Purpose: In order to develop the national guide-lines for the standardization of radiotherapy we are planning to establish a web-based, on-line data-base system for laryngeal cancer. As a first step this study was performed to accumulate the basic clinical information of laryngeal cancer and to determine the items needed for the data-base system. Materials and Methods: We analyzed the clinical data on patients who were treated under the diagnosis of laryngeal cancer from January 1998 through December 1999 In the South-west area of Korea. Eligiblity criteria of the patients are as follows: 18 years or older, currently diagnosed with primary epithelial carcinoma of larynx, and no history of previous treatments for another cancers and the other laryngeal diseases. The items were developed and filled out by radiation oncologlst who are members of forean Southwest Radiation Oncology Group. SPSS vl0.0 software was used for statistical analysis. Results: Data of forty-five patients were collected. Age distribution of patients ranged from 28 to 88 years(median, 61). Laryngeal cancer occurred predominantly In males (10 : 1 sex ratio). Twenty-eight patients (62
Today, the fashion market challenged by a maturing retail market needs a new paradigm in the "evolution of brand" to improve their comparative advantages. An important issue in fashion marketing is lifestyle brand extension with a specific aim to meet consumers' specific needs for their changing lifestyle. For fashion brand extensions into lifestyle product categories, Gen Y and Baby Boomer are emerging as "prospects"-Baby Boomers who are renovating their lifestyle, and generation Y experiencing changes in their life stage-with demands for buying new products. Therefore, it is imperative that apparel companies pay special attention to the consumer cohort for brand extension to create and manage their brand equity in a new product category. The purposes of this study are to (a) evaluate brand equity between parent and extension brands; (b) identify consumers' perceived marketing elements for brand extension; and (c) estimate a structural equation model for examining causative relationship between marketing elements and brand equity for brand extensions in lifestyle product category including home fashion items for the selected two groups (e.g., Gen Y, and Baby boomer). For theoretical frameworks, this study focused on the traditional marketing 4P's mix to identify what marketing element is more importantly related to brand extension equity for this study. It is assumed that comparable marketing capability can be critical to establish "brand extension equity", leads to successfully entering the new categories. Drawing from the relevant literature, this study developed research hypotheses incorporating brand equity factors and marketing elements by focusing on the selected consumers (e.g., Gen Y, Baby Boomer). In the context of brand extension in the lifestyle products, constructs of brand equity consist of brand awareness/association, brand perceptions (e.g., perceived quality, emotional value) and brand resonance adapted from CBBE factors (Keller, 2001). It is postulated that the marketing elements create brand extension equity in terms of brand awareness/association, brand perceptions by the brand extension into lifestyle products, which in turn influence brand resonance. For data collection, the sample was comprised of Korean female consumers in Gen Y and Baby Boomer consumer categories who have a high demand for lifestyle products due to changing their lifecycles. A total of 651 usable questionnaires were obtained from female consumers of Gen Y (n=326) and Baby Boomer (n=325) in South Korea. Structural and measurement models using a correlation matrix was estimated using LISREL 8.8. Findings indicated that perceived marketing elements for brand extension consisted of three factors: price/store image, product, and advertising. In the model of Gen Y consumers, price/store image had a positive effect on brand equity factors (e.g., brand awareness/association, perceived quality), while product had positive effect on emotional value in the brand extensions; and the brand awareness/association was likely to increase the perceived quality and emotional value, leading to brand resonance for brand extensions in the lifestyle products. In the model of Baby Boomer consumers, price/store image had a positive effect on perceived quality, which created brand resonance of brand extension; and product had a positive effect on perceived quality and emotional value, which leads to brand resonance for brand extension in the lifestyle products. However, advertising was negatively related to brand equity for both groups. This study provides an insight for fashion marketers in developing a successful brand extension strategy, leading to a sustainable competitive advantage. This study complements and extends prior works in the brand extension through critical factors of marketing efforts that affect brand extension success. Findings support a synergy effect on leveraging of fashion brand extensions (Aaker and Keller, 1990; Tauber, 1988; Shine et al., 2007; Pitta and Katsanis, 1995) in conjunction with marketing actions for entering into the new product category. Thus, it is recommended that marketers targeting both Gen Y and Baby Boomer can reduce marketing cost for entering the new product category (e.g., home furnishings) by standardized marketing efforts; fashion marketers can (a) offer extension lines with premium ranges of price; (b) place an emphasis on upscale features of store image positioning by a retail channel (e.g., specialty department store) in Korea, and (c) combine apparel with lifestyle product assortments including innovative style and designer’s limited editions. With respect to brand equity, a key to successful brand extension is consumers’ brand awareness or association that ensures brand identity with new product category. It is imperative for marketers to have knowledge of what contributes to more concrete associations in a market entry into new product categories. For fashion brands, a second key of brand extension can be a "luxury" lifestyle approach into new product categories, in that higher price or store image had impact on perceived quality that established brand resonance. More importantly, this study increases the theoretical understanding of brand extension and suggests directions for marketers as they establish marketing program at Gen Y and Baby Boomers.
This study researches the effects of common features on a no-choice option with respect to regulatory focus theory. The primary interest is in three factors and their interrelationship: common features, no-choice option, and regulatory focus. Prior studies have compiled vast body of research in these areas. First, the "common features effect" has been observed bymany noted marketing researchers. Tversky (1972) proposed the seminal theory, the EBA model: elimination by aspect. According to this theory, consumers are prone to focus only on unique features during comparison processing, thereby dismissing any common features as redundant information. Recently, however, more provocative ideas have attacked the EBA model by asserting that common features really do affect consumer judgment. Chernev (1997) first reported that adding common features mitigates the choice gap because of the increasing perception of similarity among alternatives. Later, however, Chernev (2001) published a critically developed study against his prior perspective with the proposition that common features may be a cognitive load to consumers, and thus consumers are possible that they are prone to prefer the heuristic processing to the systematic processing. This tends to bring one question to the forefront: Do "common features" affect consumer choice? If so, what are the concrete effects? This study tries to answer the question with respect to the "no-choice" option and regulatory focus. Second, some researchers hold that the no-choice option is another best alternative of consumers, who are likely to avoid having to choose in the context of knotty trade-off settings or mental conflicts. Hope for the future also may increase the no-choice option in the context of optimism or the expectancy of a more satisfactory alternative appearing later. Other issues reported in this domain are time pressure, consumer confidence, and alternative numbers (Dhar and Nowlis 1999; Lin and Wu 2005; Zakay and Tsal 1993). This study casts the no-choice option in yet another perspective: the interactive effects between common features and regulatory focus. Third, "regulatory focus theory" is a very popular theme in recent marketing research. It suggests that consumers have two focal goals facing each other: promotion vs. prevention. A promotion focus deals with the concepts of hope, inspiration, achievement, or gain, whereas prevention focus involves duty, responsibility, safety, or loss-aversion. Thus, while consumers with a promotion focus tend to take risks for gain, the same does not hold true for a prevention focus. Regulatory focus theory predicts consumers' emotions, creativity, attitudes, memory, performance, and judgment, as documented in a vast field of marketing and psychology articles. The perspective of the current study in exploring consumer choice and common features is a somewhat creative viewpoint in the area of regulatory focus. These reviews inspire this study of the interaction possibility between regulatory focus and common features with a no-choice option. Specifically, adding common features rather than omitting them may increase the no-choice option ratio in the choice setting only to prevention-focused consumers, but vice versa to promotion-focused consumers. The reasoning is that when prevention-focused consumers come in contact with common features, they may perceive higher similarity among the alternatives. This conflict among similar options would increase the no-choice ratio. Promotion-focused consumers, however, are possible that they perceive common features as a cue of confirmation bias. And thus their confirmation processing would make their prior preference more robust, then the no-choice ratio may shrink. This logic is verified in two experiments. The first is a
Corporate social responsibility has become a very important issue for researchers (Greenfield, 2004; Maignan & Ralston, 2002; McWilliams et al., 2006; Pearce & Doh 2005), and many consider it necessary for businesses to define their role in society and apply social and ethical standards to their businesses (Lichtenstein et al., 2004). As a result, a significant number of retailers have adopted CSR as a strategic tool to promote their businesses. To this end, this study sought to discover U.S. consumers' attitudes and behavior in ethical purchasing and consumption based on their subjective perception and evaluation of a retailer. The objectives of this study include: 1) determine the participants awareness of retailers corporate social responsibility; 2) assess how participants evaluate retailers corporate social responsibility; 3) examine whether participants evaluation process of retailers CSR influence their attitude toward the retailer; and 4) assess if participants attitude toward the retailers CSR influence their purchase behavior. This study does not focus on actual retailers' CSR performance because a consumer's decision making process is based on an individual assessment not an actual fact. This study examines US college students' awareness and evaluations of retailers' corporate social responsibility (CSR). Fifty six college students at a major Southeastern university participated in the study. The age of the participants ranged from 18 to 26 years old. Content analysis was conducted with open coding and focused coding. Over 100 single-spaced pages of written responses were collected and analyzed. Two steps of coding (i.e., open coding and focused coding) were conducted (Esterberg, 2002). Coding results and analytic memos were used to understand participants' awareness of CSR and their ethical purchasing behavior supported through the selection and inclusion of direct quotes that were extracted from the written responses. Names used here are pseudonyms to protect confidentiality of participants. Participants were asked to write about retailers, their aware-ness of CSR issues, and to evaluate a retailer's CSR performance. A majority (n = 28) of respondents indicated their awareness of CSR but have not felt the need to act on this issue. Few (n=8) indicated that they are aware of this issue but not greatly concerned. Findings suggest that when college students evaluate retailers' CSR performance, they use three dimensions of CSR: employee support, community support, and environmental support. Employee treatment and support were found as an important criterion in evaluation of retailers' CSR. Respondents indicated that their good experience with a retailer as an employee made them have a positive perception and attitude toward the retailer. Regarding employee support four themes emerged: employee rewards and incentives based on performance, working environment, employee education and training program, and employee and family discounts. Well organized rewards and incentives were mentioned as an important attribute. The factors related to the working environment included: how well retailers follow the rules related to working hours, lunch time and breaks was also one of the most mentioned attributes. Regarding community support, three themes emerged: contributing a percentage of sales to the local community, financial contribution to charity organizations, and events for community support. Regarding environments, two themes emerged: recycling and selling organic or green products. It was mentioned in the responses that retailers are trying to do what they can to be environmentally friendly. One respondent mentioned that the company is creating stores that have an environmentally friendly design. Information about what the company does to help the environment can easily be found on the company’s website as well. Respondents have also noticed that the stores are starting to offer products that are organic and environmentally friendly. A retailer was also mentioned by a respondent in this category in reference to how the company uses eco-friendly cups and how they are helping to rebuild homes in New Orleans. The respondents noticed that a retailer offers reusable bags for their consumers to purchase. One respondent stated that a retailer uses its products to help the environment, through offering organic cotton. After thorough analysis of responses, we found that a participant's evaluation of a retailers' CSR influenced their attitudes towards retailers. However, there was a significant gap between attitudes and purchasing behavior. Although the participants had positive attitudes toward retailers CSR, the lack of funds and time influenced their purchase behavior. Overall, half (n=28) of the respondents mentioned that CSR performance affects their purchasing decisions making when shopping. Findings from this study provide support for retailers to consider their corporate social responsibility when developing their image with the consumer. This study implied that consumers evaluate retailers based on employee, community and environmental support. The evaluation, attitude and purchase behavior of consumers seem to be intertwined. That is, evaluation is based on the knowledge the consumer has of the retailers CSR. That knowledge may influence their attitude toward the retailer and thus influence their purchase behavior. Participants also indicated that having CSR makes them think highly of the retailer, but it does not influence their purchase behavior. Price and convenience seem to surpass the importance of CSR among the participants. Implications, recommendations for future research, and limitations of the study are also discussed.
For us, there is virtually no distinction between being a responsible citizen and a successful business... they are one and the same for Wal-Mart today." ~ Lee Scott, al-Mart CEO after the 2005 Katrina disaster; cited in Green to Gold (Esty and Winston 2006). Lee Scott's statement signaled a new era in sustainability as manufacturers and retailers around the globe watched the world's largest mass merchandiser confirm its intentions with respect to sustainability. For decades, the environmental movement has grown, slowly bleeding over into the corporate world. Companies have been born, products have been created, academic journals have been launched, and government initiatives have been undertaken - all in the pursuit of sustainability (Peattie and Crane 2005). While progress has been admittedly slower than some may desire, the emergence and entrance of environmentally concerned mass merchandisers has done much to help with sustainable efforts. To better understand this movement, we incorporate the perspectives of both executives and consumers involved in the consumer packaged goods (CPG) industry. This research relies on three underlying themes: (1) Conceptual and anecdotal evidence suggests that companies undertake sustainability initiatives for a plethora of reasons, (2) The number of sustainability initiatives continues to increase in the consumer packaged goods industries, and (3) That it is, therefore, necessary to explore the role that sustainability plays in the minds of consumers. In light of these themes, surveys were administered to and completed by 143 college students and 101 business executives to assess a number of variables in regards to sustainability including willingness-to-pay, behavioral intentions, attitudes, willingness-to-pay, and preferences. Survey results indicate that the top three reasons why executives believe sustainability to be important include (1) the opportunity for profitability, (2) the fulfillment of an obligation to the environment, and (3) a responsibility to customers and shareholders. College students identified the top three reasons as (1) a responsibility to the environment, (2) an indebtedness to future generations, and (3) an effective management of resources. While the rationale for supporting sustainability efforts differed between college students and executives, the executives and consumers reported similar responses for the majority of the remaining sustainability issues. Furthermore, when we asked consumers to assess the importance of six key issues (healthcare, economy, education, crime, government spending, and environment) previously identified as important to consumers by Gallup Poll, protecting the environment only ranked fourth out of the six (Carlson 2005). While all six of these issues were identified as important, the top three that emerged as most important were (1) improvements in education, (2) the economy, and (3) health care. As the pursuit and incorporation of sustainability continues to evolve, so too will the expected outcomes. New definitions of performance that reflect the social/business benefits as well as the lengthened implementation period are relevant and warranted (Ehrenfeld 2005; Hitchcock and Willard 2006). We identified three primary categories of outcomes based on a literature review of both anecdotal and conceptual expectations of sustainability: (1) improvements in constituent satisfaction, (2) differentiation opportunities, and (3) financial rewards. Within each of these categories, several specific outcomes were identified resulting in eleven different outcomes arising from sustainability initiatives. Our survey results indicate that the top five most likely outcomes for companies that pursue sustainability are: (1) green consumers will be more satisfied, (2) company image will be better, (3) corporate responsibility will be enhanced, (4) energy costs will be reduced, and (5) products will be more innovative. Additionally, to better understand the interesting intersection between the environmental "identity" of a consumer and the willingness to manifest that identity with marketplace purchases, we extended prior research developed by Experian Research (2008). Accordingly, respondents were categorized as one of four types of green consumers (Behavioral Greens, Think Greens, Potential Greens, or True Browns) to garner a better understanding of the green consumer in addition to assisting with a more effective interpretation of results. We assessed these consumers' willingness to engage in eco-friendly behavior by evaluating three options: (1) shopping at retailers that support environmental initiatives, (2) paying more for products that protect the environment, and (3) paying higher taxes so the government can support environmental initiatives. Think Greens expressed the greatest willingness to change, followed by Behavioral Greens, Potential Greens, and True Browns. These differences were all significant at p<.01. Further Conclusions and Implications We have undertaken a descriptive study which seeks to enhance our understanding of the strategic domain of sustainability. Specifically, this research fills a gap in the literature by comparing and contrasting the sustainability views of business executives and consumers with specific regard to preferences, intentions, willingness-to-pay, behavior, and attitudes. For practitioners, much can be gained from a strategic standpoint. In addition to the many results already reported, respondents also reported than willing to pay more for products that protect the environment. Other specific results indicate that female respondents consistently communicate a stronger willingness than males to pay more for these products and to shop at eco-friendly retailers. Knowing this additional information, practitioners can now have a more specific market in which to target and communicate their sustainability efforts. While this research is only an initial step towards understanding similarities and differences among practitioners and consumers regarding sustainability, it presents original findings that contribute to both practice and research. Future research should be directed toward examining other variables affecting this relationship, as well as other specific industries.
This study attempts to examine the influence that negative WOM (NWOM) has in an online context. It specifically focuses on the impact of the service failure description and the perceived intention of the communication provider on consumer evaluations of firm competence, attitude toward the firm, positive word of mouth and behavioral intentions. Studies of communication persuasiveness focus on "who says what; to whom; in which channel; with what effect (Chiu 2007)." In this research study, we examine electronic web posting, particularly focusing on two aspects of "what": the level of service failure communicated and perceived intention of the individual posting. It stands to reason electronic NWOM that appears to be trying to damage a product’s or firm's reputation will be viewed as more biased and will thus be considered as less credible. According to attribution theory, people search for the causes of events especially those that are negative and unexpected (Weiner 2006). Hennig-Thurau and Walsh (2003) state "since the reader has only limited knowledge and trust of the author of an online articulation the quality of the contribution could be expected to serve as a potent moderator of the articulation-behavior relationship. We therefore posit the following hypotheses: H1. Subjects exposed to electronic NWOM describing a high level of service failure will provide lower scores on measures of (a) firm competence, (b) attitude toward the firm, (c) positive word of mouth, and (d) behavioral intention than will subjects exposed to electronic NWOM describing a low level of service failure. H2. Subjects exposed to electronic NWOM with a warning intent will provide lower scores on measures of (a) firm competence, (b) attitude toward the firm, (c) positive word of mouth, and (d) behavioral intention than will subjects exposed to electronic NWOM with a vengeful intent. H3. Level of service failure in electronic NWOM will interact with the perceived intention of the electronic NWOM, such that there will be a decrease in mean response on measures of (a) firm competence, (b) attitude toward the firm, (c) positive word of mouth, and (d) behavioral intention from electronic NWOM with a warning intent to a vengeful intent. The main study involved a2 (service failure severity) x2 (NWOM with warning versus vengeful intent) factorial experiment. Stimuli were presented to subjects online using a mock online web posting. The scenario described a service failure associated with non-acceptance of a gift card in a brick-and-mortar retail establishment. A national sample was recruited through an online research firm. A total of 113 subjects participated in the study. A total of 104 surveys were analyzed. The scenario was perceived to be realistic with 92.3% giving the scenario a greater than average response. Manipulations were satisfactory. Measures were pre-tested and validated. Items were analyzed and found reliable and valid. MANOVA results found the multivariate interaction was not significant, allowing our interpretation to proceed to the main effects. Significant main effects were found for post intent and service failure severity. The post intent main effect was attributable to attitude toward the firm, positive word of mouth and behavioral intention. The service failure severity main effect was attributable to all four dependent variables: firm competence, attitude toward the firm, positive word of mouth and behavioral intention. Specifically, firm competence for electronic NWOM describing high severity of service failure was lower than electronic NWOM describing low severity of service failure. Attitude toward the firm for electronic NWOM describing high severity of service failure was lower than electronic NWOM describing low severity of service failure. Positive word of mouth for electronic NWOM describing high severity of service failure was lower than electronic NWOM describing low severity of service failure. Behavioral intention for electronic NWOM describing high severity of service failure was lower for electronic NWOM describing low severity of service failure. Therefore, H1a, H1b, H1c and H1d were all supported. In addition, attitude toward the firm for electronic NWOM with a warning intent was lower than electronic NWOM with a vengeful intent. Positive word of mouth for electronic NWOM with a warning intent was lower than electronic NWOM with a vengeful intent. Behavioral intention for electronic NWOM with a warning intent was lower than electronic NWOM with a vengeful intent. Thus, H2b, H2c and H2d were supported. However, H2a was not supported though results were in the hypothesized direction. Otherwise, there was no significant multivariate service failure severity by post intent interaction, nor was there a significant univariate service failure severity by post intent interaction for any of the three hypothesized variables. Thus, H3 was not supported for any of the four hypothesized variables. This study has research and managerial implications. The findings of this study support prior research that service failure severity impacts consumer perceptions, attitude, positive word of mouth and behavioral intentions (Weun et al. 2004). Of further relevance, this response is evidenced in the online context, suggesting the need for firms to engage in serious focused service recovery efforts. With respect to perceived intention of electronic NWOM, the findings support prior research suggesting reader's attributions of the intentions of a source influence the strength of its impact on perceptions, attitude, positive word of mouth and behavioral intentions. The implication for managers suggests while consumers do find online communications to be credible and influential, not all communications are weighted the same. A benefit of electronic WOM, even when it may be potentially damaging, is it can be monitored for potential problems and additionally offers the possibility of redress.
Digital content makes big changes to our daily lives while bringing opportunities and challenges for companies. Creative firms integrate pictures, texts, videos, audios, and data by digitalization to develop new products or services and create digital experiences to promote their brands. Most articles on digital content contribute to the basic concept or development of marketing it in literature. Actually, compared with traditional value chains for common products or services, the digital content industry seems to have more potential value. Because quite a bit of digital content is free to the consumer, price is not necessarily perceived as an indicator of the quality or value of information (Rowley 2008). It becomes evident that a current theme in digital content is the issue of "value," and research on customers' perceived value of digital content is a necessity. This article argues that experiential value has an advantage in customers' evaluations of digital content. Two different but related contributions to the understanding of "value" of digital content are made here. First, based on the comparison of digital content with products and services, the article proposes two key characteristics that make experiential strategy available for digital content: intangibility and near-zero reproduction cost. On top of that, based on the discussion of the gap between company's idealized value and customer's perceived value, this article emphasizes that digital content prices and pricing of digital content is different from products and services. As a result of intangibility, prices may not reflect customer value. Moreover, the cost of digital content in the development stage may be very high while reproduction costs shrink dramatically. Moreover, because of the value gap mentioned before, the pricing polices vary for different digital contents. For example, flat price policy is generally used for movies and music (Magiera 2001; Netherby 2002), while for continuous demand, digital content such as online games and anti-virus programs involves a more complicated matter of utility and competitive price levels. Digital content companies have to explore various kinds of strategies to overcome this gap. Rethinking marketing solutions such as advertisements, images, and word-of-mouth and their effect on customers' perceived value becomes essential. China's digital content industry is becoming more and more globalized and drawing special attention from different countries and regions that have respective competitive advantages. The 2008-2009 Annual Report on the Development of China's Digital Content Industry (CCIDConsulting 2009) indicates that, with the driven power of domestic demand and governmental policy support, the country's digital content industry maintained a fast growth of some 30 percent in 2008, obviously indicating the initial stage of industry expansion. In China, anti-virus programs and other software programs which need to be updated use a quarter-based pricing policy. Customers can download a trial version for free and use it for six months or a year. If they want to use it longer, continuous payment is needed. They examine the excellence of the digital content during this trial period and decide whether to pay for continued usage. For China’s music and movie industries, as a result of initial development, experiential strategy has not been much applied, even though firms in other countries find the trial experience and explore important strategies(such as customers listening to music for several seconds for free before downloading it). For the above reasons, anti-virus program may be a representative for digital content industry in China and an exploratory study of the advantage of experiential value in customer's perceived value of digital content is done in the anti-virus market of China. In order to enhance the reliability of the survey data, this study focused on people who were experienced users of anti-virus programs. The empirical results revealed that experiential value has a positive effect on customers' perceived value of digital content. In other words, because digital content is intangible and the reproduction costs are nearly zero, customers' evaluations are based heavily on their experience. Moreover, image and word-of-mouth do not have a positive effect on perceived value, only on experiential value. That is to say, a digital content value chain is different from that of a general product or service. Experiential value has a notable advantage and mediates the effect of image and word-of-mouth on perceived value. The results of this study help provide an understanding of why free digital content downloads exist in developing countries. Customers can perceive the value of digital content only by using and experiencing it. This is also why such governments support the development of digital content. Other developing countries whose digital content business is also in the beginning stage can make use of the suggestions here. Moreover, based on the advantage of experiential strategy, companies should make more of an effort to invest in customers' experience. As a result of the characteristics and value gap of digital content, customers perceive more value in the intangible digital content only by experiencing what they really want. Moreover, because of the near-zero reproduction costs, companies can perhaps use experiential strategy to enhance customer understanding of digital content.
The purpose of the study was to introduce an integrated approach of new Casuistry and specified principlism in resolving ethical problems and studying nursing ethics. In studying clinical ethics and nursing ethics, there is no systematic research method. While nurses often experience ethical dilemmas in practice, much of previous research on nursing ethics has focused merely on describing the existing problems. In addition, ethists presented theoretical analysis and critics rather than providing the specific problems solving strategies. There is a need in clinical situations for an integrated method which can provide the objective description for existing problem situations as well as specific problem solving methods. We inherit two distinct ways of discussing ethical issues. One of these frames these issues in terms of principles, rules, and other general ideas; the other focuses on the specific features of particular kinds of moral cases. In the first way general ethical rules relate to specific moral cases in a theoretical manner, with universal rules serving as "axioms" from which particular moral judgments are deduced as theorems. In the seconds, this relation is frankly practical. with general moral rules serving as "maxims", which can be fully understood only in terms of the paradigmatic cases that define their meaning and force. Theoretical arguments are structured in ways that free them from any dependence on the circumstances of their presentation and ensure them a validity of a kind that is not affected by the practical context of use. In formal arguments particular conclusions are deduced from("entailed by") the initial axioms or universal principles that are the apex of the argument. So the truth or certainty that attaches to those axioms flows downward to the specific instances to be "proved". In the language of formal logic, the axioms are major premises, the facts that specify the present instance are minor premises, and the conclusion to be "proved" is deduced (follows necessarily) from the initial presises. Practical arguments, by contrast, involve a wider range of factors than formal deductions and are read with an eye to their occasion of use. Instead of aiming at strict entailments, they draw on the outcomes of previous experience, carrying over the procedures used to resolve earlier problems and reapply them in new problmatic situations. Practical arguments depend for their power on how closely the present circumstances resemble those of the earlier precedent cases for which this particular type of argument was originally devised. So. in practical arguments, the truths and certitudes established in the precedent cases pass sideways, so as to provide "resolutions" of later problems. In the language of rational analysis, the facts of the present case define the gounds on which any resolution must be based; the general considerations that carried wight in similar situations provide warrants that help settle future cases. So the resolution of any problem holds good presumptively; its strengh depends on the similarities between the present case and the prededents; and its soundness can be challenged (or rebutted) in situations that are recognized ans exceptional. Jonsen & Toulmin (1988), and Jonsen (1991) introduce New Casuistry as a practical method. The oxford English Dictionary defines casuistry quite accurately as "that part of ethics which resolves cases of conscience, applying the general rules of religion and morality to particular instances in which circumstances alter cases or in which there appears to be a conflict of duties." They modified the casuistry of the medieval ages to use in clinical situations which is characterized by "the typology of cases and the analogy as an inference method". A case is the unit of analysis. The structure of case was made with interaction of situation and moral rules. The situation is what surrounds or stands around. The moral rule is the essence of case. The analogy can be objective because "the grounds, the warrants, the theoretical backing, the modal qualifiers" are identified in the cases. The specified principlism was the method that Degrazia (1992) integrated the principlism and the specification introduced by Richardson (1990). In this method, the principle is specified by adding information about limitations of the scope and restricting the range of the principle. This should be substantive qualifications. The integrated method is an combination of the New Casuistry and the specified principlism. For example, the study was "Ethical problems experienced by nurses in the care of terminally ill patients"(Um, 1994). A semi-structured in-depth interview was conducted for fifteen nurses who mainly took care of terminally ill patients. The first stage, twenty one cases were identified as relevant to the topic, and then were classified to four types of problems. For instance, one of these types was the patient's refusal of care. The second stage, the ethical problems in the case were defined, and then the case was analyzed. This was to analyze the reasons, the ethical values, and the related ethical principles in the cases. Then the interpretation was synthetically done by integration of the result of analysis and the situation. The third stage was the ordering phase of the cases, which was done according to the result of the interpretation and the common principles in the cases. The first two stages describe the methodology of new casuistry, and the final stage was for the methodology of the specified principlism. The common principles were the principle of autonomy and the principle of caring. The principle of autonomy was specified; when competent patients refused care, nurse should discontinue the care to respect for the patients' decision. The principle of caring was also specified; when the competent patients refused care, nurses should continue to provide the care in spite of the patients' refusal to preserve their life. These specification may lead the opposite behavior, which emphasizes the importance of nurse's will and intentions to make their decision in the clinical situations.
Bullying has recently become a serious social problem in Korean society. Bullying, which is defined as a phenomenon that one particular student is intensively and continuously harassed or ostracized by a group of students, is apt to produce harmful effects on bullies as well as victims. Bullying has many causes including those originated from the personality of victims and bullies. This study is designed to investigate the difference in personality trait between victims, bullies, victims/bullies, and neither. The subjects of this study were 215(115 male and 100 female) 6th-grade students in the primary school in Seoul. Questionnares were distributed to the students and their carers. The student carers were also asked to answer the questions for a survey called the Korean Personality Invertory for Children(KPI-C). SPSS was used for the statistical analysis of the collected test information；ANOVA, post hoc scheffe test, and T-test were used to analyze the differences between the tested groups. The result of the study is as follows. 1) The victims, bullies, victims/bullies and neither totaled respectively 11(5.1%), 56(26.0%), 11(5.1%) and 137(63.7%). 115 were male and 100 were female. 2) The frequency of victimized is as follows：1 time is 15(7.0%), 2 times is 4(1.9%) and more than 3 times is 3(1.4%). The frequency of bullying is as follows；1 time is 40(18.6%), 2 times is 17 (7.9%) and more than 3 times is 10(4.7%). 3) The differences between froups in KPI-C test is as follows. (1) The ESR(p=.00) scale was significantly lower in the victims group than in the neither group and the HPR(p=.00) scale and PSY(p<.01) scale were significantly higher in the former than in the latter. (2) The ESR(p=.00) scale was significantly lower in the victims/bullies group than in the neither group and the SOM(p=.00) scale and HPR(p=.00) scale were significantly higher in the formaer than in the latter. (3) The SOC(p=.00) scale, PSY(p<.01) scale and AUT(p=.00) scale were significantly higher in the victims group than in the bullies group. (4) There is statistically no difference between the bullies group and the neither group. To conclusion, Victims need to learn how to cope with harsh situations, or they will have to face difficulties in relationships. Even after they experience bullying, they may not realize why they have been bullied, or speak out for themselves.
Nursing of today has as one of its objectives the solving of problems related to human needs arising from the demands of a rapidly changing society. This nursing objective, I believe, can he attained by the appropriate application of scientific principles in the giving of comprehensive nursing care. Comprehensive nursing care may be defined as nursing care which meets all of the patient's needs. the needs of patients are said to fall into five broad categories: physical needs, psychological needs, environmental needs, socio-economic needs, and teaching needs. Most people who become ill have adjustment problems related to their new situation. Because patient teaching is one of the most important functions of professional nursing, the success of this teaching may be used as a gauge for evaluating comprehensive nursing care. This represents a challenge foe the future. A questionnaire consisting of 67 items was distributed to 200 professional nurses working ill direct patient care at Yonsei University Medical Center in Seoul, Korea. 160 (80,0%) nurses of the total sample returned completed questionnaires 81 (50.6%) nurses were graduates of 3 fear diploma courser 79 (49.4%) nurses were graduates of 4 year collegiate nursing schools in Korea 141 (88,1%) nurses had under 5 years of clinical experience in a medical center, while 19 (11.9%) nurses had more than 5years of clinical experience. Three hypotheses were tested: 1. “Nurses had high levels of concept and knowledge toward patient teaching”-This was demonstrated by the use of a statistical method, the mean average. 2. “Nurses graduating from collegiate programs and diploma school programs of nursing show differences in concepts and knowledge toward patient teaching”-This was demonstrated by a statistical method, the mean average, although the results showed little difference between the two groups. 3. “Nurses having different amounts of clinical experience showed differences in concepts and knowledge toward patient teaching”-This was demonstrated by the use of a statistical method, the mean average. 2. “Nurses graduating from collegiate programs and diploma school programs of nursing show differences in concepts and knowledge toward patient teaching”-This was demonstrated by a statistical method, the mean average, although the results showed little difference between the two groups. 3. “Nurses having different amounts of clinical experience showed differences in concepts and knowledge toward patient teaching”-This was demonstrated by the use of the T-test. Conclusions of this study are as follow: Before attempting the explanation, of the results, the questionnaire will he explained. The questionnaire contained 67 questions divided into 9 sections. These sections were: concept, content, time, prior preparation, method, purpose, condition, evaluation, and recommendations for patient teaching. 1. The nurse's concept of patient teaching: Most of the nurses had high levels of concepts and knowledge toward patient teaching. Though nursing service was task-centered at the turn of the century, the emphasis today is put on patient-centered nursing. But we find some of the nurses (39.4%) still are task-centered. After, patient teaching, only a few of the nurses (14.4%) checked this as “normal teaching.”It seems therefore that patient teaching is often done unconsciously. Accordingly it would he desirable to have correct concepts and knowledge of teaching taught in schools of nursing. 2. Contents of patient teaching: Most nurses (97.5%) had good information about content of patient teaching. They teach their patients during admission about their diseases, tests, treatments, and before discharge give nurses instruction about simple nursing care, personal hygiene, special diets, rest and sleep, elimination etc. 3. Time of patient teaching: Teaching can be accomplished even if there is no time set aside specifically for it. -a large part of the nurse's teaching can be done while she is giving nursing care. If she believes she has to wait for time free from other activities, she may miss many teaching opportunities. But generally proper time for patient teaching is in the midmorning or midafternoon since one and a half or two hours required. Nurses meet their patients in all stages of health: often tile patient is in a condition in which learning is impossible-pain, mental confusion, debilitation, loss of sensory perception, fear and anxiety-any of these conditions may preclude the possibility of successful teaching. 4. Prior preparation for patient teaching: The teaching aids, nurses use are charts (53.1%), periodicals (23.8%), and books (7.0%) Some of the respondents (28.1%) reported that they had had good preparation for the teaching which they were doing, others (27.5%) reported adequate preparation, and others (43.8%) reported that their preparation for teaching was inadequate. If nurses have advance preparation for normal teaching and are aware of their objectives in teaching patients, they can do effective teaching. 5. Method of patient teaching: The methods of individual patient teaching, the nurses in this study used, were conversation (55.6%) and individual discussion (19.2%) . And the methods of group patient teaching they used were demonstration (42.3%) and lecture (26.2%) They should also he prepared to use pamphlet and simple audio-visual aids for their teaching. 6. Purposes of patient teaching: The purposes of patient teaching is to help the patient recover completely, but the majority of the respondents (40.6%) don't know this. So it is necessary for them to understand correctly the purpose of patient teaching and nursing care. 7. Condition of patient teaching: The majority of respondents (75.0%) reported there were some troubles in teaching uncooperative patients. It would seem that the nurse's leaching would be improved if, in her preparation, she was given a better understanding of the patient and communication skills. The majority of respondents in the total group, felt teaching is their responsibility and they should teach their patient's family as well as the patient. The place for teaching is most often at the patient's bedside (95.6%) but the conference room (3.1%) is also used. It is important that privacy be provided in learning situations with involve personal matters. 8. Evaluation of patient teaching: The majority of respondents (76.3%,) felt leaching is a highly systematic and organized function requiring special preparation in a college or university, they have the idea that teaching is a continuous and ever-present activity of all people throughout their lives. The suggestion mentioned the most frequently for improving preparation was a course in patient teaching included in the basic nursing program. 9. Recommendations: 1) It is recommended, that in clinical nursing, patient teaching be emphasized. 2) It is recommended, that insertive education the concepts and purposes of patient teaching he renewed for all nurses. In addition to this new knowledge, methods and materials which can be applied to patient teaching should be given also. 3) It is recommended, in group patient teaching, we try to embark on team teaching.