This study was to verify the effectiveness of the Life Review-Narrative group therapy program on decreasing depression and death anxiety in the elderly. The program was organized according to a course of life from childhood to old age. The objectives were for the elderly to enhance self-worth, to become aware of their solitary existence, to accept aging and death, to accept the life: both past and present, and to make the most of experiences in overcoming difficulties. For the most part, the program used reminiscence and re-authoring of the narrative therapy as counseling techniques. Thirty-two elderly people(16 in the experimental group, 16 in the control group) aged 60 years and over were randomly selected from patients at the Daegu Metropolitan City General Welfare Center. Two groups were identified as equivalents for the study in the pre-test. The program for the experimental group was implemented twice a week for 90 minutes per session over a 6-week period(Sep. 8-Oct.14. 2005). The pre-test(Sep. 8 2005), the post-test(Oct. 14. 2005) and the follow-up test(Nov. 14. 2005) were implemented in order to verify the effectiveness of the programs. The instruments used in the study were the Geriatric Depression Scale Short Form(Korean Version) and the Death Anxiety Scale. The data were analyzed using t-testing and One-Factor Repeated Measures ANOVA. This study supplemented other qualitative research methods in order to verify the variation in the depression and death anxiety in the elderly. The findings of the study were as follows: Significant decrease in the depression and death anxiety were reported in the experimental group. The control group however did not show any significant changes in the depression and death anxiety rates. The result of the post hoc multiple comparisons showed that the effects of the life review-narrative group therapy program has lasted effects on decreasing of the death anxiety. Nevertheless, the effects of the life review-narrative group therapy program on decreasing depression are not lasting. The study has limitations so further research is suggested.
Lee, Seo-Young;Kim, Won-Joo;Kim, Jae Moon;Kim, Juhan;Park, Soochul;Korean Society of Clinical Neurophysiology Education Committee
Annals of Clinical Neurophysiology
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v.19
no.2
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pp.118-124
/
2017
Electroencephalography (EEG) is frequently used to assist the diagnosis of brain death. However, to date there have been no guidelines in terms of EEG criteria for determining brain death in Korea, despite EEG being mandatory. The purpose of this review is to provide an update on the evidence and controversies with regarding to the utilization of EEG for determining brain death and to serve as a cornerstone for the development of future guidelines. To determine brain death, electrocerebral inactivity (ECI) should be demonstrated on EEG at a sensitivity of $2{\mu}V/mm$ using double-distance electrodes spaced 10 centimeters or more apart from each other for at least 30 minutes, with intense somatosensory or audiovisual stimuli. ECI should be also verified by checking the integrity of the system. Additional monitoring is needed if extracerebral potentials cannot be eliminated. Interpreting EEG at high sensitivities, which is required for the diagnosis of brain death, can pose a diagnostic challenge. Furthermore, EEG is affected by physiologic variables and drugs. However, no consensus exists as to the minimal requirements for blood pressure, oxygen saturation, and body temperature during the EEG recording itself, the minimal time for observation after the brain injury or rewarming from hypothermia, and how to determine brain death when the findings of ECI is equivocal. Therefore, there is a strong need to establish detailed guidelines for performing EEG to determine brain death.
Using high voltage electric fields induced by high voltage AC (10-12 kV/cm, 20 kHz) and pulsed (20-30 kV/cm, 40 Hz) electric field generator as a semipermanent and environment-friendly disinfecting apparatus, the disinfection effect of coliform group in the effluent of sewage plant was investigated. The effects of electric field strength, treatment time, discharge area of a discharge tube, water quality factors (electric conductivity, pH and SS) on its death rate were examined. The death rate of coliform group was increased with increasing electric field strength and treatment time. For AC and pulsed electric field generator, the critical electric field strength was 6 kV/cm and 2 kV/cm, respectively, and the critical treatment time was 5 min and 2 min, respectively, regardless of electric field strength. Comparing the death rate of coliform group by AC and pulsed electric fields used in this study, its death rate was higher for the latter than the former, but did not increase linearly with increasing electric field strength. The results obtained for the effects of discharge area, electric conductivity, pH and SS on the death rate of coliform group using AC electric field (12 kV/cm, 20 kHz) were as follows: its death rate showed the trend to increase linearly with increasing discharge area; for the effect of electric conductivity, its death rate was increased with increasing electric conductivity, regardless of ionic species, increased with increasing cationic valency, but was similar between the same cationic valency; the pH $5{\sim}9$ used in this study did not affect its death rate; its death rate was decreased with increasing SS concentration.
Journal of The Korean Society of Clinical Toxicology
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v.18
no.1
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pp.11-17
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2020
Purpose: This study examines errors in death certificates (DCs) issued to cases of poisoning. Methods: DCs issued in poisoning cases were retrospectively reviewed. Errors in the DC were classified as major and minor errors, and were evaluated in accordance with their impact on the process of selecting the cause of death (COD). Results: A total of 79 DCs were evaluated; 43 (54.4%) DCs were issued in the emergency department (ED), and 36 (45.6%) DCs were issued outside the ED. The average major and minor errors per DC were determined to be 0.4 and 3.3, respectively. Moreover, an average of 3.0 errors were discovered in DCs issued at the ED, and 4.4 errors in DCs issued outside the ED. The most common major errors were incorrect manner of death (11.4%, 9/79), followed by unacceptable COD (7.6%, 6/79), and the mode of dying as an underlying COD (5.1%, 4/79). The common minor errors most frequently encountered were incorrect time interval (86.1%, 68/79), followed by incorrect other significant conditions (73.4%, 58/79), and no record for date of onset (62.0%, 49/79). Conclusion: Our results indicate that the total numbers of major errors, minor errors and cases of misjudged cause of death were greater in DCs issued outside the ED than in DCs issued at the ED. The most frequently quoted major error of DCs related to poisoning was determined to be the incorrect manner of death.
Objective : This study aims to examine the association between exposure to suicide events and suicide ideation by analyzing the levels of suicide ideation among the groups with exposure to suicide death, non-suicide death, and no death in their social relationships. Methods : Data were derived from Wave I of the Longitudinal Study of Suicide Survivors' Mental Health. 1,998 adults nationwide selected using a stratified sampling method based on the Korean Census Data, were categorized into 3 groups with exposure to suicidal death, non-suicidal death, and no death. The levels of depression (Brief CES-D), subjective health status, and suicidal ideation (SSI) were measured. To examine the association between exposure to suicide and the level of suicide ideation, multiple regression analysis was used after controlling the socio-demographic and clinical factors including subjective health status and depression. Results : 32% reported their exposure to suicide. Compared to the other groups, the suicide-exposed group's level of depression and suicide ideation were significantly higher but the subjective health status was lower. Multiple regression model revealed that suicide exposure had a statistically significant association with suicidal ideation at p=0.000 even after controlling the clinical characteristics. Conclusion : HThe findings suggest that exposure to suicide is a risk factor for suicidal ideation. In the clinical field, it is necessary to consider patients' experience in exposure to suicide while treating and intervening in suicide-related cases. At the policy level, a mental health system for suicide prevention should consider this risk factor for those exposed to suicide in their family and social relationships.
The purpose of the present study was to assess the agreement of survival probability estimated by International Classification of Diseases l0th Edition(ICD-10) based International Classification of Diseases based Injury Severity Score(ICISS) with professional panel's judgment on preventable death. ICISS has a promise as an alternative to Trauma and Injury Severity Score(TRISS) which have served as a standard measure of trauma severity, but requires more validation studies. Furthermore as original version of ICISS was based ICD-9CM, it is necessary to test its performance employing ICD-10 which has been used in Korea and is expected to replace ICD-9 in many countries sooner or later. Methods : For 1997 and 1998 131 trauma deaths and 1,785 blunt trauma inpatients from 6 emergency medical centers were randomly sampled and reviewed. Trauma deaths were reviewed by professional panels with hospital records and survival probability of trauma inpatients was assessed using ICD-10 based ICISS. For trauma mortality degree of agreement between ICISS survival probability with judgment of professional panel on preventable death was assessed and correlation between W-score and preventable death rate by each emergency medical center was assessed. Results : Overall agreement rate of ICISS survival probability with preventable death judged by professional panel was 66.4%(kappa statistic 0.36). Spearman's correlation coefficient between W-score and preventable death rate by each emergency medical center was -0.77(p=0.07) and Pearson's correlation coefficient between them was -0.90(p=0.01). Conclusions : The agreement rate of ICD-10 based ICISS survival probability with of professional panel's judgment on preventable death was similar to TRISS. The W-scores of emergency medical centers derived from ICD-10 based ICISS were highly correlated with preventable death rates of them with marginal statistical significance.
Kim, Boon-Han;Kim, Moon-Sil;Kim, Hung-Kyu;Jung, Tae-Joon;Tak, Young-Ran;Chon, Mi-Young
The Korean Nurse
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v.37
no.1
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pp.98-106
/
1998
The purpose of this study was to investigate what effect providing the hospice care team with hospice education programs had on the death orientation. The subjects of study were 28 volunteers. 14 nurses. 30 clergies who registered on hospice education programs from Aug. 6th. 1996 to May 20th. 1997. The data were analysed by descriptive analysis. ANOVA. Duncan test. paired t-test. The results of the study can be summarized as follows ; 1. The degrees of death orientation were 85.70 in volunteers group. 84.31 in nurses group. and 73.00 in clergies group. So. clergies group has more positive death orientation than others(F=6.33. p=. 000). The degree of death orientation showed significant differences between age groups(F=5.78. p =.002). and religiosity(t=3.92. p=.000). There were no significant differences between the degree of death orientation and the others general characteristics of subjects. 2. The mean of death orientation was 80.04 before hospice education programs. but was 75.56 after hospice education programs(t= 3.92. p= .000). In conclusion. the subjects who received the hospice education programs showed the positive change in the degree of the death orientation. Therefore. it has been judged that education programs has been prerequisite in positive death orientation for hospice care. Furthermore. all of the hospice care members those who complete the hospice education program. will be performed efficient hospice care intervention for dying patients and their families.
Journal of agricultural medicine and community health
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v.23
no.2
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pp.215-227
/
1998
To find health problems of Pohang city and to plan the activities to solve them in the situation of localization, the mortalities of the citizens in recent three years from 1994 to 1996 were analyzed from the notices and the certificates of death. The ratios of the notices with the certificates of death In the rural area of Pohang city were higher than those of whole country, the ratios of the urban area were lower than the respective ones, and the ratio differences between the rural and urban area were increasing. It may be that medical facilities are not within easy access of the rural inhabitants. especially in the rural south district with high population density. The proportional mortality indicators(PMI) were lower them those of whole country, much lower in male. So the health status of young aged males is relatively unsatisfactory. The urban inhabitants died in hospitals about two times more than the rural inhabitants and the differences were increasing. It may be that living and housing conditions and socio-cultural differences affected on the places of death. Because it is thought that death in hospitals will be growing at high speed, it is necessary to enlarge facilities fur funeral services. The age standardized mortalities were lower than those of whole country and age grouped mortalities were also the same. There were not any consistent and meaningful findings in the sex ratios of mortality according to the age groups or the calendar years. The mortalities by neoplasms and cardiovascular diseases according to the twenty one major causes of death were rapidly increased from the middle ages in both male and female. So it is important to plan the activities for early detection and health maintenance or promotion by behavior modifications. The leading causes of death were cardiovascular diseases, hypertensive diseases, and traffic accidents. And accidental drowning because of coastal area, liver diseases in male, and low respiratory tract diseases in female were the leading causes of death in part of age groups.
Purpose: A descriptive correlation study was done to provide basic data for comprehensive nursing care by analyzing the, relationship between spiritual well-being and death anxiety of the elderly. Method: 358 respondents who lived in facilities for elders such as nursing homes and elder's rehabilitation centers were selected, and their age was over 65 years old. Paloutzian and Ellison(1982)'s spiritual well-being scale and Park(1989)'s death Anxiety scale was used. From August 2nd to November 7th, 2002, readymade questionnaires were handed out by the researcher to those who could fill it out and for those who could not fill out the questionnaires alone, the researcher read it and completed it by interview. The data were analyzed with SPSS Win 10.0 program, t-test, ANOVA, and correlation coefficient. Result: 1) The mean score for spiritual well being of the elderly was 43.95 in a possible range of 20-80. The mean score of religious well being was 22.22 and that of existential well being was 21.73 in a possible range of 10 - 40. 2) The mean score for death anxiety of the elderly was 109.04 in a possible range of 34 - 136. 3) There were significant differences in spiritual well being according to religion, and present occupation. 4) There were significant differences in death anxiety according to age, religion, and family status. 5) In testing concerning the relationship between spiritual well being and death anxiety, there was a statistically negative correlation(r=-.70 p=.000). Conclusion: There was a negative correlation between spiritual well being and death anxiety. When the nurse implicates the nursing intervention, which can promote the spiritual well-being, elder's death anxiety also can be released.
Kim, Jong Gun;Oh, Su Min;Cheon, Eui Young;Yoo, Jang Hak
Journal of the Korea Academia-Industrial cooperation Society
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v.17
no.1
/
pp.676-683
/
2016
This study examined the relationships between self-esteem, and the awareness of biomedical ethics and the quality of life and death attitude, as well as the factors influencing the death attitude among 130 nursing students in college. The data were analyzed using an independent t-test, one-way ANOVA, Pearson correlation coefficients, and multiple regression with the SPSS Win 14.0 Program. Significant positive correlations were observed between the self-esteem and death attitude, between the awareness of biomedical ethics and the death attitude. The predictors for the death attitude were self-esteem (${\beta}=.25$) and awareness of biomedical ethics (${\beta}=.11$). The model explained 21.2% (F=10.4, p<.001) of the variance. The findings indicated that more study will be needed to explore the factors influencing the death attitude and to develop education programs for reinforcing a positive death attitude among college nursing students.
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