• Journal of Korean Academy of Nursing Administration
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• v.5 no.1
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• pp.149-167
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• 1999

This study was designed and carried out to investigate the effect of Assertiveness Training on the stress response and assertive behavior of emergency room nurses from September 22, to December 21. 1997. The subjects were 45 emergency room nurses of three general hospitals of Korea University Medical Center; 25 assigned for the experimental and 20 for the control group. The Assertive Training Program was composed of cognitive training, behavioral training and progressive muscle relaxation. The subjects of the experimental group carried out the 15-minute progressive muscle relaxation according to recorded-tape once a day for 6 weeks. The cognitive and the behavioural training were conducted by the investigator for 5-8 subjects at a time for 9 series, at an interval of 4-5 days. Post-measurement were administered to all sujects in two groups three weeks after the last session. The level of general stress (Cline, 1992), job stress (Kim & Koo, 1984), physiological response to stress (cortisol, epinephrine, norepinephrine), symptoms of stress (Lee, 1984) and assertive behavior (Kim, 1982) were measured before the first and after the last experiments. Data were analysed by x2, t, paired t, Wilcoxon signed rank tests Wilcoxon rank sums tests. The results are as follows : 1. The level of general stress of the experimental group was lower than that of the control group, however, no significant difference between the two groups (P=0.234) was revealed. 2. A significant reduction of job stress was revealed in the experimental group (P=0.017). 1) A significant reduction of interpersonal conflicts in the experimental group was revealed (P=0.018). 3. The physiological stress-response were analyzed as follows : 1) A decrease of Cortisol in both the experimental and the control groups was noticed, however, the difference between the two groups was not statistically significant (P=0.991). Pre-and post-measurement of the level of Corti sol revealed that a notable decrease in the experimental group and an increase in the control group with no significant difference in the day-day subjects (P=0.765), a significant decrease was noted on the level of Cortisol of the experimental group in the night-night nurses (P=0.036). 2) An increase of Epinephrine in both groups was noticed, however, a difference was not statistically significant between the two groups (P=0.082). Pre-and post-measurement of the level of Epinephrine revealed that a notable decrease in the experimental group and an increase in the control group with no significant difference in the day-day subjects (P=0.136). increases were noted on the level of Epinephrinel of both groups in the night-night nurses (P=0.136), 3) The level of Norepinephrine of the experimental group was significantly decreased (P=0.020). Pre-and post-measurement of the level of Norepinephrine revealed that a notable decrease in the experimental group and an increase in the control group with no significant difference in the day-day subjects (P=0.073). a significant decrease was noted on the level of Norepinephrine of the experimental group in the night-night nurses (P=0.036), 4. Symptoms of stress were reduced in both groups, with no significant differences between the groups (P=0.127). 1) The physical stress symptoms were reduced in both groups, with no significant difference (P=0.386), 2) The cognitive-behavioral stress symptoms were significantly reduced in the experimental group (P=0.037). 3) The emotional stress symptoms were reduced in both groups with no significant difference between the groups (P=0.110). 5. The assertive behavior was significantly increased in the experimental group (P=0.000). This study signified the Assertiveness Training as an effective mean of self intervention for the reduction of stress of nurses assigned to emergency rooms.

• Journal of Korean Academy of Nursing
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• v.24 no.4
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• pp.623-634
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• 1994

Although the average menopausal age has not changed, women's life span has increased. Today's women live longer after their menopause than those in the past, and this calls for attention in both nursing and medical fields. Many studies have revealed how women reacted to menopause and suffered from it. But they did not discriminate the menopausal meaning and effects from the climacteric phenomena. So, this author tried to clarify what menopause itself meant to the climacteric women, by means of grounded theory methodology. The interviewees were 21 women, whose ages were between 46 and 60 years. They were selected by theoretical sampling technique, and the author tried to include all levels of important variables such as age, educational background, religion and job. Data were collected by the author through in -depth interviews and observations in July, 1994. The interviews were mostly done in the homes of the subjects, or in some cases at the author's office or in a hospital. Interviews took from 30 minutes to 2 hours. Interviews were tape recorded and transcribed later by a research assistant. Data were analyzed as gathered, by the constant comparative method proposed by Strauss and Corbin. Eleven concepts were discovered from the data, and they were grouped under six higher order categories. These six categories were "to give menopause a meaning", "to experience value change", "to have self-help strategies", "to have no strategies", "to live a life worth living", "to have a sense of powerlessness" Among these "to experionce value change" was . selected as the core category. Five major categories were systematically integrated around the core category. Women's adaptation to menopause was defined as proceeding as follows : Most women felt relief and sorrow at the same time when they faced menopause, and some only sorrow or agony. Then, they consulted with others about menopausal symptoms, or tried to think of them by themselves. Finally, they gave menopause a meaning, which was that menopause and its symptoms were natural phenomena. But menopause made women reflect on them-selves and their past lives. As they reflected on themselves, their value on life began to change. As their value changed, some women seeked self help strategies. Those self help strategies were what they had learned from collegues, professionals or mass media. The quality of their lives depended on whether they practiced self help strategies or not. Three types of lives were found. Twelve women enjoyed a life worth living, and practiced the self help strategies, because they accepted menopause a chance to change. They were characterized by a high educational level, having a professional job and a sincere faith in God. Seven women were living as usual, because they did not have the necessity to change. They were high school graduates and house wives. Two women recognized menopause a chance to change, but they did not try self help strategies. Their characteristic was low educational level. Those who did not try self help strategies complained of powerlessness to varying degrees. The educational background, full-time jobs and faith helped women adapt to menopause positively. But social support was not helpful to women's adaptation to menepause. Three hypotheses were derived from the analysis. (1) The higher the educational level, the more theneed to change. (2) Women with higher educational background will practice self help strategies more than those with lower edcational background. (3) The more women practice self help strategies, the worthier lives they will live. Suggestions for further studies are as follows. (1) Studies to test hypotheses are needed. (2) A study to find the relationship between the degree of practicing self help strategies and locus of control. (3) Spiritual approaches would better be applied to help menopausal women. (4) Education through mass media should be given mere frequently.

• Journal of Korean Academy of Nursing
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• v.23 no.4
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• pp.569-584
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• 1993

This study was done to verify validity of nursing diagnoses related to difficulty in respiratory function. First, content validity was examined by an expert group considering the etiology and the signs / symptoms of three nursing diagnoses - ineffective airway clearance, ineffective breathing pattern, impaired gas exchange. Second, clinical validity was examined by comparing the frequencies of the etiologies and signs / symptoms of the three nursing diagnoses in clinical case studies with the results of the content validity. This study was a descriptive study. The sample consisted of 23 experts (professors, head nurses and clinical instructors) who had had a variety of experiences using nursing diagnoses in clinical practice, and 102 case reports done by senior student nurses of the college of nursing of Y-university. These reports were part of their clinical practice in the ICU. The instrument used for this study was a checklist for etiologies and signs and symptoms based on the literature, Doenges and Moorhouse (1988), Kim, McFarland, McLane (1991), Lee Won Hee et al. (1987), Kim Cho Ja et at. (1988). The data was collected over four month period from May 1992 to Aug. 1992. Data were analyzed using frequencies done with the SPSS / PC＋ package. The results of this study are summarized as follows : 1. General Characteristics of the Expert Group A bachelor degree was held by 43.5% and a master or doctoral degree by 56.5% of the expert group. The average age of the expert group was 35.3 years. Their average clinical experience was 9.3 years and their average experience in clinical practice was 5.9 years. The general characteristics of the patients showed that there were more women than men, that the age range was from 1 to over 80. Most of their medical diagnoses were diagnoses related to the respiratory. system, circulation or neurologic system, and 50% or more of them had a ventilator with intubation or a tracheostomy. The number of cases for each nursing diagnoses was : · Ineffective airway clearance, 92 cases. · Ineffective breathing pattern, 18 cases. · Impaired gas exchange, 22 cases. 2. The opinion of the expert group as to the classification of the etiology, and signs and symptoms of the three nursing diagnoses was as follows : · In 31.8% of the cases the classification of etiology was clear. · In 22.7%, the classification of signs and symptoms was clear. · In 17.4%, the classification of nursing interventions was clear. 3. In the expert group 80% or mere agreed to ‘dysp-nea’as a common sign and symptom of the three nursing diagnoses. The distinguishing signs and symptoms of (Ineffective airway clearance) were ‘sputum’, ‘cough’, ‘abnormal respiratory sounds : rales’. The distinguishing sings and symptoms of (Ineffective breathing pattern) were ‘tachypnea’, ‘use of accessory muscle of respiration’, ‘orthopnea’ and for (Impaired gas exchange) it was ‘abnormal arterial blood gas’, 4. The distribution of etiology, and signs and symptoms of the three nursing diagnoses was as follows : · There was a high frequency of ‘increased secretion from the bronchus and trachea’ in both the expert group and the case reports as the etiology of ineffective airway clearance. · For the etiologies for ineffective breathing pat-tern, ‘rain’, ‘anxiety’, ‘fear’, ‘obstructions of the tract, ca and bronchus’ had a high ratio in the ex-pert group and ‘decreased expansion of lung’ in the case reports. · For the etiologies for impaired gas exchanges, ‘altered oxygen -carrying capacity of the blood’ and ‘excess accumulation of interstitial fluid in lung’ had a high ratio in the expert group and ‘altered oxygen supply’ in the case reports. · For signs and symptoms for ineffective airway clearance, ‘dyspnea’, ‘altered amount and character of sputum’ were included by 100% of the expert group. ‘Abnormal respiratory. sound(rate, rhonchi)’ were included by a high ratio of the expert group. · For the signs and symptoms for ineffective breathing pattern. ‘dyspnea’, ‘shortness of breath’ were included by 100% of the expert group. In the case reports, ‘dyspnea’ and ‘tachypnea’ were reported as signs and symptoms. · For the sign and symptoms for impaired gas exchange, ‘hypoxia’ and ‘cyanosis’ had a high ratio in the expert group. In the case report, ‘hypercapnia’, ‘hypoxia’ and ‘inability to remove secretions’ were reported as signs and symptoms. In summary, the similarity of the etiologies and signs and symptoms of the three nursing diagnoses related to difficulty in respiratory function makes it difficult to distinguish among them But the clinical validity of three nursing diagnoses was established through this study, and at last one sign and symp-tom was defined for each diagnosis.

• Journal of agricultural medicine and community health
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• v.24 no.1
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• pp.91-101
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• 1999

The home nursing care system is an integral part of the health care delivery system in order to meet the various needs of consummer, in particular, early discharge patient from the hospital, patient with long term care needed and the elderly. To find out the cost of home nursing care services, the home nursing care records of patients registered by home nursing care units established in public hospital with 150beds during the period of 1996 - 1997 were analyzed. The subjects were 102patients, 45 of male patients and 57 of female patients, those who live in a rural area in Kymiggi - Do The results obtained are as follows : 1. The male patients accounted for 44.1% of the total, with 45cases : group aged 60 years and more was the largest group, accounting for 79.5%. 2. The most frequent disease revealed was the osteoporosis which constitute 35.3% of the total registered patients, followed, in order, by malignant tumor, cerebrovascular disease. 3. It revealed that the cost per visit for the male was 47,764won ; the female, 46,078 won per visit. Noteworthy the cost per visit was high in the older patient. It was clearly that the gender, years of age and the cost per visit were statistically significant at 0.01 level and 0.05 level. 4. The cost per visit for the non complicated disease was slightly higher than the complicated disease, but it is not statistically significant, the cost per visit by type of disease varied, the cost per visit for COPD was the highest, followed, in order, by in malignant tumor, cancer, diabetes, osteoporosis etc. 5. It revealed that home nursing care cost for a eligible disease for home nursing care was less than the cost for hospitalization of the same disease, therefore, we expect that the home nursing care is cost efficiency. In conclusion, the home nursing care costs are needed to analyze further in comparison with the hospitalization costs for a certain disease.

• Journal of agricultural medicine and community health
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• v.24 no.2
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• pp.331-350
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• 1999

This study was attempted to examine relationship between personality traits and job satisfaction of community health practitioners(CHPs) working in remote rural area in order to suggest some methods to enhance their lob performance and the degrees of job satisfaction. The General Personality Test and the revised version of Job Satisfaction Questionnaire were administered to 200 of 348 CHPs in the Kwangju-Chonnam area and then the percentages, means, standard deviations and Pearson's correlation coefficients of these data were obtained, ANOVA and logistic analysis were used. The results of study were as follows : 1. CHPs without religion were more satisfied with their salary than those with religion. 2. CHPs who hoped for continuous education showed higher scores than the others on necessary job, professional pride and autonomy. Those who chose for independent job showed higher scores than the others on both necessary job and professional pride. Those who hope for long duration showed higher scores than the others on both necessary job and professional pride. Those who were satisfied with the present occupation showed higher scores than the others on pay satisfaction, necessary job, professional pride, interaction, autonomy and demand from organization. 3. Their autonomy scores differed significantly according to work status, both interaction and autonomy scores did so according to the fields of the past job in CHP, and their autonomy scores according to location of clinics. Their interaction scores differed significantly according to the frequency of home visits per mouth, both the degrees of salary satisfaction and professional pride scores did so according to the frequency of counseling education per mouth, and their professional pride scores did so according to total income per year. 4. The levels of their responsibility and self-confidence showed the highest of all personality traits variables. 5. The professional pride score of CHPs showed the highest of all job satisfaction variables. 6. Dominance were mostly correlated with autonomy and responsibility were mostly associated with professional pride. Both emotional stability and self-confidence were mostly related necessary job. In conclusion, religion, location of clinics, clinical experience, opportunity for education, dominance, self-confidence, the duration of services hoped for, satisfaction with the present occupation, the field of past job and administrative affairs were found to be the important factors in the degrees of their job satisfaction. Therefore, the methods to consider these variables will be necessary to develop for enhancing the efficiency of their Job performance and the degrees of job satisfaction.

• Journal of agricultural medicine and community health
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• v.24 no.1
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• pp.145-159
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• 1999

To find the association, between vinyl house work and the prevalence of low back pain, a questionnaire survey was made toward 215 vinyl house farmers and 228 general farmers without vinyl house who are cared by Jungjung Community health Practioners at Soobuk Myun, Damyang-gun, Chollanamdo. 1. Vinyl house farmers were significantly younger in age, higher in educational status higher survival rate of spouse, higher economic state and less cared by medical aid than general farmers. 2. Vinyl house farmers showed shorter career for agricultural work, used modern farming instrument more frequently and worked with sitting position. 3. During unbusy season in general agriculture, vinyl house farmers consumed significantly more time in agricultural work and general activity, but no significant difference of time of the above activity among busy season. 4. During the last spring season when most vinyl house work was performed, vinyl house farmers showed significantly higher prevalence of low back pain than general farmers, but no significant difference of prevalence among the two groups for the last one week. 5. By the simple analysis statistical significant related variables with low back pain was found to be sex(p<0.001), educational status(p<0.05), work posture(p<0.001) and use of modern agricultural machine(p<0.05). 6. By the multiple logistic regression the odds ratio for low back pain among vinyl house farmers were 2.08(95% confidence interval 1.31-3.00) compared to general farmers, the odds ratio among female was 2.35(95% confidence interval 1.24-4.47) to male, the odds ratio among illiterate persons were 2.60(95% confidence interval 1.24-4.47) to high school graduate, and the odds ration among primary school graduate was 2.19(95% confidence interval 1.04-4.47) to high school graduate. In conclusion because vinyl house farmers showed significantly higher rates of low back pain compared to farmers without vinyl house, continuous study to find the true cause of low back pain among vinyl-house farmers and active effort to prevent low back pain are necessary.

• Journal of agricultural medicine and community health
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• v.34 no.1
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• pp.58-66
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• 2009

Objectives: Active participation of poultry breeder in surveillance system of Avian Influenza (AI) is very important. Therefore this study was conducted to present basis data for active report of AI that is affected by media's coverage in poultry breeder. Methods: Subjects were 88 persons, 28 who were poultry breeder at epidemic area of AI and 60 who were general person at non-epidemic area. Data were collected by the trained investigator from Jul. 1 to Aug. 31, 2008. Respondents were interviewed by means of a structured questionnaire. Results: The third-person effect among perceptions of influence in media's report on the AI was higher in breeder (32.1%) than in non-breeder (10.0%). However, Confidence to media report on the AI was lower in breeder than in non-breeder. Intention to report of the AI was 71.4% in breeder respectively, was 90.0% in non-breeder. There was statistically significant lower in breeder than non-breeder. The cause of avoidance of report was 'economic damage' for 87.5%, which acocounted for the majority of cases. Confidence to media report on the AI were positively correlated with concern on the AI and perception on seriousness of the AI, but negatively correlated with the third-person effect. Conclusions: These results showed that intention to report of the AI of breeder was susceptible to influenced by the third person effect and confidence in media's report on the AI. Therefore we should give a special attention to increase active report of poultry breeder during epidemic period of AI which is consideration of reasonable strategy of media's coverage, including mind and emotion state of poultry breeder.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.17 no.1
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• pp.32-39
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• 2006

Objectives : The aim of this study was to examine the developmental and clinical characteristics associated with nocturnal enuresis in Korean children. Methods : Three hundred eighteen children with nocturnal enuresis, together with their parents, completed a parent questionnaire consisting of a Child Behavior Checklist(CBCL). Data related to the prenatal, perinatal and developmental history, past and current medical history were collected. Ninety-three normal students were selected as the control group. Results : The nocturnal enuresis group attained diurnal and nocturnal urinary control significantly later than those in the normal control group.49.2% of the children with nocturnal enuresis had the family history of nocturnal enuresis. Daytime incontinence was present in 41.3% of the nocturnal enuresis group. The percentages of sleep-related disturbances were significantly higher in the nocturnal enuresis group when compared to the normal control group.42.6% of the children with nocturnal enuresis experienced pharmacotherapy, and 0.4% experienced enuresis alarms. Conclusion : The results of this study suggest that children with nocturnal enuresis in Korea have a high genetic load and a possibility of developmental delay, which supports the neurodevelopmental point of view with regard to the etiology of nocturnal enuresis. The physicians in Korea prefer pharmacological interventions to alarm interventions in treating Korean children with nocturnal enuresis.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.15 no.2
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• pp.143-151
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• 2004

Objectives : Child and adolescent onset obsessive compulsive disorder(C-OCD) is known to be associated with poor drug response, high comorbid rate and strong genetic tendencies. Till now studies for C-OCD have been very rare in Korea. We conducted this study to investigate the informations about clinical features, familial psychiatric loading, treatment profiles and course of server C-OCD from the retrospective analysis of inpatient data of Seoul National University Children's Hospital. Method : Retrospective chart review and data analysis was performed. Twenty(male 16 : female 4) patients with final C-OCD diagnosis by DSM-IV at discharge from 1994 to 2002 were found and their medical chart, psychological data, family interview data and nursing reports were collected and analyzed. Results : 1) The sex ratio of C-OCD was male dominant(4:1). 2) Phenomenological, most common obsession was pathologic doubt, contamination fear, followed by aggressive obsession, need for symmetry, sexual obsession, most common compulsion was checking and washing, followed by breathing, movement, symmetry, repetitive asking, hoarding, mental compulsion. 3) Most common comorbid diagnosis was depression. Other axis-I diagnosis associated OCD were anxiety disorder, tic disorder, conduct and oppositional defiant disorder and psychosis. 4) Regarding psychiatric familial loadings, 17 patients(85%) had relatives with psychiatric disorders, OC-spectrum disorders(OCD or OCPD) were found in 9 patients(45%). 5) The majority of patients(75%) have received SSRI and antipsychotics treatment. The response rate above 'moderate improved" by CGI was 75%. 6) During follow-up period in outpatient clinic, five patients(25%) showed continuous complete remission, 10 patients (50%) did residual symptoms with chronic course. Conclusion : This seems to be the first systemic investigation of severe pediatric OCD patients in Korea. The children & adolescents with severe OCD in inpatient-setting showed the high comorbid rate, familial psychiatric loading, and combined pharmacotherapy with antipsychotics, As for symptoms, high rate of aggressive-sexual obsession and atypical compulsions like breathing and moving was reported in this study. Severe pediatric OCD patients, however, responded well to the combined SSRI and antipsychotics regimen.

• Korean Journal of Oriental Medicine
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• v.3 no.1
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• pp.41-65
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• 1997

The diagnostic requirements were suggested and explained regarding the systems of differentiation of symptoms and signs in the third year study of standardization and unification of the terms and conditions used for diagnosis in oriental medicine. The systems were as follows : - analysing and differentiating of epidemic febrile disease - analysing and differentiating in accordance with the Sasang constitutional medicine baced on four-type recognition - differentiation of diease according to pathological changes of Chong and Ren channels - standards for diagnosis of women's disease - standards for diagnosis of children's disease - standards for diagnosis of motor and sensor disturbance(-muscle born joint etc.) - standards for diagnosis of neuropsychiatric diease - standards for diagnosis of five sense organ diease - standards for diagnosis of external disease. The indivisual diagnosis pattern was arranged by the diagnostic requirments in the following odor : another name, notion of diagnosis pattern, index of differentiation of symptoms and signs, the main point of diagnosis, analysis of diagnosis pattern, discrimination of diagnosis pattrrn, prognosis, a way of curing a diseases, prescription, herbs in common use, dieases appearing the diagnosis pattern, documents. The standards for diagnosis of each disease was arranged by the diagnostic requirments in the following odor. another name, notion of diease, the main point of diagnosis, analysing and differentiating of disease, analysis of diease, discrimination of disease, prognosis, a way of curing and prescription of disease, dieases In western medicine appearing the disease in oriental medicine, documents.