Validity and Reliability of Korean Version of the Self-Efficacy for Managing Chronic Disease 6-Item Scale

Purpose@#The aim of this study was to examine the validity and reliability of the Korean version of the self-efficacy for managing chronic disease 6-item scale (SECD-6-K). @*Methods@#The English version of the Self-Efficacy for Managing Chronic Disease 6-item Scale first underwent forward and backward translation procedures. The SECD-6-K was then used to collect data from 350 adults diagnosed with chronic diseases. Content, construct, convergent, discriminant, and criterion validity were all evaluated. Reliability was assessed using Cronbach’s α. SPSS 25.0 and the data were analyzed using AMOS 26.0 software. @*Results@#The SECD-6-K consists of six items in two domains: disease management and health behavior. The results for construct, convergent, and discriminant validity were good. Exploratory factor analysis produced eigen values between 2.27 and 3.28, with factors total explained cumulative variance of 91.1%. Confirmatory factor analysis supported goodness of fit and reliability for the modified SECD-6-K model. The criterion validity also showed significant correlation with both the Patient Health Questionnaire and 12-item Short-Form Health Survey version 2. Finally, reliability was found to be excellent. @*Conclusion@#This study identified the high reliability and validity of SECD-6-K. The SECD-6-K is an appropriate tool for determining Korean patients’ self-efficacy in managing their chronic conditions. Therefore, this scale may be used in clinical settings as well as in educational and research settings.

Development and Effects of a Community-Based Death Education Program for Older Adults

Purpose@#This study was conducted to investigate the effects of a community-based death education program for older adults. @*Methods@#The study was conducted as a quasi-experimental study with a non-equivalent control group and pretest-posttest design. The subjects were community elders aged over 65 registered at a community health center and were convenience sampled. The experimental group consisted of 33 participants and the control group consisted of 32 participants. Experiments are conducted from June 18 to July 24, 2020. We tested our hypothesis using an independent t-test, and paired t-test. @*Results@#The experimental group had significantly higher scores for psychological well-being than the control group after treatment (t=2.24, p=.028). In general attitude toward the use of life-sustaining technology, however, only the experimental group had a significant difference before and after the experiment with lower scores compared to the control group (t=-5.41, p<.001). @*Conclusion@#We found that the community-based death education program developed in this study was partially effective in improving older adults’ psychological well-being and general attitude toward the use of life-sustaining technology.

Evaluation of Outcomes of the Busan Community-based Palliative Care Project in Korea

PURPOSE: This study aimed to evaluate the outcomes of a community-based palliative care project conducted in Busan city, Korea, from 2013 to 2015. METHODS: We selected four outcome indices based on the project's outcomes derived from a logic model and used a longitudinal and cross-sectional comparative design approach depending on the outcome index. RESULTS: The utilization rate of palliative care increased from 9.2% in 2012 to 41.9% in 2015. Regarding symptom changes in 65 patients receiving palliative care at 3 and 6 months (mean age = 72 years, standard deviation = 9.64, 55.4% women), pain, anxiety, and depression had improved. Quality of life was higher among palliative care patients compared with patients who did not receive palliative care (t = 2.09, p = .039). Regarding recognition of palliative care, civil servants at public health centers who participated in the pilot project (2013–2014) scored higher than those at public health centers who began participation in 2015 (t = 2.67, p = .008). CONCLUSION: This is the first study in Korea that systematically evaluated community-based palliative care. The Busan Community-based Palliative Care Project improved the quality of life of palliative care patients by providing services at an appropriate level and by raising the recognition of palliative care in the community. To increase the utilization ratio of palliative care and the quality of service, strategies should be developed to supplement medical support systems.

Development of a Community-Based Palliative Care Model for Advance Cancer Patients in Public Health Centers in Busan, Korea / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: A feasible palliative care model for advance cancer patients is needed in Korea with its rapidly aging population and corresponding increase in cancer prevalence. This study describes the process involved in the development of a community-based palliative care (CBPC) model implemented originally in a Busan pilot project. MATERIALS AND METHODS: The model development included steps I and II of the pilot project, identification of the service types, a survey exploring the community demand for palliative care, construction of an operational infrastructure, and the establishment of a service delivery system. Public health centers (including Busan regional cancer centers, palliative care centers, and social welfare centers) served as the regional hubs in the development of a palliative care model. RESULTS: The palliative care project included the provision of palliative care, establishment of a support system for the operations, improvement of personnel capacity, development of an educational and promotional program, and the establishment of an assessment system to improve quality. The operational infrastructure included a service management team, provision teams, and a support team. The Busan Metropolitan City CBPC model was based on the principles of palliative care as well as the characteristics of public health centers that implemented the community health projects. CONCLUSION: The potential use of the Busan CBPC model in Korea should be explored further through service evaluations.

Recognition of Good Death, Attitude towards the Withdrawal of Life-Sustaining Treatment, and Attitude towards Euthanasia in Nurses / 한국호스피스완화의료학회지

PURPOSE: To provide practical data for bioethics education, we identified correlations between recognition of good death, attitude towards withdrawal of meaningless life-sustaining treatment, and attitude towards euthanasia in nurses. METHODS: Using convenience sampling, we recruited 218 nurses who had at least six-month work experience in one of the six general hospitals with 500 or more beds in Seoul, Busan, and Gyeongsang province. All participants understood the purpose of the study and agreed to take part in the study. The research tools used included the Concept of Good Death Measure (CoGD), the measurement tool for attitudes towards withdrawal of meaningless life-sustaining treatment (WoMLST), and the measurement tool for attitudes towards euthanasia. Data were analyzed using an Independent t-test, one-way ANOVA, and Pearson's correlation coefficient using SPSS 21 for Windows. RESULTS: Nurses had normal levels on CoGD, WoMLST, and attitudes towards euthanasia. Nurses' CoGD, WoMLST, and euthanasia scores significantly differed depending on their education level, working period, and the importance of religion to them. A negative correlation was found between the CoGD and WoMLST scores, and WoMLST and euthanasia scores were positively correlated. CONCLUSION: Nurses should be trained to deal with ethical issues that may arise while caring for terminal patients. It is necessary for nurses to understand the concepts related to CoGD, WoMLST, and euthanasia, and to promote bioethics education with focus on decision-making and problem-solving ability in ethically conflicting situations.

Analysis of Characteristics and Symptoms in Home-Based Hospice-Palliative Care Patients Registered at Local Public Health Centers / 한국호스피스완화의료학회지

PURPOSE: This study was aimed at analyzing the characteristics and symptoms in home-based hospice-palliative care (HBHPC) patients registered at local public health centers. METHODS: A retrospective study was performed; Data of 144 HBHPC patients registered at six public health centers in Pusan City were analyzed, including their initial visit records (registration cards, initial pain evaluation and symptom evaluation). RESULTS: The average age of the patients was 67.7 years old. Among all, 46.2% of the patient lived alone, and 65% had middle school education or lower. The most popular (36.3%) religion was Buddhism, and 47.5% received medical assistance from the government. The most frequent diagnosis was lung cancer followed by stomach cancer and liver cancer in that order. Of all, 48.9% were functionally too weak to lead a daily life, 39.6% were under cancer treatment when registered at the public health center, and 84.5% were aware of the fact that they have reached the terminal phase. Moreover, 83.6% complained about pain, and the pain level was moderate or severe in 36.5% of them. Besides pain, fatigue was the most complained symptom (84.7%), and 49.3% of them rated their fatigue as moderate or severe. CONCLUSION: Most of the HBHPC patients were socio-economically underprivileged and complained about moderate or worse pain and symptoms. Therefore, it appears necessary to develop an integrated strategy that is tailored for each patient reflecting their characteristics.

Spirituality and Self-esteem in Middle-aged Women / 정신간호학회지

PURPOSE: This study was conducted to identify the relationship of spirituality and self-esteem in middle-aged women. METHODS: The participants were 260 women, aged 40 to 64, living in Busan City or Kyungnam Province. The measurement scale used in the study were the 'Korean Spirituality Scale' and a 'Self-esteem Scale'. The collected data were analyzed using t-test, ANOVA, Pearson' correlation coefficients, and simple linear regression with the SPSS/WIN 20.0 program. RESULTS: The level of spirituality and self-esteem of the women averaged 3.1. For differences in spirituality and self-esteem by general characteristics, there were significant differences according to religion, employment, and economic status. There was a significantly positive correlation among spirituality and self-esteem. Simple linear regression analysis showed that spirituality accounted for 49% of the variance in self-esteem. CONCLUSION: The interest in spirituality is an important in psychological nursing to meet patient demands, especially patients who are experiencing existential problems. It is necessary to provide psycho-spiritual programs for the middle-aged women to improve self-esteem. Future research with experimental designs and random sampling needs to be done to examine relationships between middle-aged women's spirituality and self-esteem.

Spirituality among Physicians and Nurses in Metropolitan Cities / 정신간호학회지

PURPOSE: This study was a descriptive survey research to investigate physicians and nurses' spirituality and to determine the general characteristics of physicians and nurses and the differences in their spirituality according to characteristics related to their works. METHODS: The participants were 120 physicians and 120 nurses working in general hospitals with more than 500 beds located in metropolitan cities. The study data were collected from Nov. 15, 2009 to Dec. 30, 2009. Spirituality was measured using 'The scale for Korean' spirituality' developed by Lee et al (2003). The scale has 30 questions answered on a five-point scale. Descriptive statistics, ANCOVA, t-test and one-way ANOVA were also used with the SPSS/WIN 170.0 program to analyze the data. RESULTS: The spirituality of physicians and nurses was slightly higher than 3 points, a theoretical mean, which was at mid-level. The nurses had a significantly higher level than the physicians in 6 dimensions of spirituality and in the dimension of awareness. For differences of spirituality according to general characteristics and work related characteristics, there were significant differences according to the importance of religion in life, religion and age. CONCLUSION: Interest in spirituality is an important for medical professionals if they were to meet various patient demands within diverse cultures and beliefs. Medical science and nursing science should be sensitive to the spiritual demands of medical professionals themselves and their patients by developing educational programs to increase spirituality in education and practical affairs.

Development of Community Health Center-Based Hospice Management Model: Pilot Project at a Community Health Center in Busan / 한국호스피스완화의료학회지

PURPOSE: This study was a part of a drive to develop a community health center-based hospice management model which is concerned with hospice care at a community health care setting and available resources of the local community. METHODS: Development of a community health center-based hospice management model involved evaluation of existing hospice-related research, including literature review, and research on hospice facilities at the study site, as well as evaluation of model operation. The latter involved community health center-based hospice test operation, and evaluation of test operation by a research team, including of a nursing professor majoring in hospice care and staffs from a community health center in Busan metropolitan city, regional cancer center, and regional terminal cancer patient medical institute. The study was conducted in the 2008 calendar year. RESULTS: The community health center-based hospice management model provides service linked with local community resources, focusing on the local community health center. Financial and administrative assistance is provided by the regional cancer center, with collaboration from academic health care professionals who guide the operation management. The community health center hospice nurse in consultation with a visiting nurse team registers terminally-ill cancer patients and, after assessment, the hospice team prioritize hospice care during team meeting. Care is delivered by staffs and volunteers. CONCLUSION: The developed community health center-based hospice operation management model maximally utilizes available community health resources to produce qualitative improvement of regional health and welfare policy through improving the lives of home-based cancer patients and their family who are in medical blind spot.

Development of Meaning in Life Scale II / 간호학회지

PURPOSE: The purpose of this study was to develop a meaning of life scale with high validity and reliability. METHOD: A conceptual framework composed of 4 phases of meanings of life was identified. And 49 preliminary items on a 4-points scale were developed through content validity. A reliability and validity test of the 49 items was conducted on 564 adults. By means of internal consistency of the 49 items, 1 item was deleted. To verify the 48 items, factor analysis, reliability test, and LISEREL were done. RESULT: Through exploratory factor analysis of the 48 items, 8 factors were extracted. These factors were labeled as 'self- awareness and self-acceptance', 'hope', 'responsibility awareness', 'love experience', 'self transcendence', 'relation experience', 'self contentedness', and 'Commitment'. Through LISEREL of the 48 items, 2 items were excluded and finally 46 itemsremained. Cronbach's Alpha of the 46 items was .94. The correlation coefficient of the Self-esteem scale was .79. CONCLUSION: By the above results, the researchers recommend the following: An exploratory study on the variables related to the meaning of life are needed for criterion validity of this scale. Studies on meaning of life of different groupa, and subjects are needed for reverification.

The Effect of Cervical Kyongrak Massage on Shoulder Pain, Shoulder Exercise Range and Mood in the Elderly / 성인간호학회지

PURPOSE: This study was to identify the effect of Cervical Kyongrak Massage on Shoulder pain, shoulder Exercise Range and Mood in the elderly. METHOD: This study used a quasi- experimental pre-test and post-test design. Data were collected from 13 April to 30 June in 2003. There were 58 elderly subjects,(30 experimental group, 28 control group) in Pusan. The experimental group took Kyongrak Massage at Cervical Kyonghyul sites around neck and shoulder for 10 minutes daily during 5days. RESULT: In the experimental group, shoulder pain(t=-9.80, p=.000), shoulder exercise Range (Flexion t=3.10, p=.003; Abduction t=7.95, p=.000; External Rotation t=5.00, p=.000) and Mood(t=-9.80, p=.000) were significantly better than control group after Cervical Kyongrak Massage. CONCLUSION: These findings indicate that Cervical Kyongrak Massage may be an effective adjunct therapy for improving shoulder pain, shoulder exercise range and mood, and is considered as a independent and available nursing intervention for elderly.

Development of Elderly Meaning in Life(EMIL) Scale / 간호학회지

PURPOSE: The purpose of this study was to develop elderly meaning in life scale with high validity and reliability. METHOD: The process of development of this scale were as follows. A conceptual framework composed of 4 phases of meaning in life of elderly was identified based on the literature review and interviews with elderlies and discussion with experts in meaning in life. Total 62 items, 4-points scale were developed. Through reliability testing, factor analysis, 40 preliminary items were selected. By means of internal consistency of 40 items, 2 items whose inner-items correlation coefficient was below .30 were deleted. Through factor analysis 1 item whose factor loading was below .30 was deleted. Finally 37 items were remained. To verify 37 items, factor analysis, reliability testing, LISEREL were done. Data were collected from 320 elderly subjects in Busan-KyungNam and Jeonla Province from May to June in 2002.. SPSS WIN. 10.0 Program was used. RESULT: The result of factor analysis of 37 items, 8 factors were extracted. These factors were labeled as 'self- awareness and self-acceptance', 'contentedness with life', 'purpose in life', 'love in family', 'role awareness', 'futuristic aspiration', 'commitment', and 'experience of love'. These factors included 4 phases of the meaning in life. Cronbach's Alpha of 37 items was .908 and correlation coefficient of PIL was .75. CONCLUSION: The researchers recommend the follows : The explorative study on the variables related to meaning in life are needed for criterion validity of this scale. The studies on meaning in life of different age groups, subjects are needed for reverification.

The Relationships between Sex-Role Identity and the Meaning in Life for a Matriarch / 여성건강간호학회지

The purposes of this study were to understand the sex role identity and the meaning in life(MIL) of matriarchs and analyze their relationships to offer basic data for effective nursing strategies for improving MIL. The data for this study was collected from the 10th of August to the 30th of November, 2000. The subjects were women registered in an occupational training program for unemployed matriarchs which is held in the Working Women's Center in Busan. The measurement tools of this study were MIL(unpublished)developed by researchers and sex role inventory designed by Kim Deuk Ran(1992). The results of this study were as follows: 1.Sex role identities of matriarchs were feminity 13.7%, masculinity 13.4%, androgyny 37.8% and undifferentiated 35.1%. 2. The mean MIL for matriarchs was 173.46+/-16.09. 3. The levels of MIL were 57.2% of the subjects felt a loss of meaning in life, i. e. existential vacuum, 42.8% were in pursuit of meaning but had not discovered it completely and 6.0% felt they had established meaning in life. 4.There were significant differences in MIL levels, concurrent to 4 types of sex role identities(F=11.93, P=.000). And according to Scheffe's post test, between feminity and masculinity, feminity and androgyny, masculinity and the undifferentiated, androgyny and the undifferentiated, there were significant differences. From the results of this study, most matriarchs felt loss of meaning in life, i. e. existential vacuum, and the group with masculine sex role identity had the highest level of MIL. In conclusion, the factors related to masculine sex role identity are necessary to develop nursing strategies for improving levels of MIL.

Meaning in Life of a Resident Community of Normal Adults / 성인간호학회지

PURPOSE: The purpose of this study was to measure meaning in life for a normal adult and to offer basic data for developing nursing strategies for improving the meaning in life of adults. METHOD: There were 351 subjects, from 20 to 60 years old, staying in Busan and KyungNam Province. The data was collected from August to October 2000. The instrument was designed by researchers. The data were analyzed with frequency, mean(+/-SD), t test and ANOVA. RESULT: 1. The mean MIL for adult was 187.7(+/-18.1). 2. The mean MIL of basic premise phase for discovery of meaning was 30.5, method phase for discovery of meaning was 111.1, and result phase for discovery of meaning was 46.4. 3. The levels of MIL, 56.4% of the subjects were in pursuit of meaning in life, 23.3% felt a loss of meaning in life. 4. There were significant differences in MIL according to the level of education(P=0.00), marital status(P=0.01) and monthly income (P=0.00). CONCLUSION: On the viewpoint of the above results, 23.3% of the subjects were in a level of existential vaccum which required keens Logotherapy. Therefore, it shows that developing nursing-logotherapy to improve the meaning in life for adults is demanded.

Development of Meaning in Life Measurement Tool / 간호학회지

The purpose of this study was to develop an instrument to measure meaning in life based on Frankl's theory of logotherapy. Data were collected from August to October, 1999 by means of questionnaires developed by researchers. The subjects were 351 adults living in Busan and Kyoung Nam province. The study was conducted as follows: 1) A conceptual framework was identified based on the extensive review of relevant literatures and interviews with adults and professionals in psychology, philosophy, theology, and nursing. 2) The 76 items, 4-points scale were developed. 3) The scale was tested on 351 adults to assess the reliability and validity, and factor analysis was done. 4) 63 items were established based on this testing and ten factors were extracted. These factors were labeled as self-awareness and self-acceptance, futuristic aspiration, valuelessness, purpose in life, contentedness with life, role awareness, experience of love, love in family, commitment, self- transcendence. Cronbach's alpha of the 63 items was .950. Comparative studies to assess construct validity and repetitive studies to heighten generalizability are needed. This tool can be utilized to measure Korean's meaning in life.

A Study on the Meaning in Life of Matriarch ; Q-Methodological Approach / 간호학회지

PURPOSE: This study is used to investigate and understand types of meaning in life of matriarch. Methods: This study is based on a Q-methodological approach. Thirty nine statements concerning meaning in life were selected. Twenty seven women were chosen as a subject group for this study. Their opinions were shown in 39 statements divided into 9 scales by forced distribution. Results: TypeIwas named "self-transcendental and future- oriented types". In this types a one pursued attitudinal value by religion. Type II was named "Realistic and responsibility fulfilling types". This type pursued creative and experiential value. Type III was named "Encounter and relationship oriented type". This types pursued experiential value. Type IV was named "Realistic self-actualizing type". This types pursued creative value. Type V was named "Altruistic and commitmental types". This type pursued creative, experiential, and attitudinal value. CONCLUSION: Considering the structure of finding the meaning in life of matriarchs, all types had responsibility and self-control in their lives and lived for present however, only typeI lived for the future. It seem necessary to understand each matriarchs meaning in life and nursing needs to develop appropriate nursing interventions based on the type matriarch she is.

The Development and Effect of a Group Counseling Program for Unemployed Matriarchs / 간호학회지

This study was designed to develop a program for unemployed matriarchs and show if the program affected their view on the meaning in life. The subjects were women registered in an occupational training program for unemployed matriarchs, which is being practiced in the 'Working Women Center' located in Busan. The researchers selected 44 persons from the group who agreed to our program. This study was done from the 10th of March, 1999 to the 9th of October. The researchers used the measurement tools, The Purpose in Life, Self-esteem, Hope and Meaning in Life which was composed of 63 items developed by them. Their Cronbach's alpha were .88, .79, .76 and .95. The researchers analyzed the data with frequency, percentage, Mean, S.D, Wilcoxon signed ranks test which were deduced from SPSS 10.0 WIN program. The results of this study were as follows: 1) The program is composed of 'becoming intimate', 'open-minded', 'exploration on self', 'relax of repressed emotion', 'self- acceptance', 'establishing the life-goal', 'enrichment of human relationship' and closing. It took 20 hours for this program to come into practice. 2) According to the analysis of the general traits of all subjects, average age was 39.36. High school graduates were 86%, college graduates were 14% and divorce were 57%, bereavement were 18%, and the rest were 25%. 3) The result of 1st progam showed self-esteem during the program was high. 4) The result of 2nd progam showed self-esteem during the program was high. 5) The result of 3rd progam showed the sum scores of meaning in life, creative meaning, and attitudinal meaning during the program was high. 6) The result of 4th progam showed the sum scores of meaning in life and creative meaning during the program was high. On the viewpoint of above results, we convinced that 'a program for unemployed matriarch is effective to establish a stronger meaning in life. Therefore, it is demanded that support for unemployed matriarchs should not only be economic help such as technical training and help of living expenses, but also psychological, professional and systematic support.

A Structural model for Quality of Life in Women Having Hysterectomies / 간호학회지

The purpose of this study was to develope and test the structural model for quality of life in women having hysterectomies. A hypothetical model was constructed on the basis of previous studies and a review of literature. The conceptual framework was built around eight constructs. Exogenous variables included in this model were marital intimacy, importance of uterus, professional support, positive coping behavior and pre-operative symptoms. Endogenous variables were spouse's support sense of loss and quality of life. Empirical data for testing the hypothetical model was collected using a self-report questionnaire from 203 women having hysterectomies at the outpatient clinics of four general hospitals and a mail survey in Pusan City. The Data was collected from December, 1997 to January, 1998. Reliability of the eight instruments was tested with Cronbach's alpha which ranged from 0.639-0.915. For the data analysis, SPSS 7.5 WIN Program and LISREL 8.12 WIN Program were used for descriptive statistics and covariance structural analysis. The results of covariance structure analysis were as follows : 1. Hypothetical model showed a good fit with the empirical data. [x2=6.93(df=5, P=.23), GFI=.99, AGFI=.94, RMSR=.019, NNFI=.97, NFI=.98, CN=440, standardized residuals(-2.14-2.10)] 2. For the parsimony of model, a modified model was constructed by deleting 3 paths and adding 1 path according to the criteria of statistical significance and meaning. 3. the modified model also showed a good fit with the data. [x2=5.26(df=7, P=.63), GFI=.99, AGFI=.97, RMSR=.014, NNFI=1.02, NFI=.99, CN=710, standardized residuals(-1.46-1.70)] Results of the testing of the hypothesis were as follows : 1. Marital intimacy(gamma11=.78, t=14.37) and professional support(gamma13=.12, t=2.12) had a significant direct effect on the spouse's support. 2. Pre-operative symptoms(gamma25=.32, t=3.12) , importance of uterus(gamma22=.20, t=2.61) and spouse's support(beta21=-.19, t=-2.43) had a significant direct effect on the sense of loss. 3. Sense of loss(beta32=-.66, t=-9.83) had a direct effect on the quality of life. Marital intimacy had a direct(gamma31=.19, t=3.33), indirect(gamma31=.14, t=2.52) and total effect(gamma31=.25, t=4.41) on the quality of life. Professional support had a direct effect(gamma33=.11, t=2.07) and total effect(gamma33=.13, t=2.31) on the quality of life. The direct effect of pre-operative symptoms(gamma35=-.36, t=-4.02) and positive coping behavior(gamma34=.15, t=2.06) had the insignificant effect on the quality of life while, due to the indirect effect these variables had overall significant effect on the quality of life. The results of this study showed that the sense of loss had the most significant direct effect on the quality of life. Marital intimacy, pre-operative symptoms and spouse's support had a significant direct effect on this sense of loss. These four variables, the sense of loss, marital intimacy, pre-operative symptoms and spouse's support, were identified as relatively important variables. The results of this study suggested that there is needed to determine if nursing intervention would alleviate this sense of loss and promote a greater quality of life in women who have had hysterectomies.

A Structural model for Quality of Life in Women Having Hysterectomies / 간호학회지

The purpose of this study was to develope and test the structural model for quality of life in women having hysterectomies. A hypothetical model was constructed on the basis of previous studies and a review of literature. The conceptual framework was built around eight constructs. Exogenous variables included in this model were marital intimacy, importance of uterus, professional support, positive coping behavior and pre-operative symptoms. Endogenous variables were spouse's support sense of loss and quality of life. Empirical data for testing the hypothetical model was collected using a self-report questionnaire from 203 women having hysterectomies at the outpatient clinics of four general hospitals and a mail survey in Pusan City. The Data was collected from December, 1997 to January, 1998. Reliability of the eight instruments was tested with Cronbach's alpha which ranged from 0.639-0.915. For the data analysis, SPSS 7.5 WIN Program and LISREL 8.12 WIN Program were used for descriptive statistics and covariance structural analysis. The results of covariance structure analysis were as follows : 1. Hypothetical model showed a good fit with the empirical data. [x2=6.93(df=5, P=.23), GFI=.99, AGFI=.94, RMSR=.019, NNFI=.97, NFI=.98, CN=440, standardized residuals(-2.14-2.10)] 2. For the parsimony of model, a modified model was constructed by deleting 3 paths and adding 1 path according to the criteria of statistical significance and meaning. 3. the modified model also showed a good fit with the data. [x2=5.26(df=7, P=.63), GFI=.99, AGFI=.97, RMSR=.014, NNFI=1.02, NFI=.99, CN=710, standardized residuals(-1.46-1.70)] Results of the testing of the hypothesis were as follows : 1. Marital intimacy(gamma11=.78, t=14.37) and professional support(gamma13=.12, t=2.12) had a significant direct effect on the spouse's support. 2. Pre-operative symptoms(gamma25=.32, t=3.12) , importance of uterus(gamma22=.20, t=2.61) and spouse's support(beta21=-.19, t=-2.43) had a significant direct effect on the sense of loss. 3. Sense of loss(beta32=-.66, t=-9.83) had a direct effect on the quality of life. Marital intimacy had a direct(gamma31=.19, t=3.33), indirect(gamma31=.14, t=2.52) and total effect(gamma31=.25, t=4.41) on the quality of life. Professional support had a direct effect(gamma33=.11, t=2.07) and total effect(gamma33=.13, t=2.31) on the quality of life. The direct effect of pre-operative symptoms(gamma35=-.36, t=-4.02) and positive coping behavior(gamma34=.15, t=2.06) had the insignificant effect on the quality of life while, due to the indirect effect these variables had overall significant effect on the quality of life. The results of this study showed that the sense of loss had the most significant direct effect on the quality of life. Marital intimacy, pre-operative symptoms and spouse's support had a significant direct effect on this sense of loss. These four variables, the sense of loss, marital intimacy, pre-operative symptoms and spouse's support, were identified as relatively important variables. The results of this study suggested that there is needed to determine if nursing intervention would alleviate this sense of loss and promote a greater quality of life in women who have had hysterectomies.

The Sexual Satisfaction in Married Women / 간호학회지

This study was conducted to explore the level of sexual satisfaction in married women. This is a descriptive study. The data was collected from July 19 to Aug 10, 1997 utilizing a questionnaire developed by researchers. Sexual satisfaction(alpha=.926) was measured by the Sexual satisfaction scale(Kim at el, 1997) which is consisted of 17-items. And data was analysed using SPSS/PC+ 7.5. The following is a summary of the study. 1. The study surveyed a total of 400 married women from Seoul, Kyungki do, and Pusan. The mean age of the subjects was 38.61 years with the range from 22 to 69 years. A large proportion of the subjects(69.3%) had received a high school education or further education. In terms of the marital satisfaction, 68.6% of subjects were moderately or highly satisfied; 6.8% were dissatisfied. 2. The mean score and standard deviation of the sexual satisfaction was 42.74+/-10.42 with the range from 17 to 68 score. 3. The variables influencing on sexual satisfaction were age, education level, income, job, stress, and perceived marital satisfaction.