• Journal of Korean Academy of Nursing
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• v.5 no.1
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• pp.93-111
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• 1975

As the hospitalized patients will be facing new stress situation due to change of his environment from home to hospital it will be very important to understand the psychological stress experienced by hospital patients not only for helping patients in the process of recovery from illness but also fulfil1ing the objective of comprehensive nursing care by understanding the needs of the patients. There is no doubt that it would be very helpful for treatment of patients as well as for improvement of nursing care if we know more about psychological needs of patients and give them adequate support to meet these needs. The study to find out the causes and degree of stress events experienced by hospitalized patients, with the objective of instituting improvement of nursing care program based on the needs of patients, was conducted during the month of September 1974 with 60 patients randomly selected from those admitted to medical and surgical wards at Yonsei Medical Center in that period The questionnaire form included 36 questions which are considered to be stress events for hospital patients, and was devide into five areas namely, such events related to 1) disease itself, 2) hospital environment, 3) nursing care and treatment, 4) communication and human relations, and 5) family and economic problems. The results of the study were as follows: 1. It was confirmed that hospitalization considered to be a stress producing factor and most patients perceived the admission to hospital as a stress factor. 2. According to the rating scale, it was found that degree of perceived stress shows a variation according to the source of stress producing event. 3. No significant differences in the mean values were observed statistically with the perceived stress levels according to demographic and other variables of patients related to hospitalization. 4. Among the questions related to disease itself, "Admission for surgery" was perceived most frequently as a stress event (97.14%) by patients. 5. With regard to the questions related to hospital environment, "death of the patient room-mate" was the most serious stress event perceived by patients (90%) and "living with hospital regulations"was considered to be less serious stress event (23.33%). 6. As for the questions related to nursing care and treatment, "limitation of freedom" was perceived as a stress factor most frequently (70.91%) by the patients and "worry for wrong treatment" turned out to be less frequent stress event (50.0%). 7. As for the questions related to communication and human relations, "difficulty to meet doctors when wanted"appeared to be the most frequent stress event by the respondents (75.86%) , followed by "no explanation about treatment or examination"(75.0%) and "no explanation about nursing care procedures"(71.66%). 8. With regard 111 tile questions related to family and economic problems, "inadequate finances for family living due to hospitalization"and "high cost of hospitalization" were the most frequent cause of stress mentioned by the patients. (80.0%). 9. As a result of application of the stepwise regression analysis, it was found that about 89% was explained by those events associated with disease itself, hospital environment and family and economic problems. By adding those events related to "nursing care and treatment" and "communication and human relation", 100% of stress associated with hospitalization was explained.

• Korean Journal of Acupuncture
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• v.21 no.1
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• pp.41-50
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• 2004

Objectives : This study was designed to investigate the differences of effects in smoking cessation after acupuncture treatment and we hypothesized that the discrepancies might be caused by individual genetic differences. Methods : Acupuncture treatment was given to the subjects three times a week for the 231 healthy male Korean smokers without personal or familial history of psychiatric or neurological illness. We evaluated for differentiate responder and non-responder who showed more than 50% decrease in the cigarette consumption or the desire for smoking were regarded as responder, and less than 25% decrease in the cigarette consumption or the desire for smoking were regarded as non-responder, respectively. Allele and genotype frequencies of the Taq1 A polymorphism of dopamine D2 receptor (DRD2) gene were compared in 231male smokers. Chai-square analyses were performed to test for an interactive effect between the DRD2 Taq1 A allele. Results : The allele frequencies and genotype distributions of DRD2 gene among the smokers (n = 231) showed significant the differences in their genotype distributions. The responder and non-responder showed the difference in genotype distribution with a prevalence of A1 allele. A slightly positive association of DRD2 Taq1 A1 genotypes with smoking was observed. Conclusions : This experiment results indicate that the present of DRD2 allele genotype showing significant difference in the genotype distributions between responders and non-responders could be explained by the difference in the genetic effect of DRD2 A1 allele.

• Journal of Hospice and Palliative Care
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• v.20 no.2
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• pp.81-92
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• 2017

Chronic obstructive pulmonary disease (COPD) is characterized by persistent airflow limitation that is usually progressive. It is a major cause of morbidity and mortality worldwide, leading to substantial and increasing economic and social burden. Palliative care for COPD patients aims to reduce symptoms and exacerbations and improve exercise tolerance and quality of life. It is difficult to make a prognosis for COPD patients due to the variable illness trajectory and advanced care of patients. However, severity of breathlessness, assessment of lung function impairment, and frequency of exacerbations can help to identify palliative care needs and determine effective methods to mitigate symptoms, which is discussed in this paper. In these patients, it is recommended to provide individualized palliative care along with curative/restorative care at the onset of COPD symptoms. Before launching a palliative care system in Korea, it is necessary to prepare pulmonary rehabilitation resources, patient-centered communication, timely palliative responsiveness, and a program for effective advanced care planning. A multidisciplinary approach involving collaboration with not only the respiratory and palliative care teams but also primary care offers a new model of care for these patients and should be considered with a priority.

• The Korean Society of Law and Medicine
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• v.16 no.1
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• pp.221-254
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• 2015

The amendment of the Korea Civil Code will take place July 1, 2013. One of the most import issues related to adult guardianship system is a part. Though more than 100 new provisions, the revised Civil Code fundamentally reformed the guardianship system to establish a system to meet the diverse and complex needs of those who need a guardian and ensure due process. The new adult guardianship system intended to respect dignity and human right of mentally incapacitated adults, to guaranee their autunomy and to minimize the public interventions for assisting them. The new guardianship system for vulnerable adult has three kinds of legal guardianship system (adult guardianship, limited guardianship and specific guardianship). Mental patients forced the hospitalization of the mental health code and will be treated as an agreement incapable person. In principle an agreement incapable person has capacity of consent. The consent of the mental patients are admitted first. It is advisable to medical care only by the consent of the guardian when the the mental patient do not agree ability. If the mental patient do not agree with the mentally ill, but there should be a supervisory capacity for a guardianship of the couple guardian supervision. In conclusion, it not lost the capacity to consent to inpatient mental illness called. Therefore, we must discuss in detail the scope of the agreement for the mental patients. Mental Health Act amendments are necessary in accordance with the amended Civil Code.

• Korean Journal of Adult Nursing
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• v.13 no.2
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• pp.209-222
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• 2001

The environment in the ICU leads to negative changes in a patient's usual sleep pattern and so contributes negatively to the patient's health condition as compared to patients in general wards. Therefore, it is thought that an important nursing intervention would be to identify the relation between noise and sleep patterns which play an important role in illness recovery. The purpose of the present study was to explore the relationship between noise in the ICU and the sleep pattern of patients admitted to the ICU. A descriptive correlation design was used to examine the relationship. Thirty-four subjects were recruited from a Medical ICU (MICU), Surgical ICU (SICU) and Coronary Care Unit (CCU) at a large university hospital in Suwon. Data were collected from September 28 to October 31 in 1999. In the present study, noise was categorized into noise level and patients' perception of noise. The objective noise level was measured using the A-Weighted Sound Level Meter. The patients' preception of noise was measured using a self-reported questionnaire developed by the researcher. Sleep patterns in this study includes both quantity and quality of sleep. These were measured using open ended questionnaires and the 'Korean Sleep Scale A' developed by Oh, Song, Kim(1998). The data was analyzed using the SPSS-WIN to test the research question, Pearson product moment correlation coefficient was run. Ancillary analysis were conducted with demographic variables to determine their relation to the main study variables. For the ancillary analysis, t-test and one-way ANOVAs were performed. The results of the present study are summerized as follows : 1. The total mean of objective noise level (10pm-6am) was 56.2dB. The means for night time noise level in individual ICUs for the SICU, MICU and CCU, were 58.7dB, 58.6dB and 48.3dB, respectively. The total mean for patients' noise perception was 42.8 out of a maximum possible score of 76. For item means of noise perception, the one ranked highest was "conversations between doctors and nurses" (3.2). The one ranked lowest was "noise from the radio" (1.2). Regarding the degree of perception for each type of noise source, the one ranked highest was "equipment noise" (2.6), the second was "conversation between medical staff" (2.4), the third was "conversation between patients, caregivers and visitors" (2.3), and the one ranked lowest was "environment noise" (1.8). 2. Looking at quantity of sleep of ICU patients, the mean nocturnal sleep time was found to be 4.9 hours. The total mean of sleep quality for ICU patients was 21.0 out of a maximum possible score of 40. 3. The relationship between perception of noise and quantity of sleep was statistically significant(r= - .41, p<.05). The relationship between perception of noise and quality of sleep was also statistically significant(r= - .47, p<.01). The results of the study indicate that personal perception of noise is related to sleep patterns. Therefore, it is suggested that nursing interventions be developed to reduce the degree of personal perception of noise and, thus, decrease sleep pattern disturbances in patients in the ICU.

• Journal of Korean Medical classics
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• v.23 no.1
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• pp.101-114
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• 2010

In the perspective of the correspondence of heaven and man[天人相應], people live through Gi of heaven and earth[天地之氣], and the human body which is a small universe[小宇宙] itself receives influence while sympathizing with the Gi and heaven[天氣]. So with unexpected incident of the Eum and Yang, four season[陰陽四時], ups and downs of warmth of cold and chilliness of warm[寒熱溫涼] differs, and the position of Gi of human[人氣] changes, regimen and application of acupuncture, and images[象] of the pulse changes. In "Maekyojeongmiron(脈要精微論)", ups and downs of Eum and Yang changes by four season[四時], and correspondence of ups and downs of pulse law is explained with compass, carpenter's square, the beam of balance and the weight of balance[規矩權衡]. Compass[規] is a measure of instrument that can draw a circle, like regulating the measure and differing the center of the circle and diameter and drawing a circle, compass is a image of Gi of Yang[陽氣] that was staying deep inside the body in winter stretching out by big fault[太過不及] of year and energy[元氣] of human in spring. Carpenter's square[矩] is a instrument that draws direction, which is a image of Gi of Yang flourishing in summer and when it gets highly flourished, again the Gi of Eum[陰氣] comes alive and falls. The beam of balance[衡] is a scale, like a scale that tilts at once when one side is slightly heavy, the beam of balance is a image Gi of yang that is fully flourished in summer and about to descent again, which is just about to fall but not going down yet. The weight of balance [權] is a image of gi of yang which as descent to the bottom and staying in the deepest place. compass, carpenter's square, the beam of balance and the weight of balance is not a direct pulse image[脈象], but standard image of pulse of pulse corresponding to the Gi of human[人氣] that changes by four season, and the explanation includes the pulse image of four season like the taut, full, floating, deeply gather[弦鉤浮營] of "Okgijinjangron(玉機眞藏論)" or taut, full, skip, float, deep [弦鉤代毛石] of "Pyeong-ingisangron(平人氣象論)". So with compass, carpenter's square, the beam of balance and the weight of balance, can judge is human correspond in Eum and Yang, four seasons, this is importantly used in examination of pulse[診脈] with existence and nonexistence, and prognosis of illness.

• Journal of Physiology & Pathology in Korean Medicine
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• v.23 no.3
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• pp.554-561
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• 2009

Soyangin-Hyeongbangpaedok-san(SHBPDS) is a herbal formula used for the common cold or upper respiratory illness. In order to investigate the effect of SHBPDS, mice were orally administered with SHBPDS alcohol extract for 7 days followed by intravenous anti-CD3 injection. In addition, splenocytes and CD4 T cells were cultured with SHBPDS in response to anti-CD3 in vitro and cytokines and transcription factors were evaluated. In vivo treatment with SHBPDS significantly augmented the expressions of the percentage of CD4 T cells and CD 69, an indicator of early T cell activation. Serum levels of IL-4 were significantly increased but those of IFN-${\gamma}$ and IL-2 did not reach statistical significance. The expressions of IFN-${\gamma}$ and T-bet mRNA were significantly downregulated in SHBPDS treated mice while those of IL-4 and C-Maf were significantly upregulated. In vitro stimulation of splenocytes and CD4 T cells by SHBPDS resulted in a reduction in IFN-${\gamma}$ secretion and STAT4 activity. The IL-4 releases from both cells were slightly reduced, but STAT6 activity was rather increased. In conclusion, SHBPDS exerted an inhibition in the expression of IFN-${\gamma}$, T-bet and STAT4 while IL-4, C-Maf and STAT6 were increased. Further studies are required to examine its pharmacological effects using more appropriate animal experiments.

• Journal of Trauma and Injury
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• v.23 no.2
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• pp.89-95
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• 2010

Purpose: Whole-body CT is a very attractive diagnostic tool to clinicians, especially, in trauma. It is generally accepted that trauma patients who are not alert require whole-body CT. However, in alert trauma patients, the usefulness is questionable. Methods: This study was a retrospective review of the medical records of 146 patients with blunt multiple trauma who underwent whole body CT scanning for a trauma workup from March 1, 2008 to February 28, 2009. We classified the patients into two groups by patients' mental status (alert group: 110 patients, not-alert group: 36 patients). In the alert group, we compared the patients' evidence of injury (present illness, physical examination, neurological examination) with the CT findings. Results: One hundred forty six(146) patients underwent whole-body CT. The mean age was $44.6{\pm}18.9$ years. One hundred four (104, 71.2%) were men, and the injury severity score was $14.0{\pm}10.38$. In the not-alert group, the ratios of abnormal CT findings were relatively high: head 23/36(63.9%), neck 3/6(50.0%), chest 16/36(44.4%) and abdomen 9/36(25%). In the alert group, patients with no evidence of injury were rare (head 1, chest 6 and abdomen 2). Nine(9) patients did not need any intervention or surgery. Conclusion: Whole-body CT has various disadvantages, such as radiation, contrast induced nephropathy and high medical costs. In multiple trauma patients, if they are alert and have no evidence of injury, they rarely have abnormal CT findings, and mostly do not need invasive treatment. Therefore, we should be cautious in performing whole-body CT in alert multiple trauma patients.

• Journal of Physiology & Pathology in Korean Medicine
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• v.24 no.3
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• pp.525-532
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• 2010

Dypepsia is the most common gastrointestinal disease and mainly occurs by stress or food. According to the cause of dyspepsia, the clinical characteristics and the curative process are different in patients. The purpose of this study is to compare acute dyspepsia patients depending on food factor and stress factor. For this study, we analyzed the cause, and the symptoms of 59 acute dyspepsia patients and divided them into two groups: one group is 27 acute dyspepsia patient group caused by stress factor (stress factor group). The other group is 32 acute dyspepsia patient group caused by food factor (food factor group). In addition, we carried out HRV test and compared HRV index between two groups. There was no significant difference in past illness involved in gastrointestinal tract diseases between two groups. There were big differences in the frequency of chest discomfort, thurst, lack of appetite, and exhaustion after meals between two groups. There were many changes of tongue fur in food factor group. But there were many changes of tongue body in stress factor group. The pulse pattern is mostly wiry in stress factor group. But, The pulse pattern is mostly slippery in food factor group. HF, TP were significantly lower than food factor group in stress factor group, it means autonomic nerve system was more suppressd in stress factor group than food factor group. Food factor group improved sooner than stress factor group. This study presented the clinically different characteristics (past medical history, symptoms, tongue diagnosis, pulse pattern, curative process) of acute dyspepsia depending on food factor and stress factor. Thus, it provides the necessity of oriental medical diagnosis and treatment called pattern identification for acute dyspepsia.

• Journal of Hospice and Palliative Care
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• v.14 no.2
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• pp.61-70
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• 2011

Recent advances in techniques and strategies use to detect cancer in its early stages and to treat it effectively has the survival rate of cancer patients and the number of long-term cancer survivors continually increasing. Unfortunately, many cancer survivors are at risk for various late and long-term effects of cancer treatments including the radiotherapy. Long-term cancer survivors can be also seen for a hospice and palliative care because of cancer recurrence and they are at risk of delayed reactions to radiotherapy. So, the understanding and knowledge of radiation reactions is required for the proper medical diagnosis, management, and coordination of the potential reactions that may occur in these care setting. In effort to increase the survival rate in cancer patients and to decrease the adverse effects of cancer treatment, many clinical studies have been and continue to be conducted. The efforts of these studies have thus resulted in the advancement of cancer treatments. Regrettably, the overall interest in how to manage adverse effects of cancer treatment such as radiotherapy appears seemingly low in clinical practice and its advanced studies as a whole are delayed and deficient. It is imperative that the medical community show an enthusiastic interest in the aftercare of cancer patients and cancer survivors in order to create a complementary integrative approach that will eliminate radiotherapy related pain/discomfort or illness in hospice and palliative care settings.