Health Related Quality of Life of Women with Disabilities and Its Affecting Factors / 간호학회지

PURPOSE: The purpose of this study was to investigate the factors that influenced health related quality of life in women with disabilities. The other purpose was to examine the correlations of activities of these women's daily life, self esteem, and health promoting behavior with health related quality of life. METHOD: The subjects consisted of120 adult disabled women. Data was collected from February to June2004 using structured questionnaires. Spearman's correlation, and multiple regression were used to test the quality of life with K-ADL, self esteem, and health promoting behaviors by using SPSS 12.0 for windows. RESULT: The health related quality of life of women with disabilities was related to educational level, marital status, residential type, cause of acquired disability and disability of spouse. In addition, it was related to self esteem (r=.385, p=0.00), health promoting behaviors(r=.428, p=0.00), K-ADL(r=-.419, p=0.00) and K-IADL(r=-.439, p=0.00). Activities of daily life, self esteem and health promoting behaviors were significant predictors 37.3% (=0.212, p=0.000) to explain quality of life in disabled women. CONCLUSION: The more self esteem, health promoting behaviors, K-ADL and K-IADL are positive, the more the health related quality of life is good. Further studies need to be done to investigate additional effects of health related quality of life and to investigate nursing approaches to improve their health related quality of life with significant predictors.

Comparison on Perceived Importance and Frequency of Nurse's Role Behaviors between Medical and Surgical Nurses / 기본간호학회지

PURPOSE: The purpose of this study was to examine differences in the perceived importance and frequency of nurse role behaviors for medical and surgical nurses and to examine the relationship between perceived importance and frequency of nurse role behaviors in the two groups. METHOD: A descriptive design was used with convenience sampling of 351 medical and surgical nurses in the 40 hospitals with over 500 beds. Data were collected using a structured questionnaire. RESULTS: 1) The total score for perceived importance of nurse role behaviors was 4.09+/-.53 for medical nurses and 4.13+/-.53 for surgical nurses. 2) The total score for frequency was 3.15+/-.54 for medical nurses and 3.24+/-.56 for surgical nurses. 3) The perceived importance of nurse role behaviors was higher than the frequency, but the difference between two groups was not significant. 4) The perceived importance of nurse role behaviors was highly correlated with frequency (r=.579, p=.000) for the two groups. CONCLUSION: Medical and surgical nurses perceived the importance nurse role behavior but the frequency of the behavior is lower. Therefore, further research is needed to develop strategies to increase the frequency of nurse role behaviors.

Analysis of the Effectiveness of Tai Chi Exercise for improving Balance / 성인간호학회지

PURPOSE: This study aims to analyze the effectiveness of Tai chi exercise for improving balance and its tendency and helps to identify directions for future research. METHOD: 19 articles from Medline search of foreign journals(1981-2003) and 5 from Korean nursing journals (1981-2003) were surveyed. The contents analyses were focused on outcome measures and relative factors regarding balance. RESULT: Variable measures for balance were used in Tai Chi studies relating to balance. They included the functional measures such as 14 single-leg stance, 7 walking in physiological measures and 7 laboratory-based balance measures were done with platform stability test. The measure of effective Tai Chi exercise depended on the health status of subjects and the methods. Health status of subjects were only on physically inactive older adults in 17 articles and arthritis patients in 7 articles in the Tai Chi study. The significant effects of Tai Chi exercise on balance was revealed after 10weeks duration. CONCLUSION: Considering the results, Tai Chi exercise is more effective than any other studies for walking balance. But the reports on the outcome are inconsistent with wide variations in the choice of balance measures. It is suggested that future studies analyze systemic change through meta analysis and have a wide variety of subjects who need postural control and balance control. The methods of measures should be distinct from the balance state of subjects for the effectiveness of Tai chi exercise.

The Preliminary Study on Music' Movement Program developed for Stroke Patients / 재활간호학회지

PURPOSE: This research with one group pre-post design was carried out to test the practical feasibility to administrate the Music' Movement program developed for the stroke patients. SUBJECTS: 12 stroke survivors at J Public Health Center in Seoul. were participated in. The average age was 68 years old. the ratio of sex was almost 5.8 :4.2, the duration of was almost over 1 year. METHOD: Music' Movement program was conducted for 2 hours x 1day x 6 weeks. The contents of Music' Movement program were consisted of the preparatory activities, main activities and the wrap up activities. The preparatory activities are ice braking, greeting, explanation of the aims of music' movement program, and introduction of stroke disease and ROM exercise. The main activities are the body motions with singing and playing musical instruments. The wrap up activities are stretching and joints and discussion of home activities. Data Collection: The outcome variables are muscle strength, finger pinch power, ROMs. flexibility, depression, and life satisfaction. Depression was measured by CES-D(Kim, I. J., 1999), life satisfaction by ladder scale(McDowell & Newell. 1996), and ADL state (Holbrook & Skilbeck, 1983). Data Analysis: SPSS/PC 10.0 for Window was used. Wilcoxon Signed Ranks Test was used to analyze outcome measures. The level of statistical significance was set at p .05. RESULTS: This program was effective to decrease the depression level of subjects(p .05). The muscle strength, hand grip power, ROMs, life satisfaction. and rehabilitation state of the subjects were slightly increased but no significant differences were found between the pre and post test. Additionally every patient replied that they were very satisfied and expressed their appreciation for this program very much. Of course they strongly want to continue to participate in and meet the peer group again. CONCLUSION: Considering these results, the practical feasibility of Music' Movement program can be supported. Therefore, this Music Movement program can be examined with the quasi-experimental design with control group and ongoing reviews. After that, this program would be applied in public health centers, medical institutes, and welfare centers for the rehabilitation of stroke patients.

Adjustment Experience of Liver Transplant Recipient / 재활간호학회지

The purpose of this phenomenological study was to understand and describe the essence and the structure of lived experience of liver transplant recipient. Five individual interviews were conducted to gather data regarding their subjective experiences. About 130 significant statements were extracted and these were clusterd into 9 themes. End stage liver disease patients chose their last treatment - liver transplantation. After liver transplantation. recipients experience vague anxiety and uneaseness related to much information and life style change that they had to accept. And they feared to lose their health again. But they felt free from medication and restriction of food. And they satisfied with regaining their physical status. Most of the recipients also had financial difficulties and social restrictions. And they experience uncertainty about their future. But they restored their previous social life. And they experience psychological wellbeing and hope. The results of this study might help nurses who work with liver transplant recipient in establishing and implementing an effective nursing intervention by understanding their lived experience.

The Survey for The Standards of Care in Rehabilitation Nurse Specialist / 재활간호학회지

The purpose of this study is to develop the standards of care in rehabilitation nurse specialist. This study was a descriptive survey. The data were collected 143 nurses who were worked in rehabilitation unit at 4 university hospital and 3 rehabilitation center in Korea from Aug. to Nov. 2000. The questionnaire was consisted of 78 items developed by the standards of care in rehabilitation nurse specialist in A.R.N. and the practice contents of care at rehabilitation unit in Korea. Collected data were analyzed by frequency, percentage, mean, S.D. ANOVA The results are as follows 1. For the adequency of the practice contents of rehabilitation nursing, area of skin care is the highest score, and safety, elimination, emotion, respiration, was ordered. 2. The adequency of the practice contents of rehabilitation nursing according to age, educational level. position. clinical experience, clinical experience in rehabilitation unit were significant difference.

The Nurses' Experiences of Clinical Practice / 성인간호학회지

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.

Affecting Factors of Homebound Bedridden Elderly's Depression / 간호학회지

PURPOSE: It was identified that how many homebound bedridden elderlies and their primary caregivers were depressed, and which factors affected the bedridden elderly's depression. METHOD: The subjects were 191 homebound bedridden elderlies and their primary caregivers. The affecting factors were classified into two categories: bedridden elderly and their primary caregiver related factors. Then bedridden elderly's factors were classified demographic and disease-related factors again. The stepwise regression was used to identify significant factors. RESULT: The prevalence of bedridden elderly's and caregiver's depression was 77.8% and 67.0%, respectively. And the model explained 33.3% of variance of bedridden elderly's depression. Cognitively-impaired female elderlies who had depressed caregivers were found to be more depressed. And caregivers who perceived burden were identified to be more depressed. CONCLUSION: It is recommended that the health professionals need to identify bedridden elderlies and caregivers at risk of depression. Especially elderlies who is in poor cognition, those who are female, and those whose caregivers were depressed might be considered carefully in all counseling or follow-up. Also the primary caregivers must be helped to access already available formal and informal support.

Development of a Curriculum for Rehabilitation Nurse Specialist Program / 재활간호학회지

The purpose of this study is to develop a systematic and efficient curriculum for the rehabilitation nurse specialist program. This research was carried out as a group work of 15 experts in order to share vanous opinions about the curriculum. and also through literature review. Articles. curriculums of other Clinical Nurse Specialist Programs. medical laws guidelines. as well as Clinical Nurse Specialist Program from the Korean Nurses Association were reviewed, and the issue was discussed throughly via group meetings. The developed cunicul urn is as follows: 1. Educational philosophy lies in the fact that the rehabilitation nurses support the patients to maximize their potential and functional level. so that they could maintain healthy state and re-adapt to changed environment. Furthermore the rehabilitation nurses are disposed of arbitrary decision power under their own responsibility. thus they take charge of we]fare and healthy environment of the local society through the patients (subjects) and local resources. 2. Educational goals are to train rehabilitation nurse specialist. who correspond to the social needs. so to say. those who have the know]edge and skills for nursing practice, education and research. 3. The curriculum consists of 37 credits, of which 24 credits are based on lectures and 13 credits based on clinical practice. General courses are 3 subjects (5 credits): nursing theory, nursing research. and laws/ethics, Mandatory courses are 8 subjects with 19 credits: advanced physical assessment, pharmacology, pathophysiology, issues in rehabilitation nursing, advanced rehabilitation nursing intervention I. advanced rehabilitation nursing intervention II. sports physiology. special rehabilitation nursing intervention. As for the clinical practice courses, assesment and evaluation for rehabilitation (64 hours), community and home based rehabilitation nursing(128 hours), hospital based rehabilitation nursing(l28 hours), institution based rehabilitation nursing(96 hours) would be treated. 4. Contents of the courses were developed to correspond with the courses' objectives and specific items. 5. Evaluation would be carried out both in the lecure and in the clinical practice. The knowledge and skills of the students would be measured to ensure full validity and credibility. However this developed curriculum should be continuously modified and updated in more desirable direction.

The Need for Rehabilitation Day Care Program Service of Stroke Survivor's Family / 재활간호학회지

This study was carried out to find out the basic data required to plan and develop Rehabilitation Day Care Program for the stroke survivor's family in Korea. The subjects comprised of 92 stroke survivor's family who discharged from 4 hospitals in Seoul during the past 2 years. The data were collected from August 3. 1998 to September 18, 1998, through interviews with questionnaires about general characteristics, activities of daily living, depression and service need of rehabilitation day care program at the outpatient clinics by trained nursing graduates. Data were analyzed with descriptive analysis, Pearson's correlation analysis, and Stepwise multiple linear regression analysis using SPSS/WIN 10.0 program. The results obtained are as follows: 1. The mean score of the general need of rehabilitation day care program of stroke survivor's family was 3.10(range 1-4). The highest need among the service categories of the rehabilitation day care program was self-care and restorative activities category(3.30). and health services referral category, recreation category, psychosocial activities category in order. The needs of each category are as follows. In the health services referral category, the need for dental examination and medical examination were highest, followed by the need for physical therapy and occupational therapy. In the psychosocial activities category, the need for family counselling was highest. In the self-care and restorative activities category, the need for ROM exercise training was highest, followed by bowel training, and ambulation training. 2. The need of family for rehabilitation day care program service displayed a correlation with the level of education. ADL. and the level of depression. and a reverse correlation with age, illness intrusiveness, depression, knowledge. subject and object burden and relationship with stroke survivors. 3. The stepwise multiple linear regression analysis revealed following results. For the need for rehabilitation day care program service. 22.6% of the variance was initially explained by level of family's knowledge about caring method for stroke survivors, 8.8% was the level of subjective burden and 5.4% was relationship with stroke survivors. In conclusion, above characteristics should be considered to develop stroke survivors' rehabilitation day care program.

The Educational contents of Rehabilitation Nursing / 재활간호학회지

The purpose of this study was to provide fundamental data to propose further directions of education on rehabilitation nursing by investigating the adequacy of the educational contents of rehabilitation nursing. This study was a descriptive survey study. The data collected at 25 universities and 24 junior colleges through questionnaires to answer the research questions from August 10 to September 30, 2000. The questionnaire was consisted of 24 items. The contents of rehabilitation nursing education were developed by consulting with the rehabilitation nursing professionals. The results are as follows Rehabilitation nursing was taught as an independent class in 15 universities and 9 junior colleges. Most professors majoring in adult nursing(66.8%) were in charge of teaching the courses. For the adequacy of the teaching contents of rehabilitation nursing, conceptual bases for rehabilitation was the highest score(4.0), and interdisciplinary rehabilitation team, activities of daily living, clients of rehabilitation, nursing process in rehabilitation nursing, functional evaluation, movement and mobility, physical therapy, occupational therapy, sensation and perception, communication/language, eating and swallowing, bladder elimination, community based rehabilitation nursing, sleep, rest &, fatigue, bowel elimination., historical perspectives of rehabilitation nursing, sexuality, pulmonary rehabilitation, pain, cardiac rehabilitation, skin integrity, family care was ordered.

Investigation of Espoused Theories in Nursing Practice / 성인간호학회지

As a nursing practice involves nurses'actions in a specific context of health care, this study has focused on exploring the espoused theories in nursing practice within the action science perspectives. Espoused theories are the belief, principles, and rationale expressed by the practitioner as guiding her/his actions in a situation of practice. The data were analysed qualitatively and 25 elements of espoused theories of nursing action were identified and clustered into 6 categories. The 25 elements of espoused theories are as follows: The clinical nurse worked in wholistic and individual nursing, focussed on the patient's needed, comfort and supportive nursing (5 theories of nursing goal); excellent skills, knowledge based, assessment and data collection, explaining, educating or a scientific basis(6 theories of nursing intervention): advocacy, value oriented, treatment, accountability and commitment(4 theories of nursing ethics); human respect, partnership, trust(3 theories of patient-nurse relationship) : knowledgable, accumulated clinical experiences and personally lived experiences, positive perspectives(4 theories of nurse), role of intervention, rewarding, peer relationship(3 theories of situations). The above mentioned espoused theories are similar to that of nursing textbooks which students learned through basic nursing education and almost the same as the Acts ofa Nurse in Korean. However, we are doubtful whether nurses actually do as they think. Therefore, it is recommended to review the theories-in-use in order to find any discrepancies between the espoused theories and the reality of nursing actions.

Social Readjustment and Relating Factors in Stroke Survivors / 성인간호학회지

Social readjustment is very important in rehabilitation of stroke survivors. The purpose of this study was to examine the level of social readjustment and related factors in stroke survivors. Especially, to find the most useful predictor for social readjustment is a major point of this research. The study included 254 outpatients who were given follow-up care after discharge from. Occupational rehabilitation and resumption of the perceived meaningful social activity prios to the stroke were used to measure social readjustment. The resumptions of first meaningful social activity was the best predictor for life satisfaction in stroke survivors(r=.245, p<.01). The substance of perceived meaningful social activities were job, meeting with friends, hobby and activities for the family. The sum of meaningful social activities (r=.175, p<.01) and occupational rehabilitation (r=.116, p<.05) were significantly related to life satisfaction. There were significant difference in IADL, depression and life satisfaction according to resumption of meaningful social activity. But, occupational rehabilitation was not related to depression. The level of social readjustment was different between occupational rehabilitation and resumption of meaningful social activity. It was 45.7% in the first meaningful social activity and 36.6% in occupational rehabilitation. The related factors with resumption of the first meaningful social activity were that of IADL, depression, illness intrusiveness and cognitive function. And the level of IADL, illness intrusiveness, cognitive function, and age were significantly related to occupational rehabilitation. In conclusion, we suggest that the resumption of the first meaningful activity in stroke survivors is the best predictor of social rehabilitation. Thus, nurses need to work for resumption of meaningful activity as well as occupational rehabilitation.

Development of an Urban Community Based Comprehensive Service Model for Bed-Ridden Elderly / 간호학회지

PURPOSE: This study aims to identify the ADL and IADL of bed-ridden elderly. Also it is used to show fuctional status, and to investigate the content and the level of nursing services provided. METHOD: The subjects were 191 elderly who received visiting nurse service through public health centers in the Seoul Metopolitan and Chungnam Province. Data collection was conducted by public health center nurses during four months in 2000. Result: As for daily living activities, 100% of subjects had at least one difficulty in ADL and IADL. Among them, only 0.5% had moderate disabilities and 99.5% had severe disabilities by HFS, 27.9% were in a semi bed-ridden state and 72.1% were completely bed-ridden by JABC. The major service provided was a visiting nurse service which was preferable to the social welfare service. In the visiting nurse service, there was no significant difference according to the elderlys' functional status. In addition there was no standadization about the qualification of the visiting nurse, and single entry point for the nursing service. CONCLUSION: The researchers urgently suggest that a community based comprehensive service model has to be developed to respond to the needs of the elderly in Korea.

An Analysis on the Contents and the Trend of Nursing Research Published in Journal of Korean Academy of Adult Nursing (1989-2000) / 성인간호학회지

"Journal of Korean Academy of Adult Nursing" has been published since 1989 and more than 330 articles have been published up 2000. We reviewed all the articles published in this journal to analyze the contents and trend of published articles and to find out the way of improvement both in quantity and quality of studies in this area. The results are as follows; 1) Ninety percent of articles were quantitative studies. Experimental design was used in 16.1% and quasi-experimental design was adapted in 73.6% of articles. Qualitative research were 10.3% of total articles reviewed. 2) Only 5.1% of articles described theoretical framework and 73.6% of experimentally designed articles included research hypotheses. 3) Among experimental studies, only one was true experimental studie design. Eighty nine point three persent had descriptive survey method among non-experimental studies. Amog the thirty four qualitative studies, phenomenologic(73.5%), grounded theory(14.7%), and ethnographic (11.8%) design were used. 4) Most of research subject were patients and few healthy people, healthcare worker, and patient family. 5) Psychosocial data collection method which used questionnaire were 53.7% and interview, physical measurement, observation were used in 22.8%, 8.2%, 5.4% of articles respectively. 6) Total number of keywords were 692, and average number of key words per article was 2.2. Health-related keyword was the most frequently used according to four metaparadigm of nursing (human, health, nursing, and environment). Environment related keyword was rarely appeared. The number and quality of nursing research in "Journal of Korean Academy of Adult Nursing" have been improved continuously. It is difficult to find out special trend or characteristics which is unique in this journal because of relatively short history of adult nursing studies. This review study was performed to analyze adult nursing studies only in the view of quantitative aspect, but it is needed to analyse qualitatively to find philosophical or theoretical trend in nursing.

A Study on Patients' Concerns about Management of Cancer Pain and Related Factors / 재활간호학회지

Pain management is a major issue in caring of cancer patients. Patients' concerns for reporting pain and taking analgesics are patient-related barriers to the management of cancer pain. Since such study has not been done at all in Korea, it is clearly needed to study on these problems. The purpose of data in order this study is to attain basic data in order to improve cancer pain management in Korea. This is done by: 1) examining the extent of patients' concerns that might be barriers to the optimal pam management, and the extent of related factors (pain management hesitancy, adequacy of using analgesics, pain severity and pain interference); 2) identifying the relationship between patients' concerns and the related factors. The data has been collected from 180 cancer patients who were hospitalized in medical wards of one university hospital in Seoul. Korea during the period from November 1. 1997 to February 28. 1998. The data has been collected through interviews with (1) Barriers Questionnaire Korean Version (BQ-K); (2) Hesitancy Experience Questionnaires (HQ); (3) Pain Management Index (PMI); (4) Brief Pain Inventory (BPI); and (5) Demographic Data. The data were analyzed by descriptive statistics and by t-test. One-way ANOVA, Pearson correlation using SPSSWlN program. The Results are as following: 1) The mean scores of Pain Management Concerns (PMC) by BQ-K were toward the moderate with a little high points(2.59). Most of the patients (99.4%) had some extent of concerns (over 1 out of maximum 5 points). Among the eight subscales of BQ-K. the Pain Management Concerns (PMC) about 'Fear of tolerance' was the highest (3.80) and 'Worry about side effects' was the least (1. 40). 2) The extent of Pain Management Hesitancy (PMH) by HQ of whom had pain on the day of the interview was a little higher than moderate score(5.53 out of maximum 10 points). 56.7% of the patients with experiencing pain used less adequate analgesics for the severity of pain than they were expected. 27.8% of them never used any analgesics at all. The mean score of pain severity by BPI was 16.59 (maximum: 40), and that of the interference with daily life by BPI was 32.03 (maximum: 70). 3) The patients who were older. less educated, and in low socio-economic status were likely to have more concerns. Pain Management Concerns (PMC) was positively correlated with Pain Management Hesitancy (PMH)(r=.75), pain severity (r= .44) and pain interference (r=.50). Those who were not using adequate analgesics had higher Pain Management Concerns (PMC) than did those who were using adequate analgesics (t=-5.42), The patients who had more Pain Management Concerns (PMC) tended to hesitate more to report pain and to use analgesics. They used more inadequate analgesics for the severity of pain and also had experienced more pain severity and interference with daily life. In conclusion, the patients' concerns for reporting pain and for using analgesics are major patient-related barriers to cancer pain management in Korea. The patients' concerns were correlated significantly with the level of the hesitancy experience, inadequate use of analgesics, the pain severity and the interference with daily life. Considering this, an educational program for cancer patients under the treatment with analgesics should be developed in order to solve these problems.

Social Support Network and Gender Difference in Post-hospitalized Stroke Patients / 기본간호학회지

Social support was found to have buffering effects on the stress response of stroke patients. Especially, the aspects of social support found to be most influential were support from a close, personal source, and overall satisfaction with support. The purpose of this study was to identify the current social network and its characteristics according to gender difference in post-hospitalized stroke patients in Korea. The sample consisted of a convenience sample of 254 patients was recruited 129 men and 125 women who were receiving follow-up care at outpatients clinics. Four aspects of social support-source, quantity, quality & type-were measured using the modified Social Support Inventory for Stroke Survivors(SSISS) which was developed by McColl & Friedland(1989). Regarding sources of social support, 61.4% reported for 'spouse' as primary caregiver and 31.9%, 'children'. But the distribution of sources of personal support were related to gender; 82.2% of male patients had support from their spouses, while only 40% of female patients reported from 'spouse' but 51.4% from 'children'. Among the children, daughters and sons were more significant support persons than daughters-in-law. The percentages for sources of these significant other support persons were 55.5% for 'children', 8.7% for 'spouse', and 8.3% for 'brothers'. The physician at the outpatient department was the main source of professional support. For the quantity and quality of social support, the primary caregiver's support was more significant than support by significant other persons. Male patients reported that primary the caregiver' support was greater than that of significant other persons, while female patients perceived significant other persons as giving greater support. Regarding the type of perceived social support, the stroke patients were highly satisfied with the primary caregiver's support in aspects of instrumental, emotional, and informational support. They also reported high satisfaction with support from significant others' support in the aspect of emotional support, while emotional and informational support from professionals was reported as satisfactory. In conclusion, gender difference in the social support network was found in that male patients perceived more support from their spouses, while female patients perceived more support from their children as compared to their spouses.

The Preliminary Study for the evaluation of the Rehabilitation Nursing Program integrated with Day Care Program of Stroke Survivors / 재활간호학회지

A Preliminary study for the evaluation of the Rehabilitation Nursing Program(RNP) implemented to the 25 stroke survivors at the Day Care Program Center of National Rehabilitation Hospital in Seoul was done at 1999. The purposes of this study was to assess the psychological effects as outcome-variables such as depression. powerlessness and self efficacy of the stroke survivors who were discharged from acute care hospitals. The Rehabilitation Nursing Program (RNP) integrated with the Day Care Program for rehabilitation was implemented and the psychological outcome variables were measured by 3 psychologic instruments of Zung Depression Scale. Millers's powerlessness and the Bandura's self efficacy scale. These instruments were translated into Korean and the contents validity and the reliability were tested. The subjects were 17 males and 8 females and 52% were aged over 51 years old and 24 % were from 31 to 50 years old. Most of them(72 %) had been educated more than high school level. The contents of RNP were 8 sessions composing of self-introduction. individualized assessment, health contract and feedback, management of depression, shaving experiences, effective communication, self efficacy teaching, health information. and daily care activities. This study found that the level of depression and the powerlessness were within average level and had not been changed the level of self efficacy after RNP were somewhat higher than before, but it was not changed significantly. According to the results. the psychological state of the subjects were not changed significantly. Only the level of self efficacy was a little improved after having the RNP. Based on theses results, the RNP should be focussed on the psychological nursing care and the psychological outcome variables were retested strictly with the enough sample size.

A Study on the Lived Experiences of Homecare Nurses / 간호학회지

THE NECESSITY AND PURPOSE OF THE STUDY: Recently the number of patients with chronic diseases and the aged patients is increasing steadily. Furthermore, due to the expansion of health insurance system, the number of patients hospitalized in the general hospital is increasing at a surprising speed. However, hospitals urge the early discharge of the patients for the efficiencies of hospital administration, and therefore, the number of patients who must be taken care of in their home is also increasing. Homecare nursing is one of the health care service for the patients at home who require continual attention and care, and now increasing attentions are given to it as one of the professional nursing fields. However, it was almost impossible to find a study on the actual experiences of the homecare nurses written by their own language in Korea, that it also posed a great difficulty in understanding their diverse experience. Considering these situation, this study will help understanding of them, and provide the fundamental data on their experiences for making policies to develop homecare nursing. METHODS OF RESEARCH: Phenomenological research method was employed to analyze the lived experiences of homecare nurses fundamentally. DATA COLLECTION: Data were collected from August 1998 to December 1998 from ten homecare nurses who worked for patients under the homecare nursing setting as model cases designated by Seoul Nurses Association and who agreed to the purpose of this study after listening to and understanding the explanation completely. The in-depth interview was carried at the time which was convenient both for the researcher and participants for one or two hours, and recovered with the approval participants. The first interview covered diverse and broad areas like the situation of homecare nursing, and their feelings and thoughts over it, and in the second and third interviews, more specific questions are asked. DATA ANALYSIS: For the phenomenological analysis, contents analysis was employed. The data collected from the participants were analyzed into the following procedures according to Van Manen 's phenomenological analysis. 1) Reserve the preconception of the researcher by restricting it inside parenthesis. 2) Make a thorough observation of the lived experiences by insight process. 3) Analyze the contents (Find out the repetitive factors) 4) Interpret the essence found. 5) State the meaning of the interpretation. RESULTS AND DISCUSSION: 1. Fear and expectation for the first visit. (unfamiliarity, awkwardness, anxiety, shivering) 2. Mingle with the family (feeling friendly with the family, becoming like a family member) 3. Being proud of her own know-how (learning the know-how, organizing alternatives, building up confidence) 4. Pity for the poor. (criticizing the current government, feeling ashamed, feeling anger) 5. Difficulty of constructing cooperative system with physicians (strenuousness, frustration) 6. Helplessness due to the lack of support system (difficulty to get supplies, annoyance, embarrassment by institutional restraints) 7. Anxiousness for heavy traffic and parking (annoyance, hastiness) 8. Ethical conflicts (pity for the patients and family, skepticism about lengthening life maintenance) 9. Burden for the possible accident (pressure, anxiety, conflict, physical exhaustion) 10. Establishment of identity as a professional (fulfillment, worth, joy) 11. Being distressed at other's ignorance

Relations between Perceived Burden and Social Support of Stroke Patient's Family Caregiver / 간호학회지

The purpose of this study was to describe the perceived burden of the stroke patient's caregiver and related factors to analyze relationships between perceived burden and social supports. A convenient sample of 225 caregivers who take care for a stroke patient at home participated in this study. Caregiver's perceived burden was measured by the objective and subjective burden scale developed by Montgomery (1985). Related factors of burden were studied in terms of the patient's instrumental activties of daily living, cognitive function, caregiver's demographic variables and caregiver's illness intrusiveness. The results were as follows: (1) The mean of objective burden score was 4.5, and subjective burden score was 3.1. These scores show that caregivers perceive moderate level of burden. (2) Caregivers' objective burden was significantly related to caregivers's illness intrusiveness (r=.62), patient's IADL (r=-.33), and patient's cognitive function (r=-.15). The subjective burden was related to the caregiver's illness intrusiveness (r=.29), the patient's IADL (r=.24), and the caregiver's age(r=.23). (3) The percentage of stroke caregivers who perceived physical support was 49.1%. The percentage of those who perceived emotional support was 61.0%, and those who perceived financial support totaled 37.6%. (4) Caregivers who received any type of social supports perceived lower subjective burden, and caregivers who received physical or psychological support perceived lower objective burden. These results emphasized the necessity of a rehabilitation programs for stroke patients and support program for family caregivers.