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A STUDY ON THE CLINICAL ANALYSIS AND PERFORMANCE IN COMPREHENSIVE NURSING CARE (전인간호의 임상학적 분석과 실행에 관한 연구)

  • 전산초
    • Journal of Korean Academy of Nursing
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    • v.4 no.1
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    • pp.1-21
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    • 1974
  • A considerable change of the Korean nursing system has been made during the last decade not only in its philosophy but also in its function and structure to meet political and scientific need of the modern society. The main purpose of this study is to develope the new concept of comprehensive nursing care, both its Philosophy and ethics, as the basic of modern clinical nursing theory and practice. Comprehensive nursing care is the concept of human centered nursing care, and it helps a man to meet the basic physical, psychological, environmental, socioeconomic and teaching needs. It also helps him to help himself to meet these needs. This concept starts from the individualized nursing care and its ultimate goal is to improve a man to have a better position in his own community so that he may able to have a meaningful life. To accomplish this goal, an individualized nursing care plan as a nursing diagnosis and problem solving method should be set up for different patients with similar diagnosis to meet their needs, because each patient has a different social background. from this viewpoint, nursing is a science as well as abstruse humanity. The performance of comprehensive nursing care is a goal and issue of modern clinical nursing care. If nursing is a science and a profession for man, it should have ethics which recognize the dignity of man and offers infinite service voluntarily, and should be able to show leadership in carrying out the nursing responsibility. This leadership finds a person's potential and encourages him to utilize it. Such concepts should develop into a nursing ideology and this ideology should become a priority in comprehensive nursing care. The following statements are the conclusion of this study. 1) Modern nursing has been developed from disease centered nursing care to comprehensive nursing care based on humanity. The primary principle of nursing was to assist in the treatment of disease, but it has been changed to the professional nursing system independently. 2) The concept of nursing is one of continuous or endless scope of dispersion. It proves that nursing is grasping the professional responsibility to be able to coordinate scientific principles Patient health problems are according to scientific principles rather than adhering to nursing technical discipline as a daily work. 3) In chapter I and Ⅱ, the philosophy and ideology of nursing have been discussed and the flow of concept of clinical nursing and the rate of progress which emerges from naturalizing performance of the concept of comprehensive nursing in clinical nursing studied. The discussion developed the theory that a nurse should be to embody nursing ideas and objectives by establishing definite conviction of professions and study. 4) In chapter lil, nursing planning based on nursing diagnosis as a method to attain ideal nursing care for humanity with a definite idea of establishing philosophy of nursing was presented. 5) From the result of survey on patient needs about treatment and nursing, it was observed that all patient had emotional stress from unknown factors. Therefore it was concluded that nurses should not only educate the patient but also give them the opportunity to communicate freely their needs and anxieties. Furthermore complaints and doubts of the patient should be carefully noted and must be considered to meet these needs. 6) Patient teaching is the most important part of comprehensive nursing care. In chapter, Ⅲ, the important of patient teaching was emphasized by demonstrating the effect of patient teaching for diabetic patient. 7) In Chapter Ⅳ, from the result of the study on nurses attitudes to comprehensive nursing care, it was pointed that the evolution of nursing education and the establishment of a complete concept and value of comprehensive nursing was necessary.

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THE CHARACTERISTICS OF CHILD AND ADOLESCENT INPATIENTS WITH SEVERE OBSESSIVE-COMPULSIVE DISORDER (심각한 소아 ${\cdot}$ 청소년 강박장애로 입원한 환아들의 특징)

  • Hwang, Jun-Won;You, So-Young;Chang, Jun-Hwan;Shin, Min-Sup;Cho, Soo-Churl;Hong, Kang-E;Kim, Boong-Nyun
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.15 no.2
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    • pp.143-151
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    • 2004
  • Objectives : Child and adolescent onset obsessive compulsive disorder(C-OCD) is known to be associated with poor drug response, high comorbid rate and strong genetic tendencies. Till now studies for C-OCD have been very rare in Korea. We conducted this study to investigate the informations about clinical features, familial psychiatric loading, treatment profiles and course of server C-OCD from the retrospective analysis of inpatient data of Seoul National University Children's Hospital. Method : Retrospective chart review and data analysis was performed. Twenty(male 16 : female 4) patients with final C-OCD diagnosis by DSM-IV at discharge from 1994 to 2002 were found and their medical chart, psychological data, family interview data and nursing reports were collected and analyzed. Results : 1) The sex ratio of C-OCD was male dominant(4:1). 2) Phenomenological, most common obsession was pathologic doubt, contamination fear, followed by aggressive obsession, need for symmetry, sexual obsession, most common compulsion was checking and washing, followed by breathing, movement, symmetry, repetitive asking, hoarding, mental compulsion. 3) Most common comorbid diagnosis was depression. Other axis-I diagnosis associated OCD were anxiety disorder, tic disorder, conduct and oppositional defiant disorder and psychosis. 4) Regarding psychiatric familial loadings, 17 patients(85%) had relatives with psychiatric disorders, OC-spectrum disorders(OCD or OCPD) were found in 9 patients(45%). 5) The majority of patients(75%) have received SSRI and antipsychotics treatment. The response rate above 'moderate improved" by CGI was 75%. 6) During follow-up period in outpatient clinic, five patients(25%) showed continuous complete remission, 10 patients (50%) did residual symptoms with chronic course. Conclusion : This seems to be the first systemic investigation of severe pediatric OCD patients in Korea. The children & adolescents with severe OCD in inpatient-setting showed the high comorbid rate, familial psychiatric loading, and combined pharmacotherapy with antipsychotics, As for symptoms, high rate of aggressive-sexual obsession and atypical compulsions like breathing and moving was reported in this study. Severe pediatric OCD patients, however, responded well to the combined SSRI and antipsychotics regimen.

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Local Autonomy, National Economy and Local Public Finance (지방자치(地方自治)와 국민경제(國民經濟) 및 지방재정(地方財政))

  • Lee, Kye-sik
    • KDI Journal of Economic Policy
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    • v.13 no.2
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    • pp.41-67
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    • 1991
  • Local autonomy of Korea's lower-level local council has been reinstated following elections last March for the first time in thirty years. Last June, we had elections for the upper-level local council. Mayors, governors, and administrative chiefs of cities, provinces and other local government bodies are slated for elections in the first half of next year. The impacts of local autonomy are taking effect in not only the political sphere, but also the administrative and economic spheres. In fact, it seems that some modification of all economic policy making and administration is inevitable. Since the initiation of local autonomy, in order to make the economy work more efficiently, it has become quite important to examine the impact of local autonomy on the national economy. The areas of local autonomy include independent legislative power, administrative power, organizational power, and most important of all, the independent public financial power of the local governments. The purpose of this paper is to examine the effects of local autonomy on the national economy and ways of enhancing the role of local public finance to facilitate settlement and development of the local autonomy system. Local autonomy will contribute to the continuous growth of our economy, allow balanced development, and generate greater efficiency. However, local autonomy can also incur economic costs causing at times short-term price instability, inefficient resource allocation, through tax competition and tax exporting, and insolvency of local government due to abusive fiscal operation. To reduce these side effects, different alternatives must be considered. Local autonomy systems generally provide more efficient resource allocation than centralization. But in the model used in Chapter 3 of this paper, the relative efficiencies of both local autonomy and centralization are determined by comparing the elasticity of substitution between national public goods and local public goods. If the elasticity of substitution is bigger than one, centralization provides a more efficient resource allocation. The development of local autonomy could be attained through democratization of the local public finance system including the following three propositions. I) The independence of public financial power of local governments should be established over central government. Furthermore, a democratically operated scheme of intergovernmental fiscal coordination is especially necessary. 2) In the operation of local finance, direct democracy is needed to induce the voluntary participation of local residents. The residents can take part in planning both the local budget and the development of the community. To attain this goal, all the results of local finance operations should be made public. 3) Among economic ill-effects of the local autonomy system, the most serious one is the possibility of insolvency of local governments. Therefore, measures to limit abusive spending by the local governments should be introduced, such as the fiscal restraints system adopted in the United States.

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Relationship between Compressive Strength and Dynamic Modulus of Elasticity in the Cement Based Solid Product for Consolidating Disposal of Medium-Low Level Radioactive Waste (중·저준위 방사성 폐기물 처리용 시멘트 고화체의 압축강도와 동탄성계수의 관계)

  • Kim, Jin-Man;Jeong, Ji-Yong;Choi, Ji-Ho;Shin, Sang-Chul
    • Journal of the Korea Concrete Institute
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    • v.25 no.3
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    • pp.321-329
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    • 2013
  • Recently, the medium-low level radioactive waste from nuclear power plant must be transported from temporary storage to the final repository. Medium-low level radioactive waste, which is composed mainly of the liquid ion exchange resin, has been consolidated with cementitious material in the plastic or iron container. Since cementitious material is brittle, it would generate cracks by impact load during transportation, signifying leakage of radioactive ray. In order to design the safety transporting equipment, there is a need to check the compressive strength of the current waste. However, because it is impossible to measure strength by direct method due to leakage of radioactive ray, we will estimate the strength indirectly by the dynamic modulus of elasticity. Therefore, it must be identified the relationship between of strength and dynamic modulus of elasticity. According to the waste acceptance criteria, the compressive strength of cement based solid is defined as more than 3.44 MPa (500 psi). Compressive strength of the present solid is likely to be significantly higher than this baseline because of continuous hydration of cement during long period. On this background, we have tried to produce the specimens of the 28 day's compressive strength of 3 to 30 MPa having the same material composition as the solid product for the medium-low level radioactive waste, and analyze the relationship between the strength and the dynamic modulus of elasticity. By controling the addition rates of AE agent, we made the mixture containing the ion exchange resin and showing the target compressive strength (3~30 MPa). The dynamic modulus of elasticity of this mixtures is 4.1~10.2 GPa, about 20 GPa lower in the equivalent compressive strength level than that of ordinary concrete, and increasing the discrepancy according to increase strength. The compressive strength and the dynamic modulus of elasticity show the liner relationship.

Effects of Red/Blue Light Ratio and Short-term Light Quality Conversion on Growth and Anthocyanin Contents of Baby Leaf Lettuce (적색/청색광의 비율 및 수확 전 광질변환이 어린잎상추의 생육 및 안토시아닌 함량에 미치는 영향)

  • Lee, Jun-Gu;Oh, Sang-Seok;Cha, Seon-Hwa;Jang, Yoon-Ah;Kim, Seung-Yu;Um, Young-Chul;Cheong, Seung-Ryong
    • Journal of Bio-Environment Control
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    • v.19 no.4
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    • pp.351-359
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    • 2010
  • To establish the optimum artificial light illumination method for baby leaf lettuce in closed plant factory system, the effects of red/blue light quality and short-term light quality conversion on growth and anthocyanin content were investigated. The growth of 'Hongha' lettuce was most favorable under red single wavelength LED light after 23 days of treatment, sequentially followed by the growth under red/blue mixed light, blue light, and fluorescent light. Total anthocyanin content in the mixed red/blue light (R57-B43) was 4.1-fold and 6.9-fold increased compared to the red LED and fluorescent light, respectively. With increasing the blue light ratio to 43%, the growth of lettuce was significantly decreased, while the relative chlorophyll content and Hunter's $a^*$ value was increased, indicating that the red/blue light ratio inversely affects on growth and anthocyanin pigment development. By changing light quality from red to red/blue mixed light source (R57-B43) for 9 days before harvest, the growth rate decreased compared to the continuous red light illumination, while the anthocyanin content dramatically increased compared to either red LED or fluorescent light. Whereas, when the light source was changed to red light, the growth rate was increased but anthocyanin content was reversely decreased. The result demonstrated that both growth and anthocyanin expression could be effectively regulated by shifting of light quality between red and red/blue mixed light source at a specific growth stage of lettuce in a plant factory.

An Empirical Study on the Influence of Humane Entrepreneurship on SMEs Performance: Focused on the Serial Multiple Mediation Effect (사람중심 기업가정신이 중소기업 성과에 미치는 영향에 관한 연구: 직렬다중매개효과 분석을 중심으로)

  • Lee, II-Han
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.15 no.2
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    • pp.221-234
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    • 2020
  • The role of entrepreneurship has become important for the continuous growth (scale-up) of companies in a rapidly changing economic environment. However, research has focused mainly on business-oriented growth that emphasizes efficiency only. However, in the era of the fourth industrial revolution, people have become more important than corporate efficiency. In particular, there are few studies on SMEs. The purpose of this study is to investigate how the characteristics of human - centered organizational culture affects the business ecosystem and firm excellence of SMEs, and how business ecosystem and firm excellence affect the performance of corporations. Therefore, this study focuses on the empathy, enablement, empowerment, and engagement of the corporate culture characteristics of the enterprise and the effects of the independent variables on the business ecosystem and the flower excellence as the parameters and the business ecosystem and company excellence. The main research subjects are the causality analysis that examines the effects on the management performance. The results of the study are as follows. Empathy, enablement, empowerment, engagement have a significant impact on the business ecosystem. In addition, the engagement have a positive effect on firm excellence. The results of empirical studies on the causal relationship between business ecosystem, corporate competence, and company excellence and business performance show that business ecosystem has no statistically significant effect on business performance. Corporate excellence has a significant effect on business performance Respectively. In addition to the above findings, this study can suggest the following implications. First, it is an empirical study of small and medium-sized enterprises (SMEs) by utilizing people-oriented entrepreneurship in addition to existing research. Small and medium-sized enterprises (SMEs) are expected to have lower perceptions of people-oriented management than large corporations or public institutions, but the analysis shows that people-centered entrepreneurship has a significant impact on the business ecosystem. Second, the research results of the serial multiple mediating effect analysis show that the higher the atmosphere of entrepreneurship in a company, the higher the atmosphere of entrepreneurship, and the parameters of business ecosystem and company excellence in the effect of people-oriented entrepreneurship on management performance. It is that the path through which people-oriented entrepreneurship influences management performance was verified by verifying the mediating effect by inputting. Lastly, it is hoped that research on people-oriented entrepreneurship in Korea's SMEs will be activated, providing a theoretical basis for transforming SMEs' business models into innovative types.

Improved Acroparesthesia During Enzyme Replacement Therapy in a Patient Lately Diagnosed with Fabry Disease (진단이 지연된 Fabry 병 환자에서 효소대체요법을 통한 사지 말단 동통의 호전을 보인 1례)

  • Yang, Aram;Kim, Jinsup;Cho, Sung Yoon;Jin, Dong-Kyu
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.17 no.3
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    • pp.92-95
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    • 2017
  • Fabry disease (FD) is an X-linked lysosomal storage disorder caused by an ${\alpha}$-galactosidase A (GLA, MIM 300644) enzyme deficiency due to pathogenic variants in the ${\alpha}$-galactosidase A gene (GLA). The disease leads to accumulation of globotriaosylceramide (Gb3) and related glycophospholipids affecting nearly all major organ systems, with the primary sites damaged by Gb3 including renal glomeruli, myocardium, neurons of the dorsal ganglion and autonomic nervous system, and vascular endothelial and smooth muscle. Progressive deposition in these organ systems present with various clinical manifestations including acroparesthesia, renal failure and heart failure. Here, we report a Chinese male diagnosed with Fabry disease in his late $4^{th}$ decades showing improvement of acroparesthesia during enzyme replacement therapy (ERT). A 48-year-old Chinese man who presented with chronic recurrent severe burning pain in his fingers and toes since the age of 10, with worse involvement of the former visited to our clinic for further evaluation. His medical history included a transient ischemic attack aged 40 and diagnosed with stage 4-5 chronic kidney disease aged 47. In the family history, the patient's brother was found to be have Fabry disease 1 month before his visit. Except for his brother, all other members of the family are healthy. Based on his medical history and family history, he was strongly suspicious for Fabry disease. He was found to have a galactose-alpha-1,3-galactose level 4.96 (Reference range, 42.5-67.9) suggestive of Fabry disease. The followed sequencing of GLA coding region in our patient revealed hemizyosity for the mutation c.988C>T (Q330X) in Exon 7. Since ERT start, he showed significant improvement in his symptoms of burning sensation of fingers and toes. On the contrary, due to deteriorating kidney function even with ERT, he is considered for kidney transplantation. Despite of diagnostic delay until late 4th decades, ERT showed a potential improvement of acroparesthesia in our patient. However, late start of ERT can lead to poor outcome in multiorgan function. Therefore, early diagnosis with high index of suspicion followed by continuous ERT with regular monitoring have an impact on quality of life in Fabry disease.

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The Change of Health Service before and after the Unification of two Health Subcenters in a Rural Area (한 농촌지역 2개면 보건지소 통합전후 보건의료사업 변화 연구)

  • Sul, Sue-Jeong;Park, Hyang;Sohn, Seok-Joon;Park, Jong;Kim, Ki-Soon
    • Journal of agricultural medicine and community health
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    • v.25 no.2
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    • pp.427-440
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    • 2000
  • A comparative study was made about health resources, medical care service statistics and public health service statistics by health subcenters at Jangdong and Jangpyung townships, Jangheung County, Chollanamdo before and after the unification of two health subcenter to improve their function. 1. While two general physicians, one dentist, 4 nurse aids arid one oral hygienist were working at two health subcenters with simple facility with examination room and public health office in 1997 prior to the unification, in 1999 after the unification of two health subcenters 14 staff including a specialist physician, a general physician, a dentist, a herb hygienist, a radiology technician and a physical therapist were working in the new health subcenters equipped with appropriate facilities in two storey building. 2. In 1997 before the unification the yearly total income of two health subcenters was 78,815 thousand won(about 14,000 won per capita) and the amount was 140,376 thousand won(about 25,000 won per capita) in 1999 after the unification. And the income was used for operation of health subcenters excluding personnel expense. 3. While 90.5% of visitors to the health subcenters came for general medical care, and 91.6% came for the revisit before the unification, after the unification 71.2% came for general medical care, 10.8% for dental care, 16.5% for oriental physician's care, 29.7% for the first visit and 70.3% for revisit. Most common problem cared for was musculoskeletal disorder like arthralgia. Average treatment cost per person per month was 9,363 won before the unification and 8,309 won after the unification. 4. Through the comparison of execution rate of public health services before and after the unification. the practice rate of most health service among target population including visiting service for chronic illness, maternal and child health service and immunization service increased after the unification. The practice rate of tuberculosis control service, hypertension control and diabetes management was a little decreased. In conclusion, continuous effort to satisfy all persons in two townships and evaluation are necessary to coincide with the spirit of unification of two health subcenters.

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The Analysis of Activities and Satisfaction of Volunteers for Hospice Care (호스피스 자원봉사자의 활동 및 만족도 분석)

  • Kim, Boon-Han;Jung, Yun;Park, Kyung-Bok
    • Journal of Hospice and Palliative Care
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    • v.5 no.2
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    • pp.163-171
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    • 2002
  • Purpose : The purpose of this study was to analyze activities and satisfaction of volunteers for hospice care. Methods : We used 271 reports of hospice care and 20 questionnaire of activities and satisfaction of volunteers for hospice care from volunteers of in a community. Window SPSS-PC was used for the data analysis and the statistical method used were the descriptive statistics, t-test, ANOVA and Pearson's correlation coefficient. Results : 1) The highest score of activity was emotional area and the next activities was physical area. 2) The degree of emotional area (t=4.94, P<.05) and spiritual area (t=3.80, P<.05) was influence by religion of volunteers. 3) The mean score of satisfaction was 3.61. 4) There was correlation between duration of activity and death experience (r=.558, P<.05), emotional care (r=.698, P<.01), spiritual care (r=.474, P<.05), satisfaction (r=.651, P<.01), and the between physical care and family care (r=.559, P<.05), and the between spiritual cue and family care (r=.512, P<.05), and between emotional care and satisfaction (r=.536, P<.05). Conclution : The above result indicated that we must develope the management and education of volunteer of hospice care for various hospice care. Also, We should to encouraged the continuous education and efficient management.

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Analysis of Benthic Macroinvertebrate Community Structure and Stability in Major Inflow Streams of Lake Andong and Lake Imha (안동·임하호 주요 유입지천의 저서성 대형무척추동물 군집구조 및 군집안정성 분석)

  • You, Hyuk;Lee, Mi Jin;Seo, Eul Won;Lee, Jong Eun
    • Korean Journal of Environmental Biology
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    • v.34 no.4
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    • pp.320-328
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    • 2016
  • This study was conducted to provide important basic information about effective management of the marine environment at major inflow streams in Lake Andong and Lake Imha. The investigation was conducted 8 times from May, 2015 (AD1, AD2, IH1, IH2) to September, 2016 (AD3, AD4, IH3, IH4), and 8 surveyed sites were selected at Lake Andong (4 sites) and Lake Imha (4 sites). The inquiry identified 114 species, $59,913.7inds.\;m^{-2}$ in Lake Andong and 112 species, $39,038.4inds.\;m^{-2}$ in Lake Imha. The results indicate that the number of species and individuals in Lake Andong is more than that in Lake Imha, because Lake Andong has a variety of riparian vegetation and a richness of organic materials. Community analysis at Lake Imha revealed a dominant index of 0.57 (${\pm}0.18$), a diversity index of 2.87 (${\pm}0.31$), an evenness index of 0.73 (${\pm}0.04$), and a richness index of 4.17 (${\pm}0.71$). The results of functional feeding group analysis showed that a high proportion of species and individuals are gathering collectors. The results of functional habitat group analysis showed that a high proportion of species and individuals are clingers. The result of a physico-chemical water assay and dissolved oxygen and electric conductivity tests revealed that these measures increased when the water temperature decreased. The result of Pearson's correlation analysis by biological factors and physico-chemical factors showed that species and electric conductivity are highly correlated with one another. Major inflow streams of Lake Andong and Lake Imha were exposed to various point pollution sources and non-point pollution sources. This implies a necessity for continuous monitoring of the aquatic ecosystems in order to effect systematic water quality management of Lake Andong and Lake Imha.