The purpose of this phenomenological study was to explore and describe the experience of people with HIV/AIDS. Three men and three women with HIV/AIDS participated in the study. They were asked open-ended and descriptive questions in order for them to talk about their experience in their own terms. Interviews were audiotaped and transcribed to maintain data integrity and to reduce perceptual bias. The transcripts were analyzed by the Colaizzi method. Member checks from the participants were used to validate the emergent themes. Seven themes emerged from the analysis. 1. People with HIV/AIDS have a strong impact and emotional reaction when receiving positive HIV test results. 2. All people with HIV/AIDS attempt to conceal HIV infection because of fear of stigma or rejection. 3. After the initial brief traumatic reaction to HIV/AIDS diagnosis, all participants feel lonely because they had no one to express or share their own experiences. 4. People with HIV/AIDS reflect on their life, think about the death and dying process and they become depressed. 5. Most participants feel that the family members who know his/her diagnosis are a big source of support. 6. According to the normativeness of infection route of HIV, the degree of guilty feeling differs among participants. 7. Although all participants think medication is a lifeline, the adherence to medication is not maintained because of side effects, denial and concealment of HIV/AIDS. The results of this study may help nurses and other health care workers to implement more efficient nursing strategies for people with HIV/AIDS by more deeply understanding their experience.

This study examines that North American Nursing Diagnosis Association(NANDA) and Home Health Care Classification(HHCC) is appropriate to classify home health care client's nursing problems and suggests a modified nursing diagnosis classification system. Two hundred and forty-nine clients' records at a general hospital were reviewed and nursing problems were diagnosed according to each classification system. Results of this study are as follows. The major client's medical diagnosis are pregnancy, childbirth and puerperium, malignant neoplasm, and benign neoplasm. Of four hundred and sixty-three nursing problems, all nursing problems made a diagnos according to HHCC, while three hundred and eighty-five made a diagnosis according to NANDA. The HHCC diagnosis included 78 more nursing problems than NANDA. The discrepancy in the results may indicate a significant advantage to HHCC diagnosis because HHCC nomenclature was created empirically from hard data. However, this may be due to limitations in the data collection method so determination of which classification system is more useful is difficult to judge. However, nursing components of the HHCC are more concrete and clearer than human response patterns of the NANDA. Also the HHCC facilitates the documentation of patient care by computer, while using a conceptual framework consisting of 20 Care Components based on the nursing process: assessment, diagnosis, outcome identification, planning, implementation and evaluation. Accordingly, the practical application of HHCC is more useful than NANDA. Limitations of this study include a retrospective data collecting method and universality of samples. Further research for various samples that use prospective data collection method is recommended.

The purpose of this study was to develop a critical pathway for case management of patients who have received Lumbar Laminectomy because of low back pain, arm and leg numbness, and radiating pain in the leg. For this study, a preliminary critical pathway was developed through a review of the literature including five critical pathways which are currently being used in the USA. In order to identify the overall service contents required by these patients, 30 cases were analyzed. These cases were taken from medical records of those with Lumbar Laminectomy between January, 1998 and December, 1998 in the department of neurosurgery at the Pusan National University Hospital in Pusan. An expert validity test was done for the preliminary critical pathway, a clinical validity test was also done using 12 patients with Lumbar Laminectomy between October 1, 1999 and January 31, 2000. After these processes, the final critical pathway was developed. The results are summarized as follows. 1. The vertical axis of the critical pathway includes the following eight items: assessment, consultation, diet, test, medication, treatment, activity, education/ discharge planning. The horizontal axis includes the time from the start of hospitalization to discharge. Analysis of the 30 medical records was done. analysis of the service contents showed the horizontal axis of the preliminary critical pathway was set from hospitalization to the 12th post operation day and the vertical axis was set to include eight items, the contents which should have occurred, according to the time frames of the horizontal axis. 2. As a result of the expert validity test, it was found that among the 233 items, 203 showed over 88% agreement and 30 of them showed less than 88% agreement, which were then revised or deleted from the critical pathway. At the preliminary meeting for the clinical validity test, the time of hospitalization on the horizontal axis was shortened to the 10th post operation day. A clinical validity test was done with 12 patients with Lumbar Laminectomy. All the cases progressed according to the critical pathway although some variances were noted in assessment, consultation, test, medication, and treatment. 3. Based on these results, a final critical pathway was determined. In conclusion, this critical pathway is partially applicable to the care of patients with Lumbar Laminectomy and needs further investigation.

The purpose of this study was to identify the effect of social support revealed in the time duration of sick role behavior compliance on the patients with hypertension using Quasi- experimental research design. Data collection was made through the interview survey technique from the hypertensive patients who received social support intervention (experimental group, n=41) and from those who were not exposed to the intervention(control group, n= 34). The subjects were registered in the cardiovascular outpatient clinic at the Chonnam National University Hospital from June 3, 1996 to November 30, 1997. X2-test or t- test, Repeated measures ANOVA were utilized in the data analysis. The results were as follows: 1. The effect of social support intervention on sick role behavior compliance was significant in 1 month(F=69.17, p=.000), 6 months (F=11.51, p=.001), and 12 months(F=.07, p=.789) and between two groups(1 month; F=153.70, p=.000, 6 months; F=13.94, p=.000, 12 months; F=6.72, p= .011). 2. The effect of social support intervention on blood pressure was not significant through all the periods of time (F=1.21, p=.274) between the two groups(F=.12, p=.732). In conclusion, it was showed that social support had an effect on sick role behavior compliance and the effect of social support continued for twelve months(F= 10.03, p=.002) However, the score of compliance tends to decrease after 6 months of intervention. Therefore, this study indicated that social support re-intervention would be needed between six and twelve months.

The purpose of this study was to examine the effect of preceptorship on On the Job Training of new nurses. The research design was a retrospective survey and one group pre-post test design. The subjects were 49 entry nurses and 49 preceptors. The data were collected from Feburary 1, 1998 to December 1, 1998. One questionnair applied in this study consisted of general characteristics, the responses of new entry nurses and their preceptors and their qualities. The other questionnair consisted of job satisfaction of new entry nurses and preceptors and their competencies. The data were analyzed for frequencies, mean score, standard deviation, t-test, and ANOVA. The results of the study were as follows: 1) Preceptees's responses were that the nurses' affiliation of unit, cooperation of other nurses, and competencies of nursing skills improved after OJT applied preceptorship. 2) Preceptors's answers were that preceptor- ship had a positive effect on their continuing education. 3) While preceptees's job satisfaction scores were high in interaction, administration, and organization, they were low in autonomy and pay. 4) Pre-competency scores were the same as post-competency scores. 5) After preceptorship, preceptors responded that their nursing skill & communication competency increased, but their nursing administration competency decreased. 6) Finally, preceptorship's other effects were as follows: 1. Checklists for preceptee education at the nursing unit were developed separately. 2. It was proved that 'preceptor interview note' was effective on manage preceptorship. 3. We obtained duty overlap periods; medical- surgical units-1 month, 5 ICU-2 months, operation room-3 months. 4. We prepared a preceptor program based on the study results.

This study was designed to offer descriptive data for nursing intervention for relief of fatigue and pain, and to distinguish by the characteristic difference and the symptoms such as fatigue and pain on Ankylosing Spondylitis (AS), Fibromyalgia(FM), and Systemic Lupus Erythematosus(SLE) patients. The sample consisted of 92 patients(AS 29; FM 30; SLE 33) who visited H-University Rheumatism Hospital in Seoul. The data were collected by a structured questionnaire from May 1, 1999 to April 30, 2000. The results were as follows: Patients of 95% experienced fatigue in the last week and a fatigue score of three disease groups were above average. The fatigue score of FM patients was highest in the other disease, but which was not a statistically significant difference(F=1.417, p=.248). The mean score of AS and FM patients in pain was higher than the SLE patients, and there was the statistical significance among the three groups on pain (F=8.239, p=.001). There wasn't a statistical difference among three groups on coping wtih pain(F=1.451, p=.240). There wasn't any correlation between fatigue and pain in each disease (AS: r=.008, p=.966; FM: r=.328, p=.077; SLE: r=.237,p=.185). Therefore, morning stiffness and pain management during sleeping is needed through good body alignment in the AS patients. Adequate rest for fatigue and multiple coping strategies for pain maybe basic nursing intervention in FM and SLE. According to their fatigue rhythm, a regular exercise program is needed for rheumatic disease because they complained of fatigue above average and their fatigue was repeated better and worse only during the one week.

The purpose of this study was to identify the factors influencing health promoting behavior of the elderly for develop health promoting intervention of old people. The subjects of this study were 167 elderly person over the age of 60, living in rural city in Korea. The data were collected by interview and self report questionnaire, during the period from May, 1999 to August. 1999 The instruments for this study were the PRQ-II by Weinert(1988), the scale of Locus of Control by Wallstone et al(1978), the scale of self efficacy by Sherer & Maddux(1982), 10 points visual analogue scale for the perceived health status and the importance of health, the health promoting behavior scale by Walker et al(1987), and the scales developed by authors for the perceived benefits of health promoting behaviors, and the perceived barriers to health promoting behaviors. The Cronbach 's alpha of these scales were .84 ~.97. The data were analyzed using descriptive statistics, Pearson's correlation coefficients, and stepwise multiple regression. The results of this study were as follows: 1. Among cognitive perceptual factors of the Health Promotion Model by Pender(1987), the scores of the importance of health, the perceived internal control of health, the self efficacy, the perceived health status, and the perceived benefits were significantly positive correlation with the scores of the health promoting behavior of the elderly. In addition, the scores of the perceived barriers were significantly negative correlation with the scores of the health promoting behavior of the elderly. 2. Among modifying factors of the Health Promotion Model by Pender(1987), the pocket money of the elderly, the scores of social support were significantly positive correlation with the scores of the health promoting behavior of the elderly. In addition, ages of old people were significantly negative correlations with the scores of the health promoting behavior of the elderly. 3. Stepwise multiple regression analysis revealed that the most powerful predictor of health promoting behavior was the self efficacy. A combination of the self efficacy, the perceived barriers, the social support, the importance of health, and the perceived internal control of health accounted for 56.2% of the variance in health promoting behavior in the elderly. From the results of this study, we concluded that the Health Promotion Model by Pender will be used to explain health promoting behavior of the elderly. We suggested that the results of this study will be considered in developing health promoting programs of elderly.

This study was the done to describe health behavior and determine affecting factors in middle aged women. The subjects of this study were 306 middle aged women, living in M city, during the period from June 28th to August. 31st 1999. The instruments for this study were Health Behavior Assesment tool developed by Kim (1998), Self esteem scale developed by Rosenberg(1965), the perceived health status scale by Lawston, et al.(1982), the Quality of life by Ro(1988), the attitude toward Climacteric symptom by Ji(1983). The data were analyzed using descriptive statistics, t-test, Pearson correlation coefficients and stepwise multiple regression. The result of this study are as follows; 1. The total mean score for Health behavior was 2.51(range 1-4). The mean scores on the subscale were 2.83 for nutrition, 2.81 for stress management, 2.71 for limitation of liking in the menstrual group, health behavior was 2.64. The mean scores on the subscale were 2.98 for nutrition, 2.85 for stress management, 2.82 for limitation of liking, 2.80 for energy conservation in the menopausal group, 2. The mean scores for cognitive-perceptual variables in the menstrual group were perception of health status: 2.61, quality of life: 3.17, self-esteem: 2.59, and attitude for climacteric symptom: 3.02. In the menopausal group the scores were perception of health status: 2.41, quality of life: 3.10, self-esteem: 2.62, attitude for climacteric symptom: 3.06. 3. Health behavior and self-esteem(r=.269, p=.000; r=.205, p=.042), attitude for climacteric symptom(r=.192, p=.005; r=.545, p=.000), quality of life(r=.385, p=.000; r= .195, p=.050) and health behavior were correlated positively, and the perception of health status and health behavior were correlated negatively(r=.-135, p=.050; r= -.207, p=.040 ) in the menstrual group and menopausal group. 4. Perception of health status, quality of life, age, self-esteem, job and marital status explained 33.7% of the variance for health behavior in the menstrual group; self-esteem and education explained 33.1% of the variance for health behavior in the menopausal group. In conclusion, health behavior should be considered when developing nursing strategies for middle-aged women, especially when dealing with perception of health status, quality of life, and self-esteem.

This Qualitative nursing research used a hermeneutic phenomenological approach to discover meaning in an self-transcendence experience. The ultimate aim of the inquiry was to discover the essence of self-transcendence experience and to promote understanding. The study used van Manen's Methodology of phenmonological research. Multiple strategies for data collecting were utilized: in depth face-to-face interview and analysis of elders' literature. The following themes of experience emerged: Accepting becoming older as a natural phenomenon, transferring to one's own sons' and daughters' oriented life. Maintaining harmonious relationship with neighbors and peer, observing real situations with silence, forming internal integrity with perseverance, compromising own's real situation, actualizing one's death, giving up roots of life, depending on God and conforming to human limitation. From this study essential themes for understanding self-transcendence experience and needs for continuing inquiry were identified.

The purpose of the study was to investigate the characteristics of the clients registered in the department of home health care nursing in a hospital and to analyze nursing intervention activities recorded in charts by application of Nursing Intervention Classification (NIC) system. For the descriptive survey study, data were collected by reviewing charts of 572 home health care clients between May, 1997 and July, 2000 at K hospital in Seoul. The average age of the clients was 66 years and the number of clients in their 70s ranked first with 28.2 percent(158 people). The mean length of home care service was 47 days with the highest frequency of less than four weeks (56 %). With regard to medical diagnosis, cancer showed the highest frequency (48%, 271 people), followed by cerebrovascular disease (19%), and pulmonary disease (6.9%). According to analysis of nursing interventions by the NIC system, the most frequently used nursing interventions in level 1 were interventions in the Physiological: Complex domain which were used 3,663 times (33%) among 11,107 total interventions. The Safety domain was the second most frequently used intervention, followed by the Physiological: Basic, and the Behavioral domains. In level 2, the Risk Management class was the most frequently used interventions with 3,108 interventions (27.9%), followed by Drug Management, and Tissue Perfusion Management classes. In level 3 interventions, Vital Sign Monitoring was the most frequently used intervention, 569 times (5.1%), followed by Health Screening, and Neurological Monitoring interventions. In sum, half of the clients in the study had cancer and were in their 70s. The most frequent reason for ending home care was death (40%), followed by readmission (28%). These findings represent clients with severe conditions referred to the home care nursing department as it was a University teaching hospital. Further research on analyzing nursing interventions performed in each institution needs to be conducted to develop a standardized list of nursing interventions to use in home health care settings.

The purpose of this study was to evaluate the knowledge level of pressure ulcer among hospital nurses through a cross-sectional survey by using the pressure ulcer knowledge assessment tool of Beitz et al.(1998). The total of subjects was 160 voluntary participants (60 were from Hospital A and 100 were from Hospital B) working at adult patients' units in two university hospitals located in the same city. None of the hospitals had expert nurses of pressure ulcer nor provided a regular pressure ulcer education program during the past one year. The survey tool consisted of 32 true-false items which were grouped into the risk factors knowledge category(13 items), the wound assessment knowledge category(4 items), and the treatment methods knowledge category(15 items). An internal consistency reliability test of the tool yielded an overall coefficient of 0.72; the coefficient for the risk factors knowledge category was 0.40, that for the wound assessment knowledge category was 0.33; that for the treatment knowledge category was 0.54. The main findings of the study are as follows. 1)Demographic characteristics of the two hospital nurses were similar except for the educational level(p=0.029) and the work units(p=0.001). These observations were maintained even if Hospital A and B were separately compared. 2)The knowledge level of the subjects about pressure ulcer in general was low as indicated by 53.3 points(of 100 possible points) on average. The knowledge level about treatment methods of pressure ulcer was the lowest as indicated by 47.0 points on average. 3)No correlation between the knowledge level of the pressure ulcer and the demographic characteristics of nurses was found except that the knowledge level of I.C.U. nurses was significantly higher(p=0.0003) than that of nurses in other units(p=0.2926) in the case of Hospital A. 4)The knowledge level of nurses in Hospital B was higher than for nurses in Hospital A. The reason was not identified, but it seems that it is related to the role of the I.C.U. or some other factors. The study results confirmed the existing literature that knowledge level of nurses about pressure ulcer is low regardless of age, educational level, or work experience. However, the working place(unit) affected the knowledge level. Further research on the exact reason for the differences in the knowledge level is needed in the future.

The purpose of this study was to develop and validate the scale to measure dementia patient's caregiver burden of Korea. In the first phase of the study, 15 caregivers of dementia patients were interviewed to provide narrative data from which items were developed. Initially 65 items were generated from the interview data of 15 caregivers. Content validity was judged by two separate panels of experts with 27 professionals and 30 family caregivers. These items were analyzed through the Index of Content Validity and 33 items were selected which met .80 or more of the CVI. This preliminary FCBSD-K was tested with 207 adult caregivers for reliability and construct validity including item analysis and orthogonal(Varimax) factor analysis. Eight items were deleted because of high or low item-item correlation. The result of the second factor analysis produced six factors that coincided with the conceptual framework posed for the scale developed. The six factors were labeled as 'physio social factor' 'emotional factor' 'family cultural factor' 'role obligation' 'guilt feeling' and 'financial & supportive system factor'. The alpha coefficient relating to internal consistency was .9264 for reliability. In conclusion, cultural factor is related to dementia patient's caregiver burden and FCBSD-K was useful in assessing the dementia patient's caregiver burden in Korea.

A quantitative descriptive survey was conducted to assess the needs of elderly people in relation to accessibility of medical care. Identifying their functional status was done and accessibility of medical care was ascertained. Using a convenient sampling method, 856 elderly aged 65 and over in Taejon-city participated. A multi-dimensional questionnaire containing sections on health status, Activities of Daily Living(ADLs) and accessibility of medical care in terms of use, time, distance, transport, cost and feeling at ease was developed by the researchers of this study to collect data. Data were collected between October and December, 1999. In general, the result of the self-reports from this study found that approximately 40% of participants had difficulties with their health status and ADLs while about 45% of the population did not access medical care. The majority of respondents stated that they had no difficulties with time distance and transport to access medical care. About two-thirds of the respondents felt that they had many or some difficulties with expenses and strategies for emergency to access medical care. Even though these findings need to be generalized, several recommendations for appropriate medical care delivery for the elderly still can be outlined from the study findings. Recommendations suggested are: To identify impediments to access medical care in emergency in elderly people and to remove those factors preventively are required. Responsible governmental involvement for solving problems of the medical care cost and additional costs in relation to separation of dispensary from medical practice for the elderly is required. More constructive and practical uses of public health community centers are recommended.

The purpose of this study was to elucidate the effects of music therapy on the preoperative anxiety of surgerial patients. The research design was a nonequivalent control, group non-synch-ronized design. The data were collected during the period from January 4 to March 17, 1999 at C-University hospital in Seoul. The subjects were sixty patients who had surgery under general anesthesia and had undergone laparotomy. They were assigned to two groups, thirty to the experimental group and thirty to the control group. They also did not have any complication, were alert enough to be interviewed and agreed willingly to participate in this study. The tool of Trait Anxiety Inventory was used to measure trait-anxiety on all patients and the Visual Analogue Scale(VAS) was used to measure state-anxiety on all patients. And systolic and diastolic blood pressure, pulse rate, and blood sugar levels were collected a the day before surgery and the preoperative period. The experimental group received music therapy with self-selected music tapes after choosing from a Music Preference Questionnaire, while the control group didn't receive music therapy. Data were analyzed by X2-test, t-test, paired t-test. The results of this study are summarized as follows: 1. The preoperative state anxiety of the experimental group was re-markably lower than that of the control group. 2. Decreasing rate in the vital signs of the experimental group was remarkably lower than that of the control group. 3. The preoperative blood sugar of the experimental group was remarkably lower than that of the control group. According to these results, Music Therapy can be regarded as an effective nursing intervention that relieves preoperative anxiety of surgical patients and helper stabilize vital signs. From this study, the following recommend-ations can be made: 1. In order to decrease surgical patient's preoperative anxiety, I suggest the nursing intervention should go side by side with music therapy.

The purpose of this study was to identify the needs which were perceived by patients who were received spinal anesthesia for surgery. The subjects consisted of 50 adult patients who were admitted to 2 university hospitals and 2 general hospitals in Pusan city and 1 general hospital in Koje City for surgery under spinal anesthesia. Thirty eight percent of subjects received information about anesthesia before the operation. The instrument for this study was developed by the researcher based on literature and a pretest. Data were collected from December 10, 1999 to February 10, 2000 and were analyzed by content analysis. The results were that there were 533 meaningful statements in the needs of spinal anesthesia patients. The needs of spinal anesthesia patients had 51 items (preoperation (6), induction of nesthesia(5), intraoperation (27), postoperation(13)) and 6 categories (information, emotional welfare, physical welfare, post anesthetic management, control of physical environment, humane treatment). From the results, it can be concluded that: 1. In the pre-operation period, we have to explain anesthesia procedures, adequate position of anesthesia, duration before anesthesia wears off and sensation of paralysis. We have to supply emotional support to relieve anxiety because of anesthesia. 2. In induction of anesthesia, we have to support patient's position for anesthesia, and relieve anxiety so that patients participate in induction of anesthesia well. 3. In intra-operative period, we have to check the level of anesthesia, and keep up a comfortable position for operation and care for physical discomfort such as thirst, nausea, vomiting, dyspnea and to maintain body temperature of the patient. Since the patient is conscious, we have to communicate with the patient to relieve anxiety, maintain privacy, inform the patient of the process of the operation and encourage the surgeon to explain the outcome of the operation. The operating team needs the careful about what they say and to place the instrument well. We have to ventilate the room air and reduce noise. 4. In the post-operative period, we have to explain the purpose and duration of bed rest, complications of anesthesia and care for physical discomfort such as pain, dysuria, headache, backache. Also we have to maintain body temperature of the patient and maintain privacy.

The purpose of this study was to explore the educational needs of kidney transplant patients and educational importance perceived by their nurses to develop a rehabilitational and educational program. Data were collected from January 29, 1999 to July 30, 1999 with interviews using a structured questionnaire. The subjects for this study were 173, of whom 107 were patients who had had a kidney transplant and had visited the out-patient department and 66 were transplant ward nurses who were taking care of the kidney transplant patients at six general hospitals located in Seoul. The questionnaire used for this study was developed by the investigator through a literature review and collected and modified by 11 professional personnel and 3 kidney transplant patients. The data were analyzed using the SAS program for numbers, percentiles, mean, standard deviation, t-test, ANOVA, and Scheff test. The results were as follows; 1) In the patient group, the total mean score for educational needs was 154.61 and the item mean score was 3.96. In the nurses group, the total mean score for perceived educational importance was 166.26 and the item mean score was 4.26. In the nurses group, perceived educational needs were scored higher than by the patient group. With regard to domains, both patient and nurses group had the highest educational needs and perceived educational importance in the domain of physical condition and the top five items in the educational needs and perceived educational importance were also in the domain of physical condition. 2) In the patient group, women and the divorce/bereavement group had higher educational needs in the domain of nutritional management, those who had been admitted longer than 4 weeks from their kidney transplant time had higher educational needs in the domains of physical condition and those who were less than 4 years from their transplant had higher educational needs in the domain of follow-up care. In the nurses group, those who were married had higher perceived educational importance in the domain of physical condition.

This ethnography was based on Kleinman's explanatory model of a health care system. It is conducted to make thick discription of illness conception of the elderly in a sociocultural context. The basic assumptions were as follows. 1) A health care system is a cultural system, and as with any other cultural system, it is a system of symbolic meanings anchored in a particular arrangement of social institutions and patterns of interpersonal relationships; 2) In all societies health care activities are more or less interrelated. Therefore, they need to be in a holistic manner as socially organized responses to disease that constitute a special cultural system; health care system; 3) Health and illness experiences are the natural process of disease. Individuals who recognized a for state of health, their family, neighbors, and communities define the state, search for causes of the health problems, and response to it. According by, they proceed to search for healing stratagies. So, understanding of the illness experience is the starting point for health care. The study participants were 12 elders aged 60 or more. The fieldwork was conducted in an agricultural clan village of Namwon city. The data collection and analysis were cyclic, from descriptive observation, domain analysis, focused observation, taxanomic analysis, selected observation, componential nalysis, and finally cultural themes were all analysed. Proxemic and text analysis techniques were used according to the characteristics of the data. The data of sociocultural context and descriptive data were collected from 1990 to 1992. Informations on illness concepts were collected during 1994 using focused observation. Data confirming and contrast observations were conducted from 1997 and 1999. Illness concepts of the elderly were taxonomized supernatural cause, non-supernatural cause, immediate cause, and ultimate cause. The supernatural ones were ancestors, god of home, god of village, and ghost such as 'sal(evil force of dead man)' and 'gagqui(ghost of begger)'. The non-supernatural ones were Ki, natural phenomenones, natural objects, foods, human and human behaviors. Immediate ones were insufficiency and overflows, discretion and consolidation, disorder and out of order, cloudness and contamination, and fluctuation and stagnation of supernatural cause and non-supernatural ones. Ultimate causes were intrusion and loss of supernatural and non- supernatural ones. The cultural themes of illness concepts of the elderly are: 1) illness concepts are not based on causality principle, but on reciprocal principle; 2) illness concepts are affected by social level and charicteristics of the patients; 3) the causes of disease are recognized as imposed both positive and negative effects on health based on interpretation of the indiviuals; 4) illness concepts reflects on principles of everyday life of the society members such as hierachial structure and group cohesiveness; 5) illness concepts are ruled on principle of reciprocity and spread; 6) illness concepts are interrelated with physical environment of the participants. It can be concluded that the illness concepts of the elderly in a traditional clan village are a component of health care system as a cultural system based on these results. The these results can be a useful basis for gerontological nursing practice and education.

The purpose of this study was to provide fundamental data for nursing intervention by assessing self-esteem and quality of life(QL) in patients on hemodialysis and peritoneal dialysis. The subjects of this study were 60 patients on hemodialysis at H university medical center in Seoul and 56 patients on peritoneal dialysis at B company. The analysis was done by using t-test, ANOVA, Scheffe and Stepwise multiple regression. The results were as follows: 1. The average self-esteem score was signifi-cantly higher in patients on hemodialysis (27.98) than in patients on peritoneal dialysis (25.64). And there were no statistically significant differences between patients on hemodialysis(128.45) and patients on peritoneal dialysis(122.83) in the scores on QL. Among four factors of QL, hemodiaysis patients showed higher score than peritoneal dialysis patients in all factors. But, only family had statiscally significant differences. Also family showed the highest score in both groups, but psychomental showed the lowest score. 2. In patients on hemodialysis, self-esteem was significantly different by occupation(t=3.122, p=.003) and in patients on peritoneal dialysis by age(F=4.450, p=.007), education level(F=7.458, p=.001) and occupation (t=2.491, p=.017). Also in patients on hemodialysis, QL was significantly different by occupation(t=2.223, p=.033) and in patients on peritoneal dialysis by education level(F=4.007, p=.024), and occupation (t=2.806, p=.007).3. Self-esteem accounted for 36.3% of variance in QL and monthly income accounted for an additional 6.1% of QL in hemodialysis patients by means of stepwise multiple regression analysis. In peritoneal patients, self-esteem accounted for 65.1% and monthly income accounted for an additional 2.7% in QL.

This study was undertaken to examine the degree of knowledge and compliance of breast self-examination with women. The subjects for this study were 474 women aged 35-65 receiving health examination from Yonsu-ku Public Health Service Center in Inchon. Data collection was conducted through the use of 2 questionnaires. Analysis of the data was done by used of descriptive statistics, t-test, ANOVA, and Pearson Product Moment Correlation Coefficient. The results of this study were as follows: 1. There were significant differences in the breast self-examination compliance rate according to age(F=5.82, p=.000), marital status(F=2.67, p=.047), educational level (F=5.83, p=.000) and household income (F=3.41, p=.018). 2. The correct answer rate for each items of breast self-examination knowledge scale was between 14.1% of a minimum rate and 65.0% for a maximum rate of 100. The degree of knowledge for relation of breast cancer and menopause, the time of the highest occurance of breast cancer, the best time of breast self-examination and inspection methods of breast self-examination shows relatively low understanding. 3. The average score of breast self-examination was 1.34 from a maximum score of 6. The score of breast self-examination with palpation methods was higher than with inspection methods. 4. A positive correlation was found between breast self-examination knowledge and compliance rate (r=.417, p=.001). According to the results, it is necessary to provide knowledge of the relationship of breast cancer and menopause, the time of the highest occurance of breast cancer, and the best time of breast self-examination and inspection methods of breast self-examination. Also, it is necessary to provide detail guidance for inspection methods and develop a program for promoting the compliance of breast self-examination.

It is well recognized that case management is required to survive in the rapidly changing medical environment. One of the case management is the critical pathway(CP) which is assumed to increase the quality of care and at the same time to decrease the length of stay in hospital. The purpose of the study was to develop a CP for the management of patients with postero-lateral fusion for lumbar spinal stenosis. Through review of literature and medical records of patients with spinal stenosis, a pilot CP was designed, including 8 different care components such as medication, laboratory tests, assessment etc., from one day before surgery to 6 days of postoperative care. Every item of the pilot CP was evaluated by a panel of experts to test the content validity. The items not agreed on by more than 4 out of 6 experts were deleted or modified to be integrated in the CP. To apply the modified CP to a clinical environment, the items reflecting treatment, medication and lab work were entered into an order communication system(OCS), and doctors and nurses were taught to use the CP. Finally, the development of CP for the patients with posterolateral lumbar fusion was completed after the application and variance analysis of the CP.

This study was undertaken to develop an instrument to be used for measuring the concept of quality of life of Korean patients with cancer multidimensionary and correctly. It can contribute in holistic nursing care for Korean cancer patients and also provide and validate basic data to help oncology nurses measure the outcome of nursing intervention correctly. To develop this instrument, the researchers first estabilished a conceptual framework based on the results of qualitative data analysis and indepth interview method Development of the scale was conducted using a method in which 31 items were assessed by subjects' self report using linear analogue scales. The subjects were 79 D.M. patients, 103 patients with acute illness, and 91 cancer patients residing in Busan, Korea. Data were collected during the period from July, 24 to August 14, 2000. This instrument consisted of 31 items with a self report scale. This instrument covered 4 dimensions of cancer patients : 1) physical wellbeing 2) psychological wellbeing 3) social wellbeing and 4)spiritual wellbeing. Each item had a possible score of 10. The reliability of the scale was tested with Cronbach's alpha. Validity was evaluated by examining the relationships of this scale, Youn's Quality of Life Questionnare scores and the Simple Quality of Life scale. Two separate runs of multiple regression were used to predict scores on the Simple Quality of Life measurement. Further validation was obtained by examining the correlation between the instrument subscores and Youn's Quality of Life measurement subscore for convergence of this scale. Examination of the discriminant. power of the instrument was done using ANOVA test. The results are summarized as follows: 1. The reliability of the instrument for the quality of life was 0.8321(Cronbach's alpha.), physical wellbeing dimension 0.6343, psychological wellbeing dimension 0.6501, spiritual wellbeing dimension 0.5883. 2. This instrument had a high correlation with Youn's Quality of Life measurement(r= 0.636) in cancer patients, whereas it had a low correlation with Simple Quality of Life measurement(r=0.455) in cancer patients. In the D.M. patients, the instrument correlated with both the Youn's Quality of Life measurement and Simple Quality of life measurement(r=0.313, r= 0.407) and in the acute stage patients, the instrument had no correlation. 3.Multiple regression of individual items on the Simple Quality of Life scores accounted for 56.8% of the variance in the Simple Quality of Life measurement, whereas, Youn's Quality of Life measurement scores accounts for 31.7%. 4. The correlations collected from the three group had the same patterns of variations but especially the instrument developed in this study had higher disciminant power than that of Youn's Quality of Life Measurement.