• Title/Summary/Keyword: Pre-feasibility

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A study on the improvement of the protective shield construction method and explosion-proof tube performance for tunnel blasting (터널 발파에 대한 방호쉴드 공법 및 방폭튜브 성능 개선 연구)

  • Sang-Hwan Kim;Soo-Jin Lee;Jung-Nam Kwon;Dong-gyun Yoo;Yong-Woo Kim;Kwang-Eun Cho
    • Journal of Korean Tunnelling and Underground Space Association
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    • v.25 no.4
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    • pp.285-303
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    • 2023
  • Interest in building underground spaces is increasing for the creation of downtown infrastructure and efficient space utilization. A representative method of utilizing underground space is a tunnel, and in addition to road tunnels, the construction of utility tunnels such as power conduits and utility conduits is gradually increasing. The current basic tunnel construction method can be divided into NATM (New Austrian Tunnelling Method) and TBM (Tunnel Boring Machine). The NATM is a reliable method, but it is accompanied by vibration and noise due to blasting. In the case of the TBM excavation method, there are disadvantages in terms of construction period and construction cost, but it is possible to improve economic feasibility by introducing appropriate complementary methods. In this study, a blasting method was develop using the NATM after TBM pre-excavation using the protective shield method. This is a method that compensates for the disadvantages of each tunnel construction method, and is expected to reduce construction costs, blasting vibration, and noise. In order to review the performance of the developed method, an experiment was conducted to evaluate the performance of explosion-proof tube to which a protective shield scale model was applied, and the impact of blasting vibration of the protective shield method was analyzed.

Application Feasibility Study of Non-local Means Algorithm in a Miniaturized Vein Near-infrared Imaging System (정맥 관찰용 소형 근적외선 영상 시스템에서의 비지역적평균 알고리즘 적용 가능성 연구)

  • Hyun-Woo Jeong;Youngjin Lee
    • Journal of the Korean Society of Radiology
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    • v.17 no.5
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    • pp.679-684
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    • 2023
  • Venous puncture is widely used to obtain blood samples for pathological examination. Because the invasive venipuncture method using a needle is repeatedly performed, the pain suffered by the patient increases, so our research team pre-developed a miniaturized near-infrared (NIR) imaging system in advance. To improve the image quality of the acquired NIR images, this study aims to model the non-local means (NLM) algorithm, which is well known to be efficient in noise reduction, and analyze its applicability in the system. The developed NIR imaging system is based on the principle that infrared rays pass through dichroic and long-pass filters and are detected by a CMOS sensor module. The proposed NLM algorithm is modeled based on the principle of replacing the pixel from which noise is to be removed with a value that reflects the distances between surrounding pixels. After acquiring an NIR image with a central wavelength of 850 nm, the NLM algorithm was applied to segment the final vein area through histogram equalization. As a result, the coefficient of variation of the NIR image of the vein using the NLM algorithm was 0.247 on average, which was an excellent result compared to conventional filtering methods. In addition, the dice similarity coefficient value of the NLM algorithm was improved by 62.91 and 9.40%, respectively, compared to the median filter and total variation methods. In conclusion, we demonstrated that the NLM algorithm can acquire accurate segmentation of veins acquired with a NIR imaging system.

Fabrication of Porous Cu Layers on Cu Pillars through Formation of Brass Layers and Selective Zn Etching, and Cu-to-Cu Flip-chip Bonding (황동층의 형성과 선택적 아연 에칭을 통한 구리 필라 상 다공성 구리층의 제조와 구리-구리 플립칩 접합)

  • Wan-Geun Lee;Kwang-Seong Choi;Yong-Sung Eom;Jong-Hyun Lee
    • Journal of the Microelectronics and Packaging Society
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    • v.30 no.4
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    • pp.98-104
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    • 2023
  • The feasibility of an efficient process proposed for Cu-Cu flip-chip bonding was evaluated by forming a porous Cu layer on Cu pillar and conducting thermo-compression sinter-bonding after the infiltration of a reducing agent. The porous Cu layers on Cu pillars were manufactured through a three-step process of Zn plating-heat treatment-Zn selective etching. The average thickness of the formed porous Cu layer was approximately 2.3 ㎛. The flip-chip bonding was accomplished after infiltrating reducing solvent into porous Cu layer and pre-heating, and the layers were finally conducted into sintered joints through thermo-compression. With reduction behavior of Cu oxides and suppression of additional oxidation by the solvent, the porous Cu layer densified to thickness of approximately 1.1 ㎛ during the thermo-compression, and the Cu-Cu flip-chip bonding was eventually completed. As a result, a shear strength of approximately 11.2 MPa could be achieved after the bonding for 5 min under a pressure of 10 MPa at 300 ℃ in air. Because that was a result of partial bonding by only about 50% of the pillars, it was anticipated that a shear strength of 20 MPa or more could easily be obtained if all the pillars were induced to bond through process optimization.

Pre- and Immediate Post-Kasai Portoenterostomy Shear Wave Elastography for Predicting Hepatic Fibrosis and Native Liver Outcomes in Patients With Biliary Atresia

  • Haesung Yoon;Kyong Ihn;Jisoo Kim;Hyun Ji Lim;Sowon Park;Seok Joo Han;Kyunghwa Han;Hong Koh;Mi-Jung Lee
    • Korean Journal of Radiology
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    • v.24 no.5
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    • pp.465-475
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    • 2023
  • Objective: To evaluate the feasibility of ultrasound shear wave elastography (SWE) for predicting hepatic fibrosis and native liver outcomes in patients with biliary atresia. Materials and Methods: This prospective study included 33 consecutive patients with biliary atresia (median age, 8 weeks [interquartile range, 6-10 weeks]; male:female ratio, 15:18) from Severance Children's Hospital between May 2019 and February 2022. Preoperative (within 1 week from surgery) and immediate postoperative (on postoperative days [PODs] 3, 5, and 7) ultrasonographic findings were obtained and analyzed, including the SWE of the liver and spleen. Hepatic fibrosis, according to the METAVIR score at the time of Kasai portoenterostomy and native liver outcomes during postsurgical follow-up, were compared and correlated with imaging and laboratory findings. Poor outcomes were defined as intractable cholangitis or liver transplantation. The diagnostic performance of SWE in predicting METAVIR F3-F4 and poor hepatic outcomes was analyzed using receiver operating characteristic (ROC) analyses. Results: All patients were analyzed without exclusion. Perioperative advanced hepatic fibrosis (F3-F4) was associated with older age and higher preoperative direct bilirubin and SWE values in the liver and spleen. Preoperative liver SWE showed a ROC area of 0.806 and 63.6% (7/11) sensitivity and 86.4% (19/22) specificity at a cutoff of 17.5 kPa for diagnosing F3-F4. The poor outcome group included five patients with intractable cholangitis and three undergoing liver transplantation who showed high postoperative liver SWE values. Liver SWE on PODs 3-7 showed ROC areas of 0.783-0.891 for predicting poor outcomes, and a cutoff value of 10.3 kPa for SWE on POD 3 had 100% (8/8) sensitivity and 73.9% (17/23) specificity. Conclusion: Preoperative liver SWE can predict advanced hepatic fibrosis, and immediate postoperative liver SWE can predict poor native liver outcomes in patients with biliary atresia.

A Study on Factors Influencing The State of Adaptation of The Hemiplegic Patients (편마비 환자의 퇴원후 적응상태와 관련요인에 대한 분석적 연구)

  • 서문자
    • Journal of Korean Academy of Nursing
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    • v.20 no.1
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    • pp.88-117
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    • 1990
  • The purposes of this study are to delineate a profile of the state of a stroke patient's adaptation at 3 months after hospitalization and to explore the relationship between the level of adaptation and the variables which influence the adaptation of hemiplegic patients. To these ends, theoretical framework was derived basically from the stress adaptation model. The basic assumption underlying the level of adaptation is influenced by the presenting focal, contextual and residual stimuli. This group of stimuli is further operationalized and represented by a perception of stress. which is the perceived effect of the disability and by the mediating variables such as sociodemographic factors as an external conditioning variables and perceived social support and hardiness personality characteristics as an internal intervening variables. The dependent varibales in this study is the level of physical, psychological and social adaptation and is hypothesized to be a function of the interaction between 3 sets of variables namely, the perceived disability effect, external conditioning variables and internal intevening varibles. A total of fourty three subjects from 3 general hospitals in Seoul were observed and interviewed with the aid of 7 structured instruments. The data were collected twice on each subject : first at the pre-discharge period arid at 3 months post-discharge from hospital for the second time. The study was carried out for the period from February to August, 1988. The instruments used for the study include 4 existing scales and 3 scales developed by the researcher for this study. They are : 1) The ADL dependency scale and the scale of the clinical physical functions for the assessment of physical adaptation. 2) the SDS(self report of depression) to measure the level of psychological adaptation. 3) The scale for the amount of social activities for the measurement of the level of social adaptation. 4) The scale for the perceived effect of disability for the measurement of the focal stimuli. 5) The health related hardiness scale and the perceived interpersonal support self evaluation list(ISEL) for the measurement of the hardiness personality character and the perceived social support. The data obtained were analyzed using percentage, oneway ANOVA, Pearson coefficients correlation and stepwise multiple regression. The findings provide valuable information about the present level of physical adaptation at 3 months after discharge. The patient revealed a decreased ADL dependency and lowered limitation of physical function as compared with pre - discharge state. Psycholcgically, the average degree of depression at follow up was within normal range of depression. Socially, the amount of social activities was very low. The one way ANOVA and the correlational analysis revealed the relationship between the 3 sets of variables and the adaptation level as follows : 1) The perceived disability effect was related to the degree of the depression and the amount of social activities but was not related to the physical adaptation. 2) Among the sociodemographic variables, sex and education were related to the difference of ADL dependency and the change of physical function. These factors indicate that women more than men and educated more than the less educated were found more independent. The education was also related to the degree of depression suggesting that the higher the educational level, the more well adapted the patients were both physically and psychologically. Age, marital status and job state were not found to be related to the patient's adaptation level. 3) Among the internal intervening variables, the health related hardiness characteristic was related to the differences of ADL dependency, physical functions and the social activities, indicating that the higher the hardiness character the higher the level of physical and social adaptation. 4) The perceived social support, another internal intervening variable, was related to the degree of depression and the social activities. This data suggest that the higher the perception of social support, the better adapted the patients were psychogically and socially. In summarizing the results of the correlational analysis, the level of physical adaptation was influenced by sex, the years of education and the hardiness character. The level of psychological adaptation was influenced by the years of education, the perceived disability effect and the perceived social support. And the level of social adaptation was influenced by the perceived disability effect, the hardiness character and the perceived social support. The stepwise multiple regression analysis shows findings as follows : 1) The most important factor to explain the difference of ADL dependency was sex, indicating females were more independent than males. 2) The most important factor to explain the difference of physical function and the degree of depression was the patient's education level. 3) The strongest explaining factor for the amount of social activities was perceived self esteem(one of the subconcepts of perceived social support). Thus the most important factors influencing the level of adaptation were found to be sex, education, the hardiness character and self esteem. From the above findings, the significance of this study can be delineated as follows : 1) Corroboration of the assumed relationship between the various variables and the adaptation level as suggested in the conceptual model. 2) Support for the feasibility of the cognitive approach for nursing intervention such as hardness character training, counselling and teaching for self-care in the chronic patients.

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Extraction of Carotenoid from Phaffia rhodozyma by Combining Permeabilizing Methods and Pulsed Electric Fields Treatments (투과성 증진 방법과 펄스전기장의 병합처리에 의한 Phaffia rhodozyma로부터의 Carotenoid 추출)

  • Kim, Nam-Hoon;Shin, Jung-Kue;Lee, Seok-Hoon;Cho, Hyung-Yong;Pyun, Yu-Ryang
    • Korean Journal of Food Science and Technology
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    • v.31 no.6
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    • pp.1529-1535
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    • 1999
  • This study was done for the extraction of carotenoid from Phaffia rhodozyma in combination with PEF and other methods. PEF treatment conditions were $30{\sim}80\;kV/cm,\;100{\sim}1000\;Hz\;and\;100{\sim}1000\;{\mu}s$. In order to increase permeability of yeast cell wall, various methods such as freezing-thawing, mechanical treatment, solvents, permeabilizing agents, and yeast cell wall lytic enzyme were used before PEF treatment. The combination of PEF $(50\;kV/cm,\;300\;Hz,\;1000\;{\mu}s)$ and conventional methods such as solvent and freezing-thawing pre-treatment had no effects on the extraction of carotenoid pigments. The extent of extracted carotenoid by the PEF $treatment(50\;kV/cm,\;300\;Hz,\;1000\;{\mu}s)$ combined with yeast cell wall lytic enzyme and mechanical pre-treatment increased 52% and 69.8% more than the sum of that by each treatment, respectively. Permeabilizing agents, especially Tween 20 and capric acid, enhanced the extraction efficiency of carotenoid pigments from P. rhodozyma cells. These results indicated the feasibility for the continuous extracting carotenoid pigments from P. rhodozyma by PEF combined with other permeabilizing methods.

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Deep Learning-based Professional Image Interpretation Using Expertise Transplant (전문성 이식을 통한 딥러닝 기반 전문 이미지 해석 방법론)

  • Kim, Taejin;Kim, Namgyu
    • Journal of Intelligence and Information Systems
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    • v.26 no.2
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    • pp.79-104
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    • 2020
  • Recently, as deep learning has attracted attention, the use of deep learning is being considered as a method for solving problems in various fields. In particular, deep learning is known to have excellent performance when applied to applying unstructured data such as text, sound and images, and many studies have proven its effectiveness. Owing to the remarkable development of text and image deep learning technology, interests in image captioning technology and its application is rapidly increasing. Image captioning is a technique that automatically generates relevant captions for a given image by handling both image comprehension and text generation simultaneously. In spite of the high entry barrier of image captioning that analysts should be able to process both image and text data, image captioning has established itself as one of the key fields in the A.I. research owing to its various applicability. In addition, many researches have been conducted to improve the performance of image captioning in various aspects. Recent researches attempt to create advanced captions that can not only describe an image accurately, but also convey the information contained in the image more sophisticatedly. Despite many recent efforts to improve the performance of image captioning, it is difficult to find any researches to interpret images from the perspective of domain experts in each field not from the perspective of the general public. Even for the same image, the part of interests may differ according to the professional field of the person who has encountered the image. Moreover, the way of interpreting and expressing the image also differs according to the level of expertise. The public tends to recognize the image from a holistic and general perspective, that is, from the perspective of identifying the image's constituent objects and their relationships. On the contrary, the domain experts tend to recognize the image by focusing on some specific elements necessary to interpret the given image based on their expertise. It implies that meaningful parts of an image are mutually different depending on viewers' perspective even for the same image. So, image captioning needs to implement this phenomenon. Therefore, in this study, we propose a method to generate captions specialized in each domain for the image by utilizing the expertise of experts in the corresponding domain. Specifically, after performing pre-training on a large amount of general data, the expertise in the field is transplanted through transfer-learning with a small amount of expertise data. However, simple adaption of transfer learning using expertise data may invoke another type of problems. Simultaneous learning with captions of various characteristics may invoke so-called 'inter-observation interference' problem, which make it difficult to perform pure learning of each characteristic point of view. For learning with vast amount of data, most of this interference is self-purified and has little impact on learning results. On the contrary, in the case of fine-tuning where learning is performed on a small amount of data, the impact of such interference on learning can be relatively large. To solve this problem, therefore, we propose a novel 'Character-Independent Transfer-learning' that performs transfer learning independently for each character. In order to confirm the feasibility of the proposed methodology, we performed experiments utilizing the results of pre-training on MSCOCO dataset which is comprised of 120,000 images and about 600,000 general captions. Additionally, according to the advice of an art therapist, about 300 pairs of 'image / expertise captions' were created, and the data was used for the experiments of expertise transplantation. As a result of the experiment, it was confirmed that the caption generated according to the proposed methodology generates captions from the perspective of implanted expertise whereas the caption generated through learning on general data contains a number of contents irrelevant to expertise interpretation. In this paper, we propose a novel approach of specialized image interpretation. To achieve this goal, we present a method to use transfer learning and generate captions specialized in the specific domain. In the future, by applying the proposed methodology to expertise transplant in various fields, we expected that many researches will be actively conducted to solve the problem of lack of expertise data and to improve performance of image captioning.

Using the METHONTOLOGY Approach to a Graduation Screen Ontology Development: An Experiential Investigation of the METHONTOLOGY Framework

  • Park, Jin-Soo;Sung, Ki-Moon;Moon, Se-Won
    • Asia pacific journal of information systems
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    • v.20 no.2
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    • pp.125-155
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    • 2010
  • Ontologies have been adopted in various business and scientific communities as a key component of the Semantic Web. Despite the increasing importance of ontologies, ontology developers still perceive construction tasks as a challenge. A clearly defined and well-structured methodology can reduce the time required to develop an ontology and increase the probability of success of a project. However, no reliable knowledge-engineering methodology for ontology development currently exists; every methodology has been tailored toward the development of a particular ontology. In this study, we developed a Graduation Screen Ontology (GSO). The graduation screen domain was chosen for the several reasons. First, the graduation screen process is a complicated task requiring a complex reasoning process. Second, GSO may be reused for other universities because the graduation screen process is similar for most universities. Finally, GSO can be built within a given period because the size of the selected domain is reasonable. No standard ontology development methodology exists; thus, one of the existing ontology development methodologies had to be chosen. The most important considerations for selecting the ontology development methodology of GSO included whether it can be applied to a new domain; whether it covers a broader set of development tasks; and whether it gives sufficient explanation of each development task. We evaluated various ontology development methodologies based on the evaluation framework proposed by G$\acute{o}$mez-P$\acute{e}$rez et al. We concluded that METHONTOLOGY was the most applicable to the building of GSO for this study. METHONTOLOGY was derived from the experience of developing Chemical Ontology at the Polytechnic University of Madrid by Fern$\acute{a}$ndez-L$\acute{o}$pez et al. and is regarded as the most mature ontology development methodology. METHONTOLOGY describes a very detailed approach for building an ontology under a centralized development environment at the conceptual level. This methodology consists of three broad processes, with each process containing specific sub-processes: management (scheduling, control, and quality assurance); development (specification, conceptualization, formalization, implementation, and maintenance); and support process (knowledge acquisition, evaluation, documentation, configuration management, and integration). An ontology development language and ontology development tool for GSO construction also had to be selected. We adopted OWL-DL as the ontology development language. OWL was selected because of its computational quality of consistency in checking and classification, which is crucial in developing coherent and useful ontological models for very complex domains. In addition, Protege-OWL was chosen for an ontology development tool because it is supported by METHONTOLOGY and is widely used because of its platform-independent characteristics. Based on the GSO development experience of the researchers, some issues relating to the METHONTOLOGY, OWL-DL, and Prot$\acute{e}$g$\acute{e}$-OWL were identified. We focused on presenting drawbacks of METHONTOLOGY and discussing how each weakness could be addressed. First, METHONTOLOGY insists that domain experts who do not have ontology construction experience can easily build ontologies. However, it is still difficult for these domain experts to develop a sophisticated ontology, especially if they have insufficient background knowledge related to the ontology. Second, METHONTOLOGY does not include a development stage called the "feasibility study." This pre-development stage helps developers ensure not only that a planned ontology is necessary and sufficiently valuable to begin an ontology building project, but also to determine whether the project will be successful. Third, METHONTOLOGY excludes an explanation on the use and integration of existing ontologies. If an additional stage for considering reuse is introduced, developers might share benefits of reuse. Fourth, METHONTOLOGY fails to address the importance of collaboration. This methodology needs to explain the allocation of specific tasks to different developer groups, and how to combine these tasks once specific given jobs are completed. Fifth, METHONTOLOGY fails to suggest the methods and techniques applied in the conceptualization stage sufficiently. Introducing methods of concept extraction from multiple informal sources or methods of identifying relations may enhance the quality of ontologies. Sixth, METHONTOLOGY does not provide an evaluation process to confirm whether WebODE perfectly transforms a conceptual ontology into a formal ontology. It also does not guarantee whether the outcomes of the conceptualization stage are completely reflected in the implementation stage. Seventh, METHONTOLOGY needs to add criteria for user evaluation of the actual use of the constructed ontology under user environments. Eighth, although METHONTOLOGY allows continual knowledge acquisition while working on the ontology development process, consistent updates can be difficult for developers. Ninth, METHONTOLOGY demands that developers complete various documents during the conceptualization stage; thus, it can be considered a heavy methodology. Adopting an agile methodology will result in reinforcing active communication among developers and reducing the burden of documentation completion. Finally, this study concludes with contributions and practical implications. No previous research has addressed issues related to METHONTOLOGY from empirical experiences; this study is an initial attempt. In addition, several lessons learned from the development experience are discussed. This study also affords some insights for ontology methodology researchers who want to design a more advanced ontology development methodology.

Inferring the Transit Trip Destination Zone of Smart Card User Using Trip Chain Structure (통행사슬 구조를 이용한 교통카드 이용자의 대중교통 통행종점 추정)

  • SHIN, Kangwon
    • Journal of Korean Society of Transportation
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    • v.34 no.5
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    • pp.437-448
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    • 2016
  • Some previous researches suggested a transit trip destination inference method by constructing trip chains with incomplete(missing destination) smart card dataset obtained on the entry fare control systems. To explore the feasibility of the transit trip destination inference method, the transit trip chains are constructed from the pre-paid smart card tagging data collected in Busan on October 2014 weekdays by tracing the card IDs, tagging times(boarding, alighting, transfer), and the trip linking distances between two consecutive transit trips in a daily sequences. Assuming that most trips in the transit trip chains are linked successively, the individual transit trip destination zones are inferred as the consecutive linking trip's origin zones. Applying the model to the complete trips with observed OD reveals that about 82% of the inferred trip destinations are the same as those of the observed trip destinations and the inference error defined as the difference in distance between the inferred and observed alighting stops is minimized when the trip linking distance is less than or equal to 0.5km. When applying the model to the incomplete trips with missing destinations, the overall destination missing rate decreases from 71.40% to 21.74% and approximately 77% of the destination missing trips are the single transit trips for which the destinations can not be inferable. In addition, the model remarkably reduces the destination missing rate of the multiple incomplete transit trips from 69.56% to 6.27%. Spearman's rank correlation and Chi-squared goodness-of-fit tests showed that the ranks for transit trips of each zone are not significantly affected by the inferred trips, but the transit trip distributions only using small complete trips are significantly different from those using complete and inferred trips. Therefore, it is concluded that the model should be applicable to derive a realistic transit trip patterns in cities with the incomplete smart card data.

A basic research for evaluation of a Home Care Nursing Delivery System (가정간호 서비스 질 평가를 위한 도구개발연구)

  • Kim, Mo-Im;Cho, Won-Jung;Kim, Eui-Sook;Kim, Sung-Kyu;Chang, Soon-Bok;Ryu, Ho-Sihn
    • Journal of Home Health Care Nursing
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    • v.6
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    • pp.33-45
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    • 1999
  • The purpose of this study was to develop a basic framework and criteria for evaluation of quality care provided to patients with the attributes of disease in the home care nursing field, and to provide measurement tools for home health care in the future. The study design was a developmental study for evaluation of hospital-based HCN(home care nursing) in Korea. The study process was as follows: a home care nursing study team of College of Nursing. Yonsei University reviewed the nursing records of 47 patients who were enrolled at Yonsei University Medical Center Home Care Center in March, 1995. Twenty-five patients were insured at that time, were selected from 47 patients receiving home care service for study feasibility with six disease groups; Caesarean Section (C/S), simple nephrectomy, Liver cirrhosis(LC), chronic obstructive pulmonary disease(COPD), Lung cancer or cerebrovascular accident(CVA). In this study, the following items were selected : First step : Preliminary study 1. Criteria and items were selected on the basis of related literature on each disease area. 2. Items were identified by home care nurses. 3. A physician in charge reviewed the criteria and content of selected items. 4. Items were revised through preliminary study offered to both HCN patients and discharged patients from the home care center. Second step : Pretest 1. To verify the content of the items, a pretest was conducted with 18 patients of which there were three patients in each of the six selected disease groups. Third step : Test of reliability and validity of tools 1. Using the collected data from 25 patients with either cis, Simple nephrectomy, LC, COPD, Lung cancer, or CVA. the final items were revised through a panel discussion among experts in medical care who were researchers, doctors, or nurses. 2. Reliability and validity of the completed tool were verified with both inpatients and HCN patients in each of field for researches. The study results are as follows: 1. Standard for discharge with HCN referral The referral standard for home care, which included criteria for discharge with HCN referral and criteria leaving the hospital were established. These were developed through content analysis from the results of an open-ended questionnaire to related doctors concerning characteristic for discharge with HCN referral for each of the disease groups. The final criteria was decided by discussion among the researchers. 2. Instrument for measurement of health statusPatient health status was measured pre and post home care by direct observation and interview with an open-ended questionnaire which consisted of 61 items based on Gorden's nursing diagnosis classification. These included seven items on health knowledge and health management, eight items on nutrition and metabolism, three items on elimination, five items on activity and exercise, seven items on perception and cognition, three items on sleep and rest, three items on self-perception, three items on role and interpersonal relations, five items on sexuality and reproduction, five items on coping and stress, four items on value and religion, three items on family. and three items on facilities and environment. 3. Instrument for measurement of self-care The instrument for self-care measurement was classified with scales according to the attributes of the disease. Each scale measured understanding level and practice level by a Yes or No scale. Understanding level was measured by interview but practice level was measured by both observation and interview. Items for self-care measurement included 14 for patients with a CVA, five for women who had a cis, ten for patients with lung cancer, 12 for patients with COPD, five for patients with a simple nephrectomy, and 11 for patients with LC. 4. Record for follow-up management This included (1) OPD visit sheet, (2) ER visit form, (3) complications problem form, (4) readmission sheet. and (5) visit note for others medical centers which included visit date, reason for visit, patient name, caregivers, sex, age, time and cost required for visit, and traffic expenses, that is, there were open-end items that investigated OPD visits, emergency room visits, the problem and solution of complications, readmissions and visits to other medical institution to measure health problems and expenditures during the follow up period. 5. Instrument to measure patients satisfaction The satisfaction measurement instrument by Reisseer(1975) was referred to for the development of a tool to measure patient home care satisfaction. The instrument was an open-ended questionnaire which consisted of 11 domains; treatment, nursing care, information, time consumption, accessibility, rapidity, treatment skill, service relevance, attitude, satisfaction factors, dissatisfaction factors, overall satisfaction about nursing care, and others. In conclusion, Five evaluation instruments were developed for home care nursing. These were (1)standard for discharge with HCN referral. (2)instrument for measurement of health status, (3)instrument for measurement of self-care. (4)record for follow-up management, and (5)instrument to measure patient satisfaction. Also, the five instruments can be used to evaluate the effectiveness of the service to assure quality. Further research is needed to increase the reliability and validity of instrument through a community-based HCN evaluation.

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