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Volume 15(1); March 2003

Original Articles
The Difference of Women's Knowledge, Attitudes and Practice Education after Education for Breast Self-examination
Yeon Ok Suh
J Korean Acad Adult Nurs 2003;15(1):5-13.   Published online March 31, 2003
PUPPOSE: The purpose of this study was to compare the effect of breast self-examination (BSE) education between at education and three months.
METHOD
The study subjects were consisted of 30 women chosen from those in a Catholic church in Seoul. The data was collected by using questionnare at two different times: immediately after the BSE education and 3 momths after.
RESULT
At three months, women who performed BSE was 50.0% and the number of BSE practce was 2.53. There was statistically significant change on the score of the knowledge, barrier and practice between at education and three months later. Susceptibility was increased after three month, but wasn't significant different. Confidence, motivation after three months were decreased from the time of initial BSE education and wasn't significantly changed. It was found that motivation about BSE explained 44.2% of variance.
CONCLUSION
The findings showed that the knowledge of BSE, and attitudes and practice were change between at the time of the first survey and at three months. Therefore, the intensive education about BSE can be effective to enhance women's health belief and practice to perform BSE for early detection of breast cancer.
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A Comparison on the Level of Pain Related to Methods of Blood Sugar test using VAS
Ja Yun Choi, Keum Seong Jang, Hyun Oh Kim, Ok Yeub Choi, Min Hee Park
J Korean Acad Adult Nurs 2003;15(1):14-21.   Published online March 31, 2003
PUPPOSE: The purpose of this study is to determine the level of pain related to a blood sugar test. Specifically, the study attempts to compare the varying degree of pains when different types of blood sugar test are used.
METHOD
A sample of 56 subjects is composed of DM patients admitted to a medical ward of C university hospital in Gwangju. Data were collected from July, 2001 to December, 2001. The blood sugar tests were administered in four different ways: (1) the use of 27G needle only, (2) the use of 27G needle followed by ice-packed treatment, (3) the use of 27G needle after EMLA cream application, and (4) the use of lancet. The degree of pain is measured with a visual analogue scale and performed twice.
RESULT
In both measures, the use of 27G needle only method is shown to cause the highest level of pain in comparison with the rest of methods (F=4.01, p=.01; F=8.14, p=.00). However, the differences in pain between time in all methods were not found to be significant (t=-.85, p=.40; t=.80, p=.42; t=.31, p=.75; t=.19, p=.85).
CONCLUSION
The study results indicate that the method using lanceter is more recommendable than the use of 27G needle only method. Further research is needed to support the current study result with the use of different measurement scales and to determine effective methods of blood sugar test to lower pain and compliance.
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Discharge Nursing Needs of Patients having Surgery with Gastric Cancer
Jong Kyung Lee, Mi Soon Lee
J Korean Acad Adult Nurs 2003;15(1):22-32.   Published online March 31, 2003
PUPPOSE: The purpose of this descriptive study was to identify the discharge nursing needs of patients who received gastrectomy.
METHOD
The subjects of this study consisted of 100 patients who had gastric surgery in 4 university hospitals in chungnam province. The instrument for this study was developed by the researcher based on literature through in-depth interviews. Data was collected from October 4 to October 30, 2000.
RESULT
The results were as follows: Discharge nursing needs were classified in 8 main categories. The 8 categories were 'emotional and spiritual support', 'nutrition and diet control', 'medication', 'treatment planning and follow up care', 'activity level', 'symptom management' 'health seeking behavior' and 'social support'. The total mean score for nursing needs was 3.89. 'Nutrition and diet control' was the highest degree of nursing needs and 'activity level' was the lowest degree of nursing needs. There were significant differences in degrees of nursing needs between different ages(F=2.74, p=.048), level of education(F= 2.91, p=.038) and period since diagnosis(F= 4.46, p=.037).
CONCLUSION
This study looked at 8 categories of discharge nursing needs. Patients identified 'nutrition and diet control' as the highest need and 'activity level' as the lowest need. Further research needs to be done to identify discharge educational needs for various age groups, educational level and for patients with varing lengths of diagnosis time to surgery.
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Patterns and Related Factors of Fatigue during Radiotherapy in Patients with Breast Cancer
Jin Hee Park
J Korean Acad Adult Nurs 2003;15(1):33-44.   Published online March 31, 2003
PUPPOSE: The purpose of this study was to identify the patterns and related factors of fatigue in patients with breast cancer undergoing radiotherapy.
METHOD
31 women with breast cancer receiving radiotherapy were recruited from the out-patient radiologic clinic of the university hospital in Seoul, Korea over a period of 3 months. Data was collected prospectively concerning three points for 5 - 6 weeks : before radiotherapy(T1), 2 weeks after starting radiotherapy(T2) and the completion of radiotherapy(T3). Data were analysed by repeated measure ANOVA, Pearson correlaton, and multiple regression.
RESULT
1. Score of fatigue increased significantly over the course of radiotherapy. 2. Score of symptom distress and emotional distress increased and functional status scores decreased significantly over time. 3. Fatigue was positively related with symptom distress and emotional distress and negatively related with functional status over the course of radiotherapy. 4. At T2, emotional distress explained 24.7% of the variation in fatigue. At T3, symptom distress(41.9%) and emotional distress(7.2%) explained the variance in fatigue.
CONCLUSION
The results of this study provided evidence that fatigue increased over the course of radiotherapy and symptom distress and emotional distress were influencing factors of fatigue in this group. The results of this study suggest that comprehensive intervention strategy for fatigue should be developed to maintain quality of life during and following radiotherapy considering these factors.
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Knowledge, Attitudes, and Educational Needs for Sexuality of the Elderly
Hye Ja Han, Nam Cho Kim, Sung Ai Chi
J Korean Acad Adult Nurs 2003;15(1):45-55.   Published online March 31, 2003
PUPPOSE: This study was to investigate the knowledge, attitudes, and educational needs for sexuality of the elderly.
METHOD
This was a descriptive study, in which data were collected from February to April 2002 from 354 elderly who were residing in Chung-Chung province.
RESULT
1. The level of knowledge regarding sexuality was below average. 2. The level of the attitudes toward sexuality of the elderly was neither positive nor negative. 3. The educational needs of the elderly were above average. 4. Higher level of knowledge on sexuality was significantly correlated with more positive attitudes and education needs for sexuality, and more positive attitudes toward sexuality was significantly correlated with more educational needs for sexuality.
CONCLUSION
Particularly men, with good health, and those who were in intimate relationships with their spouses and still engaged with active sexual life showed somewhat higher level of knowledge and positive attitudes as well as higher educational needs. Therefore, further development and applying of sexuality promotion programs for healthy elder couples should be considered in the future to enhance the quality of life of elder population. In addition, it is also suggested to develop an alternative intervention program on sexuality for elderly who are women, those with meager health, and the bereaved.
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The Life Experiences of the Sheltered Homeless
Jeong Sook Won
J Korean Acad Adult Nurs 2003;15(1):56-66.   Published online March 31, 2003
PUPPOSE: The purpose of this study is to describe the psychological aspects of experiences of men living in a homeless shelter in Seoul. This study focused on understanding about the life of the homeless in the shelter by Phenomenological method.
METHOD
The participants in this study were seven men who are living in a homeless shelter in Seoul. The following data were collected though the in-depth interviews and analyzed by the Phenomenological analytic method of Giorgi.
RESULT
There are five focal significances about the life of the homeless. (1) Unplanned Life : Difficult life comes from outside situation, Freedom, The acceptance of unconsciousness life, Laziness, Unreliability, The dissolute life, No purpose to life, Relying on drinking, (2) Self-rationalization : Feeling of defeat, Give up, Desire for a support system, Lack of willingness, Anxiety, Chivalry, Falsehoods, (3) Superficial Interpersonal Relationships : Ignorance, Pressure, Discord, Hiding from one anther, avoidance. (4) A sense of devestation : Negative perspective, Mental weakness, Difficulties in employment, ambivalance with social structure, The place to escape, Complaining against the opposite sex, Sense of regret, Lack of relationship with family, The lack of self-confidence, Loss of volition (5) The Hope of new life : Realization, Desire for change, Dreaming of married life, Dependence in God CONCLUSION: The conclusion of this study shows that the men in the shelter had various psychological reasons for being in the homeless shelter. Further studies need to be done to validate this information and formulate ways to assist these men with their psychological needs.
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The Effects of Music Therapy in the Reduction of Anxiety and Discomfort on Patients Undergoing Gastrofibroscopy
Yeon Park, Mi Soon Hong
J Korean Acad Adult Nurs 2003;15(1):67-77.   Published online March 31, 2003
PUPPOSE: This study was to examine the effects of music therapy on the levels of anxiety and discomfort in patients undergoing gastrofibroscopy.
METHOD
This study was equivalent control group pre-post test design. The subjects were 61 patients who visited H hospital internal medicine department for gastrofibroscopy ; 31 were randomly selected for the control group and the remaining 30, for the experimental group.
RESULT
1. The experimental group who used music therapy showed a significantly lower level of anxiety during gastrofibroscopy than the control group. 2. The experimental group revealed a lesser change in pulse rate between pre and post gastrofibroscopy than the control group. 3. There was a significant difference in the levels of subjective and objective discomfort during gastrofibroscopy between the two groups.
CONCLUSION
The results suggested that music therapy may help relieve anxiety and discomfort for patients undergoing gastrofibroscopy. These results showed that the use of music aided in the reduction of anxiety and discomfort during the unpleasant diagnostic procedure and, testing the effectiveness of music therapy deserves further study in other hospital settings.
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Influences of Perceived Treatment Effect and Perceived Physical Suffering on Hope of Cancer Patients in Post-operative Period
Seong Yoon Ahn, Dal Sook Kim
J Korean Acad Adult Nurs 2003;15(1):78-87.   Published online March 31, 2003
PUPPOSE: The purposes of the study were 1) to examine what relationships exist between PTE(perceived treatments effect) and PPS (perceived physical suffering) as the independent variables and hope as the dependent variable and 2) to examine whether PTE and PPS predict hope in cancer patients in their post-operative period within the Stotland's hope theory.
METHOD
The Visual Analog Scale was used for measuring PTE and PPS and the Kim and Lee's Hope Scale which had acceptable reliability and validity was used for measuring hope. The data was collected from 38 hospitalized cancer patients who were in the post-operative period with a convenient sampling method.
RESULT
There was a significant positive relationship between hope and the PTE in the low PTE group. There was a significant negative relationship between hope and the PPS in the low PPS group. There were no significant relationships between hope and the PTE in the high PTE group, and between hope and the PPS in the high PPS group. And the PTE explained hope with 71.2% of the variance in the low PTE group.
CONCLUSION
PTE in the low PTE group and PPS in the low PPS group were identified as the factors to explain hope.
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A Development of Nursing Outcome Indicators for Stroke Patients
Bo Eun Kwon
J Korean Acad Adult Nurs 2003;15(1):88-93.   Published online March 31, 2003
PUPPOSE: This study was conducted to develop nursing outcome indicators based on nursing activities done for stroke patients.
METHOD
focus group meeting and delphi technique, which consisted of clinical nurse experts, neurologist, and nursing professors. CVI(Index of Content Validity) and user validity test was performed.
RESULT
12 nursing diagnoses, 29 nursing interventions and nursing outcomes were identified. The former were from NIC and the latter were developed according to nursing interventions. They were verified by experts in focus group. 199 nursing activities were identified, 133 nursing outcome indicators were developed. In user validity, usefulness and usability were tested.
CONCLUSION
This systemic approach of measuring nursing outcomes verified nurses' positive effects in changing patients health status and nursing contributions in the health care system as a profession.
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An Inquiry into Exercise Behaviors of Middle-aged Women in Korea: A Q-methodological approach
Eun Ja Yeun, Eun Jung Ryu
J Korean Acad Adult Nurs 2003;15(1):94-104.   Published online March 31, 2003
PUPPOSE: This study was performed to identify the factors which affected exercise and the perceived exercise behaviors in women according to Q-methodology and to provide basic strategies for health promotion of middle-aged women in Korea.
METHOD
Q-methodology provides a scientific method for identifying perception structures that exist within certain individuals or groups. Thirty subjects in Seoul, Incheon, Chung-buk classified 35 selected Q-statements in to 9 points standard. The collected data was analyzed by using a QUANL pc program.
RESULT
Principal component analysis identified 3 types of exercise behavior of middle-aged women in Korea and named by the researcher. They are called persistent activity preference type, living-exercise preference type, exercise mania type. In persistent activity preference type, the middle-aged women thought activity was very helpful to achieving health and releasing stress or fatigue. Also, they recognized the relationship between physical health and psychological health. In living- exercise preference type, the middle-aged women preferred maintaining stability or nonactivity to intended exercise or activity for health. In exercise mania type, the middle-aged women thought there was no other way to keep her health than to exercise.
CONCLUSION
The findings of this study will provide the health care provider including nurse with useful information. It's very important to offer appropriate exercise intervention to the middle-aged women of each type by taking into consideration the characteristics of individual types.
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Evaluation of Participation and Management on the Cyber Hospice Specialist Program
Boon Han Kim, Ji Eun Choi
J Korean Acad Adult Nurs 2003;15(1):105-115.   Published online March 31, 2003
PUPPOSE: The research purposes analyzed the study participation and lecture evaluation of applicants in the cyber hospice specialist education course to find problems of nurse education application on the web.
METHOD
Study participants were 125 nurses for participation and 68nurses for lecture evaluation. The data was analysed by descriptive statistics.
RESULT
The results obtained from this study were as follows 1) The residence distribution of study participants was spread out across the nation. Equal distribution of education was accomplished without a difference among provinces. 2) The average study duration in the study participation was about one hour and a quarter minutes a week, and number of access to lecture notes was 65.8 times. But in a discussion room and a cooperative room, the system using rate was very low, so we considered the idea to come up with a more effective application way. 3) The participant's lecture evaluation of cyber education were generally satisfied about the quality of lecture, time, contents etc.
CONCLUSION
This study shows the possible implication for nursing fields using a web-based learning program for reeducation in a variety of fields, so nursing cyber application can be considered to come up with this more effective method.
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Healing Experience of Liver Cancer Patients by Complementary and Alternative Diet Therapy
Seung Ok Ro
J Korean Acad Adult Nurs 2003;15(1):116-125.   Published online March 31, 2003
PUPPOSE: This study was to evaluate the importance of liver cancer patient's diet and to provide guideline materials for proper nursing intervention.
METHOD
The hermeneutic phenomenological method of van Manen was applied for the in-depth interview of liver cancer patients and the cultural background studies including linguistic, literary and art works to enhance the insight and understanding, from which the meaning of the cognition and lesson of the experiences were extracted. The participants for this study were five male patients, who had been diagnosed with liver cancer, 5-15 years ago and had been treated with Transcatheter Arterial Embolization without chemotherapy. The repeated interview and close observation were carried out for nine months starting from January 2001 in Seoul, Korea.
RESULT
Eight essential themes were emerged ; (1) confliction(frustration) with hospital treatment (2) trial of every possible remedies (3) liking unpolluted natural foods(4) faithful tolerance (5) experiencing diet effectiveness (6) discovering personal control methods (7) deepen their faith in God (8) searching for healthy new life.
CONCLUSION
The alternative diet therapy influenced their life beyond the physical overcoming of cancer toward psychological and spiritual healing. The study evidenced the necessity for scientific research and education on the effectiveness and application of complementary and alternative diet therapy for the treatment of cancer in hospital practices.
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An Analysis of Related Factors for Major Nursing Diagnoses Identified for Instituionalized Elders
Hea Kung Hur, So Mi Park, Gi Yon Kim, Yun Hee Shin, Eun Shil Yim
J Korean Acad Adult Nurs 2003;15(1):126-136.   Published online March 31, 2003
PUPPOSE: The purpose of this study was to analyze related factors for major nursing diagnoses used in caring for institutionalized elders.
METHOD
This study was a descriptive study. The participants were 92 residents in a long-term care facility in Wonju, selected by convenience sampling. The instrument was a checklist designed on the basis of the related factors suggested by NANDA (1997) and a literature review. Data was collected by chart review, observation, and interviews with the participants. Data was analyzed using descriptive statistics with the SPSS WIN program.
RESULT
The most frequent nursing diagnosis was 'risk for injury', 'self-esteem disturbance', 'activity intolerance', 'impaired phyical mobility', and 'powerlessness'. The most frequent component for related factors for the five component for each nursing diagnosis was the physical component, followed by the social component. Common related factors for the nursing diagnoses were 'pain', 'change of emotional state/disorder', 'cognitive disorder', 'change of physical structure and function', and 'physical impairment', and 'immobility'.
CONCLUSION
The results of this study can contribute to the development of appropriate nursing intervention programs for elders (eg. 'Injury Prevention Programs', 'Self-esteem Improvement Programs' etc.). Clinical guidelines that gerontological nurses can use to accurately assess health problems and select appropriate nursing interventions may be developed.
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Concept Development Using Hybrid Model for the Concept, Patient Respect
Myoung Ran Yoo
J Korean Acad Adult Nurs 2003;15(1):137-145.   Published online March 31, 2003
PUPPOSE: This research is a descriptive study to explore "patient respect" in nursing. Respect was analyzed as a concept in the domain of the patient. The Hybrid Model suggested by Schwartz-Barcott and Kim was used in this study.
METHOD
For the theoretical phase, nursing and other literature were reviewed to analyze attributes and develop a working definition of the concept, respect. For the fieldwork phase, four subjects in two general hospitals in Seoul participated. With the participants' permission, the data was collected between January and April, 2002, through in-depth interview and participant observation. The data analysis progressed at the same time as the fieldwork. Data analysis proceeded according to the analysis method of Strauss and Corbin.
RESULT
The final attributes of patient respect are suggested by consideration, recognition, cordial treatment, concern, honesty, acceptance. The final definition of patient respect as a concept in the domain the of patient is suggested by "Patient respect is that the patient is recognized as an individual with worth and is accepted, and considered to be that kind of an individual person. In addition, the patient is recognized to be an independent person and is treated with concern and honesty." CONCLUSION: The results of the analyses is helpful in integrating into a comprehensive description of the concept, Patient Respect.
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A Critical Review of Literature: Mid-Range Nursing Theory of Uncertainty in Illness
Younhee Kang
J Korean Acad Adult Nurs 2003;15(1):146-153.   Published online March 31, 2003
No abstract available.
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