• Journal of Korean Academy of Nursing Administration
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• v.9 no.4
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• pp.541-557
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• 2003

Purpose: This descriptive study was designed to explore the clinical nurse's ethical value regarding human life. Method: Data were collected from September to October, 2002. Study subjects were 527 clinical nurses working in General Hospital as tertiary located in Seoul. Ethical value was measured with questionnaire developed by researchers and consisted on items regarding ethical value on human life. Result: Among the items, most nurses highly agree with the item, "When a patient requests his/her health care provider to keep his/her personal secret, the health care provider is obliged to do so." and "When a patient asks for information on his/her medicinal and dietary contents, his/her wish must be granted." Most clinical nurses mainly agree with the item. "Health care providers must always be honest to the patient and/or his/her family". However, most nurses disagree with the item, "When a patient is on the verge of death after an accident, it is justifiable to soothe his/her family by saying 'he/she is OK' instead of telling them the truth, in order to avoid a sudden shock befalling on them". Most clinical nurses mainly disagree with the items, "When a patient is on the verge of death after an accident, it is justiable to soothe his/her family by saying 'he/she is OK' instead of telling them the truth, in order to avoid a sudden shock befalling on them" and "It is justiable that various new ways of treatment should be applied to patient at his/her terminal stage to prolong his/her life, even for the purpose of research". There were significant differences in some items of ethical value according by clinical nurse's age and professional experience, current position, religion, education, marital status, continued education on ethics, and the experience of holing on life saving treatment. Conclusion: It is intensifying the notion of ethical underpinning for human rights, truthfulness is essential to a trust relationship under what circumstances. Also most clinical nurses agree with that It is essential to trust in the nurse-patient relationship, patients have the right to know and it is the ethical thing to do as health care provider.

• Journal of Hospice and Palliative Care
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• v.17 no.3
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• pp.161-169
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• 2014

Purpose: This study was conducted to comprehensively investigate nursing students' experience of their first encounter with death of a patient during clinical practice. Methods: This study took place from January 27 through March 6, 2012 with eight female senior nursing students enrolled at Pusan National University located in Y city who have experienced patient death. We collected their experience of their first death encounter during their clinical rotation by asking, "What is your first experience of patient's death during the clinical practice?" Husserl's phenomenological approach was applied in this study. Results: In this study, 17 themes, 15 clusters of themes and eight categories were derived. The categories included "Desire to avoid the reality of death", "Powerlessness", "Anticipation for recovery shifted to fear of death", "Various interpretations of death", "Limitations in their nursing practice", "Resentment of lack of nurses", "Longing to better understand death", and "Motivation for inner growth". Conclusion: Through their first encounter with death of a patient, nursing students experienced various emotions and viewed their role as hospice caregiver by projecting themselves as fully trained nurses in future. Participants considered terminal care as a part of nursing care. The result of this study indicates the need to include education of death in the nursing school curriculum.

• Journal of Hospice and Palliative Care
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• v.19 no.2
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• pp.109-118
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• 2016

The purpose of this study was to evaluate Korean advance directives (K-AD) by examining the degree of adults' acceptance and reliability of the directive itself. Methods: Survey was performed with 181 adults aged 20 or older who were recruited from three regions. A questionnaire used to examine the participants' acceptance of their K-AD in terms of visual analogue scale score of complexity, difficulty, necessity, satisfaction, recommendation. Then, a retest was carried out by asking participants to write up a K-AD again to confirm the reliability of the directives. Results: On a scale of 100, the average acceptance score was 70 or above, which represents rather high level of acceptance in all five categories. The test-retest reliability kappa values ranged from 0.592 to 0.950, and the conformity degree was moderate or high. Regarding K-AD components such as values, treatment preference, proxy appointment, differences among age groups were observed in each component. Conclusion: The results of this study suggest that K-AD is a feasible instrument to analyze its acceptability and reliability for adult population. K-AD could be utilized to help people make their own decision on their end-of-life care. Further studies are needed to confirm this study results and promote widespread use of K-AD.

• Journal of Hospice and Palliative Care
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• v.21 no.3
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• pp.75-83
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• 2018

Purpose: To provide effective palliative care, it is important to predict not only patients' life expectancy but their discharge status at a time of inpatient admission to a hospice care facility. This study was aimed to identify meaningful life expectancy indicators that can be used to predict patients' discharge status on admission to the facility. Methods: Among 568 patients who were admitted to the hospice ward of P hospital from April 1, 2016 through December 31, 2017, 377 terminal cancer patients were selected. This retrospective cohort study was performed by using performance status, symptoms and signs, socioeconomic status, laboratory findings on admission. Results: Alive discharge was associated with a good performance status that was measured with the Karnofsky and Eastern Cooperative Oncology Group (ECOG) scales and the Global health and Mental status. Less anorexia, dyspnea, dysphagia and fatigue were also associated with symptoms and signs. Associated laboratory findings were close to normal Complete Blood Cell (CBC) count, Liver Function Test (LFT) and Blood Urea Nitrogen (BUN). Conclusion: Our findings suggest that Karnofsky Performance Status (KPS), ECOG, Global health, Mental status, anorexia, dyspnea, dysphagia, fatigue, CBC, LFT, BUN are meaningful indicators when predicting discharge status for inpatients. Further investigation is warranted.

• Journal of Hospice and Palliative Care
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• v.3 no.1
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• pp.28-38
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• 2000

Purpose : This study examined characteristics of, problems of and services provided to hospice recipients and their family members at a home hospice organization. Methods : The subjects were 113 people who were discharged from one free-standing home hospice organization between November, 1994 and lune, 1999. Since the opening of the organization in November of 1994, it has provided hospice services at patients' homes with no charge. Data were collected from those subjects' records. Results : The average age of the subjects was 57.1 years; those aged 60 and over were 54%. Spouse was the most frequent(50.9%) primary caregiver followed by daughter-in-law and daughter. All the subjects were diagnosed as having cancer. Of those 41 subjects who did not know their terminal stage in the beginning, 31 subjects came to know their states. Of the subjects, 72.7% were referred from their physicians. On the average, the service duration and the number of home visits were 6.8 weeks and 7.2 times, respectively. Pain was the most prevalent problem of the subjects(89.4%). Medication management was the most frequently provided service followed by psychological supports. The reasons for discharge were death(88.5%) and refusal(8%). Home was the most frequent place of death(60%). Conclusion Home hospice service providers should be trained particularly in working with elders and in managing cancer pain. People need to be referred at an appropriate time for achieving goals of hospice. Community recognition of hospice services needs to be promoted.

• Molecules and Cells
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• v.41 no.12
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• pp.1008-1015
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• 2018

$I{\kappa}B$, a cytoplasmic inhibitor of nuclear factor-${\kappa}B$ ($NF-{\kappa}B$), is reportedly degraded via the proteasome. However, we recently found that long-term incubation with proteasome inhibitors (PIs) such as PS-341 or MG132 induces $I{\kappa}B{\alpha}$ degradation via an alternative pathway, lysosome, which results in $NF-{\kappa}B$ activation and confers resistance to PI-induced lung cancer cell death. To enhance the anti-cancer efficacy of PIs, elucidation of the regulatory mechanism of PI-induced $I{\kappa}B{\alpha}$ degradation is necessary. Here, we demonstrated that PI up-regulates nuclear factor (erythroid-derived 2)-like 2 (Nrf2) via both de novo protein synthesis and Kelch-like ECH-associated protein 1 (KEAP1) degradation, which is responsible for $I{\kappa}B{\alpha}$ degradation via macroautophagy activation. PIs increased the protein level of light chain 3B (LC3B, macroautophagy marker), but not lysosome-associated membrane protein 2a (Lamp2a, the receptor for chaperone-mediated autophagy) in NCI-H157 and A549 lung cancer cells. Pretreatment with macroautophagy inhibitor or knock-down of LC3B blocked PI-induced $I{\kappa}B{\alpha}$ degradation. PIs up-regulated Nrf2 by increasing its transcription and mediating degradation of KEAP1 (cytoplasmic inhibitor of Nrf2). Overexpression of dominant-negative Nrf2, which lacks an N-terminal transactivating domain, or knock-down of Nrf2 suppressed PI-induced LC3B protein expression and subsequent $I{\kappa}B{\alpha}$ degradation. Thus, blocking of the Nrf2 pathway enhanced PI-induced cell death. These findings suggest that Nrf2-driven induction of LC3B plays an essential role in PI-induced activation of the $I{\kappa}B$/$NF-{\kappa}B$ pathway, which attenuates the anti-tumor efficacy of PIs.

• The Journal of the Convergence on Culture Technology
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• v.9 no.1
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• pp.619-625
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• 2023

In this paper, the remote care of medical beds with multiple body pressure sensors is described. Falling is one of the factors that seriously threaten the safety of patients and harm their health. In this study, a new bed was developed to overcome this. The bed system consists of a keyboard that can operate, a keyboard controller that manages the movement of the keyboard, a sensor that measures body pressure, a sensor controller that transmits and receives sensor values, a main controller that checks it and operates automatically or manually according to the algorithm, and a server that oversees all these information. The bed system checks the patient's location through a sensor and wirelessly alerts the server through the main controller when the patient determines that there is a risk of falling, so that the nurse or nurse can recognize the patient's dangerous condition. The server may receive state data transmitted from the wired/wireless terminal to monitor whether the bed system is operating normally. The controller of the keyboard operates a keyboard-type mechanism and automatically controls the prevention of bedsores connected by body pressure sensors to physically separate the area to which the patient's pressure is applied to prevent bedsores. The main controller checks the presence of the patient's bed and transmits it to the server. In conclusion, the proposed system can smart monitor the user's state and perform remote care.

• The Journal of Korean Academic Society of Nursing Education
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• v.9 no.1
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• pp.7-16
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• 2003

The purpose of this study was to classify the subjectivity type toward death among college students and to understand the characteristics of attitudes and orientations toward death of each type. Since attitudes and orientations toward death is very subjective and unique, Q-methodology was employed in this study. Q-methodology explains the respondent's subjectivity by objectifying his subjectivity for himself. The P-sample consisted of 63 students of K university in D city. Forty statements concerning attitudes and orientations toward death, which developed by Yeun(1999) were utilized for Q-sample. Forty Q-statements were sorted according to the level of agreement or disagreement by forced normal distribution. The Q-sorts by each subjects were coded and analysed with the PC-QUANL program. Five types of subjectivity toward death were identified and labeled. Type 1 'the death- preparation' think frequently about his own death and talk openly about the problem of death with a positive attitude. Type 2 'the life-esteemed' respect the dignity of life most of all. Type 3 'the realty-oriented' do not believe the afterlife and is very concerned about the present life itself instead of thinking about death. Type 4 'the ambivalent' think importantly the aspect of present life and orient the afterlife at the same time. This type reveals opposite attitude of preparing and scaring the death at the same time. Type 5 'the destiny-recipient' attribute death to the destiny and deny suicide. On the basis of this result, the studies about applying and developing educational program on death and hospice care for nurses who care terminal cancer patients and families are needed.

• The Korean Society of Law and Medicine
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• v.9 no.1
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• pp.413-459
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• 2008

The Law has intervened to define rare circumstances in which a person should choose continuing life in United States. On the one hand, the law has traditionally acted to preservelife and to respect the sanctity of life. On the other hand, one's control over one's own body, and the right to determine what kind of medical care one will receive, is equally well respected and historically grounded. The competent patients have the right to forgo life-sustaining treatment, courts in United States have left many unanswered questions about the nature of that right. The right to choose to forgo life-sustaining treatment is a manifestation of a patient's autonomy interest. In United States, The Karen Quilan case gave rise to legislative activity in the host of state capitals, and several states had adopted statutes that formally recognized some forms of written directives describing some circumstances in which certain kinds of medical care could be terminated. These statues were sometimes dominated 'living will' acts, sometimes 'right to die' acts and ocasionally 'natural death' acts. Today virtually every state has produced a living will statue. In Korea, courts do not permit a terminally ill person to withhold or withdraw life-sustaining treatment. Living wills apply in case of terminal illness owing to a defect in legislation. Now In Korea, these lively dispute of legal policy on the preconditions and concrete procedure of living will act and natural death act. Through the legislation of living will act and natural death act, we should prepare some circumstances to respect patient's autonomy on the right to die. We should frame the cultural standard to make a decision of forgoing life-sustainin1g treatment under the discreet procedure.

• Journal of Advanced Navigation Technology
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• v.13 no.2
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• pp.224-230
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• 2009

In the latest date, medical body area networks (MBANs) are emerging as a new technology for diagnosis the human body. MBANs in the health care fields are based on short-range and low-power (e.g. ubiquitous computing) among small-sized devices, and have been used by means of medical services. In this paper, we proposed an emergency message transmission protocol using carrier sense multiple access/time division multiple access in MBANs. This scheme focuses on dependability and power-efficiency. In order to increase the reliability of the transmission, this scheme modified a MCTA slot of IEEE 802.15.3 standard to a SR-MCTA slot. SR-MCTA slot is assigned by MBAN coordinator according to requesting terminal nodes. The method, having the priority of transmission, occurs a collision packet randomly. Results from this proposed solution revel that reservation-based TDMA medical body area network(MBAN) protocol for transmitting emergency message was improved in terms of transmission delay.