Trends in Nursing Research in Korea: Research Trends for Studies Published from the Inaugural Issue to 2010 in the Journal of Korean Academy of Nursing and the Journals Published by Member Societies under Korean Academy of Nursing Science

PURPOSE: The purpose of this study was to identify trends for studies published in the Journal of Korean Academy of Nursing and journals published by member societies from inaugural issues to 2010. METHODS: A total of 6890 studies were analyzed using descriptive statistics. RESULTS: Quantitative studies accounted for 83.6% while qualitative studies accounted for 14.4%. Most frequently used research designs were quasi-experimental (91.1%) for experimental research and survey (85.2%) for non-experimental research. Most frequent study participants were healthy people (35.8%), most frequent nursing interventions, nursing skills (53.5%), and 39.8% used knowledge, attitude and behavior outcomes for dependent variables. Most frequently used keyword was elderly. Survey studies decreased from 1991 to 2010 by approximately 50%, while qualitative studies increased by about 20%. True experimental research (1.2%) showed no significant changes. Studies focusing on healthy populations increased from 2001-2005 (37.5%) to 2006-2010 (41.0%). From 1970 to 2010, studies using questionnaire accounted for over 50% whereas physiological measurement, approximately 5% only. Experimental studies using nursing skill interventions increased from 1970-1980 (30.4%) to 2006-2010 (64.0%). No significant changes were noted in studies using knowledge, attitude and behavior (39.9% ) as dependent variables. CONCLUSION: The results suggest that further expansion of true experimental, qualitative studies and physiological measurements are needed.

Patterns of Health Behavior for Weight Loss among Adults Using Obesity Clinics

PURPOSE: This ethnography was done to explore patterns of weight management behavior among adults using obesity clinics. METHODS: The participants were 12 adults who were overweight or obese and 2 family members. Data were collected from iterative fieldwork in the obesity clinics of two hospitals. Data were analyzed using text analysis and taxonomic methods. RESULTS: Weight management behaviors among participants varied according to the recognition of the body and motivation for weight control, Participants' behavior was discussed in the socio-cultural context of obesity. Patterns of weight management behavior among participants were categorized by focus: strategic self-oriented type including managements for the body as a social asset and for health, selective neglect type, and passive group value-oriented type including type dependent on others and managements for beauty. CONCLUSION: Participants' weight management behavior was guided by folk concepts of body and health. and constructed within the socio-cultural context. It is necessary for health care providers to understand physical and psychological problems arising from the repeated trials, excessive control of weight, and Western cultural discourse on beauty ideals among adults who are overweight or obese. Therefore, interventions should be tailored to address individual and community needs.

Analysis of Research Papers Published in the Journal of the Korean Academy of Nursing-Focused on Research Trends, Intervention Studies, and Level of Evidence in the Research

PURPOSE: This study aimed was done to analyze recent trends in nursing research published in the Journal of Korean Academy of Nursing by focusing on the content of nursing interventions and their level of evidence. METHODS: A total of 209 studies published between 2007 and 2008 were reviewed using analysis criteria developed by the researchers. RESULTS: The number of quantitative studies was greater than that of qualitative studies. There was a slight increase in the number of qualitative studies and studies including elderly populations, which reflects the recent population trend in Korea. More randomized controlled trials with a low risk of bias were needed to support more evidence-based nursing practice. Concerning the low rate of ethical consideration, stricter application of research ethics needs to be encouraged. CONCLUSION: The findings of this study suggest the recent trends in nursing research and the direction of nursing research and review in the Journal.

The Meaning of Illness among Korean Americans with Chronic Hepatitis B

PURPOSE: This ethnography was done to explore the meaning of illness in Korean Americans with chronic hepatitis B. METHODS: The participants were 6 patients with chronic hepatitis B and 6 general informants who could provide relevant data. Data were collected from iterative fieldwork with ethnographic interviews within Korean communities in two cities in the United States. Data were analyzed using causal chain analysis developed by Wolcott. RESULTS: The analyses revealed three meanings for the illness: hidden disease, intentionally hidden disease, and inevitably hidden disease. The contexts of meaning of illness included characteristics of the illness, social stigma, structure of health care system and communication patterns and discourse between health care providers and clients. CONCLUSION: The meaning of illness was based on folk illness concepts and constructed in the sociocultural context. Folk etiology, pathology and interpretation of one's symptoms were factors influencing illness behavior. These findings could be a cornerstone for culture specific care for Korean Americans with chronic hepatitis B.

Qualitative Research Investigating Patterns of Health Care Behavior among Korean Patients with Chronic Hepatitis B

PURPOSE: This ethnograpy was done to explore patterns of health care behavior in patients with chronic health problems. METHODS: The participants were 15 patients with chronic hepatitis B and 2 family members. Among the patients 4 had progressed to liver cirrhosis and liver cancer. Data were collected from iterative fieldwork in a department of internal medicine of I hospital. Data were analyzed using text analysis and taxonomic methods. RESULTS: Illness and disease, relationship between health care givers and clients, and communication patterns between health professions and clients were discussed as the context of health care behavior. Health care behavior of the participants was categorized by its focus: every day work centered, body centered, organ centered, and pathology centered. CONCLUSION: Participants' health care behavior was guided by folk health concept and constructed in the sociocultural context. Folk etiology, pathology, and interpretation of one's symptoms were influencing factors in illness behavior. These findings must be a cornerstone of culture specific care for the chronic diseases.

The trends of Nursing Research in the Journal of Korean Academy of Adult Nursing / 성인간호학회지

PURPOSE: The purpose of this study was to analyze the published articles in the Journal of Korean Academy of Adult Nursing from 2004 through 2006. METHODS: Two hundreds and ten articles were analyzed focusing on research methodology and key words using descriptive statistics. RESULTS: The proportion of quantitative research was 88.1%, while the proportion of qualitative research was 5.2%. The majority of the qualitative research design was survey(67.1%). Seventy-four percent of the research had verbal consent and 8% had written consent from the participants. Eight percent of the research provided conceptual framework. The prevailing data collection settings were hospitals(50.5%) and community(37.1%). For the data analysis, 95% used parametric analysis methods; descriptive statistics(26.2%), chi-square test(18.3%), t-test(18%) and ANOVA(17.4%). Key words were categorized into four nursing domain: human, health, nursing, and environment. The most frequently used domain was health. CONCLUSION: The number of the published articles in the Journal of Korean Academy of Adult Nursing has been increased and quality has been improved compared with the articles published before the 2000 year. Varied research methodology and data analysis methods were utilized.

Aging and Temporality of Aged in a Clan / 성인간호학회지

PURPOSE: This ethnography in communication aimed to explore the changes in consciousness on time and temporality as an elderly became older. This study focused on time as a primary message systems of Edward Hall. METHODS: The assumption of the study was that the aging body as an expression of biological time is a meta of physical, personal, and social time. Data were collected from iterative fieldwork in a clan between Jan, 1990 and April, 2007. The key informants were 13 women and men aged 70 years old or more at the beginning of study. Changes in physical time and temporality as the women's body declined in its physical function was analyzed. As the cultural context, informants' every life and the history of the clan were also analyzed. RESULTS: The meta-time of the informants were constituted as follows: In the low-contextual dimension, physical time perceived as longer and personal time perceived as shorter than they were young; In high-contextual dimension, informant and residents had a polychronic perspective and aged-centered time perspectives.; In the supernatural dimension of time, sacred time were reinforced by rituals. Informants extended temporality to their springs' world and ancestors' world. CONCLUSION: As the informants recognized slugged body movements and time-limited present life, their views on their life world towards the future of spring and of the sacred world of ancestors. Thereby, their identity as a member of a clan was reinforced. This result informed us on what we should focus on when caring with older women.

Aging and Temporality of Aged in a Clan / 성인간호학회지

PURPOSE: This ethnography in communication aimed to explore the changes in consciousness on time and temporality as an elderly became older. This study focused on time as a primary message systems of Edward Hall. METHODS: The assumption of the study was that the aging body as an expression of biological time is a meta of physical, personal, and social time. Data were collected from iterative fieldwork in a clan between Jan, 1990 and April, 2007. The key informants were 13 women and men aged 70 years old or more at the beginning of study. Changes in physical time and temporality as the women's body declined in its physical function was analyzed. As the cultural context, informants' every life and the history of the clan were also analyzed. RESULTS: The meta-time of the informants were constituted as follows: In the low-contextual dimension, physical time perceived as longer and personal time perceived as shorter than they were young; In high-contextual dimension, informant and residents had a polychronic perspective and aged-centered time perspectives.; In the supernatural dimension of time, sacred time were reinforced by rituals. Informants extended temporality to their springs' world and ancestors' world. CONCLUSION: As the informants recognized slugged body movements and time-limited present life, their views on their life world towards the future of spring and of the sacred world of ancestors. Thereby, their identity as a member of a clan was reinforced. This result informed us on what we should focus on when caring with older women.

A Study of Nurses' Knowledge Level and Assessment Experience of Delirium / 성인간호학회지

PURPOSE: This study was conducted to examine the knowledge level and assessment experience of nurses in regards to delirium, and to utilize the study results as baseline data for planning delirium education programs for nurses. METHODS: Subjects were 465 nurses who were working in a general hospital. A 'delirium related knowledge and assessment experience' questionnaire was used to collect data. RESULTS: Knowledge levels regarding delirium averaged 70 out of 100, and at each domain, they scored 87 for etiology of delirium, 62 for symptoms, and 69 for nursing management. The knowledge level of delirium was significantly different according to educational level (F=3.851, p=.022), past education related to geriatrics(t=2.471, p=.014), and awareness of need for in-service education on geriatric nursing(F=2.663, p=.032). About 85% of nurses had past experience of dealing with delirious patients and only 7.7% of nurses used delirious state assessment tools. CONCLUSION: According to the above results, it is necessary, not only to provide delirium related educational programs for nurses, but also to emphasize the usefulness of applying the assessment tool.

Development of a Scale to Measure Korean Ego-integrity in Older Adults / 간호학회지

PURPOSE: Ego-integrity in older adults is the central concept related to quality of life in later life. Therefore, for effective interventions to enhance the quality of later life, a scale to measure ego-integrity in older adults is necessary. This study was carried out to develop a scale to measure ego-integrity in older adults. METHODS: This study utilized cronbach's alpha in analyzing the reliability of the collected data and expert group, and factor analysis and item analysis to analyze validity. RESULTS: Seventeen items were selected from a total of 21 items. Cronbach's alpha coefficient for internal consistency was .88 for the 17 items of ego-integrity in the older adults scale. Three factors evolved by factor analysis, which explained 50.71% of the total variance. CONCLUSIONS: The scale for measuring ego-integrity in Korean older adults in this study was evaluated as a tool with a high degree of reliability and validity.

Nurse Managers in a Difficult Situation on Caring Clients: A Critical Discourse Analysis / 성인간호학회지

PURPOSE: This study aimed to explore the discourses and the patterns of problem solving behaviors among the nurse managers. The focus of the study was the difficult situations in caring with patients and their families. METHODS: Field study was performed at a for-profit hospital from March, 2004 to March, 2007. The participants of the study were 5 head nurses and 2 nurses in charge. The data were collected with iterative interviews and participant- observations. For the analysis of the data, taxonomy and critical discourse analyzing were applied. RESULTS: The nurse mangers who showed wholistic patterns of behavior took the role of a broker among the client system, professional nursing system, medical system, and other allied health system. The nurse managers whose approach was profession-centered took the role of protector of nursing system. The nurse manager who practiced nurse-oriented pattern of behavior tried not to have harm against other members of health system. The experiences of nurse managers were effected from the discourses of patriarchal and market mechanism. CONCLUSION: The situation that provoke conflict between clients and nurses become more common with the changes to the health care system and to society. Nurse managers take the role of these conflict problems. The successful solving of conflict in a nursing care setting promotes the quality of care and satisfaction of clients. Programs for enhancing nurse's problem solving competency should anchored be in their practices.

Illness and Experiences of the Body Among Aged Women / 성인간호학회지

PURPOSE: The purpose of present study was to discover the experience of the body of aged women, having had disease. Thus, the researcher tried to explore the perception of the informants and the context in which this perception emerged. METHODS: 9 aged women who had disease or trauma were recruited by snow balling and theoretical sampling methods. The iterative data collection and analyzing process proceeded between September, 1999 and January, 2005. Questions posed to the informants included: "What major change in your body comes from the disease?" "How did you feel about yourself after having had disease?". Data from interviews and participant observation was taken as text. The text was analyzed using the ongoing process of qualitative content analysing method and taxonomy of Spradley. RESULTS: Disease gives aged women a chance to reinforce the meaning of their body: the body as the most low valued component of a human, the body as a wholistic field of interacting each component of human and with natural environment and cosmos, and the body as a source of group identity. These meanings were constructed in their life world by the rules of hierarchy, reciprocity, and group cohesiveness. CONCLUSIONS: The human body is constructed as a cultural being by a social process. Nursing is concerned with the biological body and the social body. The results of this study can serve to help understand the socialization of the body and to construct a somology of nursing.

Reorganization of the Everyday Lives of Women with Lymphedema / 성인간호학회지

PURPOSE: This qualitative study aimed to understand the experiences of reorganization of everyday lives among the women with chronic health problem. METHODS: In this study, the approach and its process of sociology of everyday lives were adopted. Data for the study came from 6 informants and 9 family members of the informants by interview and participant-observation from January, 2004 to May, 2006. Qualitative content analyzing methods were adopted. RESULTS: Informants' everyday lives were reorganized as follows. During the experiences of shock from unpleasant and unclear symptoms of their body, their sight fixed on the body part. Their time also fixed on a point of present. They started to wander from medical care to folk and lay care. After they were informed that the health problem could not be treated completely, they reduced the world of everyday life and protected themselves from the chaotic unfamiliar world by setting -a- side duties as a family member and severing unessential social relationship. As they achieved a skill for managing their health problem, they gained their former pattern of everyday lives as a woman, a family member, and a social member. Finally, they created a new life world. CONCLUSION: We need more study on the development of an adaptive strategy by the informants, to intervene in the crisis of everyday life.

Meaning of Well-being for the Middle Aged Adults / 성인간호학회지

PURPOSE: This research was done to explore the meaning of 'well-being' as experienced by middle aged people. METHOD: The data were collected by individual in-depth interviews with 107 middle aged adults and it was analysed using qualitative content analysis. RESULTS: 4 components of the meaning of well-being as perceived by the participants were identified as follows: the life of free without physical discomfort and psychosocial distress; the life of comfort with plenty of time, space, material, and mind; the life of purity with natural material and honest mind; the life of harmony with extended consciousness. CONCLUSION: Therefore the identified meanings of the well-being in this study should be reflected to the nursing education and the nursing practice.

The Experience of the 'Sockalee' of Abused Elders / 성인간호학회지

PURPOSE: The purpose of this study were to identify the essential component and meaning structure of the experience of 'Sockalee' among abused elders. METHOD: This study was done using a phenomenological analytic method by Giorgi. The participants in this study were six elders who had the previous experience of 'Sockalee' as abused elders. The data were collected by interviewing the participants from May to September, 2003. Generally, three interviews for one person were performed and each interview lasted for one and half hours. RESULTS: The meanings of 'Sockalee' of abused elders were categorized with seven components. Those are (1) Unsolved family conflicts. (2) Being powerless. (3) Being pushed out. (4) Egocentric situation-recognition. (5) Strengthening egocentric situation-recognition (6) Attempts for re-powerfulness. (7) Release from abuse. (8) Situation recognition with others' position considered. CONCLUSION: Therefore, the nursing intervention must be focused on the above concerns to accomplish the successful solution for the abused elderly problems, especially approaching from the standpoint of the whole human.

Factors Influencing the Emotional State of Patients with Lymphedema / 간호학회지

PURPOSE: The purpose of this study was to investigate the emotional state and related factors in patients with lymphedema. METHODS: The subjects of this study consisted of 95 patients with lymphedema at 8 hospitals in Busan and Seoul. Data was collected by a self-administered questionnaire between March 2001 to December 2001. Data was analyzed by Pearson correlation coefficient, and stepwise multiple regression using SPSS Win 12.0. RESULTS: The mean score of the emotional state of the subjects was 3.06; of their physical symptoms, 1.84; of their Activities of Daily Living(ADLs), 2.30; and of their social activities, 3.67. The emotional states of lymphedema patients correlated with their physical symptoms, their ADLs, and their social activities. The Factor influencing the emotional state of the subjects was social activities. CONCLUSION: These results suggest that a negative emotional state is very common in patients with lymphedema, to which appropriate attention should be given. Rehabilitation programs must be implemented to improve lymphedema patients' emotional state, physical symptoms, ADLs, and social activities.

The Experiences of Family Caregiving in a Chronic Care Unit / 간호학회지

PURPOSE: The main purpose of this critical ethnography was to examines the process and discourses through which family caregivers experience while caring for their sick family member in a hospital. METHODS: This was achieved by conducting in-depth interviews with 12 family caregivers, and by observing their caring activities and daily lives in natural settings. The study field was a unit for neurologic patients. Data was analyzed using taxonomy, discourse analysis, and proxemics. All research work was iteratively processed from March 2003 to December 2004. RESULTS: Constant comparative analysis of the data yielded the process of becoming a successful family caregiver: encountering the differences and chaos as novice; constructing their world of skilled caregivers; and becoming a hospital family as experienced caregivers. During the process of becoming an experienced hospital family, the discourse of family centered idea guided their caring behaviors and daily lives. CONCLUSION: The paternalistic family caregivers struggled, cooperated, and harmonized with the patriarchal world of professional health care system. During this process of becoming hospital family, professional nurses must act as cultural brokers between the lay family caring system and the professional caring system.

An Ethnographic Study on Eating Styles of Adult Diabetics in Korea / 간호학회지

PURPOSE: The purpose of this study was to explore adult diabetics' eating styles and factors which influence them. METHOD: The study adopted an ethnographic method based on a perspective which views the eating style as a cultural phenomenon. Data was collected through a personal interview, participant observation, and documented materials from Oct.2001 to Sept. 2002. In this study, fifteen adult diabetics, with an average age of 57, participated. Data analysis was done by the Spradley's taxonomic analysis technique. RESULT: The patients' eating styles were rooted in their viewpoint on illness as well as the meaning of food. Eating styles were classified into 4 types: Pathology-centered, symptom-centered, need-centered, and role-centered. CONCLUSION: A conventional approach to the treatment and management of diabetes did not consider the patient's inner world which may play an important role in the successful management of the disease. We found that it was critical for health care personnel to understand patients' values, beliefs and their way of life in order to facilitate the most successful self-care diet.

The Concept Analysis of Ego-integrity in the Elderly / 간호학회지

PURPOSE: Ego-integrity in Erikson's stage theory is used frequently among health team members related to the care of the elderly and has specific meanings within the context of quality of life in later life. However, the concept of ego-integrity in the elderly has not been well articulated in the literature. This study was conducted clarify and conceptualize the phenomena of ego-integrity in the elderly. METHOD: A Hybrid Model of concept development was applied to develop a concept of ego-integrity, which included a field study carried out in Seoul, South Korea using in-depth interviews with old adults who were admitted as a right person for research subject according to attributes of ego-integrity analysed in the theoretical phase. RESULTS: The concept of ego-integrity emerged as a complex phenomenon having meanings in several different dimensions which encompassed several attributes. CONCLUSIONS: Ego-integrity is a concept having needs that should be treated in a specific way and it is possible to enrich the meaning and methods to manage ego-integrity in nursing interventions for promoting quality of life so that its application may have effects that have positive impacts on the elderly's well being.