The purpose of this study was to explore the change of muscle strength, muscle endurance, flexibility and activities of daily living to develop a rehabilitational program. The subjects were selected randomly among the patients who underwent kidney transplantations at one major transplantation hospital in Seoul, Korea. This study was carried out between November 23, 1999 and February 15, 2000. The subjects in this study consisted of 16 patients who had kidney transplantations between 1 month and 12 months ago prior to this study. They were all on steroids and did not take any physical exercise regularly. The muscle strength, muscle endurance, flexibility and activities of daily living were evaluated at 1st week and after 12 weeks. The data were analyzed with numbers, percentiles, mean, standard deviation and t-test. The results were as follows: 1. After 12 weeks, the grip strength was significantly decreased than 1st week (p=.0002). 2. After 12 weeks, the back lift strength was significantly decreased than 1st week (p=.0002). 3. After 12 weeks, the muscle endurance was increased than 1st week, but it was not significant(p=.5487). After 12 weeks, the flexibility was significantly decreased than 1st week (p=.0002). 5. After 12 weeks, the activities of daily living was significantly decreased than 1st week (p=.0006). Like the above result, the kidney transplant receipients' muscle strength, flexibility and activities of daily living were reduced. In order to solve this problem, the writer has found that program development to prevent the defects should be extremely required. Since now on the number of patients should expand. After the kidney transplantation, the periods of 4, 8, 12 and 16 weeks are extended. The writer proposes to examine the different phase of change in each periods.

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.

The purpose of this study was to identify factors influencing patient satisfaction and to evaluate the utility of patient satisfaction as an outcome indicator. The study was conducted by mailed questionnaire. The subjects were 900 patients discharged from adult nursing units in a tertiary teaching hospital. On the discharge date, questionnaires were distributed by two trained research assistants. The questionnaire developed by the researchers was based on Larson(1996)'s study, and consisted of 71 items with the following components: overall satisfaction, domain-specific satisfaction(administration process, hospital facility and environment, nurses, and doctors), patients' loyalty(intention to use the health care service of the hospital in the future), recommendation to others, health benefits, and demographic characteristics. Each item was rated using a five point Likert scale ranging from '1=strongly disagree' to '5= strongly agree'. The response rate was 43%(387/900). The satisfaction level with the health care service was generally high. Perceived health status was the only significant factor influencing satisfaction level. Satisfaction with doctors contributed the most to explaining overall satisfaction. Overall satisfaction was significantly correlated with patient loyalty, recommendation, to other and perceived health benefit. It was found that the score of satisfaction was positively correlated with the score of loyalty, recommendation, and health benefit. Therefore, patient satisfaction seems to be a good outcome indicator.

The ratio of the elderly population is rapidly growing due to socio-economic development and better medical services. As the average life-span of the Korean elderly becomes longer, the proportion of the elderly is increasing. Therefore, the elderly need to sustain a high quality of life. However, all these factors, such as sensory loss, decreased endurance, mobility limitation, and a loss of independence, act to diminish the quality of life among the elderly. It is necessary for elders to adapt themselves to aging, to maintain their physical functions and especially, it is important to keep their independence in activity of daily living and self care. Therefore, this study was designed to identify the degree of activity in daily living and exercise of a self-care agency and to investigate the relationship between activity of daily living and self-care agency. Also, this research aimed to contribute to nursing interventions that maintain and promote quality of life of the elderly and to enable themselves to live independently. The subject of this study were 160 elders, over age 65, who were sampled in C city. Data were collected by observation and questionnaires from May,1999 to December, 1999. The measurement tools were Barthel Index(1979), Lawton & Brody(1969) for activity of daily living and Kearney & Fleischer(1979) for self-care agency. Data were analyzed by SAS PC+ package and included descriptive analysis, t-test, ANOVA, Pearson correlation coefficient, and Cronbach's alpha. The conclusions of this study are summarized as follows; 1. The mean of ADL and IADL was 96.09 and 16.38, respectively. The score described activity of daily living among the elders in C province as moderate. Particularly, in the items of IADL, the item of medication was the highest score. 2. The mean for exercise of self-care agency was 76.48, a moderate degree. 3. The degree of ADL and IADL according to demographic characteristics was significantly different statistically in pocket money, the presence of disease, perceived health status and in occupation, pocket money, family type, the presence of disease, and perceived health status, respectively. 4. The dagree of selt-care agency according to demographic characteristics was significantly different statistically in gender, education level, economic status, and pocket money. 5. There was a significant positive correlation between activity in daily living and self-care agency. Based on these results, further research is suggested to discover the variables influencing the activity of daily living and self-care agency to develop nursing strategies for improving self-care and activity of daily living among the elderly.

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.

The relationships among self efficacy, depression and coping with cancer were examined in 194 outpatients who had received a diagnosis of cancer. The sample for this descriptive correlational study consisted of people who were at least 19 years old and had been treated for cancer at 6 hospital in Seoul. Data were collected using a self-report questionnaire. The results of this study are as follows: 1. People who attributed cancer to heredity/ family showed the highest mean score of self efficacy. People who attributed cancer to smoking showed the highest mean score of depression. and coping. 2. There were significant differences between causal attribution and depression and between causal attribution and coping. 3. There was a negative correlation between self-efficacy and depression(r=-.301, p= .000), whereas there was a positive correlation between self-efficacy and coping (r=.195, 0=.006). Finally, it is evident that identifying clear perceived causes, self-efficacy, depression and coping in patients with cancer continues to challenge researchers. Based upon this study, it is recommended that future research have a longitudinal design that allows for the identification of changes in perception, emotion and coping and, possibly, different relationships over time.

The purpose of this study was to examine the relationship among perceived health status, self-esteem, self-efficacy and health promoting behavior, and to determine the predictors of health promoting behavior in post-mastectomy patients. The study, a descriptive correlational study, was done with structural questionnaires. A total of 51 post-mastectomy subjects from C university hospital in Kwang-ju, South Korea completed mail-in self-reporting questionnaires during a three month period from March to June, 1999. The data were collected using Lawstone's(1982) perceived health status scale, Rosenberg's(1965) self-esteem scale, the modified self-efficacy scale(Shere et al, 1982), and the modified health promoting lifestyle profile (Walker et al, 1987). The data obtained were analyzed according to percentage, mean and standard deviation, principal component analysis, varimax rotation, t-test, ANOVA, Pearson's correlation, and stepwise multiple regression. The results were as follows: 1. The health promoting behavior measurement resulted in six factors. Each factor was labelled as follows: self-actualization, nutrition, stress management, exercise, health responsibility and interpersonal support. The total percent of variance explained by the six factors was 58.4%. 2. The mean score of health promoting behavior was 85.92(range 58~117). The scores of six factor were nutrition 3.20, self-actualization 2.59, stress management 2.58, interpersonal support 2.58, health responsibility 2.49, and exercise 2.34 on a four point scale. 3. When the score of health promoting behavior factors were compared by general characteristics. FactorI: self-actualization, differed significantly by the frequency of pregnancy (F=3.06, p=.037). FactorII: nutrition differed significantly by drinking experience(t=-2.26, p=.028) and the pre- or post stage of menopause(F=2.69, p=078). FactorIII: stress management differed significantly depending on regularity of mensturation(t=-2.12, p= .042). FactorIV: exercise differed significantly by type of religion (F=2.49, p=.072), marital status(F=5.03, p=.010), and feeding type (F=2.64, p=.036). FactorV: health responsibility differed significantly by regularity of mensturation(t=2.18, p=.037). 4. The total health promoting behavior score was significantly related to self-esteem and perceived health status(r=.610, p.006; r= .378, p=.006). The score of self-actualization also corresponded with self-esteem and perceived health status(r=.556, p=.001; r=.343, p=.013). 5. The predictor to explain the score of health promoting behavior was self-esteem, which accounted for 37.1% of the total variance. The predictor to explain the score of self-actualization was self-esteem, which accounted for 30.9% of the total variance. The score of nutrition was primarily affected by both premenopause and drinking experience, which accounted for 13.1% and 9.5% respectively. Finally, the score of exercise was dictated by marriage, Buddhism, no experience of breast feeding, which accounted for 17%, 9.8%, & 5.2% respectively. In conclusion, self-esteem is the main predictor for health promoting behavior in post-mastectomy women. These findings suggest a need for nursing strategies which promote self-esteem in such patients.

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.

The cause of essential hypertension is yet unknown, but in general is caused by interaction of hereditary factors, diet, obesity, lack of exercise and stress. The aging process influences various physiological mechanism related to regulation of blood pressure. So elderly hypertensives have a tendancy to consider the disease as a result of the physiological aging process. This attitude causes many complications, worsening of the disease and even early death because of inappropriate care. In order to improve self-management of elderly hypertensives in this study the researcher examined the effect of blood pressure regulation by an education program that improves self-care behavior, through increasing self-efficacy. The education program consisted of group education on hypertension and self-care strategies, and encouraging and reinforcing self-efficacy resources such as verbal persuation, performance accomplishment and vicarious experiences. A quasi-experimental pre-and post-test design was used. Thirty-two elderly hypertensives participated in the study. Eighteen in the education group and fourteen in the control group. The education program consisted of eight sessions twice a week for four weeks. There was no intervention for the control group. Data were analysed using SPSS for Windows(Version 8.0). The results were as follows. 1. There was a significant decrease in systolic and diastolic blood pressure between the experimental group and control group over three different times, and interaction by groups and over time. 2. There was no significant difference in the level of self-care behavior between the experimental group and control group over three different times, and interaction by groups and over time. 3. There was significant difference in self-efficacy of experimental and control group, depending on the measuring period, but there was no difference between these groups on interaction by groups and over time. 4. There was positive correlation between self efficacy and self care behavior depending on the measuring period. There was negative correlation between diastolic blood pressure and self-care behavior on the posttest of the program, and between systolic blood pressure and self-care behavior on the follow-up test of the program. Findings indicate that this study will contribute to develop nursing strategies for the regulation of blood pressure for the elderly, which is easy for the elderly to learn as a nonpharmacologic approach.

The purpose of this study is to analyze the structural pattern of nurses' pain management with patients who experience pain. As a research method, the Q methodology, which is useful for an objective view of a highly abstract concept, was applied. The data collecting activity of this study was from August, 21st, 2000 to November, 24th 2000. The Q-population, the previous thesis and a literature review were done. Questions about pain management by the nurse on the patients, caregivers, nursing students, doctors, nurses, and others were asked in documentary work and in-depth interviews. In all, 223 units of the Q-population were formed, and the last 35 units of the Q-population were extracted. The data on the P-sample was collected from 41 nurses who worked in the medical and surgical units of a hospital that belonges to C university in Seoul. The research results were constituted in 3 types. Type I was the 'pattern of judging by objectivity'. The statement on which most of the people highly agreed for those patterns was shown by 'If patients said that they are suffering from pain, we sufficiently performed an assessment about the etiology, location, duration and degree'. For type I, the same pain was found in different locations according to the patients, so the etiology of the pain should be identified first place. Since ways of coping are different according to pain etiology, it was thought that it is important to assess sufficiently the pain etiology, location, duration, and degree. Therefore, when patients complain of pain, the pain etiology should be identified and assessed; according to the result, pain management should be performed systematically. Type II was the 'pattern of accepting by subjectivity'. The statement on which most of the people highly agreed for those patterns was shown as 'If patients said that they are suffering from pain, the medical treatment should be performed rapidly and speedily.' For type II, when the patient complains of pain, treatment should be performed quickly in order to prevent the condition getting worse, and it is thought that activity is a reasonable duty. Further, by trying to show empathy after pain is admitted and by understanding and coping rapidly with the pain of patients, an attitude which matched the altruistic morals of nurses is being shown. Type III was the 'pattern of worrying about', and the statement on which most of the people highly agreed for those patterns was shown is 'When there is a pain, to help patients to tolerate the pain to the highest degree.' In type III, the pain is a subjective expression, so there is a difference according to every individual. Therefore, actually if there is no measurement of pain, it could be exaggerated so nurses should help patients to tolerate it to the utmost. Even if there is a way to remove pain without an analgesic drug, nurses were reluctant to perform pain management as they possibly could. Through these research results, pain management of nurses was classified in 3 types, and structural characteristics in each type were discovered. Based upon the characteristics according to the type, an individualized pain management intervention strategy should be established and the follow up work performed.

Dysphagia is common and serious problem in intracerebral hemorrhage patients. Nasogastric-tube intubation is an important method for dysphagic patients who have an intracerebral hemorrhage. But many discomforts develope in patients with a nasogastric-tube. Therefore, it is necessary to decide when to remove the tube and as early as possible. The purpose of this study is to decide the applying time of training program to facilitate deglution for dysphagic patients who have intracerebral hemorrhage. Among the 343 patients with intracerebral hemorrhage who had been admitted to P-university hospital from April, 1994 to December, 1998, the medical record of the 110 patients with nasogastric tube were reviewed retrospectively. Results from the study were as follows: 1. Nasogastric tube insert duration of improved patients was a mean of 23.2 days 2. When a L-tube was inserted and removed, the L.O.C. of improved patients was 2.6+/-0.8(in the midst of stupor or a semicoma), 1.9+/-0.5(close to drowsy), respectively. This was signifcantly different(P=0.000). 3. When a L-tube was inserted and removed, GCS of improved patients was 9.3+/-2.9, 12.1+/-2.2 respectively. This was significantly different (P=0.000). 4. The duration of nasogastric tube insertion was the longest when in a stupor(L.O.C), 6~8 points(GCS).

The purpose of this study was to develop a standardized Nursing Diagnosis/ Intervention Protocol through a literature review and validity testing. Seven nursing diagnoses were selected as major nursing diagnosis in the field of Nutritional and Eliminative problem. The nursing intervention list was made by an expert group's review of Nursing Intervention Classification(NIC) suggested nursing interventions. Nursing activities which were included in each nursing intervention were sorted to follow the nursing intervention process after review and revision. The expert group's validity testing was done twice using the Likert scale. As a result the Nursing Diagnosis/ Intervention Protocol for Nutritional and Eliminative Problems was made to include 7 Nursing Diagnoses, 51 Nursing Interventions and 631 Nursing Activities.

The purpose of this pilot study was to identify the effects of hand moxibustion therapy to decrease pain and relieve coldness of the body in women who had a hysterectomy. The conceptual framework of this study was derived from Ying-Yang, Khi and other corresponding theories. The data were collected from February to May 1997. A Graphic Rating scale was used to measure the degree of pain and Digital Infrared Thermographic Imaging(D.I.T.I) was used to examine the degree of coldness. The subjects were women who resided in Seoul and had a hysterectomy within five years. An experimental group was composed of five women who received moxibustion and a control group was composed of five who did not. The research procedure began with having both the experimental group and control group describe their general characteristics and the degree of pain they perceived. Then, Digital Infrared Thermographic Imaging(D.I.T.I) was conducted. Moxibustion was only given to the experimental group on both hands twice every day for a total of five weeks. Their perception of pain and D.I.T.I were examined weekly. The control group received no therapy. After finishing therapy, the perception of pain and D.I.T.I for both groups were also measured. According to this study, moxibustion therapy resulted in a change of body temperature on the right shoulder joint(p=0.00074), abdomen(p= 0.0047), waist(p=0.0068) and hands(p=0.0317) respectively. Also, the study results showed significant decrease (p=0.0001) in pain over time and significant improvement over body coldness.

No abstract available.