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Determination of Cost and Measurement of nursing Care Hours for Hospice Patients Hospitalized in one University Hospital (일 대학병원 호스피스 병동 입원 환자의 간호활동시간 측정과 원가산정)

  • Kim, Kyeong-Uoon
    • Journal of Korean Academy of Nursing Administration
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    • v.6 no.3
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    • pp.389-404
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    • 2000
  • This study was designed to determine the cost and measurement of nursing care hours for hospice patients hostpitalized in one university hospital. 314 inpatients in the hospice unit 11 nursing manpower were enrolled. Study was taken place in C University Hospital from 8th to 28th, Nov, 1999. Researcher and investigator did pilot study for selecting compatible hospice patient classification indicators. After modifying patient classification indicators and nursing care details for general ward, approved of content validity by specialist. Using hospice patient classification indicators and per 5 min continuing observation method, researcher and investigator recorded direct nursing care hours, indirect nursing care hours, and personnel time on hospice nursing care hours, and personnel time on hospice nursing care activities sheet. All of the patients were classified into Class I(mildly ill), Class II (moderately ill), Class III (acutely ill), and Class IV (critically ill) by patient classification system (PCS) which had been carefully developed to be suitable for the Korean hospice ward. And then the elements of the nursing care cost was investigated. Based on the data from an accounting section (Riccolo, 1988), nursing care hours per patient per day in each class and nursing care cost per patient per hour were multiplied. And then the mean of the nursing care cost per patient per day in each class was calculated. Using SAS, The number of patients in class and nursing activities in duty for nursing care hours were calculated the percent, the mean, the standard deviation respectively. According to the ANOVA and the $Scheff{\'{e}$ test, direct nursing care hours per patient per day for the each class were analyzed. The results of this study were summarized as follows : 1. Distribution of patient class : class IN(33.5%) was the largest class the rest were class II(26.1%) class III(22.6%), class I(17.8%). Nursing care requirements of the inpatients in hospice ward were greater than that of the inpatients in general ward. 2. Direct nursing care activities : Measurement ${\cdot}$ observation 41.7%, medication 16.6%, exercise ${\cdot}$ safety 12.5%, education ${\cdot}$ communication 7.2% etc. The mean hours of direct nursing care per patient per day per duty were needed ; 69.3 min for day duty, 64.7 min for evening duty, 88.2 min for night duty, 38.7 min for shift duty. The mean hours of direct nursing care of night duty was longer than that of the other duty. Direct nursing care hours per patient per day in each class were needed ; 3.1 hrs for class I, 3.9 hrs for class II, 4.7 hrs for class III, and 5.2 hrs for class IV. The mean hours of direct nursing care per patient per day without the PCS was 4.1 hours. The mean hours of direct nursing care per patient per day in class was increased significantly according to increasing nursing care requirements of the inpatients(F=49.04, p=.0001). The each class was significantly different(p<0.05). The mean hours of direct nursing care of several direct nursing care activities in each class were increased according to increasing nursing care requirements of the inpatients(p<0.05) ; class III and class IV for medication and education ${\cdot}$ communication, class I, class III and class IV for measurement ${\cdot}$ observation, class I, class II and class IV for elimination ${\cdot}$ irrigation, all of class for exercise ${\cdot}$ safety. 3. Indirect nursing care activities and personnel time : Recognization 24.2%, house keeping activity 22.7%, charting 17.2%, personnel time 11.8% etc. The mean hours of indirect nursing care and personnel time per nursing manpower was 4.7 hrs. The mean hours of indirect nursing care and personnel time per duty were 294.8 min for day duty, 212.3 min for evening duty, 387.9 min for night duty, 143.3 min for shift duty. The mean of indirect nursing care hours and personnel time of night duty was longer than that of the other duty. 4. The mean hours of indirect nursing care and personnel time per patient per day was 2.5 hrs. 5. The mean hours of nursing care per patient per day in each class were class I 5.6 hrs, class II 6.4 hrs, class III 7.2 hrs, class IV 7.7 hrs. 6. The elements of the nursing care cost were composed of 2,212 won for direct nursing care cost, 267 won for direct material cost and 307 won for indirect cost. Sum of the elements of the nursing care cost was 2,786 won. 7. The mean cost of the nursing care per patient per day in each class were 15,601.6 won for class I, 17,830.4 won for class II, 20,259.2 won for class III, 21,452.2 won for class IV. As above, using modified hospice patient classification indicators and nursing care activity details, many critical ill patients were hospitalized in the hospice unit and it reflected that the more nursing care requirements of the patients, the more direct nursing care hours. Emotional ${\cdot}$ spiritual care, pain ${\cdot}$ symptom control, terminal care, education ${\cdot}$ communication, narcotics management and delivery, attending funeral ceremony, the major nursing care activities, were also the independent hospice service. But it is not compensated by the present medical insurance system. Exercise ${\cdot}$ safety, elimination ${\cdot}$ irrigation needed more nursing care hours as equal to that of intensive care units. The present nursing management fee in the medical insurance system compensated only a part of nursing car service in hospice unit, which rewarded lower cost that that of nursing care.

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Exploration of Critical Reflection through Home Economics Pre-service Teacher's Instruction Experience (가정과예비교사의 수업경험을 통한 비판적 반성에 관한 탐구)

  • Yang, Ji Sun
    • Human Ecology Research
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    • v.56 no.3
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    • pp.301-315
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    • 2018
  • This study explores the critical reflection process experienced by home economics preservice teachers during practicum. Data were collected in a critical analysis of class, practicum review, and journals written by sixteen preservice teachers. Text material were composed of 188 transcripts on A4 paper and 36 page of mini-notes. The collected data were analyzed by a thematic coding method in qualitative research and proceeded in the order of three steps of transference, coding, and subject discovery. The emerging themes were: 1) Observing class 2) Practicing class 3) Growth of class practice 4) Reflecting class. First, the observing class was an exploration process through the viewing of daily classes that involved the process of recognizing the classroom situation and various classroom contexts. Second, the practicing class was to strengthen the consideration of the class to form a relationship that could lead to learning in educational situations. Third, the growth of class practice was intended to recognize the orientation of the subject matter with pedagogical content knowledge. Four, the reflecting class was the process of experiencing practice with a continuous understanding of the class, class reflection, and changing the perspective from the current status. There is a part where critical reflection is difficult to be promoted deeply during 4 weeks; however, there was a possibility of a reflection practice that could promote achievement through the experience of a practicing class.

Factors influencing class flow of dental hygiene students in dental hygiene care process (치위생(학)과 학생의 치위생관리과정 수업몰입 영향요인)

  • Cho, Hye-Eun;Chung, Kyung-Yi
    • Journal of Korean society of Dental Hygiene
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    • v.20 no.1
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    • pp.63-71
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    • 2020
  • Objectives: This study provides basic data for developing practical teaching methods enabling efficient execution of the dental hygiene care process. Methods: A total of 197 dental hygiene students experienced in dental hygiene care process in Gwangju and Jeonnam were surveyed from June 1 to August 30, 2019 to study their class flow, professors-student relationships, and class satisfaction level. Post survey, statistical analysis was performed using frequency analysis, independent t-test, Pearson's correlation analysis, and multiple regression analysis. Results: 1. Class fl ow was high in three lecturers (3.56), four hours per week (3.39), and four hours per week (3.94). Class satisfaction was high in three lecturers (3.99) and four hours per week (3.90) (p<0.05). 2. There was a positive correlation between class flow and professor-student relationship (r=0.519), class fl ow and class satisfaction (r=0.566), and professor-student relationship and class satisfaction (r=0.838) (p<0.01). 3. The factors influencing class fl ow were the number of lecturers (β=0.442), class hours per week (β=-0.397), and class satisfaction (β=0.385). Conclusions: Apart from finding ways to improve class satisfaction for class flow in the dental hygiene care process, efforts are required to increase the number of lecturers and class hours per week for efficient class management. Further research is needed to develop practical teaching methods.

A STUDY ON THE VERTICAL DYSPLASIA IN THE SKELETAL CLASS III MALOCCLUSION (골격형(骨格型) III급(級) 부정교합자(不正咬合者)의 수직부조화(垂直不調和)에 관(關)한 연구(硏究))

  • Shin, Mun-Chang
    • The korean journal of orthodontics
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    • v.20 no.2
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    • pp.333-354
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    • 1990
  • This study was designed to analyse vertical dysplasia such as open bite or deep bite in persons with skeletal Class III malocclusion. The subjects consisted of 60 control patients, 40 Class III open bite patients and 40 Class III deep bite patients. The mean age was 19.8 years in the control group, 17.8 years in the Class III open bite group and 16.5 years in the Class III deep bite group. The results were as follows: 1. In Class III malocclusion patients, the characteristics of the vertical dysplasia are under the palatal plane. 2. In Class III malocclusion patients, the items showing the characteristics of the vertical dysplasia are mandibular plane angle, lower gonial angle, lower facial height, dental height & inclination of the upper first molar, interincisal angle, maxillary & mandibular occlusal plane angle. 3. In Class III malocclusion patients, LPFH/LAFH ratio shows the highest significance among the facial height ratios. 4. In Class III malocclusion patients, open bite group has a upward cant of maxillary occlusal plane & downward cant of mandibular occlusal plane. And deep bite group has a downward cant of maxillary occlusal plane & upward cant of mandibular occlusal plane. 5. In Class III malocclusion patients, the molar teeth of the open bite group are measially inclined and those of the deep bite group are upright.

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Application of Distance Learning to Practical Cooking Class - With a Focus on Korean Food Cooking Class in Culinary College Students - (조리실기 과목의 원격교육 활용을 위한 실증연구 - 2년제 조리전공 대학생을 대상으로 한 한식교과목을 중심으로 -)

  • Kang, Jae-Hee;Chong, Yu-Kyeong
    • Journal of the Korean Society of Food Culture
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    • v.26 no.3
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    • pp.249-260
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    • 2011
  • The current research aims to verify whether distance learning can be adopted in practical cooking class for Korean foods in a two-year college. The distance learning education can be a supplementary method to the traditional cooking class. The face-to-face teaching method and the distance learning method were compared in order to determine which of the one is more effective teaching method in the practical cooking class. The results of the present experimental study were analyzed based on the participant's learning expectation and satisfaction, the evaluation of the experimental process, and the academic performance. The results of this study showed that the participants in the face-to-face class evaluated their class experience higher than those in the distance learning class with respect to the participant's learning expectation and satisfaction, and the evaluation of the experimental process. On the contrary, regarding the academic performance, the participants in the distance learning class showed higher scores than those in the face-to-face class. The end result supports the claim that the distance learning method is more effective in the participants for gaining cooking knowledge.

Pericardiectomy in Constrictive Pericarditis -23 Cases- (만성 교약성 심낭염의 외과적 치료)

  • 하현철
    • Journal of Chest Surgery
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    • v.28 no.2
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    • pp.143-149
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    • 1995
  • From January, 1983, to August, 1993, 23 cases of pericardiectomy for chronic constrictive pericarditis were carried out. The 15 male and 8 female patients ranged in age from 7 to 68 years[mean 39.1 years . All patients underwent pericardiectomy through a median sternotomy. Postoperative complications were low cardiac output[2 patients , wound infection[2 patients , pneumonia[2 patients , and unilateral phrenic nerve palsy[2 patients . One patient died of low cardiac output 1 day after pericardiectomy due to the associated transposition of great artery and hypoplastic right lung. Clinical and pathological findings showed that the cause of constrictive pericarditis was tuberculous in 8 cases[34.8% , idiopathic in 12 cases[52.2% and pyogenic in 3 cases[13.0% . Central venous pressure fell below 10cmH2O by immediate in 6 cases, fell below 10cmH2O by 24hrs in 5 cases and continued above 10cmH2O after 24hrs in 12 cases. Preoperative NYHA functional class of patients showed class I-1, classII-4, class III-14, and class IV-3. Postoperativly NYHA functional class was improved to class I-15, classII-6, class III-1.

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EPIDEMIOLOGIC STUDY OF THE PREVALENCE OF MALOCCLUSION IN KOREAN (한국인(韓國人) 부정교합(不正咬合) 발생빈도(發生頻度)에 관(關)한 역학적(疫學的) 연구(硏究))

  • Suhr, Cheong Hoon;Nahm, Dong Seok;Chang, Young II
    • The korean journal of orthodontics
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    • v.14 no.1
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    • pp.33-37
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    • 1984
  • The prevalence of normal occlusion and malocclusion was assessed by Angle's Classification method for 8989 school students at 7-22 years in Seoul. The occurrence of malocclusion and the need-for orthodontic treatment was 61 per cent among them. Results indicated no significant differences between the sexes for the occlusal relationships of the mandible to the maxille. The prevalence of Class I, Class II, and Class III malocclusion in all malocclusion was shown to be Class I, 45.7 per cent; Class II, 7.6 per cent; and Class III, 7.9 per cent. Class II Division 1 was observed to occur four times frequently compared to Class II Division 2 in Class II malocclusions. Class III malocclusion was shown to occur more frequently compared that of Caucasians.

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A Study on the Comparison of Costume at Lower and Middle Class in the Tudor Dynasty

  • Kim, Kyung-Hee
    • Journal of Fashion Business
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    • v.6 no.6
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    • pp.43-55
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    • 2002
  • This study intends to consider the characteristics of Tudorian costume and find out how the thoughts and cultures in those days had influences on the costume trends of low and middle class. In terms of the Tudorian costume which generated new cultural mainstreams along with blossomed civil culture, this study focuses on the characteristics and trends of costume at low and middle class, which have been little addressed in studies on western costume history or related fields, turning from the costume of upper class based on wealthy noblemen who showed off its dignity and authority along with jewelry and gorgeous ornamental craftsmanship. This study used related pictures, museum material and other literatures as its reference. It first looked into the general characteristics of western costume and considered the characteristics of costumes popularized in professionals at middle class such as apprentice, yeomen and low-class people. Professional or other middle class almost typically used to wear tunic, doublet, shirts, coat or long gown. Black was mainly used as clothes color. Similarly to upper class, silk or velvet was very often used as material. People at low class enjoyed wear costumes with simple and easy style for working. They also preferred natural color and cotton or wool as material. This study intended to find out which type of costumes people at low and middle class enjoyed wearing, rather than compare costume between such two classes.

An Ecological Study on the Environment of the Children in the Deprived Areas in Seoul (빈민지역 아동의 생활환경에 관한 생태학적 연구)

  • Kim, Chong Soon
    • Korean Journal of Child Studies
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    • v.2
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    • pp.67-82
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    • 1981
  • The present study was intended to investigate ecological characteristics of poverty areas in Seoul from the perspectives of children's development. More specifically, the objectives of the study are to examine environmental ecology of the poverty areas and it's potential psycho-social development of children. Three poverty areas and 150 children currently living in the are as were sampled ; 70 children from middle class families and 88 from lower class respectively. Focal ecological aspects surveyed family environment, outdoor play ground and facilities, and village housing structures. Psycho-social dimension's development dealt with in the study included children's perceptions of parental child rearing practices and role taking, and children's future perception and perspectives. Data were collected through interviews and observations using structured formats. Following results were obtained from the data : 1. Children from the poverty families showed a higher tendency to have working mothers than those from middle class. 2. The rate of having single room is higher for children from middle class by two times than from lower class. 3. Children from lower class tended to have less favorable perceptions of attitudes tote and their own families than those from middle class. 4. The likelihood of showing discrepancy in vocational choice for children between parents and children is higher for children from lower class and those from middle class. 5. Children from lower class tended to allot more time in playing with peers than those from middle class. 6. The size of outdoor play ground are inadequately poor both for middle and lower class children. The inadequateness is particularly severe for the lower class children, showing that the size and facilities of playing ground available for the child from lower class is less than half compared with those of the children from middle class.

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An Efficient One Class Classifier Using Gaussian-based Hyper-Rectangle Generation (가우시안 기반 Hyper-Rectangle 생성을 이용한 효율적 단일 분류기)

  • Kim, Do Gyun;Choi, Jin Young;Ko, Jeonghan
    • Journal of Korean Society of Industrial and Systems Engineering
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    • v.41 no.2
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    • pp.56-64
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    • 2018
  • In recent years, imbalanced data is one of the most important and frequent issue for quality control in industrial field. As an example, defect rate has been drastically reduced thanks to highly developed technology and quality management, so that only few defective data can be obtained from production process. Therefore, quality classification should be performed under the condition that one class (defective dataset) is even smaller than the other class (good dataset). However, traditional multi-class classification methods are not appropriate to deal with such an imbalanced dataset, since they classify data from the difference between one class and the others that can hardly be found in imbalanced datasets. Thus, one-class classification that thoroughly learns patterns of target class is more suitable for imbalanced dataset since it only focuses on data in a target class. So far, several one-class classification methods such as one-class support vector machine, neural network and decision tree there have been suggested. One-class support vector machine and neural network can guarantee good classification rate, and decision tree can provide a set of rules that can be clearly interpreted. However, the classifiers obtained from the former two methods consist of complex mathematical functions and cannot be easily understood by users. In case of decision tree, the criterion for rule generation is ambiguous. Therefore, as an alternative, a new one-class classifier using hyper-rectangles was proposed, which performs precise classification compared to other methods and generates rules clearly understood by users as well. In this paper, we suggest an approach for improving the limitations of those previous one-class classification algorithms. Specifically, the suggested approach produces more improved one-class classifier using hyper-rectangles generated by using Gaussian function. The performance of the suggested algorithm is verified by a numerical experiment, which uses several datasets in UCI machine learning repository.