• Journal of Korean Biological Nursing Science
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• v.25 no.3
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• pp.143-159
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• 2023

Purpose: The purpose of this study was to provide evidence for future research by analyzing the contents, delivery methods, and educational effects of educational programs for hemodialysis patients. Methods: A literature review was conducted in the following order: problem identification, literature search and data collection, data evaluation, data analysis, and data presentation. In total, 936 documents were retrieved from the search, and 24 documents were finally included in this study. Results: The contents of the educational programs were comprehensive hemodialysis-related knowledge education in seven studies, exercise-related education in 10 studies, diet-related education in four studies, drug-related education in one study, and complex education in two studies. The delivery methods were pamphlets in six studies, audio-visual materials in four studies, direct guidance by researchers in six studies, and multiple methods in seven studies. The effects of the educational program were divided into physical indicators, emotional indicators, and knowledge and performance related to hemodialysis. Sixteen out of 20 articles using physical indicators showed significant outcomes, and 10 out of 12 articles using emotional indicators derived positive results. Hemodialysis-related knowledge and performance were measured in eight and 10 studies, respectively, and meaningful results were found in six studies for knowledge and seven studies for performance. Conclusion: Future research will require the development of a systematic and standardized educational program with comprehensive content that can be provided to all hemodialysis patients, as well as a highly accessible education delivery method to enhance the effectiveness of education.

• Research in Community and Public Health Nursing
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• v.11 no.2
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• pp.441-452
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• 2000

The purpose of this study was to identify the prevalence of urinary incontinence and its relating factors elderly communities. Subjects of this survey consisted of 877 elderly women and men in one Kun. Korea, who were over 60 years old. The design for this study was descriptive: the subjects were interviewed by well trained investigators from July 9. 1999 to July 20. 1999. During that survey period, the subjects were interviewed with a structured questionnaire. The data were analyzed by frequency, percentage, $X^2-test$. T-test using an SAS program. The results of the study were the following: 1. The prevalence rate of urinary incontinence was 20.1 %. of the total. The types of urinary incontinence were mixed incontinence 44.3%. stress incontinence 38.1%. and urge type incontinence 17.6%. 2. The relating factors of urinary incontinence were as follows: 1) 33.5% of UI(urinary incontinence) subjects reported urine loss once a month. twice or three times a week 23.3%. one or two times a day 17.0% 2) 38.1% of elderly reported only 1 to 2 drops. 1 t-spoon 36.9%. 1 T-spoon 15.9% 3) The volume of urine loss registered by changing underwear was 63.1 %. no necessity of changing underwear was 22.1 %. or using some type of pads was 13.1%. 4) 62.5% of UI subjects never discussed their UI problem with other people. 73.9% of the total had never experienced any treatment for their UI problem. The reasons for not receiving medical cure were their typical conception about urinary incontinence taking UI as a normal part of aging 76.2% and due to their bad financial situation 9.2%. 3. Women had more prevalence of UI than men (p=0.01), and it was found that the worse the subjective health state. the higher the prevalence of UI (p=0.001). However. there was no statistical difference in daily frequency of UI (p>0.05). The more nocturnal incontinence (p=0.001), the more intermittent stream experience (p = 0.01), the more retention experience (p = 0.01), and the more incomplete the emptying experience (p=0.001), the higher the prevalence of UI. 4. UI groups had lower ADL scores than non UI groups(p=0.01). The level of depression in the group of urinary incontinence was significantly higher than that of non incontinence group (p=0.0001). As shown above, the elderly people suffering from UI haven't been treated properly: their subjective health state and their ADL competence was lower, and their depression level was higher than non UI groups. Therefore, the development of a proper urinary incontinence management program are required so that they can lead more healthy lives. Also continual case studies for the elderly people with UI are necessary.

• Industry Promotion Research
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• v.5 no.2
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• pp.51-58
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• 2020

Middle-aged women who have experienced the depression have been in pain for a long time. Depression in middle-aged women, which is rapidly increasing from their forties, has a problem that do not decrease in spite of various treatment methods. If the essential cause of depression in middle-aged women is due to the inability to detect the meaning of life because of the lack of the perception about the identity resulting from self-loss, a more qualitative research for a fundamental treatment method is required. The purpose of this study is to find out the essence and meaning of the experience of depression in middle-aged women and to help them to find their own selves through the process of individualization and to recover the whole health as well as to live as a self-transcendent being. Three Christian middle-aged women falling on critical and serious condition by BDI diagnosis were selected for the study. In-depth counseling and interviews were held from January to August 2018. In-depth counseling has provided detailed statements about the process of individualization of middle-aged women who have experienced depression, which applied 5 stages of Giorgi's Phenomenological Research Methodology. As a result, 261 semantic units and 11 sub-components were derived and structured by dividing them into two themes: depression experience and the process of individualization process, which are the subject group. This study has its significance in realizing essential meaning of pain by middle-aged women who experience depression and fundamentally preparing an opportunity to be cured through the process of individualization, as well as contributing for such middle-aged women to have abundant living by suggesting preventive measures to general middle-aged women who prepare for their old age.

• Journal of Preventive Medicine and Public Health
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• v.30 no.4 s.59
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• pp.791-804
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• 1997

Irritable bowel syndrome(IBS) is one of the common health problem that has been considered as stress-induced. This study was conducted to investigate the relationship between life style and the level of stress and IBS by structured questionnaire which included questions on life style, the self-esteemed gastrointestinal symptoms, and Psychosocial Well-being Index(PWI). Subjects were 1,498 male white collars who get the regular health check and participated in survey at Inje University Health Promotion Center from January to ,December, 1996. The overall prevalence of IBS was 37.5%(561 cases), and the level of stress by PWI score was higher in IBS group$(41.8{\pm}14.2)$ than symptom-free group$(34.6{\pm}12.6)$. As the result of comparison between the two groups, heavier smoking (adjusted O.R=2.48, 95% C.I 1.81-3.41), longer daily working time (adjusted O.R=5.19, 95% C.I 3.59-7.56), stimulatory food materials-mainly hot or salty (adjusted O.R=1.87, 95% C.I 1.44-2.45), higher body mass index (adjusted O.R=1.80, 95% C.I 1.27-2.57), and higher level of stress (adjusted O.R=2.81, 95% C.I 1.80-4.43) were estimated as risk factors of IBS. On the contrary, 6-8 hours sleeping per day (adjusted O.R=0.38 95% C.I 0.21-0.70), 3-4 times exercise per week (adjusted O.R=0.57 95% C.I 0.39-0.83), and tenure more than 20 years (adjusted O.R=0.25 95% C.I 0.16-0.35) were considered as protective factors to IBS. In summary, the assessment of the stress level might be placed in the first priority to control IBS, at least by some degree, which suggested that IBS could be controlled by avoiding such risk factors and by encouraging such protective factors.

• Journal of Korean Elementary Science Education
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• v.41 no.4
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• pp.740-753
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• 2022

This study was conducted to develop and apply an out-of-school STEAM program model based on Social-Emotional Learning (SEL) for underprivileged students in the lower grades. To this end, a STEAM program based on SEL was developed, with the following characteristics. First, by integrating traditional STEAM learning elements and SEL elements, a structured program was designed with consistent stages, including mindfulness meditation→present an authentic situation→creative design→emotional experiences→reflection. Second, the program was structured so that elementary school students could develop mathematical thinking and scientific inquiry skills in problem-solving situations in daily life. Third, the detailed themes for each STEAM program involved storytelling-based problem situations, as well as activities centered on play and sympathy to reflect the educational needs of underprivileged students. From these characteristics, a total of five programs were developed and applied to 16 teachers and 354 lower-grade elementary school students in 16 community children centers nationwide. The results were as follows. First, while students' satisfaction with the STEAM program was 4.16, there were no significant differences in STEAM satisfaction according to gender. Second, while all students' interest and self-efficacy, which was one of sub factors of STEAM attitude, were significantly improved, no significant difference was seen in STEAM attitudes according to gender. Third, although students' SEL competencies were not significantly improved, relationship skills, which were among the sub factors of SEL competencies, were significantly improved, and there were no significant differences in SEL competencies according to gender. From these results, a discussion on the effect of the out-of-school STEAM program for underprivileged students and directions for follow-up studies was suggested.

• Journal of Korean Academy of Nursing Administration
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• v.3 no.1
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• pp.51-64
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• 1997

The purpose of the study was to introduce an integrated approach of new Casuistry and specified principlism in resolving ethical problems and studying nursing ethics. In studying clinical ethics and nursing ethics, there is no systematic research method. While nurses often experience ethical dilemmas in practice, much of previous research on nursing ethics has focused merely on describing the existing problems. In addition, ethists presented theoretical analysis and critics rather than providing the specific problems solving strategies. There is a need in clinical situations for an integrated method which can provide the objective description for existing problem situations as well as specific problem solving methods. We inherit two distinct ways of discussing ethical issues. One of these frames these issues in terms of principles, rules, and other general ideas; the other focuses on the specific features of particular kinds of moral cases. In the first way general ethical rules relate to specific moral cases in a theoretical manner, with universal rules serving as "axioms" from which particular moral judgments are deduced as theorems. In the seconds, this relation is frankly practical. with general moral rules serving as "maxims", which can be fully understood only in terms of the paradigmatic cases that define their meaning and force. Theoretical arguments are structured in ways that free them from any dependence on the circumstances of their presentation and ensure them a validity of a kind that is not affected by the practical context of use. In formal arguments particular conclusions are deduced from("entailed by") the initial axioms or universal principles that are the apex of the argument. So the truth or certainty that attaches to those axioms flows downward to the specific instances to be "proved". In the language of formal logic, the axioms are major premises, the facts that specify the present instance are minor premises, and the conclusion to be "proved" is deduced (follows necessarily) from the initial presises. Practical arguments, by contrast, involve a wider range of factors than formal deductions and are read with an eye to their occasion of use. Instead of aiming at strict entailments, they draw on the outcomes of previous experience, carrying over the procedures used to resolve earlier problems and reapply them in new problmatic situations. Practical arguments depend for their power on how closely the present circumstances resemble those of the earlier precedent cases for which this particular type of argument was originally devised. So. in practical arguments, the truths and certitudes established in the precedent cases pass sideways, so as to provide "resolutions" of later problems. In the language of rational analysis, the facts of the present case define the gounds on which any resolution must be based; the general considerations that carried wight in similar situations provide warrants that help settle future cases. So the resolution of any problem holds good presumptively; its strengh depends on the similarities between the present case and the prededents; and its soundness can be challenged (or rebutted) in situations that are recognized ans exceptional. Jonsen & Toulmin (1988), and Jonsen (1991) introduce New Casuistry as a practical method. The oxford English Dictionary defines casuistry quite accurately as "that part of ethics which resolves cases of conscience, applying the general rules of religion and morality to particular instances in which circumstances alter cases or in which there appears to be a conflict of duties." They modified the casuistry of the medieval ages to use in clinical situations which is characterized by "the typology of cases and the analogy as an inference method". A case is the unit of analysis. The structure of case was made with interaction of situation and moral rules. The situation is what surrounds or stands around. The moral rule is the essence of case. The analogy can be objective because "the grounds, the warrants, the theoretical backing, the modal qualifiers" are identified in the cases. The specified principlism was the method that Degrazia (1992) integrated the principlism and the specification introduced by Richardson (1990). In this method, the principle is specified by adding information about limitations of the scope and restricting the range of the principle. This should be substantive qualifications. The integrated method is an combination of the New Casuistry and the specified principlism. For example, the study was "Ethical problems experienced by nurses in the care of terminally ill patients"(Um, 1994). A semi-structured in-depth interview was conducted for fifteen nurses who mainly took care of terminally ill patients. The first stage, twenty one cases were identified as relevant to the topic, and then were classified to four types of problems. For instance, one of these types was the patient's refusal of care. The second stage, the ethical problems in the case were defined, and then the case was analyzed. This was to analyze the reasons, the ethical values, and the related ethical principles in the cases. Then the interpretation was synthetically done by integration of the result of analysis and the situation. The third stage was the ordering phase of the cases, which was done according to the result of the interpretation and the common principles in the cases. The first two stages describe the methodology of new casuistry, and the final stage was for the methodology of the specified principlism. The common principles were the principle of autonomy and the principle of caring. The principle of autonomy was specified; when competent patients refused care, nurse should discontinue the care to respect for the patients' decision. The principle of caring was also specified; when the competent patients refused care, nurses should continue to provide the care in spite of the patients' refusal to preserve their life. These specification may lead the opposite behavior, which emphasizes the importance of nurse's will and intentions to make their decision in the clinical situations.

• Journal of Korean Academy of Nursing Administration
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• v.1 no.2
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• pp.388-407
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• 1995

This study is (a) to describe the history of Total Quality Management (TQM) generated in the industry, health care service, and nursing society ; (b) to define the concept, total quality management including the definition of quality ; (C) to explain the each principle of TQM theory developed by main theorists, E. Deming, J. Juran, and B. Crosby ; (d) to give the examples related to TQM implementation at the health care organization ; and (e) to mention the extent to which the health care organizations are able to evaluate their cultural organization toward TQM and have had the way to measure the effect of TQM implementation. TQM referred to Continuous Quality Improvement(CQI), Quality Improvement(QI), and Total Quality Improvement(TQI), was not recognized by experts in the United States industry, but by economists in Japan until the end of the 1970's. However, the United States' government led to introduce the principles of TQM to general industry as well as health care service area so that TQM became a main philosophy to manage the organizations in health care service. TQM is a structured, systematic process for creating organization-wide participation in planning and implementing continuous improvement in quality. E. Deming established the "Chain reaction in Quality" and the fourteen point of TQM. The Chain reaction in quality is to describe the relationship among the reduction of waste, rework, and delay, quality improvement, customer satisfaction, and productivity. There are fourteen points to explain the principles of TQM by E. Deming. Juran defined the "Quality Trilogy" to improve the level of quality in any organization. Quality Trilogy has three steps such as quality planning, quality control, and quality improvement for implementing the TQM projects. Crosby describes his TQM theory by establishing "Four Absolutes" and "Fourteen steps in TQM" implementation. Until now, most healthcare organizations have made efforts to organize the TQM task team and to implement TQM principles with various issues. There are three priorities to select the TQM issues : High-volume, High-risk, and Problem-prone. However, there is no absolute, credible measurement yet to evaluate the effects of TQM implementation in health care organization regardless of the classification of health care organizations, geographical background, and social influence. Thus, developing the evaluation way in terms of TQM is the foremost task in health service area. The most important thing for TQM implementation in the organization is to settle up the concept, cultural transformation from traditional management toward quality.

• Journal of Korean Academy of Nursing Administration
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• v.7 no.1
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• pp.127-144
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• 2001

The purpose of this study is to provided a basic administrative data for effective personnel management of nurses' by investigation their assessment and satisfaction with the job rotation and by analyzing the relation between their satisfaction and organizational commitment. Data were collected from Nov. 20 to Nov. 25, 2000 through self-reporting questionnaires taken by 280 nurses working at a university hospitals The 3 structured instruments were used for collecting the data; Questionnaires for measuring the utility and the problem of job rotation, Questionaires for measuring the satisfaction with the job rotation, and Mowday's Organizational Commitment Questionnaires. The data obtained were analyzed using frequency, percentage, average, standard deviation, range, Cronbach's alpha coefficients, Peason's correlation coefficients, t-test, one-way ANOVA, and chi-square test, multiple regression. The Results were as follows : 1. The supporters for regular job rotation account for 67% while the opponents to it account for 33%. The chief reason for endorsing the regular job rotation is quoted ${\lceil}$to attain more diverse job experiences${\rfloor}$, followed in order by ${\lceil}$to improve the job motivation and morale through the realization of personal needs${\rfloor}$, ${\lceil}$to place the right man in the right position${\rfloor}$. The reasons for opposing to the regular job rotation were listed in order ${\lceil}$difficulties to secure the expertise of nursing${\rfloor}$, ${\lceil}$personal needs not fully reflected in the job rotation${\rfloor}$, ${\lceil}$job rotations prompted rather by the administrative needs than by personal aptitude and ability${\rfloor}$. 2. In the assessment of job rotation, the points affirming the utility of the job rotation are $2.60({\pm}.66)$ out of possible 5 points and those admitting the problems the job rotation are $3.58({\pm}.59)$. The satisfaction with the job rotation is rated at $2.98({\pm}.55)$. 3. In the analysis into the relation between the assessment of job rotation and satisfaction with the job rotation, fairly high positive correlation is revealed between the satisfaction and utility of job rotation, whereas, considerably high negative correlation is seen between the satisfaction and problems with the job rotation(p=.000). 4. There is relatively high positive correlation between the satisfaction with the job rotation and organizational commitment(p=.000). In conclusion, the utility of on the job rotation and their satisfaction with the job rotation have positive correlation and the satisfaction with the job rotation and organizational commitment showed the positive correlation, too. Therefore, it is thought desirable to take administrative strategies well as education to improve the recognition of the job rotation's utility and to reduce the recognition of the problems with the job rotation to remain in the direction toward contributing to enhancement of the organizational commitment.

• Journal of Broadcast Engineering
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• v.9 no.1
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• pp.17-31
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• 2004

This paper proposes an algorithm for the robust transmission of video in error Prone environment using multiple description codingby optimal split of DCT coefficients and rate-distortionoptimization framework. In MDC, a source signal is split Into several coded streams, which is called descriptions, and each description is transmitted to the decoder through different channel. Between descriptions, structured correlations are introduced at the encoder, and the decoder exploits this correlation to reconstruct the original signal even if some descriptions are missing. It has been shown that the MDC is more resilient than the singe description coding(SDC) against severe packet loss ratecondition. But the excessive redundancy in MDC, i.e., the correlation between the descriptions, degrades the RD performance under low PLR condition. To overcome this Problem of MDC, we propose a hybrid MDC method that controls the SDC/MDC switching according to channel condition. For example, the SDC is used for coding efficiency at low PLR condition and the MDC is used for the error resilience at high PLR condition. To control the SDC/MDC switching in the optimal way, RD optimization framework are used. Lagrange optimization technique minimizes the RD-based cost function, D+M, where R is the actually coded bit rate and D is the estimated distortion. The recursive optimal pet-pixel estimatetechnique is adopted to estimate accurate the decoder distortion. Experimental results show that the proposed optimal split of DCT coefficients and SD/MD switching algorithm is more effective than the conventional MU algorithms in low PLR conditions as well as In high PLR condition.

• The KIPS Transactions:PartC
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• v.13C no.5 s.108
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• pp.613-620
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• 2006

From both techlical and economic viewpoints, DiffServ IP QoS architecture is accepted as a more practical solution because of the complexity Problem of the other IntServ architecture. In this paper, we propose several models to support DiffServ QoS in DSL broadband access networks and discuss about migration path from current best-effort DSL networks to DiffServ-enabled ones. Since DSL networks are recently and widely deployed in the world amount ot new investment, compatibility with existing QoS-unaware DSL systems, and compatibility with existing charging systems as well as effective support of various QoS services must be carefully considered when we design DiffServ QoS support models in DSL networks. The DiffServ models proposed in this paper are divided into static DiffServ models and dynamic DiffServ models which are near-term solutions and long-term solutions repecitively. The static DiffServ models include Flat DiffServ which suworts per-subscriber DiffServ QoS and Structured DiffServ which supports per-subscriber and per-service DiffServ QoS. And the dynamic DiffServ models include Direct DiffServ for P2P(Peer to Peer) applications and Indirect DiffServ for ASP(Application Service Provider) applications.