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Volume 19(5); December 2007

Original Articles
The Effects of a Cognitive Behavioral Stress Management Program on Diabetic Self-Care and Glycemic Control with Diabetes Mellitus Type II
Kyung Yeon Park, Hyoung Sook Park, Ji Min Seo
J Korean Acad Adult Nurs 2007;19(5):683-693.   Published online December 31, 2007
PURPOSE
The purpose of this study was to examine the effects of a cognitive behavioral stress management program on diabetic self-care and glycemic control with type 2 diabetic patients.
METHODS
Thirty three diabetic patients who were older than 40 were recruited from a public health center and conveniently assigned into both experimental(n=16) and control groups(n=17). Participants in the experimental group had attended the weekly cognitive behavioral program for 8 weeks. Data were collected from June 2005 to August 2006 and analyzed by independent t-test using the SPSS WIN program.
RESULTS
After an 8 week intervention, participants in the experimental group reported on increasement of diabetic self-care behaviors and an increasement of blood glucose levels, which were significantly different from those in the control group.
CONCLUSION
On the basis of those findings, we concluded that the cognitive behavioral stress management program has positive effects on diabetic self-care and glycemic control for the patients with DM. Further research is needed to identify the long-term effects of the cognitive behavioral program.
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A Comparative Study on Related Variables of Ego-Integrity in Elderly by Age Groups
Hee Kyung Kim
J Korean Acad Adult Nurs 2007;19(5):694-708.   Published online December 31, 2007
PURPOSE
The purpose of this study was to examine what types of customized nursing intervention for the elderly were most effective by looking at age group difference and other factors related to ego integrity.
METHODS
A secondary analysis was used with 104 elderly people. The data were analyzed using chi-square-test, Fisher's exact test, ANCOVA, Pearson's correlation analysis and multiple regression.
RESULTS
For those 80 and older, powerlessness was higher than for those in their 60s and 70s. The factors influencing ego integrity for those in their 60s were powerlessness, economic condition, source of discretionary money, and health condition; for those in their 70s - life satisfaction, self-esteem, and health condition; and for those 80 and older-life satisfaction and source of discretionary money.
CONCLUSION
In nursing for the elderly, age differences should be taken into consideration. The study suggests that for people in their 60s, the creation of jobs that allow them to earn money is important. For people in their 70s over, offering of health care and self-esteem programs through community health centers are equally important. For people in their 80s over, nursing programs for advocacy, support, and psychological care are needed in order to elevate their life satisfaction.
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Knowledge and Learning Needs Related to Coronary Artery Disease in Diabetic Patient by Glycemic Control
Min Sun Song, Hee Seung Kim, Jung Ah Oh
J Korean Acad Adult Nurs 2007;19(5):709-718.   Published online December 31, 2007
PURPOSE
The purpose of this study was to investigate the knowledge and learning needs on coronary artery disease in diabetic patients by glycemic control.
METHODS
The subjects consisted of 188 patients at the hospital who had diabetes mellitus. Data was obtained using a knowledge and learning needs questionnaire from January to April 2006.
RESULTS
Treatment method, the levels of fasting blood glucose(FBG), and 2-hour postprandial blood glucose (PP2hr) showed meaningful differences between normo-glycemic group(HbA1c<7%) and hyper-glycemic group (HbA1c> or =7%). The levels of knowledge on coronary artery disease by glycemic control tend to show higher in normo-glycemic group. Etiology and prevention of coronary artery disease were significantly higher in normo- glycemic group than in hyper-glycemic group. The levels of learning needs on coronary artery disease by glycemic control tend to show higher in normo-glycemic group. The learning needs on items of diet control were higher in normo-glycemic group than in hyper-glycemic group.
CONCLUSION
On the base of these results, we should focus on the coronary artery disease education for hyper-glycemic group. Also individual coronary artery disease educational program should be developed for the patients with different level of knowledge and learning needs.
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Health Promoting Behaviors and Influencing Factors of University Students: Optimism and Coping Skills
Nam Sun Kim
J Korean Acad Adult Nurs 2007;19(5):719-728.   Published online December 31, 2007
PURPOSE
The purpose of this descriptive study was to identify predictors on health promoting behaviors of university students.
METHODS
The participants were 310 students by convenience sampling in G city. The data were collected through a questionnaire given to the students between September 10 to November 6, 2006. Descriptive statistics, t-test, ANOVA, Pearson's correlation coefficients, and stepwise multiple regression were used to analyze the data.
RESULTS
The mean score for the level of health promoting behaviors and optimism was 2.60(+/-.31) and 2.70(+/-.55) respectively. The most frequently used coping skill was the pursuit of social support. There were positive correlations between health promoting behaviors and optimism, between health promoting behaviors and active coping skill, and between health promoting behaviors and passive coping skill. In stepwise multiple regression analysis, the most powerful predictor of health promoting behaviors was active coping skill.
CONCLUSION
The results suggest that coping skills with optimism can be considered when developing a health promotion program for university students.
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PURPOSE
The purpose of this study was to determine the effect of supportive nursing care on the level of knowledge and compliance with sick-role behavior in patients with coronary artery disease after coronary angiography(CAG).
METHODS
A quasi-experimental research was performed with 81 subjects with coronary artery disease who were admitted for CAG to a cardiovascular department. Among the selected subjects, 40 of them were assigned to experimental group and the rest of them were assigned to control group by convenience. Supportive nursing care was implemented twice by a researcher.
RESULTS
1. The mean score of knowledge related to coronary artery disease was higher in the group who received supportive nursing care than that of the control group(t=2.259, p=.027). 2. The mean score of compliance of sick role behavior was higher in the group who received supportive nursing care than that of the control group(t=4.580, p=.001).
CONCLUSION
The supportive nursing care after CAG was effective in increasing the knowledge level and compliance of sick-role behavior in patients with coronary artery disease. Further studies would be recommended to identify long-term effectiveness of supportive care on patients' outcomes.
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Nurse Managers in a Difficult Situation on Caring Clients: A Critical Discourse Analysis
Myung Ok Cho
J Korean Acad Adult Nurs 2007;19(5):739-752.   Published online December 31, 2007
PURPOSE
This study aimed to explore the discourses and the patterns of problem solving behaviors among the nurse managers. The focus of the study was the difficult situations in caring with patients and their families.
METHODS
Field study was performed at a for-profit hospital from March, 2004 to March, 2007. The participants of the study were 5 head nurses and 2 nurses in charge. The data were collected with iterative interviews and participant- observations. For the analysis of the data, taxonomy and critical discourse analyzing were applied.
RESULTS
The nurse mangers who showed wholistic patterns of behavior took the role of a broker among the client system, professional nursing system, medical system, and other allied health system. The nurse managers whose approach was profession-centered took the role of protector of nursing system. The nurse manager who practiced nurse-oriented pattern of behavior tried not to have harm against other members of health system. The experiences of nurse managers were effected from the discourses of patriarchal and market mechanism.
CONCLUSION
The situation that provoke conflict between clients and nurses become more common with the changes to the health care system and to society. Nurse managers take the role of these conflict problems. The successful solving of conflict in a nursing care setting promotes the quality of care and satisfaction of clients. Programs for enhancing nurse's problem solving competency should anchored be in their practices.
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The Clinical Competence and Related Factors of the Nursing Students: Focused on the Subjects Who Studied Problem-Based Learning
Sook Hee Lee, Mi Hee Kim, Kwang Soon Sun
J Korean Acad Adult Nurs 2007;19(5):753-762.   Published online December 31, 2007
PURPOSE
This study was to evaluate clinical competence in relation to self-directed learning, critical thinking disposition, and participating in PBL(Problem-Based Learning) group activities of nursing students.
METHODS
Data were collected from 108 nursing students in Oct. 2006.
RESULTS
Clinical competence had a significant positive correlation with self-directed learning, critical thinking disposition, and participation in PBL group activities. There was a significant difference in clinical competence according to interpersonal relationship. Participation in PBL group activities was the most influential factor of clinical competence(R2=.34). Also, the influence of clinical competence increased with the addition of self-directed learning(R2=.42).
CONCLUSION
It is essential to encourage the self-directed learning and participation in PBL group activities for the improvement of clinical competence. It is relatively important for clinical competence to consider the educational environment systematically.
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Effects of the Knowledge, Health Belief, and Self-Efficacy about Osteoporosis on Calcium Intake Behavior for Postmenopausal Osteoporosis Patients
Hye Ran Song, Hee Young So
J Korean Acad Adult Nurs 2007;19(5):763-774.   Published online December 31, 2007
PURPOSE
To identify the predictors of calcium intake behavior and examine the relationships among bone mineral density, osteoporosis knowledge, osteoporosis health belief, osteoporosis self efficacy and calcium intake behavior of postmenopausal osteoporosis patients.
METHODS
The subjects consisted of 94 patients. The measurement tools were osteoporosis knowledge test, osteoporosis health belief scale, osteoporosis self-efficacy and calcium intake frequency questionnaire. The data were analyzed using the SPSS WIN 11.0 program.
RESULTS
The bone mineral density of the lumbar were .75g/cm2, T-score -2.67 and the femur neck were .67g/cm2, T-score -2.30. There was statistically a significant correlation between calcium intake behavior and health motivation (r=.449, p=.000) among the osteoporosis health belief. In hierarchial multiple regression analysis, current spouse(12.8%) and health motivation(19.9%) of the osteoporosis health belief explained the 32.7% of variance in calcium intake behavior.
CONCLUSION
Nursing intervention should be developed for increasing the calcium intake behavior through promoting health motivation for the postmenopausal osteoporosis women having no spouse currently.
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A Study of the Subjectivity of Quality of Life in Elderly Women
Boon Han Kim, Yoon Sook Kim, Hye Won Jeon
J Korean Acad Adult Nurs 2007;19(5):775-786.   Published online December 31, 2007
PURPOSE
The purpose of the study were to categorize the subjectivity of the quality of life in elderly women and to thereby understand the differences regarding quality of life desires.
METHODS
This study used a Q-methodology to measure the quality of life in elderly women. A Q sample was collected from in-depth and objective interviews and WHOQLO. Fourteen participants rated 28 selected Q-statements on a scale of 1-7. The collected data was analyzed using PC Quanl.
RESULTS
The principal component analysis identified 4 factors regarding the quality of life of elderly women. These categories were labeled 'hopelessness-oriented', 'relationship/adaptation-oriented', 'physical suffering-oriented', and 'self satisfaction-orientated'.
CONCLUSION
Some of the factors regarding the quality of life of elderly women were determined through this research. Further research is necessary to set up and apply different the quality of life between men and women based on this result. The results of this study indicate that different approaches toward quality of life promotion programs are recommended based on the four factors of quality of life among elderly women.
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The Effects of Dementia Prevention Program on Cognition, Depression, Self-esteem and Quality of life in the Elderly with Mild Cognitive Disorder
Yun Mi Lee, Nam Hee Park
J Korean Acad Adult Nurs 2007;19(5):787-796.   Published online December 31, 2007
PURPOSE
This study was conducted to develop and evaluate a dementia prevention intervention program for the elderly with mild cognitive disorder.
METHODS
The study was nonequivalent control group pretest-posttest design. The subjects of the study were a total of 68 elderly who ranged from 21 to 24 of total scores of K-MMSE, aged over 65, in home. The program consisted of music therapy, humor therapy, art therapy, dancing therapy, recreation, and health education to enhance brain function. The program was applied to the experimental group twice a week, ninety minutes per session for eight weeks. The data were analysed by using chi-square test and t-test.
RESULTS
The variables measured in the experimental group and the control group before the intervention were not significantly different in the homogeneity test. The dementia prevention program improved the cognition(t=9.243, p<.001), self-esteem(t=.4.336, p<.001), quality of life(t=8.375, p<.001) and reduced depression(t=-3.913, p<.001).
CONCLUSION
These findings confirmed that the dementia prevention program made a contribution to improving cognitive function, self-esteem, and quality of life and also to reduce depression in the elderly with mild cognition disorder. Therefore, it is recommended that this program could be used in clinical practice as an effective nursing intervention for the elderly with mild cognitive disorder.
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Effects of Imagery on Stress, Anxiety, and Immune Cells in Patients with Acute Leukemia Receiving Chemotherapy
Soo Kyung Shim, Nam Cho Kim
J Korean Acad Adult Nurs 2007;19(5):797-808.   Published online December 31, 2007
PURPOSE
The present study is a quasi?experimental research for examining the effects of imagery on stress, anxiety and immune cells in acute leukemia patients receiving chemotherapy and utilizing the therapy for their self control and stress management.
METHODS
The subjects were 60 patients who were diagnosed with acute leukemia and scheduled to receive chemotherapy at A hospital in Seoul during the period from November 2006 to March 2007. After the start of chemotherapy, the experimental group received imagery for 4 weeks, three sessions a week, so a total of 12 sessions and 156 minutes.
RESULTS
The decrease of stress was larger in the experimental group than in the control group. Systolic blood pressure decreased significantly more in the experimental group than in the control group. In the experimental group, state anxiety decreased significantly in the 2nd week of the experiment and after the final stage of the experiment. The total number of white blood cells, and the absolute number of neutrophils and lymphocytes were showing significant differences between the time points.
CONCLUSION
Imagery is an effective intervention for reducing stress and state anxiety and stabilizing blood pressure in acute leukemia patients receiving chemotherapy.
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The Effects of Abdominal Meridian Massage on Constipation in Institutionalized Psychiatric Patients Taking Antipsychotic Drugs
Inja Kim, Yu Na Cho
J Korean Acad Adult Nurs 2007;19(5):809-818.   Published online December 31, 2007
PURPOSE
It was investigated if abdominal meridian massage has effects on constipation in institutionalized psychiatric patients taking antipsychotic drugs.
METHODS
According to the constipation screening tests, 22 patients were selected as subjects. One group pre and post repeated measurement design was used. Constipation was operationalized as perceived constipation, frequency of defecation, frequency of bowel sound, and number of medicine taken to relieve constipation. Abdominal meridian massage was given for two weeks, 10-15 minutes each time and 10 times in total.
RESULTS
Perceived constipation, frequency of bowel sound, and number of medicine taken were significantly improved after massage. Except for number of medicine taken, the effects on perceived constipation and frequency of bowel sound were found to be persistent 2 weeks after massage.
CONCLUSION
Based upon these results, abdominal meridian massage was recommended as independent nursing intervention for the relief of constipation in psychiatric patients who taking anti-psychotic drugs. Further studies to investigate the maximal duration time of effects and whether the effects of intermittent application of this method is more beneficial than the continuous application of this method are necessary.
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Factors Influencing Health Promoting Behavior of the Low-income Elderly Women in Urban
Kyung Rim Shin, Jeong Sun Kim, Myung Sook Sung
J Korean Acad Adult Nurs 2007;19(5):819-828.   Published online December 31, 2007
PURPOSE
This study was conducted to identify factors influencing health promotion behavior of the low-income elderly women in urban area.
METHODS
The subjects of this study consisted of 389 the low-income Korean elderly women over 65 years. The data was analyzed using descriptive statistics, t-test, One-way ANOVA, Pearson Correlation Coefficients, Stepwise Multiple Regression with SPSS/Win 12.0.
RESULTS
1) Activity limitation was found to have a statistically significant negative correlation. But self-rated health, self-esteem, and social support were found to have a statistically significant positive correlation with health promotion behavior 2) The factors influencing health promotion behavior were self-esteem, social support, activity limitation, self-rated health, pocket money, and religion. They accounted for 36.8% of the variance for health promotion behavior in the low-income elderly women living in urban area. The most powerful predictor was self-esteem(28.1%).
CONCLUSION
This study showed that making a thorough assessment of the predictors influencing health promotion behavior in the low-income elderly women who remain vulnerable in diverse aspects is very important to minimize their health issues and to contribute their positive health promotion.
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Quality of Life in Patients with Women Cancer Across Treatment Phases
Young Sook Tae, Youn Kung Jung
J Korean Acad Adult Nurs 2007;19(5):829-840.   Published online December 31, 2007
PURPOSE
This study was to identify the level of quality of life in patients with woman cancer across treatment phases.
METHODS
The research method was a cross-sectional descriptive study. Data was collected by questionnaires from 226 female, who were in- and out-patients. They were diagnosed with breast and uterine cancer from three university hospitals and two general hospitals. The instruments used for this study included, "the Quality Of Life Scale(QOL)". The collected data were analyzed using Frequency, Percentage, ANOVA, Two-Way ANOVA.
RESULTS
Quality of life of women cancer patients was significantly different according to three treatment phases. Quality of life of women cancer patients was not significantly different according to areas of disease in the three treatment phases. Quality of life of women cancer patients was significantly different according to level of fatigue in the three treatment phases. Quality of life of women cancer patients was significantly different according to level of perceived health status in the three treatment phases(F=60.14, p=.000). Quality of life of women cancer patients was significantly different according to education level(F=3.70, p=.027) & occupation(F=5.67, p=.018) in three treatment phases.
CONCLUSION
Strategies for intervention are needed to improve the quality of life in women cancer patients across the treatment phases. The significant several characteristics of affecting on quality of life across treatment phases should be considered in sociopsychological nursing intervention.
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Prevalence of Insomnia and Its Related Factors in Korean Women
Su Jin Shin, Kyung Rim Shin
J Korean Acad Adult Nurs 2007;19(5):841-852.   Published online December 31, 2007
PURPOSE
The purposes of this study were to investigate the prevalence of insomnia and to compare sleep patterns, demographic characteristics, and obstacles for sleep between women with and without insomnia.
METHODS
This was a descriptive study. Study participants were 1,679 Korean women aged over 20 years. Information on symptoms of insomnia, sleep patterns, and related factors was assessed by questionnaire. Symptoms of insomnia included difficulties in initiating and maintaining sleep and early morning awakening.
RESULTS
This study found that 32.0% of the study participants had insomnia, subjects with insomnia had bad sleep patterns compared to comparison group, lower educational level and menopause were closely related to insomnia, and noise, temperature, lighting, presence of bed partner, intake of caffeine, frequent urination, and pain or itching were associated with insomnia.
CONCLUSION
This study suggests that insomnia is prevalent in women and closely associated with education level and menopausal status.
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