Purpose: This study was conducted to identify the protective factors that influence suicide probability in religious male high school students. Methods: The data was collected from Nov. 5 to Dec. 10, 2009. Data were collected by self-report questionnaire from 255 students selected from 2 religious male high schools in B city. The instruments for this study were the Suicide Probability Scale for Adolescence (SPS-A), Inventory Parents Peer Attachment-Revision (IPPA-R), Spiritual Well-being Scale (SWBS), and Ego-identity Scale. The data were analyzed using t-test, one-way ANOVA, Scheffe test, Pearson correlation coefficients and stepwise multiple regression with the SPSS 14.0 program. Results: The protective factors of suicide probability in religious male high school students were identified as existential spiritual well-being (${\beta}$= -.46, p<.001), self-identity (${\beta}$= -.30, p<.001), and mother attachment (${\beta}$= -.21, p<.001). These three factors explained 61.5% of the variance in suicide probability. Conclusions: The results suggest that improvement in spirituality, ego-identity, and mother attachment for religious male high school students is important to reduce the probability of suicide.

Purpose: The purpose of this study was to test the turnover intention model for chief nurse officers in general hospitals. The variables for the study included job stress, social support, job satisfaction, and organization commitment. Methods: A predictive, non-experimental design was used with a sample of 144 chief nurse officers from 144 general hospitals. Data were collected using self-administered questionnaires and analyzed using SPSS, AMOS program. Results: The overall fitness of the hypothetical model to the data was good (${\chi}^2$=16.80, p=.052, GFI=.96, AGFI=.90, NFI=.97, CFI=.99). Job stress, social support, job satisfaction, and organization commitment explained 59.0% of the variance in turnover intention by chief nurse officers. Both organization commitment and social support directly influenced turnover intention for chief nurse officers, and job stress and job satisfaction indirectly influenced turnover intention. Conclusion: The results imply that chief nurse officers in hospitals need social support and management of job stress to increase job satisfaction and organization commitment, and lower turnover intention.

Purpose: This study examined the effectiveness of an Adolescent Motivational Interviewing Cessation program on smoking cessation change. The study was done with a nonequivalent control group pretest-posttest design. Methods: The participants were 39 high school students from G city, who were in school from September 1 to October 30, 2009. The students were assigned to the experimental group (20) and participated in the motivational interviewing cessation program or to the control group (19) who did not participate. Data analyses involved ${\chi}^2$-test, independent t-test, Repeated Measures ANOVA, and utilized the SPSS program. Results: The experimental group had significantly less daily smoking, nicotine dependence and smoking temptation in comparison to the control group. The experimental group had significantly higher stage of change in comparison to the control group. Conclusion: The results of the study indicate that a motivational interviewing cessation program delivered to adolescents who smoke is an effective method of encouraging cessation, and can be utilized as an effective nursing intervention for adolescents who smoke.

Purpose: This study was done to evaluate the effects of a short-term life review on spiritual well-being, depression, and anxiety in patients with terminal cancer. Methods: The study used a pre posttest quasi experimental design with a nonequivalent control group. Measurement instruments included the Functional Assessment of Chronic Illness Therapy-Spiritual scale (FACIT-Sp12) and the Hospital Anxiety and Depression Scale (HADS). Participants were 32 patients with terminal cancer who were receiving chemotherapy or palliative care at hospitals or at home. Eighteen patients were assigned to the experimental group and 14 to the control group. A sixty minute short-term life review session was held twice a week as the intervention with the experimental group. Results: There was a statistically significant increase in spiritual well-being in the experimental group compared to the control group. There were also significant decreases in depression and anxiety in the experimental group compared to the control group. Conclusion: The results indicate that a short-term life review can be used as a nursing intervention for enhancing the spiritual well-being of patients with terminal cancer.

Purpose: This study was to explore adaptation experience to family among women who immigrated for marriage. Specific aims were to identify problems immigrant women face as family members and how they interact with other family members. Methods: Grounded theory methodology was utilized. Data were collected from iterative fieldwork with individual in-depth interviews from 6 immigrant women as key informants, and 2 of their husbands and 2 of their mothers-in-law as general informants. Results: Through constant comparative analysis, a core category emerged as "tearing down the wall in communicating". Causal conditions were feeling frustrated in one's expectations, differences in language and life style, differences in recognition, and perceptions of discrimination and prejudice. Strategies were learning the Korean language, learning Korean culture, managing stress, mediating differences between family members, and introspecting. Intervening factors were support systems, burdens of child-rearing, and the condition of one's health. Consequences were rooting oneself in one's family and accepting one's life as it is. Conclusion: Results of the study indicate that there is a need for nurses to understand differences in communication with family members among immigrant women and to provide information and emotional support to improve the adaptation of these women to their Korean families.

Purpose: The aim of this study was to compare statistical methods to control response bias in nursing activity surveys. Methods: Data were collected at a medical unit of a general hospital. The number of nursing activities and consumed activity time were measured using self-report questionnaires. Descriptive statistics were used to identify general characteristics of the units. Average, Z-standardization, gamma regression, finite mixture model, and stochastic frontier model were adopted to estimate true activity time controlling for response bias. Results: The nursing activity time data were highly skewed and had non-normal distributions. Among the 4 different methods, only gamma regression and stochastic frontier model controlled response bias effectively and the estimated total nursing activity time did not exceeded total work time. However, in gamma regression, estimated total nursing activity time was too small to use in real clinical settings. Thus stochastic frontier model was the most appropriate method to control response bias when compared with the other methods. Conclusion: According to these results, we recommend the use of a stochastic frontier model to estimate true nursing activity time when using self-report surveys.

Purpose: This study was done to evaluate the effects of cognitive behavioral therapy in a victimized community district and to determine if the program is an effective nursing intervention to reduce posttraumatic stress disorder symptom, depression and state anxiety. Methods: A nonequivalent control group design was used for the study. The participants, 32 elementary school students, were selected from grades 4, 5, 6 and each student was assigned to either the experimental (16) or control (16) group. Cognitive behavioral therapy was used as the experimental treatment from April 9 to May 28, 2009. The experimental group received cognitive behavior therapy intervention 8 times. Data analysis was done using ANCOVA with SPSS 17.0. Results: After the intervention, the experimental group showed significantly lower levels of posttraumatic stress disorder symptoms than the control group. Conclusion: The findings from this study suggest that cognitive behavioral therapy is an effective nursing intervention to decrease the level of mental health problems of children in victimized district. Further research is required in order to identify the continuous effects of cognitive behavioral therapy.

Purpose: The purpose of this study was to explore violent experiences of home visiting health care workers in Korea. Methods: This study was a cross-sectional survey. Data were collected using self-report questionnaires from 1,640 health care workers. Data collection was done between September 1, 2009 and June 30, 2010. Results: Of the respondents, 70.6% had experienced work-related violence. Shouting (51.9%) was the most common verbal violence, followed by verbalizing sexual remarks to the health care workers (19.0%) and touching the hands (16.5%), the most common acts relating to sexual harassment. Of the respondents who had experienced violence, 50.9% told their peers about the incidents. However, the major reasons why they did not report these incidents was due to the fact that they felt it was useless to file reports and that they expected such incidents to occur as part of their job. The majority of the respondents (86.4%) wanted education on how to deal with such violence at work. Conclusion: The results of this study indicate that efforts should be made to increase awareness and to minimize violence in the workplace. Also, educational programs should be designed to improve knowledge and to prevent workplace violence.

Purpose: The purpose of this methodological study was to examine the reliability and validity of a translated Korean version of the Critical Care Pain Observation Tool (CPOT) developed for assessment of pain in critically ill nonverbal patients. Methods: A cross-sectional study design was used. Data were collected from a convenience sample of 202 critically ill patients admitted to a university hospital. Upon establishment of content and translation equivalence between the English and Korean version of CPOT, psychometric properties were evaluated. Results: The interrater reliability was found to be acceptable with the weighted kappa coefficients of .81-.88. Significant high correlations between the CPOT and the Checklist of Nonverbal Pain Indicators were found indicating good concurrent validity (r=.72-.83, p<.001). Data showed the area under the ROC curve of 0.86 with a cut-off point of 1, which resulted in 76.9% sensitivity and 88.6% specificity. The mean score of CPOT during suctioning was significantly different from that of before (t= -14.16, p<.001) or 20 minutes after suctioning (t=16.31, p<.001). Conclusion: Results of this study suggest that the CPOT can be used as a reliable and valid measure to assess pain in critically ill nonverbal patients.

Purpose: This study was done to examine the effects of nurses' perception of servant leadership on leader effectiveness, satisfaction and promoting additional effort. The focus was the mediating effects of leader trust and value congruence. Methods: Data were collected from 361 RN-BSN students and nurses participating in nationally attended in-service training programs. Data were analyzed using descriptive statistics and structural analysis with SPSS 17.0 windows program and Amos 7.0. Results: Direct effects of nurses' perception of servant leadership were negative, but mediating effects of trust and value congruency were positively correlated with leader effectiveness, satisfaction and additional effort, that is servant leadership should be effective through mediating factors. Conclusion: The study results indicate that if the middle managers of nurses can build leader trust and value congruency between nurses through servant leadership, leader effectiveness, satisfaction and additional effort on the part of the nurses could result in a positive change in the long term.

Purpose: The purpose of this study was to identify the effects of a home based exercise program for patients with stomach cancer who were undergoing oral chemotherapy. Methods: The home-based exercise program was developed from the study findings of Winningham (1990) and data from the Korea Athletic Promotion Association (2007). The home-based exercise program consisted of 8 weeks of individual exercise education and exercise adherence strategy. Participants were 24 patients with stomach cancer who were undergoing oral chemotherapy following surgery in 2007 or 2008 at a university hospital in Seoul. Patients were randomly assigned to either the experimental group (11) or control group (13). The effects of the homebased exercise program were measured by level of cancer related fatigue, NK cell ratio, anxiety, and quality of life. Data were analyzed using SPSS/WIN 13.0 version. Results: The degree of cancer related fatigue and anxiety in the experimental group decreased compared to the control group. The NK cell ratio and the degree of quality of life of experimental group increased while that of the control group decreased. Conclusion: This study result indicate the importance of exercise and provide empirical evidence for continuation of safe exercise for patients with cancer during their chemotherapy.

Purpose: This study was done to propose a structural model to explain and predict psychosocial adjustment in patients with early breast cancer and to test the model. The model was based on the Stress-Coping Model of Lazarus and Folkman (1984). Methods: Data were collected from February 18 to March 18, 2009. For data analysis, 198 data sets were analyzed using SPSS/WIN12 and AMOS 7.0 version. Results: Social support, uncertainty, symptom experience, and coping had statistically significant direct, indirect and total effects on psychosocial adjustment, and optimism had significant indirect and total effects on psychosocial adjustment. These variables explained 57% of total variance of the psychosocial adjustment in patients with early breast cancer. Conclusion: The results of the study indicate a need to enhance psychosocial adjustment of patients with early breast cancer by providing detailed structured information and various symptom alleviation programs to reduce perceived stresses such as uncertainty and symptom experience. They also suggest the need to establish support systems through participation of medical personnel and families in such programs, and to apply interventions strengthening coping methods to give the patients positive and optimistic beliefs.

Purpose: The study was done to compare effects of two endotracheal tube (ET tube) fixation methods (rotated fixation versus conventional) on unplanned extubation and skin integrity for orally intubated patients in intensive care units. Methods: The research design was a non-equivalent control group with repeated measures design. Participants were 80 patients; 40 participants assigned to each group. ET tube for the experimental participants fixed with rotated method every morning. Unplanned extubation was assessed by bedside nurses using the unplanned extubation report form. Oral mucosa and facial skin integrity were assessed using oral assessment guide and facial skin integrity assessment guide at day 3, 7, 10 and 14. Results: There was no difference in the unplanned extubation rate between the two groups. Oral mucosa impairment scores for the rotated fixation method were significantly lower at day 7 (p=.044), 10 (p=.048) and day 14 (p=.037). Also facial skin integrity impairment scores for the same group were significantly lower at day 7 (p=.010), 10 (p=.003), and 14 (p=.002). Conclusion: Results of the study suggest that the rotated fixation method is effective for these patients, to prevent impairment of oral mucosa and facial skin integrity. Further research is needed to prevent unplanned extubation.

Purpose: This study was conducted to develop and test the effects of an elder health promotion program and apply strategies for elder health leader training sessions with elders at senior citizen halls. Methods: A nonequivalent control group pretestposttest design was used. Participants were 49 elders at a senior citizen hall (intervention: 27, control: 22). The elder health promotion program consisted of health education and exercise. A professional leader led the program for 4 weeks, and then an elder health leader and research assistant led for 8 weeks (total 12 weeks). Scales for elder health promoting behaviors, perceived health status, life satisfaction and senior citizen hall capability were used and physical fitness levels were measured. Data were collected between April 21 and July 28, 2010 and analyzed using Chi-square, Fisher's exact test, t-test, and repeated measure ANOVA with SPSS/WIN 12.0. Results: Health promoting behaviors, physical fitness, perceived health status, and senior citizen hall capacity were significantly better in the experimental group after the intervention compared to the control group. Conclusion: Study findings indicate that elder health promotion programs applying strategies of elder health leader training are effective and can be recommended as nursing interventions for health promotion of these elders.

Purpose: This study was conducted to compare the degree of depression between men and women and to identify factors influencing their depression. Methods: Participants in this cross-sectional descriptive study were 263 persons over 65 years old (men: 103, women: 160). Data were collected through face to face interviews using questionnaires and were done in two urban areas in 2010. Research instruments utilized in this study were SGDS, MMSE-K, SRH, FILE, sleep pattern scale, family and friend support scale, and social support scale. Multivariate regression analysis was performed to identify factors influencing depression in elders. Results: The proportions of participants with depression were significantly different between men and women (52.4% vs. 67.5%). Regression model for depression in elderly men significantly accounted for 54%; disease stress (32%), economic stress (10%), perceived health status (4%), and family support, educational level, age, and hypertension. Regression model for depression in elderly women significantly accounted for 47%; disease stress (25%), perceived social loneliness (8%), friend support (5%), family stress (4%), and sleep satisfaction, and family support. Conclusion: Results demonstrate that depression is an important health problem for elders, and show gender differences for factors influencing depression. These results could be used in the developing depression prevention programs.