• Title/Summary/Keyword: 돌보는 가족원

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Hospice System Improvement Measures to Increase the Accessibility of Voluntary Home Death: A Comparison of the South Korean and American Hospice Systems (자택임종 증가를 위한 호스피스제도 개선 방안: 한국과 미국의 호스피스제도 비교를 중심으로)

  • Han, Da-Jeong;Choi, Young-Soon;Lee, Dong-Hyun
    • The Journal of the Korea Contents Association
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    • v.22 no.6
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    • pp.567-579
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    • 2022
  • The purpose of this study is to find a way to improve the hospice system to increase comfortable home death, which people prefer, by understanding the factors affecting the difference in the rate of home death between South Korea and America within the hospice system. This study employs the Most Similar Systems Design, which is a case study approach. The result of this study is that both countries have public health insurance systems that are identical in terms of the appropriate time for the receipt of hospice services and the application procedure, which requires that two doctors confirm the patient's hospice eligibility. The main difference is that in South Korea, inpatient hospice is prevalent, whereas routine home care is predominant in the United States. Furthermore, in the United States, hospice assistants and housekeepers support at-home daily living care. Additionally, the United States provides inpatient respite care to allow care-giver, such as family to rest and there is no restriction on hospice-eligible diseases. To increase the accessibility of voluntary home death in South Korea, it is necessary to activate and expand the home type hospice service range and provide at-home daily living care, care-giver support services. Furthermore, there should be no restrictions on hospice-eligible diseases.

Trend in Paternal Childcare Time for Preschool Children in Korea from 2004 to 2019 (아버지의 미취학자녀 돌봄시간 변화 추이 분석(2004-2019))

  • Lee, Jung-eun;Seo, Jiwon
    • Journal of Family Resource Management and Policy Review
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    • v.25 no.3
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    • pp.103-120
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    • 2021
  • Recently, the importance of the fathers role in the care of young children has been emphasized in Korea for the balance of childcare responsibilities between mothers and fathers. This study investigates the trends in paternal childcare in Korea over the last 15 years. Childcare is divided into primary and developmental care and fathers's Childcare time and participation rates are inverstigated for dual- and single-income households. Data are collected from the four waves of the five-yearly Statistics of Korea Life Time Surveys between 2004(t1) and 2019(t4) including the workday time diaries of fathers with preschool children(n1=2,264, n2=1,242, n3=959, n4=952). Three major results are identified. First, paternal childcare time and participation rates have increased with dual-income fathers spending 24 more minutes a day with their young child(ren) in 2019 than in 2004, which is nearly double. Second, in the analysis of fathers' childcare time use and participation rates comparing primary and developmental care, primary care is found to have increased more than developmental care, especially among dual income fathers: this further exhibits a reversed relation between primary and developmental care over time. Third, the determinants of paternal childcare time are fathers' age, market labor time, commuting time, gender equality consciousness, and education. In particular, market labor time was significant in all four waves, while gender equality consciousness is only significant for single-income fathers. Based on these results, a specific agenda is provided for family-friendly policies to improve the balance of childcare roles between fathers and mothers, especially encouraging increased(significant and sufficient) participation of fathers in primary care activities.

Management of Non-pain Symptoms in Terminally Ill Cancer Patients: Based on National Comprehensive Cancer Network Guidelines (말기암환자에서 통증 외 증상의 관리: 최신 NCCN(National Comprehensive Cancer Netweork) 권고안을 중심으로)

  • Lee, Hye Ran
    • Journal of Hospice and Palliative Care
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    • v.16 no.4
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    • pp.205-215
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    • 2013
  • Most terminally ill cancer patients experience various physical and psychological symptoms during their illness. In addition to pain, they commonly suffer from fatigue, anorexia-cachexia syndrome, nausea, vomiting and dyspnea. In this paper, I reviewed some of the common non-pain symptoms in terminally ill cancer patients, based on the National Comprehensive Cancer Network (NCCN) guidelines to better understand and treat cancer patients. Cancer-related fatigue (CRF) is a common symptom in terminally ill cancer patients. There are reversible causes of fatigue, which include anemia, sleep disturbance, malnutrition, pain, depression and anxiety, medical comorbidities, hyperthyroidism and hypogonadism. Energy conservation and education are recommended as central management for CRF. Corticosteroid and psychostimulants can be used as well. The anorexia and cachexia syndrome has reversible causes and should be managed. It includes stomatitis, constipation and uncontrolled severe symptoms such as pain or dyspnea, delirium, nausea/vomiting, depression and gastroparesis. To manage the syndrome, it is important to provide emotional support and inform the patient and family of the natural history of the disease. Megesteol acetate, dronabinol and corticosteroid can be helpful. Nausea and vomiting will occur by potentially reversible causes including drug consumption, uremia, infection, anxiety, constipation, gastric irritation and proximal gastrointestinal obstruction. Metoclopramide, haloperidol, olanzapine and ondansetron can be used to manage nausea and vomiting. Dyspnea is common even in terminally ill cancer patients without lung disease. Opioids are effective for symptomatic management of dyspnea. To improve the quality of life for terminally ill cancer patients, we should try to ameliorate these symptoms by paying more attention to patients and understanding of management principles.