Purpose: The purpose of this study was to identify the levels of relocation stress syndrome (RSS) and influencing the stress experienced by Intensive Care Unit (ICU) patients just after transfer to general wards. Methods: A cross-sectional study was conducted with 257 patients who transferred from the intensive care unit. Data were collected through self-report questionnaires from May to October, 2009. Data were analyzed using the Pearson correlation coefficient, t-test, one-way ANOVA, and stepwise multiple linear regression with SPSS/WIN 12.0. Results: The mean score for RSS was $17.80{\pm}9.16$. The factors predicting relocation stress syndrome were symptom experience, differences in scope and quality of care provided by ICU and ward nursing staffs, satisfaction with transfer process, length of stay in ICU and economic status, and these factors explained 40% of relocation stress syndrome (F=31.61, p<.001). Conclusion: By understanding the stress experienced by ICU patients, nurses are better able to provide psychological support and thus more holistic care to critically ill patients. Further research is needed to consider the impact of relocation stress syndrome on patients' health outcomes in the recovery trajectory.

Purpose: The purpose of this study was to examine the effect of pre-warming on body temperature, anxiety, pain, and thermal comfort. Methods: Forty patients who were scheduled for abdominal surgery were recruited as study participants and were assigned to the experimental or control group. For the experimental group, a forced air warmer was applied for 45-90 min (M=68.25, SD=15.50) before surgery. Body temperature and anxiety were measured before and after the experiment, but pain and thermal comfort were assessed only after the surgery. Hypotheses were tested using t-test and repeated measured ANOVA. Results: The experimental group showed higher body temperature than the control group from right before induction to two hours after surgery. Post-operative anxiety and pain in the experimental group were less than those of the control group. In addition, the score of thermal comfort was significantly higher in the experiment group. Conclusion: Pre-warming is effective in maintaining body temperature, lowering sensitivity to pain and anxiety, and promoting thermal comfort. Therefore, pre-warming can be recommended as a preoperative nursing intervention.

Purpose: The purpose of this descriptive study was to determine the perception of physicians and nurses on family presence during invasive procedures. Methods: The study population consisted of 100 physicians and 100 nurses from five hospitals which have more than 500 beds in B city. Data collection was done from August 20 to September 19, 2007. The Family Presence During Resuscitation (FPDR) Inventory developed by Fulbrook, Albarran and Latour (2005) was used as the study instrument. The collected data was analyzed by t-test, ANOVA and Duncan's multiple range test using SPSS/WIN 14.0 version. Results: Nurses had more positive attitudes to allowing family members to be present during invasive procedures than physicians did. However, compared to physicians, nurses had more concern about problems of confidentiality, arguing with medical team, and increased rate of legal action if family members were present during invasive procedure. Conclusion: The results of this study indicate that educational programs and policy for family presence be required within the hospital to enhance the perception of physicians and nurses to the family presence.

Purpose: The purpose of the study was to investigate the relationships between the Myers-Briggs Type Indicator (MBTI) psychological type and marital satisfaction, divorce proneness, positive affect, and conflict regulation in couple visiting a clinic. Methods: Couples (n=62) who visited "M" couple clinic participated in the study. Data were collected from March to June 2009 using the Marital Satisfaction Scale, Marital Status Inventory, Positive Affect Inventory, and Conflict Regulation Inventory. Results: The couples showed no significant differences in marital satisfaction, positive affect, and conflict regulation according to similarities between spouses in MBTI types. However, they showed significant differences in divorce proneness of husband according to a similarity in the Sensing/Intuition indicator. They also showed significant differences in divorce proneness, positive affect, and conflict regulation between the couples for ISTJ (Introversion, Sensing, Thinking, Judging) or ESTJ (Extraversion, Sensing, Thinking, Judging) types compared to other couples. Conclusion: When nurses counsel couples, they should understand that differences in psychological type between spouses affects their marital relationship. In addition, nurses should educate couples on the characteristics of each type according to the couple's types and help them to understand each other, especially for couples where one spouse is the ISTJ/ESTJ type. These interventions will improve marital satisfaction and prevent the divorce in these couples.

Purpose: The purpose of this study was to estimate nursing costs and to establish appropriate nursing fees for long-term care services for community elders. Methods: Seven nurses participated in data collection related to visiting time by nurses for 1,100 elders. Data on material costs and management costs were collected from 5 visiting nursing agencies. The nursing costs were classified into 3 groups based on the nurse's visit time under the current reimbursement system of long-term care insurance. Results: The average nursing cost per minute was 246 won. The material costs were 3,214 won, management costs, 10,707 won, transportation costs, 7,605 won, and capital costs, 5,635 won per visit. As a result, the average cost of nursing services per visit by classification of nursing time were 41,036 won (care time <30 min), 46,005 won (care time 30-59 min), and 57,321 won (care time over 60 min). Conclusion: The results of the study indicate that the fees for nurse visits currently being charged for long-term care insurance should be increased. Also these results will contribute to baseline data for establishing appropriate nursing fees for long-term care services to maintain quality nursing and management in visiting nursing agencies.

Purpose: The purpose of this study was to determine the significant factors for risk estimate of aspiration and to evaluate the efficiency of the dysphagia assessment tool. Methods: A consecutive series of 210 stroke patients with aspiration symptoms such as cough and dysphagia who had soft or regular diet without tube feeding were examined. The dysphagia assessment tool for aspiration was compared with videofluoroscopy using Classification and Regression Tree (CART) analysis. Results: In CART analysis, of 34 factors, the significant factors for estimating risk of aspiration were cough during swallowing, oral stasis, facial symmetry, salivary drooling, and cough after swallowing. The risk estimate error of the revised dysphagia assessment tool was 25.2%, equal to that of videofluoroscopy. Conclusion: The results indicate that the dysphagia assessment tool developed and examined in this study was potentially useful in the clinical field and the primary risk estimating factor was cough during swallowing. Oral stasis, facial symmetry, salivary drooling, cough after swallowing were other significant factors, and based on these results, the dysphagia assessment tool for aspiration was revised and complemented.

Purpose: This study was done to compare factors influencing children's self-esteem between two parent families and single parent families. Methods: The participants were 692 children aged 11 to 13 yr (388 in two parent families and 304 in single parent families) recruited from 20 community agencies and 5 elementary schools in Gyeonggi Province and Seoul City, South Korea. Data were collected from May to July, 2007 using a survey questionnaire containing items on self-esteem, internal control, problematic behavior, school record, family hardiness, parent-child communication and social support. The data were analyzed using SPSS 15.0 program and factors affecting children's self-esteem were analyzed by stepwise multiple regression. Results: Scores for the study variables were significantly different between the two groups. The factors influencing children's self-esteem were also different according to family type. For two parent families, internal control, problematic behavior, school record, and parent-child communication significantly predicted the level of self-esteem (adjusted $R^2$=.505, p<.001). For single parent families, social support, family hardiness, internal control, problematic behavior, school record, and parent-child communication significantly predicted the level of self-esteem (adjusted $R^2$=.444, p<.001). Conclusion: Nurse working with children should consider family type-specific factors influencing their self-esteem.

Purpose: This study was designed to build a theoretical frame to provide practical help to prevent and manage adolescent internet game addiction by developing a prediction model through a comprehensive analysis of related factors. Methods: The participants were 1,318 students studying in elementary, middle, and high schools in Seoul and Gyeonggi Province, Korea. Collected data were analyzed using the SPSS program. Decision Tree Analysis using the Clementine program was applied to build an optimum and significant prediction model to predict internet game addiction related to various factors, especially parent related factors. Results: From the data analyses, the prediction model for factors related to internet game addiction presented with 5 pathways. Causative factors included gender, type of school, siblings, economic status, religion, time spent alone, gaming place, payment to Internet cafe$\acute{e}$, frequency, duration, parent's ability to use internet, occupation (mother), trust (father), expectations regarding adolescent's study (mother), supervising (both parents), rearing attitude (both parents). Conclusion: The results suggest preventive and managerial nursing programs for specific groups by path. Use of this predictive model can expand the role of school nurses, not only in counseling addicted adolescents but also, in developing and carrying out programs with parents and approaching adolescents individually through databases and computer programming.

Purpose: The aim of this study was to construct a structural equation model that would further explain the mental health status of Korean immigrants living in Canada. Methods: Survey using a structured questionnaire was conducted with 386 people in Canada (Vancouver and Toronto). Six 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, physical health status, immigrant life stress, self esteem, and quality of life were found to have significant direct effect on mental health. In addition, factors such as physical health status, immigrant life stress, quality of life, English proficiency, family cohesion and social support were found to indirectly affect mental health. The final modified model yielded Chi-square=34.79 (p<.001), df=13, $x^2$/df=2.68, GFI=0.98, AGFI=0.94, NFI=0.95, PNFI=0.44, PGFI=0.35, RMSE=0.07 and exhibited good fit indices. Conclusion: This structural equation model is a comprehensive theoretical model that explains the related factors and their relationship with mental health in Korean immigrants. Findings of this study can contribute to the designing of an appropriate prevention strategy to further improve the mental health of immigrants in Canada.

Purpose: The purpose of this study was to investigate the factors that influenced the health-related quality of life of young-old (65-74 yr) men, old-old (75-84 yr) men, and oldest-old (85 yr or above) men in vulnerable aged received home care from public health center. Methods: The participants for this study were 318 aged Korean men living in D city. The data was collected from August to October, 2009 using structured questionnaires. Chi-square, One way ANOVA, Duncan test, Pearson's Correlation Coefficient and multiple regression with the SPSS WIN 14.0 program were used to analyze the data. Results: There were statistically significant differences among young-old, old-old, and oldest-old men regarding the health-related quality of life, health promoting behavior, IADL (Instrumental Activities of Daily Living), rehabilitation, depression, and social support. The model including variables related to physical, psychological, and social aspects of life, explained variance of the health-related quality of life of aged men differently, such as 39.6% of young-old, 35.4% of old-old, and 47.0% of oldest-old. Finally, IADL and social support were predictors in explaining the level of health-related quality of life among vulnerable old men regardless of age. Conclusion: Based on the findings of the study, nursing interventions should be developed to improve health-related quality of life of vulnerable aged men according to age differences.

Purpose: In the present study, an analysis of the life of adolescents with complex congenital heart disease (CHD) was done using grounded theory. Consideration was given to the socio-cultural context of Korea. Methods: After approval from the institutional review board of Y hospital, 12 patients ranging in age from 14 to 35 were recruited. Data were gathered using in-depth interviews. Theoretical sampling was performed until the concepts were saturated. Results: The results confirmed the life of adolescents with complex CHD as a 'journey to finding uniqueness of oneself as a person with CHD'. The life consisted of 3 stages. In the crisis stage, participants had a feeling of threat to self-existence, and made an effort to be the same as others. In the self-recognition stage, participants who had sufficient role-performance built self-esteem while those who did not fell into self-accusation. In the self-establishment stage, participants who reached sufficiency in independence and knowledge planned the future, whereas those who did not conformed to the realities of life. Conclusion: The results of present study provide help in understanding the experiences of adolescents with CHD and provide a basis for developing nursing intervention strategies for these patients.

Purpose: This study was done to examine effects of Nei-Guan acupressure on nausea, vomiting and level of satisfaction for gynecological surgery patients who were using a patient-controlled analgesia (PCA). Methods: For this study, 51 patients were assigned to one of three groups, a control group (17 patients), experimental group 1 (finger acupressure group) (17 patients), and experimental group 2 (relief band group) (17 patients). The data were collected for 24 hr in the recovery room of a university hospital located in Seoul. The 6 hr-intervals including the time of leaving the recovery room were taken into consideration. Results: The occurrence of nausea between the experimental group with Nei-Guan acupressure treatment and the control group was different. However, there was no difference in nausea and vomiting control or level of patient satisfaction between the finger acupressure group and the relief band group. Conclusion: Nei-Guan acupressure is recommended for nursing practice as a way for alleviating the opioid-induced nausea and accelerating the recovery of patients who are using PCA after surgery.

Purpose: This study was performed to identify effects of pneumoperitoneum on hemodynamic changes of hypertensive patients undergoing laparoscopic colectomy under general anesthesia. Methods: Data collection was done from January 2 to June 10, 2008. Seventy-six patients, including 38 hypertensive patients, who had taken antihypertensive drugs more than 1 month and 38 normotensive patients undergoing laparoscopic colectomy were enrolled in this study. The hemodynamic parameters were heart rate (HR), mean arterial pressure (MAP) and cardiac output (CO) which were measured 7 times from before induction of anesthesia to 5 min after deflation of the pneumoperitoneum. Collected data were analyzed using Repeated Measures ANOVA and Bonferroni comparison method. Results: HR in the hypertensive group was significantly decreased at deflation of the pneumoperitoneum and 5 min after deflation of the pneumoperitoneum (p=.012). MAP in the hypertensive group was not different from the normotensive group (p=.756). CO in hypertensive group was significantly lower than normotensive group (p<.001) from immediately after pneumoperitoneum to 5 min after deflation of the pneumoperitoneum. Conclusion: The results indicate that pneumoperitoneum during laparoscopic surgery does not lead to clinically negative hemodynamic changes in heart rate, mean arterial pressure or cardiac output of hypertensive patients, who have taken antihypertensive drugs for more than 1 month.

Purpose: The purpose of this study was to identify the effects of abdominal breathing on state anxiety, stress and tocolytic dosage for pregnant women in preterm labor. Methods: The participants were 60 pregnant women in preterm labor who were hospitalized from April to July, 2009. Thirty participants were assigned to the experimental group and 30 to the control group. None of them had any other complications except preterm labor. The modified Mason's breathing technique was used with the experimental group 3 times a day for 3 days. Data were collected using a self-report questionnaire and chart review, and analyzed with the SPSS 13.0 WIN program. Results: "State anxiety of the experimental group will be lower than that of the control group" was supported. "Stress of the experimental group will be lower than that of the control group" was supported. "The Ritodrine dosage for the experimental group will be lower than that of the control group" was supported. "The Atosiban dosage for the experimental group will be lower than that of the control group" was supported. Conclusion: These results indicate that abdominal breathing is an effective nursing intervention for pregnant women in preterm labor.

Purpose: In this study differences in behavioral problems between children at risk for Attention Deficit Hyperactive Disorder (ADHD) and normally developing children were identified. Further, relationships between parental stress, depression, and child behavioral problems according to ADHD symptoms were explored. Methods: Participants were 222 elementary school children and their parents. The ADHD risk group was determined by the Korean-ADHD Rating Scale. Data were collected using the Korean-ADHD Rating Scale, Korean version of Child Behavior CheckList (K-CBCL), Parenting Stress Index, and Beck Depression Inventory. Data were analyzed using t-test, Pearson correlation coefficients, and regression analysis. Results: 1) The ADHD risk group showed higher levels of behavioral problems, parenting stress, and maternal depression than the normal group. 2) There were significant relationships between ADHD scores and parenting stress (r=.66), maternal depression (r=.35), internal behavioral problems (r=.47), and external problems (r=.55), but, ADHD risk scores were negatively correlated with social competence (r=-.40). 3) The regression analysis revealed that ADHD levels affected the child's internal behavioral problems, mediated by maternal depression ($\beta$=.29, p<.001). Conclusion: The study results show that higher risk scores for ADHD indicate a significant effect for behavioral problems. Also, parenting stress and depression influence child's behavioral problems. These results suggest that identification of children at risk for ADHD and development of parental education programs would contribute to the prevention of behavioral problems and aggravation of the ADHD symptoms.