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A Study on Serum Lipid Levels in Elderly People in Wando Area - Based on Age, BMI, WHR - (완도지역 성인 및 노인의 혈청지질 수준에 관한 연구(I) - 연령, 신체 계측치를 중심으로 -)

  • Cha, Bok-Kyeong
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.35 no.1
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    • pp.68-77
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    • 2006
  • This study was peformed to document the association between nutrient intakes, body mass index (BMI), waist/hip ratio (WHR), and a major risk factor for chronic diseases. A three-day dietary intake survey, using a 24 hour recall method, was obtained from 187 subjects aged 46 to 84 (mean age 65.3) living in Wando island area. The average daily mean energy intakes were 1869.0 kcal for male and 1943.9 kcal for female, respectively. Daily intakes of protein for male and female were 28.0 and 30.4 g, and those of fat were 31.5 and 28.51 g, respectively Carbohydrate dependency was decreased with age. Protein dependency was increased with age. The mean intakes of energy, protein, Vit. A, Vit. D, Vit. E, Ca, Zn did not meet Korean RDA for elderly. The level of serum triglyceride was higher in males than in females and showed the tendency to increase with age in both sexes, whereas HDL-cholesterol tended to decrease with age in both sexes. The levels of serum total-cholesterol and LDL-cholesterol were significantly higher in males than in females, particularly in the age of $46\~59$ (p<0.05). The level of atherogenic index (AI) was significantly higher in females than in males, particularly in the age of 80 and over (p<0.05) Based on these results, it is evident that people in island area did not consume enough nutrient. Specially, dietary intake of protein was not adequate. This study implies that triglyceride, total-cholesterol, LDL-cholesterol, AI were increased with increasing age, BMI and WHR.

A Study on Startups' Dependence on Business Incubation Centers (창업보육서비스에 따른 입주기업의 창업보육센터 의존도에 관한 연구)

  • Park, JaeSung;Lee, Chul;Kim, JaeJon
    • Korean small business review
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    • v.31 no.2
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    • pp.103-120
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    • 2009
  • As business incubation centers (BICs) have been operating for more than 10 years in Korea, many early stage startups tend to use the services provided by the incubating centers. BICs in Korea have accumulated the knowledge and experience in the past ten years and their services have been considerably improved. The business incubating service has three facets : (1) business infrastructure service, (2) direct service, and (3) indirect service. The mission of BICs is to provide the early stage entrepreneurs with the incubating service in a limited period time to help them grow strong enough to survive the fierce competition after graduating from the incubation. However, the incubating services sometimes fail to foster the independence of new startup companies, and raise the dependence of many companies on BICs. Thus, the dependence on BICs is a very important factor to understand the survival of the incubated startup companies after graduation from BICs. The purpose of this study is to identify the main factors that influence the firm's dependence on BICs and to characterize the relationships among the identified factors. The business incubating service is a core construct of this study. It includes various activities and resources, such as offering the physical facilities, legal service, and connecting them with outside organizations. These services are extensive and take various forms. They are provided by BICs directly or indirectly. Past studies have identified various incubating services and classify them in different ways. Based on the past studies, we classify the business incubating service into three categories as mentioned above : (1) business infrastructure support, (2) direct support, and (3) networking support. The business infrastructure support is to provide the essential resources to start the business, such as physical facilities. The direct support is to offer the business resources available in the BICs, such as human, technical, and administrational resources. Finally, the indirect service was to support the resource in the outside of business incubation center. Dependence is generally defined as the degree to which a client firm needs the resources provided by the service provider in order to achieve its goals. Dependence is generated when a firm recognizes the benefits of interacting with its counterpart. Hence, the more positive outcomes a firm derives from its relationship with the partner, the more dependent on the partner the firm must inevitably become. In business incubating, as a resident firm is incubated in longer period, we can predict that her dependence on BICs would be stronger. In order to foster the independence of the incubated firms, BICs have to be able to manipulate the provision of their services to control the firms' dependence on BICs. Based on the above discussion, the research model for relationships between dependence and its affecting factors was developed. We surveyed the companies residing in BICs to test our research model. The instrument of our study was modified, in part, on the basis of previous relevant studies. For the purposes of testing reliability and validity, preliminary testing was conducted with firms that were residing in BICs and incubated by the BICs in the region of Gwangju and Jeonnam. The questionnaire was modified in accordance with the pre-test feedback. We mailed to all of the firms that had been incubated by the BICs with the help of business incubating managers of each BIC. The survey was conducted over a three week period. Gifts (of approximately ₩10,000 value) were offered to all actively participating respondents. The incubating period was reported by the business incubating managers, and it was transformed using natural logarithms. A total of 180 firms participated in the survey. However, we excluded 4 cases due to a lack of consistency using reversed items in the answers of the companies, and 176 cases were used for the analysis. We acknowledge that 176 samples may not be sufficient to conduct regression analyses with 5 research variables in our study. Each variable was measured through multiple items. We conducted an exploratory factor analysis to assess their unidimensionality. In an effort to test the construct validity of the instruments, a principal component factor analysis was conducted with Varimax rotation. The items correspond well to each singular factor, demonstrating a high degree of convergent validity. As the factor loadings for a variable (or factor) are higher than the factor loadings for the other variables, the instrument's discriminant validity is shown to be clear. Each factor was extracted as expected, which explained 70.97, 66.321, and 52.97 percent, respectively, of the total variance each with eigen values greater than 1.000. The internal consistency reliability of the variables was evaluated by computing Cronbach's alphas. The Cronbach's alpha values of the variables, which ranged from 0.717 to 0.950, were all securely over 0.700, which is satisfactory. The reliability and validity of the research variables are all, therefore, considered acceptable. The effects of dependence were assessed using a regression analysis. The Pearson correlations were calculated for the variables, measured by interval or ratio scales. Potential multicollinearity among the antecedents was evaluated prior to the multiple regression analysis, as some of the variables were significantly correlated with others (e.g., direct service and indirect service). Although several variables show the evidence of significant correlations, their tolerance values range between 0.334 and 0.613, thereby demonstrating that multicollinearity is not a likely threat to the parameter estimates. Checking some basic assumptions for the regression analyses, we decided to conduct multiple regression analyses and moderated regression analyses to test the given hypotheses. The results of the regression analyses indicate that the regression model is significant at p < 0.001 (F = 44.260), and that the predictors of the research model explain 42.6 percent of the total variance. Hypotheses 1, 2, and 3 address the relationships between the dependence of the incubated firms and the business incubating services. Business infrastructure service, direct service, and indirect service are all significantly related with dependence (β = 0.300, p < 0.001; β = 0.230, p < 0.001; β = 0.226, p < 0.001), thus supporting Hypotheses 1, 2, and 3. When the incubating period is the moderator and dependence is the dependent variable, the addition of the interaction terms with the antecedents to the regression equation yielded a significant increase in R2 (F change = 2.789, p < 0.05). In particular, direct service and indirect service exert different effects on dependence. Hence, the results support Hypotheses 5 and 6. This study provides several strategies and specific calls to action for BICs, based on our empirical findings. Business infrastructure service has more effect on the firm's dependence than the other two services. The introduction of an additional high charge rate for a graduated but allowed to stay in the BIC is a basic and legitimate condition for the BIC to control the firm's dependence. We detected the differential effects of direct and indirect services on the firm's dependence. The firms with long incubating period are more sensitive to indirect service positively, and more sensitive to direct service negatively, when assessing their levels of dependence. This implies that BICs must develop a strategy on the basis of a firm's incubating period. Last but not least, it would be valuable to discover other important variables that influence the firm's dependence in the future studies. Moreover, future studies to explain the independence of startup companies in BICs would also be valuable.

The Use of Radioactive $^{51}Cr$ in Measurement of Intestinal Blood Loss ($^{51}Cr$을 사용(使用)한 장관내(賜管內) 출혈량측정법(出血量測定法))

  • Lee, Mun-Ho
    • The Korean Journal of Nuclear Medicine
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    • v.4 no.1
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    • pp.19-26
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    • 1970
  • 1. Sixteen normal healthy subjects free from occult blood in the stool were selected and administered with their $^{51}Cr$ labeled own blood via duodenal tube and the recovery rate of radioactivity in feces and urine was measured. The average fecal recovery rate was 90.7 per cent ($85.7{\sim}97.7%$) of the administered radioactivity, and the average urinary excretion rate was 0.8 per cent ($0.5{\sim}1.5%$) 2. There was a close correlation between the amount of blood administered and the recovery rate from the feces; the more the blood administered, the higher the recovery rate was. It was also found that the administration of the tagged blood in the amount exceeding 15ml was suitable for measuring the radioactivity in the stools. 3. In five normal healthy subjects whose circulating erythrocytes had been tagged with $^{51}Cr$, there was little fecal excretion of radioactivity (average 0.9 ml of blood per day). This excretion is not related to hemorrhage and the main route of excretion of such an negligible radioactivity was postulated as gastric juice and bile. 4. A comparison of the radioactivity in the blood and feces of the patients with $^{51}Cr$ labeled erythrocytes seems to be a valid way of estimating intestinal blood loss.

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A Study on the Dietary Behavior and Image and Preference of Japanese Foods of University Students in Daegu and Kyungbuk Area (대구, 경북지역 대학생의 식사행동 및 일본음식에 대한 인상 및 기호도 조사 연구)

  • 한재숙;이연정;최석현;최수근;권상용;최영희
    • Journal of the East Asian Society of Dietary Life
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    • v.14 no.1
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    • pp.1-10
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    • 2004
  • This study was conducted to investigate the dietary behavior and image and preference of Japanese foods. The Subjects were consisted of 570 university students(243 males and 327 females) in Daegu and Kyungbuk area, Korea. The students responses to the 10 questions about image of Japanese foods were also measured on 5 point Likert scale. Data were presented by using frequency, percentage, chi-square test and T-test. The results of this study were as follows: (1) On the eating habits, 'the whole family has breakfast together with same foods everyday'scored high as 42.3% and 'foods put in a big platter by gathering everyday'as 35.8%. (2) About the eating customs, 53.5% of the subjects responded that the seat was fixed at meal time, 56.4% didn't start to eat before the patriarch started a meal and 30.9% responded that the head of a family had more foods in number and quantity. (3) On the table manners, 13.4% of the subjects were scolded about 'watching TV on eating', 11.5% about 'making left-over foods', 8.0% about 'misuse of spoon and chopsticks'. (4) The preferred ethnic foods by University students was in other of Korean, Chinese, Italian, Japanese and French foods. (5) Among subjects, 93.8% had no experience of visiting Japan and 92.6% wanted to visit Japan. Images on the Japanese foods were 'the price is too expensive' (mean 4.15) and 'the decoration is wonderful'(mean 4.05). But the subjects did not think Japanese foods as 'hot'(mean 2.21) and 'greasy'(mean 2.51). (6) The favorite Japanese food of subjects was Udon(mean 3.98), Sushi(mean 3.85) and Tempura(mean 3.69). So Udon turned out to be the most popular Japanese foods by university students in Daegu and Kyungbuk area, Korea. But they did not prefer Natto(mean 2.68), Ochazuke(mean 2.76), Okonomiyaki(mean 2.87) and Misosiru and did not eat. From the above results, Korean university students preferred Udon to Natto among Japanese traditional foods, and they estimated Japanese foods as 'too expensive'. Therefore, lowering the price and developing the cooking method for Korean taste were needed to increase the intake of Japanese traditional foods by Korean university students and.

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Comparison of Family Support and Mental Health Between the Rural and Urban Elderly (농촌과 도시지역 노인의 가족지지와 정신건강에 관한 비교)

  • Min, Kyung-Hwa;Kim, Sang-Soon
    • Journal of agricultural medicine and community health
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    • v.20 no.2
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    • pp.175-185
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    • 1995
  • This study is to compare family support and mental health between the rural and the urban elderly. In order to do that I collected the data through questioning 238 people in 3 urban areas in Busan and 201 people in 9 rural areas near Daegu. The degree of their family support is 36.70 on the average in the rural area and 40.77 in the urban area. The degree of family support of urban elderly is a little higher. According to general characters between the differences of family support in both areas, in the rural area there are differences in sex, age, whether they have a spouse or not, education level, financial state, number of children, number of co living, status of co living, subjective health status, amount of pocket money and how much they are participating in leisure activity. In the urban area there are differences in sex, whether they have a spouse or not, religion, financial state, number of co living, status of co living, subjective health status, amount of pocket money, how much they are participating in leisure activity and house pattern. In the stepwise multiple regression analysis the main variables that affect degree of family support in the rural area are age, whether they have a spouse or not and financial state which account for 33% of the total variance and in the urban area are subjective health status, financial state, whether they have a spouse or not and number of co-living which account for 35%. Health status is better in the urban area(average 36.87) than in the rural area(57.42). In each item the people whose mark was more than 75%(low) have Depression 8.4%, Somatization 8.0% in the urban area and Somatization 8.5%, Depression 8.5%, Anxiety 4.0%, Phobic anxiety 4.0%, Obsessive compulsive reaction 2.5%, Hostility 2.0%, Paranoid ideation 2.0%, Psychoticism 1.5% and Interpersonal sensitivity 1.5% in the rural area. In the mental health condition, on the basis of 4 points in both areas, the average is Somatization(rural : 1.69, urban : 1.51), Depression (rural : 1.64, urban : 1.37) and Obsessive compulsive reaction(rural : 1.33, urban : 0.99). According to the differences between mental health conditions by general characters, in the rural area the differences are presented in sex, age, whether they have a spouse or not, religion, education level, financial state, number of children, status of co living, subjective health status, amount of pocket money and how much they are participating in leisure activity, in the urban area the differences are presented in sex, whether they have a spouse or not, religion, financial state, number of co living, status of co living, subjective health status, house pattern, amount of pocket money and how much they are participating in leisure activity. In the stepwise multiple regression analysis the main variables that affect mental health condition in the rural are family support degree subjective health status, religion sex, age and financial state which account for 43% of the total and in the urban area are family support degree, subjective health status and financial state which account for 51%. In the matter of family support degree and mental health condition the rural area was -0.4555, of urban area was -0.6446. The rural area that has a high percentage in family support degree and mental health condition Depression was -0.5036, Psychoticism was -0.4265 in the urban area Psychoticism was -0.6452, Depression was -0.5955. Family support has a great influence on mental health of old people and family support and mental health condition can be different according to living area. So in their problems nursing intervention through family and nursing strategies according to living area should be established.

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Stock Price Prediction by Utilizing Category Neutral Terms: Text Mining Approach (카테고리 중립 단어 활용을 통한 주가 예측 방안: 텍스트 마이닝 활용)

  • Lee, Minsik;Lee, Hong Joo
    • Journal of Intelligence and Information Systems
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    • v.23 no.2
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    • pp.123-138
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    • 2017
  • Since the stock market is driven by the expectation of traders, studies have been conducted to predict stock price movements through analysis of various sources of text data. In order to predict stock price movements, research has been conducted not only on the relationship between text data and fluctuations in stock prices, but also on the trading stocks based on news articles and social media responses. Studies that predict the movements of stock prices have also applied classification algorithms with constructing term-document matrix in the same way as other text mining approaches. Because the document contains a lot of words, it is better to select words that contribute more for building a term-document matrix. Based on the frequency of words, words that show too little frequency or importance are removed. It also selects words according to their contribution by measuring the degree to which a word contributes to correctly classifying a document. The basic idea of constructing a term-document matrix was to collect all the documents to be analyzed and to select and use the words that have an influence on the classification. In this study, we analyze the documents for each individual item and select the words that are irrelevant for all categories as neutral words. We extract the words around the selected neutral word and use it to generate the term-document matrix. The neutral word itself starts with the idea that the stock movement is less related to the existence of the neutral words, and that the surrounding words of the neutral word are more likely to affect the stock price movements. And apply it to the algorithm that classifies the stock price fluctuations with the generated term-document matrix. In this study, we firstly removed stop words and selected neutral words for each stock. And we used a method to exclude words that are included in news articles for other stocks among the selected words. Through the online news portal, we collected four months of news articles on the top 10 market cap stocks. We split the news articles into 3 month news data as training data and apply the remaining one month news articles to the model to predict the stock price movements of the next day. We used SVM, Boosting and Random Forest for building models and predicting the movements of stock prices. The stock market opened for four months (2016/02/01 ~ 2016/05/31) for a total of 80 days, using the initial 60 days as a training set and the remaining 20 days as a test set. The proposed word - based algorithm in this study showed better classification performance than the word selection method based on sparsity. This study predicted stock price volatility by collecting and analyzing news articles of the top 10 stocks in market cap. We used the term - document matrix based classification model to estimate the stock price fluctuations and compared the performance of the existing sparse - based word extraction method and the suggested method of removing words from the term - document matrix. The suggested method differs from the word extraction method in that it uses not only the news articles for the corresponding stock but also other news items to determine the words to extract. In other words, it removed not only the words that appeared in all the increase and decrease but also the words that appeared common in the news for other stocks. When the prediction accuracy was compared, the suggested method showed higher accuracy. The limitation of this study is that the stock price prediction was set up to classify the rise and fall, and the experiment was conducted only for the top ten stocks. The 10 stocks used in the experiment do not represent the entire stock market. In addition, it is difficult to show the investment performance because stock price fluctuation and profit rate may be different. Therefore, it is necessary to study the research using more stocks and the yield prediction through trading simulation.

Steel Plate Faults Diagnosis with S-MTS (S-MTS를 이용한 강판의 표면 결함 진단)

  • Kim, Joon-Young;Cha, Jae-Min;Shin, Junguk;Yeom, Choongsub
    • Journal of Intelligence and Information Systems
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    • v.23 no.1
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    • pp.47-67
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    • 2017
  • Steel plate faults is one of important factors to affect the quality and price of the steel plates. So far many steelmakers generally have used visual inspection method that could be based on an inspector's intuition or experience. Specifically, the inspector checks the steel plate faults by looking the surface of the steel plates. However, the accuracy of this method is critically low that it can cause errors above 30% in judgment. Therefore, accurate steel plate faults diagnosis system has been continuously required in the industry. In order to meet the needs, this study proposed a new steel plate faults diagnosis system using Simultaneous MTS (S-MTS), which is an advanced Mahalanobis Taguchi System (MTS) algorithm, to classify various surface defects of the steel plates. MTS has generally been used to solve binary classification problems in various fields, but MTS was not used for multiclass classification due to its low accuracy. The reason is that only one mahalanobis space is established in the MTS. In contrast, S-MTS is suitable for multi-class classification. That is, S-MTS establishes individual mahalanobis space for each class. 'Simultaneous' implies comparing mahalanobis distances at the same time. The proposed steel plate faults diagnosis system was developed in four main stages. In the first stage, after various reference groups and related variables are defined, data of the steel plate faults is collected and used to establish the individual mahalanobis space per the reference groups and construct the full measurement scale. In the second stage, the mahalanobis distances of test groups is calculated based on the established mahalanobis spaces of the reference groups. Then, appropriateness of the spaces is verified by examining the separability of the mahalanobis diatances. In the third stage, orthogonal arrays and Signal-to-Noise (SN) ratio of dynamic type are applied for variable optimization. Also, Overall SN ratio gain is derived from the SN ratio and SN ratio gain. If the derived overall SN ratio gain is negative, it means that the variable should be removed. However, the variable with the positive gain may be considered as worth keeping. Finally, in the fourth stage, the measurement scale that is composed of selected useful variables is reconstructed. Next, an experimental test should be implemented to verify the ability of multi-class classification and thus the accuracy of the classification is acquired. If the accuracy is acceptable, this diagnosis system can be used for future applications. Also, this study compared the accuracy of the proposed steel plate faults diagnosis system with that of other popular classification algorithms including Decision Tree, Multi Perception Neural Network (MLPNN), Logistic Regression (LR), Support Vector Machine (SVM), Tree Bagger Random Forest, Grid Search (GS), Genetic Algorithm (GA) and Particle Swarm Optimization (PSO). The steel plates faults dataset used in the study is taken from the University of California at Irvine (UCI) machine learning repository. As a result, the proposed steel plate faults diagnosis system based on S-MTS shows 90.79% of classification accuracy. The accuracy of the proposed diagnosis system is 6-27% higher than MLPNN, LR, GS, GA and PSO. Based on the fact that the accuracy of commercial systems is only about 75-80%, it means that the proposed system has enough classification performance to be applied in the industry. In addition, the proposed system can reduce the number of measurement sensors that are installed in the fields because of variable optimization process. These results show that the proposed system not only can have a good ability on the steel plate faults diagnosis but also reduce operation and maintenance cost. For our future work, it will be applied in the fields to validate actual effectiveness of the proposed system and plan to improve the accuracy based on the results.

Relationship between Parental Career Support, Career Self-Regulation, and Career Identity - with Student Dep. of Radiologic Technology - (부모진로지지와 진로자기조절, 진로정체감의 관계 - 방사선과 학생 대상 -)

  • Kim, In-Sook;Lee, In-Ja
    • Journal of radiological science and technology
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    • v.38 no.3
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    • pp.295-304
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    • 2015
  • This study intended to examine the correlation of career self-regulation (plan and check-up, positive thinking, career feedback, environment formation for career) and career identity (career decision, indecisiveness, career indecision) caused by parental career support (informative, emotional, financial, and empirical) among freshmen, sophomores, and juniors in the radiotechnology department. For assessment, a survey was conducted and according to the results, there existed correlation as follows. Regarding parental career support, emotional support is plan and check-up (r=.25, p<.001), Career feedback (r=.54, p<.001), and positive thinking (r=.46, p<.001) showed high positive correlation while informative support showed correlation in all factors showing high correlation with environment formation for career (r=.22, p<.001), plan and check-up (r=.20, p<.001), career feedback (r=.24, p<.001), and positive thinking (r=.26, p<.001). Financial support career feedback (r=.33, p<.001) and positive thinking (r=.34, p<.001) showed somewhat higher correlation. All factors of environment formation for career (r=.18, p<.001), plan and check-up (r=.25, p<.001), career feedback (r=.37, p<.001), and positive thinking (r=.30, p<.001) showed high correlation. Informative support showed high correlation only with career decision (r=.27, p<.001) and financial support also showed high correlation only with career decision (r=.18, p<.001). Also, empirical support was somewhat highly correlated only with career decision (r=.23, p<.001). Regarding school-year difference depending on parental career support, there was significant difference between emotional support (F=8.52, p<.001), financial support (F=8.97, p<.001), and empirical support (F=5.36, p<.05) while informative support was dismissed. Regarding school-year difference depending on career self-regulation, there was significant difference between career feedback (F=8.48, p<.001) and positive thinking (F=16.29, p<.001) while environment formation for career and plan and check-up were dismissed. Regarding school-year difference depending on career identity, there was significant difference between career indecision (F=4.01, p<.05) and career decision (F=11.72, p<.001) while indecisiveness was dismissed. According to the analysis results, parents' active support to their child like respecting and listening to their opinion on career, provision of career related experience or information, and provision of necessary financial aid for their study or academic preparation made the students plan and exploring their career, examine accomplishment progress, have positive idea to realize their objectives. In addition, the students were able to establish the objective of their career by forming the environment that helped them realize their objectives by seeking advices and encouragement from surroundings. Meanwhile, the parents' attitude to respect and listen to their child's career related opinion affected their career decision and indecision. Although informative support helped the students' career decision, financial and empirical support caused effect only to career decision.

AN EXPLORATORY STUDY TO DETERMINE HOW ADOLESCENT STUDENT NURSES VIEW PEDIATRIC NURSING EXPERIENCE AS STRESSFUL SITUATION (소아과 간호학 실습시에 느끼는 성년기 간호학생들의 긴장감에 대한 실험적 연구)

  • Oh, Kasil
    • Journal of Korean Academy of Nursing
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    • v.4 no.3
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    • pp.33-56
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    • 1974
  • 간호를 장래의 전문직으로 택하려고 공부하는 간호학생들은 완전한 성인으로서의 발달 과정중 후기 성년기에 속한다. 이시기는 자아를 발견하고 인간이 무엇을 믿으며 인간의 가치가 무엇인가를 추구하는 중요한 시기이다. 다시 말해서 어른과 어린이의 과도기에 서서 자신의 이상적 가치와 기성사회의 기존 가치를 잘 융화시켜 독립된 인간으로서 성숙하려는 노력의 시기이다. 그러므로 성년기의 갈등은 인생의 어느 시기보다도 그 정도가 심하게 나타난다. 간호학생들은 이상의 일반적인 성년기 발달의 요구 외에도 간호대학이라는 특수한 배움의 여건 때문에 좀 더 심각한 문제에 대두된다. 특히 소아과 간호대학이라는 실습환경은 여러 가지 복잡한 병실 사정으로 많은 긴장감을 주는 학습경험이다. 어린이의 간호에는 그들의 발달과정에 따른 다양한 역활이 요구된다. 또한 병원이라는 낯선 환경과 어머니를 떨어져야하는 두려움으로 불안한 어린이와 그 어린이의 불안과 두려움으로 인해 우울과 죄의식에 있는 어머니의 간호는 여러 면에서 성년기 학생들에게 긴장감을 일으키게 하는 요인이 된다. 본 연구의 문헌조사는 주로 미국 문헌에 나타난 간호 대학생들의 성년기 성숙을 위한 발달의 요구와, 소아병실의 복잡한 여건으로 발생되는 긴장감을 다루고 있다. 문헌을 기초로 하여 저자는 긴장감을 주는 간호활동을 크게 다섯 부군으로 묶었다. 1. 어린이 환자의 신체적 간호, 2. 어린이 환자나 부모와의 원만한 대화와 상호관계를 위한 간호활동 3. 소아병실에서 요구되는 다양한 간호원의 역활 4. 어린이나 부모의 간호에 대한 의뢰심 5. 간호의 가치나 이상적 간호. 연구방법으로는 49개의 폐쇄식 질문 항목을 가진 질문지를 사용하였다. 질문 항목들은 문헌연구에서 소아과 간호학 실습시 학생들이 긴장감을 느낀다고 밝혀진 내용들이 다. 학생들은 자신의 경험을 "긴장감이 없었다. ""긴장감이 있었다. ""심한 긴장감이 있었다. ""실습 중 경험이 없었다. "의 사항 중 택일을 하게 되어 있다. 연구대상으로는 모 대학교 간호대학 학생으로 산부인과 간호학 실습을 마친 후 소아과 간호학 실습 8주를 완료한 4학년 학생 42명이었다. 자료분석의 결과는 대부분의 학생들에게 소아과 간호학 실습은 긴장감을 주는 경험이 있다고 나타났다. 다음은 연구결과 주목할만한 몇 가지 사항들이다. 1. 어린이 환자의 신체적 간호는 성년기 학생들에게 긴장감을 주는 실습 경험이었다. 특별히 심하게 긴장감을 주었던 간호활동은 어린이환자의 상태가 중한 경우로, 장기간 앓는 아이, 선천성 기형이 있는 아이, 회복이 불가능하여 죽게될 아이나 사망하는 경우의 어린이 간호였다. 이 결과는 간호학의 기본과정 즉, 기초간호학이나 내 외과 간호학 실습만으로 소아과 간호학 실습을 위한 충분한 준비가 되지 못한다는 것을 뜻 할 수도 있다. 한편, 문헌연구에서 밝힌바와 같이 어리고 연약해 보이는 어린이들의 신체조건이 학생들의 간호활동을 어렵게 하는 경우도 될 수 있겠다. 2. 간호학생들의 어린이 환자와의 대화나 원만한 인간관계에서의 긴장감은 이 연구결과로 평가나 제언이 힘들다. 조사결과에서 학생들은 주로 어린이의 상태가 좋지 않은 경우에 심한 긴장감을 가졌고 일반적인 간호의 경우에는 별로 긴장감이 없었다. 이것은 질병의 상태나 화제, 이야기 할 때의 상황에 따라 긴장감의 여부가 달라질 수 있다는 결론이 되겠다. 3. 소아병실에서의 다양한 역활을 수행하는 것은 비교적 긴장감이 많이 생기는 간호활동으로 나타났다. 그러나 재미있는 사실은 학생들이 간호원으로서의 전문가적인 입장에서, 환자나 보호자를 가르칠때는 별로 문제가 없었으나 어린이 기르는 방법이나 어린이 이해면에서 좀 더 잘 안다고 생각되는 어머니가 지켜 볼때의 어린이 간호에는 긴장감을 가진다는 사실이다. 이것은 Jewett의 연구에서 밝힌바와는 상반되는 결과다. 그의 연구에서 학설들은 부모나 어머니들에 의해 전문가로서 인정받고 기대되는 경우가 제일 어려운 경험이 있다고 밝혔다. 4. 어린이 환자나 그들 부모의 간호에 대한 의뢰심은 학생들에게 심한 긴장감을 주는 경험이 있다. 특히 신체적 간호에 대해 의뢰하는 경우에는 더 심한 긴장감을 준다고 표현한다. 일반적으로 부모가 병실에 상주하는 경우에는 그들의 의뢰심이 심하며 이것은 학생들에게 감당하기 힘든 긴장과 어려움을 주게된다. 왜냐하면 성년기의 학생들은 그들 자신이 먼저 타인에게서 이해받기를 원하며 또 관용을 베풀어주기를 원하는데 그것을 남에게 주어야 하는 입장은 학생들을 긴장되게 하는 실습활동인 것이다. 5. 학생들은 그들이 배운 간호의 이상이나 가치가 실습지에서의 여러 경우와 맞지 않는 것을 보았을 때 극심한 긴장감을 갖는다고 밝혔다. 의사나 병원 행정의 사실이 자신의 이상과 맞지 않는다는 것보다는 간호원의 간호업무의 차이에서 더 비판적인 반응을 보였다. 대부분의 성년기 학생들은 그들의 이상적인 간호원상을 그들의 선배나 실무 간호원 중에서 찾으려는 시기에 그들의 간호활동이 이론과 다른 점이나 학생 자신의 소아과 간호의 가치와 다른 것을 보았을 때는 심한 반감과 긴장감을 갖게된다. 이 문제는 어린 사람이 윗 어른과 함께 동료의식을 갖고 일하기 어려운 한국적 사회구조 때문에 더 심하게 긴장감을 주는 경험인지도 모른다. 선배 간호원의 전문인으로서의 권위와 어린이 환자 보호자의 어른으로서의 권위 사이에서 자신의 이상과 가치의 추구는 용이하지 않으며 내적 갈등은 어쩔수 없는 일 일 것이다. 6. 대부분 높은 백분율의 긴장 반응은 죽음이나 환자의 사망에 관련된 간호활동 항목에서 나타났다. 이 연구의 대상 학생들은 2, 3학년에서 죽음에 대한 강의를 들었지만 이 연구 결과에 의하면 충분한 학습 경험이 주어진 것 같지 않다. 어떠한 경우의 죽음에라도 어린이 환자나 그 보호자들의 심리를 잘 이해하고 반응을 잘 관찰해서 적절한 간호를 해 줄 수 있는 다양한 방법의 학습 경험이 필요하다고 보겠다. 7. 학생들의 긴장도가 어린이 간호에 더 심한가, 보호자 간호에 더 심한가를 알기 위한 비교 결과는 비교적 비슷한 정도로 나타났다. 8. 학생들의 소아과 간호학 실습시의 긴장도는 과거의 병실 실습기간의 장, 단이나 가정에서의 어린인 간호의 경험과는 별 연관성이 없었다. 연구의 대상자가 적기 때문에 단정을 하기는 힘이 들지만 소아과 간호학 실습이 다른 병실의 실습과는 분리되어서 완전히 다르게 다루어 져야만 하며 간호교육자들의 주의 깊은 관심과 노력이 필요한 실습교육이 라 하겠다. 이상의 전반적인 고찰에 의하면 한국 성년기 간호학생들의 소아과 간호학 실습은 미국의 경우와 마찬가지로 긴장감을 주는 경험이다. 문화배경의 다른 점은 무시하고라도 Davis와 Oleson이 결론한 바와 같이 "간호대 학생은 어디를 막론하고 다 같은 성격과 문제를 가지고 있다. " 앞으로 보다 효과적인 학생들의 소아과 간호학 실습을 위한 연구를 위해 다음의 몇 가지를 본 연구의 결과를 가지고 제언한다. 1. 보다 여러 지역에서 다양한 교육 방법을 가진 학교의 학생을 대상으로 한 연구의 필요성. 2. 학생들이 실습 전 선입견이나 이미 들어서 생긴 긴장감의 개입 여부를 밝힐 수 있는 연구. 3. 학생 개인의 과거 경침이 긴장감 유발에 미치는 영향을 위한 연구 4. 이 연구의 결과를 입증할 수 있는 종단적 연구. 5. 이 연구에서 나타난 긴장감이 학습 행위에 미치는 영향을 알기 위한 관찰적 연구. 이 연구를 위해 많은 도움을 주셨던 보스턴대학의 Dr. Kennedy와 연세대학의 여러 선생님께 심심한 감사를 드립니다.

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The detection of collapsible airways contributing to airflow limitation (기류 제한에 영향을 미치는 허탈성 기도의 분석)

  • Kim, Yun Seong;Park, Byung Gyu;Lee, Kyong In;Son, Seok Man;Lee, Hyo Jin;Lee, Min Ki;Son, Choon Hee;Park, Soon Kew
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.4
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    • pp.558-570
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    • 1996
  • Background : The detection of Collapsible airways has important therapeutic implications in chronic airway disease and bronchial asthma. The distinction of a purely collapsible airways disease from that of asthma is important because the treatment of the dormer may include the use of pursed lip breathing or nasal positive pressure ventilation whereas in the latter, pharmacologic approaches are used. One form of irreversible airflow limitation is collapsible airways, which has been shown to be a Component of asthma or to emphysema, it can be assessed by the volume difference between what exits the lung as determined by a spirometer and the volume compressed as measured by the plethysmography. Method : To investigate whether volume difference between slow and forced vital Capacity(SVC-FVC) by spirometry may be used as a surrogate index of airway collapse, we examined pulmonary function parameters before and after bronchodilator agent inhalation by spirometry and body plethysmography in 20 cases of patients with evidence of airflow limitation(chronic obstructive pulmonary disease 12 cases, stable bronchial asthma 7 cases, combined chronic obstructive pulmonary disease with asthma 1 case) and 20 cases of normal subjects without evidence of airflow limitation referred to the Pusan National University Hospital pulmonary function laboratory from January 1995 to July 1995 prospectively. Results : 1) Average and standard deviation of age, height, weight of patients with airflow limitation was $58.3{\pm}7.24$(yr), $166{\pm}8.0$(cm), $59.0{\pm}9.9$(kg) and those of normal subjects was $56.3{\pm}12.47$(yr), $165.9{\pm}6.9$(cm), $64.4{\pm}10.4$(kg), respectively. The differences of physical characteristics of both group were not significant statistically and male to female ratio was 14:6 in both groups. 2) The difference between slow vital capacity and forced vital capacity was $395{\pm}317ml$ in patients group and $154{\pm}176ml$ in normal group and there was statistically significance between two groups(p<0.05). Sensitivity and specificity were most higher when the cut-off value was 208ml. 3) After bronchodilator inhalation, reversible airway obstructions were shown in 16 cases of patients group, 7 cases of control group(p<0.05) by spirometry or body plethysmography d the differences of slow vital capacity and forced vital capacity in bronchodilator response group and nonresponse group were $300.4{\pm}306ml$, $144.7{\pm}180ml$ and this difference was statistically significant. 4) The difference between slow vital capacity and forced vital capacity before bronchodilator inhalation was correlated with airway resistance before bronchodilator(r=0.307 p=0.05), and the difference between slow vital capacity and forced vital capacity after bronchodilator was correlated with difference between slow vital capacity and forced vital capacity(r=0.559 p=0.0002), thoracic gas volume(r=0.488 p=0.002) before bronchodilator and airway resistance(r=0.583 p=0.0001), thoracic gas volume(r=0.375 p=0.0170) after bronchodilator, respectively. 5) The difference between slow vital capacity and forced vital capacity in smokers and nonsmokers was $257.5{\pm}303ml$, $277.5{\pm}276ml$, respectively and this difference did not reach statistical significance(p>0.05). Conclusion : The difference between slow vital capacity and forced vital capacity by spirometry may be useful for the detection of collapsible airway and may help decision making of therapeutic plans.

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