Purpose: This study was conducted to develop and implement a case-based small group learning program on the care of children with infectious disease, and to examine its effects on knowledge, attitude and preventive practice behaviors of daycare center teachers compared to a control group. Methods: Based on the need assessment, the case-based learning program for the management of infectious children was developed. For this quasi-experimental study, 69 teachers were recruited from 14 child daycare centers in a city located in J province. Thirty four teachers were assigned to experimental group and participated in the case-based small group learning once a week for 5 weeks. Data were analyzed using the SPSS 18.0 program to perform ${\chi}^2$-test and t-tests. Analysis of covariance was used to treat the covariate of the number of assigned children between experimental and control groups. Results: The experimental group showed significantly higher posttest scores in knowledge, attitude and preventive practice behaviors than those of control group (p<.001). Conclusion: These findings indicate that case-based small group learning is an effective educational strategy for daycare center teachers to learn infection management through the emphasis of self-reflection and discussion.

Purpose: The purpose of this study was to investigate the effects of passive upper arm exercise on range of motion, muscle strength, and muscle spasticity in hemiplegic patients with cerebral vascular disease. Methods: A quasi-experimental design with nonequivalent control group was utilized. According to inclusion criteria, 25 patients were assigned to the control group with routine care, followed by 25 to the intervention group with passive exercise for 30 minutes per session, twice a day for 2 weeks. Eighteen patients in the intervention group and 17 in the control group completed the posttest measurement, including range of motion for upper arm joints, manual muscle test, and Modified Ashworth Scale for muscle spasticity. Results: The intervention group had a significantly improved range of motion in the shoulder and wrist joints. No interaction effect was found for the elbow joint. No significant differences were found in muscle strength or muscle spasticity between the groups. Conclusion: Results of the study indicate that passive exercise safely applied for two weeks improves range of motion in joints of the upper arm in these patients. Further study with long-term follow-up is needed to verify the role of passive exercise in preventing muscle spasticity in this population.

Purpose: The purpose of this study was to analyze the effectiveness of saline solution vs. heparinized-saline for maintenance of arterial lines and to detect changes in platelet and aPTT as physiological indexes. Methods: In this nonequivalent control group, non-synchronized, double-blind study the effects of heparinized and saline solution on the maintenance of arterial lines were compared. Fifty five patients received the heparinized solution and fifty nine patients received the saline solution. All patients who had surgery in K-university hospital between September and December 2011 were eligible for participation in the study. Results: There was no statistically significant difference between the saline and the heparin group in the maintenance time of the arterial lines or the number of irrigations. There was no statistically significant difference between the groups in changes in the number of platelets and aPTT for interaction between the groups and time intervals. Conclusion: The results indicate that saline solution can be used as an irrigation solution for the maintenance of arterial lines of adult surgical patients, rather than heparinized-saline, in view of potential risk factors in the use of heparin.

Purpose: The purpose of this study was to examine the effects of an individualized nutritional education programs on nutrient intake and nutritional status of patients with colorectal cancer who are undergoing palliative chemotherapy. Methods: Forty patients with colorectal cancer (19 experimental and 21 control patients) were recruited from a chemotherapy ward at S University Hospital in Seoul, Korea. The experimental group received two individualized nutritional counseling sessions and two telephone counseling sessions over 6 weeks. The control group received nutritional counseling after completion of data collection. Nutritional education included general guidelines for food intake while receiving chemotherapy, dietary guidelines for patients with colorectal cancer, daily meal schedules to overcome cancer, and dietary guideline for each chemotherapy side effect. Data were analyzed using ${\chi}^2$-test and t-test with the SPSS program 17.0. Results: Two group comparison revealed that the experimental group had significantly improved calorie (p=.038) and total protein intake (p=.001), and serum albumin percentage change (p=.040). Body weight did not increase but remained the same as the baseline in both groups. Conclusion: Study results indicate that this individualized nutritional education programs are effective in enhancing nutrient intake and nutritional status of patients with colorectal cancer who are undergoing palliative chemotherapy.

Purpose: This study was done to explore factors relating to number of falls among community-dwelling elders, based on gender. Methods: Participants were 403 older community dwellers (male=206, female=197) aged 60 or above. In this study, 8 variables were identified as predictive factors that can result in an elderly person falling and as such, supports previous studies. The 8 variables were categorized as, exogenous variables; perceived health status, somatization, depression, physical performance, and cognitive state, and endogenous variables; fear of falling, ADL & IADL and frequency of falls. Results: For men, ability to perform ADL & IADL (${\beta}_{32}$=1.84, p<.001) accounted for 16% of the variance in the number of falls. For women, fear of falling (${\beta}_{31}$=0.14, p<.05) and ability to perform ADL & IADL (${\beta}_{32}$=1.01, p<.001) significantly contributed to the number of falls, accounting for 15% of the variance in the number of falls. Conclusion: The findings from this study confirm the gender-based fall prediction model as comprehensive in relation to community-dwelling elders. The fall prediction model can effectively contribute to future studies in developing fall prediction and intervention programs.

Purpose: This study was conducted to identify risk factors that influence the probability and severity of elder abuse in community-dwelling older adults. Methods: This study was a cross-sectional descriptive study. Self-report questionnaires were used to collect data from community-dwelling Koreans, 65 and older (N=416). Logistic regression, negative binomial regression and zero-inflated negative binomial regression model for abuse count data were utilized to determine risk factors for elder abuse. Results: The rate of older adults who experienced any one category of abuse was 32.5%. By zero-inflated negative binomial regression analysis, the experience of verbal-psychological abuse was associated with marital status and family support, while the experience of physical abuse was associated with self-esteem, perceived economic stress and family support. Family support was found to be a salient risk factor of probability of abuse in both verbal-psychological and physical abuse. Self-esteem was found to be a salient risk factor of probability and severity of abuse in physical abuse alone. Conclusion: The findings suggest that tailored prevention and intervention considering both types of elder abuse and target populations might be beneficial for preventative efficiency of elder abuse.

Purpose: The purpose of this study was to evaluate the effectiveness of spiritual intervention studies by examining biological, psychological, and spiritual outcomes. Methods: From electronic databases 2522 studies were retrieved, of which 21 studies met the inclusion criteria. These studies had 1411 participants. Two authors independently extracted data from the selected studies and assessed the methodological quality. The data were analyzed using the RevMan 5.1 program of the Cochrane library. Results: Overall effect size of spiritual intervention on spiritual and psychological (depression and anxiety) outcomes were moderate (d= -0.65 to d= -0.76, p<.001). The effects on biological outcomes (pain and functional status) ranged from -0.51 to -0.39, respectively. No publication bias was detected as evaluated by a funnel plot. Spiritual intervention had a moderate effect on psychological and spiritual outcomes and a smaller effect on biological outcomes. Conclusion: The results of this study suggest that spiritual intervention can relieve depression and anxiety. Further randomized controlled trials studies are needed to evaluate the effects of spiritual intervention on biological outcomes.

Purpose: In this study a recreational combination gymnastics program was provided for women 75 years of age or older and the effects on physical fitness (grip strength, static balance, ability to do complex movement), depression, cognitive function and quality of life were examined. Methods: A quasi-experimental study employing a nonequivalent control group, pre-post design was conducted. Participants included 53 women elders whose cognitive function was within the normal range. The women were assigned to an experimental group (27) or a control group (26). The intervention was conducted twice a week for a period of 12 weeks. Chi-square test, t-test, paired t-test, Wilcoxon rank sum test and Wilcoxon signed rank test were used for data analysis. Results: Following completion of the program, left grip strength (t=2.17, p=.035), right grip strength (t=2.04, p=.046), static balance (t=-2.18, p=.030), depression (z=-2.88, p=.004), cognitive function (t=3.96, p<.001), and quality of life (t=-3.19, p=.002) were significantly better in the experimental group. Conclusion: Findings from this study indicate that recreational combination gymnastics programs are effective in enhancing physical fitness, cognitive function, and quality of life and in decreasing depression for female elders and could therefore be regarded as positive programs for promotion of physical and mental health for older women.

Purpose: The purposes of this study were to develop a Minimal Insomnia Screening Scale for Korean adults (KMISS) and to evaluate psychometric properties and discriminant ability of the developed scale. Methods: Data from a cross-sectional survey of 959 Korean adults were analyzed to develop the summated insomnia scale, which was evaluated in terms of reliability, validity, and discriminant ability by receiver operating characteristics (ROC) curve analysis. Results: Item-total correlations ranged between .71-.79 and Cronbach's ${\alpha}$ was .87. Adequate validity was also evident. ROC-curve analysis showed area under ROC was .87 (95% CI: .84-.90) and identified the optimal cut-off score as ${\leq}20$ (sensitivity, .83; specificity, .75; positive/negative predictive values, .40/.95). Using this cut-off score, the prevalence of insomnia in the study sample was 26.3% and most frequent among women and the oldest group. Conclusion: Data supports the psychometric properties of KMISS as a possible insomnia screening instrument. KMISS also shows promise as a convenient ultra-short screening measure of insomnia for adults and epidemiological studies in community health care settings.

Purpose: The purpose of this research was to develop a scale to measure the life transition process of parents of children with autism, against the backdrop of a lack of research on this topic. Methods: Seventy preliminary items were drawn from previous qualitative research, and content validity was tested by three professors as well as three parents of children with autism. A questionnaire survey was also done between August 2011 and February 2012. Data were collected from 207 parents of children with autism and analyzed using descriptive statistics, item analysis, Cronbach's alpha, Pearson correlation coefficients, and factor analysis with the SPSS Win 15.0 program. Results: Twenty-nine items were selected to constitute the appropriate measuring scale and categorized into 5 factors explaining 63.2% of the total variance. The 5 factors were named; stages of denial (5 items), wandering (6 items), devotion (7 items), frustration (3 items), and finally acceptance (8 items). Cronbach's alpha for the 29 items was .80. Conclusion: The results of this study not only suggest assessment criteria for the life transition process of parents who have children with autism but also provide basic directions for program development to provide differentiated support and care at each stage.

Purpose: The purpose of this study was to identify the effects of compassion satisfaction and social support in the relationship between compassion fatigue and burnout among hospital nurses. Methods: The participants were 430 nurses working in general hospitals. Data were collected with self-administrated questionnaires and analyzed by hierarchical multiple regression. Results: (a) Compassion fatigue had a significant positive effect on burnout; (b) social support and compassion satisfaction had negative effects on burnout, and (c) social support and compassion satisfaction did not moderate the effects of compassion fatigue on burnout. Conclusion: These findings provide strong empirical evidence for the importance of compassion fatigue, compassion satisfaction and social support in explaining burnout of nurses. Also, it would be of great value to further define compassion fatigue and compassion satisfaction even though these concepts are not accepted in the realities of health care.

Purpose: There is evidence that parent-child cohesion is a potentially influential factor in children's self-esteem and acculturation. However, no research to date has examined cohesion with parents as a potential pathway between Korean proficiency and self-esteem or acculturation among children from multicultural families. This study was done to address these limitations by examining whether and to what extent cohesion with parents mediated the effect of Korean proficiency on self-esteem and acculturation among children from multicultural families. Methods: Data were collected from a sample of 138 mothers and their children living in Seoul, Daegu, Kyungi province, and Kyungpook province. Multiple regression analysis was used to examine the relationships between the variables of interest. Mediation effects of cohesion with parents were tested by following the procedure recommended by Baron and Kenny (1986). Results: Cohesion with parents partially mediated the relationship between Korean proficiency and self-esteem. For children's acculturation, the effect of Korean proficiency was partially mediated through father-child cohesion. Mother-child cohesion completely mediated the relationship between Korean proficiency and acculturation. Conclusion: These findings suggest that to help children from multicultural families experiencing difficulties with self-esteem or acculturation, it might be useful to develop programs that are aimed at strengthen cohesion with parents.

Purpose: This study was conducted to evaluate the validity and reliability of the Korean version of the Sexuality Attitudes and Beliefs Survey (SABS) and to assess SABS for Korean nurses. Methods: The Korean version of SABS was developed through forward-backward translation techniques. Internal consistency reliability and construct validity using confirmatory factor analysis were conducted using PASW+ PC Win (18.0) and AMOS (18.0). Data were collected from 567 nurses who worked in one of six general hospitals across the country. Results: The Korean version of SABS showed a reliable internal consistency with Cronbach's ${\alpha}$ of subscales ranging from .59 to .73. Factor loadings of the 10 items of three subscales ranged from .38 to .83. The three subscales model were validated by confirmatory factor analysis (GFI>.97, RMSEA<.05). Sexuality attitudes and beliefs for Korean nurses were more negative than that of European or American nurses. The SABS scores for Korean nurses were significantly different according to age, marriage, education, clinical experiences, and feeling about sexuality. Conclusion: The Korean version of SABS has satisfactory construct validity and reliability to measure Korean nurses' attitudes and belief toward sexuality. Education is essential to enhance importance and self-efficacy and to relieve barriers to addressing patients' sexuality.

Purpose: The purpose of this study was to investigate effects of Oral Function Improvement Exercises on salivation, xerostomia and halitosis in elderly people. Methods: The participants in the study were 48 female community-dwelling elders in D city. The Oral Function Improvement Exercises were given 3 times a week, for a total of 24 times from August to October 2011. Spitting method, Visual Analogue Scale, and halimeter (mBA-21) were used to evaluate the effects of Oral Function Improvement Exercises on salivation, xerostomia, and halitosis. The data were analyzed using ${\chi}^2$-test and t-test with the SPSS program. Results: The experimental group had significantly better salivation, and less xerostomia and halitosis than the control group. Conclusion: The results indicate that Oral Function Improvement Exercises were effective for salivation, xerostomia and halitosis in the elders. Therefore, it was suggested that Oral Function Improvement Exercise are applicable in a community nursing intervention program to improve the quality of life for elders.

Purpose: A diagnosis of breast cancer is one of the most traumatic events that threatens a woman's life, but while women adapt to and overcome these threats, they not only experience negative aspects, but also growth. The purpose of this study was to identify the many factors that affect growth, and to provide fundamental information for nursing interventions, which can help the women in their growth. Methods: The participants in this study were 131 married women patients with breast cancer, who were on medical treatment in one of two university hospitals, in Seoul and Chungnam. Data were collected for posttraumatic growth, self-esteem, cancer coping questionnaire, marital intimacy, and body image. The data were analyzed using the SPSS 19.0 program (IBM). Results: Interpersonal cancer coping, intrapersonal cancer coping (planning) and self-esteem accounted for 29.0% of posttraumatic growth. Conclusion: These findings indicate that in order to help the women's growth after the trauma of breast cancer, it is necessary to enhance their self-esteem, and to develop psycho-social nursing supportive programs.