Qualitative Research on Experience of Primary Physicians Operating Their Primary Health Care Centers / 가정의학회지

BACKGROUND: The purpose of the study was to understand how family physicians managed their primary health care centers and to identify the factors for successful management of their privative clinics. METHODS: The data was collected through individual interviews from five family physicians who operated their private clinics. All interviews were tape-recorded and transcribed into verbatim data. The data was analyzed using qualitative content analysis. RESULTS: Three major categories were identified: 1) types of physician based on major value as a doctor; 2) difficulties in operation and management; 3) desirable operating strategies for success. The first category described what kinds of value the physicians pursued as they operated their private clinics. Two different types were identified. One was intrinsic value oriented and the other was extrinsic value oriented. The second category illustrated many difficulties that family physicians faced in operating and managing their private clinics. Lack of private time, social isolation, and gap between mission and reality of practice were identified as major difficulties. Desirable strategies for the successful management were four subcategories: location; self-oriented developmental plan; specialization of the services; and activating network with larger hospitals. CONCLUSION: The results of the study would be helpful in setting up and operating private clinics through understanding the difficulties and strategies of primary physicians and recognizing mission and major value of them.

Trends of Nursing Research in the Journal of Oncology Nursing / 종양간호학회지

PURPOSE: Purpose of study was to analyze the research articles in the Journal of Korean Oncology Nursing in order to provide an direction for the future research. METHODS: This study analyzed 93 studies published in the Journal of Korean Oncology Nursing, from its beginning year to the year 2007, according to the research objectives. The frame of evaluation included years and types of publication, the theoretical frameworks, research design, subject, data collection method, keyword analysis by MeSH. RESULTS: 45.2% of studies was non-degree based studies. 95.7% of studies was not described theoretical framework in the articles. 71.0% was utilized a non-experimental design. 57% of subjects in researches was patients. 76.3% of studies were used the questionnaire for data collection. Concepts as human, nursing, and health were consistently appeared in research. But concepts of environment has been insufficiently conducted. CONCLUSION: Researches in the Journal of Korean Oncology Nursing has been changed in methodology and the topics of research for the last 7 yr. It progresses in both quantity and quality. But, it is necessary to conduct research founded on theoretical background, various research design, variability of study subjects and topics as supported by scientifically and empirically.

Response Experiences with a Semi-Quantitative Food Frequency Questionnaire : A Qualitative Study using Cognitive Interview

The purpose of this research was to understand how individuals reflect on the frequency and quantity of foods that they consume. Participants selected 5 males and 15 females aged 30 years or older were first interviewed on the frequency of their food consumption. Then based on this data, they were given a cognitive interview using the method of verbal proving. The individual cognitive interviews were recorded with consent while being conducted after complete approval by the Seoul National University Institution Review Board. The recorded material was evaluated using a thematic analysis after transcribing them into text. By analyzing stages of reflection, the major barriers to make the device difficult are revealed: 1) More difficulty in remembering events over the course of a full year due to diversification in the types of food that people consume 2) difficulty calculating the average for seasonal foods 3) difficulty estimating the amount of consumption from the photos presented 4) difficulty estimating amount of consumption from the quantity presented 5) difficulty processing foods that people think are healthy and foods are unhealthy simultaneously 6) difficulty having to consider foods where target food goes in as an ingredient; 7) difficulties arising from having to increase frequency when the amount consumed is higher than the quantity that is presented 8) difficulty having to combine the frequency and quantity of each food item when numerous foods are clustered into one category. These findings show that the less participants were involved in cooking, the more diverse their eating habits were, and the more they tried to adhere to rules of filling out the questionnaire, the more it was difficult for them to come up with an answer to the question being asked. It therefore seems necessary to construct a Food Frequency questionnaire that is attentive to these problems that arise from the recall stages.

Role-Identity of Home Care Nurse Practitioners / 간호학회지

INTRODUCTION: It is important to understand the nature of the identity through the live experiences of Home Care Nurse Practitioner(HCNP) because the role identity of a professional is constructed by continuous social interactions, This study aims to understand the construction of the role identity of HCNP. METHOD: Data was collected from 12 hospital based HCNPs. This study involved two focus group discussion sand four in-depth individual interviews. The main question was "what is the role of HCNP?" The debriefing notes and field notes were analyzed using consistent comparative data analysis method. RESULT: First, Home care (HC) is a small clinic. HCNP brings it to home to provide various services. Second, HC is the real nursing and HCNP is the 'genuine' nurse who actualizes the essence of nursing in practice. Third, HC is empowering activity to promote self-care ability of the patients and their caregivers. Forth, HC is like the dish-spinning required high-level mastery and HCNP is an expert who provides the most appropriate services to the patients. CONCLUSION: HCNPs have the role identity as a highly qualified professional who delivers services from hospital to home, actualizes the essence of nursing in practice, empowers the patients and their caregivers to have self-efficacy to recover, and offers the most appropriate nursing care.

Role-Identity of Home Care Nurse Practitioners / 간호학회지

INTRODUCTION: It is important to understand the nature of the identity through the live experiences of Home Care Nurse Practitioner(HCNP) because the role identity of a professional is constructed by continuous social interactions, This study aims to understand the construction of the role identity of HCNP. METHOD: Data was collected from 12 hospital based HCNPs. This study involved two focus group discussion sand four in-depth individual interviews. The main question was "what is the role of HCNP?" The debriefing notes and field notes were analyzed using consistent comparative data analysis method. RESULT: First, Home care (HC) is a small clinic. HCNP brings it to home to provide various services. Second, HC is the real nursing and HCNP is the 'genuine' nurse who actualizes the essence of nursing in practice. Third, HC is empowering activity to promote self-care ability of the patients and their caregivers. Forth, HC is like the dish-spinning required high-level mastery and HCNP is an expert who provides the most appropriate services to the patients. CONCLUSION: HCNPs have the role identity as a highly qualified professional who delivers services from hospital to home, actualizes the essence of nursing in practice, empowers the patients and their caregivers to have self-efficacy to recover, and offers the most appropriate nursing care.

The Experiences of Transplantation Coordinators' Practice / 간호학회지

PURPOSE: The purpose of this phenomenological study was to understand the experiences in the transplantation coordinators' practice. METHOD: Data was collected through a tape-recorded in-depth interview from nine participants who were transplantation coordinators of their hospitals. It was analyzed using the phenomenological method proposed by Colaizzi(1978). RESULTS: From significant statements, six categories of themes were integrated into the essential structure of the experiences of transplantation coordinators. Six categories of themes were 'continue to be professional during dash this way and rush that', 'burden due to persistent heavy work', 'the uniqueness in family care of the brain-dead patients', 'support of family and a professional group', 'worthiness and achievement of the patients' recovery', and 'establishment of self-confidence as a coordinator'. CONCLUSION: Although the transplantation coordinators played various roles, they had a conflict in role identity due to poor working environments. The results of this study suggested that development of an educational program, an increase in understanding for the coordinators' role, and institutional support for better working conditions are needed to get professional acknowledgement for transplantation coordinators.

Effects of Abdominal Breathing Training Using Biofeedback on Stress, Immune Response and Quality of Life in Patients with a Mastectomy for Breast Cancer / 간호학회지

PURPOSE: This study was to determine the effects of abdominal breathing training using biofeedback on stress, immune response, and quality of life. METHOD: The study design was a nonequivalent control group pretest- posttest, quasi-experimental design. Twenty-five breast cancer patients who had completed adjuvant chemotherapy were enrolled. The experimental group(n=12) was provided with abdominal breathing training using biofeedback once a week for 4 weeks. State anxiety, cancer physical symptoms, serum cortisol, T cell subsets(T3, T4, T8), NK cell and quality of life were measured both before and after the intervention. RESULT: Though state anxiety, cancer physical symptoms, and serum cortisol were reduced after 4 weeks of abdominal breathing training using biofeedback, there was no statistical significance. It showed, however, improvement in quality of life (p=.02), and T3(p=.04). CONCLUSION: Abdominal breathing training using biofeedback improves quality of life in breast cancer patients after a mastectomy. However, the mechanism of this beneficial effect and stress response requires further investigation with special consideration in subject selection and frequency of measurement. Nurses should consider this strategy as a standard nursing intervention for people living with cancer.

Women Caregivers' Experiences in Caring at Home for a Family Member with Dementia: A Feminist Approach / 간호학회지

PURPOSE: The purpose of this study was to explore women caregivers' lived experiences in caring at home for a family member with dementia and to identify conditions that oppress women in the context of family caregiving. METHOD: This study was conducted within the feminist perspectives using qualitative secondary data. Ten secondary data conveying self reflective contents were selected from the 25 original data obtained in 1999 to 2000. RESULT: Six themes that emerged from the qualitative thematic content analysis were; androcentric view of family caregiving, undervalued family caregiving by the family members, Self rationalization in the context of family caregiving, family-centric care mechanism, exemplary caring within the family context, and inter-familial relationships among women. CONCLUSION: The main focus of feminist research is to provide empowerment for the women research participants and to bring about social change of oppressive constraint through some actions. On the basis of the research findings, therefore, action strategies from feminist perspectives were suggested in some aspects of health care delivery sectors, nursing education and research sectors, and administrative sectors.

Women Caregivers' Experiences in Caring at Home for a Family Member with Dementia: A Feminist Approach / 간호학회지

PURPOSE: The purpose of this study was to explore women caregivers' lived experiences in caring at home for a family member with dementia and to identify conditions that oppress women in the context of family caregiving. METHOD: This study was conducted within the feminist perspectives using qualitative secondary data. Ten secondary data conveying self reflective contents were selected from the 25 original data obtained in 1999 to 2000. RESULT: Six themes that emerged from the qualitative thematic content analysis were; androcentric view of family caregiving, undervalued family caregiving by the family members, Self rationalization in the context of family caregiving, family-centric care mechanism, exemplary caring within the family context, and inter-familial relationships among women. CONCLUSION: The main focus of feminist research is to provide empowerment for the women research participants and to bring about social change of oppressive constraint through some actions. On the basis of the research findings, therefore, action strategies from feminist perspectives were suggested in some aspects of health care delivery sectors, nursing education and research sectors, and administrative sectors.

Secondary Analysis: Focusing on Qualitative Research / 간호학회지

PURPOSE: This article explored issues arising from secondary analysis of qualitative data and analyzed the results of qualitative secondary analysis studies published in English, focusing on the methodological aspects. METHOD: A total of 29 studies were identified as qualitative secondary analysis studies, retrieving from the CINAHL database from 1982 to 3rd week of April 2003. These studies were analyzed by publication year, research method, and type of approach to secondary analysis. RESULT: The year that the qualitative secondary analysis study first published was 1992 and the number of the studies using secondary analysis has increased after the middle of 1990s. Grounded theory was the one the most frequently used(n=11, 37.9%) and phenomenological study the second most(n=6, 20.7%). In terms of types of approach, fifteen studies(51.7%) focused on the specific concepts that were not explored in the primary studies. Nine(31.0%) focused on the specific types of participants. Six were aimed to integrate contexts or perspectives to generate more general and abstract analysis of qualitative data. CONCLUSION: The results of this article will stimulate methodological discussion of qualitative secondary analysis and activate qualitative studies using secondary analysis.

Adjustment Patterns of Illness Process of People with Hemophilia in Korea / 간호학회지

PURPOSE: The purpose of this study was to explore adjustment pattern of illness process of people with hemophilia in Korea. METHOD: 23 people with hemophilia had participated for this study. The data were collected through in-depth interviews and analyzed using Strauss & Corbin's grounded theory method. RESULT: "would be free from" was emerged as a core category and it reflects that all participants wanted to be free from the constraints of the disease. The adjustment process was categorized into two stage, the 'unstable stage' and the 'stable stage'. In the process of "would be free from" four different patterns were identified: hopelessness type; appreciation type; challenge type; and transcendence type. These types were identified based on the degree of pursuing normal life and managing the disease, and social support. The most frequently occurring type was hopelessness type but the participants of this type suffered the most. The transcendence type was the most ideal type, but it occurred the least. CONCLUSION: The results of this study indicate that people with hemophilia in Korea still suffer from the disease and they need supports. The results would be useful for health care professionals in establishing education and counseling program for the people with hemophilia.

Psychosocial Adjustment of Young Adult to Hemophilia: Living like a Normal Person / 간호학회지

PURPOSE: To explore how young adults in their 20s adjust to hemophilia. METHOD: Grounded theory method guided the data collection and analysis. A purposeful sample of 15 young adults with hemophilia participated during the period of 2000-2001. The data were collected by semi-structured individual interviews, focus group interviews, and participant observations. All interviews were audio taped and transcribed verbatim. Constant comparative analysis was employed to analyze the data. RESULT: "Living like a normal person" emerged as the basic social-psychological process. Two dimensions of the self were identified: normal self and abnormal self. "Living like a normal person" means conscious effort to focus on normal self rather than abnormal self. Five subcategories were identified : 1) pretending as if he is not hemophiliac; 2) relieving the burden; 3) maintaining best physical conditions; 4) becoming independent; and 5) reconciliating with their mothers. CONCLUSION: The results of this study indicate that young adults with hemophilia strive for living a life as a normal person. But there is a question whether it is good for their ultimate quality of life. The results indicate that our society needs to be more tolerant to differences that hemophiliacs have.

The Male Nurses' Experiences of Adaptation in Clinical Setting / 간호학회지

PURPOSE: The purpose of this study was to identified the male nurses' encounter in adapting themselves in the hospital settings dominated by the female nurses in number. METHOD: Data were collected through the in-depth interview of 16 male nurses and analysed through the grounded theory methodology. RESULT: The behaviors of male nurses for job-adaptation can be summarized as a series of struggles to consolidate their own ground. They have made tremendous efforts to hold their own ground in the nursing profession composed of a large numbers of female nurses, while they have experienced many difficulties and problems as minorities. They have struggled to adapt themselves professionally through efforts such as; challenging the social and professional barriers, identifying the job identity, empowering themselves through self-development and dedication, expanding their influence among colleagues. In spite of these efforts, they had the perception that nursing is not a lifelong occupation for them. Thus, they had tendency to find outlets of change to occupations. CONCLUSION: A specific strategy is needed to provide an environment that is helpful for males in integrating into and adapting to the nursing profession.

The Trends of Nursing Research in the Journals of Seven Branches of the Korean Academy of Nursing / 간호학회지

This study was designed to analyze the research methodology and the key concepts used in articles published in each nursing journal of seven branches of the Korean Academy of Nursing. The purpose of this study was for reflecting the trends of nursing research and suggesting the direction of future nursing research in Korea. One thousand three hundred seventy two articles published in seven nursing journals from the beginning year of 2000 were analyzed. The prevailing research designs for these journals were the non-experimental design ranging from 54.3% to 75.7%, the experimental design ranging from 6.2% to 30.4%, and qualitative research design ranging from 3.7% to 10.6%. Research subjects were 10.0% to 46.0% for clients with health problems, 2.1% to 42.4% for generally healthy persons, 1.4% to 43.9% for primary care-givers, 7.0% to 53.5% for nurses or nursing students, and 3.1% to 7.3% for health organizations or nursing organizations. The data collection method used most often self-report questionnaires using psychosocial measures. Interviewing methods and physiologic measures were used relatively few times. The domains of the key concepts that prevailed was personal domain and health domain. This study has the limitation of focusing on only the superficial structural analysis rather than in-depth content analysis of each article. However, this study is the first study for reflecting the trends of nursing research based on each journal of seven branches of the Korean Academy of Nursing.

Characteristics of Nursing Performance based on the Expertise among ICU Nurses / 성인간호학회지

PURPOSE: The purpose of this research was to describe how nurses in intensive care units (ICU) work. METHOD: A total of 18 ICU nurses participated in the research. The data was collected through individual in-depth interviews and analyzed by grounded theory method using NUDIST 4.0 software program. RESULTS: Three different patterns regarding nursing performance among ICU nurses were identified. These are 1) nursing performance of nurses who perform excellently, 2) nursing performance of nurses who do not perform well because of their lack of experience, and 3) nursing performance of nurses who do not perform well in spite of their good years of experience. These three different nursing performances were described in terms of seven different categories; 1) assessing and monitoring nursing problems, 2) clinical decision making, 3) interpersonal relationships, 4) holistic care, 5) technical skills, 6) problem solving, 7) working independently and creatively. This study also identified two intervening factors that influenced the advancement of their expertise. CONCLUSION: The results of this study might help nurse managers in developing continuing educational programs for inexperienced nurses or those nurses not performing well to become experts by a deeper understanding of the nature of nursing performance and the factors that influence nursing performance in ICU settings.

Content Analysis of Experiences of Chest Pain in Women Who Underwent the Treadmill Test with an Impression of Angina Pectoris / 성인간호학회지

PURPOSE: Experience of chest pain may be different in women from that of men and this discrepancy may cause misdiagnosis of angina contribute to mortality by this disease in women. The purpose of this study was to analyze the characteristics of chest pain and responses to the symptoms in women. METHOD: A content analysis was conducted with interviewed data obtained from women who underwent the treadmill test RESULT: Seven major categories were identified from this content analysis: attributes of chest pain; accompanied symptoms; precipitating factors; relief strategies; family support; communication with physicians; and effects of chest pain on their lives. Characteristics of pain were described as heaviness, tightness, heating sensation, tearing, and others. Duration and intensity of pain varied in a wide range. Radiating pain presented in 9 patients, and the locations of radiation were throat, neck, shoulder arm and fingers. Women tended not to respond actively to their chest pain, and didn't get appropriate support either from their family or from their physicians when they reported chest pain. CONCLUSION: Women express non-typical as well as typical patterns of pain when they experience chest pain. Clinicians have to consider the variability of symptoms when they assess women with suspicions of angina.

Effects of Biofeedback Exercise Training in Hemiplegic Patients after Stroke / 간호학회지

PURPOSE: The purpose of this study was to investigate the effects of biofeedback exercise training on muscle activity and activities of daily livings (ADL) in hemiplegic patients. An experimental group consisting of 17 people, was given biofeedback exercise training for 30- 60 minutes per week for 5 weeks, while a control group consisting of 18 people, was given normal exercise with quasi-experimental design. RESULT: The results of the study show that biofeedback exercise is effective for improving muscle activity in hemiplegic patients, especially in the hemiplegic limbs. However, this study found no significant differences in ADL and IADL between the experimental and the control groups. It implies that ADL and IADL may not be improved for a short period of time, such as 5 weeks, for people with more than five years of hemiplegia. The study suggests that the effect of biofeedback exercise on ADL and IADL should be determined in hemiplegic patients in acute stage.

Experience of Mothers with Babies by in Vitro Fertilization / 간호학회지

A phenomenological study was conducted to investigate the experiences of mothers pregnant via in vitro fertilization (IVF). Sample of nine mothers participated. Ten theme clusters emerged when the formulated meanings were organized into categories. During the infertility period, the participants were subject to self- depreciation, envy, anxiety, and depression. It changed their priorities in life from a job-oriented life to one where having a baby was the most important thing. After trying numerous alternative therapies, IVF became their last hope in having a baby. Since the success rate for IVF is low (only 20-30%), the participants for the treatment were overwhelmed with uncertainty, and it led to further anxiety, depression and despair. Success of pregnancy gave them extreme satisfaction, but they became very cautious in their day-to-day life because of their fear of abortion and early delivery. Some were even worried about the side effect of IVF during the pregnancy. Finally, the delivery of the baby gave them relief from the obligation of having a baby. Women did not have any difficulties in rearing a "test tube baby" except in the case of twins. Most women had no ethical difficulty in having a baby by IVF. However they did not wish this information to be revealed to other people. They again turned to IVF to have a son(s) when the resultory child(s) was a daughter(s). This is because of the strong preference for sons in Korean society.

The Pattern of Decision Making to Donate a Living Kidney / 간호학회지

The purpose of this study was to explore decision making phenomenon of living kidney donation experienced by kidney donors. Data were collected through semi-structured indepth interviews from 12 kidney donors. All interviewes were audiotaped and transcribed verbatim. Constant comparative analysis was used to analyze the data with NUDIST4.0 software program. The core category emerged was "wish to give (a kidney)". "Wish to give" in the deliberation process have effects on the execution of kidney donation. Based on the degree of "wish to give", three distinct patterns were identified: Voluntary, compromising, and passive. The voluntary decision making was the most frequent one, while the passive the least. The degree of "wish to give" was influenced by intimacy between the donor and the receipient, geographical locations, economical efficiency of kidney transplantation, and religion. Each pattern was explained by describing interfering and facilitating factors as well as other issues occured in the decision making process. The results of this study will help nurses make effective nursing intervention by understanding the characteristics of decision- making patterns and decision-making process to donate a living kidney.

Expertise in ICU Nursing: A Qualitative Approach / 간호학회지

The purpose of this research was to uncover the expertise of ICU nursing in Korea, and to describe nurses' practice based on the degree of skill acquisition. A total of 18 ICU nurses participated in the study. The data was collected through individual in-depth interviews and it was managed using the NUDIST 4.0 software program. The data was analyzed using interpretive phenomenology suggested by Benner. Four properties of expertise of ICU nursing were identified. These are 1) concern and love toward patients; 2) knowledge; 3) skill, and 4) abilities in interpersonal relationships. And the characterisitcs of four levels of skill acquisition, that is advanced beginner, competent, proficient, and expert, were described with exemplars. The results of this study might help nurse researchers clarify and elaborate on the concept of expertise in ICU nursing, and enable them to understand how the process of skill acquisition occurs in the ICU setting. They might also help nurse managers establish educational goals for ICU nursing for student or novice nurses.