The Effects of a Group Educational Intervention on the Prevention of Osteoporosis in Breast Cancer Patients

PURPOSE: This study was conducted to examine the effects of osteoporosis prevention education on Korean breast cancer patients' knowledge and health promoting behavior. METHODS: The participants in this study included breast cancer patients who were registered at a self-help group organized by the Breast Cancer Center of a university hospital in Seoul, Korea. The intervention group received 60 minutes'didactic instruction followed by 30 minutes' interactive session, and reinforcement education with leaflets was given three weeks after the group intervention. In order to measure the effects of the intervention, this study used valid and reliable scales on the knowledge of osteoporosis and health promoting behavior for preventing osteoporosis. A post-test was conducted 12 weeks after the intervention. RESULTS: The results showed significant improvement in three of the five factors of osteoporosis knowledge including bone physiology, the characteristics of osteoporosis, and preventive behaviors in the intervention group. Overall health promoting behavior for preventing osteoporosis had significantly increased in the intervention group compared to the control group. CONCLUSION: Osteoporosis preventive education improved breast cancer patients' knowledge of osteoporosis and health promoting behavior for preventing osteoporosis by inducing their voluntary participation in self-care activities.

Effects of a Multicultural Education Program on the Cultural Competence, Empathy and Self-efficacy of Nursing Students

PURPOSE: This study was done to examine the effects of a multicultural education program on nursing students' cultural competence, empathy, and self-efficacy. METHODS: In this quasi-experimental study, the participants were assigned to an experimental group (n=40) or a control group (n=40). The data were analyzed using independent t-test, Chi-square or Fisher's exact test, and paired t-test with the SPSS windows 18.0 program. RESULTS: After receiving the multicultural education program, the levels of cultural competence and self-efficacy in the experimental group were higher than in the control group. The level of empathy increased slightly in the experimental group while it decreased in the control group. CONCLUSION: The results of this study indicate that multicultural education is effective in raising the level of cultural competence and self-efficacy in nursing students. Thus, there is a need for continuous effort to integrate multicultural education programs in the nursing curriculum. Repeated study to test effects of these multicultural education programs should be also necessary.

The Status of Home-Based Hospice Care in Korea / 한국호스피스완화의료학회지

PURPOSE: This study was conducted to investigate how home-based hospice care is provided in Korea. METHODS: From July 2011 through August 2011, 29 hospice facilities that provide home-based hospice care were surveyed using a questionnaire. Items included in the questionnaire were general characteristics of the organization, staff members, service programs, difficulties. RESULTS: Among the surveyed, hospice care was hospital-based for 11 (37.9%) facilities, hospital-independent center-based care for four (13.8%) and home-based care only for 10 (34.5%). Near half the participants were located in Seoul and Gyeonggi-do. Caregivers included nurses for 62.1% of the participants, volunteers 62.0%, pastors 44.8%, social workers 37.9%, coordinators 31.0% and doctors 31.0%. The facilities offered service programs such as family counseling (96.6%), transfer to other facilities (93.1%), psychological support (89.7%), bereavement support (86.2%), dying care (79.3%), clinical care (75.9%) and spiritual support (75.9%). The major obstacles were financial issues (24.1%), lack of trained staff (20.7%) and staff members' lack of awareness of home-based hospice care (13.8%). CONCLUSION: In Korea, home-based hospice care is provided by an insufficient number of facilities. Moreover, the service providers are experiencing difficulties such as lack of trained staff, insufficient financial resource and staff's lack of awareness of home-based hospice care. It is necessary to increase the number of home-based hospice care facilities with consideration of even distribution across regions and standard staffing and service programs and develop related insurance policies.

Development and Evaluation of "Hospice Smart Patient" Service Program

PURPOSE: The purpose of this study was to develop and implement the Hospice Smart Patient Program and to evaluate its effectiveness. METHODS: It was quasi-experimental non-equivalent pre-post study. Breast cancer patients who underwent surgery, chemotherapy or radiotherapy, or who needed palliative care, participated in the study. Participants were divided into two groups, experimental and control groups based on their preferences. The program was developed after literature review and discussion among experts on hospice and palliative care. Participants who were in the experimental group received either face-to-face or phone "Hospice Smart Patient" Service at least once a week for 5 months. RESULTS: There was a significant difference in quality of life and communication skill between the two groups after the service was provided. In addition, participants in experimental group showed improved decision making skills, mastery sense, and understanding of hospice and palliative care, which would be beneficial in improving their quality of life. CONCLUSION: We have concluded that the "Hospice Smart Patient" Program is useful for cancer patients in decision making, improving self-control and choosing hospice care to improve their quality of life.

A Study of Subclinical Thyroid Function Disorder and the Risk of Coronary Artery Disease in Women / 성인간호학회지

PURPOSE: This paper has attempted to investigate the association between the subclinical thyroid function disorder caused by natural change in thyroid hormones or thyroid remedies and the incidence of CHD. METHODS: Data was analyzed of 7,675 women who had undergone health examinations in a hospital in Gyeonggi-do between January 2007 and December 2008. The covariation of the coronary risk factors such as age, BMI, HbA1C, systolic blood pressure, LDL:HDL-cholesterol ratio, CRP, smoking and exercise were analyzed by using logistic regression analysis. RESULTS: A significant increase in serum TSH was observed with higher age (F=26.91, p=.00). In terms of age, the risk of CHD started to gradually increase since the 40s and sharply since the 60s (chi-square=113.29, p=.00). The serum TSH was the most significant parameter influencing CHD (B=.12, p=.00). The risk of coronary artery disease was 3.12 times higher in the subclinical hypothyroidism group (OR=3.12) while no significant difference was observed in the subclinical hyperthyroidism group. CONCLUSION: Subclinical hypothyroidism may be an independent risk factors for CHD. A nurse nursing patients with thyroid disorder should be well informed of their state of subclinical thyroid function disorder and make efforts to extend their health expectancy.

Development of Educational Program for Hospice Smart Patient Service Provider / 종양간호학회지

PURPOSE: The purpose of the study was to develop an educational program reflecting the educational needs of Hospice Smart Patient service providers. METHOD: The description, goal, curriculum, method, and process evaluation of the educational program were constructed based on Modified Tyler-type Ends-Means Model followed by the analysis of current curriculum and needs of service providers. RESULTS: The curriculum was constructed based on hospice volunteer program currently offered in Korea and the recommendations of hospice service volunteers and experts. A total of 90 hr was required to complete the curriculum that was composed of 'Introduction to cancer', 'Treatment and treatment complications of cancer', 'Post-treatment nutritional care', 'Helpful information', 'Introduction to hospice and palliative care', 'Comprehension of life and death', 'Holistic hospice and palliative care', 'How to communicate as a smart patient', 'Hospice and ethics', 'Pediatric hospice', 'Bereavement management', and 'Clinical practicum'. CONCLUSION: It is necessary to implement the developed educational program and evaluate its effectiveness, as well as making the service available to a greater number of cancer patients.

Use of Home Nursing Therapy and Need of Home Care Equipments

This study was conducted with whole home care nurses nationwide to provide secondary analyzed data to understand on their usage of medical equipments and their need of them for a month. This study found that treatments given by home care nurses were nelaton catheterization, bladder washing/urethral washing, newborn care, exchange and care for nasogastric tube and suction in that order of frequency. Second, instruments and equipments used for home care were reported to be stethoscope, patient monitor, blood pressure measuring equipment, air flotation mattresses, beds for patients, mattresses, suctioning device sets, enteral feeding equipment and dressing set in that oder of frequency. Moreover, need assessment of medical instruments and equipments showed renal dialysis was most needed and patient monitor, blood pressure measuring equipment, enteral feeding equipment, solution and other supplies for renal dialysis and beds for patient were necessary in that order. In conclusion, the results of this study investigating special treatments and medical instruments and equipments used for home care patients and analyzing patients' need, were expected to be useful for expansion of application of long-term care insurance for the elderly and health insurance as well as for quality control of home care and development of medial instruments and equipments used at home.

Current Status of Clinical Practice Education in Maternity Nursing in Korea: four-year course nursing schools centered / 여성건강간호학회지

PURPOSE: This study was performed to provide data for improvement in clinical practice education through analyzing the status of clinical practice education in maternity nursing in four year course nursing schools in Korea. METHOD: Analyzed subjects were 43 schools out of 53 four year course nursing schools in Korea. RESULT: Credits in theory and clinical practice are on the decline. The relationship between goals and areas of clinical practice was not sufficient. The department was not efficient in meeting the demands between theory and practice. The number of students in a group according to clinical areas were thoughtfully assigned, and clinical practice was performed based on real situations. Instructors for clinical practice used practice lecturers, part-time lecturers, preceptors, and assistant instructors including faculty. Methods of practice education and evaluation were varied. CONCLUSION: A suitable philosophy and goals of clinical practice education maternity nursing should be established at this point in time. Furthermore, a study should be performed to analyze the relationship between goals and contents of clinical practice for maternity nursing. In addition, a standardized tool should be developed to evaluate clinical practice.

A Fundamental Study for a System Establishment of Advanced Practice Nursing for Gynecological Cancer Patients / 여성건강간호학회지

PURPOSE: This study was conducted to provide fundamental information for a system establishment of advanced practice nursing for gynecological cancer patients (APN-GCP). METHOD: Data was collected by focus group and individual interviews and analyzed in the framework of the Grounded theory method mapped by Strauss and Corbin (1990). There were 13 subjects in this study (nurses, doctors, patient and her family). RESULT: We identified 87 concepts, 22 sub-categories, and 10 categories. Categories for role expectation were arrangement of diagnosis and treatment process, giving information of treatment course, support of treatment process, patients' right toward making a decision of treatment, counseling and teaching after discharge from hospital, medical insurance and financial problems, counseling about sexual problems and use of family and community resources. All subjects perceived the necessity of an APN-GCP. An APN-GCP requires over 2~7 years clinical experience and a master's degree. Services would be performed from initial registration to termination of treatment or death, and accomplished on an outpatient clinic basis. CONCLUSION: The nursing delivery system and curriculum should be developed for a women's health nurse practitioner including APN-GCP. As a further step, cost-effectiveness and projected estimation of manpower of APN-GCP should be studied in the future.

Spiritual Care and Spiritual Wellness of Hospice Team Members / 기본간호학회지

PURPOSE: This study was conducted to identify the spiritual well-being and spiritual care of hospice team members. METHOD: Between December 2005 and February 2006, a questionnaire was given to 192 hospice team members. The instruments used in this study were the Spiritual Well-Being Scale(SWBS) developed by Paloutzian, & Ellison(1984), and a Spiritual Care Performance Scale developed by the authors. RESULTS: The levels of spiritual well-being were relatively high: significantly lower in the 25-29 years old, in the unmarried, and in the 1-2 million won income groups, and significantly higher in Protestants, Catholics, clergy, and volunteers. The levels of performance of spiritual care were intermediate; significantly higher in clergy, and those with 10 or more years of experience. There was a positive correlation between: levels of spiritual well-being and age; levels of spiritual well-being and performance of spiritual care; and levels of performance of spiritual care and age. The factors affecting the levels of spiritual well-being included religion, age, and performance of spiritual care. The factors affecting the levels of performance of spiritual care were the years of hospice experience and spiritual well-being. CONCLUSION: Because there was a positive correlation between levels of spiritual well-being and performance of spiritual care, there is a need to develop a strategies to increase the spiritual well-being of hospice team members.

An Analysis of Articles about Women's Health / 여성건강간호학회지

PURPOSE: The purpose of this study was to classify the research domains and subjects based on existing health problems, sex/gender specific crucial health differences and common risks across the life span. METHOD: Three hundred and seventy seven articles were examined that were published in 3 nursing journals from 1999 to 2004. RESULTS: Research subjects were classified into middle-aged women (23%), nurses (20%), pregnant women (17%), school girls (14%), ill women (8%), working women (4%), elderly women (4%), mothers (3%), married women (3%), and unmarried women (2%) in sequence. The total number of keywords were 820 and the mean was 2.17 per article. Research domains were health behaviors (27%), childbirth (20%), socio-cultural and economic activities (8%), illness (6%), the reproductive system (5%), and demographics (5%) in the order of frequency. Research concepts shown were universal health behaviors (8.4%), mental health (7.2%), labor and delivery (6.2%), parent roles (5.5%), breast- feeding (4.6%), violence (4.5%), climacterics (4.3%), postpartum care (4.0%), weight control behaviors (3.8%), and a healthy life (3.5%) in frequency. CONCLUSION: Based on the research results, research concepts should be chosen closely related with the existing health problems, sex/gender specific differences and common risks across the life span. Especially these matters should be taken into consideration for study: education about the risks of artificial abortion, giving information for decision making on cesarean birth, low birth rates, infection during pregnancy, and the increasing rate of divorce.

Adjustment after a Hysterectomy / 간호학회지

PURPOSE: This study examined the relationship between sexual changes and adjustment and identified the factors which affect adjustment after a hysterectomy. METHOD: The subjects were 89 women under 50 years of age registered at gynecology departments of general hospitals in Seoul. RESULT: 60.7% of the women restarted coitus during six weeks to three months post operation. They felt a decrease in vaginal secretions (68%), and abdominal and pelvic pain (59.8%), but2/3 of them didn't change the frequency of coitus and level of orgasm. With respect to the adaptability of the sexual life, there was a significant difference in the time to restart coitus, lack of vaginal secretions, abdominal and pelvic pain, change of frequency of coitus, experience of orgasm, importance of sex and avoidance of coitus, according to job, income, and health condition. CONCLUSION: It is appropriate to restart coitus six weeks to three months after surgery and preliminary information should be given to patients after surgery as abdominal and pelvic pain could be relieved after twelve months. Also, sexual adjustment can be improved if they can recognize the changes after surgery from sexual life before surgery.

Competency of Nursing Performance and Job Satisfaction of Operating Room Nurse by Type of Nurse Staffing / 여성건강간호학회지

PURPOSE: This study was designed to investigate the relationships of the types of nurse staffing, the competency of nursing performance and job satisfaction by analyzing the types of nurse staffing in operating room. METHOD: The subjects were 472 nurses who work in operating room. The instruments used in this study were three tools: competency of nursing performance, job satisfaction and type of nurse staffing. RESULT: Type 4 was most in the type of nurse staffing of the subjects. According to the type of nurse staffing, the competency of nursing performance was significantly different. There was significant difference in the competency of nursing performance according to age, marital status, bachelor, employ, position, and career, and job satisfaction according to age, position, and career. In opinion about the ideal type of nurse staffing, type 2 was most regardless of career. CONCLUSION: Type 4 which has lower competency of nursing performance was adopted in many hospitals now but, type 2 which has highest competency of nursing performance was selected by many nurses as the best one. So, it should be considered the type of nurse staffing of in operating room and change it.

Comparison of the Effects of Internet Diabetes Education by Gender in Type 2 Diabetic Patients / 여성건강간호학회지

PURPOSE: The purpose of this study was to evaluate whether the effect of Intenet diabetes education varied by gender. METHOD: An experimental group assessed pre- and post intervention was used to assess the effectiveness of diabetes education by nurses. Forty patients separated into two groups by gender partook in the study. The goal of the intervention was to keep blood glucose concentrations close to normal range. The intervention was applied weekly for 3 months. Participants were requested to input their blood glucose level, diet, and exercise diary everyday at http: //www.biodang.com by cellular phone or wire Internet. The researcher sent optimal recommendations to each patient using the short message service of cellular phones and wire Internet. All medication adjustments were communicated to the subjects' doctors. The plasma glucose levels, serum lipids, and care satisfaction were measured before and after the intervention. RESULT: Glycosylated hemoglobin (HbA1c) decreased 1.6% and 0.8% in male and female patients respectively after 3 months of education. Total cholesterol decreased 37.2mg/dl in male patients but increased 80.5mg/dl in female patients. CONCLUSION: These findings indicated that Internet diabetes education could improve HbA1c and total cholesterol in male patients.

Direct Care Stress and Job Satisfaction in Home Care Nurses* / 여성건강간호학회지

PURPOSE: This study was aimed to investigate direct care stress and job satisfaction in home care nurses. METHOD: Subjects were 139 home care nurses of hospitals in urban cities. Data was collected by a self report questionnaire. Direct care stress was measured by Community Health Nurses Perceptions of Work-Related Stressors Questionnaire. Job satisfaction was measured by a visual analogue scale. RESULTS: The average score of direct care stress was 60.4. There were significantly high direct care stress in those who had less than that 3 years experience than in their counterparts. The average score of job satisfaction was 79.5. There were significant high job satisfaction in those who willingly chose to work. Direct care stress negatively correlated with the length of office experience of the home care nurse. CONCLUSION: A direct care educational program should be developed for those who have less than 3 years experience to decrease their stress level.

Depression and Blood Glucose Testing in Women Type2 Diabetic Patients / 여성건강간호학회지

PURPOSE: The purpose of this study was to investigate the depression and the frequency of blood glucose testing in women type2 diabetic patients. METHOD: 114 Participants were recruited from the endocrinology outpatient department of a tertiary care hospital in an urban city. Depression was measured by visual analogue scale. Blood glucose testing was measured the frequency during past 1 week. RESULT: Depression was higher in hyperglycemia patient (fasting blood glucose> or =110mg/dl) than in normoglycemia patient(fasting blood glucose <110mg/dl). The blood glucose testing frequency as lower in 50-59 years old than in less than 39 years old. And it was lower in middle school graduate than in college graduate. The blood glucose testing was negatively correlated with patient's age. CONCLUSION: The depression program should be developed for hyperglycemia diabetic patients. And the blood glucose testing education program should be developed for aged and low educational level patients.

Eating Habits, Trend of Disordered Eating, Weight Reduction Practice and Body Size Evaluation of College Students in Seoul / 여성건강간호학회지

PURPOSE: To provide the epidemiological information for developing preventive programs encourage appropriate eating and weight control behaviors. METHOD: 349 college students in Seoul were administered self-report question- naires to examine eating habits, trend of disordered eating, weight reduction practice and body size evaluation from September to October 2002. Data were analyzed by SAS program for frequency, t-test, ANOVA with Scheff test. RESULT: The mean eating score was moderate and it differed by subjects' characteristics. The mean score of EAT-26 was relatively lowered, and 3.4% of the subjects score showed disordered eating behavior. It differed significantly by subjects' general characteristics. 30.4% of total sample were currently trying to lose weight and had interested in trying to lose weight. EAT-26 was significantly different by weight reduction practices and interest. Perceived body size differed by the score of eating habit and EAT-26. CONCLUSION: It can be suggested weight preoccupation have a relation to eating habits, weight control practice and disordered eating. Further study is recommended educational interventions targeting at-risk subjects.

Self-care and Physical Symptom by Gender in Korean Type2 Diabetic Patients / 여성건강간호학회지

PURPOSE: The purpose of this study was to investigate the self-care and the physical symptom and to analyse the correlation between self-care and physical symptom in type2 diabetic patients. METHOD: 201 Participants were recruited from the endocrinology outpatient department of a tertiary care hospital in an urban city. The data were collected by self report self-care and physical symptom questionnaire. RESULTS: The alcohol drinking frequency was lower in female than in male patients. The frequency of nausea or vomiting, morning headaches, lightheadedness, weakness, pain in the heart, pain in the back, stiffness in any join or muscle, and getting very tired in a short time were higher in female than in male diabetic patients. The exercise frequency was negatively correlated with physical symptom in female patients. CONCLUSION: The alcohol drinking frequency was lower in female than in male patients. The female patients had more physical symptoms than the male patients. The exercise frequency was negatively correlated with physical symptom in female patients.

Nurse's Perceptions and Educational Intentions Regarding Natural Childbirth Control Methods / 여성건강간호학회지

PURPOSE: This study was designed to identify nurses' perceptions and educational intentions regarding natural childbirth control (NCC) methods. METHOD: The participants were 313 nurses working at three general hospitals in Seoul. They were asked to complete a questionnaire composed of scales measuring knowledge and perceptions childbirth control methods, awareness of bodily changes in ovulation phase, perceptions of fetal life, which were developed by the author. Also, Chang's (2002) Sexual Autonomy Inventory was utilized. The data were analyzed by the SAS program. RESULTS: Methods of condom and rhythm were considered to be more useful for childbirth control than other methods. Only 34-54% of them knew exactly about the NCC methods using menstrual cycle, body temperature, and mucus. The mean scores of sexual autonomy and awareness of bodily changes in ovulation phase were 3.8 and 3.4 out of 5, in respect. Educational intention was different statistically by the age, marital status, future intention to use NCC methods, and perception of educational need for NCC methods. CONCLUSION: Nurses' perceptions and educational intentions regarding NCC were low, especially in nurses who were married. It is recommended to encourage nurses to learn NCC methods for clients education.

Factors Influencing on Burnout Experience in Working Nurses at Hospital / 여성건강간호학회지

This study was designed to examine the factors that influence the burnout of nurses practice healthcare in a hospital setting. Subjects for this study were 245 nurses working at University K hospital in Seoul, Korea. Data for this study was collected from 15 to 27 April, 2002. The data collection instruments used for this study are as follows: Maslach Burnout Inventory(1981), Orientation to Life Question- naire(Sense of Coherence, SOC) by Antonovsky (1987) and Modified Coping Resources Inventory developed by author. The analysis of the data was completed using the descriptive, ANOVA, Pearson correlation analysis, and stepwise multiple regression using the SAS program software. The results of this study were as follows: 1. Total mean score of burnout was 4.0. Mean scores of the subscales were; emotional exhausion 4.7, personalization 3.7, and personal accomplishment 3.4.2. Significant statistical differences according to demographic characteristics of the subjects were found in the variables of age, job position, years of working, perceived job stress, and burnout. 3. Burnout was negatively related to sense of coherence(r= -.65) and coping resources (r= -.40); subscales of SOC of comprehensibility(r= -.57), manageability (r= -.55), and meaningfulness(r= -.52); subscales of coping of self-care(r= -.36), and cognitive coping(r= -.39).4. Job stress was the highest factor influence burnout. Sixty-one percent of the total variance of burnout was experienced by variables of comprehensibility, meaning- fulness, age, self-care, manageability and leisure activities including job stress. In conclusion, it was found that a low level of burnout was related to high scores of SOC and coping resources. Job stress, manageability, and meaningfulness were the highest factors influencing the level of subscale of emotional exhausion, depersonalization, and personal accomplishment. Therefore, it is necessary to search for strategies to promote SOC and coping resources for reducing the level of burnout of nurses.