Purpose: The purpose of this study was to examine the effect of position change on the level of comfort and occurrence of bleeding after transarterial chemoembolization. Methods: This study was the nonequivalent control group non-synchronized design. The experimental group was positioned in supine with 15-30 degree Semi-folwer's position for 2 hours and then changed supine position alternatively to 30 degree lateral positioning in turn per hour for 2 hours. For the control group, 6 hour supine positions without any position change were applied. Results: The level of discomfort of the control group was scored higher level than that of the experimental group. There was no significant differences in back pain and the degrees of voiding difficulty. There were no significant differences in the incidence of bleeding complication between the two groups. Conclusion: The position change in patients after transarterial chemoembolization could be applied without any severe side effects such as bleeding complication, but it was revealed to be effective in reducing the level of discomfort.

Purpose: The purpose of study was to assess the health promoting lifestyle among hospital nurses and to investigate the relationships between the health promoting lifestyle, resourcefulness, and perceived health status. Methods: The subjects were 400 nurses working at three university hospitals. The data were collected by self-administered questionnaires from September 1st to September 30th, 2008. Results: The range of Health Promoting Lifestyle Profile (HPLP) was 71-185, the average score was 112.50, and the item mean was 2.16 (total 4). The range of resourcefulness was 9-50, and the average score was 16.56. The range of perceived health status was 4-13, and the averae score was 9.52. Health promoting lifestyle was showed significantly positive correlations with resourcefulness (r=.473, p<.001), and with perceived health status (r=.176, p<.001). The independent variables including resourcefulness, religion, working shift, sleeping hours, and exercise explained 58.6% of the variance of health promoting lifestyle. Especially, resourcefulness explained 53.2% of the variance of health promoting lifestyle. Conclusion: Resourcefulness was identified as the most important variable contributing to the performance of health promoting lifestyle.

Purpose: This study was conducted to determine the effects of a fall prevention program on gait, balance and falls efficacy in stroke patients Methods: The study utilized a non-equivalent control group pretest and post test design. Subjects were contacted at the oriental medicine ward of D hospital in B city for strokes. The subjects were 25 in the experimental group and 25 in the control group. The fall prevention program consists of fall related exercises and fall related education. Collected data were analyzed using a t-test, Chi-Square test, Fisher's exact test by SPSS 14.0 Win program. Results: The fall prevention program with exercises and education used in this study was found to be very effective in increasing gait, balance and falls efficacy in patients with stroke. Conclusion: The fall prevention program used in this study seems appropriate for stroke patients. Thus, further research to refine the efficacy and application of this program is warranted.

Purpose: The purpose of this study was to identify the effects of walking on discomfort and colon cleansing for patients having a colon lavage solution before colonoscopy. Methods: This study was a nonequivalent control group post test design. The participants were 89 patients (experimental group: 47, control group: 42) who underwent colonoscopy at G hospital in Incheon. The two groups put on step counter for an hour while taking the colon lavage solution. The experimental group was made up of patients who walked over 3,000 steps and the control group of those who walked less than 3,000 steps. Discomfort was measured using VAS and colon cleansing was measured by a specialist. Collected data were analyzed using $x^2-test$, t-test with SPSS/PC+ window version 15.0. Results: Walking while taking the colon lavage solution decreases abdominal pain before colonoscopy. Also one hour after taking the colon lavage solution, decreased nausea, abdominal pain and discomfort were found in the group which walked over 3,000 steps. Concluson: Based on the above findings, adequate walking can be used as a nursing intervention to increase comfort in patients undergoing colonoscopy.

Purpose: The purpose of this study was to investigate nurses' demands on child-care facilities. Methods: The research period was from February 24 to March 20, 2009. The data were collected from 5,033 nurses using self-administered questionnaires. The collected data were analyzed using SPSS/PC 14.0 program. Results: 71.7% of nurses answered that they would use the child-care at workplace if it is available. 48.1% of nurses answered that operating time of workplace child-care would be for 24 hours. 46.9% of nurses answered that the most important thing they considered in choosing child-care was the quality of child care. Conclusion: Expansion of child-care supports and operation of workplace child-care facility for 24 hours seem necessary for nurses who have children under 6 years old.

Purpose: The purpose of this study was to examine knowledge, perception, safety climate and compliance with hospital infection standard precautions and to identify the factors influencing nurse's compliance with standard precautions. Methods: Using the structured survey, data were collected from 292 nurses working at 4 general hospitals in the metropolitan city Seoul in October, 2008. Data were entered and analyzed with SPSS 12.0. Results: The majority of nurses were female with a mean age of 27.8. The mean score for knowledge of standard precautions was 21.2 out of 25. The nurses lacked knowledge on reusable gloves or gowns. Nurses perceived use of protective devices may not only increase time strain but also hinder development of therapeutic relationships with patients. Of safety climate factors, lack of time was the most frequently reported barrier to compliance with standard precautions. Knowledge, perception, and safety climate explained 16.1% variance of compliance with standard precautions. Conclusion: To improve nurses' compliance with standard precautions, provision of education and support for safety climate are necessary.

Purpose: The study was aimed to investigate the effects of warm fluid used during surgery on the patients' hypothermia prophylaxis and recovery after surgery. Methods: This data were collected from Jul. 13 to Nov. 31. 2009 at S hospital in M City. 60 patients who met the selection criteria were recruited in the study and divided into two groups. The warmed fluids were used for 30 patients in the experimental group, and the fluids in room air temperature were used for the others in the control group. Collected data were statistically analyzed using SPSS/win 18.0. Results: The body temperatures of the control group were significantly lower during surgery than those of the experimental group (p<.001). Shivering was significantly less occurred in the experimental group than the control group (p=.018). The experimental group used warmed fluids recovered faster than the control group. Conclusion: Warming fluid for the patients with general anesthesia was revealed to be effective in decreasing hypothermia during surgery, reducing shivering, helping recovery from the anesthesia. Further research is warranted to refine and apply this evidence in nursing practice.

Purpose: This study identified effects of laughter therapy administered to mastectomy patients as an adaptive coping mechanism. Methods: The study design was a non-synchronized design with a non-equivalent control group. Participants were 40 patients admitted to S hospital in Busan from July 1 to October 10, 2008. The laughter therapy was provided to the experimental group for 20 minutes, four times per week for 2 weeks in each patient's room. Results: The experimental and control groups showed significant differences in Mood (t=-2.314, p=.032), and Stress (t=-2.535 p=.020). Pain and serum cortisol in the experimental and control groups did not show any significant difference. Conclusion: Based on the findings the laughter therapy has significant effects on mastectomy patients' mood and stress.

Purpose: The purpose of this study was to examine the difference between direct and indirect nursing activity times according to the grade of nursing management fee. Methods: The subjects of this study were 324 working nurses at the time of 3rd grade and 319 working nurses at the 2nd grade of nursing management fee in one university hospital. Nursing activity time was measured in April and May, and in September and October of 2008 for comparison. The data were analyzed by SPSS win using frequency and t-test. Results: Direct nursing care activity time per one patient was significantly higher at 2nd grade than 3rd grade in day shift (t=-2.55, p=.012). Direct nursing care workload per one nurse was significantly lower at 2nd grade than 3rd grade in evening shift (t=2.21, p=.030), whereas indirect nursing care workload was lower at 2nd level in night shift (t=2.43 p=.016). Conclusion: The findings from this study showed that higher nurse-to-patient ratio can provide greater amount of direct nursing care activity for the patient. Also, it decreased workload of nurses. The higher nurse-to-patient ratio will be beneficial for promoting quality of nursing care as well as decreasing nurse's heavy workload.

Purpose: The purpose of this study was to identify types and characteristics of anger expression in clinical nurses. Methods: Q methodology was used to analyze each individual participant's subjectivity on anger expression. A total of forty clinical nurses arranged 32 pre-selected Q statement cards on a 9 point scale, shaping the cards' pile into a normal distribution. Then the data from the arranged cards were analyzed using the QUANL PC Program. Results: Three types of anger expression were identified; 'reasonably overcoming', 'emotionally expressing', and 'internally mitigating' including both positive and negative aspects. Conclusion: Adequate strategies to resolve anger in clinical nurses needs to be developed according to anger expression types.

Purpose: The purpose of this survey was to identify a set of performance indicators for Korean APNs (Advanced Practice Nurses). Methods: A convenience sample of 78 APNs working in 2 leading hospitals in south Korea participated in the three-round Delphi survey. In the first round, subjects were asked to propose performance indicators to evaluate the effectiveness of their practice. They rated the relevancy of each indicator during the second round. In the final round of survey, subjects rated the relevancy of indicators again in the light of second round's overall results and they also were asked to check on current and future use of indicators. Results: After 5 months of three-round Delphi survey, 60 performance indicators were identified. In regard to relevancy, the 10 highly ranked indicators were patient satisfaction, self-care ability, expertise of service, family satisfaction, nurse satisfaction, satisfaction in nursing education, advanced nursing service count, education for patient/ family, education for nurse, and compliance. Advanced nursing service count, education for patient/ family, and education for nurse are currently used as indicators by more than 70% of respondents. Conclusion: Additional research is needed to identify subsets of performance indicators for specialized areas and to determine the validity and sensitivity of indicators.

Purpose: The purpose of this study was to re-assess the replacement time intervals of Peripheral Intravenous Catheters (PICs) by investigating phlebitis rates according to the indwelling times of PICs. Methods: The study was conducted on 340 patients in S hospital by an IV team. After PIC insertion, IV team members evaluated once a day. The PICs were replaced every 96 hours, and let them in situ when the patients wanted to, in the absence of any sign of complications, from 97 hours to 153 hours. Results: Total phlebitis rate was 19.6%. There were no significantly different factors associated with the occurrence of phlebitis. The incidence rates of phlebitis were 12.6% and 7.0% before and after 72 hours of PIC insertion, and recorded zero after 96 hours. Conclusion: It would be recommendable to maintain PIC in situ for longer than 72 hours if there is no sign of complication such as phlebitis in close monitoring of PIC insertion site.

Purpose: The purpose of the study was to examine the level and correlation of compliance and barriers to self-care behavior in patients with type 2 diabetes. Methods: The participants for this study were 122 patients with type 2 diabetes enrolled in the out-patient clinic of C national general hospital. Data collection was done by self-report questionnaires. Results: The mean score of the patients with type 2 diabetes for self-care behavior was higher than average level. Level of barriers to exercise was also higher than average, and higher than other barriers of diet and medication; There were low but significant correlations between self-care behavior and barriers to diet, exercise and medication; Variance in barriers to exercise, using alcohol, regular hospital visits, medical treatment and good foot care explained 29.6% of the variance in self-care behavior. Conclusion: According to the study, the self-care behavior of medication and barriers to exercise were the highest. Barriers to exercise highly influenced self-care behavior. Barriers to diet and exercise were significantly correlated the self-care behavior. Further study or interventions are necessary to decrease barriers in patients with type 2 diabetes.

Purpose: This study investigated nursing care delivery systems in 44 university affiliated hospitals and satisfactions with the systems perceived by 226 unit managers (head nurses) of general medical surgical wards. Methods: Data were collected with questionnaires consisting of checklists asking the unit managers their nursing care delivery systems and their satisfactions with the systems. Results: Four models of nursing care delivery systems (primary, modified primary, team, and functional models) were drawn from the participants' responses. Among the four key models 35% of the units adopted team model whereas 24.3% adopted primary model and 22.6% adopted modified primary model. In spite of 35% of team model being under use, 60.6% (n=137) of the unit managers answered the nursing delivery system of their units as team model and only 6.2% (n=14) answered their units having primary or modified primary models, instead of 46.9% combining both. In regard to the satisfaction, critical thinking ability of staff nurses (members in their units) was the most dissatisfactory area regardless of models of service delivery. Conclusion: Introducing team model supplemented with core concepts of primary model (primary team delivery model) into nursing practice will reform the workplace and therefore deliver safe health care services to patients.

Purpose: This study was conducted to develop the nursing process based performance measurement tool and the evidence based care standards for nursing care in medication management and blood transfusion. Methods: The care standards and performance measurement tool were drafted through comprehensive review of relevant literature, national guidelines, hospital protocols, and standards of recognized international accrediting bodies. The proposed care standards and performance measurement tool were reviewed by the panel of experts and refined based on the panel's suggestions. Final care standards and performance measurement tool were validated by surveying the hospital nurses. Results: All items of the performance measurement tool for medication management and blood transfusion were evaluated appropriate. All contents of care standards and the measurable elements except the evaluation of discharge education were appropriate. The performance measurement tool developed in this study was found to be acceptable as a tool to evaluate quality of nursing care in medication management and blood transfusion. Conclusion: The outcomes of this study including the performance measurement tool and evidence based care standards would be the important indicators to monitor whether necessary nursing care is implemented and be the useful primary resources to improve quality of nursing care services.