• Title/Summary/Keyword: Patient's Situation

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The Medico-Legal and Ethical Problems of Withholding / Withdrawing of Futile Life-Sustaining Mechanical Respirator treatment (연명(延命)치료적 인공기계호흡요법의 보류(保留)/중지(中止)를 전후한, 법의학적 및 윤리적 문제들과 그 대처방안)

  • KIM, Keun-Youl
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.3
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    • pp.213-229
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    • 2005
  • The first and the longest criminal indictment case of Korean medico-legal battle, so called BORAMAE Hospital Incident, was finally on its end by Korean Supreme Court's decision on June 24, 2004, after 7 years long legal dispute via Seoul District Court and Seoul Superior Appeal Court's decision. Boramae Hospital case was the first Korean legal case of Withdrawing Life-sustaining treatment of mechanical respirator on 58 years old Extradural Hematoma victim who was on Respirator under Coma after multi-organ failure postoperatively(APACHE II score: 34-39). Two physicians who have involved patient's care and had helped to make discharge the Near-death patient to home after repeated demand of patient's wife, due to economic reason, were sentenced as homicidal crime. This review article will discuss the following items with the review of US cases, Quinlan(1976), Nancy Cruzan(1990), Barber (1983), Helen Wanglie(1990), Baby K (1994) and Baby L cases, along with Official Statement of ATS and other Academic dignitaries of US and World.: [1] Details of Boramae Hospital incident, medical facts description and legal language of homicidal crime sentence. [2] The medical dispute about the legal misinterpretation of patient's clinical status, regarding the severity of the victim with multi-organs failure on Respirator under coma with least chance of recovery, less than 10% probability. [3] Case study of US, of similar situation. [4] Introduction of ATS official Statement on Withdrawing/ Withholding Life sustaining treatment. [5] Patient Autonomy as basic principle. [6] The procedural formality in Medical practise for keeping the legitimacy. [7] The definition of Medical Futility and its dispute. [8] Dying in Dignity and PAS(Physician Assisted Suicide)/and/or Euthanasia [9] The Korean version of "Dying in Dignity", based on the Supreme Court's decision of Boramae Hospital incident (2004.6.24.) [10] Summary and Author's Note for future prospects.

An UHISRL design to protect patient's privacy and to block its illegal access based on RFID (환자의 프라이버시 보호와 불법 접근 차단을 위한 RFID 기반 UHISRL 설계)

  • Lee, Byung Kwan;Jeong, Eun Hee
    • Journal of Korea Society of Industrial Information Systems
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    • v.19 no.3
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    • pp.57-66
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    • 2014
  • This paper proposes the UHISRL(Ubiquitous Healthcare Information System based on Real Time Location) which manages patient, doctor, medicine by using RFID. The proposed UHISRL monitors the patient's health state, and enables us to confirm the result with Smart Phone and Tablet PC. Also, it can block Replay and Spoofing attack by using the ERHL(Extended Randomized Hash Lock) authentication scheme designed in this paper. A patient privacy is enhanced by limiting UHISRL DB access according to attributes with CP-ABE (Cipher Text - Attributed based Encryption) technique. Specially, UHISRL can prevent an unexpected accident by monitoring a chronic patient's emergency situation in real time.

A Case Study on Atopic Dermatitis with the Treatise on Febrile Diseases (상한론 처방을 이용한 아토피성 피부염 환자 1례 보고)

  • Hur, In-Hee;Byun, Hak-Sung;Sim, Sung-Yong;Kim, Kyung-Jun;Hong, Seong-Min
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.20 no.2 s.33
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    • pp.230-239
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    • 2007
  • Introduction : Atopic dermatitis is very epidermic disease in these days. Atopic dermatitis is difficult for patient to be treated because there is no specific treatment. The oriental method of atopic dermatitis is varied as patient situation and doctor's view point. The Treatise on Febrile Diseases(傷寒論) may be a hint for atopy disease. Object: Although we use various method such as acupucture, aroma therapy, a medicine for external use, we use the two decoctions in the Treatise on Febrile Diseases according to differentiation of syndromes and abdominal diagnosis. Result : After inpatient treatment in 21 days, the itching, redness, exudation, crust, lichen get better and insomnia and constipation was removed quickly. The SCORAD index is decreased from 84.2 to 25.9. Conclusion : These decoction can treat the atopic dermatitis although there is no symptom in atopy because we cure the all situation of the patient. We can cure the atopic dermatitis not only by routine remedy for various symptoms but also by diagnosis and treatment based on overall analysis of symptoms and signs.

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The awareness of medical department students about euthanasia (안락사에 대한 의료계열 학생들의 인식도)

  • Lee, Hyun-Ju;Kim, Jung Sun;Kim, Hoon;Kim, Chul-Tae
    • The Korean Journal of Emergency Medical Services
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    • v.23 no.1
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    • pp.165-178
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    • 2019
  • Purpose: This study examined medical college students' perception of euthanasia and analyzed whether there were significant differences in their perceptions based on their grade, religion, and economic situation. Methods: A questionnaire comprising items relating to students' knowledge about euthanasia, their economic situation relationships with patients, and the extent to which euthanasia would be allowed depending on the patient's condition. Results: Results by age and school year revealed there were no statistically significant differences concerning permissible levels of euthanasia. However, differences were found in the permissible levels of euthanasia according to changes in the patients' condition. Conclusion: It can be interpreted that students' personal values and religion had a great effect on the perception of euthanasia than the process of acquiring medical knowledge. The religion or values they have in your life affect your perception of euthanasia more than the process of acquiring and learning medical knowledge. The suffering of patients is the most important priority and it supports euthanasia on the grounds of relieving psychological distress for patients' families and the right of every patient to die gracefully. Nevertheless, considering the possibility of patient survival and euthanasia being used for murder, it is necessary to legislate the use of euthanasia and have the appropriate qualifications for its administration on patients.

Correlations Among the Stroke Patient Family상s Health Status, Burden and of Life (뇌졸중 환자가족의 건강상태, 부담감 및 삶의 질과의 관계 연구)

  • 이경호
    • Journal of Korean Academy of Nursing
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    • v.31 no.4
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    • pp.669-680
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    • 2001
  • Purpose: This study is used to investigate the correlation among a stroke patient family's health, burden and quality of life. Method: Data was collected from one hundred twenty family care-givers registered at K and H Hospital in Seoul. Questionnaire data was drawn up by personal interviews aided by the staff nurses. The analyses of collected data are based on the rate of 100 percentage to the average, t-test, ANOVA, DMR, Pearson Correlation. Result: (1) The influential factors on physical health proved to be age, sex, academic career, matrimonial status, present occupation, economic situation, the relationship with the patient, the patient-caring term, and the family-formation. The psychological health issues were age, final academic career, matrimonial status, the relation with patient and the family-formation. Burdens were shown to be age, matrimonial status, the relation with patient, and the patient-caring term. The quality of life was determined by age, final academic career, matrimonial status, and the relationship with the patient, the patient- caring term, and the family-formation. (2) The rate of the physical condition was 2.87, the psychological condition 2.43, the sense of burden 3.08, and the quality of life was 2.42. (3) The rate of correlation between the burden and the quality of life was (r= -.547), the psychological health and the burden was (r= -.531), the physical health and the burden was (r= -.263), physical health and quality of life was (r= .301), psychological health, and quality of life was (r= .413). Conclusion: It follows from this study that there is a very close correlation among the stroke patient family's health, the burden, and quality of life. Therefore it is necessary that we should find various nursing intervention ways in order to mitigate the burden of family when caring for the stroke patients.

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Stellate Ganglion Block for Treatment of Writer's Cramp (서경(書痙)의 성상신경절 차단요법)

  • Suh, Jae-Hyun;Park, Byung-Cheul
    • The Korean Journal of Pain
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    • v.8 no.1
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    • pp.117-119
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    • 1995
  • Writer's cramp is a gradual onset and the disorder shows itself at first only when the patient is fatigued or stressed, or when a difficulty in controlling the pen leads to inaccurate writing. The prognosis is poor and treatment is often difficult and unsatisfactory. Case 1: A-30-year old male, who had a difficulty in writing with palpitation for 10 years in front of the other men. After 5 times of stellate ganglion block, palpitation during writing did not appear and after 15 times, he could write with a slight spasm of hand muscles. Case 2: A-40-year old male, who had a difficulty in writing in a stressful situation. After 28 times of stellate ganglion block, he could write in normal work except in the strong stressful situation. From our experience, we recommend the stellate ganglion block may be an effective treatment for a writer's cramp.

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The Factors Affecting The Nurse-Patient Interaction (환자와 간호사의 상호작용에 영향을 미치는 요인)

  • Kim In-Ja;Son Haeng-Mi
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.4 no.1
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    • pp.31-42
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    • 1997
  • The factors that affect the nurse-patient interaction were identified. Sixty-six nurses participated in the cross-sectional survey. Based upon the literature, the factors were classified into 4 categories : the patient, the nurse, the family caregiver, and the situational factors. The data were collected with the open-and closed-ended questionnaire developed by researchers. In the closed-ended questionnaire, the significant factors differentiating the best-liked from the least-liked caring situation were found in all factors except the nurse factors. None of the nurse factors was found to be significant. In patient factors, the physically attractive stereotype was found to affect patient-nurse interaction. As expected, family caregiver factors were found to affect the nurse-patient interaction. The content analysis was done to identify the specific factors affecting nurse-patient interaction. In both of the best-liked and the least-liked caring situations, the patient factors were the most contributing causes as likely as 68.51% and 66.45%, respectively. Some factors that nurses perceived as causes for the best-liked and the least-liked to care were presented. In conclusion, these results show that nurses are influenced by stereotypes in caring patients. So, some programs to increase awareness of the biases of nurses are included in in-service education. Also the incentives to encourage nurses are needed.

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Implant-assisted Removable Prosthetic Rehabilitation of a Patient with Crossed Occlusion

  • Oh, Hyun-Su;Lim, Young-Jun;Kim, Myung-Joo;Kwon, Ho-Beom
    • Journal of Korean Dental Science
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    • v.14 no.1
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    • pp.32-39
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    • 2021
  • 'Crossed occlusion' is the condition in which occlusal intercuspation is lost when several teeth on upper and lower jaw remain. This report describes a clinical case in which a patient had two upper-left posterior teeth and two lower-right posterior teeth; typically known as left-right crossed occlusion. Considering the patient's general condition and financial situation, the treatment plan included placement of two implants on each jaw against the remaining teeth using surgical guide. To find out the ideal position of implants, digital diagnostic wax-up was preceded by superimposing the cast and cone beam computed tomography image, which was aided with radiographic stents. The consequent surveyed implant bridge provided stable vertical stop for fabrication of the implant assisted removable partial dentures. The patient was satisfied with the functionality and esthetics of definitive prosthesis.

A study on perception of stress and coping patterns of family members of the hospitalized in patients (가족구성원의 입원으로 인한 가족의 스트레스와 대처방안에 관한 연구)

  • Kwon Eun-Ok
    • Journal of Korean Public Health Nursing
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    • v.5 no.1
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    • pp.35-52
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    • 1991
  • The purpose of this study was to assess the degree of stress and patterns of coping for that Stressful events on family members because of the hospitalization of the patients. Stress and coping were measured with a tool on the basis of Volicer and Bell's questionnaire. In data collection, the modified 38 items of Volicer's stress scale and Bell's 18 item coping scale were administered. The subjects consisted of 259 family members of general ward-patients in Seoul National University Hospital during April in 1990. They were randomly selected on the basis of relationship of patients; patient's spouse, patient's daughters or sons. The stressors of the family members were ranked as follows; The first rank Stressful events was related to the patient's diseases and pain, the second ones was related ·to caring of their patients and family's psychosocial life. Families used long term coping method significantly more than short term ones. The results indicated that there was no difference in use of coping method between pre and post hospitalization. Finding out more about situation and optimism were the most common coping methods, and the least frequent coping method was the use of drugs. In conclusion, the identification of perceived stress and coping patterns of family members provides useful information for family nursing and aimes at better nursing care for the hospitalized in patients.

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Embarrassment; a concept analysis (당혹감(embarrassment); 개념분석)

  • Cho, Eun-Jung;Chung, Bok-Yae
    • Korean Journal of Adult Nursing
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    • v.14 no.2
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    • pp.276-286
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    • 2002
  • Purpose: The concept of embarrassment as an unpleasant emotion is important in caring for those who are in the continuum of illness and health requiring body care and facing sexual problems. In spite of its nursing implication, embarrassment has not been focused in nursing research. Therefore, the purpose of this paper is to develope a conceptual analysis of embarrassment. This analysis would help to understand comprehensively an embarrassing situation in which an intimate relationship between nurse and patient regarding body care of the patient could develope. Futhermore, it would be a basis for developing strategies for prevention of embarrassment which could lead for both patient and nurse to emotionally vulnerable situation because of their failure of self-presentation (impression management). Method: The concept analysis model suggested by Walker and Avant (1988) is used to clarify what is meant by the term 'embarrassment'. Result: This analysis defines the attributes of embarrassment such as follows. First, embarrassment is often attributed to situational factors interrupting a smooth interaction such as intimacy, confusion, vulnerability, exposure of interaction and characteristics of audience. Second, embarrassment is closely related with cognitive factor such as fear of losing face resulted from a behaviour being out of line. Third, embarrassment is closely associated with dispositional factor such as embarrassability. Fourth, embarrassment is an unpleasant and unwanted emotion arising reactively after an interaction had occurred. Fifth, embarrassment encloses physical, physiological and behavioral aspects such as a variety of unique and easily noticeable reactions and a pattern of verbal and non-verbal behaviour for coping in an embarrassing situation. The antecedents were normally socialized adolescents with normal cognitive ability, concern of losing face, embarrassability, embarrassing events related with situational intimacy, confusion, vulnerability, exposure of interaction and characteristics of audience, physical, behavioral blunders resulting in a failure of impression management. The consequences were an emotional coping behaviour, audience's embarrassment responses, and verbal and non-verbal coping strategies of interactional participants. Conclusion: It is hoped that this analysis will stimulate further exploration of this concept and study for developing systematic assessment and nursing practice that diminishes embarrassment of interactional participants.

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