Purpose. The purposes of this study were 1) to examine the differences in suicidal ideation and psychological variables by gender, 2) compare the contribution of demographic-behavioral variables and psychosocial variables in explaining the variance in suicidal ideation, and 3) identify the most important predictors of suicidal ideation for male adolescents and female adolescents. Methods. The subjects consisted of 271 male adolescents and 230 female adolescents. Data were collected through self-report questionnaires, which were constructed to include SSI-C, DEP subscale of the SCL-90-R, PACI, and SWLS. The data were analyzed by the SPSS/WIN program. Results. Suicidal ideation differed by gender. Depression and family communication differed by gender. The unique contribution of demographic-behavioral variables and psychosocial variables in explaining the variance in suicidal ideation differed between male adolescents and female adolescents. The significant predictors of suicidal ideation for male adolescents were life satisfaction, depression, and family communication, explaining $28\%$ of the variance in suicidal ideation. The significant predictors of suicidal ideation for female adolescents were depression, smoking, and life satisfaction, explaining $38\%$ of the variance in suicidal ideation. Conclusion. The findings of this study suggest that the approach to effective suicide prevention program for adolescents should consider gender differences.

Purpose. The study was conducted to identify predictors of mammography screening for rural Korean women according to 'Stage of Change' from the Transtheoretical Model which, along with the Health Belief Model, formed the theoretical basis for this study. Methods. A cross-sectional descriptive design was utilized. Through convenience sampling 432 women were selected from 2 rural areas. Data were collected by survey. Health beliefs constructs were measured with Champion's HBM Scale-Korea version. Mammography participation was measured using the Stage of Mammography Adoption Scale developed. by Rakowski, et al.(1992). Results. The most frequent stage of mammography adoption was 'contemplation' ($40.5\%$). Predictors of stage of mammography adoption included 'mammogram recommended by health professional' (beta==0.59, t=16.12, p=.000), 'perceived benefits' (beta=0.09, t=2.21, p=.050), 'perceived susceptibility' (beta=0.09, t=1.98, p=.050), and 'perceived barriers' (beta=-0.07, t=-2.05, p=.041). 'Mammogram recommended by health professional' demonstrated the greatest association with having a mammogram. Conclusion. Health professionals play key roles in improving mammography participation and should recognize the importance of their role in cancer prevention and be more actively involved in education and counseling on prevention of breast cancer.

Purpose. The purpose of this study was to evaluate the premature infants' responses to infant massage (tactile and kinesthetic stimulation). These responses measured by weight, physiological (vagal tone, heart rate, oxygen saturation) and behavioral responses (behavioral states, motor activities, and behavioral distress). Methods. This study was conducted using an equivalent control pretest-posttest design. The sample was divided into two groups of 13 infants with gestational age less than 36 weeks at birth, birth weight less than 2000g, and no congenital anomalies. The experimental group received the massage intervention twice daily for 10 days. The data were collected for 10 minutes prior to and 10 minutes after the massage. Results. The vagal tone was significantly higher after massage than before massage in the experimental group, while no change in the control group. The experimental group had significantly higher scores for awake state and motor activity than the control group. Significantly greater awake state, more fidgeting or crying, and increased motor activity were reported after massage than before massage. Conclusions. The results of this study showed that massage therapy might enhance optimal physiological responses and behavioral organization of premature infants. Nursing staff in the NICU can use massage to promote the infant's capability to respond positively to his environment and to provide developmental support for healthy premature infants.

Purpose. The main purpose of this critical ethnography was to examines the process and discourses through which family caregivers experience while caring for their sick family member in a hospital. Methods. This was achieved by conducting in-depth interviews with 12 family caregivers, and by observing their caring activities and daily lives in natural settings. The study field was a unit for neurologic patients. Data was analyzed using taxonomy, discourse analysis, and proxemics. All research work was iteratively processed from March 2003 to December 2004. Results. Constant comparative analysis of the data yielded the process of becoming a successful family caregiver: encountering the differences and chaos as novice; constructing their world of skilled caregivers; and becoming a hospital family as experienced caregivers. During the process of becoming an experienced hospital family, the discourse of family centered idea guided their caring behaviors and daily lives. Conclusion. The paternalistic family caregivers struggled, cooperated, and harmonized with the patriarchal world of professional health care system. During this process of becoming hospital family, professional nurses must act as cultural brokers between the lay family caring system and the professional caring system.

Purpose. The purposes of this study were to examine the effectiveness of a behavioral intervention program combining pelvic floor muscle exercise with bladder training for urinary incontinence and also to conduct follow-up assessment after self-training. Methods. This study was conducted using a non-equivalent control group, pretest-posttest design. The subjects were 60 middle-aged women(control group, n=30; intervention group, n=30) who experienced an episode of urinary incontinence at least once a week. The program was run over a 4 week period (once a week) and composed of urinary incontinence education, pelvic floor muscle exercise, and bladder training. Results. Overall, there was a significant difference in urinary incontinence symptoms and psycho-social well-being related to urinary incontinence between the treatment and control group. Of the variables, weekly leakage frequencies, leakage amounts on each occasion, leakage index, frequencies of nocturia, and quality of life were significantly different between the groups. Follow-up assessment (9th week) indicated that overall incontinence symptoms and psycho-social well-being were significantly different between the posttest and follow-up assessments. Most variables of incontinence symptoms and psycho-social well-being were significantly improved at follow-up assessment versus posttest. Conclusions. The program was voerall effective in terms of relieving symptoms and improving psych-social well-being related to urinary incontinence, and this effect continued after a 4-weeks self-training period. In the respect that this is a community-based application study, the results can be meaningful and applicable.

Purpose. The present study aims to verify the effectiveness of the reality therapy for patients with schizophrenia. Methods. It is designed as a quasi-experimental study by which a nonequivalent control group pretest-posttest is conducted. The test was conducted with 30 patients with schizophrenia who were hospitalized at a mental hospital in South Korea. Fifteen of the patients participated in the reality therapy program while another 15 in the control group. The effects are measured by marking scores in the areas of the locus of control, self-esteem, and problem-focused stress coping of each participant. Results. The general characteristics and dependent variables related to outcome variables were controlled to be equal between the two groups. It turns out that the internal locus of control, self-esteem, and problem-focused stress coping are statistically significant. Conclusion. Findings show that the reality therapy caused positive changes in terms of the internal locus of control, self-esteem, and problem-focused stress coping of the observed schizophrenic patients.

Background. Adequate staffing is necessary to meet patient care needs and provide safe, quality nursing care. In November 1999, the Korean government implemented a new staffing policy that differentiates nursing fees for inpatients based on nurse-to-bed ratios. The purpose was to prevent hospitals from delegating nursing care to family members of patients or paid caregivers, and ultimately deteriorating the quality of nursing care services. Purpose. To examine nurse staffing levels and related factors including hospital, nursing and medical staff, and financial characteristics. Methods. A cross-sectional design was employed using two administrative databases, Medical Care Institution Database and Medical Claims Data for May 1-31, 2002. Nurse staffing was graded from 1 to 6, based on grading criteria of nurse-to-bed ratios provided by the policy. The study sample consisted of 42 tertiary and 186 general acute care hospitals. Results. None of tertiary or general hospitals gained the highest nurse staffing of Grade 1 (i.e., less than 2 beds per nurse in tertiary hospitals; less than 2.5 beds per nurse in general hospitals). Two thirds of the general hospitals had the lowest staffing of Grade 6 (i.e., 4 or more beds per nurse in tertiary hospitals; 4.5 or more beds per nurse in general hospitals). Tertiary hospitals were better staffed than general hospitals, and private hospitals had higher staffing levels compared to public hospitals. Large-sized general hospitals located in metropolitan areas had higher staffing than other general hospitals. Occupancy rate was positively related to nurse staffing. A negative relationship between nursing assistant and nurse staffing was found in general hospitals. A greater number of physician specialists were associated with better nurse staffing. Conclusions. The staffing policy needs to be evaluated and modified to make it more effective in leading hospitals to increase nurse staffing.

Purpose. The purpose of this study was to identify subgroups of the physical and behavioral risk profiles for cardiovascular disease among industrial workers, and to examine predicting factors for the subgroups. Sample and Method. Health records of 2,616 male and female workers aged 19-56 years who were employed in an airplane manufacturing industry were analyzed. Data were analyzed using the Latent class cluster analysis. Results. Four different clusters (two high-risk groups, one low-risk group, and one normal group) were found and these clusters were significantly different by age, gender, and work type (p < .05 ). The two high-risk groups had higher chances of drinking alcohol, elevated BMI, FBS, total cholesterol, having hypertension, and were significantly older, and had relatively high chances of being day workers rather than other groups. The low-risk group had higher chances of drinking alcohol, higher BMI and total cholesterols compared to normal group, and highest portions of current smokers and shift workers in the four clusters and their mean BP was within prehypertension criteria. Conclusion. Industrial nurses should guide the lifestyle behaviors and risk factors of the high risk groups for CVD and need to intervene early for behavioral change for the low-risk group who are young and shift workers. Age, and work environment should be considered in planning for targeted preventive interventions for industrial workers.

Background. This study was done to identify the prevalence of benign prostatic hyperplasia(BPH) and BPH-related symptoms among community-dwelling elderly men in Korea. In addition, quality of life and health care-seeking behavior were explored. Methods. A total of 417 elderly men were surveyed using the IPSS (International Prostatic Symptom Score) and a structured questionnaire on health care-seeking behaviors. Results. The prevalence of BPH was $19.7\%$. Of those with BPH, $80.3\%$ reported mild symptoms, $13.2\%$ moderate symptoms, and $6.5\%$ severe symptoms. The severity of BPH-related symptoms was significantly correlated with quality of life. Among those with BPH, $42.7\%$ had never consulted with anyone about their symptoms. Conclusions. BPH has emerged as a serious public health problem in elderly men. Elderly people who experience worse symptoms of BPH have a lower quality of life. Many elderly with BPH do not seek health care, mainly due to misconceptions about BPH. The provision of educational programs for BPH may significantly improve the quality of life of elderly men.

Purpose. This paper is derived from a larger study of nurses' perceptions of their role as patient educators. The focus is to examine nurse' performance in patient education in relation to issues of their perceived responsibility and their ability to prioritize patient education. Method. A multiple-method survey design, using a questionnaire and in-depth interviews, is used to produce a comprehensive picture of the research problem examined. Result. The findings suggest that although nurses consider patient education as an integral part of their care, they fail to deliver as much as they desire in the face of work constraints. Nurses' patient education activities are mainly informal and reactional, in which case they can be easily regarded as a low priority when faced with time constraints. Conclusion. The findings suggest that there is a need for systematic approaches that enable the inculcation of patient education into routine daily care.