Purpose: The purpose of this study was to illustrate the main stream of postmodernism which has influenced theory and research in the nursing science, and then to consider the meaning and value of what the postmodern perspective has meant to nursing science in the 21st century. Method: Derrida and Foucaults philosophical thoughts that characterized postmodernism through the interpretation of their major literature was studied. Based on their philosophy, it was shownhow Derrida's idea could be applied in de constructing the core paradigm in modern nursing science. In terms of Foucault's post-structuralism, reinterpretation of the nursing science in relation to power/knowledge was completed. Result: Postmodernism created multiple and diverse paradigms of nursing theory as well as nursing research. This was accomplished by de constructing the modernism of nursing science which was based on the positivism and medical-cure centralism. Specifically, the post-structuralist perspective revealed issuesaround the relationship of power and knowledge, which dominated and produced modern nursing science. Contemporary nursing science accepts pluralism and needs no unitary meta-paradigm, which can reintegrate multiple and diverse paradigms. Conclusion: In considering the issue of nursing science in postmodernism, it can be summarized as follows: the postmodern thinking discovers and reveals diverse and potential nursing values which were veiled by the domination of western modem nursing science. These were motivated to create nursing knowledge by conversation in interpersonal relationships, which can contribute to practical utilities for the caring-healing situation.

Purpose: This study was aimed to develop a computerized reminder system and evaluate it's effect in terms of percent age change of screening, and satisfaction. Method: It was conducted through 6 phases: Analyzing the job and defining the basic input data, developing the information system, collecting and inputting data, testing the system, working with the system, and evaluating it's effect. Participants were 787 people (female 30-69 years, and males 40-49 years) in 2 dong of Suyoung gu, Busan, who haven't had cancer screening for the stomach, breast, or cervix since Dec. 2000. There were three experimental groups: a letter; calling and calling after the letter reminder, and a non-equivalent control group. To determine whether services were obtained, a telephone survey was done after two months of follow-up. Result: A cancer screening information system with five DB modules was developed. Overall compliance with screening was not statistically significantly changedbefore and after applying computerized reminders for all three screening sites. Only 16% were satisfied with the reminder. Conclusion: This data didn't show that a reminder effort was effective of screening. However, because the evaluation interval was too short to find a difference in screening rate, we recommend additional longer prospective follow up studies.

Purpose: The purposes of this study were to: (a) develop a comprehensive communication course combined with a group program for improving communication skills; and (b) examine the effects of the comprehensive communication course on interpersonal communication, relationship change, self-esteem, and depression in nursing students. Method: The experimental group consisted of 82 nursing students, and the control group, 108 nursing students. Both groups each took communication courses from March to June, 2002 and 2003. A group program for improving communication skills was conducted for each 8 subgroups of the experimental group for 90 minutes once a week during the 6 weeks, while the existing communication lecture was conducted for the control group. Both groups were post-tested after the intervention for verifying the difference of variables between the two groups, and the experimental group was also pre-tested for verifying the difference between before and after the treatment. Result & Conclusion: Interpersonal communication score of the post-test in the experimental group was significantly higher than in the control group and the depression score of the post-test in the experimental group was significantly lower than in the control group. Interpersonal communication, relationship change and self-esteem scores were significantly increased and the depression score was significantly decreased in experimental group after the treatment. In conclusion, the comprehensive communication course that was developed in this study had positive effects on communication skills in nursing students.

Purpose: This study is to evaluate the effects of drug abuse prevention program for elementary school students. Method: The design of this study is nonequivalent control group pretest-posttest design. The subjects of experimental group were 27 students and the subjects of control group were 25 students in fifth grade of elementary school in C City, Gyeongsangbuk-do. The experimental group had Drug Abuse Prevention Program, which was two days per week program, for 5 weeks. And post-test was carried out in the same way as the pre-test. Data analysis was done using frequency, percentage, mean, standard deviation, Chi-square test, t-test, Paired Samples t-test using with SPSS WIN 11.0. Result: the experimental group, to which drug abuse prevention program was given, was improved in knowledge of drug and unacceptable attitude of drug compared to the control group, but there were no significant differences of self-esteem and assertiveness between two groups. Conclusion: The drug abuse prevention program was effective to increase knowledge and attitude of drug in elementary school students.

Purpose: The purpose of this study was to examine risk factors for sexual behaviors in Korean female high school students. Methods: Data was collected by a written questionnaire from June 22 to July 18, 2002 from 522 girls, who were stratified samples from a target population of 63,375 11th grade students from 200 regular high schools and 70 vocational high schools in Seoul, Korea. We conducted multiple regression analysis using the SAS pc＋ program. Results: Risk factors for intimate behaviors were association with boy friends, differential association, family attachment, and family abuse experience. These variables cause 68% of intimate behaviors. Risk factors for sexual experiences were differential association, association with boy friend, and family attachment. These variables cause 14% of sexual experiences. Conclusion: Efforts to reduce sexual behaviors in girls should include the possible role of peers and develop peer leader programs.

Purpose: This study was to evaluate the effects of a physical activity reinforcement program on exercise compliance, depression, and anxiety in continuous ambulatory peritoneal dialysis(CAPD) patients. Method: A nonequivalent control group with a pre-post test was designed. Data collection was done from December, 2002 to June, 2003 at a hoapital. The degree of depression and anxiety of the patients was assessed by the score of SCL-90-R, and exercise compliance was measured by exercise period, frequency, time and intensity. The experimental group was composed of 19 participants who were educated based on an exercise education protocol and carried out walking exercises two to four times a week after hearing verbal persuasion biweekly through the telephone or a face-to-face interview for 12 weeks, while 17 participants in control group received no intervention. Result: 1. The experimental group showed significant improvement in self-efficacy of exercise compliance (U=79.00, p=.01), exercise period ($x^2$=20.84, p=.00), exercise frequency ($x^2$=9.03, p=.0l), exercise time ($x^2$=9.03, p=.0l) and exercise intensity ($x^2$=11.09, p=.00) compared to those of the control group. 2. The experimental group showed a lower depression score (U=84.50, p=.01) than the results of the control group. 3. However, there were no changes in anxiety level compared to the control group. Conclusion: The physical activity reinforcement program was found to have an effect on exercise compliance and the depression score of CAPD patients. The results provided evidence for the importance of physical activity and verbal persuasion in CAPD patients.

Purpose: The aim of this study was to analyze economical efficiency of home care service by comparing a cost-utility ratio(CUR) between home care and hospitalization. Method: The analytic framework of this study was constructed in 5 stages: Identifying the analytic perspectives, measurement of costs, measurement of utility, analysis of CUR, and sensitivity test. Data was collected by reviewing medical records, home care service records, medical fee claims, and other related research. Result: The mean of the annual total cost was 23,317,636 Won in home care and 73,739,352 Won in hospital care. QALY was 0.389 in home care and 0.474 in hospital care, so CUR was 299,712,545 QALY in home care and 777,841,266 QALY in hospital care. Conclusion: The findings affirmed that home care had an economical efficiency in the aspect of utility compared to hospitalization. Therefore, the findings of this study can be used to develop a governmental health policy or to expand the home care system. In addition, the cost-utility analysis framework and process of this study will be an example model for cost-utility analysis in nursing research. Therefore, it will be used as a guideline for future research related to cost-utility analysis in nursing.

Purpose: This study was to develop a substantive theory on the conquering experience of group-bullies among teenagers, and thereafter suggest a model for solving the problems. Method: Data collection and analysis was proceeded by a method of Grounded Theory. Data was collected by interviewing the participants. Five teenagers participated in this study who had already overcome the situation. Result: In the analysis 31 concepts, 6 categories, and 14 subcategories are extracted from the raw data, and all are constituted on the paradigm model. The causal condition is a painstaking of participants. The context is affirmative reconsidering and the phenomenon is conquering difficulties. The intervening condition is a positive intervention of a supporting system and the strategy for action/interaction is building a relationship. The consequences of this analysis is harmonizing. Conclusion: The results of this study suggest adequate ways of conquering group-bullies. These are positive attitudes towards solving problems and the full use of support systems surrounding them.

Purpose: The purpose of this study was to identify the effect of the exchange of saline used in surgical procedures on surgical site infections. Method: Patients with stomach cancer were assigned to the experimental group or to the control group by random sampling, respectively. The experimental group received an exchange of saline during the operation right after the excision of the stomach in a gastrectomy but the control group did not. Data were collected from the medical charts of 34 patients from Dec. 1, 2002 through May 31, 2003. Result: The surgical site infection rate of the experimental group was 5.9% while surgical site infection rate of the control group was 17.6%. In total, the surgical site infection rate was 11.8%. The experimental group maintained a normal level of WBC on post operative day 3; however, the control group, showed an increase of WBC on post operative day 3. Conclusion: The exchange of saline used in an operation immediately after the excision of the stomach in a gastrectomy decreases the contamination level of saline used in the operation, and can prevent surgical patients from a surgical site infection.

Purpose: This study was to identify the relationship between stress, social support and depression in the elderly. Method: The subjects were 283 elderly adults over 60 in Seoul. Data was collected by questionnaire surveys using convenience sampling. The instruments used in this study are the ELSI developed by Aldwin(1990), the Interpersonal Support Evaluation List developed by Cohen & Hoberman (1983), and the Geriatric Depression Scale by Yesavage & Brink(l982). Data was analyzed by the SAS program, using descriptive statistics, Pearson Correlation Coefficient, t-test, ANOVA and progressed Multiple Regression. Result: The relationship between stress and depression had a positive correlation (r=0.33), but the relationship between stress and social support had no significant correlations. The relationship between social support and depression had a negative correlation (r=-0.38). The most powerful predictor of depression was the economic status and then a combination of stress, and social support account for 39% of the variance in depression in the elderly. Conclusion: These results suggested that stress and social support deficits can be potential risk factors in old age depression. Therefore, these findings give useful information for constructing an intervention program focused on depression in the elderly.

Purpose: This study was aimed to develop a WBI(Web Based Instruction) program on safety for 3rd grade elementary school students and to test the effects of it. Method: The WBI program was developed using Macromedia flash MX, Adobe Illustrator 10.0 and Adobe Photoshop 7.0. The web site was http://www.safeschool.co.kr. The effect of it was tested from Mar 24, to Apr 30, 2003. The subjects were 144 students enrolled in the 3rd grade of an elementary school in Gyungju. The experimental group received the WBI program lessons while each control group received textbook-based lessons with visual presenters and maps, 3 times. Data was analyzed with descriptive statistics, and ${\chi}^2$test, t-test, and repeated measure ANOVA. Result: First, the WBI group reported a longer effect on knowledge and practice of accident prevention than the textbook-based lessons, indicating that the WBI is more effective. Second, the WBI group was better motivated to learn the accident prevention lessons, showing that the WBI is effective. As a result, the WBI group had total longer effects on knowledge, practice and motivation of accident prevention than the textbook-based instruction. Conclusion: We recommend that this WBI program be used in each class to provide more effective safety instruction in elementary schools.

Purpose: The purpose of this study was to compare the degree of cognitive level, nutritional status and depression in elderly according to living situations. Method: The subjects consisted of 173 elderly classifying three groups(living alone, living with spouse, living with children). Data was collected from March to June, 2003 by a structured questionnaire that included general characteristics, MMSE-K, nutritional status and depression scale. The collected data was analyzed by the SPSS program including descriptive statistics, $\chi$$^2$-test, ANCOVA, Scheffe test and Pearson Correlation Coefficient. Result: In MMSE-K, the living alone group showed suspicious dementia while the other groups were normal. The living alone group showed a high nutritional risk and all three groups showed depression. In MMSE-K, the nutritional status and depression were statistically significant by the living situation. In each group except living with spouse, MMSE-K indicated a significantly negative correlation to depression and nutritional status, while nutritional status showed a significantly positive correlation to depression. Conclusion: It is necessary to develop supportive programs for decreasing the risk of bad health in the elderly and an individual approach according to their living situation. Especially, more concern and intervention is necessary for the solitary elderly.

Purpose: The purpose of this study is to identify the influencing factors of mother-infant attachment and construct a descriptive model that explains mother-infant attachment during the early postpartum period. Method: The hypothetical model of this study consisted of 8 variables with 23 constructed paths. The subjects of this study were 152 postpartum women. Data was analyzed to test the hypothetical model using covariance structure analysis. Result: The final model which is modified from the hypothetical model improved to Chi-Square 41.92, GFI .95, AGFI .89, RMSR .02, RMSEA .06, NFI .94, and NNFI .95. Mother-infant attachment during the early postpartum period was proven to be influenced directly by neonatal perception, maternal sensitivity, and maternal-fetal attachment and also indirectly by social support, maternal-fetal attachment and maternal identity. These variables accounted for 32% of the variance of the mother-infant attachment during the early postpartum period. Conclusion: It is necessary that the nurses provide postpartum women with an intervention using social support for improving maternal identity and alleviating maternal role strain. It can be helpful to improve maternal sensitivity and in the end it will facilitate the mother-infant attachment during postpartum period.

Purpose: The purpose of this study was to develop and test a model to explain the transition state for Korean middle-aged women focusing on the transition concept. Method: A hypothetical model was constructed based on the transition model of Schumacher & Meleis(1994) and tested. Thehypothetical model consisted of 5 latent variables and 11 observed variables. Exogenous variables were demographic characteristics, obstetric characteristics, and health behavior. Endogenous variables were transition state and quality of life with 6 paths. The data from 221 middle-aged women selected by convenience was analyzed using covariance structure analysis. Result: The final model which was modified from the hypotheticalmodel improved to GFI=0.97, AGFI=0.94, NFI=0.94, and NNFI=0.95. The transition state was influenced directly by demographic characteristics, quality of life, and also indirectly by health behaviors. However, the influence of obstetric characteristics was not significant. The transition state was accountable for 68% of the variance by these factors. Conclusion: These results suggest that enhancing health behaviors of the women are necessary to increase quality of life and it consequently contributes toimproving the transition state. This model could be used to explain the health related vulnerability in these ages and to diagnosis individual women.

Purpose: The purpose of this study was to develop a program promoting adjustment to hospital life and determining its effectiveness for school aged children. Method: The sample group consisted of 76 hospitalized children in 2 University Hospitals located in Busan. The experimental group was given the program on admission and feedback was obtained on the 3rd day and again 24 hours later. Data was analyzed using t-test and ANOVA in the SPSS program package. Result: There were significant differences, in information(t=4.235, p=0.000) and coping effort criteria (t=2.922, p=0.005) between the experimental and control groups. There was a non-significant difference in attitude criteria between the two groups(t=1.009, p=0.316). Conclusion: It was found that the adjustment promoting program for hospital life for school aged children was effective, but not enough to promote self-esteem. The program, based on a learning theory, was improved and shown to be an effective and strong method to promote adjustment of school-aged children.

Purpose: The purposes of this study were to describe the relationship between depression and resilience and to identify variables associated with depression among children with nephrotic syndrome. Method: Data was collected from 45 children who were registered at one hospital in Seoul. The criteria for sample selection were 10 to 15 year-old children who were diagnosed at least 6 month prior. The instruments included a self-reported questionnaire on resilience by Kim, CDI by Beck, and MBRI by Kwak. Descriptive, Pearson correlation and multiple regression analyses were done. Result: The mean score of depression was 11.44 (range:0-54) and resilience was 97.47 (range:32-128). There were significant positive relationships between depression and age (r=0.302, p<.005) and academic achievement (r=-0.318, p<.005). In addition, negative relationships between depression and maternal attitude (r=-0.412, p<.001) and resilience (r=-0.649, p<.001) occurred. The results of multiple regression analysis showed that maternal behavior (${\beta}$=-0.421, p<.005) and resilience (${\beta}$=-0.639, p<.001) were related to depression. Conclusion: Children with higher resilience and with an affectionate mother were less depressed. Thus, it is important to identify strengths of children and help them to increase resilience and implement parenting and counseling programs for parents' of these children. Similar studies with children with other chronic illnesses are needed.

Purpose: This study was to identify the effects of the predictive factors of Internet addiction and to develop a predictive model that explains Internet addiction among adolescents in Korea. Method: Data was collected from 664 adolescents in Puasan and Ulsan. Data analysis was done using the SPSS 10.0 Win Program for descriptive and correlational statistics and the LISREL 8.53 Win Program for Covariance structural analysis. Result: The fit of the hypothetical model to the data was moderate, it was modified by deleting four paths. Compared to the hypothetical model, the revised one had a better fit to the data($\chi^2$/df=6.50, GFI=.99, AGFI=.90, RMR=.02, NNFI=.88, NFI=.98, CN=279). Gender, friend support, and loneliness had significant direct effects on Internet addiction. The direct and indirect effect of self-esteem on Internet addiction was significant. The indirect effect of family support on Internet addiction was significant but its direct effect was insignificant. The direct and indirect effects of stress and impulsiveness on Internet addiction were significant but their total effects were insignificant. Conclusion: Finally, to decrease loneliness, and to increase family support and self-esteem, an effective intervention program and education should be developed to prevent Internet addiction of adolescents.

Purpose: This study was to develop a client health status outcome evaluation instrument, and examine content validity, reliability, construct validity, and the acceptability of this instrument. Method: A preliminary list was made of such key information as standards, criteria, indicators and measures, by means of a broad review of literature within the field. After determining the preliminary instruments, the study sought to obtain examination, consensus, and modification of two groups of experts in the home-care field. Finally, the instrument examined content validity, reliability, construct validity, and the acceptability of this instrument. Result: The tool was considered of 13 criteria, 48 indicators, and 167 detail measures. The content validity index of the tool was above 0.8 according to the expert group. Regarding the reliability of the evaluators of standards 1 and 2, the degree of agreement between evaluators was high(96.4% through 98.2%). Construct validity in this study, the difference in the mean score between the baseline point and the follow up point of each of standards 1 and 2 was significant, and the mean score of the follow up point was more than that of the baseline point. After examining the acceptability of this instrument with practice managers and home care nurses in home care institutions, a positive opinion was given of this instrument, and it was indicated that to be useful and applicable in home care practice. Conclusion: The results of evaluating client outcome will contribute to overall outcome-based quality improvement and service marketing in home care by providing a constant gauge of home care effectiveness.

Purpose: The purpose of this article was to describe feminism and to propose the integration of a feminist method into qualitative nursing methodology in order to expand the body of nursing knowledge. Method: The world view of feminism including philosophy, epistemology and methodology was outlined, and a feminist grounded theory and feminist ethnography were suggested as a way of strengthening nursing research methodology using literature review. Results: Four different philosophical perspectives of feminism, that is, liberal feminism, radical feminism, Marxist feminism, and social feminism were described. Also epistemological perspectives including feminist empiricism, feminist standpoint, and postmodem feminism, were explained and were related to the methodology and methods of feminism. To enhance the strengths of nursing research within the feminist perspectives, feminist grounded theory and feminist ethnography were exemplified in the paradigm of qualitative nursing research. Conclusion: This paper suggested that incorporation of feminist approaches within nursing is a valuable attempt to expand the body of nursing knowledge and to enhance the quality of nursing care services by rectifying male-oriented knowledge and by empowering women in the care of other people as well as themselves.

Purpose: The purpose of this study was to identify the relationship between eating disorders, physical symptoms, depression and health locus of control. Method: The research design was a descriptive study done by using a constructive self-report questionnaire. A total of 464 elementary school girls were measured. The instrument was a constructive questionnaire that consisted 136 items. The subjects were divided into 4 groups according to the Body Mass Index (BMI). Data analysis was done by SPSS/WIN Programs using frequency, percentage, mean, SD, ANOVA, Pearson correlation coefficient, and stepwise multiple regression. Result: The score of eating disorders differed significantly by BMI : the score was highest in the group of obese students(F=4.208, P=.015). Stepwise multiple regression analysis revealed that the most powerful predictor of eating disorders was BMI. Conclusion: These results indicate that Korean elementary school girls need more education and counseling on diet. Also, we should take systematic efforts to reestablish the social standard of beauty to promote normal growth development.

Purpose: The purpose of this study was to identify the factors influencing file-up family stress in the family with a family member having a chronic mental illness. Method: Data was collected by questionnaires from 365 families with a member having a chronic mental illness, in an outpatient clinic of a General Hospital and Government Psychiatric Hospital in Seoul. The data was analyzed using descriptive statistics, pearson correlation coefficients, and stepwise multiple regression. Result: The score of file-up stress showed a significantly negative correlation with the score of level of hardiness (r=-.31, p=.00), family support (r=-.13, p=.00), family cohesion (r=-.25, p=.00), and sense of coherence (r=-.26, p=.00). The most powerful predictor of file-up stress was family hardiness and the variance was 11.1%. Acombination of hardiness, family support, and sense of coherence account for 14.8 % of the variance in file-up stress of the family with a member having a chronic mental illness. Conclusion: This study suggests that family support, hardiness, cohesion, and sense of coherence are significant influencing factors on file-up stress in the family with a member having a chronic mental illness.