• Journal of Korean Academy of Nursing
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• v.24 no.2
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• pp.190-205
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• 1994

Respect for human life and respect for human dignity are two basic values to which organized nursing has urged its members to adhere in their service to mankind. Thus it is the nurses’ duty to provide health care in support of sustenance of life and to pay respect for the patient’s right to dignity. In practice, however, nurses may experience dilemmas between these duties much due to the de velopment of modern advanced techniques. These dilemmas have become more complex and difficult to resolve. Nurses are often faced with situations in which the terminally ill refuse professional care, posing serious conflicts between respect for human life and respect for human rights to self-determination. In such cases, resolution of the problem is not a simple matter, thus requires intensive study into the ethical questions related to the situation. The purpose of this study was to identify ethical problems that nurses experience in caring for terminally ill patients and explore the ways to the resolution of problems within the context of the situations. The methodology used for the study was a case study method which ‘New Casuistry’ proposed by Jonsen & Toulmin(1988) and the ‘Specified Principlism’ proposed by Degrazia(1992) as an alternative to old deductive and intuitive method. Cases were developed through semistructured indepth interviews according to the casutistry method. A total of seven nurses were interviewd who were caring for therminally ill patients. Four cases out of a total 14 cases were related to the topic. Through the case analysis it became evident that nurses appreciated other values more often than respect for the patient’s right to self-determination. These other values were convenience and efficiency in nursing practice in case 1, preservation of life above all other values in case 2, provision of nursing care to fulfill the nurse’s professional obligation at most in case 3, and respect for the family’s demand against the patient’s wish in case 4. This study showed that the most important ethical problems were conflict between respect for the patient’s right to self-determination and sustenance of life for the fulfillment of professional obligation. For this problem, benefit /burden analysis from the perspective of the patient and family for the promotion of patient’s wellbeing may be a way to resolve the conflict. Further, through these analysis it was shown that physicians’ and families’ opinions dominated in the decision - making and the opinions of nurses’ and patients’ tended not to be reflected. Thus the patient's right to his or her care was not readily respected. To solve this problem. nurses should make efforts to communicate reciprocally with their patients, family members and physicians in an effort to respect for their patient’s rights to life and diginity from the point of view and values of the patient. It is also important that nurses provide good basic nursing care up to the time of death regardless of decisions about providing or not aggressive treat-ment for chronically and terminally ill patients.

• Journal of Industrial Convergence
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• v.18 no.5
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• pp.88-96
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• 2020

The rate of admission to facilities for people with developmental disabilities in Korea is very high for other types of disabilities. Therefore, 'community care', which supports life in the community for people with developmental disabilities, is very important compared to other types of disabilities. However, in Korea, families with disabilities are the problem of care and are appealing for the burden of support. This study analyzed practical cases through welfare institutional visits and interviews on support for community independence in Japan. As a result of the study, the transition of people with developmental disabilities to communities in Japan was centered on group home. The private sector is providing support for people with severe disabilities in group home to live in communities, and Sapporo City Hall is conducting private connections to solve the problem of caring for the developmentally disabled elderly parents. Accordingly, as Korean policy recommendations, it is proposed to expand group home, switch functions of living facilities for the disabled, cope with the problem of caring for the disabled by elderly parents, and provide preventive services through surveys on the actual condition of adults living alone. As practical suggestions, it is necessary to develop and distribute educational textbooks such as pictures to improve daily life skills for self-reliance, expand sufficient manpower and facilities in vocational training for self-reliance, and operate shelters for adults with developmental disabilities and their guardians.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.1
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• pp.373-379
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• 2013

Background: Although caregiving to patients with terminal illness is known to be a stressful burden to family members, little attention has been focused on work-related problems. We aimed to investigate employment status and work-related difficulties of family caregivers of terminal cancer patients, comparing with the general population. Methods: Using structured questionnaires, we assessed family caregivers of 481 cancer patients determined by physicians to be terminally ill, from 11 university hospitals and the National Cancer Center in Korea. Results: Among 381 family caregivers of terminal cancer patients (response rate, 87.6%), 169 (43.9%) were not working before cancer diagnosis, but currently 233 (63.7%) were not working. Compared with the general population (36.5%), the percentage of not working among the family caregivers was higher (OR=2.39; 95%CI=1.73-3.29). A major reason for not working was to provide assistance to the patients (71.6%). 40.6% of those who continued working and 32.3% of those who not working family members reported extreme fatigue. Caregivers of old age, those who were female, those with a lower household income, and those caring for patients with a low performance status were not working at a more significant rate. Conclusion: Family caregivers of terminal cancer patients suffer job loss and severe work-related difficulties, probably due to caregiving itself and to fatigue. We need to develop supportive programs to overcome the burden of caregivers of the terminally ill.

• The Korean Journal of Rehabilitation Nursing
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• v.4 no.2
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• pp.207-218
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• 2001

This study was carried out to find out the basic data required to plan and develop Rehabilitation Day Care Program for the stroke survivor's family in Korea. The subjects comprised of 92 stroke survivor's family who discharged from 4 hospitals in Seoul during the past 2 years. The data were collected from August 3, 1998 to September 18, 1998, through interviews with questionnaires about general characteristics, activities of daily living, depression and service need of rehabilitation day care program at the outpatient clinics by trained nursing graduates. Data were analyzed with descriptive analysis, Pearson's correlation analysis, and Stepwise multiple linear regression analysis using SPSS/WIN 10.0 program. The results obtained are as follows; 1. The mean score of the general need of rehabilitation day care program of stroke survivor's family was 3.10(range 1-4). The highest need among the service categories of the rehabilitation day card program was self-care and restorative activities category(3.30), and health services referral category, recreation category, psychosocial activities category in order. The needs of each category are as follows. In the health services referral category, the need for dental examination and medical examination were highest, followed by the need for physical therapy and occupational therapy. In the psychosocial activities category, the need for family counselling was highest. In the self-care and restorative activities category, the need for ROM exercise training was highest, followed by bowel training, and ambulation training. 2. The need of family for rehabilitation day care program service displayed a correlation with the level of education, ADL, and the level of depression, and a reverse correlation with age, illness intrusiveness, depression, knowledge, subject and object burden and relationship with stroke survivors. 3. The stepwise multiple linear regression analysis revealed following results. For the need for rehabilitation day care program service, 22.6% of the variance was initially explained by level of family's knowledge about caring method for stroke survivors, 8.8% was the level of subjective burden and 5.4% was relationship with stroke survivors. In conclusion, above characteristics should be considered to develop stroke survivors' rehabilitation day care program.

• Korean Journal of Environmental Agriculture
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• v.31 no.2
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• pp.129-136
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• 2012

BACKGROUND: The changes in the climatic conditions have brought potentially significant new challenges, most critical are likely to be its impact on local livelihoods, agriculture, biodiversity and environments. Water induced disasters such as landslides, floods, erratic rain etc., are very common in developing countries which lead to changes in biological, geophysical and socioeconomic elements. The extent of damages caused by natural disasters is more sever in least developing countries. However, disasters affect women and men differently. In most of the cases women have to carry more burden as compared to their male counterpart during the period of disasters. METHODS AND RESULTS: This study examines the impact of disasters on the local livelihood especially agriculture and income generating activities of women in three districts of Nepal. The study uses the primary data collected following an exploratory approach, based on an intensive field study. The general findings of the study revealed that women had to experience hard time as compared to their male counterpart both during and after the disaster happen. Women are responsible for caring their children, collecting firewood, fetching water, collecting grass for livestock and performing household chores. Whereas, men are mainly involved in out-migration and remained out-side home most of the time. After the disaster occurred, most of the women had to struggle to support their lives as well as had to work longer hours than men during reconstruction period. Nepal follows patriarchal system and men can afford more leisure time as compared to women. During the disaster period, some of the households lost their agricultural lands, livestock and other properties. These losses created some additional workload to women respondent, however at the same time; they learn to build confidence, self-respect, self-esteem, and self-dependency.Although Nepal is predominantly agriculture, majority of the farmers are at subsistence level. In addition, men and women have different roles which differ with the variation in agro-production systems. Moreover women are extensively involved in agricultural activities though their importances were not recognized. Denial of land ownership and denial of access to resources as well as migration of male counterparts are some of the major reasons for affecting the agricultural environments for women in Nepal. CONCLUSION: The shelter reconstruction program has definitely brought positive change in women's access to decision making. The gradual increase in number of women respondent in access to decision making in different areas is a positive change and this has also provided them with a unique opportunity to change their gendered status in society.Furthermore, the exodus out-flow of male counterparts accelerated the additional burden and workload on women.

• Physical Therapy Korea
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• v.10 no.3
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• pp.127-140
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• 2003

The purpose of this study was to determine the factors affecting on the home treatment stress in the CP (cerebral palsy) children's mothers. Direct interviews were conducted from March 17 with April 4, 2003 with 97 mothers of CP children. The average level of stress from home treatment felt by mothers with CP children was $16.97{\pm}4.04$. Stress-levels were especially high in mothers who were not satisfied with the treatment outcome (p<.05) and whose acceptance of disability was low (p<.01). Stress felt by mothers was low when their health status was high (p<.05). A physical burden was shown to have a significant correlation with the stress of the mothers during the home treatment (p<.01). Mothers with a child of Level 2 disability had lower levels of stress than those with a child of Level 4 or 5 disability (p<.01). The level of stress was higher in mothers who lagged in acquiring technical sufficiency (p<.05). Multiple regression analysis showed that one factor affecting the stress felt by mothers with CP children was the degree of acceptance of the disability (p<.01). Programs that can reduce the stress levels of mothers with CP children through home treatment and secure social systems such as professional help and economic compensation, need to be developed. Active policies should be established and executed for these mothers since stress felt by mothers significantly affects the consistency and effectiveness of treatment provided at home.

• Journal of Digital Convergence
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• v.13 no.4
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• pp.283-293
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• 2015

This study explores experiences of male family care worker who are caring for their family members with chronic health conditions at home. Qualitative methodologies were used; semi-structured in-depth interviews with seven participants. Data were analysed using thematic analysis. Results indicated that men are playing greater roles in the provision of care for family members. Findings are presented as three themes: adaptation of role transformations, development for new relationships, and learning to cope with the unexpected. The results suggest that male family care workers experience changes in the ways that they adapt their traditional roles to the new roles they assume as caregivers. Implications for social workers and other care providers are discussed.

• Journal of Korean Academy of Nursing Administration
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• v.4 no.1
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• pp.151-181
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• 1998

This study purports to find out the meanings of chemotherapy among cancer patients. The subjects of this study were selected from those patients who have taken chemotherapy at least twice at a hospital affiliated with a university. The twelve subjects agreed to join the present study and had no problem in communication with others. The data were collected through observations and interviews by the researcher. The phenomenological analysis method proposed by Giorgi was adopted for analyzing the data. The experiences of the subjects to chemotherapy were classified into 24 atributes. These attributes were also categorized into four groups such as hope, pain, fear, and ordea according to their meanings. The subjects expressed hope through the attributes such as "the wish for a new life." "the wish for healing." "the plasure form improvement of cancer." "the wish for being discharged form a hospital." "the interest in dietectic treatment." and "the trust in medical staff." Pain was represented by such attributes as "the physical pain", "the suffering from intravenous injection." "the discomfort of hospital environment." and "the economic burden." As for the attributes represention fear, "fear of being hospitalized." "tehr obscurity of uncertain situations." "the fear of side effects." "the fear of recurrence of cancer," "the lack of knowledge of the disease." Finally, nine attributes werw frouped to ordeal "the will endeavouring to recover cancer" "the adaptation to the present situation." "the giving up of being healthy," "the regret of the past life." "the recognition of significant others." "the physical changes." "the emotional changes." "the social changes." "the recollection of illness experiences." The above findings indicate that chemotherapy means hope, pain, fear, and ordeal to those cancer patinests under treatment. Hence, the nursing interventions for those cancer patients need to be directed to maintaining hope, alleviating pain and fear, and overcoming ordeal. There are some suggestions in achieving these goals : (1) the nurses caring for cancer patients need to understand the meaning of chemotherapy experienced by those patients, (2) a nursing specialty of intravenous injection needs to be developed, (3) interventions for providing emotional support should be devised, (4) nursing care should also be available to those cancer patients being dischaged at home.

• Journal of The Korean Digital Architecture Interior Association
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• v.13 no.4
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• pp.109-117
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• 2013

The purpose of this study is to present our elderly welfare policy and welfare facilities for the elderly and to propose the future direction of policy for the elderly with comparison to that of Japan. The comparative study results of Korea and Japan are as follows: As the basis of elderly welfare, care insurance for the elderly is now fixated in the two countries. On the other hand, for quantitative expansion in Korea, the quality level has been gone down. Due to qualitative evaluation, the growth of facilities has slowed and material welfare providers was also a decline in the number of operators. Two countries in the field of community welfare in recent years has been actively promoting. It is the most important to solve the social welfare problem with local councils who know the area, which is a part of the future to focus and to support. Due to huge construction investment of facility, there is the burden of operators. This facility is appropriate for an extension of the home. However, it is in the hard economic times. Until now, the number of people in a room is at least four according to the legal standard of Korea, there are a few private rooms. On the other hand, in Japan, unit-care was phased since 2002 and private rooms have been expanded. In Japan, health center for the elderly plays an important role with special elderly nursing home among facilities for the elderly. Health center provides services that are recovering, nursing, and caring to support independence for the elderly after acute phase of treatment. As treatment and care, the aim of health center is to return the elderly to home. On the other hand, there are a few health centers for returning the elderly to home in Korea. Furthermore, in Japan, a project for preventive care has been begun. The project is needed in Korea.

• Journal of Korean Academy of Nursing
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• v.24 no.3
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• pp.448-460
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• 1994

This study was conducted to investigate risk factors for senile dementia as well as care givers' stresses and thier needs for nursing care. It was done using a retrospective survey. A convenience sample or In senile dementia patients and l20 nor-mal elders in a rural area was used. The tools used in the study were the MMSE-K(Mini-Mental State Examination-Korea) for dementia screening test and a questionaire developed by the research team. Data were collected through home visits by Com-munity Health Practitioners. Data were analyzed using descriptive statistics, T-test, and Chi-square test. The findings are as follows : 1. There were significant differences in age, marital status, and religions between the two groups. 2. There was a significant difference in smoling behavior between the two groups. 3. There was a significant difference in past his-tory of cancer between groups. 4. There was a significant difference in past and present elderftmily relationship between the two groups. 5. There were significant differences in intellectual activities, assuming major role in family and seeking other's help in daily life troubles between the two groups. 6. There were significant differences in stress factors such as child problem, family conflict, health problem and illegal behavior between the two groups. 7. The major problems out by families in caring for dementia patient were catastrophic reactions, dirtiness, mood change, devouring and tremor. The most serious problems faced by families was dirtiness. with catastrophic reactions, sleep distrubance, changeableness, and a suspcio-usness following. The care givers expressed chronic fatigue, anxiety, tension, depression, disorder in daily life, shamefulness, blame from neighbours and guiltiness. 8. There is need for geriatric hospitals, nursing homes, burden sharing, and counselling or education for family care givers. A replicate study in the urban area is recommended to validate the findings of this study. To explore the impact of stress in life and ‘han’ on senile dementia, a qualitative study is recommended.