• Title/Summary/Keyword: University Autonomy

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Epidural Infusion of Morphine and Levobupivacaine through a Subcutaneous Port for Cancer Pain Management

  • Heo, Bong Ha;Pyeon, Tae Hee;Lee, Hyung Gon;Kim, Woong Mo;Choi, Jeong Il;Yoon, Myung Ha
    • The Korean Journal of Pain
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    • v.27 no.2
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    • pp.139-144
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    • 2014
  • Background: To manage intractable cancer pain, an alternative to systemic analgesics is neuraxial analgesia. In long-term treatment, intrathecal administration could provide a more satisfactory pain relief with lower doses of analgesics and fewer side-effects than that of epidural administration. However, implantable drug delivery systems using intrathecal pumps in Korea are very expensive. Considering cost-effectiveness, we performed epidural analgesia as an alternative to intrathecal analgesia. Methods: We retrospectively investigated the efficacy, side effects, and complications of epidural morphine and local anesthetic administration through epidural catheters connected to a subcutaneous injection port in 29 Korean terminal cancer patients. Patient demographic data, the duration of epidural administration, preoperative numerical pain rating scales (NRS), side effects and complications related to the epidural catheterization and the drugs, and the numerical pain rating scales on the 1st, 3rd, 7th and 30th postoperative days were determined from the medical records. Results: The average score for the numerical pain rating scales for the 29 patients decreased from $7{\pm}1.0$ at baseline to $3.6{\pm}1.4$ on postoperative day 1 (P < 0.001). A similar decrease in pain intensity was maintained for 30 days (P < 0.001). Nausea and vomiting were the most frequently reported side effects of the epidural analgesia and two patients (6.9%) experienced paresthesia. Conclusions: Epidural morphine and local anesthetic infusion with a subcutaneous pump seems to have an acceptable risk-benefit ratio and allows a high degree of autonomy to patients with cancer pain.

Support Needs for Health Promotion of Community-Dwelling People with Disabilities: Perspectives of Operators Managing Disability Supportive Housing (지역사회 거주 장애인의 건강관리 향상을 위한 지원 요구 분석: 장애인지원주택 운영 관리자의 관점에서)

  • Nam, Hye Jin;Lee, Haesun;Park, Han Nah;Lee, Sujin;Kim, Bohye;Yoon, Ju Young
    • Journal of Korean Academy of Nursing
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    • v.54 no.2
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    • pp.211-223
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    • 2024
  • Purpose: Recent studies have focused on policies aimed at supporting the independence of individuals with disabilities in communities. As part of this initiative, supportive housing, integrated care, and residential spaces offer tailored services based on individual needs and autonomy. The attitudes and knowledge of the administrators supporting supportive housing residents regarding health management can influence the well-being of individuals with disabilities. Therefore, this study aimed to explore the challenges faced by supporting housing workers in enhancing the self-management skills of individuals with disabilities. Methods: In this qualitative study, focus group interviews were conducted in August 2023 with nine administrators working to support housing in Seoul. Qualitative content analysis was used to analyze the interview data. Results: The needs and challenges in enhancing the self-management skills of individuals with disabilities were as follows: (1) the complexity of health management challenges, (2) bidirectional strategies for strengthening health management capabilities, and (3) support for systematic health management. Additionally, eight subthemes were derived. Conclusion: By investigating the difficulties experienced and identifying the necessary support requirements for supportive housing workers, this study seeks to uncover insights and identifies areas for improvement and strategies for health management. This study acknowledges the educational and institutional support necessary to improve the health and quality of life of individuals with disabilities residing in supportive housing.

Current Status of Informed Consent Form for Acupotomy in Korean Medicine Hospitals and Development of a Standard Informed Consent Form Using Delphi Method (한방병원의 침도 시술 동의서의 현황 조사와 델파이 기법을 활용한 표준 시술 동의서 개발)

  • Jihun Kim;Bonhyuk Goo;Hyongjun Kim;Kyoungsuk Seo;Myungjin Oh;Myungseok Ryu;Sang-Hoon Yoon;Kwang Ho Lee;Hyun-Jong Lee;Jungtae Leem;Hyungsun Jun;Jeong Ihn Sook;Sung Woon Choi;Tae Wook Lee;Yeonhak Kim;Yoona Oh;Kunhyung Kim;Gi Young Yang;Eunseok Kim
    • The Journal of Korean Medicine
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    • v.45 no.1
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    • pp.182-201
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    • 2024
  • Objectives: This study was conducted to develop a standard acupotomy consent form that takes into account the unique characteristics of Korean Medicine. The study was motivated by the increasing importance of patient autonomy and the growing number of legal disputes related to medical malpractice in the clinical field of Korean Medicine. Methods: The analysis phase of the study involved a survey of the current status of acupotomy consent forms in Korean Medicine hospitals nationwide. The items of each form were analyzed based on the contents of the Medical law and the standard contract for medical procedures of the Fair Trade Commission (FTC). In the development and evaluation phase, the items and contents of the acupotomy consent form were evaluated using a 5-point Likert scale and content validity was assessed through two rounds of Delphi surveys. In the improvement phase, the contents of the consent form were revised based on the results of a survey of inpatient and outpatient patients in the Department of Acupuncture and Moxibustion at Pusan National University Korean Medicine Hospital, and real-time online meeting. The final version of the standard acupotomy consent form was completed after undergoing proofreading and corrections by a linguistics expert. Results: Only 30% of Korean Medicine hospitals have implemented acupotomy consent forms. The items of the consent forms did not fully include the items presented in the Medical act and the standard contract for medical procedures of the FTC. To address this issue, two rounds of Delphi surveys and a real-time discussion were conducted with a panel of 12 experts on 27 preliminary items of consent forms. The items and contents that met the criteria for content validity ratio, convergence, and consensus were derived. Based on the derived items and content, a standard acupotomy consent form was developed. Conclusions: The standard consent form for acupotomy is anticipated to ensure patient autonomy and enhance transparency and liability in acupotomy. Furthermore, it is expected to serve as evidence in case of medical disputes related to acupotomy and contribute as a reference document for the development of standard consents forms for various procedures of Korean Medicine. However, the limitations of the study include that the survey of consent forms was limited to only training hospitals of Korean Medicine, and the standard consent form is only applicable to adults in Korea. Future studies are needed to address these limitations.

Comparative Review of Treatment Based on Syndrome Differentiation and Treatment Based on Syndrome Differentiation from Disease - Emphasis on Hypertension and Headache - (변증논치(辨證論治)와 병증변치(病證辨治) 장단점의 비교고찰 - 고혈압과 두통의 예를 중심으로 -)

  • Gi, Youjong;Shin, Sunjoong;Han, Wonyoung;Kim, Hyundo;Han, Yoochang;Lee, Sundong
    • Journal of Society of Preventive Korean Medicine
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    • v.21 no.1
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    • pp.9-17
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    • 2017
  • Objectives : Comparative review was rendered to evaluate strengths and weaknesses of two common treatment approaches of treatment based on syndrome differentiation and treatment based on syndrome differentiation from disease. A typical symptom of headache from hypertension was chosen for substantial approach of this review. Methods : Pros and cons of two different approaches to disease were evaluated based on literatures and texts focusing treatment based on syndrome differentiation and treatment based on syndrome differentiation from disease. Headache can be correlated with hypertension yet it can be induced by multiple other factors, and headache may/may not accompany hypertension. Hypertension is an example of treatment based on syndrome differentiation from disease and headache can be an example of treatment based on syndrome differentiation. Results : Treatment based on syndrome differentiation can give more autonomy and flexibility in approach to the disease, Intuition, experience, and traditional medical theory can be applied with ease. However, management and eradication of diseases are difficult and standardization of treatment is not easy among practitioners. Treatment based on syndrome differentiation from disease incorporated merits of both eastern and western medicines, achieving more evidence based diagnosis and treatment. Eradication and standardization of disorders are possible with the latter approach. Conclusions : Comparing two systems of treatment based on syndrome differentiation and treatment based on syndrome differentiation from disease with emphasis on hypertension and headache yielded medical values. Treatment based on syndrome differentiation from disease appears to be superior in medical values and effectiveness, but further evaluation and interest are needed to make advancement in Korean traditional medicine.

Job Satisfaction, Subjective Class Identification and Associated Factors of Professional Socialization in Korean Physicians (의사집단의 전문직 사회화 과정과 사회적 지위 만족도, 경제적 보상 만족도 그리고 주관적 계층인식과의 관련성)

  • Yoon, Hyung-Gon;Hwang, In-Kyoung;Mun, Yeong-Bae;Lee, Hee-Young;Yoon, Seok-Jun
    • Journal of Preventive Medicine and Public Health
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    • v.41 no.1
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    • pp.30-38
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    • 2008
  • Objectives : The aim of this study was to determine the relationship between the core properties of professional socialization and social status satisfaction, economic reward satisfaction, and subjective class identification. Methods : Medical knowledge and skill, autonomy, and professional value factors were used as essential properties of professional socialization to determine the association with job satisfaction and subjective class identification. The authors used a self-administered questionnaire survey and collected nationwide data between July and August 2003, with 211 responses used for final analysis. Results : 'Age' and 'trust and respect' were positively associated with social status satisfaction, and 'occupation' was negatively associated. 'Income' and 'trust and respect' were positively related to economic reward satisfaction, and 'practicing for oneself', and 'a sense of duty and attendance' were negatively related. 'Practicing for oneself', 'not believing explanations', and 'a sense of duty and attendance' had a positive relationship with subjective class identification. 'Income', 'knowledge system', 'medical mistakes', 'treating like goods', 'meaning and joy', and 'trust and respect' had a negative relationship. Conclusions : The core property variables of professional socialization had a different relationship with social status satisfaction, economic reward satisfaction and subjective class identification. In particular, many core property variables were associated with subjective class identification positively or negatively. The development of professional socialization would help promote job satisfaction and subjective class identification.

The Effect of a Program Combining Resistance Exercise and Group Exercise on Balance, Grip Strength, and Quality of Life of Children with Cerebral Palsy (저항성 운동과 그룹 운동을 병합한 프로그램이 뇌성마비 아동의 균형능력, 파악력 및 삶의 질에 미치는 영향)

  • Kim, Sung-Hyeon;Shin, Ho-Jin;Hahm, Suk-Chan;Park, Sun-Wook;Cho, Hwi-Young;Lee, Min-Goo
    • Journal of the Korean Society of Physical Medicine
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    • v.15 no.4
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    • pp.75-85
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    • 2020
  • PURPOSE: Cerebral palsy is a common cause of disability in children, requiring constant rehabilitation. Improving balance in children with cerebral palsy helps to alleviate daily movement and the quality of life. This study examines a program that combines Resistance Exercise and Group Exercise, and investigates the effect on trunk control ability, balance ability, maximum grip strength, and quality of life of children with cerebral palsy. METHODS: Totally, 9 children with cerebral palsy participated in this study. Resistance exercise was performed for 8 weeks, 40 minutes every day. Group Exercise was conducted for 8 weeks, 40 minutes each Sunday. All participants were evaluated by the Korean version of the trunk control measurement scale, pediatric reach test, grip strength test, and KIDSCREEN-52. RESULTS: The trunk control ability was significantly improved in all subcategories (p < .05). In the pediatric reach test, the left and right directions were significantly improved (p < .05). Maximum grip strength was significantly improved in both hands (p < .05). The quality of life significantly improved in total score, physical well-being, general moods, self-perception, autonomy, relationship with parents, and home life (p < .05). CONCLUSION: Considering the encouraging results, we propose to use Resistance Exercise and Group Exercise as programs other than rehabilitation treatment in hospitals, to improve motor function and quality of life of children with cerebral palsy.

A study on the entrepreneurial intention determinants of university students (대학생들의 창업의지 결정요인에 관한 연구)

  • Hong, Jeong-Pyo;Yang, Hae-Sool
    • Journal of Digital Convergence
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    • v.12 no.11
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    • pp.141-157
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    • 2014
  • This study explored the entrepreneurial intention of university students by empirical study on them and studied the various variables, which have impact on their entrepreneurial intention. The result of examination on the impact factors of each independent variable on entrepreneurial intention was as following. There were significant relation with individual ability in individual characteristics and with safety orientation, autonomy orientation, technology orientation and business orientation in career orientation. The examination result on the impact of entrepreneurial environment on entrepreneurial intention was as following. There was significant relation between individual network and entrepreneurial policy. It was also possible to find that a student, who received entrepreneurial education as one of control variables, has higher entrepreneurial intention than a student who did not receive entrepreneurial education. Especially, business orientation was the most significant factor on entrepreneurial intention among multiple significant variables. Therefore, diverse entrepreneurial education programs should be developed and supplied so that university students can create business idea of own and reinforce the design ability related to the business.

An Exploratory Study on the e-Learning Motives and Intent of e-Learning Learners (이러닝 학습자들의 이러닝 이용동기 및 이용의도에 관한 탐색적 연구)

  • Shin, Ho-Young
    • Journal of the Korea Convergence Society
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    • v.10 no.7
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    • pp.225-233
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    • 2019
  • The purpose of this study was to investigate the factors affecting e-learning usage intention of university students who have no prior e-learning experience. To address this issue, the study was carried out in two stages on university students at Y and K universities of Gyeongbuk province. After conducting the first survey, we constructed the measurement items and conducted the second survey on the factors that influence the learner's intention to use as the basic theory based on the results of the survey and the interviews with the experts. The result shows, first, due to the autonomy, the biggest advantage for e-learning, students' self-control decreases which affects e-learning fault. Second, university students use e-learning because of its convenience, ease of use and usefulness. However, convenience of learning space found to be useful in using e-learning, but it does not affect their actual intention to use e-learning. The result of this study can be used as basic data for the implementation of e-learning within the university and enhancing the individuals' learning effectiveness.

Work Environment and Depressive Symptoms of Webtoon Writers

  • Jinwoo Lee;Jeehee Min;Yu Min Lee;Min Young Park;Hyoung-Ryoul Kim
    • Safety and Health at Work
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    • v.15 no.2
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    • pp.172-180
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    • 2024
  • Background: Webtoon, a digital form of comics created in the Republic of Korea, has spread widely with advantages that anyone can become a cartoonist and that autonomy of creation is guaranteed. The purpose of this study is to identify the working conditions of webtoon writers and analyze the relationship between these conditions and depressive symptoms. Methods: A survey was carried out on webtoon writers and a survey data of 312 webtoon writers were analyzed. The questionnaire included basic socio-demographic characteristics, webtoon writers' contractual type, fields of activity (webtoon creator, story writer, illustrator), and working environment (labor discretion etc.). We investigated depressive symptoms and analyzed its relation to the work environment of webtoon writers. Results: Webtoon writers were exposed to long working hours, high labor intensity, limited labor discretion, negative comments from readers, and had a high prevalence of depressive symptoms. Compared to story writers who contracted directly with platforms, story writers and the illustrators who contracted with content providers (CPs) were 9.51 times (OR = 9.51, 95% CI = 1.47 - 61.33) and 6.47 times (OR = 6.47, 95% CI = 1.08 - 38.75) more likely to have depressive symptoms, respectively. Conclusions: This study emphasizes the urgent necessity to improve the overall working environment in the webtoon industry and implement measures to tackle the escalating mental health challenges faced by illustrators and story writers contracted with CPs, especially given the increasing popularity of novel comics.

Manifest Weeds and Self-Actualization of Patients with Essential Hypertension (본태성 고혈압 환자의 자기실현 및 욕구구조에 관한 연구)

  • 강익화
    • Journal of Korean Academy of Nursing
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    • v.8 no.1
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    • pp.163-180
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    • 1978
  • Much of a person's energy is spent in the effort of becoming a productive member of to-day's complex society. This activity may cause tension, and chronic unrelieved tension is an influential factor in blood pressure elevation. The problem of this study was to identify manifest needs and self-actualization of patients with essential hypertension, and to analyse and compare their manifest needs and selt-actualization with the selected general characteristics of We, sex, religion, occupation and level of education with a control group of patients with normal blood pressure readings. The purpose was to contribute to the planning of nursing interventions toward reducing the impact of complex psycho-somatic factors on the anxiety of patients with essential hypertension. The instruments used included selected items from the Edwards (1959) Personal Preference Schedule (EPPS) as adapted by Hwang (1965) and from the Personal Orientation Inventory (POI) (Shostrom 1964, 1974) adapted by Kim and Lee (1977) to measure manifest needs and self-actualization. The convenience sample was chosen from 149 persons who presented themselves for general physical examinations at Ewha University Medical Centre and 41 patients diagnosed with essential hypertension at three general hospitals in Seoul during June 1 and August 31, 1977. Forty-nine persons from the Ewha group with blood-pressure readings exceeding 150/90 were added to the experimental group. Data were analysed by the S.P.S.S. computer programme using t-test and tests for statistical significance. Statistically significant findings were as follows: A. Blood Pressure and Manifest Needs. 1. with the exception of Autonomy, patients with hypertension had significantly high scores on all variables Abasement, Achievement, Affiliation, Aggression, Dominance, Emotionality, Exhibitionism and Sex. 2. When mean scores of normal persons were compared by age groups, normal persons had higher scores in the following order on Abasement (50's, 40's, 20's, 30's), Achievement (50's, 30's, 40's, 20's), Affiliation (50's, 40's, 30's, 20's), Dominance (50's, 40's, 40's, 20's) and Exhibitionism (30's, 50's, 40's, 20's). In each case, there was a significant difference between the first and last age group scores. 3. When the mean scores of normal persons were compared by sex, normal men had higher scores than women on Achievement, Affiliation, Aggression, Dominance, Exhibitionism and Sex. Male patients had higher scores than female patients on Achievement, Dominance, Exhibitionism and Sex, but female patients scored higher in Emotionality. 4. Normal persons had higher scores related to religion in the following order on Achievement (Buddhism, no religion, Christianity). Hyper tensive patients had higher scores on. Exhibitionism (no religion, Christianity, Buddhism). 5. Normal persons had higher scores related to occupation in the following order on Achievement and Exhibitionism (unemployed, office workers, teachless, businessmen), Emotionality (office workers, unemployed, businessmen, teacher) and Sex (office workers, unemployed, teachers, businessmen). Hypertensive patients had higher scores on Achievement and Aggression (teachers, businessmen, office worker, unemployed), Dominance and Exhibitionism (businessmen, teacher, of ace workers, unemployed) and Sex (teachers, office worker, businessmen, unemployed). 6. Normal persons had higher scores related to level of edification in the following order on Abasement, Emotionality and Autonomy (secondary school graduation, university). Hypertensive patients had higher scores on Abasement (no education, primary, university, secondary), Achievement (no education, secondary, university, primary) , Dominance (university, no education, secondary, primary), Exhibitionism (university, secondary, no education, primary), and Sex (university, secondary, primary, no education). B. Blood Pressure and Self_Actualization 1, Patients with hypertension had significantly lower scores on all variables. 2. Normal persons had higher scores related to age groups in the following order on Existentiality (20's, 30's, 40's, 50's). Hypertensive patients showed no significantly different scores. 3. Normal women had higher scores than men on Time Competence. Normal men had higher scores on Feeling Reactivity. Male patients had higher scores than women on Self-Actualizing Value and Self-Regard. 4. Normal persons ha 1 higher scores related to religion on spontaneity (Buddhism, no religion, Christianity). Hypertensive patients had higher scores on Time Competence and Nature of Man (Buddhism, Christianity, no religion). 5. Normal persons had higher scores related to occupation in the following order on Existentiality (teachers, office workers, businessmen, unemployed) and Self-Regard (unemployed, office workers, teachers, businessmen). Hypertensive patients showed no significantly different scores. 6. Normal persons had higher scores related to level of education in the following order on Existentiality and Self-Acceptance (university, secondary). Hypertensive patients had higher scores on inner-Director (university, secondary, no education, primary) and Existentiality (university, secondary, primary, no education). Recommendations for nursing interventions with hypertensive patients with emotional problems or low self-actualization were made. 1. The nurse should encourage the patient through her interactions with other members of the medical team to accept counselling and health education. 2. Through her therapeutic interpersonal relationships with the patient, the nurse should help him discover the causes of his emotional tension. 3. Through her health teaching with the family, the nurse should encourage them to participate with the medical team in the patient's therapeutic plan and in providing him with the minimum possible emotional support. 4. Through frequent counselling with the obsessive-thinking and inflexible patient, the nurse should reevaluate the patient's behaviour and her interventions. 5. Seriously ill patients should be given needed reeducation by members of the professional medical team.

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