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A Study on the Development of an Instrument for Evaluating the Quality of Nursing Care (간호의 질 평가도구 개발에 관한 일 연구)

  • 유지수
    • Journal of Korean Academy of Nursing
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    • v.7 no.2
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    • pp.11-21
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    • 1977
  • Many in nursing look back on Nursing Research history and proudly point to the fact that emphasis in nursing research has changed from studying the nurse to studying nursing practice. In recent years, much emphasis has been placed on seeking a method of evaluating the quality of nursing care. In spite of these attempts, however, an instrument for evaluating the quality of nursing care that is actually applicable in the clinical area has not been found. The Purposes of this study are as follows: 1) To develop the instrument to be used in evaluating the quality of nursing care provided in the Neuro - Surgery Constant Care Unit of Severance Hospital 2) To evaluate the quality of nursing care in the clinical area. 3) To provide the necessary information for improvement of quality of nursing care. The instrument for evaluating the quality of nursing care, developed by the investigator, was composed of 7 nursing goals and divided into 65 standards of nursing performance. The 7 nursing goal are as follows : 1) Maintenance of airway 2) Maintenance of fluid at electrolyte balance 3) Maintenance of elimination 4) Personal hygiene 5) Optimum activity 6) Prevention of accidents 7) Emotional care The study population defined was composed of all the case (51) who were admitted in the Neuro- Surgery Constant Care Unit of Severance Hospital from May 7-13, 1976. The observation method was used and the data was subjected to the %, X²-test, T-test, F-test and Correlation. The results of tile study were as follows : 1. Levels of nursing performance regarding nursing goals. Seven different nursing care indices were constructed in terms of nursing goals. The index scores were grouped arbitrarily into ,j categories such as "excellent", "good", "moderate", "incomplete", and "poor"based upon the investigator′s personal judgement. a. The nursing index of maintaining airway showed that 78% of the patients fell within the "excellent" and 22% of the patients, fell within the "good" category. b. The nursing index of maintaining fluid & electrolyte balance showed that 95% of the patients fell within the "excellent" and 5 % of the patients fell within the "good" category. c. The nursing index of maintaining elimination showed that 100% of the patients fell within the "excellent" category. d. The nursing index of personal hygiene revealed that 49% of the patients fell within the "excellent" and 51% of the patients fell within the "good" category. e. The nursing index of optimum activity showed that 63% of the patients fell within the "excellent" and 32% of the patients fell within tile "good" and 5% of patients fell within the "moderate" category. f. The nursing index of prevention of accidents showed that 100% of the patients foil within the "excellent" category. g. The nursing index of emotional cart revealed that 27% of the patients fell within the "excellent", 24 % of the patients fell within tile "good", 29 % of the patients fell within the "incomplete" category. From these findings it is disclosed that the quality of nursing care provided in the Neuro- Surgery Constant Care Unit of Severance Hospital was excellent. h. There were statistically significant differences between the nursing index of physical care and emotional care. (t=8.73, D. F. =100. p<0.01) It is revealed that more physical care then emotional care was carried out by nurses. 2. Levels of nursing performance regarding general characteristics of the patients. No significant differences were observed statistically with the nursing indices of nursing goals according to the sex (t=0.084, D. F. =12, p>0.05). Age (F=0.1251, D. F. : 3.18. p 〉0.05), absence or presence of operating experiences (t=0.6032, D. F. =12, p〉0.05, levels of consciousness (F=0.31, D. F. :3. 18, p >0.05) 3. Relationship between the levels of consciousness and the nursing index of each nursing goal. There was negative correlation between the levels of consciousness and the nursing index of maintaining airway (r=-0. 5449, p<0.01) and personal hygiene (r= -0.4075, p<0.01) There was positive correlation between the levels of consciousness and the nursing index of optimum activity (r=0.3936, p <0.01) and emotional care (r=0.7819, p〈0.01). There was slight correlation between the levels of consciousness and the nursing index of maintaining fluid & electrolyte balance (r=-0.3418, 0.010.05) and preventing accidents (r=0.1441, p>0.05.

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A Study on the Effects of Reading & Discussion Activities on Children's Self-Esteem in Social Welfare Center Named 'Gongbubang' (사회복지관 '공부방' 아동의 자아존중감 증진을 위한 독서토론활동 효과 검증 연구)

  • Kim, Ji Young
    • Korean Journal of Childcare and Education
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    • v.5 no.2
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    • pp.21-42
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    • 2009
  • The purpose of this study was to examine the effects of reading and discussion activities on children's self-esteem in a social welfare center called 'Gongbubang.' A reading/discussion program was constructed to serve the purpose of the study and suit the selected children by referring to earlier studies that found reading programs were effective at boosting the self-esteem of elementary schoolers. The subjects in this study were 21 children in 'HaedamGongbubang', a general social welfare center located in an urban region in South Gyeongsang Province. Out of them, 12 children who involved four boys and eight girls were selected as an experimental group, and nine who included five boys and four girls were grouped into a control group. The reading/discussion program was implemented in eight sessions during a four-week period of time from September 23 to October 15, 2009, twice a week, 50 to 55 minutes each. The instrument used in this study was Yoon Hyang-mi(2008)'s Self-Esteem Inventory, and the collected data were analyzed with a SPSS 12.0 program. The major findings of the study were as follows: First, the reading and discussion activities had an effect on bolstering the general self, social self and academic self of the children in the Gongbubang, a social welfare center. Second, the reading and discussion activities were effective at improving the general self and academic self of the school boys in the Gongbubang, a social welfare center. Third, the reading and discussion activities had an effect on fostering the social self and academic self of the school girls in the Gongbubang, a social welfare center. The findings of the study illustrated that the reading and discussion activities had an effect on furthering the self-esteem of the children in the Gongbubang, a social welfare center, and those activities are expected to be conducive to the self-esteem of children in Gongbubangs, which are social welfare centers.

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Distribution Pattern of Vascular Plant Species along an Elevational Gradient in the Samga Area of Sobaeksan National Park (소백산국립공원 삼가지구 관속식물의 고도별 분포패턴)

  • Park, Hwan Joon;Ahn, Ji Hong;Seo, In soon;Lee, Sae Rom;Lee, Byoung Yoon;Kim, Jung Hyun
    • Journal of Korean Society of Forest Science
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    • v.109 no.1
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    • pp.1-22
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    • 2020
  • In order to evaluate the vertical distribution and distributional pattern of vascular plants in the Samga district of Sobaeksan National Park, vascular plants were surveyed along a hiking trail from the Samga Tour Support Center to the top of a mountain. The elevation range was divided into 11 sections with 100 m intervals from 400 m to 1439 m above sea level.A total of 375 taxa were listed, comprising 92 families, 235 genera, 332 species, 3 subspecies, 37 varieties, and 3 forms. The pattern of species richness along the elevational gradient showed a reverse hump-shaped trend. The species distribution pattern was positively correlated with the soil exchangeable cations Ca2+ and Mg2+, soil pH, available phosphate, and the warmth index. Furthermore, slope, soil moisture content, and soil exchangeable cations were significantly correlated with species distribution. DCA grouped herb species into two groups. Stands of each section were sequentially arranged from 400 m to 1500 m along an altitudinal gradient. Soil moisture content, soil pH, soil K2+ and Na2+, available phosphate, and slope were significantly correlated with stand distribution. This study provides important data that could be useful for conservation and the sustainable use of biodiversity in the study area. In order to understand the ecological and environmental characteristics and distribution of plant species, it will be necessary to continuously develop relative studies with continuous monitoring.

Effects of Purchasing Factors through Social-commerce of Beauty Service on the Consumer Satisfaction and the Repurchasing Intention (소셜커머스를 통한 뷰티서비스 구매요인이 고객만족과 재구매 의도에 미치는 영향)

  • Hong, Soo-Nam;Lee, Han-Joo
    • Journal of Internet Computing and Services
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    • v.15 no.6
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    • pp.133-144
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    • 2014
  • As the Internet and smartphones prevail, this study investigated the purchasing factors of a new beauty marketing method, the social commerce, and verified the relationship of such purchasing factors to consumer satisfaction and repurchasing intentions. In order to verify the validity of purchasing factors, five sub-factors, such as service, price, interaction, convenience, and interest were classified, while consumer satisfaction and repurchasing intentions are grouped into one factor, using data about 20-39 years old. According to results of this study, purchasing factors in the beauty service markets through social commerce that had effects on the consumer satisfaction were price, service, convenience, and interest, but no relationship was found with interaction. We can predict that consumers buy not based on community activities among buyers or purchasing comments of others, but rather his/her own subjective thoughts and opinions about the services. As the result of repurchasing intention according to purchasing factors, affecting sub-factors were price, service, and convenience. Repurchasing intention is an positive response that reflects satisfactions. Since low price, satisfaction on the service, and convenience for busy modern people should be met, repurchasing intentions are not affected by interest, but rather systematic and professional service. Also, higher satisfaction on service raises repurchasing intention. In this study, it is clear that not only purchasing factors through social-commerce effect the satisfaction and the repurchasing intention, but also consumer satisfaction mediates partly purchasing factors and the repurchasing intention. And as sub-factors of purchasing factors, price, service, or convenience are more important to the consumer satisfaction than community or replies activities. Thus differentiated and professional customer service, the establishment and enhancement of trendy marketing should improve long term repurchasing intentions. This will lead to the increasing revenue of personal-shop and the developments of beauty markets, so strengthening product sourcing and promotion suitable for mobile shoppers are essential.

Ecological Characteristics of Rhodotypos scandens Habitat in Imsil-gun, Jeollabuk-do, Korea (전라북도 임실군 병아리꽃나무 자생지의 생태적 특성)

  • Park, Kyung-Uk;Beon, Mu-Sup;Oh, Hyun-Kyung;You, Ju-Han
    • Journal of Environmental Impact Assessment
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    • v.24 no.4
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    • pp.352-366
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    • 2015
  • The purpose of this study is to offer the basic data to the habitat conservation and management by surveying and analysing the ecological characteristics such as the flora, vegetation structure and soil of Rhodotypos scandens habitat. The flora were summarized as 131 taxa including 57 families, 99 genera, 107 species, 1 subspecies, 17 varieties and 6 forms. The life forms grouped as in the follows; the megaphanerophytes(MM) were 21 taxa, 24 taxa of the microphanerophytes(M), 30 taxa of nanophanerophytes(N), 6 taxa of chamaiphytes(Ch), 20 taxa of hemicryptophytes(H), 17 taxa of geophytes(G), 12 taxa of therophytes(Th) and 1 taxa of hydrophytes(HH). The present conditions of communities were 8 types including Zelkova serrata, Quercus aliena, Ulmus parvifolia, Rhamnella frangulioides, Castanea crenata, Albizia julibrissin, Celtis sinensis and Robinia pseudoacacia. In case of the dominant species by layers, the tree layer species were Zelkova serrata, Quercus aliena, Ulmus parvifolia, Castanea crenata, Albizia julibrissin, Celtis sinensis and Robinia pseudoacacia, and the subtree layer species were Rhamnella frangulioides, Q. aliena, Z. serrata, A. julibrissin, U. parvifolia and Broussonetia kazinoki. The shrub layer species was Rhodotypos scandens. In the results of analyzing the diversity index, $H^{\prime}{_{max}}$ from 1.691 to 2.610, from 2.197 to 3.466 in H'max, from 0.646 to 0.903 in J' and from 0.097 to 0.354 in D. In the results of analysing the soil, there showed that acidity was 5.6, 0.5dS/m of electrical conductivity(EC), 59.1mg/kg of available $P_2O_5$, 49.7% of organic matter content, $0.4cmol^+/kg$ of exchangeable $K^+$, $13.5cmol^+/kg$ of exchangeable $Ca^{2+}$, $3.3cmol^+/kg$ of exchangeable $Mg^{2+}$.

The Correlation between the Severity of Hypoxic Ischemic Encephalopathy and the Development of Acute Renal Failure in Asphyxiated Neonates (신생아 질식 환아에서 저산소성 허혈 뇌증의 정도와 급성신부전 발생과의 연관성)

  • Park, Sung-Shin;Chung, Sung-Hoon;Song, Jun-Hyuk;Kim, Sun-Kyoung;Cho, Byoung-Soo;Kim, Sung-Do
    • Childhood Kidney Diseases
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    • v.11 no.1
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    • pp.32-40
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    • 2007
  • Purpose : We performed this study to determine the incidence of acute renal failure(ARF) in birth asphyxia and to correlate the severity of asphyxia and hypoxic-ischemic encephalopathy (HIE) and ARF in asphyxiated neonates. Methods : Data was retrospectively collected from the medical records of 33 patients with neonatal asphyxia and of 33 neonates with no asphyxia. On the basis the 5-minute Apgar score, the asphyxiated neonates were further grouped into mild(6 or 7), moderate(4 or 5), and severe asphyxia(3 or less). Asphyxiated neonates with HIE were staged by the Sarnat and Sarnat scoring system. We compared serum creatinine, blood urea nitrogen, electrolytes, and urine output on day 3 of life and the incidence and severity of intraventricular hemorrhage(IVH) between each group. Results : ARF occurred in 8(24.2%) asphyxiated neonates. Of these, 3(37.5%) were oliguric, while 1(10.0%) patient with mild asphyxia, 2(18.2%) of moderate asphyxia, and 5(41.7%) with of severe asphyxia had ARF(P>0.05). One(25%) patient with stage I HIE, 4(50%) with stage II HIE, and 3(75%) of HIE with stage III HIE developed ARF(P<0.01). There was no statistical correlation between the severity of asphyxia and HIE stage. One(7.7%) patient with grade 1 IVE, 0(0.0%) with grade 2 IVH, 2(66.7%) with grade 3 IVH, and 2(100.0%) with grade 4 IVH had ARF(P<0.01). Mortality was higher in asphyxiated neonates with ARF(P<0.05). There was no significant difference between the oliguric and non-oliguric renal failure. Conclusion : We found that the greater the degree of HIE, the higher was the incidence of ARF. Asphyxiated neonates with ARF had a poorer prognosis.

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The Inflammatory Response in Mouse Lung after Acute Sulfur Dioxide Exposure (급성 아황산가스 폭로후 흰쥐의 폐에 유발된 염증반응에 관한 연구)

  • Chin, Young-Joo;Park, Nam-Gyu;Lee, Hyeon-Suk;Kim, Dae-Soo;Earm, Jae-Ho;Cho, Myeong-Chan;Yoon, Sei-Jin;Jeong, Hwa-Sook;Song, Hyung-Geun;Sung, Ro-Hyun;Lee, Sang-Do
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.4
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    • pp.328-338
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    • 1994
  • Background: Effect of sulfur dioxide($SO_2$) exposure on airway is well known but little about the effect of $SO_2$ exposure on lung parenchyme. This study is to determine if short tenn exposure to $SO_2$ in concentration commonly found in industrialized environment cause potentially harmful effect on the lung parenchyme, and to evaluate the exposure time-response relationship between short tenn exposure to $SO_2$ and the inflammatory response in mouse lung. Method: 5ppm $SO_2$ gas was used and 48 mice were grouped into control(10), 30(9), 60(11), and 120 minute exposure(18) group. In each group, bronchoalveolar lavage(BAL) was done immediately after and at 1,2,3 days after exposure. Histological examination was performed in control and 120 minute exposure group. Results: 1) Cell response in bronchoalveolar lavage fluid. In 30 and 60 minute exposure group, compared to the control group, lymphocyte count has significantly increased(p<0.05) at 1 day after exposure but did not differ at 2 days after exposure. In 120 minute exposure group, also compared to the control group, there was significant increase in total cell, macrophage, and lymphocyte count at 1 day after exposure, (p<0.05) which lasted for 2 days but did not significantly differ at 3 days after exposure. 2) Histological findings in 120 minute exposure group. In the airway, mild epithelial cell damage and ciliary loss were noted but there was no evidence of inflammatory cell infiltration. Interstitial inflammatory infiltration was noted at 1 day after exposure, which lasted for 3 days after exposure and there was no evidence of edema or fibrosis in the interstitium Conclusions: These data indicate potentially noxious effect of $SO_2$ on the lung parenchyme as well as the airway at exposure level that are regarded as relatively safe, and the duration of injury depends on the exposure time.

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Diagnostic Performance of Routine Objective Tests and Cost-Effective Approach for Chronic Cough (만성 기침의 진단 성적과 경제적 접근 모델)

  • Jeon, Gang;Jang, Seung Hun;Song, Hae Geun;Ha, Jun-Wook;Eom, Kwang-Seok;Bahn, Joon-Woo;Kim, Dong-Gyu;Shin, Tae Rim;Park, Sang Myon;Park, Yong Bum;Kim, Chul-Hong;Hyun, In-Gyu;Jung, Ki-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.6
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    • pp.535-542
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    • 2004
  • Background : Despite the clinical clues of bronchial asthma, some chronic coughers fail to be diagnosed due to negative test results. This study was aimed at evaluating the diagnostic performance of routine objective tests and identifying a cost-effective approach for asthmatics with a chronic cough. Methods : Patients with a chronic cough of more than 3 weeks duration, and showing normal chest radiograph and spirometry were enrolled. On the first visit, objective tests, composed of serum total IgE, peripheral blood eosinophil count, spontaneous sputum eosinophil count, methacholine bronchial provocation test (MBPT) and paranasal sinus radiograph, were performed, with the simultaneous administration of oral prednisolone (0.5mg/kg) for one week. The final diagnoses were made on the basis of the test results, and the patients grouped according to their steroid responsiveness. The role of the etiologic diagnosis tests was evaluated, and the medical costs of the final management plan simulated with respect to three assumed models. Results : Sixty chronic coughers were finally analyzed. The final diagnoses were as follows: bronchial asthma 21.7%, eosinophilic bronchitis 6.7%, paranasal sinusitis 18.3%, presumptive allergy 8.3% and non-diagnostic case 45.0%. Ninety percent were steroid responder. With the bronchial asthma cases, the positive rate of MBPT was 38.5%, with sputum eosinophil count in 84.6%, serum total IgE in 38.5%, and a peripheral blood eosinophil count rate of 30.8%. When the test results and steroid responsiveness data were applied to the 3 models, the chest radiograph, spirometry, sputum eosinophil count and paranasal sinus radiograph test results, and simultaneous short term steroid treatment seemed to have acceptable diagnostic performances, which could be used as a further guide to cost-effective planning. Conclusion : Objective tests, composed of chest radiograph, spirometry, paranasal sinus radiograph and sputum eosinophil count, with simultaneous short term steroid treatment, are suggested as cost-effective approaches for asthmatics with a chronic cough.

Educational Needs of Elderly Hypertensive or Diabetes Patients and Educators for Education Program Development of Cardiocerebrovascular High-risk Group (심뇌혈관질환 고위험군 교육프로그램개발을 위한 노인 고혈압·당뇨병환자와 교육자의 교육요구도 및 지식수준에 대한 비교분석)

  • Lee, Hye-Jin;Kam, Sin
    • Journal of agricultural medicine and community health
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    • v.35 no.2
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    • pp.177-192
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    • 2010
  • Objectives: This study was conducted to examine the educational needs of elderly hypertensive or diabetes patients and educators for the education program development of cardiocerebrovascular high-risk group in community. Methods: This study was conducted with 60 hypertensive or diabetes patients aged 65 years or above (cardiocerebrovascular high-risk group) who had registered KHyDDI(Korea Hypertension Diabetes Daegu Initiative) Project and attended Hypertension Diabetes Intervention Center Program, and with 44 educators in the center between June and August, 2009. Data were collected using questionnaires including general characteristics, educational objectives, curriculum, contents, and methods. Results: The major findings of this study were as follows: In education methods, cardiocerebrovascular high-risk group and educators both preferred small-grouped(5-9 persons) or individual education, 30min-1 hour, 50%-50% of theory-practice ratio, 3 months of education. In education contents, both groups needed all the suggested contents. Five categories would be suggested for the development of education program. The first category was that there was no significant difference between cardiocerebrovascular high-risk group's needs and knowledge. The second was category of low knowledge level in cardiocerebrovascular high-risk group's knowledge. The repeated education would be necessary for this category. The third was category with large standard deviation in cardiocerebrovascular high-risk group's knowledge. Individual education would be necessary for this category. The fourth category was that there was significant difference between cardiocerebrovascular high-risk group's knowledge and knowledge assessed by educators. The improvement of educator's education skill would be necessary for this category. The fifth category was that there was significant difference between cardiocerebrovascular high-risk group and educator's needs. Conclusions: Small group or individualized and staged education reflecting above cardiocerebrovascular high risk group and educators' needs should be developed for more effective education to prevent and manage the cardiocerebrovascular disease.

Hydrogeochemical, Stable and Noble Gas Isotopic Studies of Hot Spring Waters and Cold Groundwaters in the Seokmodo Hot Spring Area of the Ganghwa Province, South Korea (강화 석모도 지역 온천수와 지하수의 수리지구화학 및 동위원소 연구)

  • Kim, Kyu-Han;Jeong, Yun-Jeong;Jeong, Chan-Ho;Keisuke, Nagao
    • Economic and Environmental Geology
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    • v.41 no.1
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    • pp.15-32
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    • 2008
  • The hydrochemical and isotopic (stable isotopes and noble gas isotopes) analyses for hot spring waters, cold groundwaters and surface water samples from the Seokmodo hot spring area of the Ganghwa province were carried out to characterize the hydrogeochemical characteristics of thermal waters and to interpret the source of thermal water and noble gases and the geochemical evolution of hot spring waters in the Seokmodo geothermal system. The hot spring waters and groundwaters show a weakly acidic condition with the pH values ranging from 6.42 to 6.77 and 6.01 to 7.71 respectively. The outflow temperature of the Seokmodo hot spring waters ranges from $43.3^{\circ}C\;to\;68.6^{\circ}C$. Relatively high values of the electrical conductivities which fall between 60,200 and $84,300{\mu}S/cm$ indicate that the hot spring waters were mixed with seawater in the subsurface geothermal system. The chemical compositions of the Seokmodo hot spring waters are characterized by Na-Ca-Cl water type. On the other hand, cold groundwaters and surface waters can be grouped into three types such as the Na(Ca)-$HCO_3$, Na(Ca)-$SO_4$ and Ca-$HCO_3$ types. The ${\delta}^{18}O\;and\;{\delta}D$ values of hot spring waters vary from -4.41 to -4.47%o and -32.0 to -33.5%o, respectively. Cold groundwaters range from -7.07 to -8.55%o in ${\delta}^{18}O$ and from -50.24 to -59.6%o in ${\delta}D$. The oxygen and hydrogen isotopic data indicate that the hot spring waters were originated from the local meteoric water source. The enrichments of heavy isotopes ($^{18}O\;and\;^2H$) in the Seokmodo hot spring waters imply that the thermal water was derived from the diffusion Bone between fresh and salt waters. The ${\delta}^{34}S$ values ranging from 23.1 to 23.5%o of dissolved sulfate are very close to the value of sea water sulfate of ${\delta}^{34}$S=20.2%o in this area, indicating the origin of sulfate in hot springs from sea water. The $^3H/^4He$ ratio of hot spring waters varies from $1.243{\times}10^{-6}\;to\;1.299{\times}10^{-6}cm^3STP/g$, which suggests that He gas in hot spring waters was partly originated from a mantle source. Argon isotopic ratio $(^{40}Ar/^{36}Ar=298{\times}10^{-6}cm^3STP/g)$ in hot spring waters corresponds to the atmospheric value.