• Title/Summary/Keyword: the development of Instrument

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Development of validated Nursing Interventions for Home Health Care to Women who have had a Caesarian Delivery (조기퇴원 제왕절개 산욕부를 위한 가정간호 표준서 개발)

  • HwangBo, Su-Ja
    • Journal of Korean Academy of Nursing Administration
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    • v.6 no.1
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    • pp.135-146
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    • 2000
  • The purpose of this study was to develope, based on the Nursing Intervention Classification (NIC) system. a set of standardized nursing interventions which had been validated. and their associated activities. for use with nursing diagnoses related to home health care for women who have had a caesarian delivery and for their newborn babies. This descriptive study for instrument development had three phases: first. selection of nursing diagnoses. second, validation of the preliminary home health care interventions. and third, application of the home care interventions. In the first phases, diagnoses from 30 nursing records of clients of the home health care agency at P. medical center who were seen between April 21 and July 30. 1998. and from 5 textbooks were examined. Ten nursing diagnoses were selected through a comparison with the NANDA (North American Nursing Diagnosis Association) classification In the second phase. using the selected diagnoses. the nursing interventions were defined from the diagnoses-intervention linkage lists along with associated activities for each intervention list in NIC. To develope the preliminary interventions five-rounds of expertise tests were done. During the first four rounds. 5 experts in clinical nursing participated. and for the final content validity test of the preliminary interventions. 13 experts participated using the Fehring's Delphi technique. The expert group evaluated and defined the set of preliminary nursing interventions. In the third phases, clinical tests were held at in a home health care setting with two home health care nurses using the preliminary intervention list as a questionnaire. Thirty clients referred to the home health care agency at P. medical center between October 1998 and March 1999 were the subjects for this phase. Each of the activities were tested using dichotomous question method. The results of the study are as follows: 1. For the ten nursing diagnoses. 63 appropriate interventions were selected from 369 diagnoses interventions links in NlC., and from 1.465 associated nursing activities. From the 63 interventions. the nurses expert group developed 18 interventions and 258 activities as the preliminary intervention list through a five-round validity test 2. For the fifth content validity test using Fehring's model for determining lCV (Intervention Content Validity), a five point Likert scale was used with values converted to weights as follows: 1=0.0. 2=0.25. 3=0.50. 4=0.75. 5=1.0. Activities of less than O.50 were to be deleted. The range of ICV scores for the nursing diagnoses was 0.95-0.66. for the nursing interventions. 0.98-0.77 and for the nursing activities, 0.95-0.85. By Fehring's method. all of these were included in the preliminary intervention list. 3. Using a questionnaire format for the preliminary intervention list. clinical application tests were done. To define nursing diagnoses. home health care nurses applied each nursing diagnoses to every client. and it was found that 13 were most frequently used of 400 times diagnoses were used. Therefore. 13 nursing diagnoses were defined as validated nursing diagnoses. Ten were the same as from the nursing records and textbooks and three were new from the clinical application. The final list included 'Anxiety', 'Aspiration. risk for'. 'Infant behavior, potential for enhanced, organized'. 'Infant feeding pattern. ineffective'. 'Infection'. 'Knowledge deficit'. 'Nutrition, less than body requirements. altered', 'Pain'. 'Parenting'. 'Skin integrity. risk for. impared' and 'Risk for activity intolerance'. 'Self-esteem disturbance', 'Sleep pattern disturbance' 4. In all. there were 19 interventions. 18 preliminary nursing interventions and one more intervention added from the clinical setting. 'Body image enhancement'. For 265 associated nursing activities. clinical application tests were also done. The intervention rate of 19 interventions was from 81.6% to 100%, so all 19 interventions were in c1uded in the validated intervention set. From the 265 nursing activities. 261(98.5%) were accepted and four activities were deleted. those with an implimentation rate of less than 50%. 5. In conclusion. 13 diagnoses. 19 interventions and 261 activities were validated for the final validated nursing intervention set.

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Development of NQ-E, Nutrition Quotient for Korean elderly: item selection and validation of factor structure (노인 대상 영양지수 개발 : 평가항목 선정과 구성 타당도 검증)

  • Chung, Min-Jae;Kwak, Tong-Kyung;Kim, Hye-Young;Kang, Myung-Hee;Lee, Jung-Sug;Chung, Hae Rang;Kwon, Sehyug;Hwang, Ji-Yun;Choi, Young-Sun
    • Journal of Nutrition and Health
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    • v.51 no.1
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    • pp.87-102
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    • 2018
  • Purpose: The purpose of this study was to develop a valid instrument for measuring the dietary quality and behaviors of Korean elderly. Methods: The development of the Nutrition Quotient for Elderly (NQ-E) was conducted in three steps: item generation, item reduction, and validation. The 41 items of the NQ-E checklist were derived from a systematic literature review, expert in-depth interviews, statistical analyses of the fifth Korean National Health and Nutrition Examination Survey data, and national nutrition policies and recommendations. Pearson's correlation was used to determine the level of agreement between the questionnaires and nutrient intake level, and 24 items were selected for a nationwide survey. A total of 1,000 nationwide elderly subjects completed the checklist questionnaire. The construct validity of the NQ-E was assessed using confirmatory factor analysis, LISREL. Results: The nineteen checklist items were used as final items for NQ-E. Checklist items were composed of four-factors: food behavior (6 items), balance (4 items), diversity (6 items), and moderation (3 items). The standardized path coefficients were used as the weights of the items. The NQ-E and four-factor scores were calculated according to the obtained weights of the questionnaire items. Conclusion: NQ-E would be a useful tool for assessing the food behavior and dietary quality of the elderly.

Development of NQ-A, Nutrition Quotient for Korean Adolescents, to assess dietary quality and food behavior (청소년을 위한 영양지수 개발과 타당도 검증)

  • Kim, Hye-Young;Lee, Jung-Sug;Hwang, Ji-Yun;Kwon, Sehyug;Chung, Hae Rang;Kwak, Tong-Kyung;Kang, Myung-Hee;Choi, Young-Sun
    • Journal of Nutrition and Health
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    • v.50 no.2
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    • pp.142-157
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    • 2017
  • Purpose: The purpose of this study was to develop a nutrition quotient for adolescents (NQ-A) to assess overall dietary quality and food behavior of Korean adolescents. Methods: Development of the NQ-A was undertaken in three steps: item generation, item reduction, and validation. Candidate items of the NQ-A checklist were selected based on literature reviews, results of the fifth Korea National Health and Nutrition Examination Survey data, dietary guidelines for Korean adolescents, expert in-depth interviews, and national nutrition policies and recommendations. A total of 213 middle and high school students participated in a one-day dietary record survey and responded to 41 items in the food behavior checklist. Pearson's correlation coefficients between the responses to the checklist items along with nutritional status of the adolescents were calculated. Item reduction was performed, and 24 items were selected for the nation-wide survey. A total of 1,547 adolescents from 17 cities completed the checklist questionnaire. Exploratory factor and confirmatory factor analyses were performed to develop a final NQ-A model. Results: Nineteen items were finalized as the checklist items for the NQ-A. Checklist items were composed of five factors (balance, diversity, moderation, environment, and practice). The five-factor structure accounted for 47.2% of the total variance. Standardized path coefficients were used as weights of the items. The NQ-A and five-factor scores were calculated based on the obtained weights of the questionnaire items. Conclusion: Nutrition Quotient for adolescents (NQ-A) would be a useful instrument for evaluating dietary quality and food behavior of Korean adolescents. Further research on NQ-A is needed to reflect changes in adolescent's food behavior and environment.

Secondary Teachers' Perceptions and Needs Analysis on Integrative STEM Education (통합 STEM 교육에 대한 중등 교사의 인식과 요구)

  • Lee, Hyo-Nyong;Son, Dong-Il;Kwon, Hyuk-Soo;Park, Kyung-Suk;Han, In-Ki;Jung, Hyun-Il;Lee, Seong-Soo;Oh, Hee-Jin;Nam, Jung-Chul;Oh, Young-Jai;Phang, Seong-Hye;Seo, Bo-Hyun
    • Journal of The Korean Association For Science Education
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    • v.32 no.1
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    • pp.30-45
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    • 2012
  • Educational communities around the world have concentrated on integrative efforts among science, technology, engineering and mathematics (Science, Technology, Engineering, and Mathematics: STEM) subjects. Korea has focused on integrative education among STEAM (Science, Technology, Engineering, Arts, and Mathematics) school subjects to raise talented human resources in the fields of science and technology. The purpose of this study was to analyze secondary school science, technology, and mathematics teacher's perceptions and needs toward integrated education and integrative STEM education. A total of 251 secondary school teachers from all areas of the country who have taught science, mathematics, and technology were surveyed by using a self-reported instrument. The findings were as follows: First, teachers have used little integrated education in their classes due to insufficient time in the actual preparation of the integrated education and the lack of expertise, teaching experience, and teaching-learning materials for the integrated education, while they have positive thoughts about the need of integrated education. Second, they presented several needs to facilitate the integrated education: development of a variety of integrated programs, school administrative and financial support, and in-service teachers' training. Third, overall perception toward integrated STEM education was not sufficient, but most teachers perceived the need toward integrated STEM education due to students' development in their creativity, thinking skills, and adaptability. Fourth, they perceived that it was imperative to develop the various integrated STEM education programs, distribute the materials, and help STEM teachers' understanding toward integrated STEM education. Fifth, they perceived that the most relevant method to integrate STEM subjects was the problem solving approach. In addition, they appreciate that the integrated STEM education is highly efficient in not only developing integrated problem solving skills and STEM related literacy, but also in positively impacting the rise of talented human resources in the fields of science and technology. In order to increase the awareness of STEM-related secondary school teachers and vitalize the integrated STEM education, it is necessary to develop and spread a variety of programs, effective teaching and learning materials, and teachers' training programs.

Method Development for the Profiling Analysis of Endogenous Metabolites by Accurate-Mass Quadrupole Time-of-Flight(Q-TOF) LC/MS (LC/TOFMS를 이용한 생체시료의 내인성 대사체 분석법 개발)

  • Lee, In-Sun;Kim, Jin-Ho;Cho, Soo-Yeul;Shim, Sun-Bo;Park, Hye-Jin;Lee, Jin-Hee;Lee, Ji-Hyun;Hwang, In-Sun;Kim, Sung-Il;Lee, Jung-Hee;Cho, Su-Yeon;Choi, Don-Woong;Cho, Yang-Ha
    • Journal of Food Hygiene and Safety
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    • v.25 no.4
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    • pp.388-394
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    • 2010
  • Metabolomics aims at the comprehensive, qualitative and quantitative analysis of wide arrays of endogenous metabolites in biological samples. It has shown particular promise in the area of toxicology and drug development, functional genomics, system biology and clinical diagnosis. In this study, analytical technique of MS instrument with high resolution mass measurement, such as time-of-flight (TOF) was validated for the purpose of investigation of amino acids, sugars and fatty acids. Rat urine and serum samples were extracted by selected each solvent (50% acetonitrile, 100% acetonitrile, acetone, methanol, water, ether) extraction method. We determined the optimized liquid chromatography/time-of-flight mass spectrometry (LC/TOFMS) system and selected appropriated columns, mobile phases, fragment energy and collision energy, which could search 17 metabolites. The spectral data collected from LC/TOFMS were tested by ANOVA. Obtained with the use of LC/TOFMS technique, our results indicated that (1) MS and MS/MS parameters were optimized and most abundant product ion of each metabolite were selected to be monitorized; (2) with design of experiment analysis, methanol yielded the optimal extraction efficiency. Therefore, the results of this study are expected to be useful in the endogenous metabolite fields according to validated SOP for endogenous amino acids, sugars and fatty acids.

DEVELOPMENT OF SCALE FOR MEASURING DELINQUENT BEHAVIOR (청소년 비행행동 측정도구 개발)

  • Kim, Hyun-Sil;Kim, Hun-Soo
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.11 no.1
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    • pp.79-90
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    • 2000
  • Objective:This study was performed in order to develop a measuring instrument for assessing and predicting delinquent behavior of the adolescents in Korea. Methods:This study was methodological research for developing a questionnaire for measuring delinquent behavior. Through the relevant literature review and personal interview using open-ended question with 12 adolescents in schools, outpatient basis and the juvenile corrective institutions, the author developed a pre-questionnaire with 31 items for assessing delinquent behavior among delinquentprone adolescents. Statistical method employed were test-retest reliability and Cronbach's alpha coefficient for testing reliability and factor analysis for testing validity of this questionnaire, and t-test for mean difference between student adolescents and delinquent adolescents, using SAS program. Subject served for this study consisted of 2,177 adolescents including 1,206 students and 971 delinquent adolescents by proportional stratified random sampling method. Results:1) Three stable factors were emerged and these contributed 52.2% of the variance in the total score. All 31 items loaded above .40 on each factor. 2) Factor I was named as antisocial delinquent behavior(17 items), factor II was named as aggressive delinquent behavior(8 items), and factor III was named as psychopathic delinquent behavior(6 items). 3) Comparison of these 3 factors between student adolescents and delinquent adolescents showed that there was a significant difference in factor Ⅰ(t=-42.91(student), -41.71(delinquent), p=.0001), factor II(t=-34.10(student), -35.72(delinquent), p=.0001), factor III(t=-14.24(student), -14.26 (delinquent), p=.0000), and total score(t=37.02(student), -36.38(delinquent), p=.0001). 4) Internal consistency reliability was tested by Cronbach's ${\alpha}$. Cronbach's ${\alpha}$ was .952 for total 31 items and .950, .866 and .721 for each 3 factors related to delinquent behavior. Conclusions:The author confirmed that this scale can use for measuring delinquent behavior, and hope to make a contribution to screening test and prevention of juvenile delinquency in Korea.

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A Study on FTA Rules of WTO (WTO의 FTA룰에 관한 연구)

  • Lee, Gyun
    • Journal of Arbitration Studies
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    • v.17 no.1
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    • pp.183-215
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    • 2007
  • The purpose of this paper is to study of WTO regulations related FTA such as Understanding on the Interpretation of Article XXIV of the General Agreement on Tariffs and Trade(GATT) 1994 and General Agreement on Trade in Service(GATS). In this study, the First introduced FTA rules of WTO in the chapter 2. The WTO agreement includes the "General Agreement on Tariffs an Trade(GATT) 1994". This instrument, known as "GATT 1994", is based on upon the original General Agreement on Tariffs and Trade referred to as "GATT 1947". The Second analyzed the relations between FTA and Article XXIV of GATT 1994 in the chapter 3. The Article XXIV of GATT 1994 is an agreement between the distinctive members for liberalizing trade. The Article XXIV of GATT 1994 is consist of three parts such as customs unions, free-trade area, and interim agreements that WTO is referred to as "Regional Trade Agreement(RTA)". There is a difference between the customs unions and the free-trade area. In the customs unions rules, the members should have the same tarifficatio and the same trade provision against non-members, but in the free-trade are a rules, the member is not necessary to have the same tarifficatio and the same trade provision against non-members. But, the both rules have a liberalization of trade in a common as a revoking tariffs and the government regulations for interfering with trade. In this case, however, the both rules include an inconsistency ele ment under WTO rules such as Most-Favoured-Nation Treatment(MFN) and National Treatment on Internal Taxation and Regulation(NTITR). This study reviewed neither inconsistency nor consistency on the both rules with the RTA of WTO under Article XXIV of GATT 1994. The Third analyzed the relations between FTA and Article V of GATS under WTO in the chapter 4. The GATS is a rule of WTO for the growing importance of trade in services for the growth and development of the world conomy. The GATS is a new rule rather than GATT's rule for concerning goods trade. The Article V of GATS under WTO is a rule that makes based on upon the Article XXIV of GATT. Therefore, If it is to be examined the Article V of GATS, it should be referred to a and an interpretation of the text of the Article XXIV of GATT. However, the Article V of GATS is on the undeveloped stage compare to the Article XXIV of GATT. Because, the statistics of WTO showed that the RTAs under the Article XXIV of GATT have 150 cases completed between nations, but the RTAs under the Article IV of GATS have 10 cases completed between nations. The Forth examined the interpretation of FTA rules under WTO in the chapter 5. Concerning the consistency issue of customs unions and free-trade area under the Article XXIV of GATT, the working parties in customs unions and in free-trade area have been reviewed the consistency is sue which had been not if to GATT. However, the parties finished to get up with one accord the both that are a consistency of argument and an inconsistency of argument with the interpretation of the Article XXIV of GATT. The interpretation of the Article XXIV of GATT has been raised as the issues when EEC by Rome Treaty established in 1957. However, the consistency is sue only agreed 6 working parties out of 69 working parties finished the reviewing of the interpretation up to the end of 1994. Also the consistency issue concerned with the special privilege measure of the customs unions and tree-trade area under the Article XXIV of GATT discussed only 3 cases between working parties up to now and did not accepted as an issue for working parties' report. In conclusion in the chapter 6, this study raised the issues of WTO that are a conference of a new round under WTO and the issues of clarity between FTA rule and WTO regulation.

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A Study on the Traditional Costumes and Tattoo of the Maori (마오리族 傳統 服飾과 文身 考察)

  • 황춘섭;정현주
    • The Research Journal of the Costume Culture
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    • v.3 no.2
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    • pp.241-260
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    • 1995
  • The Maori's traditional clothing materials, basic forms of dress, and the pattern and technique of tatoo were examined in the present study in order to deepen the appreciation of the cultural heritage of the Maori. The research method employed was the analysis of written materials. And a fild-trip was also made for the study. The study was limitted to the traditional culture of body adornment of the Maori including the clothing which is preserved and practicing by them at the present day, and the origin and the process of the historical development of those are not included in the scope of the present study. Followings are the results of the study: (1) By far the most widely used fiber for Maori clothing is abtained from what is commonly called New Zealand Flax. The fiber of kiekie(Freycinetia baueriana) and cabbage trees(Cordyline spp.) may also be used. The strong, long-lasting fiber of toi(cordyline indivisa) is used for a prestige warrior's cloak. Flat strips of ti kauka(Cordyline australi) are also used as thatch on rain cloaks. (2) Regardless of technique used, Maori weaving is always worked horizontally from left to right. Traditionally the work was suspended between two upright turuturu or weaving sticks. As the work progressed a second pair of uprights was used to keep the work off the ground. These uprights were moved forward as required. Because the weaver sat on the ground, the working edge was kept at a height that was comfortable to reach. No weaving tools are used, the wefts(aho) being manipulated by the fingers. The two main Maori weaving techniques are whatu aho patahi(single-pair twining) and whatu aho rua(double-pair twining). (3) The Maori wore two basic garments - a waist met and a cloak. The cloth of commoners were of plain manufacture, while those of people of rank were superior, sometimes being decorated with feather or dyed tags and decorated borders. Children ran more-or-less naked until puberty, being dressed only for special events. Some working dress consisted of nothing more than belts with leaves thrust under them. Chiefs and commoners usually went barefoot, using rough sandals on journeys over rough country (4) The adornment of men and women of rank was an important matter of tribal concern as it was in chiefly persons that prestige of the group was centred, The durable items of Maori persons adornment were either worn or carried. Ornaments of various kinds were draped about the neck or suspended from pierced earlobes. Combs decorated the head. Personal decorations not only enhanced the appearance of men and women, but many had protective magical function. The most evident personal ornament was the hei-tiki made of jade or other material. Maori weapons were treasured by their owners. They served on bottle and were also personal regalia. A man of rank was not fully dressed without a weapon in hand. Also weapons were essential to effective oratory. (5) No man or woman of rank went without some tattoo adornment except in extremely rare instances when a person was too sacred to have any blood shed. The untattooed were marked as beeing commoners of no social standing. This indelible mark of rank was begun, with appropriate rite and ritual, at puberty. And tattoo marked the person as being of a marriageable age. Maori tattoo was unlike most traditional tattoo in that its main line were 'engraved' on the face with deep cuts made by miniature bone chisels. The fill-in areas were not tattooed with cuts but with the multiple pricks of small bone 'combs' that only lightly penetrated the skin surface. The instrument of tattoo consisted of small pots of pumice or wood into which was placed a wetted black pigment made from burnt kauri gum, burnt vegetable caterpillars or other sooty materials. A bird bone chisel or comb set at right angles on a short wooden handle was dipped into the gigment, that a rod or stick was used to tap head of this miniature adze, causing penetration of the skin surface. Black pigment lodged under the skin took on a bluish tinge. A full made facial tattoo consisted of major spirals with smaller spirals on each side of the nose and sweeping curved lines radiating out from between the brows over the forehead and from the nose to the chin. The major patterns were cut deep, while the secondary koru patterns were lightly pricked into the skin.

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Analysis of the Work of the Head Nurse and a Work Model for the Head Nurse in University Hospitals in Korea (대학종합병원 수간호사의 업무분석과 모형연구)

  • 김인숙
    • Journal of Korean Academy of Nursing
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    • v.19 no.2
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    • pp.212-222
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    • 1989
  • When the head nurse who is pivotal in the nursing service administration of the hospital performs efficiently as a first-line manager, the effectiveness of the nursing unit, which includes the quality of nursing care, the jab satisfaction of staff members, and the cohesiveness of staff members is increased. With this point of view in mind, the researcher carried out a study to determine the actual work (the content of the work, the work process, the role of the head nurse, the activity media, and the purpose of the work) of the head nurse in a university hospital in Korea. In addition, this study was also carried out for the purpose of preparing an ideal model for the work of the head nurse. The research subjects were 39 head nurses. This included all the head nurses in two university hospitals except those who were working in outpatient care, operating rooms, central supply, nursing administration, in-service education and emergency care. Data were collected from September 24th to October 21th, 1987 and April 4th to 12th, 1988. A work activity record on which the head nurse recorded directly in a chronological narrative form, was used as the research instrument. The 234 work activity records, 39 head nurse's continuous recording over 6 days(from Monday to Saturday) were collected and analysed. The results were as follows ; 1. With regard to the work content for the total daily work of the head nurse, 45.2% of the activities were managerial activities but 58.1% of the head nurse' s time was spent in direct patient care. 2. With regard to the work process of the head nurse, specifically the location, the size and membership of groups contacted, the results were as follows : 1) Of the total daily work activities 92.4% were carried out in the nursing unit and this occupied 84.5% of total daily work time. Direct patient care was generally performed on the nursing unit and managerial work was performed in other areas. 2) Of the total daily work activities, 73% was with one or more persons and 51.2% of total daily work time was spent in groups. 3) A total of 51 persons, working in different capacities were contacted. These included 21 persons giving patient care, 19 persons working in nursing unit management, and 7 persons working in human resource management. 3. With regard to the head nurse's role in work activity, 53.3% of total daily work activities involved the informational role, 26.9%, the interpersonal role and 19.9%, the decisional role. With regard to time, 57.7% was spent in the informational role, 23.9%, in the interpersonal role and 18.3%, in the decisional role. When the head nurse performed managerial work, she gave nearly equal emphasis to all three roles when she gave direct patient care the informational role was increased. 4. With regard to the activity media, the number of unscheduled activities accounted for 27.1% of the activities, scheduled activities, 24.3%, desk work activity, 22.1%, rounds, 12.5% and telephone calls, made or received, 14.0%. In daily total work time managerial work related to desk work and scheduled activities were high, ranging from 29.8% to 29.9% but for direct patient care time, scheduled activities and unscheduled activities were high, ranging from 23.6% to 35.3%. 5. With regard to the purpose of the work performed, 54.4% of the total daily work was concerned with the team and 41.4% was concerned with the agency. The managerial work was concerned mainly with the team and the direct patient care was concerned mainly with the patient. When the frequency of an activity and time were compared no significant difference was found between the days for which the work was recorded for any of the variables : the work content, the work process, the work role, the activity media and purpose of the work. On the basis of this study the following are proposed as an ideal model for head nurse work in Korea : The managerial work should be increased to 70%. The decisional role activities should be increased to 40%. Twenty percent of the work activity should be allocated to agency, community and profession. It is believed that this model for the head nurse's work can contribute to guidelines for job description development. Finally, educational programs, organizational and structural devices, and administrative support are needed for the proper function of the head nurse in this proposed model.

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A Study on the Performance & Job Satisfaction of Visiting Nurses of district health centers in Seoul (서울시 각 구 보건소간호사의 방문간호 업무수행과 직무만족에 관한 연구)

  • Yang, Mi-Jin
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.4
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    • pp.30-40
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    • 1997
  • The change in health care environment increases the importance of Visiting Nursing Services Program. It has been performed by nurses of district health centers in Seoul since 1991. The Achievement of Visiting Nursing Services Program will be dependent upon their activities. The purpose of this study was to identify the Performance of Visiting Nurses and Job satisfaction of district health centers in Seoul. Therefore, it was to provide the fundamental data development of Visiting Nursing Services Program. The subjects were 214 Visiting Nurses of district health centers in Seoul. The data was collected by self reporting questionnaire from April 15 to April 30, 1997. Their performances and various supportive factors were measured with the instruments developed by the researcher. Job satisfaction were also measured by the instrument developed by Slavitt et al. (1978) was used. The data were, analyzed by Cronbach Alpha, mean, standard deviation, percentage, t -test, ANOVA Duncan test, Correlation Coefficient, and Stepwise Multiple Regression with SAS program. The results of this study were as follows: 1. The average of budget of Visiting Nursing Services Program of district health centers was 0.9% and the average of visiting nursing services personnel of district health centers was 10.1%. 2. With regard to the job satisfaction of Visiting Nurses the mean score was 2.92 out of 5. While the level of Job prestige / status presented as a mean score of 3.48 which was the largest among the 7 components of job satisfaction, the level of administration was the lowest showing 2.57 scores respectively. There were significant differences in the job satisfaction by age, working career of health centers(p<0.01, 0.001). 3. The average of the performance level of Visiting Nurses variables was 2.29; The variable with highest degree of performance was the teaching & consultation, establishment of performance plan, whereas the on with the lowest degree was the directive nursing services. The significant difference was found in performance level according to age, structure type of visiting nursing services, working career of health centers and working career of visiting nursing services(p<0.05). 4. With regard to the perception of the performance expertise by the Visiting Nurses the mean score was 2.37 : The variable with highest degree of performance expertise was the teaching & consultation, establishment of performance plan, whereas the on with the lowest degree was management of home-environment. The significant difference was found in performance expertise according to working career outside of health centers(p<0.05). 5. With regard to the perception of the performance necessity by the Visiting Nurses the mean was 2. 40 : the variable with highest degree of performance necessity was the teaching & consultation, establishment of performance plan, whereas the on with the lowest degree was directive nursing services. The significant difference was found in performance necessity according to working career of visiting nursing services(p<0.05). 6. A positive correlation was found between job satisfaction and performance level(r=.3731, P<0.001). Also, a weak positive correlation was found between the components of job satisfaction and performance level. 7. Stepwise multiple regression analysis revealed that the most powerful predictor was the variance of job satisfaction(R=.3557, $R^2$=.1265). Structure type of visiting nursing services and working career of visiting nursing services accounted for 19.0% of the variance in performance level in nurses. In conclusion, Job satisfaction, Structure type of visiting nursing services and Working career of visiting nursing services variables had influenced on performance level in health centers. Further research is required to confirm these findings.

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