The main purpose of this study was to explore the effect of the stress of hospitalization on the ?sleep pattern. Additionaly, this study was also to ?demonstrate how Johnson's nursing model may be applied to as nursing process. 104 hospitalized patients on surgical and medical wards were asked to rate 49 stress producing events associated with experience of hospitalization and sleep pattern scale. Five university hospitals were used as the setting for this study. Data fur the study were collected by patient interview during hospitalization, self-reports and review of charts. For the analysis of the data, the pearson's correlation analysis of covariance and regression analysis were used. The results of this study were stated as follows; 1. The mean of the hospital stress scores was 111.261(S.D.=26.160). This means that the level of the hospitalization stress is high. The mean of the sleep pattern scores was 12.204(S.D.=2.615) This means that she characteristics of the sleep pattern is poor. 2. The relationship between the hospitalization stress and sleep pattern was statistically significant at .01 level. 3. The effect of the hospitalization stress influenced strongly on the sleep pattern after sex, trait anxiety as covariates controlled. 4. The hospitalization stress revealed a 12% prediction as an influenced factor for the sleep pattern. Therefore, It can he said that the hospital stress did contribute significantly to the characteristics of the sleep pattern. Johnson's model can he also said that it is useful for the the assessment and diagnosis in nursing process.

The purpose of the present research is to evaluate the therapeutic ingredients-empathy, warmth, and intimacy - as perceived by patient in the relationship with nurses during his hospitali-zation. "Relationship Questionnaire" developed by C. B. Truax during 1963 was administered from September 1976 to December 1976 to a sampling of 61 discharged patients, 20 were received by mail questionnaire, 19 were successfully interviewed by their doctor at a regular psychotherapy meeting, 22 were contacted by nurses or psychiatric residents at discharge day. Findings showed that 1) the total mean score of therapeutic ingredients of nurses was 9. 54 ; 2) the total mean score of empathy, warmth and intimacy was 10. 10, 9.57, and 9.00 ; 3) there was the significant relationship between therapeutic ingredients and other variables -sex, education, number of admission, helpfulness ratings of admission and, present health condition- ; 4) there was no significant<relationship between therapeutic ingredients as patient's perception and age, duration of admission, or motivation of admission, or follow -up care ; 5) there was no relationship among empathy, warmth and intimacy ; 6) the ranking of the important psychiatric personnel who were marked as the helper at the treatment and understanding for patient's recovery, was psychiatric doctor and nurse and then nurse student and then nurse aid.

No abstract available.

No abstract available.

More and more emphasis is put on moral treatment in the care of psychiatric patients. Methods emp- loyed for meral treatment make use of therapeutic activity for the mentally ill patient. In some psychi- atric hospitals all of the thrapeutic activities are categorized as occupational therapy, while in others these activities are departmentally categorized recreational, musical, occupational and bibliotherapy. All of these constitute separate departmental therapise. By research, it is known at this time, that the above activities have been of great help in personality integration, reeducation and early recovery of patients, as well as in their sccial adjustment after discharge. The goal of these therapeutic activities incorporate the goals set by healthier interpersonal relationship and psychotherapy. But the therapeutic activities require a prolonged time of therapy for effectivness, economic support. special trained personnel, careful planning, guidance and proper evaluation. Therefore this treatment is a very complicated one. But it may be the most profitable therpy for certain patients. One true fact about this treament is, that simple recreation, occupation, music, reading, etc.. make the patients life in the ward more interesting and have a good effect on the interpersonal relationship between patients. Thus it has been proved that this kind of treatment demands the active and full participation of the personnel and the full support of the hospital administration.

Koreans are one of the fastest growing immigrant groups in America. Stress responses and stressors among this large cultural minority has been rarely been studied by nursing researeliers. Adjusting to life in foreign country produces a great deal of stress. Differences in culture, language, expectations and social behavior can lead to misunderstandings between health care providers and clients. These misunderstandings are not well accounted for in health assessment. This study investigated the relationship between life events or/and daily activities as a stressor and the symptoms of stress among a sample of Korean immigrants in America. The symptoms of stress scale (SOS) was used to identify stress responses and open ended questions were used to identify life events and daily activities considered by the respondents to be stressful. A simple random sample of 283 subjects was selected from the Directory of the Korean Society of Chicago, New York, Los Angeles, Philadelphia and Seattle. Demographically, the subjects ranged in age from 20 to 69 years, and the percentage of women and men was approximately 50% each. Almost ninety percent of the subjects were highly educated, 17% owners of business, 19% white collar professionals, 14% employed in sales or as skilled/unskilled labor, 27% as housewives and students and 3% had no occupation. The total group SOS mean was 0.8042; the SOS men for man was 0.7371, and for women was 0.8713. The stress response of this subject group was high, -the stress response of women higher than that for men. In an earlier study (June, 1992) with another sample, the total mean SOS score was similar to this one. The main stressful life events or/and daily activities were, in order, economic problems (N?7), interpersonal problems (N=68), children care problems (N=258), health problems (N=49), communication problems (N=42), family problems (N=38), worry about future career (N=36), and religious problems (N=25). There was a significant difference in the SOS means between the group that expressed life events or/and daily activities to be stressful and the group that did not. Interpersonal relationships and economic and family problems were stressors for those who complained about peripheral manifestations, cardiopulmonary symptoms, central-neurological symptoms, gastro intestinal symptoms, muscle tension, habitual patterns, depression, anxiety, emotional irritability and cognitive disorganization. In summary, interpersonal relationships and economic and family problems influenced stress response manifestations. Income, the number of people in the family, the year of immigration, the level of edu cation, and marital status were related to physiologi cal and psychosocial stress responses.

The study was conceived in relation to a concern over the growing gap between the needs of chronic patients and the availability of care from the current health care system in Korea. Patients with agonizing chronic pain, discomfort, despair and disability are left with helplessly unprepared families with little help from the acute care oriented health care system after discharge from hospital. There is a great need for the development of an alternative means of quality care that is economically feasible and culturally adaptable to our society. Thus, the study was designed to demonstrate the effectiveness of home health care as an alternative to bridge the existing gap between the patients' needs and the current practice of health care. The study specifically purports to test the effects of home care on health expenditure, readmission, job retention, compliance to health care regime, general conditions, complications, and self-care knowledge and practices. The study was guided by the operations research method advocated by the Primary Health Care Operations Research Institute(PRICOR) which constitutes 3 stages of research : namely, problems analysis solution development, and solution validation. The first step in the operations research was field preparation to develop the necessary consensus and cooperation. This was done through the formation of a consulting body at the hospital and a steering committee among the researchers. For the stage of problem analysis, the Annual Report of Seoul National University Hospital and the patients records for last 5 years were reviewed and selective patient interviews were conducted to find out the magnitude of chronic health problems and areas of unmect health care needs to finally decide on the kinds of health problems to study. On the basis of problem analysis, the solution development stage was devoted to home care program development as a solution alternative. Assessment tools, teaching guidelines and care protocols were developed and tested for their validity. The final stage was the stage of experimentation and evaluation. Patients with liver diseases, hemiplegic and diabetic conditions were selected as study samples. Discharge evaluation, follow up home care, measurement and evaluation were carried out according to the protocols of care and measurement plan for each patient for the period of 6 months after discharge. The study was carried out for the period from Jan. 1987 to Dec. 1989. The following are the results of the study presented according to the hypothesis set forth for the study : 1. Total expenditures for the period of study were not reduced for the experimental group, however, since the cost per hospital visit is about 4 times as great as the cost per home visit, the effect of cost saving by home care will become a reality as home care replaces part of the hospital visits. 2. The effect on the rate of readmission and job retention was found to be statistically nonsignificant though the number of readmission was less among the experimental group receiving home care. 3. The effect on compliance to the health care regime was found to be statistically significant at the 5% level for hepatopathic and diabetic patients. 4. Education on diet, rest and exercise, and medication through home care had an effect on improved liver function test scores, prevention of complications and self-care knowledge in hepatopathic patients at a statistically significant level. 5. In hemiplegic patient, home care had an effect on increased grasping power at a significant level. However, there was no significant difference between the experimental and control groups in the level of compliance, prevention of complications or in self-care practices. 6. In diabetic patients, there was no difference between the experimental and control groups in scores of laboratory tests, appearance of complications, and self-care practices. The above findings indicate that a home care program instituted for such short term as 6 months period could not totally demonstrate its effectiveness at a statistically significant level by quantitative analysis however, what was shown in part in this analysis, and in the continuous consultation sought by those who had been in the experimental group, is that home health care has a great potential in retarding or preventing pathological progress, facilitating rehabilitative and productive life, and improving quality of life by adding comfort, confidence and strength to patients and their families. For the further studies of this kind with chronic patients it is recommended that a sample of newly diagnosed patients be followed up for a longer period of time with more frequent observations to demonstrate a more clear-cut picture of the effectiveness of home care.

This study explored differences in how medical and surgical patients compare on the degree of hospital stress and their subjective physical status. Subjects were 343 medical and surgical patients in five university hospitals in Seoul and Taegu. They responded to the Hospital Stress Rating Scale and a self-report on physical status. The controlled variables were age, education, number of previous hospitalkations and seriousness of the illness. Medical and surgical patient differences on nine factors of the hospital stres scale and nine areas of physical conditions were reported as follows edptored ; 1. 1) There was not a statistically significant difference at the .05 level in the total mean score for hospital stress between medical patients and surgical patients. 2) The mean score of the factor lack of information (M=2.308) for medical patients was higher than the mean score (M=2.064) of the surgical patients. 3) The mean scores of the factor of discomfort (M=2. 130), toss of independence (M=1.889) for surgical patients were higher than for medical patients. 2. 1) There was a statistically significant difference at the .05 level in the total mean score for physical status between medical patients and surgical patients. 2) The mean scores were lower in subjective physical status for surgical patients(S) than for medical patients (M) : stomach condition (S : M=2.8433, M : M=3.0-000), self-assistance(S : M=3.0373, M : M=3.4498), movement (S : M=2.6716, M : M=3.2392), interest in your surroundings (S : M=3.0522, M ; M=3.2632). 3. Patients scoring high on the subjective physical status such as sleep, appetite, stomach condition, bowel condition and urination states had higher scores in hospital stress than with patients scoring tow on those subjective physical status. The results suggest that subjective physical status might be on expression of hospital stress. Also patients with high scores in subjective physical statas might be predicted have a high level of stress on admission. And surgical patients had a higher level of hospital stress than medical patients.

No abstract available.

This study was to explore the level of self-actu-alization of the students in Korea Air and Correspondence University. The study subjects consisted of 507 students who visited the counseling center for taking advices to several psychosocial problems due to distance education through nursing counseling. The self actualization of the subjects evaluated by the self-actualization Inventory standardized by Kim and Lee in Korea. It consisted of 130 two-choice comparative value and behavior judgements. The items also consisted of two basic scales; one is inner directed scale (107 items) and the other is time competence (23 items) which included eight subscales, each of which measures a conceptually important element of self-actualization. Analysis of finding was as follows; 1) The self-actualization mean score of the total subjects was characterized by normal value within normal range of scale. The highest subscale score was NC scale; the lowest scale was EX scale. 2) The mean score of time competence scale of female student was higher than male student's time competence scale. 3) There was no significant differences in self actualization among 4groups in age. 4) There was also no significant differences in self-actualization between the group taken one time nursing counseling and the group taken two more times nursing counseling. 5) The problems of Job, learning, personality and further study, significantly had effects on the score of self-actualization level.

PURPOSE: The purpose of this study was to investigate the effects of biofeedback exercise training on muscle activity and activities of daily livings (ADL) in hemiplegic patients. An experimental group consisting of 17 people, was given biofeedback exercise training for 30- 60 minutes per week for 5 weeks, while a control group consisting of 18 people, was given normal exercise with quasi-experimental design. RESULT: The results of the study show that biofeedback exercise is effective for improving muscle activity in hemiplegic patients, especially in the hemiplegic limbs. However, this study found no significant differences in ADL and IADL between the experimental and the control groups. It implies that ADL and IADL may not be improved for a short period of time, such as 5 weeks, for people with more than five years of hemiplegia. The study suggests that the effect of biofeedback exercise on ADL and IADL should be determined in hemiplegic patients in acute stage.

A phenomenological study was conducted to investigate the experiences of mothers pregnant via in vitro fertilization (IVF). Sample of nine mothers participated. Ten theme clusters emerged when the formulated meanings were organized into categories. During the infertility period, the participants were subject to self- depreciation, envy, anxiety, and depression. It changed their priorities in life from a job-oriented life to one where having a baby was the most important thing. After trying numerous alternative therapies, IVF became their last hope in having a baby. Since the success rate for IVF is low (only 20-30%), the participants for the treatment were overwhelmed with uncertainty, and it led to further anxiety, depression and despair. Success of pregnancy gave them extreme satisfaction, but they became very cautious in their day-to-day life because of their fear of abortion and early delivery. Some were even worried about the side effect of IVF during the pregnancy. Finally, the delivery of the baby gave them relief from the obligation of having a baby. Women did not have any difficulties in rearing a "test tube baby" except in the case of twins. Most women had no ethical difficulty in having a baby by IVF. However they did not wish this information to be revealed to other people. They again turned to IVF to have a son(s) when the resultory child(s) was a daughter(s). This is because of the strong preference for sons in Korean society.

This study, based on current home nursing services, aims at promoting measures for establishing a community-based home nursing system derived from the pilot home nursing demonstration project conducted by the Seoul Nurses Association. The study was based on an analysis of home nursing records from march 1993 to December 1999. The following is a summary analysis, based on individual characteristics of the patients, the organization, which recommended the service for their patients and personnel services. 1. The service has been used by many elderly people 60years of age or older(66.4%). and married people(60.9%). The average number of visits by service personnel for patients of city government was 23.5. This is 2.5 times as many visits by general patients. General patients(20.2%) had only one visit from service personnel, while 65.5% of patients of city government had 10 or more visits. Particularly, for government recommended patients, 72.7% of the patients were recommended by nurses, while only 21.9% where referred to the services by doctors. The main focus of a home nursing service was to maintain present health status (53.4%), and hospice(11.6%). Also to increase hospital-based home nursing services focused on recovery(55.9%) and maintain present health conditions (19.0%). 2. For general patients, 42.0% of patients were suffering from problems related to CVA, 11.3% from high blood pressure, and for patients referred from city, 21.2% from skeletal muscular disease. Results of home nursing services 29.4% of patients were able to recover or maintain their health status, but 48.9% of the patients died. Another main point of community-based home nursing services is medication(6.7%), other basic nursing services(6.1%), special treatment, instructions on how to use medical devices(5.9%), change of physical posture(4.6%), and training on changing physical positions(4.7%). As mentioned above there were some differences between the characteristics of patients who used the pilot home nursing service conducted by the Seoul Nurses Association and those hospital-based service users. The results are believed to be useful to support a community-based home nursing service model. Particularly, patients under medical supervision and patients recommended by government-run health clinics show a higher frequency and longer use of home nursing services compared to general patients or hospital-based home nursing service users. According to the study, nurses accounted for a large number of recommendations for home nursing services. Many patients with CVA, high blood pressure, skeletal muscular disease and bedsores used community-based home nursing services, while others used the service for minor treatments or maintaining their current health status. Based on the study, the researchers make several suggestions to establish a community- based home nursing service system. First, different ways of setting up a community-based home nursing system have to be mapped out based on the evaluation of the pilot home nursing service conducted by the Seoul Nurses Association. Secondly, a new, community-based, home health care nursing service model, and reimbursement payment system have to be developed. This is based on the outcome of the analysis, and implemented policy. Accordingly, efforts are needed to develop a community- based home nursing system with an intermediary role to promote the visiting nursing services of government-run health centers.

In this study, we attempted to investigate the needs and problems of the terminal cancer patients and their family caregivers to provide them with nursing information to improve their quality of life and prepare for a peaceful death. Data was collected from August 1, 1995 to July 31, 1996 at the internal medicine unit of S hospital in Seoul area with the two groups of participants who were family members of terminal cancer patients seventy four of them were in-patients and 34 were out-patients who were discharged from the same hospital for home care. The research tool used in this study has been developed by selecting the questionnaires from various references, modifying them for our purpose and refining then based on the results of preliminary study. While general background information about the patients was obtained by reviewing their medical records, all other information was collected by interviewing the primary family caregivers of the patients using the questionnaire. The data collected were analyzed with the SPSS PC+ program. The results of this study are summarized as follows; 1) Most frequently complained symptoms of the terminal cancer patients were in the order of pain(87%), weakness(86.1%), anorexia(83.3%) and fatigue(80.6%). 2) Main therapies for the terminal cancer patients were pain control(58.3%), hyperalimentation(47.2%) and antibiotics(21.3%). 3) Special medical devices that terminal cancer patients used most were oxygen device(11.1%), and feeding tube(5.6%). Other devices were used by less than 5% of the patents. 4) The mobility of 70.4% of the patients was worse than ECOG 3 level, they had to stay in bed more than 50% of a day. 5) Patients wanted their medical staffs to help relieve pain(45.4%), various physical symptoms(29.6%), and problems associated with their emotion(11.1%). 6) 16.7% of the family caregivers hoped for full recovery of the patients, refusing to admit the status of the patients. also, 37% wished for the extension of the patient's life at least for 6 months. 7) Only 38.9% of the family members was preparing for the patient's funeral. 8) 45.4% of family caregivers prefer hospital as the place for the patient's death, 39.8% their own home, and 14.8% undetermined. 9) caregivers of the patients were mostly close family members, i.e., spouse(62%), and sons and daughters or daughter-in-laws(21.3%). 10) 43.5% of the family caregivers were aware of hospice care. 46.8% of them learned about the hospice care from the mass media, 27.7% from health professionals, and the rest from books and other sources. 11) Caregivers were asked about the most difficult problems they encounter in home care, 41 of them pointed out the lack of health professionals they can contact, counsel and get help from in case of emergency, 17 identified the difficulty of finding appropriate transportation to hospital, and 13 stated the difficulty of admission in hospital as needed. 12) 93.6% of family caregivers demanded 24-hour hot line, 80% the visiting nurses and doctors, and 69.4% the volunteer's help. The above results indicate that terminal patients and their family caregivers demand help from qualified health professionals whenever necessary. Hospice care system led by well-trained medical and nursing staffs is one of the viable answers for such demands.

For producing large numbers of professional nurses who could manage 21th century's human health, it is necessary to review the direction of registered nursed' national examination which evaluates the nursing education and is granted a licence. For adapting to social expectation of the nurse, we have to nurture the nurses' problem solving capability in clinical setting. Seven divisions of Korean Academy of Nursing suggested clinical competency according to their categories. This paper was presented in the workshop for setting up direction of registered nurses' national examination. We expect that this paper would be more refine and confirm through reviewing subdivisions' learning objectives and discussing clinical minimum level of competence contents with clinical leaders.

The purpose of this study was to develop a reliable and valid instrument to measure hope for cancer patients in Korea. This Hope Scale(Kim and Lee Hope Scale : KLHS) was developed based on not only critical universal attributes explaining both basic hope (generalized hope) and specific hope but also particular characteristics varying from culture and situation, which were revealed in a comprehensive review of the literature. Initially 60 items were generated from three sources : 36 items from the Q-sample used in the Kim's study, 1992, 21 representative items(statements) from the rest Q-population of the above study, 3 items related to the newly discovered category in the new qualitative study using 10 open ended question(death and dying) from the new qualitative study on the 20 cancer patients. At first 3 items were eliminated by the critique of the content validity experts, who were high experienced nurse, nursing professors. And then 4 items were eliminated in consideration of corrected item total correlation coefficiency, theoretical framework of this study. After that, 14 items were eliminated in comparing two or three items identified with the same meaning in each factor by this research team with factor loading and communality. This Hope Scale was finally constructed with 39 items. Psychometric evaluation was done on 492 adults(104 cancer patients, 338 adults who imagined who were cancer patients ranging from 18 to 76 years old. The results revealed high internal consistency Alpha coefficiency of .9351. Principal Component Factor Analysis with Varimax Rotation resulted in 8 factors with more than 1.0 of Eigenvalue. Referring to Eigenvalues percent of variances(>60%), reproduced correlation matrix, and our theoretical framework, we decided the eight factors were the best solution to represent hope dimension sufficiently. The eight factors were "confidence in possibility of cure", "sense of internal satisfaction", "being in communion", "meaning of life", "Korean hope perspectives", "belief in god", "self confidence", "self-worth". Among these factors, "confidence in possibility of cure", "sense of internal satisfaction", "Korean hope dimensions from those of Nowotny Hope Scale and Herth Hope Scale. There was significant negative correlation of r=-.4736 between this hope scale and Beck Hopelessness Scale(BHS), and significant positive correlation of r=.3685 between this hope scale and Life Orientation Test(LOT) which indicate convergent and discriminant validity. The range of hope scores was from 71 to 244, with a mean of 171.97(SD=28.16).