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간호대학생의 무례 행동은 전문직관에 어긋날 뿐 아니라 미래에 간호 문화 및 환자 안전을 위협할 수 있으므로매우 심각하다. 따라서 본 연구는 텍스트네트워크분석을 적용하여 간호대학생 관련 무례 행동 연구의 동향을 살펴보았다. 연구과정은 문헌 수집, 단어 정제, 자료 분석 순이었다. 2015년 1월부터 2019년 10월까지 국제학술지에 출판된 관련논문 139편을 선정하여 논문 초록을 분석하였다. NetMiner 프로그램을 이용해 키워드 간 동시출현 행렬을 생성한후, 네트워크 특성 분석, 노드의 중심성 분석, 자아연결망 분석을 실시하였다. 연결중심성, 근접중심성, 매개중심성에서상위 30위 이내에 포함된 핵심주제어는 “간호학생(nursing student)”, “무례함(incivility)”, “간호학교수(nursing faculty)”, “지각(perception)”, “괴롭힘(bullying)”, “폭력(violence)”, “학습윤리(academic integrity)”, “공격(aggression)”, “사이버불링(cyberbullying)” 등이었다. 무례 행동에 해당하는 “무례함”, “괴롭힘”, “폭력”, “공격” 및 “학습윤리”에 대한 자아연결망분석을 실시한 결과, “무례함”의 에고넷 크기가 가장 컸고 이들 핵심주제어에 따라 관련 인물, 발생 장소 등에 차이가있었다. 본 연구를 통해 임상실습 현장에서 학생과 간호사, 보건의료인, 환자 사이에 발생하는 무례 행동 연구가활발함을 알 수 있었다. 학습윤리 역시 학교보다 임상실습 교육에서 더 자주 연구되고 있었는데 이에 대한 간호교육기관의 대응이 시급하다고 본다. 한편 무례 행동을 나타내는 용어가 연구자 간에 상이하게 사용되고 있으므로개념에 대한 합의가 선행되어야 하겠다. This study aimed to explore research trends of misbehaviors involving nursing students applying a text network analysis. 139 relevant studies, published in international journals from 2015 to 2019, were identified. Semantic morphemes of the abstracts were refined, and their co-occurrence matrix with 126 keywords was generated. Characteristics of the text network, node centrality, and ego-net analysis was performed using the NetMiner program. The most critical core-keywords were defined as the top 30 keywords in degree centrality, closeness centrality, or betweenness centrality. The core-keywords of “nursing student,” “incivility,” and “nursing faculty” were ranked highest regardless of a centrality type. Other core-keywords included “perception,” “bullying,” “violence,” “academic integrity,” “aggression,” “cyberbullying.” Ego-network analysis for five types of misbehaviors presented different participants or places for each while “incivility” had the largest egonet with various knowledge structure. This study concludes that a majority of misbehavior studies involving nursing students focused on students' negative experience with nurses, health professionals, or patients at clinical settings. Academic integrity was often studied with a focus of clinical education in addition to in-class education. Research trends of misbehaviors involving nursing students demonstrate unique challenge to which nursing faculty and institutions have to immediately respond.
연구 목적: 사례 관리(CM) 환자 만족도 측정에 관한 연구 결과를 고찰하여 사례관리 실무에서 활용할 수 있는 근거를 제공하고자 한다. 연구 방법: MedLine, CINAHL에서 주요용어로 case management, care management, 주제어로 patient satisfaction, client satisfaction을 이용해 문헌 검색을 실시하였다. 연구 결과: 만족도에 대한 개념은 관련 연구가 매우 부족하며, 서로 다른 이론적 접근을 하고 있으므로 그 측정에 어려움이 있다. 신뢰할 만한 만족도 측정을 위해서는 설문 문항을 서술하는 여러 가지 방법들, 측정 척도의 종류, 만족도에 영향을 미치는 혼란변수들을 주의 깊게 고려하여야 한다. 만족도는 사례관리 연구에서 흔히 측정되는 성과이지만 대부분의 관련 연구에서 사례관리의 특징이 반영된 측정 도구를 사용하지 않고 있었다. 따라서 본 논문은 다섯 개의 사례관리 만족도 측정 도구를 제시하고 그 특징을 소개하였다. 또한, 간호성과분류체계(The Nursing Outcomes Classification)에 제시된 만족도 측정항목들 중 사례관리와 관련이 높은 약 40%의 항목들을 발견하였다. 결론: 사례관리 만족도 측정 도구가 매우 부족하므로 표준 사례관리 측정도구 개발이 시급하다. 한편 사례관리사들은 만족도 측정에 대한 이해를 높이고 기존 연구 결과를 활용함으로써 보다 정확한 사례관리 만족도 평가가 이뤄지도록 노력해야 한다.
This study aimed to synthesize the best available qualitative research evidence on nurse educators' experiences with student incivility inundergraduate nursing classrooms. A meta-synthesis of qualitative evidence using thematic synthesis was conducted. A systematicsearch was performed of 12 databases for relevant literature published by March 31, 2019. Two reviewers independently conductedcritical quality appraisals using the checklist for qualitative research developed by the Joanna Briggs Institute. Eleven studies that metthe inclusion criteria were selected for review. From the pooled study findings, 26 descriptive themes were generated and categorizedinto the following 5 analytical themes: (1) factors contributing to student incivility, (2) management of student incivility, (3) impact:professional and personal damage, (4) impact: professional growth, and (5) initiatives for the future. Many nurse educators becameconfident in their role of providing accountability as both educators and gatekeepers and experienced professional growth. However,others experienced damage to their personal and professional life and lost their motivation to teach. Nurse educators recommended thefollowing strategies for preventing or better managing student incivility: institutional efforts by the university, unified approaches forstudent incivility within a nursing program, a faculty-to-faculty network for mentoring, and better teaching and learning strategies forindividual educators. These strategies would help all nurse educators experience professional growth by successfully preventing andmanaging student incivility.
The effect of the addition of the fresh medium, volume of under solid medium in double layer culture as well as the medium change after pretreating microspores on the production of embryos in microspore culture of hot pepper (Capsicum annuum L.) has been studied. When cultured after heat pre-treatment, changing pretreatment media with fresh culture media proved to be more effective for embryo production rather than supplementing additional culture media. Heat-pretreating for 3 days turned out more effective for embryo production than pretreating for 1 or 2 days. In the case of anther pretreatment, the addition of fresh medium after culture was not effective for embryo production. In pretreating microspores, however, supplementing additional fresh culture media greatly improved embryo yield and quality. The best time point of media addition was 4 days after culture commenced, and the most effective number of times of media addition was one time addition. Moreover, the effective volume of added medium in double layer culture for embryo production was 1.5 ml. The addition of media more than 1.5 ml reduced both embryo yield and quality. Double layer medium was more effective for embryo development than liquid medium. When the volume of under solid medium increased ranging from 3 ml to 7 ml, more cotyledonary embryos were produced in either 5 ml or 7 ml compared to 3 ml, even though the total number of embryos were highest in 3 ml. These results can be used as an important data for establishing an efficient microspore culture system for producing high frequency of normal embryos in hot pepper. 본 연구에서는 고추의 소포자 배양 시 전처리 후 배지의 교환 여부, 배양 후 새 배지의 첨가 및 2층배지 사용시 하층고체배지의 양이 배의 생산에 미치는 영향을조사하였다. 고온 전처리 후 배양배지를 첨가하여 배양하는 것보다 사용한 전처리 배지를 새 배양 배지로 교환하여 배양 하는 것이 배의 생산에 효과적 이었으며,고온전처리 기간은 1일이나 2일에 비해 3일이 효과적 이었다. 배양 후 새 배지의 첨가는 약전처리 시에는 효과가 없었으나 소포자 전처리 시에는 배의 유기와 발달모두 크게 향상되었다. 새 배지의 첨가 시기는 배양 4일후가, 첨가 횟수는 1회가 배의 생산에 가장 효과적이었다. 한편 2층배지 사용 시 첨가하는 새 배지의 양은 1.5 ml이효과적이었으며 이보다 많은 양을 첨가하는 경우 배의발생과 발달 모두 저하되었다. 액체배지 사용 시에 비해 2층배지 사용 시 배의 발달이 좋았다. 또 2층배지 사용 시 하층고체배지의 양이 3 ml 일 때 보다는 5 ml이나 7 ml일 때 배의 발생은 감소하였으나 배의 질이 향상되었다. 이와 같은 결과들은 고추에서 다수의 정상자엽배를 생산 할 수 있는 소포자 배양시스템을 확립하는데 중요한 기초자료가 될 것이다.
Purpose: The purpose of this study was to explain the role transition process to nurse case managers (NCMs) for Medical-aid beneficiaries in Korea. Methods: Fourteen NCMs were interviewed regarding their experiences of becoming proficient in the new role of case manger. Data were analyzed through the application of grounded theory. Results: ‘Taking root in a barren land" was the core category explaining the role transition process of NCMs. They engaged in four stages: launching, trial and error, proficiency, and wait-and-see stages. NCMs showed not only fear but also passion for case management practice. Despite their passion and effort, NCMs went through a period of trial and error. After becoming skilled, NCMs went through a stage of wait-and-see often because of job insecurity related to temporary position or few opportunities for promotion. Factors influencing NCMs" role transition process included their understanding of client characteristics, belief in case management, and support from their colleagues and families. Conclusion: NCMs experience many challenges in the process of becoming proficient NCMs. To help with their role transition, there is a need for education programs, preceptorship programs, research on their roles and functions, and regulation for securing NCMs" employment and career stability.
The purpose of this study was to develop a substantive theory of case management (CM) practice by investigating the experience of nurse case managers caring for Medical Aid enrollees in Korea. Methods: A total of 12 nurses were interviewed regarding their own experience in CM practice. Data were recorded and analyzed using grounded theory. Results: Empowerment was the core category of CM for Medical Aid enrollees. The case managers engaged in five phases as follows, phase of inquiring in advance, building a relationship with the client, giving the client critical mind, facilitating positive changes in the client's use of healthcare services, and maintaining relationship bonds. These phases moved gradually and were circular if necessary. Also, they were accelerated or slowed depending on factors including clients' characteristics, case managers' competency level, families' support level, and availability of community resources. Conclusion: This study helps understand what CM practice is and how nurses are performing this innovative CM role. It is recommended that nurse leaders and policy makers integrate empowerment as a core category and the five critical CM phases into future CM programs.
Purpose: This study was aimed to evaluate the methodological issues and comprehensiveness of workplace bullying instruments and to suggest a taxonomy of psychological abuse. Methods: Nineteen instruments applied in health care organizations and 469 questionnaire items mainly regarding psychological abuse were collected through a literature review. Three researchers classified the questionnaire items according to a “taxonomy of psychological abuse in the workplace.” Results: Many instruments of workplace bullying were developed in the 2000s using a reflective measurement model, but their psychometric property was not sufficient and the measurement model is questioned. Based on the questionnaire items, the “taxonomy of psychological abuse in the workplace” was modified by adding two new subcategories (unachievable work and unfair treatment) and clarifying some operational definitions. According to the modified taxonomy of 11 (sub)categories, the reviewed instruments assessed 6.5 (sub)categories on average. No instrument measured all (sub)categories. Category 4.2 (disrespect, humiliation, and rejection of the person) was measured in all instruments, followed by Categories 5 (professional discredit and denigration) and 1.2 (social isolation) behaviors. Conclusion: The current instruments are not comprehensive enough. It is suggested that the modified taxonomy is verified and guide more reliable and inclusive instruments in the future. Furthermore, a formative measurement model, which defines a bullying as an inventory of different types of behaviors, should be used.
As the capture fishing industry has declined, the aquaculture industry has become an important source of seafood. With this tendency all fish farming will be performed by large-scale farms where the fish are cultivated in much high density and as a result the incidence of infectious diseases increases. Therefore, vaccination has become an increasingly important part of aquaculture as a cost effective method of controlling various diseases. The early fish vaccines were the formalin inactivated bacteria or virus cultures,which were administered by either immersion or injection. Recombinant DNA biotechnology allowed us to develop orally administrated DNA and ecombinant vaccines. In terms of the manufacturing process and cost,Lemna and Spirodela is the most efficient and reliable plant expression system for the production of edible vaccine.
As the capture fishing industry has declined, the aquaculture industry has become an important source of seafood. With this tendency all fish farming will be performed by large-scale farms where the fish are cultivated in much high density and as a result the incidence of infectious diseases increases. Therefore, vaccination has become an increasingly important part of aquaculture as a cost effective method of controlling various diseases. The early fish vaccines were the formalin inactivated bacteria or virus cultures, which were administered by either immersion or injection. Recombinant DNA biotechnology allowed us to develop orally administrated DNA and recombinant vaccines. In terms of the manufacturing process and cost, Lemna and Spirodela is the most efficient and reliable plant expression system for the production of edible vaccine.