Utilization of Alternative Complementary Remedies of Stroke Patients / 성인간호학회지

PURPOSE: This descriptive survey was conducted to investigate out the utilization of alternative complementary remedies for stroke patients. METHOD: The subject for this study were 194 patients, selected from inpatients department of 11 major medical center at Busan and Ulsan. Data were collected from August 19th to November 12th, 2002 through interview schedule designed by the investigator. Data was analyzed with frequency, percentage, and Chi-squared -test by using SPSS Win 10.0. RESULTS: 71.6% of objects has used alternative complementary remedies. The use of alternative complementary remedies according to disease-related features was statistically significant in concurrent diseases(Chi-squared=15.03, p=0.001), rehabilitation treatment(Chi-squared=6.341, p=0.012) and the level of ADL(Chi-squared=19.63, p=0.000). The most frequently used therapies were diet and nutrition(31.8%). The patients with less than 3month onset and in the mid-period of treatment frequently used remedies. The reason for using remedies were the belief in it's effects on treatment, but most patients responded was not effective(30.9%) or not much improvement after using remedies. Most of the patients were recommended to use remedies by their neighbors(27.3%) and family members(25.2%). The family members were most supportive in therapy(56.1%). The 28.1% of patients responded that the remedies were effective in promoting blood circulation and 95% of the patients had not experienced side effects. CONCLUSION: These results could be the basic material in developing nursing intervention for cerebral apoplexy patients.

A Study on Self-care among the Lymphedema Patients / 성인간호학회지

PURPOSE: The purpose of this descriptive study was to gain basic data to develop a self-care protocol for the lymphedema patients. METHOD: The subjects of this study consisted of 115 patients with lymphedema from 8 hospitals and two community health and welfare centers in Busan and Seoul. The data was collected with questionnaire by self reporting of patients between March 2001 and December 2001. Data was analyzed by mean and percentage. RESULT: For self-care activities in daily life, compliance of 'use skin care preparations', 'use heat and cold', 'protect from local compression on affected limbs', 'protect from insect biting', 'use aids to protect affected limbs', 'take diuretics and take protein diet' did not reach to 50%. For self-care activities related to complex physical therapy, 28.7% of subjects complied with compression garment, 14.8% with manual lymph drainage, and 13.0% with exercise. 20.0% of subjects tried to treat with acupuncture and 13.9% with heat therapy. CONCLUSION: From this study, it is suggested that patients need to get a self-care education with correct information about self care activities and health care professionals need to develop more convenience self-care techniques of massage and exercise.

The Use of Professional Health Care Systems among the Elderly in Rural Communities / 간호학회지

PURPOSE: This ethnography is aimed at describing the health care seeking behavior of elderly details in their socio-cultural context. The research question is "under what conditions did elderly informants decide to use certain professional health care services and how do they make use of all the available resources?" METHOD: 10 sessions of fieldwork were conducted in the two agricultural villages between Sep. 1999 and Oct. 2002. The data for this paper came from participant observation with 14 informants. In the process of analysis I used proxemic and taxonomic techniques. RESULT: Informants decided to use a certain health care system according to their folk definition of illness. They prefer to use the health services where they felt more comfortable and free. They wished to be care from intuitive and holistic healers. Social network and having health resources was also important factor. CONCLUSION: We need more comprehensive research model to reach a plausible explanation. Combined qualitative-quantitative research is needed to get practical data to develop effective health care systems for the elderly.

Development of Comprehensive Nursing Intervention for the Client with Lymphedema / 성인간호학회지

PURPOSE: The purpose of this study was the development of a comprehensive nursing intervention program for the client with acute lymph stasis and stage I lymphedema. METHOD: The Quasi-experimental design using a non-equivalent control group was used. The subjects were 22 stroke patients with lymph stasis in the control group and 23 patients in the experimental group. The complex physical therapy of Casley-Smith was carried out to the control group for 10 hours, and comprehensive nursing intervention for the experimental group was carried out for 60 minutes. The data for this study was gathered from Feb. 2002 until June 2002 and pertains knowledge about lymphedema, self-care for managing lymphedema, and circumferences of affected limbs. Data was analyzed by mean, standard deviation, x2-test, and t-test. RESULT: The changes in knowledge about lymphedema, self-care practices, and circumference of affected limbs after nursing intervention did not show significant differences between control group and experiment group. CONCLUSION: It can be concluded that comprehensive nursing intervention had more efficiency than complex physical therapy in the treatment of edema for stroke patients because of it's simplicity and time saving. Thereby, the comprehensive nursing intervention program developed in this study would be a useful therapy for the clients with lymph stasis and early stage lymphedema.

Experience of Women Living with Lymphedema / 간호학회지

PURPOSE: The object of this study was to explore and describe the experience of women living with lymphedema within a socio-medical context in Korea. METHODS: Research data was collected through interviews and participant observation with 9 informants between February 2000 and July 2002. Data was examined using Spradley's taxonomy analyzing techniques. RESULTS: 5 themes were identified; 'overwhelming and despair over the ailment condition', 'distrust and abandonment of conventional medicine' 'shaming of losing maternity and femineity', 'returning to the permanent safe shelter', and 'struggling for reconstruction of one's self'. The 'chaotic' state of knowledge and health care system for lymphedmea patient affected the experiences of informants. CONCLUSIONS: This result will be a basic understanding of psychosocial impact of lymphedema for the women and to develop the comprehensive nursing program including counseling program.

Meaning of Sickness for the Elderly in a Folk Healing Practicum / 성인간호학회지

PURPOSE: This ethnography was conducted to describe the meaning of illness of the elderly in traditional folk healing performance. METHOD: This study was guided by Klienman's explanatory model of health care systems. The fieldwork was conducted in an agricultural clan of Namwon City from January of 1990 to Feburary of 2001. Research data were collected by Ehnographic interview and participant observation. Participants of this study were 10 elders aged 74 years old to 96 years old; two of them were male. The data were analysed with the techniques of taxanomy, flow and decision, and proxemics. RESULT: The meaning of illness was categorized with four compononts, that is, ritual for life, defeat and failure in power game, humiliating punishment for guilt, and Tal. CONCULSION: These meanings were constructed on physical and socio-cultural environment of this clan. The healing strategies were determined based on the meanings of illness. These results can be used to understand the health behavior of the elderly and thus ensure the quality of nursing for the elderly.

An Ethnography of the Concept of Illness by the Elderly / 성인간호학회지

This ethnography was based on Kleinman's explanatory model of a health care system. It is conducted to make thick discription of illness conception of the elderly in a sociocultural context. The basic assumptions were as follows. 1) A health care system is a cultural system, and as with any other cultural system, it is a system of symbolic meanings anchored in a particular arrangement of social institutions and patterns of interpersonal relationships; 2) In all societies health care activities are more or less interrelated. Therefore, they need to be in a holistic manner as socially organized responses to disease that constitute a special cultural system; health care system; 3) Health and illness experiences are the natural process of disease. Individuals who recognized a for state of health, their family, neighbors, and communities define the state, search for causes of the health problems, and response to it. According by, they proceed to search for healing stratagies. So, understanding of the illness experience is the starting point for health care. The study participants were 12 elders aged 60 or more. The fieldwork was conducted in an agricultural clan village of Namwon city. The data collection and analysis were cyclic, from descriptive observation, domain analysis, focused observation, taxanomic analysis, selected observation, componential nalysis, and finally cultural themes were all analysed. Proxemic and text analysis techniques were used according to the characteristics of the data. The data of sociocultural context and descriptive data were collected from 1990 to 1992. Informations on illness concepts were collected during 1994 using focused observation. Data confirming and contrast observations were conducted from 1997 and 1999. Illness concepts of the elderly were taxonomized supernatural cause, non-supernatural cause, immediate cause, and ultimate cause. The supernatural ones were ancestors, god of home, god of village, and ghost such as 'sal(evil force of dead man)' and 'gagqui(ghost of begger)'. The non-supernatural ones were Ki, natural phenomenones, natural objects, foods, human and human behaviors. Immediate ones were insufficiency and overflows, discretion and consolidation, disorder and out of order, cloudness and contamination, and fluctuation and stagnation of supernatural cause and non-supernatural ones. Ultimate causes were intrusion and loss of supernatural and non- supernatural ones. The cultural themes of illness concepts of the elderly are: 1) illness concepts are not based on causality principle, but on reciprocal principle; 2) illness concepts are affected by social level and charicteristics of the patients; 3) the causes of disease are recognized as imposed both positive and negative effects on health based on interpretation of the indiviuals; 4) illness concepts reflects on principles of everyday life of the society members such as hierachial structure and group cohesiveness; 5) illness concepts are ruled on principle of reciprocity and spread; 6) illness concepts are interrelated with physical environment of the participants. It can be concluded that the illness concepts of the elderly in a traditional clan village are a component of health care system as a cultural system based on these results. The these results can be a useful basis for gerontological nursing practice and education.