• Title/Summary/Keyword: Stepwise Approach

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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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Factors Affecting Patient Waiting Times at the Outpatient Pharmacy Department in a Tertiary Care Hospital (3차진료기관 외래약국 투약대기시간에 영향을 주는 요인)

  • Park, Hayoung;Han, Ok-Youn;La, Hyun-Oh
    • Quality Improvement in Health Care
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    • v.1 no.2
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    • pp.60-72
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    • 1994
  • Background: The number of outpatients visiting large university teaching hospitals has increased drastically with the introduction of a nationwide health care insurance in 1989 and the improvement of the socio-economic status of the population. This resulted in long waiting times for services, particularly prescribed drugs, which have been patients' chief complaints. Hospitals have tried to solve the problem with limited success because their approach lacked comprehensive research. The objective of this study is to investigate associations between waiting times and variables defining a total work system. Methods: Data for the outpatient pharmacy department in a tertiary care university teaching hospital located in Seoul was analyzed to achieve the study objective. Associations of pharmacy system variables -- work load, work force, pharmacist work schedule, machine problems, and inventory control -- with mean and 99th percentile of waiting times were examined by the hierarchical stepwise regression method. Day was a unit of the analyses. Results: The regression models explained 65.8% of variance in the mean waiting time and 61.34% in the 99th percentile of waiting times. The break-down of the printer for drug envelops, Automatic Tablet Counters (ATCs), and main computer system lasted longer than 30 minutes increased the mean for 7.7 minutes, 4.5 minutes, and 7.0 minutes, respectively, and the 99th percentile for 14.8 minutes, 9.0 minutes, and 15.7 minutes, respectively. Concerning the work force, study results showed that there were significant differences in the productivity of pharmacists with work experience more than three years, one to three years, and less than one year, and showed that peak time aid work by pharmacists at job assignments other than the outpatient pharmacy, part-time pharmacists, and the installation of ATCs were effective in reducing waiting times, Finally, study findings indicated that the operational policy of work assignment and rotation schedule, supply and inventory of drugs at work tables, and readiness for undisrupted work during the work hours could have a significant effect on waiting times. Conclusion: The study results indicated that efforts to reduce waiting times for prescribed drugs should be geared toward every components of the pharmacy work system ranging from work schedule of pharmacists and supply of dugs at work tables. These findings should provide hospital managers with right directions in battling the problem.

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Analysis of Within-Field Spatial Variation of Rice Growth and Yield in Relation to Soil Properties

  • Ahn Nguyen Tuan;Shin Jin Chul;Lee Byun-Woo
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.50 no.4
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    • pp.221-237
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    • 2005
  • For developing the site-specific fertilizer management strategies of crop, it is essential to know the spatial variability of soil factors and to assess their influence on the variability of crop growth and yield. In 2002 and 2003 cropping seasons within-field spatial variability of rice growth and yield was examined in relation to spatial variation of soil properties in the· two paddy fields having each area of ca. $6,600m^2$ in Suwon, Korea. The fields were managed without fertilizer or with uniform application of N, P, and K fertilizer under direct-seeded and transplanted rice. Stable soil properties such as content of clay (Clay), total nitrogen (TN), organic mater (OM), silica (Si), cation exchange capacity (CEC), and rice growth and yield were measured in each grid of $10\times10m$. The two fields showed quite similar spatial variation in soil properties, showing the smallest coefficient of variation (CV) in Clay $(7.6\%)$ and the largest in Si $(21.4\%)$. The CV of plant growth parameters measured at panicle initiation (PIS) and heading stage (HD) ranged from 6 to $38\%$, and that of rice yield ranged from 11 to $21\%$. CEC, OM, TN, and available Si showed significant correlations with rice growth and yield. Multiple linear regression model with stepwise procedure selected independent variables of N fertilizer level, climate condition and soil properties, explaining as much as $76\%$ of yield variability, of which $21.6\%$ is ascribed to soil properties. Among the soil properties, the most important soil factors causing yield spatial variability was OM, followed by Si, TN, and CEC. Boundary line response of rice yield to soil properties was represented well by Mitcherich equation (negative exponential equation) that was used to quantify the influence of soil properties on rice yield, and then the Law of the Minimum was used to identify the soil limiting factor for each grid. This boundary line approach using five stable soil properties as limiting factor explained an average of about $50\%$ of the spatial yield variability. Although the determination coefficient was not very high, an advantage of the method was that it identified clearly which soil parameter was yield limiting factor and where it was distributed in the field.

Mini-Array of Multiple Tumor-associated Antigens (TAAs) in the Immunodiagnosis of Esophageal Cancer

  • Qin, Jie-Jie;Wang, Xiao-Rui;Wang, Peng;Ren, Peng-Fei;Shi, Jian-Xiang;Zhang, Hong-Fei;Xia, Jun-Fen;Wang, Kai-Juan;Song, Chun-Hua;Dai, Li-Ping;Zhang, Jian-Ying
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.6
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    • pp.2635-2640
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    • 2014
  • Sera of cancer patients may contain antibodies that react with a unique group of autologous cellular antigens called tumor-associated antigens (TAAs). The present study aimed to determine whether a mini-array of multiple TAAs would enhance antibody detection and be a useful approach in esophageal cancer detection and diagnosis. Our mini-array of multiple TAAs consisted of eleven antigens, p53, pl6, Impl, CyclinB1, C-myc, RalA, p62, Survivin, Koc, CyclinD1 and CyclinE full-length recombinant proteins. Enzyme-linked immunosorbent assays (ELISA) were used to detect autoantibodies against eleven selected TAAs in 174 sera from patients with esophageal cancer, as well as 242 sera from normal individuals. In addition, positive results of ELISA were confirmed by Western blotting. In a parallel screening trial, with the successive addition of antigen to a final total of eleven TAAs, there was a stepwise increase in positive antibody reactions. The eleven TAAs were the best parallel combination, and the sensitivity and specificity in diagnosing esophageal cancer was 75.3% and 81.0%, respectively. The positive and negative predictive values were 74.0% and 82.0%, respectively, indicating that the parallel assay of eleven TAAs raised the diagnostic precision significantly. In addition, the levels of antibodies to seven antigens, comprising p53, Impl, C-myc, RalA, p62, Survivin, and CyclinD1, were significantly different in various stages of esophageal cancer, which showed that autoantibodies may be involved in the pathogenesis and progression of esophageal cancer. All in all, this study further supports our previous hypothesis that a combination of antibodies might acquire higher sensitivity for the diagnosis of certain types of cancer. A customized mini-array of multiple carefully-selected TAAs is able to enhance autoantibody detection in the immunodiagnosis of esophageal cancer and autoantibodies to TAAs might be reference indicators of clinical stage.

Estimation of Genetic Parameters and Annual Trends for Racing Times of Thoroughbred Racehorses (더러브렛 경주마의 주파기록에 대한 유전모수 추정과 연도별 개량량 분석)

  • Oh, Seung-Yoon;Park, Jong-Eun;Lee, Jeong-Ran;Lee, Jin-Woo;Oh, Hee-Seok;Kim, Hee-Bal
    • Journal of Animal Science and Technology
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    • v.51 no.2
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    • pp.129-134
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    • 2009
  • The aim of this study was to estimate genetic parameters and annual trends on the racing performance of Thoroughbred horses by a statistical analysis of the resulting records. We used the racing results of 245,979 observations for 13,458 horses recorded in 19 years of race held at Seoul and Busan racing tracks, provided by Korea Racing Authority. After a careful adjustment of some variables such as racing times, jockey and trainer numbers and the average prize a horse won, we selected significant factors that explain the result of racing records of a horse by stepwise AIC and BIC methods. The estimated heritability and repeatability were 0.322 and 0.332, respectively. The average of annual phenotypic and genetic improvement was -0.166 seconds and -0.161 seconds, respectively. Based on the statistical approach, we established reasonable animal model of well-set variables, which is important in the study on estimating performance of racing horses.

The Effects of Mental Health on the Quality of Life After Stroke (뇌졸중 후 정신건강이 삶의 질에 미치는 영향)

  • Kim, Hyeong-Min;Shim, Min-Kyu
    • Journal of Digital Convergence
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    • v.13 no.2
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    • pp.237-244
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    • 2015
  • The purposes of this study are to examine the correlations among mental health and quality of life in stroke patients and find the factors affecting quality of life. The participants were 224 inpatients diagnosed with stroke. The Stroke Specific Quality of Life(SS-QOL) was used for measuring Quality of life and the Symptom Check-List-90-Revised(SCL-90-R) was utilized to measure mental health. The relationships among the variables were examined with Pearson correlation coefficients. And the simple regression analysis and stepwise multiple regression analysis were performed to identify the predictive variables that explain changes of quality of life. There were statistically significant correlations between quality of life and mental health. Mental health was identified as a factor that explains 28% of change in quality of life. And depression was identified as a factor that explains 42% of change in quality of life. The quality of life in stroke patients, the depression was negatively related with it. When working with a stroke patient, an occupational therapist needs to address mental health aspects from the beginning of the rehabilitation process for a holistic approach and optimal outcome.

High School Students' Mathematics Learning Style and Its Characteristics According to Their MBTI Personality Disposition Types (고등학생들의 수학 학습양식과 MBTI 성격기질별 특징)

  • Kang, Yun Soo
    • Communications of Mathematical Education
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    • v.34 no.3
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    • pp.299-324
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    • 2020
  • The purpose of this study was to identify high school students' mathematics learning style and its characteristics according to their personality disposition types and to propose mathematics learning strategies fit into each personality disposition type. For this purpose, MBTI personality test and survey to find mathematics learning style for 375 high school students were executed. The results were as follows. First, many students highly evaluated the effects of private education and prefer reference book to textbook. Second, there were significant differences on following variable domains of mathematics learning style such as learning attitude, learning habit(concentrativeness to concept understanding), problem solving strategies(effort for problem comprehension, use of various strategies), self management(metacognition) by MBTI personality disposition types(SJ, SP, NT, NF groups). Third, based on the results, the following mathematics learning strategies fit into each personality disposition type were recommended. SJ type students are needed to effort creative approach for open problem and to use mindmap as mathematics learning strategy. SP type students are needed to fulfill stepwise problem solving process and to effort constantly practice long/short term learning objectives. NT type students are needed to expand opportunity to study with friends and to use SRN(self reflection note) or mathematics journal writings as mathematics learning strategy. NF type students are needed to use mathematics learning note writing activity which include logical basis for each step of problem solving and to invest more time on learning algebra which need meticulous calculation.

A Study of the Anxiety Levels of Hospitalized Psychiatric Patients in Terms of Length of Hospitalization (정신과 입원환자의 입원기간에 따른 불안정도에 관한 연구)

  • 김윤희
    • Journal of Korean Academy of Nursing
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    • v.11 no.1
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    • pp.45-63
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    • 1981
  • This study was done to determine the relationship between the anxiety levels of hospitalized psychiatric patients and various influencing variables. The purpose of this study was to determine factors that may help hospitalized psychiatric patients to experience lower levels of anxiety in relation to changing situations and provide the basic data for a dynamic approach which is important in the field of modern psychiatric nursing that understands and analyses the meaning of patients behavior. The anxiety may produce stress, which is a common experience among all human beings. Patients may merely feel uncomfortable in the state of mild anxiety, however, the severe state could be an obstacle to treatment and recovery from disease. The anxiety of the psychiatric patient is a factor which greatly influencing the patient's behavior, so his disorderd behavior is an expression of defence or pathologically fixed behavior. According the psychiatric patient's anxiety at the time of admission is the concern of the health team. The nurse's special concern has to do with understanding and supporting the patient and meeting his individual needs by frequent close contact during the entire hospitalization period, compared to other teamembers the nurse's responsibility in this regard is greated. So this study emphasizes the necessity of creating conditions these, but above all the psychiatric nurse should create a therapeutic environment by not only regarding the patient's behavior or symptoms but understanding the meaning of them. The subjects of this study were 57 psychiatric patients selected from the K neuropsychiatric hospital located in Kunsan city. Data were collected twice from the same patients within a 24 hour period after admission and 10 days after admission. (September 18th to November 8th, 1980). The data collected method was through direct interview, and the interview time was 20 minutes for each patient. Data analysis included Item Analysis & Internal Consistency Reliability Tests, Percentages, t-test, analysis of variance and stepwise multiple regression analysis. The findings of this study were as follows. A. Test of Hypothesis a. Hypothesis 1 :“The anxiety level of psychiatric patients within 24 hours after admission will be higher than those of the same patients 10 days after admission,”was accepted. (t = 3. 15 ; p < 0.005) b. Hypothesi 2:“The more the number of admissions the higher the level of anxiety related to two categories”, was accepted. (affective anxiety: F = 5.50, p < 0.005, Somatic anxiety: F = 9.12, p <.

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Factors Influencing Depression in Community-dwelling Elderly with Low Income (재가 저소득계층 노인의 우울에 영향을 미치는 요인)

  • Kim, Yong-soon;Yoo, Moon-sook;Park, Jin-hee
    • 한국노년학
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    • v.29 no.4
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    • pp.1313-1325
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    • 2009
  • Purpose: The purpose of this study was to identify the level of and factors influencing depression in community-dwelling, low-income elderly. Methods: A randomized sample of 306 subjects aged 65 and over was selected from one communities. in Korea. Data were collected through self-reported questionnaire, during the period from January to September, 2007. The data were analyzed by t-test, ANOVA, Pearson's correlation coefficient and multiple regression with SPSS/Win program. Results: The prevalence of depression was 43.8%, the mean score of depression was 6.37. Depression of the elderly significantly correlated with education level, types of the health insurance, economic levels, smoking, hypertension, arthritis, incontinence, life satisfaction, perceived health status and cognitive function. Stepwise multiple regression analysis reveled that a combination of life satisfaction, cognitive function and health insurance accounted for 67.6% of depression in elderly. Conclusion: The findings of this study suggest that the approach to effective depression prevention and management program for community-dwelling elderly should consider life satisfaction, physical and mental health and economic levels.

Improving the Performance of Deep-Learning-Based Ground-Penetrating Radar Cavity Detection Model using Data Augmentation and Ensemble Techniques (데이터 증강 및 앙상블 기법을 이용한 딥러닝 기반 GPR 공동 탐지 모델 성능 향상 연구)

  • Yonguk Choi;Sangjin Seo;Hangilro Jang;Daeung Yoon
    • Geophysics and Geophysical Exploration
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    • v.26 no.4
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    • pp.211-228
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    • 2023
  • Ground-penetrating radar (GPR) surveys are commonly used to monitor embankments, which is a nondestructive geophysical method. The results of GPR surveys can be complex, depending on the situation, and data processing and interpretation are subject to expert experiences, potentially resulting in false detection. Additionally, this process is time-intensive. Consequently, various studies have been undertaken to detect cavities in GPR survey data using deep learning methods. Deep-learning-based approaches require abundant data for training, but GPR field survey data are often scarce due to cost and other factors constaining field studies. Therefore, in this study, a deep- learning-based model was developed for embankment GPR survey cavity detection using data augmentation strategies. A dataset was constructed by collecting survey data over several years from the same embankment. A you look only once (YOLO) model, commonly used in computer vision for object detection, was employed for this purpose. By comparing and analyzing various strategies, the optimal data augmentation approach was determined. After initial model development, a stepwise process was employed, including box clustering, transfer learning, self-ensemble, and model ensemble techniques, to enhance the final model performance. The model performance was evaluated, with the results demonstrating its effectiveness in detecting cavities in embankment GPR survey data.