• Journal of Preventive Medicine and Public Health
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• v.56 no.4
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• pp.319-326
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• 2023

Objectives: The coronavirus disease 2019 (COVID-19) pandemic has increased the workload of healthcare workers (HCWs), impacting their health. This study aimed to assess sleep quality using the Pittsburgh Sleep Quality Index (PSQI) and identify factors associated with poor sleep among HCWs in Vietnam during the COVID-19 pandemic. Methods: In this cross-sectional study, 1000 frontline HCWs were recruited from various healthcare facilities in Vietnam between October 2021 and November 2021. Data were collected using a 3-part self-administered questionnaire, which covered demographics, sleep quality, and factors related to poor sleep. Poor sleep quality was defined as a total PSQI score of 5 or higher. Results: Participants' mean age was 33.20±6.81 years (range, 20.0-61.0), and 63.0% were women. The median work experience was 8.54±6.30 years. Approximately 6.3% had chronic comorbidities, such as hypertension and diabetes mellitus. About 59.5% were directly responsible for patient care and treatment, while 7.1% worked in tracing and sampling. A total of 73.8% reported poor sleep quality. Multivariate logistic regression revealed significant associations between poor sleep quality and the presence of chronic comorbidities (odds ratio [OR], 2.34; 95% confidence interval [CI], 1.17 to 5.24), being a frontline HCW directly involved in patient care and treatment (OR, 1.59; 95% CI, 1.16 to 2.16), increased working hours (OR, 1.84; 95% CI,1.37 to 2.48), and a higher frequency of encountering critically ill and dying patients (OR, 1.42; 95% CI, 1.03 to 1.95). Conclusions: The high prevalence of poor sleep among HCWs in Vietnam during the COVID-19 pandemic was similar to that in other countries. Working conditions should be adjusted to improve sleep quality among this population.

• Journal of Korea Entertainment Industry Association
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• v.13 no.8
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• pp.325-334
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• 2019

Director Lee Chang Dong said that it is the most important point for revealing the invisible beauty so that the audience could feel the unseen beauty through the . Discussing about how to find beauty that is not only visible but also invisible through the main character Mi-ja from the film, who makes a decision and reactions on her daily life by her perception that are difficult for others to take same. The film tells that how Mi-ja's ideal of a beauty can be taken the role for writing a poetry at the moment of the dead poet society, making a movie in the age of dying emotion and also when it lost fundamental values and about movie media. This study analyzed the performances of the main character Mi-ja in the film, and actress Yoon Jung Hee based on Director Lee Chang Dong's directed performance. The audience will be self-questioning and reflecting their life through the Mi-ja's an unidentifiable characteristic which something that someone cannot say, something that someone cannot express, something that tells something through Mi-ja's poem and actress herself finds the character's feelings.

• 한국노년학
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• v.39 no.3
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• pp.589-612
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• 2019

Korea has undergone rapid modernization and globalization process in the last few decades. The purpose of this study is to explore how shifting traditional values are impacting Korean elderlies and their perceptions of aging experience. In order to understand how changing social and cultural practices are affecting older adults, the similarities and differences among Korean elderlies living in three different geographical locations are examined in a multidimensional comparative framework. Life story interviews were conducted with 30 Korean elderlies (10 urban residents in Korea, 10 rural residents in Korea, and 10 residents in the US). Paying attention to within-group variation, this study particularly focused on analyzing the psychological, social, emotional, and spiritual experiences that made lives meaningful and resilient in old age in spite of physical decline. Based on analysis of narrative, the following major areas were identified as having positive or negative influence on aging experiences: physical health, emotional health, family relationship, work, leisure/social activity, and spirituality. Common themes of aging well across all settings included: "life not indebted to their offspring," "physical and mental health," and "dying well." Spirituality played a critical role in cultivating perspectives on life and accepting aging process, which were rooted in specific religious traditions participants identified (e.g., Christianity or Buddhism). Interesting differences in the meaning of work and leisure were also found between elderlies residing in Korea and the US immigrant context. One unique factor continuing to negatively affect Korean elderly in rural community was related to shame of not obtaining higher education. Implications for future research are also addressed.

• Economic Analysis
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• v.25 no.2
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• pp.1-53
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• 2019

This paper examines monetary policy quantitatively in a two-agent and small-scale New-Keynesian economy with debt-constrained households that cannot smooth their consumption intertemporally and frictionlessly since highly indebted households are not allowed to borrow above a certain debt ceiling in incomplete financial markets without additional risk premiums due to information asymmetry between savers and borrowers. We find that, in the event of cost shocks, the asymmetric responses of borrowing households without, and saving households with, dividend incomes lead to different labor supplies and consumptions over heterogeneous households, and eventually to an extension of the monetary policy transmission channels. The income effect and low elasticity of the labor supply play key roles in such asymmetric responses over heterogeneous households. We also find that the social welfare in a flexible inflation targeting (FIT) monetary policy, in which both the inflation gap and the output gap are considered in an integrated manner when policy-making, is similar to that of the Ramsey optimal monetary policy (ROP), in which the shares of debt-constrained households, as well as all economic states, including both the inflation gap and output gap, are considered comprehensively for policy-making, and that it is greater than that of simple inflation targeting (SIT) monetary policy, in which only the inflation gap is considered mechanically for policy-making. Such social welfare implies that a FIT policy may still work even in an economy with a sizable number of debt-constrained households. Further, the responses of cost shocks to consumption and labor supply are dying out more slowly under FIT and ROP policies than under an SIT policy.

• Journal of Korean Society of Environmental Engineers
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• v.34 no.8
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• pp.574-582
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• 2012

This study presents the concentrations of the polycyclic aromatic hydrocarbons (PAHs) listed as priority pollutants by United States Environmental Protection Agency (US EPA), in 98 sludges from 54 industrial wastewater treatment facilities of South Korea. The mean concentrations of ${\Sigma}_{16}PAHs$ were ranged from 32.5 ${\mu}g/kg-dw$ to 1189.3 ${\mu}g/kg-dw$ by industries, and the highest content was found in the petrochemical industry, followed by chemical, clothing manufacturing and dying, pulp and papermaking, secondary wastewater treatment, and food/beverage producing industries. Comparisons to the EU and Danish standards of ${\Sigma}_{16}PAHs$ in sewage sludge for land application showed only two samples (one from petrochemical, and the other from chemical industry) exceeded the limits. ANOVA test with PAH concentrations as variables revealed no statistically significant influences by industrial types and sampling time (i.e., seasonal variations). Pearson correlations between individual PAHs showed strong relationships (r>0.7) among 4-ring PAHs. Concentrations of acenaphthylene, anthracene, fluoranthene, benzo(a)anthracene, benzo(f)fluoranthene, benzo(k)fluoranthene, benzo(a)pyrene presented strong correlations to ${\Sigma}_{16}PAHs$. Principal component analysis discriminated entire samples into three groups by two principal components (PC1 and PC2) with 70% of data variations, in which industrial types were not of importance, but a dominance of certain PAHs. Samples in group-I, which is high PC1 and low PC2, were characterized by a dominance of 2-ring PAHs, and in group-II, PC1 and PC2 showed a linear relation, was dominant 4-ring PAHs. Group-III with low PC1 and high PC2 includes 17 samples showing a noticeably high contribution of 3-ring PAHs to ${\Sigma}_{16}PAHs$. This study provides concentrations of PAHs in industrial sludges collected from a wide variety of sources (six industrial types) and two seasons of sampling events, and the comparison of ${\Sigma}_{16}PAHs$ with other studies are also discussed.

• Korean Journal of Hospice Care
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• v.3 no.2
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• pp.34-54
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• 2003

Every one experiences death one day, however no one can knows exactly what it is because people can not experience death until it comes, it is therefore impossible to judge correctly on the phenomenon of the death. On the whole, man experiences indirect death through the mass communications such as TV drama, fiction, magazine etc because those methods can easily access by every one. In addition to this, people usually acquire the negative awareness of death through the dramatic change of story like dying of cancer for dramatic effect by giving scare and fear to the cancers. The purpose of this study is to provide basic information on the spiritual care that enables the facing death patients to accept death as a part of life and divert hope from scare about after death by comparing and analyzing of two aspects of death meaning I.e, Korean fiction and the end stage cancer patients. Additionally, for medical staff to understand the facing death cancer patients by making to aware patients correctly and provide the better quality of care. The study was performed from September 28, 2002 to February, 28 2003. The materials of this study were collected by direct data obtained from observation, interviews, note and diary of end stage of cancer patients and written materials acquired from Korean contemporary fiction. Participants of this study were 4 end stage cancer patients including 2 lung cancer patients, 1 liver cancer patient and 1 esophagus cancer patient. The methodology used in this study was divided into two types; Huberman & Miles methodology was used for fiction to find and categorize subject, and Colaizzi, one of phenomenological methodology was used for end stage cancer patients to find the major meaning, subject and categorization. 1.The death investigated in the fiction, was found as a progress of negative emotion, acceptance and sublimation, life related subjects in the negative emotion were tenacity for life, anxiety, lingering attachment, responsibility, abandonment and death related subjects were shock, isolation, fear, scare and rejection. Acceptance related subjects were acceptance, destiny, secularism, preparation and arrangement, and sublimation related subjects were sublimation through Christian and Buddhism. 2.The death showed in the participants was negative emotion, acceptance and sublimation, life related subjects were repentance, anxiety, responsibility and hopelessness, and death related subjects were dejection, solitude, anger, fear and scare. The acceptance was a type of religious acceptance that admitted instantly by reaching an understanding with the God, and death was accepted as a progress of preparation, arrangement, acceptance and hope. Sublimation related subjects were Christian sublimation and relief or destiny incurred from self-reflective sublimation through communications and thoughts. 3.The death in view of fiction and participants were positively accepted both death and negative emotion, and the study disclosed the fact that death was sublimated dependent on religion. 4.The progress of negative emotion, acceptance and sublimation was disclosed more complicated and various in the real end stage cancer patients and acceptance only found in the patients on the form of religious acceptance, according to the results compared with fiction and real end stage cancer patients. The death showed in the fiction was standardized, gradated and similar progress with psychological status of Kubler-Ross. However, death in the participants was showed complex and various feelings simultaneously, and sometimes they accepted death positively. The sublimation through religion was found in Buddhism and Christian in the fiction and mostly Christian in the participants due to a number of Hospice patients. It was found that negative emotion various types of death was more found in the participants than fiction. It is therefore necessary to study on the response of death in various types. In the participants death was incurred more systematic and variously, we knew that nursing practice focused on experience of participants is required and reality on death is much profound than we analyzed and presented, lots of situations and reactions should be premised because we can not completely rule out the negligence possibility of care mediation of participants. In caring for the facing death patients, we discovered and confirmed again through this study that the spiritual care should be needed as a mediation method.

• Journal of Hospice and Palliative Care
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• v.10 no.3
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• pp.137-144
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• 2007

Purpose: The purpose of this study is to identify and assess the needs of the cancer patients and their families and provide basic data to meet with their needs. Methods: This is a descriptive study using questionnaire method. Questionnaire were collected by mail from 76 discharged patients from a hospice ward from May until the end of October, 2004, and data were analyzed by SPSS 10.0. Results: Admitted patients had needs of pain control (85.5%), non-pain symptoms (63.2%) such as vomiting, dyspnea, ascites, etc, and emotional and spiritual problem solving (28.9%, 14.5%). Interests of patients were health care of himself/herself (65.8%), concern for their spouses left alone (32.9%), and future of their children (15.8%). In families' needs of care of 5 areas, "information on patient's status and treatment/nursing care" was shown most high score ($3.48{\pm}0.62$). In detailed questions, they request most 'to inform the prognosis of patients' and the next is 'to inform the reasons that nursing care was required'. The next highest score was to 'inform family roles' ($3.39{\pm}0.64$), and next was spiritual support ($3.11{\pm}0.79$), and emotional support ($3.08{\pm}0.72$). Expectations of family on the treatment were comfortable dying (73.4%) scored the highest. Patients' families were satisfied with volunteer service most in service area (97.4%). The next was pain control (89.5%) and nursing service (77.6%). Conclusion: Health care staff should identify the actual needs of families caring cancer patients and they should operate realistic programme which can give continuous and assistance by reflecting individual needs and characteristics. With these srategies, the quality of life of patients and families can be improved. And then the intervention programme should be developed to measure subjective nursing care needs of terminally ill cancer patients and their families.

• Journal of Hospice and Palliative Care
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• v.11 no.3
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• pp.140-146
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• 2008

Purpose: Sooner of later, end-of-life care decision-making will unfold and be settled during the professional lives of medical students. However, there is prevalent ambiguity and uncertainty between the palliative treatment and euthanasia. We conducted this survey to investigate attitudes of medical students towards end-of-life making decisions, and to find out which factors primarily influenced the attitudes. Methods: A study was conducted among medical students at one university, the Republic of Korea. A written questionnaire was sent to all the 1st, 2nd, and 3rd-year medical students. It presented 5 statements on end-of-life decision-making. Students were asked whether they agreed or disagreed with each statement. Results: The response rate was 74.4%, and 267 questionnaires were analyzed. Percentages of agreement with each statements on Voluntary active euthanasia (VAE), Physician assisted suicide (PAS), Withholding life-sustaining management, Withdrawing life-sustaining management, and Terminal sedation (TS) was 37.1%, 21.7%, 58.4%, 60.3%, and 41.6%, respectively. The grade of students, religious activity, and educational experience were determinant factors. Agreement on each statements was higher in the low religious activity group than in the high religious activity group. Agreement on TS was higher among 3rd year students during their clerkship than among 1st and 2nd year students. Age of students and the experience of dying-people care had no significant influence. Conclusion: In end-of-life decision-making, religious and educational factors influenced medical students' attitudes. Especially, the experience of education during clerkship had significant influence on the attitude. Proper teaching on end-of-life decisions should further be considered during medical students' clerkship.

• Journal of Hospice and Palliative Care
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• v.11 no.3
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• pp.147-155
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• 2008

Purpose: This study aimed to assess the educational needs for nurses who care for terminal cancer patients and their families. To identify top needs along with key issues in consideration to develope hospice training program and provide specific recommendations. Methods: A cross-sectional design with nurses from nine universities' hospice specialist courses and seven cancer centers was used. Data were collected via e-mail or mail service from March to April in 2008. One hundred seventy three questionnaires were returned (return rate: 73.6%), and 156 questionnaires were eventually analyzed. The questionnaire consisted of Mason and Ellershaw's The Self-efficacy in Palliative Care (SEPC) and self-reporting confidence and educational needs in hospice care. Results: The mean age of the participants was 37.94 years, 82.1% were staff nurses, and 44.9% completed over six months hospice education. Mean$\pm$standard deviation score for total SEPC was $2.67{\pm}.62$, which was lower than average (score 3), with communication score being the lowest ($2.49{\pm}.69$). The lowest self-reporting confidence score was $2.03{\pm}.77$ in hospice administration and management, followed by providing complement therapy ($2.34{\pm}.77$), bereavement care ($2.34{\pm}.71$), lymph edema management ($2.35{\pm}.79$), and care planning ($2.36{\pm}.81$). The participants reported that additional education is needed in all topics, with pain management score being the highest ($3.71{\pm}.50$), followed by pain and symptom evaluation ($3.67{\pm}.52$), care for dying ($3.67{\pm}.52$), and communication and counseling ($3.63{\pm}.53$). There were significant subgroup differences in SEPC and self-reporting confidence between groups who completed 6 months hospice education or not, however, no significant difference in educational need between the groups. Conclusion: This study showed the need for developing hospice training program to improve compentency of nurses in hospice palliative care.

• The Korean Society of Law and Medicine
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• v.20 no.3
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• pp.83-139
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• 2019

Recognition of liability for damages due to medical malpractice has been developed largely on the basis of two paths. First is the case where there is an error in a physician's medical practice and this infringes upon the legal interests of life and body, and the compensation for monetary and non-monetary damages incurred from such infringement on life and body becomes an issue. Second is the case where there is a breach of a physician's duty of explanation that results in a infringement on the patient's right of autonomous decision, and the compensation for non-monetary damages incurred from such infringement becomes an issue. However, even if there is a medical error, since it is difficult to prove the causation between the medical error of a physician and the infringement upon legal interests, the physician's responsibility for damage compensation is denied in some cases. Consider, for example, a case where a patient is already in the final stage of cancer and has a very low possibility of a complete recovery even if proper treatment is received from the physician. Here, it is not appropriate to refuse recognition of any damage compensation based on the reason that the possibility of the patient dying is very high even in the absence of a medical error. This is so because, at minimum, non-monetary damage such as psychological suffering is incurred due to the physician's medical error. In such a case, our courts recognize on an exceptional basis consolation money compensation for losing the chance to receive proper treatment. However, since the theoretical system has not been established in minutiae, what comes under the benefit and protection of the law is not clearly explicated. The recent discourse on compensating for damages incurred by patients, even when the causation between the physician's medical error and infringement upon the legal interests of life and body is denied, by establishing a new legal interest is based on the "legal principle of loss of opportunity for treatment." On what should be the substance of the new legal interest, treatment possibility argument, expectation infringement argument, considerable degree of survival possibility infringement argument and loss of opportunity for treatment argument are being put forth. It is reasonable to see the substance of this protected legal interest as "the benefit of receiving treatment appropriate to the medical standard" according to the loss of opportunity for treatment argument. The above benefit to the patient is a value inherent to human dignity that should not be infringed upon or obstructed by anyone, and at the same time, it is a basic desire regarding life and a benefit worthy of protection by law. In this regard, "the benefit of receiving treatment appropriate to the medical standard" can be made concrete as one of the general personal rights related to psychological legal interest.