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*

PURPOSE: The purpose of this study was to propose and test a predictive model that could explain and predict Korean nurses' turnover intentions. METHODS: A survey using a structured questionnaire was conducted with 445 nurses in Korea. Six instruments were used in this model. The data were analyzed using SPSS 15.0 and Amos 7.0 program. RESULTS: Based on the constructed model, organizational commitment, and burnout were found to have a significant direct effect on turnover intention of nurses. In addition, factors such as empowerment, job satisfaction, and organizational commitment were found to indirectly affect turnover intention of nurse. The final modified model yielded chi2=402.30, p<.001), chi2/df=2.94, RMSEA=0.07, RMR=0.03, GFI=0.90, AGF=0.87, NFI=0.88, CFI=0.92 and good fit indices. CONCLUSION: This structural equational model is a comprehensive theoretical model that explains the related factors and their relationship with turnover intention in Korean nurses. Findings from this study can be used to design appropriate strategies to further decrease the nurses' turnover intention in Korea.
Adult ; Burnout, Professional ; Female ; Humans ; Job Satisfaction ; Male ; *Models, Theoretical ; *Nursing Staff, Hospital/psychology/statistics & numerical data ; Personnel Turnover/*statistics & numerical data ; Power (Psychology) ; Questionnaires ; Stress, Psychological

No abstract available.
Colostomy* ; Humans

PURPOSE: The purpose of this study was to examine the level of knowledge and the attitudes of Korean adults toward sexuality of elderly people. METHODS: This was a descriptive study using a convenience sample of 241 adults. The questionnaire had 34 items for knowledge and 26 items for attitudes. RESULTS: The result showed that, related to sexuality of elderly people, the level of knowledge was average and attitudes were conservative. The level of knowledge was significantly higher in groups that were highly educated and of low economic status (p<.05). Attitudes toward sexuality of elderly people were significantly more conservative in female, older, less educated, and high economic status group. CONCLUSION: The findings suggest a need for more education for Korean adults regarding sexuality in elderly people.
Adolescent ; Adult ; Aged ; Analysis of Variance ; Female ; *Health Knowledge, Attitudes, Practice ; Humans ; *Intergenerational Relations/ethnology ; Korea ; Male ; Middle Aged ; *Prejudice ; *Sexuality/ethnology ; Socioeconomic Factors

The purpose of this study is to find out the effects of personal characteristics and metamemory on the older adults' memory performances and the effects of some factors on metamemory. The subjects of the study consisted of 102 old adults over the age of 60 who are living in Kangwon Province. Based on contextual perspectives of the memory-aging theory and the previous foreign researches on memory, some data were collected by means of the interview method, using questionnaires for metamemory(MIA questionnaire by Dixon, et al., 1988), and depression(GDS by Yesavage and Sheikl, 1986). The other data were collected by the testing method on the memory performance such as the immeadiate word recall task, the delayed word recall task, the word recognition task(Elderly Verbal Learning Test by Kyung Mi Choi, 1998),and the face recognition task(Face Recognition Task tool developed by this study). The results of this study were as follows; 1. The level of metamemory is 3.4 points in the 5 point scale, the grades of the task and the achievement are relatively high and the grades of the change, the control, and the strategy are relatively low in the sub-concepts. 2. The significant variables to predict old adults' metamemory are depression level, age, sex, educational attainment and religious activity. 3. The strong variables to predict memory performances are memory knowledge, memory self-efficacy, age, religious activity. 4. The strategy, the achievement, the locus, and the change concept of the metamemory have high correlations with the immediate recall task, the delayed recall task, and the word recognition task. In conclusion, the enhancement strategies of metamemory and the support of social activities are independent fields for nursing intervention. Ultimately in this respect nurses' roles are very important in developing and performing some intervention programs for old adults' memory improvement, which have significant meanings in the field of nursing science.
Adult ; Depression ; Gangwon-do ; Humans ; Memory* ; Memory, Short-Term ; Nursing ; Verbal Learning ; Surveys and Questionnaires

BACKGROUND: The clinical significance of mean platelet volume (MPV), platelet distribution width (PDW) and megathrombocyte index (MTI) is not clear. METHODS: We examined platelet indices in 900 cases of patients with hematologic disorders and compared them with those of the control to predict thrombopoiesis in the bone marrow. MPV and PDW were measured by Coulter Counter STKS (U.S.A). We calculated megathrombocyte index (MTI, the percentage of megathrombocytes) in the peripheral blood film using ocular micrometer, and examined megakaryocyte number in the bone marrow aspirates. RESULTS: In patients with acute leukemia, and aplastic anemia, MPV and MTI were lower than the control but PDW was higher. In myeloproliferative disorders, all platelet indices were higher, and in ITP (idiopathic thrombocytopenic purpura), MPV and MTI were higher but PDW was not significantly different. MTI was higher in complete remission than initial acute leukemia. All platelet indices were not significantly different between pre- and post-BMT in AML. But in aplastic anemia, MPV and MTI were higher in post-BMT than pre-BMT. MTI was a better index to screen than MPV in the decreased megakaryocyte group, but in increased megakaryocyte group, there was no difference in screening ability between MPV and MTI. CONCLUSIONS: The platelet indices in peripheral blood may be good markers for predicting thrombopoiesis in hematologic disorders and in post chemotherapy of acute leukemia. In addition, after BMT of aplastic anemia, these indices could be used as valuable markers of engraftment.
Anemia, Aplastic ; Blood Platelets* ; Bone Marrow ; Drug Therapy ; Humans ; Leukemia ; Mass Screening ; Mean Platelet Volume ; Megakaryocytes ; Myeloproliferative Disorders ; Thrombopoiesis

The purpose of this study is to find out the effects of depression on older adults' metamemory and memory performances. The subjects of the study consisted of 103 older adults over the age of 60 who are living in Kangwon Province. Some data were collected by means of the interview method, using questionnaires for metamemory (MIA questionnaire by Hultsch, et al., 1988), and depression(GDS by Yesavage and Sheikl, 1986). Other data were collected by a testing method on the memory performance, such as the immediate word recall task, the delayed word recall task, the word recognition task(Elderly Verbal Learning Test by Kyung Mi Choi, 1998), and the face recognition task(Face Recognition Task tool developed by this study). The results of this study were as follows: 1) The average point of depressed older persons' metamemory is 3.2 on a 5 point scale and was significantly lower than nondepressed older persons' point of 3.6. Looking into each sub-concept of metamemory, depressed persons' points are higher in terms of task(4.1), but are lower in terms of change(2.3), locus(2.6), and strategy(2.9) in comparison with nondepressed persons' points. 2)Depressed older persons' memory performances are all significantly lower than nondepressed person's, especially in terms of face recognition task(t=7.26, p<.0082) and word recognition task(t=6.58, p<.01). 3) In both depressed and nondepressed persons, metamemory has a close correlation with all memory tasks. In particular, depressed older persons' correlation is higher across the board, especially in memory self-efficacy of metamemory(r=.36 - .49) in comparison with nondepressed persons. 4) According to the results of analysis on the relations between metamemory and memory performances of each memory task using canonical analysis, in the case of depressed older persons, strategy, locus, capability and task have high correlation with word recognition task and delayed word recall task. Also in the case of nondepressed persons, achievement, strategy, change and locus variable have high correlation with face recognition task and immediate word recall task. As mentioned above, depression variables have a negative effect on older persons' metamemory and memory performance. In conclusion, when we care for depressed older persons with less memory ability, we have to consider the outcomes of this study are relevant. In addition, it is necessary to develop nursing intervention in order to prevent memory loss and improve memory performance in depressed older persons.
Adult ; Depression* ; Gangwon-do ; Humans ; Memory Disorders ; Memory* ; Nursing ; Verbal Learning ; Surveys and Questionnaires

PURPOSE: This study provides useful basic information about caring for elderly women. It also promotes understanding by confirming what can vitalize the women and improve quality of life in elderly women as they continue to become important in the society which is moving towards being an "aged society". METHOD: Grounded theory a qualitative research method, was use to develop new thesis regarding life's vitality in elderly women. Thirteen women participated in the research. They were women without any problems in perception or communication and who agreed to participate in the research. RESULT: The results, using analysis process of Strauss and Corbin (1990), showed that life's vitality in elderly women is to bring well-being through vitalization against weakness. CONCLUSION: Based on such these results, this study will be helpful to nursing mediation and policy development which will improve the quality of life of elderly women through better understanding and promotion of life's vitality.
Aged* ; Female ; Humans ; Negotiating ; Nursing ; Policy Making ; Qualitative Research ; Quality of Life

PURPOSE: This study aimed to explore the influence of nurse work environment and patient safety culture in hospital on instances of missed nursing care in South Korea. METHODS: A cross-sectional design was used, in which a structured questionnaire was administered to 186 nurses working at a tertiary university hospital. Data were analyzed using descriptive statistics, t test or analysis of variance, Pearson correlation, and multiple regression analysis. RESULTS: Missed nursing care was found to be correlated with clinical career, nursing work environment, and patient safety culture. The regression model explained approximately 30.3% of missed nursing care. Meanwhile, staffing and resource adequacy (β = −.31, p = .001), nurse manager ability, leadership and support of nurses (β = −.26, p = .004), clinical career (β = −.21, p = .004), and perception on patient safety culture within unit (β = −.19, p = .041) were determined to be influencing factors on missed nursing care. CONCLUSION: This study has significance as it suggested that missed nursing care is affected by work environment factors within unit. This means that missed nursing care is a unit outcome affected by nurse work environment factors and patient safety culture. Therefore, missed nursing care can be managed through the implementation of interventions that promote a positive nursing work environment and patient safety culture.
Humans ; Korea* ; Leadership ; Nurse Administrators ; Nursing Care* ; Nursing* ; Patient Safety* ; Quality of Health Care

This project was a service-cum-research effort with a quasi-experimental study design to examine the health benefits of an integrated Family Planning (FP)/Maternal & Child health (MCH) Service approach that provides crucial factors missing in the present on-going programs. THE SPECIFIC OBJECTIVES WERE: 1) To test the effectiveness of trained nurse/midwives (MW) assigned as change agents in the Health Sub-Center (HSC) to bring about the changes in the eight FP/MCH indicators, namely; (i) FP/MCH contacts between field workers and their clients (ii) the use of effective FP methods, (iii) the medically supervised deliveries, (iv) prenatal care by medically qualified personnel, (v) medically supervised deliveries, (vi) the rate of induced abortion, (vii) maternal and infant morbidity, and (viii) preinatal & infant mortality. 2) To measure the integrative linkage (contacts) between MW & HSC workers and between HSC and clients. 3) To examine the organizational or administrative factors influencing integrative linkage between health workers. STUDY DESIGN: The above objectives called for quasi-experimental design setting up a study and control area with and without a midwife. An active intervention program (FP/MCH minimum "package" program) was conducted for a 2 year period from June 1982-July 1984 in Seosan County and "before and after" surveys were conducted to measure the change. SERVICE INPUT: This study was undertaken by the Soonchunhyang University in collaboration with WHO. After a baseline survery in 1981, trained nurses/midwives were introduced into two health sub-centers in a rural setting (Seosan county) for a 2 year period from 1982 to 1984. A major service input was the establishment of midwifery services in the existing health delivery system with emphasis on nurse/midwife's role as the link between health workers (nurse aids) and village health workers, and the referral of risk patients to the private physician (OBGY specialist). An evaluation survey was made in August 1984 to assess the effectiveness of this alternative integrated approach in the study areas in comparison with the control area which had normal government services. METHOD OF EVALUATION: a. In this study, the primary objective was first to examine to what extent the FP/MCH package program brought about changes in the pre-determined eight indicators (outcome and impact measures) and the following relationship was first analyzed. b. Neverthless, this project did not automatically accept the assumption that if two or more activities were integrated, the results would automatically be better than a non-integrated or categorical program. There is a need to assess the "intergration process" itself within the package program. The process of integration was measured in terms of interactive linkages, or the quantity & quality of contacts between workers & clients and among workers. Intergrative linkages were hypothesized to be influenced by organizational factors at the HSC clinic level including HSC goals, sltructure, authority, leadership style, resources, and personal characteristics of HSC staff. The extent or degree of integration, as measured by the intensity of integrative linkages, was in turn presumed to influence programme performance. Thus as indicated diagrammatically below, organizational factors constituted the independent variables, integration as the intervening variable and programme performance with respect to family planning and health services as the dependent variable. Concerning organizational factors, however, due to the limited number of HSCs (2 in the study area and 3 in the control area), they were studied by participatory observation of an anthropologist who was independent of the project. In this observation, we examined whether the assumed integration process actually occurred or not. If not, what were the constraints in producing an effective integration process. SUMMARY OF FINDINGS: A) PROGRAM EFFECTS AND IMPACT. 1. Effects on FP use: During this 2 year action period, FP acceptance increased from 58% in 1981 to 78% in 1984 in both the study and control areas. This increase in both areas was mainly due to the new family planning campaign driven by the Government for the same study period. Therefore, there was no increment of FP acceptance rate due to additional input of MW to the on-going FP program. But in the study area, quality aspects of FP were somewhat improved, having a better continuation rate of IUDs & pills and more use of effective Contraceptive methods in comparison with the control area. 2. Effects of use of MCH services: Between the study and control areas, however, there was a significant difference in maternal and child health care. For example, the coverage of prenatal care was increased from 53% for 1981 birth cohort to 78% for 1984 birth cohort in the study area. In the control area, the same increased from 41% (1981) to 65% (1984). It is noteworthy that almost two thirds of the recent birth cohort received prenatal care even in the control area, indicating that there is a growing demand of MCH care as the size of family norm becomes smaller. 3. There has been a substantive increase in delivery care by medical professions in the study area, with an annual increase rate of 10% due to midwives input in the study areas. The project had about two times greater effect on postnatal care (68% vs. 33%) & delivery care (45.2% vs. 26.1%). 4. The study area had better reproductive efficiency (wanted pregnancies with FP practice & healthy live births survived by one year old) than the control area, especially among women under 30 (14.1% vs. 9.6%). The proportion of women who preferred the 1st trimester for their first prenatal care rose significantly in the study area as compared to the control area (24% vs 13%). B) EFFECTS ON INTERACTIVE LINKAGE. 1. This project made a contribution in making several useful steps in the direction of service integration, namely; i) The health workers have become familiar with procedures on how to work together with each other (especially with a midwife) in carrying out their work in FP/MCH and, ii) The health workers have gotten a feeling of the usefulness of family health records (statistical integration) in identifying targets in their own work and their usefulness in carrying for family health. 2. On the other hand, because of a lack of required organizational factors, complete linkage was not obtained as the project intended. i) In regards to the government health worker's activities in terms of home visiting there was not much difference between the study & control areas though the MW did more home visiting than Government health workers. ii) In assessing the service performance of MW & health workers, the midwives balanced their workload between 40% FP, 40% MCH & 20% other activities (mainly immunization). However, 85-90% of the services provided by the health workers were other than FP/MCH, mainly for immunization such as the encephalitis campaign. In the control area, a similar pattern was observed. Over 75% of their service was other than FP/MCH. Therefore, the pattern shows the health workers are a long way from becoming multipurpose workers even though the government is pushing in this direction. 3. Villagers were much more likely to visit the health sub-center clinic in the study area than in the control area (58% vs. 31%) and for more combined care (45% vs. 23%). C) ORGANIZATION FACTORS (ADMINISTRATIVE INTEGRATIVE ISSUES). 1. When MW (new workers with higher qualification) were introduced to HSC, it was noted that there were conflicts between the existing HSC workers (Nurse aids with less qualification than MW) and the MW for the beginning period of the project. The cause of the conflict was studied by an anthropologist and it was pointed out that these functional integration problems stemmed from the structural inadequacies of the health subcenter organization as indicated below; i) There is still no general consensus about the objectives and goals of the project between the project staff and the existing health workers. ii) There is no formal linkage between the responsibility of each member's job in the health sub-center. iii) There is still little chance for midwives to play a catalytic role or to establish communicative networks between workers in order to link various knowledge and skills to provide better FP/MCH services in the health sub-center. 2. Based on the above findings the project recommended to the County Chief (who has power to control the administrative staff and the technical staff in his county) the following; i) In order to solve the conflicts between the individual roles and functions in performing health care activities, there must be goals agreed upon by both. ii) The health sub-center must function as an autonomous organization to undertake the integration health project. In order to do that, it is necessary to support administrative considerations, and to establish a communication system for supervision and to control of the health sub-centers. iii) The administrative organization, tentatively, must be organized to bind the health worker's midwives's and director's jobs by an organic relationship in order to achieve the integrative system under the leadership of health sub-center director. After submitting this observation report, there has been better understanding from frequent meetings & communication between HW/MW in FP/MCH work as the program developed. Lessons learned from the Seosan Project (on issues of FP/MCH integration in Korea). 1) A majority or about 80% of the couples are now practicing FP. As indicated by the study, there is a growing demand from clients for the health system to provide more MCH services than FP in order to maintain the achieved small size of family through FP practice. It is fortunate to see that the government is now formulating a MCH policy for the year 2,000 and revising MCH laws and regulations to emphasize more MCH care for achieving a small size family through planning practice. 2) Goal consensus in FP/MCH should be made among the health workers & administrators, especially to emphasize the need of care of "wanted" child. But there is a long way to go to realize the "real" integration of FP into MCH in Korea, unless there is a structural integration FP/MCH because a categorical FP is still first priority to reduce the rate of population growth for economic reasons but not yet for health/welfare reasons in practice. 3) There should be more financial allocation: (i) a midwife should be made available to help to promote the MCH program and coordinate services, (ii) there should be a health sub-center director who can provide leadership training for managing the integrated program. There is a need for "organizational support", if the decision of integration is made to obtain benefit from both FP & MCH. In other words, costs should be paid equally to both FP/MCH. The integration slogan itself, without the commitment of paying such costs, is powerless to advocate it. 4) Need of management training for middle level health personnel is more acute as the Government has already constructed 90 MCH centers attached to the County Health Center but without adequate manpower, facilities, and guidelines for integrating the work of both FP and MCH. 5) The local government still considers these MCH centers only as delivery centers to take care only of those visiting maternity cases. The MCH center should be a center for the management of all pregnancies occurring in the community and the promotion of FP with a systematic and effective linkage of resources available in the county such as i.e. Village Health Workers, Community Health Practitioner, Health Sub-center Physicians & Health workers, Doctors and Midwives in MCH center, OBGY Specialists in clinics & hospitals as practiced by the Seosan project at primary health care level.
Abortion, Induced ; Administrative Personnel ; Child ; Child Health ; Chungcheongnam-do ; Cohort Studies ; Community Health Workers ; Consensus ; Contraception ; Cooperative Behavior ; Delivery of Health Care ; Encephalitis ; Family Characteristics ; Family Health ; Family Planning Services* ; Female ; Hand ; Health Personnel ; Health Services ; House Calls ; Humans ; Immunization ; Infant ; Infant Mortality ; Insurance Benefits ; Clinical Trial* ; Jurisprudence ; Korea* ; Leadership ; Live Birth ; Local Government ; Midwifery ; Organization and Administration ; Parturition ; Population Growth ; Postnatal Care ; Pregnancy ; Prenatal Care ; Primary Health Care ; Referral and Consultation ; Social Control, Formal ; Specialization