Purpose: The purpose of this study was to identify the effects of a value clarification program on value clarification in juvenile delinquents. This study employed a two-group pre-post test study design. Data was collected from 16 subjects from Sept. 29 to Dec. 26, 2003 at N middle school in Seoul, Korea. 9 subjects constituted the control, while the experimental group was composed of 7 subjects. Method: The structured group therapy used in this study was developed on the basis of Raths et al. (1978) theory. The subjects participated in 10 sessions of therapy that lasted 60 minutes. The instruments used were value clarification Test (Lee, 1988), and SPSS Window. Result: The experimental group showed a significant increase in value clarification after their participation in the program. Conclusion: Based upon the findings it was concluded that a value clarification program was effective in improving value clarification in juvenile delinquents in the study.

Purpose: This study was aimed to examine how subjects' characteristics and nursing service quality influence hospital revisiting intent, to compare perceptions of patients with those of nurses, Method: The questionnaire was developed and distributed to 300 patients and nurses at six general hospitals in a provincial city, Korea, For data analysis, the SPSS/PC program was used. Result: The nursing service quality's scores of patients is 3.61, that of nurses is 3.77, and there is a significant difference. The hospital revisiting intent's score of patients is 4.84, that of nurses is 4.61, and there are no significant differences. In subjects' characteristics, patients perceive that the hospital is the only different factor, and place hospital revisiting intent at $3.6\%$. Nurses perceive that education level and position are different factors, and place hospital revisiting intent at $3.3\%$. In nursing service quality, patients perceive that 2 attributes explain hospital revisiting intent at $17.8\%$ and 2 factors explain it at $16.5\%$; whereas, nurses perceive that 2 attributes explain hospital revisiting intent at $15.3\%$ and 3 factors explain it at $12.2\%$. Conclusion: There are perception gaps between consumers and providers. So nursing and hospital managers must recognize these facts and provide various marketing strategies to overcome them.

Purpose: The purpose of this study was to determine the effects of foot reflexology on fatigue and insomnia in patients suffering from coal workers' pneumoconiosis. Method: This study was a quasi-experimental study of pre-test and post-test design in a non-equivalent control group. The subjects of this study consisted of both the experimental group of twenty-nine and the control group of thirty coal workers' pneumoconiosis patients. Data was collected from December 10, 2002 to February 15, 2003. Foot reflexology was performed for 60 minutes twice a week through five weeks in the experimental group, but none in the control group. To evaluate the effects of foot reflexology, the scores of fatigue and insomnia were measured before and after the experiment in both groups. Fatigue was evaluated by Fatigue Symptoms Inventory. Insomnia was measured with the visual analogue scale (VAS). Data of this experiment was analyzed by Chi-square test, t-test, unpaired t-test and Repeated Measures ANOVA with the SAS Program. Results: The scores of fatigue and insomnia decreased in the experimental group but not in the control group. There was a significant difference of fatigue and insomnia between the two groups. Conclusion: It is suggested that foot reflexology might have beneficial effects on reducing fatigue and insomnia in patients suffering from coal workers' pneumoconiosis, and can be recommended as a nursing intervention program for patients with coal workers' pneumoconiosis.

Purpose: The purpose of this research was to address the working conditions of home health nurses through a nationwide home health agency survey conducted at hospitals. Method: The mail surveys were sent to 303 home health nurses nation wide and returned with a response rate of $71.8\%$. Result: (a) Seventy-five percent of home health agencies were established within the past5 years and half of home health nurses are over 40 years old. (b) Working conditions were considered as follows: Seventy-one percent of respondents were full-time employees, sixty-sixpercent of home health nurses had unscheduled visits on a regular day of duty and forty-eight percent were on vacation. Fifty-one percent of home health nurses have experienced traffic accidents and paid. penalties ($65.9\%$). Self-reported monthly income level per year was an average of 28,364,000 won. (c) Rates were significantly higher for shoulder pain ($61.5\%$), lower back pain ($54.1\%$), knee pain ($39.4\%$), and gastrointestinal problems ($33.0\%$). Conclusion: These baseline results show the importance of improving home health nursing working conditions, a comprehensive prevention system and safeguards from physical discomfort.

Purpose: This study aimed at developing integrated clinical performance indicators(CPIs) through the analysis of quality improvement(QI) activities of a hospital and literature review about performance measures. Method: The CPIs were developed through the following three stages; 1)Identifying preliminary CPIs 2)A staff validity test in preliminary CPIs 3)Developing final CPIs. Result: One hundred twenty-three preliminary CPIs were developed through QI activities of the target hospital for 8 years and literature review. The results of the validity test for the preliminary CPIs supported ninety-one items. Sixty-two CPIs were selected through integration, reclassification and renaming. Then, eighteen items were deleted on account of an imprecise calculation method. Finally, forty-four CPIs were confirmed. They consisted of twenty-six items at the hospital level and eighteen items at the department level. Conclusion: CPIs can be used as criteria to evaluate the performance of healthcare organizations, and to decide the quality of healthcare for customers. This study may contribute to establishing an integrated system between QI activities and performance measurement of healthcare organizations.

Purpose: This study was to examine the effects of an exercise program for middle-aged obese women. Method: The exercise program combined folk dance and resistance training. The subjects group consisted of 85 middle-aged obese women between 40 and 60 years of age. Three 8 week sessions consisted of a $55-80\%$ maximum heart rate (MHR) exercise for 60-90 minutes a day and 3 times a week from March to November, 2004. Data was collected through a pre- and post-exercise test before and after each session. Data was collected with Inbody, dynamometer and blood. This data was analyzed by descriptive statistics, and a paired t-test with an SPSS/PC(10.0 version) program. Results: There were significant positive changes in body weight, body fat mass, body mass index, percent body fat, muscle strength, muscle endurance, flexibility, and balance quality, but no significant positive changes in skeletal mass, fat free mass, percent abdominal fat(waist-hip ratio), visceral fat area, agility, total cholesterol, high density lipoprotein cholesterol, or triglycerides. Conclusion: This study showed that an exercise program has partially positive effects for middle-aged obese women. The results of this study show that exercise at community health centers should continue for middle-aged obese women's health.

Purpose: This study was aimed to evaluate the effect of an internet community on knowledge, self-efficacy, and self-care behavior in workers with hypertension. Method: The research design used was a nonequivalent control group pre-test and post-test design. Sixty hypertensive workers participated in this study(Exp.=29, Cont.=31). The data was collected from the 3rd of November 2003 to the 27th of February 2004 using an interview with questionnaires. Information related to hypertension was provided on the internet community weekly and an e-mail newsletter was sent in order to increase participation in the internet community. We used a tool developed by Park Young-Im(1994) that measured knowledge related to hypertension and self-efficacy. A tool developed by Jung Mi-Young(2001) was used for self-care behavior. The collected data was analyzed with an $x^2-test$ and t-test using the SPSS WIN 10.0 program. Result: The internet community helped workers with hypertension to increase their knowledge related to hypertension, as well as increasing their self-efficacy and self-care behavior. Conclusion: An internet community could be applied as hypertensive nursing intervention.

Purpose: This study was amied to identify the effects of a 12 week Korean traditional dance movement program on balance, depression, medical cost, medical institution's utilization and fall among elderly women. Methods: Using a quasi-experimental design, the experimental group was composed of 130 subjects and the control group was composed of 123 subjects. The experimental group participated in a 12 week Korean traditional dance movement program 3 times a week from December 2002 to February 2003. Data was analyzed with descriptive statistics, the chi-square test, paired t-test and t-test. Results: There was siginificant improvement in balance(right leg p=.000, left leg p=.004), depression(p=.000), and the medical institution's utilization(p=.001) and fall(p=.002) in the experimental group compared to the control group. Conclusion: A Korean traditional dance movement program improved balance, depression, and decreased fall and medical cost in elderly women. Therefore, we recommend this program be utilized as a health promoting program and falls preventing program for the elderly in the community.

Objectives: This study was designed to investigate the effect of delivery nursing care using essential oils on labor stress response, labor anxiety and postpartum status anxiety for primipara. Methods: This study used nonequivalent control group pretest-posttest design. The subjects of this experiment consisted of forty eight primipara with single gestation, full term, & uncomplicated pregnancies. Twenty four primipra were in the experimental and control group each. Their mean age was 27.9 years old, their mean gestation period 279.9 days. As a treatment, delivery nursing care using essential oils was applied by nurses. Data collected epinephrine, norepinephrine, anxiety during labor. In the 24 hours after birth, the data for the postpartum mother's status anxiety was collected. Data was analyzed by t-test, repeated measures ANOVA, Mann-Whitney U test, & Wilcoxon signed ranks test with SPSS Program. Results : Plasma epinephrine, norepinephrine were significantly low in the experimental group (P=0.001, P=0.033, respectively). There was no significant difference between the two groups in anxiety during labor and postpartum mother's status anxiety. Conclusion : These findings indicate that delivery nursing care using essential oils could be effective in decreasing plasma epinephrine, norepinephrine. But, that could not be verified in decreasing mother's anxiety.

Purpose: This study was done to evaluate the predictive value of aspects of the Transtheoretical model (TTM) of behavior change as applied to smoking cessation in a rural population. Method: A convenience sample was recruited from a public health center in a community. A total of 484 participants were recruited, including 319 smokers, 116 ex-smokers and 49 non-smokers. A cross-sectional and descriptive design was used in this study. Data was analyzed using descriptive statistics, frequency statistics, ANOVA and Logistic regression. Result: The major findings were 1) The participants were assessed at baseline for their current Stage of Change resulting in a distribution with $42.1\%$ in Precontemplation, $24.1\%$ in Contemplation, $9.7\%$ in Preparation, $6.2\%$ in Active, and $17.9\%$ in the Maintenance stage. 2) There were statistically significant differences of processes of change, decisional balance and situational temptation across the stages of change. 3) The main factors that affect smoking cessation were age, number of years smoking, age when began smoking, self-liberation and negative/affective situations, which combined explained $33.2\%$ of the smoking cessation. Conclusion: TTM variables measured prior to a smoking cessation program added little predictive value for cessation outcome beyond that explained by demographic and smoking history variables.

Purpose: This study was to determine the effects of abdominal breathing training using biofeedback on stress, immune response, and quality of life. Method: The study design was a nonequivalent control group pretest-posttest, quasi-experimental design. Twenty-five breast cancer patients who had completed adjuvant chemotherapy were enrolled. The experimental group(n=12) was provided with abdominal breathing training using biofeedback once a week for 4 weeks. State anxiety, cancer physical symptoms, serum cortisol, T cell subsets(T3, T4, T8), NK cell and quality of life were measured both before and after the intervention. Result: Though state anxiety, cancer physical symptoms, and serum cortisol were reduced after 4 weeks of abdominal breathing training using biofeedback, there was no statistical significance. It showed, however, improvement in quality of life (p=.02), and T3(p=.04). Conclusion: Abdominal breathing training using biofeedback improves quality of life in breast cancer patients after a mastectomy. However, the mechanism of this beneficial effect and stress response requires further investigation with special consideration in subject selection and frequency of measurement. Nurses should consider this strategy as a standard nursing intervention for people living with cancer.

Purpose: The purpose of this study was to evaluate the effects of a sex education program, which was based on the Health Belief Model, on knowledge related to sexually transmitted diseases and sexual autonomy among university students. Method: A non-equivalent control group, pretest-posttest design was used. The four session program was delivered to 18 students during 4 weeks; the control group consisted of 23 students. The theme of the first session was 'sex, gender, and sexuality: all our concern', 'dangerous sex' for the second session, 'safe sex' for the third session, and 'right sex for you and me' for the fourth session. Result: At follow-up, the knowledge related to sexually transmitted diseases and sexual autonomy were significantly greater in the intervention group than in the control group. Conclusion: A sex education program with several sessions within the theoretical frame of HBM was effective to improve knowledge related to sexually transmitted diseases and sexual autonomy. The results suggest the potential of a systematic sexual education program to teach healthy sex and to extend the program for other various populations.

Purpose: The purpose of the study was to identify the effects of problem solving nursing counseling and intensified walking exercise on diabetic self-care, coping strategies, and glycemic control among older adults with DM type II. Method: Ninety nine DM patients who were older than 50 were recruited from DM clinics or public health centers and conveniently assigned into three groups: the Polar(n=41), counseling(n=30) and control groups (n=28). Participants in both Polar and counseling groups attended weekly problem solving nursing counseling for 12 weeks. Polar heart rate monitors were used in the Polar group to intensify walking exercise. Data was collected from November 2003 to August 2004 and analyzed by ANOVA or ANCOVA using the SPSS WIN program. Result: After a 12 week intervention, participants in both the Polar and counseling groups reported increased diabetic self care behaviors and decreased blood glucose levels, which is significantly different from those in the control group. There were no distinctively different program effects between the Polar and counseling groups. Conclusion: Based on the findings, we concluded that problem solving counseling alone could have positive effects on diabetic self care and glycemic controls for older adults with DM. Future research is needed to identify long-term effects of the program.

Purpose: This study was designed to examine the effects of abdominal meridian(Kyongrak) massage on menstrual cramps and dysmenorrhea. Method: Eighty-five women (of 110 screened) enrolled in this study and were employed full-time with more than 6.0 points(in $0\~10.0$ VAS scale) in menstrual cramps or more than 20 points on the dysmenorrhea scale(range $13\~52$). The forty-two participants in the experimental group received abdominal meridian massage for 5 minutes per day during 6 days from the fifth day before menstruation to the first day of menstruation and the forty-three participants in the control group didn't receive any treatment. Data were collected from June 1st to August 30th, 2003 and analyzed using descriptive statistics, $x^2-test$, and t-test. Result: Menstrual cramps and dysmenorrhea of the experimental group were significantly lower after abdominal meridian massage than those of the control group (p<.001). Conclusion: Abdominal meridian(Kyongrak) massage was very effective for relief of menstrual cramps and dysmenorrhea. Therefore, we suggest that abdominal Kyongrak massage can be a useful nursing intervention for women with menstrual cramps or dysmenorrhea.

Purpose: This paper was aimed to inquire into Ricoeur's self -hermeneutics and narrative ethics, and apply it to personal identity constituting caring and care ethics in the practice of nursing. Its purpose is to provide a philosophical foundation for caring in nursing. Method: According to Ricoeur's narrative identity, ontological caring was interpreted as personal identity constituting caring. His ethics were described as care ethics, which contributed to preserving and promoting the personal dignity of the client, as self in search for the good life in the nursing practice. Results: Narrative understanding of the client pointed to the ontological role of care in the constitution of personal identity. From an ethical aspect of the narrative, respect for personal identity and personal dignity of the client was crucial to an ethical caring attitude, promoting self-esteem in the nursing practice. Conclusion: This paper suggested that Ricoeur's ethics could provide a philosophical basis for understanding ontological and ethical caring in nursing. This contributed to protection of the client from the threat of personal identity, as well as respecting their personal dignity.

Purpose: This study was designed to identify the degree of self-image and social support among Korean-Chinese adolescents and investigate the relationship between these variables. Method: A total of 621 Korean-Chinese adolescents in five middle schools in YanBian, China were recruited from March 1st to the 9th, 2005. Data was analysed using descriptive statistics, Pearson correlation coefficient, t-test, and ANOVA with the SPSS 11.5 program. Result: In Korean-Chinese adolescents, the total self-image score was statistically different for age, parents' education status, parents' job and living with parents. In the 12 subscales, scoresof emotional tone, impulse control, sexuality, social functioning, vocational attitudes and self-reliance had significant differences between groups regarding gender. The total self-image was in the average range. However, areas of mental health and family function were lower than average and the scale of idealism washigher than average. The adolescents perceived parent's support was higher then friend's support. There was a positive correlation between self-image and social support. Conclusion: The findings suggest there is a need to examine self-image and social support of Korean- Chinese adolescents according to their parents' marital status and a need to develop a program to help these broken family's adolescents.

Purpose: This study was done to provide fundamental data for developing a depression prediction model by discovering main factors that affect depression in patients who do maintenance hemodialysis. Method: The subjects were 191 patients doing maintenance hemodialysis selected from outpatient dialysis clinics at 9 major general hospitals, The Instrument tools utilized in this study were adapted from depression, fatigue, sleep disturbance, stress, adaptation, symptoms, daily activities, and role limitation and thoroughly modified to verify reliability and validity. The collected data was analyzed with a SPSS-PC 11.0 Window Statistics Program for real numbers, percentage, average, standard deviation, and multiple regression. Results: The correlation factor for depression was (M=2.54) fatigue(M=3.12), sleep disturbance (M=2.82), stress(M=3.04), adaptation(M=2.53), daily activities(M=2.24), symptoms(M=2.37), and role limitation(M=2.24). The strongest factor that affected depression was explained by symptoms of the patients who performed hemodialysis. The analysis of the factors that affected depression revealed a $58.4\%$ prediction in symptoms, stress, role limitation, and adaptation. Conclusion: It has been confirmed that the regression equation model(Depression=7.351 + .266$^{\ast}$symptoms + .260$^{\ast}$stress -.l89$^{\ast}$adaptation + .057$^{\ast}$fatigue) of this research may serve as a prediction factor for depression in Hemodialysis Patients.

Purpose: The purpose of this study was to identify the degree of attaining a smoking cessation goal when an agreement on means to achieve smoking cessation among male college student smokers was established. Method: This study was planned as a nonequivalent control group non-synchronized design and the sample was divided into an agreement group and a comparison group by convenience sampling in a college of G city. The data was analysed with SPSS Win10.0 using a Likelihood $x^2-test$, Odds ratio, Paired t-test and ANCOVA. Result: The theory that the degree of smoking cessation will be higher in the agreement group than the Comparison group was rejected (${\delta}$ = 2.567, p = .055). The theory that nicotine dependency will be lower in the agreement group than the comparison group was supported (F = 3.965, P = .049); however, the theory that the number of cigarettes smoked per day will be lower in the agreement group than the comparison group was rejected (F = 1.342, p = .252). Conclusion: It has been shown that an agreement on means to achieve smoking cessation goals is a key factor to success in quitting smoking.

Purpose: This study was designed to examine the relation of trait anger and anger expression to blood pressure, cholesterol, and depression in middle-aged Korean women. Methods: This descriptive correlational design was conducted using a convenient sample taken from the health center of K University Hospital located in Kyungki province, Korea. The subjects were 252 women aged 40 to 64 years. Spielberger's state trait anger expression inventory - Korean version and Beck's depression inventory were used for measuring trait anger, state anger, anger expression and depression. Data was analyzed by descriptive statistics, t-test, Pearson correlation, two-way ANOVA, and cluster analysis using a pc-SAS program. Results: The anger expression types by cluster analysis were Anger out/in type, Low anger expression type, and Anger control type. The level of cholesterol and depression were significantly higher in women with high anger in and high trait anger. In addition, the level of depression was significantly higher in women with a high anger temperament. Conclusions: Trait anger and anger in might be related to cholesterol and depression in women. However, this study does not reveal the relation between blood pressure and trait anger and anger expression.

Purpose: This study was performed to evaluate and compare health conservation and its related factors of elders in assisted living facilities or nursing homes. Method: Data for health conservation was collected from 316 elders in 10 institutions in Daegu city and Kyungpook province from February 1st to February 22nd, 2005. Data was collected by a structured questionnaire that included general characteristics, general health status, health conservation, functional health status (ADL, IADL) and depression (GDS-K) scales. The collected data was analyzed by the SPSS (version 11.5) program including descriptive statistics, t-test, -test, Pearson's correlation and stepwise method regression analysis. Result: The elders in assisted living facilities revealed lower scores in health conservation, ADL and IADL than the elders in nursing homes. Predictable variables influencing health conservation of the elders in assisted living facilities were depression and MAC (Mid-Arm Circumference) that is equal to .270, and the the elders in nursing home were depression, IADL, degree of sleep, and TSF (Triceps Skin Fold) that is equal to .409. Conclusion: The development of a health conservation program and long-term health care service system for elders in assisted living facilities are needed than for the elders in nursing homes.

Purpose: The purpose of this study was to determine the effect of EPMLM(educational program of manual lymph massage) on the arm functioning and QOL(quality of life) in breast cancer patients with lymphedema. Method: Subjects in the experimental group(n=20) participated in EPMLM for 6 weeks from June to July, 2005. The EPMLM consisted of training of lymph massage for 2 weeks and encourage and support of self-care using lymph massage for 4 weeks. The arm functioning assessed at pre-treatment, 2weeks, and 6weeks using Arm functioning questionnaire. The QOL assessed at pre-treatment and 6 weeks using SF-36. The outcome data of experimental group was compared with control group(n=20). The collected data was analyzed by using SPSS 10.0 statistical program. Result: The arm functioning of experimental group was increased from 2 weeks after(W=.224, p=.011) and statistically differenced with control group at 2 weeks(Z=-2.241, p=.024) and 6 weeks(Z=-2.453, p=.013). Physical function of QOL domain increased in experimental group(Z=-1.162, p=.050), also statistically differenced with control group(Z=-2.182, p= .030) at 6weeks. Conclusion: The results suggest that the educational program of manual lymph massage can improve arm functioning and physical function of QOL domain in breast cancer patients with lymphedema.

Purpose: Infants at neonatal intensive care units (NICU) are invariably exposed to various procedural and environmental stimuli. The study was performed to compare the pain responses in three NICU stimulants and to examine the clinical feasibility for NICU infants using CRIES, FLACC and PIPP. Method: In a correlational study, a total of 94 NICU stimulants including angio-catheter insertions, trunk-rubbings and loud noises, was observed for pain responses among 64 infants using CRIES, FLACC and PIPP. Results: A significant difference was identified among the mean scores in CRIES($F_{(2, 91)}$=47.847, p=.000), FLACC($F_{(2, 91)}$=41.249, p=.000) and PIPP($F_{(2. 91)}$=16.272, p=.000) to three stimulants. In a Post-hoc Scheff test, an angio-catheter insertion showed the highest scores in CRIES, FLACC and PIPP compared to the other two stimulations. A strong correlation was identified between CRIES and FLACC in all three stimulations(.817 < r < .945) while inconsistent findings were identified between PIPP and CRIES or FLACC. Conclusions: The results of the study support that CRIES and FLACC are reliable and clinically suitable pain measurements for NICU infants. Further studies are needed in data collection time-point as well as clinical feasibility on PIPP administration to assess pain response in infants, including premature infants.

Purpose: This study identified and compared influential variables on intention and action to quit smoking between adolescent smokers and adult smokers. Methods: For the selection of variables, the transtheoretical theory was used. A survey was conducted with 376 adolescent smokers in 4 high schools and 451 adult smokers in community settings in South Korea. Discriminant analysis was used for data analysis Results: The variables of adolescent smokers that predicted an intention to quit smoking were: smoking temptation, self re-evaluation, counter conditioning and stimulus control. The variables that predicted an action to quit smoking were: self-efficacy for smoking abstinence, pros for smoking, self reevaluation, and self liberation. The variables of adult smokers that predicted an intention to quit were: smoking temptation, pros for smoking, cons for smoking, self reevaluation. The variables that self liberation and predicted an action to quit smoking were: self efficacy for smoking abstinence, smoking temptation, and counter conditioning. Conclusions: Developing stage specific smoking intervention methods based on different ways of how individuals make a decision to quit smoking within their contexts needs to be done.

Purpose: We try to disclose how much the keywords of the papers from the Journal of the Korean Academy of Nursing coincide with MeSH terminologies and to understand the major subjects of the recent nursing research in Korea from keywords. Methods: Keywords of journals were extracted and compared with MeSH terms. The frequency of the appearance of each keyword was sorted by a descending order. Results: Coincidence rate of 1,235 keywords with MeSH terms was $51.6\%$. Out of them, depression, elderly, stress, self efficacy, quality of life, exercise, middle-aged women, and women appeared most frequently in descending order. Conclusion: Coincidence rate of the keywords with MeSH terms was at an acceptable level, however to improve it, the education of submitters and editorial board members are required, as well as the copy editor, to take a role in checking keywords. To infer the subjects of the research from keywords might well represent the recent topics of research work.