The purposes of this study were to investigate the therapeutic effects of an early exercise program after mastectomy and to provide the early exercise program protocol for patients who had undergone mastectomy. The subjects were seventy women who were diagnosed with breast cancer. They were randomly as signed either to a experimental group (n=35) that received early postoperative exercise program or to a control group (n=35) that received only education by nurses. Data were obtained for each patient from goniometric measurements of shoulder flexion, abduction, external rotation, 10 elements of functional performance, and subjective pain evaluation using visual analogue scale (VAS). All variables were measured preoperatively, three days postoperatively, and one month postoperatively. Data were compared by groups using independent t-test and Mann-Whitney U test for parametric or non-parametric data, respectively. There were no significant differences between the groups for all variables preoperatively and at three days postoperatively. But there were significant differences at one month postoperatively. The experimental group showed a statistically significant increases in shoulder flexion, abduction, and external rotation and in the pain VAS at one month postoperatively (p<.05). Also, at one month postoperatively, the experimental group had less difficulty with three elements of functional performance-doing up a 'back' zippered article of clothing, reaching the ipsilateral scapula, and contralateral scapula with the fingers on the operated side-than the control group (p<.05). The results of this study suggest that, after mastectomy, the early exercise program conducted by a well-trained physical therapist can make a significant contribution to the return of more normal shoulder function and activities of daily living and to an increased quality of life.
This study was conducted to develop job standards for clinical dietitian administering clinical nutrition therapy to diabetic patients in hospitals. Based on DACUM (Developing A Curriculum) analysis of 17 members including clinical dietitians, professors majoring in clinical nutrition and researchers, information on duties, tasks and task elements of clinical dietitians for diabetes care were derived and applied to diabetes mellitus-specific clinical nutrition care in hospitals for evaluation. The final developed job standards for clinical dietitians for diabetes care included four duties, 19 tasks and 56 task elements. The duties consisted of nutrition assessment, nutrition diagnosis, nutrition intervention, and nutrition monitoring evaluation. For application of diabetes mellitus-specific job standards in clinical nutrition care, 108 work activities were developed and classified into 90 basic and 18 recommended types. Performance rates of standardized jobs were 80.2% at nutrition assessment, 99.6% at nutrition diagnosis, 78.5% at nutrition intervention, and 32.9% at nutrition monitoring evaluation. These results can be applied as guidelines to implement jobs for diabetes mellitus-specific clinical nutrition services in clinical settings. In addition, they would be useful for education standards in educational institutions for education and training of clinical dietitian.
This study aimed at understanding the spatial characteristics in the Tugendhat house. For this study, it is need to analyze the early plans of the Tugendhat house design process. To analyze this, the study leads to how to effect on the real practice with the process. Therefore, this research investigates the conceptional design process of the house. There are 2 main characteristics of the interior space alternation. One is the closed spatial character on the 2nd floor, the other is the open spatial character on the 1st floor. It clearly shows the severance between interior and exterior on the 2nd floor. Each 2nd floor's space volume uses different materials so that each the space can show the individuality. On the 1st floor, however, it seems the interior is not as much open to the exterior, because the materiality and reflection of the glass, the objet of furniture and wall. In case of 1st floor, it has a complex concept as open and close character, because it is using the proper gardening elements and the relationship between the house and site. The exterior characteristic is separated the house from the ground with the podium and the slope, and this leads to have the discontinuity. The house clearly shows the spatial characteristics of the continuity and discontinuity, it proves that Mies tried to move onto modem architecture as a turning point.
In 1990s, the necessity of the Korean contemporary medium/small scale gallery as a place of experience rather than that of simple viewing has increased to meet from the requirements of the pluralistic and popularized society. The gallery makes efforts to form a collective street to cope with the influential of the power large scale cultural space as well as finding a novel direction in order to derive the regional sympathy in connection with the culture space of the neighborgood. In this paper, we study the 1990s Korean medium/small scale gallery in two aspects: First, the architectural techniques and elements which are introduces the audience to both interior and exterior spaces constructed by the 1990s gallery architecture, are investigated. The conventional architecture shows the blocking of the neighborhood and the trend of severance when viewing from both the architectural and the civil points. Secondly, we present the design characteristics from the several points of view such as conceptual, spacial, visual angles. The various trends of works in exhibition of the fine arts can provide a means for producing a great deal of variation in recent gallery architecture when viewing from a stage standpoint of exhibition space.
This paper aims to examine the fundamental relationship of what principles cause the aesthetic shapes in Korean sarangbang furniture of the $19^{th}$ century. Focusing on the Greimas' isotopic and semantic structure analysis, this research analyzed the traditional Korean men's furniture in four steps; signifier analysis, isotopic analysis, semantic structure analysis, and comprehensive interpretation. The results show that the expressive qualities of sarangbang furniture included visual symmetric aesthetics, and the hues of natural materials with dark tones. The manufacturing process emphasized the characteristics of natural materials; while diversity was respected in decorations, function as restrained form was also important with a concise image. Through these characteristics, sarangbang furniture revealed a balance, a harmony of contrastive elements, and a restrained aesthetics. Within these qualities, it was seen that aesthetic principles, such as "severance and communication," "artifice and nature," "restraint and manifestation," "toughness and softness," "filling and emptying" and "decoration and utility" were in a mutually supplementary relationship. At the basis of this aesthetic thought appears to be Confucianism, which had been the model for seonbi politics and scholarship.
Kim, Keum Soon;Kim, Jin A;Kwon, So Hi;Song, Mal Soon
Journal of Korean Clinical Nursing Research
/
v.16
no.1
/
pp.177-196
/
2010
Purpose: This study was conducted to develop the nursing process based performance measurement tool and the evidence based care standards for nursing care in medication management and blood transfusion. Methods: The care standards and performance measurement tool were drafted through comprehensive review of relevant literature, national guidelines, hospital protocols, and standards of recognized international accrediting bodies. The proposed care standards and performance measurement tool were reviewed by the panel of experts and refined based on the panel's suggestions. Final care standards and performance measurement tool were validated by surveying the hospital nurses. Results: All items of the performance measurement tool for medication management and blood transfusion were evaluated appropriate. All contents of care standards and the measurable elements except the evaluation of discharge education were appropriate. The performance measurement tool developed in this study was found to be acceptable as a tool to evaluate quality of nursing care in medication management and blood transfusion. Conclusion: The outcomes of this study including the performance measurement tool and evidence based care standards would be the important indicators to monitor whether necessary nursing care is implemented and be the useful primary resources to improve quality of nursing care services.
The present study was conducted to develop a standardized job description for clinical dietitians working in hospitals. A developing curriculum (DACUM) method was used for the job analysis of clinical dietitians. Based on DACUM analysis with 14 members, including clinical dietitians and professors majoring in clinical nutrition and job analysis, information on the duties, tasks, and task elements of clinical dietitians was determined. To verify the job descriptions derived from DACUM analysis, a total of 46 tertiary and general hospitals with over 500 beds were recruited for the survey. The final developed job description for clinical dietitians included 7 duties, 27 tasks, and 93 task elements. The duties consisted of nutritional assessment, nutrition diagnosis, nutrition intervention, nutrition monitoring evaluation, consultation cooperation, nutrition research, and self-development. The mean scores of perceived importance, performance, and difficulty on the clinical dietitian's task elements (out of a maximum score of 5.0) were 4.5, 3.7, and 3.5, respectively, with significant differences between the items (P<0.001). The perceived importance and performance grid of clinical dietitian's tasks showed that "construction and maintenance of collaboration" (E2) and "activity of quality improvement" (F1) received relatively low scores for performance despite their high importance scores; thus the performance of these tasks requires significant improvement. In conclusion, the job descriptions of clinical dietitians developed from this study are useful for the qualitative improvement of clinical nutrition services in hospitals.
Kim, Hee Jeong;Kim, Jeung-Im;Ahn, Sukhee;Kim, Myoung-Hee;Kim, Yunmi;Cho, Kyung Sook;Hwang, Namsuk;Choi, Jung Sun;Park, Soo Hye;Lee, Eun Hee
Journal of Korean Clinical Nursing Research
/
v.24
no.1
/
pp.10-22
/
2018
Purpose: This study was performed to establish the role and to analyze the job of MFICU (Maternal Fetal Intensive Care Unit) nurses using DACUM (Developing a curriculum). Methods: A DACUM workshop was held to define MFICU nurses' role and identify their duties and tasks. A DACUM committee was consisted of 7 nurses, 2 nursing professors and 1 medical doctor and as a result, a survey was developed which contained duties and tasks of MFICU nurse. Pre-test was carried out for the validity, finally collected the data from 97 nurses who worked at 7 MFICU and 10 delivery room. Results: A total of 60 duties, 115 tasks and 822 elements of tasks were defined on the DACUM chart and survey. The importance, frequency and difficulty of the tasks were presented the determinant coefficient (DC), the highest DC duty was 'Manage maternal ventilator' (15.09) and the lowest DC was 'Provide nursing care for leisure to gestation extension mother' (6.52). Twenty-eight tasks were differentiated between MFICU and delivery nurses significantly. And the most important, frequently, difficulty task perceived by MFICU nurse was 'Check fetal heartbeat with electronic fetal heart monitor'. Conclusion: The organized educational program and policy was needed to develop for MFICU nurses.
The purpose of this study was to evaluate the effects on maternal-fetal attachment and self efficacy for delivery using the Taekyo-oriented prenatal class. This class is for 2 hours/week for 4 weeks. The program covers the contents of fetal growth and development including their responding ability, the importance of the uterine environment, sharing the motive and purpose of pregnancy, sharing experiences about pregnancy, sharing of prejudices against delivery, training of maternal-fetal interaction, understanding delivery, relaxation breathing techniques, maternity exercises, writing letters or prayers to the baby, and declaration of loving the baby. This study took place from March 4th to June 15th, 2000, in a university hospital and community care center, and was done by with a pretest-posttest design, with 55 pregnant women who were within 32-36 weeks pregnant and who agreed to participate in this study. Data was measured twice by self-report by the Cranley's Maternal-fetal Attachment Scale(MFAS, 1981), and the Shin's(1997) Self Efficacy for Delivery Scale at the beginning and at the completion of the class. Data was analyzed by SAS. The study results were: 1. The score of maternal-fetal attachment was significantly increased after the Taekyo perspective prenatal class than before the class. (t=7.389, p=0.000) 2. The score of self efficacy for delivery was significantly increased after the Taekyo perspective prenatal class than before the class. (t=8.885, p=0.000) The above results proved that the present Taekyo perspective prenatal education program was effective in increasing maternal-infant attachment and self efficacy for delivery. Therefore, it is concluded that the existing prenatal class should include Taekyo perspective elements. However, further study is needed to compare the effects with preexisted prenatal class.
Benign peripheral nerve tumors, although infrequent, must be considered as a possible cause of pain and disability in the extremities. There are three varieties of these tumors that are of clinical importance: neurilemmomas, neurofibromas, and post-traumatic neuroma. Neurilemmomas are the most common primary solitary tumor of the peripheral nerve trunks, and are almost always benign, Neurofibromas may occur as a solitary nerve tumor, but can present as multiple lesions as in von Recklinghausen's disease. Clinically, this tumor may presents as a solitary mass in the subcutaneous tissue which is centrally located with the nerve fibers travelling through the tumor mass. Traumatic neuroma is the proliferation of nerve elements with connective tissue during the process of regeneration from severed nerves undergoing Wallerian degeration, and is therefore not a true neoplasm. A neuroma-in-countinuity is the result of partial severance of a nerve, or of a crushing or traction injury in which all or part of the epineurium and perineurium is intact. We experienced each of the three varieties. With magnification, the neurilemmoma was removed by meticulous dissection from the parent nerve preserving the normal fascicles to which it was attached. The neurofibroma was excised and the nerve was reconstructed with interposed vein graft and the neuroma-in-continuity was excised and reconstructed with sural nerve graft. We report histologic characteristics of each tumors and the methods to repair the nerve defects after tumor excision with brief discussion.
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