PURPOSE: This study examined the crisis experiencing by middle - aged women and tried to understand their lived experiences also explored the nature of their crisis. METHOD: The data was collected from 7 participants living in Incheon and Seoul from Sep. 2000 to Feb. 2001. The analysis of the data was made the phenomenological analytic method suggested by Giorgi. RESULT: The meanings of the lived experiences of the middle - aged women's crisis ; Impatience about decreased physical function : an attack of a disease, decreased strength, decreased quickness, decreased desire, increased concern of health, poor memory, easy fatigue, change of appearance, change of conjugal relations, sense of loss. Psychological, emotional disturbances : sense of emptiness, regret, sharpness, feeling gloomy, fear of dying, loneliness, feeling the want, loss of confidence. Attitude of active life : reinforcement of self experience, enrichment of understanding, search of self satisfaction, search of self development, development of support system, management of independent life. Envy feeling from relative comparison : feeling of comfort, unsatisfaction to the husband, yearning for youth. CONCLUSION: Therefore, the program should be developed for the program of physical, psychological, and emotional health and expansion of social role of the middle - aged women.
Adolescent ; Affective Symptoms ; Fatigue ; Female ; Humans ; Incheon ; Loneliness ; Memory ; Seoul ; Spouses

OBJECTIVE: The aims of this study were to determine whether childhood maltreatment contributes to the occurrence of major depressive disorder (MDD) with bipolarity, and whether there is a relationship between central serotonergic activity, as assessed using loudness dependence of auditory evoked potentials (LDAEP), and childhood maltreatment. METHODS: Thirty-five MDD patients were stratified according to the presence or absence of childhood trauma into two subgroups, childhood trauma (CT) and no childhood trauma (NCT), using the Korean version of the Childhood Trauma Questionnaire (K-CTQ). The CT group was subjected to further analysis. Several psychometric ratings were also applied. In addition, auditory processing for the loudness dependence of auditory evoked potentials (LDAEP), which was used as a marker of serotonergic activity, was measured before beginning medication. RESULTS: There was a significant difference in total Korean Bipolar Spectrum Disorder Scale score between the CT and NCT groups (t=-2.14, p=0.04). The total K-CTQ score was positively correlated with the total Beck Scale for Suicidal Ideation (BSS) score (r=0.36, p=0.036). In particular, emotional abuse was positively correlated with the total Barratt Impulsiveness Scale (r=0.38, p=0.026), BSS (r=0.38, p=0.025), and Hamilton Depression Rating Scale (HAMD) (r=0.36, p=0.035) scores. There was also a positive correlation between LDAEP and total Hypomania Personality Scale (r=0.49, p=0.02) and HAMD (r=0.58, p=0.004) scores within CT group. CONCLUSION: The findings of this study support that there is a relationship between childhood maltreatment and bipolarity in patients with MDD.
Bipolar Disorder ; Depression ; Depressive Disorder, Major* ; Evoked Potentials, Auditory ; Humans ; Pilot Projects* ; Psychometrics ; Suicidal Ideation

While in the past the almost sole availability of tricyclic antidepressants had limited antidepressant drug selection, newer drugs such as selective serotonin reuptake inhibitors, bupropion, mirtazapine and venlafaxine have vastly simplified treating depression in patients with medical illness. Appropriate selection of an antidepressant agent in medically ill patients requires a careful risk-benefit assessment of the antidepressant treatment considering the pharmacokinetic and pharmacodynamic properties of drugs, potential for drug interaction, the patient's general medical conditions, and primary symptoms of the patient's depression. The effective and safe approach to antidepressant treatment is to reduce initial dosage, to titrate upward more slowly, and to monitor closely adverse effects in patients with medical illness.
Antidepressive Agents, Tricyclic ; Bupropion ; Depression* ; Drug Interactions ; Humans ; Risk Assessment ; Serotonin Uptake Inhibitors ; Venlafaxine Hydrochloride

The purpose of this study is to investigate the correlation among the stroke patient family's health, burden and quality of life which is based upon the comparative appreciation of the adult stroke patient's family and elderly stroke patient's family. For this purpose, data were collected from the family care-givers for two groups of stroke patients under sixty years old and over sixty years of age, admitted at K Hospital and H Hospital in Seoul. The instruments for this research are based on the tool for measuring physical health and psychological health developed by Yang, Young-hee(1992), the tool for measuring the sense of burden by Seo, Mee-hae and Oh, Ga-sil(1993), and the tool for the quality of life by Noh, Yoo-ja(1988). The sampling for this study was done from December, 2000 until February, 2001. Questionnaire data were drawn up by personal interviews aided by the staff nurses. The analysis of collected data are based on general characteristics calculated at the rate of 100 percent of the average, t-test, ANOVA(some difference on a level with p<.05 being subsquently confirmed by DMR) for Health Status, Burden, Quality of Life and Pearson Correlation to verify the hypothetical correlation among the subjects. The results of this study are as follows: 1. In the adult stroke patient family, the factors influencing the physical health proved to be age, present occupation and family-formation. Here, the factors influencing psychological health turned out to be age, matrimonial status, present occupation and family-formation. In the elderly stroke patient family, the factors influencing physical health proved to be age, gender, final academic status, matrimonial status, present occupation, and relation with the patient. Here, the factors influencing the psychological health were age, final academic status, matrimonial status, present occupation, relation with the patient and family-formation. In the former case, the influencing factors upon the burden were shown to be age, final academic status, matrimonial status, relation with the patient and family-formation. In the latter case, the influences upon the burden were age, gender, final academic status, matrimonial status, present occupation and relation with the patient. In the former case, the influences on the quality of life were gender, and economic situation. In the later case, the influencing factors on the quality of life were age, final academic status, matrimonial status, present occupation, and relation with the patient. 2. The rate of the physical condition in the former case turned out to be 2.83, and the psychological condition 2.37. The physical condition of the latter case was 2.76, and the psychological condition 2.46. The rate of the burden in the former case was 3.14, and that of the latter case was 3.04. The rate of quality of life in the former case proved to be 2.46, and that of the latter case 2.55. 3. The rate of correlation between the burden and the quality of life appeared to be the high counter-correlation (r= -.573). The rate of correlation between the psychological health and the burden of a simialr (r= -.565). The rate of correlation between the physical health and the psychological health proved to be a moderate correlation (r= .372), The rate of correlation between physical health and the burden turned out to be a low counter-correlation (r= -.276). According to this study, there proved to be a very close correlation among the stroke patient family's health, the burden and quality of life. Thus, it would be necessary to find out various nursing interventions in order to mitigate the stroke patient family's burden in the process of caring for the patients.
Adult* ; Aged* ; Humans ; Nursing ; Occupations ; Quality of Life* ; Seoul ; Stroke* ; Surveys and Questionnaires

PURPOSE: This study sought to find a nursing intervention tool for enhancing elderly women's lives by investigating the causes and the meaning of their grief. METHOD: This research was derived from a phenomenological tool such as qualitative research design. The data collection took place from December of 2000 until April of 2001 Through systematic interviews and participatory observations of five elderly women attending C welfare center located in downtown Seoul the data was collected. Each interview lasted an hour and a half and was arranged five times. The analysis of this research was conducted using the Giorgi method. RESULTS: (1) There was obvious physical and physiological decline caused by aging old; as well as there being spouse health problems, additional physical suffering, signs of senility, adn insomnia, (2) Further grief was imposed by unpleasant memories of the spouse; infidelity, incapability, and even disregard of her own well-being, (3) Then there was pity for children; unfaithful children, uncertain futures of the children, and early death of a child, (4) Also, regrettable fate, painful daily acttrities, unreliable factors, bad circumstances, and feelings emptiness were reported, (5) Finally, anxiety for the future; ac sense of despair, loneliness, economic hardship, and the fear of imminent death increased grief levels. CONCLUSION: A variety of programs and social meetings for the elderly to overcome their physiological or psychological crisis should be substantially developed and supported by the government. In order to implement the social welfare for the elderly women, special consideration whether on the governmental level or the personal level, should be devoted to the elderly who live without any financial support or social concern.
Aged* ; Aging ; Anxiety ; Child ; Surveys and Questionnaires ; Female ; Financial Support ; Grief* ; Humans ; Loneliness ; Nursing ; Qualitative Research ; Seoul ; Sleep Initiation and Maintenance Disorders ; Social Welfare ; Spouses

PURPOSE: This study aims to find the sources of nurses' conflicts and to find ways to eliminate them for improved nursing care. METHOD: This study is based on a phenomenological approach. All participants were woking at K-hospital, located in Seoul. The research was performed from September 2000 to February 2001. Data was collected through interviews and observations while participants were working. Interviews lasted a duration of one and half hours and data collection accured five to six times per participant. The data were analysed by Giorgi method and the results are as follows: RESULT: Essential themes in the professional conflict of clinical nurses emerged (1) The discords of human relationships ; (2) Dissatisfaction with working conditions; (3) Lack of self-respect in one's professional expertise ; (4) Dissatisfaction with one's work ; (5) Depression accurring due to one's ability as a professional. CONCLUSION: The foregoing arguments suggest that nurses perform stressful environments in a hospital originating from the relationship among peer group, working conditions, and lack of self-respect as a nurses. Therefore, hospital authorities should strangly consider working conditions, interpersonal relationships, and working conditions in order to promote self-respect of the nurses hospitals.
Data Collection ; Depression ; Humans ; Nursing Care ; Peer Group ; Seoul

Elderly patients with dementia, delirium, schizophrenia and other psychotic symptoms are appropriate candidates for antipsychotic treatment. Risperidone is one of the newer atypical antipsychotic agents, which block serotonin and dopamine receptor, but does not block histamine and cholinergic receptor potently. Its unique pharmacologic profile would be of good advantage to the elderly patients. Elderly patients are usually more susceptible to many drug adverse effects. Compared with young patients, elderly patients who use risperidone have risks of postural hypotension, sedation, EPS and tardive dyskinesia. Starting and maintenance dosages of risperidone in elderly patients must be much lower than those recommended for younger patients. Clinicians who prescribe antipsy-chotics, including risperidone for elderly patients should start with a lower initial dosage and increase this slowly until the lowest effective dosage is reached. Polypharmacy is also a serious concern among elderly patients, who are often being treated for various medical problems. Clinicians should try to avoid prescribing multiple drugs with anticholinergic or sedative effects.
Aged ; Antipsychotic Agents ; Delirium ; Dementia ; Histamine ; Humans ; Hypnotics and Sedatives ; Hypotension, Orthostatic ; Movement Disorders ; Polypharmacy ; Receptors, Dopamine ; Risperidone* ; Schizophrenia ; Serotonin

Senile Dementia is one of the dispositional mental disorder which has been known to the world since Hippocratic age. It has become a wide-spread social problem all over the world because of chronic disease processes and the demands of dependent care for several years as well as improbability of treatment of it at the causal level. Essentially, life styles of the older generation differ from those of the younger generation. While the former is used to the patriarchal system and the spirit of filial piet and respect, the latter is pragmatized and individualized under the effects of the Western material civilization. these differences between the two generations cause conflict between family members. In particular, the pain and conflict of care-givers who take care of a totally dependent dementia patient not only is inciting to the collapse of the family union, but is expanding into a serious social problem. According to this practical difficulty, this study has tried to compare dementia care-givers' experiences inter-culturally and to help set up more proper nursing interventions, describing and explaining them through ethnographies by participant observation and in-depth interviews that enable seeing them in a more close, honest and certain way. It also tries to provide a theoretical model of nursing care for dementia patients which is proper to Korean culture. This study is composed of 12 participants(4 males, 8 females) whose ages range from 37-71 years. The relations of patients are 5 spouses(3 husbands, 2 wives), 4 daughters-in-law, 2 daughters, and 1 son-in-law. The following are the care-givers' meaning of experiences that results of the study shows. The first is "psychological conflict". It contains the minds of getting angry, reproaching, being driven to dispair, blaming oneself, giving up lives, and being afraid, hopeless, and resigned. The second is "physical, social and psychological pressure". At this stage, care-givers are shown to be under stress of both body and soul for the lack of freedom and tiredness. They also feel constraint because they hardly cope with the care and live through others' eyes. The third is "isolation". It makes the relationship of patient care-giver to be estranged, without understanding each other. they, also, experience indifference such as being upset and left alone. The forth is "acceptance". They gradually have compassion, bear up and then adapt themselves to the circumstances they are in. The fifth is "love". Now they learn to reward the other with love. It is also shown that this stage contains the process of winning other recognition. The final is "hope". In this stage they really want situations to go smoothly and hope everything will be O.K. These consequence enable us to summarize the principles of care experience such as, in the early stage, negative response such as physical, psychological confusion, pain and conflict are primary. Then the stage of acceptance emerges. It is initial positive response phase when care-givers may admit their situations. As time passes by a positive response stage emerges. At last they have love and hope. Three stages we noted above; however, there are never consistent situations. Rather it gradually comes into the stage of acceptance, repeating continuous conflict, pressure and isolation. If any interest and understanding of families or the support of surrounding society lack, it will again be converted to negative responses sooner or later. Otherwise, positive responses like hope and love can be encourage if the family and the surroundings give active aids and understanding. After all, the principles of dementia care experiences neither stay at any stage, nor develop from negative stages to positive stages steadily. They are cycling systems in which negative responses are constantly being converted. I would like to suggest the following based on the above conclusions: First, the systematic and planned education of dementia should be performed in order to enhance public relations. Second, a special medical treatment center which deals with dementia, under government's charge, should be managed. Third, the various studies approaching dementia care experiences result in the development of more reasonable and useful nursing guidelines.
Alzheimer Disease* ; Anthropology, Cultural* ; Chronic Disease ; Civilization ; Dementia ; Education ; Empathy ; Family Characteristics ; Freedom ; Hope ; Humans ; Life Style ; Love ; Male ; Mental Disorders ; Models, Theoretical ; Nuclear Family ; Nursing ; Nursing Care ; Public Relations ; Reward ; Social Problems ; Spouses

This study was to provide understanding for the juvenile problem of drug brought about by industrialization, and the importance people that we should take a role in helping to resolve the problem. The purpose of this study lies in approaching the effective methods to prevent Korean adolescents from being involved in drug by examining the factors of their experience. The method of this study is designed to grasp the adolescents' drug experience, its meaning, its structure and the nursing intervention ways. By applying a phenomenological approach which is based on a qualitative research method, the researchers hoped to reveal key data in each group. It has been carried on from October 1998 until September 1999 with sample of 5 adolescent inmates in K mental hospital located in Seoul. The data were collected by sereous personal deep interviews and observations. Collected data were analyzed according to the phenomenological method suggested by Giorgi. The results of this study are as follows: First, pleasure seeking: curiosity, joy, and fun; Second, affiliation: formation of clique with the same age; Third, escape from reality: loneliness, emptiness, heroic mind, self- confidence, self-absorption, and comfort; Forth, feeble- mindedness: anxiety, fear, and temptation; Fifth, psychological unadaptation: wandering, forfeiture, and incompetence; Sixth, physical counteraction: headache, vomiting, loss of memory, loss of appetite and loss of sensibility; Seventh, psychological confusion: illusion, auditory hallucination and dream; Eighth, recovery of self-consciousness: repentance, desire and awareness This study results in the following suggestions of the nursing intervention 1. To cultivate a wholesome game culture for the adolescents. 2. To make up the group activities so that the adolescents can establish their sense of identity through a variety of group counseling program. 3. To foster the capability to cope with the change in the process of social accommodation. 4. To enforce the social life skill for the adolescents. 5. To practice the systematic education about drug use. 6. To develop the social education programs. 7. To help the adolescents build up their sense of identity by applying the adolescent cure programs. Above all, it is necessary that school and community as well as home should establish the educational environment paying special concern and consideration to the adolescents.
Adolescent ; Anxiety ; Appetite ; Counseling ; Dreams ; Education ; Exploratory Behavior ; Hallucinations ; Hand Strength ; Headache ; Hope ; Hospitals, Psychiatric ; Humans ; Illusions ; Loneliness ; Memory ; Nursing ; Pleasure ; Qualitative Research ; Seoul ; Substance-Related Disorders* ; United Nations ; Vomiting

The object of this study is to provide the basic data for the caring of parents by understanding emotional status, physical status, and family support of parents with cardiac disease children. The subjects of this study were consisted of 105 parents of cardiac disease children admitted at 'G' hospital in Inchon, and 'S' hospital in Puchon. The data were collected from November 6 to December 21, 2000. Four instruments were used to collect the data : Spielberger's STIS, Cornell Medical Index(CMI), Yang's stress scale, and Moos's Family Environment Scale Form R, the latter 3 are modified by researcher. The collected data were tested using frequencies, percentiles, means, t-test, ANOVA, and Pearson correlation coefficient with SPSSWIN program. The results of this study were as follows: 1. There were statistically significant differences in degree of anxiety on age, number of children, and children's order of birth. 2. There was a statistically significant difference in degree of physical status on presence of the other patient in family. 3.There were not statistically significant differences in degree of stress and family support on demographic factors. 4.There were positive correlations between physical status and family support, and between anxiety and stress, but negative correlations between family support and stress, between anxiety and family support, between anxiety and physical status, and between stress and physical status.
Anxiety ; Child* ; Demography ; Gyeonggi-do ; Heart Diseases* ; Humans ; Incheon ; Parents* ; Parturition ; Child Health