• Health Policy and Management
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• v.27 no.2
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• pp.167-176
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• 2017

Background: This study aimed to analyze the impact of community health care resources on the place of death of older adults with dementia compared to those with cancer in South Korea, using public administrative big data. Methods: Based on a literature review, we selected person- and community-level variables that can affect older people's decisions about where to die. Data on place-of-death and person-level attributes were obtained from the 2013 death certification micro data from Statistics Korea. Data on the population and economic and health care resources in the community where the older deceased resided were obtained from various open public administrative big data including databases on the local tax and resident population statistics, health care resources and infrastructure statistics, and long-term care (LTC) insurance statistics. Community-level data were linked to the death certificate micro data through the town (si-gun-gu) code of the residence of the deceased. Multi-level logistic regression models were used to simultaneously estimate the impacts of community as well as individual-level factors on the place of death. Results: In both the dementia (76.1%) and cancer (87.1%) decedent groups, most older people died in the hospital. Among the older deceased with dementia, hospital death was less likely to occur when the older person resided in a community with a higher supply of LTC facility beds, but hospital death was more likely to occur in communities with a higher supply of LTC hospital beds. Similarly, among the cancer group, the likelihood of a hospital death was significantly lower in communities with a higher supply of LTC facility beds, but was higher in communities with a higher supply of acute care hospital beds. As for individual-level factors, being female and having no spouse were associated with the likelihood of hospital death among older people with dementia. Conclusion: More than three in four older people with dementia die in the hospital, while home is reported to be the place of death preferred by Koreans. To decrease this gap, an increase in the supply of end-of-life (EOL) care at home and in community-based service settings is necessary. EOL care should also be incorporated as an essential part of LTC. Changes in the perception of EOL care by older people and their families are also critical in their decisions about the place of death, and should be supported by public education and other related non-medical, social approaches.

• Journal of Trauma and Injury
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• v.23 no.2
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• pp.75-82
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• 2010

Purpose: In Korea, trauma is the $3^{rd}$ most common cause of death. The trauma treatment system is divided into pre-hospital and hospital stages. Deaths occurring in the pre-hospital stage are 50% of the total death, and 20% of those are deaths that are preventable. Therefore, the purpose of our study is to calculate the preventable death rates caused by trauma in our current pre-hospital system, to analyze the appropriateness of the treatment of traumatized patients and to draw a conclusions about the problems we have. Methods: The study was done on traumatized patients who expired at the emergency department from January 1, 2005, to December 31, 2009, at the Korea University Medical Centers in Anam, Guro and Ansan. The data on the patients were reviewed retrospectively based on characteristics, conditions on admission and trauma severity. The patient's RTS (revised trauma score) and ISS (injury severity score) was calculated. Preventable death rate was calculated by TRISS (the trauma score-injury severity score). Results: A total of 168 patients were enrolled. All patients were intubated and underwent CPR. Of the total, 72% patients were male, and traffic accidents were the most common form of trauma (52.4%), falls being second (28.6%). Head injury, solitary or multiple, was the most common cause of death (55.4%). Thirty-eight (38, 22.6%) deaths were preventable. The 22.6% preventable death rate consisted of 15.5% potentially preventable and 7.1% definitely preventable deaths. Based on a logistic regression analysis, the relationship between the time intervals until transfusion and imaging and death was statistically significant in the hospital stage. In the pre-hospital stage, transit time from the site of the injury to the hospital showed a significant relationship with the mortality rate. Conclusion: One hundred sixty-eight (168) patients died of trauma at the 3 hospitals of Korea University Medical Center. The TRISS method was used to calculate the preventable death rate, with a result of 22.6%. The only factor that was significant related to the preventable death rate in the pre-hospital stage was the time from injury to hospital arrival, and the time intervals until transfusion and imaging were the two factors that showed significance in the hospital stage. Shortening the time of treatment in the field and transferring the patient to the hospital as quickly as possible is the most important life-saving step in the pre-hospital stage. In the hospital stage, the primary survey, resuscitation and diagnosis should proceed simultaneously.

• The Journal of Internal Korean Medicine
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• v.40 no.3
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• pp.425-442
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• 2019

Objectives: This study aimed to reveal the pharmacological properties of the newly prescribed herbal mixture, Chenmadansamgamibokhap-tang(CDBT), against hypoxia-induced neuronal cell injury (especially mouse hippocampal neuronal cell line, HT-22 cells) and their corresponding mechanisms. Methods: A cell-based in vitro experiment, in which a hypoxia condition induced neuronal cell death, was performed. Various concentrations of the CDBT were pre-treated to the HT-22 cells for 4 h before 18 h in the hypoxia chamber. The glial cell BV-2 cells were stimulated with $IFN{\gamma}$ and LSP to produce inflammatory cytokines and reactive oxygen species. When the neuronal HT-22 cells were treated with this culture solution, the drug efficacy against neuronal cell death was examined. Results: CDBT showed cytotoxicity in the normal condition of HT-22 cells at a dose of $125{\mu}g/mL$ and showed a protective effect against hypoxia-induced neuronal cell death at a dose of $31.3{\mu}g/mL$. CDBT prevented hypoxia-induced neuronal cell death in a dose-dependent manner in the HT-22 cells by regulating $HIF1{\alpha}$ and cell death signaling. CDBT prevented neuronal cell death signals and DNA fragmentation due to the hypoxia condition. CDBT significantly reduced cellular oxidation, cell death signals, and caspase-3 activities due to microglial cell activations. Moreover, CDBT significantly ameliorated LPS-induced BV-2 cell activation and evoked cellular oxidation through the recovery of redox homeostasis. Conclusions: CDBT cam be considered as a vital therapeutic agent against neuronal cell deaths. Further studies are required to reveal the other functions of CDBT in vivo or in the clinical field.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.7
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• pp.4399-4402
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• 2013

Objectives: To analyze underlying disease, fatality rate and the major causes of death of in-patients with malignant tumors in Sichuan Cancer Hospital. Methods: Clinical data of in-patients from 2002 to 2012 were retrospectively analyzed. Results: The top 10 tumors (82.0%of the total) of the malignant tumors of the in-patients were lung, cervical, esophagus, breast, colorectal, nasopharynx, liver and gastric cancers, lymphomas and ovarian cancers. The overall fatality rate was 2.7% during these eleven years, 3.4% and 2.0% for male and females, respectively with statistical significance for the difference (${\chi}^2$=164.737, P<0.001). The top 10 death causes were lung cancer, liver cancer, colorectal cancer, esophagus cancer, gastric cancer, lymphoma, breast cancer, pancreatic cancer, ovarian cancer and nasopharynx cancer. In-patients with pancreatic cancer had the highest fatality rate (9.6%). There were different ranks of death causes in different sex groups and age groups. Conclusion: Prevention and control work of cancer should be enhanced not only for cancers with high incidence such as lung cancer, esophageal cancer but also for the cancers which have low incidence but high fatality rate, such as pancreatic cancer and gallbladder cancer, which would help to improve the survival rate and quality of life of cancer patients in the future.

• The Korean Journal of Health Service Management
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• v.6 no.1
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• pp.129-140
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• 2012

The purpose of this study was to identify attitude of hospital nurse's on death with dignity. The subjects of the study were 516 nurses. The data was analyzed by SPSS PC 19.0 program. 1) 82.8% participants agree to death with dignity, and they and their family will ask death with dignity in actual situations. 2) The average score of overall attitude on death with dignity was $3.13{\pm}0.52$. 3) With respect to the general characteristics of participants there were statistically significant difference in total score according to age, Marital Status, education level, religion, career, position, and existence of patients with incurable disease around. 4) With respect to the death with dignity related characteristics of participants there were statistically significant difference in total score according to agreement to death with dignity, request to my death with dignity, in case my family member requests death with dignity. Although many nurses had a positive concept of death with dignity, they still have ethical dilemmas in life-sustaining care. Therefore training programs on moral rights are necessary to provide guidelines foe end-of-life care.

• Journal of Korean Clinical Nursing Research
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• v.29 no.1
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• pp.75-84
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• 2023

Purpose: This study developed a protocol for nursing care after death for adult patients in hospitals. Methods: This was a methodological study to develop a care after death protocol. The preliminary protocol was developed based on a literature review, guidelines, and practice recommendations from groups of experts and clinical nurses. Content validity was evaluated by a group of experts (n=6) and nurses (n=30) in two hospitals. Results: The preliminary protocol recommendations were modified by validation and the open-question analysis results. The final protocol comprised three general recommendations and 43 recommendations in five steps that are verification and notification of a death, personal care of the body, viewing the patient, patient transfer, and documentation and self-care. Conclusion: This study result provides nurses with a consensus information on patient care after death and family support in a hospital setting. This nursing protocol is expected to improve the quality of care after death for adult patients and their families, and can be used for developing educational and emotional support for nurses to accomplish their important role.

• Korea Journal of Hospital Management
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• v.26 no.1
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• pp.17-25
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• 2021

This study aimed to analysis factors related to in-hospital death of injured patients by patient safety accident. A total of 1,529 inpatients were selected from Korea Centers for Disease Control and Prevention database(2013-2017). Frequency, Fisher's exact test, t-test, ANOVA, logistic regression analyses by using STATA 12.0 were performed. Analysis results show that the mortality rate was lower for female than male but the mortality rate was higher for the older age, the higher the CCI, head (or neck), multiple, systemic damage sites, internal and others, metropolitan cities based on Seoul and 300-499 based on the bed size of 100-299. Based on these findings, the possibility of using the in-depth investigation of discharge damage from the Korea Centers for Disease Control and Prevention as a data source for the patient safety survey conducted to understand the actual status of patient safety accident types, frequency, and trends should be reviewed. Also, it is necessary to prevent injury and minimize death by identifying factors that affect death after injury by patient safety accident.

• Journal of The Korean Society of Emergency Medicine
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• v.29 no.5
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• pp.529-550
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• 2018

Objective: This study investigated the most common errors on death certificates written by resident trainees of the emergency department and evaluated the effects of education on how to write a death certificate. Methods: A casebook of 31 deaths was prepared based on actual death cases in the emergency room in 2016. Ten residents completed 31 death certificates for the death casebook without any prior notice and then received education on 'How to write the death certificate.' They completed the death certificates again for the same casebook after receiving the education and the number of errors on all death certificates was again determined and divided into major and minor errors. The average number of error types was compared before and after the education. Results: Major errors occurred in 55% of all death certificates, but decreased to 32% after education. Minor errors decreased from 81% before education to 54% after education. The most common major error was 'unacceptable cause of death' (mean${\pm}$standard deviation [SD], $10.2{\pm}8.2$), and the most common minor error was 'absence of time interval' (mean${\pm}$SD, $24.0{\pm}7.7$), followed by 'absence of other significant conditions' (mean${\pm}$SD, $14.6{\pm}6.1$) before education. Conclusion: Education on 'how to write a death certificate' can help reduce errors on death certificates and improve the quality of death certificates.

• Journal of the Korean Society of Radiology
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• v.82 no.5
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• pp.1163-1185
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• 2021

Sudden cardiac death is an unexpected death originating from the heart that occurs within an hour of the onset of symptoms. The main cause of sudden cardiac death is arrhythmia; however, diagnosing underlying structural heart disease significantly contributes to predicting the long-term risk. Cardiovascular CT and MR provide important information for diagnosing and evaluating structural heart disease, enabling the prediction and preparation of the risk of sudden cardiac death. Therefore, we would like to focus on the various structural heart diseases that increase the risk of clinically-important sudden cardiac death and the importance of imaging findings.

• Korean Journal of Occupational Health Nursing
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• v.32 no.2
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• pp.68-78
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• 2023

Purpose: This study aimed to determine the moderating effect of self-esteem on the perception of death and the meaning of life among hospital nurses. Methods: The participants were 167 nurses working in two tertiary general hospitals located in city B. Data were collected from September 8 to 21, 2022. SPSS/WIN 29.0 was used for analysis along with t-test, ANOVA, Pearson correlation coefficients, and hierarchical multiple regression. Results: The study showed that the meaning of life was significantly correlated with the perception of death (r=.34, p<.001) and self-esteem (r=.31, p<.001). Self-esteem significantly moderated the relationship between the perception of death and the meaning of life (F=16.00, p<.001). Conclusion: Self-esteem may moderate the relationship between the two factors. This means that nurses with higher self-esteem have a greater tendency for their perception of death to positively impact their meaning of life. Therefore, for hospital nurses to discover the meaning of life, it is necessary to develop and apply a self-esteem enhancement program specialized for each clinical career.