• The Korean Journal of Nuclear Medicine Technology
• /
• v.25 no.2
• /
• pp.15-24
• /
• 2021

Purpose SPECT/CT was noted for its excellent correction method and qualitative functions based on fusion images in the early stages of dissemination, and interest in and utilization of quantitative functions has been increasing with the recent introduction of companion diagnostic therapy(Theranostics). Unlike PET/CT, various conditions like the type of collimator and detector rotation are a challenging factor for image acquisition and reconstruction methods at absolute quantification of SPECT/CT. Therefore, in this study, We want to find out the effect on the radioactivity concentration estimate by the increase or decrease of the total acquisition time according to the number of projections and the acquisition time per projection among SPECT/CT imaging conditions. Materials and Methods After filling the 9,293 ml cylindrical phantom with sterile water and diluting 99mTc 91.76 MBq, the standard image was taken with a total acquisition time of 600 sec (10 sec/frame × 120 frames, matrix size 128 × 128) and also volume sensitivity and the calibration factor was verified. Based on the standard image, the comparative images were obtained by increasing or decreasing the total acquisition time. namely 60 (-90%), 150 (-75%), 300 (-50%), 450 (-25%), 900 (+50%), and 1200 (+100%) sec. For each image detail, the acquisition time(sec/frame) per projection was set to 1.0, 2.5, 5.0, 7.5, 15.0 and 20.0 sec (fixed number of projections: 120 frame) and the number of projection images was set to 12, 30, 60, 90, 180 and 240 frames(fixed time per projection:10 sec). Based on the coefficients measured through the volume of interest in each acquired image, the percentage of variation about the contrast to noise ratio (CNR) was determined as a qualitative assessment, and the quantitative assessment was conducted through the percentage of variation of the radioactivity concentration estimate. At this time, the relationship between the radioactivity concentration estimate (cps/ml) and the actual radioactivity concentration (Bq/ml) was compared and analyzed using the recovery coefficient (RC_Recovery Coefficients) as an indicator. Results The results [CNR, radioactivity Concentration, RC] by the change in the number of projections for each increase or decrease rate (-90%, -75%, -50%, -25%, +50%, +100%) of total acquisition time are as follows. [-89.5%, +3.90%, 1.04] at -90%, [-77.9%, +2.71%, 1.03] at -75%, [-55.6%, +1.85%, 1.02] at -50%, [-33.6%, +1.37%, 1.01] at -25%, [-33.7%, +0.71%, 1.01] at +50%, [+93.2%, +0.32%, 1.00] at +100%. and also The results [CNR, radioactivity Concentration, RC] by the acquisition time change for each increase or decrease rate (-90%, -75%, -50%, -25%, +50%, +100%) of total acquisition time are as follows. [-89.3%, -3.55%, 0.96] at - 90%, [-73.4%, -0.17%, 1.00] at -75%, [-49.6%, -0.34%, 1.00] at -50%, [-24.9%, 0.03%, 1.00] at -25%, [+49.3%, -0.04%, 1.00] at +50%, [+99.0%, +0.11%, 1.00] at +100%. Conclusion In SPECT/CT, the total coefficient obtained according to the increase or decrease of the total acquisition time and the resulting image quality (CNR) showed a pattern that changed proportionally. On the other hand, quantitative evaluations through absolute quantification showed a change of less than 5% (-3.55 to +3.90%) under all experimental conditions, maintaining quantitative accuracy (RC 0.96 to 1.04). Considering the reduction of the total acquisition time rather than the increasing of the image acquiring time, The reduction in total acquisition time is applicable to quantitative analysis without significant loss and is judged to be clinically effective. This study shows that when increasing or decreasing of total acquisition time, changes in acquisition time per projection have fewer fluctuations that occur in qualitative and quantitative condition changes than the change in the number of projections under the same scanning time conditions.

• Korean Journal of Clinical Laboratory Science
• /
• v.37 no.2
• /
• pp.65-70
• /
• 2005

Those specifications of the CLIA analytical tolerance limits are consistent with the performance goals in Six Sigma Quality Management. Six sigma analysis determines performance quality from bias and precision statistics. It also shows if the method meets the criteria for the six sigma performance. Performance standards calculates allowable total error from several different criteria. Six sigma means six standard deviations from the target value or mean value and about 3.4 failures per million opportunities for failure. Sigma Quality Level is an indicator of process centering and process variation total error allowable. Tolerance specification is replaced by a Total Error specification, which is a common form of a quality specification for a laboratory test. The CLIA criteria for acceptable performance in proficiency testing events are given in the form of an allowable total error, TEa. Thus there is a published list of TEa specifications for regulated analytes. In terms of TEa, Six Sigma Quality Management sets a precision goal of TEa/6 and an accuracy goal of 1.5 (TEa/6). This concept is based on the proficiency testing specification of target value +/-3s, TEa from reference intervals, biological variation, and peer group median mean surveys. We have found rules to calculate as a fraction of a reference interval and peer group median mean surveys. We studied to develop total error allowable from peer group survey results and CLIA 88 rules in US on 19 items TP, ALB, T.B, ALP, AST, ALT, CL, LD, K, Na, CRE, BUN, T.C, GLU, GGT, CA, phosphorus, UA, TG tests in chematology were follows. Sigma level versus TEa from peer group median mean CV of each item by group mean were assessed by process performance, fitting within six sigma tolerance limits were TP ($6.1{\delta}$/9.3%), ALB ($6.9{\delta}$/11.3%), T.B ($3.4{\delta}$/25.6%), ALP ($6.8{\delta}$/31.5%), AST ($4.5{\delta}$/16.8%), ALT ($1.6{\delta}$/19.3%), CL ($4.6{\delta}$/8.4%), LD ($11.5{\delta}$/20.07%), K ($2.5{\delta}$/0.39mmol/L), Na ($3.6{\delta}$/6.87mmol/L), CRE ($9.9{\delta}$/21.8%), BUN ($4.3{\delta}$/13.3%), UA ($5.9{\delta}$/11.5%), T.C ($2.2{\delta}$/10.7%), GLU ($4.8{\delta}$/10.2%), GGT ($7.5{\delta}$/27.3%), CA ($5.5{\delta}$/0.87mmol/L), IP ($8.5{\delta}$/13.17%), TG ($9.6{\delta}$/17.7%). Peer group survey median CV in Korean External Assessment greater than CLIA criteria were CL (8.45%/5%), BUN (13.3%/9%), CRE (21.8%/15%), T.B (25.6%/20%), and Na (6.87mmol/L/4mmol/L). Peer group survey median CV less than it were as TP (9.3%/10%), AST (16.8%/20%), ALT (19.3%/20%), K (0.39mmol/L/0.5mmol/L), UA (11.5%/17%), Ca (0.87mg/dL1mg/L), TG (17.7%/25%). TEa in 17 items were same one in 14 items with 82.35%. We found out the truth on increasing sigma level due to increased total error allowable, and were sure that the goal of setting total error allowable would affect the evaluation of sigma metrics in the process, if sustaining the same process.

• Journal of Korea Water Resources Association
• /
• v.45 no.3
• /
• pp.301-316
• /
• 2012

Two models, TANK and SWAT (Soil and Water Assessment Tool) were compared for simulating natural flows in the Paldang Dam upstream areas of the Han River basin in order to understand the limitations of TANK and to review the applicability and capability of SWAT. For comparison, simulation results from the previous research work were used. In the results for the calibrated watersheds (Chungju Dam and Soyanggang Dam), two models provided promising results for forecasting of daily flows with the Nash-Sutcliffe model efficiency of around 0.8. TANK simulated observations during some peak flood seasons better than SWAT, while it showed poor results during dry seasons, especially its simulations did not fall down under a certain value. It can be explained that TANK was calibrated for relatively larger flows than smaller ones. SWAT results showed a relatively good agreement with observed flows except some flood flows, and simulated inflows at the Paldang Dam considering discharges from upper dams coincided with observations with the model efficiency of around 0.9. This accounts for SWAT applicability with higher accuracy in predicting natural flows without dam operation or artificial water uses, and in assessing flow variations before and after dam development. Also, two model results were compared for other watersheds such as Pyeongchang-A, Dalcheon-B, Seomgang-B, Inbuk-A, Hangang-D, and Hongcheon-A to which calibrated TANK parameters were applied. The results were similar to the case of calibrated watersheds, that TANK simulated poor smaller flows except some flood flows and had same problem of keeping on over a certain value in dry seasons. This indicates that TANK application may have fatal uncertainties in estimating low flows used as an important index in water resources planning and management. Therefore, in order to reflect actually complex and complicated physical characteristics of Korean watersheds, and to manage efficiently water resources according to the land use and water use changes with urbanization or climate change in the future, it is necessary to utilize a physically based watershed model like SWAT rather than an existing conceptual lumped model like TANK.

• The Journal of Korean society of community based occupational therapy
• /
• v.7 no.3
• /
• pp.23-34
• /
• 2017

Objective : The purpose of this study was to investigate establishment status of the mandatory courses designated by Ministry of Health & Welfare for qualification of sensory developmental rehabilitation specialist(SDRS), within curriculum of baccalaureate occupational therapy(BOT) programs in Korea Methods : This is a narrative study to investigate and analyze certain courses established in curriculums of all 4-years occupational therapy(OT) programs, which is 32 schools. Results : 1) The shared mandatory subject, 'Understanding Children with Disabilities(UDC)', has been established at 9 schools. For the branch mandatory subjects, 'Neuroscience(NS) or Neuroanatomy' has been established at all 32 schools, 'Sensory Processing Dysfunctions and Intervention(SPDI)' or 'Sensory Integration' has been established at 31 schools, and each of 'Assessment & Evaluation for Children(AEC)' and 'Practicum of Sensory Rehabilitation(PSR)' has been established 7 schools for same. 2) For the mandatory courses, all 32 schools were offering designated- and alternative courses of NS, SPDI, AEC, but there was no change in the number of schools offering the practicum course since there was no case of alterative for it. 3) In terms of general provision score, there were 4 schools for score 7, 4 schools for score 6, 2 schools for score 5, 1 schools for score 4, 2 schools for score 3, and 19 schools for score 2. Conclusion : Establishment of the mandatory courses required to the qualification of SDRS among the BOT programs in nation were investigated. Including alternative courses, all the branch mandatory courses except practicum course are established in all the 32 schools. However, the shared mandatory subject, UDC and the practicum subject were established in only few schools. In the provision level evaluation of BOT programs for the SDRS qualification, it is shown that many schools has been started the provision already but still many schools' curriculum did not reflect the willingness and accuracy well. For the schools planning successful accreditation in near future, it is recommended that they prioritize the establishment of the shared mandatory course and the practicum course since these two subjects are recognized as critical factors for that. In addition, it is also needed of comparative inspections for course title and syllabi based on the guideline provided by Ministry of Health & Welfare.

• Korean Journal of Biological Psychiatry
• /
• v.3 no.2
• /
• pp.277-287
• /
• 1996

Objective : It has been proposed that cognition and related aspects of mental functioning are decreased in depression as well as in alcoholism. The objective of the study was to compare behavioral side effects of paroxetine and amitriptyline in depressed patients accompanied by alcoholism. The focused comparisons were drug effects concerning psychomotor performance, cognitive function, sleep and daytime sleepiness during the first 2 weeks of treatment. Methods : After an alcohol detoxification period(3 weeks) and a washout period(1 week), a total of 20 male inpatients with alcohol use disorder (DSM-IV), who also had a major depressive episode(DSM-IV), were treated double-blind with paroxetine 20mg/day(n=10) or amitriptyline 25mg/day(n=10) for 2 weeks. All patients were required to have a scare of at least 18 respectively on bath the Hamilton Rating Scale far Depression(HAM-D) and Beck Depression Inventory(BDI) at pre-drug baseline. Patients randomized to paroxetine received active medication in the morning and placebo in the evening whereas those randomized to amitriptyline received active medication in the evening and placebo in the morning. All patients performed the various tasks in a test battery at baseline and at days 3, 7 and 14. The test battery included : critical flicker fusion threshold for sensory information processing capacity : choice reaction time for gross psychomotor performance : tracking accuracy and latency of response to peripheral stimulus as a measure of line sensorimotor co-ordination and divided attention : digit symbol substitution as a measure of sustained attention and concentration. To rate perceived sleep and daytime sleepiness, 10cm line Visual analogue scales were employed at baseline and at days 3, 7 and 14. The subjective rating scales were adapted far this study from Leeds sleep Evaluation Questionnaire and Epworth Sleepiness Scale. In addition a comprehensive side effect assessment, using the UKU side effect rating scale, was carried out at baseline and at days 7 and 14. The efficacy of treatment was evaluated using HAM-D, BDI and clinical global impression far severity and improvement at days 7 and 14. Results : The pattern of results indicated thai paroxetine improved performance an mast of the lest variables and also improved sleep with no effect on daytime sleepiness aver the study period. In contrast, amitriptyline produced disruption of performance on same tests and improved sleep with increased daytime sleepiness in particular at day 3. On the UKU side effect rating scale, mare side effects were registered an amitriptyline. The therapeutic efficacy was observed in favor of paroxetine early in day 7. Conclusion : These results demonstrated thai paroxetine in much better than amitriptyline for the treatment of depressed patients accompained by alcoholism at least in terms of behavioral safety and tolerability, furthermore the results may assist in explaining the therapeutic outcome of paroxetine. For example, and earlier onset of antidepressant action of paroxetine may be caused by early improved cognitive function or by contributing to good compliance with treatment.

• Research in Community and Public Health Nursing
• /
• v.14 no.2
• /
• pp.334-350
• /
• 2003

The purpose of this descriptive study was to evaluate the clinical validity of QSCCII (Questionnaire for the Sasang Constitution Classification), whose high accuracy as a constitutional diagnostic tool has been recognized by medical professionals. The subjects of this study were 568 clients from an A university hospital in Suwon. Of the subjects, 259 were health center visitors and 292 were ambulatory clinic visitors. Data were collected using self-reported questionnaire and were analyzed by $X^2$-test and one-way ANOVA. The results of this study as follows: 1. In 4 types of constitution, Soeumin type was found in 41.5% of the subjects. Taeumin type in 39.2%.,and Soyangin type in 19.2%, respectively. There was no Tayangin type found in this study. There were no significant differences on types of constitution by demographic characteristics such as age, sex, marital status, education, religion, and economic status. 2. As for 15 item-selective questionnaire, there were statistically significant differences on the response rate of the 12 items, except items such as A4, A11 and A14, by the types of constitution. When the subjects' own criteria on their constitution were compared to the given constitutional criteria on each item, 4 items such as A6, A11, A13 and A14 were advisable to be excluded from the questionnaire or to be reunited to the other criteria. In the meanwhile, 3 items such as A7, A18 and A15 were desirable to be re-categorized to the other constitutional types and reconstructed to the QSCC II questionnaire. 3. In terms of 106 true-false questionnaire, there were statistically significant differences on the response rate of 46 items by the types of constitution. The 46 items include 15 items (32.6%) of the domain of 'handling something/strength and weakness', 4 items (8.7%) of the domain of 'interpersonal relationship', 9 items (19.6%) of the domain of 'state of mind at ordinary times', 2 items (4.3%) of the domain of 'distinctive emotional characteristics' area, 11 items (23.9%) of the domain of 'specific behavioral trait' and 5 items (10.9%) of the domain of 'physical characteristics'. Therefore, the areas of 'handling something/strength and weakness' and' specific behavioral trait' mainly contributed to the classification of constitutional type. 4. When the 106 true-false items were simplified to the 46 items, statistically significant differences were found on the rate of items allocated to the 3 types of constitution. The rate of selection assigned to the 3 constitutional types of the simplified 46-item questionnaire was higher than that of the original 106-item questionnaire. Conclusions; It was concluded that the rate of selection of each lay person about his own constitutional type would be still higher even though the simplified items of QSCC II questionnaire were applied. If more replicated studies are conducted on the diverse population using the simplifying QSCC II questionnaire in the future, a more simplified standardized Sasang Constitution Questionnaire that is available to the public rather than to medical staffs in the clinical settings could be developed. Moreover, the simplified scale will help nurses deliver more efficient nursing care by providing a more rapid way of health assessment.

• Reproductive and Developmental Biology
• /
• v.28 no.3
• /
• pp.167-172
• /
• 2004

This study was performed to examine the correlations among dog sperm viabilities evaluated by flow cytometry, by microscopic evaluation (ME), by carbo-xifluorescein diacetate and propidium iodide (CFDA/PI) and by hypoosmotic swelling (HOS) test. Semen were collected from 5 dogs ranging in age from 2 to 4 years. Each ejaculate was divided into 3 aliquots and different proportions of freeze-killed cells were added to each aliquot (1:0, 1:1 and 1:3). In the other experiment, semen was extended with Sweden extender containing 5% glycerol and equex STM paste, and frozen using liquid nitrogen vapor. Fresh and frozen-thawed dog sperm viability were assessed by flow cytometry using PI staining method. The accuracy of flow cytometry was evaluated by comparing with other classic assessments, microscopic evaluation, epifluorescence microscopic analysis using CFDA/PI, and HOS test. High correlations of sperm viabilities were found among flow cytometry, epifluorescence evaluation, HOS test (p<0.01) in fresh semen. Especially, sperm viability assessed by HOS test was highly correlated with viability by flow cytometry in all the ratios of live and dead spermatozoa, 1:0, 1:1 and 1:3 (p<0.01). The viability evaluated by ME were significantly correlated with that by flow cytometry in ratios of 1:0 and 1:3 (p<0.05) however, there was no significance in ratio of 1:1. The viability evaluated by C/p were highly correlated with that by flow cytometry in ratio of 1:0 and 1:1 (p<0.01) and significantly correlated in ratio of 1:3 (p<0.05). In frozen-thawed spermatozoa, the viability determined by HOS test was considerably correlated with that by flow cytometry (p<0.01). There was significant correlation between the viabilities by ME and by flow cytometry (p<0.05). But the viability evaluated by CFDA/PI was not correlated with viability by flow cytometry. The result from this study validate the use of flow cytometry as a precise method for assessing the viability of fresh and frozen-thawed dog spermatozoa.

• The Journal of Korean Society for Radiation Therapy
• /
• v.31 no.2
• /
• pp.25-31
• /
• 2019

Purpose: Metals induce metal artifact during CT-image for therapy planning, and it occurs images distortion, which affects the volumetric measurement and radiation calculation. In the case of using megavoltage computed tomography(MVCT), the volume of metals can be measured as similar to true volume due to minimal metal artifact outcome. In this study, radiation assessment was conducted by comparing teeth volume from images of kVCT and MVCT of head and neck cancer patients, then assigning to kVCT image to calculate radiation after obtaining the similar volume of true teeth volume from MVCT. Also, formal IR image was able to verify the accuracy of radiation calculation. Material and method: 5 head and neck cancer patients who had intensity-modulated radiation therapy from Radixact^® Series were of the subject in this study. Calculations of radiation when constraining true teeth volume out of kVCT image(A-CT) and when designated specific HU after teeth assigned using MVCT image were compared with formal IR image. Treatment planning was devised at the same constraints and mean dose was measured at the radiation assess points. The points were anterior of the teeth, between PTV and the teeth, the interior of PTV near the teeth, and the teeth where 5cm distance from PTV. Result: A difference of metals volume from kVCT and MVCT image was mean 3.49±2.61cc, maximum 7.43cc. PTV was limited to where the internal teeth were fully contained. The results of PTV dose evaluation showed that the average CI value of the kVCT treatment planning without the artifact correction was 0.86, and the average CI value of the kVCT with the artifact correction using MVCT image was 0.9. Conclusion: When the Treatment Planning was made without correction of metal artifacts, the dose of PTV was underestimated, indicating that dose uncertainty occurred. When the computerized treatment plan was made without correction of metal artifacts, the dose of PTV was underestimated, indicating that dose uncertainty occurred.

• Journal of radiological science and technology
• /
• v.39 no.2
• /
• pp.149-156
• /
• 2016

Measurement of cardiac blood flow using the magnetic resonance imaging has been limited due to breathing and involuntary movements of the heart. The present study attempted to improve the accuracy of cardiac blood flow testing through phase contrast magnetic resonance imaging by presenting the adequate breathing method and imaging variables by comparing the measurement values of cardiac blood flow. Each was evaluated by comparing the breath hold retrospective 1NEX and non breath hold retrospective 1-3NEX in the ascending aorta and descending aorta. As a result, the average blood flow amount/velocity of the breath hold retrosepctive 1NEX method in the ascending aorta were $96.17{\pm}19.12ml/sec$, $17.04{\pm}4.12cm/sec$ respectively, which demonstrates a statistically significant difference(p<0.05) with the non-breath hold retrospective method 1NEX of $72.31{\pm}13.27ml$ and $12.32{\pm}3.85$. On the other hand, the average 2NEX blood flow and mean flow velocity is $101.90{\pm}24.09$, $16.84{\pm}4.32$, 3NEX $103.06{\pm}25.49$, $16.88{\pm}4.19$ did not show statistically significant differences(p>0.05).The average blood flow amount/ velocity of the breath hold retrospective 1NEX method in the descending aorta were $76.68{\pm}19.72ml/s$, and $22.23{\pm}4.8$, which did not demonstrate a significant difference in comparison to non-breath hold retrospective method 1-3 NEX. Therefore, the non breath hold retrospective method does not significantly differ in terms of cardiac blood flow in comparison with the breath hold retrospective method in accordance with the increase of NEX, so pediatric patients or patients who are not able to breathe well must have the diagnostic value of their cardiac blood flow tests improved.

• Journal of Korean Academy of Nursing Administration
• /
• v.4 no.1
• /
• pp.247-275
• /
• 1998

The purpose of this study was to offer the results of content analysis and qualitative study that explored the perceptions about quality nursing care of patients and families as consumers and to identify the implications of this study for quality nursing care management and research. The data was collected from 12 adult patients and 9 families who were admmitted at medical and surgical nursing unit of one university hospital in Seoul from October, 1996 to January, 1997. Research participants were asked to response "what do you think quality nursing care?" and similar questions during the interviews was performed. Data were analyzed using open coding and content analysis with frequencies and percents of attributes of quality nursing care. Attributes of quality nursing care and meaning of quality nursing care that patients and families perceived were explored. 1. The attributes of quality nursing care that patient and families perceived were categorized into 56 attributes. The highest response rate among the attributes was 'one's heart at ease' (76.2%), and the next high response rates were ranked in order 'consideration' , 'care about' (each 61.9% 'expert skill' (57.1%), 'deal with problem promptly' , 'information offer' (42.9%), 'intimate feeling' (38.1%), 'smile' 'service spirit' , 'do one's best' (each 33.3%), 'frequent visit' (23.8%), 'observe the time' (23.8%), 'direct nursing care' , 'speaking warmly' , give a hope' , 'address kindly' , 'a sense of duty' , 'good facilities' (each 19.0%), 'inquire after a patient health' , 'patient-centered nursing care' , 'showing an example' , 'professional knowledge' , 'careless moraly patient' , 'give encourage to patients' , 'good answer a question' (each 14.3%), 'do not imprudently' , 'do not disregard' , 'broad knowledge' , 'emergency treatment skill' , 'dependability' ,'consolation' giving a sense of security' , 'a self sacrificing spirit' , 'a sense of responsibility' 'hard - working', 'enough disposition of nursing staff (each 9.5%), 'improve patient's pride' and the rest attributes exhibited 4.7%, respectively. 2. The attributes that were identified in patients' data only were 8 categories, 'service sprit' (58.3 %) 'expert knowledge' , 'good answer a question' (each 25.0%), 'hard working' (16.7%), 'a warm character', 'professional attainments', 'do without reserve', 'satisfaction' (each 8.3%), 3. The attributes were identified to families' data only were 31 categories, 'speaking warmly' , 'direct nursing care', 'adress kindly', 'patientcentered nursing care', 'showing an example' (each 33.3%). 'do not imprudently' , 'do not disregard' , 'consolation', 'giving a sense of security', 'broad knowledge' , 'emergency treatment skill', 'dependability' ,'a self - sacrificing spirit', 'a sense of responsibility' (each 22.2%), 'improve patient's pride' , 'without discrimination' , 'show kindness' , 'individual nursing care', 'being with patient' , 'helping' , 'accuracy' , 'without any mistake' , 'love' , 'self - confidence', 'self possession', 'a self - denying spirit' , 'a sense of duty' , 'tighten discipline' , 'disposed room with similar patient to diagnosis', 'compensatory relationship between me dical team' , 'role of connection' (each 11.1 %). 4. The attributes of quality nursing care were integrated into 11 categories that they were 'patientcentered nursing care' (25.1%), 'expertise' (22.1%), 'caring'(18.1%), 'kindness'(11.1%L 'nurse attainments(10.1%), 'sincerity' (7.5%), 'good environment' (2.0%), 'effective organizational management', 'coordination', 'enough nursing staff' ( each 1.0%), 'satisfaction' (0.5%) were showed in the order of the highest rate. 5. The concept of quality nursing care were defined as 'give a satisfaction to patients by patientcentered care based on professional skill and caring with kindness and sincerity'. The description of the meaning of quality nursing care provided by this research participants, patients and families can provide important information for quality nursing care management, medical marketing, education and researches of this field. On the basis of the above findings the following recommendations are made: to suggest to utilize this results for patient care in practice setting, development of quality assessment tool in nursing care, repeat study by the same subjects and method, and to a comparative study by the same method to nurse.