Purpose
This study was performed to identify factors associated with nursing performance, classify potential profiles of nursing performance-related variables, and explain their effects on nursing performance.
Methods
The study involved 245 nurses at a University Hospital in South Korea from September 1 to 14, 2021. The participants were nurses in a ward who operated within a team and had at least 6 months of clinical experience. Structured questionnaires were used to measure variables, and data were collected online using Google Forms. Using latent profile analysis, the participants were classified into four human resource and job attitude profiles. Linear regression was used to identify relevant factors, and one-way analysis of variance was employed to examine the differences in nursing performance between the four profiles.
Results
Shared leadership (β=.30, p<.001) was most strongly associated with nursing performance, followed by authentic leadership (β=.16, p=.009), and education level (β=.15, p=.006). Significant differences in nursing performance (F=22.48, p<.001) were observed across profiles, with the groups deemed "excellent" and "best" scoring higher in nursing performance and authentic leadership compared to the "fair" and "worst" groups. However, no significant difference in education level was found across the latent profiles (p=.212).
Conclusion
This research examined the impact on nursing performance through variable-centered analysis and a person-centered approach. Accordingly, this study provides valuable insights for interpreting the results of linear regression analysis, highlighting the need to consider individual heterogeneity.

Purpose
This study was conducted to develop a conceptual framework for understanding non-adherence to self-management among patients with Chronic Obstructive Pulmonary Disease (COPD). This was accomplished through a literature review, in-depth interviews with patients, and a survey of healthcare professionals featuring semi-structured open-ended questions.
Methods
First, a systematic literature review was conducted across five databases. Next, 25 patients with COPD participated in detailed interviews that included seven semi-structured questions. Subsequently, 15 healthcare professionals completed a survey about factor categories and specific factors associated with non-adherence to COPD self-management. Categories and factors identified at least once across these three methods were documented. Finally, two researchers conducted preliminary mapping of the relationships between factor categories and individual factors, which was assessed for face validity by a third researcher. All processes were conducted from March 28, 2022, and January 30, 2023.
Results
The research revealed eight factor categories and 53 individual factors associated with non-adherence to COPD self-management. The categories encompassed personal, socioeconomic, disease-related, functional, treatment- related, health system-related, and environmental characteristics. The literature review, patient interviews, and survey of healthcare professionals yielded 35, 19, and 44 factors, respectively. Twelve factors were identified using all three sources. All processes were conducted from March 28, 2022, and January 30, 2023.
Conclusion
In this study, quantitative and qualitative methods were employed to develop a conceptual framework for non-adherence to COPD self-management. The findings indicate that effective self-management of this condition requires not only patient effort but also adaptations to complex treatment regimens, societal perceptions, and workplace environments.

Citations

• Development of a deep learning model to predict smoking status in patients with chronic obstructive pulmonary disease: A secondary analysis of cross-sectional national survey
  Sudarshan Pant, Hyung Jeong Yang, Sehyun Cho, EuiJeong Ryu, Ja Yun Choi
  DIGITAL HEALTH.2025;[Epub]     CrossRef
• Factors Associated with Non-Adherence to Self-Management Among Patients with Chronic Obstructive Pulmonary Disease: A Survey Using the Delphi Technique and Analytic Hierarchy Process
  Ja Yun Choi, Eui Jeong Ryu
  International Journal of Chronic Obstructive Pulmonary Disease.2024; Volume 19: 1247.     CrossRef

Purpose
Cancer survivors face a high risk of developing secondary cancers; thus, they should consider their primary cancer experiences as signals to adopt secondary cancer-preventive behaviors. This study examined the mediating effect of perceived threat in the relationship between cue to action and such behaviors and identified the gender effect as a moderator in breast and colorectal cancer survivors. Methods: A total of 505 cancer survivors (253 with breast cancer and 252 with colorectal cancer) participated in this study. These participants were involved in cancer-related physical activities at the outpatient oncology clinic of a tertiary teaching hospital in Korea. Participants completed structured, self-administered questionnaires, and a PROCESS macro was utilized to analyze the mediating effect of perceived threat. Results: Cue to action positively affected perceived threat (B=0.38, p <.001). Additionally, both cue to action (B=0.20, p=.047) and perceived threat (B=1.28, p<.001) positively influenced secondary cancer-preventive behaviors. In the relationship between cue to action and these behaviors, perceived threat explained 30.0% of the variance. Gender was supported as a moderator in the relationship between cue to action and perceived threat. A bootstrap analysis confirmed the mediating effect of perceived threat. Conclusion: Perceived threat can help cancer survivors understand the risk and seriousness of secondary cancer, thereby strengthening the relationship between cue to action and secondary cancer-preventive behaviors. Healthcare providers should provide accurate information as a cue to cancer survivors, enabling them to recognize the risk of secondary cancer.

Citations

• Factors impacting breast cancer survivors' performance of annual follow-up mammograms: A nationally representative study.
  Safa Elkefi, Alicia K. Matthews
  Patient Education and Counseling.2025; 130: 108428.     CrossRef
• Chinese undergraduates' mental health help-seeking behavior: the health belief model
  Haojing Wang, Zhuowen Feng, Zitong Zheng, Jiachen Yang
  Frontiers in Psychology.2024;[Epub]     CrossRef

Purpose
This study aimed to identify the relationship among post-traumatic stress disorder (PTSD), resilience, and retention intention in nurses who had experienced a traumatic event during hospital work. Methods A structured questionnaire, was administered online from September 10 to September 22, 2021 to 198 nurses who had experienced a traumatic event during work at a university hospital in G metropolitan city. Data were analyzed using three-step mediated regression analysis. Results Of the total participants, 70.7% had a high risk of PTSD. PTSD (β=-.20, p=.002) and resilience (β=.47, p<.001) had a direct effect on retention intention, and the explanatory power was 27.0%. However, the mediating effect of resilience on the relationship between PTSD and retention intention was not supported, which indicates that the relationship between post-traumatic stress and resilience was not significant (β=-.09, p=.232). Conclusion Although there was no mediating effect of resilience, PTSD and resilience are considered to be important in order to improve nurses’ retention intention. It is needed to develop strategies to prevent the occurrence of traumatic events and to formulate policies and conduct programs for stress symptom management, aimed at increasing nurses’ resilience.

Purpose
The purpose of this study was to identify risk factors for nosocomial Vancomycin-Resistant Enterococcus (VRE) infections in patients with hematologic cancer in Korea. Methods A total of 232 patients (77 in the case group and 155 in the control group) from a tertiary teaching hospital participated in this study from January 2011 to December 2017. Data concerning the disease, treatment, and nursing care were collected from electronic medical records using the coding form. Results VRE infections were found to be associated with leukemic-type cancer, longer hospital stays, high-risk antibiotic use, low-risk antibiotic use, oral antifungal agent use within one month of admission, lower serum albumin levels, and dependent self-care. Conclusion The implication of this study’s results is that VRE infections are associated with factors other than VRE colonization, which is known to be the main influencing factor. Considering these factors, it is crucial to develop programs for VRE prevention and management. In particular, oncology nurses should adhere to precaution guidelines when they have contact with patients who are undergoing a prolonged hospital stay, are having difficulties with self-care activities, or are more likely to have depressed immunity because of intensive chemotherapy and nutritional deficiency. Tools to screen risk factors for VRE infections and programs to encourage nurses’ adherence to guidelines need to be evaluated and provided continuously.

Citations

• Effect of Virtual-Reality Simulation of Indwelling Catheterization on Nursing Students’ Skills, Confidence, and Satisfaction
  Soohyun Park, Hyeon Gyeong Yoon
  Clinical Simulation in Nursing.2023; 80: 46.     CrossRef

PURPOSE
Critical care nurses are often exposed to many stressors, which may predispose them to develop work-related Post-Traumatic Stress Disorder (PTSD). Hence, this study's purpose was to identify factors associated with PTSD among nurses in the Intensive Care Unit (ICU), who had experienced trauma events.
METHODS
For this descriptive study, 169 subjects were recruited at the C University Hospital, where data were collected through the intranet from February 1 to March 16, 2018. Based on the stress, appraisal-coping model, well-structured questionnaires were used to measure PTSD as the dependent variable; and Type D personality, resilience, communication ability, problem solving ability, stress coping style, stress inducing events, and social support as independent variables. Multiple logistic regression was used to analyze PTSD related factors.
RESULTS
The mean of PTSD symptoms was 15.52±12.94; with 20.7% and 45.6% of participants falling in the PTSD high risk and Type D personality groups, respectively. Moreover, resilience was found to be 107.41±12.79, traumatic events to be 28.25±7.07, and social support to be 80.22±12.20, while the following parameters were associated with PTSD: D type personality (Odds Ratio [OR]=4.27, 95% Confidence Interval [CI]=1.62~11.21), experience of traumatic events (OR=1.08, 95% CI=1.02~1.15), resilience (OR=0.96, 95% CI=0.92~0.99), and social support (OR=0.96, 95% CI=0.92~0.99).
CONCLUSION
While examining risk factors associated with PTSD, Type D personality and the occurrence of trauma events should be considered when nurses are assigned to ICUs, along with the improvements required in hospital culture for enhancing resilience and social support.

Citations

• Professional quality of life, resilience, posttraumatic stress and leisure activity among intensive care unit nurses
  Noori Shin, Yun‐Jung Choi
  International Nursing Review.2024; 71(1): 94.     CrossRef
• The Moderating Role of Perceived Social Support in the Relation between Type D Personality and PTSD Symptoms among ICU and ER Nurses
  Sohyeon Kim, Myung-Ho Hyun
  STRESS.2023; 31(4): 197.     CrossRef
• Psychopathological Factors Associated With Burnout in Intensive Care Nurses: A Cross-Sectional Study
  Erman Yıldız
  Journal of the American Psychiatric Nurses Association.2023; 29(2): 122.     CrossRef
• Relationship among Post-traumatic Stress Disorder, Resilience, and Retention Intention in Nurses who had Perceived Traumatic Events
  Jin Young Lee, Ja Yun Choi
  Korean Journal of Adult Nursing.2022; 34(4): 403.     CrossRef
• The Impact of Social Supports on the Excessive Alcohol Use of the Middle-Aged Adults in South Korea: Do All Types of Social Supports Have Positive Effects on Excessive Alcohol Users?
  Seong-Jun Maeng, Kwang-Hyun Kim, Jun-Hyeok Kang
  International Journal of Environmental Research and Public Health.2022; 19(19): 12624.     CrossRef
• Post-traumatic Growth and it’s associations with Deliberate Rumination, Self-disclosure, and Social Support among Intensive Care Unit Nurses
  Sae Mi Min, Hee Jun Kim, Chun-Ja Kim, Jeong-Ah Ahn
  Journal of Korean Critical Care Nursing.2022; 15(2): 50.     CrossRef
• Experience of Violence and Factors Influencing Response to Violence Among Emergency Nurses in South Korea: Perspectives on Stress-Coping Theory
  Seung-Yi Choi, Hyunlye Kim, Kwang-Hi Park
  Journal of Emergency Nursing.2022; 48(1): 74.     CrossRef
• The Influence of Traumatic Events on Turnover Intention among Nurses Working in Intensive Care Units: The Moderating Effect of Emotional Intelligence
  Hyunmi Kim, Jiyoung Park
  Journal of Korean Critical Care Nursing.2021; 14(2): 70.     CrossRef
• Predictors of posttraumatic growth of intensive care unit nurses in Korea
  Ae Kyung Chang, Hyejin Yoon, Ji Hyun Jang
  Japan Journal of Nursing Science.2021;[Epub]     CrossRef
• Effect of Expressive Writing on Professional Quality of Life and Resilience among Intensive Care Unit Nurses
  Danbi You, Hye-Ja Park
  Journal of Health Informatics and Statistics.2021; 46(3): 276.     CrossRef

PURPOSE
This study compares the characteristics of patients with Chronic Obstructive Pulmonary Disease (COPD) according to hospitalization frequency due to Acute Exacerbation (AE) using a retrospective medical records review.
METHODS
From August to October 2017, COPD patients who had visited the chonnam national university hospital were classified into three groups: (1) not hospitalization (n=115), (2) hospitalized once owing to AE (n=79) and (3) hospitalized twice or more owing to AE (n=47), and their medical records were reviewed. Data were analyzed using χ2, Kruskal Wallis, and Mann-Whitney tests, and logistic regression.
RESULTS
Home oxygen therapy, metered dose inhaler use, long-acting beta2-agonist, and Inhaled Corticosteroids (ICS) were used most in patients who were hospitalized twice or more. Symptoms of dyspnea and fever, prescription of phosphodiesterase-4 and oral corticosteroid were the least frequent in the patients who were not hospitalized, and they had the best pulmonary function test results. Home oxygen therapy (Odds Ratio [OR]=9.59, 95% Confidence Interval [CI]=2.53~36.46), and prescribed ICS (OR=2.77, 95% CI=1.14~6.77) and phosphodiesterase-4 (OR=5.35, 95% CI=1.69~16.93) were significantly associated with COPD readmission. For patients who were hospitalized once, SpO2 (p=.016), the frequency of positive pressure ventilation therapy (p=.023) and monitoring of oxygen saturation in nursing activities (p=.022) were higher than that of patients who were hospitalized twice or more. There was no significant difference in discharge education between the two hospitalized groups.
CONCLUSION
Regardless of the severity of illness, presence of respiratory symptoms, drug prescribed, or admission frequency, there were no differences in nursing activities and discharge education.

Citations

• COPD Prevalence and Risk Factors in Korean Older Adults
  Do-Youn Lee
  The Journal of Korean Physical Therapy.2025; 37(1): 31.     CrossRef
• Development of a smartphone application for Korean patients with chronic obstructive pulmonary disease: Self-monitoring based action plans
  Ja Yun Choi, Maureen George, So Young Yun
  Applied Nursing Research.2021; 61: 151475.     CrossRef

PURPOSE
This study was conducted to identify factors associated with oncology nurses' adherence to Chemotherapy-Induced Neutropenia (CIN) guidelines based on Pender's Health Promotion Model (HPM).
METHODS
For this cross-sectional descriptive study, 187 nurses who worked at the oncology department of Channam National University Hawsun Hospital responded to self-administered questionnaires. A tool for CIN guideline adherence was developed through systematic search, synthesis, translation, and content validation. Data collection was conducted by a trained research assistant from September 18 to September 26, 2017. Data were analyzed using independent t-test, one-way ANOVA, Pearson's correlation coefficient, and stepwise multiple regression.
RESULTS
Stepwise multiple regression showed that guideline adherence was associated with CIN education (β=.26, p<.001), self-efficacy (β=.17, p=.018), perceived benefits (β=.16, p=.026), interpersonal factors (β=.16, p=.043), and educational level (β=.14, p=.030).
CONCLUSION
The findings of this study could be used to develop interventions focusing on CIN education and for the strengthening oncology nurses' self-efficacy and beliefs to promote adherence to CIN guidelines. In addition, repeated studies would be needed to verify application of Pender's HPM to explain nurses' adherence.

PURPOSE
The purpose of this study was to identify the factors and the relative risk associated with admission of patients with diabetes mellitus (DM).
METHODS
The sample included one hundred twenty-eight patients with type II DM. Seventy-seven patients who were admitted within six months of a hospitalization to one hospital from the first of February to the 31st of August 2014, were compared with fifty-one patients who regularly attended an outpatient clinic and had no hospitalizations.
RESULTS
Hospitalization probabilities among patients who had only diet and exercise or took oral diabetic medication were 0.03 (p=.004) and 0.21 (p=.007) times independently lower than the ones with insulin injection. The risks for hospitalization increases 6.33 times if there is absence of a spouse (p=.027) whereas the presence of a spouse seems to make hospitalization less likely. The risk among the ones having diabetic complications was 5.15 times higher than ones having no recognition of the complications (p=.040). For every one point increase in self-efficacy and every 1 mg/dL increase in high density lipoprotein (HDL) cholesterol, there was a 0.84 (p=.005) and a 0.96 (p=.036) decrease in hospitalization risk, respectively.
CONCLUSION
Nurses should be sensitive to the risk groups of hospital admission among patients with DM including no spouse, insulin injection, diabetic complications, low self-efficacy, and low HDL cholesterol.

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
• Magnitude and predictors of hospital admission, readmission, and length of stay among patients with type 2 diabetes at public hospitals of Eastern Ethiopia: a retrospective cohort study
  Lemma Demissie Regassa, Assefa Tola
  BMC Endocrine Disorders.2021;[Epub]     CrossRef
• Psychological Insulin Resistance and Low Self-efficacy as Barriers to Diabetes Self-care Management in Patients with Type 2 Diabetes
  Bohyun Kim, Youngshin Song, Jong Im Kim
  Korean Journal of Adult Nursing.2019; 31(1): 61.     CrossRef
• Factors Influencing Glycemic Control among Type 2 Diabetes Mellitus Patients: The Sixth Korea National Health and Nutrition Examination Survey (2013~2015)
  Mee Ock Gu
  Korean Journal of Adult Nursing.2019; 31(3): 235.     CrossRef

PURPOSE
The purpose of this study was to test a Winningham's psychobiologic entropy model (PEM) on cancer related fatigue (CRF) among patients with solid tumors.
METHODS
Participants consisted of 213 patients with solid tumors recruited from December, 2012 through June, 2013, in a university hospital, in Hwasun, South Korea. Primary symptoms, adjustment, physical activity, status of nutrition and fatigue were measured using structured questionnaires. Collected data were analyzed using SPSS 21.0 and AMOS 21.0 programs.
RESULTS
The modified model tested provided a reasonable fit to the data (χ2=65.80 [df=30, p<.001], TLI=.92, CFI=.95, RMSEA=.08, SRMR=.07). Primary symptoms (dyspnea, anxiety, depression and insomnia) had direct positive effects on CRF. Adjustment and status of nutrition showed indirect negative effects on CRF. However, the impact of physical activity was not significant. These variables explained 49.2% of the variance of CRF among solid tumor patients.
CONCLUSION
The findings demonstrate that the tested model explain some CRF among solid tumor patients and warrant future research considering the cancer-related clinical factors of the given population.

Citations

• Pre-post analysis of a social capital-based exercise adherence intervention for breast cancer survivors with moderate fatigue: a randomized controlled trial
  Sue Kim, Yun Hee Ko, Yoonkyung Song, Min Jae Kang, Hyojin Lee, Sung Hae Kim, Justin Y. Jeon, Young Up Cho, Gihong Yi, Jeehee Han
  Supportive Care in Cancer.2020; 28(11): 5281.     CrossRef

PURPOSE
Purposes of this study were to develop a reliable and valid checklist to assess and manage post-stroke dysphagia and to identify its utilization.
METHODS
The first step was to develop checklist through systematic literatures reviews, to test the content validity from 11 clinical experts, and to test the construct validity and the internal consistency from 97 patients with post-stroke dysphagia. The second step was to identify clinical use of the checklist from the same 97 patients.
RESULTS
A total of 18 items compromised the assessment checklist and 64 items for intervention checklist. Internal consistencies of assessment checklist and intervention checklist were .84 and .98, respectively. In both checklists, level of utilization of general appearance was the highest, while that of early signs of aspiration was the lowest. The utilization levels of two checklists were significantly higher among patients who were less than 60 years old, and had liquid diet, facial paralysis, and previous history of aspiration pneumonia.
CONCLUSION
We found that the checklists were reliable and valid. Further study is needed to develop specific strategies to improve nurses' use of assessment and intervention checklists for post-stroke dysphagia.

PURPOSE
The objective of this study was to examine the relationships between nurses' knowledge and performance for the prevention of intravascular catheter-related infections (ICRI) according to the strength of recommendations in evidence based guidelines (EBG).
METHODS
The total participants were 144 nurses working for medical.surgical unit and intensive care unit. Data were collected from July 12 to July 30, 2010 and analyzed by one way ANOVA and Pearson's correlation analysis.
RESULTS
The knowledge and performance mean scores were 0.80+/-0.17 and 3.04+/-0.31 for peripheral venous catheter (PVC) management, and 0.83+/-0.17 and 3.00+/-0.30 for central venous catheter (CVC) management respectively. The items of category IA had the highest knowledge score (F=44.70, p<.001) and the items of category II had the highest performance score (F=47.09, p<.001) in PVC management, while the items of category IA had the highest knowledge (F=20.04, p<.001) and performance scores (F=18.20, p<.001) in CVC management. Knowledge and performance scores were significantly correlated in CVC management (r=.24, p=.004), but not in PVC management (r=.03, p=.753).
CONCLUSION
EBG for the prevention of ICRI was not fully implemented in clinical settings. These findings emphasize that clinical professions need to develope strategies to enhance nursing practices with evidence based guideline.

PURPOSE
The aim of this study was to assess knowledge, attitude, correct metered dose inhaler (MDI) use and compliance with self management among patients with chronic obstructive pulmonary disease (COPD).
METHODS
The participants of this study consisted of 109 COPD patients who were outpatients in C and K hospital located in G city from March 1 to September 30th, 2010. Data were measured using self-administered questionnaires and observational checklist. The data were analyzed using SPSS/WIN 18.0 program that included mean, standard deviation, ANOVA, Sheffe test, and Pearson's correlation.
RESULTS
There were significant relationships between knowledge and attitude (r=.33, p<.001), between knowledge and correct MDI use (r=.37, p<.001), and between knowledge and self-management compliance (r=.28, p=.003). There was significant relationship between attitude and self-management compliance (r=.33. p<.001). In contrast, attitude was not significantly related to correct MDI use.
CONCLUSION
The study showed that COPD knowledge and attitude of patients were related compliance in managing their disease. Therefore, strategies need to be utilized in education programs which would improve knowledge and subsequently improve attitude and compliance.

PURPOSE
The aims of this study were to examine the trend of quantitative study in Korean Journal of Adult Nursing published between 1989-2011 and to provide future directions for nursing research in adult health nursing.
METHODS
A total of 883 published articles were reviewed, and main subject and the methodology were analyzed using descriptive statistics.
RESULTS
The most frequently cited keywords were elderly, quality of life, depression, knowledge, stress and anxiety. The survey study was the most popular research design (67.6%) followed by experimental (26.5%), and methodological study (5.5%) design. Over 80% of studies with translated or developed instruments reported reliability for psychometric analysis, while only 18% of the studies reported validity of the instruments they used. In the periods of 2006~2011, significantly more studies utilized experimental design, obtained IRB approval and written consent, and included power analysis for sample size calculation. In recent experimental study, educational program and complimentary therapy were the two most frequently used interventions.
CONCLUSION
Through the analysis of nursing studies published in Korean Journal of Adult Nursing, we found the number of experimental studies has increased and methodological rigor has improved in recent years.

PURPOSE
The purposes of this study were to identify the factors associated with the first reported fracture in osteoporotic patients.
METHODS
One hundred and sixty-four patients who presented with osteoporosis at K hospital in G city, South Korea between July and September 2010 were participated in study. Modified Korea National Health and Nutrition Examination Survey tool were used to measure participants' living habits. Computer aided nutritional analysis program (CAN-PRO) designed by Nutrition Information Center in the Korean Nutrition Society (2002) was used to analyze foods intake and to calculate the individual nutrients intake.
RESULTS
The risk of developing the first osteoporotic fracture was ten times higher in the patients between 65 to 74 years (OR=10.06, p=.010), and 28.41 times greater in those with increasing falls (OR=28.41, p<.001). Patients with higher bone marrow density (BMD) and higher consumption of animal protein diet had lower risks of developing the first osteoporotic fracture (OR=0.37, p=.011; OR=0.88, p=.040, respectively).
CONCLUSION
Risk factors for osteoporotic fracture included the age from 65 to 74 years, an increase in falls, low animal protein consumption, and reduced BMD. Systematic educational program is needed to prevent fracture in osteoporotic patients.

PURPOSE
This study was conducted to develop Web-based multimedia contents for supporting student nurses' clinical practice on critical care, and to evaluate learners' responses.
METHODS
Based on the steps of Assessment, Design, Development, Implementation, & Evaluation(ADDIE) model, a total of 13 self-directed learning modules including live lectures and real video clips were developed through faculty collaboration of nine nursing colleges in Gwangju and Chonnam province. The finally developed multimedia contents were published on the Web of the learning management system at a local e-learning center.
RESULTS
The Web contents were evaluated after self-learning by 81 junior college nursing students who were encouraged to study it at their own pace during their two-week clinical practice at a medical or surgical intensive care unit of a university hospital and two hospitals. The knowledge (t = -27.66, p < .001) and self-evaluated clinical performance level(t = 7.54, p < .001) were significantly increased after learning of the Web contents and clinical practice, and satisfaction level that measured post-test only was 4.0 out of 5 point.
CONCLUSION
The use of Web contents for critical care need to be extended as a complimentary material in a class room lecture or clinical practice of students to increase their self-learning ability and understandings of clinical knowledge and situation.

PURPOSE
S: The purpose of this study was to evaluate the extent of performance on activities in critical pathway (CP) according to eight domains and six admission days on nursing records of patients who received total hip replacement surgery.
METHODS
We reviewed 90 nursing records of patients who received total hip replacement surgery from June, 2004 to July, 2005 at C University Hospital. Data were collected using Hong's CP (2002) and were analyzed using ANOVA.
RESULTS
The domain of diet was valued the highest in CP performance scoring, followed by the domains of assessment, activities, and test. There were differences in the performance scores according to the period of admission in all of the domains. Among 132 activities in the CP, 18 activities were completely performed, of which most included activities belonging to the domain of assessment on the admission day. Twelve activities were never performed, of which most included activities belonging to the domain of treatment on the day of operation and the first day after operation.
CONCLUSIONS
Therefore, further studies on the development of a new system to increase CP utilization and on updating the contents of CP from the best practice based on evidence is recommended.

PURPOSE
The purpose of this study was to describe the pattern of changes on the score of nausea/vomiting and anxiety during one cycle of chemotherapy. METHOD: A total of 53 subjects who were admitted to C University Hospital for a period of 3 days and 2 nights for chemotherapy were selected from February to April, 2003. Total scores of nausea/vomiting were measured twice a day 3 days for a total of 6 measurements. Anxiety, anorexia, and fatigue were also measured at the first and last measurement points. Data were analyzed by one-way repeated measures, ANOVA, t-test, paired t-test, & Pearson's correlation. RESULT: The score of nausea/vomiting increased over time except for the 4th measurement point but no changes were significant over time. There were the significant differences between 1st and 2nd, and 2nd and 3rd nausea/vomiting score at p < 0.05. The scores of anxiety, anorexia, and fatigue between the first and 6th points were significantly different(t=-5.69, p=.001; t=6.25, p=.0001; t=3.65, p=.0007). CONCLUSION: Further studies are needed to identify the relationship between anxiety, and anticipatory and acute nausea/vomiting respectively.

PURPOSE
The purposes of this study were to develope and evaluate a constipation intervention program for inpatients. METHOD: To develope this program, Six phases were processed including the organization of team, the analysis of medical chart, the development of tentative constipation intervention program, the test of content validity, the test of clinical validity and the determination of final constipation intervention program. To evaluate the clinical validity of this program, 10 subjects who were in the C University Hospital were selected from March, 2001 to October, 2001. RESULT: The clinical validity was supplied by the pilot test, showing the potential effect of the program. Based on the validity results the final algorithm and the form of nursing record for this program which consist of the 3-step assessments and the intervention protocol were presented in this study. CONCLUSION: The advantage of this program is being able to assess and manage constipation simultaneously and is especially effective to patients who are at risk for developing constipation during their admission. Further study needs are also necessary to evaluate the effect of this program on the self-symptom of constipation.

PURPOSE
Purposes of this study were to understand the current trends on complementary therapy in relieving chemotherapy-induced nausea and vomiting and to suggest the future research direction.
METHOD
Subjects were selected on CINAHL, MEDLINE, Korean Academy Data Base from 1980 to 2001 which used nausea, vomiting, chemotherapy and complementary therapy as key words in experimental studies. Eight korean articles and twenty-one international articles were analyzed in terms of general characteristics, research methods, and types of complementary therapy. Data were analyzed by using descriptive statistical methods.
RESULT
Since 2000, researchers have more actively used complementary therapy. In subject characteristics, mean age was 35.5 years old, 45% of the researchers were performed with high level of incidence of chemotherapy induced vomiting, 14% of them set limit of consecutive cycle during research, and 65% of them did not comment the selecting criteria of sample. About 60% of them were designed post-test only control group; 35% used INV by Rhodes, 31% used Likert scale, and 24% used VAS for dependent variable. Muscle relaxation therapy was mostly applied for relief of nausea and vomiting.
CONCLUSION
Further studies will be needed to control extrinsic variables affecting nausea and vomiting in research design and to accumulate evidence with studies applying various complementary therapies.

PUPPOSE: The purpose of this study is to determine the level of pain related to a blood sugar test. Specifically, the study attempts to compare the varying degree of pains when different types of blood sugar test are used.
METHOD
A sample of 56 subjects is composed of DM patients admitted to a medical ward of C university hospital in Gwangju. Data were collected from July, 2001 to December, 2001. The blood sugar tests were administered in four different ways: (1) the use of 27G needle only, (2) the use of 27G needle followed by ice-packed treatment, (3) the use of 27G needle after EMLA cream application, and (4) the use of lancet. The degree of pain is measured with a visual analogue scale and performed twice.
RESULT
In both measures, the use of 27G needle only method is shown to cause the highest level of pain in comparison with the rest of methods (F=4.01, p=.01; F=8.14, p=.00). However, the differences in pain between time in all methods were not found to be significant (t=-.85, p=.40; t=.80, p=.42; t=.31, p=.75; t=.19, p=.85).
CONCLUSION
The study results indicate that the method using lanceter is more recommendable than the use of 27G needle only method. Further research is needed to support the current study result with the use of different measurement scales and to determine effective methods of blood sugar test to lower pain and compliance.