• Journal of Genetic Medicine
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• v.8 no.2
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• pp.105-112
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• 2011

Purpose: Sharing genetic information with family members is important for cancer awareness and prevention. The purpose of this study is to examine disclosure patterns of positive BRCA genetic test results to patients' relatives. Materials and Methods: A total of 106 probands who had positive BRCA genetic test results from the Korean Hereditary Breast Cancer Study participated in our study. Subjects were asked whether they had disclosed their genetic test results to first-, second-, and third-degree relatives. Univariate and multivariate analyses were used to identify factors associated with positive result sharing with close and distant relatives. Results: In total, 99 respondents (93.4%) informed at least one at-risk relative of the test result, and they all reported that they had disclosed their genetic test result to a first-degree relative. Communication of test results to other relatives occurred significantly less often, with only 31 of 99 subjects (31.3%) sharing their results with second- or third-degree relatives. In the results of univariate analyses, disclosure of genetic test results to more distant relatives was associated with marital status and months since post-test counseling. The reasons for communication were to provide information about the BRCArelated cancer risk and to recommend the genetic test. Conclusion: Most individuals with the BRCA mutation share their test results with first-degree family members; however, these results reach more distant relatives significantly less often. Therefore, it is necessary to encourage patients' communication with extended family members through systematic genetic counseling.

• The Journal of the Korea Contents Association
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• v.17 no.1
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• pp.262-269
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• 2017

The purpose of this study is to provide direction of medical education by analysing medical school student's perception structure about 'happy doctor'. In particular, this study compared perception structure between two groups of students before clerkship and after clerkship. The subject of this study were 1~4 academic year students in medical school. Students' text about 'happy doctor' were collected by open-ended questionnaire and analyzed by using sematic network analysis. Based on the result of network analysis, perception structure of each groups were confirmed. The network of each groups have 'Professionalism' group including words such as 'patient', 'treatment', 'worthwhile' in common. Three groups, 'Professionalism', 'Quality of life' and 'Self-realization' constituted the before clerkship network. And five groups, 'Professionalism', 'Time with family', 'Balance between work and household', 'Interpersonal relationship', 'Physical and psychological health' constituted the after clerkship network. The results of this study is expected to contribute for developing the basic medical education curriculum for 'happy doctor'.

• Clinical and Experimental Pediatrics
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• v.46 no.12
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• pp.1253-1259
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• 2003

Backgroud : Seizures in the neonate are relatively common and their clinical features are different from those in children and adults. The study aimed to provide the clinical profiles of neonatal seizure in our hospital. Methods : A total of 41 newborns with seizures were enrolled in this study over a period of three years. They were evaluated with special reference to risk factors, neurologic examinations, laboratory data, neuroimaging studies, EEG findings, seizure types, response to treatment, and prognosis, etc. Results : The average age at onset of seizures was $6.1{\pm}4.6days$ and the majority of patients(42%) had multifocal clonic seizure and 24% had subtle seizure. Factors that are known to increase risk of neonatal seizures include abnormal delivery history, birth asphyxia, and electrolyte imbalance, etc. However, they remain obscure in about 20% of cases. More than 50 percent showed abnormal lesions on neuroimaging studies such as brain hemorrhage, periventricular leukomalacia, brain infarction, cortical dysplasia, hydrocephalus, etc. and 17 out of 32 patients showed abnormal electroencephalographic patterns. Phenobarbital was tried as a first line antiepileptic drug and phenytoin was added if it failed to control seizures. The treatments were terminated in the majority of patients during the hospital stay. The overall prognosis was relatively good except for those with abnormal EEG background or congenital central nervous system malformations. Conclusion : Neonatal seizures may permanently disrupt brain development. Better understanding of their clinical profiles and appropriate management may lead to a reduction in neurological disability in later childhood.

• Clinical and Experimental Pediatrics
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• v.45 no.12
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• pp.1559-1570
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• 2002

Purpose : There has been no exact answer to the question of when to discontinue antiepileptic drugs(AEDs) in children with well-controlled epilepsy for a long period. This study is about the risk factors of relapse after withdrawal of AEDs in seizure(Sz)-free patients to show a guideline for discontinuation of AEDs. Methods : One hundred and sixty-nine children were diagnosed as epileptic at the Pediatric Dept. of Kyung-Hee Univ. between 1993 to 1998, in whom AEDs had been withdrawn after at least two years of Sz-free period. Univariate analysis using Kaplan-Meier survival analysis and multivariate analysis using Cox-proportional hazard model were performed for sixteen risk factors. Results : Forty-nine of the 169 patients(28.9%) had recurrence of Szs. The mean follow-up after withdrawal of AEDs was 4.1 years, mean treatment period was 4.1 years, and the mean Sz-free period was 3.3 years. Factors associated with an increased risk of relapse were young age at onset, symptomatic Sz, Sz type in West and Lennox-Gastaut syndrome, neurologic deficit, longer Sz-controlling period, shorter total treatment period, number of AEDs used(more than one drug), age at withdrawal of AEDs, and Sz-free period less than two years in univariate analysis using Kaplan-Meier mothod. From multivariate analysis, the factors indicating a significantly higher relapse risk were pre-treatment period after first Sz attack, Sz-controlling period, Sz-free period, number of AEDs used, neurologic abnormalities. Conclusion : For epileptic children who were Sz-free for more than two years, and were more than six-years-old, the discontinuation of AEDs should be considered positively, according to age of onset, Sz type, age at withdrawal of AEDs, total treatment period, Sz-controlling period, number of AEDs used, etiology, neurologic deficit, and the wishes of the patients and the their parents.

• Korean Journal of Culture and Social Issue
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• v.27 no.1
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• pp.19-34
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• 2021

Many survivors of sexual violence disclose their experience to others. When they receive negative social reactions, this can be a traumatic event for the survivor where their trust towards others is violated and can cause posttraumatic cognitions and depression. Likewise, institutional betrayal, or negative reactions from trusted institutions regarding the disclosure of sexual victimization can be a traumatic event for the survivor and is associated with depression as well. However, studies investigating the mechanism underlying the relationship between institutional betrayal and depression is yet limited. Therefore, based on cognitive behavioral theory (CBT), which is known as the most effective approach to date for understanding and treating posttraumatic symptoms, this study examined if posttraumatic cognitions mediate the relationship between institutional betrayal and depression. Questionnaires were administered to 462 women who had experienced institutional betrayal to their sexual victimization. Results showed that institutional betrayal had an effect on depression only through negative cognitions about the self and world. This suggests the importance of identifying and treating trauma-related cognitions in order to prevent or cure depression of those who had experienced institutional betrayal to their sexual victimization. Limitations and implications of this study are also discussed.

• Korean Journal of Social Welfare
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• v.63 no.1
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• pp.5-28
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• 2011

This study, based on the research on the history of life, aimed to recompose and analyze into what life progressive structure the life experience by the mentally ill, after the onslaught of the disease, developed in a bid to understand the risk progress in the mentally ill's life, and to determine what contributed to the current stabilized recovery and adjustment. Five mentally ill persons participated in the study, and Sch$\ddot{u}$tze's narrative interview was used to gather data. The gathered data were analyzed according to Sch$\ddot{u}$tze's process structure of life. The interviewees' life experiences were chronologically organized as understood, and significant stories were recomposed that not only brought about changes but also helped overcome their disabilities in the process of treatment and rehabilitation after the onslaught of the disease. As a result, their experiences were recomposed into the stage of onslaught of the mental illness and confusion, and into the stage of intensive treatment and rehabilitation. The former was categorized into suppression by the disease, repetition and endurance of the painful life, and separation from their family and frustration. The latter was categorized into the rediscovery of self through social role change, others who helped realize the life potential, the expansion of mental health services in the community, obstacle to the integration of communities, re-integration of family relationships, re-analysis of experience of the disease through the examination of the life prior to onslaught of the disease, and expectation for the future. Also, these themes were comparatively examined so as to examine the crisis progress in the mentally ill's life after the onslaught of the disease, as well as the life transfer process through positive rehabilitation. Lastly, on the basis of these results, important areas of mental health services for the mentally ill were discussed.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.20 no.7
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• pp.589-598
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• 2019

This study was conducted to build a structural equation model explaining factors that affect hemodialysis patients' quality of life to test the goodness of fit of the model and identify directly and indirectly significant paths. To accomplish this, 230 patients receiving hemodialysis registered at study hospitals in G Metropolitan City and M City were randomly selected, and 201 were used in the final analysis. Data were collected using a self reporting questionnaire from February 1 to March 31, 2014. SPSS WIN 18.0 was used for descriptive statistics and correlation analysis of the general characteristics and for reliability analysis of the research tools. In addition, AMOS 18.0 was used for confirmatory factor analysis of latent variables, to determine the goodness of fit of the hypothetic model, and hypotheses testing. The results of this study were as follows: the fit of the modified model was 41.32, GFI = .96, AGFI = .92, RMR = .04, NFI = .96, CFI = .91 and TLI = .95. Twelve out of the 22 research hypotheses that were improved and improved were statistically significant. The results indicated that hemodialysis patients' quality of life was influenced directly by self-efficacy, depression, and self-care behavior, and indirectly by sleep disturbance, stress, fatigue, and family support. These variables explained 58.6% of the variation in quality of life. Overall, these findings suggest that nursing interventions for hemodialysis patients require strategies for managing patient depression and for increasing self-efficacy and self-care behavior to improve quality of life.

• The Journal of the Korea Contents Association
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• v.21 no.10
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• pp.550-563
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• 2021

This study recognizes that the externalizing problem behaviors of child with disabilities are the result of the social interaction between mother and child, and empirically verifies its systematic causal structure and multidimensional influence relationship. It was attempted to derive practical implications that can help the smooth normalization process of children's families. Therefore, 135 children with disabilities and their mothers selected by convenience sampling were targeted, and in the relationship between maternal overprotective parenting and externalizing behaviors of child, effortful control was used as a mediating variable, and defense style of mothers and children was used as a moderating variable. A Conditional Process Analysis(CPA) that can verify the moderated mediation Effect was performed by establishing a research model. As a result of the analysis, first, the overprotective parenting behavior of mother was statistically significant in both direct and indirect effects in increasing externalizing behaviors of child, and the mediation effect by effortful control was also statistically significant. Second, it was confirmed that the moderated mediation effect of effortful control by the mother's defense style was statistically significant, and the moderated mediation effect of effortful control by the child's defense style was not statistically significant. Based on the above results, assuming the importance of the influence of maternal parenting, a direct strategy for change in maternal overprotective parenting, child's Practical implications of parallel strategies with the tendency toward effective control and suboptimal strategies through the application of mothers' coping strategies were discussed.

• Korea journal of population studies
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• v.27 no.2
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• pp.1-34
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• 2004

최근 한국사회에서는 출산율의 저하로 인한 사회경제적 영향을 우려하여 대책방안을 강구하여야 한다는 논의가 증대되고 있다. 그런데 국가정책을 개발${\cdot}$추진하기 이전에 반드시 요구되는 것은 저출산 현상의 올바른 인식과 철저한 원인규명이다. 따라서 본 연구에서는 출산율 변화의 원인을 다각적으로 살펴보고, 향후 변화방향을 전망해 보고자 한다. 먼저 자녀출산의 변화를 결혼상태 변화와 유배우부인의 출산율 변화 부분으로 나누어 살펴본 결과, 과거와는 달리 최근의 출산율 저하는 유배우 부인에 의해서가 아니라 미혼자의 결혼연장 또는 독신생활에서 기인되는 것으로 나타났다. 이들 두 요인에 영향을 주는 변수로는 경기침체 및 직장불안정, 결혼가치관의 변화와 초혼연령의 상승, 자녀양육 관심증대, 자녀양육비 부담, 가정과 직장의 양립을 위한 사회적 인프라 부족, 여성의 자아욕구 및 사회참여 증대, 자녀효용가치 감소, 이혼 등 가족해체의 증대, 그리고 불임부부의 증대 등인 것으로 판단된다. 향후 출산율 변화를 전망해 보면, 저출산을 일찍 경험한 서구 선진국의 경우와는 달리 정책의 추진에 한계가 있어 선진국보다 더 낮은 출산율을 회복하는 데는 많은 어려움이 있을 것이라는 판단이다. 더군다나 젊은 미혼남녀의 가치관이 개인주의화 되는 경향이 있다는 점을 감안한다면 출산율 회복정책을 추진한다 하더라도 한계가 있을 수밖에 없을 것이다. 수년간 실시된 각종 실태조사를 분석한 결과에 의하면 현재의 경기침체가 회복될 경우 약 20%의 출산율 상승 가능성이 있으며, 이 때의 합계출산율은 약 1.43명 수준이 될 수 있을 것으로 예견된다. 또한 종합적 체계적 출산회복정책을 효과적${\cdot}$효율적으로 추진한다면 약 10년 후에는 합계출산율이 약 1.6 수준으로 회복될 것이라는 낙관적 견해를 가져본다. 그렇지만 정책의 강도에 따라서 회복수준은 현저하게 상이할 것이다.를 진단, 치료함에 있어 진행성 신질환의 가능성을 시사하는 예후인자가 없다면 신생검보다는 지속적이고 정기적인 추적관찰만으로도 충분할 것으로 생각된다도 등은 양군 사이에 유의한 차이가 관찰되지 않았다. 발견 당시 혈청 $C_3$치의 감소는 모두 11명(61.1%)에서 관찰되었는데, 증상군에서는 7명(87.5%), 집단뇨검사군에서는 4명(40%)으로 증상군에서 혈청 $C_3$치의 감소가 보다 현저하였다. 그러나 추적관찰 기간 동안 증상군에서는 7명 중 4명, 집단뇨검사군에서는 4명 중 1명에서 혈청 $C_3$치는 정상범위로 증가하여 최종 관찰시점에서는 6명 (33.3%)에서만 혈청 $C_3$치의 감소가 지속되고 있다. 혈청 $C_3$치의 감소를 보인 경우를 다시 병리조직학적 분류에 의해 세분하여보면 발병당시에는 I형 8명(61.5%), II형에 1명(100%), III형 2명(50%)에서 관찰되었는데, 최종 시점에서는 I형 4명(30.8%), II형 1명(100%), III형 1명(33.3%)이었다. 또한 증상군에서 세포성 반월체형성과 세뇨관위축의 빈도가 높았으며, 사구체 혈관벽 비후와 사구체 간질의 증가의 정도가 집단뇨검사군에 비해 통계적으로 유의하게 높았다. 결론: 무증상성 요이상을 가진 환자에서 신장조직검사 실시 후 MPGN으로 진단되는 증례가 증가하고 있고, 오히려 증상을 동반하는 경우보다 빈도가 증가한다는 사실은 집단뇨 검사에서 소변의 이상소견이 발견되어 신장 조직검사를 실시할 경우 혈청 $C_3$치의 감소 여부에 관계없이 MPGN도 진단적 고려 대상이 되어야 한다고 생각한다.신장 조직검사를 시행한 결과 진행성 경과를 취할 수 있는 막 증식성 사구체 신염과 매우 희귀한 증례인 신유전분증 등으로 진단됨으로써 지속성 단백뇨의 경우 정확 진단적 접근이 필수적임을 알 수

• Journal of the Korean Society of School Health
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• v.4 no.2
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• pp.136-145
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• 1991

In the Soviet Union School health services are provided as an integral part of the health care delivery system, which is under the Ministry of Health. This paper presents an overview of the Soviet Union's health care delivery system, the model for the delivery of school health service, the role and training of school personnel involved in school health services and implications the Soviet model may have for the countries. 1. School health services are a part overall Soviet health system under the Ministry of Health. 2. Municipal and rural health departments implement programs at the local level. Diagnosis and treatment are conducted through "polyclinics" that are outreach divisions of a district hospital. 3. Education institutions for the development of health manpower, including medical schools and nursing schools, are under the Ministry of Health, as are medical and scientific search institutes.