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A Inquiry of the Perception of Death in School Age (학령기 아동의 죽음인식에 관한 탐색적 연구)

  • Joun, Young-Ran
    • Korean Journal of Hospice Care
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    • v.8 no.1
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    • pp.13-28
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    • 2008
  • Purpose: This paper aims to examine the subjective structures and types of school age children's perception of death through an investigative study on their perception of death in order to provide a basic material for them to understand death, and develop and carry out an effective death education program. Methods: The study method used the Q Methodology which can investigate the subjective structures and types of school age children's perception of death. For Q-population, 20 school age children were used as subjects for neutral interviews and open surveys, and through documentary research, a total of 132 statements were collected, For Q-samples, 23 statements (Q-samples) were derived through a non-structural method. P-samples were 31 school age children (8-13 year olds), Q-sorting was carried out using Q-cards, and the collected data was analyzed using the PC QUANL program. Results: As a result of the study, children's perception of death was divided into five types. The first type was functional type, characterized by prominent subjective perception regarding the elements of death, such as non-reversibility, universality, non-functionality, and causality. The second was after-life type, characterized by a strong, focus on life after death in one's perception of death, and it included children with Christian background and those who had experienced death in their immediate family. The third was religious type, characterized by a strong belief in being able to still watch over one's family and friends after one's death, resulting in a positive faith in the after-life. The fourth was fearful type, characterized by a deeper fear of death in comparison to other types. The fifth was realistic type, characterized by a strong and positive assent to the perception of good death. Conclusion: The significance of the results of this paper's study to Nursing is as follows. In terms of understanding the subjectivity of school age children's perception of death in nursing practice, and understanding the compositional elements of death presented with strong emphasis in existing literature and studies, the results will expand these understandings and allow us to understand the level of perception in school age children regarding the definition of death, after-life, and good death, be utilized as useful material in developing an effective death education program for them according to their type characteristics, and become the fertilizer for enabling the children to live a proper life and preventing the tendency to make light of death that occur in adolescence and the spread of suicides. In terms of nursing theory, the description and examination of the subjective structures and the characteristics of the different, types of school age children's perception of death can be utilized as useful material for building a model of school age children's perception of death, and be further used for teaching respect for life. In terms of nursing research, the results can contribute to research describing the effects of nursing intervention strategies and developing tools for providing psychosocial nursing in terms of giving school age children a positive perception of death according to their types as well respect for life.

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Characteristics of Phytoplankton Succession Based on the Functional Group in the Enclosed Culture System (대형 배양장치에서 기능그룹에 기초한 식물플랑크톤 천이 특성)

  • Lee, Kyung-Lak;Noh, Seongyu;Lee, Jaeyoon;Yoon, Sungae;Lee, Jaehak;Shin, Yuna;Lee, Su-Woong;Rhew, Doughee;Lee, Jaekwan
    • Korean Journal of Ecology and Environment
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    • v.50 no.4
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    • pp.441-451
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    • 2017
  • The present study was conducted from August to December 2016 in a cylindrical water tank with a diameter of 1 m, a height of 4 m and a capacity of 3,000 L. The field water and sediment from the Nakdong River were also sampled for the experimental culture (field water+sediment) and control culture (field water), respectively. In this study, we aimed to investigate phytoplankton succession pattern using the phytoplankton functional group in the enclosed culture system. A total of 50 species in 27 genera including Chlorophyceae (30 species), Bacillariophyceae (11 species), Cyanophyceae (7 species), and Cryptophyceae (2 species) were identified in the experimental and control culture systems. A total of 19 phytoplankton functional groups (PFGs) were identified, and these groups include B, C, D, F, G, H1, J, K, Lo, M, MP, N, P, S1, $T_B$, $W_0$, X1, X2 and Y. In particular, $W_0$, J and M groups exhibited the marked succession in the experimental culture system with higher biovolumes compared to those of the control culture system, which may be related to the internal cycling of nutrients by sediment in the experimental culture system. The principal component analyses demonstrated that succession patterns in PFG were associated with the main environmental factors such as nutrients(N, P), water temperature and light intensity in two culture systems. In conclusion, the present study showed the potential applicability of the functional group for understanding the adaptation strategies and ecological traits of the phytoplankton succession in the water bodies of Korea.

Current Status in Management of Children with Atopic Dermatitis and Knowledge and Practice of Preschool Teachers (보육교사의 아토피 피부염 아동 관리 현황과 아토피 피부염에 대한 지식 및 실천)

  • Cho, In-Sook;Ryu, Se-Ang
    • Child Health Nursing Research
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    • v.19 no.1
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    • pp.49-58
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    • 2013
  • Purpose: The purpose of this study was to describe current status in management of children with atopic dermatitis and to examine knowledge and care practices of preschool teachers. Methods: A survey using a self-administered questionnaire was conducted. Knowledge and practice were measured with the questionnaire by Park (2011). Data were analysed using SPSS.WIN 20.0. Results: Of the teachers, 81.3% managed children with atopic dermatitis depending on parents' needs and 58.9% reported difficulties due to limited knowledge and expressed a need for continuing education and provision of educational guidelines. Preschool teachers had a mean score for knowledge about atopic dermatitis of .75 out of 1 point. Among three domains of knowledge, signs & symptoms had the highest score and management, the lowest. The mean score for care practices for children with atopic dermatitis was 3.4 out of 4 points. Among the four domains of care practices, food had the highest score and dress & bedclothes, the lowest. Knowledge and practice of the teachers were different according to responsibility in management and educational need. The correlation between knowledge and practice was not significant. Conclusion: These results suggest that educational programs and strategies should be developed to increase preschool teachers' knowledge and improve care practice for children with atopic dermatitis.

The Effect of Mutual Trust on Relational Performance in Supplier-Buyer Relationships for Business Services Transactions (재상업복무교역중적매매관계중상호신임대관계적효적영향(在商业服务交易中的买卖关系中相互信任对关系绩效的影响))

  • Noh, Jeon-Pyo
    • Journal of Global Scholars of Marketing Science
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    • v.19 no.4
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    • pp.32-43
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    • 2009
  • Trust has been studied extensively in psychology, economics, and sociology, and its importance has been emphasized not only in marketing, but also in business disciplines in general. Unlike past relationships between suppliers and buyers, which take considerable advantage of private networks and may involve unethical business practices, partnerships between suppliers and buyers are at the core of success for industrial marketing amid intense global competition in the 21st century. A high level of mutual cooperation occurs through an exchange relationship based on trust, which brings long-term benefits, competitive enhancements, and transaction cost reductions, among other benefits, for both buyers and suppliers. In spite of the important role of trust, existing studies in buy-supply situations overlook the role of trust and do not systematically analyze the effect of trust on relational performance. Consequently, an in-depth study that determines the relation of trust to the relational performance between buyers and suppliers of business services is absolutely needed. Business services in this study, which include those supporting the manufacturing industry, are drawing attention as the economic growth engine for the next generation. The Korean government has selected business services as a strategic area for the development of manufacturing sectors. Since the demands for opening business services markets are becoming fiercer, the competitiveness of the business service industry must be promoted now more than ever. The purpose of this study is to investigate the effect of the mutual trust between buyers and suppliers on relational performance. Specifically, this study proposed a theoretical model of trust-relational performance in the transactions of business services and empirically tested the hypotheses delineated from the framework. The study suggests strategic implications based on research findings. Empirical data were collected via multiple methods, including via telephone, mail, and in-person interviews. Sample companies were knowledge-based companies supplying and purchasing business services in Korea. The present study collected data on a dyadic basis. Each pair of sample companies includes a buying company and its corresponding supplying company. Mutual trust was traced for each pair of companies. This study proposes a model of trust-relational performance of buying-supplying for business services. The model consists of trust and its antecedents and consequences. The trust of buyers is classified into trust toward the supplying company and trust toward salespersons. Viewing trust both at the individual level and the organizational level is based on the research of Doney and Cannon (1997). Normally, buyers are the subject of trust, but this study supposes that suppliers are the subjects. Hence, it uniquely focused on the bilateral perspective of perceived risk. In other words, suppliers, like buyers, are the subject of trust since transactions are normally bilateral. From this point of view, suppliers' trust in buyers is as important as buyers' trust in suppliers. The suppliers' trust is influenced by the extent to which it trusts the buying companies and the buyers. This classification of trust using an individual level and an organization level is based on the suggestion of Doney and Cannon (1997). Trust affects the process of supplier selection, which works in a bilateral manner. Suppliers are actively involved in the supplier selection process, working very closely with buyers. In addition, the process is affected by the extent to which each party trusts its partners. The selection process consists of certain steps: recognition, information search, supplier selection, and performance evaluation. As a result of the process, both buyers and suppliers evaluate the performance and take corrective actions on the basis of such outcomes as tangible, intangible, and/or side effects. The measurement of trust used for the present study was developed on the basis of the studies of Mayer, Davis and Schoorman (1995) and Mayer and Davis (1999). Based on their recommendations, the three dimensions of trust used for the study include ability, benevolence, and integrity. The original questions were adjusted to the context of the transactions of business services. For example, a question such as "He/she has professional capabilities" has been changed to "The salesperson showed professional capabilities while we talked about our products." The measurement used for this study differs from those used in previous studies (Rotter 1967; Sullivan and Peterson 1982; Dwyer and Oh 1987). The measurements of the antecedents and consequences of trust used for this study were developed on the basis of Doney and Cannon (1997). The original questions were adjusted to the context of transactions in business services. In particular, questions were developed for both buyers and suppliers to address the following factors: reputation (integrity, customer care, good-will), market standing (company size, market share, positioning in the industry), willingness to customize (product, process, delivery), information sharing (proprietary information, private information), willingness to maintain relationships, perceived professionalism, authority empowerment, buyer-seller similarity, and contact frequency. As a consequential variable of trust, relational performance was measured. Relational performance is classified into tangible effects, intangible effects, and side effects. Tangible effects include financial performance; intangible effects include improvements in relations, network developing, and internal employee satisfaction; side effects include those not included either in the tangible or intangible effects. Three hundred fifty pairs of companies were contacted, and one hundred five pairs of companies responded. After deleting five company pairs because of incomplete responses, one hundred five pairs of companies were used for data analysis. The response ratio of the companies used for data analysis is 30% (105/350), which is above the average response ratio in industrial marketing research. As for the characteristics of the respondent companies, the majority of the companies operate service businesses for both buyers (85.4%) and suppliers (81.8%). The majority of buyers (76%) deal with consumer goods, while the majority of suppliers (70%) deal with industrial goods. This may imply that buyers process the incoming material, parts, and components to produce the finished consumer goods. As indicated by their report of the length of acquaintance with their partners, suppliers appear to have longer business relationships than do buyers. Hypothesis 1 tested the effects of buyer-supplier characteristics on trust. The salesperson's professionalism (t=2.070, p<0.05) and authority empowerment (t=2.328, p<0.05) positively affected buyers' trust toward suppliers. On the other hand, authority empowerment (t=2.192, p<0.05) positively affected supplier trust toward buyers. For both buyers and suppliers, the degree of authority empowerment plays a crucial role in the maintenance of their trust in each other. Hypothesis 2 tested the effects of buyerseller relational characteristics on trust. Buyers tend to trust suppliers, as suppliers make every effort to contact buyers (t=2.212, p<0.05). This tendency has also been shown to be much stronger for suppliers (t=2.591, p<0.01). On the other hand suppliers trust buyers because suppliers perceive buyers as being similar to themselves (t=2.702, p<0.01). This finding confirmed the results of Crosby, Evans, and Cowles (1990), which reported that suppliers and buyers build relationships through regular meetings, either for business or personal matters. Hypothesis 3 tested the effects of trust on perceived risk. It has been found that for both suppliers and buyers the lower is the trust, the higher is the perceived risk (t=-6.621, p<0.01 for buyers; t=-2.437, p<0.05). Interestingly, this tendency has been shown to be much stronger for buyers than for suppliers. One possible explanation for this higher level of perceived risk is that buyers normally perceive higher risks than do suppliers in transactions involving business services. For this reason, it is necessary for suppliers to implement risk reduction strategies for buyers. Hypothesis 4 tested the effects of trust on information searching. It has been found that for both suppliers and buyers, contrary to expectation, trust depends on their partner's reputation (t=2.929, p<0.01 for buyers; t=2.711, p<0.05 for suppliers). This finding shows that suppliers with good reputations tend to be trusted. Prior experience did not show any significant relationship with trust for either buyers or suppliers. Hypothesis 5 tested the effects of trust on supplier/buyer selection. Unlike buyers, suppliers tend to trust buyers when they think that previous transactions with buyers were important (t=2.913 p<0.01). However, this study did not show any significant relationship between source loyalty and the trust of buyers in suppliers. Hypothesis 6 tested the effects of trust on relational performances. For buyers and suppliers, financial performance reportedly improved when they trusted their partners (t=2.301, p<0.05 for buyers; t=3.692, p<0.01 for suppliers). It is interesting that this tendency was much stronger for suppliers than it was for buyers. Similarly, competitiveness was reported to improve when buyers and suppliers trusted their partners (t=3.563, p<0.01 for buyers; t=3.042, p<0.01 for suppliers). For suppliers, efficiency and productivity were reportedly improved when they trusted buyers (t=2.673, p<0.01). Other performance indices showed insignificant relationships with trust. The findings of this study have some strategic implications. First and most importantly, trust-based transactions are beneficial for both suppliers and buyers. As verified in the study, financial performance can be improved through efforts to build and maintain mutual trust. Similarly, competitiveness can be increased through the same kinds of effort. Second, trust-based transactions can facilitate the reduction of perceived risks inherent in the purchasing situation. This finding has implications for both suppliers and buyers. It is generally believed that buyers perceive higher risks in a highly involved purchasing situation. To reduce risks, previous studies have recommended that suppliers devise risk-reducing tactics. Moving beyond these recommendations, the present study uniquely focused on the bilateral perspective of perceived risk. In other words, suppliers are also susceptible to perceived risks, especially when they supply services that require very technical and sophisticated manipulations and maintenance. Consequently, buyers and suppliers must solve problems together in close collaboration. Hence, mutual trust plays a crucial role in the problem-solving process. Third, as found in this study, the more authority a salesperson has, the more he or she can be trusted. This finding is very important with regard to tactics. Building trust is a long-term assignment; however, when mutual trust has not been developed, suppliers can overcome the problems they encounter by empowering a salesperson with the authority to make certain decisions. This finding applies to suppliers as well.

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An Analysis of the Competency Exam for College Education : Area of Science Inguiry (대학수학능력시험 실험 평가 문제의 분석 : 과학 탐구를 중심으로)

  • Kim, Eun-Jin;Kim, Young-Soo
    • Journal of The Korean Association For Science Education
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    • v.12 no.1
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    • pp.75-92
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    • 1992
  • The purpose of this study was to point out the problems of the competency exam for college education, a new college entrance exam, and to suggest the improvement ideas for it For this purpose, the test items of science inquiry were taken from the first, the second and the third pilot studies of the competency exam for college education which National Institute of Educational Evaluation had done. These tests were administered to 1,223 students of the general high school(422 for the 1st 400 for the 2nd, and 401 for the 3rd test). Also, those students' and the high school science teacher's opinions about the tests and the new college entrance exam were surveyed. The evaluation objectives of those test items were analyzed and the test item analyses were done. The results were as follows; (1) The evaluation objective analysis showed that most of the test The purpose of this study was to point out the problems of the competency exam for college education, a new college entrance exam, and to suggest the improvement ideas for it For this purpose, the test items of science inquiry were taken from the first, the second and the third pilot studies of the competency exam for college education which National Institute of Educational Evaluation had done. These tests were administered to 1,223 students of the general high school(422 for the 1st, 400 for the 2nd, and 401 for the 3rd test). Also, those students' and the high school science teacher's opinions about the tests and the new college entrance exam were surveyed. The evaluation objectives of those test items were analyzed and the test item analyses were done. The results were as follows; (1) The evaluation objective analysis showed that most of the test items were constructed based on the evaluation framework which was composed of scientific inquiry thinking ability, science concept, and scientific inquiry context dimensions. But, those items were unevenly distributed into a few areas of the evaluation framework. (2) The boys had higher mean scores than the girls in all of the tests, but these differences were not statistically significant. The natural science course students had significantly higher mean than the humanities course students in all of the test:(1st, F=12.643, p=0.0004 ; 2nd, F=45.757, p=0.0001 ; 3rd, F=36.162, p=0.0001). A significant interaction of sex and course was found in only 1st test( F=11.352. p=0.0008). (3) Most students answered the test was difficult and they needed more time to finish it Also, they added they had to study in a different way from the traditional one in order to prepare the new college entrance exam. Science teachers answered that those evaluation objectives of the tests corresponded well with the educational objectives of high school science and that the tests were suitable as measuring instruments of the scientific thinking abilities. But they pointed out it would be very difficult for them to teach students for preparing the exam under the exsting educational conditions. To carry out successfully the competency exam for college education, the following improvements were suggested. (1) Good evaluation methodology should be developed. (2) In-service science teacher training models on evaluation should be put in force. (3) Effective teaching models and strategies should be developed.(4) The high school science curriculum should be revised.

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Internet Marketing Strategy and Performance in the Korean Small Export Firms (한국 중소수출기업의 인터넷 마케팅 전략과 성과에 관한 연구)

  • Ko, Kyung-Sun
    • International Commerce and Information Review
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    • v.4 no.1
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    • pp.107-128
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    • 2002
  • In order to clarify the relationship between the Internet utilization of the Korean small export firms for export marketing and it's performance, first, a research model and hypothesis have been made on a theoretical basis. This research hypothesis has been examined through gathering survey data and a statistical analysis based on MANOVA. The conclusion, as well as the main point of this thesis, is that, in most cases, there was a significant statistical connection between the variables of export performances and Internet-utilized export marketing strategies, which are both based on the classical AIDA model of effective hierarchy of communication for sales and advertising. This conclusion brings forth a substantial topic as well as provides meaningful implications for the Korean small export firms when putting together a marketing strategy using the Internet. It is also hoped that this will come as a reference for other researchers henceforth. However, there is an issue of lack of representativeness when considering that the samples were chosen on the basis of the convenience sampling method. Another issue may be that a portion of the subjects were not related to actual trade, but were, in fact, Web masters who operated e-trade systems. Furthermore, there are also numerous problems of missing data, and 6 out of the 8 main hypotheses possessed the issue of fitness level with the data. Therefore, in order to enhance both the representative and fitness levels of the data of further research for this topic, future respondents will have to have special trade knowledge, as well as technical knowledge of e-trade. However, unless the Internet begins to greatly contribute to export marketing of corporations, this type of enterprising spirit by corporations in gathering suitable respondents will not surface. Although not used in examining the hypotheses of this particular thesis, the relationship between competitive and circumstantial variables, which were added to the upcoming survey, and export performances will soon be analyzed and announced in order to atone for some of the standards this thesis fell short of.

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A Study on Need Assessment in Health Promotion Programs for Developing Nursing Centers - Breast Self Examination- (간호센타 개발을 위한 건강증진 프로그램 요구사정 연구-유방자가검진 프로그램을 중심으로-)

  • Park, In-Hyae;Kang, Hae-Young;Lee, Jeong-Hee;Ryu, Hyun-Sook
    • Research in Community and Public Health Nursing
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    • v.11 no.1
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    • pp.21-36
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    • 2000
  • The purpose of this study was to assess the needs of breast self examination education (BSEE) programs for developing nursing centers. A first, we reviewed the literature of activity and management-related factors of nursing centers: and, second. we used a questionnaire to discover the degree of knowledge, attitude, and practice on breast cancer, as well as an individual's intention to participate BSEE program. 1. Reviewing the literatures of nursing center activities. Nursing centers which were administered by a professional nurse are an ideal site for faculty and student practices. With the use of nursing models of health. professional nurses in nursing centers diagnose and treat human responses to potential and actual health problems and offer holistic, client-centered health service. In nursing centers professional nursing services include health education, health promotion, and health-related research. A nursing center is comprised of the advisory and exacutive commitee; the advisory commitee serves consultants and links community needs to the nursing center, while the director of the exacutive commitee identifies the potential resources to generate funds, support, and facilitate the activities of staffs in a nursing center. Nursing centers mobilize various financal resources for reimbursement of services from college and insurance companies, collect minimum service fees from the client, and further collect fees for providing programs to community groups, this also includes membership fees, and donations. The services provided by nursing centers focus on services related to primary prevention, health maintenance & health promotion, direct nursing care for acute & chronic diseases, and holistic care for actual and potential health problems. The client satisfaction for the services was high. Students also showed positive reponses for their clinical experiences and independent working conditions. 2. The degree of knowledge, attitudes, and practices for breast cancer. and an individual's intention to participate in the BSEE program. The subjects of this study were 308 females in K-city in the Republic of Korea. Data were collected using a self-administered questionnaire. The mean age of the respondents was 35.0 years old. Those who already participated in the BSEE were 64.9%, and those who had support and encouragement to practice BSE from significant others were 25.1 %. Clients intent to participate in the BSEE were 37.0%. The mean score of knowledge(2.4 out of 5 points) and practices(1.8 out of 5 points) for breast cancer were quite low, but the mean score of attitudes was relatively positive04.5 out of 20 point) for breast cancer. Those who already had BSEE showed significantly high scores in knowledge(t=6.48, p<0.01), attitudes (t=10.54, p<0.01). and practices(t=57.07, p<0.001) for breast cancer than those who had not participated in the BSEE. In all age groups no intention to participate in the BSEE was higher than who the intention to participate. These findings suggest some strategies should be developed to increase the awareness of breast cancer's early detection.

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New Estimates of CH4 Emission Scaling Factors by Amount of Rice Straw Applied from Korea Paddy Fields (볏짚 시용에 따른 벼 재배 논에서의 메탄 배출계수 개발에 관한 연구)

  • Ju, Okjung;Won, Tae-Jin;Cho, Kwang-Rae;Choi, Byoung-Rourl;Seo, Jae-Sun;Park, In-Tae;Kim, Gun-Yeob
    • Korean Journal of Environmental Agriculture
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    • v.32 no.3
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    • pp.179-184
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    • 2013
  • BACKGROUND: Accurate estimates of total direct $CH_4$ emissions from croplands on a country scale are important for global budgets of anthropogenic sources of $CH_4$ emissions and for the development of effective mitigation strategies. Methane production resulted by the anaerobic decomposition of organic compounds where $CO_2$ acts as inorganic electron acceptor. This process could be affected by the addition of rice straw, water management and rice variety itself. METHODS AND RESULTS: Rice (Oryza sativa L. Japonica type, var Samkwangbyeo) was cultivated in four plots: (1) Nitrogen-Phosphorus-Potassium (NPK) ($N-P_2O_5-K_2O$:90-45-57 kg/ha); (2) NPK plus 3 Mg/ha rice straw (RS3); (3) NPK plus 5 Mg/ha rice straw (RS5); (4) NPK plus 7 Mg/ha rice straw (RS7) for 3 years (2010-2012) and the rice straw incorporated in fall (Nov.) in Gyeonggi-do Hwaseong-si. Gas samples were collected using the closed static chamber which were installed in each treated plot of $152.9m^2$. According to application of 3, 5, 7 Mg/ha of rice straw, methane emission increased by 46, 101, 190%, respectively, compared to that of the NPK plot. CONCLUSION(S): We obtained a quantitative relationship between $CH_4$ emission and the amount of rice straw applied from rice fields which could be described by polynomial regression of order 2. The emission scaling factor estimated by the relationship were in the range of IPCC GPG (2000).

Patient-related Barriiers to Pain Management in General Population (일반인의 통증관리 장애정도)

  • Yoo, Yang-Sook;Choe, Sang-Ok;Cho, Young-Yi;Koh, Su-Jin;Hor, Soo-Jin;Jeon, Ji-In;Kwon, So-Hi
    • Journal of Hospice and Palliative Care
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    • v.10 no.4
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    • pp.184-189
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    • 2007
  • Purpose: This study was to explore barriers to effective pain management in general population. Methods: Total 163 Participants completed the Barrier Questionnaire-II (BQ-II), a 27-item on a six point scale, from May to June in 2007. BQ-II consisted of four subscales which were 1) physical effects (PE) addressing beliefs that side effects of analgesics are inevitable and concerns about tolerance, fatalism (Fa) addressing fatalistic beliefs about cancer pain and its management, Communication (Co) addressing the beliefs of 'good patient' and concerns of distracting physician from underlying disease, and harmful effects (HE) addressing fear of addiction and harmful effect to immune system of pain medicine. Results: The BQ-II total had an internal consistency of 0.877 in this study. HE was the biggest barrier (3.03) followed by PE (2.73), Fa (2.15), and Co (1.71). Items appeared as great concerns were 'there is a danger of becoming addicted to pain medication'(3.58), 'using pain medicine blocks your ability to know if you have any new pain' (3.18), 'pain medicine is very addictive' (3.09), 'when you use pain medicine your body becomes used to its effects and pretty soon it won't work any more' (3.09), and 'drowsiness from pain medicine is difficult to control' (3.09). Only 12 respondents (7.4%) reported that they took any type of pain education, however, those who took pain education represented significantly lower barriers to pain management than who did not (P=.029). Conclusion: This result suggests the strategies for public education to surmount cancer pain.

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Operative Treatment of Congenitally Corrected Transposition of the Great Arteries(CCTGA) (교정형 대혈관 전위증의 수술적 치료)

  • 이정렬;조광리;김용진;노준량;서결필
    • Journal of Chest Surgery
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    • v.32 no.7
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    • pp.621-627
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    • 1999
  • Background: Sixty five cases with congenitally corrected transposition of the great arteries (CCTGA) indicated for biventricular repair were operated on between 1984 and september 1998. Comparison between the results of the conventional(classic) connection(LV-PA) and the anatomic repair was done. Material and Method: Retrospective review was carried out based on the medical records of the patients. Operative procedures, complications and the long-term results accoding to the combining anomalies were analysed. Result: Mean age was 5.5$\pm$4.8 years(range, 2 months to 18years). Thirty nine were male and 26 were female. Situs solitus {S,L,L} was in 53 and situs inversus{I,D,D} in 12. There was no left ventricular outflow tract obstruction(LVOTO) in 13(20%) cases. The LVOTO was resulted from pulmonary stenosis(PS) in 26(40%)patients and from pulmonary atresia(PA) in 26(40%) patients. Twenty-five(38.5%) patients had tricuspid valve regurgitation(TR) greater than the mild degree that was present preoperatively. Twenty two patients previously underwent 24 systemic- pulmonary shunts previously. In the 13 patients without LVOTO, 7 simple closure of VSD or ASD, 3 tricuspid valve replacements(TVR), and 3 anatomic corrections(3 double switch operations: 1 Senning+ Rastelli, 1 Senning+REV-type, and 1 Senning+Arterial switch opera tion) were performed. As to the 26 patients with CCTGA+VSD or ASD+LVOTO(PS), 24 classic repairs and 2 double switch operations(1 Senning+Rastelli, 1 Mustard+REV-type) were done. In the 26 cases with CCTGA+VSD+LVOTO(PA), 19 classic repairs(18 Rastelli, 1 REV-type), and 7 double switch operations(7 Senning+Rastelli) were done. The degree of tricuspid regurgitation increased during the follow-up periods from 1.3$\pm$1.4 to 2.2$\pm$1.0 in the classic repair group(p<0.05), but not in the double switch group. Two patients had complete AV block preoperatively, and additional 7(10.8%) had newly developed complete AV block after the operation. Other complications were recurrent LVOTO(10), thromboembolism(4), persistent chest tube drainage over 2 weeks(4), chylothorax(3), bleeding(3), acute renal failure(2), and mediastinitis(2). Mean follow-up was 54$\pm$49 months(0-177 months). Thirteen patients died after the operation(operative mortality rate: 20.0%(13/65)), and there were 3 additional deaths during the follow up period(overall mortality: 24.6%(16/65)). The operative mortality in patients underwent anatomic repair was 33.3%(4/12). The actuarial survival rates at 1, 5, and 10 years were 75.0$\pm$5.6%, 75.0$\pm$5.6%, and 69.2$\pm$7.6%. Common causes of death were low cardiac output syndrome(8) and heart failure from TR(5). Conclusion: Although our study could not demonstrate the superiority of each classic or anatomic repair, we found that the anatomic repair has a merit of preventing the deterioration of tricuspid valve regurgitations. Meticulous selection of the patients and longer follow-up terms are mandatory to establish the selective advantages of both strategies.

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