The demographic, psychological, social and disease characteristics were analyzed to find the sources of self-efficacy(the expectation about one's ability to engage in or execute in a behavior) in the 297 patients with rheumtoid arthritis. Except for religion and client's job, the demographic characteristics such as age. sex, partner's job, income, and educatioa] level were found to be significantly related to self-efficacy. In the group of older age, female, lower income, job with less prestige, and lower educational level, the self-efficacy was lower than the other group. Depression which measured as psychological characteristics was significantly related to self-efficacy. Social characteristics, such as social support and relationship with health professionals, were positively related to self-efficacy except for social network. Getting a high score in the area of relationship with health-professionals means that the giatients perceive that they can express themselves or decide on their own activities as much as they want. Among the disease characteristics, only disease cLlration was not significantly related to self-efficccy. The self-efficacy shows a tendency to decrease with time. Pain was negatively related to self-efficacy, Possible activity level was positively related to self -efficacy. To analyze the variables which affect self-efficacy, stepwise regressicn was implemented. As a re sult, about 42% of the self-efficacy were explained by possible activity leveI, depression, social support, and pain in that order. Based upon these results, it is recommended that the nurses who are in change of or maintain the behavior of patients wth rheumatoid arthritis consider the demographic characteristics such as age, sex, et al. Also programs which decrease the pain and depression and increase the social support and activity levels are recommended to be developed.
Arthritis ; Arthritis, Rheumatoid* ; Depression ; Female ; Health Occupations ; Humans ; Sociology

Pain management is a major issue in caring of cancer patients. Patients' concerns for reporting pain and taking analgesics are patient-related barriers to the management of cancer pain. Since such study has not been done at all in Korea, it is clearly needed to study on these problems. The purpose of data in order this study is to attain basic data in order to improve cancer pain management in Korea. This is done by: 1) examining the extent of patients' concerns that might be barriers to the optimal pam management, and the extent of related factors (pain management hesitancy, adequacy of using analgesics, pain severity and pain interference); 2) identifying the relationship between patients' concerns and the related factors. The data has been collected from 180 cancer patients who were hospitalized in medical wards of one university hospital in Seoul. Korea during the period from November 1. 1997 to February 28. 1998. The data has been collected through interviews with (1) Barriers Questionnaire Korean Version (BQ-K); (2) Hesitancy Experience Questionnaires (HQ); (3) Pain Management Index (PMI); (4) Brief Pain Inventory (BPI); and (5) Demographic Data. The data were analyzed by descriptive statistics and by t-test. One-way ANOVA, Pearson correlation using SPSSWlN program. The Results are as following: 1) The mean scores of Pain Management Concerns (PMC) by BQ-K were toward the moderate with a little high points(2.59). Most of the patients (99.4%) had some extent of concerns (over 1 out of maximum 5 points). Among the eight subscales of BQ-K. the Pain Management Concerns (PMC) about 'Fear of tolerance' was the highest (3.80) and 'Worry about side effects' was the least (1. 40). 2) The extent of Pain Management Hesitancy (PMH) by HQ of whom had pain on the day of the interview was a little higher than moderate score(5.53 out of maximum 10 points). 56.7% of the patients with experiencing pain used less adequate analgesics for the severity of pain than they were expected. 27.8% of them never used any analgesics at all. The mean score of pain severity by BPI was 16.59 (maximum: 40), and that of the interference with daily life by BPI was 32.03 (maximum: 70). 3) The patients who were older. less educated, and in low socio-economic status were likely to have more concerns. Pain Management Concerns (PMC) was positively correlated with Pain Management Hesitancy (PMH)(r=.75), pain severity (r= .44) and pain interference (r=.50). Those who were not using adequate analgesics had higher Pain Management Concerns (PMC) than did those who were using adequate analgesics (t=-5.42), The patients who had more Pain Management Concerns (PMC) tended to hesitate more to report pain and to use analgesics. They used more inadequate analgesics for the severity of pain and also had experienced more pain severity and interference with daily life. In conclusion, the patients' concerns for reporting pain and for using analgesics are major patient-related barriers to cancer pain management in Korea. The patients' concerns were correlated significantly with the level of the hesitancy experience, inadequate use of analgesics, the pain severity and the interference with daily life. Considering this, an educational program for cancer patients under the treatment with analgesics should be developed in order to solve these problems.
Analgesics ; Humans ; Korea ; Pain Management ; Surveys and Questionnaires ; Seoul

No abstract available.
Humans

No abstract available.
Humans ; Intensive Care Units* ; Critical Care*

Chronic liver disease was characterized difficult to cure, long-standing disease. Patients with chronic liver disease were searching for complementary treatments to recover form illness, while they have been treated by the doctor. This study was carried out to explore application of alternative therapies in patients with chronic liver disease. For this survey, the questionnaire were developed by researchers and the data were collected for two months. Among the 192 subjects, 155 were hospitalized and 37 were out patient department and the majority of diagnoses were chronic hepatitis (42.2%), liver cirrhosis (31.3%), primary liver carcinoma (14.6%). The results were as follows. 1. Patients who have had experiences with alternative therapies were 128, not undergone were 64. Varried alternative therapies were used and 46.9% of 128 subjects used both hospitals and alternative therapies simultaneously. 2. Patients have looked for alternative therapies in the early stage of disease (71.1%), and motivated to decide a matter of having use complementary therapies as alternatives for treatments (64.8%), and obtained information from their families and friends (48.2%), mass media (14.8%). The majority of patients were acknowledged that laternative treatments have no effectiveness really but it gives them psychological comfort. And the patients have payed a lot of money in cost of alternative therapies fee ; 1.4 times higher than hospitals. 3. Among the 128 subjects, 43.8% patients were communicated with their physicians about complementary therapies, 56.2% were not. 82.1% patients who asked their physicians were experienced negative responses of their doctors. 4. patients were expected the higher effect of alternative therapies when they have been delivered treatment by hospitals with complementary therapies (chi2=57.84, P<0.05), and then they evaluated the treatment effect better in this treatment pattern (chi2=25.26, P<0.05). And in terms of general characteristics of the patients, the only duration of illness was showed the significant relationship with the utilization of alternative therapies (chi2=8.44, P<0.05). 5. In no used alternative therapies group, the reason that they have not taken alternative therapies were ; to keep their physician's prescription, to refuse alternative therapies by their physicians, and to have no trust themselves on alternative therapies. In conclusion, the further study will be required the patients' experience using alternative therapies as the progress of disease in terms of holistic view of patients.
Complementary Therapies* ; Diagnosis ; Fees and Charges ; Friends ; Hepatitis, Chronic ; Humans ; Liver Cirrhosis ; Liver Diseases* ; Liver* ; Mass Media ; Prescriptions ; Surveys and Questionnaires

PURPOSE: This research with one group pre-post design was carried out to test the practical feasibility to administrate the Music' Movement program developed for the stroke patients. SUBJECTS: 12 stroke survivors at J Public Health Center in Seoul. were participated in. The average age was 68 years old. the ratio of sex was almost 5.8 :4.2, the duration of was almost over 1 year. METHOD: Music' Movement program was conducted for 2 hours x 1day x 6 weeks. The contents of Music' Movement program were consisted of the preparatory activities, main activities and the wrap up activities. The preparatory activities are ice braking, greeting, explanation of the aims of music' movement program, and introduction of stroke disease and ROM exercise. The main activities are the body motions with singing and playing musical instruments. The wrap up activities are stretching and joints and discussion of home activities. Data Collection: The outcome variables are muscle strength, finger pinch power, ROMs. flexibility, depression, and life satisfaction. Depression was measured by CES-D(Kim, I. J., 1999), life satisfaction by ladder scale(McDowell & Newell. 1996), and ADL state (Holbrook & Skilbeck, 1983). Data Analysis: SPSS/PC 10.0 for Window was used. Wilcoxon Signed Ranks Test was used to analyze outcome measures. The level of statistical significance was set at p .05. RESULTS: This program was effective to decrease the depression level of subjects(p .05). The muscle strength, hand grip power, ROMs, life satisfaction. and rehabilitation state of the subjects were slightly increased but no significant differences were found between the pre and post test. Additionally every patient replied that they were very satisfied and expressed their appreciation for this program very much. Of course they strongly want to continue to participate in and meet the peer group again. CONCLUSION: Considering these results, the practical feasibility of Music' Movement program can be supported. Therefore, this Music Movement program can be examined with the quasi-experimental design with control group and ongoing reviews. After that, this program would be applied in public health centers, medical institutes, and welfare centers for the rehabilitation of stroke patients.
Academies and Institutes ; Activities of Daily Living ; Aged ; Data Collection ; Depression ; Fingers ; Hand ; Hand Strength ; Humans ; Ice ; Joints ; Muscle Strength ; Music ; Outcome Assessment (Health Care) ; Peer Group ; Pliability ; Public Health ; Rehabilitation ; Seoul ; Singing ; Statistics as Topic ; Stroke* ; Survivors

The purpose of this phenomenological study was to understand and describe the essence and the structure of lived experience of liver transplant recipient. Five individual interviews were conducted to gather data regarding their subjective experiences. About 130 significant statements were extracted and these were clusterd into 9 themes. End stage liver disease patients chose their last treatment - liver transplantation. After liver transplantation. recipients experience vague anxiety and uneaseness related to much information and life style change that they had to accept. And they feared to lose their health again. But they felt free from medication and restriction of food. And they satisfied with regaining their physical status. Most of the recipients also had financial difficulties and social restrictions. And they experience uncertainty about their future. But they restored their previous social life. And they experience psychological wellbeing and hope. The results of this study might help nurses who work with liver transplant recipient in establishing and implementing an effective nursing intervention by understanding their lived experience.
Anxiety ; End Stage Liver Disease ; Hope ; Humans ; Life Style ; Liver Transplantation ; Liver* ; Nursing ; Transplantation* ; Uncertainty

This study was carried out to obtain basic data required to plan and develop Rehabilitation Day Care Program for the stroke survivors at home in Korea. The subjects comprised of 118 stroke survivors who discharged from 4 hospitals in Seoul during the past 2 years. The data were collected from August 3, 1998 to September 18, 1998, through interviews with questionnaires about general characteristics, activities of daily living, depression and service need of rehabilitation day care program at the outpatient clinics by trained nursing graduates. Data were analyzed with descriptive analysis, Pearson's correlation analysis, and Stepwise multiple linear regression analysis using SPSS/WIN program. The results obtained are as follows: 1. The mean score of the general need of rehabilitation day care program of stroke survivors was 2.78(range 1-4). The highest need among the service categories of the rehabilitation day care program was self-care and restorative activities category, and health services referral category, recreation category, psychosocial activities category in order. The needs of each category are as follows ; 1) In the health services referral category, the need for speech therapy was highest, followed by the need for physical therapy and occupational therapy. 2) In the psychosocial activities category, the need for self-help group was highest. 3) In the self-care and restorative activities category, the need for bathing was highest, followed by bowel training, and ambulation training. 4) The need for the recreation category was 2.62. 2. Among the need for the effect related to the utilization of day care program, the need for survivors' physical and psychological well-being was highest and was followed by the need for caregiver's physical and psychological wellbeing. Pearson's correlation analysis revealed following results; 1. The need for rehabilitation day care program service displayed a correlation with the level of education, ADL, and the level of depression, and a reverse correlation with age. 2. The need for the effect related to the utilization of rehabilitation day care program displayed a correlation with the level of education, ADL, and the level of depression. The stepwise multiple linear regression analysis revealed following results; 1. For the need for rehabilitation day care program service, 28.4% of the variance was initially explained by one variable, level of depression. The level of depression plus two variables, survivors' age and ADL, explained 34.2% of the variance in the need for rehabilitation day care program service. 2. For the need for the effect related to the utilization of rehabiJitation day care program, 12.4% of the variance was initially explained by one variable, level of depression. The level of depression plus one variable, level of education, explained 20.4% of the variance in the need for the effect related to the utilization of rehabilitation day care program. In conclusion, above characteristics should be considered when we are planning to develop stroke survivors' rehabilitation day care program.
Activities of Daily Living ; Ambulatory Care Facilities ; Baths ; Day Care, Medical* ; Depression ; Education ; Health Services ; Humans ; Korea ; Linear Models ; Nursing ; Occupational Therapy ; Surveys and Questionnaires ; Recreation ; Referral and Consultation ; Rehabilitation* ; Self Care ; Self-Help Groups ; Seoul ; Speech Therapy ; Stroke* ; Survivors* ; Walking

The purpose of this study was to identify the degree of learned helplessness and self-care agency in dialysis patients and the relationship between learned helplessness and self-care agency. The subjects were 168 dialysis patients who were undergoing hemodialysis and peritoneal dialysis from 1 university hospital, 1 hospital, 1 hemodialysis center in Seoul, 1 hospital in Incheon, Korea. The data were collected with two interview questionnaires which were Learned Helplessness Scale (LHS) and Self-as-Carer Inventory (SCI). The collected data were analyzed by descriptive statistics and t-test, One-way ANOVA and Pearson Correlation with SPSSWIN program. Results were obtained as follows : 1) The mean scores of learned helplessness were 45.93(range 20-80). The mean learned helplessness scores of peritoneal dialysis patient and hemodialysis (HD) patient were not different significantly. However by the aging process, the mean scores of learned helplessness has a tendency to get higher and who had a job were likely to low score of learned helplessness. 2) The mean scores of self-care agency were 142.48 (range 33-198). The mean self-care agency scores of peritoneal dialysis (PD) patient much higher than the score of it with hemodialysis. The score of self-care agency were significantly different between peritoneal dialysis patient and hemodialysis patient. The patients who have job were likely to be higher score of self-care agency than other groups. 3) There was significant relationship between the score of learned helplessness and self-care agency. In conclusion, there was an inverse relationship between learned helplessness and self-care agency in dialysis patients. Considering this, the high level of learned helplessness of dialysis patients should be intervened by nurse with a well developed edicational program or cognitive behavioral therapy.
Aging ; Cognitive Therapy ; Dialysis* ; Helplessness, Learned* ; Humans ; Incheon ; Korea ; Peritoneal Dialysis ; Surveys and Questionnaires ; Renal Dialysis ; Self Care* ; Seoul

A Preliminary study for the evaluation of the Rehabilitation Nursing Program(RNP) implemented to the 25 stroke survivors at the Day Care Program Center of National Rehabilitation Hospital in Seoul was done at 1999. The purposes of this study was to assess the psychological effects as outcome-variables such as depression. powerlessness and self efficacy of the stroke survivors who were discharged from acute care hospitals. The Rehabilitation Nursing Program (RNP) integrated with the Day Care Program for rehabilitation was implemented and the psychological outcome variables were measured by 3 psychologic instruments of Zung Depression Scale. Millers's powerlessness and the Bandura's self efficacy scale. These instruments were translated into Korean and the contents validity and the reliability were tested. The subjects were 17 males and 8 females and 52% were aged over 51 years old and 24 % were from 31 to 50 years old. Most of them(72 %) had been educated more than high school level. The contents of RNP were 8 sessions composing of self-introduction. individualized assessment, health contract and feedback, management of depression, shaving experiences, effective communication, self efficacy teaching, health information. and daily care activities. This study found that the level of depression and the powerlessness were within average level and had not been changed the level of self efficacy after RNP were somewhat higher than before, but it was not changed significantly. According to the results. the psychological state of the subjects were not changed significantly. Only the level of self efficacy was a little improved after having the RNP. Based on theses results, the RNP should be focussed on the psychological nursing care and the psychological outcome variables were retested strictly with the enough sample size.
Day Care, Medical* ; Depression ; Female ; Humans ; Male ; Middle Aged ; Nursing Care ; Rehabilitation Nursing* ; Rehabilitation* ; Sample Size ; Self Efficacy ; Seoul ; Stroke* ; Survivors*