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

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

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The Research on Online Game Hedonic Experience - Focusing on Moderate Effect of Perceived Complexity - (온라인 게임에서의 쾌락적 경험에 관한 연구 - 지각된 복잡성의 조절효과를 중심으로 -)

  • Lee, Jong-Ho;Jung, Yun-Hee
    • Journal of Global Scholars of Marketing Science
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    • v.18 no.2
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    • pp.147-187
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    • 2008
  • Online game researchers focus on the flow and factors influencing flow. Flow is conceptualized as an optimal experience state and useful explaining game experience in online. Many game studies focused on the customer loyalty and flow in playing online game, In showing specific game experience, however, it doesn't examine multidimensional experience process. Flow is not construct which show absorbing process, but construct which show absorbing result. Hence, Flow is not adequate to examine multidimensional experience of games. Online game is included in hedonic consumption. Hedonic consumption is a relatively new field of study in consumer research and it explores the consumption experience as a experiential view(Hirschman and Holbrook 1982). Hedonic consumption explores the consumption experience not as an information processing event but from a phenomenological of experiential view, which is a primarily subjective state. It includes various playful leisure activities, sensory pleasures, daydreams, esthetic enjoyment, and emotional responses. In online game experience, therefore, it is right to access through a experiential view of hedonic consumption. The objective of this paper was to make up for lacks in our understanding of online game experience by developing a framework for better insight into the hedonic experience of online game. We developed this framework by integrating and extending existing research in marketing, online game and hedonic responses. We then discussed several expectations for this framework. We concluded by discussing the results of this study, providing general recommendation and directions for future research. In hedonic response research, Lacher's research(1994)and Jongho lee and Yunhee Jung' research (2005;2006) has served as a fundamental starting point of our research. A common element in this extended research is the repeated identification of the four hedonic responses: sensory response, imaginal response, emotional response, analytic response. The validity of these four constructs finds in research of music(Lacher 1994) and movie(Jongho lee and Yunhee Jung' research 2005;2006). But, previous research on hedonic response didn't show that constructs of hedonic response have cause-effect relation. Also, although hedonic response enable to different by stimulus properties. effects of stimulus properties is not showed. To fill this gap, while largely based on Lacher(1994)' research and Jongho Lee and Yunhee Jung(2005, 2006)' research, we made several important adaptation with the primary goal of bringing the model into online game and compensating lacks of previous research. We maintained the same construct proposed by Lacher et al.(1994), with four constructs of hedonic response:sensory response, imaginal response, emotional response, analytical response. In this study, the sensory response is typified by some physical movement(Yingling 1962), the imaginal response is typified by images, memories, or situations that game evokes(Myers 1914), and the emotional response represents the feelings one experiences when playing game, such as pleasure, arousal, dominance, finally, the analytical response is that game player engaged in cognition seeking while playing game(Myers 1912). However, this paper has several important differences. We attempted to suggest multi-dimensional experience process in online game and cause-effect relation among hedonic responses. Also, We investigated moderate effects of perceived complexity. Previous studies about hedonic responses didn't show influences of stimulus properties. According to Berlyne's theory(1960, 1974) of aesthetic response, perceived complexity is a important construct because it effects pleasure. Pleasure in response to an object will increase with increased complexity, to an optimal level. After that, with increased complexity, pleasure begins with a linearly increasing line for complexity. Therefore, We expected this perceived complexity will influence hedonic response in game experience. We discussed the rationale for these suggested changes, the assumptions of the resulting framework, and developed some expectations based on its application in Online game context. In the first stage of methodology, questions were developed to measure the constructs. We constructed a survey measuring our theoretical constructs based on a combination of sources, including Yingling(1962), Hargreaves(1962), Lacher (1994), Jongho Lee and Yunhee Jung(2005, 2006), Mehrabian and Russell(1974), Pucely et al(1987). Based on comments received in the pretest, we made several revisions to arrive at our final survey. We investigated the proposed framework through a convenience sample, where participation in a self-report survey was solicited from various respondents having different knowledges. All respondents participated to different degrees, in these habitually practiced activities and received no compensation for their participation. Questionnaires were distributed to graduates and we used 381 completed questionnaires to analysis. The sample consisted of more men(n=225) than women(n=156). In measure, the study used multi-item scales based previous study. We analyze the data using structural equation modeling(LISREL-VIII; Joreskog and Sorbom 1993). First, we used the entire sample(n=381) to refine the measures and test their convergent and discriminant validity. The evidence from both the factor analysis and the analysis of reliability provides support that the scales exhibit internal consistency and construct validity. Second, we test the hypothesized structural model. And, we divided the sample into two different complexity group and analyze the hypothesized structural model of each group. The analysis suggest that hedonic response plays different roles from hypothesized in our study. The results indicate that hedonic response-sensory response, imaginal response, emotional response, analytical response- are related positively to respondents' level of game satisfaction. And game satisfaction is related to higher levels of game loyalty. Additionally, we found that perceived complexity is important to online game experience. Our results suggest that importance of each hedonic response different by perceived game complexity. Understanding the role of perceived complexity in hedonic response enables to have a better understanding of underlying mechanisms at game experience. If game has high complexity, analytical response become important response. So game producers or marketers have to consider more cognitive stimulus. Controversy, if game has low complexity, sensorial response respectively become important. Finally, we discussed several limitations of our study and suggested directions for future research. we concluded with a discussion of managerial implications. Our study provides managers with a basis for game strategies.

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A Study of the Impractical Area and Boundary of an Outer Royal Garden "Hamchunwon" Attached to Gyeonghuigung Palace (경희궁 별원(別苑) 함춘원의 실지(實地) 경역 고찰)

  • Jung, Woo-Jin;Hong, Hyeon-Do;So, Hyun-Su
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.40 no.1
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    • pp.26-42
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    • 2022
  • The purpose of this study is to examine and understand the area and the original outer boundaries of Hamchunwon(含春苑), which was the outer royal garden of Gyeonghuigung Palace, which existed before the site of the Russian legation. The results of the study are as follows. First, examining the 3 types of drawings prepared for securing the Russian legation's site and constructing a new building, it was confirmed that two low peaks, which appear to be the original terrain of Hamchunwon, existed in the north and south directions inside the site. According to the initial plan of the of the legation's site, it appears that the entrance of the legation building is connected to the Saemunan-ro in the northwest. However, according to the report made at the time when the Russian temporary minister Veber purchased the legation's site, it was recorded that the site already had a narrow entrance and a dirt road in place, and hence, it was connected to Saemunan-ro. This fact makes it possible to learn that the line of movement for officials and the original gate were located to the northwest of the site planned as the entrance of the legation building towards Hamchunwon. Second, the site was created by cutting the top of the high hill at the time of the construction of the legation building, and as a result, a two tiered staircase typed terrace was built. The ground on which the main building and the secretary's building, etc., were erected was made by cutting the highest peak and solidifying it flat, and a large quantity of soil was used for grading. In the case of the northern area of the main building, the traces of leveling the terrain by cutting the mountains are apparent, and an observation typed garden with a walking path and pavilion was formed by utilizing the physical environment equipped with an easy view. This may be considered as a use which is consistent with the topographical conditions of creating an outer royal garden to block the civilian views on a high terrain overlooking the palace. Third, Hamchunwon's fences were partially exposed in the photos from the 1880s through the 1890s, which demonstrate the spatial changes made around the US, UK, and the Russian legations. As a result of the photo analysis performed, Hamchunwon occupies the northern area of the Russian legation's site, and it is estimated that the north, west, and east walls of the legation resembled those of Hamchunwon. The area to the south of the Russian legation was originally a place made available for civilian houses, and it was possible to examine the circumstances of purchasing dozens of civilian houses and farmlands according to various materials. Fourth, Hamchunwon, which was formed as the outer royal garden of Gyeongdeokgung Palace of Lord Gwanghaegun, lost its sense of place as an outer royal garden when the entire building of Gyeonghuigung Palace was torn down and used as a construction members during the reconstruction of Gyeongbokgung Palace, and faded away as the site was sold to Russia around 1885. The area where Hamchunwon used to be located transformed into a core space of the Russian legation where the main building and garden were located after the construction of the new building. Hence, Hamchunwon, which was limited to the northern area of the Russian legation, does not carry the temporal and spatial context with Gyeongungung Palace and Seonwonjeon which were constructed after 1897, and it is determined that the view of Seonwonjeon as Baehoorim or Baegyeongrim is not valid.