• Development and Reproduction
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• v.14 no.2
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• pp.143-154
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• 2010

This article analyzes two leading Korean cases which led to opposite conclusions: the Boramae Hospital Case (Korean Supreme Court 2002 Do 995) and the Shinchon Severance Hospital Case (Korean Supreme Court 2009 Da 17471). In doing so, it pays particular attention to the acceptance, modification, and rejection of paternalism, specifically 'physician paternalism' and 'familial paternalism', both of which have long and strongly influenced the Korean medical environment. In Boramae Hospital, the Court emphasized the obligation of the physician in terms of the life of the patient (eg: protecting and preserving the life and welfare of the patient). Its position seemed to be based on the traditional physician paternalism which presupposes the ability of physicians to identify right and wrong choices according to natural laws. However, the Court saw itself as the final arbiter of who identifies and determines the real world content and consequences of that natural law. In short, the Court elevated itself to the supreme guardian of the patient, and held that its decision cannot be overruled by that of the patient's family. So without specifically referring to the importance of the family and the role of familial decisions, both long-observed traditions in medical decision-making in Korea, the Court shifted away from familial paternalism. In Shinchon Severance Hospital, the Court explained the meaning of the patient's powers of self-rulemore concretely, explaining its scope and substance in greater detail. The Court held that one can exercise the right of self-rule, even over issues such as death, in the form of 'previous medical directions'. However, this case does not represent a wholesale acceptance of medical autonomy (ie: it does not accept self-rule unconditionally). Rather, the Court accepted the importance of the opinions and decision of physicians and of the Hospital Ethics Commission, and the Court still retained to itself the authority to review and make alterations to 'material' decision. The Court did not overlook the importance of the decision of the patient's family, but it also did not relinquish its status as supreme guardian, emphasizing the 'objective' nature of a decision from the court.

• Journal of Hospice and Palliative Care
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• v.4 no.2
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• pp.145-153
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• 2001

Purpose : This study was conducted to describe the attitude of hospital staff toward the hospice program. The purpose of this study was to promote the extension and organization of hospice activities to include hospital staff. Method : This is a descriptive study using a survey method. The subjects for this study were the nurses, physicians, technicians, and support staff at Wonju Christian Hospital. Using a stratified sampling method based on position of staff, the researchers recruited 430 staff members as the sample for this study. Data collection was done through a questionnaire developed by the researchers. The data were analyzed using descriptive statistics and content analysis. Findings : 1)Ninety seven percent (n=417) of the subjects understood the concept of hospice care, and 97.4% (n=419) answered that dying patients should be respected. When considering the hospice team, the subjects of this study indicated that the team should include family members (n=245), physicians (n=77), pastors (n=41), and nurses (n=34), in that order of priority. 2) When asked to indicate priorities for systematic operation of a hospice program, the subjects indicated that the highest priority was "setting up a team for hospice service(31.4%)", followed by "setting up a hospice ward(28.6%)". Sixty seven percent(n=289) recognized the importance of the hospice activities provided by the volunteers, and 85.3%(n=367) intended to use the hospice service of the hospital. The highest merit of hospital-based hospice program is 'acomplishment of mission'. 3) The average score on attitude toward death was 2.84(maximum=4), and the best needful service except hospitalization is 'constructing of support system'. Conclusion : Most of the staff at Wonju Christian Hospital perceive the necessity for systematic hospice activities, and that to achieve this goal, administrative and structural support at the hospital governance level is the first necessity. The results of this study could be useful for any hospital which is in the first stages of setting up and promoting a hospice program.

• Journal of Korean Academy of Nursing
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• v.18 no.1
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• pp.26-33
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• 1988

내담자와 상담자간의 관계형성 추진에 관한 연구가 C. Rogers에 의해 시작된 이래, 돕는자 또는 상담자가 가져야 할 주요 조건으로서 공감, 존중, 온정, 확고부동함, 진지성, 자기노출, 직면반응 등을 들고 있으며 이중 둘 또는 세 요소 등을 선택하여 그 효과를 보고 있으나 역시 가장 주요한 요소로써는 공감을 들고 있다. 공감에 관한 연구는 그 본질의 정서적 측면, 인지적 측면 또는 복합적인 측면을 강조하면서 시도되고 있으나 간호원은 돕는자로써 환자의 문제해결을 위한 전수자적 역할을 해야한다는 점을 고려할때 간호현상에서의 공감에 관한 연구는 복합적인 측면을 강조하는 공감이 어 야 한다고 생각한다. 간호학자들도 간호원의 돕는 행위중 주요 요소로써 공감을 들고 있으며 특히 Lamonica는 공감측정을 위한 도구를 개발하였으며 공감이란 환자가 간호원이 환자의 입장을 이해하고 도와준다는 사실을 인지하고 그 고마움을 표현하는 것을 의미한다고 하였다. 본 연구자는 간호원-환자간의 촉진적 관계형성을 위한 교육내용 개발에 대한 기본 연구로써 한국인의 공감 정도를 측정할 수 있는 도구개발의 중요성을 느껴 Lamonica 의 공감측정 도구를 번역하게 되었다. 본 연구의 구체적인 목적은 미국문화권에서 사용되는 공감측정 도구가 한국인에게 적합하고 의미있게 번역되었는지를 확인하고 또한 한국인이 인지한 공감에 대한 탐색을 하는데 있다. 위 목적달성을 위하여 횡문화적 연구과정을 통한 개념분석, 도구 개발에 대한 통계분석을 시도하였다. 한국인의 공감 개념 분석을 위하여 미국 텍사스 오스틴에 있는 한국인에게 공감의 뜻, 동의어, 어떤 경우에 공감을 느꼈는지, 어떤 경우에 비공감적임을 느꼈는지를 물은 결과 한국인이 갖는 공감의 의미는 미국인의 것과 유사하지만 그 표현방법의 차이가 있음을 알게 되었다. 따라서 두 국가에서 사용되는 공감의 의미가 유사하고 또한 간호학자인 Lamonica가 개발한 공감측정 도구를 한국인에게 사용하는데 무리가 없을 것으로 판단되었다. 도구의 번역은 텍사스 주립대학 박사과정 지원생인 임상 심리 학자에게 의뢰하고 그 정확성을 판단하기 위해 인간을 대상으로 하는 학문을 연구하는 한국인(간호학, 사회학, 신문방송, 광고학, 심리학 전공)에게 그 정확성 유무를 물어 최고 27점, 최하 9점중 22점 미만인 문항에 대해서는 미국 간호학자와 의논하여 수정ㆍ보완하였다. 그 후 일반인으로 간주되는 한국인에게 그 도구의 이해 여부를 확인한 후 통계분석을 시도하였다. 대상자는 미국 텍사스 오스틴에 거주하면서 한국을 떠난지 3년 미만인 성인 45명을 대상으로 하였다. 2차에 걸친 자료수집 과정상 5명의 자료는 분석 불가능하다고 판단되어 총 40명의 자료를 spss- X를 이용하여 cronbach's alpha, test-retest stability, intercorrelation matrix 분석을 통한 결과는 다음과 같다. 1) cronbach's alpha는 1차 .9353 2차 .9666으로써 문항의 동질성을 보였고, 3, 4주 간격으로 행한 test-retest stability는 .7619(p＝000)이였다. 2) 반면에 intercorrelation matrix에서는 역관계 또는 무관계를 보였으며 84문항중 26문항의 item-to-total correlation값이 .35미만이었고 이 중 16문항은 .30 미만이었다. 이들을 제외한 68문항과 58문항의 각각의 item-to-total correlation간은 .96이었고 test retest stability 역시 .76으로써 84문항 전체에 관한 값과 유사하였다. 3) 역상관 또는 무상관의 값을 보인 문항을 미국 간호학자와 재검토한 결과 본래 문항에서의 단어 의미가 복합적이거나 불분명한 것이었고 또는 미국 문화권에서 사용되는 특이한 용어임을 알 수 있었다. 따라서 한국인 공감 측정 도구의 타당성을 높이기 위해 역통역을 시도하였다. 그후 공감에 관한 연구를 하고 있는 미국 학자에게 그 정확성을 판단하여 최종적으로 58문항이 한국인 공감측정 도구로서 적합하다는 판단을 하였다. 위 결과를 통한 결론 및 제언은 다음과 같다. 인간의 행위는 조건화된 문화권에 따라 다를 수 있으며, 이것은 같은 현상을 인지하는데도 영향을 미치게 되며 본 연구와 같이 어떤 현상에 대한 횡문화적 연구는 그 행위를 이해하는데 도움을 준다. 그러나 한국에서 간호에 대한 연구가 한국적 토착화 과정에 있으므로 그 연구 방법이나 도구사용이 서구의 것을 도입해야 하는 입장을 고려할 때 도구번역 과정은 원래의 의미나 함축성을 내포한 번역이어야 하며 소홀히 해서는 안될 과정임을 재확인되었다. 또한 추후 연구로써 다양한 계층의 다수를 대상으로 한 한국인 공감 측정 도구의 타당성을 재확인해야 하며 요인분석을 시도할 필요성이 있다고 사려된다.

• Journal of Korean Academy of Nursing
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• v.23 no.4
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• pp.585-601
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• 1993

Data on 63 patients who had had motorcycle accidents and who were admitted to four general hospitals in the Chung Chung Nam Do area from July / 1993 to August 1993 were analyzed. The tool used for this study was a structured questionnaire which consisted of ten items on self- esteem, 18 items on health locus of control and 37 items profiling health prometion lifestyle. Injury severity scores were calculated bated based on data from the patients’ medical records. The collected data were analyzed using the SPSS, yielding descriptive statistics, t-test, ANOVA, Pearson’s Product Moment Correlation. The findings of this study are as follows. 1) Of the 63 injured motorcyclists, 35(55.6%) were helmeted and 28(44.4%) were nonhelmeted, and the nonhelmeted motorcyclists were predominantly young and male. The demographic variables for the helmeted and nonhelmeted groups were heterogeneous for age and occupation. 2) The results of the comparison between the two groups showed a statistically significant difference in the injury severity score(t=-4.70, p=0.000). The helmeted group had lower scores on injury severity score (9.00±3.93) than the nonhelmeted group(14.32土5.05). More than 60% of the nonhelmeted motorcyclists had brain injuries compared to only a third of the helmeted cyclists. 3) There .was a statistically significant difference between the two groups on self esteem(t=4.5, 000). The helmeted group had a higher mean score (31.27±2.72) than the nonhelmeted group(27.46±3.80). 4) The means for Internal health locus of control (IHLC), Powerful others health locus of control (PHLC), and Chance health locus of control (CHLC) in the two groups were similar to instrument norms reported in other literature. The mean scores on the IHLC in the two groups were higher than scores on the PHLC or the CHLC. However, there was a significant difference between the mean scores for the two groups on the PHLC (t=2.85, P=0.006). 5) The mean score for the helmeted group on the health promotion lifestyle profile was higher than the mean score for the nonhelmeted group(107.30±11.10, 96.57土 15.54 respectively), and there was a significant difference between the mean scores (t=3.64, p=0.001) . The highest score for helmeted group on the health promotion lifestyle profile was in the health care domain. However, for the nonhelmeted group the highest score was in the exercise domain and the lowest score was in the health care domain. 6) With regard to the relationship between health promotion lifestyle, health locus of control and self esteem in the two groups, the correlation coefficient between health promotion lifestyle and internal health locus of control for the helmeted group was 50(p〈0.01). For the nonhelmeted group, there was no correlation between health promotion lifestyle and internal health locus of control. However, there were significant correlation between health pro-motion lifestyle and external locus of control(r=0. 46, p〈0.01), and self esteem(r=0.495, p〈0.01). 7) Among the demographic variables, age and education had an impact on individual’s self-esteem The modifying factors of age made a contribution to explaining health - promoting lifestyle. In the present study, more than 40% rf the motorcyclists were riding without a helmet. The incidence of brain injury for patients riding without a helmet was nearly twice as high in the nonhelmeted rider as compared to the helmeted rider. The nonhelmeted motorcyclists in this study had lower self-esteem, obtained a higher score on the IHLC, and were not strongly engaged in performing health promotion activities as compared to the helmeted riders. However, some of the nonhelmeted riders who had a strong belief in PHLC were positively associated with engaging in health promotion activities. Based on the results obtained from this study, strategies to promote helmet usage for motorcyclists have to be developed.

• Journal of Chest Surgery
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• v.34 no.8
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• pp.597-603
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• 2001

Background: The purpose of writing this article is to get better clinical results and further clinical improvement based on subject to 110 cases of cardiac surgery which were performed and clinically analyzed. Material and Method: Since January 1995, the patent ductus arteriosus surgery had started in our hospital. In February 1999, an open heart surgery had started and up to September 2000, total of 110 cases were performed as of double ligation of patent ductus arteriosus(10 cases) and open heart surgery(100 cases). Result: Among the patients, Korean-Chines was 74(67.3%) and Han-Chinese was 35(31.8%). Congenital heart disease was 95 cases and acquired valvular heart disease was 15 cases. 83 cases of acyanotic congenital heart disease consisted of ventricular septal defect(VSD) with associated anomaly(45 cases), atrial septal defect(ASD) with associated anomaly(20 cases), patent ductus arteriosus(PDA) with associated anomaly(11 cases), cogenital aortic stenosis(5 cases), double chamber right ventrical(1 case) and Ebstein's anomaly(1 case). Among the 12 cases of cyanotic congenital heart disease, 11 cases of tetralogy of Fallot underwent total correction. Among the 15 cases of acquired valvular heart disease, valvular replacement(7 cases), double valve replacement (3 cases), mitral valve replacement(3 cases) and aortic valve replacement(1 case) were performed. And 8 cases of valvuloplasty were performed by using of commissurotomy, chordal plasty, plasty of papillary muscle, ring type annuloplasty, repair of leaflet. Conclusion: on cogenital heart disease, short term results of surgery for acyanotic cogenital heart disease was good. Among the cyanotic congenital heart disease, tetralogy of Fallot showed a little difference of recovery according to the surgery method so that further follow up observation was needed for long term result. On acquired valvular heart disease, especially, in terms of short term result of valvuloplasty, was relatively good, but further follow up observation was also needed for long term result. There wasn's any operative mortality.

• The KIPS Transactions:PartC
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• v.10C no.5
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• pp.625-634
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• 2003

More than a decade after its initial proposal, deployment of IP Multicast has been limited due to the problem of traffic control in multicast routing, multicast address allocation in global internet, reliable multicast transport techniques etc. Lately, according to increase of multicast application service such as internet broadcast, real time security information service etc., overlay multicast is developed as a new internet multicast technology. In this paper, we describe an overlay multicast protocol and propose fast join mechanism that considers switching of the tree. To find a potential parent, an existing search algorithm descends the tree from the root by one level at a time, and it causes long joining latency. Also, it is try to select the nearest node as a potential parent. However, it can't select the nearest node by the degree limit of the node. As a result, the generated tree has low efficiency. To reduce long joining latency and improve the efficiency of the tree, we propose searching two levels of the tree at a time. This method forwards joining request message to own children node. So, at ordinary times, there is no overhead to keep the tree. But the joining request came, the increasing number of searching messages will reduce a long joining latency. Also searching more nodes will be helpful to construct more efficient trees. In order to evaluate the performance of our fast join mechanism, we measure the metrics such as the search latency and the number of searched node and the number of switching by the number of members and degree limit. The simulation results show that the performance of our mechanism is superior to that of the existing mechanism.

• Journal of Veterinary Clinics
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• v.29 no.6
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• pp.498-501
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• 2012

A 10-month-old intact male Maltese dog (body weight, 1.6 kg) presented with intermittent cough and abnormal heart sounds. The dog was diagnosed with a left-to-right patent ductus arteriosus (PDA) on the basis of the results of transthoracic echocardiography, color flow Doppler examination, and angiography. Transcatheter occlusion of the PDA was performed using the $Amplatz^{(R)}$ Canine Duct Occluder (ACDO) via the femoral artery. The device was placed under fluoroscopic guidance and successfully occluded the PDA. The continuous heart murmur disappeared immediately after the correction and no residual flow was detected. The dog was discharged the following day and regularly examined for complications and safety. This is the first report demonstrating the clinical application of ACDO for the transcatheter closure of PDA via the femoral artery in a small-breed dog in Korea.

• Journal of dental hygiene science
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• v.14 no.2
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• pp.198-206
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• 2014

The purpose of this study was to develop and validate tool for measuring the communication skills of dental hygienist. The survey was modified and revised to fit into Korean culture. Also the reliability and validity was tested in order to ensure the survey was properly evaluating communication skills of dental hygienists. A survey was conducted with outpatients in dental clinics located in Seoul, Gyeonggi, and Daejeon area. The 483 answers out of the total collected answers were used for the final analysis of the study, using PASW Statistics 18.0 and IBM SPSS AMOS 7.0 to measure the validity and reliability. The factor analysis showed that the communication skill of the dental hygienists was composed of three elements, namely 'being caring and respectful' communications, 'sharing information' communications and 'tending to comfort' communications to reduce pain and anxiety. The validity of the model examined by a confirmatory factor analysis satisfied most of the relevant requirements. All of the factors had the conceptual reliability and variant extracted index above the minimum requirements, ensuring reliability and concentrated validity. Also, the value of the square of the correlations between all latent factors which was larger than the square of the correlation between all of the factors, thus proving the discriment validity. Cronbach's ${\alpha}$ was 0.8, which shows high reliability level. In conclusion, it was proven that dental hygienist's communication skill measurement tool has high validity and reliability. Further, this study can be used to improve dental hygienists' communication skills. Therefore, this will improve oral health of clients and manage them.

• Journal of muscle and joint health
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• v.11 no.2
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• pp.187-198
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• 2004

Purpose: The purpose of this study was to identify differences of BMI, pain, depression, self-esteem and self-efficacy between rheumatoid arthritis and osteoarthritis patients. Method: The study subjects were 135 persons having chronic arthritis at rheumatology clinic and the department of orthopedic surgery of the C university hospital in D city. The data were collected from February 19th to April 7th, 2003. The data analysis consisted of $X^{2}-test$, t-test, Pearson Correlation Coefficient, and multiple regression using SPSSWIN 10.0 program. Result: 1. There were significant differences in age(p=0.000), occupation(p=0.015), marriage(p=0.028), duration of illness(p=0.000), BMI(p=0.006) and Self-efficacy(p=0.017) between rheumatoid arthritis and osteoarthritis patients. 2. In rheumatoid arthritis, the BMI and self-esteem(r=-0.239, p=0.05) were significantly correlated and also pain and self-esteem(r=-0.402, p=0.01), pain and self-efficacy(r=-0.455, p=0.01) were significantly negatively correlated. The self-esteem and depression(r=-0.622, p=0.01), self-efficacy and depression(r=-0.729, p=0.01) were significantly negatively correlated and also pain and depression(r=0.432, p=0.01), self-esteem and self-efficacy(r=-0.476, p=0.01) were significantly positively correlated. In osteoarthritis, the pain and self-esteem(r=-0.225, p=0.01) were significantly negatively correlated and also pain and self-efficacy(r=-0.493, p=0.01), self-esteem and depression(r=-0.692, p=0.01), self-efficacy and depression(r=-0.566, p=0.01) were significantly negatively correlated. The pain and depression(r=0.290, p=0.05), self-esteem and self-efficacy(r=0.383, p=0.01) were significantly positively correlated. 3. The factors influenced by the self-efficacy, the depression and age in rheumatoid arthritis explained 56.2%, the depression and pain in osteoarthritis explained 43.9%. The factors influenced by the BMI, the self-esteem in rheumatoid arthritis explained 5.7%, but there was no significantly variable in osteoarthritis. Conclusion: The results support the importance of different nursing intervention focused on BMI and self-efficacy in patients with rheumatoid arthritis and osteoarthritis. There is a need for further studies to identify relation of variables in different diseases related to arthritis.

• The Korean Society of Law and Medicine
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• v.16 no.1
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• pp.221-254
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• 2015

The amendment of the Korea Civil Code will take place July 1, 2013. One of the most import issues related to adult guardianship system is a part. Though more than 100 new provisions, the revised Civil Code fundamentally reformed the guardianship system to establish a system to meet the diverse and complex needs of those who need a guardian and ensure due process. The new adult guardianship system intended to respect dignity and human right of mentally incapacitated adults, to guaranee their autunomy and to minimize the public interventions for assisting them. The new guardianship system for vulnerable adult has three kinds of legal guardianship system (adult guardianship, limited guardianship and specific guardianship). Mental patients forced the hospitalization of the mental health code and will be treated as an agreement incapable person. In principle an agreement incapable person has capacity of consent. The consent of the mental patients are admitted first. It is advisable to medical care only by the consent of the guardian when the the mental patient do not agree ability. If the mental patient do not agree with the mentally ill, but there should be a supervisory capacity for a guardianship of the couple guardian supervision. In conclusion, it not lost the capacity to consent to inpatient mental illness called. Therefore, we must discuss in detail the scope of the agreement for the mental patients. Mental Health Act amendments are necessary in accordance with the amended Civil Code.