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Review on hazardous microcystins originating from harmful cyanobacteria and corresponding eliminating methods (유해 남세균 유래 마이크로시스틴의 위해성과 제거 방안 고찰)

  • Sok Kim;Yoon-E Choi
    • Korean Journal of Environmental Biology
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    • v.41 no.4
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    • pp.370-385
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    • 2023
  • Cyanobacterial harmful algal blooms (Cyano-HABs) are an international environmental problem that negatively affects the ecosystem as well as the safety of water resources by discharging cyanotoxins. In particular, the discharge of microcystins (MCs), a highly toxic substance, has been studied most actively, and various water treatment methods have been proposed for this purpose. In this paper, we reviewed adsorption technology, which is recognized as the most feasible, economical, and efficient method among suggested treatment methods for removing MCs. Activated carbons (AC) are widely used adsorbents for MCs removal, and excellent MCs adsorption performance has been reported. Research on alternative adsorption materials for AC such as biochar and biosorbents has been conducted, however, their performance was lower compared to activated carbon. The impacts of adsorbent properties(characteristics of pore surface chemistry) and environmental factors (solution pH, temperature, natural organic matter, and ionic strength) on the MCs adsorption performance were also discussed. In addition, toward effective control of MCs, the possibility of the direct removal of harmful cyanobacteria as well as the removal of dissolved MCs using adsorption strategy was examined. However, to fully utilize the adsorption for the removal of MCs, the application and optimization under actual environmental conditions are still required, thereby meeting the environmental and economic standards. From this study, crucial insights could be provided for the development and selection of effective adsorbent and subsequent adsorption processes for the removal of MCs from water resources.

A Study on the Expressed Desire at Discharge of Patients to Use Home Nursing and Affecting Factors of the Desire (퇴원환자의 가정간호 이용의사와 관련 요인)

  • Lee, Ji-Hyun;Lee, Young-Eun;Lee, Myung-Hwa;Sohn, Sue-Kyung
    • The Korean Journal of Rehabilitation Nursing
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    • v.2 no.2
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    • pp.257-270
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    • 1999
  • The purpose of this study is to investigate factors related to the intent of using home nursing of chronic disease patients who got out of a university hospital. For the purpose, the study selected 153 patients who were hospitalized and left K university hospital with diagnoses of cancer, hypertension, diabetes and cerebral vascular accident and ordered to be discharged and performed interviews with them and surveys on their medical records to obtain the following results. For this study a direct-interview survey and medical record review was conducted from June 28 to Aug. 30, 1998. The frequency and mean values were computed to find the characteristics of the study subjects, and $X^2$-test, t-test, factor analysis and multiple logistic regession analysis were applied for the analysis of the data. The following results were obtained. 1) When characteristics of the subjects were examined, men and women occupied for 58.8% and 41.2%, respectively. The subjects were 41.3 years old in aver age and had the monthly aver age earning of 0.99 million won or below, which was the most out of the total subjects at 34.6%. Among the total, 87.6% resided in cities and 12.4 in counties. The most left the hospital with diagnosis of cancer at 51.6%, followed by hyper tension at 24.2%, diabetes at 13.7% and cerebral vascular accident at 7.2%. 2) 93.5% of the selected patients had the intent of using home nursing and 6.5%, didn't. Among those patients having the intent, 85.6% had the intent of paying for home nursing and 14.4%, didn't. The subjects expected that the nursing would be paid 9,143 won in aver age and 47.7% of them preferred national authorities as the main servers. 86.3% of the subjects thought that home nursing business had the main advantage of making it possible to learn nursing methods at home and thereby contributing to improving the ability of patients and their facilities to solve health problems. 3) Relations between the intent of use and characteristics of the subjects such as demography-related social, home environment, disease and physical function characteristics did not show statistically significant differences among one another. Compared to those who had no intent of using home nursing, the group having the intent had more cases of male patients, the age of 39 or below, residence in cities, 5 family member s or more, no existence of home nursing servers, leaving the hospital from a non-hospitalized building, disease development for five months or below, hospitalization for ten days or more, non-hospitalization with in the recent one month, two times or over of hospitalization, leaving the hospital with no demand of special treatment, operation underwent, poor results of treatment, leaving the hospital with demand of rehabilitation services, physical disablement and high evaluation point of daily life. 4) Among those patients having the intent of using home nursing, 47.6% demanded technical nursing and 55.9%, supportive nursing. As technical nursing,' inject into a blood vessel ' and 'treat pustule and teach basic prevention methods occupied for 57.4%, respectively, topping the list. Among demands of supportive nursing, 'observe patients 'status and refer them to hospitals or community resources as available, if necessary' was the most with percent age point of 59.5. Regarding the intent of paying for home nursing, 39.2% of those patients wishing to use the nursing responded paying for technical services and 20.2, supportive services. In detail, 70.0% wanted to pay for a service stated as 'inject into a blood vessel', highest among the former services and 30.7%, a service referred to as 'teaching exercises needed to make the body of patients move', highest among the latter. When this was analyzed in terms of a relation between the need(the need for home nursing) and the demand(the intent of paying for home nursing), The rate of the need to the demand was found two or three times higher in technical nursing(0.82) than in supportive nursing(0.35). In aspects of tech ical nursing, muscle injection(1.26, the 1st rank) was highest in the rate while among aspects of supportive nursing, a service referred to as 'teach exercises needed for making patients move their bodies normally'(0.58, the 1st rank). 5) factors I(satisfaction with hospital services), II(recognition of disease state), III(economy) and IV(period of disease) occupied for 34.4, 13.8, 11.9 and 9.2 percents, respectively among factors related to the intent by the subjects of using home nursing, totaled 59.3%. In conclusion, most of chronic disease patients have the intent of using hospital-based home nursing and satisfaction with hospital services is a factor affecting the intent most. Thus a post-management system is needed to continue providing health management to those patients after they leave the hospital. Further, supportive services should be provided in order that those who are satisfied with hospital services return to their community and live their in dependent lives. Based on these results, the researcher would make the following recommendation. 1) Because home nursing becomes more and more needed due to a sharp increase in chronic disease patients and elderly people, related rules and regulations should be made and implemented. 2) Hospital nurses specializing in home nursing should be cultivated.

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Small-Scale Pond Effects on Reducing Pollutants Load from a Paddy Field (논의 양분유출 저감을 위한 저류지 효과)

  • Kim, Min-Kyeong;Kwon, Soon-Ik;Jung, Goo-Bok;Hong, Seong-Chang;Chae, Mi-Jin;Yun, Sun-Gang;So, Kyu-Ho
    • Korean Journal of Environmental Agriculture
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    • v.32 no.4
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    • pp.355-358
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    • 2013
  • BACKGROUND: Water-born pollution loads by agricultural non-point source (NPS) pollution are expected to become intensified due to ongoing precipitation change. Therefore, it is essential to develop a best management practice (BMP) that is suitable to agricultural environments in Korea. This study aimed to develop an environmental-friendly BMP to reduce NPS pollution load by agricultural activities. An eco-friendly way, small drainage pond, was suggested in this study to avoid direct drainage of agricultural runoffs and eventually reduce the amount of pollutants discharged into the surrounding aqua-environment. METHODS AND RESULTS: A small pond ($12m^2$) was constructed at the corner of a rice paddy field ($1,715m^2$) located in Suwon, Korea. Water was allowed to drain only via a small drainage pond. Sampling was repeatedly made at two locations, one from an entrance and the other from an exit of a pond, during the rice cultivation period (May to October, 2012). Generally, sampling was made only when runoff water drained through a pond, such as during and/or after rain (irrigation). The water quality analysis showed that all quality parameters (SS, $COD_{Mn}$, T-N, and T-P) were improved as water passed through the pond. The amount of runoff water was reduced by 96~100%. Suspended solids and COD concentrations was reduced by 79.3% and 45.6%, respectively. In case of T-N and T-P concentrations, the reduction rates were 52.2% and 60.5%, respectively and the amount of T-N and T-P were reduced by 16.3~73.0% and 15.4~70.1%, respectively. CONCLUSION(S): Our data implies that agricultural NPS pollution from rice paddy fields can be effectively managed when an appropriate drainage water management practice is imposed. In this paper, it was suggested that an installation of a small drainage pond can be effective to prevent not only the nutrient loss from rice fields but also pollutant discharge to surrounding water environments.

Review of Policy Direction and Coupled Model Development between Groundwater Recharge Quantity and Climate Change (기후변화 연동 지하수 함양량 산정 모델 개발 및 정책방향 고찰)

  • Lee, Moung-Jin;Lee, Joung-Ho;Jeon, Seong-Woo;Houng, Hyun-Jung
    • Journal of Environmental Policy
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    • v.9 no.2
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    • pp.157-184
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    • 2010
  • Global climate change is destroying the water circulation balance by changing rates of precipitation, recharge and discharge, and evapotranspiration. The Intergovernmental Panel on Climate Change (IPCC 2007) makes "changes in rainfall pattern due to climate system changes and consequent shortage of available water resource" a high priority as the weakest part among the effects of human environment caused by future climate changes. Groundwater, which occupies a considerable portion of the world's water resources, is related to climate change via surface water such as rivers, lakes, and marshes, and "direct" interactions, being indirectly affected through recharge. Therefore, in order to quantify the effects of climate change on groundwater resources, it is necessary to not only predict the main variables of climate change but to also accurately predict the underground rainfall recharge quantity. In this paper, the authors selected a relevant climate change scenario, In this context, the authors selected A1B from the Special Report on Emission Scenario (SRES) which is distributed at Korea Meteorological Administration. By using data on temperature, rainfall, soil, and land use, the groundwater recharge rate for the research area was estimated by period and embodied as geographic information system (GIS). In order to calculate the groundwater recharge quantity, Visual HELP3 was used as main model for groundwater recharge, and the physical properties of weather, temperature, and soil layers were used as main input data. General changes to water circulation due to climate change have already been predicted. In order to systematically solve problems associated with how the groundwater resource circulation system should be reflected in future policies pertaining to groundwater resources, it may be urgent to recalculate the groundwater recharge quantity and consequent quantity for using via prediction of climate change in Korea in the future and then reflection of the results. The space-time calculation of changes to the groundwater recharge quantity in the study area may serve as a foundation to present additional measures for the improved management of domestic groundwater resources.

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Video-assisted Talc Poudrage for the Treatment of Malignant Pleural Effusion: Analysis of Effects and Benefits (악성 늑막 삼출증에서의 비디오 흉강경하 탈크 분무의 효과 및 장점 분석)

  • Song, In-Hag;Chang, Won-Ho;Choi, Chang-Woo;Son, Jin-Sung;Kim, Dong-Hyun;Baek, Kang-Seok;Youm, Wook;Kim, Hyun-Jo
    • Journal of Chest Surgery
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    • v.40 no.7 s.276
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    • pp.492-498
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    • 2007
  • Background: Malignant pleural effusion is a common condition in neoplastic patients and palliative therapy is the usual treatment. Talc has been generally accepted to be the most effective sclerosant for chemical pleurodesis, but the optimal route of administration remains controversy. We compared the results of video-assisted thoracoscopic talc poudrage (VTP) with administering a bedside talc slurry through a chest tube (BTS) for the treatment of malignant pleural effusion. Material and Method: From December 2004 to May 2006, 20 patients with malignant pleural effusion underwent chemical pleurodesis via VTP (group A, n=10), and BTS (group B, n=10). Result: The durations of chest tube placement after the procedure were $7.0{\pm}4.0$ days (group A) and $6.7{\pm}3.6$ days (group B). The hospital stays were $24.3{\pm}9.4$ days (group A) and $30.7{\pm}21.5$ days (group B), respectively. The symptoms of dyspnea were much more improved in group A (p-value=0.014) after discharge (mean f/u group $A=8.5{\pm}2.2$ months, group B $8.0{\pm}7.4$ months). The collapsed portions of lung were better expanded in group A than in group B (p-value=0.011). Conclusion: We recommend VTP for the selected patients with malignant pleural effusion because of the advantages of dissecting the fibrous peel to relieve the atelectasis and dyspnea, and excising the pleura for diagnosis with direct viewing of the lesion.

Application of Geophysical Methods to Detection of a Preferred Groundwater Flow Channel at a Pyrite Tailings Dam (황철석 광산 광미댐에서의 지하수흐름 경로탐지를 위한 물리탐사 적용)

  • Hwang, Hak Soo
    • Economic and Environmental Geology
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    • v.30 no.2
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    • pp.137-142
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    • 1997
  • At the tailings dam of the disused Brukunga pyrite mine in South Australia, reaction of groundwater with the tailings causes the formation and discharge of sulphuric acid. There is a need to improve remediation efforts by decreasing groundwater flow through the tailings dam. Geophysical methods have been investigated to determine whether they can be used to characterise variations in depth to watertable and map preferred groundwater flow paths. Three methods were used: transient electromagnetic (TEM) soundings, direct current (DC) soundings and profiling, and self potential (SP) profiling. The profiling methods were used to map the areal extent of a given response, while soundings was used to determine the variation in response with depth. The results of the geophysical surveys show that the voltages measured with SP profiling are small and it is hard to determine any preferred channels of groundwater flow from SP data alone. Results obtained from TEM and DC soundings, show that the DC method is useful for determining layer boundaries at shallow depths (less than about 10 m), while the TEM method can resolve deeper structures. Joint use of TEM and DC data gives a more complete and accurate geoelectric section. The TEM and DC measurements have enabled accurate determination of depth to groundwater. For soundings centred at piezometers, this depth is consistent with the measured watertable level in the corresponding piezometer. A map of the watertable level produced from all the TEM and DC soundings at the site shows that the shallowest level is at a depth of about 1 m, and occurs at the southeast of the site, while the deepest watertable level (about 17 m) occurs at the northwest part of the site. The results indicate that a possible source of groundwater occurs at the southeast area of the dam, and the aquifer thickness varies between 6 and 13 m. A map of the variation of resistivity of the aquifer has also been produced from the TEM and DC data. This map shows that the least resistive (i.e., most conductive) section of the aquifer occurs in the northeast of the site, while the most resistive part of the aquifer occurs in the southeast. These results are interpreted to indicate a source of fresh (resistive) groundwater in the southeast of the site, with a possible further source of conductive groundwater in the northeast.

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Field Study For The Improvement of Medication System and Method for Inpatients at General Hospital (입원환자의 투약체계와 방법의 개선을 위한 현장연구)

  • Yoo, Hyung-Sook;Kuwan, Young-Mi;Song, Mi-Sook;Kim, Hyung-Ae;Park, Kyung-Sook
    • Journal of Korean Academy of Nursing Administration
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    • v.1 no.1
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    • pp.147-211
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    • 1995
  • Medication is a kind of medical service and a therapeutic nursing function which takes large portion of nursing service and requires complicated procedures. So many different medical personnel should be involved and cooporate each other in order to accomplish medication. Medication is also a vital nursing service, So nurse feels heavy responsibi lity in that she gives medication to the patient finally, so she has much responsibility if medication error is happened. Therefore it seems very important to clarify the problem of medication system and method, and find the subculture of medication situation because it may promote nursing productivity. The study was conducted to 1. Describe and interpret medication situation. 2. Find out the problem of medication system and method and on alternatives. 3. Compare the medication system and method of hospitals which are located in Seoul with object hospital Ethnographic methodology was used to study medication situation by doing participant observation and interview of health care personnel. Ten nurses and three nurse aids were interviewed. Two residents and internists, two phamacists and two accountants were also interviewed. Data was obtained and analized according to Developmental Research Sequence introduced by Spradly. On the basis of this data the results were as follows. 1. The overall flow of medication system was devided into six stage : first, checking doctor's order : second writing doctor's order, : third, transfering slip into the related departments such as account department, pharmacy : fourth, distribution of medication from pharmacy to unit : fifth, identifing medication by nurses : and finally, medicating to the patient. Behaviorors have been under a lot of stress in that they have to do much works, especially paperworks, So too much time were needed. They also have been suffered interpersonal conflicts among health care personnel and role conflicts in the process of doing medication service. 2. In the process of checking order, the problem was that too much time was required for checking order and paperwork. The more the order changes the more the paperwork is. Nurses have been suffering difficulties in calling internist in order to get bill. Even if writing down slip for medication order is doctor's job, Sometimes nurse has been expected to write slip by doctors or nurse would write slip beacuse of two much complexities and efforts for calling doctors. If the slip were incorrect, much time complicated procedures were more required for correcting it. So delay of administering drug would be resulted consequently. Drugs were delivered from pharmacy to units by delivery agent and phamacist. But because drugs were delivered without arranging room number of patient. Nurse should rearrange drugs in order of the room number So it had made waste time and effort, and Even when emergency drugs were needed, Prompt delivery of drug was not easy because of many reasons. For nurses, it took too long in the identification of the right drug. Actually nurses have heavy burden when medication error happens because nurse is the final actor who gives medication to the patient, So every three shift nurse ought to check drugs as soon as every shift begins. That's why it took too much time due to repeated confirming procedure. When nurses had to go patient room in order to give medications, there were difficulties in watching patient until the patient take medicine correctly. So it was impossible to check every patient wheather he took medicine or not especially in hectic situation. 3. There were many hospitals in Seoul which have similar medication system and method as object hospital according to the results of questionaire. This means that many hospitals have been suffering srimilar problems which were identified in object hospital. 4. Recommendations for promoting simplification of medication system and method were the following : Redesigning of slip from two pieces of paper into one : early discharge announcement system, and slip confirming through computer and controlling of period of prescreption from one day to two or three days : designing personal drug storage box for each patient and using it. If nurses follow the recommendations, they will make medication short & simple, and also have enough time of direct nursing care 5. Even though there were many difficulties in medicating patients. Medication itself has been considered as a caring among nurses because it makes rapport between nurse and patient. So nurses had better accept medication as a portion of nusing service not a original portion of phamacist. There are some limits in this research in terms of confining to only one unit of one hospital, and treating it especially in view of nurses' aspects, So further researchs should be continnued from various kmds of viewpoints of doctors, phamacists and so on. ${\cdot\cdot\cdot}$. Especially esthnographic study of computerized medication system and method seems to be followed.

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Simulation Conditions based Characteristics of Spatial Flood Data Extension (모의조건에 따른 홍수 유출자료의 공간적 확장 영향분석)

  • Kim, Nam Won;Jung, Yong;Lee, Jeong Eun
    • Journal of Korea Water Resources Association
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    • v.47 no.6
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    • pp.501-511
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    • 2014
  • The effects of initial conditions and input values of the rainfall-runoff model were studied in the applications of a lumped concept model for flood event data extension. For the initial conditions of the rainfall-runoff model, baseflow effects and spatial distributions of saturation points ($R_{sa}$) for the storage function methods (SFM) were analyzed. In addition, researches on the effects of rainfall data conditions as input values for the rainfall-runoff model were performed. The Chungju Dam watershed was selected and divided into 3 catchments including smaller size of 22 sub-catchments. The observed discharge and inflow amounts at Yeongwol 1, Chungju Dam, and Yeongwol 2 water level stations were individually operated as criteria for flood data extension in 30 flood events from 1993 to 2009. Direct and base flow were distinguished from a stream flow. In order to test capability of flood data extension, obtained base flow was applied to the rainfall-runoff model for three water level stations. When base flow was adopted in the model, the Nash-Sutcliffe Efficiency(NSE) was increased. The numbers of over satisfaction for model performance (>0.5) were increased over 10%. Saturation points ($R_{sa}$) which strongly influence the runoff amount when rainfall starts were optimized based on the runoff amount at three water level stations. The sizes of saturation points for three locations were similar which means saturation point size is not depending on the runoff amount. The effects of rainfall information for flood runoff were tested at 2002ev1 and 2008ev1. When increased the amount of rainfall information, the runoff simulations were closer to the simulations with full of rainfall information. However, the size of improvement was not substantial on rainfall-runoff simulations in terms of the size of total amount of rainfall.

An Exploratory Study about the Importance of Selected Nursing Activities during the Puerperal Period, as Viewed by Women in the Puerperal Period and by Nurses Caring for Them (산모와 간호원이 본 선택된 산욕기 간호활동의 중요도에 관한 탐색적 연구)

  • 박주봉
    • Journal of Korean Academy of Nursing
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    • v.8 no.1
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    • pp.152-162
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    • 1978
  • The desire to maintain health is increasing, consequently the role of nursing which has as one chief aim the solving of man′s basic problems is more and more important. Today, in spite of a growing concern about the nursing activities which nurses provide for individual human having specific needs, clinically in fact, it is questionable that individual′s expectation of nursing activities agrees with nurse′s performance of nursing activities. In this study the importance and agreement of the importance of the nursing activities during the hospitalized puerperal period as viewed by women in the puerperal period and by nurses caring for them, were assessed. The present study was undertaken in an attempt to furnish the basic data for expediting the progress of research activities in this area and further to be helpful in planning maternity nursing practice. The study population defined and selected was nurses (13) caring for women in the puerperal period and doing duty on obstetric & gynecologic ward at Y. hospital, and the women in puerperal period (39) as sum of 3 women selected by each nurse during the period of May 13th-June 4th 1976. The study data was collected by the direct interview method based on the questionnaire which the investigator made out. The study result was analyzed by percentage, t - test. The findings can be summarized as follows: 1. General characteristics of nurses doing duty on puerperal ward: a. Nurses′average age was 24.8 years old. b. 84.6% had educational background of 4 years of college. c. 69.2% had a religion. d. 53.8% were married. e. 53.8% had clinical experience of 1 year -3 years. f, 61.5% did duty on puerperal ward during 1 year -3 years. g. 46.2% desired to do duty on obstetric ? gynecologic ward. 2. General characteristics of the women who were studied during their puerperal period: a. Women′s average age was 26.4 years old. b. 79.5% had educational background above high school. c. 56.4% had a religion. d. 84.6% had living standard above medium. e. 89.7% had no occupation. f, 53,8% had previous hospitalization experience. g. 56.4% had previous delivery experience. 3. Examining the importance of 39 nursing activities during puerperal period selected by investigator, studied group of women considered that the most important nursing activity was "Record precisely about condition, medical treatment and nursing activity results etc". Nurses considered that the most important nursing activity was "Notice whether having pain and care for that". Both groups considered that the least important nursing activity was "Talk with her about topics such as news, hobbies, other interests". 4. Examining the importance of nursing activities in 4 specific categories, studied group of women considered that the most important nursing activity in physical nursing category was "Be sure of safety measure to prevent accidents, injuries", and nurses considered that the most important nursing activity was "Make her sleep and rest sufficiently". Studied group of women considered that the most important nursing activity in psychological category was "Explain about medical treatment and nursing activity ahead of time so she knows what to expect" , and nurses considered that the most important nursing activity was "Explain about puerperal period so she understands". Studied group of women considered that the most important nursing activity in relation to medical care was "Record precisely about condition, medical treatment and nursing activity results etc.", and nurses considered that the most important nursing activity was "Observing, cleaning and protecting the perineum" Studied group of women considered that the most important nursing activity in nursing category in preparation for discharge was "Instruct about personnel hygiene during puerperal period", and nurses considered that the most important nursing activity was "Instruct self-care to protect the perineum". 5. The analysis of this study showed a significant amount of disagreement computed by subtracting the nurse′s score from the patient′s score. Studied group of women put greater importance on physical nursing category, psychological nursing category, nursing in relation to medical care, than the nurses. These results were statistically significant at 0.01 level.

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Study of Patient Teaching in The Clinical Area (간호원의 환자교육 활동에 관한 연구)

  • 강규숙
    • Journal of Korean Academy of Nursing
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    • v.2 no.1
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    • pp.3-33
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    • 1971
  • Nursing of today has as one of its objectives the solving of problems related to human needs arising from the demands of a rapidly changing society. This nursing objective, I believe, can he attained by the appropriate application of scientific principles in the giving of comprehensive nursing care. Comprehensive nursing care may be defined as nursing care which meets all of the patient's needs. the needs of patients are said to fall into five broad categories: physical needs, psychological needs, environmental needs, socio-economic needs, and teaching needs. Most people who become ill have adjustment problems related to their new situation. Because patient teaching is one of the most important functions of professional nursing, the success of this teaching may be used as a gauge for evaluating comprehensive nursing care. This represents a challenge foe the future. A questionnaire consisting of 67 items was distributed to 200 professional nurses working ill direct patient care at Yonsei University Medical Center in Seoul, Korea. 160 (80,0%) nurses of the total sample returned completed questionnaires 81 (50.6%) nurses were graduates of 3 fear diploma courser 79 (49.4%) nurses were graduates of 4 year collegiate nursing schools in Korea 141 (88,1%) nurses had under 5 years of clinical experience in a medical center, while 19 (11.9%) nurses had more than 5years of clinical experience. Three hypotheses were tested: 1. “Nurses had high levels of concept and knowledge toward patient teaching”-This was demonstrated by the use of a statistical method, the mean average. 2. “Nurses graduating from collegiate programs and diploma school programs of nursing show differences in concepts and knowledge toward patient teaching”-This was demonstrated by a statistical method, the mean average, although the results showed little difference between the two groups. 3. “Nurses having different amounts of clinical experience showed differences in concepts and knowledge toward patient teaching”-This was demonstrated by the use of a statistical method, the mean average. 2. “Nurses graduating from collegiate programs and diploma school programs of nursing show differences in concepts and knowledge toward patient teaching”-This was demonstrated by a statistical method, the mean average, although the results showed little difference between the two groups. 3. “Nurses having different amounts of clinical experience showed differences in concepts and knowledge toward patient teaching”-This was demonstrated by the use of the T-test. Conclusions of this study are as follow: Before attempting the explanation, of the results, the questionnaire will he explained. The questionnaire contained 67 questions divided into 9 sections. These sections were: concept, content, time, prior preparation, method, purpose, condition, evaluation, and recommendations for patient teaching. 1. The nurse's concept of patient teaching: Most of the nurses had high levels of concepts and knowledge toward patient teaching. Though nursing service was task-centered at the turn of the century, the emphasis today is put on patient-centered nursing. But we find some of the nurses (39.4%) still are task-centered. After, patient teaching, only a few of the nurses (14.4%) checked this as “normal teaching.”It seems therefore that patient teaching is often done unconsciously. Accordingly it would he desirable to have correct concepts and knowledge of teaching taught in schools of nursing. 2. Contents of patient teaching: Most nurses (97.5%) had good information about content of patient teaching. They teach their patients during admission about their diseases, tests, treatments, and before discharge give nurses instruction about simple nursing care, personal hygiene, special diets, rest and sleep, elimination etc. 3. Time of patient teaching: Teaching can be accomplished even if there is no time set aside specifically for it. -a large part of the nurse's teaching can be done while she is giving nursing care. If she believes she has to wait for time free from other activities, she may miss many teaching opportunities. But generally proper time for patient teaching is in the midmorning or midafternoon since one and a half or two hours required. Nurses meet their patients in all stages of health: often tile patient is in a condition in which learning is impossible-pain, mental confusion, debilitation, loss of sensory perception, fear and anxiety-any of these conditions may preclude the possibility of successful teaching. 4. Prior preparation for patient teaching: The teaching aids, nurses use are charts (53.1%), periodicals (23.8%), and books (7.0%) Some of the respondents (28.1%) reported that they had had good preparation for the teaching which they were doing, others (27.5%) reported adequate preparation, and others (43.8%) reported that their preparation for teaching was inadequate. If nurses have advance preparation for normal teaching and are aware of their objectives in teaching patients, they can do effective teaching. 5. Method of patient teaching: The methods of individual patient teaching, the nurses in this study used, were conversation (55.6%) and individual discussion (19.2%) . And the methods of group patient teaching they used were demonstration (42.3%) and lecture (26.2%) They should also he prepared to use pamphlet and simple audio-visual aids for their teaching. 6. Purposes of patient teaching: The purposes of patient teaching is to help the patient recover completely, but the majority of the respondents (40.6%) don't know this. So it is necessary for them to understand correctly the purpose of patient teaching and nursing care. 7. Condition of patient teaching: The majority of respondents (75.0%) reported there were some troubles in teaching uncooperative patients. It would seem that the nurse's leaching would be improved if, in her preparation, she was given a better understanding of the patient and communication skills. The majority of respondents in the total group, felt teaching is their responsibility and they should teach their patient's family as well as the patient. The place for teaching is most often at the patient's bedside (95.6%) but the conference room (3.1%) is also used. It is important that privacy be provided in learning situations with involve personal matters. 8. Evaluation of patient teaching: The majority of respondents (76.3%,) felt leaching is a highly systematic and organized function requiring special preparation in a college or university, they have the idea that teaching is a continuous and ever-present activity of all people throughout their lives. The suggestion mentioned the most frequently for improving preparation was a course in patient teaching included in the basic nursing program. 9. Recommendations: 1) It is recommended, that in clinical nursing, patient teaching be emphasized. 2) It is recommended, that insertive education the concepts and purposes of patient teaching he renewed for all nurses. In addition to this new knowledge, methods and materials which can be applied to patient teaching should be given also. 3) It is recommended, in group patient teaching, we try to embark on team teaching.

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