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A Study on the Nursing Needs and Satisfactions of Early Postpartum Women (초기 산욕부의 간호요구도와 만족도에 관한 연구)

  • Yoo, Youn-Ja;Lee, Eun-Ju
    • Women's Health Nursing
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    • v.5 no.3
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    • pp.389-409
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    • 1999
  • This study was carried out to identify the differences between nursing needs and levels of satisfaction of postpartum women during the early postpartum period. The goal of this study was to obtain needed to develope the nursing quality for postpartum women. The subjects were 87 postpartum women who had vaginal delivery at 2 general hospital and 2 maternity hospital in the Ulsan City. The period for the data collection was from June 1 to 29, 1999. The data was gathered using an 98 items questionnaire which was a modified version of a questionnaire the developed by Y. J. Chun. Results found are as follows : 1. The general characteristics of the subjects : The majority of subjects were 25-29 yrs. (57.5%), high school and college graduates(96.5%), unemployed(75.9%), middle ranged economics(93.1%), had no religion(43.7%), male baby(52.9%), birth weight 3-3.5Kg(49.4%), wanted pregnancy(96.6%), no abortion history(50.6%), had antenatal care(89.7%), had prenatal education(32.2%), postnatal education(42.5%), intended breast feeding (46.0%), had resonable self confidence about self(20.7%), infant care(36.8%) and nuclear family pattern(82.3%). 2. The level of nursing needs of overall nursing care(3.93) and the levels of satisfaction(3.86) was relatively high. The nursing needs by category of nursing care, the highest need was in the emotional and psychological care(4.09), and the lowest need was in physical need(3.73). The satisfactions by category of nursing care, the highest satisfaction was in emotional and psychological care(4.11) and the lowest satisfaction was in education in self care(3.64). The significant differences between nursing needs and satisfactions were found on education in infant care(p=.005), and education in self care(p=.020). 3. Among items of physical care, 'accurate medication and treatment(4.21)', 'control of postpartum hemorrhage(4.13)', 'pain control and care of episiotomy wound (4.12)' and 'regular observation of postpartum conditions(4.09)' showed high nursing needs. 'Accurate medication and treatment(4.31)', 'regular observation of postpartum condition(4.24)', 'control of postpartum hemorrhage(4.22)' and 'pain control and care of episiotomy wound(4.12)' showed high satisfaction levels. 4. Among items of emotional and psychological care, 'personal treatment(4.32)', kind and faithful care(4.30)', 'detailed explanation on the treatment or nursing care(4.25)', 'adequate draping during the care and treatment(4.23)' and detailed explanation on a doubt(4.13)', showed high nursing needs, 'personal treatment(4.52)', 'kind and faithful care(4.45)', 'detailed explanation on a doubt(4.24)', 'detailed explanation on the treatment or nursing care(4.21)' and 'adequate draping during the care and treatment(4.18)' showed high satisfaction of nursing care. Difference between the level of nursing needs and satisfaction was significant except item of 'early contacts with their baby and breast feeding'. 5. Among items of environmental care, the highest level of need and satisfaction were on the items of 'neat bedding and clothes(4.05, 4.21)' and 'room cleansing or care of room(4.01, 4.28)'. Differences between the level of nursing care and satisfaction were 'room cleansing of care of room'. 6. Among items of educational needs on self care, 'sitz bath method(4.22)', 'high risk symptoms to immediate clinic visits(4.13)', 'the timing of tub bath(4.05)' and 'good secretion of breast milk(4.03)', showed high nursing needs, 'sitz bath method(4.22)' showed high satisfaction of nursing care. Differences between the level of nursing care and satisfaction were 'the timing of hair shampoo', 'the timing of tub bath', ' the method of pad change', 'postpartum exercise', 'good secretion of breast milk', 'maintenance of breast figure', 'contraindicated drugs in postpartum women', 'kegel exercise' and 'breast self examination'. 7. Among items of educational needs on infant care, 'immunization of infants(4.36)', 'symptoms of sickness to immediate clinic visits(4.28)'. 'safety and emergency care(4.28)', 'umbilical care(4.26)', 'feeding times and intervals(4.24)', 'normal growth and development of infant(4.24)' and 'infection control(4.22)', showed high level of nursing care, 'immunization of infants(4.21)', 'feeding times and intervals(4.17)', were high satisfaction items showed significant differences between the level of nursing care and satisfaction. 8. Relationship between nursing needs and levels of satisfaction among postpartum women were as follows : 1) Physical area : There were no significant differences in the level of nursing needs, but satisfaction levels were significantly different among 'working mothers', 'baby's weights', 'baby's sex', 'planning of feeding' and 'routes of receiving postpartum informations'. 2) Emotional and psychological area : The level of nursing needs were significantly different in the area of 'confidence in self care'. Satisfaction levels were significantly different among 'baby's sex', 'baby's weights', 'the confidence of infant care' and 'working mother'. 3) Environment area : There were on significant differences in the level of nursing needs, but satisfaction levels were significantly different among 'maternal age' and 'baby's weights'. 4) Education in self care : The level of nursing needs were significantly different among 'parity history' and 'type of family formation'. Satisfaction levels were significantly different among 'working mother', 'baby's sex', 'antenatal care', 'postpartum education', 'planning of feeding', 'routes of receiving postpartum informations'. 5) Education in infant care area : The level of nursing needs were significantly different among 'parity history'. Satisfaction levels were significantly different among 'baby's sex', 'receiving postpartum education or not' and 'working mother'.

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Comparison of Acceptance of Disability, Stress, Coping Methods, and Wellness between Mothers of Physical Dysfunctional or Developmental Disabilities (신체기능장애와 발달장애아동 어머니의 장애수용, 스트레스, 대처방식 및 웰니스)

  • Kang, Ji-Soon;Hwang, Ji-Won;Kim, Jung-Aa
    • Journal of the Korean Applied Science and Technology
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    • v.36 no.4
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    • pp.1385-1398
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    • 2019
  • This study was a survey study to provide the base data necessary to prepare efficient management plans for the mothers with disabled children by type, comparing degrees of disability acceptance, stress, coping method and wellness between mothers with physical functional disordered children and developmental disordered children. The study subjects were a mother who raises disordered children. Data collection was conducted from October 2018 to April 2019, and differences between the two groups were analyzed as t-test, ANOVA, and Pearson correlation. In results, Studies have shown that there are differences between the two groups as mothers with physical functional disordered children and mothers with developmental disordered children as degrees of disability acceptance, stress, treatment and wellness. Disability acceptance and coping method of mothers with physical functional disordered children (r=0.23, p=.033), disability acceptance and Wellness (r=0.51, p<.001) have shown positive correlations and disability acceptance and stress (r=-0.72, p<.001) have shown negative correlations. Disability acceptance and wellness (r=0.40, p<.001) of the mother with a developmental disordered child have shown a significant positive correlation, and disability acceptance and stress (r=-0.71, p<.001) have shown a significant negative correlations. The higher the degree of disability acceptance, the lower the stress level and the higher the coping method and wellness mothers with physical functional disordered children had. The higher disability acceptance, the lower stress degrees and the higher wellness degrees mothers with developmental disordered children had. In order to improve disability acceptance by mothers with physical functional disordered children, it was necessary to improve both coping methods and wellness with stress reducing strategy, while the mother with developmental disordered children were needed strategies to reduce stress and improve wellness.

A Collaborative Filtering System Combined with Users' Review Mining : Application to the Recommendation of Smartphone Apps (사용자 리뷰 마이닝을 결합한 협업 필터링 시스템: 스마트폰 앱 추천에의 응용)

  • Jeon, ByeoungKug;Ahn, Hyunchul
    • Journal of Intelligence and Information Systems
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    • v.21 no.2
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    • pp.1-18
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    • 2015
  • Collaborative filtering(CF) algorithm has been popularly used for recommender systems in both academic and practical applications. A general CF system compares users based on how similar they are, and creates recommendation results with the items favored by other people with similar tastes. Thus, it is very important for CF to measure the similarities between users because the recommendation quality depends on it. In most cases, users' explicit numeric ratings of items(i.e. quantitative information) have only been used to calculate the similarities between users in CF. However, several studies indicated that qualitative information such as user's reviews on the items may contribute to measure these similarities more accurately. Considering that a lot of people are likely to share their honest opinion on the items they purchased recently due to the advent of the Web 2.0, user's reviews can be regarded as the informative source for identifying user's preference with accuracy. Under this background, this study proposes a new hybrid recommender system that combines with users' review mining. Our proposed system is based on conventional memory-based CF, but it is designed to use both user's numeric ratings and his/her text reviews on the items when calculating similarities between users. In specific, our system creates not only user-item rating matrix, but also user-item review term matrix. Then, it calculates rating similarity and review similarity from each matrix, and calculates the final user-to-user similarity based on these two similarities(i.e. rating and review similarities). As the methods for calculating review similarity between users, we proposed two alternatives - one is to use the frequency of the commonly used terms, and the other one is to use the sum of the importance weights of the commonly used terms in users' review. In the case of the importance weights of terms, we proposed the use of average TF-IDF(Term Frequency - Inverse Document Frequency) weights. To validate the applicability of the proposed system, we applied it to the implementation of a recommender system for smartphone applications (hereafter, app). At present, over a million apps are offered in each app stores operated by Google and Apple. Due to this information overload, users have difficulty in selecting proper apps that they really want. Furthermore, app store operators like Google and Apple have cumulated huge amount of users' reviews on apps until now. Thus, we chose smartphone app stores as the application domain of our system. In order to collect the experimental data set, we built and operated a Web-based data collection system for about two weeks. As a result, we could obtain 1,246 valid responses(ratings and reviews) from 78 users. The experimental system was implemented using Microsoft Visual Basic for Applications(VBA) and SAS Text Miner. And, to avoid distortion due to human intervention, we did not adopt any refining works by human during the user's review mining process. To examine the effectiveness of the proposed system, we compared its performance to the performance of conventional CF system. The performances of recommender systems were evaluated by using average MAE(mean absolute error). The experimental results showed that our proposed system(MAE = 0.7867 ~ 0.7881) slightly outperformed a conventional CF system(MAE = 0.7939). Also, they showed that the calculation of review similarity between users based on the TF-IDF weights(MAE = 0.7867) leaded to better recommendation accuracy than the calculation based on the frequency of the commonly used terms in reviews(MAE = 0.7881). The results from paired samples t-test presented that our proposed system with review similarity calculation using the frequency of the commonly used terms outperformed conventional CF system with 10% statistical significance level. Our study sheds a light on the application of users' review information for facilitating electronic commerce by recommending proper items to users.

The Influence of Case-Based Learning using video In Emergency care of infant and toddlers (영유아 응급처치 교육에서의 동영상 활용 사례기반학습의 효과)

  • Cho, Hye-Young;Kang, Kyoung-Ah
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.12
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    • pp.292-300
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    • 2016
  • The purpose of this study was to investigate the effects of case-based learning about infants and toddlers on healthcare department students, using a video in an emergency care environment. A total of 57 students from a healthcare department of D university in J city were enrolled. They were divided into two groups: The experimental group (n=29) and the control group (n=28). This study is pre-post designed with a non-equivalent control group. The experimental group received a 1-week education for a duration of 3 weeks (3 sessions in total) with 180 minutes per session. The control group received a traditional curriculum of lecture. Before and after the education, we measured the knowledge and skill confidence of emergency care toward infants and toddlers, the academic self-efficacy, and problem solving ability. Data collection and intervention were carried out from November to December of 2014. Data were analyzed with x2-test, paired t-test, unpaired t-test with SPSS version 20.0 Program. The experimental group showed a significantly higher improvement of skill confidence of emergency care toward infants and toddlers (P<001), as well as preferred task difficulty among sub-items of academic self-efficacy (p=.029), approach avoidance style (P=.001), and problem solving confidence (p=.040) among sub-items of problem solving ability on preference compared with the control group. In this study, a case-based learning was verified to be an effective teaching method to enhance professional competency of healthcare department students. The findings from this study suggest that a case-based learning using various educational contents should be developed, expanded, and carried out to promote better learning.

Semi-Longitudinal Study on Growth Development of Children Aged 6 to 16 (한국인 정상아동 6세~16세의 악안면 성장에 관한 준종단적 연구)

  • Jeong, Mi;Hwang, Chung-Ju
    • The korean journal of orthodontics
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    • v.29 no.1 s.72
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    • pp.51-72
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    • 1999
  • In orthodontic field, it is very important to understand the normal growth. Such an understanding can be derived from observation of normal growth in various samples from childhood to adulthood, and this builds a foundation from which growth abnormality or variation can be defined. Thus, a broad data collection of normal children, as well as basic study reviewing such data become necessary. The relationship between the mean values of cephalometric measurements in Growth and Development was studied among the groups(boys and girls) of Korean chidren from the ages 6-years to 16-years. 220 boys 170 girls were chosen as subjects : Cephalometric X-ray were taken for 3 years and hard tissue analysis on McNamara and Ricketts Analysis which was divided into measurements of 5 parts(Cranial base, Cranial base and Maxilla & Mandible, Maxilla and Mandible, Mandible, Dental measurements). The relationship of craniofacial growth was studied. The following conclusions were obtained: 1. There were statistically significant differences in anterior cranial base between the two sexes of 14 and 15-year grouips. 2. In comparison of growth amounts among different age groups, statistically singnificant difference in Posterior facial height exhisted among $10\~11,\;12\~13\;and\;14\~15$ year-old interval groups. This pattern increased with aging. 3. Na perpendicular to A showed earlier growth peak in females(11-12years) than males(12-13years). When horizontal measurements of point A and Pogonion are compared, mandibular growth appeared to be greater. 4. Maximum growth peak of cranial base and mandible was earlier in females (11-12years) than males(13-14 years). 5. Upper central incisor flared out with aging, and there were increases in lower incisor to A-Pg, and lower incisor inclination There was significant difference between the two sexes in 10-year-old group.

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Predictive Factors of Health promotion behaviors of Industrial Shift Workers (산업장 교대근무 근로자의 건강증진행위 예측요인)

  • Kim, Young-Mi
    • Korean Journal of Occupational Health Nursing
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    • v.11 no.1
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    • pp.13-30
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    • 2002
  • Industrial shift workers feels suffer mental stresses which are caused by unfamiliar day sleep, noisy environment, sleeping disorder by bright light, unusual contacts with family, difficulty in meeting with friends or having formal social meetings and other social limitations such as the use of transportation. Such stresses influence health of the workers negatively. Thus the health promotion policy for shift workers should be made considering the workers' ways of living and shift work specially. This study attempted to provide basic information for development of the health promotion program for industrial shift workers by examining predictive factors influencing health promotion behaviors of those workers. In designing the study, three power generation plants located in Pusan and south Kyungsang province were randomly selected and therefrom 280 workers at central control, boiler and turbine rooms and environmental chemistry parts whose processes require shift works were sampled as subjects of the study. Data were collected two times from September 17 to October 8, 1999 using questionnaires with helps of safety and health managers of the plants. The questionnaires were distributed through mails or direct visits. Means for the study included the measurement tool of health promotion behavior provided by Park(1995), the tool of self-efficacy measurement by Suh(1995), the tool of internal locus of control measurement by Oh(1987), the measurement tool of perceived health state by Park(1995) and the tool of social support measurement by Paek(1995). The collected data were analyzed using SPSS program. Controlling factors of the subjects were evaluated in terms of frequency and percentage ratio Perceived factors and health promotion behaviors of the subjects were done so in terms of mean and standard deviation, and average mark and standard deviation, respectively. Relations between controlling and perceived factors were analyzed using t-test and ANOVA and those between perceived factors and the performance of health promotion behaviors, using Pearson's Correlation Coefficient. The performance of health promotion behaviors was tested using t-test, ANOVA and post multi-comparison (Scheffe test). Predictive factors of health promotion behavior were examined through the Stepwise Multiple Regression Analysis. Results of the study are summarized as follows. 1. The performance of health promotion behaviors by the subjects was evaluated as having the value of mean, $161.27{\pm}26.73$ points(min.:60, max.:240) and average mark, $2.68{\pm}0.44$ points(min.:1, max.:4). When the performance was analyzed according to related aspects, it showed the highest level in harmonious relation with average mark, $3.15{\pm}.56$ points, followed by hygienic life($3.03{\pm}.55$), self-realization ($2.84{\pm}.55$), emotional support($2.73{\pm}.61$), regular meals($2.71{\pm}.76$), self-control($2.62{\pm}.63$), health diet($2.62{\pm}.56$), rest and sleep($2.60{\pm}.59$), exercise and activity($2.53{\pm}.57$), diet control($2.52{\pm}.56$) and special health management($2.06{\pm}.65$). 2. In relations between perceived factors of the subjects(self-efficacy, internal locus of control, perceived health state) and the performance of health promotion behaviors, the performance was found having significantly pure relations with self-efficacy (r=.524, P=.000), internal locus of control (r=.225, P=.000) and perceived health state(r=.244, P=.000). The higher each evaluated point of the three factors was, the higher the performance was in level. 3. When relations between the controlling factors(demography-based social, health-related, job-related and human relations characteristics) and the performance of health promotion behaviors were analyzed, the performance showed significant differences according to marital status (t=2.09, P= .03), religion(F=3.93, P= .00) and participation in religious activities (F=8.10, P= .00) out of demography-based characteristics, medical examination results (F=7.20, P= .00) and methods of the collection of health knowledge and information(F=3.41, P= .01) and methods of desired health education(F=3.41, P= .01) out of health-related characteristics, detrimental factors perception(F=4.49, P= .01) and job satisfaction(F=8.41, P= .00) out of job-related characteristics and social support(F=14.69, P= .00) out of human relations characteristics. 4. The factor which is a variable predicting best the performance of health promotion behaviors by the subjects was the self-efficacy accounting for 27.4% of the prediction, followed by participation in religious activities, social support, job satisfaction, received health state and internal locus of control in order all of which totally account for 41.0%. In conclusion, the predictive factor which most influence the performance of health promotion behaviors by shift workers was self-efficacy. To promote the sense, therefore, it is necessary to develop the nursing intervention program considering predictive factors as variables identified in this study. Further industrial nurses should play their roles actively to help shift workers increase their capability of self-management of health.

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The Dietary Habits and Perception of Vegetable Intake of Elementary Students in Gwangju and Jeonnam (광주·전남 일부지역 초등학생의 채소류 섭취에 대한 인식)

  • Go, Young-Sook;Jeon, Eun-Raye;Jung, Lan-Hee
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.42 no.2
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    • pp.223-233
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    • 2013
  • The purpose of this study was to analyze the dietary habits and perception of vegetable intake of elementary students in Gwangju and Jeonnam Gokseong county. Data collection was conducted from 5th and 6th grade students of elementary schools in Gwangju and Jeonnam Gokseong county using a structured questionnaire survey. The SPSS program was used for statistics processing and data analysis. The chi-square test was also conducted. In terms of dietary intake habits, female students consumed their meals slower than male students. Information on dietary habits and nutrition was commonly obtained from family, including the mother or father who commonly prepared meals at home. Snacks were commonly consumed less than twice daily, with the Gwangju area having a higher frequency of snacks than the Jeonnam area. Elementary students indicated that vegetables were their least favorite food, with female students having a higher interest in vegetables than male students. The pattern and perception of vegetable intake came when the students (that did not eat vegetables) were lectured by their parents on the nutritive value of vegetables. Most students understood the important nutritional ingredients of vegetables. In the case of an interest in vegetables, the Gwangju area showed significantly more comprehension than the Jeonnam area on the definition and role of dietary fiber, the dental benefits of dietary fiber, and the identification of the environment-friendly certification mark.

Food Preferences and Nutrient Intakes of College Students in Kangwon Province (강원도 지역 대학생들의 음식 기호도 및 영양 섭취 실태 조사연구)

  • 최영심;유양자;김종군;남상명;정명은;정차권
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.30 no.1
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    • pp.175-182
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    • 2001
  • The main focus of this study was set to help college students in Kangwon province to improve and correct dietary habits and to maintain healthy life. The nutritional status and food preference of college students were examined from May to July, 1999. The collection of the research data has been made on the basis of questionnaries for 184 college students residing in Kangwon province. Statistical analysis of the data was performed using SAS package program for descriptive frequency and statistical significance. The meal skipping ratio of the subjects were 2% and for the reasons of meal skipping 45% responded "lack of time". As for main dishes, cooked rice turned out to be the most preferred by the subjects and the second and third favored by female students were bread and noodle respectively. Most preferred side-dishes were meat soup, kimchi, laver Kui,squid Bockeum, fried squid, beef Chon, squid Chorim, soy Namul, Dubuk Changachi and squid Muchim. Less preferred side-dishes include radish soup, white kimchi, mugwort fry, liver Bockeum, liver sheon and egg plant Kui. No one-plate food was disliked by the subjects. Male liked Manndukuk and female liked cuttle fish rice. The intakes of nutrient except for energy, iron and calcium for female students were the same or above the Recommended Dietary Allowances (RDA) for Koreans.

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The Impact of Childhood Cancer on The Korean Family (암 환아 발생이 가족에게 미치는 영향에 관한 연구)

  • ;;Ida Martinson
    • Journal of Korean Academy of Nursing
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    • v.22 no.4
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    • pp.636-652
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    • 1992
  • This study identified the impact of childhood cancer on the Korean family. The purpose was to contribute knowledge for family nursing and pediatric hospice care practice with sick children and their families. This descriptive study was conducted during a 6 month period with children who were being treated for cancer at six university hospitals in Seoul. The data were gathered from members of 68 families ; 24(Group A), with a child newly diagnosed with cancer : 27(Group B), with a child under treatment and without complications, and 17 (Group C), with a child in relapse. Medical records, structured questionnaires and interviews were used for data collection. The questionnaires and interview schedules had been used previously in Martinson's research in the USA and China. The findings, conclusions, and suggestions are as follows. 1. The impact of childhood cancer on the family. Members of the family experienced fear, helplessness, guilty feelings, and anger at the time of the initial diagnosis and at relapse. Mothers complained of headache, anorexia and poor appetite, weight loss, sleep disturbance, and bad dreams. Many of the fathers either lost or changed jobs, and all working mothers stopped working. Half the parents reported changes in their marital relationships such as frequent quarrels but also stronger unity. Family members perceived cancer as the most frightening disease. Change in their world view was expressed as living on faith understanding suffering, determining to live a better life, wanting to live an upright life and valuing health as the most important. Religious activities are found most helpful through this difficult experience. Financial debt due to the treatment and care of the sick child, burdened 22 families. The above mentioned impact was most evidant in Group B(those presently undergoing treatment) and Group C(those in relapse). Findings indicate that nursing care should embrace the family of a child who is being treated for cancer. 2. Characteristics of the child with cancer The majority of the children in this sample had a diagnosis of leukemia. Their mean age was 6.8 and the ratio of boys to girls was 1.12 ; 1. The mean hospitalization frequency was 13.5 times and the mean duration of illness was 16.8 months. Most of 1.he children perceived cancer as the most frightening disease ; 32.7% of the children described their sickness as serious. Children in Group C were hospitalized more frequently, stayed in hospital for longer periods, and expressed their sickness as quite serious more often than the other two groups. These findings indicate how much comprehensive pediatric hospice nursing care services are needed along with relevant research and nursing education. 3. Characteristics of the families. The mean age of the father was 39.5 and the mother, 36,6 ; they are in their most productive life period. Mothers especially expressed feelings of financial uneasiness and powerlessness about giving up their jobs, and guilty feelings for not providing enough care and concern to other children due to taking care of the sick one. The burden of caring for the sick child can bring negative changes in family dynamics which they think provoke potential health problems in members of the family These findings suggest a need for nursing support and counselling resources. Findings also suggest the need for ethical inquiry about such questions as who should give information to the child in regard to diagnosis and prognosis, when, and how. Other suggestions included : 1) Quality health care for childhood cancer such as home care and pediatric hospice programs should be established. 2) Special and practical consideration for long-term patients should be made in the present insurance coverage. The reimbursement period for long-term patients should be lengthened. 3) Further in-depth qualitative studies are needed. 4) Education programs including guided practice experience for pediatric hospice care practitioners are needed.

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A Study on Curriculum Improvement of the Korea Army Nursing Academy (국군간호사관학교 교육과정 개선을 위한 기초 연구)

  • 고자경
    • Journal of Korean Academy of Nursing
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    • v.13 no.2
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    • pp.22-43
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    • 1983
  • 1. Need for and Purpose of the Study. There is an increasing demand for curriculum improvement of the Korean Army Nursing Academy (KANA), since it was upgraded into 4-year institution of higher learning from 3-year one. In particular, it is strongly advocated that the KANA needs the outside expertise for its curriculum improvement-namely not only from the internal military view of points but also from the viewpoints of professional educational society, In line with such a necessity for the study, this study was aimed at 1) analyzing the current actual practices of KANA'S curriculum, 2) investigating the desired practices of KANA'S curriculum, and 3) identifying the discrepancy between the actual and desired practices of curriculum. 2. Problems for the Study This study had 4 problems to be answeared as follows: 1) What are the actual curriculum practices of KANA? 2) What are the desired curriculum practices of KANA? 3) How are the extents of perception of actual and desired curriculum different in four groups (student, faculty & administrator, nurse, and medical doctor in militay hospital) ? 4) What are the restraining forces that impede the change from actual to desired curriculum practices? 5) What are the relationships of curriculum component,』 in actual and desired curriculum practices? 3. Methods and Procedures This study was conducted by means of document analysis in addition to literature review and by means of needs assessment questionnaire which was developed by the researcher. The questionnaire included 62 statments with 7 questions for demographic data collection. The needs assessment questionnaire was managed to a total of 243 subjects (100 students, 46 faculty & administrators, 55 nurses, and 42 medical doctors), The collected data were treated using SPSS computer system so as to calculate mean scores, standard deviations, and correlation coefficients. The significance test was made through t-test and one-way ANOVA. The statistical significance level was set at both .05 and .01 level. 4. Major findings The major findings in this study are as follows: 1) The score of desired practices was significantly greater than that of actual practices, representing a strong need for curriculum betterment. 2) There were significant differences in the perceptions of actual practices as well as desired practices among four groups (student, faculty & administrater, nurse, and medical doctor). 3) The most frequently selected restraining forces were army's inherent character, economical limitation, and educational expertise limitations. 4) Such variables as sex, position attachment to the KANA and grade made a statistically significant effect on the perception of desired curriculum practice, while the variables like marrige, position, and military class made it on the perception of actual curriculum practice. 5) The coefficients among the curriculum components were lower in perception of the actual curriculum practices than those in the desired practices. 5. Conclusions The conclusions based on the major findings of this study are as follows: 1) The current curriculum development procedure of the KANA is not consistent with the theoretical frame of systematic development sarategy of curriculum. 2) There are wide conflicts among the groups who are supposed to participate in curriculnm development, concerning the actual and desired practices of KANN'S curriculum. 3) A great deal of need for curriculum improvement for the KANA is clearly felt, and in particular, in the process of teaching and learning. 4) Each component of curriculum is not intergrated into a whole development procedure, being segregated each other. 5) For better curriculum improvement, such restraining forces as financial and professional limitations should be eliminated. 6. Recommendations 1) For Further Research a. There is a need to replicate this study after in-depth statistical analysis of each item of need assessment questionnaire, and with more representative subjects. b. A study should be conducted which. has its focus on the analysis of restraining forces for the change from actual to desired curriculum practices of the KANA. 2) For KANA'S Curriculum Improvement a. There is a need to promote the professional expertise of the participants in curriculum development and the communication among them. b. It is desirable to establish an institution or section of administration, which is soley in charge of curriculum development. c. To better develop KANA's curriculum not only faculty and administrators but also students should be encouraged to participate in development process, while the military medical doctors' participation should be carefully considered.

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