• Journal of Hospice and Palliative Care
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• v.21 no.3
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• pp.92-103
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• 2018

Purpose: This descriptive study was conducted to examine factors that affect hospital workers in their decision to withdraw from life-sustaining treatment, such as knowledge, attitude, and perception of organ donation, transplantation, death and hospice palliative care. Methods: A questionnaire was completed by 228 workers of a tertiary general hospital, and data were analyzed using t-test, ANOVA, and Pearson's correlation by using SPSS 21.0. Results: The subjects' knowledge of biomedical ethics awareness differed by age, education level, occupation, affiliated department, and biomedical ethics education. Their knowledge of brain death, organ donation and transplantation was positively correlated with attitudes toward tissue donation and transplantation, knowledge of hospice palliative care, and perception of hospice palliative care. Their attitudes toward tissue donation and transplantation were significantly correlated with knowledge of hospice palliative care, perception of hospice palliative care, and withdrawal of life-sustaining treatment. Their awareness of death was significantly correlated with knowledge of hospice palliative care, perception of hospice palliative care and withdrawal of life-sustaining treatment. The perception of hospice palliative care was significantly correlated with withdrawal of life-sustaining treatment. Factors associated with their withdrawal of life-sustaining treatment were work at the hospice ward (32.5%), attitudes toward tissue donation and transplantation and perception of hospice palliative care. Conclusion: This study has shown that work at the hospice ward, attitudes toward tissue donation and transplantation and perception of hospice palliative care were related to attitudes toward withdrawal of life-sustaining treatment. More research is needed to further develop various curriculums based on biomedical methods.

• Journal of Hospice and Palliative Care
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• v.9 no.2
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• pp.67-76
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• 2006

Purpose: The purpose of this study was to develop education program for physicians who work at hospice palliative care settings in Korea, to practice abridged education program extracted from the full contents of the proposed education, and to improve the quality of hospice palliative care service. Methods: To develop the education program, questionnaire for hospice education need assessment (total 79 items) was distributed to 125 organizations practicing hospice service via mail and the data was collected from 1 Sep. to 10 Oct. 2004. Another questionnaire for hospice education importance assessment was asked to the palliative specialists from Sep. 23 to 17 Oct. 2004. Based on the analysis of the questionnaires, and reviewing various references and actual hospice palliative education programs of other countries, the education programs were developed. Results: Ore-day-Hospice education 2004 was conducted based on the suggested education program, and it was practiced four times on a national basis (2 times in Seoul, and once in Busan and Gwangju, respectively). 47 physicians attended the education program. The education program lasted about 7 hours, comprising 5 hours of common lectures for all attendants regardless of their professions and 2 hours of specific seminar for physicians only. Attendants positively responded to the contents of the education program. But they pointed out that the program should be offered on weekday and it should be more in-depth and more discussion based lesson. Conclusion: The suggested education program was not fully conducted yet. After practicing the abridged education program, more in-depth and discussion oriented rather than lecture-based education were suggested. It may be argued that the proposed education, which requires much longer period education, should also reflect the evaluation of the 1-day education program to successfully implement the proposed education program.

• Journal of Hospice and Palliative Care
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• v.8 no.1
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• pp.8-17
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• 2005

Purpose: This study was performed to investigate burden, job satisfaction and quality of life of nurses who take care of cancer patients. Methods: The subjects were 237 nurses working at the oncology unit of hospitals with over 500 beds in Seoul and Gyeonggi-do. Data were collected using questionnaire from the February to March, 2005. Data were analyzed through t-test, ANOVA, Pearson's correlation coefficient and stepwise multiple regression using SAS. Results: 1. The item that showed the highest level of burden was 'I feel limited even if I make efforts to reduce patients' pain. 'Burden was high in those group both who were younger than 35 years old and who had clinical experiences caring cancer patients for $3{\sim}4$ years. 2. The item that showed the lowest level of job satisfaction was 'the possibility of promotion'. Job satisfaction was high in those group both who had a spouse and were head nurses or incharge nurses. 3. The item that showed the lowest level of quality of life was 'I am physically exhausted'. Over 35 years old who had a spouse, and over 2,000,000 won monthly income made a high score in the quality of life. 4. There were negative correlations among burden, iob satisfaction and the quality of life. 5. The major factor affecting the quality of life was burden. Conclusion: The results of this study are expected to be utilized as basic data for developing support system to improve nurses' work conditions and quality of life.

• Tuberculosis and Respiratory Diseases
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• v.61 no.2
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• pp.121-128
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• 2006

Background: The "health-related quality of life" (HRQL) for patients with chronic respiratory disease has been emphasized, because chronic respiratory disease (CRD) is chronic and progressive, and it finally causes disability. HRQL instruments may be useful for monitoring patients' progress or for determining the most appropriate choice of treatment. We describe the adapting St George's Respiratory Questionnaire (SGRQ), which is a self-administered questionnaire developed by Jones et al. (1991), into the Korean version for covering three domains of health for the patients suffering with airways disease. Method: We obtained the original SGRQ from the author after gaining permission. For adaptation, we created an expert panel and translated the original questionnaire into Korean language. The translated questionnaire was then back-translated by bilingual experts and we compared it with the original questionnaire. After correction and feasibility testing, 74 patients with chronic respiratory disease (COPD, asthma, destroyed lung) completed the Korean version of the SGRQ. The clinical status of each patients was evaluated concurrently with measurement of their health status. Result: The Korean version of the SGRQ was acceptable and easy to understand. Cronbach's alpha reliability coefficient was 0.92 for the overall scale and 0.63 for the "Symptoms", subscale, 0.87 for the "Activity", subscale, and 0.89 for the "Impacts" subscales. The correlation coefficients between the overall score and the Borg scale score, oxygen saturation, and forced expiratory volume in one second ($FEV_1$) were 0.52, -0.32 and -0.26, respectively. These results support that the Korean SGRQ was correlated with other measurements. Conclusion: The Korean SGRQ was reliable and valid for patients with chronic respiratory disease, such as COPD, asthma, and destroyed lung. The SGRQ score was well correlated with other respiratory measurements as well. Although further studies should complete the adaptation work, our results suggest that the SGRQ may be used in Korea and also for international studies involving Korean CRD patients.

• Journal of Hospice and Palliative Care
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• v.10 no.4
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• pp.184-189
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• 2007

Purpose: This study was to explore barriers to effective pain management in general population. Methods: Total 163 Participants completed the Barrier Questionnaire-II (BQ-II), a 27-item on a six point scale, from May to June in 2007. BQ-II consisted of four subscales which were 1) physical effects (PE) addressing beliefs that side effects of analgesics are inevitable and concerns about tolerance, fatalism (Fa) addressing fatalistic beliefs about cancer pain and its management, Communication (Co) addressing the beliefs of 'good patient' and concerns of distracting physician from underlying disease, and harmful effects (HE) addressing fear of addiction and harmful effect to immune system of pain medicine. Results: The BQ-II total had an internal consistency of 0.877 in this study. HE was the biggest barrier (3.03) followed by PE (2.73), Fa (2.15), and Co (1.71). Items appeared as great concerns were 'there is a danger of becoming addicted to pain medication'(3.58), 'using pain medicine blocks your ability to know if you have any new pain' (3.18), 'pain medicine is very addictive' (3.09), 'when you use pain medicine your body becomes used to its effects and pretty soon it won't work any more' (3.09), and 'drowsiness from pain medicine is difficult to control' (3.09). Only 12 respondents (7.4%) reported that they took any type of pain education, however, those who took pain education represented significantly lower barriers to pain management than who did not (P=.029). Conclusion: This result suggests the strategies for public education to surmount cancer pain.

• Journal of agricultural medicine and community health
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• v.36 no.1
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• pp.36-46
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• 2011

Objectives: To investigate the experience and competence of physicians providing emergency medical services at public health sub-centers on remote Korean islands. Methods: This study enrolled 79 doctors who work at public health sub-centers on remote Korean islands. Data were collected in December 2009 via self-administered e-mail questionnaires. The response rate was 44.3%. Results: Emergent situations occurred at most (58.68%) of the public health sub-centers that were surveyed in December 2009. An average of 1.92 cases required treatment by public health physicians. Only 20.25% of the physicians were specialists in emergency medicine, while the remainder were general practitioners (GPs) without clinical experience as emergency doctors. We also found that the physicians we surveyed had insufficient knowledge of emergency medical care. At some health centers only one doctor was available, and there was no medical team in holiday, although most of the physicians indicated that the ideal number of doctors per center was two or three. In cases of emergency, patients were often sent to the mainland by ship without receiving first-aid treatment. The public health sub-centers lacked the necessary medical equipment to save lives in emergencies and lacked escort systems for emergency patients. Conclusions: The Korean government should address the importance of providing emergency care in remote areas. Health administrators should provide suitable manpower, medical equipment, guidelines for emergency medicine, and education for public health physicians on remote islands.

• The Journal of Korean Physical Therapy
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• v.3 no.1
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• pp.109-121
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• 1991

To investigate the period prevalence rate and therapeutic practic for low back pain (LBP) in the adult population of rural area, a personal interview was conducted for 2.024 persons or 20-59 years old in Seohu Myon, Andong County, Kyungpook Province between 1st and 20th of April, 1991. The period prevalence rate (l February 1990-31 January 1991) of LBP for 1,106 adults who were interviewed was $47.9\%$. The age adjusted period prevalence rate for males was $43.7\%$ and that for females was $52.3\%$ and the difference was statistically significant (p<0.005). Clinical course of th LBP was acute in $14.1\%$ of males and $9.0\%$ of females, recurrent in $57.0\%$ and $55.2\%$, and chronic in $28.9\%$ and $35.8\%$, respectively. Common causes of the LBP were insidious on set with aging without known cause$(48.1\%)$, heavy work $(15.1\%)$, and trauma $(11.3\%)$. Due to LBP $12.5\%$ of the patients were not able to stand or walk for more than an hour and $2.5\%$ were bed-ridden or unable to carry out daily routine. To have the LBP diagnosed $10.2\%$ of the patients utilized a oriental medical clinic or hospital, $31.3\%$ visited a clinic or hospital, and $56.6\%$ hat not utilized any medical facility. Main reason for not having the LBP diagnosed was that the LBP was tolerable. The most popular therapeutic method that the LBP patients chose at the first was drug and physical therapy. Herb medicine was most commonly used when the first therapeutic method was not effective and the acupuncture was the most popular choice of therapy when the second therapeutic method failed. Folk medicine was utilized in $15.5\%$ of the LBP patients and it included 36 regimens such as tincture of motherwort (Leonurus sibiricus), boiled chicken with liquor, etc. It was revealed by this survey that the LBP is a serious health problem in the rural area and many of the LBP patients do not utilize a clinic or hospital but take non-scientific folk remedy. To prevent the economic waste and side effects of the folk remedy, public health education is needed for tile rational therapy of LBP.

• The Korean Society of Law and Medicine
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• v.19 no.2
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• pp.41-72
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• 2018

In the division of labor (or teamwork) in medicine, the responsibility of medical and nursing staff should be separated or distributed to justify negligent criminal offenses. The present work refers to the standards by which the due diligence and responsibility of the individual persons are to be determined and delimited. In this context, it has been proven that objective theory as a measure of due diligence is appropriate. From a moral point of view, when assessing due diligence, it makes sense to impose greater individual or higher performance demands on the perpetrator, but law and order require that due diligence should result from socially relevant human behavior. To give objective measure of negligence and to provide the highest level of personal responsibility, so that man can not be burdened too much responsibility and it is accordingly with an equality theorem. Afterwards some points are presented, which should be considered in a concrete fact in the determination of the medical negligence. Medical action has specific characteristics such as professionalism, discretionary and exclusive, unbalance of information. These characteristics distinguish medical actions from general negligence. The general level of knowledge, the urgency, working condition and working environment of the medical facility, duration of the professional practice, assessment of the medical activity are crucial in this context. As a standard of delineation of due diligence, I have used the permitted risk and the principle of trust. In the horizontal division of labor, the principle of trust applies. The principle of trust applies in principle in cases of division of labor interaction, when doctors in the same hospital exercise their own specific occupational field or everyone works in another hospital. However, this is not true for every case. In the vertical division of labor, the principle of trust does not apply and the senior physician can not trust the assistant doctors. In this case, the principle of trust is converted into a duty of supervision for assistant doctors by the senior physician. This supervision requirement could be used as a random check.

• The Journal of Korean society of community based occupational therapy
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• v.10 no.2
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• pp.11-24
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• 2020

Objective : The Human Rights constitute one of the basic pillars of every work where persons are involved, such is the case of the occupational therapy field. Methods : In this study we investigate the human rights sensitivity and the advocacy activities of occupational therapists. The differences according to their characteristics, the relationship and the impact of the human rights sensitivity are examined and presented. Making use of online surveys 116 subjects participated in the study. Results : The measured average of human right sensitivity is 69.00 ± 17.67 point, being them distributed according to the following subcategories: to the perception of the situation corresponds 23.25±5.62 points, to the perception of the consequences 22.75±6.54 points and for the perception of the responsibility 23±6.54 points. In all the cases have been taken in account the equal rights, the right to education in disables, the right to pursue the happiness of the elderly, the right of the disables to have personal freedom, the privacy rights and the privacy rights for mental illness people. According to the working area the Human Right sensitiveness is higher in Seoul than in the Gyeongsang province meanwhile the advocacy activities is higher in Seoul and in Gyeonggi province than in Gyeongsang province. Depending of the type of service, general hospitals and rehabilitation/nursing hospitals showed higher human rights sensitivity than other service organizations According to the working field, occupational therapy group focused in elderly showed higher Human Right sensitivity than other fields. Professionals belonging groups of clinical experience from 3 to 5 years and from 6 to 10 years showed higher advocacy activities than professionals with more than 11 years of experience. A positive correlation was showed between the human rights sensitivity and the advocacy activities. For this situation, the human rights sensitiveness was divided in sub-categories in perception of the situation, perception of the consequences and perception of the responsibility. As showed by the result of multiple regression analyses the advocacy activities of human would grow up in accordance with the increase of the human rights sensitiveness of responsibility perception. Conclusion : Due to the actual lack of information, the collection and study of basic data is fundamental for the development of practical human rights educational programs and to emphasize the role of the defense of the human rights.

• Journal of agricultural medicine and community health
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• v.48 no.4
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• pp.239-250
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• 2023

Objective: This study was a preliminary study for the prevention programs for farmers' occupational diseases. It selected the priorities recognized by farmers, such as occupational diseases, and also identifies the effectiveness and feasibility of prevention programs among diseases recognized by farmers. Therefore, we plan to use it as basis data for future farmer safety and health programs. Method: The subjects of the study were farmers living in the region, selected through a snowball recruitment method, and a total of 671 people were targeted. The priority selection method was the Basic Priority Rating System (BPRS) method, and among the occupational diseases, programs to prevent musculoskeletal diseases, cardiovascular and respiratory diseases, and pesticide poisoning were surveyed on the effectiveness and feasibility of farmers. Results: Among occupational diseases, the highest priority was musculo-skeletal disease, followed by respiratory disease and pesticide poisoning. Among the programs for musculoskeletal disease, 'use of agricultural work convenience equipment and auxiliary tools' had the highest perceived effectiveness and feasibility. Among the five programs for pesticide poisoning, 'equipment of protective equipment such as pesticide protective clothing/glove' had the highest effectiveness at 67.4%, and 'compliance with pesticide use instructions' had the highest level of feasibility at 64.3%. Among the four programs to prevent respiratory diseases, 'wearing a dust mask or gas mask' was the highest at 65.5% in terms of both effectiveness and feasibility. Conclusion: When carrying out safety and health programs for farmers, the priorities recognized by farmers should be taken into consideration, and the program contents should also be developed taking into account the size of effect and feasibility recognized by farmers.