PURPOSE
The purpose of this study was to compare the difference of change in oxygen saturation, vital signs and suction time taken for the suctioning during endotracheal suctioning performed with closed suction system and with opened suction system.
METHODS
Data were collected from 31 adult patients with ventilator treatment who were admitted to a university hospital in Seoul and the collection period was from July 1 to November 15, 2005. Oxygen saturation, heart rate, respiration rate and mean arterial pressure were collected immediately prior to the suctioning intervention, during and 1 and 5 minutes after the suctioning from opened suction system and closed suction system.
RESULTS
1) The difference in oxygen saturation was statistically significant in recovery time for oxygen saturation to return to baseline values after suctioning was significantly rapid on closed suction system (p < .05). 2) The difference in heart rate, respiration rate and mean arterial pressure was statistically insignificant. 3) The suction time was shorter in closed suction system.
CONCLUSION
Closed suction system is more efficient, as compared with the open suction system in the ventilator treatment.

PURPOSE
This study developed and evaluated a systematic intervention among medical ICU nurses for preventing ventilator-associated pneumonia (hereafter VAP).
METHODS
A VAP prevention program was proposed based on a literature review, revised to fit the target situation, and validated. It was composed of one-time interventions including education, pamphlets, hand cultures, and a quiz event, as well as repeated interventions such as posters, reminders, posting hand culture results, and performance feedback. A simulated control group pretest-posttest design was used to verify the effectiveness of the VAP control program. The incidence of VAP among ICU patients was measured both during 3 months before (n = 80) and during 3 months after (n = 75) intervention.
RESULTS
The VAP prevention program's effectiveness, with a pre-intervention VAP rate of 17.38 and post-intervention rate of 11.04 per 1,000 ventilator days, showed a clinical tendency to decrease, but the difference was not statistically significant (p = .750).
CONCLUSION
A VAP prevention program of multiple interventions can be useful in decreasing the VAP rate. Given that the monthly decrease in the VAP rate was not considered statistically significant, long-term research needs to be done. Additionally, since this study targeted only nurses, it is suggested that future research targets other health care workers who can influence VAP rates.

PURPOSE
This study was to examine the effects of sleep promoting program on sleep and the immune response in the elderly with insomnia.
METHODS
The study was designed as a quasi-experimental, nonequivalent control group pre-post test design. Thirty two elders who suffered from insomnia (16 experimental and 16 control subjects) were selected among the elders who had been enrolled in two churches. The subjects in the experimental group participated in a sleep promoting program which was composed of sleep hygiene education and progressive muscle relaxation for 4 weeks. Data were analyzed using the SPSS/WIN.
RESULTS
The experimental group showed higher sleep score than that of the control group (t = 7.86, p = .00). The experimental group showed higher sleep satisfaction score than that of the control group (t = 7.61, p = .00). The sleep promoting program was not effective in enhancing immune response.
CONCLUSION
The sleep promoting program increased the sleep score, sleep-satisfaction score and B cell in immune response of elderly people suffering from insomnia. Therefore, sleep promoting program can be applied as an effective nursing intervention to promote sleep quality and sleep satisfaction.

PURPOSE
The purpose of this study was to examine the effects of hand massage on fatigue, sleep satisfaction and blood pressure of the aged in a long-term care facility.
METHODS
The data were collected from June to August 2008. The subjects were randomly recruited from a long-term care facility in Junnam Providence and were randomly assigned to the experimental group (n = 22) or control group (n = 22). Hand massage was carried out every other day in the evening for two weeks. Massage was administered to each forearm and hand for 10 minutes. Descriptive statistics, x2-test and t-test were performed using SAS program.
RESULTS
In the experimental group, the fatigue (p = .017) was significantly lower and the sleep satisfaction (p = .043) was significantly higher than for the control group.
CONCLUSION
On the basis of the results of the study, hand massage can be recommended for the elderly with sleep disturbance to reduce fatigue.

PURPOSE
This study was to compare and examine the factors influencing burden of primary family caregivers according to the severity of illness of elderly patients admitted in an intensive care unit.
METHODS
Subjects were the families of elderly patients in intensive care units of K, S and Y hospitals in Seoul. Data were collected from March to October 2007. Subjects were 108 persons over age 65. Data were analyzed by SAS statistics.
RESULTS
First, groups 5 and 3 showed higher burden than that of group 4. Second, high correlation was found between stress and burden, stress and anxiety, and burden and anxiety. Third, factors influencing family burden were found to be stress for group 5, stress, anxiety, and monthly income for group 4, and stress and patient age for group 3.
CONCLUSION
Specific nursing interventions to decrease the stress of primary family caregivers of serious ill elderly patients in an intensive care unit are needed. Additionally, more effective and systematic activation of a long-term medical insurance system for seriously ill seniors is considered necessary to mediate the burden of primary family caregivers.

PURPOSE
The purpose of this study was to develop a program for anger management based on self-efficacy.
METHODS
In this study, four types of approaches to enhance anger control were developed; 1) a role play for vicarious experiences; 2) an assertive training for anger expression; 3) a 30-minute long education program & a 20-minute long telephone call coaching for verbal persuasion; and 4) a booklet for anger management and self care behaviors. One group pretest-posttest design was used for evaluating the program. Study subjects were 6 cancer patients undergoing chemotherapy. The group were received a 4-week intervention, 60 ~ 90 minutes a day weekly, and measured the variables at baseline, 4 weeks later. Anger-in, anger-out, and anger-control were measured by STAXI-K. Data was analysed by Wilcoxon using SPSS/WIN 12.0 program. Anger situation was analysed according to primary anger-thoughts and secondary anger-thoughts based on cognitive theories of anger.
RESULTS
The program for anger management consisted of a role play, assertive training, education, telephone call coaching and a booklet. The program revealed significantly less Anger-in (Z = -1.997, p = .046), anger-out (Z = -2.207, p = .027). No difference, however, was found in anger control (Z=-1.826, p=.068).
CONCLUSION
This evaluation suggested that more assertive training and longer intervention may be needed to maximize anger control.

PURPOSE
The purpose of this study was to examine the effects of the cardiac rehabilitation program (Phase III) on cardiovascular and cardiorespiratory function in the elderly (age, > or = 60) who experienced acute myocardial infarction.
METHODS
The design of research was nonequivalent control group pretest-posttest design. Subjects were 10 people in the experimental group and 10 in the control group. The intervention program was the cardiac rehabilitation program (Phase III), and was performed for 50 ~ 60 minutes, twice a week for 8 weeks. The dependent variables were the cardiovascular and cardiorespiratory function.
RESULTS
Significant differences were shown in RHR, RSBP, SRPP, SBS, BMI, PT of the experimental group after the intervention. As for the differences in the amount of changes, there were differences among groups in RHR, RSBP, SRPP, SBS, PMET, and PT of the experimental group.
CONCLUSION
The cardiac rehabilitation program (Phase III) may be effective in improving cardiovascular function and enhancing cardiorespiratory function in elderly patients with acute myocardial infarction.

PURPOSE
This study examined family function and self-esteem among young and middle-aged adults with physical disabilities.
METHODS
The subjects of this study consisted of 116 adults with physical disabilities. Data were collected from 4 Community rehabilitation centers in C area from October to November 2008. All subjects were questioned about family function and self-esteem by the APGAR scale and the Rosenberg Self-esteem Scale. SPSS/WIN 12.0 was used for descriptive analysis, t-test, one-way ANOVA, and Pearson correlation.
RESULTS
Subjects had a moderate level of family function (5.31) and self-esteem (28.13). There were significant differences of family function according to age, monthly income, economic status, and disability site. There were significant differences in self-esteem according to age, gender, monthly income, and economic status. The level of family function and income were related to self-esteem.
CONCLUSION
These findings suggest that there is a necessity to improve family function and self-esteem among young and middle-aged adults with physical disabilities. Nursing interventions should take into account the role of family function in promoting self-esteem in people with physical disabilities.

PURPOSE
This research was carried out to evaluate the validity and reliability of the Korean version of the Summary of Diabetes Self-Care Activities Questionnaire (SDSCA) for Korean older adults with type 2 diabetes.
METHODS
Translation and back-translation were performed to develop the Korean version of the SDSCA. Then the Korean version SDSCA was applied to a sample of 112 older adults who had participated in diabetes self management education in Seoul. The internal consistency and the test-retest reliability were examined to test the reliability. Factor analysis was used to examine the construct validity.
RESULTS
The internal consistency measured with Cronbach's alpha was .77 and the total test-retest reliability was .68 with items ranging from .21 to 1.00. As the result of the factor analysis, six factors -foot care, diet, exercise, blood sugar test, medication, and smoking- were revealed as the original instrument subcategories. These six factors explained 81.17% of total variance.
CONCLUSION
The reliability and validity of the Korean version SDSCA Questionnaire was supported for use in older patients with type 2 diabetes in Korea.

PURPOSE
To describe the lived experience of nursing students when faced with clinical judgment in a nursing practicum at the hospital.
METHODS
A descriptive research design was utilized. Participants were 79 students in the clinical practicum. Participant consent was obtained for ethical protection. Data were collected from August to December 2007 using a semi-structured questionnaire. Content analysis was utilized for data analysis.
RESULTS
Two categories and 5 themes were extracted from the data for 'difficult' and 'easy' clinical judgments. For the student category, the two themes were 'knowledge' and 'skill', while the three themes for the clinical education environment category were, 'judgment of clinical symptoms and signs', 'differences between theory and practice' and 'human relationships'. For coping, 2 categories and 5 themes were extracted for the difficult clinical judgment situation, while one category and one theme were found for the easy clinical judgment situation.
CONCLUSION
To develop students' clinical judgment, there is need to develop the method of clinical skills using simulation in clinical teaching. For future research, a study on factors affecting clinical judgment of nursing students in hospitals is needed.

PURPOSE
The purpose of this study was to identify risk factors of fall and to examine its results among patients aged 60 and over diagnosed with osteoporosis.
METHODS
A retrospective descriptive survey was conducted with 91 patients admitted in a university hospital in a city. Data were collected using an interview method with a structured questionnaire, and were analyzed using descriptive statistics and multiple logistic regression.
RESULTS
In patients with osteoporosis, the intrinsic risk factors of falls were aging (OR = 3.742), gait disturbance (OR = 12.565), taking one or fewer medicine (OR = 7.873), and having two or more diseases (OR = 5.173). The extrinsic risk factors included the use of a bed (OR = 3.093), slippery floors (OR = 12.130), bathroom mat without anti-slip rubber backing (OR = 3.564), and presence of a night light on the passage from the bedroom to the bathroom (OR = 2.980).
CONCLUSION
For the elderly aged over 70 who are most vulnerable to falls, screening tests such as bone mineral density (BMD) should be conducted in health examinations and the risk of fracture caused by osteoporosis should be communicated to the vulnerable elderly. Besides, development of new exercise programs combining weightbearing exercise is needed to prevent bone loss and increase functional activities.