• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.9 no.1
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• pp.98-104
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• 1998

A 12-year-old girl with a 6 year history of childhood-onset schizophrenia required 2 hospitalizations and long-term clozapine trial due to inadequate responses to combinations of typical neuroleptics and traditional treatments of schizophrenic disorder. On admission, she had continuous auditory and visual hallucinations, persecutory delusion, emotional instability, regression of behaviors including temper tantrums as well as specific developmental delays in learning, language, and motor coordination. The clozapine trial significantly reduced most of the positive symptoms, and facilitated in successful discharge from the hospital. During the 4 year clozapine treatment, no significant adverse reactions were noted, and she returned to a structured school setting with minimal degrees of schizophrenic symptoms. From this clinical experience, we suggest that clozapine might be safe and effective in treating treatment-refractory schizophrenic children.

• Journal of agricultural medicine and community health
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• v.24 no.2
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• pp.331-350
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• 1999

This study was attempted to examine relationship between personality traits and job satisfaction of community health practitioners(CHPs) working in remote rural area in order to suggest some methods to enhance their lob performance and the degrees of job satisfaction. The General Personality Test and the revised version of Job Satisfaction Questionnaire were administered to 200 of 348 CHPs in the Kwangju-Chonnam area and then the percentages, means, standard deviations and Pearson's correlation coefficients of these data were obtained, ANOVA and logistic analysis were used. The results of study were as follows : 1. CHPs without religion were more satisfied with their salary than those with religion. 2. CHPs who hoped for continuous education showed higher scores than the others on necessary job, professional pride and autonomy. Those who chose for independent job showed higher scores than the others on both necessary job and professional pride. Those who hope for long duration showed higher scores than the others on both necessary job and professional pride. Those who were satisfied with the present occupation showed higher scores than the others on pay satisfaction, necessary job, professional pride, interaction, autonomy and demand from organization. 3. Their autonomy scores differed significantly according to work status, both interaction and autonomy scores did so according to the fields of the past job in CHP, and their autonomy scores according to location of clinics. Their interaction scores differed significantly according to the frequency of home visits per mouth, both the degrees of salary satisfaction and professional pride scores did so according to the frequency of counseling education per mouth, and their professional pride scores did so according to total income per year. 4. The levels of their responsibility and self-confidence showed the highest of all personality traits variables. 5. The professional pride score of CHPs showed the highest of all job satisfaction variables. 6. Dominance were mostly correlated with autonomy and responsibility were mostly associated with professional pride. Both emotional stability and self-confidence were mostly related necessary job. In conclusion, religion, location of clinics, clinical experience, opportunity for education, dominance, self-confidence, the duration of services hoped for, satisfaction with the present occupation, the field of past job and administrative affairs were found to be the important factors in the degrees of their job satisfaction. Therefore, the methods to consider these variables will be necessary to develop for enhancing the efficiency of their Job performance and the degrees of job satisfaction.

• Korean Journal of Hospice Care
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• v.2 no.1
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• pp.58-74
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• 2002

This paper constitutes a descriptive investigation and used a structured questionnaire to investigate nurses' and doctors' recognition of cancer patients. The subjects were extracted from the medical personnel working at the internal medicine, the surgery ward, the obstetrics and gynecology department, the pediatrics department, the cancer ward, and the emergency room of five general hospitals located in Seoul and Gyeonggi Province. The research lasted from August, 2001 to September 2001. Total 137 nurses and 65 doctors were included and made out the questionnaires directly distributed by the investigator. The study tool was also developed by the investigator and consisted of such items as the demographic and social characteristics, the medical personnel's recognition degree of cancer and cancer patients, their recognition of the management of cancer patients, and their participation in a hospice. The results were analyzed using the SPSS Window program in terms of technological statistics, ranks, t-test, and ANOVA. The reliability was represented in Cronbach' α=.75. The nurses' and doctors' recognition degree of cancer and cancer patients had an overall average of 3.86 at the 5 point-scale. The items that received an average of 4.0 or more included 'Medical personnel should explain about the cancer cure plans to the cancer patient and his or her family', 'A patient whose case has been diagnosed as a terminal cancer should be notified of it, 'If I were a cancer patient, I would want to get informed of it,' and 'Cancer shall be conquered whenever it is'. In the meantime, the items that received an average of 3.0 or less was 'My relationship with the cancer patient's family has gotten worse since I announced his or her impending death.' And according to the general characteristics and the difference test, the recognition degree of cancer and cancer patient was high among the subgroups of nurses, females, married persons, who were in their 30s, who had a family member that was a cancer patient, and who received a hospice education. The biggest number of the nurses and doctors saw 'a gradual approach over several days'(68.8%) as a method to tell a cancer patient about his or her cancer diagnosis or impending death. Those who usually tell tragic news were the physician in charge(62.8%), the family members or relatives(32.1%) and the clergymen(3.8%) in the order. The greatest number of them recommended a cancer patient's home as the place where he or she should face death because they thought 'it would stabilize his or her mentality'(91.9%) while a number of them recommended the hospital because they 'should give the psychological satisfaction to the patient'(40%) or 'should try their best until the last moment of the patient's death'(30%). A majority of the medical personnel regarded 'smoking or drinking' and 'diet' as the causes of cancer. The biggest symptom of a cancer patient was 'pain' and the pain management of a cancer patient was mostly impeded by the 'excessive fear of drug addiction, tolerance to drugs and side effects of drugs' by medical personnel, the patient, and his or her family. The most frequently adopted treatment plan of a terminal cancer patient was 'to do whatever the patient or his or her family wants' to resort to a hospice' and 'to continue active treatment efforts' in the order. The biggest reasons why a terminal cancer patient went to see a doctor were 'pain alleviation' 'control of symptoms other than pain(intravenous supply)' and 'incapability of the patient's family' in the order. Terminal cancer patients placed their major concern in 'spiritual(religious) matter' 'emotional matters' their family' 'existence' and 'physical matters' in the order. 113(58.5%) of the whole medical personnel answered they 'would recommend' an alternative treatment to a terminal cancer patient mostly because they assumed it would 'stabilize the patient's mentality.' Meanwhile, 80(41.5%) of them chose 'not to recommend it mostly due to the unverified effects and high cost of it(78.7%). A majority of them, I. e. 190(94.1%) subjects said they 'would recommend' a hospice to a terminal cancer patient mostly because they thought it would help the patient to 'mentally prepare'(66.6%) Only 17.3% of them, however, had received a hospice education, most of which was done through the hospital duty education(41.4%) and volunteer training(34.5%). The follows are results of this study: 1. The nurses and the doctors turned out to be still passive and experience confusion in dealing with a cancer patient despite their great sense of responsibility for him or her. 2.Nurses and Doctors realize the need of a hospice, but an extremely small number of them participate in a hospice education or performance. Thus, a whole recognition of a hospice should be changed, for which purpose a hospice education for nurses and doctors should be provided. 3.Terminal cancer patients preferred their home to a hospital as the place to face their impending death because they felt it would bring 'mental stability.' And most of nurses and doctors think it would be unnecessary for them to be hospitalized just for control of their symptoms. Accordingly a terminal cancer patient can be cared at home, and a home hospice care needs to be activated.

• Journal of Hospice and Palliative Care
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• v.5 no.2
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• pp.136-145
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• 2002

Purpose : This study was designed to develop an instrument that could be used for comprehensive and effective need assessment for patients with cancer. Methods : In the first phase, a conceptual framework for the instrument was established by Wingate & Lackey (1989). In the second phase, the preliminary instrument was drawn up through a review of the literature and in consultation with three professors in Nursing. In the third phase validity and reliability of the preliminary instrument were tested as follows; 1) an expert validity test of the preliminary instrument was done by nine head nurses and charge nurses who had over ten years experience caring for patients with cancer at Wonju Christian Hospital. 2) A construct validity test and reliability test was done for the instrument by 116 staff nurses selected by convience sampling from hospitals located in Kang-Won, Kyoung-Ki, and Choong-Chung Provinces. The collected data were analyzed using SPSS 10.0 WIN program. For the factors of the instrument, factor analysis was used. The reliability of the scale was analyzed by Cronbach's alpha. Results : The results of the experts' test of validity, showed that, of 32 items, only one item had less than 55.4%. It was then deleted and a total of 31 items was selected. On the basis of the results of the factor analysis, the following six components were identified: physiological, informational, spiritual, and emotional needs, available resources, and legal/financial needs. These factors explained 61.8% of the variance. In the factor analysis, the first factor (physiological needs) and the second factor (informational needs) explained 25.4% and 10.9% of the variance respectively, which were major factors for the needs of patients with cancer in Korea. Cronbach' alpha for the scale was .90 indicating internal reliability. Conclusion : This instrument can be effectively utilized for assessment of needs of patients with cancer in Korea. Use of the needs assessment instrument developed in this study will allow nurses to develop nursing interventions that provide comprehensiveness and continuity in meeting the needs of patients with cancer.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.10
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• pp.163-169
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• 2017

The purpose of this study is to present the basic data needed to improve the arts, music, and physical education provided by local child care centers based on an investigation of the current status of and satisfaction with the education. The subjects of this study were 17 local child care centers in Gyeonggi-do, South Korea, and the situation of the arts, music, and physical education programs operated from 2014 to 2016 were examined. In addition, 419 children who received the education were surveyed to evaluate their level of satisfaction. The results of this study are as follows. As regards the status of the arts education from 2014 to 2016, it was observed that three of the 17 local child care centers did not have any arts, music or physical education at all, while six of them continuously implemented all three of these programs during this period of time. Two and six of the 17 institutes had arts, music, and physical education programs for two years and one year, respectively. All of the teachers who ran the arts and music education programs of the 17 institutes were arts and music majors who were certified teachers of the liberal arts. However, the physical education programs were run as volunteer activities by college students majoring in physical education. The survey on the level of satisfaction of the children who participated in the arts, music, and physical education programs showed that they were helpful for the overall life experience of the children and that they were more helpful for the boys than for the girls. The level of satisfaction with the education was high for most of the students who participated in the programs, however the boys were more satisfied than the girls. When asked whether they would participate in the arts, music, and physical education programs again, most of the respondents answered that they would do so. The boys were more likely to participate again than the girls. Based on this study, in order to enhance the creativity and personality education of the children using the local child care centers, higher quality education is needed. Arts and music education can be used to help children to learn to communicate smoothly with their friends. In addition, it seems to be necessary to enhance the education by setting goals that are suitable for its purpose, in order to provide creative arts and music education that contributes to the physical health and emotional stability of the children.

• Journal of the Korean Institute of Traditional Landscape Architecture
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• v.32 no.3
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• pp.58-68
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• 2014

Christian Cay Lorenz Hirschfeld is often regarded as 'a father of landscape garden art.' He was an aesthetics professor and garden theoretician in the $18^{th}$ century. He put forth the most comprehensive garden theory book in five volumes between 1779 and 1785. His book, Theorie der Gartenkunst, was translated and widely circulated in his contemporary. The book, which dealt with diverse aspects of garden art such as history, design, material, and type, urged to promote the prevalence of landscape garden in European continents as well as in Germany. However, there have scarcely been discourses in the Hirschfeld's garden theory. This essay aims to review Hirschfeld's garden thoughts in his book critically and to reinterpret some issues in the contemporary landscape theory and practice. Hirschfeldian theory was the product of $18^{th}$ century German Enlightenment and romanticism. At that time, Nature was regarded as divine realm. There was a German affinity with natural world. The spread of reading culture and the fashion of travel literature were another background of the success of his garden literature. Several issues in Hirschfeld garden theory will discussed here. First, privileging garden art was the most significant contribution in his theory. He emphasized that garden art was the most advanced art form among all art genres. Second, garden art was grounded on the mimesis of nature. The ambiguous relationship between nature and art still existed in garden making. However, garden art can be flourished when utilizing the potency of nature in itself. Third, there was the association between the image and the idea in experiencing the garden. Some garden scenes stimulated the related emotional responses such as cheerful and merry, softly melancholic, romantic, solemn etc. Fourth, the movement was the essential aspect of garden art. Motion and emotion are come together in garden experience. To represent the landscape garden style in suitable way, the sketch or image seems to be preferable than the plans and views. Finally, garden art was composing of not only the physical space but also the spirit of place. He maintained the garden art as hortus moralis should be a social metaphor. Hirschfeldian garden theory has often been criticized as the lack of practical power and the old fashioned idea. However, his theory influenced on formulating the idea of public park in $19^{th}$ century. Moreover, there are still some visionary aspects of his theory such as the reevaluation of garden art, the emphasis of locality and the introduction of Mittelweg idea. Recently, gardening culture are prevalent in various realms of art and life. Hirschfeld's garden theory as humanistic landscape theory can provide us some insights in the contemporary practices.

• Journal of Hospice and Palliative Care
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• v.15 no.1
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• pp.10-17
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• 2012

Purpose: This study was conducted to identify the perception regarding palliative care among Korean doctors and referral barriers toward palliative care for terminal cancer patients. Methods: Between May and June 2010, 477 specialists mainly caring cancer patients using a web-based, self-administered questionnaire. Results: A total of 128 doctors (26.8%) responded. All respondents (100%) deemed palliative care a necessary service for terminal cancer patients. More than 80% of the respondents agreed to each of the following statements: all cancer centers should provide palliative care service (80.5%); all terminal cancer patients should receive concurrent palliative care along with anti-cancer therapies (89.1%) and caring for terminal cancer patients requires interdisciplinary approach (96.9). While more than 58% of the respondents were satisfied with their performance of physical and psychological symptoms management and emotional support provided by patient's family members, 64% of the responded answered that their general management of the end-of-life care was less than satisfactory. Doctors without prior experience in referring their patients to palliative care specialists accounted for 26.6% of the respondents. The most common barrier to hospice referral, cited by 47.7% of the respondents, was "refusal of patient or family member", followed by "lack of available palliative care resources" (46.1%). Conclusion: Although most doctors do recognize the importance of palliative care for advanced cancer patients, comprehensive and sufficient palliative medicine, including interdisciplinary cooperation and end-of-life care, has not been put into practice. Thus, more active palliative consultation or referral is needed for effective care of terminal cancer patients.

• Journal of Hospice and Palliative Care
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• v.16 no.4
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• pp.205-215
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• 2013

Most terminally ill cancer patients experience various physical and psychological symptoms during their illness. In addition to pain, they commonly suffer from fatigue, anorexia-cachexia syndrome, nausea, vomiting and dyspnea. In this paper, I reviewed some of the common non-pain symptoms in terminally ill cancer patients, based on the National Comprehensive Cancer Network (NCCN) guidelines to better understand and treat cancer patients. Cancer-related fatigue (CRF) is a common symptom in terminally ill cancer patients. There are reversible causes of fatigue, which include anemia, sleep disturbance, malnutrition, pain, depression and anxiety, medical comorbidities, hyperthyroidism and hypogonadism. Energy conservation and education are recommended as central management for CRF. Corticosteroid and psychostimulants can be used as well. The anorexia and cachexia syndrome has reversible causes and should be managed. It includes stomatitis, constipation and uncontrolled severe symptoms such as pain or dyspnea, delirium, nausea/vomiting, depression and gastroparesis. To manage the syndrome, it is important to provide emotional support and inform the patient and family of the natural history of the disease. Megesteol acetate, dronabinol and corticosteroid can be helpful. Nausea and vomiting will occur by potentially reversible causes including drug consumption, uremia, infection, anxiety, constipation, gastric irritation and proximal gastrointestinal obstruction. Metoclopramide, haloperidol, olanzapine and ondansetron can be used to manage nausea and vomiting. Dyspnea is common even in terminally ill cancer patients without lung disease. Opioids are effective for symptomatic management of dyspnea. To improve the quality of life for terminally ill cancer patients, we should try to ameliorate these symptoms by paying more attention to patients and understanding of management principles.

• Journal of Sasang Constitutional Medicine
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• v.8 no.1
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• pp.1-15
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• 1996

The Sasang Constitutional Medicine seeks the psychosomatic balance, and the Basic principle of treatment according to the symptom(病證藥理) in Sasang Constitutional Medicine could be summarize as follows. 1. The pursuit of Shape-Image Medicine (形象醫學) and the Symptoms of shape - Symptoms of disease (形置病證). It established emotion, symptoms of constitution, and symptoms of constitutional disease on the base of Shape-Image Medicine (形象醫學) which means qi (氣) is inside and shape is outside (氣裡形表). 2. The inductive medicine and positive medicine. It systematized the Symptoms of shape - Symptoms of disease (形證病證) on the base of the medical practice of the ancients and Lee Jae-Ma (李濟馬)'s own experience inductively, and it present show to control the psychosomatic balance practically. 3. The pathology centering on human. Oriental medicine is based on Yin-Yang (陰陽) and Five elements (五行) and the harmony of nature and human (天人相應) of Taoism, but Sasang Constitutional Medicine is based on emotional and ethical pathology of Confucianism (儒學). 4. The treatment according to the symptom (病證藥理) in Sasang Constitutional Medicine centering on clear qi (正氣). The promotion and demotion (補瀉) which is based on clear qi (正氣) and evil qi (邪氣) is a basic principle in Oriental medicine, but In Sasang Constitutional Medicine it is attached importance to control of clear qi and classify obedience symptom and disobedience symptom (順 逆症) as the type to oppose disease. 5. The treatment according to the psychomatic symptoms. It takes importances to control of one-sided emotion as well as the treatment of psychical symptoms, and also to remedy disease as keeping under control one's mind. 6. The preventive medicine and the medicine to develop one's health. It is in pursuit of social health to develop personality through clear qi (正氣) in real life, to prevent disease, and to spread the sickness control of individual person. Sasang Constitutional Medicine pursuits the psychosomatic balance through 'Balance', 'Control', 'Self regulating Control' of the 'Golden Mean (中庸)' with the treatment according to the symptom (病證藥理) in Sasang Constitutional Medicine.

• The Journal of Korean Society for Radiation Therapy
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• v.16 no.1
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• pp.79-89
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• 2004

This study carried a comparative analysis of quality of living perceived by cancer and hospiece patients who received radiotheraphy, and influential factors in order to provide basic data for nursing goals and establishment of strategy. The subjects of the study were 50 cancer patients who were more than twenty years old and was receiving radiotheraphy in therapeutic radiology department of C university hospital, and fourteen hospiece patients who were in J hospital in Gwangju. They were conveniently sampled according to the selection standard, and researchers personally interviewed them using questionnaire and patient scripts to obtain necessary data. The results were presented as follows: 1. When cancer and hospiece patients were examined demographically, the number of 60 year-old patients were the most. The subjects whose marriage period was more than thirty-one years were the most. In medical expense, more than $70.0\%$ of the patients bore their expenses themselves. 2. When disease-related characteristics of the cancer and pospiece patients were exmained, more than $75\%$ of the patients had experience of being in hospital, and more than $60.0\%$ experienced operation. However, for prevalence period, $57.5\%$ of the cancer patients had less than six months, and $64.3\%$ of the hospiece patients had more than two years. 3. For physical symptoms of cancer patients, $77.5\%$ had fatigue, $60.0\%$ had loss of appetite, and $52.5\%$ had loss of weight while for the hospiece patients, $100\%$ had loss of weight, and $92.9\%$ had fatigue and loss of appetite. For the cancer patients, $0.0\%$ had swelling, and $7.5\%$ had bleeding, For the hospiece patients, $7.1\%$ had change in skin, and $14.3\%$ had diarrhea. 4. Mean score of the cancer subjects were as follows: family support, social support, emotional and spiritual support, physical symptoms, and periods were 3.87, 2.88, 3.10, 2.80, and 2.94 respectively. Those of the hospiece patients were 3.80, 1.96, 1.58, 2.64 and 3.24 respectively. 5. Mean score of family support of both patients were almost identical, but in character, a considerable difference was found: 3.10 and 1.58. In qualify of living, the mean score of hospiece patients was slightly lower.