Purpose: The purpose of this study was to develop and to apply the NANDA, NOC, and NIC (NNN) linkages into a computerized nursing process program using the classification systems of nursing diagnoses, nursing outcomes and nursing interventions. Method: The program was developed with planning, analysis, design and performance stages. The program was applied to 117 patients who were admitted to orthopedic surgery nursing units from January to February, 2004. Results: Thirty-five of fifty-three nursing diagnoses were identified. Five nursing diagnoses in order of frequency were: Acute pain $(28.4\%)$, Impaired physical mobility $(15.6\%)$, Impaired walking $(8.7\%)$, Chronic pain $(5.5\%)$ and Risk for disuse syndrome $(5.0\%)$. The nursing outcomes of the 'Acute pain' nursing diagnosis tended to have higher frequencies (cumulative) in order of Pain management $(95.2\%)$, Comfort level $(35.5\%)$ and Pain level $(17.7\%)$. The nursing interventions of the 'Acute pain' nursing diagnosis tended to have higher frequencies (cumulative) in order of Pain management $(71.0\%)$, Splinting $(24.2\%)$ and Analgesic administration $(17.7\%)$. In comparison of outcome indicator scores between before and after the intervention according to the 61 nursing outcomes, the mean scores of 52 outcome indicators after the intervention were significantly higher than before the intervention. Conclusion: It is expected that this program will help nurses perform their nursing processes more efficiently.

Purpose: This paper reports a randomized controlled trial to investigate the effects of a Marital-relationship enhancement program(MREP) for marital couples. Methods: Volunteer couples from several well-being centers in Seoul were randomly assigned either to a treatment group (n=36), participating in a MREP based on Gottman's 'sound marital house' theory, or to a control group (n=35) receiving no treatment. The content of the MREP was provided to the control group after the research was completed. Data was collected from December 2003 to May 2004 using modified versions of the inventories developed by Gottman on marital satisfaction, positive affect, conflict regulation, and communication barriers. Results: Participants in the experimental group showed significant improvements in marital satisfaction, positive affects, conflict regulation, and communication-barrier scores compared to the control group. Conclusion: The present program for marital-relationship enhancement is helpful in enhancing marital relationships and regulating conflict between marital couples and, ultimately, may be useful to prevent divorce.

Purpose: The main purpose of this study was to explore nurse-patient interaction behaviors and patient satisfaction with the interaction in the emergency department. Method: This study used video technology to record complete conversations between the nurse and patient, thus obtaining the interactions naturally occurring in a clinical setting. The participants were 28 nurses and 63 patients in the emergency department at one university hospital located in Seoul. The data was collected from November, 2002 to April, 2003. The video recordings were observed for 4 hours for each case and coded using an adapted version of Roter's Interaction Analysis System (RIAS), which yields frequencies of thirty-six types of interaction behaviors. Result: The information exchange related to therapeutic items including medications, simple orientation, and situational positive talk were characterized in the nurses' interaction behaviors. Giving information about one's own condition, questions about therapeutic regimen, and showing worry were characterized in patient interaction behaviors. The patients' satisfaction with the interaction was 37.75.9 (range 9-45). Conclusion: The emergency nurse-patient interaction behavior was task-related. The results suggest that identification of effective interaction behavior in the Emergency department and an interaction skill training program could increase patient satisfaction.

Purpose: This study was to exam me the effects of auricular acupuncture on insomnia in Korean elderly. Method: The study design was a triangulation study. Subjects were 40 elderly who were 65 years and over in Seoul, and 10 subjects for a qualitive study who were saturated with interviews and observation. The first auricular acupuncture was applied for three days, and this was applied to subjects on a 5 times series. The quantative data was analyzed by SPSS PC+ and the qualitive data was analyzed by driving of core meaning and abstract concepts using a semi-structural interview and observation. Result: I. The experimental group had higher significant sleep scores than that of the control group (t=32.739, p=.001). 2. The experimental group had higher significant self- satisfaction scores on sleep than that of the control group (t=30.049, p=.001). 3. In the qualitive study, insomnia characteristics before application of auricular acupressure therapy were confirmed by physical dysfunction, recall of past, and psychological dysfunction. Insomnia characteristics after application of auricular acupressure therapy were confirmed by recovery of physical dysfunction, improving recall of past, and recovery of psychological dysfunction. Conclusion: Auricular acupuncture was effective on insomnia in Korean elderly.

Purpose: The purpose of this study was to explore the experiences of recovery from disease in the patients doing a kind of Buddhist meditation, and to develop a grounded theory about meditation. Method: Data was collected by an in-depth interview using tape-recordings from sixteen participants doing meditation. The data was analyzed using the grounded theory method proposed by Strauss and Corbin(1998). Result: The core category was discovering the true self. The participants began to do meditation because of their disease. They experienced obstacles due to incomplete religious acceptance. However, their faith grew gradually based on religious experiences that were indescribable. Finally, they entirely trusted the inner healer, which is emphasized in meditation. The strategies that they used were self reflection and seeking help for accepting deep meditation. They were stabilized in physical, psychological and social daily living. The processes of discovering the true self were identified as entering religious discipline, embodying religious discipline, self-accomplishing religious faith, and recovering mind-body health. Conclusion: This study provided the understanding of mind-body integration. Empirical research may be needed to prove scientifically the effects of meditation.

Purpose: The purpose of this study was to develop a vital signs e-book for undergraduate student nurses and evaluate the content, system and student satisfaction. Method: This study was done in three stages, the development of a vital signs e-book, implementation and evaluation. The subjects were 73 undergraduate student nurses in Y university. Result: Thirty one learning objectives were used to create the contents. A set of 5 chapters and 18 subsections were defined after validation from nurse educators. The e-book is available at http://123.134.207.23/ebook/vitalsigns. Analysis of the questionnaires showed a mean score for content, system and students satisfaction of $3.17\pm73,\;3.11\pm79,\;and\;2.96\pm.74$ respectively out of a possible 4 points. Conclusion: Nurse educators should provide quality and effective web-based courses that meet undergraduate student nurses' learning needs and they should incorporate web-based learning into traditional teaching to meet the demands of nursing education.

Purpose: This study was aimed to evaluate the effects of a maternal education program based on the temperament theory on the temperamental goodness-of-fit between mother and child. Method: The research method was a nonequivalent, control group, non-synchronized design and the experimental period was from May 10, 2004 to July 24, 2004. The subjects were mothers who had children 3-4 years old who registered in eight kindergartens or infant schools in M city. Among the total 94 subjects, 47 were allocated as an experimental group and 47 were a control group. Using the SPSS/WIN 10.0 program, the data was analyzed by a Chi-square test, and t-test. Result: 1. After treatment with a maternal education program based on the temperament theory, the experimental group significantly decreased in scores for perceived children's behavior problems in comparison to the control group(t=-4.01, p<.001). 2. After treatment with a maternal education program based on the temperament theory, the experimental group did not significantly decrease in scores for parenting stress in comparison to the control group(t=-.85, p=.40). 3. After treatment with a maternal education program based on the temperament theory, the experimental group did not significantly decrease in scores for rejective parenting behaviors in comparison to the control group(t=-1.32, p=.19). Conclusion: A maternal education program based on the temperament theory is a useful intervention to decrease perceived children's behavior problems.

Purpose: The purpose of this study was to develop and to evaluate a health promotion program for elderly. Method: Subjects were 63 elderly women (experimental group:33, control group:30). The study was a nonequivalant control group pretest-posttest design. The data was analyzed with an SPSS Window program, then the data was computed for the purpose of each study. Result: 1. In designing the program, the experimental group was given health education - 2 times per week, for 8 weeks - and they participated in recreation programs and stretching exercises five times a week. 2. Stretching exercises including health education, significantly affected the total Cholesterol, HDL-cholesterol, triglycerides, health behavior and self-efficacy. 3. The body fat weight was not significantly affected by the stretching exercises. Conclusion: This program was tested to promote the health of elderly and verified as an effective nursing intervention program, because the outcome of this program ascertains that this program enhances self efficacy of exercise, reduces Cholesterol and triglyceride levels' Increases HDL-cholesterol, and helps promote the understanding of heath behavior.

Purpose: This study was done to develop and test validity and reliability of on instrument for predicting nursing intention for SARS patient care. Method: The psychometric properties of a SARS patient care attrition prediction tool, based on the Theory of Planned Behavior, were examined in this study. The Three-phase design involved a) salient beliefs generated from clinical nurses (n=43) b) content validation by expert panel evaluations(n=5) c) face validation by plot testing (n=10) d) and instrument validation in a cross sectional survey (n=299). Psychometric analysis of survey data provided empirical evidence of the construct validity and reliability of the instrument. Result: Principal component analysis verified the hypothesized 6-factor solution, explaining $68.2\%$ of variance, and Alpha coefficients of .7538 to .9389 indicated a high internal consistency of the instrument. Conclusion: The instrument can be used by nurse administrators and researcher to assess clinical nurses' salient beliefs about caring for SARS patients, guide tailored intervention strategies to effective caring, and evaluate the effectiveness of interventions.

Purpose: This paper was conducted to test the reliability and validity of rd-SLS, developed by Podsakoff, et al. (1993) which measured 'substitutes for leadership'. Method: The subjects were 345 nurses in 5 general hospitals. Cronbach's and the Guttman split-half coefficient were used to test the reliability of rd-SLS. Factor analysis, and the correlations of the rv-SLS and SLS with rd-SLS were used for convergent and discriminant validity. Result: Cronbach's data was 0.76 and the Guttman split-half coefficient was 0.52. Twelve factors evolved by factor analysis, which explained $70.4\%$ of the total variance. This result was similar to previous study results. However, 'Indifference toward organizational rewards'-related items were classified two factors. It was not clear t hat the rd-SLS consisted of 13 concepts(factors). The correlations of the rv-SLS and SLS with the rd-SLS were 0.93 and 0.87 respectively. Conclusion: The rd-SLS showed a moderate degree of validity and reliability. Thus, it is recommended to use the rd-SLS in general nursing organizations for screening for leadership substitutes. In addition, it is necessary to clarify the concept of organizational rewards. In a further study, the factor structure of the rd-SLS may be considered.

Purpose: The purpose of this study was to evaluate a Self-efficacy-based Basic Life Support (SEBLS) program for high-risk patients' family caregivers on cardiac arrest. The SEBLS program was constructed on the basis of Bandura's self-efficacy resources as well as the International Liaison Committee on Resuscitation's '2000 Guidelines for CPR and ECC'. Method: The effect of the SEBLS program on emergency response self-efficacy and emergency response behavior such as BLS(Basic Life Support) knowledge and BLS skill performance was measured by a simulated control group pretest-posttest design. Study subjects were38 high-risk patients' family caregivers(20 experimental subjects and 18 control subjects) whose family patients were admitted to a general hospital in Incheon, Korea. Result: 1. Emergency response self-efficacy was significantly higher in the experimental subjects who participated in the SEBLS program than in the control subjects. (t=8.3102, p=0.0001). 2. For emergency response behavior, BLS knowledge (t=5.6941, p=0.0001) and BLS skill performance (t=27.8281, p=0.0001) was significantly higher in experimental subjects than in control subjects. Conclusion: A SEBLS program can increase emergency response self-efficacy and emergency response behavior, and could be an effective intervention for high-risk patient's family caregivers. Long-term additional studies are needed to determine the lasting effects of the program.

Purpose: The purpose of this study was to develop an instrument to measure nursing professional values. Method: Forty preliminary items were selected by classifying 223 basic items extracted via a literature study and in-depth interviews of subjects and testing the relevance of their contents. In order to verify the reliability and relevance of the preliminary instrument, data was collected from 504 nurses in 3 general hospitals. Result: As a result of the item analysis, 29 items were selected from a total of 40 items. Five factors were extracted by factor analysis, and the total variance was $51.5\%$. For the explanation of variances by factors, the 1 st factor, 'self-concept of the profession' accounted for $14.8\%$, the 2nd factor, 'social awareness' $12.1\%$, the 3rd factor, 'professionalism of nursing' $9.8\%$, the 4th factor, 'the roles of nursing service' $9.1\%$, and the 5th factor, 'originality of nursing', $5.6\%$. Cronbach's Alpha of those 29 items was .9168, which was high. Conclusion: This paper is meaningful in a way that it developed a tool capable of measuring nursing professional values, which reflects the characteristics of our country. In order to re-verify the relevance and stability of this tool, it is necessary that comparative studies should be conducted.

Purpose: This study was done to suggest directions for developing exercise interventions for fall prevention in the elderly in Korea in the future, Method: Twenty five articles for fall prevention exercises were reviewed and analyzed. Result: $84.0\%$ of subjects were older adults age 65 and older living in the community. The most frequently performed interventions were lower limb strength and balance exercises together $43.3\%$, group exercise $70.0\%$, exercise 3 times/week $60.0\%$, 60 min per session $36.7\%$, duration of 12 weeks and 1 year $23.3\%$ each. The most frequently used outcome variables were static balance $84.0\%$, lower limb muscle strength $72.0\%$, dynamic balance $56.0\%$, and falls $56.0\%$. The effect of exercise interventions on fall prevention was inconclusive. Lower limb strength exercises with resistance were effective for increasing muscle strength. Balance exercises with various movements for balance were effective for increasing balance. Conclusion: Exercise interventions for fall prevention is recommended for older adults with risk factors of falling. The desirable type of exercise intervention is lower limb strength and balance exercise together.

Purpose: The purpose of this study was to develop an e-Learning program about medication for nurses to enhance nurses' medication performance ability and to analyze learners' responses after studying with this program. Method: For the development of the e-Learning program, the NBISD(Network Based Instructional Systems Design) model, suggested by Jung(I999) was applied as a basic model and the instruction design theory of Gagne & Briggs(1979) and ARCS theory of Keller(I983) were applied. After the operation of this program for one month to 34 new nurses, learners' responses were analyzed. Result: Learners' knowledge of medication was greatly improved after this program. In addition learners' satisfaction with the overall education program, help in field applicability, ease of screen shift and exploration, and tutor activities were high and the contents were regarded suitable for e-Learning. Many things were advantageous such as easy accessibility, easy understandability with pictures and flash animation, practical cases and feedback from a tutor. Provision of a supplementary handout and improvement of a tight time schedule were pointed out as things to be improved. Conclusion: This e-Learning program can be used effectively for medication education for registered nurses, student nurses, and new nurses.

Purpose: This research investigated the daily experiences of patients' lives to develop a formal theory that explains the lives of schizophrenic patients. Method: A grounded theory method(Strauss & Corbin, 1998) guided the data collection and analysis. Thirteen patients who were diagnosed with schizophrenia in regional communities participated. Result: The experiences of chronic schizophrenic patients are defined as "escaping from a fallen mine" comparing their suffering to that of entrapped miners trying to free themselves from a collapsed mine tunnel with much difficulty and without hope. In observing participant's time lines of having lived with chronic schizophrenia, it advances with 'surrender', 'collapse', 'reaching out', 'rising', 'preparing to spring up', and 'starting anew'. Conclusion: The results of this study indicate that the experience of a chronic schizophrenic patient is like that of a miner caught under a fallen mine channel, who, without external help cannot escape the depths 'Of the mine, but at the same time must have conviction and hope of rescue and avert fear to cooperate with outside help. The result indicates that family members, doctors and nurses as well as an institute's persistent and active support is most critical for the patient's adjustment to social life.

Purpose: The purpose of this study was to compare the perceived importance and the perceived caring of nursing needs among oncology nurses, patients with non-terminal cancer and patients with terminal cancer. Method: A total of 83 oncology nurses, 56 patients with non-terminal cancer and 39 patients with terminal cancer served as subjects. Data was collected based on the 4-point Likert scale using a self-administered questionnaire from Mar. to Sept. 2004. Finally, data was analyzed using mean, SD, paired-test,. and ANOVA. Results: The score of the perceived importance of nursing needs was higher than that of the perceived performance of nursing needs in all three groups. There was also a difference in the degree of perceived performance of nursing needs among the three groups. In contrast, there was no difference in the total score of the perceived importance of nursing needs among the three groups, unlike the importance of informational and physical needs as a subgroup of perceived importance, where a difference was noted. Conclusions: Strategies should be developed to narrow down these gaps between nurses and patients. In particular, informational and educational programs should be designed for patients with terminal cancer.

Purpose: The purpose of this research was to examine the effects of exercise program on knowledge and attitude of excercise, and depression in low-income elderly women. Method: The research design was a nonequivalent control group pretest-posttest design. The subjects were 26 in the experimental group and 22 in the control group among 46 low-income women over age 65. The independent variable is the exercise program, and the dependent variables are knowledge and attitude of excercise and depression. The exercise program was performed for 45-50 minutes, twice a week for 8 weeks. Data was collected from March. 12. to May. 8. 2004. Result: Participants were given a pre-test and post-test for the selected variables. The experimental group reported significant improvements in their knowledge and attitude of excercise and depression scores compared with the control group. Conclusion: The results indicated that the exercise program had the potential to manage low-income elderly women's health promotion. Furthermore, the exercise program can enhance life satisfaction in low-income elderly women.

Purpose: This study was to develop and evaluate a folk play program as a nursing intervention for the elderly with dementia. Method: First, a folk play program was developed through a careful study of literature review and field-work. Second, a nonequivalent control group pre-post test was designed. The subjects of the study were the elderly with dementia staying in nursing homes; 15 were in an experimental group adopting a folk play program developed through this study, 18 in the control group on a gymnastics and walking program which is generally used. The 40 min. intervention was conducted 5 times a week for 4 weeks. Result: The folk play program improved the cognition(t=6.12, p<.001) and ADL(t=2.92, p=.014) and diminished the frequency of problematic behaviors significantly(t=-6.39, p<.001). There was a significant difference of cognition, ADL, and problematic behaviors between the control and the experimental group before and after the experiment(t=3.38, p=.002; t=2.05, p=.046; t=-7.74, p<.001). Conclusion: Compared with the gymnastics and walking program, the folk play program proved to be much more effective in the elderly with dementia in improving their cognition and ADL, as well as in diminishing their problematic behaviors. Therefore, a folk play program should be appliedas an effective and practical Korean nursing intervention for the elderly with dementia.

Purpose: This study was done to analyze the changes in smokers' subjectivity about smoking before and after participation in a 5-day hospitalized smoking cessation program. Design: Q-methodology, which provides a scientific method on subjectivity, was applied. Findings: Nine types of subjectivity changes about smoking were identified; Type I, Nicotine $craving{\to}Confident$ of self control for smoking; Type II, Nicotine $craving{\to}Cognition$ of the link between habituation and smoking, Type III, Nicotine craving ~ Nicotine craving, Type IV, smoking as a social $behavior{\to}Cognition$ of the link between habituation and smoking, Type V, smoking as a social $behavior{\to}Motive$ to turn away from being addicted to smoking to being healthy, Type VI, Habitual $smoking{\to}Confident$ of self control for smoking, Type VII, Habitual $smoking{\to}Cognition$ of the link between habituation and smoking, Type VIII, Habitual $smoking{\to}Motive$ to turn away from being addicted to smoking to being healthy and Type IX, Denial of the negative effects of $smoking{\to}Confident$ of self control for smoking Conclusion: The types of changes in smokers' subjectivity before and after the smoking cessation program in this study suggest a better tailored intervention for individual smokers. The types of changes on smokers' subjectivity provide insight about which factors of the interventions for smoking cessation are especially valued for a particular group of smokers.

Purpose : This study examined the relationship between sexual changes and adjustment and identified the factors which affect adjustment after a hysterectomy. Method : The subjects were 89 women under 50 years of age registered at gynecology departments of general hospitals in Seoul. Result : $60.7\%$ of the women restarted coitus during six weeks to three months post operation. They felt a decrease in vaginal secretions$(68\%)$, and abdominal and pelvic pain$(59.8\%)$, but2/3 of them didn't change the frequency of coitus and level of orgasm. With respect to the adaptability of the sexual life, there was a significant difference in the time to restart coitus, coitus, lack of vaginal secretions, abdominal and pelvic pain, change of frequency of coitus, experience of orgasm, importance of sex and avoidance of coitus, according to job, income, and health condition. Conclusion : It is appropriate to restart coitus six weeks to three months after surgery and preliminary information should be given to patients after surgery as abdominal and pelvic pain could be relieved after twelve months. Also, sexual adjustment can be improved if they can recognize the changes after surgery from sexual life before surgery.

Objectives : This descriptive study was conducted to examine the degree of stress, coping styles, communication with the mother and depression between headache-suffering children and headache-free children and to explore predicted factors for headache occurrence in children. Method : The subjects of this study consisted of 196 headache-free children and 107 headache-suffering children. They were 4th-6th graders of an elementary school in T city. The instruments in this study were David's stressor of children, Lazarus & Folkman's Stress Coping Style, PACI(Parent-Adolescent Communication Inventory) by Barnes & Olsen and Kovac's CDI (Children's depression inventory). Data were collected from May 2 to July 16, 2004. Results : Total stress(t=-3.76, p=.035), school stress(t=-3.02, p=.001), mass media stress(t=-1.39, p=.029) and depression(t=7.62, p=.001) in headache-suffering children were significantly higher than those of headache-free children. Problem-oriented coping skills (t=1.23, p=.023), and the score of communication with the mother(t=2.32, p=.012) in headache-suffering children were lower than those of headache-free children. Logistic regression analysis (stepwise) showed that the most powerful predictor was stressors in school, followed by depression, stressors in mass media and communication with the mother. Conclusions: This study revealed that important factors such as the degree of school stress, depression, the degree of mass media stress, communication with the mother and problem-oriented coping skills should be controlled for reducing of headaches in children.