The use of epidural narcotics to treat cancer pain was first described by Behar et al in 1979. More recently, a variety of implantable INDSs have been described for long-term intraspinal narcotic administration. Especially, among these systems INDS typeIII which is designed by Poletti et al is relatively low cost and less risk of infection, therefore this system has been widely accepted but the clinical experience is insufficient yet. 1, Problems, 1) thorough education of patients and care-givers about this system the method of drug delivery and the situations could be happen in using this system. 2) high cost of continuous drug delivery system 3) legal problems about morphine carry-out in the case of bolus infusion by syringe 1. Complications; 1) by morphine; Significant respiratory depression was not found in all 21cases. other morphine-related complications were occurred occasionally but improved within a few days by appropriate treatment. 2) by system, Blockage or leakage of catheter was occurred in 2cases and wound infection was occurred in 2cases and so reimplantation was done.
Today the occurrence and world-wide transfusion of the AIDS has brought about new problems related to family relations. The AIDS is more threatening than any other disease because of the special processes of infection trough sex and intravenous injections high care cost and terminal death. The AIDS causes conflicts among family members economic destitution and family dissolution. In the U.S Marriage without noticing of the AIDS may lead to divorce like injuries abandonment and misfeasance during marriage. But the AIDS victims should not be rejected from the rights of parental decision divorce beneficiaries and visiting rights. More discussion is needed about such issues as the pregnancy rights rongful birth action and selective nontreatment by doctors. The AIDS may influence the every party involved and interdisplinary studies should be required to solve the problem including family science laws psychology sociology and medical research as well.
Good stability and complete range of motion should be the ultimate goal of a rehabilitation program after ACL reconstruction. In previous years. the rehabilitation of the ACL reconstructed knee focused on protecting the new ligament by blocking terminal knee extension, hut, despite good stability, this approach led to numerous postoperative complications. Nowadays, most of surgeons agree the accelerated rehabilitation program based on the concept of ligamentization and clinical experience. Accelerated rehabilitation program consists of maintain of full extension of the knee, early weight bearing and prompt recovery of ROM, and closed kinetic chain exercise. Meeting this goal requires effective communication between-members of the health care team-the physician, physical therapist, atheletic trainer, and the patient. We have to know the importance of rehabilitation, knowlege about the physical therapy, and to introduce for special physical therapist and equipment.
This study aims at the operation of the hospice in the virtual space by the use of telecommunication technology. The hospice can be an efficient alternative for the elderly and terminal patients. It can achieve both the quality of life of patients and the conservations of medical resources. The virtualization creates new norms and values which are different from the conventional environments. The concepts and limitations which are crucial to the projection of the existing hospice into the virtual space are discussed. The items ranging from the hospice need to the design criteria of the modules are investigated. The most important point in constructing the virtual hospice center is the human factor, which characterizes the hospice. In addition, the real-world circumstances of the hospice should be considered in the realization of the VHC.
Recognise that suffering to some extent is very common in people with terminal illness and that family and friends also suffer but often from different causes. Need to recognise the cause of the suffering, if possible to remove the cause , if not to manage as well as possible. May not be able to alleviate the cause, but sometimes acknowledgement of the problem will suffice. A Chinese proverb sums it up well "You cannot prevent the birds of sorrow flying overhead but you can prevent them from making nests in your hair".
Fahim, Muhammad;Siddiqi, Muhammad Hameed;Fatima, Iram;Lee, Sung-Young;Lee, Young-Koo
Proceedings of the Korea Information Processing Society Conference
/
2011.04a
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pp.89-91
/
2011
Diabetes is a chronic disease which may lead to other life threatening health complications like heart disease, stroke and peripheral vascular disease that diminished quality of life. In order to assists diabetic patients, we develop a smartphone application to monitor the regular medicine intake and exercise routines through repetitive user friendly and motivational reminders. Health-practitioners including doctors and nurses can frequently view and analyze the daily routine of patients through a web-interface. This paper presents architecture to improve the quality of life with android smart phone as user terminal, and integration of webbased application through web services for health care professionals. We also explain how each of the application interacts with each other and internal integration.
Purpose : Hospice Care is considered as one of the most perfect solutions for the problems brought up as the number of chronically ill patients are increasing rapidly and most of social welfare oriented countries are seeking the quality of life. Our former studies(1996, 1997) were to find out the current status of the hospice care in Korea by surveying terminally ill patients and their family members as well as medical professionals. The former study was also to conduct the operation research by developing an information service system for training of hospice care teams and volunteers, and hospice patients management. The purpose of this study was that hospice information service system was tested by home visiting hospice care through visiting nurses. Methods : From October 1, 1997 to March 31, 1998, Twenty six terminal cancer patients were included in this study from Seoul National University Hospital and other hospital. Databases and homepage, hospice information service system were designed and developed for the information needed for the hospice care before this study by our research team and this services were available through the internet. Visiting nurses were trained about this system and they visited the patients with PC notebook and provided them hospice care with hospice information system. They collected physical, psychiatric, social data of the subjects at the first visit and during hospice care at home. Results : Sixteen subjects(61.5%) died during the study and the mean survival was 20.7 days. Anorexia(96.2%), immobility(88.5%) and pain(84.6%) were the major symptom in the 26 subjects, Altered nutrition(26.1%) and pain(12.4%) were the most frequent diagnoses in 226 nursing diagnoses of the subjects. Families understood and demanded the hospice care more than patients. And most patients and families didn't demand spiritual or social care. Conclusion : Through this demonstration study, it was found that we have to provide the information of pain management and nutritional support for patients by the nurses and visiting hospice nurse. The information service system needs to be upgraded with information and manpower of spiritual and social care according to the findings.
Lee, So Dam;Shin, Euichul;Lim, Jae-Young;Lee, Sang Gyu;Kim, Ji Man
Korea Journal of Hospital Management
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v.22
no.3
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pp.1-17
/
2017
Purposes: Diabetes is a metabolic disorder that requires continuous care in order to prevent complications, as it can impose a critical burden on families and society due to various complications, including terminal renal failure, non-traumatic lower extremity amputation, and adult blindness. The usual sources of care are "specified private clinics, public health centers, or other facilities to visit when ill or when health-related advice is needed". These usual sources of care offer preventative services, have a high overall satisfaction rate in terms of public health care, and decrease the inpatient rates and medical costs of medical aid recipients. This study analyzed the current status of diabetic patients over 20 years of age based on their possession of a usual source of care, and the effects of this possession on the frequency of their medical service usage and its costs. Methodology: Based on data from the 7th Korea Health Panel, a Tobit analysis was used to analyze the different factors that can affect the frequency of medical service usage and its costs for diabetic patients with and without a usual source of care. Findings: The medical costs of diabetic patients with a usual source of care decreased in terms of inpatient, and the outpatient visits and inpatient costs of the group with a usual source of care in the form of a mainly-visiting doctor decreased more than those of the group with a mainly-visiting medical institution only. Practical Implications: Having a usual source of care can increase the treatment continuity, leading to reduced inpatient, and having a mainly-visiting doctor as the usual source of care further increases the treatment continuity. Based on these results, a new policy is needed to increase and strengthen diabetic patients? possession of a usual source of care.
Kingsley, Marian R.N.;Cho, Won-Jung;Kim, Cho-Ja;Lee, Won-Hee;Yoo, Ji-Soo
The Korean Nurse
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v.29
no.4
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pp.51-72
/
1990
The purpose of this study was to determine whether Severance Hospice Home Care Pro gram was able to meet its objectives. This was done in order to show in detail the effects of hospice home care on the quality of life of terminally ill patients and to provide rationale for setting up more hospice home care programs in korea. The results of the study were as follows: The subjects of the study were 100 terminally ill patients who hnd died 'while in the hospice program and 64 family members who were registered with Severance Hospice Home Care Program between march 1988 and Feb. 1990. The nursing needs of these terminally ill patients were assessed by the nursing records of these patients. The need for pain control(82%) was the highest nursing need so far as the physical aspects were concerned. This was followed by poor appetite(37%), 8 dyspnea(34%), nausea and vomiting(30%) in that order of frequency. In reqard to spiritual needs, the need for religious' support was also high at 72%. Their main psychological symptoms were anxiety and fear(34% ). Burn-out was a major problem for 44% of the family members. The psychological process experiencel by the terminal ill patients was compared to the dying process, described by Kiibler Ross. In comparison of the five stages outlined by kubler Ross with the dying process of the subjects it was found that the subjects not only experienced the five stages but also experienced denial and doubt-fulness or denial with acceptance or acceptance with the expectation of a miracle. But rather than acceptance of the dying process, giving up was a frequent end point of the psychological process, of the subjects. However, when the combination of states was observed, most of the patients reached the state of acceptance in the dying process. It was difficult to identify a definite pattern of change in the psychological process of the subjects. Also it was difficult to identify the factors that influenced the psychological process. The symptoms of the terminally j]] subjects just before dying, that is, 3-4 days before dying included apparent signs of dying. These were a reduction of intake(77%), reduction of the amount of urination(63%), increase in sleeping time (64%) and acceptance of dying by patients and their families who had been unaccepting be before that time(66%). The primary care givers(family member's) degree of satisfaction with the care given to the patient by the hospice was 88.7%. The results of this study show that Severance Hospice Home Care Program had a positie effeet on the quality of life of the terminally ill patients and their family members as they faced the death of the patient. It can be seen from this study that there is an urgent need to extend hospice programs - in order to provide quality of care for terminally ill patient and their families. Based upon the reesults of this study several suggestions are presente as follows: 1) A follow up study should be carried out to identify the dying process as it is unique to Korea. 2) A comparison should be made of other hospice care programs. 3) A comparison study should- be made with subjects who do not receive any hospice care as compared to those who do by use of an experimental and control group methodology. 4) There is a need to determine a scientific method to adequeto measure the interventions carried out to meet the hospice patients nursing care needs. 5) A study should be made using quality research methodology to evaluate effects of hospiec care from the patients, their family members and the nurrse's perspective.
Background: The purpose of this study is to assess the effectiveness of family support on the quality of life in patients admitted to the hospice facility at Saemmul Hospice. Method: The subjects of this study were 152 terminal cancer patients that were admitted to the hospice facility at Saemmul hospice between January 2002 and February 2003. Their each quality of life were assessed at admission, one, three, five and seven weeks at Saemmul Hospice using a questionnaire prepared by the Saemmul hospice and were anlalyzed by means of T-test. Result: There was no difference in the quality of life score between patients with family support and patients without family support in terms of physical, psychosocial, and spiritual aspects in the admission. There was no difference in the quality of life score between the patients with frequent family member's visit(>=8) and less frequent family visit(<=7), and between the patients whose family members stayed at the facility for 24hrs and the patients without staying family members. There was no difference in the quality of life score between the patients in low-middle and low-high class among 9 classes of familial economic status(high-high, high-middle, high-low, middle-high, middle-middle, middle-low, low-high, low-middle, low-low). There was no difference in the quality of life score between the patients whose familial religion were Christianity and the patients with other religions. After 1, 3, 5, 7 weeks assessment, the scores in the physical, psychosocial, spiritual aspect of quality of life were increased. Conclusion: The results suggest that family support is important to improve the quality of life in hospice patients and hospice care team is needed to replace 24 hours of family care. There is a urgent need of trained hospice care teams, so training programs for physicians, nurses, clergies, social workers, and volunteers are necessary.
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