• Title/Summary/Keyword: Power System Quality

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Effects of Mindfulness Based Stress Reduction Program on Depression, Anxiety and Stress in Patients with Aneurysmal Subarachnoid Hemorrhage

  • Joo, Hye-Myung;Lee, Sung-Jae;Chung, Yong-Gu;Shin, Il-Young
    • Journal of Korean Neurosurgical Society
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    • v.47 no.5
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    • pp.345-351
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    • 2010
  • Objective : In this study, the Mindfulness Based Stress Reduction (MBSR) program was applied to patients presenting with depression and anxiety after surgery from spontaneous subarachnoid hemorrhage (SAH) and the effects were assessed. Methods : The subjects were patients admitted for cerebral aneurysm rupture and treated by means of surgery from March to December, 2007. More than 6 months had passed after surgery, without any special lesions showing up on computed tomography (CT), and the Glasgow outcome scale (GOS) was 5 points. Among patients with anxiety and depression symptoms, 11 patients completed the program. The MBSR program was conducted once a week, 2.5 hours each, for 8 weeks. The evaluation criteria were : 1) the Beck Depression Inventory (BDI): it measures the type and level of depression, 2) the State-Trait Anxiety Inventory : the anxiety state of normal adults without mental disorder, and 3) Heart Rate Variability (HRV) : the influence of the autonomous nervous system on the sinoarterial node varies continuously in response to the change of the internal/external environment. Results : The BDI value was decreased from 18.5 ${\pm}$ 10.9 to 9.5 ${\pm}$ 7.1 (p = 0.013) : it was statistically significant, and the depression level of patients was lowered. The state anxiety was decreased from 51.3 ${\pm}$ 13.9 to 42.3 ${\pm}$ 15.2; the trait anxiety was reduced from 50.9 ${\pm}$ 12.3 to 41.3 ${\pm}$ 12.8, and a borderline significant difference was shown (p = 0.091, p = 0.056). In other words, after the treatment, although it was not statistically significant, a decreased tendency in anxiety was shown. In the HRV measurement, standard deviation normal to normal (SDNN), square root of the square root of the mean sum of squared differences between adjacent normal to normal intervals (RMSSD), and total power (TP) showed significant increase, Physical Stress Index (PSI) showed a significant reduction, and thus an improvement in the homeostatic control mechanism of the autonomic nervous system was ween. Conclusion : The MBSR program was applied to the patients showing anxiety and depression reaction after SAH treatment, and a reduction in depression symptoms and physiological reactions were observed. The application of the MBSR program may be considered as a new tool in improving the quality of life for patients after surgery.

The Study on Blast Effects of Stemming Materials by Trauzl Lead Block Test and High Speed 3D-DIC Systems (트라우즐 연주시험 및 고속 3차원 이미지영상상관 기법을 이용한 전색재 별 발파효과에 대한 연구)

  • Ko, Younghun;Seo, Seunghwan;Kim, Sik;Chung, Youngjun;Chung, Moonkyung
    • Journal of the Korean Geotechnical Society
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    • v.37 no.10
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    • pp.13-25
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    • 2021
  • The most widely used method for determining the blast effects of explosives is the Trauzl test. This test is used to measure the explosive power (strength) of a substance by determining volume increase, which is produced by the detonation of a tested explosive charge in the cavity of a lead block with defined quality and size. In this paper, Trauzl lead block test and High speed 3D-DIC (Digital Image Correlation) system were conducted to evaluate the stemming effect of the blast hole. The effects of stemming materials can be expressed as the expansion of the cavity in a standard lead block through explosion of the explosives. The blasting experiment was conducted with emulsion explosives. The stemming material in the blast hole of lead block, which was adopted in this study, were using sand and stone chips. Results of blasting experiment and numerical analysis showed that the expansion rates of lead block were most affected by stone chips followed by sand. Also, as result of dynamic strain measurement on the lead block surface of High speed 3D-DIC system, the displacement and surface strain on the block were the highest in the experiment case of stone chips stemming.

A Study on Domestic Applicability for the Korean Cosmic-Ray Soil Moisture Observing System (한국형 코즈믹 레이 토양수분 관측 시스템을 위한 국내 적용성 연구)

  • Jaehwan Jeong;Seongkeun Cho;Seulchan Lee;Kiyoung Kim;Yongjun Lee;Chung Dae Lee;Sinjae Lee;Minha Choi
    • Korean Journal of Remote Sensing
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    • v.39 no.2
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    • pp.233-246
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    • 2023
  • In terms of understanding the water cycle and efficient water resource management, the importance of soil moisture has been highlighted. However, in Korea, the lack of qualified in-situ soil moisture data results in very limited utility. Even if satellite-based data are applied, the absence of ground reference data makes objective evaluation and correction difficult. The cosmic-ray neutron probe (CRNP) can play a key role in producing data for satellite data calibration. The installation of CRNP is non-invasive, minimizing damage to the soil and vegetation environment, and has the advantage of having a spatial representative for the intermediate scale. These characteristics are advantageous to establish an observation network in Korea which has lots of mountainous areas with dense vegetation. Therefore, this study was conducted to evaluate the applicability of the CRNP soil moisture observatory in Korea as part of the establishment of a Korean cOsmic-ray Soil Moisture Observing System (KOSMOS). The CRNP observation station was installed with the Gunup-ri observation station, considering the ease of securing power and installation sites and the efficient use of other hydro-meteorological factors. In order to evaluate the CRNP soil moisture data, 12 additional in-situ soil moisture sensors were installed, and spatial representativeness was evaluated through a temporal stability analysis. The neutrons generated by CRNP were found to be about 1,087 counts per hour on average, which was lower than that of the Solmacheon observation station, indicating that the Hongcheon observation station has a more humid environment. Soil moisture was estimated through neutron correction and early-stage calibration of the observed neutron data. The CRNP soil moisture data showed a high correlation with r=0.82 and high accuracy with root mean square error=0.02 m3/m3 in validation with in-situ data, even in a short calibration period. It is expected that higher quality soil moisture data production with greater accuracy will be possible after recalibration with the accumulation of annual data reflecting seasonal patterns. These results, together with previous studies that verified the excellence of CRNP soil moisture data, suggest that high-quality soil moisture data can be produced when constructing KOSMOS.

A Study on Appropriate Military Strength of Unified Korea (Focused on relative balance strategy and conflict scenario) (통일 한국의 적정 군사력에 관한 연구 - 분쟁 시나리오와 상대적 균형전략을 중심으로 -)

  • Hong, Bong-Gi
    • Journal of National Security and Military Science
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    • s.13
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    • pp.687-738
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    • 2016
  • To prepare for the complicated international relationship regarding Korean Peninsula after reunification, this thesis started off with the awareness that Unified Korea should build its international posture and national security at an early stage by determining its appropriate military strength for independent defense and military strategies that Unified Korea should aim. The main theme of this thesis is 'The research on appropriate military strength of the Unified Korean military'. To derive appropriate military strength of Unified Korea, this research focuses on conflict scenario and relative balance strategy based on potential threats posed by neighboring countries, and this is the part that differentiates this research from other researches. First of all, the main objective of the research is to decide appropriate military strength for Unified Korea to secure defense sufficiency. For this, this research will decide efficient military strategy that Unified Korea should aim. Than by presuming the most possible military conflict scenario, this research will judge the most appropriate military strength for Unified Korea to overcome the dispute. Second, after deciding appropriate military strength, this research will suggest how to operate presumed military strength in each armed force. The result of this thesis is as in the following. First, Unified Korea should aim 'relative balance strategy'. 'Relative balance strategy' is a military strategy which Unified Korea can independently secure defense sufficiency by maintaining relative balance when conflicts occur between neighboring countries. This strategy deters conflicts in advance by relative balance of power in certain time and place. Even if conflict occurs inevitably, this strategy secures initiative. Second, when analyzing neighboring countries interest and strategic environment after unification, the possibility of all-out war will be low in the Korean Peninsula because no other nation wants the Korean Peninsula to be subordinated to one single country. Therefore appropriate military strength of the Unified Korean military would be enough when Unified Korea can achieve relative balance in regional war or limited war. Third, Northeast Asia is a region where economic power and military strength is concentrated. Despite increasing mutual cooperation in the region, conflicts and competition to expand each countries influence is inherent. Japan is constantly enhancing their military strength as they aim for normal statehood. China is modernizing their military strength as they aspire to become global central nation. Russia is also enhancing their military strength in order to hold on to their past glory of Soviet Union as a world power. As a result, both in quality and quantity, the gap between military strength of Unified Korea and each neighboring countries is enlarged at an alarming rate. Especially in the field of air-sea power, arms race is occurring between each nation. Therefore Unified Korea should be equipped with appropriate military strength in order to achieve relative balance with each threats posed by neighboring countries. Fourth, the most possible conflicts between Unified Korea and neighboring countries could be summarized into four, which are Dokdo territorial dispute with Japan, Leodo jurisdictional dispute with China, territorial dispute concerning northern part of the Korea Peninsula with China and disputes regarding marine resources and sea routes with Russia. Based on those conflict scenarios, appropriate military strength for Unified Korea is as in the following. When conflict occurs with Japan regarding Dokdo, Japan is expected to put JMSDF Escort Flotilla 3, one out of four of its Japan Maritime Self-Defense Force Escort Fleet, which is based in Maizuru and JMSDF Maizuru District. To counterbalance this military strength, Unified Korea needs one task fleet, comprised with three task flotilla. In case of jurisdictional conflict with China concerning Leodo, China is expected to dispatch its North Sea fleet, one out of three of its naval fleet, which is in charge of the Yellow Sea. To response to this military action, Unified Korea needs one task fleet, comprised with three task flotilla. In case of territorial dispute concerning northern part of the Korean Peninsula with China, it is estimated that out of seven Military Region troops, China will dispatch two Military Region troops, including three Army Groups from Shenyang Military Region, where it faces boarder with the Korean Peninsula. To handle with this military strength, Unified Korea needs six corps size ground force strength, including three corps of ground forces, two operational reserve corps(maneuver corps), and one strategic reserve corps(maneuver corps). When conflict occurs with Russia regarding marine resources and sea routes, Russia is expected to send a warfare group of a size that includes two destroyers, which is part of the Pacific Fleet. In order to balance this strength, Unified Korea naval power requires one warfare group including two destroyers. Fifth, management direction for the Unified Korean military is as in the following. Regarding the ground force management, it would be most efficient to deploy troops in the border area with china for regional and counter-amphibious defense. For the defense except the border line with china, the most efficient form of force management would be maintaining strategic reserve corps. The naval force should achieve relative balance with neighboring countries when there is maritime dispute and build 'task fleet' which can independently handle long-range maritime mission. Of the three 'task fleet', one task fleet should be deployed at Jeju base to prepare for Dokdo territorial dispute and Leodo jurisdictional dispute. Also in case of regional conflict with china, one task fleet should be positioned at Yellow Sea and for regional conflict with Japan and Russia, one task fleet should be deployed at East Sea. Realistically, Unified Korea cannot possess an air force equal to neither Japan nor China in quantity. Therefore, although Unified Korea's air force might be inferior in quantity, they should possess the systematic level which Japan or China has. For this Unified Korea should build air base in island areas like Jeju Island or Ullenong Island to increase combat radius. Also to block off infiltration of enemy attack plane, air force needs to build and manage air bases near coastal areas. For landing operation forces, Marine Corps should be managed in the size of two divisions. For island defense force, which is in charge of Jeju Island, Ulleung Island, Dokdo Island and five northwestern boarder island defenses, it should be in the size of one brigade. Also for standing international peace keeping operation, it requires one brigade. Therefore Marine Corps should be organized into three divisions. The result of the research yields a few policy implications when building appropriate military strength for Unified Korea. First, Unified Korea requires lower number of ground troops compared to that of current ROK(Republic of Korea) force. Second, air-sea forces should be drastically reinforced. Third, appropriate military strength of the Unified Korean military should be based on current ROK military system. Forth, building appropriate military strength for Unified Korea should start from today, not after reunification. Because of this, South Korea should build a military power that can simultaneously prepare for current North Korea's provocations and future threats from neighboring countries after reunification. The core of this research is to decide appropriate military strength for Unified Korea to realize relative balance that will ensure defense sufficiency from neighboring countries threats. In other words, this research should precisely be aware of threats posed by neighboring countries and decide minimum level of military strength that could realize relative balance in conflict situation. Moreover this research will show the path for building appropriate military strength in each armed force.

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Recent Progress in Air-Conditioning and Refrigeration Research: A Review of Papers Published in the Korean Journal of Air-Conditioning and Refrigeration Engineering in 2014 (설비공학 분야의 최근 연구 동향: 2014년 학회지 논문에 대한 종합적 고찰)

  • Lee, Dae-Young;Kim, Sa Ryang;Kim, Hyun-Jung;Kim, Dong-Seon;Park, Jun-Seok;Ihm, Pyeong Chan
    • Korean Journal of Air-Conditioning and Refrigeration Engineering
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    • v.27 no.7
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    • pp.380-394
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    • 2015
  • This article reviews the papers published in the Korean Journal of Air-Conditioning and Refrigeration Engineering during 2014. It is intended to understand the status of current research in the areas of heating, cooling, ventilation, sanitation, and indoor environments of buildings and plant facilities. Conclusions are as follows. (1) The research works on the thermal and fluid engineering have been reviewed as groups of heat and mass transfer, cooling and heating, and air-conditioning, the flow inside building rooms, and smoke control on fire. Research issues dealing with duct and pipe were reduced, but flows inside building rooms, and smoke controls were newly added in thermal and fluid engineering research area. (2) Research works on heat transfer area have been reviewed in the categories of heat transfer characteristics, pool boiling and condensing heat transfer and industrial heat exchangers. Researches on heat transfer characteristics included the results for thermal contact resistance measurement of metal interface, a fan coil with an oval-type heat exchanger, fouling characteristics of plate heat exchangers, effect of rib pitch in a two wall divergent channel, semi-empirical analysis in vertical mesoscale tubes, an integrated drying machine, microscale surface wrinkles, brazed plate heat exchangers, numerical analysis in printed circuit heat exchanger. In the area of pool boiling and condensing, non-uniform air flow, PCM applied thermal storage wall system, a new wavy cylindrical shape capsule, and HFC32/HFC152a mixtures on enhanced tubes, were actively studied. In the area of industrial heat exchangers, researches on solar water storage tank, effective design on the inserting part of refrigerator door gasket, impact of different boundary conditions in generating g-function, various construction of SCW type ground heat exchanger and a heat pump for closed cooling water heat recovery were performed. (3) In the field of refrigeration, various studies were carried out in the categories of refrigeration cycle, alternative refrigeration and modelling and controls including energy recoveries from industrial boilers and vehicles, improvement of dehumidification systems, novel defrost systems, fault diagnosis and optimum controls for heat pump systems. It is particularly notable that a substantial number of studies were dedicated for the development of air-conditioning and power recovery systems for electric vehicles in this year. (4) In building mechanical system research fields, seventeen studies were reported for achieving effective design of the mechanical systems, and also for maximizing the energy efficiency of buildings. The topics of the studies included energy performance, HVAC system, ventilation, and renewable energies, piping in the buildings. Proposed designs, performance performance tests using numerical methods and experiments provide useful information and key data which can improve the energy efficiency of the buildings. (5) The field of architectural environment was mostly focused on indoor environment and building energy. The main researches of indoor environment were related to the evaluation of work noise in tunnel construction and the simulation and development of a light-shelf system. The subjects of building energy were worked on the energy saving of office building applied with window blind and phase change material(PCM), a method of existing building energy simulation using energy audit data, the estimation of thermal consumption unit of apartment building and its case studies, dynamic window performance, a writing method of energy consumption report and energy estimation of apartment building using district heating system. The remained studies were related to the improvement of architectural engineering education system for plant engineering industry, estimating cooling and heating degree days for variable base temperature, a prediction method of underground temperature, the comfort control algorithm of car air conditioner, the smoke control performance evaluation of high-rise building, evaluation of thermal energy systems of bio safety laboratory and a development of measuring device of solar heat gain coefficient of fenestration system.

The knowledge and human resources distribution system for university-industry cooperation (대학에서 창출하는 지적/인적자원에 대한 기업연계 플랫폼: 인문사회계열을 중심으로)

  • Park, Yoon-Joo
    • Journal of Intelligence and Information Systems
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    • v.20 no.3
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    • pp.133-149
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    • 2014
  • One of the main purposes of universities is to create new intellectual resources that will increase social values. These intellectual resources include academic research papers, lecture notes, patents, and creative ideas produced by both professors and students. However, intellectual resources in universities are often not distributed to the actual users or companies; and moreover, they are not even systematically being managed inside of the universities. Therefore, it is almost impossible for companies to access the knowledge created by university students and professors to utilize them. Thus, the current level of knowledge sharing between universities and industries are very low. This causes a great extravagant with high-quality intellectual and human resources, and it leads to quite an amount of social loss in the modern society. In the 21st century, the creative ideas are the key growth powers for many industries. Many of the globally leading companies such as Fedex, Dell, and Facebook have established their business models based on the innovative ideas created by university students in undergraduate courses. This indicates that the unconventional ideas from young generations can create new growth power for companies and immensely increase social values. Therefore, this paper suggests of a new platform for intellectual properties distribution with university-industry cooperation. The suggested platform distributes intellectual resources of universities to industries. This platform has following characteristics. First, it distributes not only the intellectual resources, but also the human resources associated with the knowledge. Second, it diversifies the types of compensation for utilizing the intellectual properties, which are beneficial for both the university students and companies. For example, it extends the conventional monetary rewards to non-monetary rewards such as influencing on the participating internship programs or job interviews. Third, it suggests of a new knowledge map based on the relationships between key words, so that the various types of intellectual properties can be searched efficiently. In order to design the system platform, we surveyed 120 potential users to obtain the system requirements. First, 50 university students and 30 professors in humanities and social sciences departments were surveyed. We sent queries on what types of intellectual resources they produce per year, how many intellectual resources they produce, if they are willing to distribute their intellectual properties to the industries, and what types of compensations they expect in returns. Secondly, 40 entrepreneurs were surveyed, who are potential consumers of the intellectual properties of universities. We sent queries on what types of intellectual resources they want, what types of compensations they are willing to provide in returns, and what are the main factors they considered to be important when searching for the intellectual properties. The implications of this survey are as follows. First, entrepreneurs are willing to utilize intellectual properties created by both professors and students. They are more interested in creative ideas in universities rather than the academic papers or educational class materials. Second, non-monetary rewards, such as participating internship program or job interview, can be the appropriate types of compensations to replace monetary rewards. The results of the survey showed that majority of the university students were willing to provide their intellectual properties without any monetary rewards to earn the industrial networks with companies. Also, the entrepreneurs were willing to provide non-monetary compensation and hoped to have networks with university students for recruiting. Thus, the non-monetary rewards are mutually beneficial for both sides. Thirdly, classifying intellectual resources of universities based on the academic areas are inappropriate for efficient searching. Also, the various types of intellectual resources cannot be categorized into one standard. This paper suggests of a new platform for the distribution of intellectual materials and human resources, with university-industry cooperation based on these survey results. The suggested platform contains the four major components such as knowledge schema, knowledge map, system interface, and GUI (Graphic User Interface), and it presents the overall system architecture.

Evaluation of Image Quality for Various Electronic Portal Imaging Devices in Radiation Therapy (방사선치료의 다양한 EPID 영상 질평가)

  • Son, Soon-Yong;Choi, Kwan-Woo;Kim, Jung-Min;Jeong, Hoi-Woun;Kwon, Kyung-Tae;Cho, Jeong-Hee;Lee, Jea-Hee;Jung, Jae-Yong;Kim, Ki-Won;Lee, Young-Ah;Son, Jin-Hyun;Min, Jung-Whan
    • Journal of radiological science and technology
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    • v.38 no.4
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    • pp.451-461
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    • 2015
  • In megavoltage (MV) radiotherapy, delivering the dose to the target volume is important while protecting the surrounding normal tissue. The purpose of this study was to evaluate the modulation transfer function (MTF), the noise power spectrum (NPS), and the detective quantum efficiency (DQE) using an edge block in megavoltage X-ray imaging (MVI). We used an edge block, which consists of tungsten with dimensions of 19 (thickness) ${\times}$ 10 (length) ${\times}$ 1 (width) $cm^3$ and measured the pre-sampling MTF at 6 MV energy. Various radiation therapy (RT) devices such as TrueBeam$^{TM}$ (Varian), BEAMVIEW$^{PLUS}$ (Siemens), iViewGT (Elekta) and Clinac$^{(R)}$iX (Varian) were used. As for MTF results, TrueBeam$^{TM}$(Varian) flattening filter free(FFF) showed the highest values of $0.46mm^{-1}$ and $1.40mm^{-1}$ for MTF 0.5 and 0.1. In NPS, iViewGT (Elekta) showed the lowest noise distribution. In DQE, iViewGT (Elekta) showed the best efficiency at a peak DQE and $1mm^{-1}DQE$ of 0.0026 and 0.00014, respectively. This study could be used not only for traditional QA imaging but also for quantitative MTF, NPS, and DQE measurement for development of an electronic portal imaging device (EPID).

A Study on the Necessity of Making Online Marketplace for the Korean Animation Industry (국내 애니메이션 산업의 온라인 마켓플레이스 구축 필요성 연구)

  • Han, Sang-Gyun
    • Cartoon and Animation Studies
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    • s.24
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    • pp.223-246
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    • 2011
  • Today, cultural content industry could be defined to service business rather than manufacturing business because of its own trait. Also, it has the realistic restriction that it can't hold the dominant position in the market competition when it can't provide consumers satisfaction regardless of its quality or degree of completion. In other word, it can only expect great success when the business plan and the activities get the perfect balance with its best quality and perfect of completion. As the result, it emphasizes the importance of business competition in the global market. In briefly, there is no doubt that the creativeness of content is very important in the cultural content industry but in the future, making system to maintain the distribution process and share the profits fairly will be taken more important role. Especially, animation genre has the feature, which compares to other genres, such as film or TV drama, would be free from cultural barriers, and it is a great advantage. So to speak, animation can get little influence from cultural discount. However, Korean animation can't use the advantage properly for the foreign distribution because of its poor infrastructure and short of professional human resources. For those reasons, it has been needed to set up the realistic and specific action plan to overcome the situation. Therefore, considering those needs and the situations of Korean animation facing, making B2B online marketplace could be a great solution. The online marketplace stands for taking more efficient and broad distribution channel instead of the passive way, which we have now. If we have the B2B online marketplace, we can share all the information about the Korean animation with the potential customers whom live outside of Korea at real time. It also could be use to the windows of multiple distribution, which can make additional profits and activate the optional markets for the Korean animation. Through the method, Korean animation would be expected to get the higher international competitiveness, and it would be developed in quality and quantity of the business. Finally, it would be a great chance to Korean animation, which can get the unique brand power by improving the backward distribution circumstances.

Ecological Role of Urban Stream and Its Improvement (도시하천의 생태학적 역할과 개선방안)

  • Son, Myoung-Won
    • Journal of the Korean association of regional geographers
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    • v.4 no.1
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    • pp.15-25
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    • 1998
  • A stream plays an important role as the source of drinking water, the ecological space and the living space. But the today's urban stream whose ecosystem is destroyed and water quality become worse in consequence of covering, concrete dyke construction, and the adjustment of high-water-ground[dunchi], is deprived of the function as a stream. Therefore this paper aims to elucidate the role that urban stream plays ecologically and to try to find a improvement to the problem. A stream is the pathway through which several types of the solar radiation energy are transmitted and the place which is always full of life energy. In the periphery of a stream, primary productivity is high and carrying capacity of population is great. Thus ancient cities based on agricultural products grew out of the fertile surroundings of stream. In Korea most cities of the Chosen Dynasty Period based on the agriculture have grown out of the erosional basins where solar energy is concentrated. The role of a stream in this agricultural system is the source of energy and material(water and sediment) and a lifeline. In consequence of the growth of cities and the rapid growing demands of water supply after the Industrial Revolution, a stream has become a more important locational factor of city. However, because cities need the life energy of urban streams no longer, urban streams cannot play role as a lifeline. And As pollutant waste water has poured into urban streams after using external streams' water, urban streams have degraded to the status of a ditch. As the results of the progress of urbanization, the dangerousness of inundation of urban stream increased and its water quality became worse. For the sake of holding back it, local governments constructed concrete dyke, adjusted high-water-ground[dunchi], and covered the channel. But stream ecosystem went to ruin and its water quality became much worse after channelization. These problems of urban stream can be solved by transmitting much energy contained in stream to land ecosystem as like rural stream. We should dissipate most of the energy contained in urban stream by cultivating wetland vegetation from the shore of stream to high-water-ground, and should recover a primitive natural vigorous power by preparation of ecological park.

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An Operations Study on a Home Health Nursing Demonstration Program for the Patients Discharged with Chronic Residual Health Care Problems (추후관리가 필요한 만성질환 퇴원환자 가정간호 시범사업 운영 연구)

  • 홍여신;이은옥;이소우;김매자;홍경자;서문자;이영자;박정호;송미순
    • Journal of Korean Academy of Nursing
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    • v.20 no.2
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    • pp.227-248
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    • 1990
  • The study was conceived in relation to a concern over the growing gap between the needs of chronic patients and the availability of care from the current health care system in Korea. Patients with agonizing chronic pain, discomfort, despair and disability are left with helplessly unprepared families with little help from the acute care oriented health care system after discharge from hospital. There is a great need for the development of an alternative means of quality care that is economically feasible and culturally adaptible to our society. Thus, the study was designed to demonstrate the effectiveness of home heath care as an alternative to bridge the existing gap between the patients' needs and the current practice of health care. The study specifically purports to test the effects of home care on health expenditure, readmission, job retention, compliance to health care regime, general conditions, complications, and self-care knowledge and practices. The study was guided by the operations research method advocated by the Primary Health Care Operations Research Institute(PRICOR) which constitutes 3 stages of research : namely, problem analysis solution development, and solution validation. The first step in the operations research was field preparation to develop the necessary consensus and cooperation. This was done through the formation of a consulting body at the hospital and a steering committee among the researchers. For the stage of problem analysis, the Annual Report of Seoul National University Hospital and the patients records for last 5 years were reviewed and selective patient interviews were conducted to find out the magnitude of chronic health problems and areas of unmect health care needs to finally decide on the kinds of health problems to study. On the basis of problem analysis, the solution development stage was devoted to home care program development asa solution alternative. Assessment tools, teaching guidelines and care protocols were developed and tested for their validity. The final stage was the stage of experimentation and evaluation. Patients with liver diseases, hemiplegic and diabetic conditions were selected as study samples. Discharge evaluation, follow up home care, measurement and evaluation were carried out according to the protocols of care and measurement plan for each patient for the period of 6 months after discharge. The study was carried out for the period from Jan. 1987 to Dec. 1989. The following are the results of the study presented according to the hypotheses set forth for the study ; 1. Total expenditures for the period of study were not reduced for the experimental group, however, since the cost per hospital visit is about 4 times as great as the cost per home visit, the effect of cost saving by home care will become a reality as home care replaces part of the hospital visits. 2. The effect on the rate of readmission and job retention was found to be statistically nonsignificant though the number of readmission was less among the experimental group receiving home care. 3. The effect on compliance to the health care regime was found to be statistically significant at the 5% level for hepatopathic and diabetic patients. 4. Education on diet, rest and excise, and medication through home care had an effect on improved liver function test scores, prevention of complications and self - care knowledge in hepatopathic patients at a statistically significant level. 5. In hemiplegic patient, home care had an effect on increased grasping power at a significant level. However. there was no significant difference between the experimental and control groups in the level of compliane, prevention of complications or in self-care practices. 6. In diabetic patients, there was no difference between the experimental and control groups in scores of laboratory tests, appearance of complications, and self-care knowledge or self -care practices. The above findings indicate that a home care program instituted for such short term as 6 months period could not totally demonstrate its effectiveness at a statistically significant level by quantitative analysis however, what was shown in part in this analysis, and in the continuous consultation sought by those who had been in the experimental group, is that home health care has a great potential in retarding or preventing pathological progress, facilitating rehabilitative and productive life, and improving quality of life by adding comfort, confidence and strength to patients and their families. For the further studies of this kind with chronic patients it is recommended that a sample of newly diagnosed patients be followed up for a longer period of time with more frequent observations to demonstrate a more dear- cut picture of the effectiveness of home care.

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