Purpose: The purpose of this study was to describe sexual behavior and understand the correlation between knowledge and attitude of contraception and provide preliminary data to develop a sex education program. Method: The subjects of this study were 400 university students. Data was collected from November 14 to 20, 2005 by using structured questionnaires. Result: The percent of subjects that experienced sexual intercourse was 32%. The respondents' score of knowledge of contraception was a mean score of 15.33 on a scale of 20 and there were significant differences in major departments, existence or nonexistence of sexual intercourse and sexual knowledge. The respondents' score of attitude of contraception was a mean score of 40.98 on a scale of 60 and there were significant differences in sex. There was no significant correlation between knowledge and attitude of contraception. Conclusion: A sex education program that uses practical knowledge and attitude of contraception to prevent conception should be developed rather than the present sex education that only attaches schoolbook knowledge.

Purpose: This study was conducted to explore the relationship between isoflavones intake from soy foods and perimenstrual symptoms among women. Methods: The research design was a cross sectional study. Subjects consisted of 245 women living in Korea, aged 19-49 years. The measurement tools were MDQ and FFQ. Results: Frequently consumed soy isoflavones foods were rice with soybeans, soybean paste stew, and soy paste with tofu. The amounts of soy isoflavones foods consumed in order from highest to lowest were rice with soybeans, soybean paste stew, seasoned soybean sprouts, and soy paste with tofu. Subjects were divided into three groups by isoflavones intake levels; the small intake group, moderate intake group, and large intake group. There were significant differences in some menstrual symptoms, and postmenstrual symptoms by isoflavones intake levels. In general, the moderate isoflavones intake group showed lower scores in some menstrual symptoms and postmenstrual periods compared to the small and large intake groups. Conclusions: These results suggest some positive health effects of isoflavones from soy foods on perimenstrual symptoms. More accurate, objective measurement needs to be applied and more investigation of soy isoflavones effects on many aspects of women's health need to be done in a future study.

Purpose: The aim of this study was to develop a performance measurement scale for nurses in the hospital setting and to test the reliability and validity of the scale. Methods: This study was conducted in three phases including an application of conceptual framework, development of scale items, and test of validity and reliability of the scale. In order to test validity and reliability, data was collected from 1,966 nurses who work in twenty eight hospitals nation-wide. The data was analyzed by the SAS 8.0 program using descriptive statistics, factor analysis, and reliability coefficients. Results: The Performance measurement scale consisted of 4 factors which included competency, attitude, willingness to improve, and application of nursing process, and a total of 17 items. The Four factors explained 63.45% of the total variance, and Cronbach's alpha of the scale was.92. Conclusion: The performance measurement scale developed by this study is a reliable and valid instrument that is utilized effectively to evaluate the performance of hospital nurses. Furthermore, it could be used as a sloping stone to assess educational needs of nurses, develop professionalism among nurses, and improve quality of nursing care in the hospital setting.

Purpose: This study was conducted to develop an education program for safe drug use in the rural elderly and to measure the effect of the program. Method: This study utilized a nonequivalent control group pretest-posttest design. The subjects of this study consisted of 40 older persons who were more than 65 years old and lived in G and C moon, Y gun, Gyeongsang-bukdo and visited the public health subcenter. Twenty were assigned to the experimental group and 20 to the control group. The education was provided for one and a half hours, once a week for 3 weeks. Data was collected before, right after, and one month after the program. Result: The first hypothesis was supported(F=79.24, p=0.000) showing that the knowledge scores of the drug use of the experimental group were significantly higher than those of the control group at post education and one month after education. The second hypothesis was supported(F=23.84, p=0.000) showing that the drug misuse and abuse prevention behavior scores in the experimental group were significantly higher than those of the control group at post education and one month after the education. Conclusion: This study suggests that the education for safe drug use is effective in promoting knowledge and behavior for safe drug use of the rural elderly.

Purpose: This study was to examine effects of muscle electric stimulation on chronic knee pain, activities of daily living, and living satisfaction for Korean elderly women. Methods: The design was a nonequivalent control group pretest-posttest study. Subjects were 60 (experimental: 30, control: 30) elderly women 65 years old or above with good orientation and communication. The experimental treatment was electric stimulation on both thigh quadriceps muscles for 15 minutes per time, 3 times per week, for a total of 12 weeks. Measures were the S-F McGill Pain Questionnaire and Arthritis Impact Measurement Scale for chronic knee pain, activities measurement of daily living for activities of daily living, and living satisfaction measurement for living satisfaction. Data was analyzed through the SPSS Win 12.0. Results: Chronic knee pain by S-F MPQ (t=43.563, p=.000) and chronic knee pain by AIMS (t=31.364, p=.000) were significantly decreased in the experimental group, and the activities of daily living (t=124.353, p=.000) and living satisfaction (t=71.268, p=.000) were significantly increased in the experimental group for Korean elderly women. Conclusion: Muscle electrical stimulation decreased chronic knee pain, and increased the activities of daily living and living satisfaction for Korean elderly women. Further studies for muscle electric stimulation need to be done.

Purpose: Health-related quality of life (HRQOL) in patients with cardiovascular disease in Korea has rarely been studied, mostly due to the lack of a psychometrically validated disease-specific instrument. The purpose of this study was to develop and validate a cardiovascular specific-HRQOL questionnaire (CD-QOL). Method: The CD-QOL was developed and validated as follows; item generation, pilot study, and psychometric tests. Patients were recruited from three-university hospitals. The patients were asked to complete the preliminary questionnaire comprising the content-validated items, SF-36, and CES-D. The NYHA and KASI classifications were used to classify the functional performance of the patients. The data was analyzed using correlation, factor analysis, multidimensional scaling, multitrait/multi-item matrix, ANOVA, and Cronbach's alpha. Result: Preliminarily, thirty-nine items were generated. Factor analysisextracted a five-factor solution with a total of twenty-two items. One item was deleted based upon the MDS. The remaining items were moderately correlated with the subscales of the SF-36 and associated with depression measured with the CES-D. The mean scores of patients in NYHA and KASI class I were significantly higher than those in NYHA and KASI class II or/and III, which suggested patients with better functional performance were likely to have a better HRQOL. Cronbach's alphas of the total and subscales were all greater than 0.70. Conclusion: The CD-QOL is a easily applicable instrument with excellent psychometric properties of content, criterion, factorial, convergent, and known-groups validity, and internal consistency reliability in Korean patients with cardiovascular disease.

Purpose: The purpose of this study was to develop and evaluate a quality of life scale for Korean patients with cancer (C-QOL). Methods: The C-QOL was developed and validated as follows, item generation, pilot study, and psychometric tests. A total of 337 patients diagnosed with stomach, liver, lung, colon, breast, or cervix cancer were recruited. The patients were asked to complete the preliminary questionnaire comprising the content-validated items, the SF-36, and the ECOG performance status. The obtained data was analyzed using descriptive statistics, factor analysis, multidimensional scaling (MDS), multitrait/multi-item matrix, ANOVA, t-test, and Cronbach's alpha. Results: Preliminarily twenty-six items were generated through content validity and a pilot study. Factor analysis and MDS extracted a total of 21 items with a 5-point Likert-type scale (C-QOL). The C-QOL included five subscales: physical status (6 items), emotional status (6 items), social function (3 items), concern status (2 items), and coping function (4 items). The C-QOL established content validity, construct validity, item convergent and discriminant validity, known-groups validity, reliability, and sensitivity. Conclusion: The Newly developed C-QOL is an easily applicable instrument which established psychometric properties and reflected Korean culture. It is recommended for further study to examine the responsiveness of the C-QOL using a longitudinal research design.

Purpose: Ego-integrity in older adults is the central concept related to quality of life in later life. Therefore, for effective interventions to enhance the quality of later life, a scale to measure ego-integrity in older adults is necessary. This study was carried out to develop a scale to measure ego-integrity in older adults. Methods: This study utilized cronbach's alpha in analyzing the reliability of the collected data and expert group, and factor analysis and item analysis to analyze validity. Results: Seventeen items were selected from a total of 21 items. Cronbach's alpha coefficient for internal consistency was.88 for the 17 items of ego-integrity in the older adults scale. Three factors evolved by factor analysis, which explained 50.71% of the total variance. Conclusions: The scale for measuring ego-integrity in Korean older adults in this study was evaluated as a tool with a high degree of reliability and validity.

Purpose: The purpose of this study was to examine the effects of an inpatient pulmonary rehabilitation program on dyspnea, exercise capacity, and health related quality of life in inpatients with chronic lung disease. Method: This quasi experimental study was designed with a nonequivalent control group pre-post test time series. Twenty three patients were assigned to the experimental group and nineteen to the control group. The inpatient pulmonary rehabilitation program was composed of upper and lower extremity exercise, breathing retraining, inspiratory muscle training, education, relaxation and telephone contacts. This program consisted of 4 sessions with inpatients and 4 weeks at home after discharge. The control group was given a home based pulmonary rehabilitation program at the time of discharge. The outcomes were measured by the Borg score, 6MWD and the Chronic Respiratory Disease Questionnaire(CRQ). Results: There was a statistically significant difference in dyspnea between the experimental group and control group, but not among time sequence, or interaction between groups and time sequence. Also significant improvements in exercise capacity and health related quality of life were found only in the experimental group. Conclusions: An Inpatient pulmonary rehabilitation program may be a useful intervention to reduce dyspnea, and increase exercise capacity and health related quality of life for chronic lung disease patients.

Purpose: This study is aimed to analyze and clarify the ambiguous concept of insight. Method: This study used the process of Walker & Avant's concept analysis. Results: Insight can be defined in terms of its attributes as follows: Insight 1) comes as a release to the tension of inquiry, (2) is the outcome of the process to discover the overall structure of the problem situation and psychologically restructurize it, (3) comes suddenly and unexpectedly, (4) is to clearly perceive the solution of the abstract problem, and (5) promotes obtaining another new insight. The antecedents of insight include inquiry that can not be resolved easily and also a state where basic knowledge related to the inquiry can be utilized. The consequence of the insight is (1) a new judgement is made, (2) the problem is solved, (3) previous insight is retained and transferred, and it also facilitates the generation of fresh insight, and (4) it passes into the habitual texture of one's mind. Conclusion: Nurse educators need to facilitate nursing students and nurses to accumulate systematically, various information that can become the basis of insight and provide them with an opportunity to experience a variety of problems. In addition, it is important to provide questions to learners as an education strategy to allow them to gain insight into problem solving. From now on, insight needs to be studied in conjunction with critical thinking and questioning in order to enhance nurses' ability to resolve problems.

Purpose: The purpose of this study was to identify degrees of fatigue and influencing factors for fatigue in cancer patients. Method: Data was collected by questionnaires from 115 cancer patients at 3 hospitals in Seoul. The research instruments utilized in this study were fatigue, physical symptoms, depression, family support, and health promoting behaviors. Data was analyzed using the pearson correlation, t-test, ANOVA, and stepwise multiple regression with SPSS/WIN 12.0. Result: The mean score of fatigue for cancer patients was 12.90(range: 6-36). Fatigue for cancer patients according to age group and weight change showed a significant difference. Fatigue for cancer patients showed a significantly positive correlation to physical symptoms and depression. There was a negative correlation between family support and health promoting behaviors. The significant factors influencing fatigue for cancer patients were physical symptoms, health promoting behaviors, depression, and age group, which explained about 45.9%. Conclusion: The results suggest that symptoms and depression management, nursing interventions and practices for providing health promoting behaviors according to age are needed to manage the fatigue in cancer patients.

Purpose: The objective of our study was to figure out costs of nursing services in ICU based on the PCS in order to determine an appropriate nursing fee schedule. Method: Data was collected from 2 hospitals from April 15-16 to April 22-23, 2003. The costs of nursing services in the ICU were analyzed by nursing time based on the nursing intensity. The inpatients in the ICU were classified by a PCS tool developed by the Korean Clinical Nurses Association(2000). Results: The distribution of patients by PCS in the ICU ranged from class IV to Class VI. The higher PCS in ICU consumed more nursing time. As a result, the higher nursing intensity, the more the daily average nursing costs in the ICU. Conclusion: Our study provides evidence to refine the current nursing fee schedule that does not differentiate from the volume of nursing services based on nursing time. We strongly recommend that the current reimbursement system for nursing services should be applied not only to the general nursing units but also to the ICU or other special nursing units.

Purpose: The purpose of this study was to understand the experiences of mental health hospital workers. Methods: Participants in the study were a total of 8 mental health hospital workers who consisted of nurses, social welfare workers and health managers. To prevent them from being omitted, the interviews were all recorded under the participants prior agreement. The method was analysis using the phenomenological method proposed by Colaizzi(1978). Results: The experiences of the participants of this study were classified into 15 significant areas, from which 10 subjects hard work, conflicts, heavy feeling, irritability, getting familiar, changes of recognition, aptitude determination, feeling of achievement and sense of pride were drawn out. These subjects were then grouped into 5 themes. These five themes were finally grouped into 5 categories, negative emotion, depressive emotion, changes of thinking, delight and value discovery. Conclusions: The study tried to analyze the experiences of key informants like nurses, social welfare workers and health managers all of whom were serving at mental health hospitals, contribute to social recognition about the special medical establishment, promote qualitative mental health nursing and further provide educational information necessary for understanding mental health hospital workers.

Purpose: The purpose of this study was to identify the nursing images appearing in elementary school textbooks. Method: This study targeted 130 textbooks of 13 subjects under the 7th national curriculum for elementary schools as of December 2005. Nursing-related texts, photographs, and illustrations in the textbooks were analyzed by using a content analysis method. As for the textbook analysis, two coders thoroughly read the textbooks to record nursing-related content per coding paper, respectively. Result: The total number of nursing-related content appearing in 130 textbooks of 13 subjects was 70. More nursing-related content was exhibited in the photograph and illustration domain(N=57, 81.4%) than in the text domain(N=13, 18.6%). Nursing-related content(N=70) appeared in the order of nursing activities with 56(80.0%), nursing as a job with 10(14.3%), and others with 4(5.7%). As for the nursing image of nursing-related content, positive images weremost with 30(42.9%), followed by negative images with 21(30.0%), and neutral images with 19(27.1%). Conclusion: Nursing-related content was dealt with too little, and dependent nursing activities such as medication, and assisting roles for doctor's examinations and treatments mainly appeared. Also, the main activity place was a hospital. To introduce proper and adequate nursing activities to the students, various types of nursing-related data and material should be distributed to front line schools, teachers, main authors, and publishing companies.

Purpose: This study was designed to develop Nursing Service Quality Indicators(NSQIs) in nursing homes that would lead to an appropriate evaluation and improvement of nursing service quality. Methods: The preliminary NSQIs were developed through literature reviews and analysis of existing quality indicators. A content validity testing was done twice by using a panel of experts who were from academia and the clinical areas. The final NSQIs were confirmed and applied in three nursing homes to test feasibility. Results: The preliminary NSQIs had 4 domains and 31 indicators. Two content validity testings were performed. The indicators scoring over.80 CVI for each testing were selected and modified by experts' opinions. The final NSQIs consisted of 7 domains and 33 indicators. They were applied in three nursing homes and it was revealed that all the indicators were applicable. Conclusion: In this study, it is shown that this new 'Nursing Service Quality Indicators in Nursing Homes' is suitable for a holistic evaluation of nursing service quality of elderly patients in nursing homes. This NSQIs will be able to provide a basis for establishing nursing care standards and improving the nursing care quality in nursing homes.

Background: Nursing intervention studies often suffer from a selection bias introduced by failure of random assignment. Evaluation with selection bias could under or over-estimate any intervention's effects. PS matching (PSM) can reduce a selection bias through matching similar Propensity Scores (PS). PS is defined as the conditional probability of being treated given the individual's covariates and it can be reused to balance the covariates of two groups. Purpose: This study was done to assess the significance of PSM as an alternative evaluation method of nursing interventions. Method: An intervention study for patients with some baseline individual characteristic differences between two groups was used for this demonstration. The result of a t-test with PSM was compared with a t-test without matching. Results: The level of HbA1c at 12 months after baseline was different between the two groups in terms of matching or not. Conclusion: This study demonstrated the effects of a quasi-random assignment. Evaluation using PSM can reduce a selection bias impact that affects the result of the nursing intervention. Analyzing nursing research more objectively to reduce selection bias using PSM is needed.

Purpose: This study was performed to identify current characteristics of the Journal of Korean Academy of Nursing and to explore a way to elevate it to an international level and to critique the overall review process so as to delineate the advanced, objective paper appraisal in this journal. Methods: Data was collected using self administered questionnaires to 75 journal reviewers belonging to the Korean academy of nursing and its division academy of nursing from August 15th to September 30th, 2006. Results: The majority of reviewers pointed out a lack of discrimination between the Journal of Korean Academy of Nursing and other Journals. Among the main answers of reviewers, Creativeness(52.3%) and excellence of nursing(38%) will be critical factors to develop in order to elevate to an the journal to an international level. In specific evaluation areas, reviewers preferred a subjective critique method(60%), and the condition of the decision making process regarding paper acceptance as a combination of checklist and subjective evaluation(84%). Subjective evaluation opinions with major categories will occur in the next revised evaluation format. 76% of reviewers agreed with the current objective evaluation form. Conclusions: The journal review process should be evaluated on a regular basis to elevate the journal level and a mutual agreement of the journal's scope, range, and purpose will be necessary. As a recommendation, an attempt at various approaches in journal reviews and reviewer training should be made.