The aim of this study was to investigate the differences in the level of disease condition and ADL by self-efficacy in patients with rheumatoid arthritis. The subjects of the study consisted of eighty-four outpatients with rheumatoid arthritis at a university hospital in Taegu between July 20, 1999 and August 25, 1999. The instruments used in this study were the self-efficacy developed by Lorig et al. (1989), the pain scale developed by Lee and Song(1987), the erythrocyte sedimentation rate(ESR), the pain joint count to measure disease condition scale, and the ADL scale developed by Katz et al. (1970) and Barthel(1973). Analysis of data was done by use of descriptive statistics: Pearson Correlation, Chi-square test, t-test, ANOVA and Scheffe, with the SPSS program. The major findings can be summarized as follows: 1. The first hypothesis, "There will be differences in the level of disease condition by self-efficacy in patients with rheumatoid arthritis" was partially supported. 1-1. "There will be differences in the level of pain by self-efficacy in patients with rheumatoid arthritis" was supported(F=3.422, p=.037). 1-2. "There will be differences in the level of ESR by self-efficacy in patients with rheumatoid arthritis" was the Disease Condition and supported (F=3.314, p=.041). 1-3. "There will be differences in the level of pain joints count by self-efficacy in patients with rheumatoid arthritis" was rejected(F=2.602, p=.080). 2. The second hypothesis, "There will be differences in the level of ADL by self-efficacy in patients with rheumatoid arthritis" was supported(F=7.067, p=.001). With the above results, it can be concluded that the higher level of self-efficacy contributed to the better level of disease condition and ADL in patients with rheumatoid arthritis. Therefore, by providing nursing intervention to promote the level of self-efficacy of rheumatoid arthritis patients with low self-efficacy, disease condition and ADL would be much better.

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.

Coronary intervention is now a well established method for the treatment of coronary artery disease. Coronary restenosis is one of the major limitations after coronary intervention. So medical teams advise the patients to get the follow-up coronary angiogram in 6 months after coronary intervention to know if the coronary artery stenosis recurs or not. This study was done in order to know how many patients complied with the advice, and to identify the relative factors to the compliance with getting the follow-up coronary angiogram. The subjects were 101 patients (male: 58 female: 22, mean age: 61+/-15), who received coronary interventions from Jan. 1st to Mar. 31st 1997, and their data were collected from them by questionnaires one year after intervention. The questionnaires consisted of family support scale, self efficacy scale and compliance with sick role behavior scale. The result may be summarized as follows. 1. The number of patients who complied with getting the follow-up coronary angiogram were 37 people(36.6%) and did not comply with it were 64 people(63.4%). All scores of family support(t=5.56, p<.0001), self efficacy (t=4.13, p<.0001) and compliance with sick role behavior(t=5.66, p<.0001) were significantly higher in the patients who got the follow-up coronary angiogram than in those who did not get it. But there was not any relative factor in demographic variables (p>.05). 2. The major motivations for getting follow-up coronary angiogram were recurrence of subjective symptom(40.5%), the advice of medical team(32.4%), and fear of recurrence (27.1%). The restenosis rate in patients who got the follow-up coronary angiogram was 37.8%. 3.The restenosis rate was higher in the patients who had subjective symptoms than in those who did not have any subjective symptom. So subjective symptom and restenosis rate showed a high positive correlation(r=39.9, p<.001). However, 27.2% of the patients who did not have any subjective symptom showed coronary restenosis. 4. The reasons why they did not get the follow-up coronary angiogram were economic burden(37.5%), improved symptom(34.4%), busy life schedule(10.9%), fear of invasive procedure(9.4%), negative reaction of family member(3.1%), no helper for patient(3.1%) and worry about medical team's mistake (1.6%). The relative fators on compliance with getting the follow-up coronary angiogram after coronary intervention were family support, self-efficacy and Compliance with sick role behavior. And the most important reason why the patients did not get the follow-up coronary angiogram after coronary intervention was an economic burden.

PURPOSE
This study was carried out to identify the factor of decisional balance for exercise. This was composed of a set of variables at the level of decision making when the elderly decide to do exercise. It was used to classify and identify the characteristics of the stages of change for exercise to which the elderly belong, and was used to identify the variables of decisional balance which influence the stage of change for exercise in the elderly.
METHODS
Convenient samples of 198 subjects over age 60 in Seoul( mean age=70) were selected from community living, mentally competant older adults and the data was collected from April 1, 1999 to May 31, 1999. The research instrument was the Decisional Balance Measure for Exercise(Marcus &Owen., 1992), Stage of Change Measure(Marcus et al,1992). The data was analyzed by SAS Program.
RESULTS
1. According to stage of change measure, without missing data,191 subjects were distributed in each stage of change for exercise: 50 subjects(26.1%), 7 subjects (3.6%), 52 subjects(27.2%), 4 subjects(2%), and 78(40.8%) belonged to the pre- contemplation stage, contemplation stage, preparation stage, action stage and maintenace stage. 2. Factor analysis identified 3 factors of decisional balance as appropriate factors for exercise of the elderly and named by researchers; 1)'Perceived Physical-psychological benefit', 2)'Perceived Physical-psychological burden', and 3)'Perceived time burden'. 3. The analysis of variance showed that the two components Perceived Physical - psychological benefit(F=45.95, P=.0001), and Perceived Physical-psychological burden (F=26.52, P=.0001) were significantly associated with stage of change. 4. Through the discriminant analysis, it was found that both 'Self Perceived Physical - Psychological benefit' and 'Perceived Physical-Psychological burden' were the influential variables in discriminating the three stages of change(pre-contemplation, preparation, and maintenance).
CONCLUSION
Results are consistent with the application of the Transtheoretical model, which has been used to understand how people change health behaviors. Even though this study is a cross-sectional, not a longitudinal study, the findings of this study give useful information for exercise intervention about especially the factors relating to decision making for exercise of the elderly in the different stages of change of exercise.

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 was to identify the major factors affecting performance in health promoting lifestyle of the elderly. The subjects for this study were 244 elderly person over the age of 60, living in K country, Kyongnam. Data were collected from August 31 to September 30, 1998. The collected data were analyzed with an SPSS program using frequency, percent, mean, cronbach alpha, t-test, ANOVA, Pearson' coefficients of correlation, Duncan test, and stepwise multiple regression. The results are summarized as follows. 1) The average score of performance in the health promoting lifestyle was 2.73. The variable with the highest degree of performance was regular diet(3.29), whereas the one with the lowest degree was self-control(2.22). 2) Performance in the health promoting lifestyle was significantly correlated with self esteem(r=.28, p=0.00), internal health locus of control(r=.58, p=0.00), powerful others health locus of control(r=.48, p=0.00), chance health locus of control(r=.25, p=0.00), perceived health status(r=.53, p=0.00). 3) Performance in the health promoting lifestyle was significantly correlated with such demographic variables as education level (F=9.47, P=0.00), marital status(F=2.63, P=0.05) and previous occupation(F=3.85, P=0.00). 4) The combination of internal health locus of control, powerful others health locus of control and perceived health status explained 43.4percent of the variance of health promoting lifestyle On the basis of this study, other factors affecting others health promoting lifestyle should be identified.

This study tried to suggest the basic materials that can be efficiently applied in clinical cases by understanding problems through a content analysis of an adult nursing assessment tool and opinion agreement about nurse's practical usage presently used in the hospital. The study was carried out in 36 attached hospitals in nationwide universities from May to December, 1999, the two hundred and twenty five reports were for analysis. The contents of the collected nursing assessment tool were analyzed. It was found that the tool had been used with various names and content and there were instances of partial omission of a number of items, such as documentation and time records. Other results revealed that they mostly had a systematic classification of items, formation of details a form of a check list, and the effect of saving time. In spite of the adult nursing assessment tool, it was suggested that its style be subdivided according to the specialized of a department and that standardized style be amended and supplemented. The respondents also answered that there had to be education about continuous and sufficient health assessment skills on the physical examination record. The most frequently suggested items to be added were: past history, marital status, patient and caregiver's address and telephone number. It was found that a patient's education career, economic status, religion, hygienic practice, sexual life and hobby were the most frequently omitted items on record. The reason given wes because the items were associated with his/her privacy. These results highlight the importance of analyzing the content with an complete data collection, supplying basic content for a more accurate nursing record, computerization, sharing information and standardization of the form.

Hemodialysis(HD)-associated hypotension is a frequent complication, but it is difficult to manage. Until now, several maneuvers have been tried to prevent the HD-associated hypotension. Of these, the sodium content of dialysate was regarded as an important factor for maintaining blood pressure during HD. In this study, we evaluated the effect of hypertonic dialysate on blood pressure, interdialytic weight gain and the incidence of thirst. The study was done for 6 weeks successively with 3 different groups. Each patient was dialysed with 3 different dialysates for 2 weeks: Group I(Conventional HD: sodium concentration: 137 mEq/L), Group II(Hypertonic HD: 147 mEq/L) and Group III (Sequential HD: from 147 to 140 mEq/L). Hemodynamic parameters(blood pressure, pulse rate and ultrafiltration rate), biochemical parameters(hematocrits, blood urea nitrogen, creatinine, osmolality, sodium, potassium, chloride, fasting blood sugar) and complications (interdialytic weight gain &thirsty sensation) were compared among 3 groups. The results were as follows: 1. Decline of systolic blood pressure and diastolic blood pressure at the time of a 3 hour check during hemodialysis was lower in the Group II than Group I and III (p=0.002; p=0.012). and decline of diastolic blood pressure at the time of a 4 hour check during hemodialysis was lower in the Group II and III than Group I(p=0.04). 2. ncidence of hypotensive episodes during dialysis was significantly lower in Group II than group I (p=0.0287). 3. The ultrafiltration in Group III at the time of 1 hour, 2 hour and 3 hour check during hemodialysis was higher than that in Group I and II at the time of 1 hour, 2 hour and 3 hour check during emodialysis respectively (p=0.0001; p=0.0001; p=0.0004). 4. Interdialytic weight gain was higher in Group II(3.1+/-0.8) than GroupI(2.8+/-0.8) and III (2.9+/-0.9) (p=0.0422). 5. Hematologic and biochemical results were not significantly different among 3 Groups. 6. Frequency of thirst was different in Group I, II and III, 0.05+/-0.12, 0.41+/-0.24 and 0.22+/-0.29 respectively (p=0.0259). The results suggest that hypertonic HD was effective in preventing HD-associated hypotension but interdialytic weight gain and thirst sensations were increased as compared with a conventional method. In this situation, sequential HD seems to be an alternative method to minimizes the side effect of hypertonic HD.

The purpose of this study was to identify risk factors related to sexual function of women with coronary artery disease, and to determine the predictors of sexual function. The study design, a descriptive correlational study, was done through structural questionnaire and interview. A total of 50 subjects from C University Hospital at Kwang-ju city who have undergone coronary angiography at department of cardiology were observed and interviewed from Feb. 22, 1999 to March. 23, 1999. The number of affected vessels, the level of total serum cholesterol, and the ejection fraction of 2-D echo cardiography were analyzed to evaluate the severity of coronary artery disease. And also type A behavior pattern, health behavior, Brief Index of Sexual Functioning for Women (BISF-W) were measured. The data obtained were analyzed using percentage, mean and standard deviation, t-test, ANOVA, Pearson's correlation coefficient, and stepwise multiple regression analysis via SPSS PC+. The results of this study were as follows: 1. The mean age of the subjects were 58.1 and 72.0% of those have been married over 30 years. Seventy two percentage were unemployed and monthly family income of 56.6% was less than 1,000,000 won (approximately $ 840). Eighty percent were in their postmenopausal state, and the frequency of sexual intercourse of 84.0% were two to three times per month. 2. The scores of type A behavior pattern were from 16 to 38(mean 24.94) and health behavior ranged from 21 to 43(mean 31.2). Abstinence from smoking, alcohol, and caffeine were best compliant factors and weight control and exercise were least abided ones. The result of 2D-ECHO EF showed that the half of the subjects were abnormal, and 24% had more than 240mg/dl of total serum cholesterol. The coronary angiography showed that 64% of the subjects had more than one affected vessels. 3. The predictors to explain the factor score of 'orgasm' were number of health examination, the pre- or post-menopausal state, protestant, number of coronary vessel affected, level of serum total cholesterol, and comorbid group of hypertension and diabetes, and it's total variance accounted for 52.4%. The predictors to explain the factor score of 'sexual activity' were comorbid group of hypertension and diabetes and type A behavior pattern, which accounted for 22.4% of total variance. The predictors to explain the factor score of 'sexual satisfaction' were type A behavior pattern, no religion, exercise, level of serum total cholesterol, and pre or post menopausal state, which accounted for 52.1%. The predictors to explain the factor score of 'sexual desire' were the period of marriage, type A behavior, employment or unemployment, and weight control, which accounted for 43.2%. The predictors to explain the factor score of 'external force of sexual functioning' were physical overload and exercise, which accounted for 41.1%. The predictors to explain the factor score of 'sexual activity' were family monthly income, catholics, and exercise, and which accounted for 35.4%. Above results lead us to some consensus that sexual function of women with coronary artery disease is related to various factors including vasogenic factors such as total serum cholesterol level, number of coronary vessel affected, an endocrinal factor such as menopausal state, and type A behavior pattern as a socio- pshychological factor. And also health behaviors such as fitness care, overwork, weight control, and emotional tension are contributed to sexual function.

The purpose of this study was to define the degree of the resourcefulness and the health-promoting behavior of cancer patients, to identify the relationship between the resourcefulness and the health promoting behaviors and to provide the basis for strategic nursing intervention. This study was conducted by an exploratory survey. Data were collected by self-reported questionnaires from 97 cancer patients in a university hospital in Tae-Gu from September to December of 1998. The sample data were collected by using a convenient sampling method. The following instruments were used in the study after some adaptation: Park Chai Soon's Health Promoting Lifestyle Profile, Oh Pok Ja's instrument for health promotion behavior and the Rosenbaum self-control schedule(SCS). The reliability of instruments was tested with Chronbach'alph(.79-.89). Data was analyzed by using the SAS program. T-test, ANOVA, and Pearson's coefficients of correlation. The results of this study were as follows: First, the average score of the resourcefulness variable was 22.20; the range of the score was from -30 to +81 The average score of the performance in the health promoting behavior variable was 96.13; the range of the score was from 39 to 137 Second, the resourcefulness variable was significantly different from such demographic factors as gender and perceived health status, but there was no statistically significant difference between the demographic factors and the health promoting behavior variable, except that of perceived health status. Third, the performance in health promoting behavior of cancer patients was significantly correlated with the resourcefulness of cancer patients(r= .50) In conclusion, resourcefulness was identified to be an important variable that could contribute to promote health-promoting behavior.

The purpose of this study was to identify the effect of body positioning on PaO2, SpO2, systolic blood pressure, diastolic blood pressure, pulse, and respiration(above all defined physiologic index), of patients with unilateral lung disease. The subjects for this study were eleven patients admitted to I.C.U. of K.H.M.C. with a diagnosis of unilateral lung disease confirmed by chest X-ray and the attending doctor, from January 30th. to April 20th. 1999. A quasi-experimental repeated-measures cross-over design was used to compare three body positions(semi-Fowler's, lateral decubitus with good lung dependent, and lateral decubitus with diseased lung dependent). Each subject spent 30 minutes in semi-Fowler's position and 2 hours in good lung dependent position and diseased lung dependent position. Starting in the semi-Fowler's position, then in the lateral position with the good lung dependent or the diseased lung dependent as assigned in random order. Thirty minutes after each positioning, arterial blood sample was analyzed. Measurements of all physiologic index were recorded at the specified intervals(0, 30, 60 90, and 120 minutes) in good lung dependent and diseased lung dependent position. Statistical comparison of PaO2 value was done using the Wilcoxon Signed Rank Test, and Multivariate repeated-measures analysis of variance was performed to analyse the within-subject effect of two dependent position for 2 hours on the five dependent variables: 1. PaO2 2. SpO2 3. systolic blood pressure 4. diastolic blood pressure 5. pulse. The results obtained were as follows: 1. The PaO2 value in the good lung dependent position was significantly higher than the PaO2 value in the diseased lung dependent position(Z=-2.8451, p=.002). 2. The PaO2 value in the good lung dependent position was significantly higher than the PaO2 value in the semi-Fowler's position (Z=-2.6673, p=.003). 3. The difference between the PaO2 value in the semi-Fowler's position and the PaO2 value in the diseased lung dependent position was not significant(Z=-1.2448, p=.10). 4. There were no statistically significance in the trends of physiologic index in the good lung dependent position and the diseased lung dependent position. From the results, it may be concluded that the good lung dependent position is the most effective position for patients with unilateral lung disease that improve oxygenation. Identification of positioning over time may be need further studies.

This study was conducted to investigate the relationship between self-esteem, health promoting behavior and the quality of life of the patients undergoing hemodialysis. The subjects were 86 patients undergoing hemodialysis in H hospital. The data were collected using a questionnaire. Data collection was done from January 11th to June 16th, 1999. The analysis of data was done by use of descriptive statistics, t-test, ANOVA, Pearson Correlation Coefficient and Multiple regression using the SPSS/PC+ program. The results are as follows:1.The mean of the level of self-esteem was 25.02, the level of health promoting behavior, 120.04 and the level of QOL, 128.09. 2. Test for hypothesis: Hypothesis 1. "The higher the level of self-esteem of the patients undergoing hemodialysis, the higher the level of quality of life will be." was supported(r=.296, p<.01). Hypothesis 2. "The higher the level of health promoting behavior, the higher the level of quality of life will be." was supported (r=.628, p<.001). 3.Health promoting behavior explained 39.5percent of QOL(R2=.395, F=27.040, p<.001). 4. Monthly income(F=3.85, p<.01) and marital status(F=4.64, p<.05) were significantly related to the quality of life In conclusion, this study showed that self-esteem and health promoting behavior may be important factors that can improve the quality of life of the patients undergoing hemodiaysis. This study identified that nursing plans should include these factors to help physical, psychological and social adaptation of the patients undergoing hemodialysis.

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.