PURPOSE: The purpose of this study was to provide nursing intervention with basic data extracted through investigating self-care and nursing of lymphedema in patient who have had a mastectomy. METHOD: The subjects for this study consisted of 214 mastectomy patients in 2 hospitals. The data were collected from December 1, 2004 to February 28, 2005. The instruments used for this study were both the Self-care Practice Scale by Cho, Myoung-Ok et al.(2003) which we modified and the Nursing Evaluation Scale developed by the researchers. RESULTS: The mean score of self-care on lymphedema was 59.96+/-12.46. The mean score of nursing was 25.64+/-9.25. Factors influencing the self-care were the postoperative period (F= 17.505, p<.001), the location of the tumor (F= 3.826, p=.023), menstruation (t=7.333, p=.007), and complications (F=5.427, p<.001). CONCLUSION: Self-care and nursing care on the lymphedema management were shown to be lower than expected. Especially, the score of self-care was the lowest in the more than 3 year postoperative period. Therefore, the longer the postoperative period is, the more active management on lymphedema needs to be. Also, education should be given to both nurses and patients on the importance of self-care on lymphedema with mastectomies.
Education ; Female ; Humans ; Lymphedema* ; Mastectomy* ; Menstruation ; Nursing Care* ; Nursing* ; Postoperative Period ; Self Care*

PURPOSE: This study were to examine the relationship among chronic pain, pain beliefs, pain coping, and fatigue and to define the main factors influencing chronic pain in the elderly. METHOD: Data were collected by self-reported questionnaires from 276 Korean elderly. Data analysis was done with SPSS 10.1 for descriptive statistics, t-test, ANOVA, Pearson Correlation Coefficient, and Stepwise multiple regression. RESULTS: Chronic pain score was 5.45, which was slightly higher than the average. There were significant differences in chronic pain according to age, marital state, economic state, and duration of pain. There was a significant positive correlation between chronic pain and pain beliefs, passive pain coping, physical fatigue and mental fatigue. In addition, there was a significant negative correlation between chronic pain and active pain coping. Stepwise multiple regression analysis showed that 44% of the variance in chronic pain was significantly accounted for by passive pain coping(31%), pain beliefs(8%), physical fatigue(4%), and active pain coping(1%). CONCLUSION: These results suggested that pain beliefs, pain coping, and fatigue can be influencing factors on chronic pain for the elderly. Also, the findings can provide a basis for nursing intervention development to effectively manage chronic pain for the elderly.
Aged* ; Chronic Pain* ; Fatigue* ; Humans ; Mental Fatigue ; Nursing ; Statistics as Topic ; Surveys and Questionnaires

PURPOSE: This study was designed to explore the effects of providing individualized education for hemodialysis patients on their knowledge of hemodialysis, compliance of patient role behavior, and physiologic parameters. METHOD: A quasi experimental design with a non-equivalent control group and a non-synchronized design was used. The experiment was conducted with a total of 40 hemodialysis patients (20 in the experimental group and 20 in the control group) at the artificial kidney center, C University Hospital. The experimental group was provided with individualized education, 30 minutes per session, three times per week, for two weeks. RESULTS: The experimental group had significantly higher knowledge of hemodialysis than the control group after the education. The compliance of patient role behavior was more enhanced in the experimental group than the control group. The experimental group showed significantly higher values of blood urea nitrogen, but not the values of blood creatinine, albumin, kalium, and phosphorus. CONCLUSION: The individualized education was found to be an effective intervention for improving patients' knowledge of hemodialysis and compliance of patient role behavior.
Blood Urea Nitrogen ; Compliance* ; Creatinine ; Education* ; Humans ; Kidneys, Artificial ; Phosphorus ; Renal Dialysis* ; Research Design

PURPOSE: The purpose of this study were to examine the incidence of lymphedema and to compare to physiological and psychosocial symptoms between breast cancer patients with lymphedema and without lymphedema. METHOD: Four hundreds fifty women with breast cancer receiving mastectomy were recruited from two out-patient breast clinics of A and S university hospitals in Seoul, Korea from October, 2004 to May, 2005. Lymphedema was defined by circumferential measurement. Differences greater than 2cm between the affected arm and normal arm were considered to be lymphedema. A descriptive design was used for this study and data was collected using a structured questionnaire. The data were analyzed using descriptive statistics and independent t-test. RESULTS: Lymphedema developed in 112(24.9%) of the 450 subjects. Subjects with lymphedema reported more severe sensation change of arm and more depression and confusion than subjects without lymphedema. Range of motion of shoulder as a physical indicator and social support, however, were not significantly different between the two groups. CONCLUSION: Lymphedema is recognized as an unpleasant and uncomfortable consequence of breast cancer- related treatment. Therefore, more research is needed to evaluate the impact of lymphedema on quality of life in patients with lymphedema and the efficacy of nursing intervention.
Arm ; Breast Neoplasms* ; Breast* ; Depression ; Female ; Hospitals, University ; Humans ; Incidence ; Korea ; Lymphedema* ; Mastectomy ; Nursing ; Outpatients ; Quality of Life ; Range of Motion, Articular ; Sensation ; Seoul ; Shoulder ; Surveys and Questionnaires

PURPOSE: This study was conducted to compare the process of change, decisional balance, and self-efficacy according to the stages of change of exercise on the basis of the Transtheoretical Model in order to investigate factors associated with the change of exercise in adult diabetic patients. METHOD: Data were collected from January to April 2005. The subjects were 160 patients in the G university hospital and public health center in J city. RESULTS: The entire process of change showed the significant difference depending on the stage of change(F=20.007, p=.000). For each process of change, the Consciousness Raising(F=14.602, p=.000), Dramatic Relief(F=7.751, p=.000), Environmental Re-evaluation(F=11.843, p=.000), Self Re-evaluation(F=16.035, p=.000), Social Liberation(F=10.968, p=.000), Counter-conditioning (F=24.090, p=.000), Helping Relationships(F= 7.625, p=.000), Reinforcement Management(F= 16.693, p=.000), Self Liberation(F=11.990, p= .000) and Stimulus Control(F=4.020, p=.002) demonstrated significant differences depending on the stages of change of exercise. For the decisional balance, the Pros showed the significant difference depending on the stage of change(F=14.121, p=.000). For the self efficacy showed significant difference depending on the stage of change(F=17.137, p=.000). CONCLUSION: In order to proceed the stage of change of exercise in patients with Diabetes Mellitus, intensive use of a specific process of change, a stage of change matching is needed.
Adult ; Consciousness ; Diabetes Mellitus* ; Humans ; Public Health ; Self Efficacy

PURPOSE: The purpose of this study was to identify the influencing factors on postpartum fatigue in the parturient women. METHODS: The data were collected from July to September, 2006 using self-report questionnaires. The sample was 143 healthy parturient women who visited the outpatient clinic at 2 hospitals for a routine follow up after childbirth. The data were analyzed by using SPSS 12.0 Win program. RESULTS: There were significant differences in the postpartum fatigue by age, religion, sleep hour, and complaint of perceived health problem. The postpartum fatigue were significantly correlated with infant care stress(p<0.001), sleep satisfaction(p<0.001), and feeding difficulty(p=0.016). The multiple regression analysis showed that the postpartum fatigue were significantly predicted by the infant care stress, sleep satisfaction and complaint of perceived health problem. These variables explained 31.8% of the variance of postpartum fatigue. The infant care stress was the main predictor of postpartum fatigue. CONCLUSIONS: It could be concluded that the nursing intervention for reducing the infant care stress should be developed to manage the postpartum fatigue for parturient women. Prospective studies are needed to be conducted to verify the causal relationship between infant care stress and postpartum fatigue.
Ambulatory Care Facilities ; Fatigue* ; Female ; Follow-Up Studies ; Humans ; Infant ; Infant Care ; Nursing ; Parturition ; Postpartum Period* ; Surveys and Questionnaires

PURPOSE: The purposes of this article were to analyze curricula of gerontological nurse practitioner(GNP) programs in the United States, to compare the curricula with Korean GNP programs, and to provide suggestions for better GNP programs in Korea. METHODS: Top GNP programs in the United States were identified from the US NEWS and 12 universities were included in the analyses. Class distribution, credit hours, and clinical hours were analyzed and suggestions for Korean GNP programs were made. RESULTS: Average credit hours for class lectures in the US GNP programs were 47 and emphases on physiology, pharmacology, physical assessment, and disease management were identified. Most US GNP programs(75%) provided health concerns for both middle aged and older adults. Not all US GNP programs included 'theory' or 'the introduction to GNP' classes, while these are required classes in the Korean GNP program. The mean clinical hours in the US GNP Programs were 537 which are much higher than those in the Korean GNP program. CONCLUSION: Based on the analyses, we can conclude that Korean GNP programs are lacking in many ways. Further evaluation and curricula modifications are required to settle down the program better and to have the graduates prepared more as internationally competent nurse practitioners.
Adult ; Curriculum* ; Disease Management ; Geriatric Nursing ; Humans ; Korea ; Lectures ; Middle Aged ; Nurse Practitioners* ; Pharmacology ; Physiology ; United States

PURPOSE: The purposes of this study were to describe the pattern of type D personality, to compare the life style and quality of life between type D personality and non-type D personality patients, and to investigate the factors influencing quality of life in patients with hypertension. METHODS: A cross sectional, descriptive study was used. The participants in this study were 193 outpatients who were diagnosed with hypertension at two university hospitals in urban area, Korea. The data was collected from December, 2006 to January, 2007. Type D personality was measured by the DS-14 scale. RESULTS: The prevalence of type D personality was 83.9%. Patients of type D personality were significantly different in educational status, monthly income, fat intake and exercise, and had a lower overall quality of life than patients of non-type D personality. Under controlled general characteristics and life style factors, multiple linear regression analysis was performed. The most significant factor influencing quality of life in hypertensive patients was type D personality, and this factor explained their quality of life with a variance of 14.8%. CONCLUSIONS: Various programs for psychological intervention are required to control for the distressed personality of patients with hypertension. Further studies should be conducted prospectively on a larger patient population.
Educational Status ; Hospitals, University ; Humans ; Hypertension* ; Korea ; Life Style* ; Linear Models ; Outpatients ; Prevalence ; Quality of Life* ; Type D Personality*

PURPOSE: This study was performed to investigate the type and frequency of end colostomy-related complications and to identify the risk factors for those complications. METHODS: Retrospective analysis of medical records was made in 708 patients who underwent end colostomy in Samsung Medical Center between October 1994 and February 2005. The type was divided into stomal and peristomal complications: stomal complications included bleeding, necrosis, mucocutaneous separation, prolapsed stoma, retraced stoma, stenosis, and hyperplasia; peristomal complications did peristomal varix, peristomal hernia, irritant contact dermatitis, allergic contact dermatitis, maceration, folliculitis, hyperplasia, bacterial infection, candidal infection, malignancy in the peristomal area, mechanical damage and pyoderma gangrenosum. RESULTS: For stomal complications, hyperplasia was most common(9.0%). For peristomal complications, irritant contact dermatitis was developed in 17.4%. Sex and BMI were risk factors for irritant contact dermatitis, hyperplasia, peristomal hernia, flat stoma, and retracted stoma. CONCLUSION: Teaching for preventing irritant contact dermatitis such as proper pouching and peristomal skin protection, and for comprehensive weight control should be emphasized on self care program for ostomates, while ostomy care nurse should take a careful consideration of preoperative ostomy site marking in female obese patients.
Bacterial Infections ; Colostomy ; Constriction, Pathologic ; Dermatitis, Allergic Contact ; Dermatitis, Contact ; Female ; Folliculitis ; Hemorrhage ; Hernia ; Humans ; Hyperplasia ; Medical Records ; Necrosis ; Ostomy ; Pyoderma Gangrenosum ; Retrospective Studies ; Risk Factors ; Self Care ; Skin ; Varicose Veins

PURPOSE: This study was conducted to develop an integrated undergraduate course including a PBL based on a blended learning strategy, and evaluate learners' responses. METHODS: The learning contents of cardiovascular, respiratory, and musculoskeletal medical systems, and nursing diagnoses of 'activity and rest' domain (NANADA's classification II, 2005) were analyzed. Six clinical scenarios with the clients in different life cycles were developed for PBL. Classical lecture and group presentation with on-line self learning were implemented in addition to PBL. The developed course was implemented on 84 junior nursing students in a university for 7 weeks with 5 hours per day, two days per week. Students were asked to complete structured questionnaires including problem solving, critical thinking, and nursing diagnosis differentiation abilities. RESULTS: Learner's evaluation was positive in problem solving skills and in the differentiation ability of nursing diagnoses relevant to an 'activity and rest' functional health pattern. CONCLUSION: Development and implementation of integrated courses based on a blended learning method need to be continued to enhance students' thinking and self-directed learning abilities. Supporting strategies for individual learners should be added for successful blended learning such as individual on-line feedback and consideration of individual learning outcomes.
Classification ; Humans ; Learning ; Life Cycle Stages ; Nursing Diagnosis ; Problem Solving ; Problem-Based Learning ; Students, Nursing ; Thinking ; Surveys and Questionnaires