• 제목/요약/키워드: Qualitative data analysis

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편측무시 개선을 위한 작업치료 중재 연구 분석: 국내 단일대상연구 중심으로 (Analysis of Occupational Therapy Intervention Studies for Improvement of Neglect: Single Subject Study)

  • 김진영;윤세웅;최유임
    • 재활치료과학
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    • 제12권2호
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    • pp.9-23
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    • 2023
  • 목적 : 작업치료 분야에서 편측무시 중재를 사용한 연구 중 단일대상연구를 적용한 문헌들의 내용과 특성을 확인하고, 중재 효과 및 질적 수준을 분석하기 위해 실시하였다. 연구방법 : 본 연구는 체계적 고찰이며, 2012년부터 2022년까지 최근 10년간 국내 학회지에 게재된 단일대상연구로 진행된 논문을 대상으로 하였다. 결과 : 논문 분석 결과 뇌졸중 환자를 대상으로 시행하였으며 중재제거설계가 7편으로 가장 많은 비율을 차지했고 2편이 복수 기초선 설계였다. 중재제거설계 중 4편이 ABA설계를 사용하였다. 편측무시에 적용한 중재 효과 크기를 분석한 결과 중재 효과 크기는 '매우 효과적인 중재'는 7회, '효과적인 중재'는 18회, '의심스러운 중재'는 5회, '비효과적인 중재'는 6회로 나타났다. 논문들의 질적 수준을 분석한 결과 높은 수준이 6편, 중간 수준이 3편으로 낮은 수준의 연구는 한 편도 없었다. 결론 : 연구 결과 편측무시 중재들은 불빛 자극, 로봇 보조 능동운동, 진동 자극 등 다양한 방법을 적용하고 있었다. 본 연구의 분석을 통해 임상에서 편측무시 환자에게 중재를 적용할 수 있을 것으로 생각된다.

작은도서관 순회사서 직무환경 개선방안 연구 (A Study on Improving Strategies of Itinerant Librarians' Job Environment at Small Libraries)

  • 채희라;김유승
    • 한국비블리아학회지
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    • 제33권1호
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    • pp.71-94
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    • 2022
  • 작은도서관은 양적으로 꾸준히 증가해 온 반면 인력 부재와 운영 부실 등 질적 성장에 대한 부분이 문제점으로 줄곧 지적되어왔다. 이에 공공도서관과 작은도서관의 연계와 협력 기반 구축을 목표로 2010년부터 작은도서관 순회사서 사업이 추진되었고, 그 규모는 지속적으로 확장되고 있다. 그러나 인력 부재와 운영 부실 문제는 여전히 해결되어야 할 과제로 남아있고, 순회사서의 열악한 처우와 직무환경은 개선되지 않고 있다. 이러한 맥락에서 본 연구는 순회사서가 경험하는 작은도서관의 문제점과 직무상 문제 상황들을 살펴보고, 이를 바탕으로 순회사서의 직무환경을 개선할 수 있는 방안을 모색하고자 한다. 선행연구 분석을 통해 작은도서관과 순회사서에 대해 알아보고, 순회사서와 작은도서관과 관련된 참여자를 대상으로 심층 면담을 수행하였다. 면담자료 분석을 통해 '업무권한 부족', '업무 매뉴얼 부재', '소통, 커뮤니티 부재', '통합 운영 체계 미비', '열악한 처우 및 근무환경', '업무 환경 미비', '악성 이용자', '소속감 부재로 인한 고립감' 등 총 17개 의미 주제를 추출하였고, 이를 업무, 조직, 환경, 정서, 사회, 제도 등 6가지 요인으로 범주화하였다. 이를 바탕으로 순회사서의 직무 권한 및 기준 규정 정비, 커뮤니티 조직 구축, 고용안정성 보장, 직무교육 강화 등 4가지 개선 방안을 제시하였다.

복지국가의 '자녀유무별 여성임금격차(Family gap)' 비교연구 : 가족정책과 노동시장구조의 영향을 중심으로 (A Comparative Study of family gap in Welfare States :The Role of family policy and labor market structure)

  • 허수연
    • 사회복지연구
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    • 제41권2호
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    • pp.279-308
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    • 2010
  • 본 연구는 '자녀유무별 여성임금격차(Family gap)' 의 국가별 차이를 가져오는 제도적 요인을 탐색하기 위해 OECD 14개국을 대상으로 가족정책, 노동시장 및 사회구조와 Family gap의 관계를 분석하는 것을 목적으로 한다. 이 때 가족정책을 여성의 노동역할을 지원하는 '고용지원 가족정책' 과 양육역할을 지원하는 '양육지원 가족정책' 으로 분류하여 각각이 가지는 정책적 지향에 따라 Family gap에 미치는 영향을 구분하였으며 노동시장 및 사회구조를 분석하기 위한 변수로 노동시장 성분절 구조, 임금불평등 구조, 여성의 사회적 지위와 경제적 상황을 모형에 포함하였다. 분석을 위하여 먼저 헤크만 2단계추정법(Heckman's two stage estimation)을 통해 국가별 Family gap 크기를 측정한 후 퍼지셋분석(FSQCA)을 통해 어떠한 제도적 조합이 낮은 Family gap을 가져오는지 검증하였다. 분석결과 낮은 Family gap은 '고용지원 가족정책' 의 발달과 '낮은 임금불평등 구조' 의 결합인과관계(conjunctual causation)에 의해 발생하는 것으로 나타났다. 분석결과를 통해 '자녀가 있는 여성' 의 양육으로 인한 불리함을 줄이고 상대적인 임금수준을 높이기 위한 제도적 노력으로 여성의 고용지속 및 양육의 사회화를 지원하고 여성과 남성 모두의 일-가족 양립을 지향하는 가족정책의 확충과 함께 낮은 노동지위에 있는 여성의 임금 및 고용조건의 보호가 우선과제가 된다는 정책적 함의를 제시하였다.

유방암 생존자의 운동 선호에 대한 탐색 (Exercise Program Based on Preferences of Breast Cancer Survivors)

  • 변지용;강민재;박지혜;민지희;전용관
    • 한국체육학회지인문사회과학편
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    • 제57권2호
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    • pp.611-624
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    • 2018
  • 본 연구의 목적은 유방암 생존자를 대상으로 선호하는 운동 프로그램에 대하여 심층적으로 밝히는데 있다. 그룹 운동프로그램에 참여하는 10명의 연구 참여자를 선정하였으며, 심층면담과 참여관찰을 통하여 자료를 수집하였다. 현실을 이해하고 해석하기 위하여 질적 연구방법 중 주제 분석 방법을 사용하였다. 그 결과, 유방암 생존자의 운동 선호에 대한 4개의 주제가 도출되었으며, '지도하의 운동', '함께하는 운동', '유방암 생존자 맞춤 운동 프로그램', '재미 요소'로 나타났다. 첫째, 유방암 생존자들은 지도하의 운동을 선호하는 것으로 나타났으며 운동 전문가가 필요하고 전문가에 의한 개인별 맞춤 지도가 필요하다고 언급하였다. 둘째, 유방암 생존자들은 함께하는 운동을 선호하는 것으로 나타났으며, 같이 하는 운동의 시너지 효과로 운동 참여를 촉진시키고 함께하는 대상으로는 유방암 생존자를 언급하였다. 셋째, 유방암 생존자 맞춤 운동 프로그램을 선호하는 것으로 나타났으며, 유방암 생존자 운동 프로그램에 대한 기대와 유방암 생존자를 위한 운동에 대한 그들의 생각을 언급하였다. 넷째, 유방암 생존자들이 선호하는 운동의 중요한 요소는 재미로 나타났으며, 재미있는 운동을 선호하고 재미 요인으로 음악적 측면을 언급하며 본인 스스로 재미를 느껴야한다고 하였다. 향후 유방암 생존자의 운동 선호를 반영하여 전문화된 인력과 프로그램으로 유방암 생존자의 체계적인 관리가 제공되어져야 것이다.

일 상급종합병원 병동간호사의 업무량 측정 및 간호사 배치수준의 적절성 연구: 혼합연구 설계 적용 (Analysis of the Adequacy of Nurse Staffing Level through the Estimation of Nursing Activity Hours and Implementation of Focus Group Interviews in a Tertiary Hospital: Using a Mixed-Method Design)

  • 김현주;이선희;이재정;성선숙;양희;이향열
    • 대한간호학회지
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    • 제54권2호
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    • pp.237-249
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    • 2024
  • Purpose: This study aimed to examine the adequacy of current nurse staffing levels by identifying nursing activities and workload. Methods: The study used a mixed-method design. A nursing activity survey was conducted using the work sampling method over 2 working days with 119 general ward nurses. A focus group interview was conducted with 12 nurses. Quantitative and qualitative data were analyzed using SPSS 20.0 and content analysis, respectively. Results: The most amount of time was spent on medication (in direct nursing) and electronic medical record documentation (in indirect nursing). The appropriate nurse-to-patient ratio is 1:7.7 for the day shift, 1:9.0 for the evening shift, and 1:11.9 for the night shift. However, the current nurse-to-patient ratio is 1:9.4, 1:11.0, and 1:13.8 for the day, evening, and night shifts, respectively. Therefore, the current nurse staffing level is insufficient for the workload. In the focus group interview, the main reasons cited for being unable to complete tasks within working hours were communication and coordination, and the nursing electronic medical record. The essential nursing activities of basic nursing and emotional support were overlooked owing to a heavy workload. Therefore, an adequate nurse staffing level should be higher than the measured quantitative workload. Conclusion: These results suggest the general wards of tertiary hospitals should evaluate the adequacy of their current nurse staffing and allocate sufficient nurses to improve patient safety and nursing care quality.

Multivariate Characterization of Common and Durum Wheat Collections Grown in Korea using Agro-Morphological Traits

  • Young-ah Jeon;Sun-Hwa Kwak;Yu-Mi Choi;Hyemyeong Yoon;Myoung-Jae Shin;Ho-Sun Cheon;Sieun Choi;Youngjun Mo;Chon-Sik Kang;Kebede Taye Desta
    • 한국작물학회지
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    • 제68권4호
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    • pp.343-370
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    • 2023
  • Developing improved wheat varieties is vital for global food security to meet the rising demand for food. Therefore, assessing the genetic diversity across wheat genotypes is crucial. This study examined the diversity of 168 durum wheat and 47 common wheat collections from 54 different countries using twelve agro-morphological parameters. Geumgang, a prominent Korean common wheat variety, was used as a control. Both qualitative and quantitative agronomical characteristics showed wide variations. Most durum wheats were shown to possess dense spikes (90%), while common wheats showed dense (40%) or loose (38%) spikes, with yellowish-white being the dominant spike color. The majority of the accessions were awned regardless of wheat type, yellowish-white being the main awn color. White or red kernels were produced, with white kernels dominating in both common (74%) and durum (79%) wheats. Days to heading (DH) and days to maturity (DM) were in the ranges of 166-215 and 208-250 days, respectively, while the culm length (CL), spike length (SL), and awn length (AL) were in the ranges of 53.67-163, 5.33-18.67, and 0.50-19.00 cm, respectively. Durum wheats possessed the shortest average DH, DM, and SL, while common wheat had the longest CL and AL (p < 0.05). Common wheats also exhibited the highest average one-thousand-kernel weight. Hierarchical cluster analysis, aided by principal component analysis, grouped the population into seven clusters with significant differences in their quantitative variables (p < 0.05). In conclusion, this research revealed diversity among common and durum wheat genotypes. Notably, 26 durum wheat and 17 common wheat accessions outperformed the control, offering the potential for developing early-maturing, high-yielding, and lodging-resistant wheat varieties.

장바구니 크기가 연관규칙 척도의 정확성에 미치는 영향 (Effect of Market Basket Size on the Accuracy of Association Rule Measures)

  • 김남규
    • Asia pacific journal of information systems
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    • 제18권2호
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    • pp.95-114
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    • 2008
  • Recent interests in data mining result from the expansion of the amount of business data and the growing business needs for extracting valuable knowledge from the data and then utilizing it for decision making process. In particular, recent advances in association rule mining techniques enable us to acquire knowledge concerning sales patterns among individual items from the voluminous transactional data. Certainly, one of the major purposes of association rule mining is to utilize acquired knowledge in providing marketing strategies such as cross-selling, sales promotion, and shelf-space allocation. In spite of the potential applicability of association rule mining, unfortunately, it is not often the case that the marketing mix acquired from data mining leads to the realized profit. The main difficulty of mining-based profit realization can be found in the fact that tremendous numbers of patterns are discovered by the association rule mining. Due to the many patterns, data mining experts should perform additional mining of the results of initial mining in order to extract only actionable and profitable knowledge, which exhausts much time and costs. In the literature, a number of interestingness measures have been devised for estimating discovered patterns. Most of the measures can be directly calculated from what is known as a contingency table, which summarizes the sales frequencies of exclusive items or itemsets. A contingency table can provide brief insights into the relationship between two or more itemsets of concern. However, it is important to note that some useful information concerning sales transactions may be lost when a contingency table is constructed. For instance, information regarding the size of each market basket(i.e., the number of items in each transaction) cannot be described in a contingency table. It is natural that a larger basket has a tendency to consist of more sales patterns. Therefore, if two itemsets are sold together in a very large basket, it can be expected that the basket contains two or more patterns and that the two itemsets belong to mutually different patterns. Therefore, we should classify frequent itemset into two categories, inter-pattern co-occurrence and intra-pattern co-occurrence, and investigate the effect of the market basket size on the two categories. This notion implies that any interestingness measures for association rules should consider not only the total frequency of target itemsets but also the size of each basket. There have been many attempts on analyzing various interestingness measures in the literature. Most of them have conducted qualitative comparison among various measures. The studies proposed desirable properties of interestingness measures and then surveyed how many properties are obeyed by each measure. However, relatively few attentions have been made on evaluating how well the patterns discovered by each measure are regarded to be valuable in the real world. In this paper, attempts are made to propose two notions regarding association rule measures. First, a quantitative criterion for estimating accuracy of association rule measures is presented. According to this criterion, a measure can be considered to be accurate if it assigns high scores to meaningful patterns that actually exist and low scores to arbitrary patterns that co-occur by coincidence. Next, complementary measures are presented to improve the accuracy of traditional association rule measures. By adopting the factor of market basket size, the devised measures attempt to discriminate the co-occurrence of itemsets in a small basket from another co-occurrence in a large basket. Intensive computer simulations under various workloads were performed in order to analyze the accuracy of various interestingness measures including traditional measures and the proposed measures.

이화동 벽화마을 주민과 관광객간의 장소 정체성 인식 및 경관 선호 차이에 관한 연구 (Difference of Place Identity Perception and Landscape Preference between Residents and Tourists in Ihwa-dong Mural Village)

  • 김예림;손용훈
    • 한국조경학회지
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    • 제45권1호
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    • pp.105-116
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    • 2017
  • 마을에서 벽화는 커뮤니티와 공간을 재생시키는 효과와 함께 경제적 효율성까지 겸하고 있다. 이 때문에 한국에서는 정부기관과 지자체를 중심으로 벽화조성사업을 활발히 진행하고 있고, 현재 벽화와 조형물 중심의 마을 프로젝트는 전국적으로 200곳에 이른다. 하지만 벽화마을 조성사업은 사업의 단기적 완결에 초점을 맞추어 획일화된 경관을 보급하고, 장소의 정체성을 오히려 파괴한다는 문제점이 제기되고 있다. 또한, 정부 주도 사업으로 조성된 벽화는 주민참여가 저조하여 지속가능한 경관관리가 잘 이루어지지 못하는 문제도 지적될 수 있을 것이다. 본 연구는 벽화마을의 효시로 일컫고, 각종 미디어에서 주목받으며 급격한 경관 및 공간의 변화를 겪고 있는 이화동 벽화마을을 중심으로 벽화마을의 경관 변화과정의 맥락을 비판적 관점에서 살펴보고자 하였다. 본 연구의 목적은 다음과 같다. 첫째, 이화동 벽화마을의 경관 및 장소 정체성에 대한 주체 간의 인식 차이를 살펴보고자 하였다. 이를 통해 장소의 정체성을 살리고, 경관 선호 차이를 고려한 장소 만들기에 필요한 기반을 마련하였다. 둘째, 이러한 데이터를 통해 벽화사업을 평가하고 발전방향을 모색하고자 하였다. 연구방법으로는 문헌조사를 통해 경관변화 과정의 맥락을 살펴보고, 이를 바탕으로 SNS로 재현되는 이화동의 경관자원을 분석하여 관광지로써의 현황 및 관광객들의 선호 경관을 파악하였다. 또한, 주민, 벽화사업으로 인한 새로 유입된 이주민, 관광객 각 이용집단 간 이화동 벽화마을의 장소 정체성 인식 및 경관선호의 차이를 심도 있게 알아보기 위해 현장조사 및 심층인터뷰를 진행하였다. 연구의 결과는 관광객들은 벽화 외에 의도적으로 조성하지 않은 풍경 또한 많이 주목하였는데, 선호 풍경과 선호 상점의 위치가 많은 부분 겹쳐 풍경감상이 가능한 장소의 인근 상점이 선호되고 있음을 파악하였다. 장소의 정체성에 대해 주민은 소외된 동네라는 인식이 강한 반면, 이주민과 관광객들은 비일상적 경관인 벽화를 장소의 정체성이라고 인식하였다. 경관 선호의 경우, 관광객은 휴식공간에 대한 선호가 높은 반면, 이주민과 주민은 휴식공간에 거의 주목하지 않았다. 또한, 이주민, 관광객은 특히 야간경관에 대한 선호를 보인 반면, 주민은 전혀 주목하지 않았다. 벽화사업의 방향과 관련해서는 주민과 이주민 모두 벽화조성 및 관리 등에 주체적 참여의식을 갖기보다는 정부에 의존적인 태도를 취하는 이들이 많았다. 본 연구는 전국적으로 확산되고, 도시재생, 참여디자인 등에 관해서 비판 없이 받아들여지고 있는 벽화마을 경관에 대한 문제점을 실증연구를 통해서 분석했다는 점에서 의의가 있을 것이다. 또한, 주민, 이주민, 관광객간의 장소 정체성 및 경관 선호의 차이를 분석하여 추후 벽화마을 사업에 시사점을 제공할 수 있으리라 기대한다.

질적 간호에 대한 환자와 가족의 지각 (Perceptions of Quality Nursing care of Patients and Families)

  • 지성애;권성복;박은희
    • 간호행정학회지
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    • 제4권1호
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    • pp.247-275
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    • 1998
  • The purpose of this study was to offer the results of content analysis and qualitative study that explored the perceptions about quality nursing care of patients and families as consumers and to identify the implications of this study for quality nursing care management and research. The data was collected from 12 adult patients and 9 families who were admmitted at medical and surgical nursing unit of one university hospital in Seoul from October, 1996 to January, 1997. Research participants were asked to response "what do you think quality nursing care?" and similar questions during the interviews was performed. Data were analyzed using open coding and content analysis with frequencies and percents of attributes of quality nursing care. Attributes of quality nursing care and meaning of quality nursing care that patients and families perceived were explored. 1. The attributes of quality nursing care that patient and families perceived were categorized into 56 attributes. The highest response rate among the attributes was 'one's heart at ease' (76.2%), and the next high response rates were ranked in order 'consideration' , 'care about' (each 61.9% 'expert skill' (57.1%), 'deal with problem promptly' , 'information offer' (42.9%), 'intimate feeling' (38.1%), 'smile' 'service spirit' , 'do one's best' (each 33.3%), 'frequent visit' (23.8%), 'observe the time' (23.8%), 'direct nursing care' , 'speaking warmly' , give a hope' , 'address kindly' , 'a sense of duty' , 'good facilities' (each 19.0%), 'inquire after a patient health' , 'patient-centered nursing care' , 'showing an example' , 'professional knowledge' , 'careless moraly patient' , 'give encourage to patients' , 'good answer a question' (each 14.3%), 'do not imprudently' , 'do not disregard' , 'broad knowledge' , 'emergency treatment skill' , 'dependability' ,'consolation' giving a sense of security' , 'a self sacrificing spirit' , 'a sense of responsibility' 'hard - working', 'enough disposition of nursing staff (each 9.5%), 'improve patient's pride' and the rest attributes exhibited 4.7%, respectively. 2. The attributes that were identified in patients' data only were 8 categories, 'service sprit' (58.3 %) 'expert knowledge' , 'good answer a question' (each 25.0%), 'hard working' (16.7%), 'a warm character', 'professional attainments', 'do without reserve', 'satisfaction' (each 8.3%), 3. The attributes were identified to families' data only were 31 categories, 'speaking warmly' , 'direct nursing care', 'adress kindly', 'patientcentered nursing care', 'showing an example' (each 33.3%). 'do not imprudently' , 'do not disregard' , 'consolation', 'giving a sense of security', 'broad knowledge' , 'emergency treatment skill', 'dependability' ,'a self - sacrificing spirit', 'a sense of responsibility' (each 22.2%), 'improve patient's pride' , 'without discrimination' , 'show kindness' , 'individual nursing care', 'being with patient' , 'helping' , 'accuracy' , 'without any mistake' , 'love' , 'self - confidence', 'self possession', 'a self - denying spirit' , 'a sense of duty' , 'tighten discipline' , 'disposed room with similar patient to diagnosis', 'compensatory relationship between me dical team' , 'role of connection' (each 11.1 %). 4. The attributes of quality nursing care were integrated into 11 categories that they were 'patientcentered nursing care' (25.1%), 'expertise' (22.1%), 'caring'(18.1%), 'kindness'(11.1%L 'nurse attainments(10.1%), 'sincerity' (7.5%), 'good environment' (2.0%), 'effective organizational management', 'coordination', 'enough nursing staff' ( each 1.0%), 'satisfaction' (0.5%) were showed in the order of the highest rate. 5. The concept of quality nursing care were defined as 'give a satisfaction to patients by patientcentered care based on professional skill and caring with kindness and sincerity'. The description of the meaning of quality nursing care provided by this research participants, patients and families can provide important information for quality nursing care management, medical marketing, education and researches of this field. On the basis of the above findings the following recommendations are made: to suggest to utilize this results for patient care in practice setting, development of quality assessment tool in nursing care, repeat study by the same subjects and method, and to a comparative study by the same method to nurse.

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암으로 자녀를 잃은 가족의 경험에 대한 질적연구 (The Experience of the Family Whose Child Has Died of Cancer)

  • 이정섭;김수지
    • 대한간호학회지
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    • 제24권3호
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    • pp.413-431
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    • 1994
  • The purpose of this study was to build a substantive theory about the experience of the family whose child has died of cancer The qualitative re-search method used was grounded theory. The interviewees were 17 mothers who had cared for a child who had died of cancer Traditionally in Korea, mothers are the care givers in the family and are considered sensitive to the family's thoughts, feelings. The data were collected through in-depth interviews by the investigator over a period of nine months. The data were analyzed simultaniously by a constant comparative method in which new data are continuously coded into categories and properties according to Strauss and Corbin's methodology. The 16 concepts which were found as a result of analyzing the grounded data were, -left over time, the empty place, meaninglessness, inner sadness, situational sadness, heartache, physical pain, guilt, resentment, regret, support / stigmatization, finding meaning in the death, changing attitudes about life and living, changing attitudes about health, changing religious practice and changing family relations. Five categories emerged from the analysis. They were emptiness, consisting of left over time, the empty place and meaninglessness ; sadness, consisting of inner sadness and situational sadness ; pain, consisting of heartache and physical pain ; bitterness, consisting of guilt, resentment, regret, sup-port / stigmatization and finding meaning in the death : and transition, consisiting of changing attitudes about life and living, changing attitudes about health, changing religious practice and changing family relations. These categories were synthesized into the core concept, -the process of filling the empty space. The core phenomenon was emptiness. Emptiness varied with the passing of time, was perceived differently according to support / stigmatization and finding meaning in the death, was followed by sad-ness, pain, and bitterness, and finally resulted in changes in attitudes about life and living and about health, and in changes in religious practice and family relations. The process of filling the empty space proceeded by ① accepting realty, ② searching for the reason for the child's death, ③ controlling the bitter feelings, ④ reconstructing the relationships ameng death, illness and health and ⑤ filling the emptiness by resolving causes of child's death, adopting, having another child or with work. Six hypotheses were derived from the analysis. ① The longer the bereavement, the mere the empty space becomes filled. ② The longer the hospitalization, the more sup-port the family needs. ③ The more the sadness, pain and bitterness are expressed, the mere positive changes emerge. ④ Family support faciliates the process of filling the empty space. ⑤ Higher family cohesiveness faciliates the process of filling the empty space. ⑥ The greater the variety of reasons attributed to the child's death, the greater the variety of patterns of change. Four propositions related to emptiness and bitter-ness were developed. ① When the sense of emptiness is great and bitterness is manifested by severe feelings of guilt and resentment, the longer the process of fill-ing the empty space. ② When the sense of emptiness is great and the family is highly motivated to get rid of the bitterness, the shorter the process of filling the empty space. ③ When the sense of emptiness is less and bitter-ness is manifested by severe feelings of guilt and resentment, the process of filling the empty space is delayed. ④ When the sense of emptiness is less and the family is highly motivated to get rid of the bitterness, the process of filling the empty space goes on to completion. Through this substantive theory, nurses under-stand the importance of emptiness and bitterness in helping the family that has lost a child through cancer fill the empty space. Further research to build substantive theories to explain other losses may con-tribute to a formal theory of how family health is restored after human tragedies are experienced.

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