• Title/Summary/Keyword: Patients' relatives

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호스피스 케어가 말기암환자 가족들의 죽음에 대한 인식 변화에 미치는 영향

  • Gye Gwang-Won;Kim Jae-Song;Won Ju-Hui;Lee Seong-Ok;Lee Chae-Yeong;Jo Seong-Hun;Park Yun-Mi;Yun Yeong-Mi;Lee Myeong-Suk;Ju Seon-Mi
    • Korean Journal of Hospice Care
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    • v.5 no.2
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    • pp.75-85
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    • 2005
  • The objective of this research is to provide the basic material for effective hospice care by analyzing the recognition of families who have terminally ill patients over death. To do so, this research is designed to investigate the general tendency toward death and changes after hospice care. To analyse the initial status of the recognition about the death, questionnaires were provided to the families of the terminally ill patients who were taken hospice care from June 1st, 2005 to September 10th, 2005 at Saemmul Hospice. The same questionnaires were distributed to research some changes of the recognition of the death after 3 weeks. As the Data Analysis Methodology, SPSS v.10.0 statistics program were utilized. The summary of this research is as follows. First, by gender, it is analyzed that women have more fear than men in terms of incompetence sense after death. By religion, Christians have less fear than other religious people in terms of fear toward after death and general sense of death. Second, those who experienced deaths of close family members, relatives, friends for the past 3 years have more fear toward the moment of death than those who did not experience it. Third, statistically valid difference was found in terms of fear toward the moment of death, fear toward incompetence, fear toward after death, and fear toward death before and after the hospice care was taken. Based on the result of this research, terminally ill patients' families facing death have shown significant differences on fear and incompetence before and after hospice care was offered. It is necessary that the hospice care should be settled more professionally by expanding the opportunities of hospice care and institutionalizing the system. In addition, hospice activities which are focused on providing hope after death and facing death with dignity and peace should be expanded increasingly as the family members who experienced deaths showed higher degree of fear and powerlessness and Christians have less fear toward death with the help of biblical influence. It is also required that hospice care specialized in recognizing the importance of terminal cancer patients and their families at the same time.

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Effect of Recipient's Age on the Pregnancy Outcomes in Oocyte Donation Program (난자공여 프로그램에서 난자수혜자의 연령이 임신율에 미치는 영향에 관한 연구)

  • Suh, C.S.;Oh, S.K.;Kim, S.H.;Choi, Y.M.;Kim, J.G.;Moon, S.Y.;Lee, J.Y.
    • Clinical and Experimental Reproductive Medicine
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    • v.24 no.2
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    • pp.167-177
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    • 1997
  • Oocyte donation program developed to reach the pregnancy in those patients suffering from premature ovarian failure or surgery induced menopause, particularly in their reproductive age. With technical advances and popularity of ART (assisted reproductive technology), the indication of oocyte donation program extended to low responders, and even to naturally menopaused patients that has led them quite successfully to getting in pregnancy. The purpose of this study was to evaluate which one is involved in the decline of fertility between the oocyte and uterine factor. One hundred five cycles of oocyte donation program were performed in 84 patients from Jan., 1993 to Dec., 1996. Oocytes were donated from healthy, young, fertile anonymous donors or relatives or infertile patients with supernumerary oocytes. The study population was divided into 3 groups according to the age of recipients. Group 1 was less than 35 years old, Group 2 was between 35 to 39 years old, and Group 3 was more than 39 years old. The results were as follows: The mean age of oocyte donor was $31.5{\pm}3.3$ (range; 25-36). The mean concentration of basal serum FSH and peak serum estradiol were not different among groups. The mean number of oocytes retrieved from donors, embryos transferred to recipients, and fertilization rate were not different among groups. The clinical pregnancy rate was 37.3% in Group 1, 31.6% in Group 2, and 31.6% in Group 3, respectively. The spontaneous abortion rate was 16.0% in Group 1, 16.7% in Group 2, and 16.7 in Group 3, respectively. The multiple pregnancy rate was 20.0% in Group 1, 16.7% in Group 2, 16,7% in Group 3, respectively, The implantation rate was 11.3% in Group 1, 10.3% in Group 2 and 10.0% in Group 3, respectively. All of the pregnancy outcomes were not different statistically among groups. In conclusion, endometrial receptivity does not seem to be impaired as age increases with transfer of good quality embryos and adequate endometrial preparation.

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The Hope of the Stroke Patients (뇌졸중환자의 희망)

  • 김이순
    • Journal of Korean Academy of Nursing
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    • v.27 no.1
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    • pp.212-227
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    • 1997
  • Cerebrovascular diseases in Korea is an important health problem since mortality and mobidity have been increased rapidly. It marked the 2nd cause of specific death rates in 1993. The stroke causes physical function disorder due to hemiparalysis and emotional disorder, and stroke patients experience helplessness, powerlessness. sense of alienation and loss of hope. These feelings make the rehabilitation difficult because they lose the will of life. The subjects of the study were seven citizens who live in Pusan, are over 50 years old and belong to low income-level. The data were collected from Jan. to Sep. 1995. The researcher as a caregiver and volunteer made confidence of them and asked for their agreement on the purpose of the study. The subjects expressed their experience as openheartedly as possible. The analysis of the data was made through the phenomenological analytic method suggested by Giorgi, which is as follows ; as an unit of description which include the subject' expressions and the researcher's observation, it is examined the theme that express the hope experience with the subject's language(underlining), and the focal meanings are identified. The focal meaning is the crystalization of the theme, which is written in the language of the researcher. After intergrating the focal meaning and make the situated structural description as the meaning of the hope experience identified on each subject's point. After intergrating the situated structural description and make the general structural description as the meaning of the hope experience identified on total subject's point then the systemizing of the structure of the hope experienced phenomena and the flowing of the conciousness was researched. The conclusions of this study was as follows : The ten sources of hope which the subjects experienced were sorted as under 〈mutual relations to others : spouse, children, relatives, fellow believer. health professioner. associate patient group〉, 〈spiritual dependence〉. 〈recovery of physical function〉. 〈rumination of the past life〉, 〈expectation of the future〉. 〈economic power〉, 〈belief〉, 〈ability〉. 〈spontaneous participation〉 and 〈recovery of roles〉. Their hope was spoken out by the following two kinds of linguistics. First. the hope was expressed in the affirmative expression as follows : 〈 to be dependable〉, 〈to make efforts〉, 〈to keep under control〉, 〈to desire〉, 〈to be pleasant〉, 〈to be peaceful〉, 〈to be grateful〉, 〈to give help〉, 〈self-confidence. Courage〉, 〈to be happy〉, 〈to satisfy oneself〉, 〈to share with others〉, 〈to understand〉 and 〈to be affected, be impressed〉 Second, the hope was expressed in the negative on pression as under : 〈to be distressed〉, 〈to be uneasy〉, 〈to be sorry, be unsatisfied〉 〈despair〉, 〈to abandon〉, 〈to be fearful〉, 〈to suffer〉, 〈to bear a burden〉 〈to be confused〉, 〈to be solitary〉, 〈chest trouble〉, 〈to feel heavy〉 〈grief〉, 〈to be daunted〉, 〈to get angry〉, 〈to be uncomfortable〉, 〈to have something regretable〉 and 〈to feel guilty〉. And their hope was expressed by the following four behavioral expressions : 〈physical sphere〉, 〈psychological sphere〉, 〈social support sphere〉 and 〈spiritual sphere〉. The reaction patterns of their hope experience appeared in the following 4 coping method : 〈conquest type〉, 〈dependence type〉, 〈adaptation type〉 and 〈fate type〉. Finally, in the hope structure the sense of certainty don't always coexict with the sense of uncertainty, When the stroke patients try to search for the best quality of life, the senses of certainty and uncertainty make a continual cyclic system in the hope structure.

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The Burn-out Syndrome of the Doctors and Nurses working in the Emergency department (종합병원 응급실 의사와 간호사의 탈진(burn-out) 요인에 관한 연구)

  • Kim, Nam-Soo;Yu, Seung-Hum;Sohn, Tae-Yong
    • Korea Journal of Hospital Management
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    • v.7 no.3
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    • pp.1-24
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    • 2002
  • The purpose of this study was to find the factors affecting the bum out syndrome and its degree in terms of personal, organizational and clients characteristics, and then to find the ways to reduce or eliminate those factors. The 228 doctors and the nurses who worked at the emergency departments in 6 general hospitals with more than 700 beds in Seoul were surveyed from April 15, 2002 for 15 days. A structured self-recording questionnaire was used; the t-test and ANOVA was used to analyse the median difference between the occupation, and multiple regression was employed to find the factors affecting the bum-out syndrome. The summary of this research analysis is as follows : First, of several variables, the highest frequency of the burn-out was the emotional burn-out followed by lack in personal touch toward the patients, decrease in sense of personal achievement. These results indicate that the doctors and nurses in emergency departments experience higher degree of burn-out than the social workers and the nurses who work at other departments in heath care environment as other studies revealed. Second, the analysis of the total burn-out factors showed the lower self respect, younger age, heavier work load, higher dissatisfaction rate toward remuneration and not-so-smooth relationship with the patients and their relatives the higher burn out rate. These variables explained 54% of the total variables. Third, the nurses experienced more burn-out syndrome than the doctors. The degree of self-respect, work pattern, relationship with the clients, age and remuneration were the causes of the burn-out. The doctors recorded lack in personal touch toward the patients more, while the nurses more to emotional exhaustion. The limitations of this research are the subjective answers of the respondents to certain questions and differences in sample numbers of each hospital in which some reservation can be exercised in explaining statistical significance of the data, and generalizing the conclusion. Despite of its limitation, this research has its own merit as an unpreceded research in this field, and provision of the basic materials to prevent and find causes of the burn-out syndrome among the doctors and nurses in the emergency departments.

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Doctor's and Nurses' Perception and Experiences of DNR (DNR(Do-Not-Resuscitate)에 대한 의사와 간호사의 경험 및 인지도)

  • Han, Sung-Suk
    • Journal of Korean Academy of Nursing Administration
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    • v.11 no.3
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    • pp.255-264
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    • 2005
  • This study is a descriptive research in investigating the perception of doctors and nurses with regard to DNR, and data were collected through survey questionnaires. The period of collecting data was between July 15 and October 30, 2004, distributing 128 questionnaires to 128 participants, and a total of 110 questionnaires from 55 doctors and 55 nurses were collected (86%)among 70 different hospitals. The collected data were analyzed using SAS program to get real number and percentage, and were also analyzed with $X^2$-test. The Study Results are as follows: 1. Respondents who agreed with the necessity of DNR was 97.27%, the reasons of DNR necessity were 59.20% of 'impossibility of recovery in spite of lots of efforts,' and 35.20% of 'for the purpose of choosing a comfortable and dignified death,' and 97.2% of respondents answered that it was necessary to give explanation of DNR to serious case patients, terminal patients and their family. 2. Problems derived from DNR decisions were 44.44% of 'lack of treatment and nursing,' 21.11% of 'guilty conscience about failing to do best efforts,' and 71.57% of CPR implementation right after DNR decision. 3. Reasons of implementing CRP for patients with DNR decision were 50.94% of 'for the presence of family and relatives at the point of patient's death,' 20.76% of 'guardian's change of DNR decision,' and 16.98% of 'no communication for the consent after DNR decision.' 4. With regard to who was to make DNR decision? there was a difference in the opinion between doctors' and nurses' group while the group of doctors chose 'by the consent of the family and the doctor in charge,' and the group of nurses chose 'patient's intension,' and with regard to Have you received DNR related education? and Will people who want DNR increase if there is explanation given? there was a difference between the two groups. 5. In the catholic institutions, respondents of 71.7% said that it was necessary to take DNR depending upon the situation, and 73% said that they had performed DNR before. 6. In the institutions with over 500 beds, 91.92% of respondents said that there should be an establishment of guideline book as a written format to implement DNR. From the results of this study, it was found that DNR was implemented and executed broadly in clinical fields in the absence of necessary instructions and/or guideline, and that DNR order was placed to the group of doctors who got less opportunity for proper education than did that of nurses.

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Family History Attributes and Risk Factors for Breast Cancer in Turkey

  • Gokdemir-Yazar, Ozden;Yaprak, Seval;Colak, Muhteber;Yildirim, Ediz;Guldal, Dilek
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.6
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    • pp.2841-2846
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    • 2014
  • Background: When dealing with breast cancer, early detection is closely associated with determining and closely monitoring high risk groups. The aim of this study was to determine the preventable risk factors that are specific for our country, and to understand which risk factors were most predominant. Materials and Methods: The study was planned as a case-control design. Women diagnosed with breast cancer who visited the Surgery, Obstetrics and Gynaecology, and Radiation Oncology outpatient clinics of the Izmir Dokuz Eylul University (DEU) School of Medicine were accepted as the case group. Then a control group matched for age was established among females who visited the outpatient clinics on the same days. A questionnaire prepared by the researchers was implemented using a face-to-face interview technique. The Mann-Whitney U test was used in the comparisons of the group averages, and the Pearson chi-square test in the comparisons between groups. In order to determine the dominant risk factors, binary logistical regression test was implemented. Results: A total of 138 patients, 69 cases and 69 controls, were included in the study. A significant difference can be detected between the groups in terms of BMI, smoking, breast cancer prevalence among first degree family members, presence of breast cancer among distant family members, existence of other types of cancers among family members and the age of onset of menopause (p<0.05). Logistical regression analysis revealed that the presence of breast cancer among first degree relatives increased the risk of developing breast cancer 5.7 times. Conclusions: Although some results of this study are compatible with findings in the literature, some are not. In order to determine unique risk factors, there is a clear need for large-scale studies.

Characterization of Wild-Type and Mutated RET Proto-Oncogene Associated with Familial Medullary Thyroid Cancer

  • Masbi, Mohammad Hosein;Mohammadiasl, Javad;Galehdari, Hamid;Ahmadzadeh, Ahmad;Tabatabaiefar, Mohammad Amin;Golchin, Neda;Haghpanah, Vahid;Rahim, Fakher
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.5
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    • pp.2027-2033
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    • 2014
  • Background: We aimed to assess RET proto-oncogene polymorphisms in three different Iranian families with medullary thyroid cancer (MTC), and performed molecular dynamics simulations and free energy stability analysis of these mutations. Materials and Methods: This study consisted of 48 patients and their first-degree relatives with MTC confirmed by pathologic diagnosis and surgery. We performed molecular dynamics simulations and free energy stability analysis of mutations, and docking evaluation of known RET proto-oncogene inhibitors, including ZD-6474 and ponatinib, with wild-type and mutant forms. Results: The first family consisted of 27 people from four generations, in which nine had the C.G2901A (P.C634Y) mutation; the second family consisted of six people, of whom three had the C.G2901T (P.C634F) mutation, and the third family, who included 12 individuals from three generations, three having the C.G2251A (P.G691S) mutation. The automated 3D structure of RET protein was predicted using I-TASSER, and validated by various protein model verification programs that showed more than 96.3% of the residues in favored and allowed regions. The predicted instability indices of the mutated structures were greater than 40, which reveals that mutated RET protein is less thermo-stable compared to the wild-type form (35.4). Conclusions: Simultaneous study of the cancer mutations using both in silico and medical genetic procedures, as well as onco-protein inhibitor binding considering mutation-induced drug resistance, may help in better overcoming chemotherapy resistance and designing innovative drugs.

Mutation Spectra of BRCA Genes in Iranian Women with Early Onset Breast Cancer - 15 Years Experience

  • Yassaee, Vahid Reza;Ravesh, Zeinab;Soltani, Ziba;Hashemi-Gorji, Feyzollah;Poorhosseini, Seyed Mohammad;Anbiaee, Robab;Joulaee, Azadeh
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.sup3
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    • pp.149-153
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    • 2016
  • Breast cancer is the most common cancer in Iran. In the recent years an upward trend has been observed in the Iranian population. Early detection by molecular approaches may reduce breast cancer morbidity and mortality. We provided consultation to 3,782 women diagnosed with early onset breast cancer during the past 15 years (1999-2014). To establish a data set for BRCA gene alterations of the Iranian families at risk, two hundred and fifty four women who met our criteria were analyzed. A total number of 46 alterations including 18 variants with unknown clinical significance (39.1%), 18 missense mutations (39.1%), 7 Indels (15.2%) and 3 large rearrangement sequences (6%) were identified. Further scanning of affected families revealed that 49% of healthy relatives harbor identical causative mutations. This is the first report of comprehensive BRCA analysis in Iranian women with early onset breast cancer. Our findings provide valuable molecular data to support physicians as well as patients for the best decision making on disease management.

Knowledge about Risk Factors for Breast Cancer and Having a Close Relative with Cancer Affect the Frequency of Breast Self-Examination Performance

  • Freitas, Angela Gabrielly Quirino;Weller, Mathias
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.4
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    • pp.2075-2081
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    • 2016
  • Background: Breast cancer incidence and mortality rates are increasing in North-Eastern Brazil and the patients with the disease often presented at advanced stages. The present study was focused on identifying variables that affect women's frequency of breast self- examination (BSE) performance. Materials and Methods: Data on BSE, socio-economic parameters and risk factors for breast cancer were obtained from 417 women from a community in North-Eastern Brazil by a self-informant method. To identify independent variables that affect frequency of BSE, nominal logistic regression analysis was performed. Results: Of 417 women, 330 (79.3%) reported performing BSE. Compared to high-income women, BSE performance by low-income women every month was 7.69 (OD=0.130; CI 95%: 0.044- 0.0386; p=0.000) times lower. Women who did not live in a stable union performed BSE each month 2.73 (OD=0.366; CI 95%: 0.171-0.782; p=0.010) less often than those living in a stable union. BSE performance every month and every six months or every year by women with poor knowledge about risk factors for breast cancer was 3.195 (OD=0.313; CI 95%: 0.141- 0.695; p=0.004) times and 2.028 (OD=0.493; CI 95%: 0.248- 0.979; p=0.043) times lower, compared to women with good knowledge. Participants who had a close relative with cancer performed BSE every month and every six months or every year 2.132 (OD=0.469; CI 95%: 0.220-0.997; p=0.049) times and 2.337 (OD=0.428; CI 95%: 0.219-0.836; p=0.013) times less often, compared to those women without close relatives with cancer. Conclusions: The results of this study indicated that income, marital status, knowledge about risk factors and having a close relative with breast cancer, affect the frequency of BSE performance. Information about risk factors in public health campaigns could additionally strengthen avoidance behaviour and also motivate BSE performance.

A study the concerns of patient with the knee ligament injury (무릎 인대 손상환자의 퇴원 전.후 관심사)

  • Hyun, Hye-Young;Choi, Kyung-Sook
    • Journal of muscle and joint health
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    • v.3 no.2
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    • pp.216-228
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    • 1996
  • This study has purpose to perform leaving the hospital nursing plan during hospital treatment of patient with the knee ligament Injury on the basis of the concerns between the time of leaving the hospital after 2 weeks in hospital and the concerns through practical life after leaving the hospital systematically. This study is also tried to make exercise plan to prevent atrophy of Quardriceps muscle of the thigh caused by the limitation of activities. The subjects of study are 12 people who were in the hospital in affiliation to a university in Seoul, were operated on the knee ligament, and were discharged from the hospital within 2 weeks. Data collection time was for about 4 months from December, 94 to March, 95. Research method was performed 2 times by unorganized open questions. The collection of first data is through direct interview about the concerns before leaving the hospital, and secondary data is through direct interview about the concerns by practical life and experiences after leaving the hospital. The data was categorized by classifying several common elements among similar contents according to data by the situational analysis of Giorgi. The result of this study is as follows : 1) The concerns before leaving the hospital are like that the concerns of recovery possibility, the limitation of activities, the grim realities of life, the lack of confidence about self-nursing, the eyes of the surroundings, the burden to the others, and so on. 2) The concerns after leaving the hospital are like that the demands of the inconvenience by the limitation of self-nursing, the support about self-nursing by the difficulties of performing treatment order, the support of physical activities limitation by physical tiredness and the limitation of social activities, the support of information by the necessities of education in using crutches before leaving the hospital and continuing informational needs, psychological and mental support of normal physical recovery by the worries of physical recovery and physical change, and social support by thankfulness for his family and relatives. I suggest to make more systematic leaving the hospital nursing plan and exercise education plan for nursing plan after leaving the hospital of the patients with the knee ligament injury on the basis of this content.

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