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Volume 14(2); June 2002

Original Articles
Crossmapping of Nursing Problem and Action Statements in Nursing Records with International Classification for Nursing practice
Dong Hee Ryu, Hyeoun Ae Park
J Korean Acad Adult Nurs 2002;14(2):165-173.   Published online June 30, 2002
PURPOSE
this study is to explore how useful ICNP nursing phenomena and actions classification is to describe the nursing problem and nursing action statements of nursing records.
METHOD
The number of nursing phenomena statements found in this research were 323. Out of these 323, 222 statements can be fully classified, 62 statements can be partially classified, and 39 statements can not be classified at all by terms from the ICNP phenomena classification axis.
RESULT
The number of nursing practice statements were 318, 252 of which can be fully classified, 63 statements can be partially classified, 3 statements cannot be classified at all by terms from the ICNP nursing action classification axis.
CONCLUSIONS
In order to describe all the statements found in nursing records, not only new terms but also new axis need to be added to the ICNP.
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Study of Suffering Inference by Nurses' pain Experience
Eon Na Ryoo, Kyung Sook Park
J Korean Acad Adult Nurs 2002;14(2):174-183.   Published online June 30, 2002
PURPOSE
The purpose of this study was to determine the effect of nurses' pain experience on the inference of their patients' suffering.
METHOD
Study subjects were sampled from 184 nurses who worked in general wards in one S university hospital located at Seoul. Nurses' pain experience consists of personal pain experience and professional pain experience. The Standard Measure of Inference of Suffering (Davitz and Davitz, 1981) was used for suffering inference measure, and patients' suffering which consists of physical pain and psychological distress.
RESULT
Suffering inference scores of nurses without personal pain experience revealed a higher value than that of nurses with personal pain experience. But these differences were not statistically significant. The higher intense pain was experienced, the higher were suffering inference scores. This physical pain inference score was statistically significant(p=.044). Of the nurses who had personal pain experience, suffering inference scores of nurses with unrelieved pain experience revealed a higher value than that of nurses with relieved pain experience. Physical pain and psychological distress inference scores were statistically significant(p=.010, p=.006). Suffering inference scores of nurses without professional pain experience(internal medicine, general surgery, orthopedic surgery) revealed a higher value than that of nurses with professional pain experience. Professional pain experience of internal medical illness was statistically significant in psychological distress of internal medical illness (p=.044), and professional pain experience of orthopedic surgical illness was statistically significant in physical pain of orthopedic surgical illness(p=.027).
CONCLUSION
Nurses who have experienced low pain intensity or good pain relief are inclined n to underestimate patient' pain. Although nurses who care for the same patient over a long time deal skillfully with that patient, nurses are inclined to underestimate that patients' pain. Nurses need to be aware of possible biases related to pain assessment as a result of pain experience.
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Predictive Factors for Use of Complementary and Alternative Therapies in Rheumatoid Arthritis Patients
Eun Nam Lee, Haeng Mi Son
J Korean Acad Adult Nurs 2002;14(2):184-193.   Published online June 30, 2002
PURPOSE
The purpose of this study was to assess the characteristics of the user of complementary?alternative therapies(CAT) and to identify the important predictive factors associated with them.
METHOD
This study included 142 patients attending outpatient rheumatology clinics of D Hospital in Busan between July and August in 2001. The multiple logistic regression model was developed to estimate the likelihood of user or nonuser of CAT.
RESULT
The duration of illness and chance score of health locus of control were found to be significant factors through the estimated coefficients of using CAT. Duration of illness is longer and chance score of health locus of control is higher in patients who have used CAT in past than that of nonuser. When the model performance was evaluated by comparing the observed outcome with predicted outcome, the model correctly identified 95% of user of CAT and 31% of nonuser.
CONCLUSION
In this survey, duration of illness and chance score of health locus of control are found to be significant factors in predicting utilization of CAT. Nurses who care for rheumatoid arthritis patients should take consideration into health locus of control in planning health education programs.
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The Effect of Work-site Health Promotion Program on Health Promoting Behavior, Cholesterol, and the Quality of Life of Middle-aged Workers
Jeong Sook Park, Kyung Min Park
J Korean Acad Adult Nurs 2002;14(2):194-204.   Published online June 30, 2002
PURPOSE
This study is aimed at showing the effect of work-site health promotion programs for health promoting behavior, cholesterol, and quality of life of middle-aged workers.
METHOD
Thirty-one middle-aged workers were the experimental group and thirty-one were the control group. The 8-week work-site health promotion program was given to the experimental group. After this, health promoting behavior, cholesterol and quality of life were measured by questionnaires for the experimental and control groups. Health promotion theory, flexibility and muscle strength, aerobic exercise, nutrition, stress management, cancer prevention and early detection, smoking and alcohol problems, and summary lecture were all included in the 8-week work-site health promotion program. Health promoting behavior was measured by Park's HPBS, cholesterol was measured by enzyme method, and quality of life was measured by Ro's QOL.
RESULT
The experimental group showed a higher score of health promoting behavior than the control group. There were no differences on cholesterol and quality of life between the experimental and control groups.
CONCLUSION
It is necessary that nurses provide middle-aged workers with work-site health promotion programs to improve health promoting behavior. It's necessary also to re-study this with the pre-post research design.
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The Relationship of Symptoms of Side Effects, Fatigue and Quality of Life in Stomach Cancer Patients receiving Chemotherapy
Young Hee Yang
J Korean Acad Adult Nurs 2002;14(2):205-212.   Published online June 30, 2002
PURPOSE
The purpose of this study was to investigate the level of nausea, vomiting, anorexia, fatigue and quality of life as well as to determine the relationship between those variables and identify the influencing factors on fatigue and quality of life in stomach cancer patients receiving adjuvant chemotherapy.
METHOD
Subjects were 94 stomach cancer patients undergoing postoperational chemotherapy in a general hospital in Seoul. Nausea and vomiting were measured with Rhodes et al(1984) and anorexia with one 5-point item. Fatigue was measured using Lee's tool(1999) except open questions. The tool for quality of life was modified based on the Quality of Life Index by Padilla et al(1983).
RESULT
Subjects reported low level of fatigue(mean=3.86, range=0-10) compared with the results of previous researches and moderate quality of life(mean=2.64, range=1-4). Fatigue was positively correlated with nausea, vomiting and anorexia(r=.21 ~ .55, p<.05). Quality of life was negatively correlated with nausea, vomiting, anorexia(r= -.24 ~ -.45, p<.05) and fatigue (r=-.61, p<.01). Multiple regression analysis revealed that activity level, vomiting before admission, anorexia during chemotherapy and age explained 52.8% of the variance in fatigue. Fatigue, anorexia before admission, age and sex explained 50.5% of the variance in quality of life. Fatigue and quality of life were not influenced by the stage of disease, nor weight change.
CONCLUSION
These results may contribute to a better understanding of how much the side effects of anticancer drugs can affect fatigue and quality of life in cancer patients undergoing chemotherapy. Also it is the remarkable fact that symptoms remaining after discharge such as vomiting or anorexia continued until re-admission, contributing to patients fatigue and lowered their quality of life.
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The Study of Pain, Depression and Quality of Life According to the Coping Strategy in Chronic Arthritis Patients
Hae Ju Yang, Jeong Sook Park
J Korean Acad Adult Nurs 2002;14(2):213-221.   Published online June 30, 2002
PURPOSE
The aim of this study was to investigate the difference of in the level of pain, depression, and quality of life by coping strategy in the chronic arthritis patients.
METHOD
These data were collected by means of a self-reported questionnaire from 90 chronic arthritis patients undergoing treatment at a university hospital in Daegu city from June 10, 2000 to July 15, 2000. The instruments of study were coping strategy scale by Jeon(1985), pain scale by Lee and Song(1987), depression scale by Radloff(1977) and quality of life scale by Cho(1987). Data analysis was done by SPSS Win 10.0 program and Pearson correlation, t-test, Cronbach's-alpha were used.
RESULT
The results of this study were as follows: 1. The item mean score of pain for chronic arthritis patient was 6.54. The item mean score of depression for chronic arthritis patient was 2.18. The item mean score of quality of life for chronic arthritis patient was 5.69. 2. The chronic arthritis patients with problem-focused coping experienced pain higher than those with emotion-focused coping(t=o.400, p=o.o45). The chronic arthritis patients with emotion-focused coping experienced depression higher than those with problem-focused coping(t=-2.564, p=0.012). The chronic arthritis patients with problem-focused coping experienced quality of life higher than emotion-focused coping(t=-1.682, p=0.046).
CONCLUSION
In conclusion this study showed that any coping strategy can control the arthritis patient's problem. Therfore, The development of a coping strategy to reduce pain and depression and improve the quality of life in the chronic arthritis patient will be needed.
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BACKGROUND
AND PURPOSE: After the coronary angiography procedure, patients are required to remain on bed rest to reduce the risk of bleeding and hematoma formation at the puncture site. This prolonged bed rest in the supine position is difficult for many patients, who frequently complain of low back pain. The purpose of the study was to determine whether a specially designed exercise therapy and transcutaneous electrical nerve stimulation (TENS) had an effect on the alleviation of low back pain.
METHOD
Sixty-two patients were assigned to one of three groups: specially designed exercise therapy plus TENS plus general nursing care (exercise group N=21), general nursing care plus TENS (TENS group, N=23) or general nursing care (control group, N=18). The exercise therapy consisted of five movements including stretching, pelvic tilting, knee to chest, modified situps and trunk rotation with minimizing the motion of the puncture site. The severity of low back pain was assessed by a visual analogue scale(VAS) every two hours. The use of analgesic and any development of bleeding or other complications were monitored as well. The level of serum beta-endorphin was determined before and after the three interventions.
RESULT
The pain score of the exercise group was significantly lowered compared to that of the other groups. There was no difference in the serum beta-endorphin level among three groups. Analgesic were less frequently taken by the exercise group. However the incidence of bleeding complications was not significantly different among the three groups.
CONCLUSION
Exercise therapy is more effective than general care or TENS in alleviating low back pain of the patients with coronary angiography.
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The Effect of Health Promotion Programs on Health Promoting Behavior and Cardiovascular Risk Factors of Middle-aged Women
Jeong Sook Park
J Korean Acad Adult Nurs 2002;14(2):233-243.   Published online June 30, 2002
PURPOSE
This study is aimed at testing the effect of health promotion program on health promoting behavior and cardiovascular risk factors of middle-aged women.
METHOD
The research design was the nonequivalent control group pre-post test. Twelve middle-aged women were the experimental group and ten were the control group. The 8-week health promotion program was given to the experimental group. There were health promotion theories, flexibility and muscle strength exercise, cardiopulmonary endurance exercise, nutrition, stress management, cancer prevention and early detection, management of menopause and wrap-up in health promotion program for middle-aged women. The measurement tool was Health Promoting Behavior developed by researcher using serum cholesterol, obesity rate, systolic blood pressure, and diastolic blood pressure as cardiovascular risk factors.
RESULT
The experimental group showed a higher score of health promoting behavior than the control group. There were no differences on cardiovascular risk factors(cholesterol, obesity rate, diastolic blood pressure) between the experimental and control groups except systolic blood pressure.
CONCLUSION
Conclusively, this health promotion program for middle-aged women was effective in increasing health promotion behaviors, but wasn't effective in decreasing cardiovascular risk factors except the systolic blood pressure. It seems it's necessary to re-study this using more samples and a longer duration of the program, and smaller mortality rate.
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The Research for the Nursing Theory Development
Kyung Rim Shin
J Korean Acad Adult Nurs 2002;14(2):244-255.   Published online June 30, 2002
PURPOSE
This study was to understand to the nursing theory frame contained in the traditional philosophy and western nursing theory for the theory development fit for Korean people and to identified the strategy for nursing theory development.
METHOD
To perform this study various relevant texts-western, eastern, classical and contemporary were reviewed.
RESULT
The metaparadigm of the nursing in western considers four major factors-Human being, Environment, Health and Nursing. In Korea, the metaparadigm of nursing considers three major factors-Universe, Human being (body, life, health, disease) and Nursing. The key strategy for establishing comprehensive nursing theory which combines both western and eastern is to study the nursing literature based on eastern and western philosophy. Theorists should study the life and culture of the specific nation in order to understand the essence of the thoughts and psychology of the patients and to investigate the phenomena, which will be the foundation of theory development.
CONCLUSION
Western nursing theory must be utilized to provide practical framework for the development of nursing theory, and practical approach is necessary for combining western and eastern theory.
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BMI, Body Attitude and Dieting Among College Women
Ok Soo Kim
J Korean Acad Adult Nurs 2002;14(2):256-264.   Published online June 30, 2002
PURPOSE
The purpose of the study was to investigate the relationships between objective obesity, subjective obesity, body attitudes and dieting among college women.
METHOD
The convenience sample consisted of 531 women. BMI was calculated based on self-reported weight and height. Body Attitudes Questionnaire (BAQ) was used to evaluate attitude toward women's body.
RESULT
BMI mean score was 19.75. Based on BMI, 84.2 percent of the subjects were in a normal weight range and 0.9 percent of the subjects were obese. However, 26.9 percent of the subjects evaluated themselves as obese. Forty-one percent of the subjects were on a diet to reduce thier body weight. Body attitudes were associated with BMI and subjective obesity. BMI of the dieters was higher than that of the subjects who were not on a diet. Subjective obesity was associated with dieting. BAQ subscales except 'attractiveness' were associated with dieting.
CONCLUSION
Many subjects were on a diet since they wanted to be thinner. Body attitudes were associated with dieting. Therefore, proper education is needed in weight management for young adult women.
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Analysis of the Nursing Interventions performed by neurosurgery unit using NIC
Myung Seon Oh, Kyung Sook Park
J Korean Acad Adult Nurs 2002;14(2):265-275.   Published online June 30, 2002
PURPOSE
The purpose of this study was to evaluate the selected nursing interventions and to describe the most common nursing interventions used by neurosurgery unit nurses.
METHOD
The data was collected from 65 nurses of 5 general hospitals from Jan. 8, 2001 to Feb. 28, 2001. The instrument for this study was the Korean translation of 486 nursing intervention classifications, developed by MacClosky and Bluecheck in 2000. In the 486 nursing interventions 310 nursing interventions were selected, 8 from among the 10 professional nurses group in the neurosurgery care unit. The 310 nursing interventions were used in a secondary questionnaire. In the secondary questionnaire, all 310 intervention lables and definitions were listed. The data was analysed with SPSS program.
RESULT
The results of this study are as follows. 1.The most frequently used nursing intervention domains were "physiological: complex", "physiological: basic", "Health system", "Behavior", "Safety", "Family". 2.Neurosurgery care unit core nursing interventions were performed several times a day by 50% or more of the Neurosurgery care unit. Neurosurgery core nursing intervention, 5 domain ("physiological: complex", "physiological: basic", "Health system", "Safety", "Behavior"), 16 class, 48 core nursing intervention. The most frequently used Neurosurgery core nursing interventions were Intravenous Therapy, Pressure ulcer prevention, Documentation, Airway suctioning, Medication: intravenous, Pain management, Medication: intramuscular, Shift report, Intravenous insertion, Positioning, Aspiration precaution, Pressure management, Physician support, Pressure ulcer care. 3.Compared with carrier and age of nurses, the more effective nursing interventions were "Family", Compared with the nursing place and the use of nursing interventions of nurses the most effective nursing interventions were "Health system" performed by nurse in university hospital.
CONCLUSION
The purpose of this study was to analysis the nursing intervention performed by neurosurgery unit nurses. This study analyses nursing intervention and core nursing interventions performed by neurosurgery unit nurses. Basis on this study result, neurosurgery nursing interventions will be systematized, and progression of qualitative nursing, data of computerized nusing information system will be utilized.
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Embarrassment: a concept analysis
Eun Jung Cho, Bok Yae Chung
J Korean Acad Adult Nurs 2002;14(2):276-286.   Published online June 30, 2002
PURPOSE
The concept of embarrassment as an unpleasant emotion is important in caring for those who are in the continuum of illness and health requiring body care and facing sexual problems. In spite of its nursing implication, embarrassment has not been focused in nursing research. Therefore, the purpose of this paper is to develope a conceptual analysis of embarrassment. This analysis would help to understand comprehensively an embarrassing situation in which an intimate relationship between nurse and patient regarding body care of the patient could develope. Futhermore, it would be a basis for developing strategies for prevention of embarrassment which could lead for both patient and nurse to emotionally vulnerable situation because of their failure of self-presentation (impression management).
METHOD
The concept analysis model suggested by Walker and Avant (1988) is used to clarify what is meant by the term 'embarrassment'.
RESULT
This analysis defines the attributes of embarrassment such as follows. First, embarrassment is often attributed to situational factors interrupting a smooth interaction such as intimacy, confusion, vulnerability, exposure of interaction and characteristics of audience. Second, embarrassment is closely related with cognitive factor such as fear of losing face resulted from a behaviour being out of line. Third, embarrassment is closely associated with dispositional factor such as embarrassability. Fourth, embarrassment is an unpleasant and unwanted emotion arising reactively after an interaction had occurred. Fifth, embarrassment encloses physical, physiological and behavioral aspects such as a variety of unique and easily noticeable reactions and a pattern of verbal and non-verbal behaviour for coping in an embarrassing situation. The antecedents were normally socialized adolescents with normal cognitive ability, concern of losing face, embarrassability, embarrassing events related with situational intimacy, confusion, vulnerability, exposure of interaction and characteristics of audience, physical, behavioral blunders resulting in a failure of impression management. The consequences were an emotional coping behaviour, audience's embarrassment responses, and verbal and non-verbal coping strategies of interactional participants.
CONCLUSION
It is hoped that this analysis will stimulate further exploration of this concept and study for developing systematic assessment and nursing practice that diminishes embarrassment of interactional participants.
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Social Support, Mood, and Commitment to a Plan for Exercise of Korean Adults with Chronic Diseases
Yun Hee Shin, Hee Jung Jang
J Korean Acad Adult Nurs 2002;14(2):287-295.   Published online June 30, 2002
PURPOSE
The purpose of this study was to assess social support, mood, and commitment to a plan for exercise of Korean adults with chronic diseases. Further, the relationships between social support, mood, and commitment to a plan for exercise were assessed.
METHOD
The participants in this study were 230 Korean adults over 18 years of age with chronic diseases who were recruited in hospitals or health centers. The instruments used in this study were Exercise Social Support Scale, POMS (Profile of Mood States), and Commitment to a Plan for Exercise Scale.
RESULT
The results of descriptive analysis showed that Korean adults with chronic diseases were perceived with relatively low commitment to a plan for exercise while they were perceived with moderate social support and mood states. Pearson's correlation coefficient showed significant relationship between these three variables. Stepwise regression indicated that 37% of the variance in commitment to a plan for exercise was explained by social support and vigor factor of the POMS.
CONCLUSION
Health professionals can use this information for planning a targeted strategy to increase regular exercise among Korean adults with chronic diseases in order to improve their quality of life and control disease-related symptoms.
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Characteristics of Nursing Performance based on the Expertise among ICU Nurses
Myung Sun Yi, Sang Eun Oh, Mi Ran Eom, Hyun Sook Kim, Kyoul Ja Cho, Jung Sook Choi, Kyung Sook Lee
J Korean Acad Adult Nurs 2002;14(2):296-305.   Published online June 30, 2002
PURPOSE
The purpose of this research was to describe how nurses in intensive care units (ICU) work.
METHOD
A total of 18 ICU nurses participated in the research. The data was collected through individual in-depth interviews and analyzed by grounded theory method using NUDIST 4.0 software program.
RESULTS
Three different patterns regarding nursing performance among ICU nurses were identified. These are 1) nursing performance of nurses who perform excellently, 2) nursing performance of nurses who do not perform well because of their lack of experience, and 3) nursing performance of nurses who do not perform well in spite of their good years of experience. These three different nursing performances were described in terms of seven different categories; 1) assessing and monitoring nursing problems, 2) clinical decision making, 3) interpersonal relationships, 4) holistic care, 5) technical skills, 6) problem solving, 7) working independently and creatively. This study also identified two intervening factors that influenced the advancement of their expertise.
CONCLUSION
The results of this study might help nurse managers in developing continuing educational programs for inexperienced nurses or those nurses not performing well to become experts by a deeper understanding of the nature of nursing performance and the factors that influence nursing performance in ICU settings.
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Effects of Telephone Consulting Program on Self-efficacy and Self-care in NIDDM Patients
Chun Gill Kim, Chung Hee Chung
J Korean Acad Adult Nurs 2002;14(2):306-314.   Published online June 30, 2002
PURPOSE
This study was intended to examine the effects of a telephone consulting program on self-efficacy and self-care in NIDDM patients.
METHOD
Sixty-eight NIDDM patients participated. Thirty-six were assigned to the experimental group and received the telephone consulting program from one to two times per week for 4 weeks. This program was undertaken by base on small booklet relating to diabetic disease summary, diet, drug, exercise, foot management, prevention and treatment of complications, and insulin injection methods.
RESULT
1. Hypothesis 1 that "the experimental group who receives the telephone consulting program will have higher self-efficacy score than the control group who does not have the telephone consulting" was supported (t=5.12, p= .000). 2. Hypothesis 2 that "the experimental group who receives the telephone consulting program will have higher self-care score than the control group who does not have the telephone consulting" was supported(t=5.29, p= .000).
CONCLUSION
The telephone consulting program improved self-efficacy and self-care in NIDDM patients. Accordingly, this program can be adopted as an effective nursing intervention in the care of the diabetic patients.
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