• The Korean Journal of Health Service Management
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• v.8 no.3
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• pp.219-228
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• 2014

The purpose of this study was to provide a basic data for the establishment of attitude on death, perception on hospice and attitude of DNR by nursing students. The survey was performed with 214 nursing students in Busan. The data was collected by questionnaires and were analyzed using SPSS/win 21.0 program. The period of data collection was from June 1, 2013 to June 15, 2013. The mean scores of attitude on death, perception on hospice and attitude of DNR were 2.63, 3.30 and 3.83 point. The attitude of DNR of the nursing students was significantly different according to the grade and satisfaction of major. The attitude of DNR showed the significant positive relationship with attitude on death and perception on hospice. Attitude on death and perception on hospice accounted for 16.8% of variance in attitude of DNR. Finding of this study is necessary to develop nursing understanding for the attitude of DNR by considering attitude on death and perception on hospice.

• Journal of Audiology & Otology
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• v.24 no.4
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• pp.180-190
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• 2020

Background and Objectives: Although many studies have evaluated the effect of the digital noise reduction (DNR) algorithm of hearing aids (HAs) on speech recognition, there are few studies on the effect of DNR on music perception. Therefore, we aimed to evaluate the effect of DNR on music, in addition to speech perception, using objective and subjective measurements. Subjects and Methods: Sixteen HA users participated in this study (58.00±10.44 years; 3 males and 13 females). The objective assessment of speech and music perception was based on the Korean version of the Clinical Assessment of Music Perception test and word and sentence recognition scores. Meanwhile, for the subjective assessment, the quality rating of speech and music as well as self-reported HA benefits were evaluated. Results: There was no improvement conferred with DNR of HAs on the objective assessment tests of speech and music perception. The pitch discrimination at 262 Hz in the DNR-off condition was better than that in the unaided condition (p=0.024); however, the unaided condition and the DNR-on conditions did not differ. In the Korean music background questionnaire, responses regarding ease of communication were better in the DNR-on condition than in the DNR-off condition (p=0.029). Conclusions: Speech and music perception or sound quality did not improve with the activation of DNR. However, DNR positively influenced the listener's subjective listening comfort. The DNR-off condition in HAs may be beneficial for pitch discrimination at some frequencies.

• Korean Journal of Audiology
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• v.24 no.4
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• pp.180-190
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• 2020

Background and Objectives: Although many studies have evaluated the effect of the digital noise reduction (DNR) algorithm of hearing aids (HAs) on speech recognition, there are few studies on the effect of DNR on music perception. Therefore, we aimed to evaluate the effect of DNR on music, in addition to speech perception, using objective and subjective measurements. Subjects and Methods: Sixteen HA users participated in this study (58.00±10.44 years; 3 males and 13 females). The objective assessment of speech and music perception was based on the Korean version of the Clinical Assessment of Music Perception test and word and sentence recognition scores. Meanwhile, for the subjective assessment, the quality rating of speech and music as well as self-reported HA benefits were evaluated. Results: There was no improvement conferred with DNR of HAs on the objective assessment tests of speech and music perception. The pitch discrimination at 262 Hz in the DNR-off condition was better than that in the unaided condition (p=0.024); however, the unaided condition and the DNR-on conditions did not differ. In the Korean music background questionnaire, responses regarding ease of communication were better in the DNR-on condition than in the DNR-off condition (p=0.029). Conclusions: Speech and music perception or sound quality did not improve with the activation of DNR. However, DNR positively influenced the listener's subjective listening comfort. The DNR-off condition in HAs may be beneficial for pitch discrimination at some frequencies.

• 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.

• Journal of the Korea Convergence Society
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• v.10 no.6
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• pp.393-399
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• 2019

This is a descriptive study on the perception and attitude toward DNR in adults. Structured questionnaires were used and 210 subjects were studied. In recognition of DNR, DNR was helpful for 'a comfortable dying(64.3%)'. The need for DNR in situation investigated 'For dignified dying (41.3%)' and 'to alleviate patient suffering(23.9%)'. Respondents who do not agree with DNR are shown 'Because legal issues can arise(61.7%)', 'Because human dignity is the life-sustaining priority(16.7%)'. In the attitude toward DNR, the most significant result was 'I want to know if I have an incurable disease (4.21).' There was no difference in attitudes toward DNR among adults. The DNR is not a method of Withdrawing in lifeprolonging treatment, It should be addressed in a comprehensive context in which human beings exercise autonomy over the process of dying and death.

• Journal of Korean Critical Care Nursing
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• v.4 no.1
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• pp.11-24
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• 2011

Purpose: The purpose of this study was to grasp the subjectivity of the nurses toward DNR (Do not resuscitation) order. Methods: Q methodology was employed to explore the nurses' subjectivity. Q population consisted of 292 statements that were obtained through individual in-depth interviews targeting 30 employees(nurses, doctors, staff members) and literature review. Finally, 30 nurses classified 34 statements using a 9 point scale. Results: The current survey that probed into the subjectivity of the nurses relative to DNR order abstracted four categories. The first type (restrictive acceptance type) perceived the determinants of DNR as the patient's hopeless state. The second type (evidence-based type) emphasized the decision based on the guideline. The third type (medical personnel-centered type) showed the characteristic that depends passively on the professional judgement. The fourth type (rationalistic type) emphasized rational characteristic that DNR decision needs to be made by considering several situations such as economic and psychological burden of family and the quality of life. Conclusion: These types of nurse's perception need to be considered in the nurses' continuing educational program in order to confront affirmatively and positively with ethical dilemma.

• Journal of Hospice and Palliative Care
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• v.17 no.2
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• pp.66-74
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• 2014

Purpose: This study is aimed to investigate perceptions of caregivers and medical staff toward do not resuscitate (DNR) and advance directives (AD). Methods: Participants were 141 caregivers and 272 medical staff members from five general hospitals. A questionnaire used for the study consisted of 20 items: 14 about DNR perceptions, three about AD, one each for age, gender and employment. Results: Both medical staff and caregivers strongly recognized the need for DNR and AD, and the level of recognition was higher with medical staff than caregivers (DNR ${\chi}^2=44.56$, P=0.001; AD ${\chi}^2=16.23$, P=0.001). The main reason for the recognition was to alleviate sufferings of patients in the terminal phase. In most cases, DNR and AD were filled out when patients with terminal conditions were admitted, and patients made the decisions by consulting with their guardians. Medical staff better recognized the need and for growing demand for guidelines for the DNR and AD decision making process than caregivers (${\chi}^2=7.41$, P=0.0025). Conclusion: This study showed that patients highly rely on their caregivers when making decisions for DNR and AD. Thus, it is important that patients and caregivers are provided with objective information about the decisions. Since participants' strong support for DNR and AD was mainly aimed at alleviating patients' suffering, further study is needed in the association with hospice care. Medical staff also needs to understand the different views held by caregivers and fully consider the disparity when informing patients/caregivers to make the DNR and AD decisions.

• Journal of Korean Academy of Nursing
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• v.51 no.1
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• pp.15-26
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• 2021

Purpose: This study aimed to distinguish and describe the types of perceptions of do not resuscitate (DNR) proxy decisions among families of elderly patients in a long-term care facility. Methods: This exploratory study applied Q-methodology, which focuses on individual subjectivity. Thirty-four Q-statements were selected from 130 Q-populations formed based on the results of in-depth interviews and literature reviews. The P-samples were 34 families of elderly patients in a long-term care hospital in Busan, Korea. They categorized the Q-statements using a 9-point scale. Using the PC-QUANL program, factor analysis was performed with the P-samples along an axis. Results: The families' perceptions of the DNR proxy decision were categorized into three types. Type I, rational acceptance, valued consensus among family members based on comprehensive support from medical staff. Type II, psychological burden, involved hesitance in making a DNR proxy decision because of negative emotions and psychological conflict. Type III, discreet decisions, valued the patients' right to self-determination and desire for a legitimate proxy decision. Type I included 18 participants, which was the most common type, and types II and III each included eight participants. Conclusion: Families' perceptions of DNR proxy decisions vary, requiring tailored care and intervention. We suggest developing and providing interventions that may psychologically support families.

• The Korean Journal of Health Service Management
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• v.7 no.2
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• pp.37-52
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• 2013

The purpose of this study was to compare the differences of attitude to death and perception on HPC between nursing and medical students. The data was collected by questionnaires and the period of data collection was from September 17 to October 12, 2012. The results were as followings. Statistically significant differences were found course of knowing HPC(${\chi}^2$=24.29, p<.001), reason of unactive introduction(${\chi}^2$=15.92, p=.003), having to CPR in irresponsive terminal situation to you(${\chi}^2$=4.62, p=.032) and to your family(${\chi}^2$=5.64, p=.018), decision-making about DNR(${\chi}^2$=12.28, p=.002), awareness to medical authority legal representative(${\chi}^2$=14.75, p<.001), awareness (${\chi}^2$=11.01, p=.001) and subject(${\chi}^2$=24.73, p<.001) of AD, addiction(p<.001), tolerance(p<.001), taking a point(${\chi}^2$=23.28, p<.001) of narcotic analgesics and control of pain(p=.532). The findings of the study provides the basis for expanding practice and education to hospice-palliative care for nursing and medical students.