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
This study was conducted to describe qualitatively the entities of nurse's experiences in general hospitals and to suggest basic data guiding research on developing Standards of clinical nursing practice in Korea.
METHOD
Fourteen nurses working at general hospitals with over 300 beds in Seoul were interviewed in-depth until saturation using tape-recorders and transcription.
RESULT
The central theme of clinical nursing practice experienced by subjects was "being with clients" that means accepting client's personal character, solving client's needs and providing client-centered nursing. A also "being with clients" was felt to be the responsibility of nurses which was learned from their nursing schools. The nursing strategies performed in order to be with patients were proving skillful nursing techniques, accepting, educating, emotional support, advocating, and self-reflecting, the subjects experienced somewhat problematic affects such as difficulties in interpersonal relationship, work overload, negative image of nursing, deficit of self-confidence for nursing actions, poor working conditions, and unfair treatment. Nurses at the hospital practiced with pride when they felt that they were accepted by clients.
CONCLUSION
Further research is needed to analysis problems in clinical practice and the comparison of nurses' experiences of clinical practice, with nurses' experiences in various settings.

"Journal of Korean Academy of Adult Nursing" has been published since 1989 and more than 330 articles have been published up 2000. We reviewed all the articles published in this journal to analyze the contents and trend of published articles and to find out the way of improvement both in quantity and quality of studies in this area. The results are as follows; 1) Ninety percent of articles were quantitative studies. Experimental design was used in 16.1% and quasi-experimental design was adapted in 73.6% of articles. Qualitative research were 10.3% of total articles reviewed. 2) Only 5.1% of articles described theoretical framework and 73.6% of experimentally designed articles included research hypotheses. 3) Among experimental studies, only one was true experimental studie design. Eighty nine point three persent had descriptive survey method among non-experimental studies. Amog the thirty four qualitative studies, phenomenologic(73.5%), grounded theory(14.7%), and ethnographic (11.8%) design were used. 4) Most of research subject were patients and few healthy people, healthcare worker, and patient family. 5) Psychosocial data collection method which used questionnaire were 53.7% and interview, physical measurement, observation were used in 22.8%, 8.2%, 5.4% of articles respectively. 6) Total number of keywords were 692, and average number of key words per article was 2.2. Health-related keyword was the most frequently used according to four metaparadigm of nursing (human, health, nursing, and environment). Environment related keyword was rarely appeared. The number and quality of nursing research in "Journal of Korean Academy of Adult Nursing" have been improved continuously. It is difficult to find out special trend or characteristics which is unique in this journal because of relatively short history of adult nursing studies. This review study was performed to analyze adult nursing studies only in the view of quantitative aspect, but it is needed to analyse qualitatively to find philosophical or theoretical trend in nursing.

Social readjustment is very important in rehabilitation of stroke survivors. The purpose of this study was to examine the level of social readjustment and related factors in stroke survivors. Especially, to find the most useful predictor for social readjustment is a major point of this research. The study included 254 outpatients who were given follow-up care after discharge from. Occupational rehabilitation and resumption of the perceived meaningful social activity prios to the stroke were used to measure social readjustment. The resumptions of first meaningful social activity was the best predictor for life satisfaction in stroke survivors(r=.245, p<.01). The substance of perceived meaningful social activities were job, meeting with friends, hobby and activities for the family. The sum of meaningful social activities (r=.175, p<.01) and occupational rehabilitation (r=.116, p<.05) were significantly related to life satisfaction. There were significant difference in IADL, depression and life satisfaction according to resumption of meaningful social activity. But, occupational rehabilitation was not related to depression. The level of social readjustment was different between occupational rehabilitation and resumption of meaningful social activity. It was 45.7% in the first meaningful social activity and 36.6% in occupational rehabilitation. The related factors with resumption of the first meaningful social activity were that of IADL, depression, illness intrusiveness and cognitive function. And the level of IADL, illness intrusiveness, cognitive function, and age were significantly related to occupational rehabilitation. In conclusion, we suggest that the resumption of the first meaningful activity in stroke survivors is the best predictor of social rehabilitation. Thus, nurses need to work for resumption of meaningful activity as well as occupational rehabilitation.

As a nursing practice involves nurses'actions in a specific context of health care, this study has focused on exploring the espoused theories in nursing practice within the action science perspectives. Espoused theories are the belief, principles, and rationale expressed by the practitioner as guiding her/his actions in a situation of practice. The data were analysed qualitatively and 25 elements of espoused theories of nursing action were identified and clustered into 6 categories. The 25 elements of espoused theories are as follows: The clinical nurse worked in wholistic and individual nursing, focussed on the patient's needed, comfort and supportive nursing (5 theories of nursing goal); excellent skills, knowledge based, assessment and data collection, explaining, educating or a scientific basis(6 theories of nursing intervention): advocacy, value oriented, treatment, accountability and commitment(4 theories of nursing ethics); human respect, partnership, trust(3 theories of patient-nurse relationship) : knowledgable, accumulated clinical experiences and personally lived experiences, positive perspectives(4 theories of nurse), role of intervention, rewarding, peer relationship(3 theories of situations). The above mentioned espoused theories are similar to that of nursing textbooks which students learned through basic nursing education and almost the same as the Acts ofa Nurse in Korean. However, we are doubtful whether nurses actually do as they think. Therefore, it is recommended to review the theories-in-use in order to find any discrepancies between the espoused theories and the reality of nursing actions.

Predicting factors of post-stroke depression were investigated. The subjects were 254 stroke patients who had been discharged and visited regularly the outpatient clinic for follow up care. The influencing factors were classified into five categories: demographic, disease-related, current state, social support, and illness intrusiveness. Sex, age, job, and educational level were defined as the demographic factor. The disease-related factors included stroke type, illness duration, attack frequency, and NIH score. ADL, cognitive function, and social activity were considered as the current state factors. The social support was measured as the perceived amount of social support. Illness intrusiveness means the perceived illness induced life style disruptions. Demographic, disease-related, current state, and social support were hypothesized to directly and indirectly affect post-stroke depression through illness intrusiveness. The illness intrusiveness was hypothesized to directly affect post-stroke depression. The hierarchial multiple regression was used to identify significant factors. The result showed that this model explained 43.3% of variance of post-stroke depression. And the prevalence of post-stroke depression was 38.8%. Among the demographic factors, job was identified as a main contributor to indirectly increase the post-stroke depression. Among the disease-related factors, stroke type, attack frequency, and NIH score were found to indirectly affect the post-stroke depression. Among the current state factors, ADL and social activity indirectly affected the post-stroke depression through illness intrusiveness. Social support and illness intrusiveness were identified to directly affect the post-stroke depression. This study has proved the factors likely to be implicated in the development of post-stroke depression. Based upon these results, it is recommended that the nurses who take care of post-stroke patients consider the risk factors such as social support, illness intrusiveness et al. Also programs which decrease the illness intrusiveness and increase the social support to reduce post-stoke depression recommended to be developed.

In Korea, most of the patients with chronic liver diseases have been using some kind of alternative therapies at home. however, the question is why do people turn to alternative therapy and how the patients are able to use the alternative therapies widely, though the effects have not been proven scientifically. Therefore, it is necessary to explore the process of the patients' experiences using the alternative therapies. The 16 participants were from internal- medical departments in hospital and the permission was received to participate in this study from the subjects. The data were collected with interviews and participants observations, analyzed by the grounded theory methodology of Strauss and Corbin(1990). With the analysis of the data, 15 categories were generated such as psychological pressures, barriers of role performances, distrusts of western medicine, blind obediences to the treatments, attitudes towards alternative therapies, supportive systems, obstacles to taking alternative therapies, financial burdens, collecting informations, pursuing alternative modalities, efforting diversities, analyzing by themselves, managing the body, accepting the disease, and ambivalence. The paradigm model was developed to identify the relationships of categories. The central phenomenon of the experiences of seeking alternative therapies was named jagi momdasrim. The central concept of jagi momdasrim is a mind-set to desire to wellness and to take more responsibility for one's own healing by pursuing alternate healing modalities rather than the western medical system. The process of jagi momdasrim evolved several stages such as seeking, finding, struggling, overcoming, fulfilling, and governing the diseases. Four patterns of taking alternative therapies were found as follows: the bulsin-chujong-hyung, the suyoung-hyung, the yangdari-gulchiki-hyung, the chamjae-hyung. In conclusion, the phenomenon of alternative therapies as consumer-driven force to heal the chronic liver diseases of the patients could be explained as an adaptive behavior through the process of jagi momdasrim. However, since most of the participants practicing some kind of alternative therapies had no evidences of its effects and never tried to consult with their medical doctors about alternative therapies, we should approach more actively. Therefore, it is recommended for nurses to listen and watch the patients behaviors of using alternative therapies and find out how to educate the patients about the proper and safe way to take the alternative therapies.

The purpose of this study is to find out the effects of depression on older adults' metamemory and memory performances. The subjects of the study consisted of 103 older adults over the age of 60 who are living in Kangwon Province. Some data were collected by means of the interview method, using questionnaires for metamemory (MIA questionnaire by Hultsch, et al., 1988), and depression(GDS by Yesavage and Sheikl, 1986). Other data were collected by a testing method on the memory performance, such as the immediate word recall task, the delayed word recall task, the word recognition task(Elderly Verbal Learning Test by Kyung Mi Choi, 1998), and the face recognition task(Face Recognition Task tool developed by this study). The results of this study were as follows: 1) The average point of depressed older persons' metamemory is 3.2 on a 5 point scale and was significantly lower than nondepressed older persons' point of 3.6. Looking into each sub-concept of metamemory, depressed persons' points are higher in terms of task(4.1), but are lower in terms of change(2.3), locus(2.6), and strategy(2.9) in comparison with nondepressed persons' points. 2)Depressed older persons' memory performances are all significantly lower than nondepressed person's, especially in terms of face recognition task(t=7.26, p<.0082) and word recognition task(t=6.58, p<.01). 3) In both depressed and nondepressed persons, metamemory has a close correlation with all memory tasks. In particular, depressed older persons' correlation is higher across the board, especially in memory self-efficacy of metamemory(r=.36 - .49) in comparison with nondepressed persons. 4) According to the results of analysis on the relations between metamemory and memory performances of each memory task using canonical analysis, in the case of depressed older persons, strategy, locus, capability and task have high correlation with word recognition task and delayed word recall task. Also in the case of nondepressed persons, achievement, strategy, change and locus variable have high correlation with face recognition task and immediate word recall task. As mentioned above, depression variables have a negative effect on older persons' metamemory and memory performance. In conclusion, when we care for depressed older persons with less memory ability, we have to consider the outcomes of this study are relevant. In addition, it is necessary to develop nursing intervention in order to prevent memory loss and improve memory performance in depressed older persons.

The purpose of this study is to find out the effects of personal characteristics and metamemory on the older adults' memory performances and the effects of some factors on metamemory. The subjects of the study consisted of 102 old adults over the age of 60 who are living in Kangwon Province. Based on contextual perspectives of the memory-aging theory and the previous foreign researches on memory, some data were collected by means of the interview method, using questionnaires for metamemory(MIA questionnaire by Dixon, et al., 1988), and depression(GDS by Yesavage and Sheikl, 1986). The other data were collected by the testing method on the memory performance such as the immeadiate word recall task, the delayed word recall task, the word recognition task(Elderly Verbal Learning Test by Kyung Mi Choi, 1998),and the face recognition task(Face Recognition Task tool developed by this study). The results of this study were as follows; 1. The level of metamemory is 3.4 points in the 5 point scale, the grades of the task and the achievement are relatively high and the grades of the change, the control, and the strategy are relatively low in the sub-concepts. 2. The significant variables to predict old adults' metamemory are depression level, age, sex, educational attainment and religious activity. 3. The strong variables to predict memory performances are memory knowledge, memory self-efficacy, age, religious activity. 4. The strategy, the achievement, the locus, and the change concept of the metamemory have high correlations with the immediate recall task, the delayed recall task, and the word recognition task. In conclusion, the enhancement strategies of metamemory and the support of social activities are independent fields for nursing intervention. Ultimately in this respect nurses' roles are very important in developing and performing some intervention programs for old adults' memory improvement, which have significant meanings in the field of nursing science.

The demographic, psychological, social and disease characteristics were analyzed to find the sources of self-efficacy(the expectation about one's ability to engage in or execute in a behavior) in the 297 patients with rheumtoid arthritis. Except for religion and client's job, the demographic characteristics such as age. sex, partner's job, income, and educatioa] level were found to be significantly related to self-efficacy. In the group of older age, female, lower income, job with less prestige, and lower educational level, the self-efficacy was lower than the other group. Depression which measured as psychological characteristics was significantly related to self-efficacy. Social characteristics, such as social support and relationship with health professionals, were positively related to self-efficacy except for social network. Getting a high score in the area of relationship with health-professionals means that the giatients perceive that they can express themselves or decide on their own activities as much as they want. Among the disease characteristics, only disease cLlration was not significantly related to self-efficccy. The self-efficacy shows a tendency to decrease with time. Pain was negatively related to self-efficacy, Possible activity level was positively related to self -efficacy. To analyze the variables which affect self-efficacy, stepwise regressicn was implemented. As a re sult, about 42% of the self-efficacy were explained by possible activity leveI, depression, social support, and pain in that order. Based upon these results, it is recommended that the nurses who are in change of or maintain the behavior of patients wth rheumatoid arthritis consider the demographic characteristics such as age, sex, et al. Also programs which decrease the pain and depression and increase the social support and activity levels are recommended to be developed.

The purpose of this study was to analyse the current adult nursing curriculum content in diploma and baccaleurate level nursing schools. The Study was initiated by the Korean Academic Society of Adult Nursing and data were collected from these institutions from March 1997 to April 1998. The questionnaire was constructed after several meetings of researchers which included course description, objectives, conceptual framework, credits(theory and practicum), number of teaching staffs, content and hours for each content. The questionnaire was sent to all of the nursing schools(41 baccalaureate and 62 diploma) in the nation and the response rate were 53.7% in baccalaureate and 25.8% in diploma schools. Primary analysis was took place during summer workship of 1997 Korean Academic Society of Adult Nursing. The second analysis was carried out after additional data of detailed content and hours in adult nursing course were obtained from the schools. The result of primary analysis were as below : 1) The consensus in philosophy of adult nursing was drawn. The client of adult nursing was defined as individual over 18 years who has psychological, physical, social and spiritual aspects and interacting with environment. The client is a member of family and community. The students who finished the course should be able to adapt nursing process to their clients, and improve quality of life. The client, nursing process and nursing were common concepts which included in their conceptual framework. 2) Theory credits ranged 9-18(mean 14.1), practicum credits ranged 5-12(mean 8.1). The number of teaching staffs ranged from 2-6(mean 3.2). 3) The content which most hours assigned to were neuro/endocrine(mean 30.8 hours) gastrointestinal(mean 28.4 hours), cardiovascular(mean 28.6 hours) and respiratory(mean 22.7 hours) systems. 4) Areas taught by other profession(mostly physician) were eye, ear, nose, throat integumentary, radiation therapy, neuromuscular, rehabilitation, respiratory physiology, male genitourinary, pathology and anesthesiology. 5) Contents overlap with other course content should be rearranged in each school curriculums. Improvement of RN national board examination is prerequsite in order to improve adult nursing education in Korea. The result of second analysis were as below : 1) Credits required for graduation were 130-175 in baccalaureate, 93-134 in diploma. Thirteen to Twenty-eight percent of total credits required for nursing major were credits of adult nursing. 2) Mean hours of total adult nursing lecture were 217 in baccalareuate and 212 in diploma. 3) Disease process occupied more hours than nursing process in adult nursing theory. It is suggested to include all nursing educational institutions in order to complete the survey, to delineate the core contents of adult nursing and rate of hours between theory and practise by Korean Academic Society of Adult Nursing.

Chronic liver disease was characterized difficult to cure, long-standing disease. Patients with chronic liver disease were searching for complementary treatments to recover form illness, while they have been treated by the doctor. This study was carried out to explore application of alternative therapies in patients with chronic liver disease. For this survey, the questionnaire were developed by researchers and the data were collected for two months. Among the 192 subjects, 155 were hospitalized and 37 were out patient department and the majority of diagnoses were chronic hepatitis (42.2%), liver cirrhosis (31.3%), primary liver carcinoma (14.6%). The results were as follows. 1. Patients who have had experiences with alternative therapies were 128, not undergone were 64. Varried alternative therapies were used and 46.9% of 128 subjects used both hospitals and alternative therapies simultaneously. 2. Patients have looked for alternative therapies in the early stage of disease (71.1%), and motivated to decide a matter of having use complementary therapies as alternatives for treatments (64.8%), and obtained information from their families and friends (48.2%), mass media (14.8%). The majority of patients were acknowledged that laternative treatments have no effectiveness really but it gives them psychological comfort. And the patients have payed a lot of money in cost of alternative therapies fee ; 1.4 times higher than hospitals. 3. Among the 128 subjects, 43.8% patients were communicated with their physicians about complementary therapies, 56.2% were not. 82.1% patients who asked their physicians were experienced negative responses of their doctors. 4. patients were expected the higher effect of alternative therapies when they have been delivered treatment by hospitals with complementary therapies (chi2=57.84, P<0.05), and then they evaluated the treatment effect better in this treatment pattern (chi2=25.26, P<0.05). And in terms of general characteristics of the patients, the only duration of illness was showed the significant relationship with the utilization of alternative therapies (chi2=8.44, P<0.05). 5. In no used alternative therapies group, the reason that they have not taken alternative therapies were ; to keep their physician's prescription, to refuse alternative therapies by their physicians, and to have no trust themselves on alternative therapies. In conclusion, the further study will be required the patients' experience using alternative therapies as the progress of disease in terms of holistic view of patients.

No abstract available.

No abstract available.