PURPOSE
To evaluate undergraduate nursing students' ability in clinical competence, critical thinking, and problem solving following enrollment in a clinical reasoning course.
METHODS
A clinical reasoning course utilizing a human patient simulator and scenarios was offered to 22 senior students at a College of Nursing in Seoul. Students' clinical competence was measured with a checklist of 15 items by analyzing students' performance recorded on video tapes for eight scenarios. Critical thinking disposition and problem solving were measured by a self-administered questionnaire before and after the course. Data were analyzed using descriptive statistics and Wilcoxon signed-rank test.
RESULTS
The high scored items of clinical competence were: 'obtain relevant subjective/objective data', 'interpret vital signs', 'communicate with healthcare providers', and 'utilize standard precautions including handwashing.' Students' critical thinking and problem solving scores following the course were increased with statistical significance.
CONCLUSION
A clinical reasoning course utilizing a human patient simulator creates a realistic clinical environment for nursing students and provides the opportunity to obtain clinical competence, critical thinking, and problem solving skills.

PURPOSE
The purpose of this study was to evaluate the impact of a protocol of cryotherapy and Tai Chi on women with Fibrolmyalgia Syndrome.
METHODS
The study design was a pretest and posttest quasi-experimental, nonrandom assignment. The subjects were 48 outpatients with a diagnosis of fibromyalgia based on the American College of Rheumatology Standards. The setting was a University Medical Center in S city. The protocol was self administered ten times a week, for a two week period resulting in twenty treatments.
RESULTS
A protocol of cryotherapy and Tai Chi self-help program showed significant improvement in the fibromyalgia impact as measured by reports of physical impairment, feeing good, number of missed work days, ability to perform work, reports of pain, fatigue, rest, stiffness, anxiety and depression as reported by the comparison group (p<.001). No significant differences between the two regarding in reports of the tender points (p=.062).
CONCLUSION
The results suggested that a protocol of cryotherapy and Tai Chi self-help program may be a promising multidisciplinary strategy for fibromyalgia patients.

PURPOSE
The aim of this study was to examine patients with Chronic Hepatitis B (CHB) and their level of knowledge of their disease, uncertainty, stress and health behaviors and to identify factors influencing their health behavior.
METHODS
A cross-sectional, descriptive design was used. The sample included 136 patients in a gastroenterology outpatient department at one hospital located in Seoul. The mean age of the subjects was 41 and 77.2% were male. Data were collected using a structured questionnaire from April to June 2009. The collected data were analyzed using SPSS/WIN 15.0.
RESULTS
The reported scores for knowledge of the disease, uncertainty, stress, and health behaviors were 14.43, 81.50, 26.50, 52.11, respectively. There were statistically difference between health behaviors and gender, age, marital status and antivirus treatment. A positive correlation existed between knowledge of disease and health behaviors (r=.199, p=.020). In contrast, there was a negative correlation between uncertainty and health behaviors (r=-.250, p=.003). The factors influencing health behaviors were knowledge of disease, gender, age, uncertainty, antivirus treatment, and marital status (R2=.267, p<.001).
CONCLUSION
These findings support that strategies for enhancing knowledge of disease and reducing uncertainty are needed to promote health behavior in patients with CHB.

PURPOSE
A descriptive study was conducted to examine the relationship of illness perception, self-efficacy, and self-care of patients who were diagnosed pulmonary tuberculosis.
METHODS
The study was conducted using a convenient sample from two hospitals in Incheon and Seoul. One hundred forty four patients completed a questionnaire which included questions on general characteristics, a Brief Illness Perception Scale, a Self-efficacy Scale and a Self-care Scale. Data were analyzed by using descriptive statistics, t-test, ANOVA, Pearson Moment Correlations and stepwise multiple regression analysis.
RESULTS
There was a statistically significant positive correlation between illness perception and self-care (r=.335, p=.000) and between self-efficacy and self-care (r=.687, p=.000). Stepwise multiple regression analysis revealed that among the three variables the most powerful predictor was self-efficacy. Self-efficacy and illness perception were significant factors and accounted for 54.2% of the variance of self care in pulmonary tuberculosis patients.
CONCLUSION
Self-efficacy and illness perception were influencing factors in self care among patients with pulmonary tuberculosis. Hence further interventional researches are needed that consider these two variables.

PURPOSE
This study aimed to identify the prevalence of mild cognitive impairment (MCI) among a group of community-dwelling elderly and to determine if there were differences in general characteristics, activities of daily living (ADL), perceived health status (PHS) between the MCI group and group of elderly with normal cognitive function.
METHODS
This study utilized a descriptive survey design. Six hundred and five subjects over the age 65 were recruited from an S public health center, Seoul. Data were gathered through a variety of instruments: MoCA-K, K-MMSE, K-MBI, S-IADL, and PHS scale. Data were analyzed by SPSS/WIN 18.0 using descriptive statistics, Chi-Square test and t-test.
RESULTS
The prevalence of MCI among the subjects was 46.0%. Differences in IADL, PHS, age, education, sex, and residing with a spouse were statistically significant between groups. The MCI group had lower IADL, lower PHS, were older, and had lower educational levels than the group with normal cognitive function. Further, the MCI group was less likely to live with a spouse.
CONCLUSION
It is suggested that MCI group should be targeted in developing and implementing nursing strategies to prevent dementia and improve the elderly cognitive function.

PURPOSE
This study investigated the degree of acculturation stress among North Korean Defectors and the coping method that they used to deal with it.
METHODS
Ninety-nine participants of this study were North Korean Defectors in Seoul and Daejeon. The tools of survey for this study were acculturation stress and stress-coping.
RESULTS
The score for acculturation stress among North Korean Defectors was 2.97+/-0.47 which was a moderate level of stress. The score of problem-solving coping was 3.10+/-0.47 and emotional coping got 2.85+/-0.52. On acculturation stress, there were higher scores among people who were old-aged, married, low educational levels, dissatisfied with job, low monthly income, and living alone. On problem-solving coping, there were higher score among people who have jobs. Regarding emotional coping, there were higher score in people who have jobs, dissatisfaction with job, and living alone. The higher the problem-solving coping skill, the less the acculturation stress.
CONCLUSION
Reducing of acculturation stress and increasing adaptation mechanism of North Korean Defectors are very important due to the results of this study. Therefore, adaptation programs like psycho-social counseling should be created for North Korean Defectors.

PURPOSE
This study explored cardiovascular health (CVH), depressive symptoms, and well-being among community-based Korean women according to hwa-byung (HB) symptoms.
METHODS
This cross-sectional study measured HB symptoms, depressive symptoms, quality of life (QoL), and spiritual well-being (SWB) in addition to biophysical indicators of CVH.
RESULTS
Fourteen women of the HB group are more likely to live alone with lower income than 36 women in the comparison group. Compared to the comparison group, the HB group has larger mean waist circumference and higher prevalence of abdominal obesity along with more knee arthritis and back pain. Although women in the HB group appeared worse in other CVH than their counterparts, this was not statistically significant. It is noteworthy, that the HB group showed a higher probability of having a hard cardiovascular event (CVE) within 10 years than the comparison group. Women in the HB group reported more depressive symptoms, poor QoL, and low SWB as well as smoking and sleep difficulties.
CONCLUSION
Despite the small sample size, significant relationships of HB symptoms to abdominal obesity, the probability of a hard CVE within 10 years, and psychosocial health were found. Strategies for effective community-based cardiovascular programs for Korean women may include HB screening and/or management.

PURPOSE
The purpose of this study was to explore and understand the suicide ideation and survival experience of Korean elders in America.
METHODS
A phenomenological research method guided data collection and analysis. A total of five elders reported having had suicide ideation participated. Data were collected through individual in-depth interviews. All interviews were audio taped and transcribed verbatim. Coding was used to establish different concepts and categories.
RESULTS
The following three constituents have been identified: retrospective focus based on the suicide ideation through the immigrant life, facing reality through comparison between the life in America and in Korea, survival skills and constructing view of life.
CONCLUSION
The result of this study may contribute for health professionals working at various crisis settings to understand Korean immigrant elders with suicide ideation.

PURPOSE
The study was designed to identify the factors that influence the length of stay of elderly people in the recovery room.
METHODS
The design of the study was descriptive correlation. The subjects were 196 general anesthesia patients. The data were analyzed by SPSS/WIN 17.0 program.
RESULTS
The average length of stay in the recovery room was 62.62 minutes. The length of stay in the recovery room was influenced by age (27.50%); number of diseases (12.97%) and albumin level (6.75%). Other related post operative factors (30.98%) were abnormal ABGA, shivering, PAR score, pain, arrhythmia, amount of bleeding, cardiovascular complication, hypertension and delirium. Those factors explained 78.2% out of the total variance of the length of stay. The strongest effector was the abnormal ABGA (beta=.226) and then shivering (beta=.222).
CONCLUSION
The influencing factors should be assessed and monitored for the aged before and after surgery. Further research is needed to find the exact factors for ICU transfer elderly from recovery room and emergency surgery target.

PURPOSE
This study was conducted to identify the factors that predict a current smoking behavior and higher emotional stress among male patients with acute coronary syndrome (ACS).
METHODS
The study was approved by an institutional review board from a university hospital, 2010. A face to face interview using questionnaires was performed with 185 first-time ACS male patients who were undertaken a percutaneous coronary intervention at a cardiovascular care unit. Data were analyzed using SPSS/WIN 15.0.
RESULTS
About 54% of the study subjects were currently smoking. The current smokers had dyslipidemia and reported bad eating habits compared to the non-smokers. The current smokers were younger, living alone, and reported lower perceived benefit on smoking cessation than the non-smokers, and 15% of them did not consider quitting (precontemplation stage). Smoking status was not significantly related to emotional stress. Logistic regression analysis revealed that being employed including professional or labor increased the odds of current smoking four or three times compared to the non-employed or retired. Low income or dyslipidemia also increased the likelihood of current smoking 2.8 and 2.1 times, respectively. Blue collar workers or heavy drinkers had 2.9 and 2.8 times more risks of having higher level of stress.
CONCLUSION
An occupational background and health habits should be considered to develop an effective educational strategy for smoking cessation and stress reduction among male patients with ACS.