This study was to provide firsthand description and analyais of phenomenological data of oingular, subjective, and lived experience of hardiness. Specifically, the objectives of this study were 1) to explore experience of hardiness of patients with chronic disease. 2) to describe the meaning of hardiness as it is lived. 9 patients suffering from chronic disease, such as cancer, stroke, chronic obstructive pulmonary disease and rheumatoid arthritis, were selected for this study. Data were collected from December, 1997 to April, 1998 through depth interview method. Phenomenological method described by Colaizzi was used for the phenomenological analysis of the data. After transcribing the recorded interview, the reoearcher read the data repeatedly to identify oig nificant statements, restated them succinctly, and then formulated meanings, themes, theme clusters, and categories. The formulated meanings are grouped into 5 categories control. commitment, coping, consideration, and appreciation. An exhaustive description of hardiness can be deduced from this study as follows. Patients with hardiness control the way of life and health care, commit themselves to the maintenance of enthusiastic life style and good health, cope with their disease, consider the position of their family and other patients, and thank the Aboolute and neighbors for their help.

The purpose of this study was to find out the effeet of midazolam and fentanyl on oxygcn saturation by pulse oximetry in surgical patients under spinal anesthesia. The subjects of this study were 83 patients who were operated on under spinal anesthesia, at a general hospital in Pusan. from December 1st, 1997 to March 31st, 1998. The subjects of Group 1 were 53 patients who did not receive either of midazolam and fentanyl. The subjects of Group 2 were 21 patients who received midazolam. The subjects of Group 3 were 9 patients who received both midazolam and fentanyl. Oxygen saturation was measured with a pulse oximeter by time series. The collected data were analyzed by the SPSS / PC~ program and the results of the study were as follows 1. There were no significant differences among the three experimental groups in terms of age or cardiopulmonary disease. 2. Among the three groups, there were statistically significant differences in Sp02 at 5 minutes after starting the operation or after intravenous injection of drugs. The SpO2 mean for Group 3 was 92.4%, for Group 2 it was 97.7%. and for Group 1 it was 98.2%. 3. Hypoxemia cases occurred in 88.9% of Group 3, 28.6% of Group 2, and 17.0% of Group 1, respectively. It is concluded that oxygen saturation mo4oring should be done routinely to all patients under ~spinal anesthesia, especially during operating tim4. and patients receiving midazolam and fentanyl should be monitored closely. After monitoring oxygen should be administered to all patients who developed hypoxemia.

The purpose of this study was to dcvclop nd test the validity of standardized Korean nome clature based on Nursing Intervention Classi ications (MC), developed by McCloskey and Bul chek at the University of Iowa, The four phases of the study were 1. Two professors and 15 graduate stude ts, who were taking a nursing intervention cours, translated the 433 nursing interventions of IC into Korean 2. 12 nurses with various clinical bac rounds reviewed the nomenclature, taking into nsider ation the definition and activities for each Korean nursing intervention. The Delphi method was used to determine the best appropriate nomenclature for each intervention ~. 20 academic and clinical experts in nursing were given a questionnaire to rate the validity of each Korean nomenclature using a 5 point Likert scale ranging from very inappropriate to very appropriate 4. five members of the Korean Nurses Association Research Committee reviewed the survey results and determined the most appropriate Korean nomenclature for each nursing intei veiition of NIC system. Most nomenclature had a score of more than 4.0, but seven nursing interventions had a score lower than 4.0: Critical Path Development (2.71), Calming Technique ~3.4l), Grief Work Facilitation (3.44), Order Transcription (3.44), Self Modification Assistance (3.44), and Teaching Psycho-motor Skills (3.47). These research results will be included in the nursing vocabulary dictionary to be published by Korean Nurses Association.

This retrospective descriptive study was conducted to survey the needlestick injuries(NSI) in nurses and doctors. Thc subjccts of this study wcrc 351 nurscs and 199 doctors of four teaching hospitals. Pusan. The data was gathered from March, 18 to April 9. 1988 and analyzed though SPSSWIN progra n for frequency, percentile and X2-test. According to the results of the study, 85.5% of subjects had experienced NSI (94.4% of the nurses and 73.9% of the doctors). The ratio of the experience of NSI in nurses was significantly higher than that of doctors(X2=53.54, P=.00). Most needle-stick injuries occured during the administration of intravenous injection(36.7%) in nurses, on the other hand percutaneous venipuncture for blood sampling(35.3%), suturing(27.2%) in doctors. The most ccmmon situation of these NSI was recapping contaminated needles after treatment. Only 12.0% of nurses and 38.6% of doctors reported wearing gloves when the NSI happened. 26.1% of subjects reported that they could not identify the source patient after MI. The major reason of NSI were preeeived to be carelessness%1.4%). Of these NSI, 54.6% occured in :usy or emergency situations. Among the management for NSI, exam(8.6%), mefication(9.8%) and counseling(11.7%) and reporting(2,6%. is lower than bleeding(80.3%) from the wound, deaning( 63.3%), disinfection(91.3%) and reviewing the clinical records of the patients (82.3%). In conclusion, nurses and doctors are at a high-risk of needlestick injuries but substantially they are not good at preventing and managing NSI. So efforts to reduce NSI should be directed not only at improving procedural skills for intravenous catheter insertions, but also in increasing use of barrier protection such as gloves, and so on. Also immunization and educational efforts should be made along with better designs of needles to reduce the risk of NSI. Continuing prevention and training programs for NSI are needed in order to avoid unwanted infection.

In the 21st century, the number of elderly population will reach 10% of Korean's total population, As the elderly population are increasing, the anticipation of the elderly with chronic health problem are also increased. They feel social isolation, alienation because of pain, and psychological flinching such as depression, but they can not control appropriately their chronic pain. Therefore, this study is an attempt to expose a group reminiscence therapy effect to decrease pain and depression, increasing self-esteem of the elderly as effective therapeutic nursing intervention This study is conductcd for 5 weeks from July 28 to August 31, 1997. The Subjects of this study consisted of 33 the elderly women having ronic pain. 17 of 33 residents S nursing home were ontrol group in C city. 16 of 33 resident E nursin home were experimental group in M city. The study design was a nnneqi.uivalent nontrol group with a pretest-posttest design. As for the tool for this study, Visual An logue Scale and Discriptive rating Scale were u ed to measure the pain, Zung's Depression Status nventory(DSI) which was translated by Yang S k Ha was used to measure the depression, and self-esteem scale which was translated by Byung Jae Jeon was used Lo measure self-esteem. As for the process of the study, demo raphic variables, pain, depression, self-esteem were tested with both the experimental and control grou prior to the group reminiscence. The ezperimental group was divided into 3 subgroup and a total of 4 ession of the group reminiscence therapy was performed to the experimental group for an hour at a time once a week from the first to the fourth week. Analysis of this study was computerized by using SPSS/PC. and the homogeneity which may be affected by various bariables was verifie with Chi-square and t-test, the reliablity of th tools with Cronbach's alpha, the comparison of pre and post-test with t-test in the Pain, Depression, and Self-Esteem among the experimental group and control group. The Pearson Corelation Coefficient was for analysis the relation of the Pain, Depression and Self-esteem. The results of the study can be summarized as follows ; 1. The first hypothesis, the degree of pain will be decreased on the experimental group which performed group reminiscence therapy than that of control group, was supported. VAS(t = -2.35, p=.025), DRS(t= -2.11, p=O.43). 2. The second hypothesis, the degree of depression status of the experimental group which has perfomed group reminiscence therapy will be reduced than control group was supported(t= -2.53, p= .017). 3. The third hypothesis, self-esteem of the experiinental group which has performed group reminiscence therapy will be increased than that of control group was not supported(t=1.34, p= .191). 4. The fourth hypothesis, the correlation with pain, depression, self-esteem was to appeared highly. The significance of this study through the above results shows that the Group Reminiscence Therapy is an effective nursing intervention for the elderly with chronic pain and depression.

This study was done to identify the relationships among family support, role conflict end Lii quality of life of patients with arthritis. And it was investigated the effects of family support on role conflict and the quality of their lives. The subjects were 98 patients with arthritis. The instruments used in this study were used Family Support Scale by Kang( 1985), Modified Quality of Life Scale by Ro(1988), and Role Conflict Scale developed by the researcher. The results of study were as follows : 1. Disease characteristics related to role conflict were pain iritensity( r = .35, p< .001) and limitation of activities of daily living(ADL)(r =37, p< .001). That related to quality of life was pain(r= -.27,p<.01). 2. There were no significant variations family support, role conflict and quality of life between rheumatoid arthritis and osteogenic arthritis patients. The patients with rheumatoid arthritis had more than twice the number of. affected joints as comparing to osteogenic arthrrt:s. But there were no differences the pain intensity and limitation of activity of ADL. 3. As applying to arthritis patients in general : There was a significant negative relationship between family support and role conflict(r=-.28, p<.01). There was a significant negative relationship between role conflict and quality of life(r= -.46, p<.01). There was a sigmfrcant positive re lationship between family supprt and quality of life(r=.58, p<.01). Family support, as an intervening variabe, had an impact on quality of life and role conflict. In conclusion, family support is an important variable in improving the quality of life of patients with arthritis. And especially role conflict has a significant influence on the quality of their lives, Therefore, we have to devehope nursing interventions for higher levels of family support through family education and support programs. In future studies, it would be well to investigate for effects and qualities of role conflict in the lives of patients with arthritis.

The purpose of this study was to identify the re lationship of hopelessness and spiritual-need of cancer patients. Subjects for this study were 272 cancer patients sampled from a madical center in Pusan. The data were collected from Feb. 1 to Mar. 10, 1998 using questionnaire method. Hopelessness measured hopelessness scale was the One(1986) modification of Beck(1974) and spiritual -need measured spiritual-need scale by Kim (1986) according to classification of Fish and Shelly. The questionnaire consisted of question regarding hopelessness scale(20 items 5 point) and spiritual-need scale (30 items 5 point scale). The reliability of this instrument was that the hopelessness scale was Cronbach's alpha=0.89 and the spiritual-need was Cronbach's alpha=0.93. The data were analyzed with the SFSS program using mean, standard deviation, frequency and percentage, t-test, ANOVA, Post hok test and Pearson's Correlation Coefficient. The results of this study were as follow : 1. The mean score of the total hopelessness was 2.79 in 1(lowest) -to-5(highest) scoring system. The analysis of the hopelessness according to general characteristics of the cancer patients showed duration of treatment(F=3.77), cognition prognosis(F=2.92) age(F=2.66), religional effect of life(2.48). 2. The mean score of the total spiritual-need was 3.47 in 1(lowest)-to-5 (highest) scoring system. age(F=5.517), sex(F= .919), religion(F=25.89), religional effect of life(F=18.54), diagnosis(F= 7.67), main care giver(F=4.09), cognition of disease(F=2,92), cognition of prognosis (F=331), inspiring source(F= 12.72), acceptioal attitude of present situation(F= 13.52). according to the categoiised paiL were showed to the need for meaning and purpose(9.40), to the need for love and relatedness(7.08), and to the need for being forgiven(6,93). 3. There was significant correlation between the degree of hopelessness and spiritual-need(gamma=.146, P<0.05).

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 investigate degree of the health promoting behavior and self-esteem of nursing college students, and to ide tify the relationship between self-esteem and the health promoting behavior. The sample consisted of 122 college nursing students and 100 university nursing student The instruments for this study were structured questionnaire which included health promoting behavior practice level(60 items), self-esteem(10), sociodemographic characteristics (10). Data were collected from September 14 to September 28, 1998 and analyzed by SAS rogram t-test, ANOVA, Pearson correlation coefficient, and multiple regreacion. The results of this study are as follows : 1. The results of the comparison between the two groups were not significantly different for self-esteem and health promoting behavior and socio-demographic characteristics. The average score for the health promoting behavior was high 162.5(total 240). and self-esteem was high, too 30.5(total 40). In the subcategories the highest practice level was "personal hygiene(3.30)", and the lowest level was "health management(1.57)". 2. Health promoting behavior was significantly correlated with self-esteem(r = .4970, p= .0001). 3. Self-esteem was the main factor predicting health promoting behavior and accounted for 24. 69% among variance. 4. There was a statistically significant the difference on health promoting behavior according to "personality"(t=2.58, p=.0l06), "residence pattern"(F=2.90, p=.0360) and on self-esteem according to "religion"(t=-2.20, p=.0291) and, "personality"(t = 4.40, p= .0001). In conclusion, there was not a significant difference between those of college nursing students and university nursing students on self-esteem and the health promoting behavior. Self-esteem correlated with health promoting behavior positively, and was identified to be an important variable that contributed to health promoting behavior.

This study was designed to identify the relationship between perceived social support and discernd powerlessness held by the elderly residing in a rural community. The purpose of this study was to contribute to theoretical understanding of the relationship of these two variables and eventually to the more effective adaptation of the elderly to their situation. The subjects for this study were the 89 elderly residing in a rural community. Data were collected by a questionnaire from June 2 to 20, 1998. The data were analysed by descriptive statistics, t-test, ANOVA, Pearson correlated coefficient and stepwise multiple regression using a SAS program. The results of this study can be summarized as follows. 1. The relationship between perceived social support and discernd powerlessness was significant(r = -.23502, p=.0266). Especially, discernd elderly's powerlessness shows a highly significant relationship with family and neighborhood support(family r= -.45096, p=.0001, neighborhood r= -.35681, p=.0006). In the support patterns, the discernd powerlessness of the elderly has a significant relationship to emotional, informational and evaluational support. Therefore the hypothesis that, "the lower the degree of social support peiceived by the elderly, the higher the degree of discened powerlessness" was supported. 2. Stepwise multiple regression analysis revealed that the most powerful predictor of discened powerlessness was family support in support system (R2 = .2034), and emotional support (R2 = .0627) in support patterns. 3. General characteristic related to the degree of social support was only residential status(P< .05), but the degree of family support was related to spouse(t=2.390. p<.01). residential status(t= -2.157, p<.05), and household.

This study examined burdens of primary family carcgivcrs of paticnto with cerebrovascular accidents (CVA) along with related factors. In addition, their needs for support group intervention were assessed to develop a support group to reduce the burdens of caregiving. Eighty-one primary family caregivers of patients with CVAs at a general hospital in Seoul participated in this study . The patients with CVAs aged from 26 to 83 years with mean age of 63 years. About 90% of the patients had some paralysis and 56.6% suffered speech problems. Fifty-eight percent of the primary family caregivers were spouses of the patients and 80.2% were women. Primary family caregivers' burdens were assessed by the Burden Scale originally devel oped by Zarit (1980) and Novak & Geust(1989) and modified by Jang (1995) for use in Korea. The instrument consists of six subscales time-dependent burden, developmental burden, physical burden, emotional burden, social burden, and financiaI burden. The results were as follows : 1. The average of burden score was 91.7, indicating moderate to severe level of burden. The time-dependent burden was scored highest followed by physical, developmental, social, financial, and emotional burdens. 2. of the characteristics of patients, age, gender, and severity of the disease were found to be associated with the level of burden. Of the characteristics of primary family caregivers, age and educational level were significantly related to the level of burden. Time of care since the CVA and the quality of relationship between a patient and a caregiver prior to the stroke were significant situational factors affecting the level of burden. 3. The need for support group intervention for the caregivero was very high (95.1%). The earcgivcrs of patients who had a CVA for the first time showed higher levels of need compared to those of patients who had a CVA more than once. The caregivers indicated a support group held once a month near home or hospital would be welcomed. In addition, they replied that a group composed of 9 to 10 caregivers and guided by health care professionals (e.g., physicians and nurses) would be most desirable. More than 85% of the earegivers identified the areas that they wanted intervention in as follows : knowledge, skills, and resources to care for a patient with a CVA. the counsel of health care professionals, share of their experiences with those who have similar situations, stress management skills, and methods to overcome emotional isolation due to the great responsibility for a patient. Given the results, support group is expected to be an effective way to reduce the burdens of primary family caregivers of patients with CVAs. As a follow up It is necessary to examine the effect of support group intervention on the patient's recovery and rehabilitation.

Death is the critical moment of life. All elderly are faced with death. Therefore, the elderly's notion of death must be include in holistic care for the elderly. The purpose of this study was to understand the elderly's notion of death. The research questions were "What is the elderly's notion of death?", and "What is the embedded meaning of the elderly's notion of death?". This study was conducted using an ethnographic approch. The fieldwork for this study was done from July 1996 to July 1998 on an island in Chonbuk province. Data were collected by indepth interviews and participant observation. The result of this study is as follows The elderly's notion of death was founded on 'Being a ancestor god', 'Evaluation of one's own life', 'Be sujected to the evil(BuJung : the taboo of uncleanness)' 'Being a ancestor god' means the notion of death leading to eternal life. It means a relationship to this world, So, it is required for all descendants, especialy the son. Also, they thought that the Spirit is greater importance mote thait the body, and that the spirit is embedded in bone. And so, the spirit is delivered to descendants through a propitious site for grave(MoungDang). It is thought toa change in the fortune of the descendants(Balbok). 'Evaluation of ons's own life' means that life was evaluated personally and socially throughout the dy ing process. This means reflection on an individual's life and interpersonal relationship's, and appearance social aspects of the individual death. 'BuJung(be subjected to the evil)' emerged as fear about death, and pursuit of the cause of death, Most of the causes were attributed to supernatural entities. It contributed to the inspiration of a cornmunity identity. The elderly's notion of death was the present world oriented and actualized. This study contributed to the nurse's understanding of the Korean elderly's notion of death. Implications for nursing practice, education, and research were discussed. Further research at other settings and using other research methods were recommended.

The purpose of this study was to assess how job stiess affects the nursing performance of emergerncy room nurses. Data were collected from 210 emergency room nurses at 20 general hospitals, with more than 200 beds, in Pusan, Taegu and Kungbuk province, between October 5 and October 15, 1998. The instruments used for this study were the job stress scale which was developed by Mae Ja, Kim and Mi Ok, Gu(1984), and nursing performance of nurses scale developed by Kwi Ae, Chung(1989). Data Analysis was done using t-test, ANOVA, Tukey test, and Pearson Correlation. The results were as follows : 1. The highest rank of job stress items, emergency room nursing were as follows with lessening order when physicians delegate their clinical responsibilities to nurses(M=3.12+/-0.69). The most stressed factor among the nursing works was reported as night duty(M =2.99+/-0.87). 2. The mean score of nursing performance items, to prevent patient from falling or other injury(M = 3.69+/-0.50). 3. Our study reveals that there was statistically significant negative correlation relationship between stress level and emergency room nursing performance(r= -0.14, p=0.0454), in other words, the more stress the nurses experienced, the weaker their nursing performance became. Two factors, heavy work load(r=0.30, p=0.0001), and poor compensation(r =0.15, p =0.031). were negativly related to nursing performance. 4. The study revealed that the group with monthly income experienced less stress(F=2.71, p= 0.0461). Also, the degree of stress was significantly lower in the group with work experience (F=3.01, p=0.0313). Stress varied according to position superintendent nurse showed a lower level of stress than lay nurses and change nurses (F=2.93, p=0.0349). 5. There was significant difference in the degree of nursing perfnrm~nre according to religion (F= 3.97, p=0.0088). In conclusion, there was statistically significant negative correlations between job stress and nursing performance, so there is need for special consideration in nursing administration in terms of reducing the job stress in emergency nursing. Suggestions based on this study as follows. 1. Further study is necessary to examine variables that influence job stress and nursing performance. 2. The expem~ntaI study is needed for an effectiveness of systerrntic and in-lividual effort in order to reduce or manage nurses'stress in the emergency room.

To develop optimal shift systems for an improvement of work schedule satisfaction, health and work productivity, the effects of the direction of the rotational work shifting on the circadian rhythm and adaptation of physiological components and work mistakes were investigated in nursing students. Two groups of seven volunteers participated as experimental subjects, apd seven to twenty nursing students participated as a control group. The directions of rotation work shift were as follows CW(clockwise)-shift system rotation in the direction of day shift(3 days), evening shift(3 days), off duty(l day) and night shift(5 days), and CCW (counterclockwise) -shift system rotation in the reverse direction. Urinary Na, K, and Cl levels were measured with ion-selective electrodes. The levels of performance were measured by a questionnaire to determine the number of mistakes in 12 specific items during duty. The disturbance of Na the circadian rhythm was seen on day and night shifts, especially in the CCW-rotation shift system, and the magnitude of the daily variation was greatest in the CCW-rotation system. The daily rhythms of K and Cl shifted to the right on the evening shift, and the rhythms were reversed on the night shift, which suggests that they adapted to the altered shift work. However, the levels of Cl were higher in day and night shift workers, especially in CCW-shift system. In the ease of urine salts, it seems that the students in CW-shift system more easily adapted to the altered shift. The incidence of mistakes during work were more frequent on the CCW shift than in the CW shift. These data indicate that the direction of rotation effects the worker's health and work performance. These results indicate that the CCW rotation of shift work makes it more difficult for the workers to adapt to the shift on a physiological level, and has many more negative effects on the shift workers' health when compared with the CW rotation. Thus, a clockwise rotating shift system seems to be more desirable for the optimal health and performance of nurses.

The concept of comfort has been regarded as a core concept of nursing and it has been frequently used as one of main goals of nursing care. Promoting comfort has been a very important objective in clinical nursing practice. There have been some ambiguities in defining the concept of 'comfort" among nursing scholars. Therefore it was necessary to analyse the concept of comfort for clearer definition to be able to share among scholars. This study is an attempt to analyse concept of comfort and to do it according to a series of concept development processes described by Walker and Avant. Based on the results of the study, the attributes of scope, precedence and consequence of comfort were identified : 1. Attributes 1) stability 2) directionality 3) equilibrium 4) firmness 2. Scope 1) physical 2) social 3) emotional 4) spiritua~ 3. Precedence and Consequence 1) precedence (1) instability (2) unsatisfied needs 2) consequence (1) physical & psychological relaxation (2) enhancement of self-worth (3) enhancement of self-efficacy (4) satisfied needs.