Preliminary evaluation of a web site for depressive symptoms management.

The purpose of this study was to (1) evaluate the characteristics of website users in relation to their depressive symptoms and (2) pilot test the effectiveness of the depressive symptoms management program. Computer-assisted intervention is as effective as face-to-face treatment for managing depressive symptoms, which are one of the most common and destructive mental problems. This kind of system can be particularly useful in Korea where stigmatism exists for those who seek mental health care. Investigators developed a web site for depressive symptoms management (URL: http://www.baejy.com/smile) in 2004. During the first year the number of users was 582. The findings from this study will provide an intervention strategy for the prevention and management of depression.

[A review study on the strategies for concept analysis].

PURPOSE: Concept analysis is an essential part of theory development in nursing. Thus, many strategies or methods of concept analysis have been suggested in nursing literature. However, in Korea, only limited strategies were utilized, without much consideration on a wide range of strategies in choosing a method that coincides with the characteristics of each concept to analyze. The purpose of this article was to propose various strategies for concept analysis. METHOD: A literature review method was used. RESULT: Ten methods of concept analysis were identified in the literature, and they were evaluated for advantages and limitations. In addition to the method by Walker and Avant and a hybrid model, more advanced strategies, such as triangulation method, critical analysis and the feminist approach were introduced and described in detail. The examples used in each concept analysis method were presented in table to provide the extent of utilization of each method. CONCLUSION: This article provides a wide range of strategies in identifying, clarifying, or elaborating a concept. It might help in choosing a method that best fits the concept to analyze, thus enhancing quality of concept analysis research.

Nurses' willingness to maximize opioid analgesia for severe cancer pain, and its predictor.

GOALS OF WORK: The effectiveness of cancer pain management (CPM) is influenced by nurses' willingness to maximize opioid analgesia for severe cancer pain. The purposes of this study were to identify the willingness of nurses to provide maximum-dose opioids whenever needed for CPM and to determine its associated predictors. METHODS: This multicenter study was conducted among the entire total of registered nurses in seven large hospitals in Korea. Its overall response rate was 41.6%, and the data from 930 who responded (40.1%) were analyzed. We utilized a three-step, multidimensional, multiple logistic regression to identify the predictors of nurses' willingness. MAIN RESULTS: Only 255 nurses (27.4%) indicated that they recommended the maximum dose of opioids whenever it was needed. The respondents who were more likely to recommend morphine showed the following characteristics: older nurses (odds ratio, OR, 1.57; confidence interval, CI, 1.13-2.19); they knew the effectiveness of opioids for CPM (OR 1.53; CI 1.06-2.20); rarely concerned about a patient's addiction to opioids (OR 2.16; CI 1.48-3.15), or to a family member's addiction (OR 1.81; CI 1.20-2.73); prior experience with pain assessment tools (OR 1.62; CI 1.11-2.37); practical experience caring for cancer patients with pain over 51% (OR 1.55; CI 1.09-2.19). CONCLUSIONS: Our multicenter study suggested that in order to improve nurses' willingness to recommend opioids liberally in CPM: (1) attitudes about fear of opioid addiction must be changed; (2) the efficiency of opioids in CPM must be taught; and (3) implementation of pain assessment tools must be undertaken.

[Effects of abdominal breathing training using biofeedback on stress, immune response and quality of life in patients with a mastectomy for breast cancer].

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.

Development of child and adolescent psychiatric nursing practice in Korea, 1980-2000.

PROBLEM: Although the need for mental health services for children and youth is on the rise in Korea, there are no data available regarding the current status of psychiatric nurses working with children and adolescents. METHODS: Descriptive statistics were used to analyze questionnaires from 324 respondents. FINDINGS: Only 5% of psychiatric nurses in Korea are working at child and adolescent-specific programs. The level of nurses' roles and functions vary from simple to specialized. CONCLUSIONS: More effort should be put into networking among nurses to exchange updated information and to share nursing strategies and strengthen college education for further specialization and expansion of nursing roles in the various settings.