Purpose
This study aimed to provide an overview of telomere length (TL) as an emerging biomarker in adult healthcare. Additionally, some measurement considerations and future directions for its application in adult nursing research were described. Methods A comprehensive literature review was conducted. Results TL is a widely known indicator of aging and aging-related diseases at the molecular level. Throughout the literature, TL has been established as a useful biomarker that is indicative of aging-related diseases such as cancer, metabolic diseases, and psychological distress and their resulting health conditions. The main pathway of TL shortening appears as an interaction between genetic and environmental factors through a mechanism commonly known as oxidative stress and inflammation. TL attrition may be slowed down, stopped, or even lengthened by interventions such as mindfulness, meditation, exercise, lifestyle modifications, and cognitive behavioral therapy, which have been demonstrated to have a positive effect on TL. As these interventions have been widely applied in adult nursing research, the value and scope of adult nursing science can be expanded by using TL in such research. Conclusion TL has been shown to be associated with age-related diseases, which are mainly studied in adult nursing research. Therefore, it is necessary to explore various nursing phenomena using TL as a biomarker through adult nursing research and to develop nursing interventions that have a positive effect on TL.

Citations

• A biobehavioral theoretical framework based on the mechanism of cellular aging for nursing interventions to promote autonomic balance
  Nahyun Kim, Jooyeon Park
  Journal of Korean Biological Nursing Science.2024; 26(2): 99.     CrossRef

Purpose
This study aimed to synthesize evidence for the association of psychological stress with Telomere Length (TL)-a potential biomarker of cellular aging. Methods: A systematic literature search was conducted to identify eligible studies in the Cochrane Library, PubMed, Embase, and CINHAL. In this review, we included all papers published since the initiative's inception and summarized results as of March 2022. Studies that investigated subjective stress using questionnaires and objective stress using biomarkers of adults (aged≥18 years) were included. Ultimately, 20 studies met our selection criteria. The risk of bias was assessed using the Newcastle-Ottawa Scale. Results: Fifteen of the twenty studies (75.0%) reported that individuals with higher psychological stress levels had shorter TL. Eleven of sixteen studies (68.8%) measuring subjective stress and five of eight studies (62.5%) measuring objective stress showed significant associations of psychological stress with TL. However, five studies reported no association between psychological stress and TL shortening. Although the heterogeneous studies limited the ability to draw clear conclusions, it is suggested that psychological stress might accelerate the erosion of telomere ends.
Conclusion
Our findings indicate that TL could be a useful emerging biomarker for measuring stress-related health outcomes in nursing. Further large-scale longitudinal studies using TL as a genetic biomarker with multidimensional stress measurements are needed to investigate the association between psychological stress and cellular senescence.

Citations

• A biobehavioral theoretical framework based on the mechanism of cellular aging for nursing interventions to promote autonomic balance
  Nahyun Kim, Jooyeon Park
  Journal of Korean Biological Nursing Science.2024; 26(2): 99.     CrossRef
• The Understanding and Application of Telomere Length as an Emerging Biomarker in Adult Nursing Research: A Review
  Seolbin Han, Jihee Min, Dae-Kwang Kim, In Deok Kong, Nahyun Kim
  Korean Journal of Adult Nursing.2023; 35(1): 1.     CrossRef

Purpose
This study aimed to evaluate distress, family resilience, and Quality of Life (QoL) among family caregivers of cancer patients undergoing chemotherapy and explore whether family resilience moderates the association between distress and QoL.
Methods
This is a cross-sectional study. One hundred seventeen family caregivers of cancer patients undergoing chemotherapy were recruited through the oncology outpatient clinic and two oncology wards at a tertiary university hospital. The participants completed self-reported questionnaires, including the Hospital Anxiety and Depression Scale, Family Resilience Scale-Cancer, and Caregivers’ Quality of Life Index-Cancer. Descriptive statistics, independent t-tests, one-way Analysis of Variance (ANOVA), and hierarchical regression analysis were used for statistical analysis.
Results
The mean distress score was 15.31±6.91, the mean family resilience score was 112.71±14.11, and the mean QoL score was 71.19±18.90. After controlling for potential covariates, distress was found to be negatively associated with QoL (β=-.45, p<.001), whereas family resilience was positively associated with QoL (β=.49, p<.001), explaining 62.8% of the variance. However, family resilience did not moderate the association between distress and QoL in this study.
Conclusion
Distress and family resilience are crucial factors associated with QoL in the caregivers of cancer patients undergoing chemotherapy. This finding indicates that oncology nurses should develop interventions to relieve distress and enhance family resilience to improve family caregivers’ QoL. Further studies are required to confirm the moderating role of family resilience.

Citations

• Navigate Chronic Illness: Antecedents and Consequences of Family Resilience—A Systematic Review and Meta-Analysis
  Charin Suwanwong, Darawan Raksat
  The Family Journal.2025;[Epub]     CrossRef
• Effectiveness of web-based education program on knowledge, coping, burden, and quality of life among colorectal cancer caregivers in Vietnam: a quasi-experimental study
  Hien Thi Nguyen, Hsiu-Hsin Tsai, Hong Thuy Phuong Huynh, Thuy Khanh Linh Tran, Tuan Anh Le, Li-Chueh Weng, Ching-Yu Cheng, Pei-Kwei Tsay, Wann-Yun Shieh, Chia-Yih Liu
  BMC Nursing.2025;[Epub]     CrossRef
• Mediating Effects of Family and Clinical Characteristics on the Quality of Life of Children With Spina Bifida and Their Parents
  Seung Hyeon Yang, Hyeseon Yun, Hooyun Lee, Kyua Kim, Chang Gi Park, Eun Kyoung Choi
  Journal of Advanced Nursing.2025;[Epub]     CrossRef
• The effect of mindfulness‐based interventions on caregiver burden, quality of life and psychological distress in caregivers of adults with chronic diseases: Systematic review and meta‐analysis of randomized controlled trials
  Gülyeter Erdoğan Yüce, Ayser Döner, Aylin Bilgin, Gamze Muz
  Worldviews on Evidence-Based Nursing.2024; 21(5): 528.     CrossRef
• The experiences of family resilience in patients with permanent colostomy and their spouses: A dyadic qualitative study
  Fangfang Yang, Sumin Cui, Mengyi Cai, Fangming Feng, Meihui Zhao, Mengchen Sun, Weiying Zhang
  European Journal of Oncology Nursing.2024; 70: 102590.     CrossRef
• Dyadic effects of family resilience on quality of life in patients with lung cancer and spousal caregivers: The mediating role of dyadic coping
  Jianfan Ke, Jialing Lin, Xiujing Lin, Wei-ti Chen, Feifei Huang
  European Journal of Oncology Nursing.2023; 66: 102400.     CrossRef
• Family resilience and its influencing factors among advanced cancer patients and their family caregivers: a multilevel modeling analysis
  Panpan Cui, Jiaoxia Shi, Shifeng Li, Mikiyas Amare Getu, Ruibo Wang, Changying Chen
  BMC Cancer.2023;[Epub]     CrossRef

Purpose
Patients with heart failure report low levels of physical activity and quality of life, both of which are important predictors of patient prognosis. This study aimed to investigate the effects of nurse-led motivational interviewing on self-efficacy for exercise, engagement in regular exercise, exercise capacity, and quality of life among patients with heart failure.
Methods
A randomized controlled trial design was used, and 66 Korean participants (i.e., 38 in a control group and 28 in an intervention group) aged 40~80 years who were diagnosed with heart failure were recruited between May 2012 and September 2013. The intervention group received telephone-based motivational interviews twice a week for one month. All participants were assessed for exercise regularity, levels of exercise, exercise capacity, and quality of life at baseline, one month, and three months. The data were analyzed using independent t-tests, repeated measures ANOVA, and nonparametric tests.
Results
At one month, there were significant group differences in exercise regularity (x² =6.10, p=.013) and levels of exercise (Z=-2.56, p=.024). There was a significant group-by-time effect on the quality of life (F=3.76, p=.044).
Conclusion
Nurse-led motivational interviewing was effective in increasing exercise levels and quality of life in patients with heart failure. In the future, we propose a study with a larger number of participants and a long-term follow-up study with additional contact to maintain the intervention effect.

Citations

• Empowering Trusted Messengers With Motivational Interviewing Skills: Improving Dissemination of Accurate Information to Communities
  Marie Ivantechenko, Shubarna Akhter, Damara Gutnick
  Community Health Equity Research & Policy.2024;[Epub]     CrossRef
• Effectiveness of behavioural interventions with motivational interviewing on physical activity outcomes in adults: systematic review and meta-analysis
  SuFen Zhu, Deepra Sinha, Megan Kirk, Moscho Michalopoulou, Anisa Hajizadeh, Gina Wren, Paul Doody, Lucy Mackillop, Ralph Smith, Susan A Jebb, Nerys M Astbury
  BMJ.2024; : e078713.     CrossRef
• Benefits and Harms of Digital Health Interventions Promoting Physical Activity in People With Chronic Conditions: Systematic Review and Meta-Analysis
  Graziella Zangger, Alessio Bricca, Behnam Liaghat, Carsten B Juhl, Sofie Rath Mortensen, Rune Martens Andersen, Camma Damsted, Trine Grønbek Hamborg, Mathias Ried-Larsen, Lars Hermann Tang, Lau Caspar Thygesen, Søren T Skou
  Journal of Medical Internet Research.2023; 25: e46439.     CrossRef

Purpose
The purpose of this study was to assess the research performance during Coronavirus Disease 2019 (COVID-19) pandemic among nursing researchers. Methods: A cross-sectional online survey was conducted for Korean Society of Adult Nursing where 103 subjects participated from April 15 to May 14, 2021. The survey tool developed by researchers had 32 items including difficulties in performing research activities, perception of the impact of COVID-19 on research validity, and three open-ended questions. Results: In the research planning phase, 88 subjects (90.7%) reported difficulties in the recruitment plan and 83 subjects (89.3%) reported difficulties selecting a research design. In the recruitment and data collection phase, 85 subjects (88.6%) had difficulties accessing data collection site and 78 subjects (85.7%) had difficulties in face-to-face data collection. In the provision of intervention phase (for experimental study), 26 subjects (66.7%) reported that they should have changed the method of delivery of intervention. In research administration and manpower management, 62 subjects (75.6%) reported difficulties in face-to-face meeting. In research outcome management, 65 subjects (85.5%) reported that they should have changed the way of research-related events. Lastly, 80 subjects (81.6%) perceived that difficulties caused by COVID-19 impacted research validity. Conclusion: Majority of participants perceived that the difficulties in research activities may decrease research validity. To ensure research quality during COVID-19 pandemic, we should recognize potential threats to research validity and actively pursue adaptable innovations of research designs and data collection methods.

Purpose
This study aimed to examine health-promoting behaviors among Vietnamese students in Korea and identify the factors affecting these behaviors. Methods: A survey using self-administered questionnaires was employed. Data were collected between October 2020 and May 2021 from 260 Vietnamese students whose stay in Korea has been for longer than six months and who agreed to participate in the study. Variables included health-promoting behaviors (physical activity, nutrition, stress management, and health risk behavior), self-esteem, acculturative stress, and social support. A multiple regression analysis was performed to assess the factors that might influence health-promoting behaviors. Results: Of the total participants, 56.9% were women, and the mean age was 24.60±2.58 years. The mean score of the participants on total health-promoting behaviors was 2.64±0.36, on self-esteem 2.96±0.35, on acculturative stress 2.39±0.15, and on social support 2.53±0.24. Self-esteem, acculturative stress, social support, length of stay in Korea, and education level were found to affect healthpromoting behaviors, and these variables explained 76.2% of the variance. Conclusion: There is a need to develop intervention strategies for promoting self-esteem and social support programs and coping strategies for managing acculturative stress to increase health-promoting behaviors among Vietnamese students.

Purpose
The purpose of this study was to review non-pharmacologic intervention programs designed to alleviate symptoms in adults with overactive bladder syndrome.
Methods
A systematic search using Korean and English keywords was conducted in nine electronic databases. Ten studies were included in the sample for the systematic review. The Risk of Bias (RoB) and the Risk of Bias Assessment tool for Non-randomized Study (RoBANS) were used to assess methodological rigor and quality of scientific evidence.
Results
Randomized Controlled Trials (RCTs) were used in eight studies and quasi-experimental designs were used in two studies. Non-pharmacological interventions included education, acupuncture, Tibial Nerve Stimulation (TNS), exercise (pelvic muscle exercise, Tai-chi), and Heart Rate Variability (HRV) biofeedback. The majority of the literature has been evaluated to have a low risk of bias. Nine out of 10 studies applied interventions on women only. It was shown that education, TNS, exercise, and HRV biofeedback were effective in alleviating overactive bladder syndrome symptoms, but acupuncture’s efficacy depended on the frequency and intensity of the intervention.
Conclusion
The results provide a basis for developing an intervention program to improve the symptoms of overactive bladder syndrome. Future studies should also include men as subjects. The results of the intervention should be generalized by confirming the consistency and effectiveness of the aforementioned based on its frequency and intensity.

Citations

• Effectiveness of Fluid and Caffeine Modifications on Symptoms in Adults With Overactive Bladder: A Systematic Review
  Jeongok Park, Hyojin Lee, Youngkyung Kim, Christine Norton, Sue Woodward, Sejeong Lee
  International Neurourology Journal.2023; 27(1): 23.     CrossRef

PURPOSE
The purpose of the study was to evaluate the influence of patient activation on diabetes self-care activities and diabetes-specific distress among patients with type 2 diabetes mellitus.
METHODS
This cross-sectional correlational study was a secondary data analysis, utilizing data collected from September 2016 to July 2017, for 151 adults diagnosed with type 2 diabetes in ambulatory endocrinology units of two tertiary hospitals in a metropolitan city. The instruments used for data collection included the Summary of Diabetes Self-Care Activities Questionnaire, the Patient Activation Scale, and the Brief Diabetes Distress Screening Instrument. Hierarchical multiple linear regression analyses were conducted to test the influence of patient activation levels on self-care activities and diabetes-specific distress, after controlling for demographic and clinical variables.
RESULTS
The average patient activation level was 67.8±16.72 (with the possible range from 0 to 100), and the average diabetes-specific distress level was 6.91±2.69 (with the possible range from 2 to 12). Diabetes self-care activities scores were highest in medication adherence and lowest in glucose self-monitoring. Patient activation was the significant factor influencing self-care activities, after controlling for demographic and clinical variables, but showed no significant influence on diabetes-specific distress. Oral hypoglycemic agents and insulin medications were the significant factors influencing diabetes-specific distress.
CONCLUSION
These findings indicate the importance of nursing interventions to improve patient activation and to alleviate diabetes-specific distress. Therefore, in order to improve diabetes self-care activities, it is necessary to facilitate patient activation for diabetes care.

Citations

• Diabetes self‐care activities and its correlates in patients with diabetic neuropathy
  Younhee Kang, Inkyung Park
  Journal of Clinical Nursing.2025; 34(6): 2163.     CrossRef
• Relationship between Person-Centered Climate and Patient Satisfaction in Cancer Patients: The Mediating Effects of Patient Activation and Nurse Trust
  Hyun Jin Jung, Seon Hwa Park, Jung Hwa Jo, Hyun Jo Youn, A Ram Kim, Da Hye Lee, Mi Sun Park
  Asian Oncology Nursing.2024; 24(1): 21.     CrossRef
• Influence of Digital Literacy and Patient Activation on Sick Role Behavior in Vulnerable Older Adults with Diabetes
  Young-Eun Yi, Hyun-Ju Lee
  Journal of Korean Academy of Fundamentals of Nursing.2024; 31(2): 179.     CrossRef
• Patient Activation in Cancer Patients: Concept Analysis
  Se Young Jang, Eun Sun Lee
  Korean Journal of Adult Nursing.2024; 36(1): 15.     CrossRef
• The Mediating Effect of Experiential Avoidance on the Relationship between Diabetes Distress and Self-Stigma in People with Diabetes Mellitus Type 2 in Republic of Korea
  Kawoun Seo
  Healthcare.2023; 11(20): 2773.     CrossRef
• The Mediating Effect of Acceptance Action in the Relationship between Diabetes Distress and Self-stigma among Old Adults with Diabetes in South Korea
  Hyesun Kim, Kawoun Seo
  Journal of Korean Academy of Community Health Nursing.2022; 33(4): 446.     CrossRef
• Psychometric Evaluation of the Korean Version of PROMIS Self-Efficacy for Managing Symptoms Item Bank: Item Response Theory
  Mona Choi, Chang Gi Park, Soomin Hong
  Asian Nursing Research.2022; 16(4): 187.     CrossRef
• Effects of Symptoms and Patient Activation on Sleep Disturbance in Patients with Acute Leukemia Undergoing Chemotherapy
  Suna Lee, Eunjung Ryu
  Asian Oncology Nursing.2021; 21(3): 173.     CrossRef

PURPOSE
The purpose of this study was to examine the degree of Health-Related Quality of Life (HRQoL), and determine the effect of Urinary Incontinence (UI) on HRQoL in patients after prostatectomy.
METHODS
The participants were 110 adults who had undergone radical prostatectomies at Severance Hospital in Seoul, Korea. The data of this cross-sectional study were collected between April 10, 2015, and June 12, 2015. The questionnaire included demographic and disease-related characteristics, the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), and the King's Health Questionnaire (KHQ). Descriptive statistics and multiple linear regression were used.
RESULTS
The mean age was 66.27±7.24 years. The mean score of HRQoL was 47.37 (range 0~100). The lowest-ranked domains were “physical limitations” (M=51.21) and “role limitations” (M=49.85). The HRQoL was significantly different according to the number of post-operative day. HRQoL was significantly correlated with UI, and was affected by UI. The regression model of this study accounted for 70% of the HRQoL.
CONCLUSION
UI might influence HRQoL in patients after prostatectomy. Nursing interventions with special consideration of UI are needed to improve their HRQoL.

PURPOSE
This study aimed to identify the associations among psychological insulin resistance, diabetes self-efficacy, and diabetes self-care management in Korean patients with type 2 diabetes requiring insulin therapy.
METHODS
This study was a part of a parent study, for which data were collected from December 2015 to March 2016. Participants were 192 patients with type 2 diabetes who were recommended insulin therapy but were either not taking insulin or had been taking it for less than one year. Data were analyzed using descriptive statistics and Pearson's correlation coefficient. To identify the predictors of diabetes self-care management, sociodemographic and disease-related characteristics, psychological insulin resistance, and diabetes self-efficacy were entered into the hierarchical multiple regression model.
RESULTS
The mean age of participants was approximately 63 years, and 56.3% were men. A significant negative correlation was found between diabetes self-care management and psychological insulin resistance (r=−.19, p=.010), whereas self-care management and diabetes self-efficacy were positively correlated (r=.56, p < .001). In the hierarchical multiple regression model, psychological insulin resistance and diabetes self-efficacy were both strong predictors of diabetes self-care management after controlling for covariates such as education and economic status.
CONCLUSION
The levels of both psychological resistance and diabetes self-efficacy should be considered when educating and counseling patients in order to promote diabetes self-care management. Further research is needed on what type of intervention will improve self-care management in terms of reducing psychological insulin resistance and improving self-efficacy.

Citations

• Factors influencing self-management and health-related quality of life in low-income patients with diabetes: a predictive model
  Jihyon Pahn, Youngran Yang, Sun Hee Kim
  International Journal of Nursing Studies Advances.2025; 8: 100349.     CrossRef
• Factors Influencing the Subjective Health Status of Men with Insulin-treated Type 2 Diabetes Mellitus: A Secondary Analysis Using Quantile Regression Analysis
  Kang Sun Lee, Hyuk Joon Kim, Young Man Kim, Hye Young Kim
  Journal of Korean Academy of Fundamentals of Nursing.2023; 30(4): 530.     CrossRef
• Factors affecting the health status of patients with type 2 diabetes mellitus receiving insulin treatments: A multi‐mediation path analysis
  Kang Sun Lee, Hye Young Kim, Heung Young Jin
  Journal of Clinical Nursing.2022; 31(9-10): 1285.     CrossRef
• Evaluation of the effect of training given according to Pender's Health Promotion Model on psychological insulin resistance
  Ezgi Bağrıaçık, Nurhan Bayraktar
  Human Nutrition & Metabolism.2022; 29: 200153.     CrossRef
• Diyabetli Hastalarda Psikolojik İnsülin Direnci Ölçeğinin Türkçeye Uyarlanması
  Kevser IŞIK, Hilal YILDIRIM, Zeliha CENGİZ
  Turkish Journal of Family Medicine and Primary Care.2021; 15(4): 726.     CrossRef
• Influences of Patient Activation on Diabetes Self-Care Activities and Diabetes-Specific Distress
  Sookyung Choi, Su Hyun Kim
  Korean Journal of Adult Nursing.2020; 32(1): 10.     CrossRef
• Willingness of people with Type 2 diabetes to start insulin therapy: Evidence from the South African Tshwane Insulin Project (TIP)
  Patrick Ngassa Piotie, Paola Wood, Elizabeth M. Webb, Tessa S. Marcus, Paul Rheeder
  Diabetes Research and Clinical Practice.2020; 168: 108366.     CrossRef

PURPOSE
The purpose of the study was to systematically review the associations among health literacy, psychosocial factors, and cancer-related health actions.
METHODS
PubMed, CINAHL, PsycARTICLES, KISS, RISS, and KoreaMed were searched for articles published between January 2000 and March 2018. Fourteen studies were identified and reviewed for the associations among the variables based on Von Wagner's framework on health literacy and health actions. Two researchers reviewed the articles independently using the Mixed Methods Appraisal Tool.
RESULTS
Of the 14 relevant studies, five studies analyzed all of the associations among health literacy, motivational or volitional factors, and cancer-related health actions. Eleven studies investigated the association between health literacy and motivational factors, including knowledge (n=11) and attitudes (n=6). Four studies investigated the association between health literacy and volitional factors, including self-efficacy (n=4) and efforts to search cancer-related information (n=1).
CONCLUSION
The possible paths between health literacy and cancer-related health actions mediated through the psychosocial variables were identified. Further research is warranted to substantiate the mediating pathways of the associations between health literacy and cancer-related health actions.

Citations

• Determining global trends in health literacy research using topic modeling
  Su Hyun Kim, Woojin Kang, Eunhye Yoon, Jongwook Lee
  Korean Journal of Health Education and Promotion.2023; 40(2): 79.     CrossRef
• Health literacy measures in South Korea: A scoping review
  Heeran Chun, Su Hyun Kim, Eunja Park
  Korean Journal of Health Education and Promotion.2022; 39(4): 39.     CrossRef
• Validity and Reliability of the Korean Version of Assessment of Health Literacy in Breast and Cervical Cancer Screening
  Hye Sook Shin, Eunlim Chi, Hae-Ra Han
  Journal of Korean Academy of Nursing.2021; 51(6): 769.     CrossRef
• The Impact of Sleep Quality and Education Level on the Relationship between Depression and Suicidal Ideation in Parents of Adolescents
  Ji Yeon Shim, Sook Lee, Il Hyun Lee, Yoo Mi Jeong
  Healthcare.2021; 9(9): 1171.     CrossRef

PURPOSE
The objective of the study was to identify impact of depression, fatigue, family support, and resilience on rehabilitation among cancer survivors.
METHODS
One hundred and twenty-four participants who visited an out-patient department were recruited from a university hospital in Korea. An inclusion criterion was no reported relapse following the primary cancer treatment. Data were collected from July 1st to August 31st, 2014. Data analysis included an independent t-test, ANOVA, Pearson correlation coefficients and multiple regression using the SPSS 19.0 program.
RESULTS
Rehabilitation of those with colon and breast cancer was significantly correlated with depression, fatigue, family support and resilience. In a regression analysis, cancer rehabilitation accounted for 79.2% of the variance of depression, fatigue, monthly household income and resilience. The most significant factor affecting the success of rehabilitation was depression (β=-0.39, p < .001).
CONCLUSION
The results of the study indicate the importance of managing depression for the successful rehabilitation of cancer survivors. Nurses should prioritize the development and implementation of effective interventions for the improvement of rehabilitation among cancer survivors.

Citations

• Symptom Distress and Depression in Patients with Recurrent Gynecologic Cancer Undergoing Chemotherapy: Mediating Effect of Resilience
  Eun Jung Yang, Ho Sihn Ryu
  Korean Journal of Adult Nursing.2019; 31(1): 28.     CrossRef

PURPOSE
The purpose of this study was to design a mobile-application of a cognitive training program for people who have chemo-related cognitive complaints.
METHODS
The program was developed based on the networkbased instructional system design proposed by Jung. The program consisted of several tasks centered on four cognitive domains: learning, memory, working memory, and attention. For memory learning, a target-image and all its elements (color, position, and number) were presented on the screen that had to be recognized among a number of distractor-figures. In working memory training, the previous learned target-figure according to the level of difficulty had to be remembered among many different figures. In attention training named “Find the same figure,” two identical symbols in a grid-pattern filled with different images were presented on the screen, and these had to be simultaneously touched. In attention training named “Find the different figure,” a different symbol in a grid pattern filled with same figures had to be selected. This program was developed to train for a minimum of 20 min/day, four days/week for six weeks.
RESULTS
This cognitive training revealed statistically significant improvement in subjective cognitive impairments (t=3.88, p=.006) at six weeks in eight cancer survivors.
CONCLUSION
This cognitive training program is expected to offer individualized training opportunities for improving cognitive function and further research is needed to test the effect in various settings.

Citations

• User evaluation of a mobile education application for the management of metabolic syndrome among cancer survivors
  Ji-Su Kim, Minhae Kim, Yeji Seo
  European Journal of Oncology Nursing.2023; 63: 102276.     CrossRef
• Effects of smart-care services program for breast cancer survivors
  Bok Yae Chung, Sung Jung Hong
  The Journal of Korean Academic Society of Nursing Education.2021; 27(2): 95.     CrossRef
• Development and Effectiveness of a Mobile Health Lifestyle Program for University Students
  Yeon Hee Kim, Sung Rae Shin
  Journal of Korean Academy of Community Health Nursing.2021; 32(2): 150.     CrossRef

PURPOSE
The purpose of this study was to assess the relationship between menopausal symptoms and decline in cognitive functioning of menopausal women with mediating effects of health promoting behavior.
METHODS
Using a convenience sampling, 140 menopausal women were recruited for the cross-sectional survey. Data were collected by using the Menopause Rating Scale, Health Promoting Lifestyle Profile, Everyday Cognition, and Korean Mini-Mental State Examination.
RESULTS
The mean scores for menopausal symptoms, health promotion behavior, and subjective cognitive decline were 14.40, 153.79, and 67.40 respectively. Health promotion behavior was directly affected by menopausal symptom (R2=8%). Cognitive decline was directly affected by menopausal symptom (R2=11%). Menopausal symptom (β=.33, p<.001) and health promotion behavior (β=−.21, p=.014) were found to be predictive factors in subjective cognitive decline and explained 14%. Health promotion behavior had a partial mediating effect in the relationship between menopausal symptom and perceived cognitive decline (Sobel test: Z=2.05, p=.040).
CONCLUSION
Based on the findings of this study, developing nursing intervention programs focusing on decreasing menopausal symptoms and encouraging health promotion behavior are recommended to improve cognitive decline in menopausal women.

Citations

• A Case Report of Korean Medicine in Treating Postmenopausal Syndrome with Dyspepsia and Arthralgia
  Dong-soo Seol, Tae-ha Kwon, Min-seok Go, Seong-hyun Lee, Ji-eun Oh, Sae-young Bong, Yoo-jin Lee, Cha-young Lee, Su-won Yu
  The Journal of Internal Korean Medicine.2024; 45(5): 951.     CrossRef
• The Effect of Urban Gardening Activities on Physical Activity and Sleep Quality in Middle-Aged Women
  Young-Bin Jung, Hyung-Kwon Yun, In-Chang Son, Se-Na Choi, Kwan Jeong Song
  Journal of People, Plants, and Environment.2024; 27(4): 247.     CrossRef
• Development and Impact of a Cognitive Reserve Enhancement Program for Climacteric Korean Women
  Ji Hyun KIM, Seungmi PARK
  Journal of Nursing Research.2024; 32(6): e363.     CrossRef
• Health-promoting behaviours and psychological distress in breast cancer with endocrine therapy: Mediating roles of menopausal symptoms and social support
  Xia Li, Tingting Wei, Yan Zhang, Hailing Ren, Xinyu Liu
  Post Reproductive Health.2024; 30(1): 29.     CrossRef
• The relationship between psychological distress, depressive symptoms, emotional eating behaviors and the health-related quality of life of middle-aged korean females: a serial mediation model
  Jihyun Oh, Sunghee Kim
  BMC Nursing.2023;[Epub]     CrossRef
• Evaluating Health-promoting Lifestyle Profile among Menopausal Women: A Meta-analysis
  Zeinab Moshfeghy, Hedyeh Riazi, Sepideh Hajian, Ali Montazeri
  The Open Nursing Journal.2023;[Epub]     CrossRef
• Factors influencing the health-related quality of life in Korean menopausal women: a cross-sectional study based on the theory of unpleasant symptoms
  Ji-Hyun Kang, Moon-Jeong Kim
  Korean Journal of Women Health Nursing.2022; 28(2): 100.     CrossRef
• Mediating effect of a health-promoting lifestyle in the relationship between menopausal symptoms, resilience, and depression in middle-aged women
  Sungwon Park
  Health Care for Women International.2020; 41(9): 967.     CrossRef
• A Structural Model for Chemotherapy Related Cognitive Impairment and Quality of Life in Breast Cancer Patients
  Jung Ran Lee, Pok Ja Oh
  Journal of Korean Academy of Nursing.2019; 49(4): 375.     CrossRef
• Effects of Multidisciplinary Lifestyle Modification Program on Health-promoting Behavior, Psychological Distress, Body Composition and Reproductive Symptoms among Overweight and Obese Middle-aged Women
  Ju-Hee Nho, Eun Suk Hwang
  Korean Journal of Adult Nursing.2019; 31(6): 663.     CrossRef
• Factors Influencing Adaptation to Menopause in Middle-aged Women
  Eun Joo Lee
  Korean Journal of Women Health Nursing.2018; 24(4): 336.     CrossRef

PURPOSE
This study was performed to evaluate the effects of non-pharmacological interventions on sleep disturbance amongst adults aged 55 and above.
METHODS
PubMed, Cochrane Library, EMBASE, CINAHL and several Korean databases were searched. The main search strategy combined terms including non-pharmacological interventions and presence of insomnia. Non-pharmacological interventions included cognitive behavioral therapy, auricular acupuncture, aromatherapy, and emotional freedom techniques. Methodological quality was assessed using Cochrane's Risk of Bias for randomized studies and Risk of Bias Assessment tool for non randomized studies. Data were analyzed by the RevMan 5.3 program of Cochrane Library.
RESULTS
Sixteen clinical trials met the inclusion criteria with a total of 962 participants. Non-pharmacological interventions was conducted for a mean of 5.5 weeks, 7.7 sessions, and an average of 70 minutes per session. The effects of non-pharmacological interventions on sleep quality (ES=-1.18), sleep efficiency (ES=-1.14), sleep onset latency (ES=-0.88), awakening time after sleep onset (ES=-0.87), and sleep belief (ES=-0.71) were significant, and their effect sizes were ranged from moderate to large. However, the effects on total sleep time and insomnia severity were not significant.
CONCLUSION
The findings of the current study suggest that non-pharmacological interventions have a positive impact on attitudes and beliefs about sleep, sleep quality, sleep duration, and sleep efficiency. Therefore, the findings of the study provide an evidence to incorporate various non-pharmacological interventions into nursing practice to improve both sleep quality and quantity in patients with insomnia.

Citations

• Effects of Forest Activities on Sleep and Problematic Behaviors in Young Children
  Ga-Yeon Kim, Poung-Sik Yeon
  Journal of People, Plants, and Environment.2024; 27(2): 161.     CrossRef
• Information and Communication Technology-Based Application for Cognitive Behavioral Therapy among Community-Dwelling Older Adults with Insomnia: Development and Validation Study
  Yeonhee Lee, Inseong Kim, Seonheui Lee, Soyoung Yu
  Healthcare.2024; 12(1): 106.     CrossRef
• Effects of Nonpharmacological Interventions on Sleep Quality and Insomnia in Perimenopausal and Postmenopausal Women: A Meta-Analysis
  Beomman Ha, Jisoon Kim, Wi-Young So, Seonho Kim
  Healthcare.2023; 11(3): 327.     CrossRef
• Effects of Non-Pharmacological Interventions to Improve the Sleep of Korean Elderly: A Systematic Review
  Yunhee Park, Hyun Jung Yun
  Journal of Korean Academy of Fundamentals of Nursing.2022; 29(1): 67.     CrossRef
• The Effects of Non-pharmacological Interventions on Sleep among Older Adults in Korean Long-term Care Facilities: A Systematic Review and Meta-analysis
  Sun Ok Jung, Hyeyoung Kim, Eunju Choi
  Journal of Korean Academy of Community Health Nursing.2022; 33(3): 340.     CrossRef
• Effects of Non-pharmacological Interventions on Cancer Patients with Sleep Disorder: A Meta-analysis
  Jeong Hye Chae, Young Suk Kim, Mi Young Han
  Asian Oncology Nursing.2021; 21(1): 1.     CrossRef
• Factors Affecting Sleep Disturbances in Hospitalized Patients with Colorectal Cancer undergoing Chemotherapy: A Retrospective Study
  Jihyeon Song, Smi Choi-kwon
  Korean Journal of Adult Nursing.2019; 31(1): 100.     CrossRef
• Quality of Sleep and Depression for Patients in Psychiatric Hospitals
  Sukgyoung Jeong, Aeyoung So
  Journal of Korean Academy of Psychiatric and Mental Health Nursing.2017; 26(4): 374.     CrossRef
• Cognitive Behavioral Therapy for Primary Insomnia: A Meta-analysis
  Ji-Hyun Kim, Pok-Ja Oh
  Journal of the Korea Academia-Industrial cooperation Society.2016; 17(9): 407.     CrossRef

PURPOSE
The aim of this study was to investigate the factors contributing to health-related quality of life (HRQOL) among patients with chronic hepatitis B (CHB).
METHODS
A cross-sectional, descriptive design was used. The sample included 114 patients in a gastroenterology outpatient department at one hospital located in G city. Data were collected using a structured questionnaire from June to December 2009. The collected data were analyzed using SPSS/WIN 15.0.
RESULTS
Health-related quality of life was most strongly related to age, sex, income, occupation, and the care provider. Old age, female gender, lower income, not having an occupation and having a non-medical person were associated with lower HRQOL (R2=.03~.22, p=.041~<.001).
CONCLUSION
CHB infection had a negative impact on HRQOL among the older, female gender, low socioeconomic status and not having medically knowledgeable care givers. Interventions beyond nursing care may be needed to improve the quality of health for patients with Chronic Hepatitis B.

Citations

• Factors influencing on health-related quality of life in South Korean with chronic liver disease
  Hyun Jin Kim, Hyeonsik Chu, Seonhye Lee
  Health and Quality of Life Outcomes.2018;[Epub]     CrossRef
• Quality of Life of Chronic Hepatitis C Patients and Its Associated Factors
  Hoo Jeung Cho, Euna Park
  Osong Public Health and Research Perspectives.2017; 8(2): 124.     CrossRef
• Related Factors of Quality of Life in Middle-male with Chronic Liver Disease
  Eun-Su Do, Sun-Mi Lee, Young-Sook Seo
  Journal of Digital Convergence.2015; 13(2): 267.     CrossRef

PURPOSE
This study was aimed to investigate the factors influencing problem drinking of male drinkers above 19 years old according to the life cycle.
METHODS
The study subjects consisted of a representative community sample of 2,229 male drinkers aged 19 and older from the 2011 Korean National Health and Nutrition Examination Survey. The collected data were analyzed using descriptive statistics, Rao-Scott chi2-test, simple and multiple logistic regressions.
RESULTS
The problem drinking rates were 38.7% in adolescence, 44.5% in middle age, and 23.9% in senescence. In adolescence, the predictors of problem drinking included occupation, stress recognition, and smoking. In middle age, the predictors of problem drinking were education level, depression, and smoking. In senescence, the predictors of problem drinking were not identified in this study.
CONCLUSION
The findings of this study suggested that the factors influencing problem drinking of male drinkers were different according to life cycle. Thus different intervention methods should be developed for each age group in order to intervene the problem drinking.

Citations

• Determinants of Problem Drinking by Regional Variation among Adult Males in Single-Person Households: Geographically Weighted Regression Model Analysis
  Junggeun Ahn, Heeseung Choi, Jiu Kim
  Journal of Korean Academy of Nursing.2023; 53(1): 101.     CrossRef
• Classification of Latent Classes and Analysis of Influencing Factors on the Developmental Trajectories of Problem Drinking in Adult Males: Focusing on the Differences across the Life Span
  Junggeun Ahn, Heeseung Choi
  Journal of Korean Academy of psychiatric and Mental Health Nursing.2022; 31(3): 279.     CrossRef
• Recovery of Salinity Gradient Energy with an Inorganic Sodium Superionic Conductor
  Guodong Zhou, Ying Mei, Yuhao Wang, Shenghua Zhou, Md Raziun Bin Mamtaz, Chuyang Y. Tang, Francesco Ciucci
  ACS Energy Letters.2022; 7(5): 1806.     CrossRef
• Differences in problem alcohol drinking by military service type among male professional military personnel in South Korea using Military Health Survey data
  Jeongok Park, Eunyoung Jung, Eunkyoung Bae
  BMJ Open.2021; 11(11): e045279.     CrossRef
• Identifying Latent Classes of Risk Factors for Coronary Artery Disease
  Eunsil Ju, JiSun Choi
  Journal of Korean Academy of Nursing.2017; 47(6): 817.     CrossRef
• A Path Analysis of Factors Influencing Health-related Quality of Life among Male Adults
  Bo-Kyoung Cha
  Journal of Korean Academy of Community Health Nursing.2016; 27(4): 399.     CrossRef
• Alcohol Status and Related Factors of Drinking Problems among Residents at Permanent Rental Apartments
  Youn-Ju Lee, Hee-Kyung Kim, Mihyoung Lee, Jin-Hee Yoo, Sang-Joo Park, Ki-Dong Yeu
  Journal of the Korea Academia-Industrial cooperation Society.2015; 16(2): 1227.     CrossRef
• Factors related to Problem Drinking of Male Workers according to Occupational Classes
  Eun Kyung Lee
  Journal of Digital Convergence.2015; 13(1): 375.     CrossRef

PURPOSE
The purpose of this study was to perform an economic analysis and estimate the fee for the practices that carried out by Emergency Nurse Practitioner (ENP) using relative value scale (RVS) and its conversion factor.
METHODS
First, we developed ENP's RVS for 25 advanced nursing services based on ENP's workload and its time spent by survey. A cost analysis was performed to evaluate the conversion factor of ENP's RVS. The share of ENP's contribution to fee-for-service in emergency setting was also analyzed.
RESULTS
Calculation of the RVS of 25 advanced nursing practices showed a range of points from 73.4 to 296.3 and an average of 145.1 points. The relevant conversion factor for advanced nursing practices among ENP was estimated at 12.2~15.9 won. The contribution rate of ENP's advanced nursing practices in the relative value scale of the national health insurance was estimated at 13.1~17.0%.
CONCLUSION
The practices of ENP are not compensated separately and its reimbursement is usually included in physician fee. An estimation of nursing fee and an independent fee related to ENP's services shows the contribution rate to total revenue. It suggests that emergency nurse practitioners be considered as a revenue source the in emergency room.

PURPOSE
The aim of the study was to identify the effects of education from using cellular phones and a short messaging service.
METHODS
Collected data included baseline demographics, blood pressure, abdominal circumference, total cholesterol, body mass index and health behavior index (Dietary Practice Guidelines Score, Physical Activity, Drinking frequency, Stress score, Subjective health status, and Action change stage score). Data were collected at public health centers in Chungcheongnam-do from January to December, 2011. Data obtained from Individual health counseling Programs in Chungcheongnam-do. Analysis was divided into health risk group and Disease management group, using a paired t test.
RESULTS
Following the education of using short messaging service of cellular phones Health risk group was a reduction in the systolic blood pressure, diastolic blood pressure, waist circumference. Disease management group was a reduction in the systolic blood pressure and body mass index. In both groups, there were improvement in the Health behavior index; dietary practice guidelines score, physical activity, stress score, subjective health status and action change stage scores.
CONCLUSION
These results indicated that education using short messaging service of cellular phone for Community was effective in improving health behaviors and status. By applying the results, development of customized teaching messages for stable settlement is required.

Citations

• Short-term Effects of a Lifestyle Intervention Program on Eating Behaviors, Physical Activity and Cardiovascular Risks in Korean Adults
  Jiyeon Park, Hyekyeong Kim
  Korean Journal of Health Education and Promotion.2014; 31(4): 37.     CrossRef

PURPOSE
This correlation study was designed to examine the relationships among reported violence experience, hardiness, and job satisfaction of nurses in an emergency department and to identify the factors that predict their job satisfaction.
METHODS
The study was conducted using a convenience sample of one hundred and fifteen nurses from nine hospitals. Data were collected using structured questionnaires including Assault Response Questionnaire (Jung, 2008), Dispositional Resilience Scale-15 (Bartone, 1995) and job satisfaction Questionnaire (Yun, 2004). Data were analyzed by using descriptive statistics, Pearson correlation coefficients, and multiple regression.
RESULTS
Hardiness and job satisfaction were statistically significant positive correlation (r=.44, p<.001). Further, there was a negative correlation between response to violence experiences and job satisfaction (r=-.33, p<.001) and between hardiness and response to violence experiences (r=-.41, p<.001). Emotional response and physiological responses of violence experience and hardiness were significant predictors of job satisfaction, and explained 29.6% of the total variance.
CONCLUSION
Previous experiences with violence were an important factor which contribute to lower job satisfaction as reported by emergency department nurses. However it was also noted that hardiness was an important factor that could be used to improve job satisfaction of emergency department nurses.

PURPOSE
The aim of this study was to examine patients with Chronic Hepatitis B (CHB) and their level of knowledge of their disease, uncertainty, stress and health behaviors and to identify factors influencing their health behavior.
METHODS
A cross-sectional, descriptive design was used. The sample included 136 patients in a gastroenterology outpatient department at one hospital located in Seoul. The mean age of the subjects was 41 and 77.2% were male. Data were collected using a structured questionnaire from April to June 2009. The collected data were analyzed using SPSS/WIN 15.0.
RESULTS
The reported scores for knowledge of the disease, uncertainty, stress, and health behaviors were 14.43, 81.50, 26.50, 52.11, respectively. There were statistically difference between health behaviors and gender, age, marital status and antivirus treatment. A positive correlation existed between knowledge of disease and health behaviors (r=.199, p=.020). In contrast, there was a negative correlation between uncertainty and health behaviors (r=-.250, p=.003). The factors influencing health behaviors were knowledge of disease, gender, age, uncertainty, antivirus treatment, and marital status (R2=.267, p<.001).
CONCLUSION
These findings support that strategies for enhancing knowledge of disease and reducing uncertainty are needed to promote health behavior in patients with CHB.

PURPOSE
The purpose of the study was to identify levels of anxiety, stress hormone, lymphocytes, and neutrophils of the nursing students before an examination and to examine effects of social support on those variables related to taking examinations.
METHODS
Thirty eight healthy nursing students participated. They completed the questionnaire including state anxiety, test anxiety (VAS scale) and social support two weeks before the exam and again just before the exam. Simultaneously, a venous sample for ACTH, cortisol, lymphocytes & neutrophils count was drawn by a trained nurse. Descriptive statistics, paired t-test, student t-test, and Pearson's correlation with SPSS/WIN 14.0 were used to analyze the data.
RESULTS
Test anxiety scores and cortisol level on the exam day showed a significant increment compared with those on the non-exam day. The participants with higher levels of total social support scores showed significantly lower state anxiety on the exam day than those with lower levels of total social support scores.
CONCLUSION
These data indicate a possible alteration in cortisol responsiveness to academic stress in nursing students. Social support would play an important role in modulation of academic stress.

PURPOSE
The purpose of this study was to identify symptom clusters in patients with breast cancer and to investigate the associations among them with functional status and quality of life (QOL).
METHODS
A convenient sample of 303 patients was recruited from an oncology-specialized hospital.
RESULTS
Two distinct clusters were identified: A gastrointestinal-fatigue cluster and a pain cluster. Each cluster significantly influenced functional status and QOL. Based on these two clusters, we identified subgroups of symptom clusters using K-means cluster analysis. Three relatively distinct patient subgroups were identified in each cluster: mild, moderate, and severe group. Disease-related factors (i.e., stage, metastasis, type of surgery, current chemotherapy, and anti-hormone therapy) were associated with these subgroups of symptom clusters. There were significant differences in functional status and QOL among the three subgroups. The subgroup of patients who reported high levels of symptom clusters reported poorer functional status and QOL.
CONCLUSION
Clinicians can anticipate that breast cancer patients with advanced stage, metastasis, and who receive mastectomy, and chemotherapy will have more intense gastrointestinal-fatigue or pain symptoms. In order to enhance functional status and QOL for patients with breast cancer, collective management for symptoms in a cluster may be beneficial.

PURPOSE
The purpose of this study was to understand the experiences of interpersonal relationships of head nurses in interacting with others in general hospital settings.
METHODS
The data were collected by individual in-depth interviews from seven head nurses and were analyzed using qualitative content analysis.
RESULTS
Five major categories emerged and they represent a major strategy according to five different groups of interacting people. 'Establishing trust' was identified as the key strategy in dealing with patients and family members. 'Embracing with sisterly love' and 'helping with self-defense' were major strategies for subordinate nurses and physicians, respectively. 'Respecting and recognizing' was the main approach for other professionals such as dietitians and 'emphasizing rules and educating' were a major one for non-professionals. Head nurses paid more attention and made efforts in dealing with their subordinate nurses than with other groups of people, because they felt the most difficulty in their relationship with subordinate nurses.
CONCLUSION
The results of the study showed that head nurses employ unique strategies in interacting with different groups of people to increase the efficiency of communication. This study would help nurse administrators establish an effective program for improving interpersonal relationships of head nurse.

PURPOSE
The purposes of the study were to understand the levels of older adults' perceived stresses in terms of family relationship, physical health, financial difficulty, death of family members, and household environment, and to identify the influences of the stresses on their suicidal ideation.
METHODS
The subjects were 302 older adults residing in Daegu, Korea. The data were collected by questionnaires between March and April 2007.
RESULTS
Older adults perceived the highest level of stress from the death of family members and had high levels of stresses from physical health, family relationships, financial difficulty, and household environment in order. The variables influencing suicidal ideation were stresses from family relationships, physical health, and financial difficulty.
CONCLUSION
Based on the findings, it is recommended that nurses provide in-depth screening of suicide risk for older adults who visit general health care settings through the identification of the levels of stresses in terms of family relationships, physical health, and financial difficulty. It is further suggested to provide collaborative interventions between primary health care providers and psychiatric professionals for suicide prevention and treatment in older adults.

PURPOSE
The purpose of this study was to examine the relationships among knowledge, attitudes, and the use of negative control maintenance techniques toward older adults among nurses working in geriatric hospitals (n=86).
METHODS
Data were collected from April 4th to May 30th in 2006 by using questionnaires of Fact on Aging Quiz Part I, Aging Semantic Differential Scaling, and Control Maintenance Techniques.
RESULTS
The findings showed that the nurses displayed lack of knowledge concerning older adults and their average rate of correct answer was 45.6%. They also hold some negative bias and attitudes, especially in psychological and social aspects. The level of using negative control maintenance techniques in managing older patients' problematic behaviors was reported as the mean of 5.65 with a possible range of 0-40. Nurse's knowledge of older adults was positively associated with their attitudes toward older adults, but their knowledge and attitudes were not associated with the use of negative control maintenance techniques.
CONCLUSION
It is necessary to provide educational programs for nurses that focus on a comprehensive understanding of aging with lifetime developmental perspectives. Further studies are needed to understand the factors associated with using negative control maintenance techniques and to evaluate the intervention programs in reducing the use of negative control maintenance techniques.

PURPOSE
This descriptive study was conducted to identify the use of complementary and alternative therapies, and the perception and attitudes toward CAT in Korean adults.
METHODS
The 1,010 study subjects were recruited from ten regions in South Korea. Data were collected from July to September, 2004.
RESULTS
The 43.2% of the sample(n=436) had an experience of using CAT. The subjects using CAT was more likely to have high score in the CAT perception compared to the subjects with no experience of CAT(p=.001). The primary source of information about CAT was mass media(59.7%). The 52.4% of the sample answered that CAT was supplementary and the 27.7% answered CAT was applicable to chronic pain or musculoskeletal disorders. Subjects(34.8%) pointed out that the greatest problem was no scientific informant in the use of CAT. The primary reason of using CAT was to maintain their health or to prevent disease(44.0%), and the 59.0% of the subjects responded that CAT was effective. Majority of subjects were satisfied with CAT(63.3%) and experienced no side effects of CAT(90.6%).
CONCLUSION
This study suggests that professional counseling and education for CAT is needed for Korean public as well as the research approach to test the effects of CAT.

PURPOSE
The purpose of this study is to examine the factors influencing symptom experience in patients with liver cirrhosis(LC). METHOD: A descriptive correlational study design was used. A convenience sample of 129 subjects was recruited from the gastroenterology department at two university hospitals in Seoul, Korea. Symptom experience in LC was measured with the instrument developed by the researcher based on Theory of Unpleasant Symptoms(Lenz et al, 1995) and the Child-Pugh Score, the Korean version of Profile of Mood States, and the Family Support Questionnaire were used to identify the factors influencing symptom experience. RESULTS: The mean score of symptom experience was relatively low(M=41.67, SD= 24.71). Among individual symptoms, fatigue had the highest score in all dimensions. Fatigue, abdominal distension and/or peripheral edema, muscle cramps, dry mouth, and change in appearance were explored as symptoms needing management. In the regression analysis, symptom experience was found to be influenced significantly by anxiety/depression(R2=.418, p=.000) and the severity of LC(Child-Pugh Score)(R2=.125, p=.000). These variables explained 54.3% of the variance in symptom experience(F=63.607. p=.000). CONCLUSION: It suggests that nurses need to take into consideration psychological factor as well as physiological factor in symptom management for patients with LC.

The purpose of this study was to identify the barrier factors of health behaviors of urban and rural elderly and to compare the health behaviors and level of barriers between two groups, and finally to get the basic informations about the adequate nursing strategies to promote the health state of urban and rural elderly. The subjects of this study were 177 over the age of 65, 81 elderly lived in Seoul and 96 elderly lived in rural areas. The instruments for this study were the health behavior scale(14 items) and the barrier scale (118 items) developed by Gu et al(2003). For the data analysis, SPSS PC program was utilized for descriptive statistics, chi2- test, t-test, Pearson correlation. The results of this study were ; 1. The mean score of health behaviors (range 1-4) was 2.69 in urban elderly and 2.33 in rural elderly ; there was significant difference(t=5.03, P=.00). 2. There were significant differences in levels of barriers(range 1-3) between the two groups, such as calcium intake(t=-3.16, P=.00), regular exercise(t=-3.80, P=.00), exercise time(t=-5.54, P=.00), use of stress reduction method(t=-3.45, P=.00), regular check up(t=-3.89, P=.00), vaccination(t= -3.83, P=.00). Higher levels of barriers were found in rural elderly than in urban elderly.3. Lack of habituation, lack of will power and lack of knowledge in calcium intake; lack of time, lack of habituatuion, lack of family support, lack of will power and lack of environment in exercise; lack of perceived benefit, lack of time, lack of will power and lack of knowledge in use of stress reduction method; lack of time, lack of interest, lack of habituation and lack of will power in disease prevention were significantly higher in rural elderly than in urban elderly.In the conclusion, nursing interventions should be planned based on the social environment of elderly. To promote the health state of elderly, interventions to decrease the barrier levels and to reduce the barrier factors to health behaviors should be implemented.

PURPOSE
This study was conducted to describe qualitatively the entities of nurse's experiences in general hospitals and to suggest basic data guiding research on developing Standards of clinical nursing practice in Korea.
METHOD
Fourteen nurses working at general hospitals with over 300 beds in Seoul were interviewed in-depth until saturation using tape-recorders and transcription.
RESULT
The central theme of clinical nursing practice experienced by subjects was "being with clients" that means accepting client's personal character, solving client's needs and providing client-centered nursing. A also "being with clients" was felt to be the responsibility of nurses which was learned from their nursing schools. The nursing strategies performed in order to be with patients were proving skillful nursing techniques, accepting, educating, emotional support, advocating, and self-reflecting, the subjects experienced somewhat problematic affects such as difficulties in interpersonal relationship, work overload, negative image of nursing, deficit of self-confidence for nursing actions, poor working conditions, and unfair treatment. Nurses at the hospital practiced with pride when they felt that they were accepted by clients.
CONCLUSION
Further research is needed to analysis problems in clinical practice and the comparison of nurses' experiences of clinical practice, with nurses' experiences in various settings.