• 대한간호학회지
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• 제20권2호
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• pp.227-248
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• 1990

The study was conceived in relation to a concern over the growing gap between the needs of chronic patients and the availability of care from the current health care system in Korea. Patients with agonizing chronic pain, discomfort, despair and disability are left with helplessly unprepared families with little help from the acute care oriented health care system after discharge from hospital. There is a great need for the development of an alternative means of quality care that is economically feasible and culturally adaptible to our society. Thus, the study was designed to demonstrate the effectiveness of home heath care as an alternative to bridge the existing gap between the patients' needs and the current practice of health care. The study specifically purports to test the effects of home care on health expenditure, readmission, job retention, compliance to health care regime, general conditions, complications, and self-care knowledge and practices. The study was guided by the operations research method advocated by the Primary Health Care Operations Research Institute(PRICOR) which constitutes 3 stages of research : namely, problem analysis solution development, and solution validation. The first step in the operations research was field preparation to develop the necessary consensus and cooperation. This was done through the formation of a consulting body at the hospital and a steering committee among the researchers. For the stage of problem analysis, the Annual Report of Seoul National University Hospital and the patients records for last 5 years were reviewed and selective patient interviews were conducted to find out the magnitude of chronic health problems and areas of unmect health care needs to finally decide on the kinds of health problems to study. On the basis of problem analysis, the solution development stage was devoted to home care program development asa solution alternative. Assessment tools, teaching guidelines and care protocols were developed and tested for their validity. The final stage was the stage of experimentation and evaluation. Patients with liver diseases, hemiplegic and diabetic conditions were selected as study samples. Discharge evaluation, follow up home care, measurement and evaluation were carried out according to the protocols of care and measurement plan for each patient for the period of 6 months after discharge. The study was carried out for the period from Jan. 1987 to Dec. 1989. The following are the results of the study presented according to the hypotheses set forth for the study ; 1. Total expenditures for the period of study were not reduced for the experimental group, however, since the cost per hospital visit is about 4 times as great as the cost per home visit, the effect of cost saving by home care will become a reality as home care replaces part of the hospital visits. 2. The effect on the rate of readmission and job retention was found to be statistically nonsignificant though the number of readmission was less among the experimental group receiving home care. 3. The effect on compliance to the health care regime was found to be statistically significant at the 5% level for hepatopathic and diabetic patients. 4. Education on diet, rest and excise, and medication through home care had an effect on improved liver function test scores, prevention of complications and self - care knowledge in hepatopathic patients at a statistically significant level. 5. In hemiplegic patient, home care had an effect on increased grasping power at a significant level. However. there was no significant difference between the experimental and control groups in the level of compliane, prevention of complications or in self-care practices. 6. In diabetic patients, there was no difference between the experimental and control groups in scores of laboratory tests, appearance of complications, and self-care knowledge or self -care practices. The above findings indicate that a home care program instituted for such short term as 6 months period could not totally demonstrate its effectiveness at a statistically significant level by quantitative analysis however, what was shown in part in this analysis, and in the continuous consultation sought by those who had been in the experimental group, is that home health care has a great potential in retarding or preventing pathological progress, facilitating rehabilitative and productive life, and improving quality of life by adding comfort, confidence and strength to patients and their families. For the further studies of this kind with chronic patients it is recommended that a sample of newly diagnosed patients be followed up for a longer period of time with more frequent observations to demonstrate a more dear- cut picture of the effectiveness of home care.

• 대한치과보철학회지
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• 제61권1호
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• pp.1-17
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• 2023

목적: 본 연구의 목적은 레이져 신터링, 컴퓨터 밀링, 주조의 세 가지 방법으로 제작된 비귀금속 합금 코핑의 변연 형태에 따른 변연 적합도의 변화를 관찰하는 데 있다. 재료 및 방법: 서로 다른 두 개의 변연 형태를 정확히 재현하기 위해 3D Computer-aided Design을 이용하여 지대치 삭제의 원칙에 따라 지대치를 디자인한 다음, 티타늄 블럭을 컴퓨터 밀링하여 주모델을 제작하였다. 각각의 모델에 대하여 위의 3가지 제작 방식으로 비귀금속 합금 코핑을 12개씩 제작하여, 총 72개의 코핑을 제작하였다. 각 코핑은 지대치에 적합시켜서 공초점 레이저 주사 현미경으로 근심, 협측, 원심, 설측 변연의 변연 적합도를 150배율로 측정하였다. 결과: 레이져 신터링으로 제작한 코핑의 평균 변연 오차는 deep chamfer margin에서 11.8 ± 7.4 ㎛, rounded shoulder margin에서 6.3 ± 3.5 ㎛ 였고, 그 차이는 통계적으로 유의했다 (P < .0001). 컴퓨터 밀링으로 제작한 그룹에서는 deep chamfer margin에서 53.9 ± 27.8 ㎛, rounded shoulder margin에서 48.6 ± 30.0 ㎛였고, 변연 형태에 따른 유의한 차이가 없었다 (P = .279). 주조 방법으로 제작한 그룹은 deep chamfer margin에서 18.8 ± 20.2 ㎛, rounded shoulder margin 에서 30 ± 20.5 ㎛ 였고, 그 차이는 통계적으로 유의했다 (P = .0004). 결론: 이번 실험을 통하여, 다음과 같은 결론을 얻었다. 1. 변연의 형태에 따른 변연 적합도는 레이져 신터링이나 주조 방법으로 제작된 금속 코핑의 경우 변연 형태에 따라 유의한 차이가 있었다. 2. 레이져 신터링으로 제작한 금속 코핑에서 rounded shoulder margin이 deep chamfer margin보다 우수한 변연 적합도를 보였다. 3. 주조 방법으로 제작한 금속 코핑의 경우는 deep chamfer margin이 rounded shoulder margin보다 우수한 변연 적합도를 보였다. 4. 제작 방식에 따른 코핑의 변연 적합도는 레이져 신터링이 가장 양호하였고, 그 다음 주조 방법과 밀링 방법 순으로 변연 적합도 양호하였다. 이번 연구를 통해, 지대치의 변연 형태에 따른 금속 코핑의 변연 적합도의 변화를 관찰하였으며, 레이져 신터링으로 제작하거나 디지털 밀링한 왁스 패턴을 캐스팅한 경우에는 상관 관계가 있음을 확인하였다. 임상에 적용함에 있어 지대치의 변연 형태를 고려하여 제작 방식을 결정하는 것이 추천된다.

• Asia pacific journal of information systems
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• 제24권4호
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• pp.611-635
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• 2014

Information systems (IS) have become ubiquitous and changed every aspect of how people live their lives. While some IS have been successfully adopted and widely used, others have failed to be adopted and crowded out in spite of remarkable progress in technologies. Both the technology acceptance model (TAM) and the IS Success Model (ISSM), among many others, have contributed to explain the reasons of success as well as failure in IS adoption and usage. While the TAM suggests that intention to use and perceived usefulness lead to actual IS usage, the ISSM indicates that information quality, system quality, and service quality affect IS usage and user satisfaction. Upon literature review, however, we found a significant void in theoretical development and its applications that employ either of the two models, and we raise research questions. First of all, in spite of the causal relationship between intention to use and actual usage, in most previous studies, only intention to use was employed as a dependent variable without overt explaining its relationship with actual usage. Moreover, even in a few studies that employed actual IS usage as a dependent variable, the degree of actual usage was measured based on users' perceptual responses to survey questionnaires. However, the measurement of actual usage based on survey responses might not be 'actual' usage in a strict sense that responders' perception may be distorted due to their selective perceptions or stereotypes. By the same token, the degree of system quality that IS users perceive might not be 'real' quality as well. This study seeks to fill this void by measuring the variables of actual usage and system quality using 'fact' data such as system logs and specifications of users' information and communications technology (ICT) devices. More specifically, we propose an integrated research model that bring together the TAM and the ISSM. The integrated model is composed of both the variables that are to be measured using fact as well as survey data. By employing the integrated model, we expect to reveal the difference between real and perceived degree of system quality, and to investigate the relationship between the perception-based measure of intention to use and the fact-based measure of actual usage. Furthermore, we also aim to add empirical findings on the general research question: what factors influence actual IS usage and how? In order to address the research question and to examine the research model, we selected a mobile campus application (MCA). We collected both fact data and survey data. For fact data, we retrieved them from the system logs such information as menu usage counts, user's device performance, display size, and operating system revision version number. At the same time, we conducted a survey among university students who use an MCA, and collected 180 valid responses. A partial least square (PLS) method was employed to validate our research model. Among nine hypotheses developed, we found five were supported while four were not. In detail, the relationships between (1) perceived system quality and perceived usefulness, (2) perceived system quality and perceived intention to use, (3) perceived usefulness and perceived intention to use, (4) quality of device platform and actual IS usage, and (5) perceived intention to use and actual IS usage were found to be significant. In comparison, the relationships between (1) quality of device platform and perceived system quality, (2) quality of device platform and perceived usefulness, (3) quality of device platform and perceived intention to use, and (4) perceived system quality and actual IS usage were not significant. The results of the study reveal notable differences from those of previous studies. First, although perceived intention to use shows a positive effect on actual IS usage, its explanatory power is very weak ($R^2$=0.064). Second, fact-based system quality (quality of user's device platform) shows a direct impact on actual IS usage without the mediating role of intention to use. Lastly, the relationships between perceived system quality (perception-based system quality) and other constructs show completely different results from those between quality of device platform (fact-based system quality) and other constructs. In the post-hoc analysis, IS users' past behavior was additionally included in the research model to further investigate the cause of such a low explanatory power of actual IS usage. The results show that past IS usage has a strong positive effect on current IS usage while intention to use does not have, implying that IS usage has already become a habitual behavior. This study provides the following several implications. First, we verify that fact-based data (i.e., system logs of real usage records) are more likely to reflect IS users' actual usage than perception-based data. In addition, by identifying the direct impact of quality of device platform on actual IS usage (without any mediating roles of attitude or intention), this study triggers further research on other potential factors that may directly influence actual IS usage. Furthermore, the results of the study provide practical strategic implications that organizations equipped with high-quality systems may directly expect high level of system usage.