• Journal of Hospice and Palliative Care
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• v.20 no.2
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• pp.93-99
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• 2017

Purpose: This study investigated changes in life-sustaining treatments in terminally ill cancer patients after consenting to a do-not-resuscitate (DNR) order. Methods: Electronic medical records were reviewed to select terminally ill cancer patients who were treated at the oncology unit of the Asan Medical Center, a tertiary hospital in South Korea and died between January 1, 2013 and December 31, 2013. Results: The median (range) age of the 200 patients was 59 (22~89) years, and 62% (124 persons) were male. Among all patients, 83.5% were aware of their medical condition, and 47.0% of the patients had their DNR order signed by their spouses. The median of the patients' hospital stay was 15 days, and time from admission to DNR decision was 10 days. After signing a DNR order, 35.7~100% of the life-sustaining treatments that had been provided at the time of the DNR decision making were administered. The most commonly discontinued interventions were transfusion (13.5%), blood test (11.5%) and parenteral nutrition (8.5%). Conclusion: It is necessary to define the scope of life-sustaining treatments for DNR patients. Treatment guidelines should be established as well to secure terminal patients' death with dignity after their consent to a DNR order, thereby avoiding meaningless life-sustaining treatments and allowing administration of active terminal care interventions.

• Journal of Hospice and Palliative Care
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• v.17 no.4
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• pp.270-277
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• 2014

Purpose: This is a retrospective study that investigated cancer patients' complaints of moderate or severe pain to analyze pain characteristics, pain relief interventions and their effects. Methods: The participants of this study were 363 patients who were hospitalized in the cancer ward for three to 30 days and scored 4 points or higher on the pain severity assessment. Results: The most frequent region of pain was the abdomen. The most frequent factor that exacerbated pain was movement. The most frequent pain alleviating factor was administration of analgesics. The most frequent pain type was breakthrough pain, and the most frequent non-pharmaceutical intervention for pain control was heat therapy. Among all, analgesics were routinely prescribed for 52.2% of the participants. Morphine sulfate was the most frequently used analgesic while Gabapentin was the most frequently used non-narcotic analgesic. At the time of discharge, 82.5% of the participants marked their pain intensity as 3 points or lower. Conclusion: For cancer patients complaining of moderate or severe pain, it is important to actively control pain from the beginning of admission. Thus, it is necessary to educate not only cancer patients using narcotic analgesic for pain control and their families but nurses about the effects and side-effects of drugs. Moreover, patients and their families need to learn how to assess and record pain at home to collect data that can be referred for future treatment.

• 한국노년학
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• v.30 no.4
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• pp.1263-1280
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• 2010

The present study describes the acculturation meaning of 12 Chinese-Chosun residential care attendants(RCAs) who are currently working in long-term care settings for Korean older adults. Using a qualitative research method, the findings show that the acculturation process of Chinese-Chosun RCAs consists of three stages: entrance, conflict, and adaptation. In the initial stage, the assets of the social and cultural networks among their friends and relatives, who already settled down or employed as RCAs, provided more opportunities for being employed as a RCA. However, most Chinese-Chosun RCAs experienced a number of conflicts while they adapted to mainstream society and perform caregiving tasks. They perceived discrimination, heavy workload, prejudice, and homesick. Nevertheless, they appeared to adapt effectively to Korean society and working environments because they were aware of the various benefits of working as a RCA such as higher wage and more job openings compared to other jobs, a rapport with the patients and patients' families, flexible work hours, and pride as a caregiver. This type of qualitative groundwork will be an important precursor to the design, implementation, and evaluation of acculturation research for minority immigrant workers in the Korean social welfare system.

• The Journal of the Korea Contents Association
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• v.17 no.1
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• pp.262-269
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• 2017

The purpose of this study is to provide direction of medical education by analysing medical school student's perception structure about 'happy doctor'. In particular, this study compared perception structure between two groups of students before clerkship and after clerkship. The subject of this study were 1~4 academic year students in medical school. Students' text about 'happy doctor' were collected by open-ended questionnaire and analyzed by using sematic network analysis. Based on the result of network analysis, perception structure of each groups were confirmed. The network of each groups have 'Professionalism' group including words such as 'patient', 'treatment', 'worthwhile' in common. Three groups, 'Professionalism', 'Quality of life' and 'Self-realization' constituted the before clerkship network. And five groups, 'Professionalism', 'Time with family', 'Balance between work and household', 'Interpersonal relationship', 'Physical and psychological health' constituted the after clerkship network. The results of this study is expected to contribute for developing the basic medical education curriculum for 'happy doctor'.

• Journal of agricultural medicine and community health
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• v.28 no.2
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• pp.87-105
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• 2003

Objectives: The purpose of this study was to examine the health care utilization pattern and its related factors of low-income population with abnormal results through health examination. Methods: Analysed data were collected through a questionnaire survey, which was given to 263 persons who 30 years or over with abnormal results through health examination at Health Center. This survey was conducted in March, 2003. This study employed Andersen's prediction model as most well known medical demand mode and data were analysed through 2-test, and multiple logistic regression analysis. Results: The proportion of medical utilization for thorough examination or treatment among study subjects was 51.0%. In multiple logistic regression analysis as dependent variable with medical utilization, the variables affecting the medical utilization were 'feeling about abnormal result(anxiety versus no anxiety: odds ratio 2.25, 95% confidence intervals 1.07-4.75)', 'type of health security(medicaid type I versus health insurance: odds ratio 2.82, 95% confidence intervals 1.04-7.66; medicaid type II versus health insurance: odds ratio 3.22, 95% confidence intervals 1.37-7.53)', 'experience of health examination during past 2 years(odds ratio 2.39, 95% confidence intervals 1.09-5.21)' and 'family member's response for abnormal result(recommendation for medical utilization versus no response: odds ratio 4.90, 95% confidence intervals 1.75-13.75; family member recommended to utilize medical facilities with him/her versus no response: odds ratio 19.47, 95% confidence intervals 5.01-75.73)'. The time of medical utilization was 8-15 days after they received the result(29.9%), 16-30 days after they receive the result(27.6%), 2-7 days after they received the result(20.9%) in order. The most important reason why they didn't take a medical utilization was that it seemed insignificant to them(32.4%). Conclusions: In order to promote medical utilization of low-income population, health education for abnormal result and its management would be necessary to family member as well as person with abnormal result. And follow-up management program for person with abnormal result through health examination such as home-visit health care would be necessary.

• Fire Science and Engineering
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• v.27 no.4
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• pp.61-67
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• 2013

This study was to investigate the cardiopulmonary resuscitation (CPR) outcomes and the clinical characteristics of outof- hospital cardiac arrest (OHCA) by analyzing date in one region. A total 8 patients, survived over 72 hours after ROSC. The cardiac arrest were caused by unknown (5 cases), cardiac disease (3 cases). The most common place of cardiac arrest was in the home (6 cases), witnessed cardiac arrest (8 cases), cardiopulmonary resuscitation by bystander was performed (4 cases), agonal respiration (3 cases). The initial electrocardiogram (ECG) showed ventricular fibrillation (VF) in 7 cases, pulseless electrical activity (PEA) other rhythms in 1 cases. Average time from call to scene arrival 6.1 minutes, call to hospital arrival 23.0 minutes, duration of total CPR was 8.7 minutes. The certificate of them were level 1 emergency medical technician (EMT) 6 cases, level 2 EMT 3 cases, total 3 members 7 cases. To improve the rate of survival for out-ofhospital cardiac arrest victims, development of continuous CPR educational program for lay rescue.

• Journal of Hospice and Palliative Care
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• v.11 no.1
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• pp.30-41
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• 2008

Purpose: This study was designed to investigate various role changes of nurses who have cared both medical cases and hospice patients and what they experienced. Methods: Focus group interviews were done 3 times and participants were 12 nurses who have worked in the hospice unit of medical ward. Results: Role changes in 4 areas such as holistic care, end-of-life care, care fur rare givers, and coordination of hospice team were reported by the participants. What they felt were as follows : fear, confusion, maturation, increasingly labor, regret, accomplishment, sympathy and depression. Conclusion: Although hospice care in general medical ward added extra tasks, it helped clinical nurses recover professional identity and led to growth of nursing by acquiring new knowledge and skill in hospice care.

• (The)Study of the Eastern Classic
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• no.66
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• pp.103-128
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• 2017

Slaves have been investigated around diaries or slave ownership papers of nobilities up to now. While slaves were described in tales or stories on loyal slaves or historic tales, slaves were not sufficiently examined. This paper analyzed the actual awareness on slaves through the description on slaves in Chinese poem. It was generally very difficult to deal with young slaves because young slaves were included in the lowest class without education and not an adult. The fugitive slaves were loss of labor and brought the emotional betrayal. There were spells to make fugitive slaves return. The sense of loss was nearly same in the death of slaves as in the death of family members. The longer the slaves lived with owners, the greater the sense of loss was. However, the difference of awareness on slaves per period was not identified in this paper. It can be identified only by fully examining more data on slaves. It will be the theme of further study.

• Human Ecology Research
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• v.55 no.1
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• pp.13-26
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• 2017

This study investigated the latent groups depending on married working women's work-family spillover. The effects of factors that determine mental health subgroups and differences were also analyzed. Mixture modeling was applied to the Korean Longitudinal Survey of Women & Families to achieve the research objectives. The major findings of this study were as follows. First, there were four subgroups that could be defined according to the work-family spillover: mid-level spillover group (mid-positive and mid-negative spillover group), high-level spillover group (high-positive and high-negative spillover group), low-level spillover group (low-positive and low-negative spillover group), and high-negative and low-positive spillover group. Second, the results of mixture regression analysis to test the effect of eco-system variables showed that age, academic background, non-traditional family value, number of children, work hours, wage income, and availability of the maternity leave were significant determinants of the latent groups. The probability of classifying in the high-negative and low-positive spillover group increased when women showed a lower academic background and wage income, higher number of children and older age, and longer work hours than others. Third, the high-level spillover group, and the high-level spillover group showed the lowest stress and the lowest depression; however, the low-level spillover group reported the highest stress and the highest depression. Implications, limitations, and future directions were discussed based on the results.

• Journal of Nutrition and Health
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• v.41 no.8
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• pp.776-785
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• 2008

Maternal stress was one of the common symptoms that pregnant women could have experienced during pregnant period. The purpose of this study was to investigate the relation of maternal stress with maternal nutrients intake and pregnancy outcome. Subjects were 248 pregnant women and were recruited at two hospitals in Seoul area. Individual stress levels were divided by the stress scores (total 41 scores), as low stressed group (< 12) and high stressed group (${\geqq}12$). The social characteristics, nutrient intake, anthropometric measurements and pregnancy outcome were compared between low stressed group (LSG) and high stressed group (HSG) to recognize risk factor of maternal stress. We found that subjects experience stress by various factors which were concern about newborn (40.4%), concern about health (28.8%), economic difficulties (13.2%), depress (10.1%), family relationship (2.9%), concern of house work (2.5%), human relationship (2%). In HSG, unemployed rate (p < 0.05) and pre-pregnancy BMI (p < 0.05) were higher than in LSG. Family size in HSG was larger than that in LSG (p < 0.01). Doing regular exercise with the light activity level was significantly higher in LSG (p < 0.05). The nutrient intake in LSG was slightly higher than that in HSG, but not statistically significant. Pregnancy outcome was not significantly affected by the maternal stress. In conclusion, the risk of maternal stress may be related with a life style during pregnancy. Therefore, life style for maternal stress control, such as weight control and regular exercise is recommended to prevent maternal stress.