• Journal of Hospice and Palliative Care
• /
• v.22 no.4
• /
• pp.198-206
• /
• 2019

Purpose: The Act on Hospice and Palliative Care and Decisions on Life-sustaining Treatment for Patients at the End of Life was enacted in 2016 and has taken effect since 2018 February. The content of this act was based on Physician Orders for Life-Sustaining Treatment (POLST) in the United States and we modified it for terminal cancer patients registering hospice. The object of this study is to investigate preference and implementation rate for modified Korean POLST (MMK-POLST) items in hospice ward. Methods: From February 1, 2017 to April 30, 2019, medical records regarding MMK-POLST were retrospectively analyzed for all patients hospitalized in the hospice ward of Gyeongsang National University Hospital. Results: Of the eligible 387 total cohorts, 295 patients filled out MK-POLST. MK-POLST has been completed in 133 cases (44.1%) by the patient themselves, 84 cases (28.5%) by the spouse, and 75 cases (25.4%) by their children, respectively. While only 13 (4.4%) out of 295 MK-POLST completed patients refused the parenteral nutrition and 5 patients (1.7%) for palliative sedation, the absolute majority of 288 (97.6%) patients did not want cardiopulmonary resuscitation (CPR) and ventilators and 226 people (76.9%) for pressor medications. Kappa values for the matched strength of MK-POLST implementation were poor for all items except CPR, ventilators and palliative sedation. Conclusion: Hospice patients refused to conduct cardiopulmonary resuscitation, ventilators and pressor agents. In contrast, antibiotics, parenteral nutrition and palliative sedation were favored in the majority of patients.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.17 no.4
• /
• pp.188-198
• /
• 2016

This study examined the effects of a smoking cessation coaching program based on the motivation stage applying the Transtheoretical Model to stop the smoking of patients in terms of the amount of smoking, nicotine dependence, CO level, and urine cotinine. The study design was a multi-repeat multiple repeat intermittent time series study with one-group, a pre-post design. The participants were 47 smoking patients (44 males and 3 females), who were treated at a public hospital in N city. The participants were 4 (8.51%) subjects in the action stage and 43 subjects (91.49%) in the preparation stage of the motivation stage. The coaching program intervention was conducted at the first day, second week, and 6th week. The smoking cessation maintenance of the subjects was checked at the 12th week. A chi-square test and t-test were used to analyze the data. The subjects in the action stage were kept under the condition of no smoking and nicotine dependence. After the program of subjects in the preparation stage, the amount of smoking, nicotine dependence, and CO level were significantly lower compared to the pre-test (p<.001). The findings suggest that the coaching program based on the motivation stage was effective in improving the smoking cessation for patients who smoke. On the other hand, the patients in the smoking cessation program may require much more financial assistance than those of healthy people. A greater workforce and budget will be needed for patients to stop smoking.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.15 no.8
• /
• pp.5159-5168
• /
• 2014

The study examined the relationship among metal health, metabolic syndrome and nutrient acceptance according to gender. Implemented until 2010-2012, the 5th Korean National Health and Nutrition Examination Survey, as an original document, was used for the study. The target was problem drinkers with more than 12 points under AUDIT. Regarding mental health, it was classified into stress, depression and suicidal impulse. Metabolic syndrome was defined when three causes of BMI, waist circumference, FBS, HDL and BP were out of the normal range. The nutrient intake was obtained to confirm the energy intake of nine non-nutrients (Nutrient adequacy ratio: NAR) and the proper intake of the average non-nutrient (Mean adequacy ratio: MAR). These variables were analyzed by frequency, cross analysis and multiple regression analysis through SPSS18.0. In the general features, there was a significant difference according to age, occupation and marital status. In mental health, stress, depression and suicidal impulse were examined. Metabolic syndrome was dependant on FBS, HDL and BP. The nutrient acceptance depended on calcium, vitamin A, thiamine, riboflavin, niacin, vitamin C, and MAR. Logistic regression analysis performed on the variables showed significant differences. Stress, depression, and thoughts of suicide was significantly higher in men aged 19-29 years, and women aged 30-49 years. In the case of the male, those who employed have metabolic syndrome more than those who unemployed. In terms of female, those who were belonged into the middle - low economic level have undergone with metabolic syndrome. In the part of a Mean adequacy ratio(MAR), the male who unmarried, employed, were in the middle low economic levelwere higher. In the case of the female, it was higher for those who were in the middle - low economic level. Overall, an effective way of planning the solution regarding mental health, metabolic syndrome and nutrient intake can be found by considering these features.

• Journal of Nutrition and Health
• /
• v.43 no.2
• /
• pp.189-196
• /
• 2010

Malnutrition has been associated with higher hospital costs, mortality, rates of complications and longer length of hospital stay. Several nutritional screening tools have been developed to identify patients with malnutrition risk. However, many of those require much time and labor to administer and may not be applicable to a Korean population. Therefore, the aim of this study was to develop nutritional screening tool for Korean inpatients. Then we compare nutritional screening tools that developed and previously described. Seven hundred sixty-four patients at hospital admission were screened nutritional status and classified as well nourished, malnutrition stage 1 or stage 2 by the KNNRS (Kyunghee Neo Nutrition Risk Screening), PG-SGA (Patient-Generated Subjective Global Assessment) and NRS-2002 (Nutritional Risk Screening-2002). The KNNRS, PG-SGA and NRS-2002 respectively classified 28.7%, 51.3%, 48.5% of patients as malnourished status. Compared to the PG-SGA, the KNNRS had sensitivity 60.7% (95% CI 54.2-67.0) and specificity 81.2% (95% CI 75.3-85.2). Agreement was fair between KNNRS and PG-SGA (k = 0.34). Compared to the NRS-2002, the KNNRS had sensitivity 57.8% (95% CI 53.4-60.9) and specificity 64.4% (95% CI 60.2-69.8). Agreement was poor between KNNRS and NRS-2002 (k = 0.18). These result should include that the KNNRS and PGSGA have clinical relevance and fair concordance. However the rate of malnourished patients by KNNRS were less than by PG-SGA. For more effectivity of nutritional screening and management, the criteria of KNNRS would be better revised.

• Journal of Hospice and Palliative Care
• /
• v.14 no.2
• /
• pp.91-100
• /
• 2011

Purpose: This study was performed to investigate patients' preferences on receiving life-sustaining treatments (LST) and to analyze the relationship between patients' characteristics and LST selection. We also examined any discrepancy between LST patients' choices regarding medical intervention and actual medical intervention given/not given within 48 hours before death. Methods: This cross-sectional study was performed from March 1, 2008 to August 31, 2008 in the Palliative Care Unit of Korea University Hospital. Electric medical records (EMR) of 102 hospice cancer patients were reviewed, and 74 patients with Glasgow coma scale (GCS) ${\geq}$10 at the time of signing the advance medical directives (AMD) were selected for the first analysis. Then, patients alive at the end of this study, transferred to other hospitals or dead within 48 hours were excluded, and the remaining 42 patients were selected for the second analysis. Results: Preferred LST included antibiotics, total parenteral nutrition, tube feeding, transfusion, and laboratory and imaging studies. The relationship between patients' characteristics and LST could not be analyzed due to skewed preferences. LST chosen at the time of signing the AMD and actual medical intervention given/not given in the last 48 hours showed discrepancy in most cases. Conclusion: When making AMD in hospice cancer patients, it is important to consider the time and possibility of changing the choices. Above all, patients must fully understand the AMD. Thus, LST should always be provided with careful consideration of all possibilities, because legal and social aspects of AMD have not been established yet.

• Journal of Hospice and Palliative Care
• /
• v.12 no.2
• /
• pp.72-79
• /
• 2009

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.

• The Journal of the Korea Contents Association
• /
• v.11 no.5
• /
• pp.242-251
• /
• 2011

A curriculum of study demands a change as period of time and society evolve. Therefore, at this point where changes are required, this study is to analyze and evaluate the curriculums which will enhance and improve current studies as a preceding stage. The research was based on the survey by groups of education experts and 19 universities with current curriculum of study in radiologic science, and their references. The study was focused on the scope of work by radiologic technologist, change of college systems, academic research about radiologic science, and the improvement and the future of radiologic science field in perspective to globalization and the digital era. In terms of work scope, angiography and interventional radiology at 6 to 8 schools, fluoroscopy at 4 schools, ultrasound and practices at 6 schools, magnetic resonance image at 2 schools were found to be unestablished. The basic medical subjects, humuan physiology, human anatomy and practices, medical terminology courses were set up at most schools; however, pathology at 5 schools, image anatomy at 6 schools, clinical medicine at 11 schools were yet opened. Among the basic science and engineering subjects, general biology and its practices at 11 schools, general physics and its practices at 14 schools, and general chemistry and its practices at 8 schools were established which is about a half from a total number of schools. Only 4-5 schools established digital subjects such as, health computer, computer programming, PACS which are the basic major subjects. In order to provide academic improvement in radiologic science, digitalized education and globalization, and basis for future-oriented education for the field of radiologic science, including expanded scope of work, it is acknowledged that curriculums that are opened and run at each school need to be standardized. Therefore, the need for introduction of certificate for the radiologic science education courses are suggested.

• The Journal of Korean Orthopaedic Ultrasound Society
• /
• v.3 no.2
• /
• pp.54-58
• /
• 2010

Purpose: In patients with chronic cervical pain, the facet joint is the source of the majority. Due to the difficulty of identifying the exact location of the joint that causes these symptoms, the possibility of complications and the placebo effect brings clinical application into question. In this study, we assessed the prevalence of patients with chronic cervical pain and report the diagnostic and therapeutic usefulness of ultrasonography - guided facet joint block therapy. Materials and Methods: Patients with nonspecific chronic cervical pain for more than 6 months were selected. Patients with disc herniation, sciatica-related pain were excluded from the study and 160 patients who failed in conservative treatment (physical therapy, chiropractic therapy, medication) were included in the study. Diagnostic Ultrasonography-guided facet joint block was performed with 1% lidocaine, and after two weeks, Bupivacaine 0.25% was used in patients who tested positive for lidocaine. Patients with more than 75% pain reduction during movement after facet joint block were considered positive. Results: Among the 160 patients with chronic cervical pain, 96 patients(60%) had a positive reaction after facet block using lidocaine. Among the 64 patients with a negative reaction to lidocaine, 48 patients(75%) had a positive reaction to bupivacaine. There were 48 false positive patients(50%) who showed a positive reaction to lidocaine but a negative reaction to bupivacaine. The mean VAS of the total 160 patients before blocks was 8.5, after 2 weeks follow up it decreased to 2.7 (p = 0.001) and after 4weeks 3.6 (p = 0.001). The 8 patients as an initial improvement of symptoms are not satisfied with the procedure and the 3 patients had been worsened during observation, were showed pain relief after additional ultrasonography-guided facet joint block at 4th week. Conclusion: A single ultrasonography-guided block to chronic cervical pain patients has relatively low diagnostic value since high false positive rate. The twice facet joint blocks is thought to be a useful method for interventional pain management of patients with chronic cervical pain.

• The Journal of the Convergence on Culture Technology
• /
• v.6 no.2
• /
• pp.341-348
• /
• 2020

This research is to find out which position is more effective on exercise. This study compared paricipants in their twenties on sitting position & standing position doing abdominal breathing of their respiration & abdominal muscle activation for 4 weeks. In sitting position, FEV1 was the biggest after breathing exercise. In standing position, the gap was biggest between the FEV1 & forced expiratory flow before and after the exercise. In standing and supine position, Lt. rectus abdominis before exercise and Rt. rectus abdominis after exercise muscle activities were the biggiest. Both posture exercise of repeated measure of analysis result, before and after the exercise of the rectus abdomonis muscle and external oblique muscle were not difference in both muscle activity(p>.05). Left Musculus obliquus externus abdominis before and after physical exercise, it's showed a meaningful difference(p<0.05). Before and after exercise, saw a meaningful difference the efforts of FEV1/FVC(p<0.05). The left external oblique abdominis muscle showed the most muscle activity in the supine position before/after exercising, the efforts expiratory showed the lowest muscle activity.The results from the repeated measures ANOVA regarding to before/after the volume and muscle activity, it showed significant difference between at the right rectus abdominis muscle(p<.05). This study finally gathered data about the muscle activity according to the position. This could be used to find in what position the abdominal breath exercise is the post effective & a new treatment for the patients who has worsened respiration function.

• Korean Journal of Environment and Ecology
• /
• v.23 no.5
• /
• pp.411-417
• /
• 2009

This research is intended to discover physiological and biochemical defense mechanisms against herbivores of 8 species of the genus Acerby examining the morphological characteristics of the leaf, the structure and number of leaf domatia, herbivores insects and mites feeding on leaves, which were collected from the trees growing in Mt. Chiak, Mt. Cheongtae, Mt. Jungwang, Mt. Bangtae, Mt. Taebaek and Wonju City. This research was conducted from May through July, 2009, and the results are as follows. The domatia of A. pseudosieboldianum, A. pictum subsp. mono and A. mandshuricum belongs to tuft type; that of A. palmatum, A. triflorum and A. tschonoskii pocket+tuft type; and that of A. tegmentosum pocket type. The number of domatia per leaf turned out to be the highest in the case of A. tegmentosum(20.2), and the lowest in the case of A. ginnala (4.2). Leaf surface trichomes of A. palmatum, A. pseudosiebotdianum, A. ginnala and A. mandshuricum are covered with villi; those of A. pictum subsp. mono and A. triflorum with soft, pilose type of hair, and those of A. tschonoskii with stiff, strigose hair. The trichome density of lower leaf surface is found to be higher than that of the upper leaf surface. Only in the case of A. palmatum, A. pseudosieboldianum, A. tegmentosum and A. tschonoskii, a small amount of nectar is found to be secreted from the distal vein parts of the leaf margin. The number of mites on each leaf are found to be significantly different among tree species, and average mites number per leaf was the highest in the case of A. tschonoskii (9.2/leaf), and A. mandshuricum, A. pseudosieboldianum, and A. triflorum follow it in decreasing order. Minute insects attacking the leaf of Acer spp. include Periphyllus californiensis, P. viridis, Psylla spp, and gall mites, and the number of these insects are found in Periphyllus californiensis, Psylla spp, P. viridis, and Cicadellidae sp. in decreasing order. The natural enemies of these herbivores insects are predatory mites, such as Chilocorus rubidus, Coccinella septempunctata and the nymph, Aphidius ervi, Poecilocoris lewisi and its larva, and Poecilocoris lewisi. Lasius japonicus and Formica japonica are symbiotic with aphids, and supports herbivores. Finally, our research confirmed that predatory mites attack Periphyllus californiensis and suck the body fluid of their victim. This proves that mites form a symbiotic relationship with plants through the mediation of leaf domatia. This also indicates that a protective mutualism may be more conspicuous in temperate broad-leaved trees.