The purpose of this study was to determine the impact of situational, clinical and psychsoical factors on treatment-seeking behavior among those with acute myocardial infarction(AMI). This study used a retrospective, descriptive design. The sample consisted of 72 patients aged over 30 and who were diagnosed with an acute myocardial infarction at two large university-affiliated medical centers from July 1, 1998 to March 30, 2000. But of 72, patients 5 who were an outlier in treatment-seeking time were deleted. Data were collected by using questionnaires, which included demographic data, situational, clinical and psychosocial data. Also patient interviews and chart review were used to obtain information related to treatment-seeking time. The results of this study were summarized as follows; 1. Mean time from the onset of AMI symptoms to arrival at the hospital was 12.09 +/- 11.44 hours; 2. Treatment-seeking time was not significantly different by age, gender, or education; 3. Most(44 or 65.78%) patients were at home when they began having AMI symptoms. The remaining patients were either in a public area, workplace or in a car. Patients at home delayed longer than those who had their first symptoms elsewhere, but not significantly different. Also, most patients were with another person when they began to experience AMI symptoms: a spouse(25 or 37.3%), other family member(31 or 46.3%); the remaining 11 were alone. There were no significant differences in treatment-seeking time based on whether alone or with others. Most patients(46 or 68.7%) used an ambulance rather than taking private transportation, and patients who used an ambulance were delayed longer than those who used private transportation, but there were no significant differences; 4. Time to treatment-seeking was not significantly different by blood pressure, heart rate on admission and the peak CK-MB, CPK and Cholesterol level, Killips class; 5. There were no significant statistical differences in treament-seeking times by anxiety level, mood status or control ability.

The purpose of this research was to examine the effect of support group intervention on the various adaptations of primary family caregivers caring for Cerebro-Vascular Accident patients. The nonequivalent control group pretest- posttest design within the framework of Lazarus & Folkman's stress-adaptation model was used for this experimental study. The subjects were 86 primary family caregivers caring for Cerebro-Vascular Accident patients at K hospital in Taegu, D herbal hospital in Kyung Ju, H hospital in Pohang from March, 1998 to July, 1998. Among 86 subjects, 43 were placed in an experimental group and 43 in a control group. The experimental group was treated by researcher who administered informational and emotional support group intervention once a week over a five weeks period. The data were collected through interviews. Collected data was analized by means of a chi-square test, t-test, ANCOVA, and Pearson correlation coefficient. The results of this research were as follows: 1. Physical, emotional, and social adaptation scores in the experimental group were revealed to be significantly higher than those of the control group. 2. There was significant positive correlation among physical health, subjective burden, depression and objective burden. Accordingly, it is concluded that informational and emotional support group intervention was a useful nursing intervention on the various adaptations of primary family caregivers caring for Cerebro-Vascular Accident patients.

The purpose of this study was to explain the relationship of professional self-concept, self-efficacy and job satisfaction among nephrology nurses. The subject consisted of 84 nephrology nurses who work at 17 hospitals in Kwangju, Chonnam, Chonbuk and Cheju-do. The instrument of this study was a structured questionnaire on professional self-concept, self-efficacy and job satisfaction. The data were collected from August 16 to September 10, 1999 and analyzed by Cronbach alpha, descriptive statistics, t-test, ANOVA, Scheffe's test and Pearson's correlation coefficient by using the SPSS/PC+ program. The results of the research were as follows: 1. The average item scores were 2.73 for professional self-concept and 7.16 for self-efficacy. The average item score of job satisfaction was 3.05. Professional status (3.56) among the component factors of the job satisfaction had the highest value followed by the interaction(3.46), task requirements(3.28), autonomy(2.98), organizational requirement(2.70), and pay(2.22) was the lowest. 2. The relationship between general characteristics and professional self-concept shows a significant difference with regard to position and the nurses' intention to stay. The relationship between general characteristics and self-efficacy shows a significant difference with regard to position and shift. 3. A significant positive correlation between professional self-concept and self-efficacy (r=0.462, p<0.01) was found. A significant positive correlation between professional self-concept and job satisfaction(r=0.486, p<0.01) was found. In conclusion, professional self-concept and job satisfaction of nephrology nurses are significantly related. A professional self-concept is an important factor for job satisfaction of nephrology nurses. Therefore, this study suggested that we should develop programs and policies to increase the professional self-concept of nephrology nurses for their job satisfaction.

The purposes of this study were 1) to identify determinants of exercise behavior 2) to determine theoretical frameworks that were used in other research 3) to investigate the limitations of exercise research. seventy six research papers, published between 1984-1999, were selected by searching Medline for this study. Research subjects, determinants of exercise behavior, exercise measurement, the design of studies, statistical method and theoretical background were examined. The results are as follows. 1. On the research subjects, most research papers studied healthy adults. 2. Thirteen variables were identified that were used more than 5 times in various researches were self efficacy, barrier, social support, benefit, physiological characteristics, habit, personality, intention, health status, motivation, subjective norm, attitude, and affect. The most frequently supported determinant was self efficacy, the second one was social support, the third was affect and so on. But few research papers found any significant relationship between subject norms or attitude and exercise. 3. On exercise measurement, only 22.4% of research papers considered intensity, duration, frequency as elements of exercise, and 64.5% of researches were assessed by self-reported questionnaires. 4. In research design, 80.3% of research papers were survey type research. The most frequently used statistcal method was Regression. 5. 44.8% of research papers were done without any theoretical basis. Based on the above findings the following suggestions are made: 1. Research which includes diverse populations with different levels of health status needs to be studied. 2. Determinants of exercise may be dynamic and varing in their influence, therefore, stages of exercise behavior and processes of change need to be studied. 3. In research design, more prospective, longitudinal studies are needed to identify determinants of exercise habits. 4. It is necessary to develop a reliable, valid exercise measurement tool. 5. Studies are needed to develop a theoretical framework for exercise behavior.

The purpose of this study was to understand clinical nurses' knowledge and attitudes on pain management. The subject of the study were 254 nurses working at two hospitals affiliated with a university in Seoul. The questionnaires included four areas: general knowledge on pain, knowledge on the use of analgesia, knowledge and implementation on the pain assessment scales and pain interventions and nurses' general characteristics. The data were analyzed with descriptive statistics, analysis of variance, LSD test and t-test using SPSS statistical package. The results were as follows. 1. The mean score of the general pain knowledge was 61.46 and that of knowledge on the use of analgesia was 52.19. 2. Most nurses(74%) answered with hesitation about injecting narcotic analgesia to patients. 3. The pain assessment scale which nurses knew (57.5%) and used(48.0%) extremely was a simple descriptive scale. 4. The pain intervention which nurses knew (94.5%) and implemented(92.1%) extremely was to inject analgesia. 5. The number of nurses who had learned about pain management was 49 of 254(19.3%). 6. Nurses' knowledge on the use of analgesia was of relevance to having learned pain management, but general pain knowledge was not so relevant. According to this research, I suggest the following. 1. It is necessary to develop an education program with actual practice and intervention which nurses can perform for themselves. 2. It is necessary to continuously educate about pain management in clinical wards.

This study examined burdens of primary family caregivers, and family functioning of patients with cancer. In addition, the relationship between two concepts was assessed to develop nursing intervention to reduce the burdens of caregiving, and to improve family functioning. Ninety-two primary family caregivers of patients with cancer at a general hospital in Seoul participated in this study. The patients with cancer aged from 19 to 84 years with a mean age of 51 years, and sixty-one percent were male. About 30 percent of the patients suffered liver and billiary tract cancer. Fifty-six percent of the primary family caregivers were spouses of the patients and 70.7 percent were women. Primary family caregivers' burdens were assessed by the Burden Scale originally developed by Zarit (1980) and Novak & Guest(1989) and modified by Jang (1995) for use in Korea. The instrument consists of six subscales: time-dependent burden, developmental burden, physical burden, emotional burden, social burden, and financial burden. Family functioning was assessed by the Family APGAR developed by Smilkstein(1978). The results were as follows: 1. The average burden score was 86.1, indicating a moderate level of burden. The time-dependent burden scored highest followed by developmental, physical, social, financial, and emotional burdens. The mean score of family APGAR was 9.71; among subjects 82.6% were included in dysfunctional families. 2. Of the characteristics of patients, age, gender, number of admissions, and job were found to be associated with the level of burden. There was no significant difference between patient characteristics and family functioning. Of the characteristics of primary family caregivers, caregiver's perception of patient prognosis was significantly related to the level of burden, and family functioning. Caregiver's sex and age were also related to family functioning. The quality of relationship between a patient and a caregiver was significant situational factors affecting the level of burden, and family functioning. In addition, the income of family, and help from other family members were related to the level of burden. Given the results, it is essential to develop nursing intervention to reduce burden and to improve family functioning, such as support groups.

The purpose of the study was to investigate Body Mass Index (BMI), the perception of weight problem and the level of self-esteem and depression in high school and college females. The convenience sample consisted of 303 high school females and 481 college females. Data were collected between November 1999 and December 1999. Subjects ranged in age from 15 years and 26 years. BMI was calculated based on the subject's self-reported body weight and height. Self-perception of having a weight problem was evaluated by a single item question. The Rosenberg's Self-Esteem Scale and the Center for Epidemiologic Studies Depression Scale were utilized to measure the level of self-esteem and depression symptoms. BMI mean scores were 19.92 and 19.83 in high school females and college females, respectively. Based on BMI, 79.2 percent of high school females and 85.2 percent of college females were in a normal weight range. Only 2.6 percent of high school females and 1.5 percent college females were obese. Both high school and college females perceived their body weight problem as moderately severe. The mean scores of depression were 20.33 in high school females and 21.69 in college females. Sixty percent of high school females were depressed and 73.4 percent of college students. There was no significant difference between two groups in BMI. However, high school females perceived their weight problem more severe than college females. College females had higher levels of self-esteem and depression than high school females. BMI and perceptions of weight problem revealed a positive relationship in both groups. Results of the study revealed that a perception of weight problem contributed significantly to predict the level of self-esteem and depression in both groups. BMI score had significant effect on only college females' self-esteem. In the study, even though the mean score of BMI was in a normal range, subjects perceived their weight problems as moderatley severe. Since the perception of a weight problem influenced the level of self-esteem and depression, health care providers need to teach them about the normal weight range in BMI criteria.

The purpose of this study was to examine the effect of preoperative teaching as a nursing intervention on the emotional status of the patients prior to surgery. The method of this study was Nonequivalent Control Group Non-Synchronize Design. The data were selected from H universuty hospital in Seoul, and they consisted of an experimental group-30patients, and a control group-30 patients. The questionnaire consisted of 28 Preoperative Stress Inventory(Kang, 1998), and 16 State-Trait Anxiety Inventory(Spielberger, 1972). The collected data were analized by means of frequency, percentage, x2 test, t-test and paired t-test with SPSS WIN. The results of this study were as follows: 1. The level of stress prior to surgery was significantly lower for the preoperative teaching group than for the control group(t=2.61, p< .01). 2. The level of anxiety prior to surgery was not significantly lower for the preoperative teaching group than for the control group. 3. The difference level of the anxiety level the prior to surgery was significantly higher for the preoperative teaching group than for the control group(t=2.82, p< .01). In conclusion, preoperative teaching is a beneficial nursing intervention that has a positive effect on the stress and anxiety of patients prior to surgery. Therefore it is recommended to use the preoperative teaching program as a nursing intervention for patients prior to surgery.

Nurses in today's challenging health care settings need to be skilled critical thinkers and clinical experts. The nurse must be able to use a broad knowledge base to mobilize resources, coordinate actions and evaluate outcomes in complex new situations. So the national licensing examination for registered nurses is change to improve the quality of professional competency of nurses in Korea. Prior to this, learning objectives should be developed and improved periodically. The purpose of this study is to describe the nursing competency to provide base line data for developing learning objectives in adult health nursing. This study was conducted by means of a questionnaire which was developed by the researcher after reviewing the literature. The questionnaire was based on learning objectives which were developed by a nation-wide nursing faculty majoring in adult health nursing. The subjects were 45 nurses in a middle level hospital. The collected data were treated using SPSS Win 7.5 Statistical Package so as to obtain such descriptive statistics as mean score, frequency, and to test reliability test, nonpar-Friedman test. To summarize the major findings in this study, it showed the scope of nursing competency and can guide the direction of study and methodological criteria to develop learning objectives. Recommendations for further research are: firstly, it is necessary to state learning objectives with learners'behavioral terminology; secondly, to overcome locality in scope of this study, there is a need to analyze with nation-wide sampling by an in-depth statistical analysis; thirdly, because the subjects of this study are mostly three-year graduate nurses, there is a need to compare this study with other studies of different subjects.

In this paper, I will examine the variables influencing the Quality of Life of arthritis patients and present basic materials which help arthritis patients have positive thinking in life and ultimately lead a satisfactory life. The subjects for this study are 231 inpatients and outpatients with arthritis living in J and K city in Chonbug Province. For the analysis of collected data I employed the SAS program. The variables for characteristics and the quality of life were analysed by descriptive statistics, T-test and ANOVA, and the relations among variables were analysed through Pearson Correlation; the Regression method was employed to predict the factors affecting quality of life. For the validity of reliance on measuring equipment Cronbach Alpha was used. The results of the study are as follows: (1)The mean score of quality of life of arthritis patients is 3.09(5 in the maximum). The general characteristics which affect the quality of life are age(F=5.13, p=0.0006), standard of education(F=6.49, p=0.0003), marriage status(F=7.77, p=0.0005), monthly pay(F=4.37, p=0.0020), medical benefits (F=4.85, p=0.0087), and supports(F=4.39, p=0.0050). For the disease-related characteristics, there is a significant difference in the 6 items: pain control method(F=5.92, p= 0.0002), physical therapy(F=3.25, p=0.013), whethere or not patients exercise(F=4.62, p=0.0000), regularity of exercise(F=4.79, p=0.0000), frequency of exercise(F=6.29, p=0.0001), and amount of exercise(F=4.62, p=0.0043). Depending on the type of arthritis, there is also a significant difference in the degree of pain felt. The patients with infectious arthritis suffer from pain the most, followed by those with gout, rheumatism and degenerative arthritis, in that order. Although statistics don't show any convincing evidence, those with gout perceive that they are in best health condition, followed by those with rheumatism, degenerative arthritis, and infectious arthritis, in that order(F=2.23, p=0.0669). (2)The quality of life of arthritis patients is correlated positively with perceived health status(r=0.56, p=0.0001), health promoting behavior(r=0.53, p=0.0001), family support (r=0.46, p=0.0001), amount of exercise (r=0.36, p=0.0001), ADL(r=0.36, p=0.0001), HLOC(r=0.32, p=0.0001), frequency of exercise(r=0.32, p=0.0001)in that order, while correlated negatively with the degree of pain felt(r=-0.32, p=0.0001), the number of pain regions(r=-0.19, p= 0.0041), and the duration of pain(r=-0.14, p=0.0279). (3)Regression analysis reveals that the most powerful predictor of the quality of life is perceived health status, which account for 31.11%. The other predictors of the quality of life, which account for 60.22%, are health promoting behavior(16.51%), family support(3.81%), ADL(2.52%), gender(1.86%), the number of family members(1.36%), level of pain(1.24%), duration of pain (1.08%), and level of education(0.67%). The results of the study show that perceived health status and health promoting behavior are the two most important variables. However, considering that the perceived health condition is difficult to control by nursing intervention, it is suggested that the level of expectation for patients, must be decided first, and the health promoting behavior and the family support influencing the quality of life must be taken into account as targets for nursing intervention. As a way of controlling the quality of life, I think that a more comprehensive approach comprising the above important variables along with demographic and general characteristics is needed. I also suggest that we must continue to explore the variables affecting the quality of life and include those variables in nursing intervention.

The purpose of this study is to develop and evaluate the Self Efficacy Promotion and Exercise Program to prevent of obesity and cardiovascular diseases for the kidney transplant recipients. The subjects were selected randomly among the patients who underwent kidney transplantations at one major transplantation hospital in Seoul, Korea. This study ws carried out between November 23, 1999 and February 15, 2000. The subjects in this study consisted of 16 patients who had kidney transplantations between 1 month and 12 months ago prior to this study. They were all on steroids therapy and did not take any physical exercise regularly. The subjects received the self efficacy promotion and exercise program for 12 weeks which contained self efficacy promotion education and exercise program. The weight, body fat rate, exercise time and cardiopulmonary function were evaluated before the experiment and after the experiment. The results were as follows: 1. After the experiment, the weight was significantly decreased than that of before the experiment(p=.0001). 2. After the experiment, the body fat rate was significantly decreased than that of before the experiment(p=.0010). 3. After the experiment, the exercise time was significantly increased than that of before the experiment(p=.0002). 4. After the experiment, the absolute VO2 was significantly increased than that of before the experiment(p=.0008). 5. After the experiment, the relative VO2 was significantly increased than that of before the experiment(p=.0002). This study showed that the self efficacy promotion and exercise program was effective. So it would be expected that this self efficacy promotion and exercise program could be applied as an effective independent nursing intervention widely in prevention of obesity and cardiovascular diseases for kidney transplant recipients.

The purpose of this study was to determine the effects of the music therapy, one of the dementia treatment programs, on patients' cognition, behaviors and affection, and thereby, developing a nursing intervention to help them live a quality of life. The subjects of the study were 37 dementia senial people who admitted the mental hospital at K city in chungnam province. The study was designed as repeated measures design for a single test group. The subjects were received music therapy for 40 minutes 2 times a day during 6 weeks from February 16 to March 29, 2000. The tools of study were K-MMSE developed by Park, J. H. and Kuen, Y. C.(1989), Clinical Dementia Rating developed by Morris, J(1993) at Washington university, and A fourteen symptom behavior and mood rating scale developed by Wyatt and Kupfer(1968). For the tools of music therapy, elderly favorite songs (changs, folk songs, old popular songs and children's songs) were recorded. These tapes and other tools were edited according to experts' advices. The music therapy consisted of music listening, rhythmic instrument playing and following-up singing. The therapy was performed at the lounge of the center to which the sample people could get access conveniently. A nurse was asked to observe sample people's cognition, dementia behaviors and affection, evaluated them according to the checklist scale. The collected data were processed using the SPSS WIN 7.5 program for absolute values, percentiles, mean, SD, ANOVA, GLM-repeated measure method. The items of scale and its reliability analyzed were Cronbach's alpha. The results of this study were as follows: 1. As a result of analyzing dementia elderly cognition, behaviors and affection before the music therapy, it was found that the disorder of cognition, behavior and affection was most outstanding. 2. After the therapy, the average scores of subjects' overall cognition, behavior and affection were lowered significantly. It was conceived that the music therapy should continue for 3-4 weeks. 3. Difference of cognition in test groups was significant statistically between pre-test and 2 weeks, 4 weeks, 6 weeks after test (df=3, F=6.39, p=.000), pretest and 4, 6 weeks after test (p=.01, p=.001), which suggests that a continued music therapy would be desirable to treat dementia. Difference of behaviors and affection in test groups was significant statistically between pre-test and 1-6 weeks after test (F=52.01, p = .000), pretest and 3-6 weeks after test (p=.000), which suggests that a continued music therapy would be desirable to treat dementia. 5. It was found that the music therapy was more effective in treating moderate dementia (MMSE-K score 16-23) than severe one (MMSE-K score 15 or lower), and vascular type of dementia than Alzheimer's type of one. After all, it may well be concluded that the musical therapy is an effective nursing intervention to provide the dementia elderly with a quality service and thereby, increase cognition and reduce the problematic behaviors and affection of dementia senile people.

The purpose of study was to assess how hospital nurses practice their health promoting lifestyle and to identify affecting factors. The subjects were 286 nurses working at three general hospitals in Kwang-ju. The data were collected by questionnaire from September 1st. to September 10th, 1999. The instruments for this study were the Health Promoting Lifestyle Profile developed by Walker et al., perceived health status scale developed by Ware et al., self-efficacy scale developed by Sherer et al., and social support scale developed by Cohen et al.. The data were analyzed with mean, standard deviation, t-test, ANOVA, Pearson's Correlation Coefficient and Stepwise Multiple Regression. The results of this study were as follows: 1. The mean score of health promoting lifestyle was 2.36. Interpersonal support showed the highest score(2.67) and health responsibility (1.92) showed the lowest score. The mean score of perceived health status was 3.07, self-efficacy was 2.62, and social support was 2.91. 2. The relationship between general characteristics of subjects and health promoting lifestyle showed significant differences according to duty cycle(t=4.15, p=.042), disease experience (t=5.18, p=.023), monthly income(F=3.13, p=.025), exercise frequency(F=9.12, p=.000), stress reliefe method(F=5.98, p=.000), job satisfaction(t=11.44, p=.000), and perceived fatigue(F=6.13, p=.002). 3. Health promoting lifestyle showed significant positive correlations with perceived health status (r=.2190, p=.0002), self-efficacy (r=.5137, p=.0001) and social support (r=.5181, p=.0001). 4. The combination of social support(27.1%), exercise frequency(10.4%), self-efficacy(8.8%), job satisfaction, perceived health status, perceived fatigue and explained 53.5% of the variance of health promoting lifestyle. Therefore, this study suggests that a replicate study is needed until more affecting factors other than health promoting lifestyle.