• Title/Summary/Keyword: instruction effect

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Development and Effectiveness of the Primary Hospice Education Program for Nurses (간호사를 위한 호스피스 기초 교육 프로그램 및 효과)

  • In, Sook-Jin
    • 한국호스피스완화의료학회:학술대회논문집
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    • 2004.07a
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    • pp.100-102
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    • 2004
  • Under the current medical system, a terminal patient and his/her family who are neglected inevitably face various aspects of crises including not only physical, but also psychological, social, economic, spiritual and legal problems. Nurses often look after many terminal patents with these types of complicated problems. Therefore, educating the nurses who will take care of such patents would greatly reduce stress so the patents end could their lives in peace and without losing their dignity. This research is a quasi experimental study of nonequivalent control group. A pretest-posttest design where a basic education program is developed for nurses, who frequently treat terminal patents, to understand the importance of the role of hospice and to apply their understandings to treat terminal lancer patents. A sample of the nurses were taken from those who were working in general wards at two general hospitals in Seoul during October, 2003${\sim}$December 2003. The study was composed of 46 experimental group and 43 control group. A basic hospice education program was developed by taking emphasized and overlapping parts from advanced practice hospice nurses education course, short-term education course, an extensive literature survey and by consulting three professionals as well. With the group of 5 professors with vast experiences in oncolgy, 5 nursing administrator, 3 nursing practitioner, the tentative first version of the program was developed and reviewed. Afterwards, by utilizing person to person interviews with 2 head nurses experienced with terminal patients, 1 nurse in charge of hospice, 1 nurse on the contents of the program, and a person to person rating on the educating medium by a nurse were performed. The final version of a basic education program was developed after the second revision. The hospice basic education program consists of introduction to hospice, hospice and commucation, management of pain for terminal cancer patients, physical management for terminal cancer patients, socio-psycological caring of terminal cancer patients and management of death and separation. Total education time was four hours organized into 50 minutes of instruction and 10 minutes of break. $Powerpoint^{(R)}$ software was used as the education medium. As research tools, "Knowledge on Hospice" was developed by the author after receiving a review from one expert. "Attitude of Hospice Nursing" was revised Kim(2001)'s attitude measuring tool which was based on Wang(1998), Kwon(1989), Park and Sung(1991)'s tool. "Liability on nursing terminal patients" was used as developed by Zarits(1980) and Mongomory(1985) translated by Lee(1985). For collecting data, preliminary investigation prior to 1 week of the hospice basic education program and post-investigations after 1 week and 4 weeks of the education were carried out for the nurses at a general ward who understood and agreed on the purpose of the program. Collected data were analyzed throughout t-test, $x^2-test$, Manova test and Bonferroni correction in $SAS^{(R)}$ program. The summary of the investigation is as follows: Hypothesis 1: "Educated experimental group would possess more knowledge on hospice compared to the un-educated control group" was supported after 1 (F=12.14, p=.00) and 4 (F=5.3, p=.02) weeks of education. Hypothesis 2: "Educated experimental group would take a positive attitude toward hospice nursing compared to the un-educated control group" was supported after 1(F=3.92, p=.05) and 4(F=5.05, p=.02) weeks of education. Hypothesis 3: "Educated experimental poop would feel less liability compared to the un-educated control group in nursing terminal cancer patients' was rejected. In this study, it was found that knowledge on hospice was significantly important. By applying hospice basic education programs to nurses, the education program helped nurses to take a positive attitude toward terminal patients. It was, however, seen that the education program had no effect on alleviating liability in nursing terminal patients. Therefore, it is expected that this educational program would help hospices and nurses at general wards to understand the concept and the role of hospice so that terminal patents, now neglected under current medical system, would be able to end their lives in peace.

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A Study on Major Safety Problems and Improvement Measures of Personal Mobility (개인형 이동장치의 안전 주요 문제점 및 개선방안 연구)

  • Kang, Seung Shik;Kang, Seong Kyung
    • Journal of the Society of Disaster Information
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    • v.18 no.1
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    • pp.202-217
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    • 2022
  • Purpose: The recent increased use of Personal Mobility (PM) has been accompanied by a rise in the annual number of accidents. Accordingly, the safety requirements for PM use are being strengthened, but the laws/systems, infrastructure, and management systems remain insufficient for fostering a safe environment. Therefore, this study comprehensively searches the main problems and improvement methods through a review of previous studies that are related to PM. Then the priorities according to the importance of the improvement methods are presented through the Delphi survey. Method: The research method is mainly composed of a literature study and an expert survey (Delphi survey). Prior research and improvement cases (local governments, government departments, companies, etc.) are reviewed to derive problems and improvements, and a problem/improvement classification table is created based on keywords. Based on the classification contents, an expert survey is conducted to derive a priority improvement plan. Result: The PM-related problems were in 'non-compliance with traffic laws, lack of knowledge, inexperienced operation, and lack of safety awareness' in relation to human factors, and 'device characteristics, road-drivable space, road facilities, parking facilities' in relation to physical factors. 'Management/supervision, product management, user management, education/training' as administrative factors and legal factors are divided into 'absence/sufficiency of law, confusion/duplication, reduced effectiveness'. Improvement tasks related to this include 'PM education/public relations, parking/return, road improvement, PM registration/management, insurance, safety standards, traffic standards, PM device safety, PM supplementary facilities, enforcement/management, dedicated organization, service providers, management system, and related laws/institutional improvement', and 42 detailed tasks are derived for these 14 core tasks. The results for the importance evaluation of detailed tasks show that the tasks with a high overall average for the evaluation items of cost, time, effect, urgency, and feasibility were 'strengthening crackdown/instruction activities, education publicity/campaign, truancy PM management, and clarification of traffic rules'. Conclusion: The PM market is experiencing gradual growth based on shared services and a safe environment for PM use must be ensured along with industrial revitalization. In this respect, this study seeks out the major problems and improvement plans related to PM from a comprehensive point of view and prioritizes the necessary improvement measures. Therefore, it can serve as a basis of data for future policy establishment. In the future, in-depth data supplementation will be required for each key improvement area for practical policy application.

Confucian Cultivation of Mind and Meditation - The Care Model of Cultivation Applied by Toe-gye' 『The Method on Preservation of Human mind (活人心方)』 (유가 공부론과 명상 - 퇴계 활인심방(活人心方)을 응용한 수양치료 모형 -)

  • Lee, Yun-do
    • The Journal of Korean Philosophical History
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    • no.28
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    • pp.363-386
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    • 2010
  • The purpose of this study is to examine the relationship between theory of Confucian moral cultivation and meditation. Recently our community is more interested in 'a disease of mind'. A view of world, life, values which derived from the distorted perception of 'a disease of mind' can not be treated by psychiatric methods. In this sense, 'a disease of mind' is different from psychiatric illness. In this reason, alternative therapies applying philosophy, literature, arts, and humanities are attracting attention. Meditation is also one of them. In general, Meditation has been developed in Buddhism, but its method is closely related with Confucianism. Buddhist meditation has a pessimistic view of the reality in human life, but that of Confucian philosophy has laid stress on the reality and ego in human life. At this point, the Confucian meditation could provide a clue of solution for us in treatment of a disease of human mind. So Confucian moral cultivation and meditation have a great significance for the treatment of this disease as a methodology. In general, mental healing or psychotherapy has been proceeded by way of dialogue. 'Talking Cure' was conceived to let clients themselves recognize their current situation and find out the problem: "what happened and what's wrong" in their minds. But it does not have a high possibility of successful cure for subjects who are in the state of frustration, confusion, and lost of value. And also it is very difficult to apply to special institutions such as correctional institutions and military soldier who are targeted by current application of Humanities therapy. On this sense, it seems to be valuable to apply Confucian cultivation of mind and meditation which have emphasized the importance of mind-control for this. This study tries to examine theoretically how to relate the Confucian cultivation of mind with meditation, and to suggest a model of Humanities therapy that could be applied by Toe-gye's 『The Method on Preservation of Human mind(活人心方)』. Although Confucian cultivation of mind could present a meaningful theory for curing the disease of mind, it is very difficult to put the theory into practice. It is because Confucian cultivation of mind in itself is a kind of instruction that you need to do in all of your life, and essentially it is difficult to expect a temporary effect by performance or practice. So a cure model of Confucian cultivation of mind will be suggested on this assumption and limitations. This model is attempted on the main purpose of Humanities therapy in accordance with the development of a Korean model.

A Study on Maternity Aids Utilization in the Maternal and Child Health and Family Planning (농촌(農村)에 있어서 분만개조요원(分娩介助要員)의 봉사(奉仕)에 의(依)한 모자보건(母子保健)rhk 가족계획(家族計劃)에 관(關) 연구(硏究))

  • Yeh, Min-Hae;Lee, Sung Kwan
    • Journal of Preventive Medicine and Public Health
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    • v.5 no.1
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    • pp.57-95
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    • 1972
  • This study was conducted to assess the effectiveness of service by maternity aids concerning maternal and child health in improving simultaneously infant mortality, contraception and vital registration among expectant mothers in rural Korea, where there is less apportunity for maternal and child health care. It is unrealistic to expect to solve this problem in rural Korea through professional persons considering the situation of medical facilities and the socioeconomic condition of residents. So, we intended to adopt a system of services by maternity aids who were educated formally among indigenous women. After the women were trained in maternal and child health, contraception, and registration for a short period, they were assigned as a maternity aids to each village to help with various activities concerning maternal and child health, for example, registration of pregnant women, home visiting to check for complications, supplying of delivery kits, attendance at delivery, persuasion of contraception, and invitation for registration and so on. Mean-while, four researchers called on the maternity aids to collect materials concerning vital events, maternal child health, contraception and registration, and to give further instruction and supervision as the program proceeded. A. Changes of women's attitude by services of maternity aid. Now, we examined to what extent' such a service system to expectant mothers affected a change in attitude of women residing in the study area as compared to women of the control area. 1) In the birth and death places, there were no changes between last and present infants, in study or control area. 2) In regard to attendants at delivery, there were no changes except for a small percentage of attendance (8%) by maternity aid in study area. But, I expect that more maternity sids could be used as attendants at delivery if they would be trained further and if there was more explanation to the residents about such a service. 3) Considering the rate of utilization of sterilized delivery kit, I am sure that more than 90 percent would be used if the delivery kit were supplied in the proper time. There were significant differences in rates between the study and the control areas. 4) Taking into consideration the utilization rate of the clinic for prenatal care and well baby care, if suck facilities were installed, it would probably be well utilized. 5) In the contraception, the rate of approval was as high as 89 percent in study area as compared to 82 percent in the control area. 6) Considering the rate of pre-and post-partum acceptance on contraception were as much as 70 percent or more, if motivation to use contraception was given to them adequately, the government could reach the goals for family planning as planned. 7) In the vital registration, the rate of birth registration in the study area was some what improved compared to that of the control area, while the rate of death registration was not changed at all. Taking into account the fact that the rate of confirmation of vital events by maternity aids was remarkably high, if the registration system changed to a 'notification' system instead of formal registration ststem, it would be improved significantly compared to present system. B. Effect of the project Thus, with changes in the residents' attitude, was there a reduction in the infant death rate? 1) It is very difficult problem to compare the mortality of infants between last and present infants, because many women don't want to answer accurately about their dead children especially the infants that died within a few days after birth. In this study the data of present death comes from the maternity aides who followed up every pregnancy they had recorded to see what had happened. They seem to have very reliable information on what happened in first few weeks with follow up visitits to check out later changes. From these calculaton, when we compared the rate of infant death between last and present infant, there was remarkable reduction of death rate for present infant compare to that of last children, namely, the former was 30, while the latter 42. The figure is the lowest rate that I have ever heard. As the quality of data we could assess by comparing the causes of death. In the current death rate by communicable disease was much lower compare to the last child especially, tetanus cases and pneumonia. 2) Next, how many respondents used contraception after birth because of frequent contact with the maternity aid. In the registered cases, the respondents showed a tendency to practice contraception at an earlier age and with a small number of children. In a comparison of the rate of contraception between the study and the control area, the rate in the former was significantly higher than that of the latter. What is more, the proportion favoring smaller numbers of children and younger women rose in the study area as compared to the control area. 3) Regarding vital registration, though the rate of registration was gradually improved by efforts of maternity aid, it would be better to change the registration system. 4) In the crude birth rate, the rate in the study area was 22.2 while in the control area was 26.5. Natural increase rate showed 15.4 in the study area, while control area was 19.1. 5) In assessment of the efficiency of the maternity aids judging by the cost-effect viewpoint, the workers in the Medium area seemed to be more efficiency than those of other areas.

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The difference of image quality using other radioactive isotope in uniformity correction map of myocardial perfusion SPECT (심근 관류 SPECT에서 핵종에 따른 Uniformity correction map 설정을 통한 영상의 질 비교)

  • Song, Jae hyuk;Kim, Kyeong Sik;Lee, Dong Hoon;Kim, Sung Hwan;Park, Jang Won
    • The Korean Journal of Nuclear Medicine Technology
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    • v.19 no.2
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    • pp.87-92
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    • 2015
  • Purpose When the patients takes myocardial perfusion SPECT using $^{201}Tl$, the operator gives the patients an injection of $^{201}Tl$. But the uniformity correction map in SPECT uses $^{99m}Tc$ uniformity correction map. Thus, we want to compare the image quality when it uses $^{99m}Tc$ uniformity correction map and when it uses $^{201}Tl$ uniformity correction map. Materials and Methods Phantom study is performed. We take the data by Asan medical center daily QC condition with flood phantom including $^{201}Tl$ 21.3 kBq/mL. After postprocessing with this data, we analyze CFOV integral uniformity(I.U) and differential uniformity(D.U). And we take the data with Jaszczak ECT Phantom by American college of radiology accreditation program instruction including $^{201}Tl$ 33.4 kBq/mL. After post processing with this data, we analyze spatial Resolution, Integral Uniformity(I.U), coefficient of variation(C.V) and Contrast with Interactive data language program. Results In the flood phantom test, when it uses $^{99m}Tc$ uniformity correction map, Flood I.U is 3.6% and D.U is 3.0%. When it uses $^{201}Tl$ uniformity correction map, Flood I.U is 3.8% and D.U is 2.1%. The flood I.U is worsen about 5%, but the D.U is improved about 30% inversely. In the Jaszczak ECT phantom test, when it uses $^{99m}Tc$ uniformity correction map, SPECT I.U, C.V and contrast is 13.99%, 4.89% and 0.69. When it uses $^{201}Tl$ uniformity correction map, SPECT I.U, C.V and contrast is 11.37%, 4.79% and 0.78. All of data are improved about 18%, 2%, 13% The spatial resolution was no significant changes. Conclusion In the flood phantom test, Flood I.U is worsen but Flood D.U is improved. Therefore, it's uncertain that an image quality is improved with flood phantom test. On the other hand, SPECT I.U, C.V, Contrast are improved about 18%, 2%, 13% in the Jaszczak ECT phantom test. This study has limitations that we can't take all variables into account and study with two phantoms. We need think about things that it has a good effect when doctors decipher the nuclear medicine image and it's possible to improve the image quality using the uniformity correction map of other radionuclides other than $^{99m}Tc$, $^{201}Tl$ when we make other nuclear medicine examinations.

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