Analysis of Trends and Contents of Nursing Doctoral Dissertations in Korea

PURPOSE: This study aimed to identify contents and trends of Korean nursing doctoral dissertations in terms of research methodology and theoretical characteristics. METHODS: The design of the study was descriptive study and a total of 1,089 quantitative studies completed between 1982 and 2010 were reviewed using the analytical framework developed by the researchers. RESULTS: The majority of studies utilized the experimental design (51.5%) and the others were survey design (38.8%) and methodological design (5.0%). Study subjects were shown as patients (45%), care givers (11.2%), ordinary persons (40.6%) and others (3.2%). There were growing trends in experimental design and patients as subjects. The prevailing data collection settings were hospitals (45.8%) and community (27.8%). The theoretical frameworks that studies were based on were the existing theories (37%) and a newly developed theoretical framework by a researcher (25.2%). a framework derived from other studies by the researcher (25.2%). Majority of studies (78.5%) employed a single theory as a theoretical framework. However, 31.8% of studies had no theoretical framework based on. CONCLUSION: Findings of this study provided the opportunities to shed new light on the current status of Korean doctoral dissertation and to deliberate on the future direction of nursing studies in Korea.

Types of Physical Restraint Experience in Mentally Ill Persons: Q Methodological Approach / 정신간호학회지

PURPOSE: The purpose of this study was to identify the patterns of physical restraint experience in mentally ill persons. METHODS: Q-methodology, an approach designed to discover patterns in various subjective experiences, was used. Twenty-two participants classified 36 selected Q-statements on a nine-point scale to create a normal distribution. The collected data were analyzed using the PC Quanl Program. RESULTS: Five types of physical restraint experience in mentally ill persons were identified by the participants. Type I Emotional reaction-explosive anger, Type II Emotional reaction-internalized anger, Type III Rational reaction-rejection, Type IV Rational reaction-acceptance, Type V Rational reaction-trust. CONCLUSION: The results of this study provide an understanding that different types of reactions to physical restraint experience exist and that each type has certain characteristics, which suggest a need to develop interventions specifically designed for each type of physical restraint experience.

Perceived Stress, Stress Symptoms, and Ways of Coping in Korean College Students / 정신간호학회지

PURPOSE: The purpose of this study was to identify perceived stress level, stress symptoms, and ways of coping and to examine the influences of perceived stress level and ways of coping on stress symptoms in Korean college students. METHODS: A cross-sectional descriptive survey study design was used. A sample of 1,056 male and female college students completed the Brief Encounter Psychosocial Instrument, Symptoms of Stress Inventory, and the Ways of Coping Checklist. Data was analyzed by t-test, ANOVA, Pearson correlation coefficient and multiple regression analysis using SPSS/WIN 12.0. RESULTS: The perceived stress level, stress symptoms, and ways of coping were found to be significantly positively correlated with one another. The perceived stress level and stress symptoms had a greater positive correlation with emotion-focused coping than problem-focused coping. Perceived stress, emotion-relieving coping, perceived health status, and wishful thinking coping accounted for 37.7% of the variance in college students' stress symptoms. CONCLUSION: The findings suggest that nurses, while developing and providing stress management programs, need to be aware of the perceived stress level, health perception, and the tendency to emotion-focused coping in Korean college students, as these factors all influence their total stress symptoms.

A Study on Exercise Behavior, Exercise Environment and Social Support of Middle-Aged Women / 간호학회지

PURPOSE: The purpose of this study was to identify exercise environments and social support associated with exercise behaviors in middle-aged women. METHOD: Subjects were 207 women aged between 41 and 59 yr in an urban community. The research instruments utilized in this study were exercise stages, exercise environments, exercise partners and social support scale. Subjects were given a self-report questionnaire. Data was analyzed using the SPSS Win program. RESULT: The subjects were in the stages of precontemplation (3.4%), contemplation (25.1%), preparation (40.6%), action (5.8%), and maintenance (25.1%). Subjects who engaged in regular exercise were 30.9%. The mean score of the exercise environment was 6.34. The mean score of social support was 21.28, and 65.7% of subjects had exercise partners. The score of the exercise environment was significantly associated with the exercise stage (p=.01). The number of exercise partners of regular exercise groups was significantly greater than that of non-regular exercise groups (p=.00). The score of social support of regular exercise groups was significantly greater than that of non-regular exercise groups (p=.00). The score of social support was significantly associated with the exercise stage (p=.00). CONCLUSION: Exercise environments and social support need to be considered in planning exercise programs to improve exercise behavior among middle-aged women.

Depression and Quality of Life among Family Caregivers of Patients with Parkinson's Disease in South Korea / 재활간호학회지

ression and quality of life of family caregivers of patients with Parkinson's disease(PD). METHODS: A cross-sectional descriptive study was conducted in one neurology outpatient clinic in Seoul, Korea from March to June, 2006. Sixty eight family caregivers of PD patients were participated to the study, using CES-D and SF-36. RESULTS: Mean scores of depression were 16.18+/-8.39 (range: 0-48) and it was a little lower than caregiver's who took care of Dementia patients and were higher than primary caregivers of the patients with Stroke. Time for caregiving, perceived severity, duration of PD were significantly related with depression respectively. Higher ADL scores which mean greater motor disabilities were related to higher caregiver depression. Lower income and greater medical expenditure were closely related with the depression of family caregivers respectively. The mean scores of total QOL were 435.5+/-96.5 and the mean scores of PF, SF, RE and MH were lower than general population. Time for caregiving, depression, patients' ADL scores were significantly associated with QOL respectively. People who were older and had lower educational background showed lower QOL scores respectively. CONCLUSION: Healthcare professionals should pay more attention to emotional aspects of caregivers who take care of PD patients, and develop comprehensive management strategies both for patients and their caregivers.

Subjective and Objective Caregiver Burden in Parkinson's Disease / 간호학회지

PURPOSE: Parkinson's disease (PD) is a common neurodegenerative disorder characterized by motor disabilities and increasing dependence on others for daily life activities with consequent impact on patients' and caregivers' quality of life. The aim of this study was to elucidate the burden on primary caregivers of patients with PD, and identify related factors. METHODS: A cross-sectional descriptive study. Seventy-six primary caregivers of PD patients in a neurology outpatient clinic, Seoul, Korea completed structured questionnaires, of which 68 were analyzed. The structured self-report questionnaire included (1) demographic information on the caregivers, (2) information regarding the disease characteristics of the patients, and (3) the subjective and objective caregiver burdens as assessed on Montgomery, Gonyea, & Hooyman's scale. RESULTS: The mean age of the caregivers was 54.56 years, and spouses represented the largest proportion(47.0%). Caregivers of PD patients experienced high levels of burden (mean scores on the subjective and objective burdens were 45.22 and 34.90, respectively), which were comparable to the caregiver burdens in stroke, and higher than the caregiver burdens in general chronic disease. Older caregivers and spousal caregivers experienced significantly higher burdens (p=.004 and p=.019, respectively). A greater motor disability and higher modified Hoehn and Yahr grade were related to higher caregiver burden (p=.001 and p=.018, respectively). CONCLUSION: Caring for PD patients is associated with a high level of caregiver burden. Therefore, healthcare professionals should identify the burden of caregivers who look after PD patients and develop comprehensive management strategies both for patients and their caregivers.

Mothers' Experience of Caregiving for Their Children with Schizophrenia / 간호학회지

PURPOSE: The purpose of this study was to explore Korean mothers' experiences of caregiving for their adult children with schizophrenia. METHOD: A iterative descriptive qualitative research design was used to understand and explain the caregiving experience from the perspective of mothers. The data were collected by individual in-depth interviews and one focus group interview from 11 mothers. The ages of the participants ranged from 50 to 60 years old and the ages of their sick children ranged from late 20s to early 40s. RESULTS: Three major themes were identified from qualitative thematic analysis: (a) "emotional debris from the disease," (b) "the disease that makes mothers dumb" (c) "space of rational reason." CONCLUSIONS: This study would provide health care professionals insights in establishing intervention for mothers by deeply understanding the process of recognition and acceptance of their children with schizophrenia.

Mothers' Experience of Caregiving for Their Children with Schizophrenia / 간호학회지

PURPOSE: The purpose of this study was to explore Korean mothers' experiences of caregiving for their adult children with schizophrenia. METHOD: A iterative descriptive qualitative research design was used to understand and explain the caregiving experience from the perspective of mothers. The data were collected by individual in-depth interviews and one focus group interview from 11 mothers. The ages of the participants ranged from 50 to 60 years old and the ages of their sick children ranged from late 20s to early 40s. RESULTS: Three major themes were identified from qualitative thematic analysis: (a) "emotional debris from the disease," (b) "the disease that makes mothers dumb" (c) "space of rational reason." CONCLUSIONS: This study would provide health care professionals insights in establishing intervention for mothers by deeply understanding the process of recognition and acceptance of their children with schizophrenia.

A Study of Factors Influencing on Health Promoting Lifestyle in the Elderly: Application of Pender's Health Promotion Model / 간호학회지

PURPOSE: The purpose of this study was to investigate the factors influencing health promoting lifestyle in the elderly. METHOD: The subject of this study was 305 elderly person over the age of 60, living in rural and urban, Korea. For the analysis of collected data, descriptive statistics, t-test, analysis of variance and stepwise multiple regression were used for statistical analysis with SPSS statistical program. RESULTS: The average item score for the health promoting lifestyle was 2.46. The higher score on the subscale was nutrition(2.65). The lowest score on the subscale were physical activity(2.36) and stress management(2.36). General characteristics showing statistically significant difference in health promoting lifestyle were age, residential district, live together spouse, education, religion and pocket money in the elderly. Stepwise multiple regression analysis revealed that the most powerful predictor of health promoting lifestyle in the elderly was prior related behavior(R2=.554). A combination of prior related behavior, perceived benefits of action, perceived self-efficacy, commitment to a plan of action, and interpersonal influences accounted for 64.3% of the variance in health promoting lifestyle in the elderly. CONCLUSION: The factors influencing on health promoting lifestyle for elderly were prior related behavior, perceived benefits of action, perceived self-efficacy, commitment to a plan of action, and interpersonal influences.

The Effect of Biofeedback-Assisted Relaxation on the Clinical Symptoms and Stress Responses in Patients with Chronic Headache / 신경정신의학

OBJECTIVES: This study aimed to examine the effect of biofeedback treatment on the clinical symptoms and stress responses in chronic headache patients. METHODS : We recruited 18 chronic headache patients who were treated with 8 sessions of biofeedback treatment and 18 age and sex-matched control headache patients. All subjects consisted of patients with chronic tension headache and migraine headache. Stress responses were measured using Symptoms of stress (SOS) inventory and all subjects performed Beck depression inventory (BDI), Spielberger state anxiety inventory (STAIS), and visual analogue scale (VAS). Biofeedback physiological variables including frontal and forearm EMG, electrodermal response (EDR) and skin temperature at pre-and post-treatment were also measured in all subjects. RESULTS : Compared with control patients, patients on biofeedback treatment showed significant reduction in scores of STAIS (t=3.705, p<.001), and VAS (t=3.392, p=.001) as well as SOS subscales;peripheral manifestations (t=1.788, p=.042), habitual patterns (t=2.008, p=.027), depression (t=2.081, p=.023), anxiety (t=1.990, p=.028), and total score (t=2.045, p=.025). There was a significant increase of skin temperature (t=-1.835, p=.038) only in the biofeedback treatment group. CONCLUSION : These results suggest that biofeedback treatment may be effective in relieving chronic headache by reducing psychological and physiological stress responses.

Comparison of Nursing Activities Reflected in Nursing Notes and In-depth Interviews of Nurses in an Acute Hospital / 간호학회지

PURPOSE: The purpose of this study was to compare the nursing activities delineated by interview of nurses with those on nursing notes. METHOD: The participants of interview were 18 nurses working in medical and surgical units of a large hospital in Seoul. Each nurse was asked to choose one patient who demand most nursing care among her patients. The nurse was then interviewed to describe what her nursing activities for the patient was that day. The audio-taped interview was transcribed and the content was analyzed by researchers. Nursing notes of each nurses' patients were copied and the content analyzed by researchers. Finally, themes from the interview data and those from nursing notes were compared. RESULT: Activities related to emotional or psychological nursing, education for patient and families, and problem solving related to treatment or nursing procedure were most often omitted in nursing notes. Most of the documentation in nursing notes were related to physical condition of patients or physician's orders. Nurses described that they will do better recording if they were given less patient care responsibility, had better nursing knowledge, had better recording system, and received more training on nursing record. CONCLUSION: Nursing notes did not reflect nursing activities properly. Few independent nursing roles were documented in the nursing notes. Development of nursing education program and nursing record system is needed for improvement of nursing record.

A Field Study of Posttraumatic Stress Disorder in a Community after Typhoon Rusa / 간호학회지

PURPOSE: In South Korea, as growing the need of psychological support in disaster situation psychological assessment on stress after disaster is important to find out the factors affecting coping, and to plan intervention in the community. METHOD: The volunteers of Korea Redcross who live around K city, and the research team visited all homes at Jirye town, one of the high-impact area, 4 month after the typhoon. One of the family members who is over 18 years old, answered the self-report questionnaire composed of disaster experience, damage, exposure to traumatic event, and posttraumatic stress with IES-K (Impact of Event Scale-korea) He also, described his family members symptom related to re-experiencing, hyper-arousal, and avoidance. Six hundreds households were surveyed. RESULT: The prevalence of moderate to severe PTSD symptom was 36% of the subjects. The severity of PTSD was affected by gender, economic status and affected by damaged property, physical injury, worsening existing disease, getting infectious disease, amount of experienced traumatic event before disaster, warning, taking shelter, and subjects revealed differences in somatization as severity of PTSD. According to the description, community members had re-experiencing, hyper-arousal and avoidance. CONCLUSION: At a rural area, South Korea, community members have suffered from psychological distress after disaster. So psychological interventions are required as affecting factors and also to plan for warning and shelter in disaster situation is needed for preventing PTSD.

A Study on the Verification of the Profile of Seo's Elderly Stress Scale (SESS) / 간호학회지

The purpose of this study was to verify the use of Seo's Elderly Stress Scale (SESS), which was developed in 1996. Through the modified tool, it is possible to examine the stress of Korean elders and to contribute to the welfare of them. The subjects were 350 elders over 65 years old who live in Seoul, Kwang-Ju, Yang-Ju Gun Kyung-ki Do, Ui-Jong Bu, and Young-Am Kun, Jeun-Ra Nam Do. the data of 331 elders (94%) were analyzed. Data were collected between January and March in 1996 and analyzed using the SPSS Win 8.0. The result are as follows: 1. Items with low correlation with the total items were removed. So 27 items were removed and 37 items remained. This 37 items were death in the family and/or close friends, family member's behavior not meeting expectations, marriage of daughter, marriage of son, friction with daughter- in-law, argument among children, children refuse to live with parent, children leaving home, sex injury or accident, in frequest visits from children and grandchildren, providing care for your daughter or daughter-in-law post-partum, decrease in decision making and authority in home, Lunar new year and the harvest featival, house sitting, working in the house, performing a sacrificial rite, missed birthday, not living with the eldest son, decreased eyesight, decreased strength, decreased memory, sleep pattern changes, thoughts about death, loneliness, decreased hearing, change of dental condition, change in your diet or eating style, difficulty in self care, moving because of disease or aging, argument with friend or neighbour, travel, dealing with the procedure of heritage, loss of money or property, not enough pocket money, hearing on elderly neglect in television or radio, hope of going home and ignorant from others. 2. Overlapped items were discussed by colleagues and were modified. 'marriage of daughter' and 'marriage of son' were modified in 'marriage of children'. 'self injury or accidents' and 'family accidents' were modified in to self or family accidents. 3. Factor analysis was done in order to identify validity and three factors were obtained from the result. The first factor familial relation area, included 17 items. The second factor, physical area, included 9 items. The third factor, psycho-socio-economic area, included 9 items. Cronbach coefficient alpha for the 35 items was .923. 4. Pearson's correlation was .704 between SESS and SOS (Symptoms of Stress) in order to confirm construct validity. Based on the result, the following is suggested; 1. The modified SESS needs to be reverified with elder. 2. Korean elder's health promotion can be made by development of stress intervention which was accurately measured with SESS.

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.

The Concept Analysis of Hope: Among Cancer Patients Undergoing Chemotherapy / 간호학회지

The main objectives of this study were to analyze the concept of hope, so to provide basic data to develop a valid instrument to measure hope, and to develop hope enhancing nursing intervention a program for cancer patients. The hybrid model approach was applied in three phases, the theoretical phase, the empirical phase, and the analytic phase. The study was developed on universal attributes explaining generalized hope and specific hope, which were revealed in a comprehensive review of the literature. In the empirical phase, eight cancer patients undergoing chemotherapy were interviewed to reveal causes, motivation, and their resource of hope according to The Hope Assessment Guide (Farren, Herth, & Popovich, 1995). In the analytical phase, the results of the two previous stages of the study were compared. The results were as follows: In the theoretical phase, six dimensions of hope emerged; affective, cognitive, behavioral, affiliative, temporal and contextual dimension. The antecedent of hope was loss, crisis, uncertainity, and stress. The consequences were renewal, development of new methods, safety, peace and transcendental competence. In the empirical phase, these six dimensions emerged as theoretical phases were verified and specified as these descriptive terms: feeling, intention, expectation, activity, relation, future- orientation, reality and goal-setting. The antecedent factor of hope was occurrence or recurrence of cancer. The consequence of hope was ability to cope with real condition, feeling of safety and comfort, peace, development of new strategy and recovery of disease. The major content of hope in this phase was related to specific hope, but it was also influenced on by general hope. In the analytic phase, general and specific hope was renamed as trait and state hope. All attributes emerged at the empirical phases, and also emerged at the theoretical phase. However, cognitive and contextual dimensions were revised and specified. In conclusion, the concept of hope is divided into trait hope and state hope, and state hope is an anticipatory expectation that occurs at the time of a stressful stimulus, such as being diagnosed with cancer. Hope is a multidimensional dynamic energized mental state which has the dimensions of affective, cognitive, behavioral, affiliative, temporal and contextual. There should be further studies to develope the state and trait hope scale according to definition and attributes of hope investigated in this study. In addition, considering results of the empirical phase, the family is very a important factor as a resource of hope, so it is necessary to consider family in implementing a nursing intervention program to enhance hope.