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Lived Experience of patients with Terminal Cancer : Parses Human Becoming Methodology (말기 암환자의 체험에 관한 현상학적 연구)

  • 이옥자
    • Journal of Korean Academy of Nursing
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    • v.25 no.3
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    • pp.510-537
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    • 1995
  • Human health is an integral part of experience in the process of Human Becoming. Through continual interaction with the environment human beings freely choose experience and develop as responsible beings. The process of the health experience of patient with terminal cancer is a unique. he objective of this study is to understand the lived experience of patients with terminal cancer in order to provide basic information for nursing care in the clinical setting and to develop a theoretical background for clinical practice. This study is to de-scribe and define the lived experience of patients with terminal cancer in order to provide a foundation for nursing research and education. Data collection has been done between December 1993 and November 1994. The subjects included five persons -four females and one male : one who was in her sixties, one in his fifties, two in their forties, and one who was in her thirties. The researcher has met with these patients 35 times, but at eight times the patient was in a stuporous condition and not able to participate, so these were not included in the data analysis. Parse's "Human Becoming Methodology", an existential phenomenological research methodology is used for this study. Data has been collected using he dialogical engagement process of "I and You", the participant researcher and the participant subject. Dialogical engagement was discontinued when the data was theoretically saturated. Data was analyzed using the extraction - synthesis and heuristic interpretation. The criteria of Guba and Lincoln(1985). and Sandelo wski(1986) : credibility, auditability, fitness and objectivity were used to test the validity and reliability of the data. The following is a description of the structure of the lived experience of patients with terminal cancer as defined by this study : 1. Structure : 1) Suffering through the reminiscence of past experience 2) The appearance of complex emotions related to life and connectedness 3) The increasing importance of significant people and of the Absolute Being 4) The increasing realization of the importance of health and belief 5) Desire for a return to health and a peaceful life or for acceptance of dying and a comfortable death In summary the structure of the lived experience of these patients can be said to be : suffering comes through reminiscence of past experience, and there are complex emotions related to life and connectedness. Significant people and the Absolute Being become increasingly important along with a realization of the importance of health and faith. And finally there is a desire for either a return to health and a peaceful life or for the acceptance of dying and a comfortable death. 2. Heuristic Interpretation : Using Parse's Human Becoming Methodology, the structure of the lived experience of patients with terminal cancer identified in this research is interpreted as. The lived experience of patients with terminal cancer involves the solving of past conflicts, and the experience of the healing and valuing of sorrow and pain. Through the relation of life and health, and the complex emotions that arise, the lived experience of revealing - concealing is of paradoxical emotions. The increasing importance of significant others and of the Absolute Being shows Connecting and Separating an on- going process of nearness and farness. Revision of thoughts about health and faith is interpreted as transforming and desire for restoration to health and a peaceful life or acceptance of dying and a cowfortable death, as powering. In summary, it is possible to see, in the lived experience of patients with terminal cancer, the relationship of the five concepts of Parse's theory : valuing, revealing -concealing, connecting-separating, transforming, and powering. From Parse's theory, the results of this study show that meaning is related to valuing, rhythmicity to revealing-concealing and connect-ing-separating, and cotranscendence to transforming and powering.

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Analysis of Causes for Primary Treatment Failure of Pulmonary Tuberculosis (폐결핵환자에서 초치료실패에 대한 요인 분석)

  • Park, Seung-Kyu;Choi, In-Hwan;Kim, Cheon-Tae;Song, Sun-Dae
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.6
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    • pp.1234-1244
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    • 1997
  • Background : Nowadays drug resistant tuberculosis is making problems in the treatment of pulmonary tuberculosis and its number is increasing. Several reasons for this are considered including irregular medication, poor drug compliance and wrong regimens. But there are treatment failure cases in spite of regular medication with short-term standard regimens. We reviewed clinical data of 50 patients to find out possible causes of this. Method : Subject of this study was 50 patients who failed in the primary treatment of pulmonary tuberculosis in spite of regular medication with short-term standard regimens. All of them were under treatment with secondary regimens in National Masan Tuberculosis Hospital on Oct 1996. The patient's records were analyzed retrospectively and direct interviews with patients were done. Results : There were relatively more patients in the age of 20th. Male overwhelmed in number. There were smoking in 22 patients and drinking in 24 patients during medication. 17(34%) patients had family history of tuberculosis. Public health center was the most common site for the initial diagnosis among medical institutes. 42 patients had subjective symptoms for pulmonary tuberculosis. 38 patients got sufficient explanation from medical institute about tuberculosis and medication courses. 24 patients had bilateral lesions on chest X-ray film and 43 patients had cavitary lesions. 29 patients had past history for pulmonary tuberculosis with regular medication. The results of drug sensitivity test showed resistance in 41 patients of whom we could get the results. Conclusion : Main cause of treatment failure of pulmonary tuberculosis in spite of regular medication with short-term standard regimens was drug resistance. Several factors were considered to be related to high prevalence of drug resistance, including age of 20th, male, family history for tuberculosis, bilateral lesions or remaining cavitary lesion on chest X-ray film.

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A Trend of Research in Community Health Nursing (지역사회간호학 관련 논문 연구동향 분석 -학회지 발표 논문을 중심으로-)

  • Lee, In-Sook;Kim, Yu-Na;Choi, Key-Won;Chin, Young-Ran
    • Research in Community and Public Health Nursing
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    • v.12 no.1
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    • pp.288-298
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    • 2001
  • This article makes an attempt to evaluate the extent of developing community health nursing knowledge and to suggest the direction of developing a body of knowledge henceforth through the results of analysis for contents and outcomes of all literatures. which have been published in the Journal related to community health nursing. Refer to the following for the result of this article. 1. The total number of literatures analyzed amounted to 100 pieces in Journal of community health nursing society. 78 in Journal of industrial nursing society, 134 in Journal of school health society. 40 in Journal of home care nursing society. 2. Journal of community health nursing society Health needs and educational-behavioral diagnoses, which are more concrete nursing assessments and diagnoses. formed the main current(54%) of articles published in Journal of community health nursing society since 1992. There was a quantitative growth as well as a qualitative advance. Through a classification by the type of a body of knowledge. It was found that the knowledge providing nursing practice with bases, commanded an overwhelming majority(71.8%). Also, Researches on systemic supports for nursing practice are showing a tendency to increase. 3. Journal of industrial nursing society 52.6% of research papers presented in Journal of industrial nursing society dealt with health problem of workers. assessment of risk factors, diagnosis of health behaviors. Because of the beginning of an industrial nursing, the domain of nursing management to establish the role and task, work condition, training. documentary system made up 23 percent of research, subjects. A knowledge providing nursing practice with bases have a majority, 69.2%. In addition. the subject concerning a systemic support and quality assurance was scarce but continuously presented. 4. Journal of school health society The major point of this journal is the identification of health problems and risk factors which belong to assessment and diagnosis domain(56.8%) regardless of year, Because of the interdisciplinary characteristic. The knowledge on quality assurance of nursing practice is relatively rare. But, articles related to a systemic support is plentiful. 5. Journal of home care nursing society In its infancy, there was a large number of papers concerning need assessment and diagnosis, Comparing others, this journal has introduced a good many of articles related to program management. delivery system. service fee, etc that belong to domain of systemic support for nursing practice. 6. It is showing definitely that quantity and extent of research have grown for a short period. See the analysis in terms of nursing process, studies related to the domain of assessment and diagnosis command an absolute majority regardless of kinds of journal. Although articles referring to program management and implementation is increasing in number, it is scarce to evaluate a nursing program and grope for an improvement. Also, program development based on a theoretical framework is little. Therefore much more scientific effort to ensure profession should be executed. 7. In the methodological aspect, longitudinal study needs to be carried out so that we could show the evidence based nursing theory. To develop a more general theory, we have to conduct a study of various subjects and improve a validity of tools through a repeat test. In addition, the effort for interdisciplinary cooperation is needed.

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The Efficiency of Bank Underwriting of Corporate Securities in Korea (국내 자본시장 증권인수기능의 효율성에 관한 연구 : 은행계열과 비은행계열 금융기관 비교 분석)

  • Baek, Jae-Seung;Lim, Chan-Woo
    • The Korean Journal of Financial Management
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    • v.27 no.1
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    • pp.181-208
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    • 2010
  • In July 2007, Korean government has passed "The Capital Market and Financial Investment Services Act" to further develop the capital markets and the Act was to become effective in February 2009. Using a large sample of Korean firms, we have examined (i) the effect of underwriting activities on the firm value (bond spread) comparing commercial bank and investment bank, and (ii) the determinants of the firm value changes following underwriting activities of bank. To test our goal, we collected a wide range of samples of data for bond issuing activities executed by Korean firms listed on the Korea Stock Exchange (KSE) between 2000 and 2003. Our paper is distinguished from previous studies on this subject in a way that we analyzed the effect of corporate bond underwriting activities with regard to commercial banking and investment banking. Initially, we set up a hypothesis that "Certification View" and "Conflict-of-interest View" are major driving forces behind cross-firm differences in performance following bond issuance. We find that, in general, underwriting by investment bank (securities company) brings a positive effect on the firm value (spread between bench mark rate and bond issuing rate). This result indicates that firm value has been negatively affected by the bank underwriting and provides the evidence for "Conflict-of-interest View" in Korea. Our studies have also revealed that any change in firm value following bond issuance is positively related with the firm size (total asset), operating performance, liquidity (cashflow), and equity ownership by foreign investors. Overall, our results support the view that bank underwriting activities can play an important role in determining firm value and financial strategies under "The Capital Market and Financial Investment Services Act" of 2007.

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$^{99m}Tc-DTPA$ Galactosyl Human Serum Albumin Scintigyaphy in Mushiroom Poisoning Patient : Comparison with Liver Ultrasonography (버섯 중독 환자에서의 $^{99m}Tc-galactosyl$ human serum albumin (GSA) scintigraphy 소견 : 간초음파 소견과의 비교)

  • Jeong, Shin-Young;Lee, Jea-Tae;Bae, Jin-Ho;Chun, Kyung-Ah;Ahn, Byeong-Cheol;Kang, Young-Mo;Jeong, Jae-Min;Lee, Kyu-Bo
    • The Korean Journal of Nuclear Medicine
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    • v.37 no.4
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    • pp.254-259
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    • 2003
  • $^{99m}Tc-galactosyl$ human serum albumin (Tc-GSA) is a radiopharmaceutical that binds to asialoglycoprotein receptors, which are specifically present in the hepatocyte membrane. Because these receptors are decreased in hepatic parenchymal damage, the degree of Tc-GSA accumulation in the liver correlates with findings of liver function test. Hepatic images were performed with Tc-GSA in patients with acute hepatic dysfunction by Amantia Subjunquillea poisoning, and compared with these of liver ultrasonography (USG). Tc-GSA (185 MBq, 3 mg of GSA) was injected intravenously, and dynamic images were recorded for 30 minutes. Time-activity curves for the heart and liver were generated from regions of interest for the whole liver and precordium. Degree of hepatic uptake and clearance rate of Tc-GSA were generated by visual interpretation and semiquantitative analysis parameters (receptor index : LHL15 and index of blood clearance : HH15). Visual assessment of GSA scintigraphy revealed mildly decreased liver uptake in all of subjects. The mean LHL15 and HH15 were 0.886 and 0.621, graded as mild dysfunction in 2, and mild to moderate dysfunction in 1 subject. In contrast, liver USG showed no remarkable changes of hepatic parenchyme. Tc-GSA scintigraphy was considered as a useful imaging modality in the assessment of the hepatic dysfunction.

The Social Influence of the Landscape Architecture Engineer Examination on the Establishment of Authenticity in Landscaping History Department (조경기사 '조경사' 과목이 조경역사학(造景歷史學) 분야의 진정성 확립에 미친 사회적 영향)

  • Lee, Chang-Hun;Shin, Hyun-Sil;Kim, Kyu-Seob;Lee, Won-Ho
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.36 no.3
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    • pp.128-136
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    • 2018
  • This study was centered on the protested data of the issue of "History of Landscape Architecture" in the handwritten course of landscaping articles of National Qualifications Test. The purpose of this study is to examine the types of social problems in the process of correcting erroneous historical facts. The purpose of this study was to find alternatives for the development of the field of landscape and culture history that can assist in the verification of the historical facts of the landscape sciences examination questions. The main results are as follows. First, as a result of analyzing the contents of the landscape architects' subject matter, the establishment of concept of landscape style and form and the confirmation of historical facts were investigated as important types to be established for development of landscape landscape history department. It seems that the social consensus of the expert group is needed to supplement the lack of data to refer to landscape architectural theory. Second, the analysis of the problematic narrative contents resulted in a total of five types of questionnaires. The appeared in the Undefined style and form(52.94%), Unproven historical facts(25.13%), Obscurity Era classification(11.77%), Lack of specificity(6.95%), Content scope of obscurity events(3.21%) Third, it is not only the lack of information to learn the theory by comparing and analyzing the contents of the statements in the landscape architect 's question items, but also the difference of contents between books was analyzed as the main cause of the problem. As a result of examining the characteristics and examples of the issues raised in landscape architectural problems, it was related to the social phenomenon, and it was classified into cultural factors and political factors. Fourth, the resolution of problematic issues in landscape architects' landscaping articles, which are national technical qualification tests, shows positive results. The information determined in the process of solving the perceived content can be used directly in landscaping field, and it helps the accuracy of the verification process by identifying the types and characteristics of the issues.

The Effect of the Instruction Using PSpice Simulation in 'Digital Logic Circuit' Subject at Industrial High School (공업계열 전문계고등학교 '디지털 논리 회로' 수업에서 PSpice를 이용한 수업의 효과)

  • Choi, Seung-Woo;Woo, Sang-Ho;Kim, Jinsoo
    • 대한공업교육학회지
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    • v.33 no.1
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    • pp.149-168
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    • 2008
  • The purpose of this study is to verify the effect of PSpice instruction on academic achievement in 'Combination logic circuit' unit of 'Digital Logic Circuit' in industrial high school. Three kinds of null hypotheses were formulated. Two classes of the third grade of C technical high school in Gyeong-buk were divided into experimental group and control group in order to verify null hypotheses. In the experimental design, 'Non-equivalent control group pretest-posttest' model was utilized. This experiment was conducted for six classes, the experimental group was applied to PSpice instruction method before the circuit traning while the control group was applied to traditional lecture oriented method before the circuit traning. Window SPSS 10.0 korean language version program was used for the data analysis and independent sample t-test was used to identify the average of each group. Significance level was set to .05 level. The results obtained in this study were as follows; First, PSpice instruction had not an effect on academic achievement according to a group type. However, these instruction had an effect on the following sub-domains; the psychomotor domain. Second, PSpice instruction had not an effect on academic achievement according to a studies level. However, these instruction for middle and low level students had an effect on the cognitive and psychomotor domain, and for middle level students had an effect on the affective domain. Third, PSpice instruction had not an effect on shortening of a training requirement. However, this instruction for low level students had an effect on shortening of a training requirement. The study results of simulation instruction was chiefly efficient in the psychomotor domain. We could know that simulation instruction is efficient as went to a low level students than an upper level students. Thus, We may make the study effectiveness in various instruction method.

Design and Implementation of Web Based Instruction Based on Constructivism for Self-Directed Learning Ablity (구성주의 이론에 기반한 자기주도적 웹 기반 교육의 설계와 구현)

  • Kim Gi-Nam;Kim Eui-Jeong;Kim Chang-Suk
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2006.05a
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    • pp.855-858
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    • 2006
  • First of all, Developing information technology makes it possible to change a paradigm of all kinds of areas, including an education. Students can choose learning goals and objects themselves and acquire not the accumulation of knowledge but the method of their learning. Moreover, Teachers get to be adviser, and students play a key role in teaming. That is, the subject of leaning is students. Constructivism emphasizes the student-oriented environment of education, which corresponds to the characteristics of hypeimedia. In addition, Internet allows us to make a practical plan for constructivism. Web Based Internet provides us with a proper environment to make constructivism practice md causes an education system to change. Sure Web Based Instruction makes them motivated to learn more, they can gain plenty of information regardless of places or time. Besides, they are able to consult more up-to-date information regarding their learning use hypermedia such as an image, audio, video, and test, and effectively communicate with their instructor through a board, an e-mail, a chatting etc. A school and instructors have been making effort to develop a new model of a teaching method to cope with a new environment change. In this thesis, with 'Design and Implementation of Web Based Instruction Based on Constructivism', providing online learner-oriented and indexed video lesson, learners can get chance of self-oriented learning. In addition, learners doesn't have to cover all contents of a lesson but can choose contents they want to have from a indexed list of a lesson, and they ran search contents they want to have with a 'Keyword Search' on a main page, which can make learners improve learner's achievement.

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Preferential Flow as Tested by Breakthrough Curves of Cl- and Cu2+ from Saturated Undisturbed Soil Core Samples under Steady Flow Conditions (포화 불교란 토양시료의 Cl- 및 Cu2+ 출현곡선에 의한 preferential flow의 검증)

  • Yoo, Sun-Ho;Han, Kyung-Hwa;Ro, Hee-Myong;Han, Gwang-Hyun
    • Korean Journal of Soil Science and Fertilizer
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    • v.33 no.2
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    • pp.71-78
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    • 2000
  • Preferential flow has recently been the subject of increasing interest because these phenomena contribute to solute transport in soils. Commonly, preferential flow paths are associated with macropores or highly structured soils. We presented an analysis of the measured breakthrough curves (BTCs) of $Cl^-$ and $Cu^{2+}$ ions to test the occurrence of preferential flow in soils using miscible displacement technique under steady flow conditions. We also analyzed soil water retention curves and from this curves induced cumulative pore size distribution of undisturbed soils, which sampled from Ap1, B1, and C horizons of Songjeong series soils (the fine loamy, mesic family of Typic Hapludults). In this study, miscible displacement experiment on C horizon was excluded, because it is structureless sandy loam with saturated hydraulic conductivity of $5.2cmhr^{-1}$. The saturated hydraulic conductivity of Ap1 horizon was $2.0cmhr^{-1}$, which was about 7 times higher than that of B1 horizon ($0.27cm hr^{-1}$). Cumulative pore size distribution predicted that Ap1 horizon had more macropores (pore diameter larger than $49{\mu}m$, equivalent to -6 kpa of soil matric potential) than B1 horizon. The hydrodynamic dispersion coefficient from chloride BTCs was estimated as $1.3cm^2hr^{-1}$ for B1 and $34cm^2hr^{-1}$ for Ap1 horizon. However the retardation factors of B1 and Ap1 horizon were significantly different, i.e. 1 and 0.6, respectively, which means that there was distinct partition between mobile water and immobile phase in Ap1 horizon. The copper retardation effect of Ap1 horizon was less than that of B1 horizon, even though cation exchange capacity of Ap1 horizon was higher than that of B1 horizon. Thus, breakthrough curves of $Cl^-$ and $Cu^{2+}$ obviously showed the probability that preferential flow would occur in Ap1 horizon.

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Prevalence Rate of Lead Related Subjective Symptoms in Lead Workers (연취급 근로자의 연폭로 수준에 따른 주관적 자각증상 호소율)

  • Jeong, Du-Shin;Kim, Hwa-Sung;Ahn, Kyu-Dong;Lee, Byung-Kook
    • Journal of Preventive Medicine and Public Health
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    • v.26 no.2 s.42
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    • pp.251-267
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    • 1993
  • The relationship between lead related subject symptoms and lead exposure indices was studied in 435 male lead workers in thirteen lead using industries. 212 male office workers who were not exposed to lead occupationally were also studied as a control group. Fourteen lead related symptoms were selected. They were further subdivied into 4 sub-symptom groups such as 1) gastrointestinal, 2) neuromuscular and joint 3) constitutional, and 4) psychological symptoms. Symptom questionnaires were provided to the workers and filled up by themselves and reconfirmed by interviewer(doctor). The test used fer the evaluation of lead exposure were blood lead(PbB), zinc protoporphyrin in whole blood(ZPP), hemoglobin(Hb), hematocrit (Hct), delta-aminolevulinic acid in urine(DALA). The results obtained were as follows; 1. The higher prevalence rate in the sub-group of neuromuscular and joint symptoms was observed in occupationally lead exposed subjects than non-exposed subjects. Among the sub-groups, the most frequent symptom was 'numbness of finger, hands or feet', and the prevalence of the symptom of 'arthralgia', 'weakness of fingers, hands or feet' and 'myalgia' were higher in order. 2. While the symptom which showed the biggest difference of prevalence rate among the 14 symptoms between exposed and non-exposed subjects was 'numbness of fingers, hands or feet', the symptom which showed the highest prevalence rate was 'feeling tired generally' in exposed and non-exposed subjects, but no statistical difference of symptom prevalence were observed. 3. In total study population, PbB and ZPP had dose-response relationship with 4 symtoms of neuromuscular and joint symptoms ('numbness of finger, hands or feet', 'arthralgia', 'weakness of fingers, hands or feet' and 'myalgia') and one symptom of gastrointestinal group('intermittent pains in lower abdomen'). 4. In lead exposed workers, only neuromuscular and joint symptoms group showed dose-response relationship with PbB and ZPP, 5. In lead exposed workers, the prevalance rate of overall symptoms of lead workers with age below 39 years was higher than that of lead workers with age above 40. While neuromuscular and joint symptoms group had a dose-response relationship with PbB in former group, it had a dose-response relationship with ZPP in latter group. 6. Age adjusted odds ratios of symptoms of non-exposed with exposed and odds ratios of low exposed with high exposed workers showed the dose-response relationship of lead exposure with neuromuscular and joint symptoms group('numbness of fingers, hands or feet', 'arthralgia', 'weakness of fingers, hands or feet' and 'myalgia') and gastrointestinal symptoms group('intermittent pains in lower abdoman').

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