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Volume 14(3); September 2002

Original Articles
An Effect of Health Promotion Program on Health Behavior, Perceived health Status and Life Satisfaction in the Elderly
Young Mi Jung, Ju Hee Kim
J Korean Acad Adult Nurs 2002;14(3):327-336.   Published online September 30, 2002
PURPOSE
This study is designed to develop a health promotion program for improvement of health status by means of a change of life-style and health behavior in the elderly. The purpose of this study is to provide a basis for nursing intervention strategies to promote health behaviors.
METHOD
The health promotion program consisted of health education, group discussion, emotional support, health and telephone counsel. As a quasi-experimental design, the none-quivalent control group pretest-posttest design was utilized for this study. The subjects of this study consisted of 50 people, over 60 years of age attending 2 senior colleges in S city. They were divided into two groups: 24 in the experimental group and 26 in the control group. Data was collected from July 2, 2001 to August 21, 2001. For the analysis, SPSS PC 10.0 Window version was adopted and descriptive analysis, x2-test, t-test, paired t-test, MANOVA were used for data analysis.
RESULT
The health behavior and life satisfaction of the elderly improved significantly (F=18.305, p=.000 ; F=17.478, p=.000). But there is no significant difference in the perceived health status(F=3.807, p=.057).
CONCLUSION
The health promotion program is confirmed as proper to promote the health in the elderly. In addition, assessment and support will be simultaneously done to manage the health of the elderly. Finally this study supports intervention for the elderly and provides a basis for further investigations.
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The Effect of Spiritual Nursing Intervention on Anxiety and Depression of the Hospice Patients
Mae Ok Yoon, Jeong Sook Park
J Korean Acad Adult Nurs 2002;14(3):337-347.   Published online September 30, 2002
PURPOSE
The purpose of this study was to elucidate the effects of spiritual nursing intervention on anxiety and depression of the hospice patients.
METHOD
It was devised with a quasi- experimental design using non-equivalent control group pre-post design. The data was from July 10 to September 25 in 2000 at the general hospital in CheonJu city. Subjects were 37 members of the experimental group and 30 members of the control. The tools were used Spielberger's State Anxiety Scale and Zung's Depression Inventory. The spiritual nursing intervention was carried out through Hymn, Scripture, Prayer, the therapeutic ues of self. Data were analyzed by mean, standard deviation, x2-test, t-test.
RESULT
1. After the spiritual nursing intervention, state anxiety of the experimental group was lower than those of the control (t=-5.987, p=0.000). 2. After the spiritual nursing intervention, depression of the experimental group were lower than those of the control (t=-9.128, p=0.000).
CONCLUSION
The hospice patients who were offered spiritual nursing intervention had lower anxiety and depression than not offered it. According to these results, it can be regarded as an effective one that relieved anxiety and depression of the hospice patients.
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Factors Influencing Regular Exercise of the Elderly
Yeon Hwan Park, Joo Hyun Kim, Hee Ja Kim
J Korean Acad Adult Nurs 2002;14(3):348-358.   Published online September 30, 2002
PURPOSE
The purpose of this study was to identify the factors influencing regular exercise of the elderly in discriminating regular exercise and non - regular exercise groups.
METHOD
The subjects of this study were 167 elderly over the age of 60, living in a rural city in Korea. The data was collected by interview and self report questionnaire in 1999. The Cronbach 's alpha of scales used this study were .66 ~.97.
RESULT
1. There were significant differences in doing regular exercise between the perceived importance of the health(p=021), the perceived health status(p=.050), the perceived need of the exercise(p=000), the perceived importance of the exercise(p= .000), the intent of participation in the exercise program(p=.000), IADL score(p= .022), the perceived benefits of exercise (p=.000), the emotion of exercise(p=.000), HPLP(p=.000), the self efficacy(p=.001), the perceived benefits of health promoting behaviors(p= .011), the perceived barriers of the health promoting behaviors(p=.002), and the Internal locus of control(p=.021) of the elderly. 2. Variables which showed significance for discriminating regular exercise of the elderly in this study were the perceived need of the exercise(p=.000) and the perceived benefits of the exercise(p=.000). By using the combination of these variables, the possibility of proper prediction for predicting regular exercise group was 84.8 %, non - regular exercise group was 93.9%, and total Hit ratio was 89.4%.
CONCLUSION
To improve exercise behavior in older adults, health care providers should focus of developing interventions to strengthen the perceived benefits, the perceived needs of the exercise.
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Meaning in Life of a Resident Community of Normal Adults
Soon Ock Choi, Sook Nam Kim, Kyung Il Shin, Jong Ji Lee
J Korean Acad Adult Nurs 2002;14(3):359-367.   Published online September 30, 2002
PURPOSE
The purpose of this study was to measure meaning in life for a normal adult and to offer basic data for developing nursing strategies for improving the meaning in life of adults.
METHOD
There were 351 subjects, from 20 to 60 years old, staying in Busan and KyungNam Province. The data was collected from August to October 2000. The instrument was designed by researchers. The data were analyzed with frequency, mean(+/-SD), t test and ANOVA.
RESULT
1. The mean MIL for adult was 187.7(+/-18.1). 2. The mean MIL of basic premise phase for discovery of meaning was 30.5, method phase for discovery of meaning was 111.1, and result phase for discovery of meaning was 46.4. 3. The levels of MIL, 56.4% of the subjects were in pursuit of meaning in life, 23.3% felt a loss of meaning in life. 4. There were significant differences in MIL according to the level of education(P=0.00), marital status(P=0.01) and monthly income (P=0.00).
CONCLUSION
On the viewpoint of the above results, 23.3% of the subjects were in a level of existential vaccum which required keens Logotherapy. Therefore, it shows that developing nursing-logotherapy to improve the meaning in life for adults is demanded.
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The Analysis of Research on the Home-Based Pulmonary Rehabilitation Program
Eui Geum Oh, So Hee Kim, Sun Hee Kim, Hee Ok Park, Chun Wha Lee
J Korean Acad Adult Nurs 2002;14(3):368-377.   Published online September 30, 2002
PURPOSE
The purpose of this study was to analyze the trend of research on the use of home-based pulmonary rehabilitation.
METHOD
Using Medline and CINAHL search engine, experiemental research, titled as 'home-based pulmonary rehabilitation' and 'chronic lung disease', statistics were collected. The total 29 experimental studies published between 1981 to 2000 were selected and analyzed according to the ATS guidelines.
RESULT
1) The study samples in research were mostly of men, whose lung function was moderate to severe. 2) The total period of the intervention program varied from 5 to 12 week. The program included excercise intervention and educational intervention. Psychosocial intervention was minimal. 3) The outcome of the home-based pulmonary rehabilitation had been measured mostly by physical aspects. Quality of life and cost were less frequently measured. 4) In terms of effectiveness of the home based pulmonary rehabilitation program, physiologic outcome, such as lung function and hematologic markers, there was more 'no effect' than 'positive effect', whereas there was more 'positive effect' in decreasing dyspnea, improving excercise capacity, and improving quality of life.
CONCLUSION
Based on these findings, future research on home-based pulmonary rehabilitation should be emphasized and provide standardized protocol, including psychosocial intervention, and analyses on cost and quality of life.
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Relationship between Fatigue and Sleep Quality in Patients with Cancer
Sue Kyung Sohn
J Korean Acad Adult Nurs 2002;14(3):378-389.   Published online September 30, 2002
PURPOSE
The purpose of this study was to identify the relationship of fatigue and quality of sleep in patients with cancer.
METHOD
The data was collected from January to February 2001. Study objects were recruited K university hospital in Busan, Korea. Their fatigue was measured using the Revised Piper Fatigue Scale developed by Piper et. al(1998), and quality of sleep was measured using Quality of Sleep Questionare by Oh et. al(1998).
RESULT
1) The fatigue score was mean 114.80+/-34.88(range: 22-220). The sub dimension that showed behavior/severity score at 33.70+/-13.89, affective score at 24.23+/-3.33, sensory score at 27.74+/-12.51, and cognitive/mood score at 29.11+/-3.71. And sleep quality score was mean 37.32+/-8.18. 2) There was a significant difference in religion(F=4.157, P= .008), present therapy(F=2.536, P= .043), past therapy(F= 6.625, P= .000), major caregiver(F=3.133, P= .028), and change of weight(F=7.965, P= .006), according to general characteristics in the fatigue in patients with cancer. 3) There was a significant difference in present pain(t=-2.103, P= .037) and change of weight(F=5.484, P= .005), according to general characteristics in the sleep quality in patients with cancer. 4) There was a significant negative correlation between fatigue and quality of sleep(r=- .340, P= .000).
CONCLUSION
Patients with cancer experience in fatigue. Increase in fatigue are associated with decreases in quality of sleep. Nurses must provide patients with nursing care about the occurrence of fatigue and interventions to deal with sleep disturbance.
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A Study on the Life Style in Clients with Colo-Rectal Cancer
Mi Suk Kim, Jum Yi Jun, Kyung Hee Son
J Korean Acad Adult Nurs 2002;14(3):390-400.   Published online September 30, 2002
PURPOSE
This study was to prepare the basic data for prevention of colo-rectal cancer and protection against its spread.
METHOD
The subjects for the study were 204 patients with colo-rectal cancer from the G.S. wards of five general hospitals in Busan for the period of June 1 to September 1, 2001. The instrument used was a questionaire which was developed by Junho Shin(1995). The data was analyzed by descriptive statistics, McNemar test, x2 test, paired t-test, and ANOVA.
RESULT
1. 57% of the studied subjects were male, 42.7% were more than 60 years old, 54.9% were of standard physique, 49.5% were the Buddhists, 50.5% were the middle or high school graduates, 83.8% were city dwellers, 48% were jobless, 69.6% had no-history of alimentary disease, 44.1% had no-family history of cancer, 82.8% were married. 2. Constipation(x2=36.45, p=0.0001) in clients showed a significant positive association for the pre- diagnosed, but diarrhea(x2=3.947, p=0.047) showed a significant positive association for the post-diagnosed. The preference for high seasonings(t=6.23, p=0.0001) and animal fat (t=8.35, p=0.0001) was higher significantly in the pre-diagnosed, but physical activities(x2= 30.22, p=0.0001), an eutrophic or tonic medicine(x2=30.22, p=0.0001), was of and vegetables(t=-6.20, p=0.0001) was higher significantly in the post-diagnosed. 3. There were significant differences in the life style of the pre-diagnosed according to the general characteristics except religion.
CONCLUSION
Results of the above study reveal we should be very sensitive to the change of defecation styles and consider the necessity of improving life styles as regards eating habits. When an education program is developed, the general characteristics of the subjects need to be considered.
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Development of Korean Elderly Life Quality Scale
Soo Jeong Choi
J Korean Acad Adult Nurs 2002;14(3):401-410.   Published online September 30, 2002
PURPOSE
This research was designed to develop an instrument that can be used for measuring of the quality of life for the elderly in Korea.
METHOD
Subjects were 2,110 aged people, residing in Seoul and Kyeungi-Do. In developing this instrument, the researcher first established a conceptual framework based on the literature review and interview and open questionnaire. The collected data were analyzed using the SPSS-WIN program. For the component factors of the measuring instrument, a factor analysis method and item analysis was used. The reliability of the scale was tested by Cronbach's alpha.
RESULT
1) The results of the analysis of the 32 items making up the instrument were classified into the following 4 factors: life stability, easy of resource utility, health and affection in family, establishment of support- base. 2) The reliability of the instrument for the quality of life was 0.952 (Cronbach's alpha). In the factor analysis Cronbach's alpha correlations for the 4 factors ranged from 0.736 to 0.949.
CONCLUSION
This scale could be adequately applied in assessing the quality of life for the elderly in Korea. And the results of this scale in a study can contribute to the promotion of quality of life for the elderly.
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Symptom Occurrence Related to Disease Characteristics of Adult Patients with Cancer
Hea Kung Hur, Eun Hyun Lee, Won Hee Lee, Hyang Sook So, Bok Yae Chung, Eun Sil Kang
J Korean Acad Adult Nurs 2002;14(3):411-417.   Published online September 30, 2002
PURPOSE
This study was to investigate symptom occurrence related to the disease characteristics of patients with cancer.
METHOD
A total of 301 patients with cancer participated in this study. The participants were recruited from University Hospitals located in Seoul, Wonju, Kwangju, Daegu, and Pusan. Data collection was performed by using a questionnaire on symptom occurrence. The obtained data was analyzed using SPSS computer program that included descriptive statistics, Pearson correlation, one-way ANOVA, and t-test. 1) Yonsei University (Wonju College of Medicine) 2) Ajou University 3) Home Health-Hospice Research Institute at Yonsei University 4) Research Institute of Nursing Science at Chonnam National University 5) The Institute of Nursing Science at Kyungpook National University 6) Research Institute of Wholistic Nursing Science at Kosin University.
RESULT
The mean score of fatigue was the highest (3.24), followed by loss of appetite, lack of concentration, change in appearance, pain, insomnia, change in bowel pattern, nausea/ vomiting, coughing, and dyspnea. Most symptoms were significantly correlated with each other. The level of symptom occurrence in patients with lung cancer or cervix cancer was significantly higher than the level in patients with stomach cancer. Patients receiving radiation therapy or a combined therapy of radiation therapy and chemotherapy experienced significantly higher level of symptom occurrence than those receiving chemotherapy only. Also, female patients experienced higher level of symptom occurrence than male patients did.
CONCLUSION
The sites of cancer, types of treatment, and gender influence the level of symptom occurrence of patients with cancer. Thus, these variables should be considered when assessing and planing for symptom occurrence of patients with cancer.
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The Development of Integrative Exercise Program for the Elderly
Shin Hi Han, Jeong Mo Park
J Korean Acad Adult Nurs 2002;14(3):418-427.   Published online September 30, 2002
PURPOSE
The Purpose of this research was to develop the integrative exercise program for the elderly.
METHOD
The first step was to survey the elder's health status and general health problems. The second step was to design the exercise type, intensity, time and frequency.
RESULT
1. Elders who implement the integrative exercise program had weaker health status, lower physical performance and more depression than any other places. 2. The integrative exercise program developed the preparation stage composed of stretching and Yudongkong-Ki exercise, the central stage was composed of range of motion exercise, muscle strength exercise and aerobic exercise with favorite and popular Korean music. The finishing stage was composed of joint rounding and Yudongkong-Ki exercise. The exercise intensity was RPE(rating perceived exertion) 10-11, maximal pulse rate 40-60%, duration started from 20min to 50min and frequency is 2-3times/wk.
CONCLUSION
The integrative exercise program developed by the researcher is tailored exercise that is more applicable to individual cases in community settings. Eventually, the program is safely applicable to the elders, and is expected to improve the elders' physical function and quality of life.
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The Effect of Warming Patients Before or During the Surgical Operations on the Patients' Body Temperature and Shivering
Ji Yeon Lee, Hyang Yeon Lee
J Korean Acad Adult Nurs 2002;14(3):428-437.   Published online September 30, 2002
PURPOSE
The purpose of this study is to examine the changes of surgical patients' body temperature in applying warming to patients. The study of an effective nursing intervention, which aims to prevent hypothermia during surgical operations, use of anesthesia, and to remove dermal discomforts. The nonequivalent control group pre-test/post-test design was used for this quasi-experimental study.
METHOD
The study subjects were adult patients who would take a surgical operation under general anesthesia in C Hospital; the surgical operations done were, total abdominal hysterectomy or Myomectomy; 20 patients were included in experimental group I, 20 patients were included in experimental group II, and 20 patients were in the comparative group. The total number of study subjects was 60. The data was collected from September the 1st, 2001 to October the 20th, 2001. The data was analyzed by SPSS program, F-test and Repeated measures of ANOVA. Multi-comparison method of DUNCAN was used for the sections that show the significant differences at the level of p<.05, which was a posterior examination.
RESULT
1) "The body temperatures of the three groups of patients will be respectively different at the end of the operations; experimental group I to which warming was applied before the operations, experimental group II to which warming was applied during the operations, and the comparative group with no warming being given," showed (F=12.609, p=.000). 2) "Degrees of shivering symptoms for the three groups will be respectively different at the end of the operations; experimental group I which applied warming before operations, experimental group II which applied warming during operations and the comparative group with no warming." Showed assumed (F=6.626, p=.000).
CONCLUSION
Summing up the above study, the warming assumed during operations was a more effective nursing intervention for preventing patients' hypothermia than the warming assumed before operations.
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Wishes of the Elderly
Eun Sook Kim, Kwuy Bun Kim
J Korean Acad Adult Nurs 2002;14(3):438-448.   Published online September 30, 2002
PURPOSE
This study is aimed to search the lived experiences of the participants and to analyze the contents so that we can be assured about what the elderly wish and find the appropriate nursing intervention for them in real life.
METHOD
This is based on a phenomenological approach. Participants of this study consist of people older than 65 years old. Data was collected from May to August in 2001. Data collection was done through in-depth interviews and observations. The time used in each interview was from 50 minutes to 2 hours. Each participant was interviewed three to five times. Giorgi's phenomenological analysis was used in data analysis.
RESULT
The elder's wishes are 1) a respected life, 2) a happy life, 3) a peaceful life, 4) a independent life, 5) a financially independent life, 6) a satisfactory life, 7) a mind to depend on someone, 8) a serving life, 9) a historic family, 10) a happy-ending life.
CONCLUSION
The study will contribute for the nursing intervention to enhance the quality of life and successful aging of the elderly.
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The Effect of Education on Preoperative PCA upon Postoperative Pain
Hyo Shin Seo, Kyung Sook Park
J Korean Acad Adult Nurs 2002;14(3):449-458.   Published online September 30, 2002
PURPOSE
The purpose of this study was to compare the effectiveness of a structured preoperative PCA education to that of the usual informal teaching provided by hospital staff in alleviating postoperative pain through more effective use of PCA therapy.
METHOD
As an advanced research, the knowledge about the use of PCA therapy and the attitude about the use of the pain medicine were estimated, and then as a later research, the knowledge about the use of PCA therapy, the attitude about the use of the pain medicine, and the score of the pain were estimated.
RESULT
The experimental group those who received structured preoperative PCA education had statistically significant higher knowledge regarding the use of PCA therapy(p=0.026) and more positive attitudes toward using pain medicine(p=0.004). The experimental group those who received structured preoperative PCA education reported better pain control 4(p= 0.002), 8(p=0.014) and 24 hours(p=0.018) after the operation.
CONCLUSION
The structured preoperative PCA education increases the knowledge for the use of patient's PCA therapy and changes their attitude toward the use of the pain medicine positively and consequently enable the use of PCA therapy to be more effective and then finally reduced the patient's pain after the operation.
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Content Analysis of Experiences of Chest Pain in Women Who Underwent the Treadmill Test with an Impression of Angina Pectoris
Myoung Ae Choe, Myung Sun Yi, Kyung Eh An, Eun Ok Im
J Korean Acad Adult Nurs 2002;14(3):459-469.   Published online September 30, 2002
PURPOSE
Experience of chest pain may be different in women from that of men and this discrepancy may cause misdiagnosis of angina contribute to mortality by this disease in women. The purpose of this study was to analyze the characteristics of chest pain and responses to the symptoms in women.
METHOD
A content analysis was conducted with interviewed data obtained from women who underwent the treadmill test RESULT: Seven major categories were identified from this content analysis: attributes of chest pain; accompanied symptoms; precipitating factors; relief strategies; family support; communication with physicians; and effects of chest pain on their lives. Characteristics of pain were described as heaviness, tightness, heating sensation, tearing, and others. Duration and intensity of pain varied in a wide range. Radiating pain presented in 9 patients, and the locations of radiation were throat, neck, shoulder arm and fingers. Women tended not to respond actively to their chest pain, and didn't get appropriate support either from their family or from their physicians when they reported chest pain.
CONCLUSION
Women express non-typical as well as typical patterns of pain when they experience chest pain. Clinicians have to consider the variability of symptoms when they assess women with suspicions of angina.
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Symptom Experience and Quality of Life in Patients with Chronic Lung Disease: With a Special Reference to Bronchial Asthma and Bronchiectasis
Soon Joo Park
J Korean Acad Adult Nurs 2002;14(3):470-478.   Published online September 30, 2002
PURPOSE
In this study, symptom experience and quality of life(QoL) in patients with Bronchial asthma(BA) and Bronchiectasis(BRC) were examined to develop nursing strategies.
METHOD
Data collection was done with 61 outpatients with BA and 43 outpatients with BRC in January and February, 2001. Data analyses were performed using SPSS Win 8.0.
RESULT
The mean scores of symptom experience were 11.3 and 10.8 in patients with BA and BRC, respectively. The mean score of QoL was 18.0 in patients with BA and 19.2 in patients with BRC. There were statistically significant differences in the score of the symptom experience according to sex and occupation in patients with BA, and to the religion and occupation in patients with BRC. The mean score of QoL had significant difference according to the income in patients with BA, but had no significant differences in patients with BRC. The score of QoL had significantly correlated with the degree of symptom experience in patients with BA(p=.000) and with BRC(p=.022).
CONCLUSION
The degree of symptom experience negatively correlated with QoL. Therefore, symptoms experienced by patients should be considered in development of nursing strategies for patients with BA and BRC.
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