Purpose: The purpose of this study was to identify the effects of Yakson therapy as a pain management tool oil the physiologic and behavioral reponses of infants with a painful heelstick procedure. Method: Infants were randomly assigned to a group that underwent a series of Yakson therapy and a control that received nothing before a heelstick. Heart rate, oxygen saturation, and NIPS were compared between the experimental (n=16) and control (n=16) infants during an undisturbed baseline and after a standard heelstick procedure Yakson therapy consisted of laying a hand on the back, and caressing the abdomen by hand for 5 minutes. Result: The pain scores of the Yakson group were lower than the control group. Foroxygen saturation, there were statistically significant differences between groups. For heart rate, there were no statistically significant differences between groups. Conclusion: This data suggests that Yakson therapy had a pain relief effect in behavior responses and $SaO_2$. Accordingly, Yakson therapy should be used as a nursing intervention for simple pain management for a heel prick.

Purpose: The purpose of this study was to analyze the types of suicide attitudes among the Korean elderly. Method: The Q-methodology which provides a method of analyzing the subjectivity of each item was used. Thirty-four selected Q-statements from 38 subjects were classified into a shape of normal distributionusing a 9 point scale. The collected data was analyzed using a QUANL PC program. Result: Three types of suicide attitudes for research subjects in Korean elderly were identified. Type I is understanding suicide-self conquest and labor type, Type II is opposing suicide-family band foundation type, and Type III is sympathizing with suicide-painful situation escaping type. Conclusion: The results of the study indicate that different approaches of suicide prevention programs are recommended based on the three types of suicide attitudes among Korean elderly.

Purpose: This study was to examine the effects of electrical muscle stimulation therapy on chronic knee pain in the elderly. Method: The research design was a one-group pretest-posttest design. The subjects were 45 (TE: 17, SE: 15, SY: 13) elderly, 65 years old and above with chronic knee pain. Pain was measured by the S-F McGill Pain Questuionnaire (S-F MPQ) and Arthritis Impact Measurement Scale (AIMS). Electrical muscle stimulation therapy experimental treatment was applied for 12 weeks, 3 times/week, 15 min/time. Data was collected from March 2005 to February 2006. Data was analyzed using the SPSS PC+ 12 version. Results: After receiving electrical muscle stimulation therapy, chronic knee pain in TE (S-F MPQ: t=-62.143, p=.000, AIMS: t=-29.155, p=.000), SE (S-F MPQ: t=-76.345, p=.000, AIMS: t=-39.323, p=.000), and SY (S-F MPQ: t=-43.691, p=.000, AIMS: t=-30.306, p=.000) groups were significantly decreased. Conclusion: Electrical muscle stimulation therapy can be a better effective primary nursing intervention for chronic knee pain for community dwelling elderly people with TE, SE, and SY.

Purpose: The purpose of this study was to identify the relationship between depression, perceived stress, fatigue and anger in clinical nurses. Method: A descriptive survey was conducted using a convenient sample. Data was collected by questionnaires from four hundred clinical nurses who worked at a university hospital. Radloff's CES-D for depression, Cohen, Kamarck & Mermelstein's Perceived Stress Scale, VAS for Fatigue, and Spielberger's STAXI for anger were used. The data was analyzed using the pearson correlation coefficient, students' t-test, ANOVA, and stepwise multiple regression with SPSS/WIN 12.0. Result: The depression of clinical nurses showed a significantly positive correlation to perceived stress(r=.360, p=.000), mental fatigue(r=.471, p=.000), physical fatigue(r=.350, p=.000), trait anger(r=.370, p=.000), anger-in expression(r=.231, p=.000), and anger-control expression(r=.120, p=.016). There was a negative correlation between depression and age(r=-.146, p=.003). The mean score of depression of nurses, 26, was a very high score and 40.8% of clinical nurses were included in a depression group. The main significant predictors influencing depression of clinical nurses were mental fatigue, trail anger, perceived stress, anger-in expression, and state anger, which explained about 32.7%. Conclusion: These results indicate that clinical nurses with a high degree of perceived stress, mental fatigue and anger-in expression are likely to be depressed.

Objective: The purpose of this study was to evaluate the effects of soybean intake on bone mineral density and bone turnover markers in postmenopausal rural Korean women. Method: This study was carried out during nine months from Oct. 25 2004 to Aug. 31 2005. The subjects of this study were female patients over 50 living in rural areas diagnosed with osteoporosis. There were 18 women in the experimental group and 20 in the control group. In this study, the experimental group received 100 mg of isoflavone (soybean) and calcium 1,500 mg for nine months while the control group received 1,500mg of calcium only. Results: After the soybean intake, the change of bone mineral density between the experimental group and control group was statistically significant. However, the bone turnover markers of osteocalcin and deoxypyridinoline between the experimental group and control group were not significantly different statistically. In the Pearson Correlation between bone mineral density and bone turnover markers, the osteocalcin and deoxypyridinoline of the experimental group had a positive correlation, and osteocalcin and DPD/osteocalcin ratio had anegative correlation. In the control group, osteocalcin and DPD/osteocalcin ratio had a negative correlation. Conclusions: This result showed that soybean intake changed bone mineral density in postmenopausal woman.

Purpose: This study was to investigate the knowledge and learning needs of chemotherapy in gynecological cancer patients. Method: The subjects consisted of 103 gynecological cancer patients receiving chemotherapy from April 2005 to August 2005. Data was collected using a questionnaire about knowledge and learning needs of chemotherapy. The data was analyzed by t-test, ANOVA, Scheffe test, and Pearson's correlation coefficient using SAS. Result: Average scores of knowledge and learning needs of general treatment and care were 2.74, and 3.30 respectively. Average score of knowledge and learning needs of chemotherapy were 2.54 and 3.23 respectively. Learning needs of general treatment and care and of chemotherapy were significantly different in relation to marital status, educational level, family support, the operation, and the amount of chemotherapy received. Items with the highest level of learning needs were the symptoms of recurring illness of general treatment, and minimizing side effects of chemotherapy. There were a negative correlation between knowledge and learning needs on general treatment and a positive correlation between knowledge and learning needs on chemothearpy but there were not significant statistically. Conclusion: The level of learning needs related to cancer treatment was high, whereas, that of knowledge was low. Therefore, when designing an educational program for gynecological cancer patients, understanding of learning needs is necessary. Also, consideration of a patient's characteristics, and a systematic and detailed educational program should be provided.

Purpose: The purpose of this study was to develop a critical thinking disposition scale for nursing students. Method: The developmental process was construction of a conceptual framework, development of preliminary items, verification of content validity, development of secondary items, verification of construct validity and extraction of final items. The conceptual framework and first preliminary 60 items were obtained through a review of relevant literature and the development of critical disposition scales by 10 researchers who had been studying critical thinking for one year These items were reviewed by five specialists for content validity and finally 55 items were chosen. The data was collected from October 1 to 15, 2004 and was analyzed using factor analysis and Cronbach's $\alpha$ with the SPSS program. The subjects were composed of 560 Bachelor of Science nursing students from 8 nursing schools. Result: There were 35 final items which were sorted into 8 factors. The factors were identified as 'intellectual integrity(6 items)', 'creativity(4 items)', 'challenge(6 items)', 'open-mindedness(3 items)', 'prudence(4 items)', 'objectivity(4 items)', 'truth seeking(3 items)' and 'inquisitiveness(5 items)'. The cumulative percent of variance was 55.107%. The reliability of the scale, Cronbach's alpha was.892 and the factors' ranged from.562-.836. Conclusion: The result of this study could be used for measuring critical thinking dispositions of nursing students. However, for further validity and reliability, repeated research is necessary.

Purpose: The purposes of this study were to examine the amount of daily fluid intake among nursing home residents and to explore the caregiver's perceived barriers to elderly's fluid intake. Method: Data was collected from 111 nursing home residents and 64 caregiver's in 4 nursing homes. A random, non-consecutive three days of 24 hour fluid intake was measured and recorded. The caregiver's perceived barriers to elderly's fluid intake was assessed using a structured questionnaire. Results: The average amount of daily fluid intake was 1,035(SD=359)ml with the range of 210m1 to 2,050ml. About 52% (n=58) of the subjects had a less than adequate fluid intake. The amount of daily fluid intake was significantly associated with age, mental status, physical functioning, and the number of oral medications ordered. The most frequently mentioned caregiver's perceived barrier was elderly's concern about incontinence with increased fluid intake. Conclusion: Inadequate fluid intake among nursing home residents is prevalent. To enhance adequate hydration of nursing home residents, an institution wide nursing intervention is necessary.

Purpose: The purpose of this study was to evaluate the effects of preoperative pain control education on the pain control barrier, postoperative pain and pain control satisfaction in gynecological patients. Method: The study was a quasi-experimental research design. There were 58 subjects who were admitted for gynecological surgery to D University Hospital in B city. Pain control education was provided individually to the experimental group one day before their operation day for 20 minutes with the 'Pain Control Guide Book' in the patient's admission room. The education book was made by researchers based on pain management references and patient interviews. For assessing the pain control barrier, a simplified version of Barriers Questionnaire was used, postoperative pain was assessed on a numeric scale(0-10) and satisfaction of pain control was assessed by one question. Results: The pain control barrier(F=15.828, p<.001) and the post pain score of the experimental group was lower than that of the control group. In addition, pain control satisfaction of the experimental group(t=3.612, p<.001) was higher than the control group's. Conclusion: With the above results, preoperative pain control education could be an effective nursing intervention for pain control of surgical patients.

Purpose: The purpose of this study was to compare the feeling state guided imagery(FSGI) and end state guided imagery(ESGI) on stress and performance of an intramuscular injection of nursing students. Method: The design was a time series with a nonequivalent control group pretest-posttest study. Data was collected from the 23 rd to the 25th of Nov. 2004. The subjects of this study were 40 female sophomores (21 for the ESGI, 19 for the FSGI). The instruments used in this study were the Visual Analogue Scale for Stress and the Nursing Skill Performance Check-list on Intramuscular Injection developed by the researchers(10 items). Guided imagery was provided through audiotapes for 8 minutes. A pretest was given before applying the guided imagery, posttest 1 was performed after the intervention, posttest 2 was performed before the intramuscular injection and then evaluation of the performance of the intramuscular injection was done. Data was analyzed using t-test, and Repeated Measures ANOVA. Result: The level of stress for those who received the ESGI and FEGI was not significant and the level of the nursing skill performance for those who received the ESGI was significantly higher than that of students who received the FEGI. Conclusion: The use of ESGI has an effect on learning psychomotor nursing skills and further research is needed on stress.

Purpose: The purpose of this study was to identify the relationship among quality of life, family coherence, family hardiness, and family resources of the family care-giver caring for a cancer patient. Method: Data was collected by questionnaires from 137 families with a cancer patient at a General Hospital and Government Cancer Hospital. Data was analyzed using descriptive statistics, pearson correlation coefficients, and stepwise multiple regression. Results: The score of quality of life showed a significant positive correlation with the score of the level of family sense of coherence, family hardiness, and family resources. The most powerful predictor of quality of life was sense of coherence and the variance was 30%. A combination of sense of coherence and family resources account for 34 % of the variance in quality of life of the family care-giver caring for a cancer patient. Conclusion: The results showed that family sense of coherence, hardiness, and family resources were significant influencing factors on the quality of life of the family care-giver caring for a cancer patient.

Purpose: This study was done to provide data for a nursing intervention to alleviate newborn pain clinically by investigating the effect of oral glucose. Methods: Subjects were newborns hospitalized in the nursery. Informed consent was obtained from parents of 60 newborns. A heel stick was carried out for a test on 3 groups; the experimental, placebo, and control group. The Neonatal infant pain scale(NIPS), respiration rate, heart rate, peripheral oxygen partial pressure($SpO_2$), and crying duration were measured to assess pain reaction. All neonatal behaviors were recorded on videotape. Results: There were significant differences in pain behavior during stimulus(F=4.195, p=.020), pain behavior immediately after blood-sampling (F=4.114, p=.021), and pain behavior 3 minutes after that (F=3.630, p=.033). However, there were no significant differences in heart rate, respiration rate, peripheral oxygen partial pressure or crying duration after the heel stick among the groups. Conclusions: Oral administration of glucose before a heel stick caused the reduction of neonatal pain behavior, which means that it has an effect of pain relief.

Purpose: The purpose of this study was to determine characteristics of nursing science and identify expected outcomes from baccalaureate graduates, and to develop accreditation standards and criteria reflecting the characteristics of the nursing profession. Methods: A methodological research design was utilized in this study. Related literature reviews and the nursing education program goals and objectives of the 99 nursing schools in Korea were analyzed. A cross-sectional survey research design was utilized to test the validity of the developed characteristics of the nursing profession and their accreditation criteria and standards. The face validity was from the advisory committee and public committee hearing. Results: The characteristics of nursing science were defined with five concepts including humanity, scientific knowledge, professionalism, therapeutic relationship, and facilitating well-being. The expected outcomes from graduates were identified as providing holistic nursing, critical thinking, establishing professionalism and leadership, construction of a therapeutic relationship, and skilled nursing practice. Finally6 standards and 14 criteria reflecting the unique characteristics of the nursing profession were developed for accreditation. These proposed accreditation standards and criteria are a challenge to promote the quality of nursing science.

Purpose: The purpose of this phenomenological study was to understand the experiences in the transplantation coordinators' practice. Method: Data was collected through a tape-recorded in-depth interview from nine participants who were transplantation coordinators of their hospitals. It was analyzed using the phenomenological method proposed by Colaizzi(1978). Results: From significant statements, six categories of themes were integrated into the essential structure of the experiences of transplantation coordinators. Six categories of themes were 'continue to be professional during dash this way and rush that', 'burden due to persistent heavy work', 'the uniqueness in family care of the brain-dead patients', 'support of family and a professional group', 'worthiness and achievement of the patients' recovery', and 'establishment of self-confidence as a coordinator'. Conclusion: Although the transplantation coordinators played various roles, they had a conflict in role identity due to poor working environments. The results of this study suggested that development of an educational program, an increase in understanding for the coordinators' role, and institutional support for better working conditions are needed to get professional acknowledgement for transplantation coordinators.

Purpose: The purpose of this study was to identify nicotine dependence, smoking-related attitude, and subjective norms across the stages of change for smoking cessation among adult smokers in a rural area. Method: The subjects were 276 current smokers (male=243, female=33). There were 3 stages of change for smoking cessation: pre-contemplation, contemplation, and preparation stage. Data was collected by an interview or self-reporting from February 12th to March 5th 2004, and analyzed with frequency, percentage, $X^2-test$, Fisher's exact probability test, ANOVA, and Scheffe test using the SPSS-PC program. Result: According to the stages of change, 114(41.3%) current smokers were in pre-contemplation, 110(39.9%) in contemplation, and 52(18.8%) in the preparation stage. There was a higher percentage of males than females ($X^2-test$=8.99, p=.011) in the preparation stage. The mean score of the smoking-related attitude (F:7.43, p=.001) and subjective norm(F=27.41, p=.001) were both lowest in the pre-contemplation stage and increased positively during the stages of change for smoking cessation. Conclusion: Based on these findings, the authors recommend that community-based smoking cessation programs should be developed by considering the intention or motives of current smokers and should be initiated in the preparation stage and primarily for male groups.

Purpose: Glass particle contamination of the contents of single-dose glass ampules can occur upon opening. Different aspiration techniques, different sizes of needles, different sizes of ampules, and different cutting methods were studied to determine if they had any effect on glass particle contamination. Method: Different aspiration techniques(with filter, without filter), different sizes of needles(18G, 25G), different sizes of ampules(2ml, 20m1), and different cutting methods(with cotton, without cotton) were evaluated. Method: Twenty ampules were randomly assigned in each group. Three slides containing glass particles for each ampule were made and counted under a microscope by 3 study blind persons. Result: The number of glass particle contamination is much less when using a filter rather than without a filter. The number of glass particle contamination is much less when using a 25G needle rather than on 18G needle. The number of glass particle contamination is much less when using 2ml ampules rather than 20m1 ampules. The number of glass particle contamination is much less when using cotton rather than without cotton. Conclusion: It was shown that using a filter, a small size needle, smaller sized ampules and using cotton when cutting the ampule will decrease the risk of parenteral injection of glass particles.

Purpose: Previous evaluation studies of the visiting nursing program explained an average change of the participants' health status, without considering socio-ecological characteristics and their impacts. However, these factors must affect individual health problems and lifestyles. For effective and appropriate community based programs, the Geographical Information System(GIS) can be utilized. GIS is a computer-based tool for mapping and analyzing things that happen on earth, and integrates statistical analysis with unique visualization. The purpose of this study was to evaluate visiting nursing care and to advocate the usefulness of planning and evaluating visiting nursing programs using Exploratory Spatial Data Analysis(ESDA) with GIS technology. Methods: One hundred eighty-four elderly participants with cerebrovascular risk factors who lived in 13 areas of one community received visiting nursing care. The data analyzed characteristics of pre-post change and autocorrelation by ESDA using GIS technology. Results: Visiting nursing care showed an improvement in the participants' lifestyle habits, and family management ability and stress level, while the improvements were different depending on the regions. The change of family management ability and stress level correlated with neighborhoods (Morgan's I=0.1841, 0.1675). Conclusions: Community health providers need to consider the individual participant's health status as well as socio-ecological factors. Analysis using GIS technology will contribute to the effective monitoring, evaluation and design of a visiting nursing program.

Purpose: The purpose of this study was to analyze and clarify the ambiguous concept of DNR, and to distinguish between DNR and euthanasia. Method: This study used the process of Walker & Avant's concept analysis. Result: The definable attributes of DNR were care for comfort, no further treatment and no CPR. The antecedents of DNR were the autonomy of patients and families feelings about death, the uselessness of treatment and the right to die with dignity. The process of the DNR decision should be documented and the antecedents of DNR also can be a basis for objective standards of DNR decision-making. The result of DNR was the acceptance of death by patients and families. Conclusion: DNR is decided and documented by the antecedents of DNR, and the result is a natural acceptance of death, the last process of human life. Hospice care should be activated and nurses must be patient's advocates and families' supporters in the process.

Purpose: A structural equation model was analyzed to explore the determinants of health-promoting behaviors in patients living at home in Korea who had post stroke hemiplegia. Method: Demographic characteristics, activities of daily living, religiosity, family support, self-efficacy, acceptance of disability, perceived barriers to health-promoting activities, depression, and health-promoting behavioral data was collected from 239 patients using self-report questionnaires. Result: Variables that have a direct effect on health-promoting behaviors were self-efficacy and family support. Depression, acceptance of disability, perceived barriers, activities of daily living and religiosity also influenced health-promoting behaviors in an indirect way. Conclusion: It is imperative to explore strategies for patients with post stroke hemiplegia to identify and maximize their resources, develop their self-efficacy, improve their emotional state, and enhance their physical activity and spiritual growth, which would maximize health-promoting behaviors.

Purpose: The purpose of this study was to evaluate a cognitive behavioral anger management intervention in order to increase self-consciousness and decrease anger among Korean military men, Methods: A quasi-experimental design was used for this study. Ninety two soldiers were screened for unhealthy anger expression using a questionnaire. Among them, 26 soldiers who showed unhealthy anger expression were selected for this study. They were matched by rank and assigned to either a treatment or control group. The treatment group received the intervention three consecutive times, once a week and for 120 minutes per session. Participants were assessed before and after the intervention for anger (the State-Trait Anger Scale) and self-consciousness (Self-consciousness Scale). Data was analyzed using descriptive statistics, $x^2-test$, Mann-Whitney test, and Wilcox on signed rank test. Results: There was no statistically significant decrease in anger or increase in self-consciousness between the two groups following treatment. However, there was a significant increase in private self-consciousness in the treatment group after the intervention(p=.006). Conclusion: The cognitive behavioral anger management program improves private self-consciousness in soldiers. However, Additional research is needed to explore whether long-term intervention is more effective for anger control in the military setting. The findings from this study suggest that more attention should be given to mental health care for Korean soldiers.