Development of the Basic Core Test Items of National Nurse’s License Examination

The purpose of this study is to develop a classification framework for the test elements of the National Registered Nurse’s License Examination and to divide the test items into standard and basic core on the basis of the RN’s job descriptions. And the adequa to proportion of the basic core test items is going to be identified. Method and results: In order to develop the classification framework of the National Registered Nurse’s License Examination, RN’s job descriptions, nursing standards, and the specific learning objectives of nursing courses were reviewed. And a survey was used to identify which entity would be appropriate for a reference to the basic core test items. 146 of professors from schools of nursing and members of each division of Korean Academic Society of Nursing(KASN) were participated in the survey. The study showed the 98% of respondents agreed to use RN’s job descriptions in selecting the basic core test items and 30% for the basic core test would be appropriate. And the contents, the selection criteria, and the proportion of the basic core test items were developed by the members of this research, the members of the National RN’s License Examination subcommittee, and the presidents of each division of KASN. The total of 1990 standard test items were selected among 3524 items, that 3 out of 7 members in the research team agreed to choose. Duplicated items in the standard items were deleted. 205 items out of the 1990 standard items were selected as the basic core test items. And 14 items were added in Medical Laws and Ethics which leads the total of 219 basic core test items. ln conclusion, the 99 items, 30% of total current examination items were chosen as the final basic core test items using the delphimethod. Further studies are needed to validate the current National License Examination for RN on the basis of the 99 basic core test items.ope

A five-country comparison of anxiety early after acute myocardial infarction

BACKGROUND: Anxiety is common after acute myocardial infarction (AMI) and has the potential to negatively affect physical and psychosocial recovery. There have been no cross-cultural comparisons of anxiety among AMI patients. AIMS: To evaluate whether anxiety after AMI differs across five diverse countries and to determine whether an interaction between country, and sociodemographic and clinical variables contributes to variations in reporting anxiety. METHODS AND RESULTS: A total of 912 individuals with confirmed AMI were enrolled in this prospective, comparative, cross-cultural study. Anxiety was assessed within 72 h of hospital admission using the Brief Symptom Inventory. The mean level of anxiety in the entire sample was 0.62+/-0.76, which is 44% higher than the normal mean level. Anxiety levels were not significantly different among the countries with the exception that patients in England reported lower levels of anxiety than those in the US (P=0.03). However, this difference disappeared after controlling for sociodemographic variables on which the countries differed. CONCLUSION: Patients from each country studied experienced high anxiety after AMI. Even though various cultures were represented in this study, culture itself did not account for variations in anxiety after AMI. It appears that anxiety after AMI is a universal phenomenon.ope

Effects of preoperative psychological care on postoperative recovery : an exploratory experiment

간호학과/석사[한글] [영문] The purpose of this study was to investigate the preoperative anxiety of surgical patients and to observe the effects of an experimental nursing process on the incidence of vomiting, the number of analgesics used and the voiding ability of surgical patients within a 48 hour postoperative period and also the number of postoperative days in the hospital. This study was based on a sample of 51 patients who were scheduled for abdominal surgery. They were assigned alternately to experimental and control groups. Patients assigned to the experimental group were given nursing care by the writer, using an experimental nursing process. This is a process directed toward helping the patient obtain a suitable psychological state for surgery. This process was performed by use of the following steps: 1 The nurse approached the patient with interest and concern, and observed the patient's behavior to determine the presence of anxiety. 2. The nurse explored further to find out what was causing the anxiety and what was needed to relieve it. 3. The nurse listened carefully to the patient. 4. The nurse gave an opportunity for expression of individuality. 5. The nurse showed friendliness and reassured the patient. 6. the nurse gave instruction about deep breathing, turning and coughing and gave an explanation of routine preoperative preparation which decreased the unknown and so decreased the patient's anxiety. The findings of this study are as follows: 1. The investigation of preoperative anxiety through observing and interviewing revealed patients were concerned about the following: a. Length of stay in the hospital 60.7%(31 cases) b. Condition unimproved or worse 58.8%(30 cases) c. Postoperative pain and discomfort 56.8%(29 cases) 2. The results of the study regarding the four hypothesis wre as follows: a. Preoperative psychological care did not reduce the number of analgesics needled during the 48 hour period following surgery. b. Preoperative psychological care did not reduce the postoperative incidence of vomiting. c. Preoperative psychological care had no influence on voiding ability following surgery. d. Preoperative psychological care significantly reduced the number of postoperative days in the hospital. The experimental nursing process proved to be successful in decreasing the length of postoperative hospitalization(improving rate of healing). This study has domonstrated further that the relief of anxiety(emotional distress) is part of the nurses' professional role. In order to be sure psychological care is given it is important to make a nursing care plain which includes a plan for the psychological care needed by the patients. As this care is given it can be checked off by each nurse just as medication and treatment are checked after they are give.restrictio

Self-efficacy and Compliance in Patients with Chronic Heart Failure: The Effect of a Self-management Program using Decision Tree

Purpose: The purpose of this study was to identify effects of a self-management program on self-efficacy and compliance in patients with CHF. Hypothesis: 1) Patients with CHF who are provided with a self-management program will show higher self-efficacy scores than a control group. 2) Patients who are provided with a self-management program will show higher compliance scores than a control group. Method: This study was designed as a nonequivalent non-synchronized pre-posttest control group. There were eight patients in the experimental group, and twelve in the control group. According to NYHA classification, all patients belonged under the classesⅡ to Ⅳ. Data were collected using the instruments developed by the researchers. Data were analyzed using descriptive statistics and Mann Whitney U test. Result: There were significant differences in self-efficacy scores and compliance scores between the experimental and control group. Conclusion: By utilizing the program, patients were able to monitor their symptoms routinely, comply with therapeutic regimen, and feel better able to positively influence their disease. Therefore, better compliance means fewer readmissions of patients with CHF.ope

Developing and Testing the Effects of a Psychosocial Intervention on Stress Response and Coping in Korean Breast Cancer Survivors : A Pilot Study

Purpose: The purpose of this study was to develop a socioculturally-appropriate psychosocial intervention program for Korean patients with breast cancer and test its effects on stress, anxiety, depression, and coping strategies. Methods: One group pretest and posttest design was used to test the effects of the intervention. A post-intervention interview was conducted to refine the nature of the intervention. A convenience sample of 10 breast cancer survivors was recruited from the outpatients clinics. Psychosocial intervention was developed to provide the health education, stress management, coping skill training and support weekly(90min) for 6 weeks. Results: There was a significant decrease in stress scores following the intervention(Z= -2.388, p=0.017). However, no significant changes were noted in the use of problem-focused and emotion-focused coping strategies, nor in the changes of anxiety and depression levels. Content analysis of interview data revealed six clusters; changes in perception, changes in problem solving approaches, changes in anger management, changes in life pattern, social support and reduction of perceived stress. Conclusions: Based on quantitative and qualitative data, we recommend the refinements of the intervention in the following areas for future studies: 1) duration, activities, and progression of psychosocial intervention; 2) research design and sample size; and 3) measurements.ope

(An) empirical study on patient stress and family visiting

간호학과/박사[한글]스트레스는 사람이 어떤 사고나 또는 급격한 환경변화에 당면하였을 때 초래되는 것을 흔히 볼 수 있다. 더우기 병원이나 중환자실에 입원하는 환자에게는 질병자체는 물론 병원 특히 중환자실과 같은 위협적인 환경에서 받는 스트레스는 더욱 심화된다. 이러한 스트레스가 오래 지속될 때 질병의 경과 뿐만아니라 예후에 까지도 많은 영향을 미친다는 가설과 가족이라는 사회적 지지체제는 스트레스를 완화하고 질병의 위험을 감소시킨다는 가설이 많은 연구에서 지지되고 있다. 그러나 대부분의 병원제도가 중환자실의 가족방문을 엄격히 제한하고 있어 환자는 가족과 함께 있는 시간이 충분치 않아 가족으로부터 정서적 지지를 받는 양과 정도도 제한받게되어 있음을 볼 수 있다. 그러므로 본 연구는 중환자실에 입원한 환자의 스트레스와 가족의 방문과의 관계를 분석 규명하기 위하여 시도되었다. 연구의 목적을 달성하기 위하여 첫째 근자의 스트레스 요인을 규명하고 그 요인과 환자성격 및 인구학적 특성과의 관계를 분석 규명하였다. 둘째 중환자실에 입원한 환자 가족의 요구를 규명하고 그 요구와 가족의 불안 및 인구학적 특성과의 관계를 분석 규명하였다. 셋째 가족의 방문이 환자 스트레스에 미치는 영향을 분석 규명하였다. 연구대상은 1982년 5월 1일부터 8월 30일까지 4개월간 Y대학과 K대학 부속병원 중환자실에 입원한 환자 52명과 그의 직계 가족 52명으로 하였고 연구방법은 면접과 관찰방법을 사용하였다. 연구도구는 연구자가 개발한 스트레스요인도, 가족의 요구척도 및 환자의 불안행동 반응척도외에 Spielberger의 상태불안 척도, Wallston외 3인의 건강조절위 척도를 이용하였다. 자료의 분석은 요인분석을 통해 스트레스 요인과 가족의 요구를 규명하였으며 그요인과 제변수와의 관계는 Pearson Correlatinn, t-test, ANOVA로 분석하였고 가족의 방문 전과후의 스트레스차이는 Paired t - test로 검증하였고 환자의 스트레스에 영향을 미치는 주 요요인은 Stepwise Multilple Regression으로 분석 규명하였다. 연구 결과는 다음과 같다. 1. 중환자실에서의 환자 스트레스 요인과 환자의 성격 및 인구학적 특성과의 관계: 환자의 스트레스요인은 요인분석을 통해 「질병 자체로 인한 문제」 「중환자실의 심리적 환경」 「사회경제적 문제」 「치료와 검사과정으로 인한 문제」 「격리감으로 인한 문제」「절대안정으로 인한 문제」 「중환자실의 물리적 환경」 「간호원의 태도」 「자아 개념의 손상」등 9개 요인으로 규명되었다. 환자의 스트레스 요인 인지도와 환자의 성격 및 인구학적 특성과의 관계는 .05수준에서 통계적으로 유의한 결과를 나타내지 않았으므로 환자의 스트레스 요인 인지도에 환자의 성격 및 인구학적 제특성이 영향을 미치지 않았다. 2. 중환자실에 입원한 환자 가족의 요구와 가족의 불안 및 인구학적 제특성과의 관계: 가족의 요구는 요인분석을 통해 「환자의 치료과정에 대한 정보제공」 「환자상태에 대한정보제공」 「이용할 수 있는 자원에 대한 정보제공」 「종교적 도움에 대한 정보제공 」 「환자방문의 융통성 제공」 「간호원과의대화」 「환자 간호에 대한 정보제공」 「감정표현의 기회제공」 「담당의사와의 대화」 「환자 간호에의 참여 」등 10개 요인으로 규명되였다. 가족의 요구 인지도와 가족의 불안 및 인구학적 제특성과의 관계는 .05수준에서 통계적으로 유의한 결과를 나타내지 않았으므로 가족의 요구인지도에 가족의 불안 및 인구학적 제특성이 영향을 미치지 않았다. 3. 가족의 방문이 환자 스트레스에 미치는 영향 : 가족의 방문이 환자 스트레스에 미치는 영향을 규명하기 위한 가설의 검증 결과, 제1가설: "가족의 방문전과 후의 혈압은 차이가 있을 것이다"는 수축기 혈압; t=-1.48,d.f=51, p> .05 :이완기 혈압; t=-1.15, d.f=51, p > .05로 기각되었다 . 제2가설: "가족의 방문전과 후의 맥박수는 차이가 있을 것이다"는 t=-.20, d.f=51, p > .05로 기각되었다. 제3가설: "가족의 방문전과 후의 호흡수는 차이가 있을 것이다"는 t=.30, d.f=51, p > .05로 기각되었다. 제4가설: "가족의 방문전과 후의 주관적 감정은 차이가 있을 것이다"는 t=10.829,d.f=51, p< .001로 채택되었다. 제 5가설: "가족의 활동과 환자의 불안 행동과는 상관관계가 있을 것이다"는 r=-.0475, p > .05로 기각되었다. 이상의 5가지 가설의 검증결과로 가족의 방문은 환자에게 생리적으로 스트레스를 초래하지 않았음이 증명되었고 환자의 주관적 감정을 긍정적 정서로 변화시켰으며, 방문하는 동안 가족의 활동은 환자의 불안행동반응을 증가시키지 않았다. 따라서, "가족의 방문은 환자의 스트레스를 완화시킬 것이다"라는 본가설이 채택되었다. 그외에 환자 스트레스에 영향을 미치는 주요요인은 방문하는 동안 가족의 활동, 환자의 가족에 대한 호감도, 가족의 요구도와 불안으로 규명되었다. 결론적으로 중환자실에서 환자는 다양한 스트레스 요인을 감지하고 있으며 가족의 방문은 환자의 스트레스를 완화시킬 수 있고 특히 방문가족의 긍정적 정서는 환자의 스트레스 완화에 긍정적 영향을 미친다고 할 수 있다. [영문]Illness or disability necessitating hospitalization results in separation from normal life and is likely to produce stress. This is intensified even more for the patient in the intensivecare unit, because the patient is housed in a strange and threatening environment, and if the stress is prolonged it may increase the incidence of illness and delay recovery. The family is able to play a major role in helping the stock member make appropriate adjustments and in reducing the patient's stress. this study was done for the purpose of analysing the relationship between visits of family members and patient is stress .The subjects consisted of 52 patients who had been in the ICU for 2 days and their family members who were observed and interviewed on two days, during the last of 3 daily visiting hours. The instruments used for this study were the Patient Stressor Scale, the Family Needs Scale and the Patient Anxiety Behavior Scale developed by the researcher and the State-Anxiety Scale developed by Spielberger, Gorsuch, and Lushene(1970) and the Locus of Control Scale developed by Wallston, et al. Analysis of data was done by use of X**2 -tests t-test, ANOVA, Pearson Correlation Coefficients, Factor Analysis and Stepwise Multiple Regression Analysis. The results of study were as fellows : 1. In the factor analysis, the patient Is stressors were classified according to 9 factors and the cummulative percentage of these factors was 72.9%. The stressors were absolute bed rests socioeconomic problems, illness itself, psychosocial environment of I.C.U., physical environment of the I.C.U., treatment and diagnostic measures, nurses' attitudes, isolation and damage of self-esteem. The patient is stressor perception when compared with their characteristics and Locus of Control showed no significance at the .05 level. 2. Family needs were classified according to 10 factors and the cumulative percentage of these tractors was 71.8%. Family needs included information about the patient's treatment, condition, available resources, religious help, felxibility of family visiting hours, communication with nurse, emotional ventilation, communication with doctor and involvement in patient care. The family's need perception when compared with their characteristics and anxiety levee showed no significance at the .05 level. 3. In the relationship between fatally visiting and patient's stress, the patient's blood pressured pulse, and respiration rate, following visits of the family member showed no significance at the .05 level. But family visiting changed the patient's subjective feeling positively (t=10.829, d.f.=51, P <0.001). There was no significant correlation between family activity and patient's anxiety behavior response at the .05 level. Therefore the basic hypothesis, "the family visit will decrease the patient is stress level" was accepted. In addition, by using Stepwise Multiple Regression Analysis it was determined that the main influencing factors on the patinet's stress were activity of the family, degree of good feeling toward family member, the needs of the family and anxiety of the family member. In conclusion, most patients in the I.C.U. perceive various stressors and family member visits decrease the patient's stress especially when the family member has low levels of anxiety and need.prohibitio

Clinical Track Faculty: Merits and Issues

Clinical track faculty (CTF) has been in operation for more than two decades in the United States, and 12 of the top 20 schools of nursing with the highest National Institutes of Health funding in the United States have CTF in place. Yet, only limited articles have been published regarding the merits and issues related to its operation. This article examines the advantages/merits of establishing CTF in schools of nursing, discusses the qualification criteria and types of appointment for CTF, and analyzes issues related to operating CTF in Korea. A questionnaire survey and two workshops were conducted involving faculty from a college of nursing and clinical nurse managers from university-affiliated medical centers and community agencies. Most of the respondents indicated that establishing CTF was advantageous. Merits included the following: increasing reality-based clinical education and training; decreasing the reality shock of students; increasing student satisfaction; and linking education, practice, and research more effectively. Major issues were as follows: getting the approval of medical centers/universities; developing an agreement on CTF operation between the college of nursing and clinical agencies; clarifying types and criteria of appointment and promotion; and developing a statement on role and compensation policies. Most issues are similar to what U.S. schools of nursing have faced, except for the first one. In conclusion, establishing CTF in Korea appears to be highly desirable. Merits outweigh issues/concerns, and Korean nursing schools may look for an opportune time for obtaining the approval of medical centers/universities. Nursing schools in other countries that face a similar challenge of providing clinical teaching with high research performance may consider instituting CTF.ope

An Analysis of the Work of Visiting Health Care Providers In Public Health Centers

The purpose of this study was to analyze the work of visiting health care providers in public health centers. A descriptive analysis of self-records for work data from 875 visiting health care providers working in 242 public health centers in South Korea was done. The results of the study are as follows: 1. The number of households for each visiting health care provider ranged from under 100 households to over 500 households. 2. Low performance was found for several items on the work list for visiting health care providers. 3. There were significant differences in the work performance of visiting health care providers between nurses and nursing assistants. 4. There were significant differences in the work performance of visiting health care providers according to region. In conclusion. work performance of visiting health care providers was low and differed according to type of occupation and region. This study suggest the need for further studies which analyse the quality of visiting health care providers and services, and the visiting health care system.ope

A Study for the Evaluation of Students on a Practical Performance of the Home Health Care

This study was conducted to investigate the evaluation of students on a practical performance of the home health care and to provide data for practical education on the home care nurse institution. Research was performed from March to December. 2002. 40 Respondents participated in the evaluation four times. The data were analysed by using the SPSS/PC + version 10. 0. The results of this study were as followings: 1. The average age of the subjects was 32. Majority of the subjects were interested in home health care. Majority of the subjects were staff nurse(57.5%) and workers at general hospitals(50%). 2. According to the result of the comparison of practical performances. performance evaluations of 20 items were higher when they admitted special practice than when they admitted any other practice. There was an positive increase in the evaluation of health assessment. nursing documentation. explanation. coping with emergency status. coordination and self assertion. In addition to health assessment. CPR. oxygenation. education & consultation. developmental assessment of child. nursing documentation. mastering nursing practice and consideration of client were significantly different. 3. The subjects were useful for practical circumference where they are working at. From these research findings. the following suggestions have been drawn: it is needed to manage practical curriculum variously and to include not only clinical aspect but also organic or administrational aspect and to reflect on students' needs and to choose to be reasonable items and to develop instruments for evaluation capability of home care nurse.ope

Correlates of fatigue in Koreans with chronic lung disease

OBJECTIVES: The purpose of this study is to explain the multidimensional characteristics of fatigue in Korean persons with chronic lung disease. FRAMEWORK: The Unpleasant Symptom Theory by Lenz et al (1995) provided the theoretical framework for the study. DESIGN: A descriptive correlational study design was used. SAMPLE: A convenience sample of 128 subjects (age = 64.2 +/- 11.3; forced expiratory volume in 1 second percent predicted value = 64.5 +/- 28.8%) was recruited from the outpatient respiratory clinic at a large university hospital in Korea. INSTRUMENTS: Fatigue was measured with the Multidimensional Fatigue Inventory. To identify the factors influencing fatigue, demographic variables, physiological variables, psychological variables, and a situational variable were measured. RESULTS: Subjects had a moderate degree of fatigue in general. The mean score for physical fatigue was relatively higher than that of mental fatigue. Using regression analysis, 48.4% of the variance in overall fatigue was explained by dyspnea and negative mood state. CONCLUSION: This study provides an understanding of multidimensional characteristics of fatigue experienced by Korean persons with chronic lung disease. It suggests that nurses need to include fatigue in their assessments and develop interventions to decrease dyspnea and negative mood in the management of fatigue.ope