• 제목/요약/키워드: Physical and psychological health

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Association between Socioeconomic Status and Altered Appearance Distress, Body Image, and Quality of Life Among Breast Cancer Patients

  • Chang, Oliver;Choi, Eun-Kyung;Kim, Im-Ryung;Nam, Seok-Jin;Lee, Jeong Eon;Lee, Se Kyung;Im, Young-Hyuck;Park, Yeon Hee;Cho, Juhee
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권20호
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    • pp.8607-8612
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    • 2014
  • Background: Breast cancer patients experience a variety of altered appearance - such as loss or disfigurement of breasts, discolored skin, and hair loss - which result in psychological distress that affect their quality of life. This study aims to evaluate the impact of socioeconomic status on the altered appearance distress, body image, and quality of life among Korean breast cancer patients. Materials and Methods: A cross-sectional survey was conducted at advocacy events held at 16 different hospitals in Korea. Subjects were eligible to participate if they were 18 years of age or older, had a histologically confirmed diagnosis of breast cancer, had no evidence of recurrence or metastasis, and had no psychological problems at the time of the survey. Employment status, marital status, education, and income were assessed for patient socioeconomic status. Altered appearance distress was measured using the NCI's cancer treatment side effects scale; body image and quality of life were measured by the EORTC QLC-C30 and BR23. Means and standard deviations of each outcome were compared by socioeconomic status and multivariate linear regression models for evaluating the association between socioeconomic status and altered appearance distress, body image, and quality of life. Results: A total of 126 breast cancer patients participated in the study; the mean age of participants was 47.7 (SD=8.4). Of the total, 83.2% were married, 85.6% received more than high school education, 35.2% were employed, and 41% had more than $3000 in monthly household income. About 46% had mastectomy, and over 30% were receiving either chemotherapy or radiation therapy at the time of the survey. With fully adjusted models, the employed patients had significantly higher altered appearance distress (1.80 vs 1.48; p<0.05) and poorer body image (36.63 vs 51.69; p<0.05) compared to the patients who were unemployed. Higher education (10.58, standard error (SE)=7.63) and family income (12.88, SE=5.08) was positively associated with better body image after adjusting for age, disease stage at diagnosis, current treatment status, and breast surgery type. Similarly, patients who were married and who had higher education had better quality of life were statistically significant in the multivariate models. Conclusions: Socioeconomic status is significantly associated with altered appearance distress, body image, and quality of life in Korean women with breast cancer. Patients who suffer from altered appearance distress or lower body image are much more likely to experience psychosocial, physical, and functional problems than women who do not, therefore health care providers should be aware of the changes and distresses that these breast cancer patients go through and provide specific information and psychosocial support to socioeconomically more vulnerable patients.

종합병원 입원환자의 공간사용 및 프라이버시 만족도 (Space Usage and Satisfaction with Privacy in General Hospital Inpatients)

  • 최인영;박혜경
    • 한국과학예술포럼
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    • 제36권
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    • pp.391-400
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    • 2018
  • 병원건축에서 사용자중심의 치료환경을 위해서는 효율성 및 경제성을 우선한 기능적 측면에서의 접근이 아닌 사용자의 심리·행태적 요구의 반영이 필요하다. 신체적 정신적으로 유약한 상태인 환자의 경우 익숙하지 않은 환경 속에서 심리적 압박감을 경험하게 된다. 그러나 선행연구 대부분이 물리적 환경에 대한 평가에만 주목하고 있어 병원이라는 특수한 환경에서의 환자들의 불안, 스트레스와 같은 심리·행태적 접근은 미흡한 실정이다. 이에 본 연구는 종합병원 입원환자를 대상으로 주요 공간의 공간사용 및 프라이버시 만족도를 살펴보았다. 이는 물리적, 행태·심리적 측면의 복합적 측면에서의 사용자중심 종합병원 디자인을 위한 기초자료를 제공하는데 의의가 있다. 연구를 위해 문헌연구와 현장조사, 설문조사를 진행하였다. 종합병원의 주요 기능공간과 병원프라이버시에 대해 고찰하고, 현장조사를 실시하여 조사대상의 계획현황을 파악하였다. 그리고 설문조사를 통해 기능 공간의 이용도 및 만족도, 프라이버시 만족도를 조사하였다. 연구결과는 다음과 같다. 첫째, 공간 이용도의 경우 전반적으로 보통 정도로 평가하였으며, 병실 및 로비를 일상적 공간으로 사용하는 것으로 나타났다. 연령별로 40대의 이용도가 가장 높으며 30대 이하의 경우 상대적으로 낮게 나타났다. 둘째, 공간 만족도는 보통 이상으로 만족하는 것으로 나타났으며, 특징적으로 디자인 된 로비공간에 대한 만족도가 가장 높게 나타났다. 사례별로는 수평적 전원형으로 계획하여 보다 넓은 면적을 확보한 B사례의 만족도가 높게 나타나 차이를 보였다. 셋째, 병원프라이버시의 경우, 보통수준으로 만족하는 것으로 나타났으며, 상대적으로 프라이버시 요구가 높은 반면 획득 수준이 낮음을 알 수 있었다. 그리고 프라이버시 만족도가 병원 전체 만족도에 영향을 미치는 중요한 요소임을 알 수 있었다.

漢江 水質保全 行政에 관한 硏究 (A Study on the Administration for the Han River Water Quality Control)

  • Kim, Kwang Hyop
    • 한국환경보건학회지
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    • 제10권2호
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    • pp.9-40
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    • 1984
  • This thesis purports to overview the diverse administrative and organizational factors and plannings developed by the government organizations, municipal or otherwise, to tackle the Han River water pollution issues in the past years. This thesis also looks into the ever-worsening Han River water pollution problems, in particular, in terms of the various government plans ostensibly designed to reduce the pollution level but with little success. Also dealt with are the efficiencies with which the laws and decrees on water pollution the administrative organizations put to use in the prosecution of the diverse antiwater pollution projects involving the Han River basin. From the early 1960's up to the 1970's the government had concentrated on the growth-oriented economic policy with the result that little attention had been paid to the water pollution and other environmental issues that are bound to arise from the massive economic growth. Belatedly, the five-year Hah River Development Project was initiated in 1982 with emphasis on reducing the water pollution level at Hah River to the minimum. The following are the gists of the thesis and recommendations for the future antiwater pollution plans by the administrative organizations: 1. Documents to date indicate that the irrigation projects along the Han River area had been the main focus of attention during the Yi Dynasty and under the Japanese rule of the country. 2. Despite that the water pollution issue became the subject of many debates among the academic and research institutions in the 1960's and in the 1970's, the administrative organizations in charge of the Han River water quality control failed to come up with a concrete plan for the river's water quality control. 3. Nevertheless, the water pollution of the Han River area in fact began in the 1950's, with the unprecedented concentration into Seoul of population and the industrial facilities on a larger scale, in particular, enforced by the government's strong growthoriented policy in its Economic Development plans in the 1960's. 4. Starting in the 1960's, the Han River water pollution level dramatically increased, but the government was reluctant to promulgate or put into effect strong measures to curb the many factors contributing to the river water pollution, thus worsening the environmental issues along the Han River basin. 5. The environmental protection law and other laws and decrees relating to the antiwater and air pollution issues that were subsequently put into effect underwent so many changes that efficient anti-water pollution policies could not be effected for the Han River basin. The frequent organizational reshuffle within the administrative units concerned with environmental problems has resulted in the undue waste in personnel management and finance. 6. The administration on the environmental protection could not be efficiently carried out due to the organizational overlapping. Under the existing law, frequent organizational frictions and inefficiency are bound to occur among the central government offices themselves, as well as between the central government and the Seoul city administration, and among the city's administrative offices over the conservation of the Han River basin and over the river's anti-water pollution issue. 7. In the planning and prosecution of the Han River project, political influences from the president down to the lower-level politicious appear to have been involved. These political influences in the past had certainly had negative influence on the project, nevertheless, it appears that in the recent years, these political influences are not all that negative in view of the fact that they serve as a positive contributing factor in developing a better water quality control project along the Han River basin. The following are a few recommendations based on the data from the thesis: First, officials in charge of the Han River water quality control should pay attention to a careful screening of the opinions and recommendations from the academic circles and from the public should be made so that the government could better grasp the core issues in the environmental problems that require preventive and other necessary measures. Second, vigorous redistribution policies of population and industrial facilities away from the Seoul area should be pursued. Third, the government should refrain from revising or revamping too frequently the laws and decrees on the anti-water pollution, which is feared to cause undue inconveniences in the environmental administration. Fourth, a large-scale streamlining should be made to the existing administrative organization in an effort to do away with the inter- and intra-organizational friction. It is recommended that a secretariat for the Hah River basis conservation be established. Fifth, High-level administrative officials, with a thorough knowledge and vision on the Han River water quality control, should be prepared to better deal with the budgeting and personnel management for the Han River water pollution control not only at the control government, but also at the Seoul city municipal government levels. Environmental issues should be kept distinct from political issues. Environmental issues should not serve as a window-dressing for sheer political purposes. Sixth, the Hah River proiect should also include, along with the main Han River basin, those areas covering North Han River, South Han River, and the tributaries to the main river basin. The 'Han River Basin Water Quality Control Board' should be established immediately as a means of strengthening the current Han River basin water quality control policy. Seventh, in drawing up the Han River proiect, the administrative officials should be aware that Han River basin is a life line for those people in the region, providing them with not only a sheer physical space, but with a psychological living space for their everyday life.

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보건소 재가암환자관리사업 대상자의 서비스 요구도 분석 (Needs Assessment for the Beneficiaries of Home-Based Cancer Patients Management Project)

  • 이주형;박정임;강지훈;염정호;고대하;권근상
    • 농촌의학ㆍ지역보건
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    • 제36권4호
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    • pp.238-250
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    • 2011
  • 지속적인 암환자 및 암 관련 의료비용 급증은 환자 개인의 고통 및 경제적 부담으로 작용할 뿐만아니라 사회적인 부담이 되고 있다. 이에 재가암 환자에 대한 통증관리 등의 서비스 제공은 의료 비용을 절감하는데 효과가 있을 것으로 여겨지고 있다. 따라서 재가암환자에 대한 적절한 의료 및 복지 서비스 등을 제공하기 위한 자료로 활용하고자 재가암환자관리사업 수혜자의 서비스 요구도에 대하여 각 보건소의 재가암환자관리사업 담당자가 재가암환자관리사업 수혜자 방문시 면접조사방법으로 조사하였고, 불충분응답자 15명을 제외한 661명을 최종 분석대상으로 하였다. 재가암환자의 서비스 요구도에 대한 요인분석 결과 5가지 영역으로 분류할 수 있었고, 요인별 신뢰도는 0.593~0.890이었다. 요구도의 순위는 사회적 지지, 정보 및 교육제공, 심리적 문제해결, 신체증상해결, 가사도움 순으로 조사되었다. 대상자를 암 치료 및 진행 정도에 따라 말기암 환자, 치료중인 암환자, 암 완치자로 분류하였을 때, 말기암환자의 요구도가 가장 높게 나타났으며, 사회적지지, 심리적 문제 해결, 정보 및 교육 순서로 요구도가 높았다. 나머지 그룹에서는 사회적지지, 정보 및 교육, 심리적 문제 해결 순으로 말기 암환자와 차이를 보였다. 뿐만 아니라, 연령별, 거주 지역별, 종교 유무에 따른 서비스 요구도에 차이가 관찰되었고, 이를 바탕으로 현재 제공되고 있는 재가암환자관리의 효율적인 추진을 위해 대상자 분류, 연령별 및 거주 지역별 특성에 따른 서비스가 제공될 수 있도록 해야 할 것이다.

라이프스타일 재설계 프로그램이 뇌졸중 노인의 시간 사용과 삶의 질에 미치는 효과 (The Effects of Lifestyle Redesign Program on Time Usage and Quality of Life for Elderly with Stroke)

  • 김형민;전병진
    • 대한지역사회작업치료학회지
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    • 제9권3호
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    • pp.21-30
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    • 2019
  • 목 적 : 본 연구는 작업 균형(Occupational Balance)과 성공적인 노화연구(Well Elderly Research Study)를 이론적 근거로 라이프스타일 재설계 프로그램을 적용하여 뇌졸중 노인의 시간 사용과 삶의 질에 미치는 효과를 확인하고자 하였다. 연구방법 : 요양병원에 거주하는 뇌졸중 노인 총 40명(실험군 20명, 대조군 20명)을 대상으로 통제집단 사전사후검사 설계(pretest-posttest control group design)를 시행하였다. 라이프스타일 재설계 프로그램에 참여하기 전 2주 동안 사전평가를 실시하였고, 이 후 10주 동안 주 7회 라이프스타일 재설계 프로그램을 적용하였으며, 이 후 1주 동안은 사후 평가를 실시하였다. 대상자의 시간 사용은 통계청(2009) 생활시간 조사표를 사용하였고, 삶의 질의 경우 세계보건기구 삶의 질 평가도구(WHOQOL-BREF)를 사용하였다. 결과 : 프로그램 적용 전과 후의 시간 사용량 비교 결과 실험군의 경우 휴식과 수면(t=-4.89, p<.001), 여가(t=-4.67, p<.001)에서 통계적으로 유의한 차이를 확인할 수 있었다. 또한 집단 간 비교 결과 역시 휴식과 수면(t=-2.24, p<.01) 그리고 여가(t=3.57, p<.01)에서 통계적으로 유의한 차이가 나타났다. 삶의 질 비교 결과 두 그룹 간 통계적으로 유의한 차이가 나타났다(t=6.80, p<.001). 삶의 질 하위영역을 살펴보면 신체적 건강영역(t=6.08, p<.001), 심리적 건강영역(t=5.21, p<.001), 생활 환경영역(t=3.60, p<.01)에서 통계적으로 유의한 차이를 확인할 수 있었다. 결론 : 라이프스타일 재설계 프로그램은 요양병원에 거주하는 뇌졸중 노인의 휴식과 수면의 시간 사용은 줄이고, 여가생활에 참여하는 시간 사용을 늘려주었으며, 그로 인해 삶의 질이 향상되는 결과를 나타내었다.

사회 네트워크를 이용한 사용자 기반 유헬스케어 서비스 추천 시스템 개발 (Development of User Based Recommender System using Social Network for u-Healthcare)

  • 김혜경;최일영;하기목;김재경
    • 지능정보연구
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    • 제16권3호
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    • pp.181-199
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    • 2010
  • 인구의 고령화 및 건강에 대한 관심이 증가됨에 따라 유헬스케어 서비스는 발병 후 관리관점에서 발병 전의 예방 관점으로 그 목적이 점차 이동하고 있다. 그러나 기존의 유헬스케어 서비스는 원격진료 차원의 의료 서비스 성격이 강하여, 만성 성인병과 같은 대사 증후군을 예방 및 관리하기에는 한계가 있을 뿐만 아니라, 관리자 중심의 단방향 서비스를 제공함으로 인해 사용들이 중도에 이용을 포기하는 비율이 높았다. 이와 같은 문제를 해결하기 위하여, 본 연구에서는 사회 네트워크를 이용한 사용자 기반 유헬스케어 서비스 추천 시스템을 제안하였으며, 실세계에서 유헬스케어 서비스 추천 시스템의 활용 가능성을 제시하기 위하여 실제 의료원에서 대사 증후군 예방 및 관리를 위해 처방한 식단 및 운동 정보를 기반으로 유비쿼터스 컴퓨팅 환경에서 적용가능한 시스템을 구현하였다. 본 연구에서 제안한 시스템은 사용자가 선호하지 않는 서비스가 네트워크를 통해 확산될 가능성을 낮추는 동시에 추천의 신뢰성 제고를 위해 네이버들이 이용한 서비스를 공유함으로써 전체적인 추천 품질을 높인다. 즉, 사용자의 식습관 및 운동습관 등과 같은 생활습관을 개선하기 위하여 사회 네트워크를 활용함으로써 사용자간의 자율협업을 통한 개인화된 추천이 가능하다. 따라서 본 연구에서 제안하는 유헬스케어 서비스 추천 시스템은 생활습관 개선을 위하여 사용자에게 적합한 식단 및 운동을 제공하고, 생활습관의 개선을 통해 만성 성인병과 같은 대사증후군을 사전에 예방할 수 있을 것으로 기대된다.

간호 교육에 대한 일 연구 -2년제 초급대학 과정 중심으로- (A Study of The Nursing Education Concerning Two Years Associate Degree Nursing Program)

  • 변창자
    • 대한간호학회지
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    • 제4권3호
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    • pp.63-79
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    • 1974
  • 1. The purpose of this study. The purpose of this study is to plan and investigate short-term nursing education of two-years associate degree program to produce middle-level professional nurses which are needed by-society and nation. Current nursing education in Korea is divided into four years degree program, three years diploma program Even (though) there are differences in the aims of their education, the curriculums are not much different between the education for producing leaders which is its basic purpose and training middle-level professional nurses. Therefore the purpose of associate degree program lies in minimizing the waste of time and finance which are invested for long-term education for middle-level professional nurses. And also this coincide with the policy of national technical training and definite supply of nurse manpower according to health policy for effective role and ability of nurse. 2. The method of study. This is based on the study of literature, research on the actual condition and investigation of opinion- through questionnaire. L) The study of literature: Domestic and foreign literatures for two years associate degree program were studied and investigated. 2) Research on the actual condition : Current three years nursing education program was collected and analysed. 3) Investigation of opinion. The problem of curried nursing education system and the possibility of two years associate degree program were investigated through questionnaire. 3. The result of the study. 1) The trend of recent nursing education. a. The aims of nursing in past chiefly taking care of physical disease of patient has recently changed to nursing of character including physical, mental, socio-economic, educational and psychological condition. b. For the performing systematic and effective nurse's duty according to her role, the-change of educational system which is classified as a range of education the period of education and certificate after graduation has been enforced or fulfilled. c. Nursing education also has a trend to become a collage or two years associate degree program which can get same legal protection as other educational institutions whose basic purpose is education. Attached nursing school to hospital is getting disappeared because of disadvantage of educational system. 2) Problems. Depending upon research on actual condition of current 3 years nursing education program. a. There are too many subjects. b. Contents of education could be doubled because major subjects are subdivided in detail. c. The credits for graduation are too heavy comparing to the period of study or the ability of students. (The necessary credits are 150.8 for three years according to actual investigation 4. There is no certain standard in organizing curriculum therefore there are too much differences between schools. 4. Basic Plan. The plan for two years associate degree program in nursing education depending on demand of professional nursing field of society is based on following items. 1) Training middle-level professional nurse lay emphasis on liberal arts and basic major field. 2) Liberal arts are divided into required and optional subjects and students could take courses by choice. 3) Major subjects are compound together by fields and they become the sciences of nursing Ⅰ,Ⅱ,Ⅲ,Ⅳ and every items has its educational purposes and contents major study includes laboratory practice and clinical experience. 4) The required credits for graduation are to which means 17-18 credits a semester. The above has been planned to solve the problems of current three years nursing education program. In conclusion for the achievement of this system, following items are needed. 1) It is necessary to change educational administration and system such as amendment of educational law or order of educational application of law. 2) Qualified professors should be available to understand and develope the idea or purpose of this educational system. 3) Local medical institutions should be opened widely and educational for clinical training. 4) The job after graduation should he secured positively.

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자살시도자와 자살 사망자의 자살 방법, 스트레스 요인 및 정신과적 진단 (Suicide Method, the Recent Stressors, Psychiatric Diagnosis of Suicide Attempters and Suicide Completers)

  • 오시현;안지혜;서지효;구혜린;김민정;장혜연;김석주
    • 수면정신생리
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    • 제29권1호
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    • pp.15-20
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    • 2022
  • 배 경: 본 연구는 자살시도자와 자살사망자 간 자살방법, 스트레스 요인, 정신과적 진단에 차이가 있는지 확인하고자 하였다. 방 법: 두 가지 후향적인 자료를 분석에 사용하였다. 자살시도자의 경우 삼성서울병원의 의무기록을 확인하여 680명의 의무기록을 수집하였고 한국생명존중재단의 심리부검과정을 통해 11,722명의 자살사망자 데이터를 제공받았다. 두 가지 자료의 자살방법, 스트레스 요인, 정신과적 진단에서의 차이를 확인하였다. 결 과: 자살사망자는 자살시도자에 비해 남성이 많았고 연령대가 높은 것으로 나타났다. 자살 방법 중 목 매달기나 농약 음독과 같은 방법이 자살사망자와 관련이 있었다. 자살시도자의 경우 둔기를 이용해 손목을 긋거나 약물을 음독하는 경우와 연관이 있는 것으로 나타났다. 모든 종류의 스트레스 요인이 자살사망자에게서 높았으며, 특히 경제적인 문제와 신체적인 문제가 자살사망자에게서 높은 비율로 나타났다. 진단의 경우 연령과 성별에 따른 영향을 배제하자 자살시도자와 자살사망자 간 차이를 규명할 수 없었다. 결 론: 자살시도자와 자살사망자 사이에 자살 방법, 스트레스 요인에 차이가 있다는 것을 확인하였다. 이는 경제적인 문제와 신체적인 문제가 동반된 경우 자살 사망의 위험이 더 높을 수 있음을 시사한다.

교대근무자에서 각 교대근무간의 수면양상 및 자율신경계 활성도 비교 (Comparison of Sleep Patterns and Autonomic Nervous System Activity among Three Shifts in Shiftworkers)

  • 윤인영;하미나;박정선;송병근
    • 수면정신생리
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    • 제7권2호
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    • pp.96-101
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    • 2000
  • 목 적 : 본 연구는, 교대근무자에 있어 세 교대근무간의 수면양상과 자율신경계활동성을 비교함으로써, 근무자들은 어떤 근무시에 가장 적합하다고 느끼는지 그리고 교대근무자의 심리적, 신체적 문제점의 특성은 무엇인지를 알아보고자 하였다. 또한 본 연구는 근무자들이 교대근무에 좀 더 효과적으로 적응하는데 도움을 주고자 기획되었다. 방 법 : 3일 정도 연속적으로 한 교대근무를 한 후 1일 휴무, 그 다음에 다른 교대로 넘어가는 빠른 순환주기의 교대근무자 51명이 연구에 참여하였다. 각 대상은 수면일기를 작성하였으며 수면잠복기, 수면기간시간, 수면 중 깨어난 횟수를 세 교대근무간에 비교하였다. Epworth 졸음척도와 시각아날로그척도를 사용하여 졸음을 평가하였으며 기분상태는 기분상태척도로 평가하였다. 심박수변동성과, 스트레스 호르몬(아드레날린, 노르아드레날린) 및 그 대사산물을 측정하여 자율신경계 활동성을 살펴보았다. 심박수변동성에는 저주파영역의 스펙트럼 파워, 고주파영역의 스펙트럼 파워, 저주파영역의 파워와 고주파영역의 파워간의 비가 포함되었다. 결 과 : 수면기간시간은 오후근무시 가장 길었고 수면잠복기는 밤근무시 가장 짧았다. 깨어났을 때의 각성도는 오전근무시 가장 저하되었고 작업 중의 각성도는 밤근무 중 가장 떨어지는 것으로 나타났다. 밤근무시 근무자들은 신체적인 피곤감과 인지기능의 저하를 호소하였다. 심박수변동성의 비교를 통해 오후근무시 부교감신경계가 가장 활성화된다는 것을 알 수 있었으며 아드레날린 및 노르아드레날린 분비도 통계적인 의미는 없었지만 오후근무시 가장 감소하였다. 결 론 : 본 연구결과 오후근무가 교대근무자에게 가장 적합한 것으로 나타났다. 오전근무시에는 빛을 아침에 투여하고 밤근무시에는 근무 중에 빛을 투여하면 교대근무에의 적응이 촉진될 것으로 생각된다.

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질적 간호제공을 위한 간호단위 시범 운영 효과에 관한 임상적 연구 (A Clinical Study for Promoting Quality Nusing Care in a University Hospital)

  • 이애주;김선한;성영희;유순애;권인각;정연이;남혜경;권은정
    • 대한간호
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    • 제32권5호
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    • pp.66-77
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    • 1994
  • The purpose of this study was to develop a new nursing unit which can meet changing health care needs, enhance patients' satisfaction and nurses' job satisfaction, and finally guarantee quality nursing care with present manpower. For this, one medical unit was selected as a unit for quality care. And one medical unit which is similar in staffing and patients' characteristics was selected as a control unit. To assess present problems and identify the remedies to the problems a hospital-wide survey and a workshop were performed. According to the survey results, educational programs and improvement of the facilities and equipment supply system, managereal support for interdepartmental cooperation and intensification of bed-side nursing care were adopted as main principles for operating model unit, This model unit was operated for 3 months from Sep. 1, 1992 to Nov. 30, 1992. To evaluate the effectiveness of the model unit, derect/indirect nursing care hours, patients' satisfaction to nursing care, nurses' job satisfaction, and quality care index were measured. Direct/indirect nursing care hours were compared with that of the control unit, and patients' and nurses' satisfaction and quality care index were measured before and after operating model unit and compared with each other. The results of the study were as follows; 1. In the model unit mean direct nursing care hours per cach shift was 146.88 minutes and indirect nursing care hours was 354.72 minutes. The ratio of the direct nursing care hour to indirect nursing hour was 29.6 ; 70.4 and that of the control unit was 26.9 : 73.1. Direct nursing care hour in model unit was longer than that of the control unit. But, the difference was not significant. In subcategories of direct nursing care, the time spent in mobility and exercise, conservation of body temperature, hygiene, and communication and health education were longer than that of the con" trol unit. 2. Indirect nursing care hour in model unit was shorter than that of the control unit. But, the difference was not significant. In subcategories of indirect nursing care, the time spent in drug management and ward arrangement was shorter than that of the control unit. 3. Patients' satisfaction to nursing care was increased significantly after operating the model unit (T=-3.48, P=-0.002) and satisfaction to subcategories of physical comfort measure, psychological cate, and unit management components were significantly higher than before. 4. In the model unit, nurses' total job satisfaction was increased significantly after operating the model unit(Z=2.1004, P=.0357) and satisfaction to subcategory of satisfaction to administration was significantly higher than before (Z=-2.0732, P=.0382). 5. After operating the model unit, quality care index was increased from 89 to 93. With this results, it can be summarized that all the measures tried for quality care, such as educational programs, managereal support for interdepartmental cooperation, and improvement of the equipment and facility provision resulted in partial increase in direct nursing care hours, nurses satisfaction to their job and patients' satisfaction to nursing care. In can be postulated that managereal support and motivation without proper staff supplementation is not enough for increasing direct nursing care hours. And for the enhancement of the level in clinical nursing, and staff supplement must be considered sincerely and the measures for reducing indirect nursing care hours, such as computerization of nursing care activities, improvement of facilities and equipment and facilities supply system, must be instituted in addition.

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