Purpose: This study was conducted to develop a behavioral checklist to predict an autistic disorder and to identify the earliest detecting time. Method: One hundred and fifty eight children including normal, autistic, institutionalized normal, and retarded were assessed using critical interaction behavioral markers from literature review. Data was collected by semi-structured mother-child interaction by videotape recording and analyzed byfactor analysis, Cronbach a, Kappa, $x^2$, and Duncan. Result: Ten behavioral markers were sorted into 2 factors; joint-attention and synchronized behavior. Autistic children were impaired in pretend play, odeclarative pointing, proimperative pointing, gaze-monitoring, referential looking, showing, joint-attention, rhythmical vocal exchange, and synchronized laughing. The sychronized behavior was also a critical marker to predict the autistic disorder. However, it was difficult to differentiate autistic disorder from mental retardation. In addition, the appropriate detecting time was around 18 months after birth. Conclusion: This checklist should be behavior markers to predict autistic disorder and could be useful as educational material at children's clinics, parents class, and for caregivers in the health center. In addition, early detection should lead to treatment being started as soon after 18 months of age as possible.

Purpose: The purpose of this study was to explore the psychosocial adjustment process in adolescents with epilepsy in the context of Korean society and culture. Method: A grounded theory method was used for data collection and analysis. Participants for this study were 9 adolescents who regularly visited an epilepsy clinic in a university hospital. The data was collected through in-depth interviews during the period from November, 2002 to June, 2003. Data collection and analysis were performed simultaneously. Result: Twenty-three categories emerged including 'suffering', 'psychological stigma', and 'social isolation from one's peers'. Categories were divided into paradigms which consisted of conditions, actions/ interactions, and consequences. 'Reconstructing life' was the core category in this study. The theoretical scheme was described by organizing categories around the core category. Conclusion: This study provides a framework for the development of individualized nursing interventions to care for adolescents with epilepsy.

Purpose: The main purpose of this study was to investigate that the stages of change in smoking cessation behavior among coronary artery disease patients for six months progressed following the stages of change suggested by the transtheoretical model. Method: Subjects for this descriptive survey were 59 coronary disease patients who were smoking or who had stopped smoking for less than six months. Result: In the baseline, the distribution of the subjects’ stages of change was as follows: pre-contemplation stage 25.4%, contemplation stage 25.4%, preparation stage 22%, and action stage 27.1%. After six months, more subjects in the contemplation(33.3%) and preparation stages(30.8%) progressed to the action stage than those of the pre-contemplation stage(0%). Eighty-one percent of the subjects in the action stage at baseline progressed to the maintenance stage. The relationship between the numbers of smoking cessation attempts for six months and stages of change at baseline was significant(p=.001). However, the relationships between self-efficacy and nicotine dependence at baseline and progression in stages of change after six months were not significant. Conclusion: Progression in the stages of change for six months among subjects corresponded to the stages of change suggested by the transtheoretical model. Hence, future development and evaluation of intervention programs should be tailored individually considering each patient's stage of change.

Purpose: The purpose of this longitudinal study was to examine the relationship between postpartum care performance and postpartum health status. Sample: The study subjects were 82 mothers who delivered full-term infants at 3 hospitals at P city. Data were collected for their health status at the postpartum unit and the sample was followed up to 6 weeks postpartum to collect postpartum care performance and health status. Results: Mothers rated postpartum care performance as moderate to high and especially rated the maternal role attainment the highest. Mothers experienced 4 physical symptoms and moderate levels of fatigue. In addition, they experienced moderate levels of positive affect and low levels of negative affect at both times. Canonical correlation revealed that ostpartum care performance was related to postpartum health status with 2 significant canonical variables. The first variate indicated that mothers who performed hospitality, physical and emotional recovery, self-caring, and role attainment well showed higher positive affects, lower negative affects, fewer physical symptoms, and lower levels of fatigue. The second variate showed that the greater the performance of caring and physical and emotional recovery, the fewer physical symptoms and lower levels of fatigue. Conclusion: Although Korean traditional postpartum care performance was related to postpartum health status, the further study is needed to identify the causal relationship between them. Nurses need to integrate the perspective of westernized postpartum care and Korean traditional views of postpartum approach to maintain and promote women's health.

Purpose: This study was to evaluate the validity of the Pediatric Index of Mortality Ⅱ(PIM Ⅱ). Method: The first values on PIM Ⅱ variables following ICU admission were collected from the patient's charts of 548 admissions retrospectively in three ICUs(medical, surgical, and neurosurgical) at P University Hospital and a cardiac ICU at D University Hospital in Busan from January 1, 2002 to December 31, 2003. Data was analyzed with the SPSSWIN 10.0 program for the descriptive statistics, correlation coefficient, standardized mortality ratio(SMR), validity index(sensitivity, specificity, positive predictive value, negative predictive value), and AUC of ROC curve. Result: The mortality rate was 10.9% (60 cases) and the predicted death rate was 9.5%. The correlation coefficient(r) between observed and expected death rates was .929(p<.01) and SMR was 1.15. Se, Sp, pPv, nPv, and the correct classification rate were .80, .96, .70, .98, and 94.0% respectively. In addition, areas under the curve (AUC) of the receiver operating characteristic(ROC) was 0.954 (95% CI=0.919～0.989). According to demographic characteristics, mortality was underestimated in the medical group and overestimated in the surgical group. In addition, the AUCs of ROC curve were generally high in all subgroups. Conclusion: The PIM Ⅱ showed a good, so it can be utilized for the subject hospital. better.

Purpose: The purpose of this study was to verify the effect of aromatherapy massage on constipation in the elderly. Method: This study for 10 day, employed a randomized control group pretest-posttest design. The experimental group received abdominal massage using essential oils with Rosemary, Lemon, and Peppermint, and the control group received a placebo massage. To evaluate the effect of aromatherapy, the degree of constipation was measured using the CAS (constipation assessment scale) and the number of bowel movements per week. Data was analyzed by repeated measures of ANOVA using the SPSS program. Result: The score of CAS of the experimental group was significantly lower than that of the control group. In addition the average number of bowel movements in the experimental group was higher than that of the control group. The effect of aromatherapy lasted 2 weeks after treatment, while the placebo effect lasted 7~10 days after treatment. Conclusion: The finding of this study showed that aromatherapy helps relieve constipation in the elderly.

Objective: The aim of this study is to explore the variation in perceptions about problem-based learning(PBL) according to the level of academic achievement and learning attitude in the nursing students of a junior college (3-year program). Method: Students (n=39) learned the respiratory and cardiac system with seven PBL packages and group-based learning for a semester in 2002. Students were asked to write reflective journals that focused on their learning perception after an experience with each learning package. A total of 208 journals were used for analysis. Result: Students positively perceived that PBL making them increase their sense of responsibility for learning and felt satisfaction with the learning process, and had a confidence in the use of clinical nursing interventions. On the other hand, they negatively perceived that PBL was a burden because it took more time than traditional learning tasks, and they experienced an anxiety about regular tests and felt conflicts and diffidences in the learning process. The negative perceptions were expressed more often from students with a low academic achievement and low learning attitude compared to others. Conclusion: Students perceived the PBL as effective in understanding the learning concepts in the clinical practice environment. PBL need to be supplemented by feedback-based lecture and facilitative strategies for academically low-achieved students.Objective: The aim of this study is to explore the variation in perceptions about problem-based learning(PBL) according to the level of academic achievement and learning attitude in the nursing students of a junior college (3-year program). Method: Students (n=39) learned the respiratory and cardiac system with seven PBL packages and group-based learning for a semester in 2002. Students were asked to write reflective journals that focused on their learning perception after an experience with each learning package. A total of 208 journals were used for analysis. Result: Students positively perceived that PBL making them increase their sense of responsibility for learning and felt satisfaction with the learning process, and had a confidence in the use of clinical nursing interventions. On the other hand, they negatively perceived that PBL was a burden because it took more time than traditional learning tasks, and they experienced an anxiety about regular tests and felt conflicts and diffidences in the learning process. The negative perceptions were expressed more often from students with a low academic achievement and low learning attitude compared to others. Conclusion: Students perceived the PBL as effective in understanding the learning concepts in the clinical practice environment. PBL need to be supplemented by feedback-based lecture and facilitative strategies for academically low-achieved students.

Purpose: The purpose of this study was to examine the effects of a stress management program on mental health and coping behavior for children of alcoholics. Method: Data was collected from January to February, 2003. The subjects were 20 adolescents from 13 to 18 years old. Data was analyzed using descriptive statistics, chi-square test, and t-test with the SAS program. Result: There were statistically significant differences in mental health, active coping, positive cognitive restructuring, and support-seeking for problem solving between the experimental group and the control group. Conclusion: The stress management program helped children of alcoholics by enhancing self-esteem, providing information about alcohol, and improving emotional and problem focused coping abilities. This eventually enhanced mental health.

Purpose: The purpose of this research was to provide basic data in the control of depression found in patients with fibromyalgia by analysing the main factors that affect them. Method: The subjects were 207 out-patients in three university medical centers diagnosed with fibromyalgia according to the conditions by American College of Rheumatology (1990). Depression was measured by the CES-D Scale. Dependant variables, such as stress and anxiety were measured by the VAS Scale and physical activity was measured using 10(4-point-scale) questions developed by the researcher. The number of tender points was converted to scores based on the criteria of the ACR(1990) and of Yunus. Self-efficacy was measured by the Self-Efficacy Scale developed by Lorig et al. (1989) for arthritis patients. Result: The main factors that affect depression of patients with fibromyalgia were self-efficacy, anxiety, physical activity, tender points fatigue, and family support, which explained 49% of the depression. Conclusion: It has been confirmed that the regression equation model of this research may serve as a predictor of depression in patients with fibromyalgia.

Purpose: The purpose of this study was to develop an instrument of task performance evaluation for clinical nurses, thus testing the validity and the reliability of the scale. Method: Data was collected from 84 Head Nurses and 255 General Nurses. A conceptual framework, composed of 4 factors of meaning in task performance evaluation, was identified through review of the relevant literature. A total of 78 items were developed and were used on a five-point likert scale. Through factor analysis, items whose factor loading was below 0.50 were deleted, thus 35 items remained. To test the validity and reliability of the instrument, the SPSS 11.0 windows program was used. Result: The results of the factor analysis indicated that 4 factors were classified and the cumulative percent of variance was 67.54%. The results of the reliability test indicated that Cronbach's coefficient of the total 35 items was over 0.9176. The results of the factor analysis indicated that factor loadings of all items was over 0.50. Conclusively, the validity and the reliability of the scale were proven. Conclusion: This study was identified as a tool with a high degree of reliability and validity.

Purpose: This research was conducted to determine the effects of a fall prevention program on knowledge, self-efficacy, prevention activity, and depression in the low-income elderly women. Method: The design of this study was a nonequivalent control group pretest-posttest design. There were 22 subjects in the experimental group and 22 in the control group. A fall prevention program was performed for approximately 40 minutes, once a week for 6 weeks. Results: The results of this study were as follows: There were statistically significant differences of knowledge, self-efficacy, and prevention activity related to falls and depression between the experimental group and control group. Conclusion: In conclusion, the fall prevention program used in this study is appropriate for the elderly, therefore this program is strongly recommended for community-based health and welfare centers.

Purpose: The purpose of this study was to develop a health conservation scale with high validity and reliability for institutionalized elderly. Method: The process of development of this scale was as follows. A conceptual framework composed of 4 phases of health conservation of institutionalized elderly was identified based on the literature review with elderlies and discussions with experts in health conservation. A total of 75 items, on a 4-point scale were developed. Through reliability testing and factor analysis, 57 preliminary items were selected. By means of internal consistency of the 57 items, 18 items whose inner-items correlation coefficient was below .40 were deleted. Through factor analysis, 2 items whose factor loading was below .40 were deleted. Finally 37 items remained. To verity the 37 items, factor analysis, reliability testing, and correlation was done. Data were collected from 207 institutionalized elderly subjects in Daegu, Kyungpook, Busan, and KyungNam Province from August. 2003 to February. 2004. Result: In the result of factor analysis of the 37 items, 4 factors were extracted. These factors were labeled as ‘personal integrity’, ‘conservation of energy', ‘structural integrity’, and ‘social integrity'. These factors included 4 phases of health conservation. Cronbach's Alpha of 37 the items was .9424 and the correlation coefficient of HPLP was .723. Conclusion: The researchers recommend the following: An explorative study on the variables related to health conservation is needed for criterion validity of this scale. Studies on health conservation of different age groups, and subjects are needed for verification.

Purpose: The purpose of this study was to identify the influencing factors on the development of pressure ulcers in patients undergoing surgery which lasted more than two hours. Method: One hundred nineteen surgical adult patients were included in the study. Data was measured on each participant from December 2003 to February 2004. It was collected using a structured researcher-administered sheet and analyzed by descriptive statistics, t-test, chi-square test and logistic regression analysis. Result: The prevalence of a perioperative pressure ulcer was 26.1%. The level of moisture, friction and shear, length of surgery, and perioperative irrigation were significantly higher in the pressure ulcer group than those in the non-pressure ulcer group. The level of activity and level of consciousness were significantly lower in the pressure ulcer group than those in the non-pressure ulcer group. Significant influencing factors on the development of pressure ulcer were 'moisture' and 'irrigation' and those variables explained 23.1% of varience in the development of a pressure ulcer during surgery. Conclusion: It is necessary to develop a strategy to prevent pressure ulcer by taking 'moisture' and 'irrigation' into account during the preoperative, perioperative and postoperative period.

Purpose: This study was aimed at developing an efficient nursing method for the management of constipation by comparing the effects of abdominal meridian massage on the symptoms of constipation. Method: The subjects were determined by the Rome II criteria and the Constipation Assessment Scale from Aug 30 through Sep 26, 2002. They were randomly divided into two groups: one experimental group of 16, another control group of 15. Abdominal meridian massage was given to the experimental group and no massage was given to the control group. The frequency of defecation and severity of constipation by CAS were measured. The data was analyzed with the t-test, $x^2$-test, and repeated measures ANOVA. Results: There was a significant improvement in frequency of defecation, and severity of constipation in the experimental group compared to the control group. Conclusion: Abdominal meridian massage can be considered an effective nursing method for the management of constipation among CVA patients.

Purpose: This study was aimed at finding the effects of cycled lighting on body weight, physiological variables and the behavioral state of LBWI (low birth weight infants) in the NICU. Method: The subjects were 20 LBWI at 2 NICUs. They were assigned to an experimental or control group which consisted of 10 subjects in each. Cycled light was applied to the experimental group for 10 days. Result: It was certified that the application of cycled lighting resulted in increased body weight and O2 saturation, and decreased heart rate of the LBWI. However, there was no effect in decrease of respiration and stabilization of the behavioral state. Conclusion: The application of cycled lighting might be a nursing intervention which would in turn have positive effects on the growth of LBWI.

Purpose: The purpose of this study was to develop an empowerment program as a nursing intervention for mothers who care for a child with cerebral palsy at home and to determine the effects of the program on those mothers' self efficacy, coping behavior and burden. Method: An non-equivalent control group pretest-posttest design was used in this study. An Empowerment program was developed based on Dunst & Trivette's model. Using the program, the study was carried out from Dec. 13, 2003 to Jan. 17, 2004, mothers whose children, aged 1 to 6, were outpatients of the Dept. of Rehabilitation Medicine, at P University Hospital or registered at educational institutions for early disabled children. The experimental group of subjects were included in the new empowerment program which was held for two and half hours every week for 6 times. Results: After treatment with the Empowerment Program, the experimental group was found to be significantly increased in score for self efficacy(t=4.55, p<.01), coping behavior(t=5.54, p<.001), objective burden(t=-3.96, p<.01) and subjective burden(t=-5.05, <.01), in comparison to the control group. Conclusion: The Empowerment Program is very effective in increasing self efficacy and coping behavior of mothers having a child with cerebral palsy and decreasing their burden. Finally, this study would recommend that an empowerment program should be extended to community facilities such as public health offices and welfare centers.

Purpose: This study was conducted to develop and evaluate a Web-based program for the maternal role of primiparas who use the internet. Method: The study process was a systems requirements analysis, design and development of a program, program testing by experts, program implementation, and program evaluation by users. A nonequivalent control group non-synchronized design was used. The data was collected from October 5th, 2002 to February 24th, 2003. Result: 1. Based on inquiries into mothers' needs, a Web-based support program was developed. The program was then modified from feedback received from experts. 2. In a sub-scale analysis of mothers' perception of a baby, amenability and persistence was significantly higher in the intervention group. The differences in the mean score of maternal self-confidence and maternal satisfaction were significant. 3. Cyber counseling was done for a total of 73 cases and the most frequent problems for counseling were feeding and nutrition (28.8%), followed by baby care, and health problems. Conclusion: It was proven that a Web-based support program provided appropriate support to primiparas and was effective in promoting their maternal role. Therefore, this study suggests that a Web-based support program for primiparas can become a powerful nursing intervention on virtually all mother and infant health concerns.

purpose: The purpose of this study was to identify the effects of foot reflexology on nausea, vomiting and fatigue in breast cancer patients undergoing chemotherapy. Method: The research was a quasi-experimental study using a non-equivalent pre-post design and was conducted from Jan. 26, to Mar. 20, 2004. The subjects consisted of 34 patients with 18 in the experimental group and 16 in control group. A pretest and 2 posttests were conducted to measure nausea, vomiting and fatigue. For the experimental group, foot reflexology, which was consisted of 4 phases for 40 minutes, was given by a researcher and 4 research assistants. The collected data were analyzed by repeated measures ANOVA using the SPSS WIN 10.0 program. Results: There was a statistically significant decrease in nausea, and vomiting in the experimental group compared to the control group over two different times. In addition, there was a statistically significant decrease in fatigue in the experimental group compared to the control group over two different times. Conclusion: Foot reflexology was effective on nausea, vomiting and fatigue in breast cancer patients receiving chemotherapy in this study. Therefore, foot reflexology can be usefully utilized as a nursing intervention in the field of cancer nursing for breast cancer patients receiving chemotherapy.

Purpose: The purpose of this study was to investigate the effect of aromatherapy on pain, depression, and feelings of satisfaction in life of arthritis patients. Method: This study used a quasi-experimental design with a non-equivalent control group, pre-and post-test. The sample consisted of 40 patients, enrolled in the Rheumatics Center, Kangnam St. Mary's Hospital, South Korea. The essential oils used were lavender, marjoram, eucalyptus, rosemary, and peppermint blended in proportions of 2:1:2:1:1. They were mixed with a carrier oil composed of almond (45%), apricot(45%), and jojoba oil(10%) and they were diluted to 1.5% after blending. The data were analyzed using an 2-test, Fisher's exact test, t-test and paired t-test. Result: Aromatherapy significantly decreased both the pain score and the depression score of the experimental group compared with the control group. However, aromatherapy didn't increase the feeling of satisfaction in life of the experimental group compared with the control group. Conclusion: The result of this study clearly shows that aromatherapy has major effects on decreasing pain and depression levels. Based on our experiment's findings, we suggest that aromatherapy can be a useful nursing intervention for arthritis patients.

Purpose: This study was to identify the relationship between perceived stress, anger expression, and level of depression in cancer patients. Method: A cross-sectional descriptive study design was used. Data was collected by uestionnaires from 185 in- and out-patients who were diagnosed with cancer at 3 university hospitals and the National Cancer Center using Spielberger et al.’s Anger Expression Scale, Cohen, Kamarch & Mermelstein's Perceived Stress, and Derogatise's SCL-90. The data was analyzed using descriptive statistics, Pearson correlation coefficient, and stepwise multiple regression with SAS/PC. Result: The perceived stress in cancer patients indicated a significant positive correlation to anger-in(r=.288, p=.000), anger-out(r=.232, p=.001), and depression(r=.68, p=.000), but no significant correlation to anger-control. The anger-in of cancer patients showed a significant positive relationship to anger-out(r=.53, p=.000), and depression(r=.383, p=.000), but no significant correlation to anger-control. Anger-out showed a significantly negative correlation to anger-control (r=-.248, p=.001) and a positive correlation to depression (r=.240, p=.001). The most significant predictor which influenced depression in cancer patients was perceived stress, followed by anger-in and hobby, and these factors explained their depression with a variance of 54%. Conclusion: These results suggested that cancer patients with a high degree of perceived stress are likely to be high in anger-out and anger-in. Perceived stress and anger-in are major factors which affect depression in cancer patients.