A Study on Degree of Daily Living Activities among Women with Osteoarthritis (여성 골관절염 환자의 일상생활 수행능력)
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- Journal of muscle and joint health
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- v.5 no.1
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- pp.57-71
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- 1998
This study purports to examine sociodemographic characteristics and those factors associated with osteoarthritis in women experiencing the disease in order to make suggestions for the prevention and management of osteoarthritis in women. The subjects were 143 women who were diagnosed to have osteoarthritis and under follow-up care at an outpatient department of a university-affiliated hospital. The data were collected through personal interviews by using the structured questionnaire between October 6 and October 24, 1997. The degree of daily living activities was measured with 24 items, which were made based upon Katz Index, Barthel Index and Functional Status Index. Each item has 4 response categories : (1) being able to do alone with any difficulty, (2) being able to do alone with some difficulty, (3) being able to do alone with the help of a person or an instrument, (4) not being able to do at all. The data was analyzed with correlation analysis, t-test, ANOVA, and regression analysis. The results are summarized as follows : 1. As for the age of the subjects, 59.4% were between 45 and 64 years, while 28% were 65 years and above. The subjects having religion were 71.7% and 44.1% of the subjects were protestants. The educational level was low : 31.5% graduated from elementary school, while 30.1% had no formal education. Those married subjects were 72%. Fifty nine percent of the subjects evaluated their economic status as middle class. 2. Those people from whom the subjects currently receive some help were spouses in 35.8% of the subjects. Likewise, 50% of the subjects indicated spouse as the people from whom they want to receive help. 3. The score of the ability of daily living activities ranged between 48 and 96, with the mean of 78.94. Those means of physical activity, ADL(activities of daily living) and IADL(instrumental activities of daily living) were 14.89, 13.97 and 50.09, respectively. Except for the items of carrying heavy stuff and of washing clothes in the sitting position the subjects showed independence in more than 90% of the items, where Independence is defined as being able to do alone or with the help of a person or an instrument. 4. The increase in age was a significant predictor of the decrease in the ability of daily living activities. Those graduated from middle school and above showed a significantly higher degree in the ability of daily living activities than those with less educational level. The married women revealed significantly higher scores in physical activity, ADL, and IADL than the unmarried ones. The ability of daily living activities was not significantly related to having religion, economic status and living with family. 5. The average duration of experiencing osteoarthritis was 4 years and 7 months. Regarding the site of the onset, 65% of the subjects indicated knees. The women with osteoarthritis for less than 3 years were 65%. The ability of daily living activities was significantly different by the duration of illness : the longer the duration of illness, the less the ability of activities. The above findings suggest the need for developing those programs for prevention disabilities in performing daily living activities and for managing diseases targeting the women of middle and old age, with low educational level, and with unmarried status. In addition, there should be developed an instrument for measuring the ability of daily living activities which reflects daily lives of Korean women with osteoarthritis in order to examine comprehensive effects of osteoarthritis on women's daily lives in this country.
Purpose: Infrastructure inspection and its diagnostics technique have been rapidly developing recently. Therefore, it is important to secure the reliability of diagnostic equipment, and this paper deals with inspection of diagnostic equipment, introduction to a certification system and development plans for infrastructure. Method: Several certification systems are established and introduction plans are reviewed through experts by synthesizing the contents of certification research for existing infrastructure diagnosis equipment. In addition, the revision of the law for introduction of the system is reviewed, detailed operation regulations are prepared and phased development plans are reviewed, which are based on the operation scenario. Result: Inspection and certification plans were constructed through four routes in order to consider infrastructure inspection and diagnostic equipment in use, and new diagnostic equipment using state-of-the-art technology. Furthermore, market confusion depending on the introduction of a new certification system is minimized and reliability is secured by transforming a simple inspection system in the short term into a formal certification system in the long term. The law amendments according to the introduction of the system were reviewed and detailed operation regulations were developed. Also, phased development plans, which are based on the long-term development scenario including manpower, infrastructure and specifications, were presented. Conclusion: It is important to secure reliability through the distribution and certification of diagnostic equipment using 4th industrial technology to strengthen the safety management of infrastructure at the national level since the infrastructure is various in type and increasingly large in size. It is also essential to train human resources who can use new technology with inspection and diagnosis system in order to enhance the safety management of all infrastructures. Moreover, it is necessary to introduce a regular inspection system for infrastructure that combines loT technology in the long-term point of view and to promote the introduction by giving active incentives to institutions that actively accept it.
In order to prepare the mashing materials for "Takju", Korean wine, with potatoes they were steamed, dryed, and pulverized, and their chemical components were analyzed. As a brewing method of Takju with potatoes, general 2nd stage process with Ipkuk and Bunkuk (enzyme sources), commonly used now, was carried out and the effects of preparing conditions of Ipkuk(koji) with potato flour, mashing materials and brewing conditions on the contents of Takju mash and of storing time on the contents of Takju, were investigated and the results obtained were summarized as follows. 1. Chemical components of steamed potatoes and potato flour were Moisture; 76.2, 10.8%, Total sugar; 16.1, 69.8%, Reducing sugar; 3.45, 13.4%, Crude protein; 2.1, 11.3%, Total acid; 0.012, 0.023% and Volatile acid; 0.0012, 0.0025% respectively 2. The most effective preparing conditions of Ipkuk with potato flour were to incubate the potato flour added 40-50% of water for 48 hours by general preparing process of Koji, and liquefying and saccharogenic amylase activities of Ipkuk incubated at above conditions were
INTRODUCTION Due to the high broadband internet penetration rate and its group-oriented culture, various types of online communities operate in Korea. This study use 'Uses and Gratification Approach, and argue that members' usage-needs satisfaction with brand community is an important factor for promoting community commitment. Based on previous studies identifying the effect of brand image on consumers' responses to various marketing stimuli, this study hypothesizes that brand image can be a moderate variable affecting the relationship between usage-needs satisfaction with brand community and members' commitment to brand community. This study analyzes the influence of usage-needs satisfaction on brand community commitment and how apparel brand image affects the relationships between usage-needs satisfactions and community commitments. The hypotheses of this study are proposed as follows. H1-3: The usage-needs satisfaction of apparel brand community (interest, transaction, relationship needs) influences emotional (H1), continuous (H2), and normative (H3) commitments to apparel brand communities. H4-6: Apparel brand image has a moderating effect on the relationship between usage-needs satisfaction and emotional (H4), continuous (H5), and normative (H6) commitments to apparel brand communities. METHODS Brand communities founded by non-company affiliates were excluded and emphasis was placed instead on communities created by apparel brand companies. Among casual apparel brands registered in 6 Korean portal sites in August 2003, a total of 9 casual apparel brand online communities were chosen, depending on the level of community activity and apparel brand image. Data from 317 community members were analyzed by exploratory factor analysis, moderated regression analysis, ANOVA, and scheffe test. Among 317 respondents answered an online html-type questionnaire, 80.5% were between 16 to 25 years old. There were a total of 150 respondents from apparel brand communities(n=3) recording higher-than-average brand image scores (Mean > 3.75) and a total of 162 respondents from apparel brand communities(n=6) recording lower-than-average brand image scores(Mean < 3.75). In this study, brand community commitment was measured by a 5-point Likert scale: emotional, continuous and normative commitment. The degree of usage-needs satisfaction (interest, transaction, relationship needs) was measured on a 5-point Likert scale. The level of brand image was measured by a 5-point Likert scale: strength, favorability, and uniqueness of brand associations. RESULTS In the results of exploratory factor analysis, the three usage-needs satisfactions with brand community were classified as interest, transaction, and relationship needs. Brand community commitment was also divided into the multi-dimensional factors: emotional, continuous, and normative commitments. The regression analysis (using a stepwise method) was used to test the influence of 3 independent variables (interest-needs satisfaction, transaction-needs, and relationship-needs satisfactions) on the 3 dependent variables (emotional, continuous and normative commitments). The three types of usage-needs satisfactions are positively associated with the three types of commitments to apparel brand communities. Therefore, hypothesis 1, 2, and 3 were significantly supported. Moderating effects of apparel brand image on the relationship between usage-needs satisfaction and brand community commitments were tested by moderated regression analysis. The statistics result showed that the influence of transaction-needs on emotional commitment was significantly moderated by apparel brand image. In addition, apparel brand image had moderating effects on the relationship between relationship-needs satisfaction and emotional, continuous and normative commitments to apparel brand communities. However, there were not significant moderate effects of apparel brand image on the relationships between interest-needs satisfaction and 3 types of commitments (emotional, continuous and normative commitments) to apparel brand communities. In addition, the influences of transaction-needs satisfaction on 2 types of commitments (continuous and normative commitments) were not significantly moderated by apparel brand image. Therefore, hypothesis 4, 5 and 6 were partially supported. To explain the moderating effects of apparel brand image, four cross-tabulated groups were made by averages of usage-needs satisfaction (interest-needs satisfaction avg. M=3.09, transaction-needs satisfaction avg. M=3.46, relationship-needs satisfaction M=1.62) and the average apparel brand image (M=3.75). The average scores of commitments in each classified group are presented in Tables and Figures. There were significant differences among four groups. As can be seen from the results of scheffe test on the tables, emotional commitment in community group with high brand image was higher than one in community group with low brand image when transaction-needs satisfaction was high. However, when transaction-needs satisfaction was low, there was not any difference between the community group with high brand image and community group with low brand image regarding emotional commitment to apparel brand communities. It means that emotional commitment didn't increase significantly without high satisfaction of transaction-needs, despite the high apparel brand image. In addition, when apparel brand image was low, increase in transaction-needs did not lead to the increase in emotional commitment. Therefore, the significant relationship between transaction-needs satisfaction and emotional commitment was found in only brand communities with high apparel brand image, and the moderating effect of apparel brand image on this relationship between two variables was found in the communities with high satisfaction of transaction-needs only. Statistics results showed that the level of emotional commitment is related to the satisfaction level of transaction-needs, while overall response is related to the level of apparel brand image. We also found that the role of apparel brand image as a moderating factor was limited by the level of transaction-needs satisfaction. In addition, relationship-needs satisfaction brought significant increase in emotional commitment in both community groups (high and low levels of brand image), and the effect of apparel brand image on emotional commitment was significant in both community groups (high and low levels of relationship-needs satisfaction). Especially, the effect of brand image was greater when the level of relationship-needs satisfaction was high. in contrast, increase in emotional commitment responding to increase in relationship-needs satisfaction was greater when apparel brand image is high. The significant influences of relationship-needs satisfaction on community commitments (continuous and normative commitments) were found regardless of apparel brand image(in both community groups with low and high brand image). However, the effects of apparel brand image on continuous and normative commitments were found in only community group with high satisfaction level of relationship-needs. In the case of communities with low satisfaction levels of relationship needs, apparel brand image marginally increases continuous and normative commitments. Therefore, we could not find the moderating effect of apparel brand image on the relationship between relationship-needs satisfaction and continuous and normative commitments in community groups with low satisfaction levels of relationship needs, CONCLUSIONS AND IMPLICATIONS From the results of this study, we draw several conclusions; First, the increases in usage-needs satisfactions through apparel brand communities result in the increases in commitments to apparel brand communities, wheres the degrees of such relationship depends on the level of apparel brand image. That is, apparel brand image is a moderating factor strengthening the relationship between usage-needs satisfaction and commitment to apparel brand communities. In addition, the effect of apparel brand image differs, depending on the level and types of community usage-needs satisfactions. Therefore, marketers of apparel brand companies must determine the appropriate usage-needs, depending on the type of commitment they wish to increase and the level of their apparel brand image, to promote member's commitments to apparel brand communities. Especially, relationship-needs satisfaction was very important factor for increasing emotional, continuous and normative commitments to communities. However the level of relationship-needs satisfaction was lower than interest-needs and transaction-needs. satisfaction. According to previous study on apparel brand communities, relationship-need satisfaction was strongly related to member's intention of participation in their communities. Therefore, marketers need to develope various strategies in order to increase the relationship- needs as well as interest and transaction needs. In addition, despite continuous commitment was higher than emotional and normative commitments, all types of commitments to apparel brand communities had scores lower than 3.0 that was mid point in 5-point scale. A Korean study reported that the level of members' commitment to apparel brand community influenced customers' identification with a brand and brand purchasing behavior. Therefore, marketers should try to increase members' usage-needs satisfaction and apparel brand image as the necessary conditions for bringing about community commitments. Second, marketers should understand that they should keep in mind that increasing the level of community usage needs (transaction and relationship) is most effective in raising commitment when the level of apparel brand image is high, and that increasing usage needs (transaction needs) satisfaction in communities with low brand image might not be as effective as anticipated. Therefore, apparel companies with desirable brand image such as luxury designer goods firms need to create formal online brand communities (as opposed to informal communities with rudimentary online contents) to satisfy transaction and relationship needs systematically. It will create brand equity through consumers' increased emotional, continuous and normative commitments. Even though apparel brand is very famous, emotional commitment to apparel brand communities cannot be easily increased without transaction-needs satisfaction. Therefore famous fashion brand companies should focus on developing various marketing strategies to increase transaction-needs satisfaction.
This project was a service-cum-research effort with a quasi-experimental study design to examine the health benefits of an integrated Family Planning (FP)/Maternal & Child health (MCH) Service approach that provides crucial factors missing in the present on-going programs. The specific objectives were: 1) To test the effectiveness of trained nurse/midwives (MW) assigned as change agents in the Health Sub-Center (HSC) to bring about the changes in the eight FP/MCH indicators, namely; (i)FP/MCH contacts between field workers and their clients (ii) the use of effective FP methods, (iii) the inter-birth interval and/or open interval, (iv) prenatal care by medically qualified personnel, (v) medically supervised deliveries, (vi) the rate of induced abortion, (vii) maternal and infant morbidity, and (viii) preinatal & infant mortality. 2) To measure the integrative linkage (contacts) between MW & HSC workers and between HSC and clients. 3) To examine the organizational or administrative factors influencing integrative linkage between health workers. Study design; The above objectives called for quasi-experimental design setting up a study and control area with and without a midwife. An active intervention program (FP/MCH minimum 'package' program) was conducted for a 2 year period from June 1982-July 1984 in Seosan County and 'before and after' surveys were conducted to measure the change. Service input; This study was undertaken by the Soonchunhyang University in collaboration with WHO. After a baseline survery in 1981, trained nurses/midwives were introduced into two health sub-centers in a rural setting (Seosan county) for a 2 year period from 1982 to 1984. A major service input was the establishment of midwifery services in the existing health delivery system with emphasis on nurse/midwife's role as the link between health workers (nurse aids) and village health workers, and the referral of risk patients to the private physician (OBGY specialist). An evaluation survey was made in August 1984 to assess the effectiveness of this alternative integrated approach in the study areas in comparison with the control area which had normal government services. Method of evaluation; a. In this study, the primary objective was first to examine to what extent the FP/MCH package program brought about changes in the pre-determined eight indicators (outcome and impact measures) and the following relationship was first analyzed; b. Nevertheless, this project did not automatically accept the assumption that if two or more activities were integrated, the results would automatically be better than a non-integrated or categorical program. There is a need to assess the 'integration process' itself within the package program. The process of integration was measured in terms of interactive linkages, or the quantity & quality of contacts between workers & clients and among workers. Intergrative linkages were hypothesized to be influenced by organizational factors at the HSC clinic level including HSC goals, sltrurture, authority, leadership style, resources, and personal characteristics of HSC staff. The extent or degree of integration, as measured by the intensity of integrative linkages, was in turn presumed to influence programme performance. Thus as indicated diagrammatically below, organizational factors constituted the independent variables, integration as the intervening variable and programme performance with respect to family planning and health services as the dependent variable: Concerning organizational factors, however, due to the limited number of HSCs (2 in the study area and 3 in the control area), they were studied by participatory observation of an anthropologist who was independent of the project. In this observation, we examined whether the assumed integration process actually occurred or not. If not, what were the constraints in producing an effective integration process. Summary of Findings; A) Program effects and impact 1. Effects on FP use: During this 2 year action period, FP acceptance increased from 58% in 1981 to 78% in 1984 in both the study and control areas. This increase in both areas was mainly due to the new family planning campaign driven by the Government for the same study period. Therefore, there was no increment of FP acceptance rate due to additional input of MW to the on-going FP program. But in the study area, quality aspects of FP were somewhat improved, having a better continuation rate of IUDs & pills and more use of effective Contraceptive methods in comparison with the control area. 2. Effects of use of MCH services: Between the study and control areas, however, there was a significant difference in maternal and child health care. For example, the coverage of prenatal care was increased from 53% for 1981 birth cohort to 75% for 1984 birth cohort in the study area. In the control area, the same increased from 41% (1981) to 65% (1984). It is noteworthy that almost two thirds of the recent birth cohort received prenatal care even in the control area, indicating that there is a growing demand of MCH care as the size of family norm becomes smaller 3. There has been a substantive increase in delivery care by medical professions in the study area, with an annual increase rate of 10% due to midwives input in the study areas. The project had about two times greater effect on postnatal care (68% vs. 33%) at delivery care(45.2% vs. 26.1%). 4. The study area had better reproductive efficiency (wanted pregancies with FP practice & healthy live births survived by one year old) than the control area, especially among women under 30 (14.1% vs. 9.6%). The proportion of women who preferred the 1st trimester for their first prenatal care rose significantly in the study area as compared to the control area (24% vs 13%). B) Effects on Interactive Linkage 1. This project made a contribution in making several useful steps in the direction of service integration, namely; i) The health workers have become familiar with procedures on how to work together with each other (especially with a midwife) in carrying out their work in FP/MCH and, ii) The health workers have gotten a feeling of the usefulness of family health records (statistical integration) in identifying targets in their own work and their usefulness in caring for family health. 2. On the other hand, because of a lack of required organizational factors, complete linkage was not obtained as the project intended. i) In regards to the government health worker's activities in terms of home visiting there was not much difference between the study & control areas though the MW did more home visiting than Government health workers. ii) In assessing the service performance of MW & health workers, the midwives balanced their workload between 40% FP, 40% MCH & 20% other activities (mainly immunization). However,