Purpose: This study was to analyze research reports published in Korea on cardiac rehabilitation for patients with cardiovascular disease. Methods: Based on inclusion criteria, 19 research reports were included in this review. Published year of selected articles was between 1996 and 2008. Nineteen studies were analyzed by guidelines of the cardiac rehabilitation programs done by the American Heart Association(AHA) and Scottish Intercollegiate Guidelines Network(SIGN). Results: The characteristics of patients were mostly of ischemic heart disease, 50-59 yr old, and male. Educational sessions were administered twice, and each lesson lasted less than 30 min. Exercise was done 3 times per week for 6 weeks. Most educational content were about risk factors, but there was no information, such as coping with feelings. Most exercise was performed as ROM, treadmill, and cycle ergometer. A large percentage of outcome indicators were health behavior, hemodynamic changes, and exercise capacity. There was more 'no effect' than 'positive effect' in trait anxiety and depression, whereas similar in physiologic domain. Conclusion: Various types of cardiac rehabilitation in Korea were performed by researchers. Therefore, we need to develop the standard protocol, to add psychosocial intervention, and to study cost effectiveness of cardiac rehabilitation.

Purpose: The purpose of this study was to determine the effect of Dehydroepiandrosterone(DHEA) administration alone or exercise combined with DHEA before steroid treatment on rat hindlimb muscles. Methods: Male Sprague-Dawley rats were assigned to one of three groups: a steroid group(S, n=10) that had no treatment for 7 days before steroid treatment; a DHEA-steroid group(DS, n=8) that had 0.34 mmol/kg/day DHEA injection once a day for 7 days before steroid treatment and an exercise+DHEA-steroid group(EDS, n=9) that ran on the treadmill combined with 0.34 mmol/kg/day DHEA injection for 7 days before steroid treatment. At 15 days all rats were anesthetized and soleus, plantaris and gastrocnemius muscles were dissected. Body weight, food intake, muscle weight, myofibillar protein content and cross-sectional area of the dissected muscles were determined. Results: The DS group showed significant increases(p<.05) as compared to the steroid group in body weight, and muscle weight of gastrocnemius muscles. The EDS group showed significant increases(p<.05) as compared to the S group in body weight, muscle weight, myofibrillar protein content, and Type II fiber cross-sectional area of soleus, plantaris and gastrocnemius muscles. Conclusion: Exercise combined with DHEA administration before steroid treatment prevents steroid induced muscle atrophy, with exercise combined with DHEA administration being more effective than DHEA administration alone in preventing muscle atrophy.

Purpose: The purpose of this study was to investigate the determinants of job satisfaction of hospital nurses. The focus was on work rewards. A causal model of job satisfaction of hospital nurses was constructed based on situational perspectives. Methods: The sample for this study consisted of 505 nurses from 2 general hospitals located in Seoul and Kyeonggi Province, Korea. Data were collected with self-administrated questionnaires and analyzed by hierarchical multiple regression. Results: All variables except workload were positively correlated with job satisfaction. It was found that three task reward variables(workload, meaning, and participation), two organizational reward variables(security and promotional chances) and one social reward variable(family support) had significant influence on nurses' job satisfaction. The explained variance for job satisfaction was 41.4%. The data further indicate that task rewards were the most significant determinants of nurse job satisfaction. Conclusion: Theses findings provide strong empirical evidence for importance of task, organizational and social reward variables in explaining job satisfaction of nurses. The model used for this study will be useful for predicting nurse job satisfaction.

Purpose: The purpose of this study was to explore and describe healing effects of the forest on alcoholics through a forest experience program. Methods: The qualitative data was gathered from one focus group discussion with 6 alcoholics and individual interviews with 8 alcoholics. They had all participated in a "healing forest" program. All interviews were recorded and transcribed according to thematic content analysis processes. Results: The four main themes on the attributes of forest were "a lively living being", "placidity and tranquility", "acceptive atmosphere", and "beautifulness as it is" which revealed the participants' perceived nature of the forest which was attributed to the healing effects. Eight other themes on participants' positive changes included "revived senses", "aspired to live", "relieved and relaxed from being tense", "gaining insight on self", "having an acceptive attitude", "becoming compliant with his/her life", "learning that life is being together" and "recognizing the value of one's existence". Conclusion: The findings of the study illustrated the participants' self-healing processes through interactions with the nature of the forest. Nursing interventions utilizing healing atmospheres such as "healing forest" programs can be considered helpful in providing a venue to alcoholics to reflect on their lives affirmatively.

Purpose: The purpose of this study was to identify the influence of the type-D personality on quality of life and illness intrusiveness. Methods: This study was a cross-sectional study. Data were collected using self-reported questionnaire from 200 patients with coronary artery disease(CAD). Variables were measured with the Type-D Scale-14(DS14), Korean Health Related Quality of Life Scale(KoQoLS), and the Illness Intrusiveness Rating Scale(ILRS). Results: Of the patients, 38% were classified as type-D personality. Among the 10 subcategories of quality of life, the highest mean score was bodily pain($5.84{\pm}2.85$) and the lowest was role limitation($1.52{\pm}1.20$). Among 13 item of illness intrusiveness, the highest mean score was health($3.78{\pm}1.73$) and the lowest was family relationships($2.14{\pm}1.58$). There were significant differences in all the subcategories of quality of life between type-D and non type-D except for subcategories of bodily pain and role limitation. However, there were no significant differences in illness intrusiveness between type-D and non type-D. Conclusion: Type-D is an important factor in quality of life in patients with CAD, but no correlations between type-D and illness intrusiveness were found. These results can be used as basic data for developing cardiac rehabilitation programs to improve quality of life in type-D patients.

Purpose: This study was done to examine the effects of aromatherapy on stress and stress responses in adolescents. Methods: A two-group cross-over design was used for this study. The experimental treatment was aroma essential oil inhalation and the placebo treatment was carrier oil inhalation using a necklace. The sample included 36 female high school students. Fisher's exact test, t-test, and paired t-test using SPSS/WIN program were used to analyze the data. Results: Stress levels were significantly lower when the students received the aroma treatment compared to when they received the placebo treatment. The stress responses except salivary IgA levels were significantly lower when the students received the aroma treatment. Conclusion: Aroma inhalation could be a very effective stress management method for high school students. Therefore, it is recommended that this program be used in clinical practice as an effective nursing intervention for high school students.

Purpose: To evaluate the effects of case management using Resident Assessment Instrument-Home Care(RAI-HC) in home health service for older people. Methods: All elders were assessed at baseline and 3 months later using RAI-HC. The change of function in the intervention group was compared with that of a conventional intervention group. Function was measured with Activities of Daily Living(ADL), Instrumental Activities of Daily Living(IADL), Cognitive Performance Scale(CPS), Depression Rating Scale(DRS), Pain and the number of Clinical Assessment Protocols(CAP). Results: Among ninety two elders participated in the program, 59 were allocated to the case management group and 33 to the conventional group. The intervention, home health service by a nurse over a 3 month period, consisted of comprehensive assessment, case conference for care plan, direct care, education and referral, and outcome evaluation. The percent of elders whose function improved in the intervention group was greater than the conventional group for depression(odds ratio [OR]: 10.941, confidence interval [CI]: 2.338-51.206), IADL(OR: 4.423, CI: 1.151-16.999) and the number of CAP(OR: 11.443, CI: 3.805-34.410). Conclusion: Case management was effective for older people in the community. The effect might have resulted from individual, systematic intervention, however, standards of service including eligibility criteria for case management and collaboration of multi-disciplines is required for more effective home health service programs.

Purpose: The purposes of this study were(a) to identify smoking behavior by following a cohort representative of the population of 4th grade elementary schoolers in South Korea over a four-year period(2004-2007), and(b) to explore predictors of smoking initiation among non-smokers in Wave 1. Methods: Secondary data, the Korea Youth Panel Study, was analyzed in this study. First, frequencies or percentages were calculated to identify smoking behavior(i.e., smoking initiation, smoking intensity, and smoking duration). Second, binary logistic regression analysis was performed to examine significant factors related to smoking initiation. Results: Smoking initiation and daily smoking were more pronounced when the participants entered middle school. In bivariate analysis, statistically significant predictors of smoking initiation were loneliness at school, self-control, delinquent behavior, depressive symptoms, and stress. However, after controlling for other factors, only a high level of risk-taking tendency and a greater number of delinquent behaviors remained statistically significant. Conclusion: Based on greater involvement in smoking among first-year middle schoolers, smoking prevention strategies should be provided to elementary schoolers rather than middle schoolers. A risk-taking tendency and delinquent behaviors should be considered as proxy measures to detect the high-risk group for smoking initiation.

Purpose: This descriptive study was done to identify the relationship between health literacy and health status and to provide basic data for developing nursing interventions for Korean-Chinese elders living in Yanbian, China. Methods: For data collection, intentional sampling of 300 elders was used. The questionnaire was composed of 5 items based on "Ministry of Health, the People's Republic of China(2008)" to measure health literacy, 33 health status items from the "Korean Health Status Measure for Elderly People" developed by Shin(2002), revised for use in China, and 9 general characteristics. Data were analyzed using SPSS Win 13.0 program. Results: Total level of health literacy was relatively high(68.7%). Elders had high scores for taking medicines according to doctor's instruction, but lower ones for full comprehension through communication with doctors. Health status was high for emotional, physical, and social function in that order. There were significant differences between general characteristics and health status for gender, age, marital status, education, family, smoking, and alcohol consumption in that order. Results of multiple regression analysis for factors influencing health status showed that self-report health level was the most influential, followed by health literacy, age, gender. Conclusion: Health literacy is the main factor affecting health promotion among minority elders indicating a need to develop health promotion programs for elders who have low health literacy.

Purpose: The purpose of this study was to examine the effects of unilateral sciatic nerve injury on unaffected hindlimb muscles of rats. Methods: Adult male Sprague-Dawley rats were assigned to one of three groups: control(C) group(n=10) that had no procedures, sham(S) group(n=10) that underwent sham left sciatic nerve transection, and sciatic nerve transection(SNT) group(n=9) that underwent left sciatic nerve transection. At 15 days rats were anesthetized, and the soleus, plantaris and gastrocnemius muscles were dissected. Results: Muscle weight of the unaffected plantaris muscle in the SNT group was significantly lower than in the other two groups. Type II fiber cross-sectional areas of the unaffected plantaris and gastrocnemius muscles in the SNT group were significantly smaller than in the other two groups. The decrease of muscle weights and Type I, II fiber cross-sectional areas of the unaffected three muscles in the SNT group were significantly less than that of the affected three muscles. Conclusion: Hindlimb muscle atrophy occurs in the unaffected side after unilateral sciatic nerve injury, with changes in the plantaris and gastrocnemius muscle being more apparent than changes in the soleus muscle. These results have implications for nursing care, in the need to assess degree of muscle atrophy in unaffected muscles as well as affected muscles.

Purpose: The purpose of this study was to identify the relationship of peer relationships, self-reported attachment security, perceived parental rearing attitudes, and loneliness in upper elementary school-age children. Methods: The data were collected from 207 students in grades 5 or 6, and descriptive statistics, t-test, Pearson correlation coefficients and Stepwise multiple regression were used with the SPSS/PC 12.0 program to analyze the data. Results: There was a significant difference in loneliness between the upper 25% and lower 25% groups of peer relationships, perceived parental rearing attitudes, and self-reported attachment security. Stepwise multiple regression analysis showed affection-hostility in parental rearing attitudes, validation and conflict in peer relationships, and attachment security explained 39.6% of the total variance in loneliness. Conclusion: These results may contribute to a better understanding of loneliness in upper elementary school-age children. The results of the present study indicate a need to develop nursing interventions to prevent and manage children‘s loneliness.

Purpose: In this research multi-level analysis was done to identify factors related to quality of services. Patient characteristics and organizational factors were considered. Methods: The data were collected from the Health Insurance Review and Assessment Service(HIRA) data base. The sample was selected from 17,234 patients who had been admitted between January 2007 and May 2008 to one of 253 long-term care hospitals located in Seoul, six other metropolitan cities or nine provinces The data were analyzed with SAS 9.1 using multi-level analysis. Results: The results indicated that individual level variables related to quality of service were age, cognitive ability, patient classification, and initial quality scores. The organizational level variables related to quality of service were ownership, number of beds, and turnover rate. The explanatory power of variables related to organizational level variances in quality of service was 23.72%. Conclusion: The results of this study indicate that differences in the quality of services were related to organizational factors. It is necessary to consider not only individual factors but also higher-level organizational factors such as nurse' welfare and facility standards if quality of service in long term care hospitals is to be improved.

Purpose: In this study rest-activity rhythm, sleep pattern and quality of life of patients with restless legs syndrome were compared with those of a normal group. Methods: The participants in this study were 36 patients with restless legs syndrome diagnosed by a neurologist and 36 participants in the normal group. An actigraph, sleep diary, Pittsburgh Sleep Quality Index and Insomnia Severity Index scale were used as measurement tools for the study. Chi-square test, Lamda test, t-test and Kendall's correlation with SPSS 12.0 program were used to analyze the data. Results: Patients with restless legs syndrome had a higher rest-activity rhythm curve of Least 5 hr's activity(L5) and Most 10 hr's activity(M10) than those of normal group and sleep problems included decreased sleep efficiency and increased sleep latency, wake time and number of awakenings. The scores for the subscales of quality of life in patients with restless legs syndrome were lower than the normal group for general health, physical functioning, role limitations due to emotional problems, role limitation due to physical problems, social functioning, bodily pain, vitality and mental health. Conclusion: The results suggest that further studies are needed to identify rest-activity rhythm according to symptom severity and to develop nursing interventions which consider rest-activity rhythm.

Purpose: The purpose of this study was to assess changes in pain, fatigue, anorexia, anxiety and quality of life(QOL) in patients with cancer who were on chemotherapy. Methods: Symptoms and QOL were examined both before chemotherapy and after 2 cycles of chemotherapy. The participants were 76 cancer patients receiving chemotherapy in one of 7 hospitals. Results: The patients experienced a mean of 2.22-2.23 symptoms out of 4 symptoms. Patients who were female, or suffered from breast or colorectal cancer experienced more symptoms. Fatigue at present, and most severe fatigue and anorexia in the previous 3 weeks increased significantly. Anxiety and QOL decreased significantly after 2 cycles of chemotherapy. Number of symptoms, anorexia at present, most severe anorexia in past 3 weeks, and anxiety had negative correlations. QOL before chemotherapy showed a positive correlation with QOL after 2 cycles of chemotherapy. In a regression analysis, anxiety, QOL at baseline, income, and the most severe pain in the past 3 weeks were significant predictors of QOL. Conclusion: Physical and psychological factors were significant predictors of both QOL and each subscale, and these factors correlated with each other. These results demonstrate the needs for early assessment and intervention from the start of chemotherapy to decrease symptoms and improve QOL.

Purpose: The aim of this study was to construct a structural equation model that would further explain the continuously increasing substance use disorder in Korean adolescents. Methods: Survey visits using a structured questionnaire were conducted with 3,885 students in 2 middle schools and 2 high schools in Busan. A total of 13 instruments were used in this model. The analysis of data was done with both SPSS 14.0 for descriptive statistics and AMOS 5.0 for covariance structure analysis. Results: Based on the constructed model, belief on substance use was found to have a significantly direct effect in influencing adolescent substance use. In addition, other factors such as family environment, satisfaction with school life, self-concept, social support, and personality vulnerability indirectly affected substance use. The final modified model yielded Chi-square=2,987(p<.001), df=121, ${\chi}^2$/df=22.1, GFI=.96, AGFI=.93, NFI=.91, PNFI=.72, PGFI=.72, RMSEA=.07 and exhibited fit indices. Conclusion: This study constructed a model that addresses the factors related to adolescent substance use and explains the relationship of these factors in influencing substance use among Korean adolescents. Findings from this study can contribute to designing appropriate prevention strategies to reduce substance related disorders in adolescents.