• Title/Summary/Keyword: reliability test

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Research of Diffusion Bonding of Tungsten/Copper and Their Properties under High Heat Flux

  • Li, Jun;Yang, Jianfeng
    • Proceedings of the Materials Research Society of Korea Conference
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    • 2011.05a
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    • pp.14-14
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    • 2011
  • W (tungsten)-alloys will be the most promising plasma facing armor materials in highly loaded plasma interactive components of the next step fusion reactors due to its high melting point, high sputtering resistance and low deuterium/tritium retention. The bonding technology of tungsten to Cu alloy was one of the key issues. In this paper, W/CuCrZr diffusion bonding has been performed successfully by inserting pure metal interlay. The joint microstructure, interfacial elements migration and phase composition were analyzed by SEM, EDS, XRD, and the joint shear strength and micro-hardness were investigated. The mock-ups were fabricated successfully with diffusion bonding and the cladding technology respectively, and the high heat flux test and thermal fatigue test were carried out under actively cooling condition. When Ni foil was used for the bonding of tungsten to CuCrZr, two reaction layers, Ni4W and Ni(W) layer, appeared between the tungsten and Ni interlayer with the optimized condition. Even though Ni4W is hard and brittle, and the strength of the joint was oppositely increased (217 MPa) due primarily to extremely small thicknesses (2~3 ${\mu}m$). When Ti foil was selected as the interlayer, the Ti foil diffused quickly with Cu and was transformed into liquid phase at $1,000^{\circ}C$. Almost all of the liquid was extruded out of the interface zone under bonding pressure, and an extremely thin residual layer (1~2 ${\mu}m$) of the liquid phase was retained between the tungsten and CuCrZr, which shear strength exceeded 160 MPa. When Ni/Ti/Ni multiple interlayers were used for bonding of tungsten to CuCrZr, a large number of intermetallic compound ($Ni_4W/NiTi_2/NiTi/Ni_3T$) were formed for the interdiffusion among W, Ni and Ti. Therefore, the shear strength of the joint was low and just about 85 MPa. The residual stresses in the clad samples with flat, arc, rectangle and trapezoid interface were estimated by Finite Element Analysis. The simulation results show that the flat clad sample was subjected maximum residual stress at the edge of the interface, which could be cracked at the edge and propagated along the interface. As for the rectangle and trapezoid interface, the residual stresses of the interface were lower than that of the flat interface, and the interface of the arc clad sample have lowest residual stress and all of the residual stress with arc interface were divided into different grooved zones, so the probabilities of cracking and propagation were lower than other interfaces. The residual stresses of the mock-ups under high heat flux of 10 $MW/m^2$ were estimated by Finite Element Analysis. The tungsten of the flat interfaces was subjected to tensile stresses (positive $S_x$), and the CuCrZr was subjected to compressive stresses (negative $S_x$). If the interface have a little microcrack, the tungsten of joint was more liable to propagate than the CuCrZr due to the brittle of the tungsten. However, when the flat interface was substituted by arc interfaces, the periodical residual stresses in the joining region were either released or formed a stress field prohibiting the growth or nucleation of the interfacial cracks. Thermal fatigue tests were performed on the mock-ups of flat and arc interface under the heat flux of 10 $MW/m^2$ with the cooling water velocity of 10 m/s. After thermal cycle experiments, a large number of microcracks appeared at the tungsten substrate due to large radial tensile stress on the flat mock-up. The defects would largely affect the heat transfer capability and the structure reliability of the mock-up. As for the arc mock-up, even though some microcracks were found at the interface of the regions, all microcracks with arc interface were divided into different arc-grooved zones, so the propagation of microcracks is difficult.

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Importance-Performance Analysis of Service Quality of In Campus Specialty Coffee Shop (대학내 커피전문점 서비스품질에 대한 중요도-수행도 분석)

  • Kim, Hyun-Ah
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.37 no.8
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    • pp.1069-1078
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    • 2008
  • The purposes of this study were to identify the consumer behavior using in campus specialty coffee shop and to establish the marketing strategies through Importance-Performance Analysis (IPA) of service quality. Questionnaires were distributed to 725 students at K University located in Masan, from April 23 to May 3, 2007. Finally, 621 questionnaires were included in the final analysis (response rate: 85.7%). For statistical analysis, SPSS (12.0) was used to conduct the descriptive analysis, t-test, factor analysis and reliability test. The results of this study were as follows. The average cost of using specialty coffee shop in campus was \ 2,096, the average staying time was 25.92 min and the average number of visits per month was 2.17 times. The importance level of 'employee's attitude', 'physical environment', 'sensory quality of coffee', 'beverage features', 'representativeness' were 3.88, 3.79, 3.73, 3.67, 3.28 points, respectively. Also, the performance level of 'sensory quality of coffee', 'beverage features', 'employee's attitude', 'physical environment', 'representativeness' were 3.13, 3.06, 3.05, 2.77, 2.61, respectively. The importance and performance levels of service quality of specialty coffee shop in campus were significantly different (p<.001). Establishment of marketing strategies for in campus speciality coffee shop was possible through the IPA of service quality. Strategies for improving customer satisfaction were to secure enough chairs/ tables, to procure comfortable chairs for customer and to ensure the quality of coffee bean and service of employee.

A Study on the Nursing Performance of the Home Care Nurses in Seoul (서울지역 가정간호사의 업무수행능력 실태조사)

  • Suh, Moon-Ja;Park, Ho-Ran;Kang, Hyun-Sook;Kim, So-Sun;Shin, Kyung-Lim;Kim, Keun-Soon;Kim, Hae-Sook
    • Journal of Home Health Care Nursing
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    • v.6
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    • pp.46-58
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    • 1999
  • The purpose of this research was to find out the state of the nursing performance of the home care nurses in Seoul in order to provide the data for the practical work guide. The data were collected from fifty home care nurses working in 22 institutions located in Seoul. The research tool used for this research was modified and tested by Song Jong-Rye(1999) which was originally modified the standard tool of American Nurses Association (1998) and was partly supplement and adjusted for this research. The reliability of this tool was Cronbach's $\alpha$=.0982. The collected data were statistically processed using SAS for t-test, ANOVA. $Scheff\'{e}$ test. Among the surveyees, 50% have been working as a home care nurse more than three years and 74.0% of them were married. And 52% have B.S degree with certification of home care nurse from the certification program for Home Care Nurses affiliated at nursing schools. Half of the home care nursing organizations were based on the general hospitals, and most(78%) of the responsible senior personnels of those organizations were nurses. The following results are drawn from this research. 1) The level of nursing performance by the task sectors General performance level of home care nurses was relatively high in grade of 3.06 from total 4.00. Among the task sectors. the ethical field scored the highest points, and the next were nursing intervention, professional training, and data gathering, and the research sector scored the lowest point. 2) The level of nursing performance by general features of home care nurses Statistically relevant correlation between performance according to the duration of working experience as a nurse(p=0.8951) and performance according to the duration of working as home care nurse(p=0.2263) did not emerge. Also, performance by marriage status(p=0.2218), education(p=0.5733), and taking the certification program for home card nurse(p =0.1560) has no statistically meaningful correlation. 3) The level of nursing performance by the type of home care nursing organizations There exists a significant difference(p=0.002) between performances by the types of organizations. Most of the responsible senior personnels of the home care nursing organization were nurses. The level of nursing performance of the home care nursing organization under nurse management was relatively higher than that of home care nursing organizations led by medical doctors or non-medical professional, but this was not proved as statistically meaningful(p =0.3617). 4) The level of nursing performance by task sectors according to the characteristic of home care nursing service organization There exists a significant difference between nursing performances by task sectors according to the characteristics of home care nursing organization(p=0.002). In case of model research center of one College of Nursing, the nursing performance in the sectors of organization, theory, and data gathering were lower than that of in hospital based home care nursing service. And in case of local home care centers, performances in sectors of organization, theory, data gathering, nursing intervention. professional training, and research sectors were significantly low. Based on the obtained results, overall performance of home care nurses can be appraised as relatively good. Especially, performances in sectors of the nursing intervention, nursing plan. and data gathering including the in direct nursing were recorded high scores. From this, it can be concluded that high quality of nursing is relatively practicing for home patients at these days. Since the high quality of nursing for patients was directly related to the level of nursing performances of home care nurses, it is required to improve practical performance level of them by making constant evaluation and running continual education program and supplementing curriculum for the sectors with low scores.

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A comparative study of educators vs, non-educators designed to improve dental radiographic quality control - Focusing on theories of dental radiographic and practical training and clinical practice education - (치과방사선 질관리 향상을 위한 교육자 대비 비교육자 비교연구 - 치과방사선학 이론 및 실습교육과 임상실습교육을 중심으로 -)

  • Kim, Seung-Hee;Hong, Su-Min;Lee, Kwang-Ok
    • Journal of the Korean Society of Radiology
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    • v.6 no.5
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    • pp.421-426
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    • 2012
  • The purpose of this study was to investigate the knowledge of dental hygiene students of the quality assurance of dental radiation such quality assurance and related educational experiences in an effort to accelerate the preparation of a curriculum for systematic quality-assurance. The subjects in this study were 453 dental hygiene students who participated in dental radiography courses. Varied statistical analyses such as frequency analyses, reliability, chi-square, and independent samples t-tests were conducted on the data collected, using SPSS 12.0. Scheffe test was also used after one-way ANOVA as post-hoc tests. Results showed that (a) the students' acknowledge level of Radiographic Quality Assurance was $7.71{\pm}1.7$ out of 12 on average. The more theory and practical classes students took, the higher points they got (p<0.001); (b) Most of the students experienced 1-3 lessons out of 13 in practical training and 26.3% of students did not take any practical lesson. ;(c)Students who did not take any practical training got 7.20 points out of 13, students who took 1-3 lessons got 7.84 points out of 13, students who took 4-5 lessons got 7.87 points out of 13, and students who took more than 6 lessons got 8.14 points out of 13 on average. The more practical classes they took the higher acknowledge level they were. Therefore it needs to provide adequate practical lessons to them.

암환자 인식에 관한 연구 - 간호사ㆍ의사를 중심으로

  • Jo, In-Hyang
    • Korean Journal of Hospice Care
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    • v.2 no.1
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    • pp.58-74
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    • 2002
  • This paper constitutes a descriptive investigation and used a structured questionnaire to investigate nurses' and doctors' recognition of cancer patients. The subjects were extracted from the medical personnel working at the internal medicine, the surgery ward, the obstetrics and gynecology department, the pediatrics department, the cancer ward, and the emergency room of five general hospitals located in Seoul and Gyeonggi Province. The research lasted from August, 2001 to September 2001. Total 137 nurses and 65 doctors were included and made out the questionnaires directly distributed by the investigator. The study tool was also developed by the investigator and consisted of such items as the demographic and social characteristics, the medical personnel's recognition degree of cancer and cancer patients, their recognition of the management of cancer patients, and their participation in a hospice. The results were analyzed using the SPSS Window program in terms of technological statistics, ranks, t-test, and ANOVA. The reliability was represented in Cronbach' α=.75. The nurses' and doctors' recognition degree of cancer and cancer patients had an overall average of 3.86 at the 5 point-scale. The items that received an average of 4.0 or more included 'Medical personnel should explain about the cancer cure plans to the cancer patient and his or her family', 'A patient whose case has been diagnosed as a terminal cancer should be notified of it, 'If I were a cancer patient, I would want to get informed of it,' and 'Cancer shall be conquered whenever it is'. In the meantime, the items that received an average of 3.0 or less was 'My relationship with the cancer patient's family has gotten worse since I announced his or her impending death.' And according to the general characteristics and the difference test, the recognition degree of cancer and cancer patient was high among the subgroups of nurses, females, married persons, who were in their 30s, who had a family member that was a cancer patient, and who received a hospice education. The biggest number of the nurses and doctors saw 'a gradual approach over several days'(68.8%) as a method to tell a cancer patient about his or her cancer diagnosis or impending death. Those who usually tell tragic news were the physician in charge(62.8%), the family members or relatives(32.1%) and the clergymen(3.8%) in the order. The greatest number of them recommended a cancer patient's home as the place where he or she should face death because they thought 'it would stabilize his or her mentality'(91.9%) while a number of them recommended the hospital because they 'should give the psychological satisfaction to the patient'(40%) or 'should try their best until the last moment of the patient's death'(30%). A majority of the medical personnel regarded 'smoking or drinking' and 'diet' as the causes of cancer. The biggest symptom of a cancer patient was 'pain' and the pain management of a cancer patient was mostly impeded by the 'excessive fear of drug addiction, tolerance to drugs and side effects of drugs' by medical personnel, the patient, and his or her family. The most frequently adopted treatment plan of a terminal cancer patient was 'to do whatever the patient or his or her family wants' to resort to a hospice' and 'to continue active treatment efforts' in the order. The biggest reasons why a terminal cancer patient went to see a doctor were 'pain alleviation' 'control of symptoms other than pain(intravenous supply)' and 'incapability of the patient's family' in the order. Terminal cancer patients placed their major concern in 'spiritual(religious) matter' 'emotional matters' their family' 'existence' and 'physical matters' in the order. 113(58.5%) of the whole medical personnel answered they 'would recommend' an alternative treatment to a terminal cancer patient mostly because they assumed it would 'stabilize the patient's mentality.' Meanwhile, 80(41.5%) of them chose 'not to recommend it mostly due to the unverified effects and high cost of it(78.7%). A majority of them, I. e. 190(94.1%) subjects said they 'would recommend' a hospice to a terminal cancer patient mostly because they thought it would help the patient to 'mentally prepare'(66.6%) Only 17.3% of them, however, had received a hospice education, most of which was done through the hospital duty education(41.4%) and volunteer training(34.5%). The follows are results of this study: 1. The nurses and the doctors turned out to be still passive and experience confusion in dealing with a cancer patient despite their great sense of responsibility for him or her. 2.Nurses and Doctors realize the need of a hospice, but an extremely small number of them participate in a hospice education or performance. Thus, a whole recognition of a hospice should be changed, for which purpose a hospice education for nurses and doctors should be provided. 3.Terminal cancer patients preferred their home to a hospital as the place to face their impending death because they felt it would bring 'mental stability.' And most of nurses and doctors think it would be unnecessary for them to be hospitalized just for control of their symptoms. Accordingly a terminal cancer patient can be cared at home, and a home hospice care needs to be activated.

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Analysis of Influencing Factors Related to Health Promotion Behavior in Hospital Radiological Technologists (종합병원 방사선사의 건강증진행위 관련요인 분석)

  • Ko, Jong-Kyung;Kwon, Duk-Mun;Kang, Yeong-Han
    • Journal of radiological science and technology
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    • v.32 no.4
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    • pp.381-391
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    • 2009
  • Purposes : The purpose of this study was to analyze factors that could affect health of radiological technologists, which is useful for health care and development of programs for health promotion. Methods : Subjects were 234 of radiological technologists who work in general hospitals. Some questionnaires were made about perceptions of health condition and promotional behavior of health for this study. The questionnaires of health perception were 20 items that consist of the present condition of health, health concern and sensitivity. The reliability was sufficient(Cronbach's $\alpha=0.79$). The other questionnaires about health promotion behavior were 47 items that consist of self-realization, health responsibility, exercise, nutrition, personal relationships, and stress management. The results turned out to bewas sufficient (Cronbach's $\alpha=0.93$). Every data was treated statistically, comparison of average(t-test, ANOVA), correlation, and multiple regression. Results : Related factors to health promotion behavior were age, marriage, salary, class of one's position, career, employment, and religion, in general features. In health life habit, related factors were smoke and exercise. Results of health promotion behavior was 2.90 of mean score, 0.37 of standard deviation. Correlations between factors of health perception and health promotion behavior was positive(p<0.01). Health promotion behavior were affected by sensitivity, presents condition of health, exercise, smoke, career. Sensitivity was the most affectable variable, which means that promotional behavior score became higher and higher as the score of sensitivity and present condition were increased. In addition, persons who exercise regularly, had been smoked, and has higher career showed higher score of promotional behavior. Conclusion : Radiological technologists have to keep their health, trying not to infected by a disease. Most of all, no smoking and regular exercise are the most important thing to all of members.

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Development and Animal Tests of Prototype Oxygen Concentrator (국산 산소 농축기의 개발 및 동물실험)

  • 변정욱;성숙환;이태수
    • Journal of Chest Surgery
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    • v.31 no.7
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    • pp.643-649
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    • 1998
  • Background: For the patient with chronic obstructive pulmonary disease requiring long-term oxygen therapy, oxygen concentrator machines are already widely available for use in home. In this study, we used mongrel dogs as test subjects to compare the functional efficiency and safety of the oxygen concentrator developed by our own research team with those of the imported FORLIFE(TM) machine made by AIRSEP Corp. Method and method: To test mechanical reliability, the concentrations of oxygen delivered were measured after 4 hours of continuous operation. Sixteen mongrel dogs were divided into two equal groups. Mongrel dogs in group A were given oxygen using the imported oxygen concentrator, and those in group B using the machine developed. 5 l/min of oxygen were given, after which vital signs were analyzed, arterial blood gases measured, and blood chemistry tests carried out. Results: After 4 hours of continuous operation, the imported model performed better, giving 98${\pm}$3% oxygen, compared to our model, which gave 91${\pm}$1%. In the animal experiments, oxygen concentrations were measured at the inlet of face mask 1, 2, 3, and 4 hours after continuous administration, and there was no statistically significant difference(repeated measures of analysis of variance p=0.70) between the values of 70.6${\pm}$2.5%, 67.1${\pm}$2.9%, 68.2${\pm}$2.6%, and 64.9${\pm}$3.9% that were measured from group A, and the values of 65.1${\pm}$4.8%, 65.2${\pm}$3.6%, 68.7${\pm}$4.3%, and 66.0${\pm}$5.0% measured from group B. Before oxygen administration, and at 1, 2, 3, and 4 hours after oxygen administration, arterial blood partial pressure of oxygen 87.2${\pm}$2.5 mmHg, 347.4${\pm}$29.3 mmHg, 353.4${\pm}$21.2 mmHg, 343.0${\pm}$28.8 mmHg, and 321.6${\pm}$24.4 mmHg, respectively, were read from group A, which were not statistically different (p=0.24) to the values of 102.5${\pm}$9.6 mmHg, 300.3${\pm}$17.1 mmHg, 321.6${\pm}$23.7 mmHg, 303.4${\pm}$27.4 mmHg, and 273.5${\pm}$25.9 mmHg read from group B. Nonetheless, the arterial blood partial pressure of oxygen values appear to be somewhat higher in dogs that were given oxygen using the imported oxygen concentrator. Conclusions: From these results the prototype oxygen concentrator developed appears to function relatively satisfactorily compared to the imported, established model, but may be criticized for the excessive noise generated and poor long-term endurance or consistency, which need improvement.

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A Study on the Moderating Effect of Perceived Voluntariness in the Organizational Information System Usage and Performance (정보시스템 사용과 성과에 있어서 자발성의 조절효과에 관한 연구)

  • Lee, Seung-Chang;Lee, Ho-Geun;Jung, Chang-Wook;Chung, Nam-Ho;Suh, Eung-Kyo
    • Asia pacific journal of information systems
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    • v.19 no.2
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    • pp.195-221
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    • 2009
  • According to an industry report, a large number of organizations have invested in Organizational Information System(OIS) in the past few years. Several research results indicate that successful investments in OIS lead to productivity enhancement, while failed ones result in undesirable consequences such as financial losses and dissatisfaction among employees. In spite of huge investments, however, many organizations have failed in achieving the hoped-for returns from OIS. Thus, understanding user acceptance, adoption, and usage of new IS(Information Systems) is an important issue for IS practitioners. Indeed, study of the user acceptance of new information system has been one of the most important research topics in the contemporary IS literature. Several theoretical models are tested to examine 'user acceptance' and 'usage behavior' in IS context. While many research models incorporate 'ease of use' or 'usefulness' as important factors in explaining user acceptance, Technology Acceptance Model(TAM) has been one of the most widely applied models in user acceptance and usage behavior. Even in recent IS studies that employ theories of innovation diffusion in the area of IS implementation, a major focus has been on the user's perception of information technologies. In this research, we study 'voluntariness' as an important factor in IS acceptance by users. Voluntariness is defined as "the degree to which the use of the innovation is perceived as being voluntary, or of free will" When examining the diffusion of accepting OIS, a thoughtful consideration should be given to 'perceived voluntariness.' Current article has following research questions: 1) What models are appropriate to explain the success of OIS? and 2) How does the 'voluntariness' affect the success of OIS? In order to answer these questions, a research model is proposed to describe the detailed nature of association among three independent variables (IT usage level, task interdependency, and organizational support), a mediating variable (IS usage), a dependent variable (perceived performance), and a moderating variable(perceived voluntariness). The central claim of this article is that organizations hardly realize expected returns from OIS investments unless perceived voluntariness is effectively managed after operating OIS. As an example of OIS in this study we have selected the Intranet of Republic of Korea Air Force (ROKAF). ROKAF has implemented the Intranet in an attempt to improve communication and coordination within the organization. To test our research model and hypotheses, survey questionnaires were first sent out to 400 Intranet users. With the assistance of ROKAF, Intranet users were initially identified among its members, and subjects were randomly drawn from the pool. 377 survey responses were finally returned. The unit of measurement and analysis in this research is a personal level. Path analysis based on structural equation modeling was used to test research hypotheses. Construct validity represents accordance between the theoretical base concept of constructs and its measurement items. Tests for the reliability and discriminant validity are accepted, thus verifying our survey instrument. In this research, we have proposed a conceptual framework to highlight the importance of perceived voluntariness after organization deploys OIS. The results of our analysis present several key finding. First, all three independent variables (IT usage level, task interdependency, and organizational support) have significant effects on IS usage, which will eventually improve performance. Thus, IS usage plays a mediating role between antecedent variables (IT usage level. task interdependency, and organizational support) and performance improvement. Second, the effect of the task dependency was the highest for IS usage among the three antecedent variables. This is highly plausible since one of the Intranet's major capabilities is to facilitate communication among members within an organization. Accordingly, we conclude that the higher the task dependency, the higher Intranet usage. The effect of user's IT usage level was the second, while the effect of the organizational support was the third. Finally, the perceived voluntariness plays a pivotal role in enhancing perceived performance in personal level after launching the Intranet. Relationships among investigated variables were significantly different between groups with a high level and a low level of voluntariness. The impact of the Intranet usage on the performance was greater in the higher level voluntariness group than in the lower one. For the lower level voluntariness group, the user's IT usage had the highest effect on the Intranet usage among the three antecedent variables. In short, our study suggests that the higher the perceived voluntariness is the more IS usage will be. Perceived voluntariness was found to have a moderating effect on the relationships among user IT usage level, task interdependency, IS usage, and perceived performance, supporting all the hypotheses on the moderating effect. Most of all, user IT usage level has the strongest influence on IS usage, indicating that users with superior IT usage are more likely to enjoy a high level of perceived performance.

A Study on the Standardization of QSCC II (Questionnaire for the Sasang Constitution Classification II) (사상체질분류검사지(四象體質分類檢査紙)(QSCC)II의 표준화(標準化) 연구(硏究) - 각 체질집단의 군집별(群集別) Profile 분석을 중심으로 -)

  • Kim, Sun-Ho;Ko, Byung-Hee;Song, Il-Byung
    • The Journal of Korean Medicine
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    • v.17 no.2 s.32
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    • pp.337-393
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    • 1996
  • The purpose of this study is to evaluate and standardize the four scales of Questionnaire for the Sasang Constitution Classification  II (QSCCII). QSCCII is newly prepared by statistical item analysis and is designed to examine its diagnostic discriminability. QSCCII is administered to 1366 random informants. From the survey, we could get the data for the standardization. The criteria of standardization are based on the data from 265 informants who are examined by professionals. Collectted data are analyzed by internal consistency, variation analysis(ANOVA), Duncan test and discrimination analysis of SPSS PC+ V4.0 program. The results are as follows reliability of four scales for QSCCII is relatively valid. The internal consistency of Tae-yang(太陽) (太陽) scale is Cronbach's a=0.5708. That of So-yang(少陽) scale is a=0.5708. That of Tae-eum(太陰) scale is a =0.5922. That of So-eum(少陰) scale is a=0.6319. 2. There is a significant difference between each group through variation analysis of four scales. 3. The process of standardization is based on the average value and standard deviation with respect to age and sex difference of each criteria 4. This study suggests a source of standardization of Sasang Constitution Classification by providing norms in which the differences of age, sex, and number of items are taken into deep consideration. QSCC Ⅱ, therefore, can be applied to every age(the 10's to the 60's) and sex groups. 5. The recalculation of the raw-score to standard value (T-score) shows that the diagnostic discriminability (Hit-ratio: 70.08%) of QSCC Ⅱ brings about 37% improvement than proportional chance criteria (33.33%). Especially, Hit-ratios of Tae-eum In(74.5%) and So-eum In(70.8%) are higher than that of So-yang In(60.0%). 6. QSCC has discriminability only to male informants. Compared with QSCC, however, QSCC II has relatively efficient discriminability both to male and female informants. 7. These results would be a demonstration of the fact that the QSCC II could be used as a tool for sasang constitution classification.

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Effects of a Critical Pathway of Posterolateral Fusion in Patients with Lumbar Spinal Stenosis (측후방융합술을 시행한 요추관협착증 환자의 Critical Pathway 적용효과)

  • Park, Hae-Ok
    • Journal of Korean Academy of Nursing Administration
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    • v.7 no.2
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    • pp.265-284
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    • 2001
  • The case management has been applied to improve the quality of care and the cost-effectiveness in the most health care institutions. In a way of case management, the critical pathway(CP) has been executed in many acute care settings, focused on the diagnoses with high cost, high volume, and high risk. This study was conducted to develop a case management program using CP as an intervention of patients with lumbar spinal stenosis for the surgery of posterolateral fusion, and to find out the effects of the critical pathway on the quality of nursing care, patient satisfaction as an outcome of care, length of stay and medical charge, and nurses' job satisfaction. At the same time, patients' functional states were checked with the Oswestry Low Back Pain Index, to show that the CP would not decrease the patients' function compared to the control group. The subjects were 25 control patients with a usual operation of lumbar fusion and 25 experimental patients with CP. They were all female, aged $50s{\sim}70s$, admitted in the Orthopedic surgery ward of a university hospital. Also nurses on the floor using CP were asked to respond to measurement tool of job satisfaction before and after the application of CP, and compared with other nurses on the different wards. Data were analyzed with t-test for continuous variables and chi-square for non-parametric variables in addition to the reliability test of the measurement tools. The results of this study were as followings: 1. Patients' functional states The differences in Oswestry scores of the experimental and control groups assessed at preoperation and at discharge were not statistically significant. The change in scores of the experimental group measured at preoperation and at discharge was larger than that of the control group, however the difference was not statistically significant. The results indicate that the CP did not decrease the patients' functional status. 2. The quality of nursing care The total of quality of nursing care given to the experimental group was better than that of the control group(P=.000). In addition, the experimental group showed better scores of quality of every item of care than the control group(P=.000 -.004). 3. Patient satisfaction Patients of the experimental group were not more satisfied with general care than the control group. But they were more satisfied with discharge care of 'explanation about medication, body posture, and brace application' and 'explanation about the adjustment of daily living and exercise during recovery'(P= .047, P=.028). 4. Nurses' job satisfaction Nurses working with the CP showed more job satisfaction than before the CP introduction(P=.048). But the control group of nurses on a different floor showed no change in job satisfaction at the same period of time. 5. Length of stay and medical charge The mean length of stay of the experimental group was shorter than that of the control group without statistical significance. The charge of medication and treatment of the experimental group were smaller than that of the control group(P=.011, P=.000). The results of the study support that the case management using critical pathway enables to improve the quality of care and job satisfaction, to reduce the medical charge, and consequently to increase satisfaction with care. However, the case management should be instituted focusing on the quality improvement of nursing and the client satisfaction, not just for the purpose of cost-effectiveness of health care facilities.

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