• Title/Summary/Keyword: death acceptance

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Subjective Attitudes towards Terminal Patients of Nursing Students with Clinical Practice Experience: Application of Q Methodology (임상실습을 경험한 간호대학생의 말기환자에 대한 주관적 태도: Q방법론 적용)

  • Lee, Eun Ju;Hwang, Kyung-Hye;Cho, Ok-Hee
    • Journal of Hospice and Palliative Care
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    • v.22 no.4
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    • pp.156-165
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    • 2019
  • Purpose: This study was conducted to identify subjective attitudes towards terminal patients in nursing students who had clinical practice. The types of subjective attitude were classified by applying Q methodology. According to those types, basic reference data for the development of educational programs were provided. Methods: Thirty-four final Q samples were selected, and Q classification with a nine-point scale was performed with P samples of 43 nursing students. A key factor analysis was conducted with the collected data using the PC QUANAL program. Results: Nursing students' attitudes towards terminal patients were grouped into three types. The total variable was 49.96%. Students with Type 1 ("wish for life-sustaining medical treatment") thought that terminal patients accurately understood their medical condition and wanted to prolong their lives. Others with Type 2 ("need for service and support") believed that a multidisciplinary nursing system needs to be established to help terminal patients prepare for death. Students with Type 3 ("awareness and acceptance of death") thought that terminal patients wanted to die with dignity at a hospice unit. Conclusion: This study analyzed various types of attitude towards terminal patients, as perceived by nursing students with clinical training experience. Development of educational programs for each attitude type analyzed in this study could contribute to systematic training programs for nursing students caring for terminal patients.

A Study on the Modern Implication and Religious Value of Medicine Buddha Faith (약사여래 신앙의 현대적 의미와 신앙적 가치 고찰)

  • Kim, Jung-Suk
    • The Journal of the Korea Contents Association
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    • v.22 no.6
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    • pp.428-438
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    • 2022
  • The purpose of this study was to examine the modern implication and religious value of the Medicine Buddha faith. Accordingly, the theoretical background of Medicine Buddha faith was reviewed based on various literature, including Bhaisajyaguru Sutra, a representative literature on Medicine Buddha, and the two key goals of Medicine Buddha faith were set up and analyzed. As a result of this study, the modern implication and religious value of the Medicine Buddha faith were presented as follows. First of all, it is the modern implication of the Medicine Buddha faith. First, the Medicine Buddha faith promotes a shift in the perspective that disease is the subject of healing, not treatment. Second, the Medicine Buddha faith expands diseases not only to medical diseases but also to disabilities and makes them an object of healing. Third, the Medicine Buddha faith promotes healing through performance that strengthens the positivity of the mind. Next is the religious value of the Medicine Buddha faith. First of all, the Medicine Buddha faith has strong religious acceptance. Second, the Medicine Buddha faith is characterized by being accepted by modern people beyond religion and sect. Based on the results of this study, this study made suggestions to improve the quality of life of modern people suffering from pain in their daily lives due to diseases and unnatural death.

Age Differences of Wisdom and Its Correlation with Successful Aging among Middle-aged and Elder Adults (지혜의 연령차와 중노년기 심리적 적응과의 상관)

  • Kim, Min Hee;Min, Kyung Hwan
    • 한국노년학
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    • v.30 no.3
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    • pp.947-971
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    • 2010
  • The present research is aimed at to examine the relationships between wisdom and age, also between wisdom and its psychological adaptation among middle and elder adults in Korea. Moreover, using data on 240 middle-aged and elder adults, the relationship between different aspects of wisdom and aging well were not only examined, but also explored age differences of wisdom through adulthood. The major findings from the study are summarized as follows. first, the wisdom scores of middle-aged and elder adults were significantly higher than those of young adults. While 'cognitive competency' and 'positive life attitude' factors had no significant differences. It means that 'cognitive competency' and 'positive life attitude' wisdom could be stable across adulthood. However, 'moderation and balance' and 'sympathetic interpersonal relationship' wisdom of elders were significantly higher than those of young adults. second, in middle and elder adults, Wisdom was found to be positively related with life satisfaction, well-being, death acceptance, experiences of positive emotion, generativity, ego integration, and positive life review. while on the other hand, contrast wisdom to be negatively related with depression, fear of death, perceived stress and experiences of negative emotion. The results from the study were examined by ecological validity of wisdom. Accordingly, a number of limitations and implications of the research were acknowledged.

Experience of Home-Based Hospice Care of Terminal-Cancer Patients (말기암환자에서 가정호스피스완화 돌봄 경험)

  • Kim, Boon Han;Kang, Hwa Jung
    • Journal of Hospice and Palliative Care
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    • v.17 no.4
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    • pp.223-231
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    • 2014
  • Purpose: The purpose of this study was to understand terminal cancer patient's experiences of home-based hospice care. Methods: The data were collected from July 2011 through September 2010. Data were collected from 10 terminal cancer patients who received home-based hospice care services and by using in-depth interview. The data were analyzed using Colaizzi's phenomenological method. Results: Data were classified by 25 themes comprising 14 theme clusters and five categories. The five categories were 'life quality deterioration', 'appreciation', 'acceptance of the rest of their lives', 'Prepared for death with religion', 'negative coping'. Conclusion: Systematic hospice care should be provided to understand life experience of patients with terminal cancer who receive home-based hospice care, to help them overcome negative experiences and grow a positive perspective.

Cellular-uptake Behavior of Polymer Nanoparticles into Consideration of Biosafety

  • Do, Jeong-Hoe;An, Jeong-Ho;Joun, Yong-Seung;Chung, Dong-June;Kim, Ji-Heung
    • Macromolecular Research
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    • v.16 no.8
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    • pp.695-703
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    • 2008
  • Nanoparticles have tremendous potential in cancer prevention, detection and augmenting existing treatments. They can target tumors, carry imaging capability to document the presence of tumors, sense pathophysiological defects in tumor cells, deliver therapeutic genes or drugs based on the tumor characteristics, respond to external triggers to release an appropriate agent, document the tumor response, and identify the residual tumor cells. Nanoparticles < 30 nanometers in diameter show unexpected and unique properties. Furthermore, particles < 5 nanometers in size can easily penetrate cells as well as living tissues and organs. This study evaluated the safety of nano materials in a living body and the relationship between the living tissue and synthetic nano materials by examining the in-vitro cytotoxicity of poly(lactic-co-glycolic) acid (PLGA) nano-spheres and fluorescein isothiocynate(FITC)-labeled dendrimers as polymer nanoparticles. PLGA was chosen because it has been used extensively for biodegradable nanoparticles on account of its outstanding bio-compatibility and its acceptance as an FDA approved material. The dendrimer was chosen because it can carry a molecule that recognizes cancer cells, a therapeutic agent that can kill those cells, and a molecule that recognizes the signals of cell death. Cytotoxicity in L929 mouse fibroblasts was monitored using MTT assay. Microscopic observations were also carried out to observe cell growth. All assays yielded meaningful results and the PLGA nanoparticles showed less cytotoxicity than the dendrimer. These nano-particles ranged in size from 10 to 100 nm according to microscopy and spectroscopic methods.

Relationship Between Attachment, Post-traumatic Growth, and Self-realization of Middle-aged Women (중년여성의 애착, 외상 후 성장 및 자기실현과의 관계)

  • Kim, Ok-Hee;Kim, Youn-Kyoung
    • The Journal of the Korea Contents Association
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    • v.16 no.12
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    • pp.507-517
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    • 2016
  • This study examines the types and characteristics of traumatic events middle-aged women experience and to explore the effects of attachment in the process of post-traumatic growth and forming a self-realization. 221 of participants were middle-aged women from the area of Seoul, Gyeong-Gi and the survey was composed of post-traumatic experience questionnaire, attachment scale, post-traumatic growth scale, self-realization scale. The type and characteristics of traumatic experience by middle-aged women were executed by frequency analysis and correlation with the structural equation model validation was used in order to analyze the relationship between each variable. the major findings are First, the loss of someone close(such as death, breaking up, divorce, breaking off) was reported as something general yet the biggest crisis event, Second, looking at the relationship between attachment, post-traumatic growth and self-realization, the secure parental attachment and spiritual transformation showed the correlation in all subregions except the subvariables of humanity and self-acceptance and Third, the results of Structural Equation Modeling shows that attachment has a static effect on post-traumatic growth and self-realization, and post-traumatic growth appeared to be the mediating factor of attachment and self-realization.

The Need for Hospice Care in Families of Patients with Cancer (암 환자 가족의 호스피스 요구도)

  • Kim, Shin-Jeong;Kim, Young-Soon;Kang, Kyung-Ah
    • Research in Community and Public Health Nursing
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    • v.15 no.4
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    • pp.639-647
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    • 2004
  • Purpose: The purpose of this study was to analyze the need for hospice care programs in families of patients with cancer. Method: The study surveyed 98 families who were taking care of patients with cancer. This survey was conducted from August 2004 to October 2004 at two general hospitals in Seoul. The data were collected through a self-reporting questionnaire of 22 items. The items were classified into five areas by factor analysis to identify the construct validity. The reliability of the tool was established by Cronbach's alpha as .93 and the data collected were analyzed by descriptive statistics, t-test and ANOVA. Results: 1) The degree of need for hospice care of the subjects showed a high average of $3.26({\pm}3.7$). The need for 'emotional care of patients showed the highest mean' (M=3.47), 'management of terminal physical symptoms' (M=3.34), 'control of secondary physical problems' (M =3.26), 'acceptance of the family's difficulty' (M=3.12), 'spiritual care for preparing for death' (M=2.96), respectively. 2) With respect to the demographic characteristics of the subjects, there were statistically significant differences in hospice care needs, according to the onset of diagnosis (F=3.110, p=.030). Conclusion: Hospice care must be provided considering the needs of families of patients with cancer. In this sense, this country's needs as well as hospice nurses' higher concern and support for hospice care of patients require further education and program development to meet the current demands.

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Acceptance, Modification and Rejection of Paternalism in Korean Medical Law (한국 의료법에서 후견주의 이념의 수용, 변형 그리고 거부 - 치료중단에 대한 법원 판결을 중심으로 -)

  • Kim, Na-Kyoung;Harmon, Shawn H.E.
    • Development and Reproduction
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    • v.14 no.2
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    • pp.143-154
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    • 2010
  • This article analyzes two leading Korean cases which led to opposite conclusions: the Boramae Hospital Case (Korean Supreme Court 2002 Do 995) and the Shinchon Severance Hospital Case (Korean Supreme Court 2009 Da 17471). In doing so, it pays particular attention to the acceptance, modification, and rejection of paternalism, specifically 'physician paternalism' and 'familial paternalism', both of which have long and strongly influenced the Korean medical environment. In Boramae Hospital, the Court emphasized the obligation of the physician in terms of the life of the patient (eg: protecting and preserving the life and welfare of the patient). Its position seemed to be based on the traditional physician paternalism which presupposes the ability of physicians to identify right and wrong choices according to natural laws. However, the Court saw itself as the final arbiter of who identifies and determines the real world content and consequences of that natural law. In short, the Court elevated itself to the supreme guardian of the patient, and held that its decision cannot be overruled by that of the patient's family. So without specifically referring to the importance of the family and the role of familial decisions, both long-observed traditions in medical decision-making in Korea, the Court shifted away from familial paternalism. In Shinchon Severance Hospital, the Court explained the meaning of the patient's powers of self-rulemore concretely, explaining its scope and substance in greater detail. The Court held that one can exercise the right of self-rule, even over issues such as death, in the form of 'previous medical directions'. However, this case does not represent a wholesale acceptance of medical autonomy (ie: it does not accept self-rule unconditionally). Rather, the Court accepted the importance of the opinions and decision of physicians and of the Hospital Ethics Commission, and the Court still retained to itself the authority to review and make alterations to 'material' decision. The Court did not overlook the importance of the decision of the patient's family, but it also did not relinquish its status as supreme guardian, emphasizing the 'objective' nature of a decision from the court.

The Attitude of the Bereaved Family Attending a Bereavement Memorial Service (사별가족모임과 관련된 사별가족 태도 연구)

  • Jung, In-Soon;Shim, Byoung-Yong;Kim, Young-Seon;Lee, Ok-Kyung;Han, Sun-Ae;Shin, Ju-Hyun;Lee, Jong-Ku;Hwang, Su-Hyun;Ok, Jong-Sun;Kim, Hoon-Kyo
    • Journal of Hospice and Palliative Care
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    • v.8 no.2
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    • pp.143-151
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    • 2005
  • Purpose: Bereavement Memorial Service has been held every year by the hospice team at St. Vincent's Hospital for the purpose of supporting the bereaved family who feel grief and mourning. The purpose of this study is to find out the attitude of the bereaved attending at bereavement memorial service (BMS) and to find out the areas needing improvements to set up better memorial service. Methods: Hospice team sent invitation card to 180 families of patients who admitted and passed away at hospice ward Nov., 2003${\sim}$Oct., 2004. Among them 22 families attended the BMS meeting, which was held on 26th Nov., 2004. The researcher collected data from 22 families with 'Questionnaire' survey. Except identifying data and 2 dichotomy questions, we used open-ended questionnaire. 1 researcher conducted a telephone interview survey in 18 families who couldn't attend at BMS meeting. Results: The median age was 56 (range $16{\sim}19$) and there were 37 females and 3 males. They were patient's wife (22), mother (4), husband (5), daughter (4), mother-in-law (1), siblings (1), brothers wife (1). Duration after bereavement, $1{\sim}3$ months (17) was the highest frequency. 36 families agreed 'the dead experienced the death with dignity'. The reason of agreement to the death with dignity was 'the patient died in preparation' (16). 'the patient died in well-being condition spiritually' (9), 'the patient died in comfort physically (7). 4. persons thought the dead died with indignity. The bereaved defined 'the death with dignity' as follows: 'acceptance of death & death in spiritual well-being' (9), 'death in physical comfort condition' (7), 'the death in psycho-social well-being' (3), non-respondents (10). Most families (21) were still in difficulty to overcome bereavement grief. The answer regarding the method to overcome the difficulty was 'with spiritual sublimation' (13), 'with devotion of oneself in daily life' (10), 'with devotion to mourning as it is' (3). With regard to their attitude to invitation, 'having joy and thanks from hospice team' (21), 'grief' (4), 'suffering' (4). Toward the existence of hesitation about attendance at BMS meeting, the result as follows. Nonexistence of hesitation respondent (34), existence respondent (6), the reason for hesitation was various; 'the meeting reminds me of the suffering times', 'the meeting makes me to recall, and it will be likely to cry', and so on. The needs and feelings to memorial service meeting were various; 'it was meaningful time', 'it was good to recall about the dead', 'more meeting annually' and so on. In respect of the most difficulty after bereavement, in attendant family, 'depression' (10) was the highest frequency, whereas, in non-attendant family, the most difficult thing was 'financial problem/role difficulty (6). Conclusion: This study shows the rate of attendance was high in bereaved whose bereavement duration $1{\sim}3$ month. Most of bereaved were still suffering from bereavement grief within 1 year. Although most families didn't hesitate and felt positive mood to invitation, the rate of attendance was low. Comparing with two groups between attendant family and non-attendant, the latter felt more difficulty in 'financial problem/role difficulty, on the other hand, the former felt difficulty in 'depression'. Hereafter, the additional study about the factor relating to these attitude and needs of the bereaved relating to memorial service will be necessary.

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Comparison of In Vitro Cell Transformation Assay Using Murine Fibroblasts and Human Keratinocytes

  • Ahn, Jun-Ho;Park, Sue-Nie;Yum, Yung-Na;Kim, Ji-Young;Lee, Michael
    • Toxicological Research
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    • v.24 no.1
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    • pp.37-44
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    • 2008
  • The in vitro cell transformation assays (CTA) were performed using BALB/3T3 murine fibroblasts and HaCaT human keratinocytes in order to evaluate concordance between both in vitro CTAs and carcinogenicity with compounds differing in their genotoxic and carcinogenic potential. Six test articles were evaluated, two each from three classes of compounds: genotoxic carcinogens (2-amino-5-nitrophenol and 4-nitroquinoline-N-oxide), genotoxic noncarcinogens (8-hydroxyquinoline and benzyl alcohol), and nongenotoxic carcinogens (methyl carbamate and N-nitrosodiphenylamine). Any foci of size $\geq$2 mm regardless of invasiveness and piling was scored as positive in CTA with BALB/3T3. As expected, four carcinogens regardless of their genotoxicity had positive outcomes in two-stage CTA using BALB/3T3 cells. However, of the two genotoxic noncarcinogens, benzyl alcohol was positive CTA finding. We concluded that, of the 6 chemicals tested, the sensitivity for BALB/3T3 system was reasonably high, being 100%. The respective specificity for BALB/3T3 assay was 50%. We also investigated the correlation between results of BALB/3T3 assay and results from HaCaT assay in order to develop a reliable human cell transformation assay. However, evaluation of staining at later time points beyond the confluency stage did not yield further assessable data because most of HaCaT cells were detached after $2{\sim}3$ days of confluency. Thus, after test article treatment, HaCaT cells were split before massive cell death began. In this modified protocol for this HaCaT system, growing attached colonies were counted instead of transformed foci 3 weeks since last subculture. Compared to BALB/3T3 assay, HaCaT assay showed moderate low sensitivity and high specificity. Despite these differences in specificity and sensitivity, both cell systems did exhibit same good concordance between in vitro CTA and rodent carcinogenicity findings (overall 83% concordant results). At present the major weakness of these in vitro CTA is lack of validation for regulatory acceptance and use. Thus, more controlled studies will be needed in order to be better able to assess and quantitatively estimate in vitro CTA data.