• Journal of muscle and joint health
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• v.6 no.1
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• pp.100-135
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• 1999

Typical symptoms of rheumatic disease affect overall daily living and cause severe stress. Individuals afflicted with rheumatic disease have many illness-related stresses. Pain was the predominantly perceived stress followed by limitation in mobility, difficulties in carrying out activities of daily living. helplessness, dependency on others, threat to self-esteem, interference in social activity, interference in family relationships. difficulties performing at work, and discomfort of the treatment. Patients with chronic arthritis are subjected to long periods of continuous stress, which may require the management by the health care provider. In these cases, the purpose of the nursing is helping to promote health through supporting patient's coping. Therefore, for the nursing intervention to be effective, it is critical to build a theoretical framework that describes stress-coping for chronic arthritis. Thus, the purpose of this dissertation is to present a theoretical framework which describes the stress-coping processes and to empirically test pathos of this framework for the people with chronic arthritis. The foundation upon which this framework is built in the Erickson, Tomlin, and Swain(1983) theory of Modeling and role-Modeling. The subjects were 275 patients with rheumatoid arthritis or osteoarthritis who visited the outpatient clinic. A hypothetical model of stress-coping was tested by covariance structure analysis with PC-LISREL 8.12 program. As a result, the overall fit was good(Chi-square=94.49, P=0.00, RMR=0.067, GFI=0.95, AGFI=0.91, NNFI=0.93, NFI=0.91) for the hypothetical model. The results of hypothesis testing were as follows : Basic need satisfaction had a statistically significant influence on illness-related experience, emotional stress and coping resources. Internal health locus of control had a statistically significant influence on coping resources. However, independent variables(basic need satisfaction, internal health locus of control, illness-related experience, emotional stress and coping resource) did not have significantly influence on coping. And then, the hypothetical model was modified by considering both the theoretical implication and statistical significance of the parameter estimates. The revised model had a better fit to the data(Chi-square=83.11(P=0.00), RMR=0.061, GFI=0.96, AGFI=0.92, NNFI=0.95, NFI=0.92). Hypothesis emerged from the revised model was tested. The results of hypothesis testing were as follows : Basic need satisfaction had a statistically significant influence on illness-related experience, emotional stress and coping resources. Internal health locus of control had a statistically significant influence on illness-related experience and coping resources. Internal health locus of control, illness-related experience, emotional stress and coping resources had a significantly influence on coping. According to the results of this dissertation, basic need satisfaction and internal health locus of control play a central role in appraisal of illness-related experience and coping resources. And illness related-experience, emotional stress, and coping resources affect on coping activities. In summary, nursing interventions to enhance basic need satisfaction and internal health locus of control will decrease illness related experience and emotional stress and increase coping resources. Increased coping resources will prompt coping activities.

• Journal of Korean Academy of Nursing
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• v.24 no.3
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• pp.389-412
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• 1994

This study was done to investigate stress and coping methods of mothers with brain disease children. The subjects for this study were obtained by taking a sample of mothers with brain disease children hospitalized in neurosurgery ward of K medical center in Seoul from Nov. 20, 1992 to Mar. 10, 1993. The collected date were analized by S.P.S.S. program(frequency, percentage, mean, t-test, ANOVA, Pearson Correlation). The results of the study were as follow. 1. The mean of the degree of mothers' stress was 3.681. Of the stress categories, illness treatment (4.216) was highest, and the next were in order of ill-ness status and prognosis(4.154) , family relation-ships and personal roles(3.202), interpersonal relationships(2.916). 2. The mean of the degree of mothers' coping method was 2.930. Of the coping method categories, communication with medical team or parents in similar situations(3.332) was highest, and the next were in or-der of family cooperation and optimistic thought about the situation(3.241), reforcement of self esteem and maintenance of psychological stability(2.538). 3. There was not seen a stastically significant correlation between stress factors and coping methods of mothers. But with categories, the higher the stress to illness status and prognosis was, the hight coping methods' degree of communication with medical team or parents in similar situations was shown a positive correlation, if not high (r=.2776, P=.046) . And the higher the stress to illness treatment was, the higher coping methods' degree of communication with medical team or parents in simial situations was shown a positive correlation, if not high (r=.2727, P=.049). 4. With the difference of stress according to mothers' general characteristics, religion and monthly income shew a statically significant difference. The mothers' group who have a religion shew the higher degree of stress(t=-3.17, P=.003), The group who get the most income shew highest degree of stress (F=.4693, P=.0156). With the difference of coping according to mothers' general characteristics, the most support-ing person, satisfaction with husbands and mothers' own health status shew a statistically significant difference. The group who get the most support from parents-in-law(F=3.7508, P=.013), the group who are much satisfied with husband(F=3.589, P=.016), and the group whose health status are good(F=3.3675, P=.046), shew the highest coping degree. 5. There were no significant difference in degree of stress and coping by children's characteristics The significance of the study will be concluded as follows. 1. Investigating the stress factors, which mothers are perceiving, it will be utilized as the basic materials of nursing plan so as to reduce the stress of mothers. 2. In searching for the ways of mothers' more helpful coping methods, it shows the necessity of the active nursing intervention for the mothers in the process of coping with their stress. That is, the nurse should serve the earnest nursing as counselor, supporter, educator, and information - provider. 3. Recogning mothers as well as children with brain disease as a client, the nurse will be able to help the mother, who is taking care of the children, cope with the stress situation well, and to make a contribution to the recovery, rehabilitation, and health of the children and to the enhancement of the family' health.

• Child Health Nursing Research
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• v.4 no.2
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• pp.274-285
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• 1998

Improvements in therapy have resulted in increasing numbers of children being successfully treated for cancer. However the agrressiveness of therapy & uncertainty about prognosis are associated with many adverse effects, psychological as well as physical for both the child & family. The purpose of this study were to measure the degree of perceived uncertainty, self-efficacy & coping, and then to examine the relationship between the perceived uncertainty, self-efficacy & coping in parents of children cancer patients. The subjects of this study consist of 140 parents with pediatric cancer, registered at pediatric cancer ward & Out Patient Department. Data was collected from July 1st to August 15th 1998. The tools used in this study were Mishel's the Parents' Perception of Uncertainty Scale (28 item, 4 likert scale), Shere's Self-Efficacy Scale (17 item, 5 likert scale) & Folkman & Lazarus Ways of Coping Checklist(34 items, 4 likert scale). Data was analyzed by t-test, Anova, Pearson Correlation coefficient. Results of this study are summerized as follows 1. Parents perceived their uncertainty to be slightly high(Mn 2.41). The degree of perceived uncertainty by the four components were followed as lack of clarity (2.60), unpredictability(2.59), ambiguity(2.51) & lack of information(1.90). The degree of perceived uncertainty of parents with pediatric cancer revealed to be influenced significantly by the family outcome, reliability about health care provider & perceived severity of illness. 2. The range of parents' self-efficacy was measured iron 35 to 85 point, so revealed slightly high. The degree of self-efficacy related to be Influenced signiicantly by the sequency of child birth, family religion & degree of perceived support. 3. The degree of parents' coping was measured slightly high (Mn 2.78). The degree of coping related to be influnced significantly by the sequency of child birth, number of sible & degree of perceived support. 4. parents' uncertainty was related inversely to the parents' self-efficacy(r=-.38, p<.001) & coping(r=-.26, p<.001). And also parents' self-efficacy was positively related to coping(r=.56, p<.001) From the above results, it can be concluded that predicting & controlling parents' uncertainty with children cancer are necessary to improve positive coping strategies. This information may be used as a foundation for developing nursing interventions to decrease perceived uncertainty & to foster self-efficacy & coping for parents with children cancer.

• Journal of Korean Academy of Nursing
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• v.28 no.2
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• pp.270-279
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• 1998

Since death is an extremely subjective and unique experience, if we take into account the lack of understanding about death due to the difficulty in methodology, it is very important to try to understand the subjectivity of death. In this respect, Q-methodology that explains and shows the respondent's subjectivity by objectifying his subjectivity is employed as a solution to the questions in this study. Therefore, the purpose of this study was to provide data on how medical personnel should treat their patients, when it comes to death : by finding out the opinions of those who are being treated, namely the patients, and those who are providing the treatment, namely the medical personnel. It also by examined the characteristics and relationships between these two groups on attitudes to death. The results of this study show that medical per sonnel have two(fate-receipient, reality-oriented) types of response and patients have three (religion-dependent, science-adherent, sardonist) types. Medical personnel saw patients as having three (life-attached. traditionalist, death-rejector) types of response and to patients saw medical personnel as having two (rationalist, humanist)types. The relationship between the above-mentioned types will be examined in a coorientation model, the subjectivity of the medical personnel and the patient toward death indicates a relatively high understanding between the two groups under the great proposition of 'death'. Therefore, in their relationship with people who are facing death, the provider of care, namely the medical personnel, should identify the subjectivity of the patient before approaching them. By doing this, they can minimize the conflicts they might experience in establishing a therapeutic relationship, reduce suffering, and help the patient in greeting a more comfortable death. Throughout the study, Q-methodology expands our understanding of coorientation model that has only been approached with R-methodology. This study confirmed Q's potentiality and its validity in human subjective matters.

• The Korean Society of Law and Medicine
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• v.8 no.2
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• pp.69-118
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• 2007

In providing general medical treatments, the medical service contract between the patient and the doctor is the mutually responsible onerous contract. However, the nature of the mutually assumed contract standings of the patient and the doctor has been changing since the implementation of the national health insurance program. For instance, besides the cases of beyond excessive medical charges and medical negligence, if the doctor charged for his/her medical treatments violating the post-treatment/nursing cover criteria, the overpaid medical charge, regardless of being collected with the patient's consent, has to be refunded back to the patient. Medically needed aspects, treatment results, and unfair benefits favoring the patient are not at all taken into consideration in the health insurance scheme. This makes it easier for patients to get refunds for their share of the medical payments by involving the Health Insurance Review & Assessment Service or the National Health Insurance Corporation, without engaging in civil law suits (for reimbursement claim) against doctors. In other words, the doctor's responsibility to provide medical treatments and the patient's responsibility to pay for the medical treatment provided within the contractual realm are being demolished by the administrational arbitration of the National Health Insurance system. The basic rights of medical service providers, and the patient's right to choose are as important constitutional rights, as the National Health Insurance program, which is essential in the social welfare system. Furthermore, the development of the medical fields should not be prevented by the National Health Insurance system. If the medical treatment services can be divided into necessary treatments, general treatments, and high quality treatments, the National Health Insurance is supposed to guarantee the necessary and general treatments to provide medical treatments equally to all the insured with limited financial resources. However, for the high quality treatments, it is recommended that they should not be interfered by the National Health Insurance system, and that they should be left to the private contract between the patient and the doctor.

• The Korean Society of Law and Medicine
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• v.15 no.2
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• pp.195-223
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• 2014

Nurses are medical care providers most closely associated with the national health. Their works are subdivided and specialized, and it is such a factor making nurse's role more important, and with the appearance of specialized nurses, they have secured a position as an independent medical care provider. As the domain of nurse's service becomes broader, there are more accidents and disputes related to nurses. However, there are not many studies conducted on such problems, and even when medical disputes take place related to nurses, the court does not make consistent judgments as a matter of fact. Besides, as the ambiguity of nurse's range of service and the lack of nursing workforce work as a factor causing nurse's medical malpractice, more legal discussions and studies are required to seek proper solutions to such problems. Thus, as a plan to clarify legal issues likely to occur due to nurse's medical practice, this study classified nurse's work into medical assistance practice and other jobs based on their own independent judgments, and proposed establishing concrete regulations on the range of their work, while reviewing common problems extracted from precedents related nurse's medical malpractice. Moreover, while examining Japanese precedents related to the Act of Medical Service Personnel, Nurses and Midwives, which is the sole act of nurses in Japan, this study reviewed the necessity of revising the present nurse-related regulations in Medical Service Act, or enacting a sole act of nurses.

• Korean Parent-Child Health Journal
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• v.8 no.1
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• pp.3-16
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• 2005

Purpose: This study was to investigate the stress of parents while they were rearing their children. Method: This study reviewed the preceding research related to parents' stress and breeding stress with consideration of modem society, family system and parents' role. Results: In the parent-child relationship, parents feel stressed when they found it difficult to come up with an expectation to the parents' role of rearing child. Therefore, considering the health of parents and children, it is important to mediate parents who are under stress. Moreover, since parents cannot handle this problem all alone, it should be discussed and solved not only by individual but also by family, and further by social context. The parent-child relationship in early infancy is a core element to the development of an individual. Parents have influence on a child's development the most and play a big role. In particular, many parents these days believe that parent-child relationship is changing in a democratic way and a couple breeds their child together. However, in reality, the relationship has not been changed and is even regarded as more difficult situation than it was in the traditional society. Parents are oppressed with not being adapted to social changes and advance, and child also feels the same. Conclusion: Parents need education and support for child rearing without having any stresses. Health care provider consider this issues and to build a healthy parent-child relationship by helping parents.

• The Korean Journal of Emergency Medical Services
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• v.16 no.2
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• pp.91-102
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• 2012

Purpose : This study was designed to identify factors influencing burnout of nurses in emergency medical center. Methods : Data were collected by questionnaires from 178 emergency room nurses randomly selected from 6 general hospitals in two metropolitan cities. Measures were burnout, QEC, depression, decision latitude and job demand. Data were analysed using frequencies, means, standard deviation, t-test or one way ANOVA, Pearson's correlation coefficients and multiple regression with SPSS/win 18.0 version. Results : The mean score for burnout in emergency room nurses was 2.59 out of possible 4. There were significant differences in burnout according to exercise, leisure, position, job demand and depression. Burnout correlated negatively with exercise and leisure, and positively with job demand and depression. Factors influencing burnout in emergency room nurses were identified as exercise(${\beta}$=-.399, p<.001), leisure(${\beta}$=-.354, p<.001), job demand(${\beta}$=.301, p=.006) and depression(${\beta}$=.189, p=.021). These factors explained 49.8% of burnout reported by emergency room nurses. Conclusion : The result indicate which factors are major factors influencing burnout in emergency room nurses in general hospitals. Therefore, these factors may serve as predictors of burnout in emergency room nurses.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.7
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• pp.4805-4815
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• 2015

Dementia is targeted at the elderly and dependent family members, care providers, and the types of problem behaviors of the elderly with dementia by care providers learn how to cope with the relationship was tried for. Dementia in the elderly problem behaviour is the program's descriptive statistics, t-test, ANOVA, and dementia in the elderly problem behaviors for coping with behavior and the relationship between discrete variable using correlation analysis. The findings support the family and nursing experience of senile elderly issues, acting as a provider edge actions appeared the most high, and repeat the same question or request. ', ' Making loud noises or shouting. ' and '. 'Being stubborn, not listening to the words of the caregiver.' etc. In addition, this study, which appeared in dementia in the elderly cope with behavior based on behavioral problems and discuss the ' Verbal discussion ', ' Removal of the cause for incidents ' and ' Restriction of actions ' action causes this correlation. Therefore, caring for the elderly with dementia in a nursing institution and sanction providers related to dementia in the elderly appear to be frequently problem behaviors of the problematic behavior is not much need to be able to cope with the regular education, this study to the development of behavioral problems in dementia patients by an individualized nursing intervention program for caregivers caring for dementia patients, as basic materials will be provided.

• Korean Journal of Occupational Health Nursing
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• v.6 no.2
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• pp.156-167
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• 1997

In Korea, based on the Revised Law of Occupational Safety and Health a new entity of institution was set up in 1990 to provide occupational health services to SSE in which three sorts of personnel as a team have to be involved. These institutions, in charge of scores to hundreds of workplace area-wide, have been providing occupational health services without payment from employers or employees, and government reimburses through the Occupational Injury Prevention Insurance since 1993. As a service provider, a team is composed of doctors, nurses and industrial hygienists. Undergraduate and postgraduate educations for the SSE occupational health are not specified and the question on the performance of the personnel has been raised. This study was designed to analyze the facilitating factors of and barriers to the performance and its improvement of these personnel. In 1997, the survey was conducted with all 58 institutions. Structured questionnaires were mailed to 200 personnel who were providing the occupational health service for SSE. The response rate was 51.7% for doctors, 58.6% for nurses, and 60.3% for industrial hygienist, respectively. Results are as follows : 1) There is a guideline for occupational service mandated by the government. Under the guideline, the minimum frequency of visiting workplace is assured with six times of doctors, 17 times for nurse and industrial hygienist in a year. There are one doctor for every 200 factories, one nurse and one hygienist for every 100 factories. 2) All respondents have basic qualification for occupational health service. About 16.7%. of doctors are certified in industrial medicine or preventive medicine, and 64.7% of industrial hygienists had first grade certification. Totally 66.7% of personnel have been involved in occupational health for more than one year. 3) As a support system for the performance improvement, 66.3% respond that they have been provided with educational materials, advice related to industrial environment and guidance of MSDS from Korea Industrial Safety Corporation. Most respondents indicate the lack of concern of employers and employees as a main barrier to the improvement of the service. Also they are in the need of the training opportunity more focused on SSE. The Governments policy for SSE is a principal facilitating factor. Training program focused on SSE situation, manpower, technical support, etc. are areas to be improved to have a better occupational health service for SSE in Korea.