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Volume 16(1); March 2004

Original Articles
Knowledge and Attitudes of Oncology Nurses Toward Cancer Pain Managements
Soung Wha Gong, Jji Yha Bang, Min Sook Seo, Sin Sook Hyun, Hee Jung Kim, Mi Ae Lee, Mi Ae Lee, Hyen Hee You, Jae Kyoung Her, Eun Ae Kim, Kyung Sook Park
J Korean Acad Adult Nurs 2004;16(1):5-16.   Published online March 31, 2004
PURPOSE
The purpose of this study is to evaluate the knowledge and attitudes of oncology ward nurses toward cancer pain management and to find ways to improve the educational program for nurses. METHOD: A total of 209 nurses working at the oncology ward of three hospitals in Seoul and a Gyenggi Province. The survey instrument used was the 32-item scale for evaluating nurses knowledge and attitudes originally developed by McCaffery and Ferrell'(1990), that was by Kim'(1997). RESULTS: In terms of the nurses knowledge of pain management, the result showed that the nurses scored an average of 67.8 out of 100 for phamacokinetics of opioids, 84.8 for classification of analgesics, 60.1 for pain assessment, and 70.7 for drug administration. 18.2% of the nurses hesitate to inject the narcotic agent because of concerns regarding the drug's potential side effects. there was significant difference in the knowledge of pain management according to the general characteristics of pain in terms of the nurses age(p=.001), position (p=.016), years of experiences(p=.002), experience of cancer pain education(p=.001). CONCLUSION: The also showed that nurses working at cancer ward lack knowledge. It is important to provide intensive education to nurses about cancer pain management.
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Factors Influencing Life Satisfaction the Elderly living alone
Myung Suk Lee
J Korean Acad Adult Nurs 2004;16(1):17-26.   Published online March 31, 2004
PURPOSE
This study was to identify factors that influence the life satisfaction of solitude elderly. METHOD: The subject were 100 homebound the elderly living alone(age=76.58) who were live in M city located in Jeollanamdo. Data were collected from June 1 to September 30, 2002. The instrument used for this study were a survey of general characteristics, residential environment, MUNSH, Health Self-rating scale, ADL, loneliness and POMS. The data was analyzed using descriptive statistics, t-test, and stepwise Multiple Regression. RESULT: In general the perceived health status was poor, but ADL was moderate., loneliness was high but mood and life satisfaction were low. In regression analysis, life satisfaction was significantly influenced by mood(51%), ADL(4%), loneliness(3%), and perceived health status(1%). These variables explained 59% of the variances in the life satisfaction.CONCLUSION: The result suggests that health care professionals should give more attention to helping the elderly raise their life-satisfaction. A further study is necessary to find out an effective nursing intervention for a better those in a comfortable residential environment, decreasing the loneliness and to promoting the mood for those elderly who live alone.
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Analysis of Nursing Studies on Hardiness Published in Korea
Young Ock Kim
J Korean Acad Adult Nurs 2004;16(1):27-36.   Published online March 31, 2004
PURPOSE
The purpose of this study was to identify patterns and trends of hardiness studies and to suggest the direction of further research. METHOD : Forty-seven hardiness studies were collected through internet searching and were reviewed by some criteria. RESULT : The results showed that hardiness studies have increased rapidly since 1990's. Eighteen studies were thesis' for degrees and others were for non- degree research studies. All studies employed the non-experimental design, particularly correlational studies. In the sampling method, all studies used non-probability sampling. Most commonly used instrument for hardiness measurement was Pollock(1986)'s HRHS. In the majority of research, hardiness was treated both as a composite measure and 3 subscales. Hardiness-related concepts were 27 and classified into 5 categories such as health behavior, stress, adaptation, support, and others. Most common statistical technique was Pearson's correlation coefficient, followed by regression, ANOVA, path analysis. CONCLUSION: To be utilized as practical nursing knowledge, hardiness studies should be done with more empirical analysis such as experimental research, and Meta-analysis is needed to compare the effect size and significance of composit and 3 subscales of hardiness construct.
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Development and Effect of East-West Self-Help Group Program for Rehabilitation of Post-Stroke Clients: A Preliminary Study
Hyun Sook Kang, Won Ock Kim, Jeong Wha Kim, Myoung Ja Wang, Joung Hee Cho
J Korean Acad Adult Nurs 2004;16(1):37-48.   Published online March 31, 2004
PURPOSE
The purpose of this preliminary study was to develop and evaluate the effects of East-West Self-help program for Rehabilitation of post-stroke clients. METHOD: This program is developed through literature review, survey and seminar. The program is consisted of six sessions twice a week for 6 weeks. This program is composed of health education on stroke, exercise, oriental nursing interventions, and therapeutic recreation. The outcomes have been evaluated on the basis of perceived health status, self-efficacy, U/E function, ADLs and subjective response. RESULTS: 1) After the 6 week program, the perceived health status had improved and the score of rehabilitation self-efficacy increased significantly. 2) After the 6 week program, the score of BADL increased significantly, but, the score of IADL was not statistically significant. 3) After the 6 week program, the amount of use and quality of movement of the affected U/E were increased significantly. 4) All of the participants showed satisfaction with this program. CONCLUSION: Considering these research results, the program is effective in improving functional abilities and self-management ability. Therefore this program could be continuously developed and implemented as a community based self-helf group program for post-stroke clients.
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A Study on Quality of Life of those who have Breast Cancer Patients taking Chemotherapy
Ju Hyeon Shim, Kyung Sook Park
J Korean Acad Adult Nurs 2004;16(1):49-59.   Published online March 31, 2004
PURPOSE
This study is a descriptive research study to measure the quality of life of those who suffer from breast cancer and take the chemotherapy. METHOD: The Subjects were 70 breast cancer patients who took the chemotherapy from September 2 to October 31, 2003. Quality of life was measured by Ferrell's measurements. RESULTS: Quality of life indicators were spiritual domain=6.44, physical domain= 5.45, social domain=4.15, and mental domain= 3. 95. Whole quality of life was 4. 68 out of 10 points. The quality of life of those with a practicing religion was significantly higher than those without(F=3.88, P=0.026). Subjects who were less than 2 months post-operation had higher points in the physical domain than those who were more than 2 months post-operation (t= 2.76, p=0.007). Subjects who had less than 4 treatments of chemotherapy had higher points in the physical domain than those who had more than 4 treatments of chemotherapy (t=2.03, p=0.046). COLCLUSION: The results of this study serve as a meaningful source to promote quality of life of breast cancer patients who undergo chemotherapy. The results can also be applied to the development of education programs and counseling materials for chemotherapy patients. Health care strategy can also raise the quality of life of brest cancer patients.
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The Types of Smoking Cessation Among Adult Smokers: Q Methodological Approach
Sung Rae Shin, Sung Ok Chang, Sang Suk Kim
J Korean Acad Adult Nurs 2004;16(1):60-71.   Published online March 31, 2004
PURPOSE
The purpose of this study was to analyze the subjectivity of smoking cessation methods of smokers. METHOD: The Q. methodology which provides a method of analyzing the individual's subjectivity was used. The 34 subjects classified 38 selected Q-statements into a 9 point scale to make a normal distribution. The collected data was analyzed using a QUANL PC program. RESULTS: Three types of smoking cessation among smokers were identified. Type I, Family Centered; Type II, Suppressing Temptation; Type III, Self Overcoming. CONCLUSION: This study results revealed that different approaches of support programs are needed to address the three types of smoking cessation and their characteristics
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Factors Related to the Stage of Mammography Screening in Married Korean Women
Hea Kung Hur, So Mi Park, Gi Yon Kim
J Korean Acad Adult Nurs 2004;16(1):72-81.   Published online March 31, 2004
PURPOSE
The purpose of this study was to examine factors related to different stages of mammography screening based on the transtheoretical model (TTM) and health belief model (HBM). METHOD: 143 women were recruited from community centers in W city. The mean age was 44.08 (SD=7.78) and 74 (51.7%) had experienced education on preventative behavior related to breast cancer. The Decisional Balance Scale (Pros and Cons of mammography) and Stages of Adoption of Mammography Scale by Rakowski et al. (1992) and the revised Health Belief Model Scale (Perceived Seriousness, Perceived Susceptibility and Health Motivation) by Champion (1993) were used. RESULTS: According to the stage of adoption of mammography, 17.4% of the women were in pre-contemplation, 45.5% in contemplation, 24.5% in action, and 12.6% in maintenance. The mean differences for pros, and the decisional balances between the stages of mammography adoption were significant (F=8.84, p=.000; F=7.20, p=.000). Education related to prevention of breast cancer was the most important variable. Prevention education, history of breast disease and pros of mammography explained the stages of mammography adoption (R2=26%).
CONCLUSION
Findings support TTM as a useful tool for improving mammography adherence. Behavioral interventions that target decisional balance and health belief can effectively promote adherence to mammography.
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The Effects of Nursing Education using CD ROM on the Anxiety and Knowledge of Patients having Minor Surgery
Yeon Ja Hwang, Yeon Hwan Park, In Seon Park, Nam Yee Kim, Jeng Mee Kim, Jin Young Kim
J Korean Acad Adult Nurs 2004;16(1):82-89.   Published online March 31, 2004
PURPOSE
The purpose of this study was to investigate the effect of nursing education using a CD ROM on the anxiety and knowledge of the patients having minor surgery. METHOD: Forty patients hospitalized in K hospital in Seoul from April to August 2002 participated in this study. In the experimental group, twenty patients received nursing education on the operational procedures and post-operational care. The control group, received conventional nursing care only. Anxiety experienced by patients was measured by Spielberger's State-Trait Anxiety Inventory, and knowledge was measured by an instrument developed by Rahe et al. The data were analyzed by SPSS statistical program. RESULTS: There were no significant differences in anxiety level between two groups. However, subjects in the experimental group were found to have significantly higher postoperative knowledge levels than those in the control group, and were very satisfied with the CD ROM program.
CONCLUSION
The nursing education program using CD ROM before minor surgery proved to be an effective nursing intervention to increase knowledge of patients and contribute to their self care after discharge. To decrease anxiety of the surgery, the nursing education program should be combined with supprortive emotional nursing intervention, such as touch, and massage.
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Effects of Psychosocial Stress Management on Stress and Coping in Student Nurses
Cho Ja Kim, Hea Kung Hur, Duck Hee Kang, Bo Hwan Kim
J Korean Acad Adult Nurs 2004;16(1):90-101.   Published online March 31, 2004
PURPOSE
The purpose was to examine the effectiveness of a psychosocial stress management program on stress and coping in student nurses. METHOD: A nonequivalent control group pre-posttest design was used. A convenience sample of 24 students from the Department of Nursing, Wonju College of Medicine, Yonsei University were assigned to experimental (n=12) and control groups (n=12). Stress was measured using the Visual Analog Scale (10 points) and blood cortisol. Coping was measured using a scale modified by So (1995) based on the Ways of Coping Checklist developed by Folkman and Lazarus (1985). Depression was measured using the CES-D by Radloff (1977) and state anxiety, using the State Anxiety Inventory by Spielberger (1976). The psychosocial stress management program included education, relaxation (Korean Dan Jeon-typed Breathing and music), and social support. RESULTS: Results showed for the two groups, 1) a significant difference in stress scores (U= 19.50, p=0.002), 2) no difference in cortisol levels (8am, 4pm), 3) a significant difference in problem-focused coping (U=25.50, p=0.007), 4) no difference in emotion-focused coping, and 5) no difference in state anxiety and depression. CONCLUSION: By utilizing the program, students were able to learn how to control their stress and improve their coping. Therefore with a partial modification, psychosocial stress management can be useful for continual management of stress in student nurses.
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Effects of Perceived Social Support on Self Esteem in Elderly
Yang Gyeong Yoo, Sung Hee Ko, Kwuy Bun Kim, Seung Hee Chung
J Korean Acad Adult Nurs 2004;16(1):102-110.   Published online March 31, 2004
PURPOSE
This study was done to identify the degree that perceived social support effects the self esteem of the elderly. METHOD: A structured questionnaire was administered to 203 elderly subjects from April 2003 to June 2003. The data were analyzed with an SPSS program for descriptive statistics, Pearson`s correlation coefficients, t-test, ANOVA, and stepwise multiple regression. RESULTS: The level of social support was moderate; family support received the highest score among sources of support. In types of support, appraisal support was the highest score and material was the lowest. The level of self esteem was also moderate. The score of social support showed a slightly high positive correlation with self esteem. In general characteristics, several variables were significantly related to self esteem. The most powerful predictor of self esteem was material support by family and the variance explained was 19.6%. A combination of material support by family, informational support by relatives, perceived economic status, perceived health status, and having a subject to depend on accounted for 39.8% of the variance in self esteem of the elderly. CONCLUSION: To increase the self esteem of the elderly, it is necessary to consolidate material support by family.
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A Study on the Use Patterns of Alternative Therapy in the Elderly
Kyung Rim Shin, Sun Young Park, Su Jin Shin
J Korean Acad Adult Nurs 2004;16(1):111-122.   Published online March 31, 2004
PURPOSE
The purpose of this study was to describe the using pattern of alternative therapies in the elderly.
Method
197 subjects, persons who were more than 60 years old, we interviewed. We modified and complemented Shin's(2000) instrument in accordance with purpose of this study. Data were analyzed statistically by using SAS program. RESULTS: 1. It was shown that 66.84% of subjects have utilized one or more types of alternative therapy. 2. It was shown that the most frequently used types are acupuncture (48.83%), and ethmoid bone therapy (42.75%). 3. Acupuncture was shown to be the most satisfactory type of therapy (14.50%). 4. There was a significant difference in the use ratio by sex; female 73.47% and male 60.20%. 5. Among users of alternative therapies, the most frequent responses to each question were as follows; 1. Motive of Use - "for complete cure of symptoms" (32.31%). 2. Side effects - "no side effects" (95.97%). CONCLUSION: We found that elderly persons used alternative therapies more frequently than others perpulations. Diet therapy and Hand therapy were most commonly used in older people. Although the elderly use alternative therapy, they cannot place confidence in its scientific reliability. Therefore, we need to examine the effects of alternative therapy.
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The Effect of Horticultural Program on Cognitive Function, Activities of Daily Living(ADL) and Hand Grip Strength of Institutionalized Dementia Patients
Yun Jung Lee, Shin Mi Kim
J Korean Acad Adult Nurs 2004;16(1):123-134.   Published online March 31, 2004
PURPOSE
The purpose of this study was to examine the effect of use of a horticultural program on the cognitive function, activities of daily living, and hand grip strength of institutionalized dementia patients. METHOD: Twenty three study participants completed a five week protocol comprised of one week of baseline and four weeks of treatment. The study design was a one group repeated measurement study. For the first and fifth week of the study period, data was collected with 3 instruments: Korean Version of Hasegawa Dementia Scale (HDS-K), Katz's ADL index, hand grip strength. Data analysis was conducted by SPSS version 10.0. RESULTS: Total HDS-K score(p=.000), Activities of daily living(p=.013) and hand grip strength(p=.001) was significantly improved after treatment compared to the baseline. CONCLUSION: The horticultural program was effective for improving cognitive function, ADL and hand grip strength of the dementia patients. Repeated studies utilizing a control group are needed, using various durations, plants and processes, to confirm these results and to standardize the horticultural program protocol.
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Effects of Aroma Oil Inhalation on Nausea Vomiting and Anorexia in Cancer Patients Receiving Chemotherapy
Eun Sook Jung, Byung Sook Lee
J Korean Acad Adult Nurs 2004;16(1):135-145.   Published online March 31, 2004
PURPOSE
The purpose of this study was to examine the effects of aroma oil inhalation using peppermint and bergamot on nausea vomiting and anorexia in cancer patients receiving chemotherapy. METHOD: Study subjects were 30 patients who had experienced nausea and vomiting when they had been hospitalized in K university hospital located in D city after receiving more than two Cisplatin combination chemotherapy treatments. Among them 15 patients were in the experimental group doing aroma oil inhalation and the other 15 patients were in the control group without aroma oil inhalation. The data were collected from February 1, 2002 to May 17, 2002. The data were analyzed with SPSS WIN 10.0 program using frequency, percentage, chi-square-test, t-test, Repeated Measures ANOVA. RESULTS: 1) The degree of nausea and vomiting in the experimental group with aroma oil inhalation using peppermint and bergamot were significantly lower than that of the control group. 2) The degree of anorexia in the experimental group with aroma oil inhalation using peppermint and bergamot were significantly lower than that of the control group. CONCLUSION: aroma oil inhalation was effective for relieving patients' nausea vomiting and anorexia receiving chemotherapy. Therefore, it is proposed that aroma oil inhalation should be applied as a supportive nursing arbitration method to relieve patients' nausea vomiting and anorexia who are receiving chemotherapy.
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The Effects of Aromatherapy Hands Massage on the Preoperative Anxiety of Hemorrhoidectomy
Mi Hae Sung, Su Jin Kim, Eun Hae Park, Kyung Ae Choi
J Korean Acad Adult Nurs 2004;16(1):146-155.   Published online March 31, 2004
PURPOSE
The Purpose of this study was to explain the effects of aromatherapy massage on the preoperative anxiety of hemorrhoidectomy patients, and to provide the effective and holistic nursing care to them. METHOD: The research design was a nonequivalent control group non-synchronized design. The data were collected during the period from November 1 to November 30, 2003 at K-Hospital in Seoul. The subjects were fifty patients who were to have a hemorrhoidectomy under general anesthesia. They were assigned to two groups, 25 subjects to the experimental group and 25 subjects to the control group. The State Anxiety Inventory tool was used to measure state-anxiety on all patients the day before surgery. Systolic and diastolic blood pressure, and pulse rate were measured on the day before surgery and the preoperative period. The experimental group received aromatherapy massage on the hand with lavender oil. Data were analyzed by x2 test, independent t-test, paired t-test. RESULTS: 1. Hypothesis 1, that the level of preoperative state-anxiety of the experimental group who received aromatherapy massage would be lower than that of the control group who did not received aromatherapy was supported(p=.047). 2. Hypothesis 2was that the Physiological index of the preoperative anxiety of the experimental group who received aromatherapy would be lower than that of the control group who did not received aromatherapy. The 1st subhypothesis that "the level of the preoperative systolic and diastolic blood pressure of the experimental group would be less than that of the control group" was not supported. CONCLUSION: Aromatherapy massage can be regarded as a partially effective nursing intervention that relives the preoperative anxiety of surgical patients and stabilizes vital signs.
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A Study on the Critical Thinking Disposition about Student Nurse
Seung Ae Yang, Duk Yoo Jung
J Korean Acad Adult Nurs 2004;16(1):156-165.   Published online March 31, 2004
PURPOSE
This descriptive - comparison study was conducted to investigate the critical thinking disposition of senior nursing students in three types of nursing program.
Method
The convenience sample was drawn from 472 nursing students. Instruments used in this study were made California Critical Thinking Disposition Inventory developed by Facione & Facione (1994). Data was analyzed by descriptive statistics, t-test, ANOVA, Scheffe test with SAS 6.12 program. RESULTS: 1. The total mean score of critical thinking disposition was 279.06. Inquisitiveness was the highest with an mean score 45.50, while systematicity was the lowest with mean score of 36.15. There was a statistically significant difference in critical thinking disposition(F=14.36, p=.00)according to senior nursing students in three types of nursing programs. 2. There was a statistically significant difference in critical thinking disposition(F=5.53, p=.00) according to age, marital status(t=-3.15, p=.00), religion(F=3.26, p=.02) and critical thinking course taken previously(t=3.10, p=.00). CONCLUSION: There was a statistically significant difference in critical thinking disposition(F=14.36, p=.00) according to senior nursing students in three types of nursing program. There was a statistically significant difference in Critical thinking disposition according to age, marital status, religion, logic, philosophy, critical thinking course.
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