The purpose of this study was to identify the perception of nurse experts on the contribution of nursing interventions to Nursing Outcomes Classification NOC nursing outcomes. A nursing outcome is a nursing-sensitive patient outcome primarily affected by nursing interventions. As one of the standardized language systems of nursing outcomes, the NOC must be examined for applicability before it is used in Korea. Data were collected in February and March 2003 using a 5-point Likert scale. For data collection, 230 quality improvement (QI) or quality assurance (QA) nurses from general hospitals in Korea were asked to rate the extent that nursing interventions contribute to each of the NOC nursing outcomes (2000) in their hospitals. Ninety-six nurses from 63 hospitals responded and the response rate was $41.7\%$. Mean scores for perception of contribution of nursing interventions to each of the NOC nursing outcomes ranged from 2.18 to 4.54. Vital Signs Status had the highest score (M = 4.54), and Abuse Recovery: Financial, the lowest score (M = 2.18). Of the seven NOC domains, the mean score was highest for Physiologic Health (M = 3.91) and lowest for Community Health (M = 2.92). Of the 29 NOC classes, the mean score for perceived contribution was highest for Metabolic Regulation (M = 4.32) and lowest for Community Well-Being (M = 2.92). Participants perceived that nursing interventions in general hospitals in Korea contributed, at least to a certain extent, to most of the NOC nursing outcomes. Based on these results, NOC should have relatively good applicability in Korea.

Purpose. Nursing research is recognized as an essential basis for the continuous development of the scientific nursing knowledge and practice. An understanding of the barriers and attitudes to research among nurses is important to improve clinical nursing research activities. Method. Data were collected from nurses at a general hospital, located in D city, using a self-reported questionnaire, from March 15th to April 4th, 2003, and 133 questionnaires were used for the analyses. A 5 point-scale instrument was used to measure barriers and attitudes towards nursing research, with a Cronbach's alpha of .85 and .89, respectively. Results. Nurses had limited experience in research and were not well prepared to conduct it. Lack of experience, training and time were the major barriers for conducting research. However, the nurses had positive attitudes toward research. There was a difference in barriers (t = 2.68, P = .02) and research attitudes (t =- 2.74, P = .00) according to the nurses' position. Also, the nurses' research experience influenced research attitudes (t = -3.27, P = .00). The degree of research preparation (F = 6.98, P = .00) had an effect on the attitudes toward nursing research but not on the barriers. Conclusion. There is an urgent need to promote both the ability and environment for clinical nurses to actively participate in research. As the majority of nurses had little experience and low confidence in research and perceived many barriers, this promotion can be accomplished by enhancing their confidence in research through continuing education and by gradually eliminating the barriers to research.

Purpose. This correlation study was undertaken to examine the relationships between daily life stress, self-efficacy and university student life adjustment and to analyze the self-efficacy affecting that university student life adjustment. Methods. 265 university students were recruited from several participating required undergraduate classes. They were surveyed as the subject of this study. Data collection was conducted through the use of questionnaires. Results. The university life adjustment level showed a maximum score of 9 with the mean score 5.22. A negative correlation was found between daily life stress and university life adjustment. Also, there was positively correlation between self-efficacy and university life adjustment. Self-efficacy and daily life stress accounted for $23\%$ of the variance in university student life adjustment. Conclusion. According to the results, self-efficacy is a useful concept in helping overall university life adjustment. Therefore, university student consultation office or nurse should consider the program based on self-efficacy in order to help university students to better adapt to university life.

Introduction. Cardiovascular disease has the potential to lead to sudden in-flight incapacitation and permanent grounding. The aims of this study are to examine the relationships between lifestyle, job stress and blood lipid levels of male aircrew personnel of a Korean airline and to identify which factors influence their hyper-lipidemia. Methods. Two hundred sixteen male aircrew personnel completed a questionnaire by self-report and consented to participate in the study. The questionnaire collected data related to job stress, life style, serum cholesterol levels and general characteristics of the aircrew. The cholesterol levels of the subjects were collected from their most recent health check-up records. Subjects were divided into two groups (the desirable group and the risk group) based on their serum cholesterol level, 200 mg/dl. Results. Mean age and marital status were significantly different between the two groups. More subjects in the risk group had habits of eating high lipid foods, while more subjects in the desirable group exercised more frequently than the risk group. In logistic regression analysis, after controlling age and marital status, types of working situation (domestic duty or international duty, odds ratio=.390, p=.018), diet (odds ratio=.429, p=.037), and exercise (odds ratio=.320, p=.055) were influencing factors on aircrew's serum cholesterol lev-els. Conclusions. The cholesterol level of aircrew personnel is closely related to their lifestyle, such as lipid diet and exercise. The type of work situations, e.g. staying in an airplane for long periods of time or staying abroad, may influence these diet patterns and exercise habits.

Purpose. The purpose of the study was to categorize nursing students' subjectivity in their attitude toward their jobs, and thereby understand the differences among these attitude types. Methods. The study used a Q-method to measure nursing students' attitude toward jobs identity types. In-depth and objective interviews and literature review formed Q sample. The P sample consisted of 25 nursing students. Results. The results of the study show that nursing students can be categorized into three types, depending on their attitudes toward their jobs. The firs type, 'interest-oriented' students, strongly disagree to the follow-ing: giving priority to job over marriage, standing unfair treatment in the workplace, the importance of pro-motion opportunity, irresponsibility, and uncertainty. The 'reward-oriented' students, on the other hand, strongly disagree to the following: indifference to career prospects, employment-related relocation of residence, irresponsibility, standing difficulties, and compromises with others. The third type of nursing students is the possession-oriented students, who strongly disapprove of irresponsibility, refusal to compromise with reality, standing unfair job allocation or promotion and career uncertainty. Conclusions. The study on nursing college students' attitude toward their jobs is meaningful in the following aspects: First, the study clarifies nursing college students' attitudes toward their job by categorizing it. Second, the study confirms the changing attitudes of nursing students toward jobs with the change of times and calls for proper educational programs to foster healthy career attitudes. Third, proper decision-making as regards jobs and job allocation for nurses, or their career attitudes, is beneficial to individuals, the medical industry, and society.

Purpose. This study was designed to examine the effect of asthma management education program applied to allergic asthma patients receiving immunotherapy due to house dust mite on their stress and compliance with health care regimens. Methods. A quasi experimental design with non-equivalent control group and non-synchronized design was used. The subjects of this study were 61 patients who were receiving immunotherapy at intervals of a week after their symptoms were diagnosed as house dust mite allergic asthma at the pulmonary department of a university hospital in Seoul. They were divided into an experimental group of 29 patients who received asthma management education and a control group of 32 patients. The asthma management education pro-gram was composed of group education (once) and reinforcement education (three times) with environmental therapy and immunotherapy to house dust mite. Results. Stress significantly decreased in the experimental group compared to that in the control group. Compliance with health care regimens significantly increased in the experimental group compared to that in the control group. Conclusions. The results suggested that the asthma management education program is effective for the management of stress and the improvement of compliance in patients with allergic asthma to house dust mite.

Purpose. The purpose of this study was to determine the relationship between peer and parental factors and smoking behavior of adolescents in urban cities and to investigate whether there are gender differences. Methods. A stratified and random cluster sampling design was used to obtain a cross-sectional sample of high school students in two urban cities. The sample consisted of 512 Korean adolescents (256 boys and 256 girls) aged 15 to 18 (mean age 16.7$\pm$.58). Self-reported questionnaire consisted of adolescent smoking behavior, peer smoking and alcohol use, parental smoking and alcohol use, father-mother-peer relationships and perceived social support from peers and parents. Multiple logistic regression analysis was used to examine the hypothesized model. Results. The findings showed that peer and parental factors accounted for $30.3\%$ of the variance in adolescent smoking and peer smoking was most strongly associated with adolescent smoking behavior (OR = 10.18). In addition, peer smoking (OR = 4.71), peer alcohol use (OR = 4.21), and peer relationships (OR = 1.03) were significantly associated with boys' smoking behavior. In girls, peer smoking (OR = 26.50) and parent smoking (OR = 5.48) were significantly associated with smoking behavior. Conclusions. Consistent with previous findings, peer smoking is a significant factor on adolescent smoking. Specifically, boys would be more influenced from peers than girls. Therefore, smoking prevention programs for adolescents might be focused on the social context such as, resisting to peer pressure and enhancing the self-efficacy to control.

Purpose. This study examined the characteristics of fatigue and the relationship between fatigue and its related factors in Korean patients on hemodialysis. Methods. A cross-sectional correlational study was conducted with 104 patients on hemodialysis in Seoul, Korea. Finding. Of a total of 104 subjects, eighty-one ($77.9\%$) complained of fatigue. Fatigue severity was measured by the self-rating Visual Analogue Scale-Fatigue (VAS-F) with a mean score of 36.5 (SD = 17.49, range 2 - 81). The mean duration of fatigue was 3.8 hours (SD = 5.3, range 0 - 24). Depression was most significantly correlated with fatigue (beta = .43, p<.00), with interdialytic weight gain (beta = .25, p<.05) being the second most significant correlate. Conclusion. This study shows that nursing interventions for patients who experience fatigue while on hemodialysis should be focused on both psychological problems, such as depression, as well as on physiological problems, such as interdialytic weight gain.

Purpose. The purpose of this study was to obtain a clearer understanding of spirituality and examine the process of spirituality through defining the meaning and attributes of spirituality. Method. Concept analysis was done in the three phases, theoretical phase, fieldwork phase, and analytical phase suggested in the Hybrid Model. Five people participated in the fieldwork phase. Results. Spirituality is activated through self-awareness which occurs as spirit being activated through self-introspection, and through restoration of the relationship with Supreme Being. This interconnectedness with Supreme Being has an absolute impact on one's harmonious interconnectedness with self and neighbors, thus leads all the critical attributes of spirituality to be revealed. The core energy of this harmonious inter-connectedness is love. When activated, it has a great impact on an individual as integrative energy, leads one to go beyond everyday experience as well as to have new perspectives, and to live a satisfactory life in every aspect. Conclusion. The results of this study suggest that promotion of connectedness is the most important element in spiritual nursing interventions. The results can also be used effectively in developing spirituality assessment scales and theory.

Purpose. This cross-sectional survey was conducted to described the compliance of Breast Self-Examination of middle-aged women using a convenient sample, and to examine relationships between the compliance of BSE and Health Beliefs, and the influencing factors on the compliance of BSE. Methods. The subjects were 373 literate volunteers who were from 41 to 60 years of age who visited 6 public health centers. From June 7, 2004 to August 20, 2004, data were collected by 5 research assistants using a self-report questionnaire. The questionnaire was used to obtain information on the general characteristics, knowledge, health beliefs, and compliance of BSE. Results. The findings of this study suggested that there were significant differences in the scores of the perceived susceptibility and severity between compliers and non-compliers of the BSE. BSE compliance was significantly correlated with knowledge, perceived susceptibility, and perceived severity. The most powerful predictor of BSE compliance was the perceived susceptibility. The perceived susceptibility, the perceived severity, the knowledge and educational level accounted for $41.8\%$ of the variance in middle aged women's BSE compliance. Conclusion. Increase in knowledge about breast cancer, with a concomitant increase in both perceived susceptibility and perceived severity could produce a subtle cue or motivating force sufficient to affect a behavior change. Further research is needed to examine the qualitative difference between BSE and other early detection behaviors.

Purpose. The purpose of this study was to identify direct, mediating, and moderating relationships of mood disturbance, symptom experience, and attentional function in Korean women with breast cancer based upon a middle-range theory of unpleasant symptoms. Methods. This study used a cross-sectional, correlational design. A convenience sample of 125 women receiving chemotherapy for breast cancer was recruited from a university hospital in South Korea. The women completed questionnaires on mood disturbance, symptom experience, and attentional function using the Linear Analogue Self-Assessment Scale, the Symptom Experience Scale, and the Attentional Function Index, respectively. Results. Each mood disturbance and symptom experience showed a significant relationship with attentional function. Symptom experience did not act as a mediator between mood disturbance and attentional function, but it did act as a moderator: patients with a higher level of mood disturbance exhibited a lower level of attentional function when their symptoms were at the level of medium, but not when their symptoms were either high or low. Conclusion. This suggests that clinical interventions for attenuating the influence of mood disturbance on attentional function may be effective only in women experiencing medium level of symptoms.

Purpose. This study was done to identify and test a model of the psychosocial variables that influence adherence to therapeutic regimens in patients with hypertension. Method. A convenience sample of 219 patients with hypertension who were enrolled in an outpatient clinic of a cardiovascular center in Korea participated in the study. They completed self-administered questionnaires anonymously. The questionnaire was based on the Social Action Theory model and a literature review. The explanatory model was constructed and tested using structural equation modeling in order to examine the effects within the model. Results. The results of this study showed that perceived self-efficacy was the strongest factor influencing patient adherence in this sample. Adherence to therapeutic regimens in patients with hypertension was influenced by self-efficacy, patient-provider relationship, social support, and depression. Conclusions. Adherence to therapeutic regimens in patients with hypertension was most strongly influenced by self-efficacy. These findings suggest that nursing interventions to promote patient adherence should focus on the promotion of self-efficacy including improvement in patient-provider relationship and social support, and reduction in depression.

Purpose. The purposes of this study were to 1) describe the type and frequency of aggressive behavior of cognitively impaired nursing home resident, 2) develop a caregiver training program on prevention and management of aggressive behavior, 3) examine the effects of caregiver training program on the incidence of aggressive behavior of cognitively impaired nursing home resident, and 4) examine the effects of caregiver training program on nursing staff's aggressive behavior management skills. Methods. One-group, time series, quasi-experimental design with a pre-test and two post- tests was used. Data were collected from cognitively impaired home residents (N = 32) and nursing staff (N = 36) in a proprietary nursing home using Ryden Aggression Scale I, II, and Aggressive Behavior Management Scale. Data were entered and analyzed by descriptive statistics and repeated measures ANOVA. Results. Incidence of aggressive behavior was high with a mean score of 3.09 (SD = 3.11) at baseline. Caregiver training program was developed based on Progressively Lowered Stress Threshold (PLST) model and gerontological and psychiatric literature. The mean scores of aggressive behavior at baseline, Post I, and II did not differ significantly although the difference approached to the significant level (F = 2.925, p = .066). Nursing staff's aggressive behavior management skills increased at Post I, and at Post II when compared to baseline, and the difference was significant (F=12.736, p=<.00l). Conclusion. Caregiver training program showed potential impact on reduction of aggressive behavior in elders with cognitive impairment and was effective in increasing nursing staff's aggressive behavior management skills.