This paper aims to examine what nursing discipline has accomplishd to date and projects what could be its preferred future from global perspective. Major contextual factors that influence nursing are examined in light of their significance on the progress of nursing discipline. These include evolution of society, and trends in higher education and health care market. The perspective of world health is gained from WHO, an organization recognized for its mission for the health of people worldwide. As the future builds on the present that, in turn, builds on the past, major milestones of nursing discipline, particularly that of education system from the inception of nursing to present is highlighted. The importance of research to advance science and improve peoples health are presented along with a call for nursing research to be responsive to societal needs. The preferred future for nursing discipline is presented integrating the trends of society, higher education, and health care environment. Doctoral education that is the hallmark of nursing scholarship is further elaborated in terms of its mission, needs, and quality attainment. Data from the International Network of Doctoral Education in Nursing are presented along with information about current attempts in developing quality criteria and indicators for doctoral education in nursing worldwide. Majority of information in this paper comes from the United States, unless specified otherwise.

The purpose of this study is to examine the effect of social support intervention on mood and maternal confidence of premature's mothers. The social support intervention is known to induce improved mood state and provide information on caretaking so as to increase the maternal confidence in the mother of a premature. To systematically investigate its effect, this study employed a nonequivalent randomized post-repeated quasi-experimental design. The intervention was given individually to mothers of prematures five times spanning five weeks. The sample consisted of the 50 mothers (experimental 27, control 23) of a premature. The data were collected using the structured questionaires twice as post tests. Various instruments were used in this study. The POMS developed by Lee(1990) was used to measure the mothers' mood state, Mother and Baby Scales by Wolke et al (1987). The results are as follows: 1. For the hypothesis test to see the effect of the social support intervention, the mean of the experimental group and the control group was compared by means of t-test and the following results are obtained. Hypothesis I. "The mood state of mothers with social support intervention is more positive than that of the mothers without such intervention." was not statistically supported and thus discarded (t=.799, p=.429). However the mean scores were 49.68 and 51.38 for the experimantal and control group, respectively, indicating more positive mood for the experimental group. Hypothesis II. "The maternal confidence of mothers with social support intervention is higher than that of the mothers without the tervention." was statistically supported (t=3.667, p=.001). 2. The mean score of the mood state was highest before discharge (52.29), meaning most negative, declined to 49.68 shortly after the discharge, again increased a bit to 50.07 at four weeks after the discharge, and stabilized to 49.22 around six weeks after the discharge. On the other hand the mean score of the maternal confidence was continuously increased with time. In view of the above results, it is concluded that the social support intervention with a preprogrammed protocol has the definite positive effect on increasing the maternal confidence and positive effect on improving mother's mood state.

Service quality is, unlike goods quality, an abstract and elusive term. However, quality is very important to marketers and consumers in that it has many strategic benefits in contributing to profitability of marketing activities and consumers' problem-solving activities. The main purpose of this study is 1) to explore the differences of perception between consumers and providers about nursing service quality. 2) to identify the useful tool between two tools measuring nursing service quality. To achieve these purposes of the study, the questionnaire was developed and distributed to 210 nurses who worked at seven subjected hospitals in Seoul. Also, 280 people who had a direct experience with the subjected hospital nursing services at the time of screening were involved. They were randomly selected at the seven subjected hospitals during August to September of 1998. Among them, 165 responses from nurses and 229 responses from others resulted in worthy finds. The measurement instrument for a nursing services quality evaluation was modified from the SERVQUAL model originated from Parasuraman, Zeithaml, and Berry (1988). The reliability coefficient of the scale was calculated and showed high degree of internal consistency (Cronbachs' Alpha = .9353). For data analysis, SPSS/PC was used for descriptive statistics, t-test, ANOVA and regression analysis. The results were as follows : 1) In the perception about nursing services quality, there were gap between consumers and providers. Especially the critical attributes in point of perception nursing services quality, naming satisfy, hygiene and performance factors, are very different contents. 2) In the comparison analysis of the usefulness tools it was turned out that SEVPERF model is more appropriate than SERVQUAL model. And in the analysis to identify the construct validity of the tool, it is turned out that the relationship between the constructing factors of the tool and the general satisfaction is significant.

This study was conducted to evaluate the effects of the program for the autistic children which was designed to promote mother-child attachment. The subjects of this study were consisted of 11 pairs of mother and child( 7 for participant group:PG, 4 for non-participant group: NPG), who were diagnosed as Pervasive Developmental Disorder. The intervention was consisted with play activity centered mother-child interaction, educational activity for mothers, lecture, video-feedback, and supports. The main data were collected by video-taping and analyzed by Wilcoxon Rank Sign Test, and Content Analysis. The results obtained were as follows, 1. Before the program, there were no significant group differences on the children's and the mother's characteristics. After the program, total score on the attachment of PG was higher than that of NPG, but not significant. Only proximity-seeking behaviors and contact-maintaining behaviors were higher significantly(p<.05). Then the characteristics on contact- maintaining behaviors of PG were lasting longer and reciprocal than those of NPG. 2. After the program, the score on mother's nurturing behavior of PG was significantly more increased. The mother's behaviors to her child of PG became more child- centered, positively responsive, expressive supportively. But there were pretty big individual difference. It can be concluded that Mother-child Attachment Promotion Program is effective. Thus it can be recommended to be a early intervention model for autistic children.

The purpose of this study is to explore the concept spirituality and to gain understanding of nursing intervention that may improve spiritual well-being. The concept analysis framework developed by Walker and Avant (1995) was used to clarify the concept. In the study, 'Harmonious interconnectedness', 'Transcendence', 'Integrative Energy' and 'Purpose and Meaning in Life' emerged as the critical attributes of spirituality. The first attribute, 'harmonious Inter- connectedness', has three categories including intrapersonal, (self), interpersonal (others/ nature) and transpersonal (the Supreme Being). The second attribute, 'Transcendence', is defined as the ability to extend one's own self beyond the limits of usual experiences and to achieve new perspectives. This attribute is demonstrated by 'coping with situations', to 'self-healing', and 'transformation'. The third attribute of spirituality is 'Integrative Energy', which integrates all dimensions and acts as a creative and dynamic force that keeps a person growing and changing. 'Integrative Energy is also defined as an inner resource that gives a sense of empowerment. Therefore the highly spiritual person demonstrate 'inner peace', 'growing', 'inner strength,' and 'well-being'. The fourth attribute 'Purpose and Meaning in Life' represents a sense of connectedness with one's inner values and with a greater purpose in life. It is demonstrated by 'hope' and 'a powerful life'. In this study, the antecedents of the spirituality represented as 'spirit' and its potential enablers were 'Introspection/reflection', 'Interconnectedness with all living things', and an 'Awareness of a Higher-Power'. The consequences of this concept may be described as 'physical, psychosocial, and spiritual well-being'. Empirical referents of this are 'purposeful life' 'self-worth' 'hope' 'love' 'service' 'forgiveness' 'trust/belief' 'inner peace' 'self-actualization' 'religious practices' 'transformation' 'inner strength' and 'coping'. In conclusion, spirituality can be defined based on these critical attributes. Spirituality is a dynamic, integrative energy based on a feeling of harmonious interconnection with self, others and a higher power. Through it, one is enabled to transcend and to live with meaning and purpose in life.

The study was aimed at developing an independent hospice center model that would be best suited for Korea based on a literature review and the current status of local and international hospices. For the study, five local and six international hospice organizations were surveyed. Components of the hospice center model include philosophy, purpose, resources (workers, facilities, and equipment), allocation of resources, management, financial support and hospice team service. The following is a summary of the developed model: Philosophies for the hospice center were set as follows: based on the dignity of human life and humanism, help patients spend the rest of their days in a meaningful way and accept life positively. On the staff side, to pursue a team-oriented holistic approach to improve comfort and quality of life for terminally ill persons and their families. The hospice center should have 20 beds with single, two, and four bed rooms. The center should employ, either on a part-time or full-time basis, a center director, nurses, doctors, chaplains, social workers, pharmacists, dieticians, therapists, and volunteers. In addition, it will need an administrative staff, facility managers and nurses aides. The hospice should also be equipped with facilities for patients, their families, and team members, furnished with equipment and goods at the same level of a hospital. represented by a center director who reports to a board and an advisory committee. Also, the center director administers a steering committee and five departments, namely, Administration, Nursing Service, Social Welfare, Religious Services, and Medical Service. Furthermore, the center should be able to utilize a direct and support delivery systems. The direct delivery system allows the hospice center to receive requests from, or transfer patients to, hospitals, clinics, other hospice organizations (by type), public health centers, religious organizations, social welfare organizations, patients, and their guardians. On the other hand, the support delivery system provides a link to outside facilities of various medical suppliers. In terms of management, details were made with regards to personnel management, records, infection control, safety, supplies and quality management. For financial support, some form of medical insurance coverage for hospice services, ways to promote a donation system and fund raising were examined. Hospice team service to be provided by the hospice center was categorized into assessment, physical care, emotional care, spiritual care, bereavement service, medication, education and demonstrations, medical supplies rental, request service, volunteer service, and respite service. Based on the results, the study has drawn up the following suggestions: 1. The proposed model for a hospice center as presented in the study needs to be tested with a pilot project. 2. Studies on criteria for legal approval and license for a hospice center need to be conducted to develop policies. 3. Studies on developing a hospice charge system and hospice standards that meet local conditions in Korea need to be conducted.

This study was a quasi-experimental study to confirm the effects of a memory training program using efficacy sources. The purpose was to develop an effective memory training program for elderly people and to identify the effects of the memory training program. This study was carried out between February 24 and July 18, 1999 and the subjects of the study were 102 elderly people who were participants at a welfare institute in Seoul. The experimental group (51) and the control group (51) were assigned by means of participation order. The control group was matched to the experimental group and was selected considering age, sex, and religion. The experimental group participated in the memory training program. The memory training program was based on the literature of Fogler & Stern (1994), Wang & Lee (1990), Lee (1991) and Lee (1993). The memory training program was given twice a week for two weeks with each program lasting two hours. Task centered memory self-efficacy was measured using the Memory Self-Efficacy Scale developed by Berry & Dennehey (1989) and Meta Memory was measured by the MIA developed by Dixon et al. (1988) Memory performance was measured by the word list developed by Cho Sung Won (1995) and the face recognition task (Face Recognition Task developed for this study). Data were analyzed by SPSS PC and the results are described below. 1. The experimental group which participated in the Memory Training Program showed higher task centered memory self-efficacy scores as compared to the control group (t=4.354, P=.0001). 2. The experimental group which participated in the Memory Training Program showed higher metamemory scores as compared to the control group (t=4.733, P=.0001). 3. The experimental group which participated in the Memory Training Program showed higher memory performance scores as compared to the control group (t=7.500, P=.0001). The memory performance involved an immediate word recall task, a delayed word recall task, a word recognition task, and the face recognition task. 4. In the experimental group, there was significant correlation between the task centered memory self-efficacy scores and the metamemory scores (r=.382, P=.006), but the correlation between the task centered memory self-efficacy scores and the memory performance scores and between the metamemory scores and the memory performance scores were not significant. The results showed that task centered memory self-efficacy, meta memory and memory performance improved following the Memory Training Program including the memory process, changes in memory with aging, and appropriate use of memory strategies. Memory Training Program is an effective nursing intervention for improving memory in elderly people and, also, in people with complaints of memory loss.

This study was attempted to evaluate how the self efficacy promotion and exercise training program effect on the postoperative general conditions of transplant recipients after kidney transplantations. The subjects were selected randomly among the patients who underwent renal trans- plantations at three major transplantation hospitals in Seoul, Korea. This study was carried out between November 1999 and March 2000. The observed subjects in this study consisted of 56 patients. The exercise training group(n=16) received the self efficacy promotion and exercise training program for 12 weeks which contained general knowledge for compliance instruction, exercise training and self efficacy promotion education. The self efficacy group(n=18) received general knowledge for compliance instruction and self efficacy promotion education but no exercise training was given. The control group(n=22) were not offered any education. The knowledge for compliance, self efficacy, physical conditions(weight, muscle strength, muscle endurance, flexibility), lab studies (hemoglobin, creatinine, cholesterol), activities of daily living and quality of life were evaluated 3 times, before the experiment, at 8 weeks and at 12 weeks. The data were analyzed with mean, standard deviation, Chi-square test, ANOVA and Scheff test. The results were as follows: 1. The knowledge and self efficacy score of the exercise training group and self efficacy group were significantly increased than those of the control group(p=.0001). 2. The weight of the exercise training group was significantly decreased compared to those of the self efficacy group and the control group(p=.0001). Muscle strength (grip strength, back lift strength), and flexibility of all 3 groups were significantly changed(p=.0001). However, muscle endurance in all 3 groups showed no significant differences. 3. The hemoglobin level of the exercise training group and the self efficacy group were significantly increased compared to that of the control group(p=.0001) and the cholesterol levels of the exercise training group and the self efficacy group were significantly decreased compared to that of the control group(p=,0001). However, the creatinine levels in all 3 groups showed no significant differences. 4. The activities of daily living scores of the exercise training group was significantly increased than that of the control group (p=.0003), and the quality of life scores of the exercise training group and the self efficacy group were significantly better than that of the control group(p=.0001). It would be expected that this self efficacy promotion and exercise training program could be applied widely as an effective nursing intervention for kidney transplant recipients.

The purpose of this study was to analyze womens' health problems using Green & Kreuter's 1991 PRECEDE model and to develop a model for a womens' health care center located in the community. The subjects were recruited from Wonju City. 1. The results showed that 23% of the sample population felt there was a need for a womens' health care center. The mean number of health problems was 3.1. The prevalence rate, was 44.4%, and the rate for an artificial abortion, was 36.4%. Also 30.5% did not have a health examination in the past year. Women using the hospital for medical care accounted for 45% of the sample, while 40% used the drugstore. The average score on the HPLP was 2.41, and this was influenced by self-efficacy, family support, sexual role, and health locus of control. There are a few educational programs in the city provided by the Wonju Health Center and by community health nurse practitioners. 2. The nursing center, as defined in North America, is a nurse-anchored system of primary health care delivery or neighborhood health center. Centers offer various services ranging from primary care to the more traditional such as education, health promotion, wellness screening, and coordination of services by advanced practice nurses. For examples in Sweden MCH centers provide total services for childbearing women and their families, sexual counseling and education for adolescents, and screening by midwives for cervical cancer. 3. The developed model combines purpose, target population, organization, and services, and is related to health resources. The purpose is primary health care and promotion of the quality of life. The target population can be grouped according to the life cycle, (premarriaged age group, the childbearing/child rearing age group, and middle aged and elderly women) and focuses on self-help. The organization of the center includes an advisory committee to plan and evaluate, and a health services team that will be multidisciplinary to provide health care, counseling education, and research. The model development suggested that a variety of women's health care centers are needed to insure adequate management of women's health. Follow-up research using PROCEED is needed to analyze health outcomes. Also a health nursing specialist system is required to develop health promotion, and improve the quality of life of women.

This study examined all the research published in Journal of Korean Academy of Nursing (JKAN) for last 30 years, from its beginning year to year 1999, based on an objective frame of evaluation. The purpose of this study is to reflect the trend of nursing research in Korea to date, and to provide an optimal direction for future research. The total number of 959 studies were analyzed with the following results. 1. Since 1990s, the number of non-degree based research has been larger than that of degree-based research compared to 1970s and 1980s. Both collaborative and funded research has been particularly increased in a gradual rate. 2. Research on nurses or nursing students has decreased while research on more diverse populations such as patients, patient families, or community-dwelling healthy clients has increased. 3. While essential nursing concepts such as human, nursing, and health have been consistently dealt as main research topics, research related to the concept of environ- ment has been insufficiently conducted. 4. It was remarkable that the quality of nursing research has been improved due to the acknowledgement of the importance of the empirical research method within the nursing community. 5. Qualitative research has appeared in the journal since the late 1990s, but it is still regarded to be in its novice stage. 6. Although the utilization of research findings for expanding the nursing body of knowledge has been wide in diverse specialties, most studies are limited to focus on concept development or evolution yet. also, in some of these research finding are utilization already considerably as to develop nursing interventions. Based on these findings, conclusions are extended to the following discussions: For the last 30 years, nursing research in Korea has shown an acute methodological development in both quantity and quality. However, there has been a lack of research on theory development although it is one of the ultimate goals in nursing. Further research should be empirical enough to be utilized in an actual nursing care context, and thus to be basis of developing culturally competent nursing theories in Korea.

The purpose of this study was to describe and understand how diabetics dealt with the result of the various changes of lifestyle. The grounded theory approach of qualitative research methods was used for building a substantive theory about that. The subjects of this study were 10 clients who experienced diabetes from 4 to 30 years. The data was collected from August 1999 to November 1999 through in-depth interviews utilizing home visitation and telephone interview technique then it was and analyzed simultaneously by a constant comparative method in which the new data was continuously coded into categories and properties according to Strauss & Corbin,s methodology. One hundred six concepts were found and they were grouped into 35 categories and then into 14 categories. The results were as follows difficulty, unable to overcome the changes, disposition, disease process, tiredness, supportive environment, perception, handling, concent- ration, mastering, endurance, avoidance, giving up and tailoring. The core phenomenon was 'tiredness' and these categories were synthesized into one core concept, the process of tailoring. The process of tailoring in diabetics consisted of : 1) going through difficulty of disease management 2) experiencing tiredness from the difficulty of disease management 3) perception of disease from tiredness 4) undergoing various self-management 5) controlling the process of tailoring by one's own method. Six hypotheses were derived from the relation of these concepts and four types were from intensity of tiredness, direction of disposition, type of disease process and the level of supportive environment and perception. This study offers better understanding on diabetic experiences and may facilitate more appropriate interventive strategies to provide support, information and knowledge. The nurses should utilize the results to help diabetics enjoy their lives without any trouble and must continuously develop nursing knowledges and skills.

The purpose of this research was to uncover the expertise of ICU nursing in Korea, and to describe nurses' practice based on the degree of skill acquisition. A total of 18 ICU nurses participated in the study. The data was collected through individual in-depth interviews and it was managed using the NUDIST 4.0 software program. The data was analyzed using interpretive phenomenology suggested by Benner. Four properties of expertise of ICU nursing were identified. These are 1) concern and love toward patients; 2) knowledge; 3) skill, and 4) abilities in interpersonal relationships. And the characterisitcs of four levels of skill acquisition, that is advanced beginner, competent, proficient, and expert, were described with exemplars. The results of this study might help nurse researchers clarify and elaborate on the concept of expertise in ICU nursing, and enable them to understand how the process of skill acquisition occurs in the ICU setting. They might also help nurse managers establish educational goals for ICU nursing for student or novice nurses.

The purpose of this study was to verify the validity of the Patient Severity Classification Tool by examining the correlations between the APACHE Ⅲ and the Patient Severity Classification Tool and to propose admission criteria to the ICU. The instruments used for this study were the APACHE Ⅲ developed by Knaus and the Patient Severity Classification Tool developed by Korean Clinical Nurses Association. Data was collected from the 156 Medical ICU patients during their first 24 hours of admission at the Seoul National University Hospital by three trained Medical ICU nurses from April 20 to August 31 1999. Data were analyzed using the frequency, $x^2$, Wilcoxon rank sum test, and Spearman rho. There was statistically significant correlations between the scores of the APACHE III and the Patient Severity Classification Tool. Mortality rate was increased as patients classification of severity in both the APACHE III and the Patient Severity Classification Tool scored higher. The Patient Severity Classification Tool was proved to be a valid and reliable tool, and a useful tool as one of the severity predicting factors, ICU admission criteria, information sharing between ICUs, quality evaluations of ICUs, and ICU nurse staffing.

This study investigated the relationship between the nurse's followership, job satisfaction and organizational commitment. The sample consisted of 173 nurses of 2 private university hospitals. The instruments used in this study were the followership scale (Kelly, 1994), the job satisfaction scale (Slavitts et al., 1978), the organizational commitment questionnaire (Mowday et al., 1979) and the demographic questionnaire. SPSS/WIN program was used for descriptive statistics, ANOVA, and Pearson correlation analysis of data. The results were as follows: 1) The styles of followership were classified as pragmatist followers (73.4%), exemplary followers (19.7%), passive followers (4.6%), and alienated followers (2.3%). 2) The mean of independent/critical thinking was 3.32 (M=3.0), and active involvement was 3.04 (M=3.0). As a whole, the mean of followership was 3.18 (M=3.0), job satisfaction was 2.82 (M=2.5), and organizational commitment was 3.97 (M=3.5). 3) Significant differences were found in the degree of clinical nurses' perception of followership according to the demographic characteristics such as age, education, position, and career. 4) Significant differences were found in the degree of clinical nurses' perception of followership according to followership styles. 5) The followership was significantly related to job satisfaction and organizational commitment. In conclusion, the nurse's followership is considered as an important concept and this suggested that the concept could be used as a major variable in measuring effectiveness of nursing organization.

This study was carried out to assess the perception of decisional balance of Korean subjects about 4 health behaviors and to identify the influencing factor of decisional balance for exercise acquisition, smoking cessation, mammography screening and Kegel's exercise acquisition. All are representative health behaviors nurses can intervene in Korea based on the Transtheoretical model. Convenient samples of 2,484 subjects (191; exercise, 169; smoking cessation, 1903; mammography screening and 221; Kegel's exercise) were selected from cities and counties over 9 provinces throughout Korea, and the data was collected from January 1, 1999 to February 29, 2000. The research instrument were the Decisional Balance Measure for Exercise (Marcus & Owen., 1992), Smoking Cessation (Velicer et al., 1985), Mammography Screening (Rakowski et al.,1992) and Kegel Exercise (Lim, 1999) and Stage of Change Measure for Exercise (Marcus et al, 1992), Smoking Cessation (DiClemente et al., 1991), Mammography Screening (Rakowski et al.,1992) and Kegel's Exercise (Lim, 1999). The data was analyzed by the SAS Program. The results are as follows; 1. According to the stage of change measure, 2,484 subjects were distributed in each stage of change for four health behaviors: 1,233 subjects (49.8%), 745 subjects (30.2%), 113 subjects (4.7%), 156 subjects (6.5%), and 216 (8.7%) belonged to the pre- contemplation stage, contemplation stage, preparation stage, action stage and maintenance stage. They were all series of stages of change in their efforts to do health behavior. 2. Factor analysis identified 3 factors (1 of Pros, 2 of Cons) for the exercise, 4 factors for smoking cessation (2 of Pros, 2 of Cons), 2 factors (1 of Pros, 1 of Cons) for the mammogram screening and 2 factors (1 of Pros, 1 of Cons) for Kegel's exercise of decisional balance. 3. The analysis of variance and multiple comparison analysis showed that for all 4 samples, the Cons of changing the problem behaviors outweighed the Pros for subjects who were in the pre- contemplation stage, The opposite was true for subjects in action and maintenance stage. 4. Through the discriminant analysis, it was found that one factor of Pros for exercise, one factor of Cons for smoking cessation, 1 factor of Cons for mammogram screening and one factor of Cons for Kegel's exercise were the more influencing factors, than others in discriminating the stages of change. Results are consistent with the applications of the Transtheoretical model, which have been used to understand how people change health behaviors. This results provide some evidence that subject's report of his/her health behavior corresponds to beliefs about usefulness of related health behaviors. The results of this study have implications for patients' health education and health intervention strategies. The findings of this study give useful information for nursing educators for 4 health behaviors, especially the factors relating to decision making in the different stages of change.

The main objectives of this study were to analyze the concept of hope, so to provide basic data to develop a valid instrument to measure hope, and to develop hope enhancing nursing intervention a program for cancer patients. The hybrid model approach was applied in three phases, the theoretical phase, the empirical phase, and the analytic phase. The study was developed on universal attributes explaining generalized hope and specific hope, which were revealed in a comprehensive review of the literature. In the empirical phase, eight cancer patients undergoing chemotherapy were interviewed to reveal causes, motivation, and their resource of hope according to The Hope Assessment Guide (Farren, Herth, & Popovich, 1995). In the analytical phase, the results of the two previous stages of the study were compared. The results were as follows : In the theoretical phase, six dimensions of hope emerged; affective, cognitive, behavioral, affiliative, temporal and contextual dimension. The antecedent of hope was loss, crisis, uncertainity, and stress. The consequences were renewal, development of new methods, safety, peace and transcendental competence. In the empirical phase, these six dimensions emerged as theoretical phases were verified and specified as these descriptive terms: feeling, intention, expectation, activity, relation, future- orientation, reality and goal-setting. The antecedent factor of hope was occurrence or recurrence of cancer. The consequence of hope was ability to cope with real condition, feeling of safety and comfort, peace, development of new strategy and recovery of disease. The major content of hope in this phase was related to specific hope, but it was also influenced on by general hope. In the analytic phase, general and specific hope was renamed as trait and state hope. All attributes emerged at the empirical phases, and also emerged at the theoretical phase. However, cognitive and contextual dimensions were revised and specified. In conclusion, the concept of hope is divided into trait hope and state hope, and state hope is an anticipatory expectation that occurs at the time of a stressful stimulus, such as being diagnosed with cancer. Hope is a multidimensional dynamic energized mental state which has the dimensions of affective, cognitive, behavioral, affiliative, temporal and contextual. There should be further studies to develope the state and trait hope scale according to definition and attributes of hope investigated in this study. In addition, considering results of the empirical phase, the family is very a important factor as a resource of hope, so it is necessary to consider family in implementing a nursing intervention program to enhance hope.

The relationship between the attitude and satisfaction for sexuality of pregnant women was observed to provide rationales of nursing intervention to help promote healthy sexual lifestyles. Questionnaires were collected from 211 obstetric outpatients of H university hospital in C city, Korea from February to May 1999. The research tools were D.S.F.I (Derogatis Sexual Function Inventory in Korean, Chronbach's $\alpha=$ 0.710) and Sexuality Satisfaction Method (Kim, 1997, Chronbach's $\alpha$ =0.864). Data was analyzed for frequency, mean, standard deviation, Pearson correlation, t-test and ANOVA by Windows SAS. The results of this study were as follows: Mean age of the subjects were 29.8; the average score of attitude to sex was moderate (27.60), and that of satisfaction sex was high (54.11); the positive relationship was shown between attitude and satisfaction for sexuality (r=0.51, p=.000); the higher educational and income levels of pregnant women and their husbands, were the better the attitude and satisfaction for was; professional women had better attitude than housewives. According to the results, it is suggested that the study is necessary to develop an effective nursing intervention related with the sexuality of pregnant women.

This study was conducted to identify a effect of the comprehensive self-regulation program for hypertensives as a nursing intervention on self-care performance and the physiologic parameters in rural areas. For this purpose, a nonequivalent control group and a pre and post-test quasi- experimental design was used. Fifty-four were evaluated subjects from two Community Health Practitioner Posts in the suburbs of Taejon City. The subjects of the control and experimental groups were matched for age and sex. The self-regulation program developed by author given to the experimental group. The program consisted of group education on hypertension and self-care, self-regulation including the blood pressure self-monitoring, recording of self-care activities, and encouraging and reinforcing self-efficacy. The whole program was carried out from September to November of 1999. The data were analyzed by repeated measure ANCOVA, t-test, and ANCOVA. The results were as follows ; There was significant improvement in the scores on knowledge (F=.68, P=.004), perceived self-efficacy (F=26.39, P=.000), self-care performance (F=26.11, P=.000) of the experimental group compared with those of the control group. There was no significant change on the score of locus of control, perceived benefits and perceived barrier, blood cholesterol level, body weight between two groups (P>.05). From these results, it can be concluded that the self-regulation program is an effective nursing strategy to promote self-care performance of hypertensives in rural area.

The purpose of this study was to determine the effect of walk training on leg strength, flexibility, postural stability, balance and gait in home bound elderly women. Eighteen elderly women of the experimental group aged between 70 and 90 years image who have normal vision, hearing and Romberg test. They participated in the 12 week walk training. The subjects of the experimental group practiced walk training 3 times a week for during 12 weeks. During the 40 minute workout, the subjects practiced 5 minutes of warming-up exercises, 30 minutes of conditioning exercises and 10 minutes of a cool-down exercise. The intensity for the conditioning phase was determined by subject' heart rates, which ranged from 60% to 70% of age-adjusted maximum heart rates. The body composition, leg strength, flexibility, postural stability, balance and gait were measured prior to and after the experimental treatment. The body fat, lean body mass, leg strength (ankle dorsiflexor, plantarflexor, inversor and eversir, knee flexor, extensior), flexibility (range of motion of ankle dorsiflexion, plantarflexion, inversion and eversion), and postural stability of the experimental group were significantly greater than those of the control group. Duration of standing on the right foot and that of standing on the left foot of the experimental group was greater than that of the control group. Total balance scores of the experimental group were significantly higher than those of the control group. Among 13 items for balance, the scores of experimental group in balance with eyes closes, turning balance, sternal nudge, neck turning, one leg standing balance and back extension were higher than those of the control group. Total scores of gait of the experimental group were significantly higher than those of the control group following the walking training. Scores of experimental group in step height, step length and walk stance while walking among 9 items for gait were significantly higher than those of the control group. The results suggest that walk training can improve physical fitness for prevention in home bound elderly women.

This study is a methodical research to develop a health behavior assessment scale for patients with rheumatoid arthritis, and to test the validity and reliability of the instrument. The research procedure was as follows; 1) The first step was to develop conceptual framework based on a comprehensive review of the literature, in-depth interviews patients with rheumatoid arthritis. This conceptual framework was organized in eight dimensions; pain management, exercise, rest, diet control, active committment, self-management, positive thinking, interpersonal maintenance. Initially 56 items were selected from 164 statement. 2) These items were reviewed by panel of eight specialists and the Index of Content validity (CVI) was calculated, and forty six items were selected which met more than 70% on the CVI. 3) 174 rheumatoid arthritis pateints were interviewed, and data was gathered from Jan. 25 to Feb. 18, 1999 for test reliabilities and validities of the scale. The item analysis was carried out and 40 items were selected. Factor analysis by varimax rotation was carried out to test construct validity. The internal consistency by chronbach's $\alpha$ was calculated. The findings were as follows; 1) Item analysis and factor analysis were carried out to test the validity of the health behavior assessment scale. The item analysis was based on the corrected item`s to total correlation coefficient (.30 or more), and information about the alpha estimate. However, this was only if this item was deleted from the scale. As a result of the item analysis, forty items were selected. Thirty items were selected by a initial factor analysis by varimax rotation, and ten items were deleted because of factor complexity. In the secondary factor analysis, eight factors were labled as 'positive thinking', 'exercise', 'rest', 'pain management', 'active committment', 'self-management', 'diet control', and 'interpersonal maintenance', each similar with the conceptual framework. 2) Chronbach's $\alpha$ coefficient to test reliability of the scale was. 903 for total the thirty items. The Scale for assessing health behavior developed in this study was identified to be a tool with a high degree of reliability and validity. Therefore this scale can be effectively utilized for assessment in the health behaviors of the patients with rheumatoid arthritis.

The present study is a descriptive study to investigate nurses’perception of barriers to research utilization. A total of 274 participants in this study consisted of registered nurses working in a large, urban and academic medical center. A questionnaire packet containing the Barriers Scale, and a demographic profile was distributed to nurses and they were asked to return the packet to a return-box in the Nursing Office after completion. The greatest barrier was insufficient time on the job to implement new ideas. Next was ‘implications for practice are not made clear'. Also the item of the English language in research articles was considered to be the ninth barrier. The greatest mean score of each of the sub-scales was the communication factor. The were followed by the organization, research, and nurse factors. Compared with the means from other studies, the mean scores of the communication and research factors were higher in this study. Nurses who had not taken a class of research methods found the communication and research factors as a higher barrier than those who did. Also, nurses who did not participate in a conference last year perceived the research factor as higher than those who did. It is recommended that English and research classes should be strengthened in educational nursing programs. The researchers should also describe the section of implication for practice as more detail and clearer for the understanding of nurses; Lastly journals in a libraries or online journal systems should be easily accessible.

The purpose of this quasi-experimental study was to explore the effect of aromatherapy massage on the mood, the milk ejection reflex, and the immunoglobulin A of the breast milk of mothers who gave birth through a Cesarean section delivery. Twenty mothers who had Cesarean section were selected as an experimental group, and twenty-two were in the control group. Lavander and Rosemary oil mixed with Jojova carrier oil was used to massage the back, both axillar and breasts. Aromatherapy massage was done once a day for 20 minutes by the researcher. Each session consisted of 4 minutes for warm-up, 14 minutes for massage and 2 minutes for closure. The levels of IgA within the breast milk was analyzed by an immunoturbidimeter assay (Cobas INTEGRA, Roche, Swiss) before and after aromatherapy massage. Mood and milk ejection reflex were measured by self-reports at the same time. The data were analyzed using SPSS 7.5 and the hypotheses were tested by ANCOVA and the Pearson coefficient correlation. The results were as follows : 1) Score of mood increased significantly after the use of aromatherapy massage. 2) Score of milk ejection reflex increased significantly after the use of aromatherapy massage. 3) Level of IgA of breast milk did not change significantly after the use of aromatherapy massage.4) After the use of aromatherapy massage, there wasn't any correlation among mood, milk ejection reflex, and level of IgA of breast milk. In conclusion, the results suggest that aromatherapy massage is an effective nursing intervention to enhance the mood and the milk ejection reflex and to increase the rate of breastfeeding in the breastfeeding mothers under stresses like a Cesarean section.

This study was conducted to explore the nurse's perception of technological development and professional self-concept. The research subjects were 560 clinical nurses in Korea, who worked the general hospitals in Seoul, Kyeonggi, and the Kangwon province. Data sampling was done for the month, of December. 1997. The research tool consisted of 82 items questionnaires which were demographic data, TIQ, PSCNI. The research findings were as follows: 1. Nurses perceived the technological development as slightly positive (Mean =48.8). Also, nurses saw that the fastest developing technological nursing unit was the cardiac care unit, while the lowest technological developing nursing unit was the psychiatric unit. 2. The view of technological development was found to be significantly different according to religion (P=.0109), marital status (P=.0431), and the practical setting (P=.0048). Professional self concept was significantly different according to age (P=.0001), religion (P=.0001), education (P=.0007), marital status (P=.0000), career (P=.0001), and position (P=.0000). 3. The relationship between a nurse's perception of technological development and professional self-concept was highly correlated(r=.26, P=.0001). In the results of the multiple regression, the factors influencing professional self-concept were career, the nurse's perception of technological development, the level of technological development in nursing unit, and education. All these parameters showed the explaining power of 15.4% of the professional self-concept. In conclusion, nurses recognized the technological development was related to the professional self-concept. This study shed light on the meaning of technological development and vision of the nursing profession. Inservice education program should be developed to help the adaptability to technological development and conduct the qualitative research to explore the world of technological development which the nurses are experiencing in nursing.