• Journal of Korean Academy of Nursing
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• v.22 no.4
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• pp.636-652
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• 1992

This study identified the impact of childhood cancer on the Korean family. The purpose was to contribute knowledge for family nursing and pediatric hospice care practice with sick children and their families. This descriptive study was conducted during a 6 month period with children who were being treated for cancer at six university hospitals in Seoul. The data were gathered from members of 68 families ; 24(Group A), with a child newly diagnosed with cancer : 27(Group B), with a child under treatment and without complications, and 17 (Group C), with a child in relapse. Medical records, structured questionnaires and interviews were used for data collection. The questionnaires and interview schedules had been used previously in Martinson's research in the USA and China. The findings, conclusions, and suggestions are as follows. 1. The impact of childhood cancer on the family. Members of the family experienced fear, helplessness, guilty feelings, and anger at the time of the initial diagnosis and at relapse. Mothers complained of headache, anorexia and poor appetite, weight loss, sleep disturbance, and bad dreams. Many of the fathers either lost or changed jobs, and all working mothers stopped working. Half the parents reported changes in their marital relationships such as frequent quarrels but also stronger unity. Family members perceived cancer as the most frightening disease. Change in their world view was expressed as living on faith understanding suffering, determining to live a better life, wanting to live an upright life and valuing health as the most important. Religious activities are found most helpful through this difficult experience. Financial debt due to the treatment and care of the sick child, burdened 22 families. The above mentioned impact was most evidant in Group B(those presently undergoing treatment) and Group C(those in relapse). Findings indicate that nursing care should embrace the family of a child who is being treated for cancer. 2. Characteristics of the child with cancer The majority of the children in this sample had a diagnosis of leukemia. Their mean age was 6.8 and the ratio of boys to girls was 1.12 ; 1. The mean hospitalization frequency was 13.5 times and the mean duration of illness was 16.8 months. Most of 1.he children perceived cancer as the most frightening disease ; 32.7% of the children described their sickness as serious. Children in Group C were hospitalized more frequently, stayed in hospital for longer periods, and expressed their sickness as quite serious more often than the other two groups. These findings indicate how much comprehensive pediatric hospice nursing care services are needed along with relevant research and nursing education. 3. Characteristics of the families. The mean age of the father was 39.5 and the mother, 36,6 ; they are in their most productive life period. Mothers especially expressed feelings of financial uneasiness and powerlessness about giving up their jobs, and guilty feelings for not providing enough care and concern to other children due to taking care of the sick one. The burden of caring for the sick child can bring negative changes in family dynamics which they think provoke potential health problems in members of the family These findings suggest a need for nursing support and counselling resources. Findings also suggest the need for ethical inquiry about such questions as who should give information to the child in regard to diagnosis and prognosis, when, and how. Other suggestions included : 1) Quality health care for childhood cancer such as home care and pediatric hospice programs should be established. 2) Special and practical consideration for long-term patients should be made in the present insurance coverage. The reimbursement period for long-term patients should be lengthened. 3) Further in-depth qualitative studies are needed. 4) Education programs including guided practice experience for pediatric hospice care practitioners are needed.

• Journal of Korean Academy of Nursing
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• v.18 no.2
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• pp.197-210
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• 1988

The purposes of this study were : 1) to assess the level of pain and to identity the varieties and the degree of pain-related behavior, 2) to measure the level of correlation between the level of pain and the degree of pain- related behavior, 3) to test the correlation between the Korean Pain Rating Scale (KPRS) and Graphic Rating Scale(GRS), and 4) to gather data relevant to the Socio-demographic status of the subjects. The level of pain was measured by KPRS and GRS developed by the researchers. The KPRS consists of three dimensions ; the sensory, the affective and the miscellaneous and the GRS of two separate scales ; the intensity scale and the unpleasantness scale. Of the 2, 025 who had visited orthopedic and neurosurgical out-patients department of 11 university hospitals in various districts of Korea with the episode of Joint pain, 405 subjects were self-selected by responding to the data gathering tools and questionaires mailed. The results are summaried as follows : 1. Maale(217, 53.6%) exceeded female patients(188, 46.4%) in number and the onset of joint pain was more prevalent in the age groups of the 20s and the 30s. 160(39.5%) had been hospitalized for the treatment of, and 87(21.5%) had retired because of the joint pain. 2. Mean pain score measured by KPRS was 128.31 (range; 0-1.344.8) ; mean sensory score was 43.23(range ; 0-645.88%), mean affective score was 46.09(range ; 0- 356.72), and mean miscellaneous score was 39.99(range ; 0-341.68). Mean pain scores measured by GRS were ; sensory intensity score ; 109.1(range ; 0-200) and distress score ; 99.1 (range ; 0-200). 3. The prevalent sites of joint pain revealed to be the right knee joint(203; 50.1%), left knee joint(181(44.7%), left ilium(147, 36.3%), lumbar region (106; 26.2%), hip joint(92; 22.7%) and the ankle(84; 20.7%). 4. The average sleep hour was 6.8hours per day and the average rest hour during the day hours was 3.3hours (range 0-20). 5. The average duration of suffering from joint pain was 49.1 months. 6. Most of the subjects(298; 73.6%) used some sorts of pain relieving practices ; the most prevalent pain relieving practice was the compliance with the physician prescribed treatments(34.4%). 7. The level of discomfort in carrying out the ADL(activities of daily living was 101.16(38.83) and the level of needs for aid in carrying out the ADL was 76.62(31.79). 8. The interrelation between KPRS total score and GRS sensory intensity score(.4438), as well as that of GRS distress score(r＝.4446) were not highly correlated, however, sensory and affective dimension within KPRS (.7547) and pain intensity and distress score of GRS(.6975) revealed moderate intercorrelation. 9. Pain-related behaviors such as discomfort in carrying out ADL, the need for aids in carrying out ADL, frequency of pain relieving practices, varieties of pain sites and length of rest hours during the day hours revealed to be highly correlated with the level of pain measured by KPRS, GRS sensory intensity scale and GRS distress scale. The following are recommended ; 1. Test for the correlation of KPRS total score and the summated score of GRS ; sensory intensity and distress scores. 2. Possibilities of utilization of the pain-related behaviors which revealed high correlation as indirect assessment tool for measuring the level of pain.

• Journal of agricultural medicine and community health
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• v.42 no.3
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• pp.119-131
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• 2017

Objectives: The purpose of this study was to compare the diabetic management indicators between agriculture, forestry, and fishery workers (AFF) and other occupational adults (non-AFF) in community-dwelling diabetes. Methods: The study population consisted of 22,127 diabetic population ${\geq}19years$ who participated in the 2015 Community Health Survey. Chi-square test and logistic regression analysis was used to compare the diabetic management indicators between AFF and non-AFF. Socioeconomic characteristics such as age, gender, education level, monthly household income, National Basic Livelihood Security status, and marital status was sequentially adjusted. Results: Among total diabetic population, 3,712 people (16.8%) was AFF and 18,415 people (83.2%) was non-AFF. The fully-adjusted odds ratio [OR] (95% confidence interval [CI]) of current non-medical treatment (0.72, 0.66-0.79), measurement of hemoglobin A1c (0.61, 0.55-0.67), screening for diabetic retinopathy (0.76, 0.70-0.83), screening for diabetic nephropathy (0.75, 0.70-0.81), non-alcoholic or moderate drinking (0.70, 0.64-0.78), nutrition label reading (0.83, 0.71-0.98), low salt preference (0.85, 0.78-0.93), dental examination (0.60, 0.54-0.66), scaling experience (0.84, 0.77-0.93), regular toothbrushing (0.66, 0.58-0.76), and diabetes management education (0.84, 0.77-0.92) was significantly lower in AFF compared to non-AFF. In contrast, the fully-adjusted OR (95% CI) of AFF's low stress level (1.39, 1.26-1.52) and adequate sleep duration (1.22, 1.13-1.32) was significantly higher than non-AFF, which are better indicators of diabetic management in AFF. Conclusions: Overall, the level of diabetes management of AFF was not as good as that of non-AFF. In order to improve the level of diabetes management of AFF, a delicate diabetes intervention strategy considering the occupational characteristics of AFF will be needed.

• Sim-seong Yeon-gu
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• v.31 no.2
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• pp.113-150
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• 2016

Chobun refers to a temporary grave covered with straw thatch that contains a corpse until its flesh is gone. When all the flesh has rotted away, the straw grave is disassembled and only the bones are retrieved. Therefore, Chobun is an example of a secondary burial custom (German : Doppel Bestattung) that is composed of a first temporary funeral for processing the corpse's flesh, and a second permanent burial of the final remains (bones or ashes). The duration of the temporary burial is determined by the time needed for decomposing the flesh of the deceased. Building a Chobun progresses putrefaction and reduction to bone. In the literature of alchemy, putrefaction and new life occur simultaneously. The purpose of rotting is to make the flesh disappear, leaving only its essence. It is making the physical body enter a spiritual state, so that the dead can enter into a different world. One must endure the unstable rotting process until the smell of flesh has faded. The rotting process is the attitude of accepting the terrible, polluted aspect of the corpse, while maintaining a helpless, passive posture, in order to allow new possibilities. When we try to approach an archetypal aspect of the unconscious, it is often experienced in threatening, aggressive ways. In the individuation process, the unconscious offers us the blessing of a new spiritual awakening and renewed sense of life, only when we have the courage to see this terrifying and contaminated side of our psyche. This is exactly what putrefaction means. Bone and skeleton symbolize the indestructible, imperishable, and essential elements of life. Bone is the minimum unit and foundation for regeneration, where new life can grow. Reduction to bone is moving back to the origin of life, to the womb. Psychologically, it means discarding one's ego-centeredness and allowing the Self to lead the entire process of individuation. Going through the painful process of reduction to a skeleton for the purpose of further development is a declaration of the death of the ego, aiming at the liberation from perishable flesh and acquisition of the spiritual, regenerative, and immortal elements of life. Chobun also denotes the yearly decay and revival of life, especially of vegetal life. In Chobun, this symbolic meaning of the vegetal cycle of life is emphasized to represent the part of life that survives even after death. Vegetation related to Chobun deals with the continuity of life and psychologically with the Self. Images of vegetation are closely related to the existence of life beyond death, which is the existence of the Self, the source of energy that constantly renews and rejuvenates the consciousness.

• Tuberculosis and Respiratory Diseases
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• v.41 no.4
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• pp.379-388
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• 1994

Background : In sleep apnea syndrome, arterial oxygen saturation($SaO_2$) decreases at a variable rate and to a variable degree for a given apneic period from patient to patient, and various kinds of cardiac arrythmia are known to occur. Factors supposed to affect arterial oxygen desaturation during apnea are duration of apnea, lung voulume at which apnea occurs, and oxygen consumption rate of the subject. The lung serves as preferential oxygen source during apnea, and there have been many reports related with the influence of lung volume on $SaO_2$ during apnea, but there are few, if any, studies about the influence of oxygen consumption rate of an individual on $SaO_2$ during breath holding or about the profile of arterial oxygen resaturation after breathing resumed. Methods : To investigate the changes of $SaO_2$ and heart rate(HR) during breath holding(BH) and rebreathing(RB) and to evaluate the physiologic factors responsible for the changes, lung volume measurements, and arterial blood gas analyses were performed in 17 healthy subjects. Nasal airflow by thermistor, $SaO_2$ by pulse oxymeter and ECG tracing were recorded on Polygraph(TA 4000, Gould, U.S.A.) during voluntary BH & RB at total lung capacity(TLC), at functional residual capacity(FRC) and at residual volume(RV), respectively, for the study subjects. Each subject's basal metabolic rate(BMR) was assumed on Harris-Benedict equation. Results: The time needed for $SaO_2$ to drop 2% from the basal level during breath holding(T2%) were $70.1{\pm}14.2$ sec(mean${\pm}$standard deviation) at TLC, $44.0{\pm}11.6$ sec at FRC, and $33.2{\pm}11.1$ sec at RV(TLC vs. FRC, p<0.05; FRC vs. RV, p<0.05). On rebreathing after $SaO_2$ decreased 2%, further decrement in $SaO_2$ was observed and it was significantly greater at RV($4.3{\pm}2.1%$) than at TLC($1.4{\pm}1.0%$)(p<0.05) or at FRC($1.9{\pm}1.4%$)(p<0.05). The time required for $SaO_2$ to return to the basal level after RB(Tr) at TLC was not significantly different from those at FRC or at RV. T2% had no significant correlation either with lung volumes or with BMR respectively. On the other hand, T2% had significant correlation with TLC/BMR(r=0.693, p<0.01) and FRC/BMR (r=0.615, p<0.025) but not with RV/BMR(r=0.227, p>0.05). The differences between maximal and minimal HR(${\Delta}HR$) during the BH-RB manuever were $27.5{\pm}9.2/min$ at TLC, $26.4{\pm}14.0/min$ at RV, and $19.1{\pm}6.0/min$ at FRC which was significantly smaller than those at TLC(p<0.05) or at RV(p<0.05). The mean difference of 5 p-p intervals before and after RB were $0.8{\pm}0.10$ sec and $0.72{\pm}0.09$ sec at TLC(p<0.001), $0.82{\pm}0.11$ sec and $0.73{\pm}0.09$ sec at FRC(p<0.025), and $0.77{\pm}0.09$ sec and $0.72{\pm}0.09$ sec at RV(p<0.05). Conclusion Healthy subjects showed arterial desaturation of various rates and extent during breath holding at different lung volumes. When breath held at lung volume greater than FRC, the rate of arterial desaturation significantly correlated with lung volume/basal metabolic rate, but when breath held at RV, the rate of arterial desaturation did not correlate linearly with RV/BMR. Sinus arrythmias occurred during breath holding and rebreathing manuever irrespective of the size of the lung volume at which breath holding started, and the amount of change was smallest when breath held at FRC and the change in vagal tone induced by alteration in respiratory movement might be the major responsible factor for the sinus arrythmia.