• Journal of Trauma and Injury
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• v.27 no.4
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• pp.126-132
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• 2014

Purpose: The field trauma triage for injured patients is essential for trauma care system. In this study, agreement of patient evaluation between by prehospital EMS personnel and by hospital staffs and the appropriateness of prehospital triage were evaluated. Methods: This observational study was conducted from September to October 2012 for 5 weeks. During this period, EMT evaluated patient's severity according to guideline for field triage and recorded. Same guideline was applied in 26 hospitals for patients with EMS use. Kappa statistics were used to measure agreement for each item of guideline. Finally, over-triage and under-triage rate of EMT were calculated. Results: During study period, total 3,106 patients were transferred to 26 hospital emergency departments with EMS use. Kappa statistics for "vital signs" items were 0.45 for mentality lower than V and 0.44 for systolic blood pressure lower than 90 mmHg as a moderate agreement. In "anatomy of injury" items Kappa statistics were very low. In "mechanism of injury" items Kappa statistics were 0.28 for high-rise fall down and 0.27 for high energy traffic accident but in other items Kappa statistics were very low. 362 patients (12.0%) were over-triaged and 281 patients (9.3%) were under-triaged. Conclusion: Field triage can be applied but need to evaluate and modify in order to become accurate and sensitive for decision of transportation.

• Journal of Korean Academy of Nursing
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• v.26 no.1
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• pp.223-247
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• 1996

This study was done to provide information which would lead to nursing care of the elderly being more holistically through an understanding of the phenomena of powerlessness based on the lived experience of powerlessness by the elderly, the meaning the elderly give to such phenomena, and what essence of powerlessness is. The methodology used in this study was Max Van Manen's phenomenological method based on the philosophy of Merleu-Ponty and a concerted approach was realized through the 11 steps suggested in the Van Manen's method. Data collection was done from March 2, 1995 to December 30, 1995. The subjects for this study were four elderly persons who lived with their families and who were over 60 years of age. Data were collected about the lived experience of the elderly, this researcher's experience of powerlessness, the linguistic meaning of powerlessness, idioms of the word or a feeling of powerlessness, and descriptions of powerlessness in the elderly as they appeared in the literature, are works, and phenomenological literature. All data were used to provide insights into the phenomena of powerlessness. Data about the experience of powerlessness by the elderly were collected through open interviews, participation, and observation. In the analysis of the theme of this study, the aspects of the theme, powerlessness in the elderly were clarified, thereby abstracting and finding meaningful statements by the elderly about their feeling of powerlessness, and then those significant statements were expressed as linguistic transformations. The summarized findings from the study are as follows : 1. Five meanings of powerlessness in the elderly were defined. 〈weakness〉, 〈dependence〉, 〈frustration〉, 〈worthlessness〉 and 〈giving up〉. 2. 〈Weakness〉 means that the elderly experience, not only their aging but also, their becoming weak and the loss of physical function frequently caused by diseases. 〈Dependence〉 means that the elderly experience dependence without any influence from the surroundings and that elderly patients who are hospitalized lose their autonomy, follow entirely their doctor's prescriptions, use aid equipment and directions, and depend only on those things. 〈Frustration〉 means that the elderly experience the loss of their roles from the past, there by feeling that there is no work for them to do anymore and therefore feel unable to do anything. 〈Worthlessness〉 means that the elderly experience the feeling of losing their social roles from the past, having no financial ability, thereby being a burden to their children or the people around them, and therefore regarding themselves useless. 〈Giving up〉 means that the elderly experience the feeling of closeness to death in the final stage of their lifetime, lose hope to be healed from their disease, and recognize the incontrollability of their own body. 3. From a general view of the meaning of the theme the powerlessness in the elderly-the most essential meaning of the theme is the 〈sense of loss〉. For the elderly are experiencing a sense of loss in the situation of being elderly and therefore being often hospitalized. Brief definitions of the five phenomena could be 〈weakness〉 meaning the loss of physical strength, 〈dependence〉 the loss of mentality caused by disease and hospitalization, 〈frustration〉 and 〈worthlessness〉 the loss of social performance caused by the loss of social functions from the past, and lastly 〈giving up〉 the loss of the controllability of such situations of aging and suffering disease. In light of the discussion above, it is understandable that the hospitalized elderly experience powerlessness not only as it related to their diseases but also to their normal aging, and this related to other characteristics of being elderly means that the 〈sense of loss〉 is the very essence of their powerlessness. 4. While most cases are of the normal elderly experiencing powerlessness in relation to their social network, cases of elderly who are hospitalized are of those experiencing powerlessness in relation to the loss of their physical desire. 5. The findings discussed above can serve as guidelines for nurses who take care of the ill elderly who are hospitalized and that can provide cues to appropriate nursing service, recognizing that the subjective experience of the objective age of the elderly is so important. Nurses can provide highly qualitative nursing service, based on their deep understanding of the suffering of the elderly due to feelings of powerlessness.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.7 no.1
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• pp.29-50
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• 2001

This research have been made to define how the IADL (Instrumental Activity of Daily Living) performance and the subjective health index of the Aged are affected by their residential circumstance, gender and age, and how deeply these two factors are related and interact. For the period of June 1 to July 31, 2000, we had conducted a questionnaire and direct interview with 693 persons over age sixty-five (65) in Daejon and in other adjacent area, grouping into three different residential types The Aged living at home, The Aged living at welfare facilities and The Aged living alone, and studied on how the IADL performance and the subjective health index of the Aged are influenced and interact as per their characteristics, daily activity and mentality. We had analyzed all the data obtained through this research by the method of : - analysis of frequency as per specific factors by SPSS 1O.0/PC+, - $x^2$ test, - t-test, - ANOVA, - multiple regression analysis by factors. The research concludes followings : a. It appears that the three (3) factors such as gender, age and residential circumstance of the Aged deeply affect the IADL performance and subjective health index of the Aged. (p<0.01) b. With regard to IADL performance of the Aged by the gender, it was analyzed that the female-Aged gains 23.8 point on average, which shows the performance of the female-Aged is less independent. (p<0.01). In addition, it was also found that the IADL performance is becoming less and less independent following their age increasing. In analyzing IADL performance by the residential type, it appears that the Aged living at welfare facilities gains the lowest 21.5 points and is least independent. It was also found that the Aged living at welfare facilities need some assistances from others for their performing IADL. (20-24 point) (p<0.001) c. With regard to the subjective health index of the all-Aged participated in this research, the analysis indicates 8.8 point and this is considered as a point of general standard (7-10 point). In analyzing this index by the gender, the female-Aged gains only 8.6 point which explains a lot of female-Aged consider they are not really healthy. (p<0.001) In analyzing this index by the residential type, the Aged living at welfare facilities and the Aged living alone gain the comparatively lower point, - respectively 8.4 point for the Aged living at welfare facilities and 8.8 point for the Aged living alone. The Aged living at these two residential types express they are obviously in a bad situation of health. (p<0.001) d. With regard to the factors affecting the IADL performance and the subjective health index of the Aged, it was analyzed that the IADL performance can largely be affected by the factors such as depression, frequency of going-out and age rising, and that the subject health index can also deeply be affected by depression, pain and by how much they are satisfied with their current living conditions. e. It was analyzed that the interacting between the IADL performance and the subjective health index is not that strong but even weak. As a result, we were able to conclude that the IADL performance is less independent in case of the female-Aged, the Aged living at welfare facilities, and following the age rising. As for the subjective health state the Aged themselves are aware of, we concluded that the female-Aged, the Aged living at welfare facilities and the Aged living alone, are more critical about their health. From this research, we were able to realize that, when the OMT (Orthopedic Manual Therapy) needed, the physical therapists are really required to have a correct and cautious understanding of the situation in which the aged persons are, and take care of them with more concerns and more improved treatment.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.6 no.3
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• pp.414-433
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• 1999

The purpose of this study is to identify the needs which are perceived by one of the familiy members who have head injury parients by traffic accidents in the intensive care units. Subjects were 70 families members of head injury patients admitted to 2 general hospitals NICU located Pusan city, 1 general hospital NICU located Ulsan city from December 1. 1998 to February 28. 1999. For this study, 70 family members were interviewed with aid of a Likert scale which was developed by researcher for this study. For development of the survey instrument, literature review and open questionnaire technique with family members and the nurses working in NICU. The 50needs-items were classified into 7 groups according to the homogeneity of the items with the support of literature review. For the content validity, the instrument was reviewed by 1 nursing professor and the internal reliability of this instrument was Cronbach alpha=0.94 which is highly accepted. Data was analyzed by a SPSS computer program. Data analysis included frequency. percentage, mean, standard variance and t-test or ANOVA. The results were as followings : 1. The general characteristics of head injury patients shows that the male was 74.3%, the female was 25.7% and age distribution shows that the fifty-fifty nine years was 30%, the highest. Of religion the buddhism was the most, The diagnosis distribution shows that epidural hematoma was 32.9% and subdural hematoma was 24.3%. The mentalility distribution shows that semicoma was 31.4% and stupor was 31.4%. Hemiplegia was 42.9% 2. The general charaterisrics of the family needs of head injury patients shows that thirty-thirty nine years was 31.4%, the highest. sex distribution shows that the male was 20%, the female was 80%. Of religion the buddism was the most. 3. The family needs of head injury patients was $3.03{\pm}0.42$, needs for the information of a patient's condition was $3.65{\pm}0.48$, the highest. And needs for the information of care and treatment was $3.48{\pm}0.48$, needs to be supplied with comfortable facilities for family was $3.04{\pm}0.66$, needs to be participate in a patient's care was $2.90{\pm}0.55$, needs to be informed about the available resources was $2.83{\pm}0.59$, needs to be supported emotionally for family was $2.79{\pm}0.55$, needs for religious assistance was $2.51{\pm}0.85$. 4. Examining the family needs of head injury patients according to patient's characteristics, mentality, plegia degree and operation were shown be variables to make an effect on the needs for the head injury patients family. At all, according to severity of head. injury, the family needs of head injury patients was high. 5. Examining the family needs of head injury patients according to their general characteristics, we could know that religion, job. income were shown to be variables to make an effect on the family needs. Through the examination it can be seen that the characteristics of head injury patients and the family needs of head injury patients. In conclusion, the family needs of head injury patients was almost same the family needs of ICU patients. Therefore we must involve the family's care of head injury patients and we must provide exact and repeated explanation, education and support the family of head injury patients. As this study was resulted in selecting the families admitted to NICU of some general hospital, we couldn't stretch the result in our favor. Therefore, continuous studies are suggested.

• Journal of Intelligence and Information Systems
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• v.25 no.3
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• pp.63-88
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• 2019

The goal of this paper is to investigate changes in North Korea's domestic and foreign policies through automated text analysis over North Korea represented in South Korean mass media. Based on that data, we then analyze the status of text mining research, using a text mining technique to find the topics, methods, and trends of text mining research. We also investigate the characteristics and method of analysis of the text mining techniques, confirmed by analysis of the data. In this study, R program was used to apply the text mining technique. R program is free software for statistical computing and graphics. Also, Text mining methods allow to highlight the most frequently used keywords in a paragraph of texts. One can create a word cloud, also referred as text cloud or tag cloud. This study proposes a procedure to find meaningful tendencies based on a combination of word cloud, and co-occurrence networks. This study aims to more objectively explore the images of North Korea represented in South Korean newspapers by quantitatively reviewing the patterns of language use related to North Korea from 2016. 11. 1 to 2019. 5. 23 newspaper big data. In this study, we divided into three periods considering recent inter - Korean relations. Before January 1, 2018, it was set as a Before Phase of Peace Building. From January 1, 2018 to February 24, 2019, we have set up a Peace Building Phase. The New Year's message of Kim Jong-un and the Olympics of Pyeong Chang formed an atmosphere of peace on the Korean peninsula. After the Hanoi Pease summit, the third period was the silence of the relationship between North Korea and the United States. Therefore, it was called Depression Phase of Peace Building. This study analyzes news articles related to North Korea of the Korea Press Foundation database(www.bigkinds.or.kr) through text mining, to investigate characteristics of the Kim Jong-un regime's South Korea policy and unification discourse. The main results of this study show that trends in the North Korean national policy agenda can be discovered based on clustering and visualization algorithms. In particular, it examines the changes in the international circumstances, domestic conflicts, the living conditions of North Korea, the South's Aid project for the North, the conflicts of the two Koreas, North Korean nuclear issue, and the North Korean refugee problem through the co-occurrence word analysis. It also offers an analysis of South Korean mentality toward North Korea in terms of the semantic prosody. In the Before Phase of Peace Building, the results of the analysis showed the order of 'Missiles', 'North Korea Nuclear', 'Diplomacy', 'Unification', and ' South-North Korean'. The results of Peace Building Phase are extracted the order of 'Panmunjom', 'Unification', 'North Korea Nuclear', 'Diplomacy', and 'Military'. The results of Depression Phase of Peace Building derived the order of 'North Korea Nuclear', 'North and South Korea', 'Missile', 'State Department', and 'International'. There are 16 words adopted in all three periods. The order is as follows: 'missile', 'North Korea Nuclear', 'Diplomacy', 'Unification', 'North and South Korea', 'Military', 'Kaesong Industrial Complex', 'Defense', 'Sanctions', 'Denuclearization', 'Peace', 'Exchange and Cooperation', and 'South Korea'. We expect that the results of this study will contribute to analyze the trends of news content of North Korea associated with North Korea's provocations. And future research on North Korean trends will be conducted based on the results of this study. We will continue to study the model development for North Korea risk measurement that can anticipate and respond to North Korea's behavior in advance. We expect that the text mining analysis method and the scientific data analysis technique will be applied to North Korea and unification research field. Through these academic studies, I hope to see a lot of studies that make important contributions to the nation.

• Journal of Physiology & Pathology in Korean Medicine
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• v.20 no.4
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• pp.766-783
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• 2006

This study describes philosophical background regarding '虛' in oriental medicine in an effort to understand the relationships among some of the Eastern philosophy in accordance with differentiated meanings in several resources by analyzing examples of '虛' in Huang Di Nei Jing. The various usages of '虛' used in Huang Di Nei Jing are as follows: naming; condition of pulse; emptiness; '太虛' which was referred universal space by Chinese ; insufficiency, lack or scarcity, deficiency ; and the description of vitality, mental faculties. 外丹修煉(training by external substances) had the attitude do that withdraw the death by taking external materials. The meaning of '虛'in 外丹修煉 is similar to that in oriental medicine in terms of deficiency. That is, both 外丹修煉 and the oriental medicine consider that the death and disease are caused by the deficiency of something. However, there also exists difference between 外丹修煉 and the oriental medicine. 外丹修煉 supplements through withdrawal prohibition due to the characteristic of unchangeability and stern or immortal while oriental medicine provides concrete object of deficiency. 精(essence of life), 氣(ki, functional activity), and fe(vitality) not only have been considered as basic component of human body, but they also have been an important subject of health preservation for longevity with health in Taoism and oriental medicine. In oriental medicine, 精 and 氣 have been perceived as physical basis of human body and 神 as controller. 內丹修煉(Training of internal active substances) 掠nds to return to '虛', the early state of life through individual training, and attempts to withdraw death through continuous recurrence. The oriental medicine and 內丹修煉 held great value of 神 among health preservation of 精, 氣, and 神. They seek theoretical basis from philosophical Taoism. However, '虛' in Taoism is different from that in training by internal substances and oriental medicine: '虛' in philosophical Taoism has metaphysical concept which refers overcome of life and death, but '虛' in 內丹修煉 and oriental medicine have empirical concept. '太虛' is considered as formless space where it is emp Dut filled with 氣. It is conceptualized with the premise of the relevant adaptation of human body to natural environment theory referring that the interaction between the heaven and the earth makes changes; all creation is originated , and human is affected by the interaction of the heaven and the earth. Furthermore, in $\ulcorner$運氣七篇$\lrcorner$ (Seven chapters described about the five circuit phases and the six atmospheric influences), the expression that the earth is in the center of '太虛' and huge amount of 氣 supports it proves that $\ulcorner$運氣七篇$\lrcorner$ adapts '渾天設'(Chaotic universe thee). In Taoism, '虛' is the grounds where all creation is generated in the optimal condition of Tao. As regards the aspect of mentality, it is the condition in which one can free from the dualistic concepts such as right and wrong, beauty and ugliness, life and death, and so on. Although the ultimate goal of oriental medicine, the achievement of longevity without sickness, might contrast with the Taoist belief that perceives life and death as the natural phenomena or the flowing of the 氣, and eliminates all international, the idea of Taoism that one should live substantial life with naivety, and make Harmony with the nature might be influential to the oriental medicine.

• Journal of Physiology & Pathology in Korean Medicine
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• v.19 no.5
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• pp.1129-1136
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• 2005

The writer reports the conclusions gained from study about the cause of the hypersensitive large intestine syndrome with Dongeuibogam as the central figure through researching the disharmony among Body Essence, Vital Energy, Mentality, and Blood, mutual action of five viscera and six bowels, and external shapes. The hypersensitive large intestine syndrome is generally chronic and recurred in many cases, so it is more efficacious than symptomatic to treat according to find the contradictions of individual shapes. The shapes and cases suffering frequently the hypersensitive large intestine syndrome are Gi-kwa and Sin-kwa, having a long nose, having a bruised spot on Triple warmer, man with inclined mouth, Taeeum type, man with congested fluids, man with colic symptoms. The hypersensitive large intestine syndrome in Oriental medicine is recognized of diarrhea, constipation, abdominal pain, abdominal distention and fullness caused by seven emotions. In Dongeuibogam it can be found out the similarity in depressive symptoms due to disorder of Gi, stagnation of Gi, dysphasia due to disorder of Gi, diarrhea due to disorder of Gi, fullness of due to Gi, diarrhea due to phlegm-retention, retention of undigested food, immoderate drinking, hypo-function of the spleen, or deficiency, abdominal pain from colic symptom, and difficulty in defecation and urination, internal injury, diarrhea due to weakness and fatigue. If the Jung, Gi, Sin, and Hyul composed the human body is broken harmony, the function of large intestinal transmission would be fallen, so similar symptoms like the hypersensitive large intestine syndrome are gotten. Especially Gi-kwa suffers diarrhea, constipation abdominal pain, and abdominal distention and fullness due to depressive symptoms from disorder of Seven emotions or Seven Gi. And Sin-kwa suffers from the hypersensitive large intestine syndrome due to emotional restlessness having an influence on rhythmic movement of abdomen. Examining between five viscera and six bowels and the hypersensitive large intestine syndrome, Liver cannot disperse well having influence on mutual relation of Liver-Large intestine, Heart reduces the function of defecation and urination not to control the seven emotions, Lung having exterior and interior relation with intestine has an influence on primordial energy and let the main symptoms occur, Spleen circulating the body fluid let the main symptoms occur due to malfunction of circulation, Kidney locating in lower part of the body has deep connection with intestine, so let the disorder. Urinary bladder is connected with intestine in moisture metabolism, Stomach is connected in receive and transmission, Small intestine is connected in absorption and excretion, from small intestine pain disturbing the abdominal movement, Samcho managing the catharsis of lower heater if declined its function causes the hypersensitive large intestine syndrome. The colic symptoms of Front private parts which disorder in lower abdomen give rise to abdominal pains, difficulty in defecation and urination due to Cold are similar to the hypersensitive large intestine syndrome. The treatments of applying the shapes of colic syndrome advocated by Master Park can be efficacious cure in clinic. Researching after the clinical cases of Master Park advocating Hyungsang medicine, we came to know that plenty of prescriptions of internal injury are applied and take good effects.

• Tuberculosis and Respiratory Diseases
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• v.51 no.4
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• pp.334-345
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• 2001

Background : Pulmonary tuberculosis(TB) is still prevalent and remains a significant clinical problem for the elderly. However, the disease presents in many ways, and there are frequent adverse drug reactions that may prevent the early diagnosis and treatment of elderly TB patients compared to the young. The purpose of this study was to determine whether or not there are any differences in the clinical feature of pulmonary tuberculosis(TB) in both the diagnosis and treatment between the young (less than 64 years) and the elderly (65 years and more). Methods : The medical records of 125 young and 70 elderly pulmonary TB patients, who were diagnosed with and treated for pulmonary TB at the Seoul Municipal Boramae Hospital from November 1991 to January 1997, were analyzed retrospectively. Results : Anorexia(12% vs. 31.4%), general weakness (20.0% vs. 54.3%), dyspnea(21.6% vs. 37.1%) and an abnormal mentality (0.8% vs. 15.7%) were more frequent presenting symptoms in elderly TB patients, whereas hemoptysis (32.8% vs. 10.0%) and fever (BT > $37^{\circ}C$, 58.4% vs. 35.7%) were more frequent in the young. The elderly had a higher number of cardiovascular and chronic obstructive pulmonary diseases as underlying illnesses. In chest PA, there were no differences in the location of the TB lesion, but the appearances were initially diagnosed more frequently as pneumonia or lung cancer (8.8% vs. 30.0%, p<0.05) in the elderly. There was no difference in the detection rate of acid fast bacilli(AFB) in the sputum between the two groups. There were no differences in the treatment response and follow-up loss. However, adverse drug reactions (13.6% vs. 45.7%, p<0.05), and changes in medication (4.9% vs. 25.7%, p<0.05) during treatment occurred more frequently in the elderly. One among the 125 young patients died from tuberculosis whereas 6 among the 70 elderly patients died from the disease. Conclusion : Because the clinical and radiological presentations were more atypical, a sputum AFB smear and culture should be done immediately in the elderly who are TB. The elderly experienced more frequent adverse drug reactions and mortality during treatment, but the response to treatment was good and rapid.

• Asia-Pacific Journal of Business Venturing and Entrepreneurship
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• v.7 no.2
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• pp.195-205
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• 2012

This study examines runaway youths at risk in a youths' shelter who are preparing for an independent life and both the facilitating and adverse factors to personal characteristics and independence of runaway youths at risk with the aim to grasp their recognition of independence and level of desire for it and find out necessary factors for a successful independence in multidimensional perspectives including the economic independence, educational independence, psychological independence, and social independence for their sound growth. This will provide the basis for desirable interventions for youths runaway youths at risk to prepare for an independent life. The findings of this study on the factors that affect the preparation for an independent life are as follows: First, as a result of analyzing the effect of micro-systematic factors on the preparation for an independent life, it turned out that problem-solving abilities and self-efficacy had influence on the preparation for a career Second, as a result of analyzing the effect of mesoscopic-systematic variables on the preparation for an independent life, it turned out that the preparation for a career were affected by whether to participate in independence preparation programs and institutional supports, and that career maturity of runaway youths at risk were affected only by the relationship with teachers and participation in independence preparation programs. Third, as a result of analyzing the effect of macro systematic variables on the preparation for an independent life, it turned out that the preparation for a career were affected by participation of the local community and service network, and that participation of the local community was an predictor variable that would affect a career maturity of runaway youths at risk. Fourth, as a result of analyzing ecological systematic variables that might affect the preparation for a career, it turned out that intervening variables and macro systematic variables had the most powerful influence on the preparation for a career among runaway youths at risk. It is necessary, therefore, to provide education programs organized by policies in order to develop problem-solving abilities and vocational capabilities so that runaway youths at risk, and to train and appoint more professional teachers at shelters. Programs for independence preparation need to be developed actively and practically in consideration of the characteristics of shelters, and the network with the local community for support also need to be established in utilization of the human resources and service programs of the community. With the understanding of leaving home of runaway youths at risk as the previous stage of an independence, there should be a housing support for their stable settlement in the perspective of housing welfare until become adults. In addition, there should be education specialized programs for occupation and careers to train runaway youths at risk as professionals including such areas as health, mentality, learning, and voluntary work for their sound growth.

• Journal of Hospice and Palliative Care
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• v.18 no.2
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• pp.85-96
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• 2015

In Korea, modern art therapy was developed in the 1960s and 1970s in the form of supplementary activities for patients in psychiatry. Along with the foundation of the Korean Association for Clinical Art in 1982 by psychiatric doctors, the therapy involved more various arts forms such as music, art, dance, poetry therapy, and psychodrama. More organizations with specific expertise opened such as the Korean Art Therapy Association, Korean Art Therapy Association, etc. in the 1990s and the Korea Arts Therapy Institute in 2001. As of April 2015, the members of the Korean Art Therapy Association total 15,000, including 6,200 regular members. The arts in integrative arts therapy (IAT) is an individual's creative activity which is related to his inner world, and the forms of IAT include music, drawing, dance and poetry therapy. From the aspect of phenomenology, IAT is psychophysical therapy involving the arts that helps patients recognize and perceive their experiences with an aim of at a recovery of the body and creativity from the phenomenological aspect. It is also a therapeutic activity that targets growth and development of the body and mind. Meta-analysis of the effects of art therapy with a focus on that involving music, drawing, dance movement and IAT in recent years in Korea, significant effects were observed in all factors but physical function. The biggest effect was mentality adaptation followed by activity adaptation and physiology. In the run up to the implementation of the daily flat-rate system for the health insurance reimbursement for palliative care in July 2015, the Ministry of Health and Welfare is reviewing the coverage of music therapy, drawing therapy and flower therapy, which are currently practiced by 56 hospice institutes in Korea. This is a meaningful step because the coverage of hospice and palliative care came after that of art therapy for psychiatric patients was approved in 1977. Still, there is a need clarify the therapeutic mechanism by exploring causality among the treatment media, mediation type and treatment effects. To address the issue of indiscriminately issued licenses, more efforts are needed to ensure expertise and identity of the licensed therapists through education, training and supervision.