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Introduction: This study aims to explore how older people structure the subjectivity that accompanies the development of gerotranscendence in late adulthood within a specific sociocultural context. Method: Q methodology, a common method for assessing subjectivity, was applied. Results: The four subjective frames of reference that accompany the development of gerotranscendence, represented by four corresponding Q-factors, were (a) generation awareness, (b) awareness of aging, (c) awareness of the big picture of life, and (d) awareness of temporality. Discussion: The subjective frames of reference that characterize the development of gerotranscendence in late adulthood are closely related to cultural and psychosocial environmental influences over the course of an individual’s life.

This study explored to develop a situation-specific theory explaining the healthy life of Korean patients with chronic kidney failure undergoing hemodialysis.Chronic kidney failure (CKF) patients have to reorganize their lives around their hemodialysis sessions for their survival. Nursing interventions based on specific theories may promote their health-related behaviors and outcomes. However, few theoretical frameworks or theories are available to guide hemodialysis patients on how to construct their lives under various constraints, while considering their experiences and sociocultural contexts.An integrated approach was used to develop the situation-specific theory based on the network episode model (NEM), a review of related literature, and four of the authors' studies on hemodialysis patients' lives.The major concepts in the proposed theory include sociocultural context, social networks, individual-level factors, illness experiences, health-related behaviors, and health outcomes. Each major concept includes several relevant subconcepts.We used this theory to identify factors involved in shaping the illness experiences, health-related behaviors, and outcomes of Korean CKF patients undergoing hemodialysis. By exploring the links between these factors, we explained the healthy life that considers the uniqueness of Korean patients' sociocultural context, social network, and individual-level factors. Nurse and other healthcare professionals could integrate the proposed situation-specific theory into the development of nursing interventions based on this theory to promote health-related behaviors and outcomes of Korean CKF patients undergoing hemodialysis.

Discovering and developing ideal cell culture methods is important for cell biology, drug development, and cell therapy. Recent studies have explored and demonstrated the use of nanoscale structures and patterns that influence cell behavior, such as 3D scaffolds. In this study, we analyzed the effects of nanopatterned-surface dishes using chondrocytes as model cells. Chondrocytes grown on nanopatterned dishes exhibited rounded shapes. Interestingly, chondrocytes have a lower COL10 mRNA level when cultured using nanopatterned dishes. The nanopatterned dishes induced G0-/G1-phase cell cycle arrest and reduced the rate of proliferation. Our results suggest that nanoscale structures can directly control cellular behaviors and can be used for chondrocyte cell culture without causing chondrocytes to lose their functions. These results help to elucidate cellular responses and behaviors in native-like environments, and this information can be used to improve human health.

The final hours before death can be the most significant time for the dying. Adequate preparation for death can help reduce patients’ fears. Research on end-of-life experiences suggests that deathbed visions are not uncommon, but many doctors and nurses find this a difficult subject to approach. A 2

Purpose: This study was designed to provide qualitative data to explore the nurses' experience of caring for elders who are dying. Methods: Data were collected from ten nurses who had experiences in nursing elders who were dying and receiving care in long term care facilities in Korea. Analysis of data was done by conventional content analysis. Results: In this study, 8 essential themes were extracted; 'beginning of dying with uncertainty', 'approach- ing death in daily life', 'effort for medical intervention', 'arranging the last meeting with significant others', 'becoming elder's family member inside who shared elder's life', 'rumination about the situation of elders' dying and accumu- lated experience, 'empirical understanding and coping with human death', 'results depends on nurses'role' Conclusion: The results of the study suggest that nursing care manuals and prediction tools regarding end-of-life care for elders need to be developed and preparation of advance directives for elders in the long-term care settings should be required.

The objective of this study was to explore infected Koreans' perceptions, knowledge, and experiences of living with a hepatitis B virus (HBV)-positive diagnosis. The qualitative, descriptive study with a purposive sampling method was utilized. Participants were recruited from hepatology outpatient clinics at an urban Korean university hospital. The findings of this study illustrate the complexity and uncertainty of living with an invisible virus once that one's HBV positive status is known. The themes highlight misunderstanding, confusion, uncertainty, and various perceptions of health management with which the patients have been living. Education of both the general public and people with HBV infection is necessary to reduce HBV infection by preventing transmission of the virus and protecting the livers of infected patients from further damage.

The objective of this ethnography is to describe the meaning of death as experienced by the elderly. The authors collected data through participant observation and ethnographic interview with 14 key informants in a Korean clan between September 1994 and November 2001. They examined the data using taxonomy, proxemics, and value analysis techniques. Meanings of death included the end of pain, the dispersion of existence, moving to the next life by transcending the boundary, returning to the original place, and escalating into the world of the men’s group. These meaning are constructed in a sociocultural context of research fields and in accordance with patterns of behavior in everyday life.

Purpose: The purpose of this study was to identify trends for studies published in the Journal of Korean Academy of Nursing and journals published by member societies from inaugural issues to 2010. Methods: A total of 6890 studies were analyzed using descriptive statistics. Results: Quantitative studies accounted for 83.6% while qualitative studies accounted for 14.4%. Most frequently used research designs were quasi-experimental (91.1%) for experimental research and survey (85.2%) for non-experimental research. Most frequent study participants were healthy people (35.8%), most frequent nursing interventions, nursing skills (53.5%), and 39.8% used knowledge, attitude and behavior outcomes for dependent variables. Most frequently used keyword was elderly. Survey studies decreased from 1991 to 2010 by approximately 50%, while qualitative studies increased by about 20%. True experimental research (1.2%) showed no significant changes. Studies focusing on healthy populations increased from 2001-2005 (37.5%) to 2006-2010 (41.0%). From 1970 to 2010, studies using questionnaire accounted for over 50% whereas physiological measurement, approximately 5% only. Experimental studies using nursing skill interventions increased from 1970-1980 (30.4%) to 2006-2010 (64.0%). No significant changes were noted in studies using knowledge, attitude and behavior (39.9%) as dependent variables. Conclusion: The results suggest that further expansion of true experimental, qualitative studies and physiological measurements are needed.

Purpose: This ethnography was done to explore patterns of weight management behavior among adults using obesity clinics. Methods: The participants were 12 adults who were overweight or obese and 2 family members. Data were collected from iterative fieldwork in the obesity clinics of two hospitals. Data were analyzed using text analysis and taxonomic methods. Results: Weight management behaviors among participants varied according to the recognition of the body and motivation for weight control, Participants" behavior was discussed in the socio-cultural context of obesity. Patterns of weight management behavior among participants were categorized by focus: strategic self-oriented type including managements for the body as a social asset and for health, selective neglect type, and passive group value-oriented type including type dependent on others and managements for beauty. Conclusion: Participants" weight management behavior was guided by folk concepts of body and health. and constructed within the socio-cultural context. It is necessary for health care providers to understand physical and psychological problems arising from the repeated trials, excessive control of weight, and Western cultural discourse on beauty ideals among adults who are overweight or obese. Therefore, interventions should be tailored to address individual and community needs.

Purpose: This ethnography was done to explore the meaning of illness in Korean Americans with chronic hepatitis B. Methods: The participants were 6 patients with chronic hepatitis B and 6 general informants who could provide relevant data. Data were collected from iterative fieldwork with ethnographic interviews within Korean communities in two cities in the United States. Data were analyzed using causal chain analysis developed by Wolcott. Results: The analyses revealed three meanings for the illness: hidden disease, intentionally hidden disease, and inevitably hidden disease. The contexts of meaning of illness included characteristics of the illness, social stigma, structure of health care system and communication patterns and discourse between health care providers and clients. Conclusion: The meaning of illness was based on folk illness concepts and constructed in the sociocultural context. Folk etiology, pathology and interpretation of one’s symptoms were factors influencing illness behavior. These findings could be a cornerstone for culture specific care for Korean Americans with chronic hepatitis B.

PURPOSE: Ego-integrity in older adults is the central concept related to quality of life in later life. Therefore, for effective interventions to enhance the quality of later life, a scale to measure ego-integrity in older adults is necessary. This study was carried out to develop a scale to measure ego-integrity in older adults. METHODS: This study utilized cronbach's alpha in analyzing the reliability of the collected data and expert group, and factor analysis and item analysis to analyze validity. RESULTS: Seventeen items were selected from a total of 21 items. Cronbach's alpha coefficient for internal consistency was .88 for the 17 items of ego-integrity in the older adults scale. Three factors evolved by factor analysis, which explained 50.71% of the total variance. CONCLUSIONS: The scale for measuring ego-integrity in Korean older adults in this study was evaluated as a tool with a high degree of reliability and validity.

PURPOSE The purpose of this study was to investigate the emotional state and related factors in patients with lymphedema. METHODS The subjects of this study consisted of 95 patients with lymphedema at 8 hospitals in Busan and Seoul. Data was collected by a self-administered questionnaire between March 2001 to December 2001. Data was analyzed by Pearson correlation coefficient, and stepwise multiple regression using SPSS Win 12.0. RESULTS The mean score of the emotional state of the subjects was 3.06; of their physical symptoms, 1.84; of their Activities of Daily Living(ADLs), 2.30; and of their social activities, 3.67. The emotional states of lymphedema patients correlated with their physical symptoms, their ADLs, and their social activities. The Factor influencing the emotional state of the subjects was social activities. CONCLUSION These results suggest that a negative emotional state is very common in patients with lymphedema, to which appropriate attention should be given. Rehabilitation programs must be implemented to improve lymphedema patients' emotional state, physical symptoms, ADLs, and social activities.

Purpose The main purpose of this critical ethnography was to examines the process and discourses through which family caregivers experience while caring for their sick family member in a hospital. Methods This was achieved by conducting in-depth interviews with 12 family caregivers, and by observing their caring activities and daily lives in natural settings. The study field was a unit for neurologic patients. Data was analyzed using taxonomy, discourse analysis, and proxemics. All research work was iteratively processed from March 2003 to December 2004. Results Constant comparative analysis of the data yielded the process of becoming a successful family caregiver: encountering the differences and chaos as novice; constructing their world of skilled caregivers; and becoming a hospital family as experienced caregivers. During the process of becoming an experienced hospital family, the discourse of family centered idea guided their caring behaviors and daily lives. Conclusion The paternalistic family caregivers struggled, cooperated, and harmonized with the patriarchal world of professional health care system. During this process of becoming hospital family, professional nurses must act as cultural brokers between the lay family caring system and the professional caring system.

PURPOSE The purpose of this study was to explore adult diabetics' eating styles and factors which influence them. METHOD The study adopted an ethnographic method based on a perspective which views the eating style as a cultural phenomenon. Data was collected through a personal interview, participant observation, and documented materials from Oct. 2001 to Sept. 2002. In this study, fifteen adult diabetics, with an average age of 57, participated. Data analysis was done by the Spradley's taxonomic analysis technique. RESULT The patients' eating styles were rooted in their viewpoint on illness as well as the meaning of food. Eating styles were classified into 4 types: Pathology-centered, symptom-centered, need-centered, and role-centered. CONCLUSION A conventional approach to the treatment and management of diabetes did not consider the patient's inner world which may play an important role in the successful management of the disease. We found that it was critical for health care personnel to understand patients' values, beliefs and their way of life in order to facilitate the most successful self-care diet.

Purpose: This study was conducted to explore nursing education modality for facilitating undergraduate students' critical thinking within the Korean nursing education context. Methods: Data were collected from four group inter- views from two focus groups, which were composed of six nursing professors in each group. Data were analyzed using qualitative content analysis. Results: Five themes with 13 sub-themes involving 10 categories were delineated. The five themes were managing shared resources, a supportive system in preparing qualified faculty, reflective thinking (self-directed learning), theory courses for understanding nursing resources, and clinical practi- cum for exercising critical thinking. Conclusion: A nursing educational model for facilitating critical thinking within Korean context was suggested. This could be used as an accelerator in developing nursing undergraduate course programs for critical thinking in Korea.

Purpose: This study was undertaken to identify which delirium screening instrument would be more useful in clin- ical practice. Methods: Data were collected from 118 nurses from six hospitals in five provinces in Korea. For the delirium screening three instruments were compared: NEECHAM Confusion Scale (NEECHAM), Nursing Delirium Screening Scale (Nu-DESC), Delirium Observation Scale (DOS). The MMSE-K was used for concurrent validity. The nurse subjects were surveyed as to the practical clinical value of each instrument. Cronbach's ⍺ coefficient and Kuder-Richardson 20 were used to confirm the reliability. Results: The range of three scales reli- ability was .70~.82 and the range of correlation coefficient was .63~.82 with MMSE-K. For sensitivity of NEECHAM, Nu-DESC and DOS was 1.00, 1.00 and 0.81 respectively and specificity NEECHAM, Nu-DESC and DOS was 0.88, 0.89 and 0.89 respectively. Nurses rated the practical use of the DOS scale as significantly easier to use than the NEECHAM and Nu-DESC. Conclusion: NEECHAM, Nu-DESC and DOS scales were acceptable in terms of reliability, validity, sensitivity and specificity. However, nurses rated the DOS scale as easier scale to use and had more relevance to their practice.

Purpose: This study aimed was done to analyze recent trends in nursing research published in the Journal of Korean Academy of Nursing by focusing on the content of nursing interventions and their level of evidence. Methods: A total of 209 studies published between 2007 and 2008 were reviewed using analysis criteria developed by the researchers. Results: The number of quantitative studies was greater than that of qualitative studies. There was a slight increase in the number of qualitative studies and studies including elderly populations, which reflects the recent population trend in Korea. More randomized controlled trials with a low risk of bias were needed to support more evidence-based nursing practice. Concerning the low rate of ethical consideration, stricter application of research ethics needs to be encouraged. Conclusion: The findings of this study suggest the recent trends in nursing research and the direction of nursing research and review in the Journal.

Purpose: This ethnograpy was done to explore patterns of health care behavior in patients with chronic health problems. Methods: The participants were 15 patients with chronic hepatitis B and 2 family members. Among the patients 4 had progressed to liver cirrhosis and liver cancer. Data were collected from iterative fieldwork in a department of internal medicine of I hospital. Data were analyzed using text analysis and taxonomic methods. Results: Illness and disease, relationship between health care givers and clients, and communication patterns between health professions and clients were discussed as the context of health care behavior. Health care behavior of the participants was categorized by its focus: every day work centered, body centered, organ centered, and pathology centered. Conclusion: Participants’ health care behavior was guided by folk health concept and constructed in the sociocultural context. Folk etiology, pathology, and interpretation of one’s symptoms were influencing factors in illness behavior. These findings must be a cornerstone of culture specific care for the chronic diseases.

Purpose Ego-integrity in Erikson's stage theory is used frequently among health team members related to the care of the elderly and has specific meanings within the context of quality of life in later life. However, the concept of ego-integrity in the elderly has not been well articulated in the literature. This study was conducted clarify and conceptualize the phenomena of ego-integrity in the elderly. Method A Hybrid Model of concept development was applied to develop a concept of ego-integrity, which included a field study carried out in Seoul, South Korea using in-depth interviews with old adults who were admitted as a right person for research subject according to attributes of ego-integrity analysed in the theoretical phase. Results The concept of ego-integrity emerged as a complex phenomenon having meanings in several different dimensions which encompassed several attributes. Conclusions Ego-integrity is a concept having needs that should be treated in a specific way and it is possible to enrich the meaning and methods to manage ego-integrity in nursing interventions for promoting quality of life so that its application may have effects that have positive impacts on the elderly's well being.

PURPOSE This study was conducted to develop gerontological curriculum model which reflects the need of Korean society. METHOD Three round Delphi survey method was applied to find consensus of gerontological nursing competencies (knowledge, attitudes and skills) for graduates of nursing schools from the panel of gerontological nursing practice experts. Important concepts in gerontological nursing were delineated from literature review and discussions of gerontological nursing educators. Based on these results the gerontological nursing curriculum model was developed and course structure outlined by the researchers as a group. RESULT As the result of delphi survey, 32 items of knowledge, 29 items of attitude, and 21 items of skill were identified. The curriculum model constructed around a cube with three plane- functional capacity levels, settings, and nursing practice. Specific knowledge, attitudes and skills for gerontological theory and practicum course were suggested. Competency items were assigned to theory and/or practice. CONCLUSION A curriculum model for gerontological nursing has been developed by a group of gerontological nursing educators. The curriculum model should be further tested and developed with detailed theory and practicum course outline and textbooks.