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Levels of Barriers to Pain Management of Cancer Patients and their Nurses (암 환자와 간호사의 통증관리 장애정도)

  • Yoo, Yang-Sook;Lee, Won-Hee;Cho, Ok-Hee;Lee, So-Woo
    • Journal of Hospice and Palliative Care
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    • v.8 no.2
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    • pp.224-233
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    • 2005
  • Purpose: This study was conducted to provide basic data for developing an effective strategy for cancer pain management by comparing the levels of barriers to pain management of metastatic or advanced cancer patient and their nurses. Methods: The subject of this study were 155 patients who were treated for metastatic or advanced cancer at one of three hospitals in Seoul from January 2004 to January 2005, and 153 nurses who take care of those patients. The levels of barriers to pain management were measured using a tool developed by Gunnarsdottir et al. (2002), 27 questions on a six point scale. The levels of stresses were measured using a tool modified from a stress response measurement reported by Goh Gyung-bong et al. (2000), 27 questions on a five point scale. The levels of barriers in cancer patients were analyzed using t-test and ANOVA, while the data obtained from patients and nurses were compared by t-test. Results: Higher levels of barriers to pain management were found in three groups: 'less than middle school,' 'not treated with anti-cancer chemotherapy,' and 'ECOG of 2.' The level (2.55) of barriers to pain management in the patient group was higher than that (1.76) of the nurse group. Both of the two groups had high levels of barriers in two variables: 'There is a danger of becoming addicted to pain medicine.' and 'Using pain medicine blocks your ability to know if you have any new pain.' There was not a significant difference in the levels of stresses between the two groups. Conclusion: It was found that, for effective cancer pain management practices, it would be necessary to provide cancer patients and their nurses with education and training about pain management and related barriers.

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Application of the Homogenization Analysis to Calculation of a Permeability Coefficient (투수계수 산정을 위한 균질화 해석법의 적응)

  • 채병곤
    • Journal of Soil and Groundwater Environment
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    • v.9 no.1
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    • pp.79-86
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    • 2004
  • Hydraulic conductivity along rock fracture is mainly dependent on fracture geometries such as orientation, aperture, roughness and connectivity. Therefore, it needs to consider fracture geometries sufficiently on a fracture model for a numerical analysis to calculate permeability coefficient in a fracture. This study performed new type of numerical analysis using a homogenization analysis method to calculate permeability coefficient accurately along single fractures with several fracture models that were considered fracture geometries as much as possible. First of all, fracture roughness and aperture variation due to normal stress applied on a fracture were directly measured under a confocal laser scaning microscope (CLSM). The acquired geometric data were used as input data to construct fracture models for the homogenization analysis (HA). Using the constructed fracture models, the homogenization analysis method can compute permeability coefficient with consideration of material properties both in microscale and in macroscale. The HA is a new type of perturbation theory developed to characterize the behavior of a micro inhomogeneous material with a periodic microstructure. It calculates micro scale permeability coefficient at homogeneous microscale, and then, computes a homogenized permeability coefficient (C-permeability coefficient) at macro scale. Therefore, it is possible to analyze accurate characteristics of permeability reflected with local effect of facture geometry. Several computations of the HA were conducted to prove validity of the HA results compared with the empirical equations of permeability in the previous studies using the constructed 2-D fracture models. The model can be classified into a parallel plate model that has fracture roughness and identical aperture along a fracture. According to the computation results, the conventional C-permeability coefficients have values in the range of the same order or difference of one order from the permeability coefficients calculated by an empirical equation. It means that the HA result is valid to calculate permeability coefficient along a fracture. However, it should be noted that C-permeability coefficient is more accurate result than the preexisting equations of permeability calculation, because the HA considers permeability characteristics of locally inhomogeneous fracture geometries and material properties both in microscale and macroscale.

A Study on the Behaviour of Prebored and Precast Steel Pipe Piles from Full-Scale Field Tests and Class-A and C1 Type Numerical Analyses (현장시험과 Class-A 및 C1 type 수치해석을 통한 강관매입말뚝의 거동에 대한 연구)

  • Kim, Sung-Hee;Jung, Gyoung-Ja;Jeong, Sang-Seom;Jeon, Young-Jin;Kim, Jeong-Sub;Lee, Cheol-Ju
    • Journal of the Korean GEO-environmental Society
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    • v.18 no.7
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    • pp.37-47
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    • 2017
  • In this study, a series of full-scale field tests on prebored and precast steel pipe piles and the corresponding numerical analysis have been conducted in order to study the characteristics of pile load-settlement relations and shear stress transfer at the pile-soil interface. Dynamic pile load tests (EOID and restrike) have been performed on the piles and the estimated design pile loads from EOID and restrike tests were analysed. Class-A type numerical analyses conducted prior to the pile loading tests were 56~105%, 65~121% and 38~142% respectively of those obtained from static load tests. In addition, design loads estimated from the restrike tests indicate increases of 12~60% compared to those estimated in the EOID tests. The EOID tests show large end bearing capacity while the restrike tests demonstrate increased skin friction. When impact energy is insufficient during the restrike tests, the end bearing capacity may be underestimated. It has been found that total pile capacity would be reasonably estimated if skin friction from the restrike tests and end bearing capacity from the EOID are combined. The load-settlement relation measured from the static pile load tests and estimated from the numerical modelling is in general agreement until yielding occurs, after which results from the numerical analyses substantially deviated away from those obtained from the static load tests. The measured pile behaviour from the static load tests shows somewhat similar behaviour of perfectly-elastic plastic materials after yielding with a small increase in the pile load, while the numerical analyses demonstrates a gradual increase in the pile load associated with strain hardening approaching ultimate pile load. It has been discussed that the load-settlement relation mainly depends upon the stiffness of the ground, whilst the shear transfer mechanism depends on shear strength parameters.

Mock-up Test of Temperature Crack Reduction Method Application by Setting Time Control of Mat Foundation Mass Concrete (응결시간조정에 의한 매트기초 매스 콘크리트의 온도균열저감 공법적용의 Mock-up Test)

  • Han, Cheon-Goo;Lee, Jae-Sam;Noh, Sang-Kyun
    • Journal of the Korea Institute of Building Construction
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    • v.9 no.4
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    • pp.55-61
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    • 2009
  • Recently, the number of high-rise buildings being built in Korea by major construction companies for residential and commercial use has been increasing. When constructing a high-rise building, it is necessary to apply massive amounts of concrete to form a mat foundation that can withstand the huge load of the upper structure. However, it is of increasing concern that due to limitations in terms of the amount of placing equipment, available job-sites and systems for mass concrete placement in the construction field, it is not always possible to place a great quantity of concrete simultaneously in a large-scale mat foundation, and for this reason consistency between placement lift cannot be secured. In addition, a mat foundation Is likely to crack due to the stress caused by differences inhydration heat generation time. To derive a solution for these problems, this study provides test results of a hydration heat crack reduction method by applying placement lift change and setting time control with a super retarding agent for mass concrete in a large-scale mat foundation. Mock-up specimens with different mixtures and placement liftswere prepared at the job-site of a newly-constructed high-rise building. The test results show that slump flow of concrete before and after adding the super retarding agent somewhat Increases as the target retarding time gets longer, while the air content shows no great difference. The setting time was observed to be retarded as the target retarding time gets longer. As the target retarding time gets longer, compressive strength appears to be decreased at an early stage, but as time goes by, compressive strength gets higher, and the compressive strength at 28 days becomes equal or higher to that of plain concrete without a super retarding agent. For the effect of placement lift change and super retarding agent on the reduction of hydration heat, the application of 2 and 4 placement lifts and a super retarding agent makes it possible to secure consistency and reduce temperature difference between placement lifts, while also extending the time to reach peak temperature. This implies that the possibility of thermal crack induced by hydration heat is reduced. The best results are shown in the case of applying 4 placement lifts.

Difference of Anxiety of Parents: before & after the VCUG (배뇨요도방광조영술 검사 전후 부모의 불안감에 대한 비교)

  • Lee, Na-Ra;Oh, Jung-Min;Yim, Hyung-Eun;Yang, Jae-Won;Yoo, Kee-Hwan;Hong, Young-Sook;Lee, Joo-Won
    • Childhood Kidney Diseases
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    • v.14 no.1
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    • pp.62-70
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    • 2010
  • Purpose : The voiding cystourethrogram (VCUG) is the investigation of choice in detecting the vesicoureteral reflux in urinary tract infections in children. As it is a potentially distressing and invasive test, most of the parents are so concerned about the child's stress. In this study, we compared the difference of the state of anxiety of parents before and after the VCUG. Methods : We divided 68 parents whose children underwent VCUG into 2 groups; who have given an explanation about VCUG in detail using pictures (group 1) Vs. who have given an oral explanation only (group 2). All the parents submitted the same questionnaire 2 times before and after the VCUG, which consisted of State-Trait-Anxiety-Inventory X-I (STAI-X-I) and visual analog scale (VAS) on the perception of worry, anxiety, confusion and pain. Results : Before VCUG, the perception of pain was higher in group 1 (P<0.05). After VCUG, the anxiety and confusion were significantly higher in group 2 than group 1 (P<0.05). In group 1, STAI-X-I scores, the perception of worry and anxiety were significantly decreased after the VCUG (P<0.05). In group 2, the confusion and pain were increased after VCUG (P<0.05). Conclusion : It showed that doctor's explanation on the procedure in advance may raise the perception of pain and the possibility of refusal by parents. But the STAI-X-I, worry, anxiety after VCUG were significantly decreased in group 1, while the confusion and pain were increased in group 2. Therefore we suggest that prior and sufficient explanation about invasive procedure like VCUG can be helpful in ameliorating the anxiety of the parents.

The Effect of Structured Information on the Sleep Amount of Patients Undergoing Open Heart Surgery (계획된 간호 정보가 수면량에 미치는 영향에 관한 연구 -개심술 환자를 중심으로-)

  • 이소우
    • Journal of Korean Academy of Nursing
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    • v.12 no.2
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    • pp.1-26
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    • 1982
  • The main purpose of this study was to test the effect of the structured information on the sleep amount of the patients undergoing open heart surgery. This study has specifically addressed to the Following two basic research questions: (1) Would the structed in formation influence in the reduction of sleep disturbance related to anxiety and Physical stress before and after the operation? and (2) that would be the effects of the structured information on the level of preoperative state anxiety, the hormonal change, and the degree of behavioral change in the patients undergoing an open heart surgery? A Quasi-experimental research was designed to answer these questions with one experimental group and one control group. Subjects in both groups were matched as closely as possible to avoid the effect of the differences inherent to the group characteristics, Baseline data were also. collected on both groups for 7 days prior to the experiment and found that subjects in both groups had comparable sleep patterns, trait anxiety, hormonal levels and behavioral level. A structured information as an experimental input was given to the subjects in the experimental group only. Data were collected and compared between the experimental group and the control group on the sleep amount of the consecutive pre and post operative days, on preoperative state anxiety level, and on hormonal and behavioral changes. To test the effectiveness of the structured information, two main hypotheses and three sub-hypotheses were formulated as follows; Main hypothesis 1: Experimental group which received structured information will have more sleep amount than control group without structured information in the night before the open heart surgery. Main hypothesis 2: Experimental group with structured information will have more sleep, amount than control group without structured information during the week following the open heart surgery Sub-hypothesis 1: Experimental group with structured information will be lower in the level of State anxiety than control group without structured information in the night before the open heart surgery. Sub-hypothesis 2 : Experimental group with structured information will have lower hormonal level than control group without stuctured information on the 5th day after the open heart surgery Sub-hypothesis 3: Experimental group with structured information will be lower in the behavioral change level than control group without structured information during the week after the open heart surgery. The research was conducted in a national university hospital in Seoul, Korea. The 53 Subjects who participated in the study were systematically divided into experimental group and control group which was decided by random sampling method. Among 53 subjects, 26 were placed in the experimental group and 27 in the control group. Instruments; (1) Structed information: Structured information as an independent variable was constructed by the researcher on the basis of Roy's adaptation model consisting of physiologic needs, self-concept, role function and interdependence needs as related to the sleep and of operational procedures. (2) Sleep amount measure: Sleep amount as main dependent variable was measured by trained nurses through observation on the basis of the established criteria, such as closed or open eyes, regular or irregular respiration, body movement, posture, responses to the light and question, facial expressions and self report after sleep. (3) State anxiety measure: State Anxiety as a sub-dependent variable was measured by Spi-elberger's STAI Anxiety scale, (4) Hormornal change measure: Hormone as a sub-dependent variable was measured by the cortisol level in plasma. (5) Behavior change measure: Behavior as a sub-dependent variable was measured by the Behavior and Mood Rating Scale by Wyatt. The data were collected over a period of four months, from June to October 1981, after the pretest period of two months. For the analysis of the data and test for the hypotheses, the t-test with mean differences and analysis of covariance was used. The result of the test for instruments show as follows: (1) STAI measurement for trait and state anxiety as analyzed by Cronbachs alpha coefficient analysis for item analysis and reliability showed the reliability level at r= .90 r= .91 respectively. (2) Behavior and Mood Rating Scale measurement was analyzed by means of Principal Component Analysis technique. Seven factors retained were anger, anxiety, hyperactivity, depression, bizarre behavior, suspicious behavior and emotional withdrawal. Cumulative percentage of each factor was 71.3%. The result of the test for hypotheses show as follows; (1) Main hypothesis, was not supported. The experimental group has 282 minutes of sleep as compared to the 255 minutes of sleep by the control group. Thus the sleep amount was higher in experimental group than in control group, however, the difference was not statistically significant at .05 level. (2) Main hypothesis 2 was not supported. The mean sleep amount of the experimental group and control group were 297 minutes and 278 minutes respectively Therefore, the experimental group had more sleep amount as compared to the control group, however, the difference was not statistically significant at .05 level. Thus, the main hypothesis 2 was not supported. (3) Sub-hypothesis 1 was not supported. The mean state anxiety of the experimental group and control group were 42.3, 43.9 in scores. Thus, the experimental group had slightly lower state anxiety level than control group, howe-ver, the difference was not statistically significant at .05 level. (4) Sub-hypothesis 2 was not supported. . The mean hormonal level of the experimental group and control group were 338 ㎍ and 440 ㎍ respectively. Thus, the experimental group showed decreased hormonal level than the control group, however, the difference was not statistically significant at .05 level. (5) Sub-hypothesis 3 was supported. The mean behavioral level of the experimental group and control group were 29.60 and 32.00 respectively in score. Thus, the experimental group showed lower behavioral change level than the control group. The difference was statistically significant at .05 level. In summary, the structured information did not influence the sleep amount, state anxiety or hormonal level of the subjects undergoing an open heart surgery at a statistically significant level, however, it showed a definite trends in their relationships, not least to mention its significant effect shown on behavioral change level. It can further be speculated that a great degree of individual differences in the variables such as sleep amount, state anxiety and fluctuation in hormonal level may partly be responsible for the statistical insensitivity to the experimentation.

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Analysis of Quantitative Indices in Tl-201 Myocardial Perfusion SPECT: Comparison of 4DM, QPS, and ECT Program (Tl-201 심근 관류 SPECT에서 4DM, QPS, ECT 프로그램의 정량적 지표 비교 분석)

  • Lee, Dong-Hun;Shim, Dong-Oh;Yoo, Hee-Jae
    • The Korean Journal of Nuclear Medicine Technology
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    • v.13 no.3
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    • pp.67-75
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    • 2009
  • Purpose: As to the analytical method of data, the various programs in which it is used for the quantitative rating of the Tl-201 myocardial perfusion SPECT are reported that there is a difference. Therefore, the measured value error of the mutual program is expected to be generated even if the quantitative analysis is made against data of the same patient. Using quantitative index that able to represent myocardial perfusion defect level, we aimed to determine correlation among three myocardial perfusion analysis programs 4DM (4DMSPECT), QPS (Quantitative Perfusion SPECT), ECT (Emory Cardiac Toolbox) that be used generally in most departments of Nuclear Medicine. Materials and Methods: We analyzed the 145 patients who were examined by Tl-201 gated myocardial perfusion SPECT in department of nuclear medicine at Asan Mediacal Center from December 1th 2008 to February 14th 2008. We sorted as normal group and abnormal group. Normal group consist of 80 patients (Male/Female=38/42, age:$65.1{\pm}9.9$) who have low possibility of cardiovascular disease. And abnormal group consist of 65 patients (Male/Female=45/20, age:$63.0{\pm}8.7$) who were diagnosed cardiovascular disease with reversible perfusion defect or fixed perfusion defect through myocardial perfusion SPECT results. Using the 4DM, QPS, and ECT programs, the total defect extent (TDE) such as LAD, LCX, RCA and the summed stress score (SSS) have been analysed for their correlations and statistical comparison with the paried t-test for the quantitative indices analysed from each group. Results: The correlation of 4DM:QPS, QPS:ECT, ECT:4DM each group result from 145 patients is 0.84, 0.86, 0.82 at SSS, 0.87, 0.84, 0.87 at TDE, and both index showed good correlation. In paired t-test and Bland-Altman analysis results showed no statistically significant difference in the comparison of QPS:ECT at the mean SSS and TDE, 4DM:QPS, ECT:4DM comparative analysis results showed statistically significant difference at SSS and TDE index. The correlation of 4DM:QPS, QPS:ECT, ECT:4DM program results from abnormal group (65 patients) is 0.72, 0.72, 0.70 at SSS and 0.77, 0.70, 0.77 at TDE and TDE and SSS has a good correlation. In abnormal group, paired t-test and Bland-Altman analysis results showed no statistically significant difference at QPS:ECT SSS (p=0.89) and TDE (p=0.23) comparison, 4DM:QPS, ECT:4DM comparative analysis results showed statistically significant difference at SSS and TDE index (p<0.01). In normal group (80 patients), paired t-test and Bland-Altman analysis results showed no statistically significant difference at QPS:ECT SSS (p=0.95) and TDE (p=0.73) comparison. And 4DM:QPS, ECT:4DM comparative analysis results showed statistically significant difference at SSS and TDE index (p<0.01). Conclusions: The perfusion defect of the Tl-201 myocardial perfusion SPECT was analyzed in not only the patient in whom it has the cardiovascular disease but also the patient in whom the possibility of the cardiovascular disease is few. In the comparison of the all group research, the mean of the TDE and SSS, 4DM was lower than QPS and ECT progrms. Each program showed good correlation and the results showed statistically significant difference. However, in this way, it is determined to be compatible about the analysis value in which the large-scale side between the programs uses each program a difference in a clinical in the Bland-Altman analyzed result in spite of the good correlation and cannot use. but, this analyzed result will be able to be usefully used as the reference material for the clinical read and is expected.

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A Study on the Function of Oral Medicine as the Secondary Clinic Based on Analysis on Admissive Channel and Case Features (내원경위 분석과 환자 특성 평가에 따른 2차 진료기관으로서 구강내과 역할에 대한 연구)

  • Lee, You-Mee;Lee, Jung-Hyun;Lim, Hyun-Dae
    • Journal of Oral Medicine and Pain
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    • v.31 no.3
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    • pp.199-210
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    • 2006
  • The epidemiological researches on the inpatients hospitalized at the oral medicine ward have been continuously carried out since 1970, and most researches have been performed by centering around the oral medicine wards of college hospitals. Numerous specialists have been produced after the establishment of oral medicine, and they have been active in various fields. As dental clinics have gotten bigger, the function of oral medicine in the secondary clinics is being brought out. As admissive channel, case features, case composition and otherwise have not been researched for a long time, the related researches should be carried out from now on. Hereupon, this study was carried out by targeting the 100 inpatients hospitalized at the oral medicine ward of Sun Hospital located in Daejeon Korea, through questionnaire. As the result, the following results were derived. 1. The ages of the inpatients in Sun Hospital were $29.21{\pm}11.31$ on the average; 71 females' mean average was $29.63{\pm}11.29$ and 29 males' mean average was $28.17{\pm}11.48$. In regard of school career, the patients who finished high-school course or higher accounted for 78%; the patients' school career seemed to be relatively high. The patients who complained of temporomandibular pain accounted for the highest proportion with 65%. In motivation to visit this hospital, internet surfing was 11%, mass media was 10%, acquaintance's introduction was 38%. The patients, who were hospitalized at another hospital due to the same symptom, accounted for 56%. The dental clinics, which made the patients visit this hospital, accounted for 20%. The patients, who were previously aware that the present symptom should be treated by oral medicine, accounted for 38%. The patients, who were not aware of the fact in advance, were 62%. The respondents of 51% answered that they were aware of the fact one month or below before hospitalization. 2. The patients, who complained of craniocervical ache, accounted for 58%; the patients, whose ache aches affect dailylife, were 22%. Continuous ache was 14% and intermittent ache was 68%, and dull pain was 23%. 3. Life variations were compared with each other by using SRRS (Social Readjustment Rating Scale). In consequence, the variation within 3 years indicated a significant difference in the both groups but the variation within 6 months did not indicate any differences. 4. In regard of the questionnaire on the incidents happened for a week, the ache-group was compared with the group free from the ache. As the result, the number of strain arisen for a week, the decrease of favorite works and sudden fear indicated a significant difference. Pleasant feeling and the decrease of interests in looks did not indicate a significant difference, but came close to the significance. 5. In the questionnaire on impatience, the ache-group indicated higher value but there was not a significant difference. 6. In the questionnaire on the symptoms caused by stress, the two groups indicated significant differences in the item of 'the teethridge itches and feels a tooth rising' and 'the occiput or the nape is stiff.' In the item 'the inside of the cheek or the teethridge are widely peeled off, accompanied with ache and hemorrhage', 'the face has acne or pimple' and 'headache frequently attacks', a significant difference was not observed but the two groups came close to the significance.

A study on the factors to affect the career success among workers with disabilities (지체장애근로자의 직업성공 요인에 관한 연구)

  • Lee, Dal-Yob
    • 한국사회복지학회:학술대회논문집
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    • 2003.10a
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    • pp.185-216
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    • 2003
  • This study was aimed at investigating important factors influencing career success among regular workers. The current researcher scrutinized the degree to which variables and factors affect the career success and occupational turnover rates of the research participants. At the same tune, two hypothetical path models established by the researcher were examined using linear multiple regression methods and the LISREL. After examining the differences among the factors of career success, a comparison was made between the disabled worker group and the non-disabled worker group. A questionnaire using the 5-point Likert scale was distributed to a group of 374 workers with disabilities and 463 workers without disabilities. For the data analysis purpose, the structural equation model, factor analysis, correlation analysis, and multiple regression analysis were carried out. The results of this study ran be summarized as follows. First, the results of factor analysis showed important categories of conceptual themes of career success. The initial conceptual factor model did not accord with the empirical one. A three-factorial model revealed categories of personal, family, and organizational factor respectively. The personal factor was composed of the self-esteem and self-efficiency. The family factor was consisted of the multi-roles stress and the number of children. Finally, the organizational factor was composed of the capacity for utilizing resources, networking, and the frequency of mentoring. In addition, the total 10 sub areas of career success were divided by two important aspects; the subjective career success and the objective career success. Second, both research participant groups seemed to be influenced by their occupational types. However, all predictive variables excluding the wage rate and the average length of work years had significant impact on job success for the disabled work group, while all the variables excluding the frequency of advice and length of working years had significant impact on job success for the non-disabled worker group. Third, the turnover rate was significantly influenced by the age and the experience of turnover of the research participants. However, the number of co-workers was the strongest predictive variable for the worker group with disabilities, but the occupation choice variable for the worker group without disabilities. For the disabled worker group, the turnover rate was differently influenced by the type of occupation, the length of working years, while multi-role stress and the average working years at the time of turnover for the worker group without disabilities. Fifth, as a result of verifying the hypothetical path model, it showed that the first model was somewhat proper and could predict the career success on both research participant groups. In the second model, the Chi-square, the degree of freedom (($x^2=64.950$, df=61, P=0.341), and the adjusted Goodness of Fit Index (AGFI) were .964, and the Comparative Fit Index (CFI) were .997, and the Root Mean Squared Residual (RMR) was respectively. .038. The model was best fitted and could predict the career success more highly because the goodness of fit index in the whole models was within the allowed range. In conclusion, the following research implications can be suggested. First, the occupational type of research participants was one of the most important variables to predict the career success for both research participant groups. It means that people with disabilities require human development services including education. They need to improve themselves in this knowledge-based society. Furthermore, for maintaining the career success, people with disabilities should be approached by considering the subjective career success aspects including wages and the promotion opportunities than the objective career success aspects.

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An Empirical Study in Relationship between Franchisor's Leadership Behavior Style and Commitment by Focusing Moderating Effect of Franchisee's Self-efficacy (가맹본부의 리더십 행동유형과 가맹사업자의 관계결속에 관한 실증적 연구 - 가맹사업자의 자기효능감의 조절효과를 중심으로 -)

  • Yang, Hoe-Chang;Lee, Young-Chul
    • Journal of Distribution Research
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    • v.15 no.1
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    • pp.49-71
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    • 2010
  • Franchise businesses in South Korea have contributed to economic growth and job creation, and its growth potential remains very high. However, despite such virtues, domestic franchise businesses face many problems such as the instability of franchisor's business structure and weak financial conditions. To solve these problems, the government enacted legislation and strengthened franchise related laws. However, the strengthening of laws regulating franchisors had many side effects that interrupted the development of the franchise business. For example, legal regulations regarding franchisors have had the effect of suppressing the franchisor's leadership activities (e.g. activities such as the ability to advocate the franchisor's policies and strategies to the franchisees, in order to facilitate change and innovation). One of the main goals of the franchise business is to build cooperation between the franchisor and the franchisee for their combined success. However, franchisees can refuse to follow the franchisor's strategies because of the current state of franchise-related law and government policy. The purpose of this study to explore the effects of franchisor's leadership style on franchisee's commitment in a franchise system. We classified leadership styles according to the path-goal theory (House & Mitchell, 1974), and it was hypothesized and tested that the four leadership styles proposed by the path-goal theory (i.e. directive, supportive, participative and achievement-oriented leadership) have different effects on franchisee's commitment. Another purpose of this study to explore the how the level of franchisee's self-efficacy influences both the franchisor's leadership style and franchisee's commitment in a franchise system. Results of the present study are expected to provide important theoretical and practical implications as to the role of franchisor's leadership style, as restricted by government regulations and the franchisee's self-efficacy, which could be needed to improve the quality of the long-term relationship between the franchisor and franchisee. Quoted by Northouse(2007), one problem regarding the investigation of leadership is that there are almost as many different definitions of leadership as there are people who have tried to define it. But despite the multitude of ways in which leadership has been conceptualized, the following components can be identified as central to the phenomenon: (a) leadership is a process, (b) leadership involves influence, (c) leadership occurs in a group context, and (d) leadership involves goal attainment. Based on these components, in this study leadership is defined as a process whereby franchisor's influences a group of franchisee' to achieve a common goal. Focusing on this definition, the path-goal theory is about how leaders motivate subordinates to accomplish designated goals. Drawing heavily from research on what motivates employees, path-goal theory first appeared in the leadership literature in the early 1970s in the works of Evans (1970), House (1971), House and Dessler (1974), and House and Mitchell (1974). The stated goal of this leadership theory is to enhance employee performance and employee satisfaction by focusing on employee motivation. In brief, path-goal theory is designed to explain how leaders can help subordinates along the path to their goals by selecting specific behaviors that are best suited to subordinates' needs and to the situation in which subordinates are working (Northouse, 2007). House & Mitchell(1974) predicted that although many different leadership behaviors could have been selected to be a part of path-goal theory, this approach has so far examined directive, supportive, participative, and achievement-oriented leadership behaviors. And they suggested that leaders may exhibit any or all of these four styles with various subordinates and in different situations. However, due to restrictive government regulations, franchisors are not in a position to change their leadership style to suit their circumstances. In addition, quoted by Northouse(2007), ssubordinate characteristics determine how a leader's behavior is interpreted by subordinates in a given work context. Many researchers have focused on subordinates' needs for affiliation, preferences for structure, desires for control, and self-perceived level of task ability. In this study, we have focused on the self-perceived level of task ability, namely, the franchisee's self-efficacy. According to Bandura (1977), self-efficacy is chiefly defined as the personal attitude of one's ability to accomplish concrete tasks. Therefore, it is not an indicator of one's actual abilities, but an opinion of the extent of how one can use that ability. Thus, the judgment of maintain franchisee's commitment depends on the situation (e.g., government regulation and policy and leadership style of franchisor) and how it affects one's ability to mobilize resources to deal with the task, so even if people possess the same ability, there may be differences in self-efficacy. Figure 1 illustrates the model investigated in this study. In this model, it was hypothesized that leadership styles would affect the franchisee's commitment, and self-efficacy would moderate the relationship between leadership style and franchisee's commitment. Theoretically, quoted by Northouse(2007), the path-goal approach suggests that leaders need to choose a leadership style that best fits the needs of subordinates and the work they are doing. According to House & Mitchell (1974), the theory predicts that a directive style of leadership is best in situations in which subordinates are dogmatic and authoritarian, the task demands are ambiguous, and the organizational rule and procedures are unclear. In these situations, franchisor's directive leadership complements the work by providing guidance and psychological structure for franchisees. For work that is structured, unsatisfying, or frustrating, path-goal theory suggests that leaders should use a supportive style. Franchisor's Supportive leadership offers a sense of human touch for franchisees engaged in mundane, mechanized activity. Franchisor's participative leadership is considered best when a task is ambiguous because participation gives greater clarity to how certain paths lead to certain goals; it helps subordinates learn what actions leads to what outcome. Furthermore, House & Mitchell(1974) predicts that achievement-oriented leadership is most effective in settings in which subordinates are required to perform ambiguous tasks. Marsh and O'Neill (1984) tested the idea that organizational members' anger and decline in performance is caused by deficiencies in their level of effort and found that self-efficacy promotes accomplishment, decreases stress and negative consequences like depression and emotional instability. Based on the extant empirical findings and theoretical reasoning, we posit positive and strong relationships between the franchisor's leadership styles and the franchisee's commitment. Furthermore, the level of franchisee's self-efficacy was thought to maintain their commitment. The questionnaires sent to participants consisted of the following measures; leadership style was assessed using a 20 item 7-point likert scale developed by Indvik (1985), self-efficacy was assessed using a 24 item 6-point likert scale developed by Bandura (1977), and commitment was assessed using a 6 item 5-point likert scale developed by Morgan & Hunt (1994). Questionnaires were distributed to Korean optical franchisees in Seoul. It took about 20 days to complete the data collection. A total number of 140 questionnaires were returned and complete data were available from 137 respondents. Results of multiple regression analyses testing the relationships between the each of the four styles of leadership shown by the franchisor as independent variables and franchisee's commitment as the dependent variable showed that the relationship between supportive leadership style and commitment ($\beta$=.13, p<.001),and the relationship between participative leadership style and commitment ($\beta$=.07, p<.001)were significant. However, when participants divided into high and low self-efficacy groups, results of multiple regression analyses showed that only the relationship between achievement-oriented leadership style and commitment ($\beta$=.14, p<.001) was significant in the high self-efficacy group. In the low self-efficacy group, the relationship between supportive leadership style and commitment ($\beta$=.17, p<.001),and the relationship between participative leadership style and commitment ($\beta$=.10, p<.001) were significant. The study focused on the franchisee's self-efficacy in order to explore the possibility that regulation, originally intended to protect the franchisee, may not be the most effective method to maintain the relationships in a franchise business. The key results of the data analysis regarding the moderating role of self-efficacy between leadership behavior style as proposed by path-goal and commitment theory were as follows. First, this study proposed that franchisor should apply the appropriate type of leadership behavior to strengthen the franchisees commitment because the results demonstrated that supportive and participative leadership styles by the franchisors have a positive influence on the franchisee's level of commitment. Second, it is desirable for franchisor to validate the franchisee's efforts, since the franchisee's characteristics such as self-efficacy had a substantial, positive effect on the franchisee's commitment as well as being a meaningful moderator between leadership and commitment. Third, the results as a whole imply that the government should provide institutional support, namely to put the franchisor in a position to clearly identify the characteristics of their franchisees and provide reasonable means to administer the franchisees to achieve the company's goal.

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