Purpose In in-vitro laboratories of nuclear medicine department, when the reagent lot or reagent lot changes Comparability test or parallel test is performed to determine whether the results between lots are reliable. The most commonly used standard domestic laboratories is to obtain %difference from the difference in results between two lots of reagents, and then many laboratories are set the standard to less than 20% at low concentrations and less than 10% at medium and high concentrations. If the range is deviated from the standard, the test is considered failed and it is repeated until the result falls within the standard range. In this study, several tests are selected that are performed in nuclear medicine in-vitro laboratories to analyze parallel test results and to establish criteria for customized percent difference for each test. Materials and Methods From January to November 2018, the result of parallel test for reagent lot change is analyzed for 7 items including thyroid-stimulating hormone (TSH), free thyroxine (FT4), carcinoembryonic antigen (CEA), CA-125, prostate-specific antigen (PSA), HBs-Ab and Insulin. The RIA-MAT 280 system which adopted the principle of IRMA is used for TSH, FT4, CEA, CA-125 and PSA. TECAN automated dispensing equipment and GAMMA-10 is used to measure insulin test. For the test of HBs-Ab, HAMILTON automated dispensing equipment and Cobra Gamma ray measuring instrument are used. Separate reagent, customized calibrator and quality control materials are used in this experiment. Results 1. TSH [%diffrence Max / Mean / Median] (P-value by t-test > 0.05) C-1(low concentration) [14.8 / 4.4 / 3.7 / 0.0 ] C-2(middle concentration) [10.1 / 4.2 / 3.7 / 0.0] 2. FT4 [%diffrence Max / Mean / Median] (P-value by t-test > 0.05) C-1(low concentration) [10.0 / 4.2 / 3.9 / 0.0] C-2(high concentration) [9.6 / 3.3 / 3.1 / 0.0 ] 3. CA-125 [%diffrence Max / Mean / Median] (P-value by t-test > 0.05) C-1(middle concentration) [9.6 / 4.3 / 4.3 / 0.3] C-2(high concentration) [6.5 / 3.5 / 4.3 / 0.4] 4. CEA [%diffrence Max / Mean / median] (P-value by t-test > 0.05) C-1(low concentration) [9.8 / 4.2 / 3.0 / 0.0] C-2(middle concentration) [8.7 / 3.7 / 2.3 / 0.3] 5. PSA [%diffrence Max / Mean / Median] (P-value by t-test > 0.05) C-1(low concentration) [15.4 / 7.6 / 8.2 / 0.0] C-2(middle concentration) [8.8 / 4.5 / 4.8 / 0.9] 6. HBs-Ab [%diffrence Max / Mean / Median] (P-value by t-test > 0.05) C-1(middle concentration) [9.6 / 3.7 / 2.7 / 0.2] C-2(high concentration) [8.9 / 4.1 / 3.6 / 0.3] 7. Insulin [%diffrence Max / Mean / Median] (P-value by t-test > 0.05) C-1(middle concentration) [8.7 / 3.1 / 2.4 / 0.9] C-2(high concentration) [8.3 / 3.2 / 1.5 / 0.1] In some low concentration measurements, the percent difference is found above 10 to nearly 15 percent in result of target value calculated at a lower concentration. In addition, when the value is measured after Standard level 6, which is the highest value of reagents in the dispensing sequence, the result would have been affected by a hook effect. Overall, there was no significant difference in lot change of quality control material (p-value>0.05). Conclusion Variations between reagent lots are not large in immunoradiometric assays. It is likely that this is due to the selection of items that have relatively high detection rate in the immunoradiometric method and several remeasurements. In most test results, the difference was less than 10 percent, which was within the standard range. TSH control level 1 and PSA control level 1, which have low concentration target value, exceeded 10 percent more than twice, but it did not result in a value that was near 20 percent. As a result, it is required to perform a longer period of observation for more homogenized average results and to obtain laboratory-specific acceptance criteria for each item. Also, it is advised to study observations considering various variables.
The rule of the Warsaw Convention of 1929 are well known and still being all over the world. The Warsaw Convention is undoubtedly the most widely accepted private international air law treaty with some 140 countries. In the international legal system for air transportation, the Warsaw Convention has played a major role for more than half century, and has been revised many times in consideration of the rapid developments of air high technology, changes of social and economic circumstances, need for the protection of passengers. Some amendments became effective, but others are still not effective. As a result, the whole international legal system for air transportation is at past so complicated and tangled. However, the 'Warsaw system' consists of the Warsaw Convention of 1929 the Guadalajara Convention of 1961, a supplementary convention, and the following six protocols: (1) the Hague Protocol of 1955, (2) the Guatemala Protocol of 1971, (3) the Montreal Additional Protocols, No.1, (4) the Montreal Additional Protocol No.2, (5) the Montreal Additional Protocol No.3, and (6) the Montreal Additional Protocol No.4. of 1975. As a fundamental principle of the air carrier's liability in the international convention and protocols, for instance in the Warsaw Convention and the Hague Protocol, the principle of limited liability and a presumed fault system has been adopted. Subsequently, the Montreal Inter-carrier Agreement of 1966, the Guatemala City Protocol, the Montreal Additional Protocol No.3, and the Montreal Additional Protocol No. 4 of 1975 maintained the limited liability, but substituted the presumed liability system by an absolute liability, that is, strict liability system. The Warsaw System, which sets relatively low compensation limits for victims of aircraft accidents and regulates the limited liability for death and injury of air passengers, had become increasingly outdated. Japanese Airlines and Inter-carrier Agreement of International Air Transport Association in 1995 has been adopted the unlimited liability of air carrier in international flight. The IATA Inter-Carrier Agreement, in which airlines in international air transportation agree to waive the limit of damages, was long and hard in coming, but it was remarkable achievement given the political and economic realities of the world. IATA deserves enormous credit for bringing it about. The Warsaw System is controversial and questionable. In order to find rational solution to disputes between nations which adopted differing liability systems in international air transportation, we need to reform the liability of air carriers the 'Warsaw system' and fundamentally, to unify the liability system among the nations. The International Civil Aviation Organization(ICAO) will therefore reinforce its efforts to further promote a legal environment that adequately reflects the public interest and the needs of the parties involved. The ICAO Study Group met in April, 1998, together with the Drafting Committee. The time between the "Special Group on the Modernization and Consolidation of the 'Warsaw system'(SGMW)" and the Diplomatic Conference must be actively utilized to arrange for profound studies of the outstanding issues and for wide international consultations with a view to narrowing the scope of differences and preparing for a global international consensus. From 11 to 28 May 1999 the ICAO Headquarters at Montreal hosted a Diplomatic Conference convened to consider, with a view to adoption, a draft Convention intended to modernize and to integrate replace the instruments of the Warsaw system. The Council of ICAO convened this Conference under the Procedure for the Adoption of International Conventions. Some 525 participants from 121 Contracting States of ICAO attended, one non-contracting State, 11 observer delegations from international organizations, a total of 544 registered participants took part in the historic three-week conference which began on 10 May. The Conference was a success since it adopted a new Convention for the Unification of Certain Rules for International Carriage by Air. The 1999 Montreal Convention, created and signed by representatives of 52 countries at an international conference convened by ICAO at Montreal on May 28, 1999, came into effect on November 4, 2003. Representatives of 30 countries have now formally ratified the Convention under their respective national procedures and ratification of the United States, which was the 30th country to ratify, took place on September 5, 2003. Under Article 53.6 of the Montreal Convention, it enters into force on the 60th day following the deposit of the 30th instrument of ratification or acceptation. The United States' ratification was deposited with ICAO on September 5, 2003. The ICAO have succeeded in modernizing and consolidating a 70-year old system of international instruments of private international law into one legal instrument that will provide, for years to come, an adequate level of compensation for those involved in international aircraft accidents. An international diplomatic conference on air law by ICAO of 1999 succeeded in adopting a new regime for air carrier liability, replacing the Warsaw Convention and five other related legal instruments with a single convention that provided for unlimited liability in relation to passengers. Victims of international air accidents and their families will be better protected and compensated under the new Montreal Convention, which modernizes and consolidates a seventy-five year old system of international instruments of private international law into one legal instrument. A major feature of the new legal instrument is the concept of unlimited liability. Whereas the Warsaw Convention set a limit of 125,000 Gold Francs (approximately US$ 8,300) in case of death or injury to passengers, the Montreal Convention introduces a two-tier system. The first tier includes strict liability up to l00,000 Special Drawing Rights (SDR: approximately US$ 135,000), irrespective of a carrier's fault. The second tier is based on presumption of fault of a carrier and has no limit of liability. The 1999 Montreal Convention also includes the following main elements; 1. In cases of aircraft accidents, air carriers are called upon to provide advance payments, without delay, to assist entitled persons in meeting immediate economic needs; the amount of this initial payment will be subject to national law and will be deductable from the final settlement; 2. Air carriers must submit proof of insurance, thereby ensuring the availability of financial resources in cases of automatic payments or litigation; 3. The legal action for damages resulting from the death or injury of a passenger may be filed in the country where, at the time of the accident, the passenger had his or her principal and permanent residence, subject to certain conditions. The new Montreal Convention of 1999 included the 5th jurisdiction - the place of residence of the claimant. The acceptance of the 5th jurisdiction is a diplomatic victory for the US and it can be realistically expected that claimants' lawyers will use every opportunity to file the claim in the US jurisdiction - it brings advantages in the liberal system of discovery, much wider scope of compensable non-economic damages than anywhere else in the world and the jury system prone to very generous awards. 4. The facilitation in the recovery of damages without the need for lengthy litigation, and simplification and modernization of documentation related to passengers. In developing this new Montreal Convention, we were able to reach a delicate balance between the needs and interests of all partners in international civil aviation, States, the travelling public, air carriers and the transport industry. Unlike the Warsaw Convention, the threshold of l00,000 SDR specified by the Montreal Convention, as well as remaining liability limits in relation to air passengers and delay, are subject to periodic review and may be revised once every five years. The primary aim of unification of private law as well as the new Montreal Convention is not only to remove or to minimize the conflict of laws but also to avoid conflict of jurisdictions. In order to find a rational solution to disputes between nations which have adopted differing liability systems in international air transport, we need fundamentally to reform their countries's domestic air law based on the new Montreal Convention. It is a desirable and necessary for us to ratify rapidly the new Montreal Convention by the contracting states of lCAO including the Republic of Korea. According to the Korean and Japanese ideas, airlines should not only pay compensation to passengers immediately after the accident, but also the so-called 'condolence' money to the next of kin. Condolence money is a gift to help a dead person's spirit in the hereafter : it is given on account of the grief and sorrow suffered by the next of kin, and it has risen considerably over the years. The total amount of the Korean and Japanese claims in the case of death is calculated on the basis of the loss of earned income, funeral expenses and material demage (baggage etc.), plus condolence money. The economic and social change will be occurred continuously after conclusion of the new Montreal Convention. In addition, the real value of life and human right will be enhanced substantially. The amount of compensation for damage caused by aircraft accident has increased in dollar amount as well as in volume. All air carrier's liability should extend to loss of expectation of leisure activities, as well as to damage to property, and mental and physical injuries. When victims are not satisfied with the amount of the compensation for damage caused by aircraft accident for which an airline corporation is liable under the current liability system. I also would like to propose my opinion that it is reasonable and necessary for us to interpret broadly the meaning of the bodily injury on Article 17 of the new Montreal Convention so as to be included the mental injury and condolence. Furthermore, Korea and Japan has not existed the Air Transport Act regulated the civil liability of air carrier such as Air Transport Act (Luftverkehrsgestz) in Germany. It is necessary for us to enact "the Korean Air Transport Contract Act (provisional title)" in order to regulate the civil liability of air carrier including the protection of the victims and injured persons caused by aircraft accident.
HSDPA (High-Speed Downlink Packet Access) is a 3.5-generation asynchronous mobile communications service based on the third generation of W-CDMA. In Korea, it is mainly provided in through videophone service. Because of the diffusion of more powerful and diversified services, along with steep advances in mobile communications technology, consumers demand a wide range of choices. However, because of the variety of technologies, which tend to overflow the market regardless of consumer preferences, consumers feel increasingly confused. Therefore, we should not adopt strategies that focus only on developing new technology on the assumption that new technologies are next-generation projects. Instead, we should understand the process by which consumers accept new forms of technology and devise schemes to lower market entry barriers through strategies that enable developers to understand and provide what consumers really want. In the Technology Acceptance Model (TAM), perceived usefulness and perceived ease of use are suggested as the most important factors affecting the attitudes of people adopting new technologies (Davis, 1989; Taylor and Todd, 1995; Venkatesh, 2000; Lee et al., 2004). Perceived usefulness is the degree to which a person believes that a particular technology will enhance his or her job performance. Perceived ease of use is the degree of subjective belief that using a particular technology will require little physical and mental effort (Davis, 1989; Morris and Dillon, 1997; Venkatesh, 2000). Perceived pleasure and perceived usefulness have been shown to clearly affect attitudes toward accepting technology (Davis et al., 1992). For example, pleasure in online shopping has been shown to positively impact consumers' attitudes toward online sellers (Eighmey and McCord, 1998; Mathwick, 2002; Jarvenpaa and Todd, 1997). The perceived risk of customers is a subjective risk, which is distinguished from an objective probabilistic risk. Perceived risk includes a psychological risk that consumers perceive when they choose brands, stores, and methods of purchase to obtain a particular item. The ability of an enterprise to revolutionize products depends on the effective acquisition of knowledge about new products (Bierly and Chakrabarti, 1996; Rothwell and Dodgson, 1991). Knowledge acquisition is the ability of a company to perceive the value of novelty and technology of the outside (Cohen and Levinthal, 1990), to evaluate the outside technology that has newly appeared (Arora and Gambaradella, 1994), and to predict the future evolution of technology accurately (Cohen and Levinthal, 1990). Consumer innovativeness is the degree to which an individual adopts innovation earlier than others in the social system (Lee, Ahn, and Ha, 2001; Gatignon and Robertson, 1985). That is, it shows how fast and how easily consumers adopt new ideas. Innovativeness is regarded as important because it has a significant effect on whether consumers adopt new products and on how fast they accept new products (Midgley and Dowling, 1978; Foxall, 1988; Hirschman, 1980). We conducted cross-national comparative research using the TAM model, which empirically verified the relationship between the factors that affect attitudes - perceived usefulness, ease of use, perceived pleasure, perceived risk, innovativeness, and perceived level of knowledge management - and attitudes toward HSDPA service. We also verified the relationship between attitudes and usage intention for the purpose of developing more effective methods of management for HSDPA service providers. For this research, 346 questionnaires were distributed among 350 students in the Republic of Korea. Because 26 of the returned questionnaires were inconsistent or had missing data, 320 questionnaires were used in the hypothesis tests. In UK, 192 of the total 200 questionnaires were retrieved, and two incomplete ones were discarded, bringing the total to 190 questionnaires used for statistical analysis. The results of the overall model analysis are as follows: Republic of Korea x2=333.27(p=0.0), NFI=0.88, NNFI=0.88, CFI=0.91, IFI=0.91, RMR=0.054, GFI=0.90, AGFI=0.84, UK x2=176.57(p=0.0), NFI=0.88, NNFI=0.90, CFI=0.93, IFI=0.93, RMR=0.062, GFI=0.90, AGFI=0.84. From the results of the hypothesis tests of Korean consumers about the relationship between factors that affect intention to use HSDPA services and attitudes, we can conclude that perceived usefulness, ease of use, pleasure, a high level of knowledge management, and innovativeness promote positive attitudes toward HSDPA mobile phones. However, ease of use and perceived pleasure did not have a direct effect on intention to use HSDPA service. This may have resulted from the fact that the use of video phones is not necessary for everyday life yet. Moreover, it has been shown that attitudes toward HSDPA video phones are directly correlated with usage intention, which means that perceived usefulness, ease of use, pleasure, a high level of knowledge management, and innovativeness. These relationships form the basis of the intention to buy, contributing to a situation in which consumers decide to choose carefully. A summary of the results of the hypothesis tests of European consumers revealed that perceived usefulness, pleasure, risk, and the level of knowledge management are factors that affect the formation of attitudes, while ease of use and innovativeness do not have an effect on attitudes. In particular, with regard to the effect value, perceived usefulness has the largest effect on attitudes, followed by pleasure and knowledge management. On the contrary, perceived risk has a smaller effect on attitudes. In the Asian model, ease of use and perceived pleasure were found not to have a direct effect on intention to use. However, because attitudes generally affect the intention to use, perceived usefulness, pleasure, risk, and knowledge management may be considered key factors in attitude development from which usage intention arises. In conclusion, perceived usefulness, pleasure, and the level of knowledge management have an effect on attitude formation in both Asian and European consumers, and such attitudes shape these consumers' intention to use. Furthermore, the hypotheses that ease of use and perceived pleasure affect usage intention are rejected. However, ease of use, perceived risk, and innovativeness showed different results. Perceived risk had no effect on attitude formation among Asians, while ease of use and innovativeness had no effect on attitudes among Europeans.
Purpose: Bereavement Memorial Service has been held every year by the hospice team at St. Vincent's Hospital for the purpose of supporting the bereaved family who feel grief and mourning. The purpose of this study is to find out the attitude of the bereaved attending at bereavement memorial service (BMS) and to find out the areas needing improvements to set up better memorial service. Methods: Hospice team sent invitation card to 180 families of patients who admitted and passed away at hospice ward Nov., 2003
Over the past decade, there has been a rapid diffusion of technological devices and a rising number of various devices, resulting in an escalation of virtual reality technology. Technological market has rapidly been changed from smartphone to wearable devices based on virtual reality. Virtual reality can make users feel real situation through sensing interaction, voice, motion capture and so on. Facebook.com, Google, Samsung, LG, Sony and so on have investigated developing platform of virtual reality. the pricing of virtual reality devices also had decreased into 30% from their launched period. Thus market infrastructure in virtual reality have rapidly been developed to crease marketplace. However, most consumers recognize that virtual reality is not ease to purchase or use. That could not lead consumers to positive attitude for devices and purchase the related devices in the early market. Through previous studies related to virtual reality, there are few studies focusing on why the devices for virtual reality stayed in early stage in adoption & diffusion context in the market. Almost previous studies considered the reasons of hard adoption for innovative products in the viewpoints of Typology of Innovation Resistance, MIR(Management of Innovation Resistant), UTAUT & UTAUT2. However, product-based antecedents also important to increase user intention to purchase and use products in the technological market. In this study, we focus on user acceptance and resistance for increasing purchase and usage promotions of wearable devices related to virtual reality based on headgear products like Galaxy Gear. Especially, we added a variables like attitude confidence as a dimension for user resistance. The research questions of this study are follows. First, how attitude confidence and innovativeness resistance affect user intention to use? Second, What factors related to content and brand contexts can affect user intention to use? This research collected data from the participants who have experiences using virtual rality headgears aged between 20s to 50s located in South Korea. In order to collect data, this study used a pilot test and through making face-to-face interviews on three specialists, face validity and content validity were evaluated for the questionnaire validity. Cleansing the data, we dropped some outliers and data of irrelevant papers. Totally, 156 responses were used for testing the suggested hypotheses. Through collecting data, demographics and the relationships among variables were analyzed through conducting structural equation modeling by PLS. The data showed that the sex of respondents who have experience using social commerce sites (male=86(55.1%), female=70(44.9%). The ages of respondents are mostly from 20s (74.4%) to 30s (16.7%). 126 respondents (80.8%) have used virtual reality devices. The results of our model estimation are as follows. With the exception of Hypothesis 1 and 7, which deals with the two relationships between brand awareness to attitude confidence, and quality of content to perceived enjoyment, all of our hypotheses were supported. In compliance with our hypotheses, perceived ease of use (H2) and use innovativeness (H3) were supported with its positively influence for the attitude confidence. This finding indicates that the more ease of use and innovativeness for devices increased, the more users' attitude confidence increased. Perceived price (H4), enjoyment (H5), Quantity of contents (H6) significantly increase user resistance. However, perceived price positively affect user innovativeness resistance meanwhile perceived enjoyment and quantity of contents negatively affect user innovativeness resistance. In addition, aesthetic exterior (H6) was also positively associated with perceived price (p<0.01). Also projection quality (H8) can increase perceived enjoyment (p<0.05). Finally, attitude confidence (H10) increased user intention to use virtual reality devices. however user resistance (H11) negatively affect user intention to use virtual reality devices. The findings of this study show that attitude confidence and user innovativeness resistance differently influence customer intention for using virtual reality devices. There are two distinct characteristic of attitude confidence: perceived ease of use and user innovativeness. This study identified the antecedents of different roles of perceived price (aesthetic exterior) and perceived enjoyment (quality of contents & projection quality). The findings indicated that brand awareness and quality of contents for virtual reality is not formed within virtual reality market yet. Therefore, firms should developed brand awareness for their product in the virtual market to increase market share.
The purpose of this paper is to review the representative Buddhist policies enforced during the reign of Gwanghaegun (光海君), the 15th king of the Joseon Dynasty, and the aspects of the Buddhist community affected by them. Through this, the influence and dynamism of Buddhism during the reign of Gwanghaegun will be revealed. Some of the findings will run contrary to what is popularly known about Joseon Buddhism and the policy of Sungyueokbul (崇儒抑佛), 'Revering Confucianism and Supressing Buddhism.' During the Joseon Dynasty, Neo-Confucianism was taken as an ideological background, and consequently, Buddhism was ostracized by the ruling class who advocated the exclusion of heretical views. This also characterized King Gwanghaegun's reign during the Mid-Joseon Dynasty. In reality though, the ruling class held mixed opinions about Buddhism, and this influenced the Buddhist community in the Gwanghaegun Period. The military might of Japan demonstrated during the Japanese Invasion of Korea in 1592, led the ruling class to recognize Buddhism, and as a result, the status of Buddhism rose to a certain extent. Based on its elevated status and the aftermath of the Japanese Invasion of Korea, the Buddhist community engaged in social welfare activities inspired by the notion of requiting favors, and the Buddhist community gained recognition for providing relief services. As a result, the number of monks increased, and the economic situation improved as land ownership was granted to temples and monks. This is the means by which the Japanese Invasion of Korea influenced the Buddhist policies of the Gwanghaegun Period and changed the religious topography of Buddhism. During the reign of King Gwanghaegun, the ruling class regarded Buddhism as heretical, but offered posthumous titles to monks who engaged in meritorious services during the Japanese invasions of 1592~1598. Favorable and/or preferential treatment was also granted to some Buddhist monks. In addition, monks began to perform labor projects that demanded organizational and physical strength, such as those which related to national defense and architecture. However, throughout the Gwanghaegun Period, the monks were paid a certain amount of compensation for their labor, and the monks' responsibility for labor increased. This can be understood as a partial reconciliation with Buddhism or an acceptance of Buddhism rather than the suppression of Buddhism often presented by historians. As for policies which affected Buddhism, the Buddhist community showed signs of cooperation with the ruling class, the creation and reconstruction of temples, and the production of Buddhist art. Through close ties with the ruling class, Buddhism during the Gwanghaegun Period saw the Buddhist community actively responded policies that impacted Buddhism, and this allowed their religious orders to be maintained. In this way, it was also confirmed that the monk, Buhyu Seonsu (浮休 善修) and his disciple Byeogam Gakseong (碧巖 覺性), took up leadership roles in their Buddhist community. The Buddhist-aimed policies of Gwanghaegun were implemented against the backdrop of the Buddhist community, wherein the ruling class held mixed opinions regarding Buddhism. As such, both improvements and set backs for Buddhism could be observed during that time period. The ruling class actively utilized the organizational power of Buddhism for national defense and civil engineering after the Japanese invasions of 1592~1598. Out of gratitude, they implemented appropriate compensation for the Buddhists involved. The Buddhist community also responded to policies that affected them through exchanges with the ruling class. They succeeded in securing funds and support to repair and produce Buddhist temples and artworks. A thoughtful inspection of the policies towards and responses to Buddhism during the Gwanghaegun Period, shows that Buddhism actually enjoyed considerable organizational power and influence. This flies in the face of the general description of Joseon Buddhism as "Sungyueokbul (revering Confucianism and supressing Buddhism)."
The problem addressed by this study was to determine the effect of nurse - patient agreement on the means to achieve nursing goals in the early postpartum period of primiparous mothers. It was hypothesized that the experimental treatment would result in hegher self-confidence and satisfaction in maternal role performance. This purpose was to contribute to the planning of nursing care to enhance self- confidence and satisfaction in maternal role performance and to the development of relevant nursing theory. Especially, the early postpartum period is crucial toward in recovery from childbirth and attainment of the maternal role. Maternal role attaintment is a complex social and cognitive process of stimulus -response accomplished by learning. Most women attain the maternal role sucessfully. But, some primiparous mothers experience difficultites in attainment of the maternal role due to lack of experience and knowledge. Self-confidence and satisfaction in maternal role performance are important factors in attainment and adjustment to the maternal role (Mercer, 1981a, 1981b ; Lederman, Weigarten, and Lederman, 1981 :Bobak and Jensen, 1985). Nursing is defined as behaviors of nurses add patients that attain nursing goals through action, reaction, interaction, and transaction. For attainment of nursing goals, active participating transactions must occur by agreement on the means to achieve those goals through nurse -patient mutual goal setting and establishment of their active relationships(King, 1981, Ha, 1977). Based on King's theory of goal attainment (1981), this stuy was planned as a non-equivalent control group, non -synchronized quasi -experimental design using agreement on the means to achieve nursing goals in early postpartum as the experimental treatment. The data were collected from July 20 to Sep. 1, 1991 by questionnaires with 60 primiparous mothers planing to breast feed after normal deliveries at W hospital in Pusan, Korea. The subjects were divided into a control group(conventional group) -those admitted from July 20 to Aug. 12, and an experimental group(agreement group) - those admitted from Aug. 13 to Sep. 1. The instument for agreement on the means to nursing goals in the early postpartum period included five steps - identification of disturbances of problems through action, reaction, and interaction with primiparous mothers : mutual early postpartal nursing goal setting : exploration of the means to achieve goals ; agreement on the means (self- care, ealry maternal -infant contact, performance of mothering behavior, and communicating about the infant's behavior and health condition) : implementation of the means. This instrument was developed on the basis of King's elements that lead to transactions in nurse-patient interactions. Lederman et al's (1981) scale for Confidence in ability to cope with tasks of motherhood and Lederman et al's(1981) scale for Mother's satisfaction with motherhood and infant care were used to measure self-confidence and satisfaction in maternal role performance ·with the subjects immediately after admission and on the day of discharge. Self-care performance in the experimental group was measured by self -evaluation tool developed by the investigator from the literature concerned. The tools to measure Pelf-confidence and satisfaction in maternal role performance, and the tool to measure self-evaluation of self-care performance were tested for internal reliability. Cronbach's Alphas were 0.94, 0.94, and 0.63. The data were analysed by using in S.P.S.S. computerized program and included percentage, x²-test, t-test, ANOVA, and Pearson Correlation Coefficient. The conclusions obtained from this study are summerized as follows : 1. The degree of self-confidence in maternal role performance of the total subjects group measured before the experimental treatment was above average with a mean score of 2.77(range 2.14-3.64). Out of 14 items, those with relatively high mean scores were ‘I would like to be a better mother than I am’(3.95), and ‘I have my doubts about whether I am a good mother’(2.87). Those with low mean scores were ‘I know that my baby wants most of the times’(2.28), ‘When the baby cries, I can tell what she /he wants’(2.37), and ‘I have confidence in my ability to care for the baby’(2;50). That is, the self - confidence of Primiparous mothers was considerably high in mothering, but rather low in activities concerning the infant care and understanding of the infant behavior. The degree of satisfaction in maternal role performance of the total subjects group measured before the experimental treatment was high with a mean score of 3.18(range 1.92-3.92). Out of 13 items, those with relatively high mean scores were ‘I am glad 1 had this baby now’(3.75), ‘I play with the baby between feedings when s/he is awake and quiet’(3.67), and ‘I enjoy being a mother’(3.27). Those with low mean scores were ‘I am upset about having too many responsibilities as a mother’(2.78), ‘It bothers me to get up for the baby at night’(2.82), and ‘I get annoyed if the baby frequently interrupts my activities’.(2.82), That is, the satisfaction of primiparous mothers was considerably high in mothering and infant care, but rather low in restraints in time or on the mother's self accomplishment and development. 2. Agreement on the means to achieve nursing goals in the early postpartum period included process of mutual goal setting, exploration of the means to achieve goals, and ahreement in concert means to achieve goals based on the mothers' condition, concerns, self-perception of the nurse - patient interactions. In the process of agreement, there was agreement that the means to achieve goals should be through trust and establishment of active relationships with the nurse through identification of problems according to planned nursing goals and active interaction, such as explanations, teaching, changing of opinions, acceptance or rejection of explanations, and proposing of questions. Therefore agreement on the means to achieve nursing goals in the early postpartum period appears to be an effective nursing intervention for primiparous mothers. 3. The degree of self- confidence in maternal role performance of the exprimental group was higher than that of the control group(t＝3.95, p＜0.01). Out of 14 items, those with higher score in the experimental group were ‘I would like to be a better mother than I am’(t＝1.93, p＜0.05), ‘I know that my baby wants most of the times’(t＝2.75, p＜0.01), ‘When the baby cries, 1 can tell what she/he wants’(t＝2.10, p＜0.05), ‘I have confidence in my ability to care for the baby’(t＝3.72, p＜0.01), ‘I trust my own judement in deciding how to care for the baby’(t＝1.96, p＜0.05), ‘I feel that I know my baby and what to do for him /her’(t＝2.44, p＜0.01), ‘I am concerned about being able to meet the baby's needs’(t＝2.87, p＜0.01), ‘I know what my baby likes and dislikes’(t＝3.26, p＜0.01), ‘I don't know to care for the baby as well as I should’(t＝2.07, p＜0.05), and ‘I am unsure about whether I give enough attention to the baby’(t＝3.04, p＜0.01), That is, the degree of self-confidence in mothering, activities concerning infant care, and understanding of infant behavior of the experimental group was higher than that of the control group. Therefore, the first hypothesis, that the degree of self-confidence in maternal role performance of the experimental group would be higher than that of the control group, was supported(t＝3.95, p＜0.01). 4. The degree of satisfaction in the maternal role performance of the exprimental group was higer than that or the control group(t＝2.31, p＜0.05). Out of 13 items, those with higher score in the experimental group were ‘I am glad I had this baby now’(t＝2.29, p＜0.05), ‘I enjoy taking care of the baby’(t＝2.4g, p＜0.01), ‘It is boring for me to care for the baby and do the same thing over and over’(t＝2.87, P＜0.01), ‘I am unhappy with the amount of time I have for activities other than childcare’(t＝2.51, p＜0.01), and ‘When bathing and diapering the baby, I would like to be doing something else’(t＝2.43, p＜0.01). That is, the degree of satisfaction in mothering, infant care, and restraints in time of on the mother's self accomplishment and development in the experimental group was higher than that of the control group. Therefore, the second hypothesis, that the degree of satisfaction in maternal role performance of the experimental group would be higher than that of the control group, was supported(t＝2.31, p＜0.05). 5. The third hypothesis, that the higher the degree of satisfaction in materenal role performance, the higher the degree of self-confidence in materenal role performance in the experimental group, was supported (r＝0.57, p＜0.01)