Purpose. The purpose of the study was to assess the level of nurses' genetic knowledge and the perception of nurses' role in genetics. The ultimate goal of this paper is to educate practicing nurses so that they can counsel individuals and families with genetic problems, on the basis of better understanding of genetic diseases. Methods. A total of 969 clinical nurses in 11 general hospitals completed a self-administered questionnaire including basic genetic knowledge and perception of their role. The instruments were made by the author with the help of some experts on genetics. T-test, ANOVA, and Pearson Correlation were used to analyze the data. Results. The results of this study indicated that nurses revealed a vast knowledge deficit in genetics and the need for genetic content in nursing curriculum. The results also showed that nurses' sources of information about genetics largely came from the mass media. The nurses also expressed great interest in educating and counseling patients. Overall, the survey found a positive correlation between the nurses' level of knowledge and their degree of interest in genetics. Conclusion. In conclusion, education and training of clinical nurses in genetics is critical in integrating genetics with nursing science. Therefore, the development of educational programs for nursing knowledge and counseling as well as basic curriculums in genetic nursing at universities are essential in the near future.

Purpose. The number of elders in institutions has increased as family supporting systems have changed in Korea. The purpose of this study were to understand the life satisfaction among elders in institutions and to identify the factors influencing on life satisfaction. Methods. The instruments used were Yun(1982)'s scale modified Memorial University of Newfoundland Scale for Happiness(MUNSH) in life satisfaction, ADL and IADL in activity level, Self-rating Depression Scale(SDS) in depression and Norbeck Social Support Questionnaire(NSSQ) scale in social support. Also, Perceived health status was measured by Visual Graphic Rating Scale. The subject of this study is 107 cognitively intact and ambulatory elders in 7 institutions in Daegu city and Kyungpook province. The data have been collected from May 1 to June 30, 2001. For the analysis of collected data, frequency analysis, mean, standard deviation, Pearson's correlation and stepwise multiple regression analysis were used for statistical analysis by SPSS win(version 9.0) program. Results. Life satisfaction for the elders in institutions showed negative correlation with SDS, and positive correlation with activity level. The regression form of the stepwise multiple regression analysis to investigate the influencing factors of life satisfaction for the elders in institutions was expressed by y =90.988-0. 733x1-0.188x2-0.069x3-0.565x4 (xl: SDS x2: Social support x3: Activity level x4: Monthly pocket Money) and 57.9% of varience in life satisfaction was explained by the model. Conclusion. The factors influencing on life satisfaction among the elders in institutions were SDS, social support, activity level and monthly pocket money. According to the results of this study, depression, social support and activity level are considered the prime causal factors for life satisfaction.

Purpose. The purpose of this study was to identify the stage of change of smoking cessation behavior and investigate factors associated with the stage of smoking cessation behavior according to the transtheoretical model. Methods. The participants, 297 smokers & quitters were selected by a stratified random sampling from 127 high school sophomore students in B city. Data were collected from April 6th to 16th, in 2002 using the structured self-report questionnaire. Results. The subjects were distributed in each stage of change of smoking cessation behavior: there were 46 subjects (15.5%) in precontemplation, 73 subjects (24.6%) in contemplation, 67 subjects(22.3%) in preparation, 56 subjects (18.5%) in action, 55 subjects (18.5%) in maintenance. Compared to the precontemplation and contemplation, people in preparation tended to smoke daily more and smoked for a shorter time, and as precontemplation progressed to the maintenance, past 1 year smoking cessation frequency increased and friends smoking decreased. Smoking onset age was the earliest in preparation, and the latest in maintenance. Helping relationships and self relationships are used a lot in precontemplation and also in contemplation. In preparation, self liberation and helping relationships are used a lot, in action, self liberation and helping relationships, and in maintenance, self liberation and environmental reevaluation. At each stage, the score of negative affect situation was the highest, but the one of negative affect situation, positive social situation, habitual strength, weight control decreased as precontemplation progressed to the maintenance. While the score of social pros and coping pros decreased with increasing stage, the one of cons tended to increase. Through stepwise discriminant analysis, it was found that social pros, smoking onset age, delf-libration were the most influencing powers among factors associated with the stages of smoking cessation behavior. Conclusions. This study suggested that, in developing an effective smoking cessation intervention for adolescents, all the stage of a client's cessation had to be assessed prior to applying intervention programs. In addition, the results of this study will become a pillar of smoking cessation program planning and application.

Background. A midwife is a medical professional who has a nursing license, and is also licensed as a midwife with one additional year of education. In this globalization era, a midwife's role is increasing in importance for women and children's health care worldwide. Purpose. The primary purpose was to analyze midwifery education programs in Korea and other nations. The secondary purpose was to define strategies to improve midwifery education and practice, and to extend the role of a midwife women and children's health care in Korea. Methods & Results. 1) The definition of a midwife and midwifery practice recognized internationally by World Health Organization (WHO) and International Council of Nurse Midwives (ICNM) was identified. 2) Midwifery education programs of Korea, U.S.A., Sweden, Australia, and Japan, were investigated and discussed. 3) Core competencies for the basic midwifery practice suggested by ACNM of the U.S.A. were reviewed as standard of midwifery practice. 4) As for the midwifery education system, a Masters degree program in a college of nursing is suggested. 5) The role of a midwife includes not only health care of childbirth women and newborn babies, but also a lifelong health care of women as well as her family and children. Conclusion. An effort to extend the midwife's role and to improve service is imperative. The Laws/Acts related to midwives should be revised in regard to education, and practices, and the national examination for midwifery licensure needs revision to qualify for international approval. Also, midwifery curriculum and standards of practice need to be evaluated periodically, and an effective system needs to be established to renew midwife licenses.

Background. Breast cancer is the most common form of cancer among Korean women. Only 14 % of urban women and 10% of rural women in Korea, however, participated in breast cancer screening behavior in 1998 (Korean Ministry of Health & Welfare, 1999). Purpose. The aim of this study was to evaluate the effect of community-based breast self-examination (BSE) education programs in Korea. Methods. First, breast cancer risk appraisals were done with 1,977 rural women. Of the 1,977 women, nearly 30% (n=494) had a higher or equal to borderline risk of developing breast cancer. This quasi-experimental study was conducted to target these women with a high or equal to borderline risk of breast cancer. The risk appraisal feedback and breast self-examination education were used as an intervention for breast cancer prevention and early detection. Results. After a 3-month follow-up, 30.5% of the women in the intervention group performed regular BSE compared to 10.2 % of women in the control group. The mean knowledge score related to breast cancer and BSE was significantly higher for the women in the intervention group than that in the control group.

Background. Although there have been a great number of research studies based on the model of uncertainty in illness, few studies have considered the appraisal portion of model. Purpose. The purpose of this study was to test the mediating effect of appraisal in the model of uncertainty in illness. Additionally, this study aimed to examine the relationships among uncertainty, symptom severity, appraisal, and anxiety in patients newly diagnosed with atrial fibrillation. Methods. This study employed a descriptive correlational and cross-sectional survey design using a face-to-face interview method. Patients diagnosed with atrial fibrillation within the previous 6 months prior to data collection were interviewed by Mishel Uncertainty in Illness Scale-Community Form, appraisal scale, Symptom Checklist-Severity V.3, and State Anxiety Inventory. Results. A total of 81 patients with atrial fibrillation were recruited from two large urban medical centers in Cleveland, Ohio, U.S.A.. Symptom severity was the significant variable in explaining uncertainty ($\beta$=0.34). Individuals with greater symptom severity perceived more uncertainty. Uncertainty was appraised as a danger rather than opportunity, and those with greater uncertainty appraised a greater danger (p<.0l). While the appraisal of opportunity had the negative relationship with anxiety (r=-0.25), the appraisal of danger was positively associated with anxiety (r=0.78). The measure of goodness of fit (Q) of the model was .7863, and the significant test (X$^2$) for the Q was statistically significant (df =3, p<.00l). Accordingly, the overall mediating model of uncertainty in illness was proven not to be fit to the empirical data of patients with atrial fibrillation. Consequently, the mediating effect of appraisal was not supported by the empirical data of this study. Conclusion. The findings of this study were discussed in terms of their relevance compared with those of previous studies or theoretical framework and the plausible explanations on study findings. Lastly, in order to expand the present body of knowledge on uncertainty in illness model, recommendations for the future nursing studies were included.

Purpose. This study was conducted to understand the degree of internet addiction tendency and to find out the factors influencing this addiction tendency among middle school students in Gyeong-buk area. Methods. A total of 450 middle school students in the Daegu and Gyeong-buk area were surveyed in this study. Data collection was conducted through the use of questionnaires. Results. Internet addiction among middle school students was relatively low (Average user). In the overall ratio distribution, however, students who were classified as either addicted or at risk of addiction accounted for a high percentage, 27%. A positive correlation was found between Internet addiction and Internet expectation, depression and parent control over Internet use. A negative correlation was found between Internet addiction and interpersonal relationship, parent support and self-control. Multiple regression analysis revealed that the most powerful predictor of Internet addiction tendency was depression. Conclusion. Through the above results, it would be necessary to develop an Internet addiction prevention program for adolescents taking into account for the psychological factors such as depression and Internet use habits. In the future study, the need assessment will be useful for developing this prevention program.

Propose. An effective rehabilitation program had been developed for psychiatric patients' self management of medication and symptoms in Korea. The rehabilitation program was designed to allow the patients to understand their illness, cope with their medical regimen, and prevent a relapse by recognizing any of the symptoms when they recur. Methods. The developed program utilizes the self efficacy method reported by Bandura, it includes manuals and videotapes focusing on real life situations, small group discussions, and telephone coaching. This study investigated the effects of this program with respect to various predictable variables in psychiatric rehabilitation. Thirty eight patients were selected for this study, 18 in the experimental program and 20 as controls. Results. The results showed that the subjects who attended this educational program reported significantly more improvement in attitude toward medication compliance (p=0.033), and significantly less relapse warning symptom scores (p=0.000) than the controls. Conclusion. This program may be a useful psychoeducational resource for professionals in the field of clinical practice in psychiatry.

Purpose. 1) To identify the time taken from symptom onset to the arrival at the hospital (pre-hospital delay time) and time taken from the arrival at the hospital to the initiation of the major treatment (in-hospital delay time) 2) to examine whether rapid treatment results in lower mortality. 3) to examine whether the pre- and in-hospital delay time can independently predict in-hospital mortality. Methods. A retrospective study with 586 consecutive AMI patients was conducted. Results. Pre-hospital delay time was 5.25 (SD=10.36), and in-hospital delay time was 1.10 (SD=1.00) hours for the thrombolytic therapy and 50.24 (SD=121.18) hours for the percutaneous transluminal coronary angio-plasty (PTCA). In-hospital mortality was the highest when the patients were treated between 4 to 48 hours after symptom onset using PTCA (p=.02), and when treated between 30 minutes and one hour after hospital arrival using thrombolytics (p=.01). Using a hierarchical logistic regression model, the pre- and in-hospital delay times did not predict the in-hospital mortality. Conclusion. Pre- and in-hospital delay times need to be decreased to meet the desirable therapeutic time window. Thrombolytics should be given within 30 minutes after arrival at the hospital, and PTCA should be initiated within 4 hours after symptom onset to minimize in-hospital mortality of AMI patients.

Purpose. The purpose of this study was to examine the effects of a rehabilitation program on hope and self-efficacy in a sample of homeless adolescent substance abusers at a halfway house in Seoul, Korea. Methods. Five residents of a halfway house were provided with a 16-week rehabilitation program based on a cognitive-behavioral approach. To evaluate the effectiveness of the program, this study used a single-case experimental design with the variables - hope and self-efficacy - being measured at pre-, post-, and follow-up tests. Results. While three participants showed considerable positive changes in hope and self-efficacy after the program, two participants did not show any positive changes. Despite this lack of consistent patterns in the effectiveness of the rehabilitation program, there was a qualitative change in social status (such as academic and work status) for the participants at the follow-up test. Conclusion. A rehabilitation program based on a cognitive-behavioral approach may improve the hope and self-efficacy of homeless adolescent substance abusers at a halfway house and help them to reintegrate into society.

Purpose. Despite many smoking cessation programs, many patients with CAD continue to smoke or re-smoke. The processes of change and self-change for smoking cessation is emphasized. The purpose of present study was to investigate decisional balances and processes of change according to stages of change for smoking cessation in the patients with CAD. Methods. This descriptive study was performed using the self-reported questionnaires from 157 male patients with CAD who have smoking experiences. The questionnaires consisted of decisional balances toward smoking (pros/cons) and processes of change including 7 factors. Results. 45.2% of the subjects had myocardial infarction and 54.8% for angina pectoris. Major stages of change were maintenance, contemplation, and precontemplation in 62%, 14%, and 18% respectively. The mean score of pros smoking was 31.07 and cons smoking was 32.52. The mean scores of processes of change were high in all 7 factors, especially in self determination. The pros smoking in precontemplation stage was significantly higher than those in other stages. Between contemplation and precontemplation stages, processes of change showed significant differences in stimulus control, self determination, information management, and dramatic relief. Conclusion. This study suggests that decisional balances and processes of change are stage-specific. As this study, smoking cessation program in the patients with CAD must put priority on the patients group in pre-contemplation and contemplation stages, and stress self determination and dramatic relief.