• Title/Summary/Keyword: Nursing Performance Evaluation

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A Study on Effectiveness of the Home Care Services for the Low Income Inhabitants (일부 지역사회 저소득층 주민을 대상으로 한 가정간호사업의 효과에 관한 연구)

  • Lee Kunja;Kim Myongsoon;Yang Younghee
    • Journal of Korean Public Health Nursing
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    • v.6 no.2
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    • pp.70-107
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    • 1992
  • This study was intended to assess the need of home nursing care and analyze the effect of home nursing care, and find out the problems during the performance of home nursing care for the chronic patients among the low-income people in urban area. Data collection by interview was carried out from Nov. 1991 to Jul. 1992. The main results were as follows; 1) Total subjects for the need assessment of home nursing care were 123 households wi th 488 persons in a urban poor area. Over half of households $(57.7\%)$ was teenage family. The overall living conditions were poor and the average monthly income was 580 thousands won. $74.8\%$ of subjects was covered by medical care insurance and only $4.7\%$ was covered by public assistance. The morbidity rate was $8.2\%$ among 488 subjects and $27.5\%$ of them was not treated at all, $30\%$ was treated in utilizing pharmacies or local clinics. 2) The subjects of home nursing care were 46 with Hypertension or DM who agreeded the participation of study among registered patients at a public health center in Incheon. Home visiting was performed at intervals per one month for one year. Most of them were the elder(mean age=61 years) and long term patients(7.8 years continued). Home nursing care was effective. That is, blood pressure(including systolic and diastolic pressure) was significantly reduced (t(n=22)=2.31, P=.031, t(n=24)=4.16, P=.000 respectively) and knowledge of disease(t(N=46)=-7.63, P=.000), attitude of disease (t(N =46) = -4.92, P=.000), and self-care(t(N =46) = -4.89, P= .000) were significantly improved through home nursing care. But there was no difference in blood sugar for diabetics between the beginning and the end of visits. At the beginning of visit for home nursing care, sex$(\beta=-0414,\;t=-3.012)$ and nursing need({3=.310, t=2.164) were influencing self-care, and duration of disease$(\beta=.297,\;t=2.106)$ and nursing need $(\beta=.385, t=20417)$ were influencing blood pressure, blood sugar level. Namely, the subjects who were male and had higher nursing need showed better self-care and the longer duration of disease and the higher nursing need were relationship with the better blood pressure and blood sugar level. At the end of visit for home nursing care after one year, the blood pressure and blood sugar level was influenced by age $(\beta.320,\;t= 2.242)$, duration of disease ($(\beta.352,\;t= 2.395)$ and nursing need $(\beta=.350,\;t=2.623)$ and self-care had no influencing factor. The higher age and the longer duration of disease and the higher nursing need were relationship with the better blood pressure and blood sugar level. 3) The problems that were found out during the performance of home nursing care were the absent of useful protocols for services and the clear evaluation base, and the difficulty of teaching elders who were the major part of our subjects.

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A Methodological Quality Evaluation of Nursing Cost Analysis Research based on Activity-based Costing in Korea (활동기준원가계산(Activity-Based Costing; ABC) 기반 간호원가분석 연구의 방법론적 질 평가)

  • Lim, Ji-Young;Noh, Wonjung;Mo, Jin-A
    • The Journal of the Korea Contents Association
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    • v.16 no.7
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    • pp.279-290
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    • 2016
  • This study was performed to evaluate the methodological quality of nursing costs analysis research based on the activity-based costing in Korea. Data were collected from database of Research Information Shraing Service, Korean studies Information Service System, DBpia and National Assembly Library. Eight studies were published on thesis and journal until Oct, 2015. Quality assessment tool was consisted in 5 factors based on activity-based costing. Studies of 87.5% were calculate the nursing units' costs in the hospital. All papers were appropriate in labor costs in resource factor and activity factor, but only 2 paper was appropriate in overhead cost allocation. Through this result, we found the necessity of improving accuracy in nursing costs analysis. These results can be helpful to manage cost and performance in nursing practice.

Development of Web-based Multimedia Contents for the Critical Care Practice of Nursing Students through Inter-College Collaboration (대학 간 통합 웹기반 중환자간호실습 콘텐츠 개발 및 적용)

  • So, Hyang-Sook;Bae, Yeong-Suk;Kim, Young-Ock;Kim, Su-Mi;Kang, Hee-Young;Choi, Ja-Yun;Yang, Jin-Ju;Kim, Nam-Young;Ko, Eun;Hwang, Seon-Young
    • Korean Journal of Adult Nursing
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    • v.20 no.5
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    • pp.778-790
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    • 2008
  • Purpose: This study was conducted to develop Web-based multimedia contents for supporting student nurses' clinical practice on critical care, and to evaluate learners' responses. Methods: Based on the steps of Assessment, Design, Development, Implementation, & Evaluation(ADDIE) model, a total of 13 self-directed learning modules including live lectures and real video clips were developed through faculty collaboration of nine nursing colleges in Gwangju and Chonnam province. The finally developed multimedia contents were published on the Web of the learning management system at a local e-learning center. Results: The Web contents were evaluated after self-learning by 81 junior college nursing students who were encouraged to study it at their own pace during their two-week clinical practice at a medical or surgical intensive care unit of a university hospital and two hospitals. The knowledge (t = -27.66, p < .001) and self-evaluated clinical performance level(t = 7.54, p < .001) were significantly increased after learning of the Web contents and clinical practice, and satisfaction level that measured post-test only was 4.0 out of 5 point. Conclusion: The use of Web contents for critical care need to be extended as a complimentary material in a class room lecture or clinical practice of students to increase their self-learning ability and understandings of clinical knowledge and situation.

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The Development Process and the Contents of the Self-management Education Program Integrated with Exercise Training (HAHA program) for Older Adults with Chronic Diseases (만성질환 노인을 위한 운동교실 통합 자기관리교육 프로그램(하하프로그램)의 개발과정과 내용)

  • Kim, Seon-Ho;Song, Mi-Soon;Park, Yeon-Hwan;Song, Wook;Cho, Be-Long;Lim, Jae-Young;So, Wi-Young
    • Journal of muscle and joint health
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    • v.18 no.2
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    • pp.169-181
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    • 2011
  • Purpose: This paper presents the development process and the final contents of the sellf- management education program integrated with exercise training (Healthy Aging Happy Aging, HAHA program) for community residing older adults with chronic diseases. Methods: The program evaluation methodology was applied which is an interactive program development process based on needs assessment, formative evaluation, process evaluation and outcome evaluation. The program was developed and revised while the program was implementing to 22 hypertension (HT) and 32 diabetic (DM) participants. Results: The final program has two sub-programs for HT and DM participants utilizing self-efficacy resources. They share four common components; 1) health screening of exercise risks, 2) weekly 1-hour group self-management education classes, 3) biweekly 1-hour group exercise training and 4) a mid-term individual counseling. Both sub-programs were 12-weeks long but have different education and exercise contents. Participants-rated mean satisfaction scores were 3.47/4 and 3.61/4 for HT and DM program respectively. Attendance rate were 83.1% ~ 92.3% for the classes. Conclusion: The HAHA program developed by multidisciplinary team which reflected participants needs was accepted well by participants evidenced by high attendance rate and perceived satisfaction level.

A Study on the Differences of Perception between Consumers and Providers about Nursing Service Quality, and the Usefulness of Tools Measuring Nursing Service Quality (간호서비스 질에 대한 지각차이 및 측정도구에 관한 연구)

  • Lee, Mi-Ae
    • Journal of Korean Academy of Nursing
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    • v.30 no.5
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    • pp.1121-1132
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    • 2000
  • Service quality is, unlike goods quality, an abstract and elusive term. However, quality is very important to marketers and consumers in that it has many strategic benefits in contributing to profitability of marketing activities and consumers' problem-solving activities. The main purpose of this study is 1) to explore the differences of perception between consumers and providers about nursing service quality. 2) to identify the useful tool between two tools measuring nursing service quality. To achieve these purposes of the study, the questionnaire was developed and distributed to 210 nurses who worked at seven subjected hospitals in Seoul. Also, 280 people who had a direct experience with the subjected hospital nursing services at the time of screening were involved. They were randomly selected at the seven subjected hospitals during August to September of 1998. Among them, 165 responses from nurses and 229 responses from others resulted in worthy finds. The measurement instrument for a nursing services quality evaluation was modified from the SERVQUAL model originated from Parasuraman, Zeithaml, and Berry (1988). The reliability coefficient of the scale was calculated and showed high degree of internal consistency (Cronbachs' Alpha = .9353). For data analysis, SPSS/PC was used for descriptive statistics, t-test, ANOVA and regression analysis. The results were as follows : 1) In the perception about nursing services quality, there were gap between consumers and providers. Especially the critical attributes in point of perception nursing services quality, naming satisfy, hygiene and performance factors, are very different contents. 2) In the comparison analysis of the usefulness tools it was turned out that SEVPERF model is more appropriate than SERVQUAL model. And in the analysis to identify the construct validity of the tool, it is turned out that the relationship between the constructing factors of the tool and the general satisfaction is significant.

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Analysis of Cost and Efficiency of a Medical Nursing Unit Using Time-Driven Activity-Based Costing (시간-동인활동기준원가계산(Time-Driven Activity-Based Costing)을 이용한 일 내과병동 간호단위 원가계산 및 효율성 분석)

  • Lim, Ji-Young;Kim, Mi-Ja;Park, Chang-Gi
    • Journal of Korean Academy of Nursing
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    • v.41 no.4
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    • pp.500-509
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    • 2011
  • Purpose: Time-driven activity-based costing was applied to analyze the nursing activity cost and efficiency of a medical unit. Methods: Data were collected at a medical unit of a general hospital. Nursing activities were measured using a nursing activities inventory and classified as 6 domains using Easley-Storfjell Instrument. Descriptive statistics were used to identify general characteristics of the unit, nursing activities and activity time, and stochastic frontier model was adopted to estimate true activity time. Results: The average efficiency of the medical unit using theoretical resource capacity was 77%, however the efficiency using practical resource capacity was 96%. According to these results, the portion of non-added value time was estimated 23% and 4% each. The sums of total nursing activity costs were estimated 109,860,977 won in traditional activity-based costing and 84,427,126 won in time-driven activity-based costing. The difference in the two cost calculating methods was 25,433,851 won. Conclusion: These results indicate that the time-driven activity-based costing provides useful and more realistic information about the efficiency of unit operation compared to traditional activity-based costing. So time-driven activity-based costing is recommended as a performance evaluation framework for nursing departments based on cost management.

A Survey of Teaching Effectiveness and the Development of an Evaluation Instrument for Clinical Education (임상실습지도자의 효율성 조사와 임상평가도구 개발)

  • Kwon, Mi-Ji
    • The Journal of Korean Physical Therapy
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    • v.14 no.1
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    • pp.177-186
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    • 2002
  • The purpose of this study was to contribute to the development of clinical instruction by students ratings of teaching effectiveness in clinical education. The instrument used in this study was teaching effectiveness of clinical nursing by Yu and modified evaluation method by Kern and Mickelson. The results were are follows 1. Among the 12 categorial components of clinical teaching effectiveness, the highest satisfaction was 'encouraging to think for themselves' and the lowest was 'attitude of teacher and evaluation' 2. To compare teaching effectiveness between sex, 'resource for student' and 'professional competence' showed statistical significance. 3. To compare teaching effectiveness among clinical practice stage, 'encouraging' 'role model', 'professional competence', 'organization of subject mater' and 'attitude of teacher and evaluation' showed statistical significance. 5. Interrater ICCs for evaluation method did not showed statistical significance and interitem ICCs showed statistical significance. This article presents goal of clinical education, development of clinical instructor's educational program and a standardized method to measure clinical performance.

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A Study on the Perception and Improvement Plans of Performance Based Pay System of Elementary School Teachers and Elementary School Health Teachers (교원 성과급 제도에 대한 초등교사와 초등보건교사의 인식과 개선방안)

  • Yeo, Soon-Young;Kim, Yun-Shin;Kim, Hyeon-Suk
    • Journal of the Korean Society of School Health
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    • v.24 no.2
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    • pp.141-154
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    • 2011
  • Purpose: The purpose is to provide basic information for establishing improvements on performance-based pay's evaluation method of health teachers. Methods: For subjects, 200 teachers at public elementary schools and 200 health teachers at public elementary schools in Gyeonggi-do were conveniently sampled, and then surveyed through a questionnaire. The questionnaire was to recognize recognition of teachers working under the teacher's performance-based pay system, which was quoted in the questionnaire of Choi ji-hye (2005) and Lee mi-gyeong (2008). Inquiry for the recognition of teachers on evaluation of health teacher's performance-based pay system and improvements on the performance-based pay's evaluation method of health teachers were used after consultation with five incumbent health teachers and a review with the thesis director. Results: The performance-based pay's evaluation method of health teachers has the same method with general teachers in schools, so it is not fair to evaluate the performance of health teachers. The ways to improve the performance-based pay evaluation method of health teachers is as follows: first, the approval on improving 'the number of class hours' which is a detailed item of a teacher's performance evaluation criterion to 'the number of health lesson hours per week and the number of students visiting the school infirmary per week'; second, improving 'life guidance' into 'counseling results of medically-treated students, parents of students and personal hygiene guidance'; third, improving 'a teacher in charge' into 'awarding of points by being recognized as a health teacher in charge of all students and considering the economic situation of the region,; forth, improving 'difficulty of position' into 'the number of health-teacher's annual promotion task items and the treatment number of issuing and receiving of official documents', and improving the 'task difficulty' into 'importance and urgency of emergency patient management, risk level and urgency of infectious diseases and avoiding work in charge' appeared to be more than 90% respectively. Conclusion: The performance-based pay system of teachers being carried out every year should be executed by preparing fair evaluation criteria suitable for task properties and the role of health teachers with different evaluation criteria compared to general teachers.

Clinical Application of Objective Structured Clinical Examination (OSCE) for Novice Nurses (신규간호사의 실무능력평가를 위한 OSCE(객관적구조적임상수기평가) 개발과 적용)

  • Cheung, Nam-Youn;Song, Young-Shin
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.13 no.3
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    • pp.334-342
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    • 2006
  • Purpose: The purpose of this study was to develop and examine the feasibility of OSCE for novice nurses. Method: The study was designed using a methodological design. Data were collected from January to February, 2005. Nine stations were developed for the examination. Five minutes was allowed for each station. The examination was administered to 2 groups of novice nurses. Results: OSCE for clinical performance improvement which consisted of nine 5-minute long stations, was developed. Those stations were tested by 79 beginning nurses who were divided into 2 groups. Reliability ranges for Cronbach's alpha were $0.399{\sim}0.811$ and the mean value was 0.797. Total mean score for the OSCE was 66.75. Total score for the 2nd group was significantly higher than the 1st group. The nurses were satisfied with the OSCE method and process. Conclusion: The OSCE can be an effective tool for evaluating clinical nursing skills in novice nurse. More reliable and valid stations need to be developed and then repeated evaluation of the nurses can be done.

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An experimental study on the impact of an agreement on the means to achieve nursing goals in the early postpartum period of primiparous mothers and enhance their self-confidence and satisfaction in maternal role performance (산욕초기 초산모의 간호목표달성방번 합의가 어머니 역할수행에 대한 자신감 및 만족도에 미치는 영향에 관한 실험적 연구)

  • 이영은
    • Journal of Korean Academy of Nursing
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    • v.22 no.1
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    • pp.81-115
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    • 1992
  • 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)

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