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Refusal of care by chronically and terminally ill patients : An ethical problem faced by nurses (간호사의 간호 제공 의무와 말기 환자의 간호 거부에 관련된 윤리 문제에 관한 연구)

  • 엄영란;홍여신
    • Journal of Korean Academy of Nursing
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    • v.24 no.2
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    • pp.190-205
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    • 1994
  • Respect for human life and respect for human dignity are two basic values to which organized nursing has urged its members to adhere in their service to mankind. Thus it is the nurses’ duty to provide health care in support of sustenance of life and to pay respect for the patient’s right to dignity. In practice, however, nurses may experience dilemmas between these duties much due to the de velopment of modern advanced techniques. These dilemmas have become more complex and difficult to resolve. Nurses are often faced with situations in which the terminally ill refuse professional care, posing serious conflicts between respect for human life and respect for human rights to self-determination. In such cases, resolution of the problem is not a simple matter, thus requires intensive study into the ethical questions related to the situation. The purpose of this study was to identify ethical problems that nurses experience in caring for terminally ill patients and explore the ways to the resolution of problems within the context of the situations. The methodology used for the study was a case study method which ‘New Casuistry’ proposed by Jonsen & Toulmin(1988) and the ‘Specified Principlism’ proposed by Degrazia(1992) as an alternative to old deductive and intuitive method. Cases were developed through semistructured indepth interviews according to the casutistry method. A total of seven nurses were interviewd who were caring for therminally ill patients. Four cases out of a total 14 cases were related to the topic. Through the case analysis it became evident that nurses appreciated other values more often than respect for the patient’s right to self-determination. These other values were convenience and efficiency in nursing practice in case 1, preservation of life above all other values in case 2, provision of nursing care to fulfill the nurse’s professional obligation at most in case 3, and respect for the family’s demand against the patient’s wish in case 4. This study showed that the most important ethical problems were conflict between respect for the patient’s right to self-determination and sustenance of life for the fulfillment of professional obligation. For this problem, benefit /burden analysis from the perspective of the patient and family for the promotion of patient’s wellbeing may be a way to resolve the conflict. Further, through these analysis it was shown that physicians’ and families’ opinions dominated in the decision - making and the opinions of nurses’ and patients’ tended not to be reflected. Thus the patient's right to his or her care was not readily respected. To solve this problem. nurses should make efforts to communicate reciprocally with their patients, family members and physicians in an effort to respect for their patient’s rights to life and diginity from the point of view and values of the patient. It is also important that nurses provide good basic nursing care up to the time of death regardless of decisions about providing or not aggressive treat-ment for chronically and terminally ill patients.

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A Study on the Systematic Integration of WASP5 Water Quality Model with a GIS (GIS와 WASP5 수질모델의 유기적 통합에 관한 연구)

  • 최성규;김계현
    • Spatial Information Research
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    • v.9 no.2
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    • pp.291-307
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    • 2001
  • In today's environmental engineering practice, many technologies such as GIS have been adopted to analyze chemical and biological process in water bodies and pollutants movements on the land surface. However, the linkage between spatially represented land surface pollutants and the in-stream processes has been relatively weak. This lack of continuity needs to develop a method in order to link the spatially-based pollutant source characterization with the water quality modeling. The objective of this thesis was to develop a two-way(forward and backward) link between ArcView GIS software and the USEPA water quality model, WASP5. This thesis includes a literature review, the determination of the point source and non-point source loadings from WASP5 modeling, and the linkage of a GIS with WASP5 model. The GIS and model linkage includes pre-processing of the input data within a GIS to provide necessary information for running a model in the forms of external input files. The model results has been post-processed and stored in the GIS database to be reviewed in a user defined form such as a chart, or a table. The interface developed from this study would provide efficient environment to support the easier decision making form water quality management.

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Effects of Fitness Management Class for Wellness Convergence - Based on Fitness, Obese Indices, Metabolic Syndrome Factors - (융복합적인 웰니스를 위한 교양체육 수업의 효과 - 체력, 비만 및 대사증후군 지표 중심으로-)

  • Lee, Ji-Young;Kim, Myoung-Su;Lee, Shin-Ho
    • Journal of Digital Convergence
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    • v.13 no.5
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    • pp.329-336
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    • 2015
  • The purpose of this study was to develop and manage fitness management class by experimenting effects of fitness management class on obese indices, metabolic syndrome risk factors and health and skill-related fitness in university students. Progress of fitness management class by exercise prescription program according to level of students health and fitness. Comparison of obesity indices, metabolic syndrome risk factors and health and skill-related fitness between fitness management class group and control(physical education class) group in before- and after-16week exercise prescription program. Decision of class contents and establishment of fitness management class. The effects of fitness management class appeared to higher than control group on obese indices, metabolic syndrome risk factors and health and skill-related fitness. In conclusions, we suggest that fitness management class for wellness convergence is effective for health promotion of students.

A Study on the Acceptance Decision Factors of Mobile Services: Focusing on Expanding Technology Acceptance Model by Intrinsic Motivation (모바일 서비스 수용결정요인에 관한 연구 - 내재적 이용동기에 의한 정보기술수용모형의 확장을 중심으로 -)

  • Choo, Shi-Gak;Sohn, Young-Kon;Jeon, Sang-Gil
    • Management & Information Systems Review
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    • v.30 no.4
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    • pp.117-146
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    • 2011
  • The objective of this study is to investigate factors influencing user's intention to use by expanding TAM(Technology Acceptance Model). Based on this model, this study developed a comprehensive model and user's motivation factors such as extrinsic and intrinsic motivation to describe their intention to accept WCDMA service. For this purpose those who have subscribed to and use the current mobile communication service - all of whom were 13 to 49 years old living in Seoul or other large cities - were surveyed. Structural equation model was conducted to identify and validate the relationship of overall variables relating to mobile service acceptance. The analysis results indicate that intrinsic motivations in mobile service acceptance process have significant impacts on perceived usefulness and perceived ease to use. The results of this study also proposed the way to boost mobile service user's extrinsic and intrinsic motivation for coming up with strategies on how to improve effectiveness of communication and marketing. Future directions and limitations are also discussed.

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A Study on the 'fragmentation' trend of modern film montage (현대영화 몽타주의 '파편화(fragmentation)' 경향 연구)

  • LEE, Jiyoung
    • Trans-
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    • v.3
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    • pp.29-53
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    • 2017
  • The film scholar Vincent Amiel divides into three types of montage through his book The Aesthetics of Montage ; Montage narratif, Montage discursif, and Montage decorrespondances. These three categories are the concept that encompasses the aesthetic class to which most movies belong. Early films pursued the essential and basic functions of editing, which tend to be modified in the direction of enhancing the director's goals over time. In this way, "Expressive Montage" is one of most important concepts of montage, not as a 'methodology' that combines narrative but as a 'purpose'. In the montage stage, the expressive montage work is done through three steps of decision. The process of 'combining' to combine the selected films in a certain order, after the process of 'selection' which selects only necessary parts of the rush film, and 'connection' to determine the scene connection considering the duration of the shot. The connection is the final stage of the montage. There are exceptions, of course. When fiction films of classical narratives use close-ups, or when using models or objects of neutered animals, the film induces the tendency of a "montage decorrespondances" rather than a "montage narratif" or "montage discursif". This study attempts to analyze the tendency of montage of works with 'uncertain connection' through 'collage' used by close-ups and montage decorrespondances as 'fragmentation tendency of modern films'. The fragmentation of the montage in contemporary film breaks the continuous and structural nature of the film, and confuses the narration structure that is visible on the surface of the film. The tendency of the fragmentation of the montage, which started from this close-up, seems to give an answer to the extensibility of the modern image.

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The Awareness of Teachers and College Students towards Sustainable Development and Education for Sustainable Development (지속가능발전 및 지속가능발전교육에 대한 대학생과 교사들의 인식)

  • Lee Sun-Kyung;Lee Jae-Young;Lee Soon-Chul;Lee Yu-Jin;Min Gyeong-Seok;Shim Suk-Kyung;Kim Nam-Soo;Ha Kyung-Hwan
    • Hwankyungkyoyuk
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    • v.19 no.1 s.29
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    • pp.1-13
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    • 2006
  • This study was aimed to explore the level of awareness of Korean teachers and college students towards sustainable development(SD) and education for sustainable development(ESD). A survey was conducted to understand the present status of awareness of SD and ESD among 317 college students and 625 teachers in Korea from April to May of 2005. The questionnaire included items asking whether they heard about terms such as sustainability or sustainable development, the source of information on SD, the level of understanding or the urgent task for SD in Korea. It also included questions about experiences in participating in or conducting ESD, the need for ESD, important areas in and the modality for ESD and the willingness to participate in ESD. The results showed that the level of awareness on SD among teachers was low compared to college students, who have a relatively high level of access on SD issues through textbooks and classes in high school. Interestingly, most of college students replied that they never received any ESD, even though they learned SD in class. Both the teacher and student group thought that tile priority of sustainable development should be an 'environment-related' area in the social, economical and environmental perspectives. Most of the students and teachers considered the concept of SD as 'pursuing the balance between environmental protection and economic development.' Some of the teachers recognized the concept of sustainable development in the paradigm of continuous economic development. Both groups responded that the urgent task related to sustainable development is 'environmental protection' and the 'reduction of poverty.' On the other hand, they had experiences in teaching related to natural resources, gender equity, health, human rights, climate changes and other SD issues in class, but not under the name of ESD. They also emphasized 'critical thinking and problem solving & decision-making' in education. Most of the students and teachers responded that it was needed to carry out ESD, and that the way of life for SD would be the priority. It is suggested that various pedagogy and modalities according to various target groups should be considered in providing ESD. It is necessary to use more effective strategies for ESD rather than just introducing the concept of SD. Also, it is needed to review the ESD practices of teachers and improve the quality of education within the scope of ESD.

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A Study on the Communication of the Functional Family (기능적인 가족의 커뮤니케이션에 관한 이론적 접근)

  • 조윤경
    • Journal of Families and Better Life
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    • v.2 no.1
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    • pp.131-150
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    • 1984
  • The purpose of this study is to explore the family as an interaction system, concentrating on the mutual influences between communication and family development; (1) how Communication patterns affect family relationships, and (2) how relationships among family members affect communication. In order to do this Galvin, Brommel used the following frame work; family is a system in which communication regulates cohesion and adaptability by a flow of message patterns through a defined network of evolving interdependent relationships. A family system consists of members, the relationships among them, the family attributes, the members attributes and an environment in which family functions. Within the framework of common cultural communication patterns, each family has the capacity to develop its own communication code based on the experiences of individual members and the collective family experience. Most of us develop our communication skills within the family context learning both the general cultural language and the specific familial communication code. Communication may be viewed as a symbolic, transactional process as the process of creating and sharing meanings. To say that communication is a process implies a continuous interaction of an indefinite large numbers of variables with a concomitant,. continuous change in the values taken by these variables. Finally the process implies change, Family functions include the primary functions of cohesion and adaptability, and supporting functions of family images, themes, boundaries, and biosocial issues. The primary functions reveal concepts integrated family interaction and supporting function, along with those of cohesion and adaptability, give shape to family life. the characteristics of developed relationships of richness, uniqueness efficiency, substitutability, pacing , openness spontaneity, and evaluation are reflected in the verbal and nonverbal behaviors with which family members negotiated a set of common meanings and develop thier own unique message system. The message system is the major element of communication process and influences both the form and the content of thier relationship and in create and share meanings. Family systems need to provide order and predictability for thier members, specifically focusing on communication rules and the networks by which messages are transmitted. Most rules emerge as a result of multiful interactions. There are basic rules and rules about rules, or metarules. Perceiving the rules of family system is very difficult because often family members don't think about the basic rules, much less the metarules. Breaking the rule may result in the creation of a new set because the system may recalibrate itself to accept more variety of behavior. Families develop communication networks to deal with the general issue. Family adaptability may be seen through the degree of flexibility in forming and reforming networks and networks become a vital part of the decision- making process and relate to the power dynamics operating within the family. Networks also play an integral part in maintaining the roles and rules operating with the family system. Thus networks and rules have mutual influence. The family -of -origin issues influence all aspects of family communication and account for many of the communication patterns, rules and networks and the role of the family -of-origin influences as a primary force for communication on behavior of newly forming systems. Each family system develops its own communication meanings. There is not one right way to communicate within a family but may be indefinitly large change of family life and communication behavior. Study on functional family communication helps to gain a better understanding of dynamics of family communication and ability of a new insight into the family.

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The Evaluation of Sasang Constitution with Use of Health Examination Data in Workplace (산업장내(産業場內) 건강검진(建康檢診) 자료(資料)를 활용(活用)한 사상체질(四象體質)의 평가(評價))

  • Kwon So-Hui;Lee Ki-Nam
    • Journal of Society of Preventive Korean Medicine
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    • v.6 no.2
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    • pp.1-18
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    • 2002
  • The subjects were 420 workers who received oriental and western health examination both in the workplaces for 1 month. This study was planned for the reflection of western health examination results through evaluation of Sasang constitution with use of data from western health examination, and for the presentation of basic data applicable to constitutional medicine with preventive medicine. Data that were collected in field research were analyzed into frequencies, One-Way ANOVA, Chi-square testing by the study purposes, and the research results were as follows: 1. The distribution of Sasang constitution in 420 subjects was Taeumin > Soumin > Soyangin, and the general characteristics of subject by Sasang constitution were no significant difference. 2. For the measured values for body by the subject of Sasang constitution, Taeumin had higher value for height, body weight, systolic and diastolic blood pressure than other 2 constitutions. Soumin had the lowest values in average for all items, and on the other hand, Soyangin had high pulse pressure compared to other constitutions. It was significant difference between constitutions. 3. For the hematological average, Taeumin had high average for FBS, Total-C, GPT, and Taeumin ,and Soyangin had high in Hb compared to Soumin. Soyangin had the highest average for ${\gamma}-GPT$, and there were significant differences between FBS, Total-C, Hb, GPT, ${\gamma}-GTP$, excepting for GOT. 4. For the result of health examination by the Sasang constitution of subject, Taeumin showed the highest percentage in the items of obesity, primary care, secondary suspicion, and showed significant difference by the constitution. For the distribution of the past disease history by the health examination result of Sasang constitution, Taeumin and Soumin had high prevalence rate for hypertension, liver disease, and Soyangin had high prevalence rate for liver disease, hypertension. For the requirement of lifestyle improvement to the subject, the highest requirements by the Sasang constitution were physical exercise for Soumin, regulation of body weight for Taeumin, and it showed significant difference. For the requirement of primary care by the constitution, the highest requiremetns were obesity control for Taeumin, blood pressure control for Soumin, Soyangin, and liver suspicion was the highest distribution for each constitution in the case of having decision for secondary suspicion.

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A Study on the Color Grouping System to Fashion (섬유컬러 그루핑 체계에 관한 연구)

  • 이재정;정재우
    • Archives of design research
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    • v.17 no.3
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    • pp.27-38
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    • 2004
  • It is important for designers to be supported with their decision-making on colours which is often based on personal distinction rather than logical dialogue that may lead to confusion within communicating with others. To help these problems and to gain productivity, we would like to propose a way to define colour grouping method. In other words, the purpose of this study is to help to improve the communication and productivity within the design and designers. The grouping was based and inspired by from the studies of Kobayashi, Hideaki Chijiawa, Allis Westgate and Martha Gill. The study of grouping is based on the "tones" of each group, as they seem to reflect a designer s sentimentalism of chosen colours the best. Each of these groups will be named Bright , Pastel ,Deep and Neutral The general concept of each groups are: - Bright: high quality of pixels of primary colour - Pastel: primary colour with white - - Deep: Primary colour with gray or black - Neutral: colours that does not include any of above Each of the colour group has been allocated into Si-Hwa Jung's colour charts and colour prism to visualize the relationships between the colour groups. These four groups and the colours included in them will be broken down to smaller groups in order to make colour palette. This would break the barrier and result in using colours in groups as well as crossover coordination. This study would result in new ways of using colurs for designers designers

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A Study on the Effects of the Information Asset Protection Performance on the Organization Performance: Management Activity and Control Activity (정보자산보호 성과가 조직성과에 미치는 영향에 관한 연구: 관리활동과 통제활동을 중심으로)

  • Kim, Kyung-Kyu;Shin, Ho-Kyoung;Park, Sung-Sik;Kim, Beom-Soo
    • Journal of Information Management
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    • v.40 no.3
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    • pp.61-77
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    • 2009
  • Recently, enterprises are protecting information assets with the various means of control and management. Nevertheless, they are confronted with the dilemma which the higher securitylevel they request, the lesser efficiency and productivity in short terms they acquire by the inconvenience of business process. In addition, in spite of the steady increase of organization's investment on information protection, the systematic way for the performance measurement of information protection has not been suggested, so that in reality, it is difficult to make the decision to invest on information-protection and elicit the direction to improve it. For this reason, this study intended to establish the concept of the protection and security of information assets of enterprises and to categorize the type of activities to protect information assets into management activity and control activity, and analyze the effects of management activity and control activity for information asset protection on the performance of information asset protection activity and organization. For this research, questionnaire survey was conducted with literature study and the PLS(Partial Least Square) was used to analyze the measurement model and hypotheses testing. The PLS analysis results indicate that management activity for information asset protection affects information asset protection performance. Further, organizational performance is influenced by information asset protection performance. Practical implications of these findings and future research implications are also discussed.