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Development of validated Nursing Interventions for Home Health Care to Women who have had a Caesarian Delivery (조기퇴원 제왕절개 산욕부를 위한 가정간호 표준서 개발)

  • HwangBo, Su-Ja
    • Journal of Korean Academy of Nursing Administration
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    • v.6 no.1
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    • pp.135-146
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    • 2000
  • The purpose of this study was to develope, based on the Nursing Intervention Classification (NIC) system. a set of standardized nursing interventions which had been validated. and their associated activities. for use with nursing diagnoses related to home health care for women who have had a caesarian delivery and for their newborn babies. This descriptive study for instrument development had three phases: first. selection of nursing diagnoses. second, validation of the preliminary home health care interventions. and third, application of the home care interventions. In the first phases, diagnoses from 30 nursing records of clients of the home health care agency at P. medical center who were seen between April 21 and July 30. 1998. and from 5 textbooks were examined. Ten nursing diagnoses were selected through a comparison with the NANDA (North American Nursing Diagnosis Association) classification In the second phase. using the selected diagnoses. the nursing interventions were defined from the diagnoses-intervention linkage lists along with associated activities for each intervention list in NIC. To develope the preliminary interventions five-rounds of expertise tests were done. During the first four rounds. 5 experts in clinical nursing participated. and for the final content validity test of the preliminary interventions. 13 experts participated using the Fehring's Delphi technique. The expert group evaluated and defined the set of preliminary nursing interventions. In the third phases, clinical tests were held at in a home health care setting with two home health care nurses using the preliminary intervention list as a questionnaire. Thirty clients referred to the home health care agency at P. medical center between October 1998 and March 1999 were the subjects for this phase. Each of the activities were tested using dichotomous question method. The results of the study are as follows: 1. For the ten nursing diagnoses. 63 appropriate interventions were selected from 369 diagnoses interventions links in NlC., and from 1.465 associated nursing activities. From the 63 interventions. the nurses expert group developed 18 interventions and 258 activities as the preliminary intervention list through a five-round validity test 2. For the fifth content validity test using Fehring's model for determining lCV (Intervention Content Validity), a five point Likert scale was used with values converted to weights as follows: 1=0.0. 2=0.25. 3=0.50. 4=0.75. 5=1.0. Activities of less than O.50 were to be deleted. The range of ICV scores for the nursing diagnoses was 0.95-0.66. for the nursing interventions. 0.98-0.77 and for the nursing activities, 0.95-0.85. By Fehring's method. all of these were included in the preliminary intervention list. 3. Using a questionnaire format for the preliminary intervention list. clinical application tests were done. To define nursing diagnoses. home health care nurses applied each nursing diagnoses to every client. and it was found that 13 were most frequently used of 400 times diagnoses were used. Therefore. 13 nursing diagnoses were defined as validated nursing diagnoses. Ten were the same as from the nursing records and textbooks and three were new from the clinical application. The final list included 'Anxiety', 'Aspiration. risk for'. 'Infant behavior, potential for enhanced, organized'. 'Infant feeding pattern. ineffective'. 'Infection'. 'Knowledge deficit'. 'Nutrition, less than body requirements. altered', 'Pain'. 'Parenting'. 'Skin integrity. risk for. impared' and 'Risk for activity intolerance'. 'Self-esteem disturbance', 'Sleep pattern disturbance' 4. In all. there were 19 interventions. 18 preliminary nursing interventions and one more intervention added from the clinical setting. 'Body image enhancement'. For 265 associated nursing activities. clinical application tests were also done. The intervention rate of 19 interventions was from 81.6% to 100%, so all 19 interventions were in c1uded in the validated intervention set. From the 265 nursing activities. 261(98.5%) were accepted and four activities were deleted. those with an implimentation rate of less than 50%. 5. In conclusion. 13 diagnoses. 19 interventions and 261 activities were validated for the final validated nursing intervention set.

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The Interaction Effect of Foreign Model Attractiveness and Foreign Language Usage (외국인 모델의 매력도와 외국어 사용의 상호작용 효과)

  • Lee, Ji-Hyun;Lee, Dong-Il
    • Journal of Global Scholars of Marketing Science
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    • v.17 no.3
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    • pp.61-81
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    • 2007
  • Recently, use of foreign models and foreign language in advertising is a general trend in Korea even though the effect has not been well-known..Most of the previous research shows rather an opposite effect claiming marketing communication is more effective when higher congruity between marketing communication and consumer's cultural values are achieved. However, the introduction of global culture due to the expansion of new media such as Internet or cable television makes the congruity not the best choice of marketing strategy. In addition, use of highly attractive models in advertising to increase the effect of advertising is general. However, recent studies show that targeted women audience tend to compare themselves to the highly attractive models and do experience negative sentiment. Bower (2001) proved the difference between 'comparer' and 'noncomparer' when women face highly attractive models. The results show that a comparer who has an intention to compare highly attractive model (HAM) with herself has a significantly negative effect on model expertise, product argument, product evaluation and buying intention. Therefore, HAM is not always a good choice and model attractiveness plays a role in the processing other cues or changing the advertising effect from result of processing other cues. The purpose of this study is to investigate the effect of the use of foreign language on the advertising response of the audience with regard of the model attractiveness. For the empirical study, the virtual advertising using foreign models (HAM, NAM), brand names and slogans(Korean, English) were used as stimuli. The respondents of each stimulus were 75('HAM-Korean'), 75('NAM-Korean'), 66('HAM-English') and 66 ('NAM-English') respectively. To establish the effect of marketing communication, the attitude for media(AM), the attitude for product(AP), targetedness(TD), overall quality(OQ), and purchase intention(PI) with 7 point likert scale were measured. The manipulation was verified to check the difference between HAM attractiveness assessment (m=3.27) and NAM attractiveness assessment (m=5.12). The mean difference was statiscally significant (p<.05). As a result, all consequences were significantly changed with model attractiveness, and overall quality evaluation(OQ) were significantly changed with language. The interaction effect from model attractiveness and language was significant on attitude toward the product(AP) and purchase intention(PI). To analyze the difference, the mean values and standard deviation of consequences were compared. The result was more positive when model attractiveness was high for all consequences. For language effect, the assessment was more positive when English was used for OQ. Considering model attractiveness and language simultaneously, HAM-Korean was more positive for AP and PI, and NAM-English was more positive for AP and PI. In other words, the interaction effect was confirmed by model attractiveness and language. As mentioned above, use of foreign models and foreign language in advertising was explained by cultural match up hypothesis (Leclerc et al. 1994) which claimed that culture of origin effect. In other words, in advertising, use of same cultural language with the foreign model could make positive assessment for OQ. But this effect was moderated by model attractiveness. When the model attractiveness was low, the use of English makes PI high because of the effect of foreign language which supported the cultural match up hypothesis. When the model attractiveness was low, the use of Korean made AP and PI high because the effect of foreign language was diluted. It was a general notion that the visual cues got processed before (Holbrook and Moore, 1981; Sholl et al, 1995) compared to linguistic cues. Therefore, when consumers were faced HAM, so much perception was already consumed at processing visual cues making their native language of Korean to strongly and positively connected with the advertising concept. On the contrary, when consumers were faced with NAM, less perception was consumed compared to HAM, making English to accompany cultural halo effect which affected more positively. Therefore, when foreign models were employed in advertising, the language must be carefully selected according to the level of model attractiveness.

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A Review of the Neurocognitive Mechanisms for Mathematical Thinking Ability (수학적 사고력에 관한 인지신경학적 연구 개관)

  • Kim, Yon Mi
    • Korean Journal of Cognitive Science
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    • v.27 no.2
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    • pp.159-219
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    • 2016
  • Mathematical ability is important for academic achievement and technological renovations in the STEM disciplines. This study concentrated on the relationship between neural basis of mathematical cognition and its mechanisms. These cognitive functions include domain specific abilities such as numerical skills and visuospatial abilities, as well as domain general abilities which include language, long term memory, and working memory capacity. Individuals can perform higher cognitive functions such as abstract thinking and reasoning based on these basic cognitive functions. The next topic covered in this study is about individual differences in mathematical abilities. Neural efficiency theory was incorporated in this study to view mathematical talent. According to the theory, a person with mathematical talent uses his or her brain more efficiently than the effortful endeavour of the average human being. Mathematically gifted students show different brain activities when compared to average students. Interhemispheric and intrahemispheric connectivities are enhanced in those students, particularly in the right brain along fronto-parietal longitudinal fasciculus. The third topic deals with growth and development in mathematical capacity. As individuals mature, practice mathematical skills, and gain knowledge, such changes are reflected in cortical activation, which include changes in the activation level, redistribution, and reorganization in the supporting cortex. Among these, reorganization can be related to neural plasticity. Neural plasticity was observed in professional mathematicians and children with mathematical learning disabilities. Last topic is about mathematical creativity viewed from Neural Darwinism. When the brain is faced with a novel problem, it needs to collect all of the necessary concepts(knowledge) from long term memory, make multitudes of connections, and test which ones have the highest probability in helping solve the unusual problem. Having followed the above brain modifying steps, once the brain finally finds the correct response to the novel problem, the final response comes as a form of inspiration. For a novice, the first step of acquisition of knowledge structure is the most important. However, as expertise increases, the latter two stages of making connections and selection become more important.

The Competition Policy and Major Industrial Policy-Making in the 1980's (1980년대 주요산업정책(主要産業政策) 결정(決定)과 경쟁정책(競爭政策): 역할(役割)과 한계(限界))

  • Choi, Jong-won
    • KDI Journal of Economic Policy
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    • v.13 no.2
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    • pp.97-127
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    • 1991
  • This paper investigates the roles and the limitations of the Korean antitrust agencies-the Office of Fair Trade (OFT) and the Fair Trade Commission (FTC) during the making of the major industrial policies of the 1980's. The Korean antitrust agencies played only a minimal role in three major industrial policy-making issues in the 1980's- the enactment of the Industrial Development Act (IDA), the Industrial Rationalization Measures according to the IDA, and the Industrial Readjustment Measures on Consolidation of Large Insolvent Enterprises based on the revised Tax Exemption and Reduction Control Act. As causes for this performance bias in the Korean antitrust system, this paper considers five factors according to the current literature on implementation failure: ambiguous and insufficient statutory provisions of the Monopoly Regulation and Fair Trade Act (MRFTA); lack of resources; biased attitudes and motivations of the staff of the OFT and the FTC; bureaucratic incapability; and widespread misunderstanding about the roles and functions of the antitrust system in Korea. Among these five factors, bureaucratic incompetence and lack of understanding in various policy implementation environments about the roles and functions of the antitrust system have been regarded as the most important ones. Most staff members did not have enough educational training during their school years to engage in antitrust and fair trade policy-making. Furthermore, the high rate of staff turnover due to a mandatory personnel transfer system has prohibited the accumulation of knowledge and skills required for pursuing complicated structural antitrust enforcement. The limited capability of the OFT has put the agency in a disadvantaged position in negotiating with other economic ministries. The OFT has not provided plausible counter-arguments based on sound economic theories against other economic ministries' intensive market interventions in the name of rationalization and readjustment of industries. If the staff members of antitrust agencies have lacked substantive understanding of the antitrust and fair trade policy, the rest of government agencies must have had serious problems in understanding the correst roles and functions of the antitrust system. The policy environment of the Korean antitrust system, including other economic ministries, the Deputy Prime Minister, and President Chun, have tended to conceptualize the OFT more as an agency aiming only at fair trade policy and less as an agency that should enforce structural monopoly regulation as well. Based on this assessment of the performance of the Korean antitrust system, this paper evaluate current reform proposals for the MRFT A. The inclusion of the regulation of conglomerate mergers and of business divestiture orders may be a desirable revision, giving the MRFTA more complete provisions. However, given deficient staff experties and the unfavorable policy environments, it would be too optimistic and naive to expect that the inclusion of these provisions alone could improve the performance of the Korean antitrust system. In its conclusion, this paper suggests several policy recommendations for the Korean antitrust system, which would secure the stable development and accumulation of antitrust expertise for its staff members and enough understanding and conformity from its environments about its antitrust goals and functions.

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Subtalar Arthroscopy : Indication and Results (거골하 관절경 : 적응증과 그 결과)

  • Ahn, Jae-Hoon;Lee, Kwang-Won;Kim, Ha-Yong;Lee, Seung-Hun;Choy, Won-Sik;Kim, Seung-Kwon
    • Journal of the Korean Arthroscopy Society
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    • v.11 no.1
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    • pp.39-44
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    • 2007
  • Purpose: To evaluate the results of subtalar arthroscopy and to define the indications for the procedure. Materials and Methods: Fifty-four patients were followed up for more than 1 year after subtalar arthroscopy. The mean age was 40 years, and the mean follow-up period was 18 months. Preoperative diagnoses included sinus tarsi syndrome in 19 cases, degenerative arthritis in 13 cases, calcaneal fracture in 10 cases, arthrofibrosis in 5 cases, os trigonum syndrome in 3 cases, talar fracture in 3 cases, talocalcaneal coalition in 3 cases and calcaneal tumor in 1 case. Clinically AOFAS ankle-hindfoot scale and satisfaction of the patients were evaluated. Results: There were 23 synovectomies, 13 subtalar fusions, 11 diagnostic arthroscopies, 5 adhesiolyses, 4 loose body removals, 3 excisions of os trigonum and 1 arthroscopic reduction of fracture. Twenty-five ankle arthroscopies and 11 modified Brostrom's operations were performed for the accompaning 17 ankle impingment syndromes, 11 chronic ankle instabilities and 7 osteochondral lesions of talus. AOFAS ankle-hindfoot scale was increased from 33 points preoperatively to 77 points postoperatively in subtalar fusion group, and was increased from 69 points preoperatively to 89 points postoperatively in other-than-fusion group. Ninety one percent of patients were satisfied with the procedures. There were no serious complications related to the subtalar arthroscopy. Conclusion: Subtalar arthroscopy appears to be safe and highly accurate procedure for subtalar pathology, although it requires technical expertise.

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Changing Aspects of the Wall Types of Hahoe Village (하회마을 담장 형태의 변화양상)

  • Kim, Dong-Hyun;Lee, Won-Ho
    • Journal of the Korean Institute of Landscape Architecture
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    • v.45 no.5
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    • pp.87-96
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    • 2017
  • This study focuses on the Andong Hahoe Village and seeks to identify the shape of the walls since the 1970s. The change of walls can be divided into four periods based on characteristics of materials, shape and distribution. The following is a summary of the results: First, In the 1970s, when Andong Hahoe Village was not designated as a cultural heritage, roof tiles hung on the earthen walls in the middle of the village were major forms. On the outside of the village, rice straw and pine needles were put on the earthen walls or bush clover walls were put in place around if walls were not built. Second, after being designated as a cultural heritage in the 1980s, readjustments for cultural heritages were carried out at the primary stage. However, the distribution of cultural heritages and major changes were not determined at this time since readjustments were mainly focused on the renovation of derelict houses or maintenance of infrastructures. Third, in the past the use of stone bricks for the Hahoe Village site had been difficult, but in the 1990s, replacements with soil-stone walls were identified and the usage of roof tiles increased. The portion of earthen walls, which used to be the major form in the prior era, decreased and this seems to have continued until the 2000s. Fourth, via a field survey, it was found that most of Hahoe village walls consisted of soil cement bricks mixed with cement, steel, lime, gravel. etc. Also, the scope of straw-stricken walls and bush clover walls were reduced to a section of area outside of the village. Fifth, from the 1970s to the present, there were changes to the walls in Hahoe Village including an increase in usages of new materials and an expansion of houses with tiled roofs on top in accordance with the replacement of walls of existing houses. Relevant reasons for this have been identified, such as the fading value of Fungsui(風水) and lack of original records, insufficient awareness and expertise in non-building areas, and the relationship between residents on repairing the wall.

Success Factors of the Supdari(A Wooden Bridge) Restoration in Jeonju-River through Citizens' Initiative (적극적 주민참여를 통한 전통문화시설 복원 성공요인 분석 - 전주천 섶다리 놓기 사업을 중심으로 -)

  • Kim, Sang-Wook;Kim, Gil-Joong
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.28 no.1
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    • pp.93-101
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    • 2010
  • This paper aims to analyze success factors for the construction of Supdari(a traditional wooden bridge to connect small streams temporarily), which is a citizens' initiative project to revitalize local community in Jeonju-River, Jeonju City. Recently Supdari has been restored for the use of belongings in local festivals. But Jeonju-River Supdari was designed and built to unite local citizens and connect river-divided villages. This project shows how investing social capital like Supdari makes the community vitalize through citizen's active participation. As a citizen leading project, there were several critical factors for sucess. At first, there were some noticeable ways to encourage local citizen's participation in online and offline. In the online, the Supdari internet cafe introduced what is a Supdari, how to make it and where we build using various media of UCCs and photos. In the offline, the small scaled model of Supdari was made and exhibited in the entrance of the village and related several seminars were hosted to discuss how to construct Supdari with citizens, local assembly men and public officials together. The Second is the movement to restore traditional and cultural resources for the community recovery triggered the supports from local councils and many civic groups. Civic groups supported ecological and structural expertise to guarantee environment friendly and stable construction. And local councils mediated citizen's and administrative office's opinions. The third is flexible administrative management to help citizen's ideas to be realized. Officials extended setting period of Supdari on the condition with the civic-control safety management.

A Study on Development of Guideline on Writing Technical Document for Electrical Medical Devices: Dental X-ray Equipment (치과용엑스선장치의 기술문서 작성을 위한 가이드라인 개발 연구)

  • Lee, Seung-Youl;Kim, Jae-Ryang;Lee, Jun-Ho;Park, Chang-Won
    • Journal of radiological science and technology
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    • v.39 no.4
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    • pp.651-660
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    • 2016
  • Due to recent population aging, the number of check-up for senior citizens has increased steadily. According to this trend, the market size of dental X-ray equipment and the number of approval and review for these devices have simultaneously increased. The technical document of medical device is required for approval and review for medical device, and medical device companies needs to have work comprehension and expertise, as the document needs to include the overall contents such as performances, test criteria, etc.. Yet, since most of domestic manufacturers or importers of medical devices are small businesses, it is difficult for them to recruit professional manpower for approval of medical devices, and submission of inaccurate technical documents has increased. These problems lead to delay of the approval process and to difficulties in quick entering into the market. Especially, the Ministry of Food and Drug safety (MFDS) standards of a dental extra-oral X-ray equipment, a dental intra-oral X-ray equipment, an arm-type computed tomography, and a portable X-ray system have been recently enacted or not. this guideline of dental X-ray equipment adjusting revised standards was developed to help relative companies and reviewers. For this study, first, the methods to write technical document have been reviewed with revised international and domestic regulations and system. Second, the domestic and foreign market status of each item has been surveyed and analyzed. Third, the contents of technical documents already approved by MFDS have been analyzed to select the correct example, test items, criteria, and methods. Finally, the guideline has been developed based on international and domestic regulation, through close review of a consultative body composed of academic, industrial, research institute and government experts.

토양 및 지하수 Investigation 과 Remediation에 대한 현장적용

  • Wallner, Heinz
    • Proceedings of the Korean Society of Soil and Groundwater Environment Conference
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    • 2000.11a
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    • pp.44-63
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    • 2000
  • Situated close to Heathrow Airport, and adjacent to the M4 and M25 Motorways, the site at Axis Park is considered a prime location for business in the UK. In consequnce two of the UK's major property development companies, MEPC and Redrew Homes sought the expertise of Intergeo to remediate the contaminated former industrial site prior to its development. Industrial use of the twenty-six hectare site, started in 1936, when Hawker Aircraft commence aircraft manufacture. In 1963 the Firestone Tyre and Rubber Company purchased part of the site. Ford commenced vehicle production at the site in the mid-1970's and production was continued by Iveco Ford from 1986 to the plant's decommissioning in 1997. Geologically the site is underlain by sand and gravel, deposited in prehistory by the River Thames, with London Clay at around 6m depth. The level of groundwater fluctuates seasonally at around 2.5m depth, moving slowly southwest towards local streams and watercourses. A phased investigation of the site was undertaken, which culminated in the extensive site investigation undertaken by Intergeo in 1998. In total 50 boreholes, 90 probeholes and 60 trial pits were used to investigate the site and around 4000 solid and 1300 liquid samples were tested in the laboratory for chemical substances. The investigations identified total petroleum hydrocarbons in the soil up to 25, 000mg/kg. Diesel oil, with some lubricating oil were the main components. Volatile organic compounds were identified in the groundwater in excess of 10mg/l. Specific substances included trichloromethane, trichloromethane and tetrachloroethene. Both the oil and volatile compounds were widely spread across the site, The specific substances identified could be traced back to industrial processes used at one or other dates in the sites history Slightly elevated levels of toxic metals and polycyclic aromatic hydrocarbons were also identified locally. Prior to remediation of the site and throughout its progress, extensive liaison with the regulatory authorities and the client's professional representatives was required. In addition to meetings, numerous technical documents detailing methods and health and safety issues were required in order to comply with UK environmental and safety legislation. After initially considering a range of options to undertake remediation, the following three main techniques were selected: ex-situ bioremediation of hydrocarbon contaminated soils, skimming of free floating hydrocarbon product from the water surface at wells and excavations and air stripping of volatile organic compounds from groundwater recovered from wells. The achievements were as follows: 1) 350, 000m3 of soil was excavated and 112, 000m3 of sand and gravel was processed to remove gravel and cobble sized particles; 2) 53, 000m3 of hydrocarbon contaminated soil was bioremediated in windrows ; 3) 7000m3 of groundwater was processed by skimming to remove free floating Product; 4) 196, 000m3 of groundwater was Processed by air stripping to remove volatile organic compounds. Only 1000m3 of soil left the site for disposal in licensed waste facilities Given the costs of disposal in the UK, the selected methods represented a considerable cost saving to the Clients. All other soil was engineered back into the ground to a precise geotechnical specification. The following objective levels were achieved across the site 1) By a Risk Based Corrective Action (RBCA) methodology it was demonstrated that soil with less that 1000mg/kg total petroleum hydrocarbons did not pose a hazard to health or water resources and therefore, could remain insitu; 2) Soils destined for the residential areas of the site were remediated to 250mg/kg total petroleum hydrocarbons; in the industrial areas 500mg/kg was proven acceptable. 3) Hydrocarbons in groundwater were remediated to below the Dutch Intervegtion Level of 0.6mg/1; 4) Volatile organic compounds/BTEX group substances were reduced to below the Dutch Intervention Levels; 5) Polycyclic aromatic hydrocarbons and metals were below Inter-departmental Committee for the Redevelopment of Contaminated Land guideline levels for intended enduse. In order to verify the qualify of the work 1500 chemical test results were submitted for the purpose of validation. Quality assurance checks were undertaken by independent consultants and at an independent laboratory selected by Intergeo. Long term monitoring of water quality was undertaken for a period of one year after remediation work had been completed. Both the regulatory authorities and Clients representatives endorsed the quality of remediation now completed at the site. Subsequent to completion of the remediation work Redrew Homes constructed a prestige housing development. The properties at "Belvedere Place" retailed at premium prices. On the MEPC site the Post Office, amongst others, has located a major sorting office for the London area. Exceptionally high standards of remediation, control and documentation were a requirement for the work undertaken here.aken here.

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An Examination of Knowledge Sourcing Strategies Effects on Corporate Performance in Small Enterprises (소규모 기업에 있어서 지식소싱 전략이 기업성과에 미치는 영향 고찰)

  • Choi, Byoung-Gu
    • Asia pacific journal of information systems
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    • v.18 no.4
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    • pp.57-81
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    • 2008
  • Knowledge is an essential strategic weapon for sustaining competitive advantage and is the key determinant for organizational growth. When knowledge is shared and disseminated throughout the organization, it increases an organization's value by providing the ability to respond to new and unusual situations. The growing importance of knowledge as a critical resource has forced executives to pay attention to their organizational knowledge. Organizations are increasingly undertaking knowledge management initiatives and making significant investments. Knowledge sourcing is considered as the first important step in effective knowledge management. Most firms continue to make an effort to realize the benefits of knowledge management by using various knowledge sources effectively. Appropriate knowledge sourcing strategies enable organizations to create, acquire, and access knowledge in a timely manner by reducing search and transfer costs, which result in better firm performance. In response, the knowledge management literature has devoted substantial attention to the analysis of knowledge sourcing strategies. Many studies have categorized knowledge sourcing strategies into intemal- and external-oriented. Internal-oriented sourcing strategy attempts to increase firm performance by integrating knowledge within the boundary of the firm. On the contrary, external-oriented strategy attempts to bring knowledge in from outside sources via either acquisition or imitation, and then to transfer that knowledge across to the organization. However, the extant literature on knowledge sourcing strategies focuses primarily on large organizations. Although many studies have clearly highlighted major differences between large and small firms and the need to adopt different strategies for different firm sizes, scant attention has been given to analyzing how knowledge sourcing strategies affect firm performance in small firms and what are the differences between small and large firms in the patterns of knowledge sourcing strategies adoption. This study attempts to advance the current literature by examining the impact of knowledge sourcing strategies on small firm performance from a holistic perspective. By drawing on knowledge based theory from organization science and complementarity theory from the economics literature, this paper is motivated by the following questions: (1) what are the adoption patterns of different knowledge sourcing strategies in small firms (i,e., what sourcing strategies should be adopted and which sourcing strategies work well together in small firms)?; and (2) what are the performance implications of these adoption patterns? In order to answer the questions, this study developed three hypotheses. First hypothesis based on knowledge based theory is that internal-oriented knowledge sourcing is positively associated with small firm performance. Second hypothesis developed on the basis of knowledge based theory is that external-oriented knowledge sourcing is positively associated with small firm performance. The third one based on complementarity theory is that pursuing both internal- and external-oriented knowledge sourcing simultaneously is negatively or less positively associated with small firm performance. As a sampling frame, 700 firms were identified from the Annual Corporation Report in Korea. Survey questionnaires were mailed to owners or executives who were most erudite about the firm s knowledge sourcing strategies and performance. A total of 188 companies replied, yielding a response rate of 26.8%. Due to incomplete data, 12 responses were eliminated, leaving 176 responses for the final analysis. Since all independent variables were measured using continuous variables, supermodularity function was used to test the hypotheses based on the cross partial derivative of payoff function. The results indicated no significant impact of internal-oriented sourcing strategies while positive impact of external-oriented sourcing strategy on small firm performance. This intriguing result could be explained on the basis of various resource and capital constraints of small firms. Small firms typically have restricted financial and human resources. They do not have enough assets to always develop knowledge internally. Another possible explanation is competency traps or core rigidities. Building up a knowledge base based on internal knowledge creates core competences, but at the same time, excessive internal focused knowledge exploration leads to behaviors blind to other knowledge. Interestingly, this study found that Internal- and external-oriented knowledge sourcing strategies had a substitutive relationship, which was inconsistent with previous studies that suggested complementary relationship between them. This result might be explained using organizational identification theory. Internal organizational members may perceive external knowledge as a threat, and tend to ignore knowledge from external sources because they prefer to maintain their own knowledge, legitimacy, and homogeneous attitudes. Therefore, integrating knowledge from internal and external sources might not be effective, resulting in failure of improvements of firm performance. Another possible explanation is small firms resource and capital constraints and lack of management expertise and absorptive capacity. Although the integration of different knowledge sources is critical, high levels of knowledge sourcing in many areas are quite expensive and so are often unrealistic for small enterprises. This study provides several implications for research as well as practice. First this study extends the existing knowledge by examining the substitutability (and complementarity) of knowledge sourcing strategies. Most prior studies have tended to investigate the independent effects of these strategies on performance without considering their combined impacts. Furthermore, this study tests complementarity based on the productivity approach that has been considered as a definitive test method for complementarity. Second, this study sheds new light on knowledge management research by identifying the relationship between knowledge sourcing strategies and small firm performance. Most current literature has insisted complementary relationship between knowledge sourcing strategies on the basis of data from large firms. Contrary to the conventional wisdom, this study identifies substitutive relationship between knowledge sourcing strategies using data from small firms. Third, implications for practice highlight that managers of small firms should focus on knowledge sourcing from external-oriented strategies. Moreover, adoption of both sourcing strategies simultaneousiy impedes small firm performance.