Purpose: The purpose of this study was to identify the relationship between physical activity and sleep patterns of the elderly. Methods: The subjects of this study were 154 elderly who visited a community senior center in Korea. Data was collected by an interview and a self reported questionnaire, during the period from June to October, 2006. Physical activity was measured by IPAQ Korean version(2006), and sleep pattern by Korean Sleep Scale A developed by Oh et al.(1998). Results: The prevalence of chronic illness in the subjects was 73.4 %. The mean time of vigorous activity was $6.62{\pm}31.27$ minutes/day during the past week. Moderate activity time was $28.85{\pm}50.31$ minutes/day and walking time was $28.85{\pm}50.3$ minutes/day. The total sleep time was $397.63{\pm}111.53$ minutes/day. Physical activity of the elderly significantly correlated with sex, chronic illness, job, and sleep patterns of the elderly. Stepwise multiple regression analysis revealed that the most powerful predictor of sleep pattern was the satisfaction of sleep. A combination of the number of chronic illnesses, moderate physical activities(MET), and total time of sleep accounted for 44.4% of the sleep pattern. Conclusions: Moderate physical activity is more effective than vigorous physical activity for improving the sleep quality of the elderly.

Purpose: A user centered web-based mental health management system may be particularly useful in Korea where there is widespread diffusion of personal computers and internet connectivity. The purpose of this paper was to describe the development of a web-based system for mental health management in adolescents using principals of a user centered design. Method: Our design process includes five distinct phases: needs assessment, analysis, design, development/testing/revision, and application release. Results: Web content includes an introduction, information about mental health management in adolescents, self-assessment and guidance, interventions for improving mental health, directory of self-help groups, and counseling and additional community resources. The web site was released using the URL: http://www.baejy.com/youth. Conclusion: The end result was a web based mental health management system for adolescents with a high degree of usability. The author believes that web-based mental health interventions in the future have true potential in helping Koreans who are suffering, or at risk, for mental health problems, particularly because of the stigma related to psychiatric therapy in Korea.

Purpose: This study was aimed at understanding the nature of the suffering of families with patients in mental health nursing homes and hoped to contribute to the rehabilitation process of those with a chronic mental disorder. Method: Research methodology was based upon Parse's human becoming research methodology. Results: a) Despite the despair the family feels by the violence caused by their now-institutionalized relative, they also realize anew the importance of their role as protectors b) Although they fear social stigmatization they also try to be supportive, out of guilt feelings; c) They regret their severe rearing style and wish to be more sympathetic, d) They find courage and hope through family therapy, which leads to a better understanding of the illness, e) With hopes of rehabilitation, the family members feel happy and go through an emotional release, by sharing the pain with each other. Conclusion: Families of nursing home residents share a focus on the process of human-health-universe. This is a positive,'human-becoming' process with which, based on past feelings of despair, fear, resignation, and pain, one can render meaning into his or her experiences in the present in the pursuit of love, conquest, hope, liberty and success.

Purpose: This study was to explore the prevalence of alcohol experiences and to identify the expectancy on the effects of alcohol and alcohol knowledge in early adolescents. Method: The cross-sectional survey of 1854 students from seven middle schools in one district of Seoul was conducted by convenience sampling. Alcohol experience and early onset of alcohol use were measured by the Youth Risk Behavior Survey. Alcohol expectancy was measured by an Alcohol Effects Questionnaire. Result: Over sixty five percent of adolescents reported that they had previous drinking experiences. The participants with no alcohol drinking experience had a lower level of alcohol knowledge than those with experience(t=2.73, p=.007). In expectancy on effects of alcohol, girls had a more positive alcohol expectation than boys(t=-2.54, p=.011). Alcohol knowledge negatively correlated with alcohol expectancy(r=-.40 p=.000). In regression of alcohol expectancy, gender and alcohol knowledge were significant predictors explaining 17%. Conclusion: The results support that alcohol expectancy is an important link with early drinking experiences and alcohol knowledge, focusing on the importance of gender differences. Therefore, an alcohol prevention program in early adolescence is needed and should be focused on multidimensionality of the alcohol expectancy with developmental and psychosocial factors for early adolescents.

Purpose: The purpose of this study was to compare suicide mortality by region in South Korea. Method: Suicide mortality differentials were calculated for several mortality indicators by geographical regions from raw data of the cause of death from KNSO. Results: The results are as follows; the Crude suicide death rate was 22.63 per 100,000. The highest was in Kangwon showing 37.84% whereas, Chungnam, and Jeonbuk followed after. Suicide was 4.4% of all causes of death, but Inchon and Ulsan showed a higher proportion. The male suicide death rate was 31.12 per 100,000 and females 14.09. The ratio of gender suicide mortality was 2.21, per 100,000 and was the highest in Jeju. For age-specific suicide death rates, the rate increased as age advanced, showing 2.33 per 100,000 in 0-19years, 18.68 in 20-39, 30.48 in 40-59, 63.33 in 60 years and over. In Ulsan, Kangwon, and Inchon, age-specific suicide death rates of the 60 and over age group were higher than other regions, Daegu, Busan, and Kangwon showed a higher age-specific suicide mortality of the 40-59 age group, and Kangwon, Jeonnam, and Chungnam had a higher age-specific suicide mortality of the 20-39 age group. Conclusions: Suicide mortality differed by region. These results can be used for a regional health care plan and planning for suicide prevention by regions.

Purpose: Effective communication is an essential aspect of nursing care. This qualitative study was performed to analyze nurse-patient conversations about medication. Method: The nurse-patient dialogue was collected by video tape recording during the nurse's duty time in an internal medicine ward. One hundred seventy-eight episodes were extracted from the conversation. Using conversational analysis, the functional phases and patterns of dialogue sequence pertaining to medication were analyzed. Results: Conversations about medication were very brief dialogues, so 68.8% of the dialogue had a duration of less than 20 seconds. However, it was a systematic and comprehensive dialogue which had structures and sequential dialogue patterns. Four functional phases were explored. greeting, identifying the patient, medicating, finishing. The medicating phase was essential, in which the nurse gave the drug to the patient and provided information initiated by the nurse simultaneously. The patterns of the dialogue sequence represented were the nurse provided information first, and then, patients responded to the nurse as accepting, rejecting, raising an objection, or asking again later. Conclusion: As the results of this study show, a nurse's role is important as an educator. For effective conversation about medication, the development of an educational program should be considered, which includes knowledge about medication and communication skills.

Purpose: The main purpose of this study was to develop a substantive theory on the life of patients with heart transplantation in the context of Korean society and culture. The question for the study was 'What is the life of patients like with a heart transplant?'. Method: A grounded theory method guided the data collection and analysis. Participants for this study were 12 adults who regularly visited a Cardiovascular ambulatorium in a medical center. The data was collected through an in-depth interview and analyses were performed simultaneously. Result: 'Developing a new life to live on borrowed time' was the core category in this study. It revealed two types of life, one is living in peace and another is thinking positive. Conclusion: This study provides a framework for the development of individualized nursing interventions to care for patients with Heart Transplantation. The findings may provide pointers for health professionals about ways to improve support for heart transplant recipients.

Purpose: This study was to analyze the trend of research on intervention for patients with metabolic syndrome. Method: Using Pubmed, Medline, and CINAHL search engines, a randomized controlled trial(RCT) researching titles such as 'metabolic syndrome', 'intervention', 'lifestyle modification', or 'community-based' were collected. A total of 16 researches were analyzed based on the guidelines of the National Cholesterol Education Program - Adult Treatment Panel(NCEP-ATP III). Results: 1) The total period of the intervention was from 12 to 24 weeks, the frequency was 3 to 5 times per week, and the duration of each session was from 45 to 60 minutes. The types of intervention included exercise, diet, and medication. Among these types, diet was performed most frequently. 2) The outcomes of the intervention was measured with physical aspects such as anthropometric measures, body composition, or biological markers. No studies have evaluated psychosocial outcomes such as quality of life. 3) In terms of effectiveness of the intervention, anthropometric indicators, body composition, or serological markers showed positive effects, whereas results on endothelial or urine indicators were inconsistent. Conclusion: Methodological research developing comprehensive therapeutic lifestyle modification programs and intervention studies are needed for patients with metabolic syndrome. In addition, effects should be evaluated with multidimensional perspectives.

Purpose: The purpose of this study was to examine the effects of daily exercise before steroid treatment on mass, the type I and II fiber cross-sectional area, and myofibrillar protein content of hindlimb muscles in a rat model. Method: Adult male Sprague-Dawley rats were randomly assigned to one of three groups: a control group(n=10) that had a normal saline injection for 7days, a steroid group(n=10) that had a steroid injection for 7days, and an exercise-steroid group(n=10) that ran on the treadmill for 7days before a steroid treatment. Body weight and food intake were measured every day. At 15 days all rats were anesthetized and the soleus, plantaris and gastrocnemius muscles were dissected. Result: The exercise-steroid group showed significant increases as compared with the steroid group in body weight, muscle weight of the soleus and gastrocnemius, type II muscle fiber cross-sectional area of plantaris, and myofibrillar protein content of the soleus, plantaris, and gastrocnemius. As compared with the control group, the steroid group showed significant decreases in body weight and diet intake, muscle weight, the type II fiber cross-sectional area and myofibrillar protein content of the soleus, plantaris, and gastrocnemius muscles. Conclusion: Daily exercise before steroid treatment attenuates hindlimb muscle atrophy, with type II muscle changes more apparent than type I muscle changes.

Purpose: The purpose of this study was to explore the experiences of parenting from the parents of children with ADHD and to develop a grounded theory about their experiences. Method: This study was a qualitative research study that used a grounded theory to understand and discuss the parenting experiences of parents of children with ADHD in a greater depth. Grounded data was collected through an in-depth interview from twelve participants with ADHD children. The data was analyzed using the grounded theory method. Results: 'Approaching the normal' emerged as the core phenomenone. Parenting experiences for parents of children with ADHD referred to a process of bringing the children, back on track of normal growth development, and their functioning in the family at a normal level and establishing a new normalcy. The process of approaching the normal involved a basic social-psychological process, such as 'living a day in hell', 'accepting', 'confronting the conflicts', 'lowering expectations', and 'making a new normalcy'. Conclusion: The outcomes of this study, which observed the parenting process of parents of children with ADHD, could enhance nurses' understanding of ADHD and help nurses become major mental health service providers for the mental health of children with ADHD and their families.

Purpose: The purpose of this study was to identify the effects of a multi agent obesity control program in obese school children. This program was composed of strategies to modify diet and exercise habits and to change cognitive behavior variables(stress, coping, and self-efficacy). Method: The subjects were 40 obese school children who participated in our project voluntarily via homepage, TV, newspaper, public paper and school official documents. The program was implemented daily for 4 sessions per day for ten days from August 16 to 26, 2004. The daily program consisted of exercise therapy, dance therapy, cognitive behavior therapy and aroma therapy. The data was analyzed by paired t-test using the SPSSWIN program. Result: There was a significant decrease in children's waist-hip ratio(p=.04) and in children's stress(p=.00) after the program. There was a significant increase in children's self-confidence after the program(p=.02) and a significant decrease in children's diet habit after the program(p=.02). Conclusion: This study provides evidence that a multiagent obese control program is effective in changing waist-hip ratio, stress, self-confidence, and diet habits in obese school children.

Purpose: The purpose of this study was to describe the experiences of job satisfaction in clinical nurses. Methods: Data was collected from three focus groups composed of 17 hospital nurses. Each focus group had an interview for an average of two and a half hours with the guidance of researchers. The main question was 'how do you describe your lived experience of job satisfaction as a clinical nurse?' Qualitative data from the field notes and transcribed notes were analyzed using a grounded theory methodology developed by Strauss and Corbin. Results: The core category of experience of job satisfaction in clinical nurses was identified as 'Finding success.' Supportive interpersonal relationships and environment affected this category. In the process of attaining job satisfaction through finding success, the participants were using four interactional strategies such as giving meaning, finding self-esteem, extending the horizon of life, and strengthening self-capability. The dimensions of job satisfaction in clinical nurses were the sense of achievement, stability, and pride. Conclusion: The results of this study yields very useful information for nursing mangers to design a program which enhances job satisfaction of clinical nurses based on interactional strategies.

Purpose: The study aimed to identify the effects of a newborn care education program on newborn care confidence and behavioral accuracy of primiparas in a postpartum care center. Method: This was a quasi-experimental study with a non-equivalent control group non-synchronized design. Subjects were 29 primiparas selected from a postpartum care center in D and P hospitals in Ulsan. The intervention was a newborn care education program which was composed of education with a booklet, demonstration, watching a video, and verbal encouragement. The outcome variables were newborn care confidence and behavioral accuracy. Data was collected from Feb. 1 to Mar 22 in 2005 with self-administered questionnaires and observation by researchers. Data was analyzed using the $X^2-test$, Fisher's exact test, t-test and ANCOVA. Result: The experimental group showed significantly higher score changes between the pre-test and post-test in confidence and behavioral accuracy than the control group. Conclusion: The newborn care education program showed positive effects on newborn care confidence and behavioral accuracy of primiparas in a postpartum care center. Therefore, we recommend that this program should be applied in postpartum care centers.

Propose: The purpose of this study was to help families decrease and alleviate the burden on family care-givers taking care of elderly patients. Method: Data was collected by a questionnaire from 100 family members who were registered in the department of home health care nursing at 4 hospitals of H University Medical Center from September 20 to October 25, 2005. The collected data was analyzed using Mean and Standard Deviation, Pearson Correlation Coefficient, t-test and One-Way ANOVA with the Duncan's test, and Stepwise multiple regression. Result: The average burden on family care-givers of elderly patients with chronic diseases was 3.31. The social burden was the highest(M=3.68), the lowest was the emotional burden(M=2.95). In ADL of elderly patients with chronic diseases, all 10 questions showed an average point above 2.50. The dependency level of going up and down the stairs was the highest(M=2.88). Conclusion: This research is necessary for the application of a plan in the social support system in order to reduce the burden on family care-givers who are taking care of elderly patients with a chronic disease.

Purpose: The purpose of this study was to describe and to analyze real communication about a patient's discomfort between a patient with cancer and a nurse. Method: A dialogue analysis method was utilized. Fifteen patients and 4 nurses who participated in this research gave permission to be videotaped. The data was collected from January, 3 to February 28, 2006. Results: The communication process consisted of 4 functional stages: 'introduction stage', 'assessment stage', 'intervention stage' and 'final stage'. After trying to analyze pattern reconstruction in the 'assessment stage' and 'intervention stage', sequential patterns were identified. In the assessment stage, if the nurse lead the communication, the sequential pattern was 'assessment question-answer' and if the patient lead the communication, it was 'complaint-response'. In the intervention stage, the sequential pattern was 'nursing intervention-acceptance'. Conclusion: This research suggests conversation patterns between patients with cancer and nurses. Therefore, this study will provide insight for nurses in cancer units by better understanding communication behaviors.