Postpartum depression is one of the most serious problems in maternal health because it affects not only the mother but also her family. Postpartum depression disturbs the maternal-infant interaction and attachment. However, most postpartum depression patients ignore this problem and do not seek treatment. Many clinicians and researchers realize there is a need to develop a postpartum depression scale. Thus, this study has been designed to development of a postpartum depression scale. Data were collected through a survey over a period of three months. Subjects who participated in the study were 167 Korean mothers in their postpartum period. The author used a convenience sampling method. The analysis of the data was done with SPSS PC+ for descriptive statistics, item analysis and factor analysis. Initially 62 items were generated from the interview data of eight postpartum depression patients and from a literature review. This preliminary scale was analyzed for reliability and validity. The results of this analysis are as follows. 1. Initially 62 items were analyzed through the index of Content Validity(CVI)and 48 items were selected. 2. Seven factors were extracted through the principal component analysis, and these contributed 61% of the variance in the total score. Finally 46 items in the scale loaded .41~.84 on one of seven factors. 3. Each factor was labeled. Factor 1 was labeled 'emotional phenomena-emotional upset' and included 13 items, factor 2 was labeled 'cognitive phenomena-self concept disturbance' and included seven items, factor 3 was labeled 'relationship to baby-negative feeling' and included six items, factor 4 was labeled 'relationship to baby-overload' and included eight items, factor 5 was labeled 'negative maternal identity' and included five items, factor 6 was labeled 'biophysiological phenomena-disturbance of physical functioning' and included four items, and factor 7 was labeled 'interpersonal relationship phenomena-blamed others' and included three items. 4. Cronbach Coefficient Alpha for internal consistency was .95 for the total 46 items. Finally, the author suggests that this scale could be adequately applied in assessing the postpartum depression of mothers during the postpartum period. The results of this study can contribute to designing an appropriate postpartum depression prevention strategy.

The purpose of this study is to explore types of postpartum depression and to understand the nature and structure of the postpartum depression by using Q-methodological approach. As a way of research, 55 statements concerning postpartum depression were selected through individual interviews with postpartum mothers and literature review. 30 women were chosen as a subject group for the study, with opinions shown in 55 statements divided into 9 scales by forced distribution. PC QUANL Program was used for analysis and Q-factors were analyzed by using principal component analysis. As a result, postpartum depression experience was classified into 5 types. There are "Role -Strain Type", "Unattributional Depression Type", "Psychosomatic Symptoms Type", "Self-Compassion Type", and "Role-Crisis Type". Type I was named "Role-Strain Type", referring to the strain generally experienced by mothers with regard to the new role as a mother and as a social member. Type II was named "Unattributional Depression Type", referring to the symptom experienced by people who were in a state of vanity and a sense of loss. They often break into tears for no specific reasons. In case of Type III, people in a state of "Psychosomatic Symptoms Type" develop physical symptoms after suffering from inherent emotional conflict. Type IV was named "Self-Compassion Type" refers to the symptom shown by those who feel pity for their children and for themselves. And they show inability to cope with the reality properly. Type V was named "Role-Crisis Type", which is experienced by people who have a burden and a severe fear of their own job and their children in their mind, also showing serious conflict with maternal role. Futhermore, it was carried out to examine structure of postpartum depression in terms of degree of depression and adjustment ability. Type I showed mild degree of depression and relatively good adjustment ability. Type II showed broad range of degree in depression and moderate adjustment ability. Type III showed moderate depression and relatively low adjustment ability. Type IV revealed relatively serious degree of depression and the lowest adjustment ability. Type V revealed very serious degree of depression and the lowest adjustment ability. As a result, considering the structure of postpartum depression, Type I is considered to be a normal depression sympton which most mothers generally experience, followed by Type II, Type III, Type IV and Type V, each of which show increasingly worse degree of depression and lower adjustment ability. In conclusion, it seems to be it is necessary to understand distinct symptoms of postpartum depression and to examine the characteristics and structure of those types, so that it could lead to more individual nursing approach.

This study was designed and undertaken to identify the degree of burden and depression in family caregivers of patients with stroke and to determine whether burden was directly related to depression. The data were collected from October 23th to November 20th, 1995. The subjects in this study were 80 caregivers, that is, one family member and 80 patients with stroke who were hospitalized in one oriental medicine hospital located in Taejon City. The questionnaires consisted of questions regarding burden(13 item, 6 point scale) and depression(20 item, 4 point scale). Data were analyzed using percentages, means, t-test, ANOVA and Peason-correlation coefficients, done with the SAS program. The results of this study are as follows; 1. The score for family caregiver's burden was higher than the mid level for the 13 items. 2. The score for of family caregiver's depression was relatively low. 3. The relationship between burden and depression showed a significant inverse correlation. 4. In the relationships between total burden and general characteristics of the family caregivers; there were no significant differences. But, in the relationship between objective burden and general characteristics of the family caregivers; age and education had statistically significant differences. That is, the 40's group felt more objective burden than any other age group and the high education group more than the illiterate group. 5. In the relationship between depression and general characteristics of the family caregivers; sex, education and monthly income had statistically significant differences. That is, female caregivers felt more depression than males, and the lower the level of education and the lower the monthly income, the higher the degree of depression. 6. In the relationships between burden and general charateristics of the stroke patients, only subjective burden according to the patients' sex was significantly different. That is, caregivers felt more subjective burden when caring for male patients than for female patients. 7. In the relationships between depression and general charateristics of the stroke patients, only the patients' economic status showed a statistically significant difference. That is, caregivers felt more depression in case of patients' low economic status.

In an attempt to investigate the effect of a muscle strengthening exercise program on muscle strength, pain, depression, self-efficacy and quality of life of patients with knee osteoarthritis, a pre-experiment, one group pre-test and post-test design, was planned. Muscle strengthening exercise was carried out from May 22 through August 14, 1995 at isokinetic exercise room in rehabilitation department of University Hospital in Taejon. The subjects were seven female clients conveniently sampled from University Hospital located in Taejon, between 39 and 61 years of age, who had a osteoarthritis in knee. Muscle strengthening exercise program was composed of three sessions per week, one isokinetic exercise at angular velocity of 60degrees and 180degrees with Cybex isokinetic dynamometer and two resistance home exercise sessions with elastic band. Data were analyzed with frequency, percentage of change, Friedman test, Duncan test using SAS program. Results were obtained as follows: 1) Flexion and extension muscle strength at angular velocity of 60degrees and 180degrees were increased after 12weeks' exercise than those of before experiment. But exept flexion muscle strength at angular velocity of 180degrees (F=3.34, P=0.0261), there was no statistically significant difference among muscle strengths, which is measured every 3 weeks. 2) Pain was decreased after 6weeks' exercise than that of before experiment, and after 12weeks' exercise than that of 6weeks' exercise. There was statistically significant difference(F=4.28, P= 0.0396). 3) Depression was increased after 6weeks' exercise than that of before experiment, and after 12weeks' execise than that of 6weeks' exercise. There was no statistically significant difference between before experiment and after 6weeks' exercise. But, there was statistically significant difference between after 6weeks' exercise and 12weeks' exercise (F=9.38, P=0.0035). 4) Self-efficacy was decreased after 6weeks' exercise than that of before exercise. But, it was increased after 12weeks' exercise than that of before exercise and after 6weeks' exercise. But there was no statistically significant difference (F=1.46, P=0.2706). 5) Quality of life was increased after Gweeks' exercise than that of before exercise, and after 6weeks' exercise than that of 12weeks' exercise. But there was no statistically significant differ-ence(F=1.06, P=0.3816). Thus, the significant of muscle strengthening exercise for the improvement of muscle strength, pain, depression, is verified. But, this study was a preexperiment with small size subjects. So, controlled experimental study is necessary to determine the effect of this muscle strengthening exercise program on muscle strength, pain, depression, self-efficacy, and quality of life of patients with knee osteoarthritis.

The Purpose of this study was to build a substan tive theory about the experience of postpartum depression. The qualitative research method used was grounded theory. The interviewees were eight mothers who had experienced postpartum depression. The data were collected through in-depth interviews with audiotape recording done by the investigator over a period of twelve months. The data were analyzed simultaniously by a constant comparative method in which new data were continuously coded into categories and properties according to Strauss and Corbin's methodology. Analysis the grounded data resulted in 28 concepts being identified. Eight categories emerged from the analysis. The categories were regret, loss of freedom, isolation of oneself, heartache, loss, emotional upset, avoidance, recovery. These substantive categories are consistant with preious research results. Causal conditions included: regret, loss of freedom. Phenomena: heartache, loss, emotional upset. Context: isolation oneself. Intervention condition: avoidance. Action/interaction strategies: desire for recovery. Consequences: recovery. These categories were synthesized into the core concept-The process of filling the empty loss of self The process of the experienced postpartum depression was (1) change after delivery, (2) searching for a reason for depression, (3) effort to recover from postpartum depression, (4) recovery from postpartum depression and return to previous life. The process of recovery from postpartum depression was proceeded by (1) support from others, especially husband, (2) resolution of stressful life events, (3) reconstructing of life goals and resolution strategies, (4) acceptance of depression and seeking psychiatric treatment. Seven hypotheses were derived from the analysis. (1) Mothers who experienced stressful life event and economic problem are more depressive. (2) Mothers who have conflict with parents are more depressive. (3) The more somatic symptoms, the more depression. (4) Social support faciliates recovery from postpartum depression. (5) Mothers who have lower self-esteem are more depressive. (6) Mother's role overload disturbs recovery from postpartum depression. (7) Ideal maternal identity faciliates recovery from postpartum depression. Through this substantive theory, nurses can understand the importance of postpartum depression management.

PURPOSE: The purpose of this study was to identify the change and difference and relationship of postpartum depression and physical image. METHOD: The subjects consisted of 86 postpartum women at one general hospital in Seoul. The data was collected from September to November 2001. The instrument used for this study were SRD (Self-Rating Depression Scale) and Norris' Body Image Scale to evaluate depression and body image. The collected data was analyzed with frequency, mean, t-test, paired t-test, ANOVA and Pearson's correlation coefficient. RESULT: The result of this study were as follows: 1.The mean score of D2 was significantly higher than D1(p=.003). There was no difference significantly B1 and B2(p=310). 2. There was significant correlation between the two, D1-D2(r=.381, p<.01), B1-B2(r=.364, p<.01), D1-B1(r=.579, p<.01), D2-B2(r= .567, p<.01). (D1: depression of postpartum 1-3days, D2: depression of postpartum 6-8weeks, B1: body image of postpartum 1-3days, B2: body image of postpartum 6-8weeks) CONCLUSION: There was very high postpartum depression in postpartum women, but body image was positive. Also, there was correlated to postpartum depression and body image. Thus it is necessary to implement nursing intervention focused on to decrease the postpartum depression and to enhance the body image of the postpartum women.

PURPOSE: The purpose of this study was to examine the levels of depression experienced by Korean hospital nurses (N=198) and to identify discriminating factors of their depression experience among personal and environmental characteristics. METHOD: A cross-sectional survey design was used to answer the research questions. A sample consisted of 198 hospital nurses in Korea. The data were collected from May 1999 to March 2000. Descriptive and discriminant analyses were utilized. RESULT: Korean nurses experienced low levels of depression. Twenty nine percent of nurses in the study experienced depression based on the cut-point suggested by Radloff. Role ambiguity, working in the tertiary hospital, work satisfaction in autonomy, professional status and interaction within nurses were significant discriminating factors for nurses' depression. These factors correctly discriminated 71% of the sample (Hit ratio= .71). CONCLUSION: Based on the findings of this study, developing managemental intervention programs and examining the effects of the program for nurses to reduce their depression experience are suggested.

PURPOSE: It was identified that how many homebound bedridden elderlies and their primary caregivers were depressed, and which factors affected the bedridden elderly's depression. METHOD: The subjects were 191 homebound bedridden elderlies and their primary caregivers. The affecting factors were classified into two categories: bedridden elderly and their primary caregiver related factors. Then bedridden elderly's factors were classified demographic and disease-related factors again. The stepwise regression was used to identify significant factors. RESULT: The prevalence of bedridden elderly's and caregiver's depression was 77.8% and 67.0%, respectively. And the model explained 33.3% of variance of bedridden elderly's depression. Cognitively-impaired female elderlies who had depressed caregivers were found to be more depressed. And caregivers who perceived burden were identified to be more depressed. CONCLUSION: It is recommended that the health professionals need to identify bedridden elderlies and caregivers at risk of depression. Especially elderlies who is in poor cognition, those who are female, and those whose caregivers were depressed might be considered carefully in all counseling or follow-up. Also the primary caregivers must be helped to access already available formal and informal support.

PURPOSE: The purpose of this study was to describe physical health and depression status, as well as to assessing factors that influence the physical health status.
METHOD
The data was collected from July to August 2000. Study participants were 252 community-dwelling elderly who were recruited from 10 senior centers located in Seoul, Korea. Their physical health status was measured using the Physical Health Status Measurement Scale developed by Choi and Jung (1991), and depression was measured using BDI-II developed by Beck et al. (1996).
RESULTS
1) The physical health status score was 4.00 +/-0.68 (range :1-5). The sub-dimension that showed the highest score was personal hygiene ability at 4.62+/-0.95, and the lowest score was sexual function at 2.20+/-1.38. 2. The depression score was 17.99+9.79 (range : 0-63). Regarding the sub-dimensions, the depression scores were higher in the domain of interest with sexuality, general weakness, difficulty in concentration, and fatigue. 3. Deeper levels of depression were correlated with a declining physical health status. 4. The most influential factor on physical health was depression, and the explaining variance was 31.68%.
CONCLUSION
It is concluded that elder subjects in senior centers had fairly good physical health and self-care ability. Also, they did not have significantly high levels of depression. Therefor, health promotion of elderly, it is recommended that elder individuals should be regarded as a respectful and useful segment of our society. Along with this basic concept, there should be a social milieu that does not snow prejudice. Moreover, health care professionals should give more attention to helping the elderly achieve a minimal level of ALD, and, particularly, to raise sexuality and help energize the lives of elder individuals.

PURPOSE: The purpose of this study was to examine depression in order to identify and improve health care policies promoting health among Korean women. METHOD: There were 329 participants, all older than 18 years old, and staying in Kyungki-Do, city. The data was collected from July to September 1999. The instrument used for this study was the CES-D (Center for Epidemiologic Studies Depression Scale) to evaluate depression. The collected data was analyzed with frequency, percentage, t-test, ANOVA, X2-test and Multiple logistic Analysis. RESULT: The result of this study are as follows: 1. Among the participants, 90.6% had normal to mild depression and 9.4% had severe depression. 2. For general characteristics, there were significant difference in the degree of depression according to age(P=0.0001), and marital status(P=0.0001). As for health related characteristics, the depression scores were affected by health perception(P= 0.0001), menopause(P=0.0005), stress (P= 0.0001) and sexual activity (P=0.0001). 3. There was a significant relationship between marital status and stress. CONCLUSION: This study suggests that a replicate study is needed. The results are also is useful in developing various nursing intervention programs.

The purpose of this study was to investigate the effects of coping mechanisms on uncertainty and depression. The subjects were 71 cancer patients selected from Junbook National University Hospital, and the data collection period was from June 21 to October 19 of 2000. Uncertainty was measured by using Mishel's Uncertainty Scale, problem- focused coping, and emotional-focused coping. The data was collected by a questionnaire developed by Lee (1984), and then depression measured by using Beck's depression scale. Data was analyzed with SPSS/WIN 7.5 program by Pearson Correlation Coefficients, and Path analysis. The results were as follows : 1. The mean uncertainty score was 59.17, the mean problem-focused coping score was 48.78, the mean emotional-focused coping score was 42.52. 2. The mean depression score was 15.77. 3. Uncertainty in illness was significantly related to depression (p=0.003) and emotional-focused coping (p=0.028), but uncertainty was not associated with coping mechanisms. 4. When analyzed multiple regression between uncertainty, problem-focused coping, emotional- focused coping, and depression, more specifically emotional-focused coping showed a stronger association with depression than problem-focused coping. 5. Depression was highly correlated with economic status (p=0.015), educational background (p=0.005), duration of disease (p=0.045). 6. Problem-focused coping and emotional-focused coping appeared to function as moderators instead mediators on the relation between uncertainty and depression. In addition, as a whole, uncertainty showed a significant moderating effect on depression, while problem-focused coping did on depression. Finally, limitation of present findings were discussed and implications for future studies are suggested.

In this paper, we examined the depression of stroke patient's caregivers and analyzed influencing factors of the depression. The subjects were 215 caregivers who have takencare of stroke survivors in their home. The conceptual model of this study consisted of the caregiver's depression, perceived burden, illness intrusiveness, and patient's ADL. Modified Korean CES-D, modified subjective and objective Burden Scale, Illness intrusiveness(II), and Instrumental Activity of Daily Living(IADL) were used to measure concepts. Path analysis was used to test the model of this study. The results were as follows: 1. The mean depression score was 11.6 which was below the cut-off score of the CES-D. This score indicates that the subjects were higher than normal adults' mean score but not depressive. Eighty-six out of 215 caregivers(40%) were above the cut-off score. This finding was different from previous research results, and the reason might be the patients' capability of ADL. In a group of low capability patient's activities of daily living, caregiver's depression score was 15.5. 2. Caregiver's depression was positively related to caregiver's burden and illness intrusiveness, but negatively related to patient's activities of daily living. 3. The caregiver's perceived burden and illness intrusiveness directly influenced on their depression. Furthermore, the and caregiver's illness intrusiveness led to depression indirectly through their burden. A patient's activities of daily living didn't influence directly on depression but indirectly through caregiver's illness intrusiveness and burden.

The purpose of this study was to examine the comparative between depression and stress related to life events among women in the menopausal stage. Menopausal stages were divided into two groups: Pre and post- menopausal stages. The degree of depression and stress related to life events between pre and post menopausal women were compared to each other. Women, aged between 41 and 59 years, answered self-reported questionnaires which included Zung's depression scale and life events scale modified by Lee (1984). Findings were as follows; 1) The mean score of premenopausal women who experienced depression was 39.66, and for post-menopausal women the score was 41.45. There was no significant differences in depression levels between pre and post menopausal group.s (t=-1.55, p=.122). 2) Menopausal women experienced low levels of stress related to life events. There were no significant differences between pre and post menopausal groups(t=.527, p>.05). Both pre and post menopausal groups were highly concerned about education issues of their children and disharmony between couples. 3) There was a significant relationship between depression and stress related to life events among post-menopausal groups (r=.22, p<.01). Based on the findings of this study, the menopausal depression was associated with stress related to life events, especially among post-menopausal women. Feelings of lost fertility and feminine attributies result in menopausal depression, which is significantly correlated with women's negative perception of their life events. Therefore, nursing intervention needs to develop to help reduce the levels of depression and overcome their negative perception of the menopausal experience. Nurses should develop nursing strategies to help menopausal women to have positive perceptions and enhance quality of life by assisting their adaptability to physiological and psychological changes related to menopause.

The hemodialysis patients with chronic renal disease have experienced negative emotions, especially depression among with physical, social, and psychological changes. Based upon a stress-coping theory, group imago psychotherapy which can induce effective coping through self awareness and positive emotional responses is implemented to the hemodialysis patients. The effects of the imago psychotherapy in regards to comfort and depression are studied here. Group imago psychotherapy was performed on forty-three subjects(twenty subjects in the experimental group and twenty-three subjects in the control group). The results of the study were as follows. After being given group imago psychotherapy, the comfort scores of the experimental group were significantly higher than those of the control group (F=15.33, p= .003). Moreover, after being given treatment, the depression scores of the experimental group were significantly lower than those of the control group (F=9.14. p=.0044). Specifically, the scores on comfort in the experimental group under emotion-focused coping style were significantly higher than those of the control group (F=18.59, p= .0002). The mean difference on comfort scores in the experimental group under problem - focused coping style was higher than that of the control group. But their scores were not significant (F=0.19, p= .6729). The scores on depression in the experimental group under emotion-focused coping style were significantly lower than those of the control group (F=14.62, p= .0006). The mean difference on depression scores in the experimental group under problem - focused coping style was much lower than that of the control group. But their scores were not significant (F=0.31, p=.5947). There was a significant positive correlation between comfort and depression variables. After group imago psychotherapy the hemodialysis patients recognized positive changes in emotional reponses, self awareness, self control, ease of mind, and felt overall more relaxed. Imago psychotherapy is a nursing intervention which as this study has shown can improve to comfort. The
results
of this study can be applied to general nursing practices. In the view of holistic nursing, the development of the nursing practice combined with imago psychotherapy will contribute to the enlargement of the nursing field with conventional nursing practices.