Purpose : The prevalence of symptoms in patients with terminal cancer varies considerably and these symptoms are very difficult to control. However, patients can spend their last days or hours of life without suffering pain with appropriate care. One of the major concerns during last days of life is to predict the time of death. We would like to investigate symptom prevalence during terminal cancer patients' last 48 hours in Korea, and therefore contribute to predict the time of death and to help to determine appropriate treatments. Methods : The data for this study was recorded from 92 of 132 patients who died with terminal cancer at the hospital between February 1 and October 31, 2000. We investigated the symptom prevalence during the last 48 hours through medical obligation record and analyzed the changes of symptom prevalence at the admission, $48{\sim}24$ hours and $24{\sim}0$ hours before death. Results : The predominant symptom prevalence was pain (57.6%), followed by confusion (55.4%), dyspnea (48.9%), voiding difficulty (42.4%) in the last 48 hours before death. From the statistical analysis for the changes of symptom prevalence in time, pain, nausea and vomiting were decreased but noisy and moist breathing, sweating, groan, restlessness and agitation, and loss of consciousness were increased (P<0.05). Conclusion : The results from this study show the tendency to increase of prevalence of noisy and moist breathing, sweating, groan, restlessness and agitation as well as loss of consciousness in 48 hours before death. Therefore the symptoms above can be used for the important indicators to predict the imminent death.
Kim, Yun Hee;Lee, Seung Hun;Lim, Ho Seop;Choi, Young Jin;Kim, Yun Jin;Lee, Sang Yeoup;Lee, Jeong Gyu;Jeong, Dong Wook;Yu, Kyoung Hwa
Journal of Hospice and Palliative Care
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v.18
no.4
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pp.314-321
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2015
Purpose: It is well known that a terminal cancer condition affects not only patient themselves but their family members because the patients experience a variety of symptoms. This study was aimed to investigate modifiable factors that influence family caregivers' quality of life, depression, and anxiety. Methods: From January 2015 through May 2015, a survey was conducted with 61 family caregivers of hospice patients who were hospitalized in two university hospitals and one municipal hospital in Busan. The questionnaire was consisted of characteristics of family caregivers and patients, the Korean version of the Caregiver Quality of Life Index-Cancer (CQOLC-K), Beck's Depression Inventory II (BDI-II), Beck's Anxiety Inventory (BAI), and patient's symptom controlling scores rated by family caregivers. Results: Family caregivers' depression was associated with religion. Quality of life and depression of family caregivers were also influenced by monthly household income. Patient age was inversely related to family caregiver's quality of life ($r_s=-0.259$, P=0.043). Family caregivers' quality of life was associated with patient's anxiety (r=0.443, P=0.001). Family caregivers' depression was affected by patient's constipation (r=0.276, P=0.046), anxiety (r=0.508, P<0.001), and daytime drowsiness (r=0.377, P=0.005). And family caregivers' anxiety was influenced by patients' sleep disturbance (r=0.276, P=0.046), depression (r=0.297, P=0.031), and anxiety (r=0.357, P=0.009). Conclusion: According to our findings, family caregivers had higher quality of life and less depression and anxiety when symptoms in hospice patients were well controlled.
Purpose: The purpose of this study is to provide baseline data for the development of an educational program for hospice care for college students. Methods: A survey was conducted at three universities in B city with 143 students from September 5, 2014 through September 26, 2014. The data were analyzed by the SPSS 18 program. This study was approved by IRB. Results: The college students' spiritual well-being was at a medium level. Their attitudes to death were neutral, and perception of hospice care was at a medium level. Most of the participants (93.0%) had no training in hospice care. The participants' awareness of the purpose of hospice care was at a relatively high level. Their awareness of the need for hospice care was at a moderate level. The participants' spiritual well-being and their attitudes to death showed a weak but positive correlation (r=0.179, P=0.030). The relationship between their spiritual well-being and awareness of hospice care were positively correlated (r=0.203, P=0.015). Conclusion: The participants' perception of hospice care was low. Most of them had no experience of hospice care education. Also, the higher the spiritual stability was, the higher the participants' perception of the purpose and the necessity of hospice care was. And their perception of the hospice care varied depending on their family relationship, satisfaction with school life, and cognition of hospice care. Therefore, we need consider these variables to develop a hospice education program to enhance college students' attitudes to death and their perception of hospice care.
Purpose: The purpose of this study was to test the correlation between the levels of spiritual well-being and spiritual nursing care of nurses for cancer patients and to provide baseline data for spiritual nursing care. Methods: In the study, there were 209 nurses involved who cared for cancer patients, and they were from Christian General Hospital in a city, Jeonju. Data were collected from September 17 to 30 in 2008 using structured questionnaires. The data were analyzed using research methods, including descriptive statistics, t-test, ANOVA, Duncan test, and Pearson correlation coefficients. Results: The mean score of spiritual well-being of nurses was $63.41{\pm}10.32$ (range $20{\sim}80$) and that of spiritual nursing care was $26.96{\pm}7.05$ (range $15{\sim}60$). There was a significant positive correlation between the spiritual well-being of nurses and their spiritual nursing care (r=.353, P=.000). Conclusion: The spiritual well-being and spiritual nursing care have a positive correlation. The level of spiritual well-being of nurses was relatively significant, whereas that of spiritual nursing care was relatively low. Therefore, it is recommended, for spiritual nursing care that nurses responsible for cancer patients should pursue more spiritual growth, attend church services regularly, and should further be educated in their care and responsibility.
With Korea's rapid entry to aged society, elderly population has become a major age group both in the whole society and medical field and its importance will be constantly stressed out. Elderly population is also important in the field of oral medicine which deals with chronic and recurrent diseases in the orofacial region of non-dental origin but there exist few studies indicating epidemiology of elderly patients in this regards. This study aimed to investigate change of age distribution of new patients in a university-based dental hospital and oral medicine clinic for last decade and to investigate clinical epidemiology of elderly patients (${\geq}$ 65 years) of oral medicine clinic. This study was performed retrospectively using medical records of the new patients in Dankook University Dental Hospital in 2001 and 2011. According to the study, percentage of elderly new patients increased in both dental hospital and oral medicine clinic and degree of the increase was greater in oral medicine clinic than in the whole hospital (p=0.000). 13.5% of adult patients ${\geq}$ 18 years of oral medicine clinic were elderly patients ${\geq}$ 65 years. 83% of elderly patients were suffering from one or more systemic diseases. Although TMD was the most common reason for elderly patients who visited oral medicine clinic, oral soft tissue diseases, dry mouth, burning mouth syndrome and oromandibular dystonia was more frequently diagnosed in elderly patients compared to adult patients aged 18 to 64 years. Pain severity and interference of Brief Pain Inventory and depression and anxiety scores of Hospital Anxiety Depression Scales were higher in elderly patients than in the adult patients (p<0.05). Increase of elderly patients with chronic oral diseases and pain needs more attention of dentists and specialists of oral medicine to improvement of assessment and development of tailored management because large portion of the elderly patients have systemic diseases, polypharmacy and impaired communication, possibly restricting treatment options.
The purpose of this study was to examine the influence of the communication competence and empathy abilities of dental hygiene students on their interpersonal relationship abilities. The subjects in this study were 578 students who majored in dental hygiene at five randomly selected colleges. Out of the colleges, three were located in North Chungcheong province, and one was located in the city of Daejeon. The other one was located in South Gyeongsang province. Data were gathered using structured questionnaires from April 1 to May 7, 2013. The major findings of the study were as follows: 1. The respondents got a mean of $3.23{\pm}0.49$, $85.80{\pm}10.12$ and $83.27{\pm}8.37$ in interpersonal relationship abilities, communication competence and empathy abilities respectively. 2. As for communication competence, empathy abilities and interpersonal relationship abilities by general characteristics, there were statistically significant differences according to age, academic year, clinical practice experience and satisfaction with major. 3. The relationship of communication competence and empathy abilities to interpersonal relationship abilities was analyzed, and interpersonal relationship abilities were found to have a strong significant positive correlation to communication competence, empathy abilities and the subfactors of the two. 4. As a result of analyzing which variables affected interpersonal relationship abilities, it's found that interpersonal relationship abilities were under the influence of age, clinical practice experience, communication competence, empathy abilities. These variables made a 57.2% prediction of interpersonal relationship abilities. The above-mentioned findings suggest that communication competence and empathy abilities exerted an influence on interpersonal relationship abilities. Therefore curriculums and educational programs should be developed in consideration of these variables to ensure the stable college lives and successful relationship building of dental hygiene students who are on the way to adulthood and will serve as health care personnels in the future.
Kim Jeung-kee;Choi Young-Min;Lee Hyung-Sik;Hur Won-Joo
Radiation Oncology Journal
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v.14
no.3
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pp.237-244
/
1996
Purpose : The accurate dosimetry of independent collimator equipped for 6MV and 15MV X-ray beam was investigated to search for the optimal correction factor. Materials and Methods : The field size factors, beam quality and dose distribution were measured by using 6MV, 15MV X-ray Field size factors were measured from $3{\times}3cm^2$ to $35{\times}35cm^2$ by using 0.6cc ion chamber (NE 2571) at Dmax. Beam qualities were measured at different field sizes, off-axis distances and depths. Isodose distributions at different off-axis distance using $10\times10cm^2$ field were also investigated and compared with symmetric field. Result: 1) Relative field size factors was different along lateral distance with maximum changes in $3.1\%$ for 6MV and $5\%$ for 15MV. But the field size factors of asymmetric fields were identical to the modified central-axis values in symmetric field, which corrected by off-axis ratio at Dmax. 2) The HVL and PDD was decreased by increasing off-axis distance. PDD was also decreased by increasing depth For field size more than $5{\times}cm^2$ and depth less than 15cm, PDD of asymmetric field differs from that of symmetric one ($0.5\~2\%$ for 6MV and $0.4\~1.4\%$ for 15MV). 3) The measured isodose curves demonstrate divergence effects and reduced doses adjacent to the edge close to the flattening filter center was also observed. Conclusion . When asymmetric collimator is used, calculation of MU must be corrected with off-axis and PDD with a caution of underdose in central axis.
Kim, Sung Hoon;Hong, Seung A;Cho, Yoon Jung;Lee, Sang Lak;Kwon, Tae Chan
Clinical and Experimental Pediatrics
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v.45
no.5
/
pp.622-628
/
2002
Purpose : The purpose of this study is to ascertain the clinical manifestations and associated cardiac anomalies of dextrocardia. Methods : Twenty-four pediatric patients, who were admitted to, or visited, Dongsan Medical Center Keimyung University and were diagnosed with dextrocardia between January 1996 and July 2001, were enrolled in this study. All patients received echocardiogram and abdominal ultrasonogram to identify structural cardiac anomalies and visceral position. Results : Among 24 patients, 7 cases were situs solitus(29.2%), 10 cases(41.6%) were situs inversus and 7 cases(29.2%) were situs ambiguous. Most were diagnosed within a week of life(87.5%). They were most commonly cyanotic(45.8%), but eleven cases(45.8%) had no specific symptoms or signs. Nineteen cases(79.2%) had accompanied cardiac anomalies, and pulmonary stenosis or atresia were the most common among them. All the cases of situs solitus and ambiguous had associated cardiac anomalies, but half of the situs inversus had that. Eleven cases were dead by cardiac or extracardiac anomalies during follow up and the mortality rate was higher in situs solitus or ambiguous group than situs inversus group. Conclusion : Dextrocardia accompanies different cardiac and extracardiac anomalies. It's very important to diagnose dextrocardia and associated cardiac or extracardiac anomalies in the early stages of life to improve prognosis.
This article considers the experimental foundations of geographical phenomena for the distribution of lodging houses and the development of lodging Information Systems in Shin-Chon Area. This system allows the rural students to find their lodging houses conveniently. We examine the geographical reality of lodging houses in Shin-chon area and explores the lodging information system, reflecting how students select the lodging houses. Criteria for selection of lodging houses are travel time to school, interior facilities, rent fee, members, owners of lodging houses, which are collected by field swvey. The lodging information system is built in integration of Visual Basic with spatial data which are created in Mapinfo and Arcview through MapObject, component GIS software. This system provide query tools to efficiently investigate data as well as interactive map display. Also it displays the characteristics of a selected lodging houses using the identify tool on the map.
Journal of Korean Academy of Fundamentals of Nursing
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v.2
no.1
/
pp.67-85
/
1995
The purpose of this study was to determine the effects of rhythmic movement therapy for adaptation state in mastectomy patients. The quasi-experimental study was designed using nonequivalent control group pretest-posttest design within the framework of Laszarus & Folkman's stress-adaptation model. The subjects of the study were composed thirty-two mastectomy patients, of these fifteen were assigned to the experimental group and seventeen to the control group. Rhythmic movement therapy was carried out twice a week for thirty-five, minutes or forty minutes for six weeks period from August 22 to September 30 in 1994. Data was collected before and after the experimentation. Collected data was analyzed by mens of chi-square test, t-test, two-way ANOVA, Pearson's correlation coefficient with $SPSS/PC^+$. The results were summarized as follows : 1. Physical symptom score in the experimental group and control group was not significant difference. 2. Joint Movement Parameter in the experimental group and control group was significant difference. 3. Depression score in the experimental group and contrl group was significant difference. 4. Body image score in the experimental group and control group was significant difference. 5. Stress perception score in the experimental group and control group was significant difference. 6. Social adjustment score in the experimental group and control group was significant difference. 7. Each adaptational level in the experimental group and control group according to type of Health Locus of Control were partially significant difference. Depression score and social adjustment score between the experimental group and control group according to others Health Locus of control were significant difference. This data suggest that rhythmic movement therapy was more effective in the group of Others health Locus of Control. 8. Each adaptational level between the experimental group and control group according to amount of spouse support were not significant difference. 9. The significant positive correlation between physical symptom score and body image, between body image and social adjustment, were observed. The significant negative correlation between stress perception score and social adjustment, between depression and body image, between depression and social adjustment, were observed. This data suggest that the more physical symptom score increased, the more body image increased and the more body image, the more social adjustment. And then the more stress perception score decreased, the more social adjustment increasded and the more depression score, the more body image and social adjustment. Thus it is concluded that the rhythmic movement therapy was a useful nursing intervention for adaptation of mastectomy patients.
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