• Title/Summary/Keyword: Recovery program

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Effects of a Critical Pathway of Posterolateral Fusion in Patients with Lumbar Spinal Stenosis (측후방융합술을 시행한 요추관협착증 환자의 Critical Pathway 적용효과)

  • Park, Hae-Ok
    • Journal of Korean Academy of Nursing Administration
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    • v.7 no.2
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    • pp.265-284
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    • 2001
  • The case management has been applied to improve the quality of care and the cost-effectiveness in the most health care institutions. In a way of case management, the critical pathway(CP) has been executed in many acute care settings, focused on the diagnoses with high cost, high volume, and high risk. This study was conducted to develop a case management program using CP as an intervention of patients with lumbar spinal stenosis for the surgery of posterolateral fusion, and to find out the effects of the critical pathway on the quality of nursing care, patient satisfaction as an outcome of care, length of stay and medical charge, and nurses' job satisfaction. At the same time, patients' functional states were checked with the Oswestry Low Back Pain Index, to show that the CP would not decrease the patients' function compared to the control group. The subjects were 25 control patients with a usual operation of lumbar fusion and 25 experimental patients with CP. They were all female, aged $50s{\sim}70s$, admitted in the Orthopedic surgery ward of a university hospital. Also nurses on the floor using CP were asked to respond to measurement tool of job satisfaction before and after the application of CP, and compared with other nurses on the different wards. Data were analyzed with t-test for continuous variables and chi-square for non-parametric variables in addition to the reliability test of the measurement tools. The results of this study were as followings: 1. Patients' functional states The differences in Oswestry scores of the experimental and control groups assessed at preoperation and at discharge were not statistically significant. The change in scores of the experimental group measured at preoperation and at discharge was larger than that of the control group, however the difference was not statistically significant. The results indicate that the CP did not decrease the patients' functional status. 2. The quality of nursing care The total of quality of nursing care given to the experimental group was better than that of the control group(P=.000). In addition, the experimental group showed better scores of quality of every item of care than the control group(P=.000 -.004). 3. Patient satisfaction Patients of the experimental group were not more satisfied with general care than the control group. But they were more satisfied with discharge care of 'explanation about medication, body posture, and brace application' and 'explanation about the adjustment of daily living and exercise during recovery'(P= .047, P=.028). 4. Nurses' job satisfaction Nurses working with the CP showed more job satisfaction than before the CP introduction(P=.048). But the control group of nurses on a different floor showed no change in job satisfaction at the same period of time. 5. Length of stay and medical charge The mean length of stay of the experimental group was shorter than that of the control group without statistical significance. The charge of medication and treatment of the experimental group were smaller than that of the control group(P=.011, P=.000). The results of the study support that the case management using critical pathway enables to improve the quality of care and job satisfaction, to reduce the medical charge, and consequently to increase satisfaction with care. However, the case management should be instituted focusing on the quality improvement of nursing and the client satisfaction, not just for the purpose of cost-effectiveness of health care facilities.

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Effects of Treadmill Exercise on Alpha-synuclein Mutation and Activated Neurotrophins in Nigrostriatal Region of MPTP-induced Parkinson Models (MPTP 파킨슨 모델의 트레드밀 운동이 알파시누크린 변성과 흑질선조체내 신경성장인자 활성화에 미치는 영향)

  • Park, Jae-Sung;Kim, Jeong-Hwan;Yoon, Sung-Jin
    • Journal of Korean Medicine Rehabilitation
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    • v.19 no.2
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    • pp.73-88
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    • 2009
  • Objectives : Neuronal changes that result from treadmill exercise for patients with Parkinson's disease(PD) have not been well documented, although some clinical and laboratory reports suggest that regular exercise may produce a neuroprotective effect and restore dopaminergic and motor functions. However, it is not clear if the improvements are due to neuronal alterations within the affected nigrostriatal region or result from a more general effect of exercise on affect areas and motivation. In this study, we demonstrate that motorized treadmill exercise improves the neuronal outcomes in rodent models of PD. Methods : We used a chronic mouse model of parkinsonism, which was induced by injecting male C57BL/6 mice with 10 doses(Every 12 hour) of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (30 mg/kg) and probenecid (20 mg/kg) over 5 days. These mice were able to sustain an exercise training program on a motorized rodent treadmill at a speed of 18 m/min, $0^{\circ}$ of inclination, 40 min/day, 5 days/week for 4 weeks. At the end of exercise training, we extracted the brain and compared their neuronal and neurochemical changes with the control(saline and sedentary) mice groups. Synphilin protein is the substance that manifestly reacts with ${\alpha}$-synuclein. In this study, we used Synphilin as a manifest sign of recovery from neurodegeneration. We analyze the brain stems of the substantia nigra and striatum region using the western blotting technique. Results : There were no expression of synphilin in the saline-induced groups. The addition of MPTP(1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine) greatly accelerated synphilin expression which meant an aggregation of ${\alpha}$-synuclein. But, the MPTP-induced treadmill exercise group showed significantly lower expression than the MPTP-induced sedentary group. This means treadmill exercise has a definite effect on the decrease of ${\alpha}$-synuclein aggregation. Conclusions : In this study, our results suggest that treadmill exercise promoted the removal of the aggregation of ${\alpha}$-synuclein, resulting in protection against disease development and blocks the apoptotic process in the chronic parkinsonian mice brain with severe neurodegeneration.

Survey of Sedation Practices by Pediatric Dentists (소아치과의사의 진정법 사용에 대한 실태조사)

  • Yang, Yeonmi;Shin, Teojeon;Yoo, Seunghoon;Choi, Seongchul;Kim, Jiyeon;Jeong, Taesung
    • Journal of the korean academy of Pediatric Dentistry
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    • v.41 no.3
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    • pp.257-265
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    • 2014
  • The aim of this study was to establish the appropriate guidelines in the sedation techniques and to organize the continuing education programs for the sedation in future under the direction of Committee on Sedation, Education and Research under the Korean Academy of Pediatric Dentistry(KAPD). The surveys on the sedation technique were performed on 111 organizations which practices the sedation and responded to the survey via online and e-mail by February 2014. The collected survey were analyzed. The purpose of sedation was mainly to manage the children's behavior and its uses were primarily on 3~4 years old children. The most frequent duration of treatment was 1~2 hours to treat both maxillary and mandible. The preferred dosages of sedative drugs were chloral hydrate(CH) 50~70 mg/kg, hydorxyzine(Hx) 1~2 mg/kg, and intramuscular midazolam(Mida IM) 0.1~0.2 mg/kg. The preferred combination of the sedative drugs were CH + Hx + $N_2O/O_2$(67.6%), CH + Hx + Mida submucosal administration (SM) + $N_2O/O_2$(29.7%), and Mida IM + $N_2O/O_2$(23.4%). The administration of additional sedatives was carried out at 48%, mainly using Midazolam. 87.5% of the respondents experienced the adverse effects of the sedation such as vomiting/retching, agitation during recovery, subclinical respiratory depression, staggering, and etc. Among them, only 20% periodically retrain the emergency management protocol. About the discharge criteria for patients after the sedation, the respondents either showed a lack of clear criteria or did not follow the recommended discharge criteria. 86% of the respondents expressed the interests in taking a course on the sedation and they wanted to learn mostly about the sedation-related emergency management, the safe dosage of the sedative drugs, and etc. The use of sedation in pediatric dentistry must be consider a patient's safety as top priority and each dentist must show the evidence of sound practices for the prevention of any possible medical errors. Therefore, KAPD must establish the proper sedation guidelines and it needs to provide the systematic technical training program of sedation-related emergency management for pediatric dentists.

Effects of Edge Area and Burn Severity on Early Vegetation Regeneration in Damaged Area (가장자리와 산불피해강도가 산불피해지역 초기식생재생에 미치는 효과)

  • Lee, Joo-Mee;Won, Myoung-Soo;Lim, Joo-Hoon;Lee, Sang-Woo
    • Journal of Korean Society of Forest Science
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    • v.101 no.1
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    • pp.121-129
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    • 2012
  • The edge area with burn severity is known as significant factor that has great effects on the ecosystem recovery. However, there is little study on the edge area and its effects in the South Korea. Thus, this study aimed to analyze immediate responses of vegetation following forest fires due to combined effect of burn severity and edge-interior effect. Burn Severity (BS), or ${\Delta}NBR$ values were computed using satellite images of pre and post-forest fire in Samcheock areas. The burn forest was classified 231 $1-km^2$ girds and these grids were further reclassified into 4 groups by BS type (low BS and high BS areas) and forest areas (edge areas and interior areas). These four groups of grids including low BS-interior (group A), low BS-edge (group B), high BS-interior (group C) and high BS-edge (group D). Post-fire vegetation responses measured with (${\Delta}NDVI$) among four groups were then compared and tested by T-test. The results indicated that group C (${\Delta}NDVI$=0.047) and D (${\Delta}NDVI$ = 0.059) showed considerably greater vegetation regeneration than those of low BS areas including group A (${\Delta}NDVI$ = -0.039) and group B (${\Delta}NDVI$ = -0.036). It was also observed that edges areas showed greater vegetation regeneration than interior areas when BS is the same. Group B (${\Delta}NDVI$ = -0.036) showed greater (${\Delta}NDVI$) values than group A (${\Delta}NDVI$ = -0.039) in low BS condition. Similar relationship is observed between group C and group D in high BS condition. Thus adequate restoration practices for burned areas might need to pay close attention to interior areas with low BS to minimize the secondary damages and to rehabilitate the burned forests.

An exploratory study on practice-oriented reconceptualization of self-sufficiency : Service providers' reflections on their own experiences from the field (현장의 시각으로부터 구조화된 자활 개념 탐색 연구 : 자활사업 실무자의 이해를 중심으로)

  • Choi, Sangmi;Hong, Song-Iee
    • Korean Journal of Social Welfare Studies
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    • v.49 no.3
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    • pp.5-33
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    • 2018
  • A self-sufficiency service has worked as a typical workfare policy combined with public assistance in Korea since 2000. Despite of its long history, three core pillars in administrating the self-sufficiency service, policy, research, and practice, have respectively understood the meaning of self-sufficiency in terms of their own interests. As a result, the self-sufficiency service has recently faced with its own identity issues by showing failures to its environmental changes. The current situation makes it necessary to reconceptualize the definition of self-sufficiency by exploring its in-depth understanding perceived by service providers. Specifically, we analyzed practical reflections on 35 service providers' experiences which were collected via focus group interviews for two hours. The study findings presented that service providers had two antithetical approaches towards self-sufficiency. While a dominant approach to self-sufficiency has been concentrated on improving clients' economic outcomes such as employment, job retention, the escape from welfare trap, and increasing earnings and assets, the other approach has been extended to empower clients and achieve their well-being and quality of life. Yet, these contrary perspectives have led to suffer from their role confusions and identity crisis between the work-ready process and the employment-oriented outcomes. Specifically, they described self-sufficiency in terms of psychological, social, and integrated aspects. The psychological aspect included a process of developing inner strengths, intensifying job motivation, and coping with barriers of employment. The social aspect meant a path toward social integration through recovering human relationships. The integrated aspect covered more comprehensive support for their recovery of daily life and autonomy to make a decision for their own life. In conclusion, the study findings suggest that self-sufficiency should be more extensively considered as a stepwise process towards work-ready preparations beyond ultimate economic outcomes. Such an extended concept of self-sufficiency could contribute to restructuring the whole practice of self-sufficiency including organizational and program changes in the fields.

A Study on the Effect of Startup's Innovation Orientation on Growth Aspiration (창업기업의 혁신지향성이 성장열망에 미치는 영향에 관한 연구)

  • Oh, Hyemi;Lee, Chaewon;Kim, Jinsoo
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.16 no.5
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    • pp.1-14
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    • 2021
  • Innovation and Scale-up of Start-up companies are becoming important national tasks. In the past, it was spread the start-up policy paradigm such as 'Start-up America', 'Start-up Chile', 'Start-up Britain' to overcome the recession globally. However as the economic recovery has become more visible recently in advanced economies, it is shifting from a start-up support policy to a scale-up oriented policy paradigm such as 'Scale-up America', Scale-up UK', 'Scale-up Denmark'. It is necessary to enter the scale-up phase beyond the start-up phase to increase the number of high-quality jobs and to continue economic growth. Therefore, it is necessary to grow the start-up into a strong medium-sized company and to lay the foundation for survival. Therefore, the purpose of this study is to consider the antecedent factors that influence the scale-up aspiration for the start-up firm to grow into a scale-up company, and empirically identifies the differences between the stages of economic development and entrepreneurs in the country. In order to accomplish the purpose, this study predicted scale-up by aspiration which is a predictor of scale-up behavior because it is difficult to achieve visible growth in a short period of time due to the characteristics of start-up companies. In order to empirically explore these relationships, the data were collected from nascent entrepreneurs who have less than 3.5 years of the Adult Population Survey(APS) among the subjects surveyed by the Global Entrepreneurship Monitor(GEM) and the national economic development stage are divided into Innovation-driven, Efficiency-driven, Factor-driven type economies. For the test hypotheses, this study adopted the multi-level model analysis for comparison between national economic development stages and using the R 3.5.0 program. The results of this study are as follows. There is difference between the national economic development and the entrepreneur in the relationship between innovation orientation of entrepreneurs and scale-up aspirations. As the economy of the country develops, the innovation activity of the entrepreneur becomes more active. Since start-ups are heavily influenced by entrepreneurs, there is a difference in the degree of aspiration depending on how innovative an entrepreneur is in the same environment. In terms of the relationship between innovation orientation and scale-up aspiration, the fear of failure was found to differ between national economic development and entrepreneurs. The fear of failure differ from country to country, and this is one of the important factors affecting entrepreneurial activities. It is expected that the factors influencing the growth of the start-up companies which are identified through the results of these studies, will be used to create a suitable scale-up ecosystem according to the national economic development stage.

"Critical Application of Witness Commentaries: The Case of Guerrilla Warfare in the Korean War" ("증언자료의 비판적 활용 - 6.25전쟁 시기 유격대의 경우")

  • Cho, Sung Hun
    • The Korean Journal of Archival Studies
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    • no.12
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    • pp.137-178
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    • 2005
  • The anticommunist guerrillas' activities that aretheconcern of this article took place largely in North Korea or behind the enemy-held lines. Verifying their history is accordingly difficult and requires careful attention, but despite their active operations the military as well as the scholarly community have been lax in studying them. The Korean War came to be perceived as a traditional, limited war with regular battles, so that the studies addressed mostly the regular operations, and guerrilla warfare is remembered as an almost 'exclusive property' of the communist invaders; a small wonder that the anticommunist guerrillas have not been studied much and the collection of materials neglected. Therefore, in contrast with the witness accounts concerning regular battles, witness resources were of a small volume about these "patriots without the service numbers." For the above reasons the guerrilla participants and their later-organized fellowships took to the task of leaving records and compiling the histories of their units. They became active preservers of history in order to inform later generations of their works and also to secure deserved benefits from the government, in a world where none recognized their achievements. For instance, 4th Donkey Unit published witness accounts in addition to a unit history, and left video-recordings of guerrilla witnesses before any institute systematized the oral history of the guerrillas. In the case of Kyulsa ("Resolved to Die") Guerrilla Unit, the unit history was 10 times revised and expanded upon for publication, contributing substantially to the recovery of anticommunist guerrilla history which had almost totally lacked documented resources. Now because the guerrilla-related witness accounts were produced through fellowship societies and not individually, it often took the form of 'collective memory.' As a result, though thousands of former guerrillas remain surviving, the scarcity of numerous versions of, or perspectives upon, an event renders difficult an objective approach to the historical truth. Even requests to verify the service of a guerrilla member or to apply for decoration or government benefits for those killed in action, the process is taken care of not at the hands of the first party but the veteran society, so that a variety of opinions are not available for consideration. Moreover, some accounts were taken by American military personnel, and since some historians, unaware of official documents or evaluation of achievements, tended to center the records around their own units and especially to exaggerate the units' performances, they often featured factual errors. Thefollowing is the means to utilize positively the aforementioned type of witness accounts in military history research. It involves the active use of military historical detachments (MHD). As in the examples of those dispatched by the American forces during the Korean War, experts should be dispatched during, and not just after, wartimes. By considering and investigating the differences among various perspectives on the same historical event, even without extra documented resources it is possibleto arrive at theerrors or questionable points of the oral accounts, supplementing the additional accounts. Therefore any time lapses between witness accounts must be kept in consideration. Moreover when the oral accounts come from a group such as participants in the same guerrilla unit or operation, a standardized list of items ought to be put to use. Education in oral history is necessary not just for the training of experts. In America wherethefield sees much activity, it is used not only in college or graduate programs but also in elementary and lifetime educational processes. In comparison in our nation, and especially in historical disciplines, methodological insistence upon documented evidences prevails in the main, and in the fields of nationalist movement or modern history, oral accounts do not receive adequate attention. Like ancient documents and monuments, oral history also needs to be made a regular part of diverse resource materials at our academic institutes for history. Courses in memory and history, such as those in American colleges, are available possibilities.

A Study on the Garden Culture and Ideology based on the Confucianism and Taoism of the Song Dynasty - Focused on Zhū Xī(朱熹) and Báiyùchán(白玉蟾) - (송대(宋代) 유가와 도교에 근거한 원림 문화와 사상 고찰 - 주희(朱熹)와 백옥섬(白玉蟾)을 중심으로 -)

  • Park So-Hyun
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.41 no.1
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    • pp.10-20
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    • 2023
  • Zhū Xī, the representative of Confucianism, and Báiyùchán, the representative of Taoism in the South Song Dynasty, showed different sense of appreciation and enjoyment on the same space that was Mountain Wǔyí in their ideologically cultural ways. Based on the temples Wŭyíjīngshè(武夷精舍) where Zhū Xī stayed and Zhĭzhĭān(止止庵) where Báiyùchán resided, this study revealed their lives in such temples to look into their appreciation on ideology and space. Then, based on the words 'YiBoEumYeong [移步吟詠]' shown on the poetry they chanted in relation with Wǔyíjiǔqū from its 1st valley to its 9th valley, this study examines their understanding of scenery and system of appreciation that appeared in dynamic ways to conclude: First, even same scenery shows different understanding of scenery and appreciation of space in accordance with the viewers' thinking ways of culture. Second, as the Confucianism and Taoism influenced in ideologically cultural ways to develop each other in the Song dynasty, they absorbed their merits each other to supplement shortcomings in their own. In this process, they made it clear that their own propositions were different between them in their essential meanings although they used common terms for such propositions. Third, as the Confucian master who compiled the Neo-Confucianism of the South Song dynasty, Zhū Xī regarded Wŭyíjīngshè and Wǔyíjiǔqū as a place of learning and a place of seeking the truth to go for 'being unified with nature' so that everyday life can be united with Tao of Li [理] everywhere beyond the limited appreciation of the scenery. That is, this thought works for 'recovery of nature of our own [復其性]', the learning goal of Confucianism, and is aimed to 'cultivate the essential nature of our own(性情涵養)' through such beautiful nature. Fourth, as the master of Keumdan family of the South Song Taoism, Báiyùchán regarded Zhĭzhĭān and Wǔyíjiǔqū as a Taoist temple that has a long history rooting from Taesangwon temple, a clean place of discipline to become a Taoist hermit through hard training. He, therefore, directly referred to Zhĭzhĭān and Wǔyíjiǔqū in relation with the Taoist legends remaining in Wǔyíjiǔqū such as hermits' dinners, female hermits, leaving the human world as a hermit and so on as ways for becoming a hermit so that he went for the level of perfectly going out of human world and becoming a hermit. He, therefore, defined Mountain Wǔyí as a world and universe of hermits where he himself too hovered between outside and inside of poetry literature as a hermit through the mood and attitude of keeping himself enjoying the scenery as a hermit.

Analysis and Improvement Strategies for Korea's Cyber Security Systems Regulations and Policies

  • Park, Dong-Kyun;Cho, Sung-Je;Soung, Jea-Hyen
    • Korean Security Journal
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    • no.18
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    • pp.169-190
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    • 2009
  • Today, the rapid advance of scientific technologies has brought about fundamental changes to the types and levels of terrorism while the war against the world more than one thousand small and big terrorists and crime organizations has already begun. A method highly likely to be employed by terrorist groups that are using 21st Century state of the art technology is cyber terrorism. In many instances, things that you could only imagine in reality could be made possible in the cyber space. An easy example would be to randomly alter a letter in the blood type of a terrorism subject in the health care data system, which could inflict harm to subjects and impact the overturning of the opponent's system or regime. The CIH Virus Crisis which occurred on April 26, 1999 had significant implications in various aspects. A virus program made of just a few lines by Taiwanese college students without any specific objective ended up spreading widely throughout the Internet, causing damage to 30,000 PCs in Korea and over 2 billion won in monetary damages in repairs and data recovery. Despite of such risks of cyber terrorism, a great number of Korean sites are employing loose security measures. In fact, there are many cases where a company with millions of subscribers has very slackened security systems. A nationwide preparation for cyber terrorism is called for. In this context, this research will analyze the current status of Korea's cyber security systems and its laws from a policy perspective, and move on to propose improvement strategies. This research suggests the following solutions. First, the National Cyber Security Management Act should be passed to have its effectiveness as the national cyber security management regulation. With the Act's establishment, a more efficient and proactive response to cyber security management will be made possible within a nationwide cyber security framework, and define its relationship with other related laws. The newly passed National Cyber Security Management Act will eliminate inefficiencies that are caused by functional redundancies dispersed across individual sectors in current legislation. Second, to ensure efficient nationwide cyber security management, national cyber security standards and models should be proposed; while at the same time a national cyber security management organizational structure should be established to implement national cyber security policies at each government-agencies and social-components. The National Cyber Security Center must serve as the comprehensive collection, analysis and processing point for national cyber crisis related information, oversee each government agency, and build collaborative relations with the private sector. Also, national and comprehensive response system in which both the private and public sectors participate should be set up, for advance detection and prevention of cyber crisis risks and for a consolidated and timely response using national resources in times of crisis.

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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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