Relationship between Psychosocial Factors and Symptom Experience in Patients with Cardiovascular Disease: Over a Six-month Follow-up Period / 기본간호학회지

PURPOSE: The purpose of this study was to identify the relationship between psychosocial factors and symptom experience of patients with cardiovascular disease over a 6-month follow-up period. METHOD: Baseline data for each of the 138 patients were collected. Eighteen patients were dropped for a final total of 120 patients in the present study. To monitor patients' symptom experience after discharge, each patient was interviewed by telephone, and interviewed directly with a questionnaire at each clinic visit. RESULTS: Mean scores for hostility, anger, anxiety, and depression were 51.63, 22.87, 48.95, and 41.21, respectively. Mean scores for the level of symptom experience at discharge, 3 months and 6 months after discharge were 32.83, 24.79, and 26.70, respectively. There were significant differences in the level of hostility by gender, BMI, job, and monthly income. Also the differences in the level of anxiety and depression were statistically significant according to gender and existence of spouse. In the regression analysis, depression was identified as the significant factor associated with symptom experience at discharge, 3 months, and 6 months after discharge. CONCLUSION: This study presented baseline data to elucidate whether psychosocial factors were associated with the progression of cardiovascular diseases. Accordingly, it suggests that nurses need to take into consideration psychosocial factor as well as physiological factor in symptom management for patients with cardiovascular disease.

Factors Influencing Functional Status in Patients with Heart Failure / 간호학회지

PURPOSE: The purpose of this study was to identify the factors that influence the functional status of patients with heart failure. METHOD: A descriptive, correlational study design was used. The participants in this study were 260 patients with heart failure who were admitted at Y University and U University in Seoul, Korea. Between September 2005 and December 2005 data was collected by an interview using a questionnaire and from medical records. The Functional status was measured with KASI. Physical factors (dyspnea, ankle edema, chest pain, fatigue, and sleep dysfunction), psychological factors (anxiety and depression), and situational factors (self-management compliance and family support) were examined. RESULT: In general, the functional status, anxiety, depression, self-management compliance, and family support was relatively not good. The level of fatigue was highest and the level of ankle edema was lowest for physical symptom experiences. In regression analysis, functional status was significantly influenced by dyspnea(23%), age(13%), monthly income(7%), fatigue(3%), ankle edema(2%), depression(1%), and length of stay in the hospital(1%). These factors explained 50% of the variables in the functional status. CONCLUSION: These results suggest that psycho-physiological symptoms management should be a focus to improve the functional status in patients with heart failure.

Development of Standards and Criteria for Accreditation of a Baccalaureate Nursing Education Program: Reflections on the Unique Characteristics of the Nursing Profession / 간호학회지

PURPOSE: The purpose of this study was to determine characteristics of nursing science and identify expected outcomes from baccalaureate graduates, and to develop accreditation standards and criteria reflecting the characteristics of the nursing profession. METHODS: A methodological research design was utilized in this study. Related literature reviews and the nursing education program goals and objectives of the 99 nursing schools in Korea were analyzed. A cross-sectional survey research design was utilized to test the validity of the developed characteristics of the nursing profession and their accreditation criteria and standards. The face validity was from the advisory committee and public committee hearing. RESULTS: The characteristics of nursing science were defined with five concepts including humanity, scientific knowledge, professionalism, therapeutic relationship, and facilitating well-being. The expected outcomes from graduates were identified as providing holistic nursing, critical thinking, establishing professionalism and leadership, construction of a therapeutic relationship, and skilled nursing practice. Finally6 standards and 14 criteria reflecting the unique characteristics of the nursing profession were developed for accreditation. These proposed accreditation standards and criteria are a challenge to promote the quality of nursing science.

Attitude, Beliefs, and Intentions to Care for SARS Patients among Korean Clinical Nurses: An Application of Theory of Planned Behavior / 간호학회지

PURPOSE: This study examined Korean clinical nurses' intentions to care for SARS patients and identify determinants of the intentions. Theory of planned behavior was the framework to explain the intentions of Korean nurses for SARS patients care. METHODS: A convenient sample of six hundreds and seventy nine clinical nurses from four university-affiliated hospitals located in Seoul and in Kyung-gi province was used. Self-administered (83-items) questionnaire was used to collect data. Intentions, attitude, subjective norm, perceive behavioral control, behavioral beliefs, normative beliefs, and control beliefs were the study variables. All items were measured using 7-point Likert scale (-3 to +3). Data were analyzed using descriptive statistics, Pearson correlation method, and stepwise multiple regression methods. RESULTS: Intentions and attitudes toward SARS patient care among Korean clinical nurses were moderate, but their subjective norm and perceive behavioral control of SARS patients care were negative. Stepwise multiple regression analysis indicated that attitude toward SARS patient care, perceived behavioral control, subjective norm were the determinants of the intentions for SARS patients care as theory proposed. Among the behavioral beliefs, "SARS-patient caring would be a new experience", "during SARS-patient caring, I should be apart from my family", "after completing SARS-patient caring, I would be proud of myself being able to cope with a stressful event" and "with my SARS-patient caring, patients could recover from SARS" were the significant determinants. Among the normative beliefs, colleague approval, spouse approval, and physician approval were significant determinants of the intentions. Among the control beliefs, "SARS-patient caring would be a challenge" "SARS-patient caring is a professional responsibility", "tension during the care of SARS patients" and "support from team members" were the significant determinants of the intentions. CONCLUSIONS: Korean clinical nurses in this study were not willing to care for SARS patients and showed negative attitude toward the care. They believed their friends and family were not approved their care for SARS patients. Nurses were in conflicts between professional responsibilities to care for SARS patients and personal safety. This study was the first to understand stress and burden of Korean clinical nurses who are in front line to care for newly developed communicable disease such as SARS. Under the circumstance where several fatal communicable diseases are predictable, conflicts between professional responsibility and their personal risks should be taken into considerations by nurses themselves and by nursing administrators in order to improve quality of care.

The Effects of Psychosocial Interventions to Improve Stress and Coping in Patients with Breast Cancer / 간호학회지

PURPOSE: The purpose of this study was to examine stress, coping, and immune response effects of a psychosocial intervention program based on the PNI model and Stress-Appraisal-Coping for Korean patients with breast cancer. METHODS: A nonequivalent control group pretest-posttest design was used. The participants who had survived breast cancer and lived in Wonju city and the surrounding area were assigned to an intervention group (N=21) or a control group(N=18).We conducted a 12-week intervention, 2 hours a day weekly, and measured the variables at baseline, six and twelve weeks later. Dependent variables are: stress, anxiety-depression and anger, and immune response. RESULTS: Patients in the psychosocial intervention program reported significantly less stress perception (U=31.500, p=.023), more problem solving ability and less problem avoidance in coping (U=20.500, p= .013; U=29.500, p=.040), and less anxiety-depression (U=22.000, p=.023). No difference, however, was found in anger and immune responses between the two groups. Intervention effects were evident at week 6 and 12 for anxiety-depression, and at week 6 for problem avoidance in coping, the same time that NK cell counts and the T8 decreased. CONCLUSIONS: These results suggested positive effects of a psychosocial intervention program. However, the results are inconclusive due to the small sample.

Effects of Psychosocial Stress Management on Stress and Coping in Student Nurses / 성인간호학회지

PURPOSE: The purpose was to examine the effectiveness of a psychosocial stress management program on stress and coping in student nurses. METHOD: A nonequivalent control group pre-posttest design was used. A convenience sample of 24 students from the Department of Nursing, Wonju College of Medicine, Yonsei University were assigned to experimental (n=12) and control groups (n=12). Stress was measured using the Visual Analog Scale (10 points) and blood cortisol. Coping was measured using a scale modified by So (1995) based on the Ways of Coping Checklist developed by Folkman and Lazarus (1985). Depression was measured using the CES-D by Radloff (1977) and state anxiety, using the State Anxiety Inventory by Spielberger (1976). The psychosocial stress management program included education, relaxation (Korean Dan Jeon-typed Breathing and music), and social support. RESULTS: Results showed for the two groups, 1) a significant difference in stress scores (U= 19.50, p=0.002), 2) no difference in cortisol levels (8am, 4pm), 3) a significant difference in problem-focused coping (U=25.50, p=0.007), 4) no difference in emotion-focused coping, and 5) no difference in state anxiety and depression. CONCLUSION: By utilizing the program, students were able to learn how to control their stress and improve their coping. Therefore with a partial modification, psychosocial stress management can be useful for continual management of stress in student nurses.

Effects of Psychosocial Stress Management on Stress and Coping in Student Nurses / 성인간호학회지

PURPOSE: The purpose was to examine the effectiveness of a psychosocial stress management program on stress and coping in student nurses. METHOD: A nonequivalent control group pre-posttest design was used. A convenience sample of 24 students from the Department of Nursing, Wonju College of Medicine, Yonsei University were assigned to experimental (n=12) and control groups (n=12). Stress was measured using the Visual Analog Scale (10 points) and blood cortisol. Coping was measured using a scale modified by So (1995) based on the Ways of Coping Checklist developed by Folkman and Lazarus (1985). Depression was measured using the CES-D by Radloff (1977) and state anxiety, using the State Anxiety Inventory by Spielberger (1976). The psychosocial stress management program included education, relaxation (Korean Dan Jeon-typed Breathing and music), and social support. RESULTS: Results showed for the two groups, 1) a significant difference in stress scores (U= 19.50, p=0.002), 2) no difference in cortisol levels (8am, 4pm), 3) a significant difference in problem-focused coping (U=25.50, p=0.007), 4) no difference in emotion-focused coping, and 5) no difference in state anxiety and depression. CONCLUSION: By utilizing the program, students were able to learn how to control their stress and improve their coping. Therefore with a partial modification, psychosocial stress management can be useful for continual management of stress in student nurses.

Developing and Testing the Effects of a Psychosocial Intervention on Stress Response and Coping in Korean Breast Cancer Survivors: A Pilot Study / 간호학회지

PURPOSE: The purpose of this study was to develop a socioculturally-appropriate psychosocial intervention program for Korean patients with breast cancer and test its effects on stress, anxiety, depression, and coping strategies. METHODS: One group pretest and posttest design was used to test the effects of the intervention. A post-intervention interview was conducted to refine the nature of the intervention. A convenience sample of 10 breast cancer survivors was recruited from the outpatients clinics. Psychosocial intervention was developed to provide the health education, stress management, coping skill training and support weekly(90min) for 6 weeks. RESULTS: There was a significant decrease in stress scores following the intervention(Z= -2.388, p=0.017). However, no significant changes were noted in the use of problem-focused and emotion-focused coping strategies, nor in the changes of anxiety and depression levels. Content analysis of interview data revealed six clusters; changes in perception, changes in problem solving approaches, changes in anger management, changes in life pattern, social support and reduction of perceived stress. CONCLUSIONS: Based on quantitative and qualitative data, we recommend the refinements of the intervention in the following areas for future studies: 1) duration, activities, and progression of psychosocial intervention; 2) research design and sample size; and 3) measurements.

Self-efficacy and Compliance in Patients with Chronic Heart Failure: The Effect of a Self-management Program using Decision Tree / 성인간호학회지

PURPOSE: The purpose of this study was to identify effects of a self-management program on self-efficacy and compliance in patients with CHF. Hypothesis: 1) Patients with CHF who are provided with a self-management program will show higher self-efficacy scores than a control group. 2) Patients who are provided with a self-management program will show higher compliance scores than a control group. METHOD: This study was designed as a nonequivalent non-synchronized pre-posttest control group. There were eight patients in the experimental group, and twelve in the control group. According to NYHA classification, all patients belonged under the classesl to lV. Data were collected using the instruments developed by the researchers. Data were analyzed using descriptive statistics and Mann Whitney U test. RESULT: There were significant differences in self-efficacy scores and compliance scores between the experimental and control group. CONCLUSION: By utilizing the program, patients were able to monitor their symptoms routinely, comply with therapeutic regimen, and feel better able to positively influence their disease. Therefore, better compliance means fewer readmissions of patients with CHF.

Priorities of Nursing Research Areas in Korea / 간호학회지

PURPOSE: This study was to identify priority areas of nursing research in Korea. METHOD: A data analysis was done for the PhD subjects (n=133) who responded at the national level two-rounds delphi survey. Subjects were asked to assign a score from 1 to 7 for 29 nursing research areas regarding 3 aspects: the degree of nurses research leadership; the degree of contribution to nursing professions; and the degree of contribution to health and welfare of patients/clients. RESULT: For the overall three aspects, research area on clinical nursing practice was identified as the first priority, followed by nursing education, home health nursing, nursing research, and chronic disease. For nursing research leadership, research area on clinical nursing practice, nursing education, home health nursing, nursing research, and nursing diagnosis were identified. Concerning contribution to the nursing profession, the first priority was nursing education, followed by clinical nursing practice, nursing research, nursing policy, and home health nursing. Concerning contribution to the health/welfare of patients, clinical nursing practice, home health care, geriatric nursing, chronic disease, and symptom management were ranked as top 5 research priorities. CONCLUSION: The findings of this national survey will assist in building insights into the research needs of nurses practicing in Korea.

Survey on the Health Information Need of the Community Health Practitioners / 대한의료정보학회지

This research was initiated as a preliminary work-up of information system development for primary health care delivery by community health practitioners in rural areas in Korea. The study was focused on the necessary information for enhancing the works of the community health practitioners and that required for health promotion and maintenance within the community. The data were obtained by a questionnaire survey from 458 community health practitioners who participated in computer related education from June 25th to September 26th, 2001. Only 288 (62.9%) of 458 responses were selected for evaluation due to incomplete returns. The majority(76.8%) of participants was using computer once a day at the healthcare centers and the duration of computer usage was more than one year in most cases. The primary usage of computer was for making documents, sending and receiving e-mails, and searching information on the internet. On the contrary, other skills and functions as data management, statistics, web development, games, program development, e-business, and searching for books and articles were not as readily utilized. The essential information for enhancing the performance of the community health practitioners appeared to be that related to drugs and diseases primarily. Other items for respondents in the decreasing order of importance were minimizing manual paper-works, computerized business, computer education, and media development and materials for health education, respectively. The overall information need of respondents was the highest on health and disease, and that on others such as health education, health promotion, elderly care, and fitness exercises were high also. In summary, the community health practitioners should have applicable information system to enhance their performance by obtaining necessary health maintenance and promotion information; by networking available resources; and by enabling them to adapt to rapidly changing policies and work environment. The outcome of this study may provide information elements necessary in development of Health Information Systems for community health practitioners.

Evaluation of Government Assisted Visiting Nursing Services of Health Center in 2000 / 간호학회지

PURPOSE: This study is a fact-finding research to understand the status of visiting nursing services operated by health centers in Korea and it aims to provide basic information for policy development on operation and management of visiting nursing services in health centers. METHOD: This study investigates the results of visiting nursing services in 242 health centers from Jan. 10 through Dec. 30, 2000, where 3,106 visiting nurses were employed by the public work program. RESULT: In 2000, 129,401 new household as service recipients was identified and that was 0.9% of Koreas total households (15,137,000), and 5.8% of low income households (2,242,000). The highest high risk group was dementia patients(aver. 55.2/1,000 person). Average number of households visited by visiting nurse were 4.5 households per day and the first-visited houses per visiting nurse were 1.1 households per day. The re-visiting rate was 71.3%. Total 4,059,130 service items were provided and assessment ranked the highest with 33.7%. The satisfaction level of clients on the nurses was an average of 3.17 points in the scale of 4 and the nursing service was a 2.60 points in a scale of 3. CONCLUSION: Visiting nursing service should continue to provide comprehensive healthcare services in cost-effective ways while cooperating with others.

Nurse's Adoption on a Planned Organizational Change / 간호학회지

With the dynamically changing environment of society, managing change is the vital element of organizations's survival and growth. Health care organizations have expended enormous resources to restructure patient care delivery. Despite the growing literature describing these organizational innovations, there is a paucity of credible data that reflects systematic measurement and evaluation of such changes. This study examined the nurses' psychological response toward the work process redesign, newly introduced by the nursing department in a acute care hospital. The aim of the study was to figure out how nurses's general perception of change and perceived attributes of change affected their acceptance of change during the organizational transition. This was descriptive-correlational. The sample for the study included 50 head nurses and 135 staff nurses. Data was analyzed using SPSS PC+, version 10.0. The major findings of the study were as follows: First, the mean score of the perception of change was 71.2 (SD=13.8) with the range of 0-100, which means nurses generally perceived change positively. There were significant differences in perception of change by gender and education level. Head nurses perceived change more positively than staff nurses. The higher education level showed the more positive view of change. Second, among the perceived attributes of change, trialability had the highest mean score, which means nurses perceived the change more positively if it is testable on a limited basis. Relative advantage was perceived the most negatively. Finally, factors influencing the acceptability of the work-process redesign were perceived comparability, complexity, relative advantage, and observability, which accounted for 43.7% of the variance in the acceptability of change.This study evaluated the preliminary effects of the nursing process for reengineering, focusing on nurses' acceptability towards change. The usefulness of this research study was to determine the factors influencing acceptance of organizational members during transitional periods of change and to suggest effective strategies for increasing adoption as well as for decreasing resistance to change.

Factors Influencing Functional Status in People with Chronic Lung Disease / 간호학회지

PURPOSE: The purpose of this study was to identify factors that influence the functional status of chronic lung disease patients. METHOD: A descriptive, correlational study design was used. The study was conducted at the outpatient respiratory clinic of the large university hospital in Korea. A convenience sample of 128 chronic lung patients (age = 64.2 yrs; 106 COPD, 17 bronchiectasis, 5 DILD) with mean FEV1 64.4 % predicted. Functional status was measured with SIP. Physical variables (FEV1% predicted, dyspnea, fatigue, pulmonary symptom distress), psychological variables (mood, stress), and situational variable (sleep quality) were examined. Dyspnea was measured by the BDI, fatigue was measured with the MFI. Mood was measured with the modified Korean version of POMS. Sleep quality was measured with the Pittsburgh Sleep Quality Index. Potential independent variables for the regression were age, gender, years since diagnosis, FEV1% predicted, dyspnea, fatigue, pulmonary symptom distress, stress, and sleep quality. RESULT: In general, functional status was relatively good. In regression analysis, functional status were significantly influenced by dyspnea, mood, age and fatigue. These variables explained 70 % of the variances in functional status. CONCLUSION: The results suggest that psychophysiologic symptom management should be a focus to enhance the functional status in this group.

Development of a Home Health Care Nursing Intervention List through Analysis of Home Health Care Nursing Records / 기본간호학회지

The purpose of this study was to identify nursing diagnoses and nursing interventions that are found in the home health care patients, and to establish a basis for a standardized Nursing Intervention List that would help nurses doing home health care nursing. For this study, the records of 150 home health care clients who were discharged, from the Home Health Care Center at Yonsei Medical Center, between January to July, 2001 were analyzed. Of the 43 nursing diagnoses recorded for these clients are 43, the most frequent diagnoses were in the area of Exchanging. There were 2,814 nursing interventions which is a mean of 4.73 nursing interventions per diagnosis. We confirmed that most of the interventions were related to 'education' and 'advice'. We present a Home Health Care Nursing Intervention List that was developed based on the results of this study. It has the five 5 criteria of the ICNP classification, Observing, Management, Performance, Caring, and Informing.

Development of Standardized Nursing Diagnosis/Intervention Protocol for Nutritional and Eliminative problems / 성인간호학회지

The purpose of this study was to develop a standardized Nursing Diagnosis/ Intervention Protocol through a literature review and validity testing. Seven nursing diagnoses were selected as major nursing diagnosis in the field of Nutritional and Eliminative problem. The nursing intervention list was made by an expert group's review of Nursing Intervention Classification(NIC) suggested nursing interventions. Nursing activities which were included in each nursing intervention were sorted to follow the nursing intervention process after review and revision. The expert group's validity testing was done twice using the Likert scale. As a result the Nursing Diagnosis/ Intervention Protocol for Nutritional and Eliminative Problems was made to include 7 Nursing Diagnoses, 51 Nursing Interventions and 631 Nursing Activities.

Contents Development of Nursing Information Network / 대한의료정보학회지

There is no nursing information network related to nursing research, clinical test, drug, and law, although primary responsibility is on nurses about medication, and clinical laboratory test such as blood sampling. Majorities of education for nurses on medication and clinical laboratory test are not systematic, and education on medical law that can be protect nurses' right is very limited. Therefore, information exchange and communication among clinical nurses is required to expand nursing knowledge and professionalism. This study was conducted to develop nursing information contents on nursing research trend, drug, clinical test, nursing law, and medical atlas. Those can fulfil the nurses' informational needs. As a result of contents development, nursing information site was constructed that can offer all nursing related informations using direct link services. In this site, nurses can integrate informations on nursing research, nursing education, and nursing practice systematically with diversity.

The Situational, Clinical and Psychosocial Factors Related to Treatment-Seeking Behavior Among Those with Acute Myocardial Infarction / 성인간호학회지

The purpose of this study was to determine the impact of situational, clinical and psychsoical factors on treatment-seeking behavior among those with acute myocardial infarction(AMI). This study used a retrospective, descriptive design. The sample consisted of 72 patients aged over 30 and who were diagnosed with an acute myocardial infarction at two large university-affiliated medical centers from July 1, 1998 to March 30, 2000. But of 72, patients 5 who were an outlier in treatment-seeking time were deleted. Data were collected by using questionnaires, which included demographic data, situational, clinical and psychosocial data. Also patient interviews and chart review were used to obtain information related to treatment-seeking time. The results of this study were summarized as follows; 1. Mean time from the onset of AMI symptoms to arrival at the hospital was 12.09 +/- 11.44 hours; 2. Treatment-seeking time was not significantly different by age, gender, or education; 3. Most(44 or 65.78%) patients were at home when they began having AMI symptoms. The remaining patients were either in a public area, workplace or in a car. Patients at home delayed longer than those who had their first symptoms elsewhere, but not significantly different. Also, most patients were with another person when they began to experience AMI symptoms: a spouse(25 or 37.3%), other family member(31 or 46.3%); the remaining 11 were alone. There were no significant differences in treatment-seeking time based on whether alone or with others. Most patients(46 or 68.7%) used an ambulance rather than taking private transportation, and patients who used an ambulance were delayed longer than those who used private transportation, but there were no significant differences; 4. Time to treatment-seeking was not significantly different by blood pressure, heart rate on admission and the peak CK-MB, CPK and Cholesterol level, Killips class; 5. There were no significant statistical differences in treament-seeking times by anxiety level, mood status or control ability.

A Study on the Physiological and Psychological Factors related to Successful Weaning from a Mechanical Ventilator / 간호학회지

This study was performed to identify the physiological and psychological variables related to successful weaning from a mechanical ventilator. The subjects of this study were 22 patients who received mechanical ventilation therapy for more than 3 days in intensive care units. Before the weaning trial, baseline data for following physiologic variables were obtained: spontaneous respiration rate, blood pressure, pulse rate, PaO2, PaCO2, PEEP, static compliance, minute ventilation, tidal volume, rapid shallow breathing index(f/VT), SaO2, PaO2/FiO2 and mean arterial pressure. During spontaneous breathing, physiologic and psychologic variables such as vital signs, ABG, perspiration, chest retraction, paradoxical respiration, dyspnea, anxiety, confidence and efficacy were measured. Successful weaning was defined as sustaining spontaneous respiration over 24 hours after extubation. Weaning failure was defined as the development of more than one of following signs: (1) hypoxemia, (2) CO2 retention or (3) perspiration, tachypnea, chest retraction, tachycardia, arrhythmia, hypotension or hypertension. Subjects (N=18) who successfully weaned from mechanical ventilator were compared with subjects (N=4) who failed. The results are as follows; Eighteen percents of the subjects failed during the weaning trial. Most subjects in the failed group were mechanically ventilated for long-time. This result shows that the success of weaning is more difficult in long-term ventilation patients. In the baseline data that was measured before weaning trial, the mean score of PaO2 in the successfully weaned group was 121mmHg. This is significantly higher than the mean score of PaO2 in the failed group(95mmHg). However, the scores of pH, tidal volume, f/VT, pulse rates, blood pressure, mean airway pressure, SaO2, and PaCO2 were similar between the two groups. Specially the scores of f/VT index as a predominant predictor for successful weaning were not significant (f/VT=44.4) and (f/VT=47). During spontaneous breathing, the scores of dyspnea and anxiety level in the successfully weaned group were less than those of the failed group. On the contrary, the scores of confidence and efficacy in the successful group were greater than those of the failed group. In conclusion, the baseline data that were measured before weaning trial were similar between the both groups, therefore future studies are needed to focus on searching other variables besides physiological parameters related to weaning outcome.

A Survey on the Delay Time Before Seeking Treatment and Clinical Symptoms in Patients with Acute Myocardial Infarction / 간호학회지

Many patients of acute myocardial infarction showed delay time before seeking treatment although they needed immediate thrombolytic therapy once they perceived their symptoms. The objectives of this study were to identify the relationship between clinical symptoms and the delay, and to find the time spent before seeking the treatment. This study was a retrospective research. The delay time for the treatment consisted of the length of delay from symptom onset to patients' decision (T1), from patients' decision making to finding transportation (T2), and from taking transportation to the first hospital arrival(T3). The subjects were 89 patients who were admitted in the ICU and Cardiac Ward at Chonnam University Hospital with the first attack of acute myocardial infarction. The data was collected for three months from March 1st to May 31st of 1998 through questionnaires and reviewing patients' charts: The chart information was suppled by two nurses working at the ICU and Cardiac Ward. The data was analyzed by using frequency, mean and ANOVA through the SAS program. The results of study summarized as follows: 1. Sixty two patients (69.7%) were male and twenty seven patients (30.3%) were female, the ratio of male to female was 2.3 : 1. 2. In daily life, the 70.8% of the patients felt chest pain and discomfort fatigue in 67.4%, dyspnea in 57.3%, and pain in arm, neck, and jaw in 52.8%. During the attack, 97.8% of the patients felt chest pain and discomfort dyspnea in 82.1%, pain in arm, neck, jaw in 67.4% and perspiration in 51.7%. 3. The length of time a patient spent seeking time for treatment (T1+T2+T3) was 94.6 minutes, in which the time for patients' decision making for treatment (T1) was 70.3 minutes, time for finding transportation (T2) was 8.2 minutes, and time for the transportation of the patient to the first hospital (T3) was 16.1 minutes. Time for patients' decision making to go to a hospital(T1) was 74.2% of the total time sought for treatment.