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

The purpose of this study was to call attention to the mental, physical and occupational hazards of the anticancer-drug-handling nurses by examining the possible urinary mutagenicity and measuring physical symptoms and stress level of the nurses exposed to anticancer drugs. The experimental group of the urinary mutagenicity assay was 14 nurses handling anticancer drugs at the medical wards of a hospital located in J city; the control group was 12 psychiatric nurses of the same hospital. The test material was the nurses' 24hrs urine, which was concentrated by XAD-2 column chromatography. Tester strains were TA98( +/- S9 mix), TA100( +/- S9 mix), TA1535( +/- S9 mix) and TA1537( +/- S9 mix); Salmonella mammalian-microsomal test (Ames test) was employed for the urinary mutagenicity assay. The physical symptoms of which the nurses experienced were investigated through self-reports on open-questionnaires. The stress levels of the experimental group were measured by a stress measuring instrument developed by this author. Reliability of this instrument was found to be adequate (Cronbach's Alpha=0.9079). To ascertain the urinary mutagenicity of the experimental group, the mean and the standard deviation of the colonies of Tester strains appearing on the minimal plates were taken and compared differences between two groups. T-test was employed for the significance test of two groups. The physical symptoms were compared between the two groups through the analysis of the nurse' self-reports. The mean and standard deviation of the stress levels of the experimental group were also calculated and were examined through t-test. The results were summarized as follows: 1. The experimental group revealed significantly higher urinary mutagenicity both in the activation method test and the non-activation method test of the tester strains TA98, TA100 and TA1535. In the case of TA1537, two groups showed no difference in the non-activation method test, but the activation method revealed difference. 2. The physical symptoms were also much more frequently reported in the experimental group. 79. 3% of the experimental group reported more than 1 kind of physical symptoms. On the other hand, 33.2% of the control group complained of 1 kind of physical symptom. The items with high symptom frequency were 'headache', 'itching sensation', 'corneal congestion', 'skin allergy'. 3. The mean score of stress in the experimental group was 2.41(range 1-4). The experimental group showed the stress level above 2.0 in the 14 of 15 items in all. The highest stress level were recorded in the following items in the order quoted, 'I fear that anticancer drug may touch any part of body while handling it.', 'I feel concerned there is no protective countermeasure against anticancer drug handling.', 'I am afraid the anticancer drug handling may produce a fetal loss in the future'.

SIGNIFICANCE OF THE STUDY: Acute myocardial infarction (AMI) is a major cause of death in Korea. Delay in seeking treatment may cause unnecessary exacerbation of the disease and early mortality from AMI. Patients' recognition of symptoms of an AMI and response to those symptoms may influence the delay time. Bystanders' role in patients' seeking treatment after AMI has not been studied in previous research. Understanding reasons for delay in seeking treatment is important in developing interventions for reducing these delays and increasing survival rate from AMI. PURPOSE OF THE STUDY: A retrospective survey was conducted with 144 AMI patients to: (1) investigate time from symptom onset to arrival at the first hospital for treatment of AMI; (2) describe patient's and bystander's response to the patient's symptoms; (3)examine whether patient's and bystander's responses affect delay time.
RESULTS
The mean of overall pre-hospital delay time was 13.64 (21.86) hours and it consisted of patients' delay of 13.64 (22.32) hours and transportation time of 24.86 (19.41) minutes. People living in rural area delayed longer than people living in urban area. Pre-hospital delay time was associated with the bystander: patients delayed longer when they were with their spouse, family and friends than when with colleagues at work. Calling 119 saved transportation time, but did not reduce overall pre-hospital delay time.
CONCLUSION
AND SUGGESTIONS: Patients delay longer than the time window for a successful reperfusion therapy when they experience symptoms of AMI; and calling 119 does not diminish this delay. Bystanders' adequate response to the patients' symptom may reduce the delay time in seeking treatment. Findings from this study may suggest that health education and public campaigns are needed to increase people's recognition of symptoms of an AMI and to promote adequate response from bystanders to the AMI symptoms. In addition, public campaigns urging car operators to yield to the emergency vehicle are needed in order to reduce transportation time.

SIGNIFICANCE OF THE STUDY: Acute myocardial infarction (AMI) is a major cause of death. Most of the deaths from AMI, if diagnosed and treated early enough, can be prevented. Delay in treatment may cause unnecessary exacerbation of the disease and even death in AMI patients. PURPOSE OF THE STUDY: A retrospective survey was conducted to (1) investigate the delay time in AMI patients' seeking treatment from symptom onset to arrival at the first hospital (overall pre-hospital delay), the length of time taken for decision-making (patients' delay) and transport (transportation time); (2) to identify factors associated with delay times; (3) to compare delay times between the group who called 119 and the group who did not.
RESULTS
The mean of overall pre-hospital delay time was 17.42 (+/-24.03) hours and it was consisted of patients' delay, 17.07(+/-24.45), and transportation time, .84 (+/-2.34). None of socio-demographic variables such as age, sex, marital status, monthly income, education, and living environment was associated with either the patients' delay or the overall delay time. Living rural area (F=4.483, p=.016), having previous MI (F=35.252, p=.000), and other heart disease (F=69.435, p=.000) decreased transportation time; having previous heart disease decreased overall pre-hospital delay(F=4.489, p=.039); and having angina (F=92.907, p=.000) and CAD (F=9.724, p=.003) increased transportation time. Place of symptom attack, bystander, whether patients or bystander called 119, modes of transportation, intensity of pain, presence of typical chest pain and anxiety perceived by patients were not associated with any of delay times. No significant differences appeared between the group who called 119 and the group who did not in any of delay times.
CONCLUSION
AND SUGGESTIONS: Although number of patients who arrive at the hospital early enough for treatment tend to be increasing, considerable number of patients still delayed longer than desired when they experienced symptoms of AMI, and calling 119 did not diminish this delay because patients delayed mostly before they decided to call. Living urban area, having previous MI, and heart disease decreased transportation time whereas having previous heart disease decreased the overall pre-hospital delay time and having previous angina and CAD increased transportation time. Further studies to identify reasons for real late arrivals as well as public campaigns to reduce delay time in treatment are needed.

PURPOSE: To extend the understanding on climacteric symptoms, and to improve women's health and the quality of life by providing the basic data relating to the climacteric symptoms of natural menopausal women and artificial menopausal women.
METHOD
The subjects of this study were 149 women selected conviniently (89 natural menopausal women and 60 total hystrectomy women) who have visited the climacteric clinic of G. hospital in Inchon, the MENSI questionnaire which was developed by Sarrel (1995)was modified considering Korean culture for the measuring tool of this study with 20 items of question(Cronbach'salpa =.76), duration of data collection with the questionnaire was 5 months from Sept. 1, 2000 to Jan. 30, 2001.
Result
Artificial meanopausal women showed statistically significant higher menopausal symptoms than the natural menopausal women in the most of the items, and psychiatric and urogenital symtoms of artificial menopausal women were significantly higher than those of the natural menopausal women.
CONCLUSION
Nursing intervention for psychological support upon artificial menopausal women and their spouses is recommended more than natural menpause women.

The theory of unpleasant symptoms is a middle-range theory proposed by Lenz and her colleagues (1997). Analysis and evaluation of this theory was performed using Fawcett (1999) and Fawcett and Downs's (1992) guidelines. Results of the theory analysis and evaluation suggest that the theory of unpleasant symptoms has theoretical and social significance and parsimony. However, a lack of internal consistency was evident. For empirical adequacy of the theory, it is recommended that research be conducted examining the complexities of the interaction effects, reciprocal relationships, and medication effects among physiological, psychologic, and situational factors, symptoms, and performance. The knowledge derived from the research findings should be used in practice for patients experiencing symptoms.

The purpose of this study was to identify the influencing factor on Symptoms of Stress of Middle Aged Women. The subjects of this study were 35 middle aged women who lives in Seattle, Washington in U.S, and 74 middle aged women who lives in Seoul. Data collection was performed at the University of Washington and Seoul from Oct. 1998 to May. 1999. Data collected through 4 types of questionnaires : SOS, Ways of Coping, Mood Status, Perceived Stress. The results of this study are as follows: 1. The stress symptoms showed positive correlation with emotion-oriented coping, mood status, and perceives stress. 2. Stepwised multiple regression analysis revealed that most powerful predictor of Stress Symptoms was mood status. A combination of perceived stress, mood status and ways of coping account for 64% of the variance in Symptoms of stress in Middle aged women. From the results of the study, the following recommendations are presented as follow: 1. It is necessary to replicate this study with a larger sample. 2. It is necessary to develop a stress management program focused on ways of coping, mood status, perceived stress for middle aged women.

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.

The purpose of this study was to identify the level of Symptoms of Stress, Stress Reaction, Health Promoting Behavior, and Quality of Life in Korean Immigrant Middle Aged Women. The subjects of this study were 33 middle aged women who live in Seattle, Washington, U.S.A. Data collection was performed at the U.W from Oct. 1998 to May. 1999. Data collection time was one hour and data was collected through 4 types of questionnaires : SOS, Health Promoting Behaviors, Quality of Life and Demographic data form, and the Physiologic Stress Profile was collected by J&J I-410 biofeedback equipment. The data was analyzed by descriptive statistics and the pearson correlation coefficient using the SAS program. The results of this study are as follows: 1. The level of physiological stress reaction and stress symptoms showed high level and quality of life showed low in general. 2. The Stress Reaction and Symptoms of Stress showed significant negative correlation with health promoting behavior, quality of life in the middle aged women. 3. The health promoting behavior showed significant positive correlation with quality of life in the middle aged women. In conclusion, the physiological stress reaction, symptoms of stress, and health promoting behavior were major influencing factor to quality of life in Korean Immigrant Women. From the results of the study, the following recommendations are presented as follow: 1. It is suggested that the study for developing the health promotion program focused on stress self-regulation for Korean immigrant women. 2. It is suggested that the comparative study for Korean immigrant women and Women in Korea. 3. It is necessary to broaden the scope of nursing practice for middle aged healthy women, so nurses can include a health promotion program focused on stress self-regulating as part of nursing care.

Researchers have rarely explored menopausal experience in the context of the totality of women's lives, subsequently making the picture of menopause incomplete, discrete and fragmented. Respecting the totality of women's lives, this study addressed how a vulnerable group of women-low income Korean immigrant women-experience menopause within a context of multiple transitions. This is a cross- sectional study using methodological triangulation. A sample of 119 first-generation Korean immigrant women aged 40 to 60 years, who were in low-income jobs, was recruited using convenience sampling methods. From the total sample, 21 peri- or post- menopausal women were recruited for in-depth interviews following the collection of the survey data. Questionnaires, short interviews, and in- depth interviews were used to collect data. The quantitative data were analyzed using descriptive and inferential statistics. Thematic analysis was used to interpret interview data. The findings indicate that menopause was given the lowest priority amidst women's multiple and demanding roles within a gendered multiple transitional (immigration, work and menopause) context. The lack of language clarity to describe women's experience, cultural background, inadequate knowledge, and lack of social supports made menopause hidden, invisible, and inaudible. Conclusions and implications for nursing practice are guided by the goal of understanding women's experiences and meanings of menopause and supporting women through reflecting these experiences into their health care.

The purpose of this study was to analyze the relationship among the health promoting behaviors, self-reported climacteric symptoms and depression on a cross-sectional survey design. The subjects were 108 middle-aged women who were non-hystrectomized and ranged in age from 40 to 60. They were selected in Seoul and Kyoung-ki province, Korea. Data were collected from Oct. 25 to Nov. 10, 1997 by a structured questionnaire. The instrument used for this study was the revised Health Promotion Lifestyle Profile(HPLP) developed by Walker, Sechrist and Pender, revised Climacteric Symptoms Scale developed by Chi, Sung Ai, and the Beck's Depression Inventory(BID). The data were analyzed by the SPSS/PC+ program using t-test, ANOVA and Scheffe test as a post hoc and Pearson Correlation Coefficient. The results of the study were as follows ; 1. The mean score of health promoting behaviors was low(2.42+/-0.35). There were statistically significant difference in the score of health promoting behaviors according to the educational background, family income, marital satisfaction, and whether or not taking a restorative food(t=-2.07, F=2.60~7.57, p<0.05). 2. The mean score of self-reported climacteric symptoms was 1.69 ; 99% of middle-aged women had symptoms. There were statistically significant difference in the score of middle-aged women's self-reported climacteric symptoms according to the age, number of children, educational background, occupation, family income, marital satisfaction, whether or not receiving hormone replacement therapy(HRT) or consultation experience with a professional, and perceived health status(t=-2.04~3.69, F=2.87~11.63, p<0.05). 3. The mean score of depression was 10.84. There were statistically significant differences in the score of the depression according to the age, number of children, educational background, occupation, marital satisfaction, whether or not receiving menopausal treatment of consultation by a professional, and perceived health status(t=-2.25~3.00, F=3.50~9.24, p<0.05). 4. Women's degree of health promoting behaviors was a negative correlation with the degree of climacteric symptoms(r=-0.19, p=0.03) and the degree of depression(r=-0.23, p=0.01). The degree of climacteric symptoms was a positive correlation with the degree of depression(r=0.64, p=0.01). In conclusion, health promoting behavior should be considered when developing nursing strategies for middle-aged women, especially when dealing with climacteric symptoms and depression.

PURPOSE: The purpose of this study was to investigate the relationships among depression, somatic symptoms, and activities of daily living of elderly women in urban areas. METHOD: After obtaining participant's consent forms, a one-time, face-to-face, and private interview was conducted with each participant from Sep, 2006 to Jan, 2007 by trained graduate-level students. The questionnaire consisted of K-GDS, PHQ-15, Barthel Index, and Instrumental Activity of Daily Living. The collected data was analyzed with the SPSS/PC 12.0 program, which was used for frequency, percentage, mean, standard deviation, Pearson correlation coefficients, and multiple regression. RESULTS: The major findings of this study were as follows 1) 34.1% of participants belonged to the depression group. 2) There were significant relationships between depression and monthly income, somatic symptoms, ADL, IADL, and number of chronic disease. 3) Significant factors influencing depression were somatic symptoms, ADL, and monthly income. CONCLUSION: The results of this study give useful information for designing interventions and program development for appropriate depression management and care for elderly women.