Appling Nursing Theory to Clinical Practice of Home Health Care (가정간호실무에 적용가능한 이론적틀)
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- Journal of Korean Academic Society of Home Health Care Nursing
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- v.11 no.1
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- pp.5-13
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- 2004
The home health care industry has grown rapidly and can be expected to continue to grow in the foreseeable future. Home health care refers to the practice of nursing applied to clients with a health condition in the clients place of residence. clients and their designated care givers are the focus at home health nursing practice. The goal of care is to initiate. manage and evaluate the resources needed to promote the clients optimal level of well-being and function. Nursing activities necessary to achieve this goal may warrant preventive maintenance and restorative emphases to prevent potential problems from developing. Many project program were suggested home health care model for Korea's health care system and policy direction for expansion and establishment of home health care .But the aim of this paper is to provide on overview for theoretical frame work in home health care. Theories and conceptual frameworks or models are important nursing because they define and guide the boundaries of professional practice and identify key nurse-patient-caregiver relationships that emerge with caring. Following is the research with an investigation of the literature review in the University of Arizona international medline database, In conclusion, are as followers: First, many nursing theorists have had a tremendous impact on nursing practice. the following highlights those nursing theorists that are particularly helpful in understanding home health care. 1. Florence Nightingale : Our earliest theoretical legacy. Nightingale's believes are reflected in basic infection control practice such as hand washing and infectious waste disposal and are key nursing interventions in home care. 2. Martha Roger's :Science of unitary human beings theory. Rorger's believed that the focus of shared. non invasive healing modelities is the human environmental field rather than direct physical care. These modelities continue to evolve as our awareness (reflecting greater diversity, faster rhythms, motions, and ways of knowing) transcends time and space, allowing individuals to get in touch with their integral nature of unbroken wholeness. On people as ever changing energy fields have special relevance in home care especially with hospice and palliative care applications. 3. Madeline Leininger's; Transcultural nursing theory. Home care nurses move through a variety of communities and often care for patients from different cultural back grounds. Therefore Leininger's work has a good that with home care because home care nursing practice is very culturally focused. 4. Dorothea Orem's : Self care deficit theory. Orem's theory views care as something to be performed by both nurses and patients. The role of the nurse is to provide education and support that help patients acquire the necessary activities to perform self-care. Orem's theory is foundational to have care because it begins to truly acknowledge the role of the patient in managing his or her own health. which is referred to as self-care. 5. Margaret Neuman's; Health as expending consciousness theory. Neuman believes that health compasses disease and reflects an underlying pattern of person-environment interaction. A key application of 'Neuman's work to home care is for nurses to understand that health and illness do not necessarily exist at opposite ends of a continuum. 6. Jean Watson's: Theory of human caring. Watson's theory of human caring in nursing proposes human caring as the moral ideal of nursing. Nurses participate human caring to protect, enhance and preserve humanity by assisting individuals to fing meaning in illness. pain and existence and to help others gain self knowledge. self control. and self healing such thinking lends richness to theory development. as well as clinical practice in home care. Second, Robin Rice : Dynamic self determination for self care. (A theoretical framework for home care) Dynamical self determination for self care can be useful to home care nurses in a variety of ways. As research tool it can be reflected in the interview process when the home visit. The home care nurse's role is that of facilitator of patient self-determination for self care through numerous strategies. including patient education and case management.
This study is a descriptive investigation into the image of nurses, and attempted to help to advance the profession of nursing and to provide basic data for developing strategies to improve the image of nurses. The Subject of this study was a group of 380 persons from a K Medical Centre in Seoul, including the hospital patients and their guardians, as well as the doctors, assistants and hospital administrative staff. The data have been collected from the 10th to the 30th of May, 2003. We have developed a research tool of 40 questions divided into three categories using a tool developed by Kim, H.J and KIm, H.O.(2001) verifying its construct validity. The reliability of the tool was Cronbache's
The emergence of the field of organizational buying behavior in the mid-1960’s with the publication of Industrial Buying and Creative Marketing (1967) set the stage for a new paradigm of thinking about how business was conducted in markets other than those serving ultimate consumers. Whether it is "industrial marketing" or "business-to-business marketing" (B-to-B), organizational buying behavior remains the core differentiating characteristic of this domain of marketing. This paper explores the impact of several dynamic factors that have influenced how organizations relate to one another in a rapidly increasing interdependence, which in turn can impact organizational buying behavior. The paper also raises the question of whether or not the major conceptual models of organizational buying behavior in an interdependent world are still relevant to guide research and managerial thinking, in this dynamic business environment. The paper is structured to explore three questions related to organizational interdependencies: 1. What are the factors and trends driving the emergence of organizational interdependencies? 2. Will the major conceptual models of organizational buying behavior that have developed over the past half century be applicable in a world of interdependent organizations? 3. What are the implications of organizational interdependencies on the research and practice of organizational buying behavior? Consideration of the factors and trends driving organizational interdependencies revealed five critical drivers in the relationships among organizations that can impact their purchasing behavior: Accelerating Globalization, Flattening Networks of Organizations, Disrupting Value Chains, Intensifying Government Involvement, and Continuously Fragmenting Customer Needs. These five interlinked drivers of interdependency and their underlying technological advances can alter the relationships within and among organizations that buy products and services to remain competitive in their markets. Viewed in the context of a customer driven marketing strategy, these forces affect three levels of strategy development: (1) evolving customer needs, (2) the resulting product/service/solution offerings to meet these needs, and (3) the organization competencies and processes required to develop and implement the offerings to meet needs. The five drivers of interdependency among organizations do not necessarily operate independently in their impact on how organizations buy. They can interact with each other and become even more potent in their impact on organizational buying behavior. For example, accelerating globalization may influence the emergence of additional networks that further disrupt traditional value chain relationships, thereby changing how organizations purchase products and services. Increased government involvement in business operations in one country may increase costs of doing business and therefore drive firms to seek low cost sources in emerging markets in other countries. This can reduce employment opportunitiesn one country and increase them in another, further accelerating the pace of globalization. The second major question in the paper is what impact these drivers of interdependencies have had on the core conceptual models of organizational buying behavior. Consider the three enduring conceptual models developed in the Industrial Buying and Creative Marketing and Organizational Buying Behavior books: the organizational buying process, the buying center, and the buying situation. A review of these core models of organizational buying behavior, as originally conceptualized, shows they are still valid and not likely to change with the increasingly intense drivers of interdependency among organizations. What will change however is the way in which buyers and sellers interact under conditions of interdependency. For example, increased interdependencies can lead to increased opportunities for collaboration as well as conflict between buying and selling organizations, thereby changing aspects of the buying process. In addition, the importance of communication processes between and among organizations will increase as the role of trust becomes an important criterion for a successful buying relationship. The third question in the paper explored consequences and implications of these interdependencies on organizational buying behavior for practice and research. The following are considered in the paper: the need to increase understanding of network influences on organizational buying behavior, the need to increase understanding of the role of trust and value among organizational participants, the need to improve understanding of how to manage organizational buying in networked environments, the need to increase understanding of customer needs in the value network, and the need to increase understanding of the impact of emerging new business models on organizational buying behavior. In many ways, these needs deriving from increased organizational interdependencies are an extension of the conceptual tradition in organizational buying behavior. In 1977, Nicosia and Wind suggested a focus on inter-organizational over intra-organizational perspectives, a trend that has received considerable momentum since the 1990's. Likewise for managers to survive in an increasingly interdependent world, they will need to better understand the complexities of how organizations relate to one another. The transition from an inter-organizational to an interdependent perspective has begun, and must continue so as to develop an improved understanding of these important relationships. A shift to such an interdependent network perspective may require many academicians and practitioners to fundamentally challenge and change the mental models underlying their business and organizational buying behavior models. The focus can no longer be only on the dyadic relations of the buying organization and the selling organization but should involve all the related members of the network, including the network of customers, developers, and other suppliers and intermediaries. Consider for example the numerous partner networks initiated by SAP which involves over 9000 companies and over a million participants. This evolving, complex, and uncertain reality of interdependencies and dynamic networks requires reconsideration of how purchase decisions are made; as a result they should be the focus of the next phase of research and theory building among academics and the focus of practical models and experiments undertaken by practitioners. The hope is that such research will take place, not in the isolation of the ivory tower, nor in the confines of the business world, but rather, by increased collaboration of academics and practitioners. In conclusion, the consideration of increased interdependence among organizations revealed the continued relevance of the fundamental models of organizational buying behavior. However to increase the value of these models in an interdependent world, academics and practitioners should improve their understanding of (1) network influences, (2) how to better manage these influences, (3) the role of trust and value among organizational participants, (4) the evolution of customer needs in the value network, and (5) the impact of emerging new business models on organizational buying behavior. To accomplish this, greater collaboration between industry and academia is needed to advance our understanding of organizational buying behavior in an interdependent world.
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.