This study was undertaken to find out the perception of marital relationship and to understand the typology. The Q-population consisted of 153 statements that were collected and 33 Q-samples were selected. The P-samples for this study were made up of 30 who were married. Each responded to a Q-set of marital relationship according to 9-point scale. The results of Q-sorting were coded and analysed using QUANL PC program. Typological observations were as follows. 1) One in body and spirit type : In type 1, couples had different backgrounds respectively but felt one in body and spirit. 2) Companionship type : 2. Couples had not so much a hierarchial as a horizontal relationship. Couples perceived themselves as interdependent and friends. 3) Adaptation type : Couples readily adapted themselves to a marital relationship. They only depended on their spouses at times and stressed the relationship. Marriage was accepted as destiny rather than choice. On the basis of these results, we suggest: When a marriage is in trouble, that we assess the type of marital relationship in advance and intervene with a proper program. In addition, practical intervention programs need to be developed tailored to the type of subjective perception about the marital relation.

The purpose of this study was to understand the nature and structure of "uncertainty of chronically ill patients" by explaining it more scientifically. This study is based on the unique experiences, which individual uncertainty experiences differ from others. In this sense, Q-methodology which includes self-psychology and abductive logics is applied to the study. The results indicate that there are six types of uncertainty of chronically ill patients : my own fault, self-esteem loss, self-care determination, cure-doubt, reality-restructure, and past-tenacity reality-absence. Thus,"uncertainty of chronically ill patients"is defined from the study as the process in which continuous transition and evaluation of possibility cause changes in human recognition, attitude, action, etc.. The significance of the study is threefold : (1) discovery of six types of uncertainty of chronically ill patients in Korean people, (2) the better understanding of "uncertainty of chronically ill patients", (3) possible developments of nursing concept and assessment and intervention technique based on the new dimension of the understanding in uncertainty for nursing of chronically ill patients from this research.

The environment in the ICU leads to negative changes in a patient's usual sleep pattern and so contributes negatively to the patient's health condition as compared to patients in general wards. Therefore, it is thought that an important nursing intervention would be to identify the relation between noise and sleep patterns which play an important role in illness recovery. The purpose of the present study was to explore the relationship between noise in the ICU and the sleep pattern of patients admitted to the ICU. A descriptive correlation design was used to examine the relationship. Thirty-four subjects were recruited from a Medical ICU (MICU), Surgical ICU (SICU) and Coronary Care Unit (CCU) at a large university hospital in Suwon. Data were collected from September 28 to October 31 in 1999. In the present study, noise was categorized into noise level and patients' perception of noise. The objective noise level was measured using the A-Weighted Sound Level Meter. The patients' preception of noise was measured using a self-reported questionnaire developed by the researcher. Sleep patterns in this study includes both quantity and quality of sleep. These were measured using open ended questionnaires and the 'Korean Sleep Scale A' developed by Oh, Song, Kim(1998). The data was analyzed using the SPSS-WIN to test the research question, Pearson product moment correlation coefficient was run. Ancillary analysis were conducted with demographic variables to determine their relation to the main study variables. For the ancillary analysis, t-test and one-way ANOVAs were performed. The results of the present study are summerized as follows: 1. The total mean of objective noise level (10pm-6am) was 56.2dB. The means for night time noise level in individual ICUs for the SICU, MICU and CCU, were 58.7dB, 58.6dB and 48.3dB, respectively. The total mean for patients' noise perception was 42.8 out of a maximum possible score of 76. For item means of noise perception, the one ranked highest was "conversations between doctors and nurses" (3.2). The one ranked lowest was "noise from the radio" (1.2). Regarding the degree of perception for each type of noise source, the one ranked highest was "equipment noise" (2.6), the second was "conversation between medical staff" (2.4), the third was "conversation between patients, caregivers and visitors" (2.3), and the one ranked lowest was "environment noise" (1.8). 2. Looking at quantity of sleep of ICU patients, the mean nocturnal sleep time was found to be 4.9 hours. The total mean of sleep quality for ICU patients was 21.0 out of a maximum possible score of 40. 3. The relationship between perception of noise and quantity of sleep was statistically significant(r= - .41, p<.05). The relationship between perception of noise and quality of sleep was also statistically significant(r= - .47, p<.01). The results of the study indicate that personal perception of noise is related to sleep patterns. Therefore, it is suggested that nursing interventions be developed to reduce the degree of personal perception of noise and, thus, decrease sleep pattern disturbances in patients in the ICU.

The purpose of this study is to develop and evaluate the Self Efficacy Promotion and Exercise Training Program to decrease anxiety and depression and to increase the quality of life for kidney transplant recipients. The subjects were selected randomly among the patients who underwent renal transplant at three major transplantation hospitals in Seoul, Korea. The observed subjects in this study consisted of 56 patients who had renal transplantations between one to twelve months prior to this study. The patients did not take any regular physical exercise. This study was carried out between November, 1999 and March, 2000. The study groups were divided into 3 groups; exercise training group (n=16), self efficacy group (n=18) and control group (n=22). The exercise training group received self efficacy promotion and exercise training program for 12 weeks. The self efficacy group received self efficacy promotion education, but no exercise training was given. The control group was not offered any education. The anxiety, depression and quality of life were evaluated 3 times, before the experiment, after 8 weeks and after 12 weeks. The data were analyzed with mean, standard deviation, Chi-square test, ANOVA and Scheff test. The results were as follows: 1. After the experiment, anxiety and depression scores of the exercise training group and self efficacy group were more significantly decreased than those of the control group (p=.05). 2. After the experiment, the quality of life score of the exercise training group and self efficacy group were more significantly increased than those of the control group (p=.05). This study showed that the Self Efficacy and Exercise Training Programs were effective. Therefore, it is expected that the Self Efficacy Promotion and Exercise Training Program could be widely applied as an effective independent nursing intervention to decrease anxiety and depression and to increase quality of life for kidney transplant recipients.

Spiritual health is an important indicator in the quality of life of patients with cancer. The purpose of this study was to validate a Spiritual Health Inventory (SHI) for patients with cancer developed by Highfield (1989). The SHI was translated into Korean, back-translated into English. The study sample was 96 patients with cancer. The data were collected from September, 1999 to February, 2000 for 6 months. Statistic analysis was done with the SPSS PC+ (Version 10.0) program: descriptive statistics, factor analysis, Pearson correlation coefficient, and one-way ANOVA. The results are as follows: 1. The reliability score was examined using Cronbach's alpha and found to be .79. 2. Construct validity was examined using factor analysis. Four factors were identified and named: Peace of mind (19.1% of variance), Hope (9.7%), Self-esteem (6.4%), Trust (6.0%). The total of 41.2 percent of the variance. 3. The Pearson correlation coefficient score of 4 factors was between r = .24~ .42. 4. SHI was identified as multidimension, that is The relationship with GOD, as absolute being, the relationship with others, the relationship within oneself. 5. There were differences in response in items especially related to GOD. The following recommendations can be made on the above findings: 1. Replicate with a minimum sample of 150 and test for concurrent validity. 2. Since spirituality is a dynamic concept, longitudinal study is also necessary. 3. Concept analysis using a qualitative study based on religious preference is recommended. 4. The items such as 12, 13, 15, 17, 19, 22, 24, 26 indicated conceptual ambiguity for Korean populations and further study is needed on item deletion or new items.

This study was conducted to compare activities of daily living, fatigue and depression between rheumatoid arthritis patients and healthy persons. The subjects consisted of 53 rheumatoid arthritis patients and 53 healthy persons at a university hospital in Daegu City. Data were collected by means of structured interviews with questionnaires from July 20, 1999 to August 25, 1999. The instrument used in this study were the activities of daily living scale developed by Katz et al. (1970) and Barthel(1973), Multidimensional Assessment of Fatigue by Belza et al.(1995) and CES-D(Center for Epidemiologic Studies-Depression) scale. Analysis of data was done by use of descriptive statistics, Pearson Correlation, Chi-square test, t-test, ANOVA, MANCOVA and Duncan with the SPSS program. The major findings are summarized as follows: 1. The first hypothesis that the rheumatoid arthritis patients will have a lower degree of activities of daily living than the healthy persons was supported (F=4.584, p=.035). 2. The second hypothesis that the rheumatoid arthritis patient will have a higher degree of fatigue than the healthy persons was supported (F=7.799, p=.006). 3. The third hypothesis that the rheumatoid arthritis patients will have a higher degree of depression than the healthy persons was supported (F=4.768, p=.031). With the above results, it can be concluded that rheumatoid arthritis patients had a lower degree of activities of daily living and a higher degree of fatigue and depression than the healthy persons. Therefore, by providing appropriate nursing intervention, activities of daily living would be much better and fatigue and depression would be alleviated.

The purpose of this study is to investigate the correlation among the stroke patient family's health, burden and quality of life which is based upon the comparative appreciation of the adult stroke patient's family and elderly stroke patient's family. For this purpose, data were collected from the family care-givers for two groups of stroke patients under sixty years old and over sixty years of age, admitted at K Hospital and H Hospital in Seoul. The instruments for this research are based on the tool for measuring physical health and psychological health developed by Yang, Young-hee(1992), the tool for measuring the sense of burden by Seo, Mee-hae and Oh, Ga-sil(1993), and the tool for the quality of life by Noh, Yoo-ja(1988). The sampling for this study was done from December, 2000 until February, 2001. Questionnaire data were drawn up by personal interviews aided by the staff nurses. The analysis of collected data are based on general characteristics calculated at the rate of 100 percent of the average, t-test, ANOVA(some difference on a level with p<.05 being subsquently confirmed by DMR) for Health Status, Burden, Quality of Life and Pearson Correlation to verify the hypothetical correlation among the subjects. The results of this study are as follows: 1. In the adult stroke patient family, the factors influencing the physical health proved to be age, present occupation and family-formation. Here, the factors influencing psychological health turned out to be age, matrimonial status, present occupation and family-formation. In the elderly stroke patient family, the factors influencing physical health proved to be age, gender, final academic status, matrimonial status, present occupation, and relation with the patient. Here, the factors influencing the psychological health were age, final academic status, matrimonial status, present occupation, relation with the patient and family-formation. In the former case, the influencing factors upon the burden were shown to be age, final academic status, matrimonial status, relation with the patient and family-formation. In the latter case, the influences upon the burden were age, gender, final academic status, matrimonial status, present occupation and relation with the patient. In the former case, the influences on the quality of life were gender, and economic situation. In the later case, the influencing factors on the quality of life were age, final academic status, matrimonial status, present occupation, and relation with the patient. 2. The rate of the physical condition in the former case turned out to be 2.83, and the psychological condition 2.37. The physical condition of the latter case was 2.76, and the psychological condition 2.46. The rate of the burden in the former case was 3.14, and that of the latter case was 3.04. The rate of quality of life in the former case proved to be 2.46, and that of the latter case 2.55. 3. The rate of correlation between the burden and the quality of life appeared to be the high counter-correlation (r= -.573). The rate of correlation between the psychological health and the burden of a simialr (r= -.565). The rate of correlation between the physical health and the psychological health proved to be a moderate correlation (r= .372), The rate of correlation between physical health and the burden turned out to be a low counter-correlation (r= -.276). According to this study, there proved to be a very close correlation among the stroke patient family's health, the burden and quality of life. Thus, it would be necessary to find out various nursing interventions in order to mitigate the stroke patient family's burden in the process of caring for the patients.

This study was conducted to examine if the revised HPM was appropriate to explain smoking quitting behavior. A convenience sample of 400 college students enrolled in the universities located in Seoul and Kyunggi-Inchon province was selected. According to the study results, smoking-specific cognitions and affect included in the study could significantly explain commitment to a plan to quit smoking which was one of the behavioral outcomes in the revised HPM. The study result showed that among predictors, smoking-related affect, perceived benefit of quitting smoking, and perceived self-efficacy significantly explained commitment to a plan to quit smoking, but perceived barriers and interpersonal influences did not. The model for smoking quitting behavior formulated with smoking-specific cognitions and affect was statistically significant and the model explained 48 percent of variance in smoking quitting behavior. More specifically, it was shown that among smoking-specific cognitions and affect, only smoking-related affect, interpersonal influences, and perceived self-efficacy were the significant predictors to explain smoking quitting behavior. Smoking-related affect was the most important variable to explain smoking quitting behavior, followed by perceived self-efficacy. However, the influence of commitment to a plan to quit smoking on smoking quitting behavior was not statistically significant. Lastly, the model for smoking quitting behavior formulated with individual characteristics and experiences could explain 13 percent of the variance in behavior to quit smoking. Although the model is statistically significant, only the number of quitting attempts had significant and direct influence on behavior to quit smoking, while the remaining variables did not.

The purpose of this study was to develop Intensive Care Unit (ICU) admission and discharge criteria that would lead to the appropriate utilization of ICU resources and nursing services. For this study, a conceptual framework was developed through a review of the literature. Then in order to identify the overall health condition of patients in the ICU, and to draw up preliminary criteria, the medical records of 58 patients who were admitted to the ICU of Y Medical Center in Seoul between March, 1999 to February, 2000 of were analyzed. Two expert validity tests were done for the preliminary criteria for admission and discharge with 21 patients over 18 years of age who were admitted patients and for 12 patients who were discharged between May 30, 2000 and June 5, 2000 a clinical validity test was also done. After this process, the final admission and discharge criteria were developed. The results of this study are summarized as follows: 1. After a review of the literature, there were 9 categories for admission criteria cardiologic, gastrointestinal, neurologic, endocrine, post-op care of major surgery, vital signs, laboratory values, and a category of miscellaneous items. Discharge criteria had 3 categories which were vital signs, laboratory values, and a category of miscellaneous items. 2. From the medical records of the 58 patients who were admitted to the ICU, 45 items for preliminary criteria for admission and 17 for discharge were identified. 3. The two expert validity tests showed that of the 45 items 29 admission items received over 75 percent agreement. The 16 admission items which received less than 75 percent agreement were revised or deleted from the admission criteria. Of the 17 discharge items, 11 had over 75 percent agreement and 6 less then 75 percent agreement. These were revised or deleted from the discharge criteria. 4. In the clinical validity test, 14 admission items showed more than 75 percent agreement and 11 discharge items more than 83 percent agreement. 5. The final criteria consisted of 29 items for admission and 11 items for discharge. Since patients being considered for admission to the ICU have complex problems, there is a need to make the decision based on more than a single issue. This tool will insure that the ICU nursing care and treatment resources are appropriately used by allowing a multi-professional health team to make admission and discharge decisions.

The purpose of this study was to identify the frequency of Urinary Incontinence and lower urinary tract symptoms, to identify life style problems for UI of Women in anIsland. The sample consisted of 88 women in an island, a urinary symptom questionnaire developed by Jackson, et. al. and a demographic questionnaire were used to collect the data. The results of study were as following. 1. It was reported that the subjects have experienced UI and various lower urinary symptoms such as stress incontinence, nocturia, intermittency, abnormal stream, feeling of incomplete emptying and also they have experienced some degree of 'bother' 2. It was reported that the subjects have experienced various life style problems for UI 3. There was significant relationship between age and urgency (p=0.0262), bladder pain (p=0.0268), abnormal strength of stream (p=0.0074), inability to stop midstream (p=0.0026), and ability to perform daily tasks (p=0.0488), 4. There was a significant relationship between the number of discharges and urgency (p=0.0273), abnormal strength of stream (p=0.0307), and inability to stop midstream (p=0.0122). 5. There was a significant relationship between menopause and bladder pain (p=0.0020), abnormal strength of stream (p=0.0245), and inability to stop midstream (p=0.0002). 6. There was a significant relationship between the degree of experiences for lower urinary tract symptoms and life style behavior. Therefore, based on the results, a developing and carrying out of adequate UI care program is needed.

The purpose of this study was to identify correlation of stress, coping patterns and physical symptoms in cancer patient's caregiver. The stress was measured by VAS( Visual Analogue Scale). The coping methods were measured using the modified Ways of Coping Questionnaire by Yang (1998) and the actual physical symptoms were investigated. The phases of patient illness consisted of 1st (initial) stage, and 2nd (recurred) stage and 3rd (terminal) stage based on literature (Lewandowski & Jones, 1988). The data were collected by a survey conducted from March to July, 2000 and which included 196 cancer patients' caregivers from two hospitals in Seoul. The data were analyzed using paired t-test, unpaired t-test, ANOVA, Scheffe test and Pearson correlation coefficient. The results were as follows: 1. The average of caregivers' stress scores was 62.5. Problem-focused coping methods were significantly used more than emotion-focused coping methods by the cancer patients' caregiver. The mean number of caregivers' physical symptom was 1.03. 2. There were significantly high level of stress in women, those who were more than 60 years old, those who had a low education level, those who had no job, those who are patients' wives' and those who are terminal patients' caregiver. There were significantly low levels of coping in women, those who were more than 60 years old, those who had low education levels, those who had no job and those who are patients' wives. There were significantly higher number of physical symptoms in women, and those who have no job. 3. Caregivers' stress was significantly correlated to problem-focused coping methods (r=-.21, p=.006), and physical symptom (r=-.28, p=.0001). In conclusion, attempts to develop nursing interventions for cancer patients' caregiver in women, those who are more than 60 years old, with a low education level, have no job, and are cancer patients' wives could have an improvement on positive coping methods and provide relaxation from stress in the patients' experience.

The purpose of this study is to explore perception types and to understand the nature of experience of nursing students' clinical education by using the Q methodology. A Q sample was developed through a review of the literature and descriptions about nursing students' experience in clinical practice. Thirty-six statements made up the finalized Q sample. The P sample consisted of 33 third grade nursing students in K university. Q statements were written on separate cards and were given to the 33 subjects to sort according to degree of agreement or disagreement. The Q-sorts by each subject were coded and analysed with the Quanl PC program. A a result, three major perception types, namely, 'alienation of ideal and reality', 'active participation', and 'perception of limitation of ability' were identified. By identifying the nature of the three types, this study suggests efficient strategies for developing clinical educational programs according to the perception types of nursing students. Clinical education would thereby be more valuable.

The purpose of this study was to investigate the effect of a hand massage program on anxiety, vital sign and pain in clients with ischemic heart disease. The design utilized for this study was quasi-experimental with a nonequivalent control group non-synchronized design The subjects were fifty-four patients, twenty-eight for the experimental and twenty-six for the control group, who were admitted with ischemic heart diease at a cardiac intensive care unit in K medical center of K university. This study was carried out from May, 1999 to March, 2000. The level of anxiety and pain measured by Visual Analogue Scale, systolic blood pressure, diastolic blood pressure and pulse rate were measured before and after hand massage, the state of Anxiety was measured by the Spielberger (1970) scale at admission and after hand massage for three days. The collected data were processed by using the SPSS PC program and analyzed using X2 -test and t-test. The result of this study are as follows: 1. The scores of VAS anxiety and State of anxiety of the experimental group were lower than those of the control group. 2. The degree of systolic blood pressure, diastolic blood pressure and pulse rate of the experimental group were lower than that of the control group. 3. The score of VAS pain of the experimental group was lower than that of the control group. The results suggested that hand massage can decrease VAS anxiety, State of anxiety, vital signs and VAS pain of patients who were admitted with ischemic heart disease at cardiac intensive care unit Therefore, it is proposed that hand massage is an appropriate nursing intervention to relieve anxiety of the patients who were admitted with ischemic heart disease at a cardiac intensive care unit.