• Title/Summary/Keyword: Intervention process evaluation

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A Comparison of Acute Effect of Air Stacking Using Resuscitator Bag versus Balloon on Pulmonary Functions (도수 소생기와 풍선을 이용한 공기 누적이 폐 기능에 미치는 즉각적인 효과 비교)

  • Ryu, Ji-Yun;Lee, Dong-Yeop;Hong, Ji-Heon;Kim, Jin-Seop;Kim, Seong-Gil
    • Journal of The Korean Society of Integrative Medicine
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    • v.9 no.1
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    • pp.23-31
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    • 2021
  • Purpose : To compare the immediate effects of air stacking maneuver using resuscitator bags and balloons. Methods : Twenty healthy young adults participated in this study. Forced vital capacity (FVC) and peak cough flow (PCF) tests were performed at pre-intervention, and then, the maximum insufflation capacity (MIC), forced expiratory volume in 1 s (FEV1), FEV1/FVC, peak expiratory flow (PEF), and peak cough flow (PCF) were measured using the air stacking maneuver via resuscitator bags and balloons. Interventions were randomly performed, and a 40-min break was provided between interventions. The evaluation process in this study was conducted in accordance with the guidelines of the American Thoracic Society (ATS) 2019. To compare the three outcomes measured at pre-and post-interventions, repeated measures analysis of variance was performed. Results : A significant difference was found in the MIC, FEV1, PEF, and PCF after the air stacking maneuver using resuscitator bags and balloons, whereas no significant difference was observed between resuscitator bags and balloons. Conclusion : No significant difference was found in the immediate effect of the air stacking maneuver using resuscitator bags and balloons in this study. Air stacking maneuver using balloons can increase the success rate of the techniques by providing visual feedback on the amount of air insufflation when performed with balloon blowing exercise. Balloons are cheaper and easier to buy compared to manual resuscitator bags; therefore, education on the air stacking maneuver using balloons will have a positive effect on pulmonary rehabilitation.

A Caring Program for Health Promotion among Women Who Have Experienced Trauma: A Quasi- Experimental Pilot Study

  • Kim Goun;Kim, Heejung;Park, Jeongok;Kang, Hee Sun;Kim, Soojin;Kim, Sunah
    • Journal of Korean Academy of Nursing
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    • v.53 no.5
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    • pp.500-513
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    • 2023
  • Purpose: Women are more vulnerable to post-traumatic stress (PTS) than men, causing several health problems. Nurses should understand and work with women who have experienced trauma and provide interventions to promote their physical, social, and mental health. Methods: This quasi-experimental pilot study used a one-group pre-test/post-test design. Data were collected from 14 women recruited between December 2019 and May 2020 from a self-sufficiency support center in South Korea for sexually-exploited women who had experienced trauma. The program consisted of six one-on-one intervention sessions per week for six weeks. Each session averaged 60~120 minutes. Participants were assessed at pre-test, post-test, and one-month follow-up. Changes in outcome variables over time were analyzed using the Wilcoxon signed-rank and Friedman tests. Results: The caring program for health promotion was divided into six sessions: understanding the self, sharing traumatic events and negative emotions, reframing the meaning of traumatic events, identifying thoughts and physical and emotional responses, developing health promotion activities, and maintaining a positive attitude during the process of change. As a result of the caring program, PTS (F = 36.33, p < .001), depression (F = 24.45, p < .001), health-promoting behaviors (F = 7.06, p = .004), and self-esteem (F = 19.74, p < .001) among the participants differed significantly at pre-test, post-test, and follow-up. Conclusion: This study provides foundational information for the implementation of a theory-driven program by nurses in clinical and community settings to provide comprehensive care for women who have experienced trauma.

A Qualification Study on the Repeated Self-injury of Adolescent (임상군 청소년의 반복적인 자해 경험에 대한 연구)

  • Yun-Ju Lee;Kye-Seong Lee
    • Journal of Industrial Convergence
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    • v.22 no.8
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    • pp.85-93
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    • 2024
  • The purpose of this study is to understand the meaning and context of adolescents' experiences of repetitive self-injury and to suggest that self-injurious behavior has characteristics of addictive disorder. In-depth interviews were conducted from December 26, 2022 to January 1, 2023 by using a semi-structured questionnaire for six adolescents who are attending outpatient psychiatirc clinic showing repetitive behavior of self-injury. The data were analyzed using Colaizzi's phenomeno-logical method focused on deriving the common attributes of all participants. We classified derived common attributes in the aspect of the diagnostic criteria of DSM-5 addictive disorder. 21 sub-themes and 6 categories were derived by gathering common meanings from 268 semantic units. The six categories of this study were raging pain, a wound that cannot not be revealed, extreme pores being pierced, continuous longing for self-harm, process of moving forward with pain. In the future, there is a need to develop various systematic intervention programs, including effective coping methods to help clinical adolescents' recover from self-injury, and further evaluation and research on them.

Development and Evaluation of Patient Safety Reporting Promoting Education Program (환자안전보고 촉진 교육프로그램의 개발 및 평가)

  • Kim, Myoung-Soo;Kim, Yun-Hee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.1
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    • pp.284-295
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    • 2012
  • The purpose of this study was to develop and evaluate patient safety reporting promoting strategy for nurses to improve nursing care quality. The process included three phase - construction, implementation and evaluation phase. Before the construction phase has two kinds of subcategories as analysis and verification. Analysis phase was consisted of literature review and field study, and verification was conducted by two specialist. At the construction phase, patient safety reporting system, educational materials, planning for public relation, and reward preparation were developed. After implementation during 12 weeks, we evaluated pre-post scores of satisfaction, stress of conscience, job performances. The participants were 51 nurses working for a hospitals. The program was developed and then administered to the experimental group for 12 weeks. One group pretest-posttest design was used for this study. Data were analyzed using descriptive analysis, paired t-test with the SPSS WIN 18.0 program. After the intervention, job performance scores improved significantly from 3.62 to 3.75(t=2.653, p=.009). But job stress didn't changed significantly(t=.785, p=.434). These strategy can be applied to many clinical setting that will be helpful to promote patient safety reporting for nurses.

Development of the Model for Total Quality Management and Cost of Quality using Activity Based Costing in the Hospital (병원의 활동기준원가를 이용한 총체적 질관리 모형 및 질비용 산출 모형 개발)

  • 조우현;전기홍;이해종;박은철;김병조;김보경;이상규
    • Health Policy and Management
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    • v.11 no.2
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    • pp.141-168
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    • 2001
  • Healthcare service organizations can apply the cost of quality(COQ) model as a method to evaluate a service quality improvement project such as Total Quality Management (TQM). COQ model has been used to quantify and evaluate the efficiency and effectiveness of TQM project through estimation between cost and benefit in intervention for a quality Improvement to provide satisfied services for a customer, and to identify a non value added process. For estimating cost of quality, We used activities and activity costs based on Activity Based Costing(ABC) system. These procedures let the researchers know whether the process is value-added by each activity, and identify a process to require improvement in TQM project. Through the series of procedures, health care organizations are service organizations can identify a problem in their quality improvement programs, solve the problem, and improve their quality of care for their costumers with optimized cost. The study subject was a quality improvement program of the department of radiology department in a hospital with n bed sizes in Metropolitan Statistical Area (MSA). The principal source of data for developing the COQ model was total cases of retaking shots for diagnoses during five months period from December of the 1998 to April of the 1999 in the department. First of the procedures, for estimating activity based cost of the department of diagnostic radiology, the researchers analyzed total department health insurance claims to identify activities and activity costs using one year period health insurance claims from September of the 1998 to August of the 1999. COQ model in this study applied Simpson & Multher's COQ(SM's COQ) model, and SM's COQ model divided cost of quality into failure cost with external and internal failure cost, and evaluation/prevention cost. The researchers identified contents for cost of quality, defined activities and activity costs for each content with the SM's COQ model, and finally made the formula for estimating activity costs relating to implementing service quality improvement program. The results from the formula for estimating cost of quality were following: 1. The reasons for retaking shots were largely classified into technique, appliances, patients, quality management, non-appliances, doctors, and unclassified. These classifications by reasons were allocated into each office doing re-taking shots. Therefore, total retaking shots categorized by reasons and offices, the researchers identified internal and external failure costs based on these categories. 2. The researchers have developed cost of quality (COQ) model, identified activities by content for cost of quality, assessed activity driving factors and activity contribution rate, and calculated total cost by each content for cost for quality, except for activity cost. 3. According to estimation of cost of quality for retaking shots in department of diagnostic radiology, the failure cost was ₩35,880, evaluation/preventive cost was ₩72,521, two times as much as failure cost. The proportion between internal failure cost and external failure cost in failure cost is similar. The study cannot identify trends on input cost and quality improving in cost of qualify over the time, because the study employs cross-sectional design. Even with this limitation, results of this study are much meaningful. This study shows possibility to evaluate value on the process of TQM subjects using activities and activity costs by ABC system, and this study can objectively evaluate quality improvement program through quantitative comparing input costs with marginal benefits in quality improvement.

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A Grounded Theory Approach on Peoples' Adaptation Experience with Fibromyalgia Syndrome (섬유근통증후군 환자의 질병 적응경험에 관한 근거이론 연구)

  • Jeong, Chu-Yeong;Kim, Myung-Hee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.12
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    • pp.381-393
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    • 2016
  • This was a qualitative study to explore and better understand the adaptation experience and processes of peoples with fibromyalgia syndrome (FMS), as well as to develop a substantive theory using the grounded theory method. There were 13 patients (12 females and 1 male) who received FMS treatment from Rheumatic Medicine outpatient department of one general hospital. The data were collected through an in-depth interview between January and May of 2014. Transcribed interview contents were analyzed by the grounded theory method of Corbin and Strauss (2008). As a result, a total of 98 concepts, 26 sub-categories, and 10 categories were identified through the open coding process. The process of adaptation experience showed 4 steps: perception of uncertainty and limited condition, evaluation of self-control possibility and determinations of expectations of life, searching and trying of strategies, as well as self-regulation. The 4 types of adaptation experience were expansionary, complacently, effusively and withering. The 'protective self-regulation' theory was derived from the core category of 'learning to self-regulation method'. Patients with FMS has repeatedly attempted these strategies of protective self-regulation in order to gain stability from uncertainty and limited condition of the disease. Based on these results, it is necessary to develop an educational program for patients and families which has appropriate nursing intervention strategies in accordance with the types of adaptation.

The New International Division of Labor:Re-evaluation (신국제노동분업의 재평가)

  • 고태경
    • Journal of the Korean Regional Science Association
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    • v.11 no.1
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    • pp.79-91
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    • 1995
  • As an exit to solve the economic depression of the development countries in the early twentieth century, the 'old international division of labor' developed. The economic crisis(i.e., under-consumption crisis) was due to the absence of the mode of regulation compatible with the extensive regime of accumulation(i.e., "Fordist" regime). The crisis was solved by the state intervention through the creation on institutions in order to increase the level of consumption. Until the late 1960s when "high Fordism" reached(i.e., a harmonious relation between the monopoly mode of regulation and the intensive accumulation of capital), the developed core countries enjoyed a remarkable economic growth. The external market was not a necessity for the economic growth because there were increases in labor productivity and proportional increases in real wages and thus increases in consumption level. In the 1970s, however, the core faced with economic crisis again. Due to the breakdown of the postwar "Fordist" regime of capital accumulation and the post 1973 world depression, the core needed the Third World as a solution for their internal and international economic crisis. Thus the 'new international division of labor'(NIDL) arose. The "Fordist" method of production(i.e., the divisions of production process) led to the territorial division of labor and to the detailed division of labor. The aim of the NIDL is to exploit reserve armies of labor on a world scale and thus to reduce production costs. According to the NIDL model, the Third World countries have been developing by the core countries' investment on mainly labor-intensive industries and thus have been playing an important role in the global economy. And the NIDL theorists argue that multinational corporations have increasingly invested in the Third World nations and contributed to the economic growth in those regions. Tables presented in the paper show that the global trend since the 1970s does not follow the argument exactly as the NIDL theorists predicted. On the contrary, the core countries focus on developing technology, adopting the automation of production process, and trading within the core countries rather than on investing in the periopheral countries. The continuing investment of multinational corporations into the periphery is not because of cheap labor force but because of the market potentials in the regions. Majority of corporations of the core tries to reduce production costs by investing in technological development more intensively and also by changing regional strategies (i.E., investment from metropolitan areas to medium - or small - size cities, focusing on agglomeration economy, boosting regional diversification, etc.) within their own countries. The main purpose of the paper is to review and to criticize the NIDL theory based on some empirical data.IDL theory based on some empirical data.

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Design of Teacher's Folding Back Model for Fundamental Theorem of Calculus (미적분학의 기본정리에 대한 교사의 Folding Back 사고 모형 제안)

  • Kim, Bu-Mi;Park, Ji-Hyun
    • School Mathematics
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    • v.13 no.1
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    • pp.65-88
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    • 2011
  • Epistemological development process of the Fundamental Theorem of Calculus is considered in a history of mathematical notions and the genetic process of the Fundamental Theorem is arranged by the order of geometric, algebraic and formalization steps. Based on this, we studied students' episte- mological obstacles and error and analyzed the content of textbooks related the Fundamental Theorem of Calculus. Then, We developed the "Folding Back Model" of the fundamental theorem of calculus for students to lead meaningful faithfully. The Folding Back Model consists of "the Framework of thou- ght"(figure V-1) and "the Model of genetic understanding of concept"(figure V-2). The framework of thought in the Folding Back Model is included steps of pedagogical intervention which is used "the Monitoring working questions"(table V-3) by the mathematics teacher. The Folding Back Model is applied the Pirie-Kieren Theory(1991), history of mathematical notions and students' epistemological obstacles to practical use of instructional design. The Folding Back Model will contribute the professional development of mathematics teachers and improvement of thinking skills of students when they learn the Fundamental Theorem of Calculus.

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Revised STandards for Reporting Interventions in Clinical Trials of Acupuncture(STRICTA) : Extending the CONSORT Statement (STRICTA(침 임상연구에서 중재 보고를 위한 표준) 개정판: CONSORT Statement의 확충안)

  • Lee, Hyang-Sook;Cha, Su-Jin;Park, Hi-Joon;Seo, Jung-Chul;Park, Jong-Bae J.;Lee, Hye-Jung
    • Korean Journal of Acupuncture
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    • v.27 no.3
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    • pp.1-23
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    • 2010
  • Objectives and methods : The Standards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA) were published in five journals in 2001 and 2002. These guidelines, in the form of a checklist and explanations for use by authors and journal editors, were designed to improve reporting of acupuncture trials, particularly the interventions, thereby facilitating their interpretation and replication. Subsequent reviews of the application and impact of STRICTA have highlighted the value of STRICTA as well as scope for improvements and revision. To manage the revision process a collaboration between the STRICTA Group, the CONSORT Group, and the Chinese Cochrane Centre was developed in 2008. An expert panel with 47 participants was convened that provided electronic feedback on a revised draft of the checklist. At a subsequent face-to-face meeting in Freiburg, a group of 21 participants further revised the STRICTA checklist and planned dissemination. Results : The new STRICTA checklist, which is an official extension of CONSORT, includes six items and 17 sub-items. These set out reporting guidelines for the acupuncture rationale, the details of needling, the treatment regimen, other components of treatment, the practitioner background, and the control or comparator interventions. In addition, and as part of this revision process, the explanations for each item have been elaborated, and examples of good reporting for each item are provided. In addition, the word "controlled" in STRICTA is replaced by "clinical", to indicate that STRICTA is applicable to a broad range of clinical evaluation designs, including uncontrolled outcome studies and case reports. Conclusions : It is intended that the revised STRICTA, in conjunction with both the main CONSORT Statement and extension for nonpharmacologic treatment, will raise the quality of reporting of clinical trials of acupuncture.

Implementation of Patient Experience Assessment and Subsequent Changes at the Ground Level in Health Care: Patient Experience Employees' Perspective (환자경험 평가와 의료 현장의 변화: 의료기관 환자경험 업무 담당자의 관점)

  • Song, Yeong-Chae;Yoon, Eun-Sil;Han, Se-Young;Tae, Ji-Yeon;You, Soo-Kyeong;Do, Young-Kyung
    • Quality Improvement in Health Care
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    • v.28 no.1
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    • pp.14-33
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    • 2022
  • Purpose: To examine whether the Patient Experience Assessment (PEA) has led to perceptible changes at the ground level of health care, as a way of evaluating PEA as a policy intervention for quality improvement. Methods: Four focus group discussions (FGDs) were conducted, each comprising six to eight participants who were employees responsible for patient experience at their respective hospitals. The primary focus of the FGDs was on questions such as: 1) How do hospitals respond to PEA? 2) What significant changes were observed after the implementation of PEA? 3) What were the unintended consequences of implementing PEA, if any? 4) What areas of improvement have been identified for maximizing the potential of PEA? Results: Two broad themes emerged out of the FGDs: changes observed post implementation of PEA, and areas for improvement of PEA. Four significant changes were reported by participants: changes in perception and attitude regarding patient experience in hospital employees, increased active involvement by the hospital leadership, enhanced efforts to improve patient experience, and increased cooperation between such activities. Furthermore, eight areas of improvement were identified, which have been grouped in three categories: improving the process of data collection for PEA, introducing additional catalysts to facilitate further changes, and paying attention to structure- and patient-level constraints that must be addressed in parallel. Conclusion: The implementation of PEA led to perceptible changes within hospitals, which implies that it can serve as an effective catalyst for improving patient experience. A number of areas of improvement that would aid in maximizing the potential of PEA were also identified.