The Effects of a Standardized Preoperative Education Program on Stomach Cancer Patients undergoing Gastrectomy

PURPOSE: The purpose of this study was to identify the effects of a standardized preoperative education program on self-care knowledge, performance, satisfaction, and physical recovery in the stomach cancer patients undergoing gastrectomy. METHODS: A nonequivalent control group non-synchronized design was utilized and 63 participants who underwent gastrectomy (31 for experimental group, 32 for control group) were recruited at a university hospital from May to August 2015. RESULTS: There were significant differences between the groups in self-care knowledge (F=17.63, p<.001), performance (F=-9.25, p<.001) and satisfaction (F=-6.91, p<.001). Although the pain levels (F=974.57, p<.001) showed significant differences in each group and 3 time intervals (F=18.26, p<.001), there was no interaction of group and time (F=0.09, p=.917). The highest body temperature at 48 hours after surgery (F=1.32, p=.192), as well as presence of atelectasis (F=2.23, p=.213) indicating a chance of pulmonary complications, and the time of first gas pass (F=-1.05, p=.299), presence of paralytic ileus (F=0.13, p=.719) were not significantly differ. CONCLUSION: The preoperative education program developed in this study can be utilized as a part of nursing interventions and be beneficial to patients who undergo stomach cancer surgery for their thorough understanding.

Development and Evaluation of an Enteral Nutrition Protocol for Dysphagia in Patients with Acute Stroke

PURPOSE: The study was done to develop an evidence-based enteral nutrition (EN) protocol for effective nutritional support for dysphagia in patients with acute stroke, and to evaluate effects of this protocol on clinical outcomes. METHODS: A methodological study was used to develop the EN protocol and a quasi-experimental study to verify the effectiveness of the protocol. The preliminary EN protocol was drawn by selecting recommendations from previous well-designed EN guidelines, and then developing additional recommendations based on high-quality evidence. Content validation was assessed by an expert group, and clinical applicability by care providers and patients. The scale-level content validity index of the final EN protocol was 0.99. Assessment was done of differences in percentage of caloric goals achieved and presence of undernutrition, aspiration pneumonia, and gastrointestinal (GI) complications after application of the EN protocol. RESULTS: In the EN protocol group, the percentage of caloric goals achieved (R2=.24, p=.001) and the reduction of GI complications (p=.045) were significantly improved, but the presence of undernutrition (p=.296) and aspiration pneumonia (p=.601) did not differ from the usual care group. CONCLUSION: Results indicate that the new EN protocol for dysphagia in patients with acute stroke significantly increased their nutritional intake and reduced GI complications.

Development of a Nursing Competency Scale according to a Clinical Ladder System for Intensive Care Nurses / 간호행정학회지

PURPOSE: This study was done to develop a nursing competency scale according to a clinical ladder system for intensive care nurses. METHODS: Index of content validation was done by 20 clinical experts and 80 nurses in Intensive Care Units (ICU). RESULTS: The process and results of study are as follows. First, 12 nursing competencies were used in the establishment of the clinical ladder system (Jang, 2000). Second, the first draft of the competency lists was developed. It was based on the clinical nurses' behavioral indicators of nursing competency by Jang (2000), and was modified and supplemented through various literature reviews including competency standards for specialist intensive care nurses in Australia and consultation with 2 clinical nurses with over 10 years experience in the ICU. Third, the draft was examined by 20 clinical experts for content validity. Finally, the final draft was analysed using clinical validity where 20 nurses in each ladder participated. The final number of items was fixed at 309. CONCLUSION: The tool represents expected nursing competency of nurses working in ICU. Intensive care nurses can recognize their strengths and weaknesses, and identify directions for their professional growth by analysing results of their competency evaluation using this tool.

The Effects and Variances of the Critical Pathway of Laparoscopic Colon Resection in Colon Cancer Patients

PURPOSE: To investigate the effectiveness and variance of a critical pathway (CP) for laparoscopic colon resection in colon cancer patients, and nurses'satisfaction with the CP. METHODS: A CP for laparoscopic colon resection was applied to the CP-group that included 50 patients, who underwent elective colon resection between March and May, 2011. The non-CP group included 51 patients who had the same operation without the CP applied from March to May, 2010. RESULTS: The means of length of hospital stay were 11.7 and 7.3 days (p<.001) and the lengths of postoperative hospital stay were 8.6 and 5.1 days (p<.001) in the non-CP group and CP group, respectively. There was no significant difference between two groups for total healthcare costs, pain score, complications, or emergency room visits within 30 days after discharge. By examining variances of the CP, there were 162 variances and the most frequent cause was patient's condition. Nurses'satisfaction with the use of CP was favorable and the mean score of satisfaction was 3.76 on the 5 point Likert scale. CONCLUSION: There are clear benefits to use of CP, resulting in standardized and effective patient care. In conclusion, analysis of variance data can assist in evaluating and revising CP for optimal care and reducing variances.

Development and Psychometric Evaluation of the Resuscitation Self-efficacy Scale for Nurses

PURPOSE: The purpose of this study was to develop and evaluate psychometric properties of the instrument, Resuscitation Self-Efficacy Scale for nurses. METHODS: This was a methodological study for instrument development and psychometric testing. The initial item pool derived from literature review and experts resulted in 30 items linked to resuscitation self-efficacy. A convenience sample of 509 Korean nurses from eleven academic teaching hospitals participated in a survey to examine psychometric properties of the scale. To examine construct validity, exploratory factor analysis and known-group comparison were used. Cronbach's coefficient alpha was used to determine the scale's internal consistency reliability. RESULTS: The final scale included 17 items with four-component structure termed 'Recognition', 'Debriefing and recording', 'Responding and rescuing', and 'Reporting'. These four factors accounted for 57.5% of the variance. Each subscale and the total scale demonstrated satisfactory internal consistency: .82; .88; .87; .83; and .91 respectively. Experienced nurses reported significantly higher self-efficacy mean scores in both total and subscales compared to new graduate nurses. CONCLUSION: The Resuscitation Self-Efficacy Scale for nurses yields reliable and valid results in appraising the level of resuscitation self-efficacy for Korean nurses. Further study is needed to test and refine the scale.

Development and Evaluation of a Web-based Education Program on Appropriate Antibiotic Use in Korean Adolescents / 기본간호학회지

PURPOSE: This study was done to develop a web-based education program on appropriate antibiotic use and test the effects of the program on knowledge and attitudes towards antibiotic use in Korean adolescents. METHODS: The web-based education program was developed through an extensive literature review and professional advisory meetings including technical assistance from a web-based education programmer and content experts. A convenience sample of 851 students from middle and high schools participated in the assessment of effects of the program. Knowledge and attitudes of the students towards antibiotic use and satisfaction with the web-based education program were measured. Descriptive statistics and paired t-test were used to analyze the data. RESULTS: There were significant improvements in knowledge and attitudes towards antibiotic use following self-learning via the web-based education program in both middle and high school students. High school students demonstrated higher scores in knowledge and attitudes than middle school students. CONCLUSION: The results of this study indicate that this web-based education program on appropriate antibiotic use is a convenient and effective medium for self-learning in adolescents. Therefore the web-based program should be put into wide use as an effective and convenient teaching method for health education in secondary schools.

Public Knowledge and Attitudes Regarding Antibiotic Use in South Korea

PURPOSE: This study was conducted to examine public level of knowledge and attitudes regarding antibiotic use and potential drug resistance. METHODS: A cross-sectional face-to-face survey of 1,177 residents aged 18 or over was conducted in Korea. A quota sampling method was used. RESULTS: Most respondents (70%) did not know that antibiotics are ineffective in treating coughs and colds. Two-thirds of the respondents were unaware of the conditions under which antibiotic resistance occurs, despite understanding the concept of resistance. Lower education level and older age were independently associated with inadequate knowledge. Lower education level, older age, inadequate knowledge and no exposure to the education campaign were independently associated with poor attitude. CONCLUSION: The results of this study demonstrate that the general public has misunderstandings and a lack of knowledge with regard to antibiotic use, despite a national educational campaign. However, the campaign may have had an effect on the public's attitudes towards antibiotics.

Relationship of Children's Perception of Mothers' Parenting Attitude to Self-esteem and School Adjustment in Children with Congenital Heart Disease

PURPOSE: The main purpose of this study was to describe the relationship of mothers' parenting attitude as perceived by the child to self-esteem, and school adjustment of school age children with Tetrology of Fallot (TOF). METHODS: In this study a self-administered questionnaire survey was used to collect the data. The participants included 38 children who were registered in a pediatric cardiology clinic in one tertiary medical center. Their ages were between 11 and 15 years. They were diagnosed with TOF, and had no other congenital problems. Data were collected from November 1 to November 30, 2009. After obtaining telephone consent from the mothers and children, questionnaires were mailed to 64 participants and 38 questionnaires were returned. Data were analyzed using Statistical Package for the Social Sciences (SPSS) WIN 15.0 version. RESULTS: There was a significant correlation between perceived parenting attitude, self-esteem, and school adjustment of children with TOF. CONCLUSION: Children who perceive their mothers' parenting attitude to be more positive also report higher self-esteem and better school adjustment. These findings are similar to other studies done with healthy school age children. However, parents of children with TOF may require different parenting approaches to foster positive self-esteem and school adjustment.

Development of a Scenario and Evaluation for Simulation Learning of Care for Patients with Asthma in Emergency Units / 기본간호학회지

PURPOSE: The purpose of this study was to develop a scenario and evaluate students' performance in simulation learning of care for patients with asthma in emergency units. METHODS: Meetings of experts were used to develop a scenario based on actual patients and textbook material. An evaluation protocol was developed to evaluate the simulation learning. The scenario was used in 2006 with six groups of 26 senior nursing students who participated voluntarily. RESULTS: The scenario was developed according to the nursing process for 15 minutes of simulation learning. The nursing students were able to demonstrate their knowledge and skills. The results showed a need to improve problem solving ability. In the self-evaluation, the students reported that simulation learning helped them to integrate their knowledge to practice and recognize their weaknesses and strengths. However, the scores for self-confidence about patient care after the simulation learning were low (4.8/10). CONCLUSION: The scenario in this study gave the students the experience of providing qualified and secure nursing care under conditions similar to reality. Further development of a variety of scenarios for simulation learning is needed.

The Life of Adolescent Patients with Complex Congenital Heart Disease

PURPOSE: In the present study, an analysis of the life of adolescents with complex congenital heart disease (CHD) was done using grounded theory. Consideration was given to the socio-cultural context of Korea. METHODS: After approval from the institutional review board of Y hospital, 12 patients ranging in age from 14 to 35 were recruited. Data were gathered using in-depth interviews. Theoretical sampling was performed until the concepts were saturated. RESULTS: The results confirmed the life of adolescents with complex CHD as a 'journey to finding uniqueness of oneself as a person with CHD'. The life consisted of 3 stages. In the crisis stage, participants had a feeling of threat to self-existence, and made an effort to be the same as others. In the self-recognition stage, participants who had sufficient role-performance built self-esteem while those who did not fell into self-accusation. In the self-establishment stage, participants who reached sufficiency in independence and knowledge planned the future, whereas those who did not conformed to the realities of life. CONCLUSION: The results of present study provide help in understanding the experiences of adolescents with CHD and provide a basis for developing nursing intervention strategies for these patients.

Adolescents' Knowledge and Attitudes towards Antibiotic Use / 기본간호학회지

PURPOSE: The aim of this study was to identify knowledge and attitudes on antibiotic use held by adolescents (middle and high school students) in Korea. METHODS: Data were collected from a convenience sample of 651 students residing in 5 major cities in Korea. The questionnaire was developed after an extensive literature review and professional advisory meetings. Descriptive statistics, t-test, chi square test, ANOVA, and Pearson correlation coefficients with the SPSS program were used to analyze the data. RESULTS: Respondents correctly answered 6.23 antibiotic-related questions out of 15 questions. Two thirds of the respondents knew viruses caused most colds and coughs, but 80% did not know that antibiotics do not work against viruses. High school students' attitudes towards antibiotics were somewhat negative. More middle school students than high school students asked doctors for antibiotics for a cold. High school students did not check if antibiotics were included in their prescription for a cold. There was no significant correlation between knowledge and attitudes towards antibiotic use. CONCLUSION: Education programs on appropriate antibiotic use need to be developed for these students. Continual reinforcement and repetition of the contents are required to change attitudes.

Development of an Eye Care Protocol for ICU Patients / 기본간호학회지

PURPOSE: The purpose of this study was to develop an eye care protocol for intensive care unit (ICU) patients. METHOD: A systematic review was conducted to develop an eye care protocol for ICU patients. Searches were performed using computerized databases (CINAHL, MEDLINE, EBM Review) and citation search from 1996 to January 2007. For the keywords, "eye care", and "randomized controlled trial" were used to identify experimental studies regarding eye care for ICU patients. After reviewing the collected studies, a preliminary eye care protocol algorithm was created. Then, content validity was examined with ophthalmologists and ICU nurses. RESULTS: Six studies were included to serve as a basis for framing of the preliminary algorithm. The final eye care protocol was completed after verifying the preliminary algorithm's content validity. The final eye care protocol was organized in the following manner: 3 items in the assessment stage, 7 items in the no-risk stage, 4 items in the low-risk stage, and 5 items in the high-risk stage. CONCLUSION: The results indicate that, for ICU patients, nurses can broaden their knowledge regarding ocular diseases, as well as improve their practice-based eye care nursing performance.

Knowledge, Perception & Practice of Eye Care Nursing among Nurses in Intensive Care Units / 기본간호학회지

PURPOSE: The purpose of this study was to identify levels of knowledge, perception, and practice of eye care as part of nursing care in the ICU. METHOD: A descriptive, cross-sectional study design was used. The participants in this study were 269 registered nurses working in the ICUs of five university hospitals in Seoul, Korea. Between November 2005 and December 2005, data were collected using a semi-structured questionnaire developed by the researchers, and analyzed using the SPSS Program. RESULTS: In general, levels of knowledge of nursing care for the eyes were moderate among ICU nurses, but levels of perception of nursing care for the eyes were very high. Of the respondents, 61.7% reported that they would consult a doctor whenever they found an eye problem. Only 42.4% nurses answered that they provide eye care as part of the daily routine and 43.9% nurses responded that they cleanse the eye lids with wet saline gauze. In regression analysis, the practice of eye care as part of nursing was significantly influenced by perception of nursing care for the eyes, and knowledge of interventions for nursing care for the eyes. CONCLUSION: These results suggest that education on care of the eyes for ICU nurses and the development of a standardized eye care protocol should be done to improve quality of nursing care in the ICU.

The Relationship of Individual Characteristics, Perceived Health Status, Body Image, and Health Promoting Behavior in Hospital Nurses / 성인간호학회지

OBJECTIVE: The purpose of this study were to: (1) describe the individual characteristics, perceived health status, body image, and health promoting behaviors of staff nurses working in a metropolitan hospital and (2) determine the relationship of perceived health status, body image, and health promoting behaviors. METHODS: Data were collected from 311 staff nurses working at one of university affiliated hospitals using a self-administered questionnaire for perceived health status(SF 36 V2), body image(BAQ), and health promoting behaviors (HPLP-II) and using the report of year 2002 employee physical check-up results for health related characteristics. RESULTS: Most of nurses were within the normal range of BMI, total cholesterol, and liver enzymes but 42.2% had systolic BP above 120mmHg and 37.3% hemoglobin below 12g/dL. Although 96.4% of BMI score indicated 'underweight' or 'normal', 'feeling fat' showed the highest. Among health promoting behaviors the most frequently reported one was spiritual growth and the least one was engagement in physical activity. In the correlational analysis, health promoting behaviors had the positive relationships with perceived health status, vitality, mental health, attractiveness, strength and fitness (p=.000 - .004). CONCLUSION: These findings provide information that is relevant in designing interventions to enhance health promoting behaviors among nurses working in a hospital.

Analysis of the Nursing Curricula in Graduate Programs in Korea / 간호학회지

This study was designed to analyze the nursing curricula in graduate programs and suggest the direction of future nursing curricula. Thirty-two nursing curricula for a master's degree and fifteen curricula for a doctoral degree from general graduate programs, fifteen nursing curricula for a master's degree from fifteen educational graduate programs, eight nursing curricula for master degree from eight out of twelve public health graduate programs, three nursing curricula for a master's degree from three administrative graduate programs, and four nursing curricula for a master's degree from four clinical nursing graduate programs, were analyzed. Consequently, It was hard to find a clear difference between the educational goals and objectives, the subjects open in nursing curricula for a master's degree and those for a doctoral degree of graduate programs. The educational graduate programs, public health graduate programs, administrative graduate programs, and clinical nursing graduate programs, each program showed ittle diffrent in each educational goal and objective. However, because the various kinds of subjects open in each program were not based on the core curricula, the quality of the nursing curricula need to be evaluated and develope the curricula to difference are the goal and objective. Accordingly, future studies need to be focused on developing core nursing curricula reflecting the characteristics of each graduate program.

Nurse's Adoption on a Planned Organizational Change / 간호학회지

With the dynamically changing environment of society, managing change is the vital element of organizations's survival and growth. Health care organizations have expended enormous resources to restructure patient care delivery. Despite the growing literature describing these organizational innovations, there is a paucity of credible data that reflects systematic measurement and evaluation of such changes. This study examined the nurses' psychological response toward the work process redesign, newly introduced by the nursing department in a acute care hospital. The aim of the study was to figure out how nurses's general perception of change and perceived attributes of change affected their acceptance of change during the organizational transition. This was descriptive-correlational. The sample for the study included 50 head nurses and 135 staff nurses. Data was analyzed using SPSS PC+, version 10.0. The major findings of the study were as follows: First, the mean score of the perception of change was 71.2 (SD=13.8) with the range of 0-100, which means nurses generally perceived change positively. There were significant differences in perception of change by gender and education level. Head nurses perceived change more positively than staff nurses. The higher education level showed the more positive view of change. Second, among the perceived attributes of change, trialability had the highest mean score, which means nurses perceived the change more positively if it is testable on a limited basis. Relative advantage was perceived the most negatively. Finally, factors influencing the acceptability of the work-process redesign were perceived comparability, complexity, relative advantage, and observability, which accounted for 43.7% of the variance in the acceptability of change.This study evaluated the preliminary effects of the nursing process for reengineering, focusing on nurses' acceptability towards change. The usefulness of this research study was to determine the factors influencing acceptance of organizational members during transitional periods of change and to suggest effective strategies for increasing adoption as well as for decreasing resistance to change.

Factors Influencing Functional Status in People with Chronic Lung Disease / 간호학회지

PURPOSE: The purpose of this study was to identify factors that influence the functional status of chronic lung disease patients. METHOD: A descriptive, correlational study design was used. The study was conducted at the outpatient respiratory clinic of the large university hospital in Korea. A convenience sample of 128 chronic lung patients (age = 64.2 yrs; 106 COPD, 17 bronchiectasis, 5 DILD) with mean FEV1 64.4 % predicted. Functional status was measured with SIP. Physical variables (FEV1% predicted, dyspnea, fatigue, pulmonary symptom distress), psychological variables (mood, stress), and situational variable (sleep quality) were examined. Dyspnea was measured by the BDI, fatigue was measured with the MFI. Mood was measured with the modified Korean version of POMS. Sleep quality was measured with the Pittsburgh Sleep Quality Index. Potential independent variables for the regression were age, gender, years since diagnosis, FEV1% predicted, dyspnea, fatigue, pulmonary symptom distress, stress, and sleep quality. RESULT: In general, functional status was relatively good. In regression analysis, functional status were significantly influenced by dyspnea, mood, age and fatigue. These variables explained 70 % of the variances in functional status. CONCLUSION: The results suggest that psychophysiologic symptom management should be a focus to enhance the functional status in this group.

An Analysis on the Contents and the Trend of Nursing Research Published in Journal of Korean Academy of Adult Nursing (1989-2000) / 성인간호학회지

"Journal of Korean Academy of Adult Nursing" has been published since 1989 and more than 330 articles have been published up 2000. We reviewed all the articles published in this journal to analyze the contents and trend of published articles and to find out the way of improvement both in quantity and quality of studies in this area. The results are as follows; 1) Ninety percent of articles were quantitative studies. Experimental design was used in 16.1% and quasi-experimental design was adapted in 73.6% of articles. Qualitative research were 10.3% of total articles reviewed. 2) Only 5.1% of articles described theoretical framework and 73.6% of experimentally designed articles included research hypotheses. 3) Among experimental studies, only one was true experimental studie design. Eighty nine point three persent had descriptive survey method among non-experimental studies. Amog the thirty four qualitative studies, phenomenologic(73.5%), grounded theory(14.7%), and ethnographic (11.8%) design were used. 4) Most of research subject were patients and few healthy people, healthcare worker, and patient family. 5) Psychosocial data collection method which used questionnaire were 53.7% and interview, physical measurement, observation were used in 22.8%, 8.2%, 5.4% of articles respectively. 6) Total number of keywords were 692, and average number of key words per article was 2.2. Health-related keyword was the most frequently used according to four metaparadigm of nursing (human, health, nursing, and environment). Environment related keyword was rarely appeared. The number and quality of nursing research in "Journal of Korean Academy of Adult Nursing" have been improved continuously. It is difficult to find out special trend or characteristics which is unique in this journal because of relatively short history of adult nursing studies. This review study was performed to analyze adult nursing studies only in the view of quantitative aspect, but it is needed to analyse qualitatively to find philosophical or theoretical trend in nursing.

A Study on the Lived Experiences of Homecare Nurses / 간호학회지

THE NECESSITY AND PURPOSE OF THE STUDY: Recently the number of patients with chronic diseases and the aged patients is increasing steadily. Furthermore, due to the expansion of health insurance system, the number of patients hospitalized in the general hospital is increasing at a surprising speed. However, hospitals urge the early discharge of the patients for the efficiencies of hospital administration, and therefore, the number of patients who must be taken care of in their home is also increasing. Homecare nursing is one of the health care service for the patients at home who require continual attention and care, and now increasing attentions are given to it as one of the professional nursing fields. However, it was almost impossible to find a study on the actual experiences of the homecare nurses written by their own language in Korea, that it also posed a great difficulty in understanding their diverse experience. Considering these situation, this study will help understanding of them, and provide the fundamental data on their experiences for making policies to develop homecare nursing. METHODS OF RESEARCH: Phenomenological research method was employed to analyze the lived experiences of homecare nurses fundamentally. DATA COLLECTION: Data were collected from August 1998 to December 1998 from ten homecare nurses who worked for patients under the homecare nursing setting as model cases designated by Seoul Nurses Association and who agreed to the purpose of this study after listening to and understanding the explanation completely. The in-depth interview was carried at the time which was convenient both for the researcher and participants for one or two hours, and recovered with the approval participants. The first interview covered diverse and broad areas like the situation of homecare nursing, and their feelings and thoughts over it, and in the second and third interviews, more specific questions are asked. DATA ANALYSIS: For the phenomenological analysis, contents analysis was employed. The data collected from the participants were analyzed into the following procedures according to Van Manen 's phenomenological analysis. 1) Reserve the preconception of the researcher by restricting it inside parenthesis. 2) Make a thorough observation of the lived experiences by insight process. 3) Analyze the contents (Find out the repetitive factors) 4) Interpret the essence found. 5) State the meaning of the interpretation. RESULTS AND DISCUSSION: 1. Fear and expectation for the first visit. (unfamiliarity, awkwardness, anxiety, shivering) 2. Mingle with the family (feeling friendly with the family, becoming like a family member) 3. Being proud of her own know-how (learning the know-how, organizing alternatives, building up confidence) 4. Pity for the poor. (criticizing the current government, feeling ashamed, feeling anger) 5. Difficulty of constructing cooperative system with physicians (strenuousness, frustration) 6. Helplessness due to the lack of support system (difficulty to get supplies, annoyance, embarrassment by institutional restraints) 7. Anxiousness for heavy traffic and parking (annoyance, hastiness) 8. Ethical conflicts (pity for the patients and family, skepticism about lengthening life maintenance) 9. Burden for the possible accident (pressure, anxiety, conflict, physical exhaustion) 10. Establishment of identity as a professional (fulfillment, worth, joy) 11. Being distressed at other's ignorance

Development of a Critical Pathway for the Patients following Lumbar Laminectomy / 성인간호학회지

The purpose of this study was to develop a critical pathway for the patients following lumbar laminectomy. Development of this critical pathway was the fundamental phase to implement case management, which is a new health care delivery system. For this study, a preliminary critical pathway was developed first through a literature review and analysis of the medical records and seven critical pathways being used currently in Korea and the USA. In order to identify the health care services provided for the patients, who had lumbar laminectomiess and to draw up the conceptual framework, 30 medical records were analyzed from January, 1997 to December, 1997 at the Spinal Center in the Yonsei University Medical Center. The results of this study are as follows: 1. The vertical axis of the critical pathway included the following 7 items: test, assessment, treatment, activity, medication, diet, teaching and discharge planning; and the horizontal axis included the time frame from the pre-operative day to the third post-operative day. 2. Analysis of the 30 medical records indicated that the average length of stay was 13.7 days, including 4.8 days from admission to operation, and 8.9 days from operation to discharge. 3. According to the validity study using seven experts, 54 items, among the total of 86 items, reached over 86% agreement, while 32 items showed less than 86%. These 32 items were reviewed for deletion or modification before inclusion. A final critical pathway then was developed. On the basis of this research, it is anticipated that this critical pathway can be uesd in clinical situations to provide care for the patients following lumbar laminectomy in the most effective and efficient manner.