• 대한간호학회지
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• 제35권1호
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• pp.154-164
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• 2005

Purpose: The purpose of this study was to develop an empowerment program as a nursing intervention for mothers who care for a child with cerebral palsy at home and to determine the effects of the program on those mothers' self efficacy, coping behavior and burden. Method: An non-equivalent control group pretest-posttest design was used in this study. An Empowerment program was developed based on Dunst & Trivette's model. Using the program, the study was carried out from Dec. 13, 2003 to Jan. 17, 2004, mothers whose children, aged 1 to 6, were outpatients of the Dept. of Rehabilitation Medicine, at P University Hospital or registered at educational institutions for early disabled children. The experimental group of subjects were included in the new empowerment program which was held for two and half hours every week for 6 times. Results: After treatment with the Empowerment Program, the experimental group was found to be significantly increased in score for self efficacy(t=4.55, p<.01), coping behavior(t=5.54, p<.001), objective burden(t=-3.96, p<.01) and subjective burden(t=-5.05, <.01), in comparison to the control group. Conclusion: The Empowerment Program is very effective in increasing self efficacy and coping behavior of mothers having a child with cerebral palsy and decreasing their burden. Finally, this study would recommend that an empowerment program should be extended to community facilities such as public health offices and welfare centers.

• The Journal of Korean Physical Therapy
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• 제21권4호
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• pp.23-30
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• 2009

Purpose: This study investigated the efficacy of task-related circuit training aimed at improving balance in individuals discharged from rehabilitation facilities following a stroke. Methods: We recruited 12 stroke patients (34-66 years of age) to participate in a task-related circuit training program. Baseline assessment included a history of stroke and an assessment using the Mini-Mental State Examination Korea (MMSE-K). After a baseline assessment, follow-up assessments were administered pre- and post-training. These included Berg Balance Scale (BBS), Functional Reach Test (FRT), and the Time Up & Go Test (TUG). Physiotherapists trained study subjects under the one-to-one supervision of students from the department of physical therapy. Circuit class study participants attended 90-minute treatment sessions, one day a week for 12 weeks (from September to December 2008). The program consisted of a light warm-up period (10 min), physical exercises for improving balance (20 min), tasks focused on improving balance (50 min) and a cool-down period (10 min). Results: Scores for the BBS assessment increased significantly (from 43.2 to 49.7) after the training (p<0.05). Reach distance on the FRT increased substantially (from 27.7 cm to 47.0 cm), although the improvement was not significant (p>0.05). The average time on the TUG test decreased significantly (from 23.7 sec to 19.5 sec) after the training (p<0.05). Conclusion: The task-related circuit training program improved the balance and mobility of subjects, indicating that such a group program is useful for stroke patients who are discharged from the hospital. More such task-related programs set in a community environment should be developed.

• 한국사회복지학
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• 제47권
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• pp.272-309
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• 2001

It is a recent trend to emphasize community services for the rehabilitation of the mentally ill. However, it is also necessary to provide social work services for those living in the institutions, who is the most underprivileged in our society. To deal with interpersonal skill deficits which is one of the main characteristics of the mentally ill, social skills programs are being utilized, usually in the communities, but not in the institutions. Therefore, the objective of this study is to develop and evaluate institution-relevant program for the improvement of assertiveness, which is the basic ability among the interpersonal skills, and self-esteem, which is the emotional basis of assertiveness. Because there has been little literature on such a program, a preliminary program had been implemented in order to include the peculiarities of the life in the institutions on the main program. The evaluation of the program effect was done by pretest-post test control group design, and its results are as follows. Firstly, in regard to program effectiveness, the pre and post test showed that self-esteem improved in a statistically meaningful way, but that assertiveness did not so. However, the staff verified the improvement of the group members' assertiveness to some degree in their actual lives. Secondly, in regard to the group process, the group interaction improved in a statistically meaningful way between 2nd and 5th session, and the improvement maintained till the program termination. Also the group members evaluated the program as helpful in their everyday lives. Therefore it can be said that the result of this program is encouraging. In light of this, several suggestions were made: utilizing more dynamic techniques in the program; developing the advanced level of the program; making an effort to change environmental structures as well as individuals; applying this kind of program to another living facilities such as those for the homeless or handicapped.

• 대한지역사회작업치료학회지
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• 제1권2호
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• pp.11-20
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• 2011

목적 : 시설노인들의 시간 사용이 일상생활 수행 능력에 미치는 영향을 알아보고, 이를 시설노인의 작업 중재 기법으로 시간 관리 및 라이프스타일 재설계의 기초 자료를 제공하고자 한다. 연구방법 : 2008년 8월 11일부터 2008년 8월 22일까지 대전광역시에 소재한 S요양시설에 입소되어 있는 65세 이상의 노인 20명을 대상으로 인터뷰, 타임테이블, FIM을 사용하여 자료를 수집을 하였다. 결과 : 연구 대상자들의 일반적 특성과 일상생활수행능력에는 유의한 차이가 없었다. 능동적 기본적 일상생활활동과 수단적 일상생활활동의 시간 사용이 많을수록 일상생활수행능력은 높았다(p<0.01). 능동적 여가의 시간 사용량이 많을수록 일상생활수행능력은 높았다(p<0.05). 결론 : 본 연구를 통해 대전지역 시설 노인들의 시간 사용량을 알 수 있었고, 시설 노인들의 시간 사용량이 일상생활수행능력과 관련이 있음을 알 수 있었다. 시설 노인들의 시간 사용량의 효율성을 높이기 위해서 작업치료사의 역할이 요구되며 시설 노인들이 보다 능동적이며 긍정적인 삶을 유지할 수 있는 중재 방안을 마련해야 할 것이다.

• 대한지역사회작업치료학회지
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• 제3권2호
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• pp.33-46
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• 2013

목적 : 가상현실 프로그램과 현실화된 과제 지향 프로그램이 노인의 균형에 어떠한 영향을 미치는지 그 효과를 비교해 보고자 한다. 연구방법 : 12명의 건강한 노인을 대상으로 가상현실 프로그램과 현실화된 과제 지향 프로그램을 각각 6주간 주 2회씩 실시하였다. 균형 능력 변화를 위해 버그 균형 척도(Berg Balance Scale: BBS), 이동 능력검사(Timed Up and Go: TUG), 한 발 서기 검사(One-Legged Stance Test: OLST), 5회 반복 앉았다 일어서기 검사(5-Repetition Sit-To-Stand Test: 5R-STS Test)를 사용하였다. 결과 : 분석결과 프로그램 전 후에서는 통계적으로 유의한 결과를 얻지 못하였다. 하지만 세 집단 간 비교에서는 버그 균형 척도, 한 발 서기 검사 중 눈 뜨고 좌, 우에서 통계적으로 유의한 결과를 얻었으며 사후 검정결과 눈 뜨고 검사 - 좌에서 가상현실 프로그램과 현실화된 과제 지향 프로그램 간에 유의한 결과를 얻었다. 결론 : 현실화된 과제 지향 프로그램은 노인의 균형 능력 향상에 좀 더 긍정적이었으며 임상 및 지역사회에서 좀 더 쉽게 수행할 수 있는 프로그램으로 유용하게 사용될 수 있을 것이라 생각된다.

• 가정간호학회지
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• 제6권
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• pp.5-18
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• 1999

This study was attempt to encourage for developing on rehabilitation delivery system and programs as a substitute service instead of hospitalization for accident patients at work, such as hospital based home health care nursing service. It needs vary substitutes service of hospitalization to curtail the length of stay for inpatients who were hospitalized with workers compensation insurance. It focused on developing an estimation of early discharge day of accident inpatients based on a detail statement of treatment for 115 inpatients who were hospitalized at General Hospital in 1997. This study has four specific purpose as follows. First, to find out the status of health service utilization. Second, to estimate the early discharge days and income increasing effect based on the early discharge for those patients. Third, to identify the factors to affect total medical expenditure and the length of stay for those inpatients. Forth, to figure out the need of utilizing home health care nursing service for accident patients. In order to analyze of the length of stay and medical expenditure for inpatients who were hospitalized due to the accident, the authors conducted with micro-analysis and macroanalysis from medical records and medical expenditure records. Micro-analysis was done by nominal group discussion of 4 expertise with the critical criteria. such as a decrease in the amount of treatment after surgery, treatments, tests, drugs and changes in the tests consistency, drug methods, vital signs, start of ROM exercise, doctor's order, patient's outside visiting ability, stable conditions. In addition to identify affected variables for medical expenditure. the length of stay and income effect due to early discharge day, the data was analyzed with multiple regression analysis and linear regression analysis model by SPSS-PC for windows and Excell program. Results of this study as follows. First, the mean length of stay was 37.1 days, whereas the mean length of stay due to early discharge was 28.2 days at the hospital. The estimation of early discharge days were shown that depends on the length of stay. The longer length of stay, the longer length of early discharge days, such as under 7 days length of stay patients was to estimated the mean length of stay was 4.9 days and early discharge days was 4.6. whereas the mean length of stay was 122.6 days and early discharge days was 92.0 respectively. The mean medical expenditure per day were found to be 133.409 Won. whereas the mean medical expenditure per day was shown negative linear trends according to the length of stay at the hospital. The estimation results of the income effect due to 11 early discharge days per bed was around 2,150,000 won. However, it means not the real benefits from early discharge, but the income increasing amount without considering medical prime cost in general hospital. Therefore, it needs further analysis on the cost containments and benefits under the considering as well turn over rates per bed as the medical prime costs. The length of stay was most significant and the sign was positive to the total medical expenditure, as expected. Surgery and patient's residential area also an important variable in explaining medical expenditure. The level of complications was most significant variable in explaining the length of stay. The level of the needs on horne health care nursing service which can be used for early discharge accident patients were shown very high. The needs distribution varied from 65.5% of patients and 88.9% of caregivers, to 96.4% of doctors, and 99.1% of nurses. In addition horne health nurse responded that they can be managed the accident inpatients from early discharge. From these research findings. the following suggestions has been drawn it needs to develop strategies on rehabilitation delivery system in order to focused on consumer's side which is planned for 21 century health policy in Korea. Vary intermediate facilities and horne health care would have been developed in the community based for comprehensive rehabilitation services as a substitutes of hospitalization for shortening the length of stay of hospitalizations. In hospital based horne health care nursing service, it's available immediately to utilize for the patients who wanted rehabilitation services as a substitutes of hospitalization under the cooperations with workers compensation insurance company.

• 정신신체의학
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• 제21권1호
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• pp.62-71
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• 2013

연구목적 본 연구는 경기도 일지역의 음주실태, 위험음주와 알코올사용장애의 정도 및 지역사회 음주정책 요구도 조사를 위해 수행되었다. 방 법 연구대상자는 경기도 안산시 거주 19세 이상 65세 미만 성인 1,000명으로 2011년 6월부터 7월까지 두 달 간 조사하였다. 조사설문지는 연구목적에 의해 구성한 사회인구학적 특성 문항, Alcohol Use Disorder Identification Test(AUDIT)와 Cut down, Annoyed, Guilty, Eye-opener(CAGE) 척도, 지역사회 음주문제 해결에 대한 서비스 및 정책 요구도에 대한 문항으로 구성하였다. 자료분석은 SPSS version 18.0 통계프로그램을 이용하였다. 결 과 대상군의 평생음주율은 97.4%이고, 이들 중 21.9%가 주 2~4회 음주 빈도를 보였으며, 유해음주 빈도는 남성의 24.4%로 남성 4명 중 1명은 한 번의 좌석에서 소주 한 병 또는 맥주 4병 이상을 마시는 빈도가 주 1회 이상이었다. 음주시작 연령은 평균 20.3세이나 19세 이전에 음주를 시작하는 경우가 51.6%이었다. AUDIT 척도를 적용한 유해음주 및 알코올사용장애의 비율은 각각 14.9%, 3.3%, CAGE 척도 기준을 적용하였을 때 알코올사용장애자는 9.6%였다. 조사응답자들의 지역사회 음주문제에 대한 서비스 및 정책요구도는 예방교육(57.2%), 치료시설 연계(50.1%), 알코올상담과 개입(41.7%), 그리고 재활프로그램(39.8%) 순이었다. 결 론 본 연구결과, 경기도 도시 지역의 유해음주와 알코올사용장애 등 문제음주의 정도는 높은 비율로 나타나며, 지역주민들의 음주문제 관련 요구도와 음주시작연령에 대한 고려를 통해 효과적인 음주예방프로그램과 정책개발이 요구된다.

• 한국노년학
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• 제29권4호
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• pp.1539-1557
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• 2009

본 연구는 이용시설 참여노인을 대상으로 노인의 삶의 질 요인을 분류하고, 노인특성에 따른 삶의 질의 차이를 분석하고, 노인의 삶의 질에 영향을 미치는 이용시설 프로그램 참여도 및 자아존중감, 우울의 영향을 분석함으로써, 이용시설 프로그램의 문제점과 향후 바람직한 프로그램의 대안을 제시하여 노인의 삶의 질 향상에 도움을 주는데 그 목적이 있다. 연구목적을 달성하기 위하여 경남지역에 위치한 노인이용시설 6곳을 이용하는 노인 269명을 대상으로 분석하였다. 그 결과 첫째, 노인의 삶의 질 요인을 분석한 결과 경제생활에 대한 삶의 질, 이웃에 대한 삶의 질, 건강에 대한 삶의 질, 배우자에 대한 삶의 질 등 4가지 요인으로 분류되었다. 삶의 질 척도에서 이웃에 대한 삶의 질이 가장 높았고, 건강에 대한 삶의 질, 경제생활에 대한 삶의 질 순으로 나타났으며, 이 중 배우자에 대한 삶의 질이 가장 낮게 나타났다. 둘째, 노인특성에 따른 삶의 질의 차이를 분석한 결과, 경제생활에 대한 삶의 질은 노인특성에 따라 통계적으로 의미 있는 차이는 없는 것으로 나타났다. 이웃에 대한 삶의 질은 남성이 높았으며, 학력이 낮을수록 삶의 질이 높게 나타났다. 건강에 대한 삶의 질은 신체적 건강에서 건강한 편일 때 삶의 질이 높았다. 배우자에 대한 삶의 질은 남성이, 학력이 높을 때, 동거상태에서는 부부만 살 때, 결혼상태에서는 부부가 함께 살고 있을 때, 용돈수준이 높을 때 삶의 질이 높은 것으로 나타났다. 셋째, 노인의 삶의 질에 영향을 미치는 영향요인을 분석한 결과, 자아존중감은 경제생활에 대한 삶의 질에 정적인 영향을 미치는 것으로 나타난 반면, 우울은 부적인 영향으로 나타내었다. 우울과 후생복지사업 프로그램 참여는 이웃에 대한 삶의 질에 부적인 영향을 나타난 반면 지역사회활동 프로그램 참여는 이웃에 대한 삶의 질에 긍정적인 영향을 주는 것으로 나타났다. 우울과 재활프로그램은 건강에 대한 삶의 질에 부적인 영향을 미치는 변인으로 나타났다. 교양교육 프로그램은 배우자에 대한 삶의 질에 정적인 영향을 미치는 것으로 나타난 반면, 건강증진 프로그램은 부적인 영향을 미치는 변인으로 나타났다. 본 연구의 결과는 이용시설 프로그램의 문제점과 향후 바람직한 프로그램의 대안을 제시하여 노인의 삶의 질 향상을 위한 기초자료로 의미가 있다.

• Journal of Yeungnam Medical Science
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• 제12권2호
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• pp.347-365
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• 1995

도시 보건소 직원의 보건소 업무에 대한 인식 및 태도를 파악하기 위하여 대구직할시 7개 보건소 직원 310명을 대상으로 1994년 8월 15일부터 9월 30일까지 설문조사를 실시하여 252명(회수율 81.3%)의 자료를 분석하여 다음과 같은 결과를 얻었다. 조사대상은 남자가 95명(37.3%), 여자가 157명(62.3%)이고, 60.3%가 대졸이상자였다. 현재 근무부서의 시설이 보건사업을 수행하는데 적합하다고 한 의견이 28.6%, 적합하지 않다가 51.1%였고, 보유 기자재가 사업수행에 적합하다가 19.4%, 적합하지 않다가 39.0%였으며, 보건소의 인력수가 적정하다가 28.6%, 적합하지 않다가 44.8%였다. 근무부서의 예산이 보건사업 수행에 적합하다고 한 의견이 13.1%, 적합하지 않다가 38.5%였다. 지방자치제 실시후 사업내용이 바뀌어야 한다고 한 의견이 51.9%, 지방자치제의 실시가 자신의 근무부서의 업무에 도움이 된다고 한 의견이 25.4%, 도움되지 않는다가 24.6%였다. 지방자치제 실시에 따라 보건소의 조직과 기능이 개선되어야 한다는 의견은 78.6%였다. 사업 목표량의 설정이 해당 부서나 지역의 실정에 비추어 맞게 책정되어 있다는 의견이 11.1%, '그렇지 않다'가 43.3%였다. 업무 수행을 위한 전문적인 지식이나 기술에 대한 교육을 더 받아야 한다고 한 의견이 57.5%, 더 받을 필요없다가 20.6%였고, 자신의 업무수행에 자율성이 있다고 생각하는 견해가 35.7%, 자율성이 없다가 25.8%였으며, 현재 하고 일에 만족한다가 39.3%, 만족하지 못한다가 16.3%였다. 보건소의 인사관리에 대해서는 11.5% 합리적이라고 하였고, 47.3%가 불합리적 이라고 하였으며, 보건소가 주민들로부터 신뢰를 받고 있다는 의견이 41.3%, '그렇지 않다'는 의견이 13.1%였다. 보건소에서 지역주민에게 제공하는 서비스 중에서 잘 시행되고 있는 사업은 결핵관리, 일반진료, 모자보건사업의 순이었으며, 부족한 사업은 보건교육, 치과진료, 위생, 통합보건사업의 순이었다. 향후 보건소에서 주민에게 제공해야 할 서비스로는 노인보건사업, 가정의료사업, 재활보건사업, 당뇨병관리, 고혈압관리, 학교보건사업, 정신보건사업의 순으로 지적하였다. 보건소 근무자들은 시설, 기자재, 인력, 예산, 인사관리, 사업목표량의 설정 및 평가, 인사관리 등에 대해서는 부정적인 의견이 많았으며, 업무수행을 위한 보수교육, 지방자치제 실시를 통한 업무의 변화, 업무의 자율성, 업무의 만족도 면에서는 대체로 긍정적인 의견을 가진 것으로 나타났다.

• 대한간호학회지
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• 제18권2호
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• pp.162-188
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• 1988

The purpose of this study is to guide the direction of the Korean nursing education to analysize ⑴ the philosophy and objectives ⑵ curriculum, and ⑶ educational environment. This analysis is based on the data from 50 nursing schools (14 4-year colleges and 35 3-year colleges) The survey was conducted from Dec. 1986 through Jan. 1987 by mail. 1) Educational philosophy and objectives 10 4-year colleges and 8 3-year college program have curricular philosoph. Most popular curricular philosophies are human beings, health, nursing, nursology, nursing education, nurses role in the present and in the future. 10 nursing schools mentioned that human being is the subject to interact with : environment physically, mentally and socially. 2 schools mentioned that health is the state of functioning well physically, mentally and socially. 13 schools mentioned that the nursing is the dynamic act to maintain and to promote the highest possible level of health. 4 schools mentioned that the nursology is an applied science. 4 schools mentioned that nursing education is the process to induce the behavioural changes based on the individual ability. There is different opinion about the nurses' role between 4-year college and 3-year college. In the responses from 4-year colleges they focus on the leadership in effective changes, self-regulating and self-determining responsibilities, applying the new technology, continuing education, and participation in research to further nursing knowledge. In the responses from 3-year colleges, they focus on the education in college, primary health care nursing, direct care provider and public health education. Among 50 respondents 40 schools have educational goals which can be divided into two categories. One is to establish the moral and the other is to develop the professionalism. 2) Curriculm The analsis of curriculum is only based on the data from the 4-year colleges because the most of 3-year colleges follow the curriculum guideline set by the Ministry of Education. a) Comparison of the credits in cultural subject and in nursing major. The average required credit for graduation is 154.6 and the median credit is the range of 140-149. The average credit of cultural subjects is 43.4. In detail, the average number of credit of required course and elective courses are 24.1 and 19.3 respectively. The average credit for major subject is 111.2. In detail, the average credit for required courses and electives course are 100.9 and 10.4 respectively. In 5 colleges, students are offered even on elective course b) Comparison of the credit by class. The average earned credits are as follows : 41.1 in freshman, 400 in sophormore 38.3 in junior and 32.4 in senior. Cultural subjects are studied in early phases. c) Comparison of the compulsory and elective cultural subject by institute. The range of credit is 7-43 in compulsory cultural subjects and there are lot of differences among institutions. While all respondents require liberal arts as compulsary subjects, few respondents lists social science, natural science and behavioral science as required subjects. Social science-related subjects are frequently chosen as cultural subjects d) Distribution of creditsin cultural subjects by institute. The liberal art subjects are taught in 20 institute. English and physical education courses are taught in all instituions. The social science subjects are taught in 15 colleges and the basic Psycology and the Basic sociology are the most popular subjects. The natural science subjects are taught in 7 colleges and Biology and Chemistry are the most popular subjects among them. e) Distribution of credits in major basic courses by institute. Most of the institutes select Anatomy, Microbiology, Physiology, biochemistry and Pathology as basic major courses. f) Comparison of the required and elective courses for nursing major by institutions. Subjects and credit ranges in major are varing by institute. More than half of the respondents select the following subjects as required major subjects. (1) Adults Health Nursing and Practice (19.5 credits) (2) Mother and Child Care and Practice (8.9 credits) (3) Community Health Care and Practice (8.5 credits) (4) Psychiatric Nursing Care and Practice (8.1 credits) (5) Nursing Management and Practice (3.9 credits) (6) Fundamental of Nursing, Nursing Research and Health Assessment and Practice. Three institutions select Introduction to nursing, Rehabilitation Nursing, School Nursing, Public Health Nursing, Nursing English, Communication, Human Development as electives in nursing major. 3) Educational environment a) Nursing institution There are forty-three 3-year colleges and seventeen 4-year colleges and 81.4% of which are private b) Number of students and faculty 19.2% of the students are in 4-year colleges and 80.8% of the students are in 3-year colleges. In 4-year colleges, the number of nursing faculty members is in the other of assistant professor, instructor and professor. In 3-year colleges, the orderiis lecturer, associate professor, full time instructor and assistant professor. In 4-year colleges, 18.8 students are allocated per nursing faculty and in 3-year colleges, 33.1 students are allocated per nursing faculty. c) Clinical practices 66.7% of the 4-year colleges practice over 1201 hours in clinic and 28.5% of 3-year colleges practice over 1201 hours in clinic. In 4-year colleges, 11.5 students are allocated per nursing faculty and in 3-year colleges,17 students are allocated per nursing faculty The survey shows no difference in the procedure between 4-year colleges and 3-year colleges but 3-year colleges choose the more variety practicing site such as special hospital and community health clinic. d) Audiovisual facilities The survey shows a lot of difference in audiovisual facilities among institution and 3-year colleges are less equipped than 4-year colleges.