients in Acute Care Hospitals
Choi, Jeeeun , Lee, Sujin , Park, Eunjin , Ku, Sangha , Kim, Sunhwa , Yu, Wonhye , Jeong, Eunmi , Park, Sukhee , Park, Yusun , Kim, Hye Young , Kim, Sung Reul
J Korean Acad Nurs 2024;54(2):151-161.   Published online May 31, 2024
DOI: https://doi.org/10.4040/jkan.23127
AbstractAbstract PDF
Purpose
Patients’ perception of fall risk is a promising new indicator for fall prevention. Therefore, a fall risk perception questionnaire that can be used rapidly and repeatedly in acute care settings is required. This study aimed to develop a short version of the fall risk perception questionnaire (Short-FRPQ) for inpatients.
Methods
For the psychometric measurements, 246 inpatients were recruited from an acute care hospital. The construct (using confirmatory factor analysis and discriminant validity of each item), convergent, and known-group validities were tested to determine the validity of the Short-FRPQ. McDonald’s omega coefficient was used to examine the internal consistency of reliability.
Results
In the confirmatory factor analysis, the fit indices of the Short-FRPQ, comprising 14 items and three factors, appeared to be satisfactory. The Short-FRPQ had a significantly positive correlation with the original scale, the Korean Falls Efficacy Scale-International, and the Morse Fall Scale. The risk of falls group, assessed using the Morse Fall Scale, had a higher score on the Short-FRPQ. McDonald’s omega coefficient was .90.
Conclusion
The Short-FRPQ presents good reliability and validity. As patient participation is essential in fall interventions, evaluating the fall risk perception of inpatients quickly and repeatedly using scales of acceptable validity and reliability is necessary.
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The Development of a Tool for Assessment of Spiritual Distress in Cancer Patients
Kim, Jin Sook , Ko, Il-Sun , Koh, Su Jin
J Korean Acad Nurs 2022;52(1):52-65.   Published online February 28, 2022
DOI: https://doi.org/10.4040/jkan.21120
AbstractAbstract PDF
Purpose
This study was conducted to develop a scale to measure spiritual distress in cancer patients.
Methods
A total of 69 preliminary items for the spiritaul distress assessment tool (SDAT) were compiled, based on a literature review, selection of empirically relevant items through concept analysis of hybrid models, confirmation of content validity by experts, cognitive interviews, and a pretest. Self-administered questionnaires were collected between April 1 and July 31, 2018, from 225 cancer patients at four medical institutions and one nursing home. The data were analyzed using item analysis, exploratory factor analysis, convergent and discriminant validity, and Pearson correlation for criterion validity. Reliability was tested by Cronbash’s α coefficient.
Results
The final version of the SDAT consisted of 20 items. Five-factors, loss of peace, burden of family, avoidance of confronting death, guilt and remorse, regret for not being able to apololgize and forgive were extracted, and showed 62.8% of total variance. The factors were confirmed through convergent and discriminant validity. Criterion validity was confirmed by functional assessment chronic illness therapy spiritual well-being scale 12 (FACIT-Sp12). The overall Cronbach’s α was .91, and the coefficients of each subscale ranged from .78~.83.
Conclusion
The SDAT for cancer patients is valid and reliable. It is suggested that the tool can be used to measure spiritual distress in cancer patients.
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Untact Visit Service Development Based on an Application Reflecting the Circumstances during COVID-19: Focusing on Utilization in the Pediatric Intensive Care Units
Woo, Dahae , Yu, Hanui , Kim, Hyo Jin , Choi, Minyoung , Kim, Dong Hee
J Korean Acad Nurs 2021;51(5):573-584.   Published online October 31, 2021
DOI: https://doi.org/10.4040/jkan.21143
AbstractAbstract PDF
Purpose
This study aimed to develop an untact visit service based on an application that can be utilized in the pediatric intensive care unit (PICU) during COVID-19.
Methods
This study adopted the double diamond process of service design comprising the discovery, defining, and development stages.
Results
We developed an untact visit service based on an application that considered the child’s status, schedule, photo, and video messages, and so on. Moreover, we derived a service flow regarding the required roles and the type of flow shown between each stakeholder.
Conclusion
Considering the ongoing pandemic, the untact visit service is designed to increase rapport and participation of parents, share the child’s information in real-time, and provide one-stop service without increasing healthcare providers’ work. It will be a useful visit service that can be applied and evaluated in various hospital settings and the PICU.
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A Concept Analysis of Quality Nursing Care
Juanamasta, I Gede , Aungsuroch, Yupin , Gunawan, Joko
J Korean Acad Nurs 2021;51(4):430-441.   Published online August 31, 2021
DOI: https://doi.org/10.4040/jkan.21075
AbstractAbstract PDF
Purpose
This study aimed to perform a concept analysis of quality nursing care.
Methods
Walker and Avant’s concept analysis method was used to carry out this study.
Results
The defining attributes identified were as follows: caring, the nurse-patient relationship, and patient needs. Antecedents included patient characteristics, individual factors (age, education, knowledge, competence, and experience), job position, and environmental factors. The consequences of quality nursing care have significant influence on both patients and nurses.
Conclusion
The findings can aid researchers in obtaining a better understanding of quality nursing care, and stakeholders can consider the factors related to quality nursing care and its consequences to improve the nursing process.
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Motives for Empathy among Clinical Nurses in China: A Qualitative Study
Zhu, Yu , He, Ming-Mei , Zhu, Ji-Min , Huang, Li , Li, Bai-Kun
J Korean Acad Nurs 2020;50(6):778-786.   Published online December 31, 2020
DOI: https://doi.org/10.4040/jkan.20123
AbstractAbstract PDF
Purpose
This study aimed to explore the motives of clinical nurses for experiencing empathy with patients and their families based on a self-determination theory framework.
Methods
Semi-structured face-to-face interviews with twenty-one nurses at four tertiary hospitals in Anhui, China, were conducted, recorded and transcribed. A content analysis with a directed approach was performed.
Results
An analysis of the interview transcripts revealed three categories of empathy motivation: autonomous motivation, controlled motivation and a lack of empathy motivation. Autonomous motivation included personal interests, enjoyment and a sense of value, pure altruism, assimilation, and recognition of the importance of empathy. Controlled motivation highlighted pressures from oneself and others, the possibility of tangible or intangible rewards, and avoidance of adverse effects. Finally, a lack of empathy motivation referred to a lack of intention for empathy and denial of the value of empathy.
Conclusion
This study provides a deep understanding of the motives underlying empathy in nurses. The results reveal the reasons for empathy and may support the development of effective strategies to foster and promote empathy in nurses.
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Original Articles
Effects of Oral Gargling with Aroma Solution in Psychiatric Inpatients: A Non-Randomized Controlled Trial
Jung, Yun Ah , Kim, Hee Sook
J Korean Acad Nurs 2020;50(2):200-209.   Published online April 30, 2020
DOI: https://doi.org/10.4040/jkan.2020.50.2.200
AbstractAbstract PDF
Purpose
The purpose of this study was to examine the effects of oral gargling with an aromatic solution on xerostomia, objective oral status, and oral health-related quality of life in psychiatric inpatients.
Methods
A nonequivalent control group with a non-synchronized design was used in this study. The experimental group (n=34) received oral gargling with an aroma solution, while the control group (n=33) gargled with 0.9% normal saline. Dependent variables were measured at pre-, post-, and follow-up test. Data were analyzed using an c2-test, Fisher’s exact probability test, t-tests, and repeated measures ANOVA using SPSS/WIN v.21.0.
Results
After the intervention, significant differences were revealed in xerostomia (F=15.30, p <.001), objective oral status (F=38.44, p <.001), and oral health-related quality of life (F=62.70, p <.001) with an interaction effect between group and time.
Conclusion
These findings indicate that gargling with an aroma solution is more effective than 0.9% normal saline for the oral health of psychiatric inpatients. Therefore gargling with an aroma can be safely recommended as a brief, economical, and positive intervention in clinical settings.
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Development and Effect of a Fall Prevention Program Based on the King's Goal Attainment Theory for Fall High-Risk Elderly Patients in Long-Term Care Hospital
Bom Mi Park, Ho Sihn Ryu, Kyeung Eun Kwon, Chun Young Lee
J Korean Acad Nurs 2019;49(2):203-214.   Published online April 30, 2019
DOI: https://doi.org/10.4040/jkan.2019.49.2.203
AbstractAbstract PDF
Purpose

The purpose of this study to develop a fringed fall prevention program based on King's goal attainment theory and education. This study is applied to the personal, interpersonal, and social systems of fall high-risk patients to test its effects.

Methods

This study was a nonequivalent control group pre- and post-test design. There were 52 fall high-risk patients in the experimental group and 45 in the control group. The experimental group received six sessions, with the group sessions lasting 60 minutes and the individual sessions lasting 20~30 minutes. Data were analyzed using descriptive statistics, an χ2-test, a paired sample t-test, and a Wilcoxon signed-ranks test utilizing IBM SPSS software.

Results

For the 3-month intervention period, the fall prevention program was found to be particularly effective for patients in the experimental group (from 3.38 to 1.69 per 1000 patient days; p=.044), as opposed to the control group (from 1.94 to 1.49 per 1000 patient days; p=.300). For the 6-month follow up period, the fall prevention program was again found to be effective for patients in the experimental group (from 3.26 to 0.76 per 1000 patient days; p=.049) compared to the control group (from 1.98 to 1.01 per 1000 patient days; p=.368).

Conclusion

These results indicate that the fringed fall prevention program is very effective in reducing falls, not only during the intervention period, but also after the intervention period has ended. We can therefore recommend this program for use concerning fall high-risk patients in long-term care hospitals.

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Development of the Patient Caring Communication Scale
Myoung Lyun Heo, Sook Bin Im
J Korean Acad Nurs 2019;49(1):80-91.   Published online February 28, 2019
DOI: https://doi.org/10.4040/jkan.2019.49.1.80
AbstractAbstract PDF
Purpose

This study attempted to develop a scale that measures the level of patients' recognition of the nurses' care, based on Watson's caring theory, and confirmed its reliability and validity.

Methods

The items were developed through a literature review and an expert content validity test. The questionnaires were administered to 285 inpatients of internal medicine and surgical units at two general hospitals. Construct validity was tested using exploratory and confirmatory factor analysis, and reliability was tested using Cronbach's alpha.

Results

This process resulted in a preliminary scale composed of 34 items; We used item analysis and five exploratory factor analyses, and consequently selected 14 items composed of three factors (respect, genuineness, and relationality). The confirmatory factor analysis verified the model fit and convergent and discriminant validity of the final items; criterion validity was confirmed with the positive correlation with the measurement scale of the patient-perceived quality of nursing . The overall scale reliability had a Cronbach's alpha of .92, which indicated internal consistency and reliability.

Conclusion

The developed scale showed content, construct, and criterion validity, and reliability, as well as convergent validity for each item and discriminant validity between the factors. This makes it suitable for use in a diverse range of future studies on nurse communication using structural equation models.

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Chronically Ill Patients' Perception of Hospital Nurses
Byoung-Sook Lee, Mi-Aie Lee, Yong-Sook Eo
J Korean Acad Nurs 2018;48(3):311-322.   Published online June 30, 2018
DOI: https://doi.org/10.4040/jkan.2018.48.3.311
AbstractAbstract PDF
Purpose

The purpose of this qualitative research was to investigate chronically ill patients' perception of hospital nurses.

Methods

Individual in-depth interviews and qualitative content analysis were used for data collection and analysis respectively. Participants were 13 chronically ill hospitalized patients or outpatients in three universities hospitals. All interviews were recorded and transcribed verbatim. Data were analyzed using the qualitative content analysis suggested by Graneheim and Lundman (2004).

Results

Three themes emerged from the 10 sub-themes, which were categorized from the 21 condensed meaning units by interpreting the underlying meanings. The three themes were “person giving comfort and support by caring”, “person facilitating the process of healing”, and “person taking the initiative in power relations”. Two themes involved positive experiences of patients and the other included negative ones.

Conclusion

The results showed that the participants perceived the hospital nurses as devoted to caring for patients and facilitating treatments, but authoritative in performing their duty. Based on these results, it is recommended that hospital nurses improve their nursing knowledge, skills and humanistic attitude.

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An Effect of Nursing-Logotherapy on Purpose in Life and Finding Meaning, and Hope of the patients of Mental Illness
Jong Ji Lee
Journal of Nurses Academic Society 1997;27(4):727-739.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.4.727
AbstractAbstract PDF

The purpose of this study was to present an effective nursing intervention for helping the patients of mental illness by determining the effect of nursing-logotherapy on purpose in life and finding meaning, and hope of the patients of mental illness by developing and applicating program of nursing-logotherapy. The data was collected from March to September in 1995, and its subjects were the patients of mental illness who was appropriate to the standard of this study among the patients of mental illness who hospitalized into Neuro-Psychiatric ward of M. and B. hospital located in Pusan area. They were all 60 subjects, thirty of them for an experimental group and the rest for a control group. The research design was an equivalent control group pre-test and post-test design as an quasiexpe-rimental research and the conceptual framework was an interpersonal model. The data analysis was computerized by using SP-SS/PC+ and hypothesis testing was done with 2-way ANCOVA and simple correlation. Results were summarized as follows : 1. There were significant changes of purpose in life and finding meaning in an experimental group before and after treatment and a control group before and after. 2. There were significant changes of hope in an experimental group before and after treatment and a control group before and after. 3. The positive correlation between purpose in life and finding meaning and hope of the patients of mental illness were observed. Consequently, nursing-logotherapy could significantly increase the purpose in life and finding meaning, and of hope, so it could be said an effective nursing intervention for helping the healing of the patients of mental illness.

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Development of Concrete Sensory Information for Patients Undergoing Catheterization
Cho Ja Kim, Hwa Soon Kim
Journal of Nurses Academic Society 1997;27(2):433-443.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.2.433
AbstractAbstract PDF

Cardiac catheterization is a diagnostic procedure which is intrusive and anxiety provoking. Patient education and information offer have been suggested as effective nursing interventions to reduce patients' anxiety and stress. Main objectives of this study are : 1) to develop concrete objectives information for patients undergoing cardiac catheterization ; 2) to analyze the types of information included in the newly developed concrete objective information. The subjects of this study are 11 patients who were admitted to the CCU of a general hospital in Seoul. The subjects were provided with preparatory information about cardiac catheterization by using interview and a booklet. After the procedure, the subjects were asked to describe additional information which they suggest to be added into the booklet and the physical sensations felt during the procedure. The results of the study are summarized as follows : Most subjects were satisfied with the preparatory information that was provided by interview and the booklet before the procedure. But patients suggested several problems related to the content of the booklet. First, they reported difficulty to differentiate the terms-coronary angio gram and cardiac catheterization. Also, some patients expressed that they feared after reading the information about the incision of inguinal area. Subjects responded that the information about the direct process of the test did not reduce their anxiety and the information was not detail enough. Next, most subjects would want to know about the monitor and the sound from monitor. They said that they could not hear instructions from doctor of nurse during the procedure due to tension. Considering above response results, the need for more effective way to provide information, like visual and auditory information through video tape for giving information is suggested. Sensations related to the procedure were the smell coming from sterilization of inguinal area, stinging pain in groin when the doctor inserts a needle into artery, and the sensation of pressure and moving of vessels surrounding neck when the catheter was inserted and visualized on fluoroscopy. Besides, subject reported hot sensation and burning feeling in face and chest area, and nausea when dye is injected by hand. In the analysis of information content, there was 79% agreement on the actual units of analysis that were coded. In the analysis of type of information, procedural information was 60.4%. Concrete objective information was 28.1%, and other information was 11.5%. Agreement of the coders in categorizing the units of information was determined by using Cohen's kappa which corrects for chance agreement. Cohen's kappa was .84.

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Lived Experience of the Family Members of Gastric Cancer Patients
Myung Sun Yi
Journal of Nurses Academic Society 1997;27(2):275-288.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.2.275
AbstractAbstract PDF

The purpose of the study is to explore and describe the lived experience of family members with gastric cancer patients using the grounded theory methodology. The participants were ten spouses of gastric cancer patients who had some kind of treatment at the hospital. They were asked open-ended and descriptive questions in order for them to talk about their experiences in their owl terms. As the interview progressed the questions became more specific to discuss themes and working hypotheses that emerged from the analysis of previous interviews. All interviews were tape-recorded and transcribed for the analysis. Constant the core category that was emerged from the comparative analysis is "magmaggam" which can be described as a psychological distress due to a high level of uncertainty regarding the health of the patient and the future of the caregivers. Psychological distress includes several emotional feelings such as frustration, anxiety, fear, guilty, and self depreciation. Subcategories or strategies related to the core category are 1) managing illness, 2) using folk medicine, 3) giving the patient a reason to live, 4) being patient, 5) losing reality, 6) anticipatory experience on the patient's death and parting, and 7) changing interpersonal relationships. The results of this study would help clinical nurses to develop nursing intervention to help spouses of gastric cancer patients establish efficient coping strategies in dealing with the problems they face.

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The Effect of Structured Patient Education on Knowledge and Behavior about Selfcare in Hemodialysis Patients
Young Ran Jeong
Journal of Nurses Academic Society 1997;27(1):120-127.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.1.120
AbstractAbstract PDF

The purpose of this study was to identify the effect of structured patient education on knowledge and behavior about selfcare in hemodialysis patients, and to find the strategy to promote their selfcare behavior. In conclusion, structured patient education in hemodialysis patients was improved the level of knowledge and behavior about selfcare. But there was a little relationship between the knowledge and behavior about selfcare. That is ; structured patient education is the effective nursing intervention to improve their selfcare knowledge and behavior, but further research is needed to find the factor to increase selfcare behavior in hemodialysis patients.

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A Study of the Experience of Patients with Terminal Cancer Who are in an Independent Hospice Center
Boon Han Kim, Young Ran Tak, Mi Young Chon
Journal of Nurses Academic Society 1996;26(3):668-677.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1996.26.3.668
AbstractAbstract PDF

This study is a phenomenological study done to promote understanding of the dying process in patients with terminal cancer who were in an independent hospice center. The purpose of study was to explore and understand indepth information on the dying process in order to provide data for holistic hospice care in nursing and to give insights in to practical applications in the nursing care. In ?depth interviewing was done from may, through November, 1995 with 11 patient with cancer who were being cared for at K Hospice Care Center. Experiences in the dying process were discussed as they expressed feelings about death including (a) feeling of isolation because family members try to hide the diagnosis of cancer, (b) hopelessness, (c) guilt, anger, and hostility, (d) suffering from pain, (e) fear of death. However, subjects did not deny death itself and were developing peace of mind and acceptance of death through religion.

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An Analytical Review on Fatigue of Cancer Patients
Yun Jung Lee, Dal Sook Kim
Journal of Korean Academy of Nursing 2002;32(6):897-905.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2002.32.6.897
AbstractAbstract PDF

PURPOSE: The purpose of this study was to discuss and address the state of the knowledge development and the nature of knowledge regarding fatigue. METHOD: This study analyzed the 63 fatigue related articles published from 1990 to 2001. The analysis schema was 'Alternative linkages among philosophy, theory, and method for nursing science' (Kim, 1993). RESULT: The 63 articles had been studied only within 5 types among all 96 types of linkages. Most of the articles (59 among 63 articles) had been studied within scientific realism and deductive logic. Fifty-three articles among 59 articles were the type of explanatory and predictive theory, grasping reality by the etic method on the controlled setting. CONCLUSION: This study suggests more development of knowledge regarding fatigue with various logics, especially with discovery logic such as inductive and retroductive or methods in multiple designs on various subjects under various philosophy needed for nursing practice.

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The Trajectory of Fatigue and Quality of Life in Stomach Cancer Patients Receiving Chemotherapy
Young Hee Yang
Journal of Korean Academy of Nursing 2002;32(4):482-491.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2002.32.4.482
AbstractAbstract PDF

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.

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Analysis of Services and Cost in CVA Patients by Severity in Hospital-based Home Health Care
In Sun Jang, Na Mi Hwang
Journal of Korean Academy of Nursing 2001;31(4):619-630.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2001.31.4.619
AbstractAbstract PDF

PURPOSE: The purpose of this study was to analyze the differences in terms of services and cost between CVA without typical diseases (Group I), and CVA with typical diseases (Group II), in their Hospital-based home health care. METHOD: The subjects of this study were 308 CVA patients who used home care nursing during the second phase demonstration project of their hospital-based home health care. Results: The results of the study was as follows 1. Group II had more home visit (15.3/12.7) (p>0.05), and cases of death when home care (16.8/11.4) (p<0.05). 2. Group II needed more services than Group I such as bladder irrigation, skin care, bed sore care, glycerin enema, finger enema, lung care, urine sugar test, monitoring and surveillance of fluid infusion and R.O.M exercise (p<0.05). 3. The variables that showed statistical significance in the regression analysis were family style, OPD visit, level of consciousness, patient's state on termination of home care, and some extend of home health care services (R2=0.373, 0.205). CONCLUSION: Home nursing care needs to be planned by severity in Hospital-based home health care for CVA patients.

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A Study on the Triage and Statitical Data of Patients in the Emergency Room, PNU
Young Hae Kim, Hwa Ja Lee, Seok Ju Cho
Journal of Korean Academy of Nursing 2001;31(1):68-80.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2001.31.1.68
AbstractAbstract PDF

The purpose of this study is to analyze ER patient's Triage and other statistical data. The subjects were 12,618 patients who visited the ER during the year 1998. The study showed the following results; 1. The male vs female ratio was 1.3 : 1.0, the male were in the majority (56.6%), and the age range of 20-29 old was the majority (15.3). The patients who visited ER at 8-10 pm were the majority (11.5%). On Sunday the number of patients who visited the ER were 2,189, and the majority were 17.4%. On Saturday the number of patients was visited the ER were 1,944 patients the second majority (15.4%). Their traffic means : the general passenger cars (75.5%), 119 or hospital ambulance (11.3%). 2. The reasons of visiting ER were : diseases (59.2%), injuries (23.7%). The disease vs injury ratio was 100 : 69. 3. Triage : urgent 40.7%, non-urgent 38.2%, acute 17.8%, and critical 3.2%. 4. The time of waiting and staying in the ER by the Triaget: the average time was 572 minutes (9.53 hrs.). The majority of critical patients (20.5%), acute patients (24.7%) and urgent patients (21.2%) stayed 12-24 hrs., but the majority of non-emergent (27.8%) stayed not longer than one hour. 5. Treatments by the Triage : the 42.9% of critical patients, and 61.3% of acute patients, 57.5% of urgent patients were admitted. But 91.8% of the non-emergents were discharged and 4.7% was admitted. Mortality of total ER visiter were 1.7%. DAA portion was 0.86%. 26.6% of the critical patients were DAA. DAA vs DOA ratio was 1.3 : 1.0. 6. Visiting time, monthly and seasonal distribution by the Triage : the majority of critical patients (12.2%), visited 10-12 am. The majority of acute (12.9%) and urgent (11.7%) visited 4-6 pm, but the majority of non-emergents (15.1%) visited during 8-10 pm. Autumn visiter were the majority (27.6%). The percentage of non-emergent visited in Spring was 41.4% and Autumn was 41.3%. The percentage of urgents who visited in the Summer was 45.3% and the Winter was 40.4%. By clinical departments: the 48.0% of critical patients was NS. The 45.5% of acute and the 33.6% of urgent patients were IM. But the majority of non-emergent patients was PS (21.2%), and the second majority of non-emergent patients was oral Surgery (12.8%).

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The Development and Test of Self-Efficacy Promotion Program on Self-care of Hemodialysis Patients
Mi Ryeong Song
Journal of Korean Academy of Nursing 2000;30(4):1066-1077.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2000.30.4.1066
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The purpose of this study is to develop self-efficacy promotion program and to test its effects on self-efficacy, self-care, physiologic index of hemodialysis patients after applying this program to them. Preliminary study was carried out to identify the levels and types of self-care, self-efficacy of hemodialysis patients. To develop self-efficacy promoting program, several discussions with nursing professors and nurse specialists on hemodialysis patients were made after in-depth literature review on the area. Through these processes, the self-efficacy promoting program including 20 minutes long videotape and other counciling documents were completed. This videotape consisted of specific self-care techniques for hemodialysis patients including management of fistula, measurement of blood presure and body weight, special diets, medications, exercise and rest, management of physical problems and social adjustment. Two group equivalent pre and post test quasai-experimental research design was used in this study. The total subjects were 34 hemodialysis patients who received hemodialysis three time per week at 1 university hospital. Seventeen experimental group subjects were matched with control group subjects in sex and age. Data were analysed with the SPSS window program. Homogeniety between experimental and control group pretest data was tested by 2 and t-test. There were no significanct differences in general characteristics, illness history, specific self-efficacy and self-care between the two groups. The differences of general self-efficacy of two groups were tested with the Repeated Measure ANCOVA because of significant differences of pretest data of general self efficacy between two groups. The differences of self-efficacy and self-care of two groups were tested with Repeated Measure ANOVA and the differences of physiologic indecies including blood potassium level and blood phosphorus level and interdialytic weight gain were tested by t-test. The results were as follows: 1. There was no significant difference in general self-efficacy between the two groups over four different time, and no interaction by groups and by time. 2. There was significant difference in specific self-efficacy between the two groups over four different time, and interaction by groups and by time. 3. There was significant difference in self-care between the two groups over four different time, and interaction by groups and by time. 4. There were no significant differences of blood potassium level and blood phosphorus level, but there was significant difference of interdialytic weight gain between the two groups. From the results above, it can be concluded that the self-efficacy promotion program for hemodialysis patients was effective to improve degree of specific self-efficacy and self-care and to decrease interdialytic weight gain. Considering results, the followings are recommended: 1) Repeated studies are needed for another hemodialysis patients. 2) This program can be used for improving degree of self-efficacy and self-care of hemodialysis patients by nurse practitioner and nurse educator.

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A Grounded Theory Approach to the Comfort Experience of Hospitalized Patients
Kyung Hee Kim, Keum Soon Kim, Kyu Sook Kang, Hyun Sook Kang, Won Ock Kim, Hoon Jung Paik, Jong Soon Won, Nan Young Lim, Ihn Sook Jeong, Hye Jin Kwon
Journal of Korean Academy of Nursing 2000;30(3):750-763.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2000.30.3.750
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This study is based on grounded theory methodology by Strauss & Corbin(1998). Ten hospitalized subjects were interviewed for data collection. In the process of data analysis, 'acceptance' is found to be the causal condition, while 'health professionals' skillfulness', 'ward environment', 'history of hospitalization', and 'general conditions' were identified as context, 'felling of relief' as the core phenomenon, 'self-efficacy', 'support of others', and 'life style' as the intermediate situation, 'passive reaction', 'alternative reaction' and 'active reaction' as the strategy and 'stabilization', 'satisfaction', 'hope' and 'carrying out' as consequences. 'Feeling of relief' is found to go through the three stages of recognition-generation-maintenance after the five different patterns. 1) In case the health professionals are skillful, the ward environment is favorable, the general conditions of the patients improved and as a result the feeling of relief is strong, during the first hospitalization, the self-efficacy of the subjects tends to be strong. They proceed toward the goal set for themselves with a renewed hope and active or alternative reaction toward the feeling of relief. 2) The subjects tend to proceed toward the goal set for themselves with a renewed hope and active and alternative reaction toward the feeling of relief in case health professionals are skillful, the ward environment is favorable the general conditions of the subjects improved, self-efficacy is strong, and lifestyle is autonomous, during the second hospitalization even though support of others is merely superficial. 3) The subjects tend to stabilize, and satisfy themselves with the given situation with passive and alternative reaction to the feeling of relief in case health professionals are skillful and the ward environment is favorable but the general conditions worsened and accordingly the feeling of relief, is weak and life style is dependent during the second hospitalization although the subjects' self-efficacy is strong and support of others is specific. 4) The subjects tend to stabilize and satisfy themselves with the given situation with passive and alternative reaction to the feeling of relief in case health professionals are unskillful the ward environment is unfavorable, the general conditions improved, support of others is specific but life style is dependent and self-efficacy is weak during the first hospitalization. 5) The subjects tend to stabilize and satisfy themselves with the given situation in case health professionals are unskillful the ward environment is unfavorable but the general conditions improved support of others is specific and as a result self-efficacy is strong but life style is dependent.

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A Survey on the Delay Time Before Seeking Treatment and Clinical Symptoms in Patients with Acute Myocardial Infarction
Oh Jang Park, Cho Ja Kim, Hyang Yeon Lee, Hae Ok Lee
Journal of Korean Academy of Nursing 2000;30(3):659-669.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2000.30.3.659
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Many patients of acute myocardial infarction showed delay time before seeking treatment although they needed immediate thrombolytic therapy once they perceived their symptoms. The objectives of this study were to identify the relationship between clinical symptoms and the delay, and to find the time spent before seeking the treatment. This study was a retrospective research. The delay time for the treatment consisted of the length of delay from symptom onset to patients' decision (T1), from patients' decision making to finding transportation (T2), and from taking transportation to the first hospital arrival(T3). The subjects were 89 patients who were admitted in the ICU and Cardiac Ward at Chonnam University Hospital with the first attack of acute myocardial infarction. The data was collected for three months from March 1st to May 31st of 1998 through questionnaires and reviewing patients' charts: The chart information was suppled by two nurses working at the ICU and Cardiac Ward. The data was analyzed by using frequency, mean and ANOVA through the SAS program. The results of study summarized as follows: 1. Sixty two patients (69.7%) were male and twenty seven patients (30.3%) were female, the ratio of male to female was 2.3 : 1. 2. In daily life, the 70.8% of the patients felt chest pain and discomfort fatigue in 67.4%, dyspnea in 57.3%, and pain in arm, neck, and jaw in 52.8%. During the attack, 97.8% of the patients felt chest pain and discomfort dyspnea in 82.1%, pain in arm, neck, jaw in 67.4% and perspiration in 51.7%. 3. The length of time a patient spent seeking time for treatment (T1+T2+T3) was 94.6 minutes, in which the time for patients' decision making for treatment (T1) was 70.3 minutes, time for finding transportation (T2) was 8.2 minutes, and time for the transportation of the patient to the first hospital (T3) was 16.1 minutes. Time for patients' decision making to go to a hospital(T1) was 74.2% of the total time sought for treatment.

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Correlation Between Knowledge and Educational Needs Related to Recurrent in Coronary Artery bypass graft patients
Hee Seung Kim, Min Jeong Park
Journal of Korean Academy of Nursing 2000;30(3):549-559.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2000.30.3.549
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The purpose of this study was to investigate the correlation between the knowledge and educational needs related to recurrent in coronary artery bypass graft patients as a basis to provide an individual nursing education for the population. The subjects consisted of 110 patients who had coronary artery bypass graft(CABG) at Asan Medical Center in Seoul and Sechong hospital in Buchon. Data was obtained from a knowledge questionnaire and a learning needs questionnaire between November 1998 and February 1999. Data were analyzed using SAS program for Wilcoxon rank sum test and Spearman correlation coefficient. The results were as follows : 1. With regard to the 18 items to measure knowledge, the mean (median) of items 'don't know' was 4.9(4) items. The mean (median) of items answered wrong was 3.2(3) items. The number of items answered 'don't know' tend to show higher in those who had less education, blue color jobs and myocardiac infarction history than in their counter parts. 2. With regard to the level of knowledge by questionnaire about CABG, The most "I dont know" (59.1%) highly response was 'He has to be treated with anticoagulant drug to prevent revasculized vessel from obstructing.' The seond highest response (56.4%) was 'If you were hypotensive, the coronary attack would collapse. 'During the hospitalized day, the patient has complete bedrest.' The highest error probability was cholesterol has not to intake.', 'After surgery, the sexual life is need controlled for 1 year. 3. The mean of educational needs was 3.38. With regard to the level of learning needs by sentence about CABG, 'Food that benefit heart disease', 'Recurrence possibility of heart disease', 'Management
method
of operation site', 'Risk symptom that visit hospital or report immediately' were higher than other sentenses. With regard to the level of learning needs by factor 'food(5 items)', 'disease(9 items)' and 'exercise(3 items)' showed the highest than other factors. The educational needs by patients characteristics tend to show higher in males, under the age of 49, middle or high school degree, previous experience of admission with coronary artery disease, history of myocardial infarction, expierience of PTCA, history of cerebro-vascular accident, previous expierience of smoking than in their counter parts. 4. The number of items answered 'don't know', wrong and correct weren't correlated with the level educational needs. As the results, the number of items answered 'don't know' tend to show higher in those who had less educated, blue color jobs and myocardiac infarction history than in their counter parts. There were higher frequency of items answered 'don't know' in those who had no hypertension . There were higher frequency of items answered 'don't know' on anti-thrombolitic theraphy, hypotension and pain relief. Also there were higher frequency of items answered wrong on bed rest period, cholesterol intake, and sexual life. Educational needs were higher in young age group, had previous experience of procesure and history of other disease. And when we educate CABG patients, education for diet, recurrence possibility of disease, management methods of operation site and risk symptom should be emphasized. There were higher frequency of items answered 'don't know' in those who had no hypertension.

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Effects of Group Art Therapy Program on Self-Esteem and Mental Health Status in Chronic Schizophrenic Inpatients
Kil Soo Chung
Journal of Korean Academy of Nursing 1999;29(6):1314-1323.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1999.29.6.1314
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The purpose of the study was to determine the effects of the 8-week, 15-session group art therapy program on self-esteem and mental health status in chronic schizophrenic inpatients. The sample consisted of two groups of chronic schizophrenic inpatients: 10 patients with an average of total disease duration of 8.90 years who participated in a 8-week group art therapy program, and 8 comparison subjects with an average of total disease duration of 8.25 years who did not participate in the program. A pretest-posttest quasiexperimental design was used to assess self-esteem and mental health status at the beginning and at the end of the 8-week, 15-session group art therapy program. The time points for obtaining data were matched for both groups. The effectiveness of the 8-week group art therapy program was assessed by Rosenberg's Self-esteem Scale(Rosenberg, 1965) and SCL-90- R(Derogatis et al., 1973). SPSSWIN 8.0 was utilized for data entry and analysis employing Mann-Whitney U test. The findings of the study indicated the followings: (a) No significant differences were found between two groups in self-esteem and (b) The experimental group showed significantly lower scores in obsessive-compulsive symptom dimension and interpersonal sensitivity symptom dimension on the SCL-90-R than the comparison group after participating in the group art therapy program. In conclusion, the findings showed the possibility of applying group art therapy as an effective nursing intervention for patients with lack of verbal communication skills and social interaction to improve their interpersonal relationship.

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The Comparison of the coping Patterns of Cancer Patients and Their Caregivers According to the Phases of Illness
Young Hee Yang
Journal of Korean Academy of Nursing 1998;28(4):970-979.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1998.28.4.970
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Cancer has been considered a life-threatening disease and coping patterns could have a string impact the physical and psychological health of patients and their family. The purpose of this study was to identify the change of coping patterns according to the phases of illness in the patients with cancer and their family caregivers and to compare the coping patterns of patients with those of their caregivers. The phases of illness consisted of 1st(initial) stage, 2nd(metastatic or recurred) stage and 3rd(terminal) stage based on literature. The coping methods were measured using the modified Ways of Coping Questionnaire by Lazarus and Folkman(1984). Seventy-nine patients(35 in stage 1,31 in stage 2, and 13 in stage 3) and ninety-two caregivers(38 in stage 1,30 in stage 2 and 24) agreed to participate from two general hospitals in Seoul and Choongnam. No significant changes were found in the coping patterns according to the phases of illness in both groups. Patients in stage 2 and caregivers in stages 2 and 3 problem-focused coping methods were significantly used more than emotion-focused coping methods. Patients in stage 1 significantly used two coping strategies that were cognitive reconstruction and emotion expression more than caregivers. Patents in stage 2 significantly used emotion-focused coping methods including minimizing threat, blame, and emotion expression excepting wishful thinking more than caregivers. We need more research to identify the relationship between the coping methods and their efficiencies through long-term observation and attempt to develop the nursing interventions that could have an improvement on positive coping methods and provide guidance on the problems the patients experience.

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A Study on Spiritual Well-being of Hemodialysis Patients
Chung Nam Kim, Woi Hyun Hong
Journal of Korean Academy of Nursing 1998;28(4):1036-1046.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1998.28.4.1036
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The purpose of this study was to investigate the spiritual well-being of hemodialysis patients and the correlation between spiritual well-being and demographic characteristics and disease related characteristics. The subjects for this study were 98 patients who were diagnosed as having chronic renal failure and were being treated at the hemodialysis units of three hospitals located in Seoul, Pusan and Taegu, Korea. Data were collected from October 27, 1997 to November 15, 1997 by an investigator interviewing with a structured questionnaire. Palautizion and Ellison(1982)'s spiritual well-being scale was used after some modification. The results of this study are as follows; To analyze the differences between demographic characteristics, spiritual well-being, and disease characteristics and the spiritual well-being, T-test and ANOVA were used. 1. There were statistically significant differences in spiritual well-being for the demographic characteristics of age(p=0.0145) religious affiliation(p=0.0001) and level of education(p=0.04). 2. There were statistically significant differences in spiritual well-being for the disease characteristics perceived health status(p=0.0014) and vigor(p=0.01). 3. The mean score for spiritual well-being in hemodialysis patients was 57.10of a possible range 22-88. Among the components of spiritual well-being, the mean score for religious well-being was 27.01 of a possible range 11-44, and for existential well-being 30.09 of a possible range of 11-44. 4. Correlation between general characteristics and spiritual well-being showed that there were significantly positive correlations for level f education(p=0.0036), perceived health status(p=0.0001), vigor(p=0.0036), perceived health status(p=0.0001), vigor(p=0.0036) and religion (p=0.0004).

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Actual Physical Symptom and Stress in Caregivers of Patients with Cerebrovascular Disease
Hee Seoung Kim, Hyeoun Ae Park, Mi Jeong Oh
Journal of Korean Academy of Nursing 1998;28(3):695-704.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1998.28.3.695
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This study amis for examines the actual physical symptom and stress in caregivers of patients with cerebrovascular disease. The data were collected by a survey conducted from August to September, 1997 which included 65 caregivers of cerebrovascular disease patient in 4 hospitals located in Seoul. The caregiver's stress was measured by Choi(1992)'s instrument and the actual physical symptoms were investigated. The data were analyzed using ANOV, Scheffe test, pearson correlation coefficient and stepwise multiple regression. The results were as follows : 1. The mean number of caregiver's physical symptom was 3.5. There were significantly higher number of physical symptom in women, those of who have a religious affiliation, those of two perceive their own health status perceived s bad, and those of two perceived their patients disease condition as serious than in their counterparts. Also, the number of caregiver's physical symptom was significantly higher in caregivers whose patients have a paralysis symptom and the disease onset as spontaneous. 2. The average of caregiver's stress was 57.9. The caregiver's stress was the highest in between the ages of 50 and 59. There were also significantly higher level of stress in women, those of two perceived the disease condition of their patient as serious than in counterparts. 3. The most common caregiver's physical symptom was fatigue(87.7%). This was followed by insomnia(58.5%) and muscle (47.4%). 4. Caregiver's physical symptom was positively correlated with caregiver's stress and negatively correlated with patient's activity of daily life. 5. The most important variable affecting the caregiver's physical symptom was patient's activity of daily life which accounted for 12.7% of the total variance in stepwise multiple regression analysis. The most important variable affecting the caregiver's stress was the patient disease condition perceived by the caregiver that accounted for 12.1% of the total variance.

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A Study of CVA patients' Experience of the Illness
Sun Young Nam
Journal of Korean Academy of Nursing 1998;28(2):479-489.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1998.28.2.479
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This work was done for 9 patients having experience of a herb medical treatment after being diagnosed as CVA during a year from January, 1996 to December, 1996 by using an ethnographic research method. The summarized result of this research are following. I. The Experience of The Illness. First, the falling-ill phase is the time that they have the first stork of paralysis and the decision pattern of medical institution' comes out. The emotional experience in the period is something like 'frustration', 'anxiety', 'despair', and 'expectation'. Second, the active-treatment phase is the time that the patients as well as their family or care giver not only show the positive attitude and actively participate in the illness treatment but also show a lot of interest in medical institutions and activities of health recovery. There is a primary factor of the continuation of treatment as an experience of treatment and being crushed and sensitivity as an experience of the illness. Third, the rehabilitation phase is the time that the patients or their family become tired and insensitive to the treatment and recuperation, and then reduce the treatment activity. There is a primary in fluence factor of the discontinuance of treatment as an experience of treatment and physical experience and emotional experience as an experience as an experience of the illness. The physical experience is divided into 'personal-hygiene care', and 'the sphere of activity'. The emotional experiences are 'blaming someone', 'contempt' and 'despair' as a negative experience and 'hope' as a positive experience. II. Coping Strategy. There are a physical coping, an emotional and mental coping, a coping, a social coping, and a spiritual coping as a coping strategy used for the patients to overcome their illness and adjust themselves to their altered life. First, the physical coping comes out as 8 categories, 'using and auxiliary tool', 'doing exercise', 'protecting', 'improving their diet', 'taking care of something', 'using subsidiary medicines', 'trying a folk remedy', and 'having interest in their health'. Second, for the emotional and mental coping, there are 'accepting' and 'trying' as a positive coping and a failure of control as a negative coping. Third, the social coping is appeared as 'being supported'. Fourth, the spiritual coping is recognized as 'recourse to God' and 'preparation of death'. After all, the elderly CVA patients in a agricultural area choose the act of treatment based on the traditional belief and the relationship with a caretaker. A personal health can be maintained by taking care of themselves and controling their mind, and the overcome of the illness is decided on the basis of traditional concepts and cultural principles in which the patients as well as the family, neighbors and take care should work out together and cooperate with each other in order to achieve that.

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The Experiences of Patients in Intensive Care Units(ICU)
Young Hae Kim, Mi Jee Koo, So Hee Kim, Young Mi Kim, Nae Young Lee, Koung Oh Chang
Journal of Korean Academy of Nursing 2007;37(6):924-931.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2007.37.6.924
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PURPOSE: The purpose of this study was to describe the essence of the experiences of patients in an ICU, and to understand them from the patients' point of view. METHODS: Participants in this study were six patients in P hospital. Data collection consisted of in-depth interviews and an observation method done from January to April in 2005. The method was analysis using the phenomenological method proposed by Colaizzi(1978). RESULTS: The themes were classified into eight theme clusters. The eight theme clusters were finally grouped into four categories, 'shock', 'pain', 'gratefulness' and 'pleasure of revival'. CONCLUSION: The ICU patients had negative experiences in physical.mental critical situations, but also positive experiences in consolation and nurses and families' encouragement. Therefore, ICU nurses must support patients and their families to minimize the negative experiences and maximize the positive experiences.

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