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STUDY OF THE EFFECT OF COMPREHENSIVE NURSING CARE ON THE ADJUSTMENT OF CHILDREN TO HOSPITALIZATION (유.소아를 위한 포괄적 간호가 그들의 병원생활 적응에 미치는 영향에 관한 연구)

  • 이자형
    • Journal of Korean Academy of Nursing
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    • v.3 no.3
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    • pp.97-110
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    • 1973
  • The goal of modern nursing is to provide comprehensive nursing care to patients. If comprehensive nursing care to children (within the hospital setting) is to be provided, consideration of the stage of growth and development of the child is especially important. From clinical observation, it appeared that nurses often disregarded individual requirements of children in giving nursing care. Therefore, the purpose of this study is to show that comprehensive nursing care which is based on an understanding of the growth and development of the child contributes to both the child and the mother's adaptability to the child's hospitalization. Method: Sixty children, three to three year of age, hospitalized at the Yonsei University Pediatric Ward ware studied. From April 1, 1973 to May 5, 1973, children admitted to the hospital were assigned to either an experimental or a compare groups. There were 30 children in each group. The sex and age of the children in each group was similar. In both groups were more male than female children. In the experimental group, each mother stayed with hot child continuously during his hospitalization. In the compare groups, the mother or some other member of the family stayed with the child. Each day on the child's admission the investigator visited the ward from 1-2 P.M. to 9-10 P.M., in order to provide comprehensive care for the experimental -group. The assistance given the nurses by the investigator was in the form of conferences regarding care and in giving direct care to the child and his mother. The compare group of children received nursing care as usually provided by the hospital. The instruments used to obtain the data for analysis were as follows: 1. The fear and anxiety reaction of the child was recorded by observation of the investigator for four areas: 1) separation from parent and relatives 2) reaction to Doctor and Nurse with white gowns 3) reaction to nursing care 4) reaction to injection and tests, etc. 2. Regression in area of eating, sleeping, and elimination were recorded by the investigator by questioning the mother and by observation. 3. Adaptability to the hospitalization was recorded by direct questioning of the children for areas of emotional and social adjustment. For children older than 3 years of age or children not seriously ill, using the simple I. Q. test this was possible for only 35 of the total 60 children. Result: 1. 55 percents of the total 60 children had been prepared by their parents for hospitalization. The children who had received prior preparation accepted hospitalization more readily than those who had received no preparation. (χ²=4.6 Ρ<0.05) 2. On admission 31.7 percent of the children expressed verbal fear of their discase or treatment. 25 percent felt that the disease was due to their mistake. 3. There was a significant difference in the reaction of the child to separation from the parent or relatives between the two groups. The experimental groups showed less anxiety due to separation than the compare group. (χ²=4.34 Ρ<0.05) In both groups there was less anxiety due to separation among school age (6-12 years) children than among preschool age (3-5 years) children. (χ²=9.22 Ρ<0.05) 4. More than half of the children in both groups reacted with fear and avoidance to doctor and/or nurses wearing white gowns. (χ²=0.06 Ρ<0.05) 5. The experimental group reacted more favorably to nursing in general than the compare group. (χ²=4.8 Ρ<0.05) 6. There was no difference in the fear and refused reaction to special tests and/or such as X-rays and injections, etc. between the groups. (χ²=3.77 Ρ<0.05) 7. More children in the compare group showed regressive tendencies in eating, sleeping, and elimination habits than in experimental groups. (χ²=2.3 Ρ<0.05 χ²=3.88 Ρ<0.05 χ²=4.9 Ρ<0.05) 8. There was a significant difference in the adaptability to hospitalization between the two groups. The experimental groups adapted more readily. (χ²=2.02 Ρ<0.05) 9. For children who had higher I.Q. s the adaptability to hospitalization was better regardless of the group. (χ²=5.03 Ρ<0.05) However, because of the small number of cases (60), this finding cannot be extrapolated without further verification. The date demonstrates that there was a greater adaptability to hospitalization by the child when comprehensive nursing care was given. By planning care and applying knowledge of growth and development to meet, nurses are in a position to prevent some of the psychological trauma associated with hospitalization.

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Menstrual Experience of Adolescent Girls (사춘기 여성들의 월경경험)

  • 정현숙
    • Journal of Korean Academy of Nursing
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    • v.26 no.2
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    • pp.257-270
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    • 1996
  • Studies on menstruation have focused only on menstruation itself and menstrual disorders. The menstruating girls or women have been neglected. So, the purpose of this study was to understand menstrual experience of adolescent girls in their perspective and build a theory on it, The specific purpose of this study were to find initial reaction of the girls, their strategies to adapt to menstruation. consequences of their efforts, influencing factor, and patterns of experience. The subjects of this study were eleven adolescent girls who experienced menarche three months to twenty-six months before the interview time. They were selected purposively. Their ages were in range of twelve and sixteen. One of them was a elementary school girl, three high school girls, and seven middle school girls. Two girls were handicapped because of cerebral palsy. All of them had some knowledge about menstrual physiology and hygiene during menstruation. Data were collected from September, 1994 to July, 1995. Data collection & analysis were done according to the grounded theory methodology by Strauss & Corbin(1990). Data collecting method was the long interviews and observation. Each interview took from 1 hour to 2 hours. Interview were tape-recorded and transcribed later by author. Data were analyzed immediately after interviews. Based on the results of previous interview, next interview were planned until gathered data reached the saturation point. Results were as follows. One hundred and six concepts were found. Those concepts were grouped into twenty eight categories and then fourteen higher categories. Twenty eight categories were as follows. “want to hide”, “bewildered”, “sense of burden”, “sense of heterogeneity”. “gladness”. “sense of superiority”, “negative empathy”, “positive empathy”, “limited hygenic control”, “sense of timing”, “lack of knowledge”, “lack of support”, “advance knowledge”, “informational support”, “emotional support”, “endurance”, “prayer”, “disclosing”, “avoidance”, “diversion”, “sense of powerlessness”, “discovery of sex identity”, “sense of maturation”, “sense of stability”, “acceptance of menstruation ”. fourteen higher categories were as follows. “negative feeling”, “posive feeling”, “exchange of feeling”, “limited hygenic control”, “sense of timing”, “accumulated experience”, “dysmenorrhea”, “level of knowledge”, “need for support”, “perceived support”, “sharing of feeling”, “self-control”, “passive acceptance”, “active acceptance”. The core category was “emotional shaking”, which consisted of “positive feeling” and “negative feeling”. “Emotional shaking”comes up to every adolescent girls experiencing menarche, independently of any contextual conditions, and its dimension has two directions : positive one and negative one. Its influencing factors were time of menarche, advance knowledge, support from the significant persons, expression and self-regulation. Even if they showed different process of adaptation to menstruation, general process of adaptation were as follows : 1. stage of emotional shaking 2. stage of acceptance 3. stage of internalization of the menstrual experience. Seven patterns existed on the process of adaptation to menstruation after menarche. Those are as follows. 1. If girls thought their menarche came too early and they had not much knowledge on menstruation, they had a kind of negative feeling. If they did not get enough support and dysmenorrhea superimposed, they came to accept menstruation passively. 2. If girls had menarche too early. they had negative feeling, even though they had enough advance knowledge. But support helped them accept menstruation easily. 3. If girls had menarche too early, they had negative feeling, even though they had enough advance knowledge on menstruation. But by experiencing subsequent menstruations and disclosing feeling, they began to accept menstruation. 4. If girls had menarche too lately and they had enough advance knowledge on menstruation. they had positive feeling. If dysmenorrhea superimposed later, their feeling turned in to negative one. But they came to accept menstruation positively by disclosing feeling and getting support. 5. If girls had menarche too early, they had negative feeling, even though they had enough advance knowledge on menstruation. In addition to this. if dysmenorrhes superimposed while they did not get enough support, they felt powerless and came to accept menstruation passively. 6. If girls had menarche too early and did not get enough advance knowledge, they had negative feeling. But disclosing feeling and support made them get sense of homogeneity and began to accept menstruation. 7. If girls had handicap, they had negative feeling, even though they had enough advance knowledge and menarche was late. But Menarche made them get feel sexual identity. Their limited hygenic control and negative empathy from their mothers made them accept menstruation passively. To let adolescent girls take their menstrual experience as a part of their lives forming a positive sense of feminine identity, it needs qualified teaching and, support and deep concern of the significant others. Nurses including school nurses should try to develop an educational program, which include menstrual physiology. hygiene during menstrual period, meaning of menstruation and impact of menstruation on the development of female sexual identity.

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The Fashion Professionals Required by the Ladies Apparel Manufacturers in Daegu (대구지역 숙녀복업계 기업주가 요구하는 패션전문인)

  • 김효은
    • Journal of the Korea Fashion and Costume Design Association
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    • v.4 no.1
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    • pp.111-130
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    • 2002
  • This study performed a structural questionnaire survey and non-structural interview of the ladies apparel manufacturers in Daegu on the qualification for the employees, skills required for job performance, job training, automatic manufacturing systems, and the use of computer. The results are as follows. 1. Almost all of the apparel manufacturing systems were Pair System, except one Line System in one company. In terms of outsourcing, most of the manufacturers answered “yes,” and in 1998 the outsourcing process was sewing, but in the year 2002, outsourcing has been increased :12 manufacturers(57.1%) outsourcing most of the processes except patterning, 3(14.3%) outsourcing the finish of sewing. 2. The workforce of 1998 and that of 2002 shows a significant difference(P<. 01) between office work and management. The number of office workers has decreased from 15 down to 5.3 people. On the other hand, that of the management has slightly increased from 5.3 to 9.2 people. The number of the manual workers has decreased from 32.2 to 28.7 people. And the number of tailoring and patterning workers has slightly decreased, but the number has increased in sewing from 3.7 to 7.0 people. 3. The wage of an employee shows a significant difference between a sewing assistant(P<. 01) and a production manager(P<. 05), and the wage of a sewing assistant, in particular, has slightly raised from ₩905,000 to ₩1,054,000. 4. The qualifications required of employees are “cooperative human relations”(30.8%), “diligence,” and “ability for job analysis”(26.9%), and “positive thinking” (15.4%) in 1998, and “ability for job analysis”(38.5%), “cooperative human relations”(34.6%), and “positive thinking” (15.4%) in 2002. The areas for job openings are significantly different(P<. 01) depending on the year. Job openings in the design section has increased from 1(3.8%) to 16 manufacturers (61.5%), and decreased in tailoring section from 22(84.6%) to 2 manufacturers(7.7%). Job openings in the sewing section have increased form 2(7.7%) to 6 manufacturers (23.1%). In terms of sex of the employees, there is a significant difference(P<. 001). 19 companies(73.1%) wanted “male” in 1998, but 8 companies(30.8%) answered that they want “female” and 17 companies(65.4%) answered that “it does not matter.” About the educational background, there was a significant difference between the years. The number of the companies that want junior college graduates with an associate degree has increased(15 companies(57.7%). There was a significant difference(P<. 05) in major of the employee. The number of the companies that want fashion majors has increased from 5(19.2%) to 20(76.9%). 5. In terms of job skills required, there was no significant difference. In 1998, “production skills” (46.2%) and “ability for job analysis” (26.9%) were required, and in 2002, “ability for job analysis” (42.3%) and “emotional skills” (26.9%). 6. In regard to training for job skills, “fashion professional training” has slightly decreased from 65.4% in 1998 to 46.2% in 2002, however, “training for job analysis” has slightly increased from 30.8% in 1998 to 46.2% in 2002, which indicates the fact that “fashion professional training” and “ability for job analysis” have been emphasized. 7. The number of the manufacturers purchased apparel CAD has increased from 1(3.8%) to 3(11.5%), and the number of the manufacturers that have no plan for purchase has increased from 16(61.5%) in 1998 to 15(57.7%), still taking up a big proportion. 8. About the use of computers in manufacturing, there is a significant difference(P<. 05). The number of the manufacturers using computer has increased from 5(19.2%) to 15(57.7%) and that of the manufacturers which do not use computers has decreased from 17(57.7%) to 8(30.8%). 9. In the interviews with the owners of the manufacturers, they pointed that schools should give more weight on practical training courses, the invitation of experts in the specific field, complex production systems, training courses for sewing, field trip courses, and furthering specialty education, personality and vocational education.

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A Web-based Internet Program for Nutritional Assessment and Diet Prescription by Renal Diseases (웹기반의 신장질환별 영양평가 밑 식사처방 프로그램)

  • 한지숙;김종경;전영수
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.31 no.5
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    • pp.847-885
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    • 2002
  • The purpose of this study was to develop a web-based internet program for nutritional assessment and diet Prescription by renal diseases. Renal diseases were classified by nephrotic syndrome, renal failure, hemodialysis and peritoneal dialysis. The system consisted of five parts according to their functions and contents. The first part is to assess the general health status such as body weight, obesity index, basal metabolic rate and total energy requirement by the input of age, sex, height, weight and degree of activity. The second part was designed to investigate dietary history of patient, that is, to find out his inappropriate dietary habit and give him some suggestions for appropriate dietary behavior by investigating his dietary history. This part also offers the diet and nutrition management by personal status with renal disease, and the information for food selection, snacks, convenience foods, dine-out, behavioral modification, cooking methods, food exchange lists and terms. The third part is evaluating their energy and nutrients intake by comparing with recommended dietary allowance for Koreans or standardized data for patient with renal disease. In this part, it is also analyzing energy and nutrients of food consumed by food group and meals, and evaluating the status of nutrient intake. The fort]1 one, a major part of the system, is implementing the diet and menu planning by using food exchange lists. This Part Provides the patient with menus lists and I day menu suitable to his weight, activity and the status of renal disease. The fifth part is providing information on energy and nutrients of foods and drinks, and top 20 foods classified by nutrients. These results are finally displayed as tabular forms and graphical forms on the computer screen.

THE BEST TEETH COMBINATION TO PREDICT MESIODISTAL DIAMETERS OF THE UNERUPTED CANINE AND PREMOLARS OF KOREANS (한국인에서 미맹출 견치와 소구치의 근원심 폭경 예측을 위한 최적의 치아조합)

  • Kim, So-Hwa;Kim, Seong-Oh;Choi, Hyung-Jun;Choi, Byung-Jai;Lee, Jae-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.34 no.3
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    • pp.430-437
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    • 2007
  • The probability table of Moyers and prediction equation of Tanaka and Johnston that have been the most frequently used, cannot produce accurate prediction when used in Korean because they are based on the Caucasian popularity of the Northern European race. The method of Moyers or Tanaka and Johnston predicts sizes of the unerupted canine and premolars on the basis of the sizes of mandibular incisors. However, some of the recent papers raise a question as to whether the mandibular incisors are the best combination to predict the sizes of the unerupted canine and premolars. The purpose of this study is to determine which sum or combination of sums of permanent tooth widths present the best prediction for the unerupted canine and premolars in a Korean sample, to calculate a specific linear regression equation for this population, and to evaluate the clinical significance. A new linear regression equation was calculated based on the data of 178 Korean young adults(70 women, 108 men, mean age 21.63 years) with complete permanent dentitions. Fifty three more children(28 girls, 25 boys, mean age 14.22 years) were used as a validation sample for the application of the multiple linear regression equation. The conclusions were as follows: 1. The combination of the sums of permanent upper central incisors, lower lateral incisors and upper first molars was the best predictor for the unerupted canine and premolars in this sample($r=0.65{\sim}0.80$). 2. The multiple linear regression equation was calculated including sex and arch as additional predictor variables. male, upper: $Y\;=\;0.332{\times}X_0\;+\;6.195$ male, lower: $Y\;=\;0.332{\times}X_0\;+\;5.269$ female, upper: $Y\;=\;0.332{\times}X_0\;+\;5.929$ female, lower: $Y\;=\;0.332{\times}X_0\;+\;5.003$. The determination coefficient of the equation was 64% and a standard error of the estimate was 0.71mm. 3. In about 97% of the validation sample, the estimation of the tooth width sums of unerupted canine and premolars using the new multiple linear regression equation was smaller than 1mm compaired with the actual values.

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The Determinants of Health Promoting Behavior of Industrial Workers (산업장 근로자의 건강증진행위와 자아개념 및 건강의 중요성 인식에 관한 연구)

  • Kim, Chung Nam
    • Korean Journal of Occupational Health Nursing
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    • v.7 no.1
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    • pp.5-19
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    • 1998
  • This descriptive-correlational study was conducted to identify the major factors affecting health promoting behaviors. 344 workers who employed in four different manutacturing plants in Taegu and Kyungbuk area were selected by convenience sampling method. Data were collected from April let to April 18th, 1998 by ready structured questionaires. The purpose of this study was to offer the basic data for health promotion theory development and health promotion strategy planning. This study was based on Pender's Health Promotion Model and examined three variables health promoting behavior, self-concept and perceived importance of health. The Life Style and Health Habit Assessment scale(LHHA) developed by Pender(1982).The Self-concept scale developed by Choi(1972) and the Health Value scale developed by Wallston, Maides and Wallston(1980) were used for this study. Data was analyzed by percentage, mean. t-test. ANOVA, Pearson Correlation Coefficient, and Stepwise Multiple Regression. The major findings of this study are as follows ; 1. The average level of health promoting behavior practice was 63.2% and possible range was from 62 to 248 point. The mean score of respondent's positive self-concept was 75.8. 81.4% of respondents put a high priority on the importance of health. 2. There was a significant difference between the practice level in the category of general self care and less amount of working hours per day(P=0.000), less amount of working hours per week(P=0.000). There was a significant difference between the practice level in the category of nutrition and age(0.002), marital status(0.000), working hour per day(0.008), working hours per week(0.001), There was a significant difference between the practice level in the category of nutriton and sex(0.000), age(0.000), marital status(0.025), education level(0.000), working hours per day(0.002), working hours per week(0.006). There was a significant difference between the practice level in the category of sleep and rest and age(0.003), marital status(0.002), working hours per day(0.001), working hours per week(0.001). There was a significant difference between the practice level in the category of stress management and working hours per day(0.001), working hours per week(0.002). There was a significant difference between the practice level in the category of self-actualization and working hours per day(0.050). 3. General characteristics influencing the respodent's self-concept were level(P=0.009) and worksite(P=0.001). 4. The results of the hypothesis tests are as follows The first hypothesis, that "The respondent who have more positive self-concept will have higher scores in the practice of health promoting behavior." was supported(r=0.2973, P=0.0001). The second hypothesis that "The respondent who have higher perception level on importance of health will have higher scores in the practice health promoting behavior." was rejected(r=- 0665, P=0.2225). 5. The most important factor that affects health promoting behavior practice was working hours per week(6.0%). The combination of working hours per week, age, education level accounted for 10.0% of the variance in health promoting behavior. In conclusion, the results of this study on industrial workers supported Pender's health promotion model in partial and showed the relatedness between self concept and the practice of health promoting behavior. Further research is required to find factors influencing health promoting behaviors of industrial workers.

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Clinical Characteristics and Prognostic Factors of Severe Community-Acquired Pneumonia (중증 지역사회획득 폐렴의 임상상 및 예후 예측인자에 관한 연구)

  • Oh, Heung-Kook;Seo, Ji-Young;Kim, Dong-Kyu;Choi, Jeong-Eun;Mo, Eun-Kyung;Park, Myung-Jae;Lee, Myung-Goo;Hyun, In-Gyu;Jung, Ki-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.5
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    • pp.1072-1082
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    • 1997
  • Background : To characterize the clinical features and determine the prognostic factors of severe community-acquired pneumonia. This study is the first of its kind in Korea. Methods : Recruited were 40 patients diagnosed as severe community-acquired pneumonia in Hallym University Hospital from January 1, 1989 through July 31, 1996. Patients were analysed retrospectively for age, sex, underlying disease, respiration rate, hypoxemia, requirement of mechanical ventilation, involvement on chest radiograph, shock, and the serum concentration of BUN and albumin. All parameters were compared between survived and dead group. Results : Male to female ratio was 2.07 : 1. The mean age was $63.1{\pm}17.5$years(range 25~90years) with 65% of patients aged equal to or more than 60. The major underlying diseases were old pulmonary tuberculosis(12.5%), chronic obstructive pulmonary disease(7.5%), bronchial asthma(5%), bronchiectasis(2.5%), and diabetes mellitus(22.5%). Microbiologic diagnosis was made in 26 out of 40 patients(65%). The most common causative organism was S. pneumoniae(17.5%, 7/40) followed by S. aureus(15.0%, 6/40), K. Pneumoniae(12.5%, 5/40), M. tuberculosis(7.5%, 3/40), H. influenzae(2.5%, 1/40), coagulase negative staphylococcus(2.5%, 1/40), P. aeruginosa(2.5%. 1/40), E. cloaceae(2.5%, 1/40), and E. coli(2.5%, 1/40). M. pneumoniae was detected in no patient. The most frequent drugs administered in single or combination therapy were aminoglycosides(75%, 30/40), second- and third-generation cephalosporin(40%, 16/40 and 27.5%, 11/40), macrolides(27.5%, 11/40), and amoxicillin/clavulanic acid(22.5%, 9/40). Of the 40 patients, 14 died of severe community-acquired pneumonia(37.5%). Among them, seven patients (50%) expired within 72h of hospital arrival. According to multivariate analysis, mortality was significantly associated with requirement of mechanical ventilation, bilateral pulmonary involvement, and serum albumins$\leq$3.0g/dl. Conclusion : An understanding of the clinical characteristics and prognostic factors in severe community-acquired pneumonia identified in this study will optimize therapeutic approach in this disease and help decreasing its notorious mortality rate.

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Congenital Bronchoesophageal Fistula of Adult in Korea (한국내 성인에서의 선천성 기관지 식도루)

  • Yum, Ho-Kee;Choi, Soo-Jeon;Kim, Dong-Soon
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.4
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    • pp.907-913
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    • 1997
  • Background : Congenital bronchoesophageal fistula(BEF) presented in adult life is a rare disorder and has characteristic clinical findings such as paroxysmal cough after water ingestion and recurrent respiratory infections. It usually manifested recurrent pneumonia and chronic cough with purulent phlegmon which was mis-or under-diagnosed as chronic bronchitis, bronchiectasis or lung abscess so forth. Methods : We reviewed retrospectively 13 cases of congenital BEF in adult of Paik Hospital, College of Medicine, Inje University including 22 cases of congenital BEF previously reported in literature of Korea from 1979 through 1995. Results : The mean age at diagnosis was $40.2{\pm}14.3$. There was no difference in sex ratio(Male : Female 18 : 17). The most common symptom was cough(91.4%), followed by chronic sputum(74.3), hemoptysis(25.7), and paroxysmal nocturnal cough at specific position(20%). Twenty one of 31 patients who were able to review have the most specific sign, Ono's sign presented as paroxysmal cough after liquid ingestion. By classification of Braimbridge-Keith, Fourteen(45.1%) of 31 patients were group I (associated with esophageal diverticulum), 15(48.4%) were group II (simple fistula), and group Ill and IV was one case in each. The opening of fistula confined to right lower lobe in 26(76.5%), left lower lobe in 6(17.6%), and left main bronchus in 2(5.9%) cases. Conclusion : Congenital bronchoesophageal fistula is uncommon disorder which has characteristic histories and specific symptoms such as chronic and recurrent lower respiratory infections, and paroxysmal cough after liquid ingestion. Medical attention and careful history should be done in patients who have localized recurrent lower respiratory infections in right lower lobe.

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Survival Difference of Combination Chemotherapy versus Supportive Care in the Patients with Stage Ⅳ Non-Small Cell Lung Cancer (4기 비소세포폐암 환자에서 복합화학요법군과 보존적치료군의 생존율 비교연구)

  • Kim, Byeong Hun;Lee, Kyung Hee;Doh, Gab Suk;Lee, Eun Jung;Kim, Seong Mok;Chung, Jin Hong;Lee, Kwan Ho;Hyun, Myung Soo
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.4
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    • pp.536-546
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    • 1996
  • Background : The survival benefit of combination chemotherapy comparing supportive care to patients with advanced non-small cell lung cancel, especially stage IV non-small cell lung cancer patients with metastatic disease, is controversial. The main goal of this study was to evaluate the difference in survival between patients treated with chemotherapy and those who were not and to identify prognostic factors in the patients with stage IV non-small cell lung cancer. Methods : From January 1989 to December 1994, total 67 patients including 20 patients treated with combination chemotherapy and 47 patients treated with only supportive care in stage IV non-small cell lung cancer patients with metastatic disease were enrolled in this study. Combination chemotherapy consisted of etoposide $120mg/m^2$ iv for 3 days and cis-platin iv day 1 every 4 weeks. The treatment groups were retrospectively analyzed by age, sex, histologic cell type, weight loss, serum LDH level, ECOG performance status and major organ metastasis. Results : The significant prognostic factors influencing survival on this study were ECOG performance status and histologic subtype. Overall response rate by combination chemotherapy was 30%(complete response 0%, partial response 30%). Median survival of overall patients was 13.6 weeks and median survival of Chemotherapy group, 20 weeks, was significantly longer than that of supportive care group, 11.7 week(p<0.01). Median survival of responded in patients receiving chemotherapy, 45.5 weeks, was significantly longer than that of non-responder, 17.3 weeks(p<0.05). 1 year-survival rate of chemotherapy group and supportive care group was 15N and 8%, respectively. Nausea or vomiting, alopecia and anemia were seen in nearly most cases after this combination chemotherapy. Toxicities above grade 3 included neutropenia, anemia, thrombocytopenia, infection, fever, nausea, vomiting and alopecia. But this combination chemotherapy was relatively well tolerated except one treatment-related death from sepsis associated with severe granulocytopenia. Conclusion : These results suggest that systemic chemotherapy might be helpful to the stage IV non-small cell lung cancer patients with good performance status and large scale randomized prospective trials should be performed.

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Development and Application of Issue-Centered Teaching.Learning Process Plan for Environment-Friendly Housing Education (환경친화적 주생활 교육을 위한 쟁점중심 교수.학습 과정안 개발 및 적용)

  • Park, Hee-Jeong;Cho, Jae-Soon
    • Journal of Korean Home Economics Education Association
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    • v.21 no.3
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    • pp.45-64
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    • 2009
  • The purpose of this study was to develope issue-centered teaching learning process plan for environment-friendly housing education and to apply it to the housing section of Technology Home Economics in a middle school. PRO-CON cooperative group model was used for the teaching learning process plans of 2-session lessons according to the ADDIE model. In the development stage, 7 activity materials and 20 teaching learning materials (4 reading texts, 12 pictures and photos, & 5 moving pictures) were developed for 2-session lessons. The plans applied to the 7 classes, 222 students, in the third grade of the G middle school in Gyeonggi-do during July 10th-17th, 2008. The results showed that the final pro-con was influenced by the rationals of juries' pro-con of each team and the representative's discussion besides one's environmental perspective. The intention to implement environment-friendly housing activities was significantly increased between before and after the lessons. The contents, methods, goals, and process of the 2-session lessons were evaluated over medium to somewhat higher levels. Those evaluations except methods and general satisfaction with the lessons were differed by sex, students' and their families' interests in environments but not by the type of housing. These results might support that pro-con cooperative group model of controversial issues on parking lot would be appropriate to environment-friendly housing lessons and could apply to broad issues on housing and various schools in other areas.

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