• Journal of Korean Academy of Nursing
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• v.29 no.1
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• pp.161-173
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• 1999

The purpose of this study was to develope and test the structural model for quality of life in women having hysterectomies. A hypothetical model was constructed on the basis of previous studies and a review of literature. The conceptual framework was built around eight constructs. Exogenous variables included in this model were marital intimacy, importance of uterus, professional support, positive coping behavior and pre-operative symptoms. Endogenous variables were spouse's support, sense of loss and quality of life. Empirical data for testing the hypothetical model was collected using a self-report questionnare from 203 women having hysterectomies at the outpatient clinics of four general hospitals and a mail survey in Pusan City. The Data was collected from December, 1997 to January, 1998. Reliability of the eight instruments was tested with Cronbach's alpha which ranged from 0.639-0.915. For the data analysis, SPSS 7.5 WIN Program and LISREL 8.12 WIN Program were used for descriptive statistics and covariance structural analysis. The results of covariance structure analysis were as follows : 1. Hypothetical model showed a good fit with the empirical data. ［$\chi$$^2$＝6.93(df＝5, P＝.23), GFI＝.99, AGFI＝.94, RMSR＝.019, NNFI＝.97, NFI＝.98, CN＝440, standardized residuals(-2.14-2.10)］ 2. For the parsimony of model, a modified model was constructed by deleting 3 paths and adding 1 path according to the criteria of statistical significance and meaning. 3. The modified model also showed a good fit with the data. ［$\chi$$^2$＝5.26(df＝7, P＝.63), GFI＝.99, AGFI＝.97, RMSR＝.014, NNFI＝1.02, NFI＝.99, CN＝710, standardized residuals(-1.46-1.70)］ Results of the testing of the hypothesis were as follows : 1. Marital intimacy(${\gamma}$11＝.78, t＝14.37) and professional support(${\gamma}$13＝.12, t＝2.12) had a significant direct effect on the spouse's support. 2. Pre-operative symptoms(${\gamma}$25＝.32, t＝3.12), importance of uterus(${\gamma}$22＝.20, t＝2.61) and spouse's support($\beta$2l＝-.19, t＝-2.43) had a significant direct effect on the sense of loss. 3. Sense of loss($\beta$32＝-.66, t＝-9.83) had a direct effect on the quality of life. Marital intimacy had a direct(${\gamma}$31＝.19, t＝3.33), indirect(${\gamma}$31＝.14, t＝2.52) and total effect(${\gamma}$31＝.25, t＝4.41) on the quality of life. Professional support had a direct effect(${\gamma}$33＝.11, t＝2.07) and total effect(${\gamma}$33＝.13, t＝2.31) on the quality of life. The direct effect of pre-operative symptoms(${\gamma}$35＝-.36, t＝4.02) and positive coping behavior(${\gamma}$34＝.15, t＝2.06) had the insignificant effect on the quality of life while, due to the idirect effect these variables had overall significant effect on the quality of life. The results of this study showed that the sense of loss had the most significant direct effect on the quality of life. Marital intimacy, pre -operative symptoms and spouse's support had a significant direct effect on this sense of loss. These four variables, the sense of loss, marital intimacy, pre-operative symptoms and spouse's support, were identified as relatively important variables. The results of this study suggested that there is needed to determine if nursing intervention would alleviate this sense of loss and promote a greater quality of life in women who have had hysterectomies.

• Journal of Korean Academy of Nursing
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• v.22 no.1
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• pp.81-115
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• 1992

The problem addressed by this study was to determine the effect of nurse - patient agreement on the means to achieve nursing goals in the early postpartum period of primiparous mothers. It was hypothesized that the experimental treatment would result in hegher self-confidence and satisfaction in maternal role performance. This purpose was to contribute to the planning of nursing care to enhance self- confidence and satisfaction in maternal role performance and to the development of relevant nursing theory. Especially, the early postpartum period is crucial toward in recovery from childbirth and attainment of the maternal role. Maternal role attaintment is a complex social and cognitive process of stimulus -response accomplished by learning. Most women attain the maternal role sucessfully. But, some primiparous mothers experience difficultites in attainment of the maternal role due to lack of experience and knowledge. Self-confidence and satisfaction in maternal role performance are important factors in attainment and adjustment to the maternal role (Mercer, 1981a, 1981b ; Lederman, Weigarten, and Lederman, 1981 :Bobak and Jensen, 1985). Nursing is defined as behaviors of nurses add patients that attain nursing goals through action, reaction, interaction, and transaction. For attainment of nursing goals, active participating transactions must occur by agreement on the means to achieve those goals through nurse -patient mutual goal setting and establishment of their active relationships(King, 1981, Ha, 1977). Based on King's theory of goal attainment (1981), this stuy was planned as a non-equivalent control group, non -synchronized quasi -experimental design using agreement on the means to achieve nursing goals in early postpartum as the experimental treatment. The data were collected from July 20 to Sep. 1, 1991 by questionnaires with 60 primiparous mothers planing to breast feed after normal deliveries at W hospital in Pusan, Korea. The subjects were divided into a control group(conventional group) -those admitted from July 20 to Aug. 12, and an experimental group(agreement group) - those admitted from Aug. 13 to Sep. 1. The instument for agreement on the means to nursing goals in the early postpartum period included five steps - identification of disturbances of problems through action, reaction, and interaction with primiparous mothers : mutual early postpartal nursing goal setting : exploration of the means to achieve goals ; agreement on the means (self- care, ealry maternal -infant contact, performance of mothering behavior, and communicating about the infant's behavior and health condition) : implementation of the means. This instrument was developed on the basis of King's elements that lead to transactions in nurse-patient interactions. Lederman et al's (1981) scale for Confidence in ability to cope with tasks of motherhood and Lederman et al's(1981) scale for Mother's satisfaction with motherhood and infant care were used to measure self-confidence and satisfaction in maternal role performance ·with the subjects immediately after admission and on the day of discharge. Self-care performance in the experimental group was measured by self -evaluation tool developed by the investigator from the literature concerned. The tools to measure Pelf-confidence and satisfaction in maternal role performance, and the tool to measure self-evaluation of self-care performance were tested for internal reliability. Cronbach's Alphas were 0.94, 0.94, and 0.63. The data were analysed by using in S.P.S.S. computerized program and included percentage, x²-test, t-test, ANOVA, and Pearson Correlation Coefficient. The conclusions obtained from this study are summerized as follows : 1. The degree of self-confidence in maternal role performance of the total subjects group measured before the experimental treatment was above average with a mean score of 2.77(range 2.14-3.64). Out of 14 items, those with relatively high mean scores were ‘I would like to be a better mother than I am’(3.95), and ‘I have my doubts about whether I am a good mother’(2.87). Those with low mean scores were ‘I know that my baby wants most of the times’(2.28), ‘When the baby cries, I can tell what she /he wants’(2.37), and ‘I have confidence in my ability to care for the baby’(2;50). That is, the self - confidence of Primiparous mothers was considerably high in mothering, but rather low in activities concerning the infant care and understanding of the infant behavior. The degree of satisfaction in maternal role performance of the total subjects group measured before the experimental treatment was high with a mean score of 3.18(range 1.92-3.92). Out of 13 items, those with relatively high mean scores were ‘I am glad 1 had this baby now’(3.75), ‘I play with the baby between feedings when s/he is awake and quiet’(3.67), and ‘I enjoy being a mother’(3.27). Those with low mean scores were ‘I am upset about having too many responsibilities as a mother’(2.78), ‘It bothers me to get up for the baby at night’(2.82), and ‘I get annoyed if the baby frequently interrupts my activities’.(2.82), That is, the satisfaction of primiparous mothers was considerably high in mothering and infant care, but rather low in restraints in time or on the mother's self accomplishment and development. 2. Agreement on the means to achieve nursing goals in the early postpartum period included process of mutual goal setting, exploration of the means to achieve goals, and ahreement in concert means to achieve goals based on the mothers' condition, concerns, self-perception of the nurse - patient interactions. In the process of agreement, there was agreement that the means to achieve goals should be through trust and establishment of active relationships with the nurse through identification of problems according to planned nursing goals and active interaction, such as explanations, teaching, changing of opinions, acceptance or rejection of explanations, and proposing of questions. Therefore agreement on the means to achieve nursing goals in the early postpartum period appears to be an effective nursing intervention for primiparous mothers. 3. The degree of self- confidence in maternal role performance of the exprimental group was higher than that of the control group(t＝3.95, p＜0.01). Out of 14 items, those with higher score in the experimental group were ‘I would like to be a better mother than I am’(t＝1.93, p＜0.05), ‘I know that my baby wants most of the times’(t＝2.75, p＜0.01), ‘When the baby cries, 1 can tell what she/he wants’(t＝2.10, p＜0.05), ‘I have confidence in my ability to care for the baby’(t＝3.72, p＜0.01), ‘I trust my own judement in deciding how to care for the baby’(t＝1.96, p＜0.05), ‘I feel that I know my baby and what to do for him /her’(t＝2.44, p＜0.01), ‘I am concerned about being able to meet the baby's needs’(t＝2.87, p＜0.01), ‘I know what my baby likes and dislikes’(t＝3.26, p＜0.01), ‘I don't know to care for the baby as well as I should’(t＝2.07, p＜0.05), and ‘I am unsure about whether I give enough attention to the baby’(t＝3.04, p＜0.01), That is, the degree of self-confidence in mothering, activities concerning infant care, and understanding of infant behavior of the experimental group was higher than that of the control group. Therefore, the first hypothesis, that the degree of self-confidence in maternal role performance of the experimental group would be higher than that of the control group, was supported(t＝3.95, p＜0.01). 4. The degree of satisfaction in the maternal role performance of the exprimental group was higer than that or the control group(t＝2.31, p＜0.05). Out of 13 items, those with higher score in the experimental group were ‘I am glad I had this baby now’(t＝2.29, p＜0.05), ‘I enjoy taking care of the baby’(t＝2.4g, p＜0.01), ‘It is boring for me to care for the baby and do the same thing over and over’(t＝2.87, P＜0.01), ‘I am unhappy with the amount of time I have for activities other than childcare’(t＝2.51, p＜0.01), and ‘When bathing and diapering the baby, I would like to be doing something else’(t＝2.43, p＜0.01). That is, the degree of satisfaction in mothering, infant care, and restraints in time of on the mother's self accomplishment and development in the experimental group was higher than that of the control group. Therefore, the second hypothesis, that the degree of satisfaction in maternal role performance of the experimental group would be higher than that of the control group, was supported(t＝2.31, p＜0.05). 5. The third hypothesis, that the higher the degree of satisfaction in materenal role performance, the higher the degree of self-confidence in materenal role performance in the experimental group, was supported (r＝0.57, p＜0.01)

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.4
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• pp.188-198
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• 2016

This study examined the effects of a smoking cessation coaching program based on the motivation stage applying the Transtheoretical Model to stop the smoking of patients in terms of the amount of smoking, nicotine dependence, CO level, and urine cotinine. The study design was a multi-repeat multiple repeat intermittent time series study with one-group, a pre-post design. The participants were 47 smoking patients (44 males and 3 females), who were treated at a public hospital in N city. The participants were 4 (8.51%) subjects in the action stage and 43 subjects (91.49%) in the preparation stage of the motivation stage. The coaching program intervention was conducted at the first day, second week, and 6th week. The smoking cessation maintenance of the subjects was checked at the 12th week. A chi-square test and t-test were used to analyze the data. The subjects in the action stage were kept under the condition of no smoking and nicotine dependence. After the program of subjects in the preparation stage, the amount of smoking, nicotine dependence, and CO level were significantly lower compared to the pre-test (p<.001). The findings suggest that the coaching program based on the motivation stage was effective in improving the smoking cessation for patients who smoke. On the other hand, the patients in the smoking cessation program may require much more financial assistance than those of healthy people. A greater workforce and budget will be needed for patients to stop smoking.

• Journal of Hospice and Palliative Care
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• v.13 no.2
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• pp.98-108
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• 2010

Purpose: The purpose of this study was to identify the relationship between fatigue and quality of life (QOL) of Korean cancer inpatients. Methods: The data were collected from May to August 2007. Study subjects were recruited at D, Y and A university hospitals in Daegu and Kyungpook, Korea. The research instruments utilized in this study were fatigue (FACT-F) and quality of life (FACT-G) in Korean version 4. Data were analyzed with descriptive statistics, t-test, ANOVA, and Pearson correlation using SPSS Win 12.0 program. Results: Fatigue of subjects showed a significant difference according to the type of treatment, change in weight, performance status, exercise, and sleep. The QOL of subjects showed a significant difference according to the purpose of treatment, change in weight, performance status, exercise, and sleep. The mean score of fatigue was 22.48 and the mean score of QOL was 55.52. The fatigue was negatively related to QOL, physical well-being, emotional well-being, and functional well-being. Conclusion: The results suggest the needs for intervention in order to reduce fatigue and to improve QOL of cancer inpatients.

• Women's Health Nursing
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• v.6 no.1
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• pp.142-152
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• 2000

This study is a descriptive study to offer an actual basic data as Nursing intervention strategy of nurses before delivery in order that pregnant women in Korea may effectively practice Taekyo by examining the relation after apprehending level of recognition and practice of our pregnant women about Taekyo. This study collected questionnaires from 801 pregnant women who visited general hospitals in 10 areas(Seoul, Daejon, chunan, Daegu, Kummi, $Ky{\check{o}}ngju$, $P{\ddot{o}}hang$, Busan, $J{\ddot{o}}nju$, and $Y{\ddot{o}}nkwang$) for prenatal care through an outpatient obstetrics and gynecology from July 15 to August 30, 1999. This study used the tool of lee, Ki Young(1993) revised an complemented by investigator to measure recognition of Taekyo and the tool of Jang, Shun Buk and Park, Young Ju(1996) revised and complemented by investigator to measure practice of Taekyo. The Cronbach's alpha value of each tool was .88 in recognition of Taekyo, while the value was .90 in practice of Taekyo. For data analysis, this study used the descriptive and statistical analysis, Pearson correlation, t-test, ANOVA, Tukey's post hoc contrast, and Stepwise multiple regression in accordance with the purpose of this study with using SPSS Win 7.5 program. The results were as follows ; 1. The practice of Taekyo was low in comparison with recognition of Teakyo by showing average 4.28 points and standard deviation 0.48 at level of recognition of pregnant women about Taekyo on the basis of 5 points and showing to show average 2.81 points and standard deviation 0.36 at practice level on the basis of 4 points. 2. They showed the higher level of recognition on Taekyo at high educational background of pregnant woman(F=3.735, p=.005), Roman catholicism (F=4.570, p=.002), satisfied married life(F=5.448, p=.004), high monthly income(F=6.096, p=.000) and cases of hoping pregnancy(F=2.525, p=.012). 3. They showed the higher level of practice on Taekyo at high educational background of pregnant woman(F=2.883, P=.022), Roman catholicism(F=3.616, p=.032), satisfied married life(F=19.924, p=.000), good health condition(F=2.386, p=.017), cases of hoping pregnancy(F=0.677, p=.000), cases of planning pregnancy with husband(F=3.024, p=.001), cases of regular prenatal care before delivery(F=0.241, p=.005), cases of maternal breast feeding (F=9.132, p=.000), and the number of less children(F=2.763, p=.041). 4. In result of examining correlation between recognition and practice of Taekyo, they showed high level of practice on Taekyo under high level of recognition of pregnant women on Taekyo by showing the statistically significant correlation. 5. In result of examining the related factors that affect recognition and practice of Taekyo y the object, practice of Taekyo had 16.8 percents of explanatory range, purpose of practicing Taekyo 8.5 percents of explanatory range, and monthly income 1.9 percent of explanatory range as variables of affecting recognition of Taekyo. The total explanatory range was 27.2 percents, Recognition of Taekyo had 16.1 percents of explanatory ragne, time of starting Taekyo 3.2 percents, health condition 2.2 percents of explanatory range, condition of hoping pregnancy 1.1 percent of explanatory range, satisfaction of married life 0.8 percent of explanatory range, and religion 0.6 percent of explanatory range as variables of affecting practice of Taekyo. The total explanatory range was 24.0 percents.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.12
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• pp.292-300
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• 2016

The purpose of this study was to investigate the effects of case-based learning about infants and toddlers on healthcare department students, using a video in an emergency care environment. A total of 57 students from a healthcare department of D university in J city were enrolled. They were divided into two groups: The experimental group (n=29) and the control group (n=28). This study is pre-post designed with a non-equivalent control group. The experimental group received a 1-week education for a duration of 3 weeks (3 sessions in total) with 180 minutes per session. The control group received a traditional curriculum of lecture. Before and after the education, we measured the knowledge and skill confidence of emergency care toward infants and toddlers, the academic self-efficacy, and problem solving ability. Data collection and intervention were carried out from November to December of 2014. Data were analyzed with x2-test, paired t-test, unpaired t-test with SPSS version 20.0 Program. The experimental group showed a significantly higher improvement of skill confidence of emergency care toward infants and toddlers (P<001), as well as preferred task difficulty among sub-items of academic self-efficacy (p=.029), approach avoidance style (P=.001), and problem solving confidence (p=.040) among sub-items of problem solving ability on preference compared with the control group. In this study, a case-based learning was verified to be an effective teaching method to enhance professional competency of healthcare department students. The findings from this study suggest that a case-based learning using various educational contents should be developed, expanded, and carried out to promote better learning.

• Journal of Hospice and Palliative Care
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• v.8 no.2
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• pp.173-182
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• 2005

Purpose: This study was carried out to provide the basic information for developing intervention programs for volunteers by identifying the burdens felt by hospice volunteers and the factors related to such burdens. Methods: The subjects were 243 hospice volunteers at 8 hospitals of The Catholic University of Korea. A questionnaire was carried out: 25 questions about the burdens to the participants and 47 questions about the quality of life. The data obtained was analyzed using the SAS program to conduct t-test, ANOVA, Duncan test, and Pearson's correlation coefficient test. Results: 1. The mean total score of the burdens felt by the hospice volunteers was $53.3{\pm}10.4$. There was no significant difference in the level of burden depending on the demographic characteristics of the hospice volunteers. But the burden in care of high education and low quality of life increased significantly. 2. The level of burden to the hospice volunteers decreased significantly as their families more favored their volunteer activities. The subjects felt the highest burden in: family care, physical care spiritual care, emotional care, and after-death care, in this order. 3. The level of burden related to each factors was high in the burden due to patient care, sense of achievement, and volunteer activities, in this order. 4. There was a reverse correlation between the level of burden to hospice volunteers and their quality of life. Conclusion: In order to reduce the burdens to hospice volunteers and to help them tate care of patients more effectively, it would be necessary to provide the education programs about practical patient care problems and to develop measures for improving their quality of life, taking into account their level of education, family's support, and difficulties in their volunteer activities.

• Journal of Korean Academy of Nursing
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• v.25 no.2
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• pp.372-389
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• 1995

The frequency with which administration of chemotherapy for gynecological cancer treatment is used has increased along with the use of surgery and radiotherapy Among the various side effects of chemotherapy, stomatitis causes a problem of function and sensation in the oral cavity. This oral discomfort can be categorized into two components ; perceived oral symptoms and observed oral symptoms. If the oral problem continues, it may cause infection, bleeding and nutritional deficiencies. As a result of this condition, compliance with the treatment process can be affected as well as the prognosis for the cancer patients. But as the oral discorrfort usually appears after chemotherapy, it is often not reported to the health care personnel as a patient problem. Without problem identification of the oral discomfort and ability to assess the problem, effective intervention cannot be planned. Therefore, this study was conducted to identify the pattern and the degree of oral discomfort due to cancer chemotherapy and thus to provide data for identification of the patient problem and for nursing assessment. The design of this study was a longitudinal de-scriptive study The subjects were in - patients who received chemotherapy under the diagnosis of gynecological cancer between Mar. 15, 1994 and May 15, 1994 at a general hospital in Seoul, Korea. The number of subjects was 64 and they were divided into two groups, one of 41 (A : 5FU & Neoplatin), the other of 23(B : Neoplatin, Cytoxan, Adriamycin), according to the treatment regimen. The data were collected for 24 days using self-re-port instruments. The instruments were the 「Perceived Oral Symptom Assessment Tool」 and 「Observed Oral Symptom Assessment Tool」 developed by this researcher. Data were analyzed using the SPSS-PC program, ANOVA, t-test, paired t-test and the Pearson Correlation Coefficient were applied. The results of this study are as follows : 1. In A regimen the peak time for perceived oral symptom scores was the fifth day after chemotherapy, and the tenth day for observed oral symptom scores. Both of the problems started on first day of chemotherapy and were not resolved completely until the 24th day after treatment. 2. In B regimen, the peak time for perceived oral symptom scores was on the seventh day after chemotherapy, and the eighth day for observed oral symptom scores. It was noted that perceived oral symptom scores were higher than observed oral symptom scores consistently for 24 days. Both also started on first day of chemotherapy, and were not resolved completely until the 24th day after chemotherapy. 3. There were no differences statistically in perceived oral symptom scores between A and B regimen. The loss of appetite and xerostomia caused the most severe discomfort in both of these two groups. 4. The were no differences statistically in observed oral symptom scores between the A and B regi moil. In the A regimen, the highest observed symptom scores were the lips, gingiva, tongue and buccal membrane in that order. But in the B regimen, the highest observed symptom scores were tongue, lips, buccal membrane and gingiva in that order. 5. In A regimen, the patients who had gingival edema and dentures had significantly higher perceived oral symptom scores. And those who had gingival edema and bleeding, foul odor and aphthous stomatitis had significantly higher observed oral symptom scores. 6. In B regimen, the patients who had the experience of stomatitis in the last course of chemotherapy had significantly higher perceived oral symptom scores. Those who had gingival edema had significantly higher observed oral symptom scores. 7. In the A regimen there was no correlation between lab values for lymphocytes and albumin with perceived oral symptom scores and observed oral symptom scores. In the B regimen, there was a significant negative correlation between lymphocytes and albumin with the observed oral symptom scores, but not between perceived oral symptom scores and lymphocytes and albumin values. In conclusion, the nurse should expect that the patient undergoing chemotherapy will complain severely about subjective discomfort and before objective physical change is observed. Also the patients who have chronic oral problems such as dentures, gingival edema and bleeding, foul odor, aphthous stomatitis will complain of severe oral discomfort due to chemotherapy.

• Women's Health Nursing
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• v.7 no.1
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• pp.30-43
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• 2001

This was a pre-experimental study to confirm the breast-feeding ability and effect of follow up care on the breast-feeding rate and the breast-feeding method by the mother-infant breast-feeding assessment tool for the mothers who got the breast-feeding education. The subjects were 46 mothers who experienced normal delivery of infants at a college hospital in K-city, Kyungsangbuk-do, from July 1 to October 21, 2000. The instrument for data obtainment were The Mother-Infant Breast-Feeding Assessment Tool of Johnson et al. (1999), and The Breast- Feeding Method Measurement Tool of Jeong, Geum-hee(1997). This instrument was reliable, showing Cronbach $\alpha$.751. This study classified them into 3 groups: at high risk for breast-feeding failure, at risk for breast-feeding problems, and at low risk for breast-feeding failure by the mother-infant breast-feeding assessment tool on the day of discharge from the hospital after delivering individual breast-feeding education to the subjects. This study investigated the breast-feeding rate and the breast-feeding method through mail questionnaire at the four week after childbirth, and through the phone counselling and the home visit for follow up care at the first week and the second week after childbirth. The sixth week after childbirth, this study investigated the breast-feeding rate by phone. The data analyzed the hypothesizes by $x^2$-test, paired t-test, ANOVA, Wilcoxon signed rank test, Wilcoxon rank sum test and trend analysis using SPSS/PC+ WIN 10.0 program. The results were as follows : 1) Hypothesis 1-1, "there won't be any difference the breast-feeding rate of a group at risk for breast-feeding failure by the time elapsed" was supported through constant the breast-feeding rate, because changes in the breast-feeding rate by the time elapsed after childbirth wasn't statistically significant(t= -1.501, p=.270). Hypothesis 1-2, "there won't be any difference the breast-feeding rate of group at low risk for breast-feeding failure by the time elapsed" was supported through constant the breast-feeding rate, because changes in the breast-feeding rate by the time elapsed after childbirth wasn't statistically significant(t=-1.732, p=.225). 2) Hypothesis 2-1, "there won't be any difference between the breast-feeding method of group at risk for breast-feeding failure for four weeks after childbirth and just after childbirth” was rejected, because the mean point of post test appeared to be higher than that of pre test(t=-7.267, p=.000). Hypothesis 2-2, "there won't be any difference between the breast-feeding method of the group at low risk for breast-feeding failure for four weeks after childbirth and just after childbirth" was rejected, because the mean point of post test appeared to be higher than that of pre test(t=-2.501, p=.012). 3)The 3rd hypothesis, "there won't be any difference between breast-feeding method of groups at risk for breast-feeding problems and at low risk for breast-feeding failure at the 4th week after childbirth and just after childbirth" didn't show any difference between the breast-feeding method of groups at risk for breast-feeding problems and at low risk for breast-feeding failure in the advance test(t=-1.521, p=.130) but there was difference between them in post test (t=-2.012, p=.044). As a result, the 3rd hypothesis was supported by pre test, but it was rejected by post test. In conclusion, this study confirmed breast- feeding education and follow up care just after childbirth were effective for the breast-feeding rate and method. Accordingly, it is proposed that successful nursing intervention of breast-feeding to be necessary by continuously providing follow up care through the mother-infant breast-feeding assessment tool as well as to execute individual breast-feeding education to mothers just after childbirth.

• Journal of Korean Academy of Nursing Administration
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• v.5 no.1
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• pp.149-167
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• 1999

This study was designed and carried out to investigate the effect of Assertiveness Training on the stress response and assertive behavior of emergency room nurses from September 22, to December 21. 1997. The subjects were 45 emergency room nurses of three general hospitals of Korea University Medical Center; 25 assigned for the experimental and 20 for the control group. The Assertive Training Program was composed of cognitive training, behavioral training and progressive muscle relaxation. The subjects of the experimental group carried out the 15-minute progressive muscle relaxation according to recorded-tape once a day for 6 weeks. The cognitive and the behavioural training were conducted by the investigator for 5-8 subjects at a time for 9 series, at an interval of 4-5 days. Post-measurement were administered to all sujects in two groups three weeks after the last session. The level of general stress (Cline, 1992), job stress (Kim & Koo, 1984), physiological response to stress (cortisol, epinephrine, norepinephrine), symptoms of stress (Lee, 1984) and assertive behavior (Kim, 1982) were measured before the first and after the last experiments. Data were analysed by x2, t, paired t, Wilcoxon signed rank tests Wilcoxon rank sums tests. The results are as follows : 1. The level of general stress of the experimental group was lower than that of the control group, however, no significant difference between the two groups (P=0.234) was revealed. 2. A significant reduction of job stress was revealed in the experimental group (P=0.017). 1) A significant reduction of interpersonal conflicts in the experimental group was revealed (P=0.018). 3. The physiological stress-response were analyzed as follows : 1) A decrease of Cortisol in both the experimental and the control groups was noticed, however, the difference between the two groups was not statistically significant (P=0.991). Pre-and post-measurement of the level of Corti sol revealed that a notable decrease in the experimental group and an increase in the control group with no significant difference in the day-day subjects (P=0.765), a significant decrease was noted on the level of Cortisol of the experimental group in the night-night nurses (P=0.036). 2) An increase of Epinephrine in both groups was noticed, however, a difference was not statistically significant between the two groups (P=0.082). Pre-and post-measurement of the level of Epinephrine revealed that a notable decrease in the experimental group and an increase in the control group with no significant difference in the day-day subjects (P=0.136). increases were noted on the level of Epinephrinel of both groups in the night-night nurses (P=0.136), 3) The level of Norepinephrine of the experimental group was significantly decreased (P=0.020). Pre-and post-measurement of the level of Norepinephrine revealed that a notable decrease in the experimental group and an increase in the control group with no significant difference in the day-day subjects (P=0.073). a significant decrease was noted on the level of Norepinephrine of the experimental group in the night-night nurses (P=0.036), 4. Symptoms of stress were reduced in both groups, with no significant differences between the groups (P=0.127). 1) The physical stress symptoms were reduced in both groups, with no significant difference (P=0.386), 2) The cognitive-behavioral stress symptoms were significantly reduced in the experimental group (P=0.037). 3) The emotional stress symptoms were reduced in both groups with no significant difference between the groups (P=0.110). 5. The assertive behavior was significantly increased in the experimental group (P=0.000). This study signified the Assertiveness Training as an effective mean of self intervention for the reduction of stress of nurses assigned to emergency rooms.