• Journal of Society of Preventive Korean Medicine
• /
• v.10 no.1
• /
• pp.33-51
• /
• 2006

With the reduction of contagious diseases throughout the world and prolonged life expectancy has lead into increase of habitual related diseases. Industrial development and better economic situation made people more concerned about their health. As primary illnesses are subdued in the past years, health care system and the public value prevention and well-being more than the treatment itself. Based on this trend, this study focused on the view of life from the perspective of Oriental medicine as it's peculiarities, regimen methods, and the definition of healthy life are evaluated. Following results were obtained: - View of life in Oriental medicine focused on two basic principles of interrelationship between the organs internally, inter-dependency with the natural environment and social surrounding externally as recognition and respect between the medium were valued. - Sustaining and maintaining good health in Oriental medicine are closely related to prenatally healthy pregnancy and fetation, as well as prenatal training. Postnatal maintenance includes accommodation to seasonal changes, adequate food intake, mind control, various regimen methods and avoidance of wrong doings. - Defining health includes body's internal condition and external influences, principles of essence, qi, spirit, and yin and yang, harmony and balance, and individuality. - To conclude, good health in Oriental medicine is defined as 'external adaptation to society and natural environment, and internal balancing of individual difference with accumulation of essence, nurturing and circulating qi, and every material around the body in harmony and balance."

• Journal of Hospice and Palliative Care
• /
• v.14 no.2
• /
• pp.91-100
• /
• 2011

Purpose: This study was performed to investigate patients' preferences on receiving life-sustaining treatments (LST) and to analyze the relationship between patients' characteristics and LST selection. We also examined any discrepancy between LST patients' choices regarding medical intervention and actual medical intervention given/not given within 48 hours before death. Methods: This cross-sectional study was performed from March 1, 2008 to August 31, 2008 in the Palliative Care Unit of Korea University Hospital. Electric medical records (EMR) of 102 hospice cancer patients were reviewed, and 74 patients with Glasgow coma scale (GCS) ${\geq}$10 at the time of signing the advance medical directives (AMD) were selected for the first analysis. Then, patients alive at the end of this study, transferred to other hospitals or dead within 48 hours were excluded, and the remaining 42 patients were selected for the second analysis. Results: Preferred LST included antibiotics, total parenteral nutrition, tube feeding, transfusion, and laboratory and imaging studies. The relationship between patients' characteristics and LST could not be analyzed due to skewed preferences. LST chosen at the time of signing the AMD and actual medical intervention given/not given in the last 48 hours showed discrepancy in most cases. Conclusion: When making AMD in hospice cancer patients, it is important to consider the time and possibility of changing the choices. Above all, patients must fully understand the AMD. Thus, LST should always be provided with careful consideration of all possibilities, because legal and social aspects of AMD have not been established yet.

• Journal of Hospice and Palliative Care
• /
• v.22 no.4
• /
• pp.145-155
• /
• 2019

Purpose: Amendment to the Act on Decisions on Life-sustaining Treatment was recently enacted to designate long-term care hospitals as providers of hospice and palliative care. Despite its benefit of providing improved accessibility to end-of-life care, the amendment has raised concerns about its effect on quality of service. This study aimed to use information obtained from an expert group interview and previous studies to compare how cancer patients, family caregivers, physicians, and the general Korean population perceive the potential benefits and risks of this amendment. Methods: We conducted a multicenter cross-sectional study from July to October 2016. The included participants answered a structured questionnaire regarding the extent to which they agree or disagree with the questionnaire items indicating the potential benefits and risks of the amendment. Chi-square tests and univariate and multivariate logistic regression analyses were performed. Results: Compared with the general population, physicians agreed more that long-term care hospitals are currently not adequately equipped to provide quality hospice and palliative care. Family caregivers found improved access to long-term care hospitals more favorable but were more likely to agree that these hospitals might prioritize profits, thereby threatening the philosophy of hospice care, and that families might cease to fulfill filial responsibilities. Compared with the general population, cancer patients were more concerned about the potentially decreased service quality in this setting. Conclusion: Although potential service beneficiaries and providers expected improved accessibility of hospice and palliative care services, they were also concerned whether the system can provide adequate quality of end-of-life care.

• Journal of Hospice and Palliative Care
• /
• v.20 no.1
• /
• pp.8-17
• /
• 2017

Globally, efforts are being made to develop and strengthen a palliative care policy to support a comprehensive healthcare system. Korea has implemented a hospice and palliative care (HPC) policy as part of a cancer policy under the 10 year plan to conquer cancer and a comprehensive measure for national cancer management. A legal ground for the HPC policy was laid by the Cancer Control Act passed in 2003. Currently in the process is legislation of a law on the decision for life-sustaining treatment for HPC and terminally-ill patients. The relevant law has expanded the policy-affected disease group from terminal cancer to cancer, human immunodeficiency virus/acquired immune deficiency syndrome, chronic obstructive pulmonary disease and chronic liver disease/liver cirrhosis. Since 2015, the National Health Insurance (NHI) scheme reimburses for HPC with a combination of the daily fixed sum and the fee for service systems. By the provision type, the HPC is classified into hospitalization, consultation, and home-based treatment. Also in place is the system that designates, evaluates and supports facilities specializing in HPC, and such facilities are funded by the NHI fund and government subsidy. Also needed along with the legal system are consensus reached by people affected by the policy and more realistic fee levels for HPC. The public and private domains should also cooperate to set HPC standards, train professional caregivers, control quality and establish an evaluation system. A stable funding system should be prepared by utilizing the long-term care insurance fund and hospice care fund.

• Journal of Hospice and Palliative Care
• /
• v.16 no.3
• /
• pp.166-174
• /
• 2013

Purpose: This study aims to identify factors that influence middle-aged men's attitude towards death. Methods: The study enrolled 204 middle-aged (range=40~59 years) male residents of Daegu in Korea. Using a structured questionnaire, data were collected in October 4~30, 2010. For data analysis, we used descriptive statistics, t-test, one-way ANOVA, Scheff$\grave{e}$'s test, Pearson correlation coefficient, and stepwise multiple regression with SPSS WIN 14.0. Results: Participants' attitude towards death significantly differed according to educational level, religion, volunteer activities, and perceived health status. Moreover, their attitude towards death was negatively correlated with life stress and depression and positively correlated with self-esteem, life satisfaction, and coping behavior. The factors influencing the attitude towards death were life satisfaction, daily stress, religion, and depression, which explained approximately 25.7% of the total variance. Conclusion: Middle-aged men perform a crucial role in our society, and their attitude toward death affects how they cope with a situational crisis such as a terminal cancer or withdrawal of life sustaining treatment. Therefore, it is necessary to develop and implement a support program for middle-aged men, which offers them with various strategies to better manage their daily stress and improve their life satisfaction and coping skills.

• Korean Journal of Adult Nursing
• /
• v.18 no.4
• /
• pp.543-552
• /
• 2006

Purpose: The purpose of this descriptive study was to investigate the pattern of physical restraints used in ICUs and to identify influencing factors of application and removal of restraints. Method: The subjects of this study were 90 restrained patients out of 215 patients over 6 years old who were admitted to 6 ICUs in SMC during a 2 weeks period. The data was collected through a questionnaire of characteristics, guidelines and nursing care of restraint uses. The data were analyzed by non-parametric statistic with the use of the SAS program. Results: The restraints were applied to 31.4% of subjects. Mean time of physical restraint was $36.76{\pm}55.7$ hours. There were significant difference with mean time and frequency according to duty shift. GCS, restless behavior and discomfort factors, medical devices, and life sustaining devices had significant relation with application of restraints. In addition, the mean time of restraints used were related significantly with GCS, restless behavior, and discomfort factors. Conclusion: The used of restraints were dependent on mainly the nurses' decision. Thus ICU nurses have to develop the guidelines to applying restraints and removal of restraints in regard to patients rights and ethics. Continuous monitoring and evaluation of application of the restraints is essential in professional nursing.

• The Korean Society of Law and Medicine
• /
• v.11 no.2
• /
• pp.239-274
• /
• 2010

Advance directive refers to a description of the treatment method a patient wants to be provided with in case where the person is unconscious or lacks an ability to decision making in a future period or a declaration of intention that delegates and appoints another person who makes a decision regarding a treatment method on behalf of the person. Advance directive is usually a document form, but oral statement is acceptable as well. Advance directive may have a variety of forms though, it basically consists of two basic forms. That is, one is a living will, and the other is a surrogate decision making. Though the importance of advance directive has been emphasized, and the necessity of adopting the system has been strongly argued for so far, the debates on criteria, method, and procedure alike have not yet reached an agreement. It is because even the concept of advance directive is more or less ambiguous, and each specific method has its own theoretical limitations and practical constraints. Thus the inquiries on advance directive raised in the study are summarized as the meaning, practicability, and philosophical foundation of the advance directive. Firstly, the theoretical limitations of Advance directive may be categorized into conceptual and moral limitations. In case of conceptual limitations, authors of advance directives may not be well aware, in advance, of the particular situation in which he or her will experience in the future, and patients may experience the change in his or her values and lack the understanding and information about the future situation due to the changes in treatment methods. In case of moral limitations, a patient has a limited moral autonomy right and self identity that have an impact on his or her preference. Secondly, in case of practical constraints for advance directive, there exist cultural features, low ratio of documentation, as patients themselves admit, and low predictability and stability of patient's own preference regarding life-sustaining care. And the problem of validity and accuracy in proxy's decision making is also raised. Those who administer a living will, especially, may have a difficulty in understanding the directive by a patient, so that the accuracy of execution cannot be secured. In the sense, it is needed to implement a legal device in order to solve such problems. In summary, it is urgently required to understand the limitations and explore desired alternatives to overcome the relevant problems in advance, which must contribute to successfully adopting and effectively operating the advance directive system in Korea.

• Journal of The Korea Institute of Healthcare Architecture
• /
• v.20 no.4
• /
• pp.81-89
• /
• 2014

Purpose : An aging phenomenon was recognized as only negative aspect, which impediment a development with the decrease of a developing population and increase of social burden. Nevertheless, the problem of aging cannot be treated as a problem of individuals or social burden. Because Every mankind sometime will be the person directly involved the aging. Methods : Korea, predict to reach the aging society with over 20 percent of elderly in the whole population in 2020, should find an active political plan for responding. Because a previous discussion about the aging phenomenon focused on social welfare, the housing plan for the elderly with a consideration of the physical environment for sustaining elderly's life with happiness will be primary task. Results : This research considers housing policy, focusing on the medical service. It is because statistics, which 85 percent of elderly people suffer from chronic diseases because of physical aging signify the importance of medical service to the elderly in every-day-life. Implications : We prescribe the elderly as a population over 65. In this duration, the elderly retirees from the workplace e and spend the majority of time in their home. Thus, for the elderly, the residential space is a field of action and passageway connecting with the surroundings For the solution of physical space preparing the aging phenomenon, the combination of residential and medical function creates a new type of a lifestyle.

• Journal of Computing Science and Engineering
• /
• v.1 no.1
• /
• pp.1-30
• /
• 2007

In this paper we have provided an extensive survey of the databases and other resources related to the current research in bioinformatics and the issues that confront the database researcher in helping the biologists. Initially we give an overview of the concepts and principles that are fundamental in understanding the basis of the data that has been captured in these databases. We briefly trace the evolution of biological advances and point out the importance of capturing data about genes, the fundamental building blocks that encode the characteristics of life and proteins that are the essential ingredients for sustaining life. The study of genes and proteins is becoming extremely important and is being known as genomics and proteomics, respectively. Whereas there are numerous databases related to various subfields of biology, we have maintained a focus on genomic and proteomic databases which are the crucial stepping stones for other fields and are expected to play an important role in the future applications of biology and medicine. A detailed listing of these databases with information about their sizes, formats and current status is presented. Related databases like molecular pathways and interconnection network databases are mentioned, but their full coverage would be beyond the scope of a single paper. We comment on the peculiar nature of the data in biology that presents special problems in organizing and accessing these databases. We also discuss the capabilities needed for database development and information management in the bioinformatics arena with particular attention to ontology development. Two research case studies based on our own research are summarized dealing with the development of a new genome database called Mitomap and the creation of a framework for discovery of relationships among genes from the biomedical literature. The paper concludes with an overview of the applications that will be driven from these databases in medicine and healthcare. A glossary of important terms is provided at the end of the paper.

• Journal of the Health Care and Life Science
• /
• v.9 no.1
• /
• pp.1-9
• /
• 2021

In this study, a model in which certification standards were added to the health information management practice program was studied and presented in order to understand the EMR certification standards implemented by the Korea Health and Medical Information Service. In the practice program, the certification standard function for patient information management was added to the health information management education system to practice and understand patient information management that corresponds to the functional standard of the EMR certification system. The EMR certification standard practice program for patient information management is composed of the following certification standards. registration number and personal information management, treatment reservation schedule management, personal information revision history management, identification of people with the same name, integrated management of multiple registration numbers, patient search by identification information, patient search by health care type, surgical procedure consent record and inquiry, record/inquiry of consent form for personal information use, display of life-sustaining medical decision information, registration/inquiry of external medical institution documents, registration and inquiry of external examination results. In this way, by operating and practicing the functions of the health information system according to the certification standards, it is possible to understand and practice the certification standards and details of patient information management in the functional area of the certification standards. In addition, since the function of the EMR certification standard can be checked, it will be possible to improve the management ability of the electronic medical record system of the health information manager in the medical institution.