• Title/Summary/Keyword: medical quality improvement

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Performance Evaluation of an Electrometer for Quality Control and Dosimetry in Radiation Therapy (방사선 치료의 정도관리 및 선량측정에 이용되는 전리계의 성능평가)

  • Kim, Chang-Seon;Kim, Chul-Yong;Park, Myung-Sun
    • Progress in Medical Physics
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    • v.11 no.2
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    • pp.123-130
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    • 2000
  • The performance of an electrometer directly affects on the accuracy and precision in radiation dosimetry. This study is to list of the quality control for maintaining performance and to perform evaluation tests of an electrometer. Performance tests selected include proper polarizing voltages, warm-up and equalization time, leakages, long-term stability, linearity, and effect of ambient conditions. An electrometer connected with a rigid stem ionization chamber was evaluated with a Strontium-90 check device. Bias voltage was measured directly on the input socket. Equalization time is the time required for reaching threshold of charged state after the power is on or the bias voltage is changed. Pre- and post-signal leakages are defined as the accumulation of signal with no exposure and after exposure, respectively. Over three months period, the electrometer's long-term stability was measured by comparison of the temperature-pressure corrected readings. Linearity was expressed as the deviation of readings from multiple short exposures from one continuous exposure. Effect of ambient conditions was expressed as the zero drift of the electrometer over 17-34$^{\circ}C$ temperature ranges. For two nominal values, 300 and 500 volts, measured voltages were lower by 2.5 and 5.8%, respectively. The warm-up time, 20 minutes, was longer than the lamp time by 9 minutes and the equalization time was less than 1 minute. Without exposure, the zero-drift was 0.002 scale-unit in 15 minutes and the leakage after 10 minutes exposure was minimal. The IQ-4 was stable over 99.4% for three-month periods. Deviation from the linearity was 0.9% for measurement scale, 0.000-9.991. Over 17-34$^{\circ}C$ temperature range, the zero-drift was minimal, less than 0.2%. For a clinically-used electrometer, a list for the basic peformance evaluations is proposed. By running this program, the measurement error using an electrometer can be reduced and in turn the improvement in accuracy and precision of radiation dosimetry can be achieved.

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Quality Assurance Program of Electron Beams Using Thermoluminescence Dosimetry (열형광선량계를 이용한 전자선 품질보증 프로그램에 관한 연구)

  • Rah Jeong-Eun;Kim Gwe-Ya;Jeong Hee-Kyo;Shin Dong-Oh;Suh Tae-Suk
    • Progress in Medical Physics
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    • v.16 no.2
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    • pp.62-69
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    • 2005
  • The purpose of this study has been performed to investigate the possibility of external audit program using thermoluminescence dosimetry for electron beam in korea. The TLD system consists of LiF powder, type TLD-700 read with a PCL 3 reader. In order to determine a calibration coefficient of the TLD system, the reference dosimeters are irradiated to 2 Gy in a $^{60}CO$ beam at the KFDA The irradiation is performed under reference conditions is water phantom using the IAEA standard holder for TLD of electron beam. The energy correction factor is determined for LiF powder irradiated of dose to water 2 Gy in electron beams of 6, 9, 12, 16 and 20 MeV (Varian CL 2100C). The dose is determined according to the IAEA TRS-398 and by measurement with a PTW Roos type plane-parallel chamber. The TLD for each electron energy are positioned in water at reference depth. In this study, to verify of the accuracy of dose determination by the TLD system are performed through a 'blind' TLD irradiation. The results of blind test are $2.98\%,\;3.39\%\;and\;0.01\%(1\sigma)$ at 9, 16, 20 MeV, respectively. The value generally agrees within the acceptance level of $5\%$ for electron beam. The results of this study prove the possibility of the TLD quality assurance program for electron beams. It has contributed to the improvement of clinical electron dosimetry in radiotherapy centers.

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A Comparative Study on the CT Effective Dose by the Position of Patient's Arm (전신 PET/CT 검사에서 환자의 팔 위치에 따른 CT 유효선량의 비교 연구)

  • Seong, Ji-Hye;Park, Soon-Ki;Kim, Jung-Sun;Park, Seung-Yong;Jung, Woo-Young
    • The Korean Journal of Nuclear Medicine Technology
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    • v.16 no.1
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    • pp.44-49
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    • 2012
  • Purpose: In the whole body PET/CT scan, it is natural to lift the patient's arm for its quality improvement. However, when the lesion is located in head and neck, the arms should be located lower. This study was designed to compare the CT effective dose for each arm position applying Automatic Exposure Control (AEC). Materials and Methods: 45 patients who had $^{18}F$-FDG whole body PET/CT scan were studied with Biograph Truepoint 40 (SIEMENS, GERMANY), Biograph Sensation 16 (SIEMENS, GERMANY), Discovery STe 8 (GE healthcare, USA). The CT effective dose of 15 patients for each equipment was measured and comparatively analyzed in both arm-lifted position and lower-arm position. ImPACT v1.0 program was used as the method of measurement for CT effective dose. For the statistics analysis, Paired t-test which paired with SPSS 18.0 statistic program was applied. Results: In the case of arm-lifted, it was measured as $6.33{\pm}0.93mSv$ for Biograph Sensation 16, $8.01{\pm}1.34mSv$ for Biograph Truepoint 40, and $9.69{\pm}2.32mSv$ for Discovery STe 8. When arms are located lower position, it was measure as $6.97{\pm}0.76mSv$, $8.95{\pm}1.85mSv$, $13.07{\pm}2.87mSv$ for each. CT effective dose according to the arm position was 9.2% for Biograph Truepoint 40, 10.5% for Biograph Sensation 16, and 25.9% for Discovery Ste 8. The statistics analysis showed the meaningful difference ($p$<0.05). Conclusion: For the whole body PET/CT case, CT effective dose applying AEC was decreased the radiation exposure of the patients when the arm was lifted for 15.2% of average value. The patient who has no lesion in head and neck would decrease the artifact occurrence in objective part and lower the CT effective dose. Also, for the patient who had lesion in head and neck, the artifact in objective part can be lower by putting the arms down, the fact that CT effective dose increases should be concerned in its whole body PET/CT scan.

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Needs and Satisfaction of Cancer Patients on the Medical Services in Jeju Special Self-Governing Province (제주지역 암환자의 의료서비스 요구도 및 만족도 분석)

  • Kim, Woo-Jeong;Kim, Min-Young;Chang, Weon-Young;Choi, Jae-Hyuck
    • Journal of Hospice and Palliative Care
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    • v.13 no.3
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    • pp.153-160
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    • 2010
  • Purpose: The purpose of the present study was to investigate needs and satisfaction on the medical services of cancer patients in Jeju Special Self-Governing Province. Methods: Total 174 cancer patients, who visited at the clinic of Jeju National University Hospital, submitted informed consent and participated in this study from July 13 to July 30, 2009. Self questionnaire was used and data were analyzed with Kolmogorov-Smirnov test, Mann-Whitney U test, ANOVA, and Kruskal-Wallis test. Results: Participants expressed the needs of most economical support (3.38 out of 4), followed by counseling of treatment plan (3.22), information of disease (3.07), and disease management except cancer (2.97). Participants were satisfied most with religious counseling (3.41), followed by nursing service support (3.39), employment counseling (3.26), and counseling for family or interpersonal relationships (3.26). The satisfaction of economical support was the lowest (1.98). Satisfaction of men was higher than women, and needs in patients who were living with children was the highest. Patients who were living alone or with children showed the lowest satisfaction about the medical services. There were no significant differences in the general characteristics, however, participants who were older than 60 years of age or had higher income showed lower needs and higher satisfaction. There were no significant differences in the medical characteristics, however, thyroid cancer patients and patients who were treated with radiation therapy or transarterial embolization showed low satisfaction. Conclusion: Cancer patients seemed to need more economical support, information of treatment or disease, and symptom management. Furthermore, there were various needs about the services, depending on family formation or economical support of patients. Therefore, it is certain that patients who were suffering from other cancers, except the 5 major cancers, needed more services. In conclusion, continuous and systemic policy to consider patient's characteristics and needs are needed in community as well as health care system.

Development of Quality Assurance Software for $PRESAGE^{REU}$ Gel Dosimetry ($PRESAGE^{REU}$ 겔 선량계의 분석 및 정도 관리 도구 개발)

  • Cho, Woong;Lee, Jaegi;Kim, Hyun Suk;Wu, Hong-Gyun
    • Progress in Medical Physics
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    • v.25 no.4
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    • pp.233-241
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    • 2014
  • The aim of this study is to develop a new software tool for 3D dose verification using $PRESAGE^{REU}$ Gel dosimeter. The tool included following functions: importing 3D doses from treatment planning systems (TPS), importing 3D optical density (OD), converting ODs to doses, 3D registration between two volumetric data by translational and rotational transformations, and evaluation with 3D gamma index. To acquire correlation between ODs and doses, CT images of a $PRESAGE^{REU}$ Gel with cylindrical shape was acquired, and a volumetric modulated arc therapy (VMAT) plan was designed to give radiation doses from 1 Gy to 6 Gy to six disk-shaped virtual targets along z-axis. After the VMAT plan was delivered to the targets, 3D OD data were reconstructed from 512 projection data from $Vista^{TM}$ optical CT scanner (Modus Medical Devices Inc, Canada) per every 2 hours after irradiation. A curve for converting ODs to doses was derived by comparing TPS dose profile to OD profile along z-axis, and the 3D OD data were converted to the absorbed doses using the curve. Supra-linearity was observed between doses and ODs, and the ODs were decayed about 60% per 24 hours depending on their magnitudes. Measured doses from the $PRESAGE^{REU}$ Gel were well agreed with the TPS doses at central region, but large under-doses were observed at peripheral region at the cylindrical geometry. Gamma passing rate for 3D doses was 70.36% under the gamma criteria of 3% of dose difference and 3 mm of distance to agreement. The low passing rate was resulted from the mismatching of the refractive index between the PRESAGE gel and oil bath in the optical CT scanner. In conclusion, the developed software was useful for 3D dose verification from PRESAGE gel dosimetry, but further improvement of the Gel dosimetry system were required.

Correlations between the Capacity of In Vitro Fertilization and the Assays of Sperm Function and Characteristics in Frozen-thawed Bovine Spermatozoa (소 동결-융해 정자에 있어서 체외수정능력과 정자 기능 및 성상 분석법간의 상관관계)

  • Ryu, B.Y.;Chung, Y.C.;Kim, C.K.;Shin, H.A.;Han, J.H.;Kim, S.H.;Moon, S.Y.;Kim, H.R.;Choi, H.
    • Korean Journal of Animal Reproduction
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    • v.26 no.3
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    • pp.275-289
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    • 2002
  • The objective of this study was to develop an in vitro assessment of sperm fertilizing capacity of bulls and investigate the factors influencing sperm function and characteristics of frozen-thawed bovine spermatozoa. in vitro fertilization (IVF), the evaluation of motility and normal morphology, HOST (hypoosmotic swelling test), Ca-ionophore induced acrosome reaction, luminol and lucigenin-dependent chemiluminescence for the measurement of reactive oxygen species (ROS), the measurement of malondialdehyde formation for the analysis of lipid peroxidation (LPO), and the evaluation of DNA fragmentation using the method of 747-mediated nick end labelling (TUNEL) by flow cytometry were performed in frozen-thawed bovine spermatozoa. Correlations between the rates of fertilization, blastocyst formation after IVF and the values of respective assays were investigated. 1. IVF rate and blastocyst formation rate averaged 64.4% and 34.3% for spermatozoa from high -fertility bull group and averaged 18.5% and 6.2% for spermatozoa from low-fertility bull group, respectively. There were significantly different between two bull groups. Sperm motility and percentage acrosome reaction averaged 79.0% and 66.2% for spermatozoa from high-fertility bull group and averaged 40.7% and 22.9% for spermatozoa from low-fertility bull group, respectivitely. There were not different between two bull groups. 2. Luminol depenent chemiluminescence, LPO and DNA fragementation averaged 6.4, 2.0 nmol and 2.6% from spermatozoa from high-fertility bull group and averaged 6.5, 3.1 nmol and 7.4% for spermatozoa from low-fertility bull group, respectively. There were significantly different between two bull groups. There was no significant difference in lucigenin dependent chemiluminescence between two bull groups. 3. Fertilization rate was positively correlated with motility and the rate of Ca-ionophore induced acrosome reaction, but negatively correlated with the frequency of luminol-dependent chemiluminescence, the rate of LPO, and the percentage of sperm with DNA fragmentation. There was no correlation between fertilization rate and the percentage of swollen spermatozoa, normal morphology, and the frequency of lucigenin-dependent chemiluminescence. 4. Blastocyst formation rate was positively correlated with the rate of Ca-ionophore induced acrosome reaction, but negatively correlated with the frequency of luminol-dependent chemiluminescence, the rate of LPO, and the percentage of sperm with DNA fragmentation. There was no correlation between blastocyst formation rate and motility, the percentage of swollen spermatozoa, normal morphology, and the frequency of lucigenin-dependent chemiluminescence. In conclusion, these data suggest that ROS significantly impact semen quality. The assays of this study may provide a basis fur improving in vitro assessment of sperm fertilizing capacity.

Nutrition Survey in Koje Island (거제도(巨濟島) 주민(住民)의 영양실태조사(營養實態調査))

  • Oh, Seoung-Ho;Chang, Soo-Kyung;Park, Michael Myung-Yun
    • Journal of Nutrition and Health
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    • v.10 no.4
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    • pp.43-58
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    • 1977
  • Kojedo is the second largest island in Korea and a total population of 115,500 is living on the island of 394.69 sq. km. Under the direction of three nutrition professors, nutrition surveys in two villages in Kojedo, namely Siljun Ri in Hachung Myon and Soowol Ri in Shinhyun Myon, were carried by 30 college senior students majoring in nutrition from August to 20 August 1977. From a total of 176 households of the two villages, 67 households were randomly selected and 390 family members of the households were subjcets of the nutrition surveys. The precise weighing method was used in evaluating the kinds of foods and nutrient intakes of the subjects for three consecutive days. Thirty-seven pre-school children aged between 3 to 6 years and 27 fertile women were examined for biochemical findings and physical status. The main purposes of the surveys are to provide baseline data on nutrition in Kojedo Island for the Kojedo Community Development Project and to compare the nutritional status of the villages of Siljun Ri and Soowol Ri. Siljun Ri is located in the pilot project area of the Koiedo Community Health Project sponsored since December 1970 by the Christian Medical Commission of the World Council of Churches. While Soowol Ri is a control village for comparison. The results obtained are summarized as follows: Food Intake The average food intake per person per day in Siljun Ri, 1064 grams (91.7% in vegetable foods and 7.6% in animal foods) was 90 grams more than that of Soowol Ri, 974 grams (92.8% in vegetable foods and 5.9% in animal foods). However, the food intake per pre-school child in Siljun Ri, 485 grams (92.6% from vegetable foods and 6.4% from animal foods) was 21 grams lower than that of the Soowol Ri, 506 grams (88.5% from vegetable foods and 6.5% from animal foods). The average intake of beans was 16 grams(1.5% out of the total food intake) in Siljun Ri and 21 grams(2.2% of the total food intake)in Soowol Ri. The villagers should be guided for more consumption of soybeans to improve the quality of protein intake from vegetable foods. Nutrient Intake The adult intake in Siljun Ri and Soowol Ri were 2,529 kcal and 2,511 kcal respectively. The average energy intake of pre-school childen in Siljun Ri was 948 kcal and that for adult and 1,500 kcal for childen aged between 4 to 6 years-given by the Korea FAO Association, the diets in both villages were not adequate. Average daily protein intake of the subjected adult in Siljun Ri was 78.4 grams and that of Soowol Ri was 76.2 grams, while pre-school children took 30.7 grams in the former village and 31.7 grams in the latter village per child per day. The protein intake in both villages were lower than the recommended allowances, 80 grams for adult and 45 grams for $4{\sim}6$ years childen, and animal protein intake of the all subjects was very much lower than the RDA. The main charecter of the diet has been found low in quality of protein and high in carbohydrate. The calcium intakes of the pre-school children in both villages, 251.9 milligrams in Siljun Ri and 218.8 milligrams in Soowol Ri, were very much lower than the recommended allowance of 500 milligrams per day. It is apparent that the diet for children should be supplemented with calcium. Among the vitamin group, the daily average intakes of vitamin A and $B_{2}$(thiamine), $B_{2}$(riboflavin), C(ascorbic acid), and niacin were not adequate for the children in both villages. Especially the intake of riboflavin, 0.4 milligrams in both village children, was much lower than the RDA, 0.9 milligrams per day. Physical Characteristics Average height, weight, chest and head circumference of the pre-school children in both villages were similar to those of the Korean standard given by the Korean Paediatrics Association except that the average height of pre-school boys in Siljun Ri was 8 cm higher than the Korean standard of 105 cm. The mean values of upper arm circumference and skinfold thickness of pre-school boys in both villages were the same, 15.4 cm for upper arm circumference and 6.8 mm for skinfold thickness, but the mean values of those of the girls in Siljun Ri were higher than those of pre-school grils in Soowol Ri. Biochemical Findings Avera ge hemogobin value of boys and girls in both villages was the same, 11.1 grams per 100 ml of blood. The incidence of anemia (Hb value below 11g/100ml) was similar in both viltagesr 36.4% for boys and 50% for girls in Siljun Ri and 37.5% for boys and 50% for girls in Soowol Ri. Average hemoglobin values of fertile women were 10.7g% in Siljun Ri and 10.8% in Soowor Ri. The incidences of anemia(Hb valre brlow 12g/100ml) were 100% in Siljun Ri and 86.7% in Soowol Ri. The anemia of these subjects may be caused mainty low intake of good quality protein and iron intake from vegetable food. Recommendation In general, the nutritional status of a community health pilot village is not higher than that of control village due to the lack of nutrition improvement guldance services. Nutrition education should be delivered to the villagers as a main part of the health education artivities. The emphasis should be on building better health through bttter food habits and better food production as well as on preventing malnutrition and diseasrs. It can be an invaluable part of community developnent. Since nutrition is considered to be at least one-half of MCH care, no village or home visits should be made without careful provision for teaching and demoastrating something simple and practical on nutrition. The nurse, midwife, and village health worker should be the chief promoters of nutrition.

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A study on dietary habits, nutrient intakes and dietary quality in adults of a health screening and promotion center according to non-alcoholic fatty liver disease (건강증진센터 고객의 비알콜성 지방간 유무에 따른 식습관 및 영양섭취, 식사의 질에 관한 연구)

  • Chang, Ji Ho;Lee, Hye Seung;Kang, Eun Hee
    • Journal of Nutrition and Health
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    • v.47 no.5
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    • pp.330-341
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    • 2014
  • Purpose: The purpose of this study was to evaluate dietary habits, food intakes, nutrient intakes, and diet quality of non-alcoholic fatty liver disease in a health screening and promotion center. Methods: The total number of study subjects was 10,111 adults, where 3087 subjects (30.5%) were diagnosed as NAFLD. The dietary intakes were obtained using a food frequency questionnaire. They were then compared with the dietary reference intakes could be used in the future for development of diet and nutrition guidelines s (KDRIs). Results: Mean age of subjects in the normal group was $52.9{\pm}10.3yrs$ and body mass index (BMI) was $22.4{\pm}2.6kg/m^2$, and those of the NAFLD group were $55.1{\pm}9.2yrs$ and $25.4{\pm}2.9kg/m^2$. BMI, blood pressure of the NAFLD group were significantly higher than those of the normal group. The rates of skipping breakfast, overeating, and eating out were significantly could be used in the future for development of diet and nutrition guidelines er in the NAFLD group (p < 0.05, p < 0.000, p < 0.000 respectively). The speed of eating was fast in the NAFLD group (p < 0.000). The NAFLD group consumed significantly higher amounts of grains, meats, fish, seaweeds, kimchies, sugars, sweets, coffee, teas, and oils compared to the normal group (p < 0.05). Meanwhile, intakes of starch products, fruits, milk, and milk products were significantly lower in the NAFLD group compared with those of the normal group (p < 0.05). Riboflavin, calcium, and dietary fiber nutrient adequacy ratio (NAR) of the NAFLD group were significantly lower than those of the normal group. The Korean's dietary diversity score (KDDS) of the NAFLD group was lower than that of the normal group. Conclusion: In conclusion, we suggest that diet guidelines, such as increasing the intake of calcium and dietary fiber, reducing the intake of energy, fat, and simple carbohydrates, are necessary to improvement of NAFLD. The results could be used in the future for development of diet and nutrition guidelines for NAFLD.

Analysis of the First Time User Experience of the online memorial platform and suggestion of service developments (온라인 장례 플랫폼의 초기 사용자 경험 분석및서비스 개발 제안)

  • Jueun Lee;Jindo Hwang
    • Journal of Service Research and Studies
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    • v.14 no.1
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    • pp.44-62
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    • 2024
  • The development of online funeral services and social issues of eco-friendly funeral culture have raised awareness of the new need for online funeral culture. There have been several attempts to revitalize online funeral services in domestic institutions and companies, but the effect is weak. The purpose of this study is to propose a design that can improve the accessibility and usability of online memorial services by analyzing the usability problem factors through a First Time User Experience analysis of the online memorial platform. Therefore, in this study, in order to identify the problem factors of the online memorial platform, a literature review on the UX, OOBE, and FTUE theories was conducted. The subject of the study was the app 'Memorial'. Before analyzing the First-Time User-Experience, IA was compared and analyzed with other similar services to understand the characteristics of the UX service of the app 'Memorial', which is the subject of the study. In addition, tasks corresponding to the Unpack-Setup/Configure-First Use stage were performed on 10 subjects who had no experience using the online memorial platform. The experimental process was expressed as the UX Curve to identify factors that caused negative experiences. As a result, the major problem factors included unnecessary UI elements, the need for sensitive personal information at the membership stage, and lack of immersion in the service. The improvements included strengthening community functions to facilitate the sharing of emotions and promote smooth communication between users. We proposed UI/UX service developments that enhanced the app by incorporating these insights. In order to verify the effectiveness, serviceability, and value of the developed prototype, an interview with a expert was conducted. The interviewes consisted of three service design experts. This study was conducted to contribute to the quality improvement and activation of the recently emerging online funeral services. The study is significant as it aims to understand the current status of these services and identify the factors necessary to improve service accessibility and usability. Subsequent studies require in-depth user verification of how much the proposed improvement plan affects the actual user experience.

Ethnosientific Approach of Health Practice in Korea (한국인의 건강관행에 대한 민속과학적 접근)

  • 김귀분;최연희
    • Journal of Korean Academy of Nursing
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    • v.21 no.3
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    • pp.396-417
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    • 1991
  • In order that nursing care an essential quality of nursing practice be acceptable and satisfying, it is necessary that client's culture be respected and that nursing practice be appropriate to that culture. Since cultural elements are an important influence on health practices and life patterns related to medical treatment, recovery from and prevention of disease, nurses need to have an understanding and knowledge of social and cultural phenomena to aid in the planning of nursing interventions. To understand the health practices surrounding health and illness, the health beliefs and practices of both folk and professional healing systems should be ascertained. Cultural data are required to provide care of high quality to clients and to reduce possible conflict between the client and the nurse. It is nursing's goal to provide clients from various cultures with quality nursing care which is satisfying and valuable. The problem addressed by this study was to identify Korean health practices which would contribute to the planning of professional caring practice with the culture : ultimately this study was intended to make a contribution to the development of the science of nursing. The concrete objectives of this study were ; 1) to identify Korean health practices, 2) to interpret the identitial health practices through traditional cultural thought, and 3) to compare the Korean health practices with those of other cultures. The investigator used the ethnosceintific approach outlined by spradly in a qualitative study. To discover ancestral wisdom and knowledge related to traditional health practeces, the subjects of this study were selected from residents of a small rural mountain village in south west Korea, a place considered to be maintaining and transmitting the traditional culture in a relatively well -preserved state because of being isolated from the modern world. The number of subjects was 18, aged 71 to 89. Research data were collected from January 8 to March 31, 1990. Five categories of health practices were identified : “Manage one's own mind”, “Moderation in all thing”, “Live in accord with nature”, “Live in mutuality with others”, and “Live to the best of one's ability”. Values derived from these ways of thinking from Confucianism, Taoism and Buddhism help fashion a traditional way of life, examplified by the saying “Benifience to all”. Korean thought and philosophy is influenced primerily by Confucianism, Confucian principles of ethics, embedded deeply in the peoples' minds, form the idea that “heaven and human being are intimately united” based on concept that “heaven is, so to speak, reason”. Twoe Gae's theory of existential subjectivity develops the concept of self which is the basis of the spirit of reverence in modern Confucian philosophy. The human md is granted from heaven out of the idea of matter, and what control the mind is the spirit of reverence. Hence the idea of “The primacy of the mind" and provided that one should control one's own mind. The precepts of duty to parents, respect for elders and worship of ancestors, and moderation in all behavior put a restraint on life which directed that one live earnestly according to Nature's laws with their neighbors. Not only Confucianism, but also Buddism and Taoism have had an important effect upon these patterns of ideas. When compared with western culture, Korean health practices tend to be more inclusive, abstract and intuitive while westerner health practices found to be mere concrete, practical and personal. Values and beliefs based and pragmatism and existentialism infuence western civilization, Ethical values may be founded on utilitarianism, which considers what is good for the persons in their circumstances as the basis of conduct and takes a serious view of their practical lives including human aspirations rather than an absolute truth. These philosophical and ethical ideas are foundations for health practices related to active, practical and progressive attitudes. This study should be enable nursing not only to understand clients as reflections of the traditional culture when planning nursing practice, but to dovelop health education corresponding to cultural requiments for the purpose of protection against disease and improvement of health, and thus promote sound health practice. Eventually it is hoped that through these processes quality nursing care as the central idea of the science of nursing will be achieved.

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