• Asia pacific journal of information systems
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• 제23권4호
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• pp.53-84
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• 2013

With rapid development of ICT (Information and Communications Technology), new services by the convergence of mobile network and application technology began to appear. Today, smart phone with new ICT convergence network capabilities is exceedingly popular and very useful as a new tool for the development of business opportunities. Previous studies based on Technology Acceptance Model (TAM) suggested critical factors, which should be considered for acquiring new customers and maintaining existing users in smart phone market. However, they had a limitation to focus on technology acceptance, not value based approach. Prior studies on customer's adoption of electronic utilities like smart phone product showed that the antecedents such as the perceived benefit and the perceived sacrifice could explain the causality between what is perceived and what is acquired over diverse contexts. So, this research conceptualizes perceived value as a trade-off between perceived benefit and perceived sacrifice, and we need to research the perceived value to grasp user's continuous intention to use of smart phone. The purpose of this study is to investigate the structured relationship between benefit (quality, usefulness, playfulness) and sacrifice (technicality, cost, security risk) of smart phone users, perceived value, and continuous intention to use. In addition, this study intends to analyze the differences between two subgroups of smart phone users by the degree of personal innovativeness. Personal innovativeness could help us to understand the moderating effect between how perceptions are formed and continuous intention to use smart phone. This study conducted survey through e-mail, direct mail, and interview with smart phone users. Empirical analysis based on 330 respondents was conducted in order to test the hypotheses. First, the result of hypotheses testing showed that perceived usefulness among three factors of perceived benefit has the highest positive impact on perceived value, and then followed by perceived playfulness and perceived quality. Second, the result of hypotheses testing showed that perceived cost among three factors of perceived sacrifice has significantly negative impact on perceived value, however, technicality and security risk have no significant impact on perceived value. Also, the result of hypotheses testing showed that perceived value has significant direct impact on continuous intention to use of smart phone. In this regard, marketing managers of smart phone company should pay more attention to improve task efficiency and performance of smart phone, including rate systems of smart phone. Additionally, to test the moderating effect of personal innovativeness, this research conducted multi-group analysis by the degree of personal innovativeness of smart phone users. In a group with high level of innovativeness, perceived usefulness has the highest positive influence on perceived value than other factors. Instead, the analysis for a group with low level of innovativeness showed that perceived playfulness was the highest positive factor to influence perceived value than others. This result of the group with high level of innovativeness explains that innovators and early adopters are able to cope with higher level of cost and risk, and they expect to develop more positive intentions toward higher performance through the use of an innovation. Also, hedonic behavior in the case of the group with low level of innovativeness aims to provide self-fulfilling value to the users, in contrast to utilitarian perspective, which aims to provide instrumental value to the users. However, with regard to perceived sacrifice, both groups in general showed negative impact on perceived value. Also, the group with high level of innovativeness had less overall negative impact on perceived value compared to the group with low level of innovativeness across all factors. In both group with high level of innovativeness and with low level of innovativeness, perceived cost has the highest negative influence on perceived value than other factors. Instead, the analysis for a group with high level of innovativeness showed that perceived technicality was the positive factor to influence perceived value than others. However, the analysis for a group with low level of innovativeness showed that perceived security risk was the second high negative factor to influence perceived value than others. Unlike previous studies, this study focuses on influencing factors on continuous intention to use of smart phone, rather than considering initial purchase and adoption of smart phone. First, perceived value, which was used to identify user's adoption behavior, has a mediating effect among perceived benefit, perceived sacrifice, and continuous intention to use smart phone. Second, perceived usefulness has the highest positive influence on perceived value, while perceived cost has significant negative influence on perceived value. Third, perceived value, like prior studies, has high level of positive influence on continuous intention to use smart phone. Fourth, in multi-group analysis by the degree of personal innovativeness of smart phone users, perceived usefulness, in a group with high level of innovativeness, has the highest positive influence on perceived value than other factors. Instead, perceived playfulness, in a group with low level of innovativeness, has the highest positive factor to influence perceived value than others. This result shows that early adopters intend to adopt smart phone as a tool to make their job useful, instead market followers intend to adopt smart phone as a tool to make their time enjoyable. In terms of marketing strategy for smart phone company, marketing managers should pay more attention to identify their customers' lifetime value by the phase of smart phone adoption, as well as to understand their behavior intention to accept the risk and uncertainty positively. The academic contribution of this study primarily is to employ the VAM (Value-based Adoption Model) as a conceptual foundation, compared to TAM (Technology Acceptance Model) used widely by previous studies. VAM is useful for understanding continuous intention to use smart phone in comparison with TAM as a new IT utility by individual adoption. Perceived value dominantly influences continuous intention to use smart phone. The results of this study justify our research model adoption on each antecedent of perceived value as a benefit and a sacrifice component. While TAM could be widely used in user acceptance of new technology, it has a limitation to explain the new IT adoption like smart phone, because of customer behavior intention to choose the value of the object. In terms of theoretical approach, this study provides theoretical contribution to the development, design, and marketing of smart phone. The practical contribution of this study is to suggest useful decision alternatives concerned to marketing strategy formulation for acquiring and retaining long-term customers related to smart phone business. Since potential customers are interested in both benefit and sacrifice when evaluating the value of smart phone, marketing managers in smart phone company has to put more effort into creating customer's value of low sacrifice and high benefit so that customers will continuously have higher adoption on smart phone. Especially, this study shows that innovators and early adopters with high level of innovativeness have higher adoption than market followers with low level of innovativeness, in terms of perceived usefulness and perceived cost. To formulate marketing strategy for smart phone diffusion, marketing managers have to pay more attention to identify not only their customers' benefit and sacrifice components but also their customers' lifetime value to adopt smart phone.

• 마케팅과학연구
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• 제19권4호
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• pp.57-63
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• 2009

随着电子商务指数式增长(电子商务), 营销人员正试图获得通过强调服务质量和服务方面的相互作用而导致客户满意度或行为后果的竞争优势. 特别是对于服装, 服务质量是鼓励客户电子忠诚的关键因素之一, 并增加电子商务中服装零售的成功. 因此, 本研究探讨电子服务质量(电子SERVQUAL)的因素和根据Parasuraman等人(2005)的研究框架对网上服装购物的电子忠诚度的独特影响. 这项研究的具体目标是确定的基本层面的E - SERVQUAL, 分析有关在网上服装购物中电子SERVQUAL对点在忠诚度的影响的结构模型. 对于服务质量, 在网上购物方面的理论框架, 我们比较分析了有关传统和电子服务质量的因素的文献并确定了核心的两个方面和恢复服务. 这项研究的假设是电子SERVQUAL对电子忠诚度的影响. 客户满意度对电子服装网上购物服务的忠诚度有积极影响和客户满意度在电子SERVQUAL对服装网上购物电子忠诚度影响中的中介作用. 根据文献我们制成了一份自填式的问卷. 我们在美国从居住在大城市的有在网上购买服装产品的在线消费者中获得了252份有用的问卷. 通过因子分析(例如, 探索, 验证)评估了有效性和可靠性, 结构方程模型, 包括测量和结构模型, 通过线性结构8.8程序评估了包括测量和结构模型的结构方程模型. 结果显示, 网上购物网站的电子SERVQUAL的五个因素: 赔偿, 执行, 效率, 系统可用性和反应能力. 这支持在网上服装购物方面Parasuraman(2005)的E-S-QUAL包括两个方面的核心服务(如满足, 效率, 系统可用性)和恢复相关的服务(例如, 补偿, 回应). 在结构方程模型中, 有5个电子SERVQUAL因素的外生潜变量, 两个内生潜变量(例如客户满意度, 电子忠诚度). 对于测量模型, 各代表概念的因子载荷有显著的统计学意义, 比 0.60大, 内部一致性信从 0.85 至 0.8 8 不等. 在估计电子SERVEQUAL因素的结构模型, 系统的可用性对电子忠诚的直接和积极的作用, 而效率对网上服装购物的电子忠诚度有负面影响. 然而, 满足不是解释网上服装购物的电子SERVQUAL结果的重要指标. 这一发现意味着, 可被理解为系统提供服务的质量可能会增加对服装网上购物的客户满意度. 然而, 电子忠诚取决于服务质量没有被支持, 因为在网上服装购买中, 通过价值或满意度的中介作用, 服务质量对电子忠诚度(例如再购买意图)有间接影响. 此外, 获得赔偿和回应被发现对客户满意度有显著影响, 会影响网上服装购买的电子忠诚度. 因此, 获得赔偿和回应对电子忠诚度有显著的间接影响. 这表明, 恢复特定的服务因素在客户满意度最大化方面的重要作用, 以及维护客户对网上服装购物网站的忠诚度方面的重要作用. 研究结果在管理和研究方面都有启示. 时装营销者可以在建立与客户的长期关系的基础上, 不断测量顾客感知与恢复服务有关的服务质量等问题, 例如对问题和返回的迅速反应, 客户购买之后的问题赔偿. 为了保持电子忠诚, 在消费者购买服装中恢复服务对消费者第一次选择网站起到重要作用. 由于网上购物的消费者可以在任何地方购物, 提高竞争优势的营销策略是为消费者提供更好的服务质量, 最大限度地满意, 并把创造客户网上服装购买的电子忠诚度. 从研究的角度来看, 解释这些结果时, 本研究的一些局限需要被考虑. 对于未来的研究, 调查结果为这一重要主题理论和实证方面的进一步的研究提供了依据. 根据研究结果, 更全面的模型预测电子SERVQUAL的结果可以被开发和测试. 对全球时装市场, 这项研究可以扩展使用多国样本的跨文化的方法来研究服装的电子服务质量.

• 농업과학연구
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• 제5권1호
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• pp.15-28
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• 1978

흙의 전단강도(剪斷强度) 옹벽(擁壁)이나 사면(斜面)의 안정(安定) 혹은 구조물기초(構造物基礎)의 설계등(設計等)의 문제(問題)를 해결(解決)하는데 중요(重要)한 것으로 알려져 있다. 직접전단시험기(直接剪斷試驗機)는 수직응력(垂直應力)의 불균일성(不均一性), 진행성파괴(進行性破壞), 측면마찰(側面摩擦)의 영향등(影響等)에 대(對)하여 해결(解決)하여야 할 문제(問題)를 내포(內包)하고 있다. 그러나 본시험(本試驗)에서는 그의 장치(裝置)가 간편(簡便)하여 널리 사용(使用)되고 있는 직접전단시험기(直接剪斷試驗機)를 사용(使用)하여 밀도(密度)와 함수비(含水比)를 변화(變化)시키면서 비배수(非排水) 급속전단시험(急速剪斷試驗)을 하여 다음과 같은 결과(結果)를 얻었다. 1. 건조밀도(乾燥密度)가 증가(增加)함에 딸라 전단강도(剪斷强度)는 큰 값을 나타내고 같은 밀도(密度)에서도 입도배합(粒度配合)이 양호(良好)한 흙에서 전단강도(剪斷强度)는 큰 값을 나타냈다. 2. 점착력(粘着力)은 건조밀도(乾燥密度)가 커짐에 따라 증가(增加)하는 경향(傾向)을 나타냈으나 내부마찰각(內部摩擦角)은 일률적(一律的)인 증가(增加)의 경향(傾向)이 나타나지 않았다. 3. 함수비(含水比)가 증가(增加)함에 따라 전단강도(剪斷强度)는 감소(減少)하였고 이와같은 현상(現象)은 입도배합(粒度配合)이 양호(良好)한 흙에서 더욱 현저하게 나타났다. 4. 점착력(粘着力)은 흙의 함수비(含水比)가 최적함수비(最適含水比)에 가까울 때 최대(最大)로 되고, 내부마찰각(內部摩擦角) 함수비(含水比)가 증가(增加)함에 따라 감소(減少)하였다. 이와같은 현상(現象)은 입도배합(粒度配合)이 양호(良好)한 SDC-1 시료(試料)에서 더욱 현저하게 나타났다. 5. 점착력(粘着力)은 공극비(空隙比)가 증가(增加)함에 따라 감소(減少)하였고 내부마찰각(內部摩擦角)은 이와 같은 경향(傾向)이 나타나지 않았다.

• 한국습지학회지
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• 제17권1호
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• pp.62-74
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• 2015

도시지역은 생태적 기능 쇠퇴 등 다양한 위협에 처해있다. 이러한 도시환경을 개선, 복원하기 위한 노력의 일환으로 연못형습지(Pond) 유형이 많이 조성되고 있다. 본 연구는 농촌의 반 자연형 습지 특성을 분석하여 도시지역 습지의 개선방안을 알아보았다. 수질환경 개선방안으로 인근 하천의 자연수를 유입하거나 강우의 직접유입을 제안하였다. 토양환경 중 토양산도, 유기물, 전질소 함량 등을 분석한 결과 농촌지역과 차이가 나는 원인으로는 도시지역이 인공적인 수문공급, 고사체 제거, 인공토양, 방수재 사용 등을 제시하였고 개선방안으로 설계, 시공 시 자연재료 사용, 자연형 수문상태, 가을철 식물 방치 등을 제안하였다. 조사 대상지에서 출현한 식물상은 도시지역에서 35과 69종류, 농촌지역은 53과 142종류가 확인되었고, 평균은 도시지역 4개소는 18.5과 29.3종류, 농촌지역 4개소는 26.3과 53.5종류로 큰 차이로 분석되었다. 원인으로 농촌지역이 도시지역에 비해 일년생식물에서 차이를 거론할 수 있고 개선방안으로 일년생식물이 넓게 정착 할 수 있도록 토양 및 수질 등의 기반환경을 다양하게 조성 할 것을 제안하였다. 귀화식물은 도시지역과 농촌지역에서 큰 차이는 확인되지 않았지만 도시지역의 경우 출현한 식물 중 약 1/4이 귀화식물로 구성되었다. 또한 귀화율 평균이 17.4%로, 농촌지역 귀화율 평균인 7.7% 보다 큰 차이로 높게 분석되었으므로 생활형 분석결과와 마찬가지로 일년생식물이 높게 출현 할 수 있도록 다양한 서식환경 조성을 제시하였다. 또한 도시지역 습지의 기능 향상을 위해서는 습지조성에서부터 높은 가치로 평가 될 수 있도록 배치, 재료, 서식환경 등을 고려 할 것을 제시하였다. 이상의 연구결과는 도시지역의 생물다양성 증진 및 개선을 위해 큰 역할을 담당 할 수 있는 연못형습지의 조성, 개선, 창출 등에 활용되길 기대한다.

• 대한소아치과학회지
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• 제27권1호
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• pp.169-179
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• 2000

초기 우식병소와 건전한 치질은 광학적 특성 이 다르다는 사실에 근거하여 치과 치료용으로 개발된 가시광선 영역의 아르곤 레이저의 형광현상, 즉 물체에 조사되어 반사된 및은 물체의 광학적 특성에 따라 파장이 달라지는 특성을 이용하여, 우식 치질과 건전한 치질간의 광학적 특성의 차이를 아르곤 레이저 빛을 통한 색조의 차이로 유도 전환하는 시스템을 개발하고 이를 이용하여 초기 치아우식 병소를 조기에 시각적으로 탐지하여 data화 하는 새로운 우식활성검사법을 개발하는데 본 연구의 목적이 있다. 연구는 3단계로 나누어 1단계는 아르곤 레이저 형광법의 초기 우식병소 탐지능력을 평가하였으며 2단계는 임상에서 아동들을 대상으로 아르곤 레이저 형광법을 이용하여 초기 우식병소가 있는 치아의 갯수를 집계하고 이 수치에 대한 우식활성검사법인 $Cariescreen^{(R)}$ test, 그리고 일종의 구강환경검사인 우식경험치아의 수(dDfFtT) 검사와의 상관성을 평가하였다. 3단계는 이와 같은 자료를 기준으로 하여 레이저 형광법을 이용하여 검사할 수 있는 새로운 우식활성검사 모델을 만들고 이와 같은 검사법의 민감도, 타당도, 진단력 등을 분석하여 진단학적 측면에서 활용 가능성을 평가하고자 하였으며 그 결과는 다음과 같다. 초기 우식병소의 조직학적 깊이가 증가될수록 레이저 형광법을 이용하여 측정한 광밀도가 증가하였으며 이들 사이에는 높은 상관관계 (=0.7015)가 있었다. 또한 통계학적으로 회귀분석을 시행한 결과 병소의 깊이와 광밀도와 사이에는 정비례 관계의 직선방정식 관계를 나타내었다. 레이저 형광법을 이용한 우식활성검사법은 $Cariescreen^{(R)}$ test 그리고 dDfFtT 검사 등과 높은 상관관계를 나타냈다. 또한 레이저 형광법을 이용한 우식활성 검사법은 dDfFtT검사를 기준으로 48%의 민감도, 52%의 특이도, 45%의 진단력을 보였으며 $Cariescreen^{(R)}$ test를 기준으로 48%의 민감도, 51%의 특이도, 36%의 진단력을 보였다. 이상의 결과를 종합하면 레이저 형광법을 이용하여 측정한 초기 우식병소의 광밀도는 실제 초기우식병소의 조직학적병소의 깊이를 평가하는데 높은 진단학적 신뢰성을 보여주고 있으며 레이저 형광법을 이용한 우식활성검사는 진단학적 지표를 기준으로 볼 때, 그리고 검사절차와 시간, 비용 등의 면으로 볼 때 향후 임상적으로 활용 가능성이 높은 것으로 사료된다.

• 한국의류학회지
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• 제29권12호
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• pp.1562-1570
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• 2005

본 연구는 한국에서 의류 및 패션관련 학과를 졸업한 전문인력들이 앞으로 거대시장으로 성장할 중국 패션시장에 취업할 수 있는 효과적인 방법을 모색한·것이다. 연구의 방법은 한국의 많은 의류제조업체가 진출해 있는 중국 대련시의 7개 의류제조업체 대표자의 직접 면접방식을 사용하였으며, 면접의 기간은 2005년 2월 25일부터 3월 15일까지, 7월 28일부터 31일까지 2회에 걸쳐서 였다. 면접의 결과는 대련시의 상당수 의류제조업체들이 전문인력공급에 직면해 있었고$(100\%)$, 특히 비숙련직 노동자보다는 숙련직 및 중간관리자의 인력공급문제가 심각한 것으로 나타났다. 또한 이들은 앞으로 단순 제조방식에서 탈피하여 부가가치가 높은 분야로 진출-의류브랜드를 설립 혹은 기획 및 유통의 확장하려는 경 향을 보이고 있었다. $(85.7\%)$. 이와 같은 결과는 한국섬유산업연합회 및 KOTRA등에서 발표한 결과와 유사하여 한국의류제조업체의 $60\%$이상이 중국에 진출해 있는 현실에서 시급히 해결해야 할 문제라고 보여진다. 따라서 연구의 결과를 종합하여 다음과 같은 제안을 하고자 한다. 첫째는 중국어와 중국경제, 문화에 관한 전반적인 지식습득이 가능한 교과목을 설강하여 문화적인 차이를 인지케 한다. 둘째, 중국으로의 현장실습 및 견학, 인턴쉽 프로그램을 강화한다(면접을 실시 한 많은 회사들이 협조에 동의함). 셋째, 많은 의류제조업체들이 의류브랜드 런칭 및 기획, 유통분야를 강화하고자 하는 계획을 갖고 있으므로 브랜드 런칭에 관한 교육을 심화하석 변화하는 중국패션시장에 적응케 한다. 이러한 연구는 앞으로 한국의 패션전문인력이 진출할 수 있는 거대한 중국취업시장 진입을 위 한 토대로 활용될 것으로 기대된다.

• Archives of Reconstructive Microsurgery
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• 제5권1호
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• pp.24-34
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• 1996

There are many kinds of free flaps for management of extensive soft tissue defect of extremities in orthopaedic field. Free vascularized scapular flap is one of the most useful and relatively easy to application. This flap has been utilize clinically from early eighties by many microsurgical pioneers. Authors performed 102 cases of this flap from 1984 to 1995. We have to consider about the surgical anatomy of the flap, technique of the donor harvesting procedures, vascular varieties and anatomical abnormalities and success rate and the weak points of the procedure. This flap nourished by cutaneous branches from circumflex scapular vessels emerges from the lateral aspect of the subscapular artery 2.5-5cm from its lateral origin passing through the triangular space(bounded by subscapularis, teres minor, teres major, long head of triceps). The terminal cutaneous branch runs posteriorly around the lateral border of the scapular and divided into two major branches, those transeverse horizontally and obliquely to the fascial plane of overlying skin of the scapular body. We can utilize these arteries for scapular and parascapular flap. The vascular pedicle ranged from 5 to 10 cm long depends on the dissection, usually two venae comitantes accompanied circumflex scapular artery and its major branches. The diameter of the circumflex scapular artery is more than 1mm in adult, rare vascular variation. Surgical techniques : The scapular flap can be dissected conveniently with prone or lateral decubitus position, prone position is more easier in my experience. There are two kinds of surgical approaches, most of the surgeon prefer elevation of the flap from its outer border towards its base which known easier and quicker, but I prefer elevation of the flap from its outer border because of the lowering the possibilities of damage to vasculature in the flap itself which runs just underneath the subcutaneous tissue of the flap and provide more quicker elevation of the flap with blunt finger dissection after secure pedicle dissection and confirmed the course from the base of the pedicle. There are minimal donor site morbidity with direct skin closure if the flap size is not so larger than 10cm width. This flap has versatility in the design of the flap shape and size, if we need more longer and larger one, we can use parascapular flap or both. Even more, the flap can be used with latissimus dorsi musculocutaneous flap and serratus anterior flap which have common vascular pedicle from subscapular artery, some instance can combined with osteocutaneous flap if we include the lateral border of the scapular bone or parts of the ribs with serratus anterior. The most important shortcoming of the scapular free flap is non sensating, there are no reasonable sensory nerves to the flap to anastomose with recipient site nerve. Results : Among our 102 cases, overall success rate was 89%, most of the causes of the failure was recipient site vascular problems such as damaged recipient arterial conditions, and there were two cases of vascular anomalies in our series. Patients ages from 3 years old to 62 years old. Six cases of combined flap with latissimus dorsi, 4 cases of osteocutaneous flap for bone reconstruction, 62 parascapular flap was performed - we prefer parascapular flap to scapular. Statistical analysis of the size of the flap has less meaningful because of the flap has great versatility in size. In the length of the pedicle depends on the recipient site condition, we can adjust the pedicle length. The longest vascular pedicle was 14 cm in length from the axillary artery to the enter point cutaneous tissue. In conclusion, scapular free flap is one of the most useful modalities to manage the large intractable soft tissue defect. It has almost constant vascular pedicle with rare anatomical variation, easy to dissect great versatility in size and shape, low donor morbidity, thin and hairless skin.

• Clinical and Experimental Pediatrics
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• 제49권4호
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• pp.394-400
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• 2006

목 적 : 세기관지염은 영유아에서 흔한 하기도 감염이며 RSV 바이러스가 가장 흔한 원인 바이러스다. 그러나 RSV 감염에 대한 능동면역을 이용한 예방은 아직 이용할 수 없는 실정이다. 본 임상고찰은 최근 5년 동안 2세 이하의 어린이에서 RSV 감염에 의한 세기관지염의 임상양상을 평가하고자 하였다. 방 법 : 1999년 1월부터 2003년 12월까지 원광대학교병원 소아과에 입원한 환아 가운데 생후 24개월 미만이며 하부호흡기 감염의 증거가 있는 환아 513명 중 비강 분비물에서 RSV 항원 양성인 소아 127명을 대상으로 하여 흉부 X-선, 임상양상과 기본 혈액검사 소견을 조사하였다. 결 과 : 1999년부터 2003년까지 5년간 각 연도별 발생은 2001년에 43례(34%)로 가장 많은 발생을 보였다. 5년 통산 월별 발병은 11월에 37례(29%)로 가장 많았고 매년 늦가을부터 겨울철에 발병이 집중되는 양상을 보였다. 주요 임상소견은 기침이 120례(94%)에서 나타났고 수포음은 78례(61%)에서 청진되었고 호흡곤란과 천명은 각각 27례(21%), 21례(17%)에서 관찰되어 수포음의 청진이 하기도 감염의 주요 소견이었다. 가장 흔한 흉부 X-선 소견은 폐의 과도한 공기음영이었고 110례(87%)에서 관찰되었다. 122례에서 합병증없이 회복되었으나 5례에서 2일간 기계적인 인공호흡 치료가 필요하여 고위험군에 속하는 환아의 집중관리가 요구된다. 결 론 : 5년간 입원환자로 본 RSV에 의한 하부호흡기 감염은 늦가을과 겨울철에 발병이 많았지만 일년내내 하기도 감염 환아가 발생하였으며, RSV 감염으로 주로 고위험군 소아에서 중한 경과를 취하는 경우가 있어서 RSV 호흡기 감염에 대한 인구를 기초로 한 감시체계와 범국가적인 체계적 조사로 유병률 및 유행에 대한 평가가 필요할 것으로 사료된다.

• 대한구순구개열학회지
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• 제3권1호
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• pp.23-31
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• 2000

전방 기저 설피판은 비교적 큰 구개 결손을 폐쇄하는데 안전하고 효과적이었으며 후에 장골 이식을 위한 건전한 피복을 제공하였다. 그리고 치조열 결손의 순측면까지 완전히 피복하기 위한 목적으로 양측성 치조열에 적용되도록 재단된 Y-형의 변형은 결과가 믿을 만하였으며 합병증도 무시할 만 하였다.

• 가정∙방문간호학회지
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• 제6권
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• pp.33-45
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• 1999

The purpose of this study was to develop a basic framework and criteria for evaluation of quality care provided to patients with the attributes of disease in the home care nursing field, and to provide measurement tools for home health care in the future. The study design was a developmental study for evaluation of hospital-based HCN(home care nursing) in Korea. The study process was as follows: a home care nursing study team of College of Nursing. Yonsei University reviewed the nursing records of 47 patients who were enrolled at Yonsei University Medical Center Home Care Center in March, 1995. Twenty-five patients were insured at that time, were selected from 47 patients receiving home care service for study feasibility with six disease groups; Caesarean Section (C/S), simple nephrectomy, Liver cirrhosis(LC), chronic obstructive pulmonary disease(COPD), Lung cancer or cerebrovascular accident(CVA). In this study, the following items were selected : First step : Preliminary study 1. Criteria and items were selected on the basis of related literature on each disease area. 2. Items were identified by home care nurses. 3. A physician in charge reviewed the criteria and content of selected items. 4. Items were revised through preliminary study offered to both HCN patients and discharged patients from the home care center. Second step : Pretest 1. To verify the content of the items, a pretest was conducted with 18 patients of which there were three patients in each of the six selected disease groups. Third step : Test of reliability and validity of tools 1. Using the collected data from 25 patients with either cis, Simple nephrectomy, LC, COPD, Lung cancer, or CVA. the final items were revised through a panel discussion among experts in medical care who were researchers, doctors, or nurses. 2. Reliability and validity of the completed tool were verified with both inpatients and HCN patients in each of field for researches. The study results are as follows: 1. Standard for discharge with HCN referral The referral standard for home care, which included criteria for discharge with HCN referral and criteria leaving the hospital were established. These were developed through content analysis from the results of an open-ended questionnaire to related doctors concerning characteristic for discharge with HCN referral for each of the disease groups. The final criteria was decided by discussion among the researchers. 2. Instrument for measurement of health statusPatient health status was measured pre and post home care by direct observation and interview with an open-ended questionnaire which consisted of 61 items based on Gorden's nursing diagnosis classification. These included seven items on health knowledge and health management, eight items on nutrition and metabolism, three items on elimination, five items on activity and exercise, seven items on perception and cognition, three items on sleep and rest, three items on self-perception, three items on role and interpersonal relations, five items on sexuality and reproduction, five items on coping and stress, four items on value and religion, three items on family. and three items on facilities and environment. 3. Instrument for measurement of self-care The instrument for self-care measurement was classified with scales according to the attributes of the disease. Each scale measured understanding level and practice level by a Yes or No scale. Understanding level was measured by interview but practice level was measured by both observation and interview. Items for self-care measurement included 14 for patients with a CVA, five for women who had a cis, ten for patients with lung cancer, 12 for patients with COPD, five for patients with a simple nephrectomy, and 11 for patients with LC. 4. Record for follow-up management This included (1) OPD visit sheet, (2) ER visit form, (3) complications problem form, (4) readmission sheet. and (5) visit note for others medical centers which included visit date, reason for visit, patient name, caregivers, sex, age, time and cost required for visit, and traffic expenses, that is, there were open-end items that investigated OPD visits, emergency room visits, the problem and solution of complications, readmissions and visits to other medical institution to measure health problems and expenditures during the follow up period. 5. Instrument to measure patients satisfaction The satisfaction measurement instrument by Reisseer(1975) was referred to for the development of a tool to measure patient home care satisfaction. The instrument was an open-ended questionnaire which consisted of 11 domains; treatment, nursing care, information, time consumption, accessibility, rapidity, treatment skill, service relevance, attitude, satisfaction factors, dissatisfaction factors, overall satisfaction about nursing care, and others. In conclusion, Five evaluation instruments were developed for home care nursing. These were (1)standard for discharge with HCN referral. (2)instrument for measurement of health status, (3)instrument for measurement of self-care. (4)record for follow-up management, and (5)instrument to measure patient satisfaction. Also, the five instruments can be used to evaluate the effectiveness of the service to assure quality. Further research is needed to increase the reliability and validity of instrument through a community-based HCN evaluation.