• Korean Journal of Health Psychology
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• v.14 no.3
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• pp.579-596
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• 2009

This study aimed to develop the Korean tool of competency to consent to psychiatric treatment and to analyze the reliability and validity of this tool. Also the developed tool's efficiency in determining whether a patient possesses treatment consent competence was checked using the Receiver Operating Characteristic curve and the relevant indices. A total of 193 patients with mental illness, who were hospitalized in a mental hospital or were in community mental health center, participated in this study. We administered a questionnaire consisting of 14 questions concerning understanding, appreciation, reasoning ability, and expression of a choice to the subjects. To investigate the validity of the tool, we conducted the K-MMSE, insight test, estimated IQ, and BPRS. The tool's reliability and usefulness were examined via Cronbach's alpha, ICC, and ROC analysis, and criterion related validation was performed. This tool showed that internal consistency and agreement between raters was relatively high(ICC .80~.98, Cronbach's alpha .56~.83)and the confirmatory factor analysis for constructive validation showed that the tool was valid. Also, estimated IQ, and MMSE were significantly correlated to understanding, appreciation, expression of a choice, and reasoning ability. However, the BPRS did not show significant correlation with any subcompetences. In ROC analysis, full scale cutoff score 18.5 was suggested. Subscale cutoff scores were understanding 4.5, appreciation 8.5, reasoning ability 3.5, and expression of a choice 0.5. These results suggest that this assessment tool is reliable, valid and efficient diagnostically. Finally, limitations and implications of this study were discussed.

• The Korean Society of Law and Medicine
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• v.20 no.2
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• pp.43-82
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• 2019

In Korea surrogate medical decision makings happen without legal grounds. The purpose of this article is to research the issues in preparing policies for decision-making on behalf of unrepresented patients. As aspects of comparative law, there are two approaches. One of them is to regulate default surrogate list. If no agent or guardian has been appointed, some legislatures provide that members of patient's family who is reasonably available, in descending order of priority of not, may act as surrogate: (1) the spouse, unless legally separated; (2) an adult child; (3) a parent; or (4) an adult brother or sister. If none of them is eligible to act as surrogate, some legislatures allow close friends to make health-care decisions for adult individuals who lack capacity. On the other hand there are other legislatures which provide no surrogate decision maker list but oblige the responsible authority to determine with advice of family members or friends of the patient. In the end the first approach can not guarantee that the surrogate decision maker like family members or friends will determine in the best interest of the patient.

• Journal of Music and Human Behavior
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• v.3 no.1
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• pp.13-28
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• 2006

Autistic children have difficulties in communication. They tend to have more difficulties in general expression than in understanding sentences. This thesis tested the effect of music activities on children who have difficulties in language expression. As a research method, a group of autistic middle school students was selected who were attending normal schools. Three male students were selected for the test of K-ABC and CARS. Music treatments on the selected students were applied fifteen times, twice a week, for thirty minutes every time. The total treatment process could be divided into two stages. The stage one included the first twelve treatments and the stage two included following three treatments. In the stage one, the selected autistic students learned twenty four musics under real-world-like social circumstances. In the stage two, the students repeatedly learned the twenty four musics. A week before beginning the music treatment, the students were tested by PRES and a test developed by the author of this thesis. And a week after all treatments were completed, the students were tested again with the same test method to check if the students' expressive language ability got improved. The results of the research were as the following: First, the music treatment helped improve the autistic student's ability of expressing themselves such as 'requesting', 'rejecting', 'applying social customs' and 'providing information'. Second, the author of this thesis first had a hypothesis that the tested students might show different levels of achievements according to their intellectual ability or expressive language ability in K-ABC test, PRES and CARS. But it was not true. The student's level of achievement by music activities was proved not to have a significant correlation with their intellectual or expressive language abilities in the tests. Third, it was found that, through pre- and post-test of PRES, the music treatments could improve the receptive language ability as well as the expressive language ability. It saw great effect that musical data that utilize in specially this research investigator according to children's ability, autistic children write lyrics setting in social circumstance that is revealed much routinely and composes. To front, expect that suitable a lot of musics are developed in function and ability of subject person for elevation of expressive language ability.

• Journal of Oriental Neuropsychiatry
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• v.16 no.2
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• pp.251-257
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• 2005

In this case study, We treated a transcortical aphasia patient with herbal medicine, acupunture and language therapy. We assessed the progress of the patient with Western Aphaia Battery(K-WAB), Boston Naming Test(BNT) and analysed the patient's speech at the series of pictures. The score of K-WAB and K-BNT was improved, the rate of statement at the theme of the picture was improved and the neologistic and verbal paraphasia was reduced. We think that the analysing the speech of the patient at the series of pictures to evaluate the practical problem of the patient would be useful. Further study is necessary about the utility of this assessment tools.

• The Journal of the Korea Contents Association
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• v.14 no.10
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• pp.393-402
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• 2014

This study aims to testify the effect of reading and writing abilities improvement program for elementary school children from multicultural families. Methods: The research design used in this study was a non-equivalent control group pretest-posttest research design. The participants were divided into two groups, an experimental group(n=9) and a control group(n=8). Data were analysed by using Mann-Whinety U test, Wilcoxon Signed Ranks, Cohen's d with SPSS(PASW)18.0 program. Result: Significant differences were found in scores for reading ability (z=-2.668, p=.008, ES(d)=0.6) and writing ability (z=-2.670, p=.008, ES(d)=0.5) in experimental group. Conclusion: The results indicate that the reading and writing abilities improvement program should be used with elementary school children of multicultural families to help them and to improve their reading and writing abilities.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.3 no.1
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• pp.106-116
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• 1992

This study were purposed to find out parental perceptions of child adjustment associated with parenting stress with autistic children and differences of parenting stress between autistic children's parents and normal children's. Subjects were 27 autistic children's parents, 28 normal children's, 4 teachers with autistic children. 'Scales were Parenting Stress Index(PSI), Eyberg Child Behavior Index(ECBI), Childhood Autism Rating Scale(CARS), Social Maturing Scale(SMS). The results of this study were as follows. 1) In total parenting stress, parents with autistic children had significantly higher scores than normal's. 2) In child domain of parenting stress, fathers with autistic children had significantly higher than mothers on the other components except Mood and Demandingness. 3) In parent domain of parenting stress, parents with autistic children had significantly higher than nomal's on Restrict of role, Attachment, Sense of Competence. All mothers of normal and autistic children had significantly higher than fathers on the other components except Repression. 4) In parenting perceptions associated with parenting stress level of autistic children's parents. Low level group perceived their children as higher adaptibility than teacher's evaluation and high level group perceived them as equal to teacher's.

• The Journal of Korean Academy of Sensory Integration
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• v.20 no.2
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• pp.36-45
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• 2022

Objective : The objective of this study was to determine a discriminat validity of the Sensory Processing Scale-Children (SPS-C) for children with and without Sensory Processing Disorder (SPD). Method : The SPS-C was completed by parents of 151 Korean children including 68 typically developing children (control group), 83 children with SPD (known group) in the age range 3-5 years, in South Korea. ANCOVA with sex as covariable was used to identified the difference between the children with typically development and SPD. Results : Sensory processing differences in sensory domains and sensory factors were detected and the gender differences were not effective between typically developing children and children with SPD. Significant differences were found in all sensory domain score and total score except proprioceptive processing in sensory domain. In sensory factors, significant differences were found in overrsensitivity, underresponsivity, and discrimination, but sensory seeking was not significant. SPS-C was a valid assessment tool to identify or screen of SPD in Korea. Conclusion : The psychometric characteristics for the standardization study of SPS-C were presented, and the discriminant validity to screen the children with sensory processing problems was presented as a verified evaluation tool. SPS-C will be helpful in screening, analyzing and interpreting characteristics of sensory processing, and establishing an intervention plan.

• The Korean Society of Law and Medicine
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• v.23 no.1
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• pp.37-80
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• 2022

By analyzing informed consent and the refusal of emergency medical treatment (called patient dumping) under the current Emergency Medical Service Act, this study suggests that an emergency medical professional is only liable for patient dumping if their duty to protect the patient's life takes precedence over the patient's right to self-determination. In emergency medical situations, as in general medical situations, medical treatment should be performed after the emergency medical professional informs the patient about the medical treatment, including its necessity and methods, and obtains consent from the patient. Refusing or evading the performance of emergency medical services on the excuse of the informed consent not considering a waiver or alteration of informed consent requirements without reasonable reasons violates the Emergency Medical Service Act and thus makes an emergency medical professional liable to administrative disposition or criminal penalty. In other words, depending on the existence of a waiver of alteration of the informed consent, patient dumping may be established. If the patient is a minor or has no decision-making ability, and their legal representative makes a decision against the patient's medical interests, the opinion of the legal representative is not unconditionally respected. A minor also has the right to decide over their body, and the decisions of their legal representatives should be in the patient's best interests. If the patient refuses treatment, in principle, the obligation of life protection of emergency medical professionals is the top priority. However, making these decisions in the aforementioned situations in the emergency medical field is difficult because of the absence of explicit regulations regarding these exceptional problems. This study aims to organize the following precedents of the Supreme Court of Korea. The court states that, when balancing the conflicting interests between the duty to provide emergency medical service and the duty to inform is unavoidable for emergency medical professionals, they should put the duty to protect the patient's life ahead of the duty to inform if the patient's life matters. Exceptionally, when a patient has seriously considered whether they should receive treatment before the emergency medical situation, their right to self-determination can be considered equal to the obligation of emergency medical professionals to provide emergency medical treatment. This research also suggests that an amendment of the Emergency Medical Service Act should include the following. First, the criteria for determining the decision-making ability of emergency patients should consist of medical content. Second, additional consent from a medical professional is unnecessary for first-aid treatment. Finally, new provisions for emergency medical obligations for minors, new provisions for the decision standard when there are conflicting opinions about the treatment of a patient, and new penalty provisions for professionals who suspend emergency medical examinations and treatments need to be established.

• Journal of Hospice and Palliative Care
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• v.19 no.1
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• pp.26-33
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• 2016

Purpose: This study was conducted to identify clinical characteristics of oncologic patients at a point when they signed their do-not-resuscitate (DNR) orders. Methods: From January through December 2014, we retrospectively analyzed the records of 197 patients who passed away after agreeing to a DNR order in the hemato-oncology department of a tertiary hospital. Results: Of all, 121 patients (61.4%) were male and 76 (38.6%) were female, and their average age was 58.7 years. Ninety-four patients (47.7%) had gastrointestinal cancer. The ECOG performance status at admission was grade 3 in 76 patients (36.5%) and grade 4 in 11 (5.6%). The patients' mean hospital stay was 20 days. The mean duration from the admission to DNR decision was 13 days, and the mean duration from DNR decision to death was seven days. Conclusion: Study results indicate that a decision on signing or refusing a DNR order was made by medical staff mostly based on the opinions of patients' guardians rather than the patients themselves. This suggests that patients' own wishes are not well respected. Thus, it is urgent to establish institutional devices to enhance cancer patients' autonomy regarding DNR and to define an adequate timing for withdrawal of treatments.

• The Korean Society of Law and Medicine
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• v.24 no.2
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• pp.147-196
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• 2023

Advances in brain science have made it possible to stimulate the brain to treat brain disorder or to connect directly between the neuron activity and an external devices. Non-invasive neurotechnologies already exist, but invasive neurotechnologies can provide more precise stimulation or measure brainwaves more precisely. Nowadays deep brain stimulation (DBS) is recognized as an accepted treatment for Parkinson's disease and essential tremor. In addition DBS has shown a certain positive effect in patients with Alzheimer's disease and depression. Brain-computer interfaces (BCI) are in the clinical stage but help patients in vegetative state can communicate or support rehabilitation for nerve-damaged people. The issue is that the people who need these invasive neurotechnologies are those whose capacity to consent is impaired or who are unable to communicate due to disease or nerve damage, while DBS and BCI operations are highly invasive and require informed consent of patients. Especially in areas where neurotechnology is still in clinical trials, the risks are greater and the benefits are uncertain, so more explanation should be provided to let patients make an informed decision. If the patient is under guardianship, the guardian is able to substitute for the patient's consent, if necessary with the authorization of court. If the patient is not under guardianship and the patient's capacity to consent is impaired or he is unable to express the consent, korean healthcare institution tend to rely on the patient's near relative guardian(de facto guardian) to give consent. But the concept of a de facto guardian is not provided by our civil law system. In the long run, it would be more appropriate to provide that a patient's spouse or next of kin may be authorized to give consent for the patient, if he or she is neither under guardianship nor appointed enduring power of attorney. If the patient was not properly informed of the risks involved in the neurosurgery, he or she may be entitled to compensation of intangible damages. If there is a causal relation between the malpractice and the side effects, the patient may also be able to recover damages for those side effects. In addition, both BCI and DBS involve the implantation of electrodes or microchips in the brain, which are controlled by an external devices. Since implantable medical devices are subject to product liability laws, the patient may be able to sue the manufacturer for damages if the defect caused the adverse effects. Recently, Korea's medical device regulation mandated liability insurance system for implantable medical devices to strengthen consumer protection.