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A Comparative Study of Tuberculosis Mortality Rate between Urban and Rural Area (도시 농촌간 결핵 표준화사망률 변화양상 비교)

  • Kang, Moon-Young;Na, Baeg-Ju;Lee, Moo-Sik;Kim, Keon-Yeop;Hong, Ji-Young;Kim, Eun-Young;Sim, Young-Bin
    • Journal of agricultural medicine and community health
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    • v.30 no.2
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    • pp.127-135
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    • 2005
  • Objectives: This study was conducted to investigate the trend of tuberculosis mortality rate by years and by areas. Methods: We calculated raw and age-adjusted mortality rate of tuberculosis from 1995 to 2002. The calculation was based on the data from resident registration data and death certification registration data gathered by 232 basic local authority. We used direct age standardization method for calculating age-adjusted mortality rate. We compared patterns of change in tuberculosis mortality rate of metropolitan areas, cities, and countryside by determinating the comparability of medels to explore linear relationship. We also analyzed the data of mortality rate between urban and rural area by comparing ANOVA and post-hoc by two periods: one from 1995 to 1998, and the other from 1999 to 2002. Results: In national mortality rate, both raw and age-adjusted mortality rate showed negative linear relationship. However, the graph become more horizontal: the slope line is close to zero. From 1995 to 1998, countryside showed significantly higher age-adjusted mortality rate than in metropolitan areas and cities. Ever after considering more horizontal graph in national mortality rate, the data shows that the countryside still have significantly higher mortality rate from 1999 to 2002. In model diagnostic checking, metropolitan areas and cities showed apparently linear pattern on the decrease of age-adjusted mortality rate. Pattern of mortality rate in countryside was decreased initially, but became flat. Conclusions: Further research is necessary to explore the characteristics of quality of tuberculosis control program in rural area. Different approach and strategies should be considered to decrease tuberculosis mortality rate in rural areas.

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A Study on the Effectiveness of Care of Patients with Alzheimer s Disease According to Residence Arrangement and Types of Services (치매노인의 거주형태 및 서비스유형에 따른 간호관리의 효과분석)

  • 홍여신;박현애;조남옥
    • Journal of Korean Academy of Nursing
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    • v.26 no.4
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    • pp.768-781
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    • 1996
  • The problem of care of patients and families with Alzheimer's disease has become a conscious raising social policy issue in Korea. The government of the Republic of Korea has become cognizant of the situation and has begun searching for ways to remedy it. Thus, there is a need for a comprehensive under-standing of the situation in which patients and their families are struggling and the enormous problems of care. With a realization of the urgent need, this study was done to investigate the situation and the care needs of families with patients with Alzheimer's Disease, and to compare the effectiveness of services utilized by the families in terms of cost and effects on patient's conditions and on family live. The Subjects for the study were 29 families with hospitalized patients, 25 families utilizing hospital outpatient clinics, 14 families utilizing day care facilities, and 16 families with homebound patients. A total of 84 families were interviewed by four trained interviewers using structured and semistructured questionnaires. The data produced from these interviews included : the patient's stage of Alzheimer's disease, patient's bizarre behavior, hours spent on patient care per day, family burden and quality of life, direct and indirect costs encountered in the care of patients, and the families' evaluation of the effectiveness of the services received. The data were analyzed to determine the relationships between family charactersistics, patient's conditions and services utilization. The effectiveness of each of the service entities was assessed through families evaluation and hoped for service and comparisons were made between services in terms of the cost-effectiveness ratios. After initial comparison of cost-effectiveness ratios, further analysis was done to compare between groups for incremental effectiveness for each incremental unit of cost to determine the most cost-effective service entities. The findings of the study are as fellows : 1. The choice of living arrangement and the types of services are a function of the stage of Alzheimer's condition and the economic status of the family. 2. Comparision of the cost of care showed that most expenses were encountered in by families with hospitalization, families using outpatient services, and families using day care services in that order. The least expense was involved in the care of homebound patients. The economic burden felt by families was in the same order as expenses. 3. The average number of hours spent on daily patient care was 9.9 hours for the outpatient clinic users, 9.7 hours for homebound patients, and 5.4 hours for day care users. 4. There were significant differences in the patient's conditions (CDRL), bizarre behaviors and the families's burden by living arrangement and /or types of service. However, no significant difference was found between groups in the family's quality of life. 5. The families rated the services of day care center as most effective for the care of the patients and families, except for a few families who had experienced some improvement in the patient's conditions. The outpatient clinic users expressed psychological comforts mainly in that the patient was being taken care of. For those hospitalized patients, families expressed the comfort of being relieved of the burden of care and that the patient is being professionally cared for. Form the analysis of the costs, hours of patient care, patient's bizarre behaviors, family's quality of life and burdens, and family's evaluation of services, it is concluded that up to the mid stage of Alzheimer's condition, the utilization of day care center services is found to be the most cost-effective, and toward the end stage of the Alzheimer's disease, it is hoped that there will be a establishment of long term or short term in-patient facilities for the protection of patients and preservation of the integrity of families for less cost. Thus. it was concluded that the family centered system of care is the most effective for Korea with systematic support systems developed for the care of patients and their families according to the needs of families as the patient's condition deteriorates.

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A Study on the Nurses' Contingent Employment and Related Factors (간호사의 비정규직 고용실태 및 관련요인에 관한 연구)

  • Choi, Sook-Ja
    • Journal of Korean Academy of Nursing Administration
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    • v.5 no.3
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    • pp.477-500
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    • 1999
  • Korean labor market has showed remarkable change of the increase in the amount of unemployment and contingent employment since IMF bailout agreement. There is a theoretical position to explain this increase in contingent employment at hospitals with the notion of flexibility. The high flexibility of employment due to the increase of contingent employees is becoming very important part in new business strategy of hospitals. The types of contingent employment of the nurse are part-time employment temporary employment, fixed-term employment, and internship which was introduced in early 1999. Recently, Korean health care industry managers have paid attention to the customer oriented service, rationalization of business administration, service quality control so that they can adjust their business to outer environment. Especially their efforts concentrate on the wage reduction through efficient and scientific control of man power because wage shares about 40% of total cost. This dissertation aims at verifying the phenomena of the contingent employment of the nurse and analyzing the related factors and problems. To rephrase these aims in ordinal: First, verifying the phenomena of contingent employment of the nurse. Second, verifying the problems of that phenomena. Third, analyzing the related factors of the contingent employment of the nurse. To accomplish these research goals, a statistical survey was executed. in which 384 questionnaires-66 for manager nurses, 318 for contingent nurses - were given to nurses working at 66 hospitals-which have at least 100 beds-in Seoul. Among them, 187 questionnaires-38 from manager nurses, 149 from contingent nurses'- 'were returned. Then, the data coded and submitted to T-test, $X^2$ -test, variance analysis(ANOVA), correlation analysis, multiple regression analysis, Logistic Regression with SAS program. The research results of the contingent nurses are followings: 1. The average career term at the present hospital 8.4 months: duty-on days per month are 24.2 days: working time per day is 7.9 hours. These results showed little difference from regular nurses. 2. Their wage level is about 70% of regular nurses except for internship nurses whose wage level is 41% of regular nurses. To break down the wage composition, part-time nurses and internship nurses get few allowance and bonus. And contingent nurses get very low level of additional pay except for fixed-term nurses who are under similar condition of employment to regular nurses. These results show that hospital managers are trying to reduce the labor cost not only through the direct way of wage reduction but through differential treatment of bonus, retirement allowance, and other additional pay. 3. The problem of contingent employment: low level of pay; high level of turn-over rate: weakening of union; low level of working condition: heavy burden of work; inhuman treatment. The contingent nurses consider these problems more seriously than manager nurses do. What manager nurses regard problematic is the absence of feeling-belonged and responsibility of the contingent nurses. 4. The factors strongly related with the rate of the number of contingent nurses for the number of regular nurses; gross turn-over nurses; average in-patients per day; staring wage of graduate from professional college: the type of hospital ownership; the number of beds; the gap between gross newcomer nurses and gross turn-over nurses. The factors related with their gross wage per month; the number of beds; applying of health insurance; applying of industrial casualty insurance; applying of yearly-paid leave; the type of hospital ownership; average out-patients per day; gross turn-over nurses. The meaningful factors which make difference by employment type: monthly-paid leave; physiological leave. The logistic regression analysis using these two factors shows that monthly-paid leave is related with the type of hospital ownership; the number of beds; average out-patient per day, and physiological leave is related with the gross newcomer nurses; gross turn-over nurses; the number of beds.

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A Study on Make-up Culture of Korea, China and Japan (한국.중국.일본 여성의 색조대장문화)

  • 박보영;황춘섭
    • Journal of the Korean Society of Costume
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    • v.39
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    • pp.217-237
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    • 1998
  • The present research is to study the make-up culture of Korea and its neighboring countries such as China and Japan during the period from the prehistoric age to the 19th cen-tury. The research was made by documents analysis. The results are summerised as follows : (1) A man has a basic instinct to beautify himself. There was not a significant difference between the make-up behavior of men and women in its primal stage. It was by the start of farming and the division of labor that made the make-up behavior as a feminine culture. The difference of sexual role caused the con-ceptual difference between manly beauty and womanly beauty. It was very natural for women to regard the make-up as the best way for showing their feminine beauty. In Korea, China and Japan, there were vari-ous kinds of primal actions such as tattooing, body-painting, and tooth make-up which were used in the purpose of body protection, incantation, ornament, and so on. Ass their ornamental purpose was becoming more important, these primal actions became the basis of the feminine make-up culture. Nowadays make-up, having mental and emo-tional function, is helpful to increasing self-satisfaction, promoting good personal relation-ship, and attracting attention from the other sex. It also has other functions of showing social status, wealth, age, sex, courage, power, and so on. (2) The representative make-up product used widely in the three countries was Boon (powder) which decides the overall color of face. The key point in the production of Boon was to increase its power of adsorption. The invention of Yunboon (power mixed with lead) solved this major problem of Boon. Yeonji which decides the color of cheek was the mixture of Boon and the powder of Honghwa (a kind of red-colored flower or tree). Mimook (eyebrow pencil) was developed to match up with the various and changing currencies of penciling eyebrows in each nation and times, Yeonji and Joosa (red sand) were used as Jinji (lip stick). The predominant color of Jinji was red. As miscellaneous methods of partial make-up, there were Kon-ji used in a wedding cer-emony in korea, Aek-hwang, Hwa-jeon, Sa-hong, and Myun-yup in China, and Chi-heuk, a peculial method of partial make-up in japan. (3) There were various factors which decided the characteristics of make-up culture usually reflects international atmosphere, the form of government, economic situation, re-ligious and social ideology, aesthetic sense, symbolizing meanings of colors, and so on. The up and down of an influentian country was one of the major factors which decided the characteristics of the make-up culture of its neighboring countries. When a country took a liberal form of government, it had diverse and splendid tendencies in its make-up culture. The better a nation's economic situation is, the more abandant and various its make-up culture is, and sometimes, the more eccentric and decadents it was. In the field of make-up production, the three countries had their own characteristics. But, as a whole, China was the leading nation who spread the culture and products of make-up to Korea and Japan. Though the Chinese make-up culture and products were usually spread to Japan through Korean, there was some evidence of direct exchanges between China and Japan through its dispatches of Kyun-Tang-Sa(Japanese delegation to the Tang Dynasty). While religion had a positive influence on the development of make-up culture by introducing new methods of make-up, Confucianism exercised strict control over the make-up cul-ture. The currencies in arts and changes of esthetic sense introduced new methods and booms to the make-up culture. Literature made people pay increasing attentions to the countenances of women and changed the standards of esthetic sense. We can find out that the social status of woman was also reflected in the make-up culture. As the social status of women became higher, the feminine make-up culture also developed more then ever. As mentioned above, the make-up cultures of the three countries reflected their social values, esthetic senses, and emotional feelings. Through their cultural exchanges, the three countries could develop various make-up products and methods.

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Characterization of Entomopathogenic Fungus from Trialeurodes vaporariorum and Evaluation as Insecticide (온실가루이 병원성 곰팡이의 특성 및 살충제 개발을 위한 평가)

  • Yoon, Hwi Gun;Shin, Tae Young;Yu, Mi Ra;Lee, Won Woo;Ko, Seung Hyun;Bae, Sung Min;Choi, Jae Bang;Woo, Soo Dong
    • Korean Journal of Microbiology
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    • v.49 no.1
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    • pp.64-70
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    • 2013
  • The greenhouse whitefly, Trialeurodes vaporariorum, is an economically important pest for greenhouse crops because they cause direct damage by feeding on plant nutrients and indirect damage as transmits many virus vectors. It has recently become a serious problem because of the continuous use of insecticide resulting in resistance among greenhouse whitefly population. To overcome these problems, in this study, the biological characteristics and virulence of an entomopathogenic fungus isolated from the cadaver of nymph greenhouse whitefly were investigated. Isolated fungus was identified as Isaria fumosorosea by morphological examinations and genetic identification using sequences of the ITS, ${\beta}$-tubulin, and EF1-${\alpha}$ regions. This fungus was named as I. fumosorosea SDTv and tested for the virulence against nymphs T. vaporariorum and the cold activity, the thermotolerance and the stability of UV-B irradiation on conidia. Mortality rate of greenhouse whitefly showed from 84 to 100% and the virulence increased with increasing conidial concentrations, $1{\times}10^5$ to $10^8$ conidia/ml. Conidia were stable at $35^{\circ}C$, 0.1 $J/cm^2$ of UV irradiation and germinated after 8 days at $4^{\circ}C$. Additionally, the activities of chitinases and proteases produced by I. fumosorosea SDTv were varied according to the medium. In conclusion, I. fumosorosea SDTv which showed high mortality rate against greenhouse whitefly will be used effectively in the integrated pest management programs against the greenhouse whitefly.

Effects of Ibandronate on the Expression of Matrix Metalloproteinases in Human U2OS Osteosarcoma Cells (사람 U2OS 골육종 세포에서 Matrix Metalloproteinase의 발현에 Ibandronate가 미치는 영향)

  • Jung, Sung-Taek;Seo, Hyoung-Yeon;Xin, Zeng-Feng;Kim, Yang-Kyung;Kim, Hyung-Won
    • The Journal of the Korean bone and joint tumor society
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    • v.15 no.2
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    • pp.111-121
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    • 2009
  • Background: Osteosarcoma is one of the most common primary malignant tumors of bone occurring mainly in children and adolescents. Although surgery combined with chemotherapy has markedly improved patient survival during the last years, the use of anticancer drugs is still associated with serious problem, such as the frequent acquisition of drug-resistant phenotypes and occurrence of "secondary malignancies". Several solid tumors display enhanced expression of matrix metalloproteinases (MMPs), and recently clinical trials have been initiated on MMP-inhibitors. On the other hand, bisphosphonates (BPs) are inhibitors of bone resorption, and widely used to treat osteoclast-mediated bone diseases. Also they appear to possess direct antitumor activity. Methods: One osteosarcoma cell line (U2OS) was treated with ibandronate (0, 0.1, 1, $10{\mu}M$) for 48 hours. Cell viabilities were determined using MTT assay, the mRNA levels of MMP-2 and MT1-MMP were detected by reverse-transcription polymerase chain reaction, the amount of MMP-2 and MT1-MMP protein were measured by Westernblot, the activities of MMP-2 were observed by Gelatin zymography, and Matrigel invasion assays were used to investigate the invasive potential of osteosarcoma cell lines before and after ibandronate treatment. Results: The invasiveness of U2OS cell line was reduced dose-dependently following 48 hour treatment of up to $10{\mu}M$ of the ibandronate at which concentration no cytotoxicity occurred. Furthermore, the gelatinolytic activities and protein and mRNA levels of MMP-2 and MT1-MMP were also suppressed by increasing ibandronate concentrations. Conclusion: Given that MMP-2 is instrumental in tumor cell invasion, it is very likely that the reduction in osteosarcoma cell invasion by ibandronate is a consequence, at least in part, of suppressed expression of both MMP-2 and MT1-MMP. Isolation of a molecule (s) responsible for the bisphosphonate inhibition of tumor cell invasion would pave the way for the development of a new generation of metastasis inhibitors.

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The Efficiency Analysis of CRM System in the Hotel Industry Using DEA (DEA를 이용한 호텔 관광 서비스 업계의 CRM 도입 효율성 분석)

  • Kim, Tai-Young;Seol, Kyung-Jin;Kwak, Young-Dai
    • Journal of Intelligence and Information Systems
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    • v.17 no.1
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    • pp.91-110
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    • 2011
  • This paper analyzes the cases where the hotels have increased their services and enhanced their work process through IT solutions to cope with computerization globalization. Also the cases have been studies where national hotels use the CRM solution internally to respond effectively to customers requests, increase customer analysis, and build marketing strategies. In particular, this study discusses the introduction of the CRM solutions and CRM sales business and marketing services using a process for utilizing the presumed, CRM by introducing effective DEA(Data Envelopment Analysis). First, the comparison has done regarding the relative efficiency of L Company with the CCR model, then compared L Company's restaurants and facilities' effectiveness through BCC model. L Company reached a conclusion that it is important to precisely create and manage sales data which are the preliminary data for CRM, and for that reason it made it possible to save sales data generated by POS system on each sales performance database. In order to do that, it newly established Oracle POS system and LORIS POS system concerned with restaurants for food and beverage as well as rooms, and made it possible to stably generate and manage sales data and manage. Moreover, it set up a composite database to control comprehensively the results of work processes during a specific period by collecting customer registration information and made it possible to systematically control the information on sales performances. By establishing a system which unifies database and managing it comprehensively, impeccability of data has been greatly enhanced and a problem which generated asymmetric data could be thoroughly solved. Using data accumulated on the comprehensive database, sales data can be analyzed, categorized, classified through data mining engine imbedded in Polaris CRM and the results can be organized on data mart to provide them in the form of CRM application data. By transforming original sales data into forms which are easy to handle and saving them on data mart separately, it enabled acquiring well-organized data with ease when engaging in various marketing operations, holding a morning meeting and working on decision-making. By using summarized data at data mart, it was possible to process marketing operations such as telemarketing, direct mailing, internet marketing service and service product developments for perceived customers; moreover, information on customer perceptions which is one of CRM's end-products could feed back into the comprehensive database. This research was undertaken to find out how effectively CRM has been employed by comparing and analyzing the management performance of each enterprise site and store after introducing CRM to Hotel enterprises using DEA technique. According to the research results, efficiency evaluation for each site was calculated through input and output factors to find out comparative CRM system usage efficiency of L's Company four sites; moreover, with regard to stores, the sizes of workforce and budget application show a huge difference and so does the each store efficiency. Furthermore, by using the DEA technique, it could assess which sites have comparatively high efficiency and which don't by comparing and evaluating hotel enterprises IT project outcomes such as CRM introduction using the CCR model for each site of the related enterprises. By using the BCC model, it could comparatively evaluate the outcome of CRM usage at each store of A site, which is representative of L Company, and as a result, it could figure out which stores maintain high efficiency in using CRM and which don't. It analyzed the cases of CRM introduction at L Company, which is a hotel enterprise, and precisely evaluated them through DEA. L Company analyzed the customer analysis system by introducing CRM and achieved to provide customers identified through client analysis data with one to one tailored services. Moreover, it could come up with a plan to differentiate the service for customers who revisit by assessing customer discernment rate. As tasks to be solved in the future, it is required to do research on the process analysis which can lead to a specific outcome such as increased sales volumes by carrying on test marketing, target marketing using CRM. Furthermore, it is also necessary to do research on efficiency evaluation in accordance with linkages between other IT solutions such as ERP and CRM system.

A Study On Interrelationship Between Korean And Mongolian Costume Laying Emphasis On The Age Of Mongolia's Invasion Upon Corea (한국(韓國).몽고복식(蒙古服飾)의 상관성(相關性) 연구(硏究)(II) - 고려시대(高麗時代)의 몽고침략기(蒙古侵略期)를 중심(中心)으로 -)

  • Son, Kyung-Ja
    • Journal of the Korean Society of Costume
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    • v.16
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    • pp.15-42
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    • 1991
  • A nation's culture isn't consisted by the characteristics of the nation only, but it is greatly affected by the geographical features and natural conditions, and it could be also dominated by the continual effect through mutual contact on economic exchange or social problem and political interests with neighboring countries. It is a well known fact that the contact of culture between Korea and Mongolia established under the special political situation that Corea was invaded by Won. But more basically, the Nomad including Mongolia had influenced upon neighboring countries, therefore, our country was also greatly influenced on consisting of our own culture by them. Moreover. the fact that our language belongs to their language's category(mostly Tweigru and Mongolian language) proves that the origin of our culture was deeply related with Mongolia. Accordingly, we could not limit the cultural relation between Korea and Mongolia within a special era. But especially, since unification of China by Mongolia, Won which appeared as a new great nation had dominated Corea for one hundred years, and the Corea's costume culture had a point of conversion to the mongolian. Therefore, this study expects to comment upon the relations of costume between Corea and Mongolia from a view point of Corea's tribute and royal gifts gifts by Mongolia written on the reference literatures. 1) From the ancient times, between our country and Mongolia there has been a direct or indirect exchange caused by the people's movement or invasion due to very closed neighboring. The relations between Corea and Mongolia have started from the mongolia's requests of tribute for the reason why they helped Corea against the Keoran's invasion, and these relation had continued by King Kongmin's age. 2) Mongolia had plundered a tribute such as dress, cereals, horses, military supplies, soldiers, maiden and little girls etc. from Corea, and therefore, a great confusion occurred on political, economic and social fields. And since King Chungyoul of Corea got married with a Princess of Won, the Corea's position was placed as the Buma nation(nation of son in law) and then high class people of Corea preferred to follow the mongolian costume such as Byunbal (pigtail), Ho dress (mongolian dress), Rouges, Chockturi (a kind of formal cap) and Doturak pigtail ribbon, and some have been applied up to date. On the other hand, the custom of Corea had transmitted to the Mongolian nobility, they called it "Corea Yang(style)". 3) The costume of Corea could be divided into three different periods, the first is the period influenced by Tang and Song's regime, the second is affected by the Won's costume and the third is applying the Myung's regime in the end of Corea. The Mongolian dress was based on the Ho dress form and it has been developed through compounding artistic traditional fields and foreign customs in long history. And Mongolia is composed of various tribes, therefore, they have their own dress for each tribe. Our country and Mongolia had a similar dress form based on Ho dress and both used the Chacksukunggo (jacket with small sleeves and slacks) and Seon(line). And the ornaments of costume such as Chockturi, Doturak pigtail ribbon and Rouges had transmitted and fixed down as a traditional wedding garment, but the Rouges has been used by noble women from the ancient times in our country. Since a member of the Society of Korean Costume has visited Mongolia in August 1990 for the first time, I really recognized the neccesity of more detailed study on the costume relation between Korea and Mongolia, and I will proceed with the study on various fields of costume under cooperation of Institute of Oriental Academy of Mongolia.

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A line study on movement expression in Dragonball of Toriyama Akira (토리야마 아키라의 <드래곤볼>에 나타난 운동표현에 관한 선 연구)

  • Cho, Dai-Ho;Park, Keong-Cheol
    • Cartoon and Animation Studies
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    • s.31
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    • pp.153-176
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    • 2013
  • In the early 20th century, the some of futurist painter was attempted to represents the 'fast-paced' and 'dynamism' on a two-dimensional picture. The expression of fast-paced and dynamic for look like move image in the painting have evolved as a variety of visual symbol. Visual symbols that represent these movements were settled as the line of the most movement expression in the comic. The of Toriyama Akira gained worldwide popularity is emphasized speed and dynamism as the action genre in cartoon, is nice a data to research the line of the movement expression of cartoon. There is three terms as the action line, The speed line, the effect line on the movement expression in The glossary of in the dictionary of , but it not easy to Separate them by means similar. This study is willing to says the semantically problem of previous lines on the movement expression and to present a new alternative in order to study the line on the movement expression of . This study Separate the line on movement expression from symbolic the perspective and try to newly define by using, was classified lines of four kinds by add the afterimage line on existing the speed line, the motion line, the effect line. First, the speed line was defined as 'The line expressing the movement expression of a moving target as the concept of speed'. It on the way of expression was subdivided the direct as speed line when it alter the shape of the target and the indirect speed line when it alter the background of the target. Second, the motion line was defined as 'The line simplified the moving form or the moving path of moving target'. Third, the effect line was defined as 'the line emphasizing the movement expression of a moving target by Sensory expression or emotional expression. Fourth, the afterimage lines was defined as 'The line expressing slowly moving or swaying the movement expression of target to the afterimage effect. The terminology presented in this study will be able to help the understanding of the line on the movement expression .

Development of the Information Delivery System for the Home Nursing Service (가정간호사업 운용을 위한 정보전달체계 개발 I (가정간호 데이터베이스 구축과 뇌졸중 환자의 가정간호 전산개발))

  • Park, J.H;Kim, M.J;Hong, K.J;Han, K.J;Park, S.A;Yung, S.N;Lee, I.S;Joh, H.;Bang, K.S
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.4
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    • pp.5-22
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    • 1997
  • The purpose of the study was to development an information delivery system for the home nursing service, to demonstrate and to evaluate the efficiency of it. The period of research conduct was from September 1996 to August 31, 1997. At the 1st stage to achieve the purpose, Firstly Assessment tool for the patients with cerebral vascular disease who have the first priority of HNS among the patients with various health problems at home was developed through literature review. Secondly, after identification of patient nursing problem by the home care nurse with the assessment tool, the patient's classification system developed by Park (1988) that was 128 nursing activities under 6 categories was used to identify the home care nurse's activities of the patient with CAV at home. The research team had several workshops with 5 clinical nurse experts to refine it. At last 110 nursing activities under 11 categories for the patients with CVA were derived. At the second stage, algorithms were developed to connect 110 nursing activities with the patient nursing problems identified by assessment tool. The computerizing process of the algorithms is as follows: These algorithms are realized with the computer program by use of the software engineering technique. The development is made by the prototyping method, which is the requirement analysis of the software specifications. The basic features of the usability, compatibility, adaptability and maintainability are taken into consideration. Particular emphasis is given to the efficient construction of the database. To enhance the database efficiency and to establish the structural cohesion, the data field is categorized with the weight of relevance to the particular disease. This approach permits the easy adaptability when numerous diseases are applied in the future. In paralleled with this, the expandability and maintainability is stressed through out the program development, which leads to the modular concept. However since the disease to be applied is increased in number as the project progress and since they are interrelated and coupled each other, the expand ability as well as maintainability should be considered with a big priority. Furthermore, since the system is to be synthesized with other medical systems in the future, these properties are very important. The prototype developed in this project is to be evaluated through the stage of system testing. There are various evaluation metrics such as cohesion, coupling and adaptability so on. But unfortunately, direct measurement of these metrics are very difficult, and accordingly, analytical and quantitative evaluations are almost impossible. Therefore, instead of the analytical evaluation, the experimental evaluation is to be applied through the test run by various users. This system testing will provide the viewpoint analysis of the user's level, and the detail and additional requirement specifications arising from user's real situation will be feedback into the system modeling. Also. the degree of freedom of the input and output will be improved, and the hardware limitation will be investigated. Upon the refining, the prototype system will be used as a design template. and will be used to develop the more extensive system. In detail. the relevant modules will be developed for the various diseases, and the module will be integrated by the macroscopic design process focusing on the inter modularity, generality of the database. and compatibility with other systems. The Home care Evaluation System is comprised of three main modules of : (1) General information on a patient, (2) General health status of a patient, and (3) Cerebrovascular disease patient. The general health status module has five sub modules of physical measurement, vitality, nursing, pharmaceutical description and emotional/cognition ability. The CVA patient module is divided into ten sub modules such as subjective sense, consciousness, memory and language pattern so on. The typical sub modules are described in appendix 3.

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