• Journal of Music and Human Behavior
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• v.16 no.2
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• pp.27-51
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• 2019

This case study aimed to investigate changes in self-expression following participation in a rap making program with adolescent survivors of childhood cancer. The rap making program was constructed based on the contextual support music therapy model. Three adolescent survivors of childhood cancer participated in six 80-minute individual sessions. During the sessions, each participant engaged in the following tasks: song discussion, lyric creation, and rapping over a selected beat. At pre and posttest, the Self-Expression Scale was completed by participants. Their verbal expressions lyrics were observed during the sessions, and individual interviews with the participants were conducted at the completion of the program. The results demonstrated that the mean rating of the Self-Expression Scale increased after the rap making intervention. Analysis of the participants' verbal expressions and lyrics demonstrated that participants were experiencing difficulties adjusting to school that they wanted to resolve. Furthermore, the analysis of the interviews at posttest found that participants experienced positive changes in self-perception, self-expression, and expectations for their future, compared to the pretest when the participants expressed negative self-perceptions due to difficulties in interpersonal relationships at school and physical limitations. This indicates that rap making can be an effective resource for providing this population with the means to recognize positive attributes about themselves and improve self-expression.

• Journal of Hospice and Palliative Care
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• v.22 no.1
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• pp.39-47
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• 2019

Purpose: This study was performed to investigate the current status of pediatric palliative care provision and how it is perceived by the palliative care experts. Methods: A descriptive study was conducted with 61 hospice institutions. From September through October 2017, a questionnaire was completed by experts from the participating institutions. Data were analyzed using SPSS 21.0. Results: Among 61 institutions, palliative care is currently provided for pediatric cancer patients by 11 institutions (18.0%), all of which are concentrated in Seoul, Incheon and Gyeonggi and Gyengsang provinces; 85.2% of all do not plan to provide specialized pediatric palliative care in the future. According to the experts, the main barriers in providing pediatric palliative care were the insufficient number of trained specialists regardless of the delivery type. Experts said that it was appropriate to intervene when children were diagnosed with cancer that was less likely to be cured (33.7%) and to move to palliative care institutions when their conditions worsened (38.2%); and it was necessary to establish a specialized pediatric palliative care system, independent from the existing institutions for adult patients (73.8%). Conclusion: It is necessary to develop an education program to establish a nationwide pediatric palliative care centers. Pediatric palliative care intervention should be provided upon diagnosis rather than at the point of death. Patients should be transferred to palliative care institutions after intervention by their existing pediatric palliative care team at the hospital is started.

• Clinical and Experimental Pediatrics
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• v.49 no.12
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• pp.1329-1339
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• 2006

Purpose : Failure of hematopoietic stem cell transplantation(HSCT) may be encountered in practice because of either relapse of the malignancy or dysfunction of the graft. Second HSCT may be the only option for some patients whose initial HSCT failed. Methods : From May, 1991 to December, 2004, 115 HSCTs were performed at the Pediatric Blood & Marrow Transplantation Center, Chonnam National University. This study was a retrospective analysis of the medical records of 15 patients who received the second HSCT after initial graft. Results : Among eight patients with nonmalignant diseases, two patients underwent the second HSCT because of primary graft failure and five because of late graft rejection. The remaining Fanconi anemia patient was re-transplanted due to development of AML. Two patients died and one experienced primary graft failure, but is still alive. The Kaplan-Meier 5-year overall survival rate was 75 percent and the disease free survival rate was 62.5 percent in nonmalignant diseases. All malignant patients underwent second transplants because of relapses. Four died of relapse and one of treatment-related complications. The Kaplan-Meier 2-year overall and event free survival rate was 28.6 percent each in malignant diseases. Conclusion : Second HSCT for graft dysfunction of nonmalignant disease seems to be feasible and should be considered as a standard practice. The relapse of malignant diseases remains a big obstacle even after the second HSCT, although a small portion of patients might be salvaged. Further investigation of novel therapeutic strategies, as well an the understanding of the biology should be explored.