This study was conducted to develop and evaluate guidelines for cancer patients' symptoms management such as nausea/vomiting, fatigue, constipation, diarrhea, and oral mucositis. Based on the literature review, assessment path to identify each stage of five symptoms were also developed. Guidelines for symptom management of each stage of the symptoms were developed. Guidelines then were evaluated by a panel of experts. Finally, 95 cancer patients were recruited and asked to use the guidelines for their symptom management Levels of understanding of and satisfaction with assessment path and management guidelines were surveyed. Prevalence rate of five symptoms varied ranging from 20% (diarrhea) to 47% (nausea/vomiting). Regarding the level of understanding of each symptom most of the cancer patients indicated that they were easy and sufficient. Regarding the easiness of use of the symptom management guidelines, most of cancer patients indicated that they were easy to use. Regarding the nursing intervention on each symptom, most of cancer patients indicated that they were easy and helpful. More information was added with feedback from the patients. The result of this study has implications on development of customized patient education materials based on assessment path and symptom management guidelines.

PURPOSE
This study aims to analyze the effectiveness of Tai chi exercise for improving balance and its tendency and helps to identify directions for future research. METHOD: 19 articles from Medline search of foreign journals(1981-2003) and 5 from Korean nursing journals (1981-2003) were surveyed. The contents analyses were focused on outcome measures and relative factors regarding balance. RESULT: Variable measures for balance were used in Tai Chi studies relating to balance. They included the functional measures such as 14 single-leg stance, 7 walking in physiological measures and 7 laboratory-based balance measures were done with platform stability test. The measure of effective Tai Chi exercise depended on the health status of subjects and the methods. Health status of subjects were only on physically inactive older adults in 17 articles and arthritis patients in 7 articles in the Tai Chi study. The significant effects of Tai Chi exercise on balance was revealed after 10weeks duration. CONCLUSION: Considering the results, Tai Chi exercise is more effective than any other studies for walking balance. But the reports on the outcome are inconsistent with wide variations in the choice of balance measures. It is suggested that future studies analyze systemic change through meta analysis and have a wide variety of subjects who need postural control and balance control. The methods of measures should be distinct from the balance state of subjects for the effectiveness of Tai chi exercise.

PURPOSE
Illness intrusiveness (illness induced lifestyle disruption) by symptoms was investigated in 439 patients with rheumatoid arthritis. METHOD: The cross-sectional and retrospective survey design was used. Fatigue, disability, pain, and depression were considered as symptoms of rheumatoid arthritis. RESULT: Patients were reported to perceive more illness intrusiveness than other chronic disease patients such as end stage renal disease, bipolar disorder, and peritoneal dialysis patients. They were especially intrusive into work, health, and active recreation domains. Stepwise regression analysis identified four variables counting for 26% of illness intrusiveness variances: fatigue, disability, marital status, and depression. All of the symptoms except pain were found to significantly predict illness intrusiveness. Fatigue explained 16% of illness intrusiveness variances. CONCLUSION: Fatigue and depression usually overlooked by health professionals must be carefully assessed and managed to reduce perceived illness for rheumatoid arthritis patients.

PURPOSE
Many studies have shown that regular exercise produces positive effects on health. The purpose of this study was to examine the differences of health-related quality of life by stage of exercise and the interaction effect of age, sex and stage of exercise. METHOD: A total of 1266 participants were interviewed with structured questionnaire. Stage of exercise was assessed with a single item and respondents were classified with respect to exercise intention and behavior. Health-related quality of life was measured with SF-36 Health Survey Questionnaire. RESULT: Health-related QOL were found to be different by stage of exercise. The subjects who were reached maintenance stage showed significantly higher scores on physical functioning, bodily pain, general health perception, mental health, role limitation due to emotional problems, social functioning, and vitality than those in preparation, contemplation, and precontemplation stage. In addition a significant interaction effect between stage of exercise and age was found on physical functioning, bodily pain, general health perception, mental health, and vitality. CONCLUSION: Perceived health-related QOL varies with stage of exercise. This finding suggests that health is related to both intention and behavior of exercise. Therefore it is important to consider cognitive-motivational and behavioral stage of change for developing exercise programs.

PURPOSE
Perceived barriers to exercise were investigated for adults.
METHOD
A total 1266 subjects were selected by a quota sampling method with age, gender, and residence. Perceived barriers were categorized under 4 groups: knowledge, psychological, physical, and external factors. All 23 items of perceived barriers were responded on a dichotomous (yes/no) scale.
RESULT
Mean number of perceived barriers was 4.61 and 87.9% subjects perceived at least one barrier which prevented involvement in exercise. External barriers ranked highest, followed in order by psychological, knowledge, and physical barriers. Most factors of perceived barriers were found to be different by age, gender, and residence, in that, the younger, female, living in Daejeon subjects were found to respond with more barriers than the older, male, living in Chungju or Seoul.
CONCLUSION
Perceived barriers to exercise are differenct by age, gender, and residence. Therefore, it is recommended that age, gender, and residence of subjects must be considered in order to develop exercise programs and public campaigns.

The purpose of this study was to identify the trends of resourcefulness researche studies for suggesting the future direction of study. Study design, types of subjects, measurement tools, study concept, and outcome were examined by reviewing 61 research studies published from 1980 to 1999. The results were as follows: 1. There were 24 works in the 1980s and 37 works in 1990, according to the published year of resourcefulness study. Non-experimental studies like descriptive study, correlational study and comparative study were more frequent than experimental studies. 2. Research studies that consisted of 30- 100 subjects were the most numerous with 27 studies in all. The majority of study subjects was shown as healthy students and depressive patients. 3. Most studies used Rosenbaum's Self Control Schedule(SCS) for assessing resourcefulness. Reliabilities of resourcefulness researches were cronbach alpha= .70 or more. According to statisitical tests done for internal validity, SCS was negatively correlated to maladaptation. Factor analysis revealed that the most parsimonious structure was 3 to 6 factors. The total communality variance in the SCS was about 40 %. Other tools used with the SCS were about coping, depression, satisfaction of life and symptoms, self management and health romotion. 4. In correlational studies, concepts like depression, anxiety, and psychological symptoms were related to resourcefulness negatively. Adaptive functioning, life satisfaction and self achievement had positive correlations to resourcefulness. 5. Studies on comparison between a healthy person and depressive patient or smoker and non-smoker were done. There were coping, depression, symptom, self efficacy, health problem and self-control as comparative concepts. 6. Study subjects consisted of depressive patients in 9 of 18 experimental studies. The majority of studies were done with cognitive-behavioral therapy as an experimental intervention. The most effective treatment was revealed in high resourcefulness group. Since the above findings, resourcefulness research increased since 1980 and mostly non-experimental design for quantitative study were done. In the field of nursing, research about resourcefulness was in an initial stage. It is expected that further research needed to be done. Recommendations on the basis of the present research suggest that it is necessary to replicate studies, develop nursing intervention enhancing resourcefulness and apply it to patients with chronic diseases including cancer.

Fatigue is regarded as a universal and unavoidable side effects of chemotherapy. Most of patients in chemotherapy prefer resting and reducing their level of activity, but reduced physical activity can actually decrease physical strength and functional status to produce secondary fatigue. The purpose of this study was to determine the effects of rhythmic walking exercise on physical strength, fatigue, and functional status of breast cancer patients in adjutant chemotherapy. A matched control group pretest-pottiest design was used. Seventeen subjects of the experimental group were taught the rhythmic walking exercise(Winningham etal, 1990) on their first visiting day and encouraged to practice it at home throughout that treatment cycle(four weeks). Participants kept an everyday exercise diary that included pulse rates, exercise time and subjective data. The rhythmic walking exercise consists of approximately 30-minute walking, everyday if possible for 4 weeks. Outcomes were measured by each instrument :1) physical strength by the treadmill test estimated the walking ability. The subject is instructed to walk as long as possible to the level of their tolerance ;2)functional status by the Inventory of Functional Status-Cancer(Tollman et al, 1991) ; and 3)fatigue was measured by the Piper Fatigue Scale in both groups at five different times-before beginning chemotherapy(pretest) and one time per week for 4 weeks. Data were analyzed with mean, standard deviation, X2-test, t-test, repeated measure MANOVA using SPSSWIN program. Results were obtained as follows :1)The physical strength of the experimental group was significantly higher than that of the control group following the rhythmic walking exercise(t=3.92, p<.001). 2)The fatigue scores of the experimental group measured at the end of each week were significantly lower than those of the control group following the rhythmic walking exercise (1st week ; F=6.51, p<.016, after 1st week ; 863, p<.0001, after 2nd week ; F=46.754, p<.0001, after 3rd week ; F=60. 183, p<.0001, after 4th week). 3)The functional status of the experimental group was significantly higher than that of the control group following the rhythmic walking exercise (t=13.20, p<.0001). The results suggest that the appropriate rhythmic walking exercise for the breast cancer patients in adjutant chemotherapy can improve physical strength and functional status, and ultimately decrease the secondary fatigue.

A review of the literature on cancer pain revealed that many persons with cancer receive inadequate analgesia for pain control, due in part to a lack of knowledge of the control of cancer pain by both physicians and nurses. This study is composed of two parts : one is to train nurses to change their knowledge of and attitude toward the pain management of patients having cancer and to evaluate the effectiveness of this training in comparison with other non-trained group ; the other is to test the applicability of the pain management method knowledge and attitude in the levels of pain of oncology patients. General characteristics of nurses such as age, education, educational experiences of cancer pain management were not different in both groups except the clinical experience. General characteristics of cancer patients and pain-related variables such as pain, sleep, daily activities, treatment modalities, causes of pain were not different in both groups except the educational levels of patients. After an eight-hour educational program given to the experimental nurse group, the knowledge and attitude about assessment of cancer pain, pain medication, and pharmacological knowledge were significantly higher in the experimental group than in the control group, while knowledge about classification of analgesics was not significantly different. The amount of analgesics, measured by the morphine equivalent doses, used in the experimental group was significantly lower than in the control group in the first and the last days. The experimental group used more systematic ways of drug changes from non-narcotic analgesics to narcotic analgesics than the control group. This indicated that the control group used fentanyl patches more commonly than in the control group. Cancer pain scores of both group of patients were measured on an hourly bases for a week in both groups. The patients' pain scores of the first day of measurement in experimental group were not significantly higher than those of control group of patients, while those of the last day were significantly higher than those of the control group. This study supports the need for educational program for the management of cancer pain to the nurses and the doctors.

No abstract available.