• Korean Journal of Adult Nursing
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• v.14 no.3
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• pp.368-377
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• 2002

Purpose: The purpose of this study was to analyze the trend of research on the use of home-based pulmonary rehabilitation. Method: Using Medline and CINAHL search engine, experiemental research, titled as 'home-based pulmonary rehabilitation' and 'chronic lung disease', statistics were collected. The total 29 experimental studies published between 1981 to 2000 were selected and analyzed according to the ATS guidelines. Result: 1) The study samples in research were mostly of men, whose lung function was moderate to severe. 2) The total period of the intervention program varied from 5 to 12 week. The program included excercise intervention and educational intervention. Psychosocial intervention was minimal. 3) The outcome of the home-based pulmonary rehabilitation had been measured mostly by physical aspects. Quality of life and cost were less frequently measured. 4) In terms of effectiveness of the home based pulmonary rehabilitation program, physiologic outcome, such as lung function and hematologic markers, there was more 'no effect' than 'positive effect', whereas there was more 'positive effect' in decreasing dyspnea, improving excercise capacity, and improving quality of life. Conclusion: Based on these findings, future research on home-based pulmonary rehabilitation should be emphasized and provide standardized protocol, including psychosocial intervention, and analyses on cost and quality of life.

• The Korean Society of Law and Medicine
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• v.23 no.4
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• pp.75-102
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• 2022

In this article, 「Act on the hospice and palliative care and decisions on life-sustaining treatment for patients at the end of life」, 「Act On The Improvement Of Mental Health And The Support For Welfare Services For Mental Patients」, 「Organs Transplant Act」, 「Safety And Management Of Human Tissue Act」, 「Pharmaceutical Affairs Act」, 「Prevention Of Acquired Immunodeficiency Syndrome Act」, 「Tuberculosis Prevention Act」, 「Infectious Disease Control And Prevention Act」 were reviewed. Patients' right to self-determination and consent in these laws are related to civil law. even though they are closely related to the civil law in relation to patients' right to self-determination and consent. In order to consistently operate medical administration, it is necessary to understand the principles of civil law decision-making.

• Journal of Hospice and Palliative Care
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• v.9 no.1
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• pp.1-10
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• 2006

Purpose: Terminal cancer influences on patients as well as their family members. This research was performed to evaluate the quality of lift of primary family caregivers and to investigate the influencing factors. Methods: The results of survey were collected from 81 family caregivers who were taking care of hospitalized terminal cancer patients at an oncology department of university hospital in Daejeon from March 2005 to January 2006 with questionnaires. The questionnaires were consisted of the general characteristics of the subjects, and 36-items short-form Health Survey (SE-36) Korean version to evaluate the quality of life of family caregivers, the characteristics of patients and family caregivers' caring trait. Results: Family caregivers' mean (${\pm}SD$) SF-36 score was 47.9 (${\pm}20.7$). Influential factors on family caregivers' life quality were daily raring hours, economic burden, type of treatment; only supportive care, caring duration, sex, the numbers of ADLs (activity of daily livings) items that patients needed help in order by stepwised multiple logistic regression analysis (overall $R^2=0.639$, P=0.044). Conclusion: Daily raring hours and economic burden were two influential modifiable factors on family caregivers' quality of life. Therefore, social supportive systems are required to reduce family caregivers' daily caring hour and economic burden.

• Journal of Hospice and Palliative Care
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• v.7 no.2
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• pp.238-247
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• 2004

Purpose: Pain management is often needlessly suboptimal. Health care professionals are seldom trained in pain management, may not realize the importance of pain management or recognize that a patient is in pain, and may fear prescribing opioid medications. Noting that one of the problems related to health care professionals is poor assessment of pain, we studied a trend of pain severity and satisfaction with pain controls after using TTS-fentanyl in order to determine whether a regular pain assessment was effective for controlling cancer pain. Methods: We assessed the pain as a $5^{th}$ vital sign after using TTS-fentanyl in 471 hospitalized cancer patients during 4 days. The data were collected from September, 2003 to December, 2003. Pain severity was assessed by using a numeric pain intensity scale($0{\sim}10$) by ongoing pain assessment. Results: Pain assessment as a $5^{th}$ vital sign had led to reduce patient's pain scores. High degrees of satisfaction scores in both patients and doctors with TTS-fentanyl were observed. They were also negatively correlated with the pain severity. Conclusion: Regular pain assessment was effective in the management of cancer pain.

• Journal of Hospice and Palliative Care
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• v.14 no.4
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• pp.218-226
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• 2011

Purpose: This study aimed to explore the public attitude toward the development of national health program for cancer survivorship. Based on the results of this survey suggest the necessity of national health program for cancer survivorship. Methods: We surveyed 1,015 adults who were over 20 years of age from the sixteen cities and local districts of Korea. We conducted a telephone survey with a structured questionnaire on the post-treatment care at the nation and on the permission as the handicapped for cancer. Results: Fifty-six percent of respondents answered that post-treatment program at the national level is very necessary and twenty-seven percent replied that it is necessary. Respondents emphasized 'Expanding insurance coverage for post-treatment care' (29.8%) and 'Systematic education and rehabilitation programs after treatment' (25.6%). This study found that a lower educational level [adjusted odds ratio (aOR)=1.36; 95% confidence interval (CI)=1.04~1.77], earning under 300 per month [aOR=1.36; 95% CI=1.04~1.77], being married (60.2%) [aOR=1.79; 95% CI=1.34~2.37] and thought higher level of cancer treatment in Korea than the advanced (64.4%) [aOR=1.56; 95% CI=1.15~2.12] influenced the positive attitude toward a national health program. Sixty-eight percent of respondents answered 'Strongly agree' or 'agree' to permission for cancer survivors as the handicapped. People who have been married (72.4%) [aOR=1.89; 95% CI=1.41~2.53] and who have had a lower educational level [aOR=1.35; 95% CI=1.03~1.78] responded that they agree more to permission for cancer survivors as the handicapped. Conclusion: This study shows the positive public attitude of the public toward the national health program for the cancer survivors.

• Journal of Hospice and Palliative Care
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• v.12 no.1
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• pp.27-31
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• 2009

Purpose: Lymphedemas are tissue fluid swellings, usually on the arms or legs, and occur as a result of impaired lymphatic drainage. Presently, the most effective treatment available is complete decongestive physiotherapy (CDP). However, this therapy is ineffective in some patients and surgery may be indicated. Herein, we examined the efficacy of minimally invasive needle aspiration of the most enlarged areas in hypodermic adipose tissues, of patients who had failed CDP. Methods: We included 21 patients who were diagnosed with lymphedema stage II-III in the upper or lower extremities and visited the lymphedema clinic at a university hospital from September 1, 2003 to February 28, 2004. All patients had been treated with CDP at least once, but had failed to respond to the therapy for more than one year. Nine patients had breast cancer and 12 had cervical cancer. We identified the area with the most severe edema by using MRI and performed a 16-gauge angio-needle aspiration on the area. The patients were followed up for 3 months. Effectiveness of the treatment was evaluated by comparing the volume of edema before and after the treatment using Wilcoxon signed rank-test. Results: The mean reduction ratio of the volume of edema comparison normal volume was 41.1${\pm}$35.3% (P=0.001). There were no major or minor operative complications except localized hemorrhage. Conclusion: We conclude that a needle aspiration prior to other surgical treatments is relatively safe and effective for those patients who are unresponsive to CDP.

• Journal of Home Health Care Nursing
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• v.10 no.1
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• pp.58-72
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• 2003

The purpose of this study was to describe the perceived burden of the terminally III patients's caregiver and to analyze relationship between the perceived burden and the various demographics, illness characteristics, family relationships, and economic factor of the family & patients. The sample of 132 caregivers who care for the terminally III patients Kyung-Gi province, Seoul, Korea. The period of this study was from August to September, 2002. The perceived burden of the family caregiver was measured by the burden scale(20 items, 4 point scale) developed by Montgomery et al. (1985). The Data was analyzed using SAS-program by t-test and ANOVA. The results were as follows; 1. The mean of the family caregiver's burden score was 3.02. The score showed that caregivers perceive severe the level of burden. The hight items of the family caregiver's burden were' I feel it is painful to watch patient's diseases'(3.77). 'I feel afraid for what the future holds for my patients'(3.66), 'I feel it reduced to amount of privacy time'(3.64). 2. The caregiver's burden was significantly related to patient's gender(F=3.17, p= 0.0020), patient's job(F=2.49, p=0.0476), caregiver's age(F=4.29, p=0.0030), and caregiver's job(F=2.49, p=0.0476). 3. The caregiver's burden according to illness characteristics showed no significant difference. 4. The caregiver's burden was significantly associated with patient's family relationship (F=4.05, p=0.0041), patient's care mean period in a day(F=47.18,

• Journal of Hospice and Palliative Care
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• v.11 no.1
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• pp.42-50
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• 2008

Purpose: Undertreatment of canter pain, especially due to the differences in the perception of pain between the patients and caregivers, is a well recognized problem. The purpose of this study were to determine if there exist differences in communication about pain intensity scores between patients and their family caregivers in Korea. Methods: A total of 127 patient-family caregiver dyads who have experienced canter pain participated in this study at a hospital in Seoul for six months. The data were obtained by fare to face interview with a structured questionnaire based on Brief Pain Inventory-Korean version and other previous researches. The clinical information for all patients was compiled by reviewing their medical records. Results: Patients' 'worst-pain for 24-hour' and 'right-now-pain' scores estimated by family caregivers were significantly higher than those by patient themselves. The degree of agreement between patients and family caregivers in the estimate of patients' 'worst-pain for 24-hour' intensity categories was 78.7% for 'severe pain', 40% for 'no pain', 27.5% for 'mild pain' and 22.9% for 'moderate pain'. In case of 'right-now-pain' intensity categories, the agreement was 50% for 'severe pain', 47.2% for mild pain, 46.3% for 'no pain', and 26.3% for 'moderate pain'. Conclusion: This study demonstrates that the degree of agreement between patients and family caregivers in the estimate of patients 'pain intensity categories was less than 50% except for 'severe pain'. The results indicate that Korean family caregivers tend to overestimate the canter pain intensity of their caring patients, especially, when a lancer patient has 'moderate' or 'mild pain'. Health Providers are advised to educate patient-family caregiver dyads to use a pain measurement scale to promote their agreement in pain Intensity stores. Further analyses and studies are needed to identify the factors and differences that influence their communication about pain intensity scores between patients and their family caregivers.

• Journal of Hospice and Palliative Care
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• v.19 no.2
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• pp.163-169
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• 2016

Purpose: The unmet medical service needs of caregivers critically influence their caring for terminal cancer patients, but not much research has been done in this regard. Thus, the purpose of this study is to investigate the association between caregivers' characteristics and their unmet medical service needs. Methods: The survey was conducted with 109 family caregivers of terminal cancer patients admitted to four hospice units. The data were collected from March 2014 through December 2014 using a structured questionnaire. The unmet medical service needs were measured using 14 items which were adopted and modified by authors. Results: Seven areas of unmet medical service needs were shown to be significant. A well-educated group showed stronger needs for counsel about cancer screening and complementary-alternative medicine and health supplement food. A never-smoked group was identified with less need for sexual dysfunction counsel. Counsel about family and personal relations was more necessary for current drinkers and current workers, and less necessary for the married. Insurance counsel was more needed for a no-religion group. Occupation counsel was less necessary for healthy patients. Financial support was less necessary for the married group. Conclusion: Based on the results, it is highly recommended to further investigate the unmet medical service needs of family caregivers for terminal cancer patients and causes of the unmet needs.

• 한국호스피스완화의료학회:학술대회논문집
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• 2004.07a
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• pp.103-105
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• 2004

Every one experiences death one day, however no one can hows 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. Every one experiences death one day, however no one can knows exactly what it is because people ran 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 lancer 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.