Stroke patients have increased with the overall aging of our population, 60 years and older. Recently the number of stroke patients has been on the increase even among younger people in their thirties. The family support is frequently mentioned as a major variable which plays an important role in helping the patients adapt themselves to their hemiplegic situations. The purpose of the study was to examine between family support and activities of daily living(ADLs)abilities for the hemiplegic patients, and to provide the basic data to help the patients carry out their ADLs on their own. The sample for the study included 106 hemiplegic patients and their family members. The data were collected using a focused, structured interviews. The major findings of the study were as follows: 1. The hemiplegic patients perceived that their family supports were very high(Mean, 49.00). 2. The degree of family support was significantly higher in female. high economic status, and non-use of brace patients than in male, poor economic status, use of brace patients. 3. The ADL abilities of the hemiplegic patients were significantly higher in ambulatory, younger, and longer-period-of-illness patients and patients who used a cane as a assistive device. 4. The family support for the hemiplegic patients showed a statistically significant Cor relationship with their performance of ADL(r=.30809. p=0.0013). 5. The performance of ADL for the ambulatory patients were mainly affected by the degree of family support, the period of the hemiplegic illness, the use of brace, informal care giving, and the age. These variables explained 50% of variance. 6. The length of illness was a statistically significant affecting variable for ADL performance in OPD and assistive device in IPD. In conclusion, the higher the hemiplegic patients perceived the degree of family support, the better they performed ADL. We should develop nursing methods which enhance the family support for the hemiplegic patients in order to increase their performance of ADL.

This study examined the relationship between the level of hardiness and self-care agency of persons with a colostomy. The purpose of the study was to explore the effect of hardiness on self-care agency of persons with a colostomy and to identity factors influencing on. The ultimate goal was to help nurses improve the person's self-care agency and to contribute theoretical base for the planning of supportive nursing interventions to increase the level of self care. The subjects for the study consisted of 43 persons aged above eighteen below seventy had had Miles operation and permanent colostomy. The data were collected from July, 1998 to September 15, 1998. The instruments used for this study were the Health-Related Hardiness (Pollock, 1984) and the Self-carer As Inventory Scale(Genden & Taylor, 1988). The Self-Carer As Inventory translated by So Hyang-sook and was modified by author of this study. The data were analysed by using SAS computerlized program and included number, percentage, t-test, ANOVA and Pearson Correlation Coefficient. The results of the study are summarized as follows. 1. Hardiness was significantly related to Self-care agency(r=-0.531. p=0.0002). That is, the higher the hardiness, the higher the level of Self-care agency. 2. In the relationship between general characteristics and traits of persons with a colostomy and hardiness were significant difference in monthly income (F=2.79, p=0.03), problem in stoma management (F=3.29, p=0.01). 3. In the relationship between general characteristics and traits of persons with a colostomy and Self-care agency were significant difference in monthly income (F=2.93, p=0.03), problem in stoma management(F=2.93, p=0.01). Therefore, in order to increase the level of Self-care agency of ostomate Nurses should be helpful to provide them with hardiness training to strengthen their control, commitment and challenge(subconcepts of hardiness).

The purpose of this study was to identify the degree of sexual adjustment and quality of life in married men with spinal cord injuries and to furnish primary data to sexuality rehabilitation nursing practice which can lead to ideal sexual life and quality of life those men with SCI. Seventy married men with SCI were conveniently sampled in Kwangju, Suncheon, Mokpo and Seoul for responding the questionnaire, which was based on this research. With the research scale, SIS (Sexual interest and satisfaction) by Siosteen et al.(1990) and SB(Sexual behaviour) by Kreuter et al.(1996) were used for the measurement of sexual adjustment. And, for measuring quality of life was used SCI QL-23(Spinal cord injury of life-23) scale by Lundqvist et al.(1997). Data were collected from January 20 to March 20, 1999, using a structured questionnaire. A hundred volumes of questionnaire were used. and 85 volumes were collected, 70 volumes were used as research data after excluding 15 volumes unsuitable to data analysis. The obtain data were analysed using percentage, t-test, ANOVA, Duncan test, and Pearson's correlation by SAS PC+ program. The results were as follows: 1. The mean score of sexual interest and satisfaction of the subjects was 8.42. out of 18. The ways of their sexual behavior after spinal cord injuries were embracing and caressing (62.9%), kissing(58.6%), caressing breast with hands (55.7%), caressing breast with hands (52.9%), caressing genitals with hands (37.2%), caressing genitals with mouth(30.0%) and sexual intercourse (18.6%). The mean score of quality of life was 52.53 out of 100. 2. Age(F=3.24, p=.045) and caregiver (F=4.02, p=.022)were major variables which reveals significant differences in terms for sexual interest and satisfaction. The later results on Duncan's test showed that subjects who were in their 30s or 40s were significant higher than subjects whose age were in their 50s in their sexual interest and satisfaction. Also subjects with their spouse's care or mother's care were higher than those with other's care. 3. Subjects with incomplete paraplegia were higher than those with the complete paraplegia in sexual interest and satisfaction (F=3.01, p=.036). 4. Variables that showed the significant differences in the quality of life were education(t=2.860, p=.007) and period of marriage(t=2.125, p=.037). and occupational status(t=-2.161, p=.034). High school graduates, those who married before spinal cord injuries and those who didn't have occupation were higher than the other subjects. 5. Variables that revealed significant differences in the quality of life were time passage after spinal cord injuries(F=8.72, p=.001) and injured level of spinal cord(F=3.32, p=.042). Duncan's test showed that subjects who had lived for less than 4 years were higher those with time passage of 5-9 years and 10 years. Also subjects with lumbar injuries were higher than those with thoracic injuries in terms of quality of life. 6. There was negatively correlated between sexual interest and satisfaction and quality of life(r=-.256, p<.05). As a result of these findings sexuality rehabilitation for individuals with SCI was very important issue for their quality of life. Thus, registered nurses who care clients with SCI should activily participate in the client's sexual needs. Also, various sexual behaviors as well as sexual intercourse should be encouraged for the sexual adjustment of client's with SCI.

Pain management is a major issue in caring of cancer patients. Patients' concerns for reporting pain and taking analgesics are patient-related barriers to the management of cancer pain. Since such study has not been done at all in Korea, it is clearly needed to study on these problems. The purpose of this study is to attain basic data in order to improve cancer pain management in Korea. This is done by: 1) examining the extent of patients' concerns that might be barriers to the optimal pain management, and the extent of related factors (pain management hesitancy, adequacy of using analgesics, pain severity and pain interference); 2) identifying the relationship between patients' concerns and the related factors. The data has been collected from 180 cancer patients who were hospitalized in medical wards of one university hospital in Seoul, Korea during the period from November 1, 1997 to February 28, 1998. The data has been collected through interviews with (1) Barriers Questionnaire - Korean Version (BQ-K); (2) Hesitancy Experience Questionnaires (HQ); (3) Pain Management Index (PMI); (4) Brief Pain Inventory (BPI); and (5) Demographic Data. The data were analyzed by descriptive statistics and by t-test, One-way ANOVA, Pearson correlation using SPSSWIN program. The Results are as following: 1) The mean scores of Pain Management Concerns (PMC) by BQ-K were toward the moderate with a little high points(2.59). Most of the patients (99.4%) had some extent of concerns (over lout of maximum 5 points). Among the eight subscales of BQ-K, the Pain Management Concerns (PMC) about 'Fear of tolerance' was the highest (3.80) and 'Worry about side effects' was the least (1.40). 2) The extent of Pain Management Hesitancy (PMH) by HQ of wnom had pain on the day of the interview was a little higher than moderate score(5.53 out of maximum 10 points). 6.7% of the patients with experiencing pain used less adequate analgesics for the severity of pain than they were expected. 27.8% of them never used any analgesics at all. The mean score of pain severity by BPI was 16.59 (maximum: 40), and that of the interference with daily life by BPI was 32.03 (maximum: 70). 3) The patients who were older, less educated, and in low socio-economic status were likely to have more concerns. Pain Management Concerns (PMC) was positively correlated with Pain Management Hesitancy (PMH) (r=.75), pain severity (r=.44) and pain interference (r=.50). Those who were not using adequate analgesics had higher Pain Management Concerns (PMC) than did those who were using adequate analgesics (t=-5.42). The patients who had more Pain Management Concerns (PMC) tended to hesitate more to report pain and to use analgesics. They used more inadequate analgesics for the severity of pain and also had experienced more pain severity and interference with daily life. In conclusion, the patients' concerns for reporting pain and for using analgesics are major patient-related barriers to cancer pain management in Korea. The patients' concerns were correlated significantly with the level of the hesitancy experience, inadequate use of analgesics, the pain severity and the interference with daily life. Considering this, an educational program for cancer patients under the treatment with analgesics should be developed in order to solve these problems.

The propose of this study was to identify fatigue, pain and coping of pain and to compare the variables between fibromyalgia and chronic arthritis. The sample consisted of 133 patients who visited H university hospital. Data were collected by questionnaire from May 1 to September 30, 1999. Data was analyzed by descriptive statistics, $x^2$-test, pearson correlation coefficient, and ANOVA. As a results, most of all patients felt fatigue and the mean score of the fatigue was above average. The mean score of rheumatoid arthritis and fibromyalgia patients on pain was higher than Osteoarthritis patients, and there was the statistically significant difference among three groups on pain(F=10.63, p=0.00). There was also the statistical difference among three groups on coping of pain(F=4.74, p=0.01). The mean score of rheumatoid arthritis and fibromyalgia patients on coping of pain was higher than Osteoarthritis patients. Fatigue showed positive relationship with pain(r=.262, p=.002), and pain showed positive relationship with coping of pain(r=.319, p=.000). According to this finding, fibromyalgia patients and rheumatoid arthritis patients felt high fatigue and pain, therefore the development of nursing intervention for relieving fatigue and pain would be needed.

The purpose of this study was to examine the knowledge and practice of the Clean Intermittent Self Catheterization (CIC) conducted by Spinal Cord Injury Patients (SPIC) or their significant others as an activity of daily living at their homes or working places. Forty-seven patients were participated in this study. Three questionnaires developed by researchers for this study were used to collect demographic data, knowledge and practice skill of CIC. Descriptive statistics and ANOVA were used to analyze the data. Nineteen (19) patients experienced Urinary Track Infection (UTI) during the last one years and two of them have had several times of UTI. Knowledge level of the participant was not high enough to perform correct CIC. Some evidences indicated that the knowledge did not apply to their practice. Systematic analysis and development of educational content based on this study results was recommended and the systematic instructional design before actual patient education was strongly recommended.

The purpose of this study is to identify and describe a process of sexual adjustment of individuals with spinal cord injury: and to describe and explore positive and negative influences on the adjustment process. This qualitative study was conducted with 10 Korean individuals with spinal cord injury who had been physically disabled for more than one year. Data were collected and analysed at a same time using grounded theory method. Major categories of this study showed a process how the individuals with spinal cord injury adjust to their individual life as sexual beings. The process included and individual responses to the behavioral efforts including and . Initially physical aspects of sexuality seemed to be affected by spinal cord injuries. The changed physical aspects then influenced other aspects of their sexual life. Life satisfaction of each individual as a sexual being revealed as very subjective. It could be defined according to how the individual approved their sexual life no matter what and how much behavioral effort the person had done. In this study 3 types of sexual adjustment aspects were explored: 'Active adjustment' 'Passive adjustment' 'Maladjustment'. There were negative and positive factors influencing the adjustment process of individuals with spinal cord injury. Those factors might come from themselves, from families, or from social situations. Findings of this study suggested that sexual life of individuals with spinal cord injury should not be understood as a physical or behavioral matter. It was a combination of physical, psychological and social aspects of life. Therefore, appropriate rehabilitation programs for the sexual adjustment of individuals with spinal cord injury need to concern heterogeneous life values of them and obtain individualized services for each individual at a different stage of the sexual adjustment process.

A Preliminary study for the evaluation of the Rehabilitation Nursing Program(RNP) implemented to the 25 stroke survivors at the Day Care Program Center of National Rehabilitation Hospital in Seoul was done at 1999. The purposes of this study was to assess the psychological effects as outcome-variables such as depression, powerlessness and self efficacy of the stroke survivors who were discharged from acute care hospitals. The Rehabilitation Nursing Program (RNP) integrated with the Day Care Program for rehabilitation was implemented and the psychological outcome variables were measured by 3 psychologic instruments of Zung Depression Scale, Millers's powerlessness and the Bandura's self efficacy scale. These instruments were translated into Korean and the contents validity and the reliability were tested. The subjects were 17 males and 8 females and 52% were aged over 51 years old and 24% were from 31 to 50 years old. Most of them (72%) had been educated more than high school level. The contents of RNP were 8 sessions composing of self-introduction, individualized assessment, health contract and feedback, management of depression, shaving experiences, effective communication, self efficacy teaching, health information, and daily care activities. This study found that the level of depression and the powerlessness were within average level and had not been changed the level of self efficacy after RNP were somewhat higher than before, but it was not changed significantly. According to the results, the psychological state of the subjects were not changed significantly. Only the level of self efficacy was a little improved after having the RNP. Based on theses results, the RNP should be focussed on the psychological nursing care and the psychological outcome variables were retested strictly with the enough sample size.

Stroke is one of the leading causes of death in Korea. Because of their sequelae, strokes are categorized as a sudden-onset, constant course chronic illness which needs continuous efforts for rehabilitation. Unfortunately, there are few community based rehabilitation program for post-stroke patients who stay at home. The authors developed a community based selp-help management program for post-stroke patients to enhance their rehabilitation process. The program consists of five sessions and each session contains health education. ROM exercise, ADL training, and stress management like foot reflexology. A professor and two graduate students of nursing college coordinated the program. To test the effects of the program we conducted a 5 week program to the 10 conveniently selected post-stroke patients who were living in Kang-buk district of Seoul. The Questionnaires about ADLs, IADLs, depression and life satisfaction were asked to the all subjects before and after program. The hand grisp power and muscle strength of four limbs were measured at the end of each sessions. The analysis of data revealed that the program was effective to increase the ADLs, IADLs, and muscle strength and to decrease the depression levels of subjects. However, there was no significant difference between pre and post hand grisp power and life satisfaction. Because the program was effective to Improve the physical and psycholocial function of subjects, we suggest continual development and Implementation of community based self-help management programs.