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Volume 20(6); December 2008

Original Articles
Implementing and Evaluating a Nurse Led Hereditary Cancer Genetics Educational Program in a Korean Breast Cancer Surgery Clinic
Kyung Sook Choi, Myung Hee Jun, Sei Hyun Ahn, Gwen Anderson
J Korean Acad Adult Nurs 2008;20(6):815-828.   Published online December 31, 2008
PURPOSE
This study was to develop and evaluate the clinical utility of the breast and ovarian cancer genetic counselling program specific for 20 Korean women(KBOCGP).
METHODS
The KBOCGP was developed using three types of approaches: an ethnography among Korean women who underwent BRCA1/2 test, designing and implementing one week clinical genetic educational course for clinical cancer nurses, educational observation visits to three American cancer genetic counselling programs. And then pre-experimental design was implicated to evaluate the change of the women's knowledge about the hereditary breast and ovarian cancer and the level of the satisfaction with genetic counselling.
RESULTS
The mean score of the knowledge has significantly increased from 7.45 +/- 3.86 to 11.55 +/- 2.21(t = 5.63, p < .001). The level of the satisfaction with the counselling was very high (27.47 +/- 1.35). Because most of the subjects have young kids, they showed strong concerns about their kids' getting cancer.
CONCLUSION
This new KBOCGP is the satisfactory program for the education and communication of the genetic information to the Korean women with HBOC. But it is needed more to strengthen the cultural sensitivity especially to Korean family relationships. Authors recommend that this program be provided by other nurses who are counselling women at high risk of breast cancer.
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Health Locus of Control and Compliance of Treatment in Acute Coronary Syndrome Patients after Percutaneous Coronary Intervention
Su Jin Shin
J Korean Acad Adult Nurs 2008;20(6):829-838.   Published online December 31, 2008
PURPOSE
The purpose of this study was to explore the differences of health locus of control and treatment compliance according to general characteristics and severity in acute coronary syndrome(ACS) patients after percutaneous coronary intervention.
METHODS
This descriptive study was conducted with a convenient sample of 103 ACS patients. The dependent variables were measured by the scales for the Multidimensional Health Locus of Control and the Treatment Compliance. The collected data were analyzed by the Fisher's exact test, Chi-square and t-tests, and ANOVA using the SPSS/WIN program.
RESULTS
Pre-interventional severity was significantly different between men and women. In terms of internal health locus of control, there was a significant difference according to gender, educational status, economic status, and severity. The level of medication compliance was the lowest among the sub-scales of treatment compliance.
CONCLUSION
These findings suggest that clinical nurses should evaluate the general characteristics and severity of the patients with ACS for providing tailored nursing interventions.
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PURPOSE
This study was conducted to examine the effects of aroma-therapy combined with heat application on pain, ROM of lower limb joints, and discomfort from activities of daily living(ADL) among the patients with rheumatoid arthritis.
METHODS
Aroma blended oil was rubbed over the knees and ankles of 19 experimental group A and 20 B, and then heat therapy was given using an electric hot & wet poultice pad to only group A. There was no treatment on the 19 control group. There was measured for pain, ROM of lower limb joints and discomfort of ADL. The data was analyzed using SPSS/WIN 11.0 program.
RESULTS
In comparing the effects of pain reduction by time, the ROM of lower limb joints, and discomfort of ADL, there were significant differences among three groups. There was no significant difference between experimental group in pain scale by time, range of ROM of knee and ankle joint and discomfort of ADL.
CONCLUSION
On the basis of results, aroma-therapy can be applied as a nursing intervention to reduce pain for not only rheumatoid arthritis patients but also for other patients with other diseases.
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Experience on Emotional Support of Hospital Nurses
Hyun Joo Park, Bok Yae Chung, Ok Hee Kim, Yun Kyung Kim, Hyo Ja An, Young Nae Lee, Hye Sun Byun, Kyung Soon Jeong, Ji Youn Kim
J Korean Acad Adult Nurs 2008;20(6):852-865.   Published online December 31, 2008
PURPOSE
This study was designed to explore what experiences nurses had while caring and providing emotional support for patients.
METHODS
Participants were eight nurses working at hospitals for more than one year. Data were collected from June, 2006 to January, 2007 through in-depth interview by using tape-recordings. Data were analysed with the phenomenological method proposed by Colazzi(1978).
RESULTS
From significant statements, 4 clustered themes, 7 themes and 23 sub-themes were extracted from the essential meaning of the emotional experience of hospital nurses. The 4 clustered themes were 'movement of mind', 'affection and service for patients', 'worthwhile and conflict' and 'control oneself'. The 7 themes were 'special feeling', 'rapport formation', 'consideration', 'human interaction', 'value discovery', 'loss of volition', and 'keep to balance'.
CONCLUSION
Although nurses had tough experiences for providing care for patients' emotional support, they had also experienced spiritual maturity from its experience. The result of this study would contribute for nurses not only to care for patients who need emotional support but also to develop knowledge in nursing.
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Health Status, Depression and Social Support of Elderly Beneficiaries of the National Basic Livelihood Security System
Jung Hee Kang, Jeong Ah Kim, Kasil Oh, Kyong Ok Oh, Sun Ock Lee, Sook Ja Lee, Hoa Yun Jun, Hye Ryoung Kim
J Korean Acad Adult Nurs 2008;20(6):866-882.   Published online December 31, 2008
PURPOSE
The purpose of this study was: 1) To investigate health status(health behavior, health problem and cognition), depression and social support of elderly beneficiaries of the National Basic Livelihood Security System. 2) To identify the relationships among health status, depression and social support.
METHODS
This descriptive study used a cross-sectional design. The study sample was a total of 883 elderly recipients supported from the National Basic Livelihood Security System. Quotas for sampling were designed and conducted nationwide throughout Korea.
RESULTS
The mean age was 76.2 and the 79.6% of the sample were female. The scores for the health behavior, health problem, ADL, and cognition were 23.9, 4.4, 39.6 and 24.9, respectively. Additionally, the depression score was 19.8 and the social support score was 63.2. Gender, age, education, religion, marital status and monthly income were found as important variables in increasing health status and in decreasing depression among the elderly. Furthermore, depression showed a positive correlation with health problems, but showed negative correlations with health behavior, ADL, and cognition. The upper 25% of social support recipients suffered less depression than the lower 25% of the recipients. Subjects with more social supports had higher ADL scores and less health problem.
CONCLUSION
These findings provide significant practical implications for nursing intervention, including social support for the elderly receiving assistance from the National Basic Livelihood Security System.
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The Effects of Aroma Hand Massage on Pruritus, Fatigue and Stress of Hemodialysis Patients
Seoung Ja Kang, Nam Young Kim
J Korean Acad Adult Nurs 2008;20(6):883-894.   Published online December 31, 2008
PURPOSE
This study was to examine the effects of aroma hand massage on pruritus, fatigue and stress of the patients undergoing hemodialysis.
METHODS
This study was a nonequivalent control group pretest-posttest design. Study sample was conveniently recruited from two hospitals(28 for experimental and 30 for control group). The experimental group went through aroma hand massage on hand without AVF for 5 min for 12 times mixed with Lavender, Chamomile and Geranium oils in the ratio of 4 : 4 : 2, which was diluted 3% with sweet almond crrier oil 100 ml. The collected data were analyzed using SPSS/WIN 12.0.
RESULTS
The 1st hypothesis, 'Experimental group who has received aroma hand massage will have lower rate of pruritus than the control group' was accepted(t = -5.084, p = .001). The 2nd hypothesis, 'Experimental group who has received aroma hand massage will have lower rate of fatigue than the control group' was accepted(t = -2.557, p = .015). The 3rd hypothesis, 'Experimental group who has received aroma hand massage will have lower rate of stress than the control group' was accepted(t = -5.537, p = .001).
CONCLUSION
The aroma hand massage has shown to be an effective nursing intervention to reduce the pruritus, fatigue and stress among patients undergoing hemodialysis. Therefore, the massage is needed to continuously be applied to hemodialysis patients to improve their quality of life.
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Analysis of Nursing Researches about Organ Donation and Transplantation in Korea
Hye Sook You, Hyang Sook So, Hye Sook Kim
J Korean Acad Adult Nurs 2008;20(6):895-904.   Published online December 31, 2008
PURPOSE
This study analyzes the trends of nursing researches about organ donation and transplantation, and recommends the direction of future nursing studies in Korea.
METHODS
Ninety-nine researches based upon organ donation and transplantation in Korea were analyzed by descriptive statistics.
RESULTS
Among them 58 papers were master's theses and 9 were doctoral dissertations. Articles about organ beneficiaries were seventy. The 47 articles among them were for kidney transplantation. By the types of research design, there were 73 quantitative studies, 19 qualitative studies, and 9 methodological studies. In correlation studies, the quality of life of subjects were evaluated the association with stress, social support, self-efficacy, and compliance. In experimental studies, the independent variables were self efficacy promotion exercise, steroid medication, educational programs regarding an organ transplantation and a brain death, Danjeon breathing exercise, and telephone counseling. The methods of qualitative studies were based on the grounded theory, phenomenology, interpretive phenomenology, and ethnography. The dominant concepts of qualitative researches were experiences of a decision-making of donors and of recipients for organ transplantation.
CONCLUSION
Descriptive surveys or correlation studies were predominant on the nursing research about organ transplantation. Qualitative studies were conducted to some extent. It is recommended to conduct clinically applicable interventional researches with the experimental design.
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Comparative Study on Fall Related Characteristics between Single and Recurrent Falls in Community-Dwelling Older Women
Hyoung Sook Park, Rang Chang, Kyung Yeon Park
J Korean Acad Adult Nurs 2008;20(6):905-916.   Published online December 31, 2008
PURPOSE
The purpose of this study was to identify the influencing factors on the single and recurrent falls in community-dwelling older women.
METHODS
Seventy eight volunteers aged over 65 were included in the study. The participants experienced at least one fall within the past one year. Data were measured on each participant from May 2007 to September 2007, collected using structured researcher-administered sheets and measuring their physical strengths and analyzed by descriptive statistics, t-test, chi-square test, Mann-Whitney U test and logistic regression analysis.
RESULTS
The prevalence of recurrent falls were 53.8%. The level of education(Z = -2.455, p = .014) and the presence of spouse(chi-square = 4.843, p = .044) showed significant differences between the single-fall group and the recurrent-fall group in the study. Significantly predicting factor on the recurrent falls was the level of education and the variable explained 20.1% of variants in the occurrence of recurrent falls.
CONCLUSION
Although a variety of factors affected the single fall in the elderly women, the level of education and the presence of spouse proved to be the significant factors in their recurrent falls. These factors proven to be significant as the result of this should be reflected in the development of effective programs for preventing the elderly from recurrent falls.
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Assessment of the Optimum LDL : HDL-cholesterol(LDL : HDL-C) Ratio for Predicting CHD
Soon Gyo Yeoum
J Korean Acad Adult Nurs 2008;20(6):917-931.   Published online December 31, 2008
PURPOSE
This study was aimed to determine the optimum low-density lipoprotein : high-density lipoprotein-cholesterol (LDL : HDL-C) ratio for predicting coronary heart disease(CHD) in Korean people.
METHODS
It was analyzed this data of 5,431 adults who had undergone health examinations in a hospital in Gyeonggi-do between January 2006 and December 2007. The covariation of the coronary risk factors such as age, HbA1C, systolic blood pressure(SBP), and waist-to-stature ratio(WSR) were analyzed by using logistic regression analysis.
RESULTS
The LDL : HDL-C ratio in the male and female groups was mostly distributed between 1.5 and 4.0. The LDL : HDL-C ratio was the most significant cholesterol-related parameter influencing CHD(male: B = .306, p = .054, female : B = .940, p = .010), followed by LDL-C and total cholesterol. It was observed a sharp increase in the odds ratios for LDL : HDL-C ratios of 2.25 - 2.50(male) and 2.00 - 2.25(female). A significant difference was observed in both male(2.25 : chi-square = 2.494, p = .072) and female(2.00 : chi-square = 413.742, p = .000) groups.
CONCLUSION
The risk level of CHD was set to 2.25 for males and 2.00 for females. Therefore, the optimum LDL : HDL-C ratio for Koreans should be far lower than that for the people in western countries.
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Comparisons on Coping Skills and Physical Health between Realistic Optimists and Unrealistic Optimists in University Students
Aee Lee Kim
J Korean Acad Adult Nurs 2008;20(6):932-940.   Published online December 31, 2008
PURPOSE
The purpose of this descriptive study was to compare ways of coping and physical symptoms of realistic optimist with unrealistic optimist in university students.
METHODS
The participants for this study were students from three university, located in Seoul and Gangwon province. The data were collected by a questionnaire given to the students.
RESULTS
The most frequently used coping skills of realistic/unrealistic optimist was the pursuit of social support. Realistic optimists are likely to use not only active coping skills but also passive coping skills, on the other hand unrealistic optimists tend to less use all coping skills. But in physical health, it doesn't show a significant differences except gastro-intestinal symptoms between two group.
CONCLUSION
Based on the finding of this study, it is needed nursing intervention for strengthening realistic optimism for helping university students cope with stress and health.
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The Effects of Aroma Inhalation on Sleep and Fatigue in Night Shift Nurses
Soon Bok Chang, Sang Hui Chu, Yeong In Kim, Sun Hee Yun
J Korean Acad Adult Nurs 2008;20(6):941-949.   Published online December 31, 2008
PURPOSE
This study was conducted to describe the effects of aroma inhalation on sleep and fatigue in night shift nurses.
METHODS
The research design was one group pre-posttest design. The subjects were 17 night shift nurses who work at neurosurgery intensive care unit of K hospital of C university in Seoul. During three consequent night shifts, the participants were worn the Actigraph to measure the sleep pattern on their wrist since their first night shift work. The quality of sleep and fatigue was measured by survey when they awoke at 6 pm after second night shift work. And these measures were repeated during the night shifts in second and third week. Aroma inhalation was applied before going to bed after finishing each night shift work during second and third week. SPSS 12.0 program was used for data analysis.
RESULTS
There were no statistically significant differences in sleep latency and total sleeping time. However, significant differences were found in the sleep efficiency, awakening number, sleep quality, subjective symptom and intensity of fatigue.
CONCLUSION
These results showed that aroma inhalation had positive effects on the pattern and quality of sleep and reducing fatigue in night shift nurses.
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Comparison of Claustrophobia, Noise Sensitivity and Vital Signs according to Anxiety Sensitivity Level before and after MRI
Young Hae Park
J Korean Acad Adult Nurs 2008;20(6):950-959.   Published online December 31, 2008
PURPOSE
The present study was conducted in order to examine claustrophobia, noise sensitivity and vital signs according to anxiety sensitivity level in patients who have Magnet Resonance Imaging(MRI).
METHODS
With 100 outpatients, we measured anxiety sensitivity, claustrophobia, noise sensitivity and vital sign before and after MRI. Measuring tools were ASI, CLQ-M, and NSI. Data were collected from February to March, 2008.
RESULTS
The ASI score was higher in women than in men(p < .05), and no statistically significant difference was observed according to age, region of scanning, experience in MRI, and the use of contrast agent. Both men and women patients showed the same ASI score and decrease in CLQ-M and NSI between before and after MRI. In women, ASI, CLQ-M and NSI were in positive correlation with one another(p < .001), and in men, there was no correlation between ASI and CLQ-M, and positive correlation was observed with NSI(p < .05). In comparison according to ASI level, blood pressure and pulse rate were not different in men and women. CLQ-M was not different in men, but was different in women(p < .001). NSI was different in both men and women(men p < .05; women p < .001).
CONCLUSION
MRI may cause claustrophobia in patients with high anxiety sensitivity, and noise appears to aggravate anxiety. In particular, claustrophobia was more serious in women than in men. Therefore, it is necessary to develop nursing interventions to reduce anxiety sensitivity particularly for female patients, and to make plans to educate and lower noise before MRI in order to reduce claustrophobia.
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Analysis of Clinical Nursing Activities Using Home Hospice Nursing Intervention Standards
Jinsun Yong
J Korean Acad Adult Nurs 2008;20(6):960-972.   Published online December 31, 2008
PURPOSE
The purpose of this study was to validate the nursing intervention standards of home care to home care setting for a guide in giving quality care to home hospice patients.
METHODS
The developed nursing standards were applied to 79 home hospice patients at K hospital, C university. Data were collected through the developed nursing intervention standards of home care with 19 selected nursing interventions and 418 associated nursing activities from January to June in 2006.
RESULTS
The performance frequency was 509 times for total nursing interventions and 7,815 times for total associated nursing activities. The most frequently used nursing activity was 722 times(9.24%) on teaching prescribed medication, followed by surveillance(718 times, 9.18%), and vital signs & neurologic monitoring nursing intervention(701 times, 8.97%). The highest mean nursing activity performance rate showed on Intravenous therapy(82%), followed by dying care(81%), and vital signs & neurologic monitoring (80%). Among 418 nursing activities, there were three classifications: 168 as core activities, 165 as major, and 85 as accessory activities.
CONCLUSION
The final validated nursing intervention standards can guide home care nurses to perform quality care and contribute to computerized nursing services and request of nursing fees.
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