• Title/Summary/Keyword: 암 환자 가족

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Application of Transposable Elements as Molecular-marker for Cancer Diagnosis (암 진단 분자 마커로서 이동성 유전인자의 응용)

  • Kim, Hyemin;Gim, Jeong-An;Woo, Hyojeong;Hong, Jeonghyeon;Kim, Jinyeop;Kim, Heui-Soo
    • Journal of Life Science
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    • v.27 no.10
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    • pp.1215-1224
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    • 2017
  • Until now, various oncogenic pathways were idenfied. The accumulation of DNA mutation induces genomic instability in the cell, and it makes cancer. The development of bioinformatics and genomics, to find the precise and reliable biomarker is available. This biomarker could be applied the early-dignosis, prediction and convalescence of cancer. Recently, Transposable elements (TEs) have been attracted as the regulator of genes, because they occupy a half of human genome, and the cause of various diseases. TEs induce DNA mutation, as well as the regulation of gene expression, that makes to cancer development. So, we confirmed the relationship between TEs and colon cancer, and provided the clue for colon cancer biomarker. First, we confirmed long interspersed nuclear element-1 (LINE-1), Alu, and long terminal repeats (LTRs) and their relationship to colon cancer. Because these elements have large composition and enormous effect to the human genome. Interestingly, colon cancer specific patterns were detected, such as the hypomethylation of LINE-1, LINE-1 insertion in the APC gene, hypo- or hypermethylation of Alu, and isoform derived from LTR insertion. Moreover, hypomethylation of LINE-1 in proto-oncogene is used as the biomarker of colon cancer metastasis, and MLH1 mutation induced by Alu is detected in familial or hereditary colon cancer. The genes, effected by TEs, were analyzed their expression patterns by in silico analysis. Then, we provided tissue- and gender-specific expression patterns. This information can provide reliable cancer biomarker, and apply to prediction and diagnosis of colon cancer.

The Effects of Mental Health and Family Problem Solving Communication on Cancer Adjustment of Women with Cancer in Nursing Hospital (요양병원 여성 암 환자의 정신건강, 가족문제해결 의사소통이 암 적응에 미치는 영향)

  • Lim, Sunyoung;Ma, Ryewon;Park, Hyesun
    • Journal of The Korean Society of Integrative Medicine
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    • v.8 no.2
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    • pp.29-39
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    • 2020
  • Purpose : This study investigated the relationship among adjustment of cancer, mental health, and family problem solving communication of women with cancer. The purpose of this study was to determine how to improve the adjustment of cancer of women and improve women's mental health to form family problem solving communication. Methods : This correlational study was conducted among 101 women with cancer living in the Seoul region. Data collection occurred from August 1, 2018, to August 23. The data are reported as means and standard deviations and were analyzed with t tests, ANOVA, and Pearson's correlation regression using SPSS version 21.0. Results : The results of this study showed that adjustment to cancer significantly correlated with the education level of the participants (F=3.27, p<.05) and self-help group participation (F=3.156, p<.05). In this study, the mental health of female cancer patients significantly affected their adjustment to cancer (F=13.13, p<.001). These results explained 19.7% of the variance (F=13.13, p<.001) in mental health and adjustment to cancer in female cancer patients. Conclusion : In this study, mental health was significantly affected adjustment to cancer. The results suggest that adjustment to cancer can be promoted through the development and application of a nursing intervention program considering the mental health of female cancer patients. In addition, further research is required to identify the factors in consideration of various variables in addition to the sociodemographic and disease-related variables that may affect the adjustment to cancer of female cancer patients in nursing hospitals.

Clinical Characteristics of Terminal Lung Cancer Patients Who Died in Hospice Unit (일개 호스피스 병동에서 임종한 말기 폐암 환자의 임상적 고찰)

  • Kim, Yu-Jin;Lee, Choon-Sub;Lee, Ju-Ri;Lee, Jung-Ho;Hong, Young-Hwa;Lee, Tae-Gyu;Moon, Do-Ho
    • Journal of Hospice and Palliative Care
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    • v.10 no.2
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    • pp.78-84
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    • 2007
  • Purpose: The prevalence of lung cancer is increasing continuously these days. We studied clinical characters of the terminal lung cancer patients who had died in hospice units and our study is the basic report for efficient hospice and palliative care to the lung cancer patients. Methods: We retrospectively reviewed the medical records of 129 terminal lung cancer patients who had died in Sam Anyang Hospice Unit from March 2003 to December 2006. The survival days during the hospice and palliative care were analyzed using Kaplan-Meier method of SPSS 13.0. Results: There were 93 males (72%) and 36 females (28%), and median age of patients was 68 years (range $37{\sim}93$). Eighty two patients (64%) took analgesics, the others 47 (36%) not. The most prevalent reason for admission was dyspnea (47 patients, 36%) and it was different from the terminally ill cancer patients being hospitalized because of pain. And the most common symptom was general weakness (103 patients, 80%). One hundred twenty of the paitents (93%) were administered opioid analgesics, and IV morphine shots were mostly used (103 patients, 80%). Sedation was used in 87 patients (67%), and midazolam was mostly used (68 patients, 53%). The median survival in hospice and palliative care was 35 days and the median hospitalization was 24 days. Conclusion: It is very important to manage dyspnea in terminal lung cancer patients. The length of hospice and palliative care for the terminal lung cancer patients is still short. Therefore continuous education and promotion of hospice and palliative care is needed for an effective care for the patients, their families and doctors.

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A Survey on the Certification and Curriculum Development for Hospice and Palliative Care Professionals (호스피스.완화의료 전문인력 자격인증방안과 교육과정개발을 위한 설문조사)

  • Kang, Jin-A;Kim, Do-Yeun;Shin, Dong-Wook;Kim, Si-Young;Lee, Soon-Nam
    • Journal of Hospice and Palliative Care
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    • v.13 no.1
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    • pp.32-40
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    • 2010
  • Purpose: The survey was aimed to provide basic data to develop a certification system for hospice and palliative care professionals. Methods: National Cancer Center (NCC) and the Korean Society for Hospice & Palliative Care (KSHPC) conducted the survey for hospice and palliative care professionals who worked at 34 Palliative care units designated by the Ministry of Health, Welfare, and Family Affairs (MW) and the members of the KSHPC. The survey was conducted via e-mail from June 17 to 23, 2009. Total 220 professionals were surveyed. Results: Most of the hospice and palliative care professionals reported a great need for certification system: Physician, 90% (n=51) nurse, 84% (n=134) social worker, 89% (n=35). In regard with the requirement for the certification, a majority of physicians (46%) preferreddiploma course, while social workers (46%) preferred training course for medical social workers. Concerning the certification body, physician (45%) preferred the KSHPC and the MW almost equally, while nurses (50%) and social workers (60%) preferred the MW highly. As for the body to develop and accredit advance training course for each professionals, most of the physicians (51%) preferred the KSHPC, whereas nurses and social workers preferred collaboration of the MW (or NCC) with the professional society, such as the KSHPC (23%), the Korean Hospice & Palliative nurses association for nurses (21%), or the Korean association of (medical) social workers (37%). Lastly, all respondents preferred the course format of once a week, full day, and some field study at weekend. Conclusion: Korean hospice and palliative care professionals identified the great need for the certification system, therefore, the adequate system development must be followed to reflect their voice.

A Study on the Effective Half-life after the High Dose Radioactive Iodine (131I) Therapy for Thyroid Cancer Patients (갑상선암 환자에서 고용량 방사성요오드 치료 후 유효반감기에 대한 연구)

  • Kim, Seongcheol;Gwon, DaYeong;Kim, Yongmin
    • Journal of the Korean Society of Radiology
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    • v.11 no.7
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    • pp.597-603
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    • 2017
  • High-dose $^{131}I$ therapy has been generally carried out to remove remaining thyroid tissue or to cure metastasize lesion of patients who received full thyroidectomy due to differentiated thyroid cancers. In case high-dose $^{131}I$ therapy is carried out for a patient, the patient should be hospitalized being isolated for a certain period in order to restrict the amount of exposure to radiation of people at large from the patient within the limit of a level of radiation. Effective half-life is an important value to calculate how family members are exposed to radiation from a patient or to decide the period of isolation of the patient from the family members. Therefore, in this study we calculated the effective decay constant, effective half-life and period of isolation of high-dose $^{131}I$ therapy patient using NM670 SPECT/CT. As a result of carrying out this study, the effective half-life of high-dose $^{131}I$ therapy patients was derived and the time to reach the discharge level of 1.2 GBq was confirmed. When they were compared with each other in each of curative doses, the effective half-life did not have significant difference, but the time when the level of radiation remaining in the interior of the body to reach the criteria of isolation and discharge showed significant difference and it could be confirmed that the higher the curative dose the longer the period of isolation becomes. When the effective half-lives in each type of preparation were compared with each other, they did not show significant difference. However, When the times to reach the level of radiation that is the criteria of isolation and discharge in each type of preparations, they showed significant difference. The cause of the shortening of the isolation period for rhTSH patients group is decided to be low curative dose. Accordingly, if the current national health insurance (the insurance is applied to using of rhTSH in 3.7 GBq or lower) is maintained, while discerning them in each of types of preparation, we would be able to discharge patients at the time earlier than the current period of isolation (2 nights and 3 days).

Hospice Education among Hospice Professionals and Its Regional Variations in Korea -Outcomes from a 2008 Hospice Palliative Care Institutions Support Project- (한국 호스피스.완화의료 전문인력 교육의 지역적 변이 -2008년 말기 암환자 전문기관 활성화 지원사업 신청기관 인력을 중심으로-)

  • Kang, Jin-A;Shin, Dong-Wook;Hwang, Eun-Joo;Kim, Hyo-Young;Ahn, Seong-Hoo;Yoo, Yang-Sook
    • Journal of Hospice and Palliative Care
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    • v.12 no.3
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    • pp.132-138
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    • 2009
  • Proper education of hospice professionals is essential for ensuring quality of end-of-life care. In 2005, 'End-of-life Care Task Force Team' by Ministry of Health and Welfare established '60 hours of hospice education' as basic requirement for hospice professionals. This study is aimed to determine how many of the hospice professionals meet with the criteria and whether there are significant regional variations. Methods: We analyzed the data from 46 hospice organizations, which submitted the application to the 2008 designation program of Ministry of Health, Welfare, and Family Affairs. Data included details of the educational records of each hospice professionals. Results: Total 673 hospice professionals were included in the analysis. Overall, only 41.5% (279/673) met the requirement. Nurses (46.8%; 177/378) were more likely to meet the requirement than doctors (35.8%; 38/106), social workers (32.0%; 24/75) and clergies (35.1%; 40/114). Hospice professionals of the organizations in metropolitan area received more education than those in small cities or rural area (52.4% vs. 25.0% for doctors, 50.6% vs. 43.9% for nurses, 42.9% vs. 25.5% for social workers). By geographic areas, hospice professionals in southeast regions received less education than other part of Korea (28.1% vs. 43.0${\sim}$48.8%, respectively). Conclusion: Less than half of the Korean hospice professionals has received proper amount of hospice education, and significant regional variations existed. National programs to promote the education of hospice professionals and eliminate its disparities are greatly warranted. Implementation of the 60-hour currirulum for hospice professionals, based on the train-the-trainer model, would be regarded as one potential solution.

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Current Research Trends in Hospice-Related Domestic Nursing Research Theses (1998~2017) (호스피스 관련 국내 간호연구 논문 동향(1998~2017))

  • Kim, Won Soon
    • Journal of Hospice and Palliative Care
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    • v.22 no.1
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    • pp.19-29
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    • 2019
  • Purpose: In this study, the hospice nursing research trend in 1998~2017 was investigated by analyzing research articles on hospice nursing. Methods: Literature search was performed with keywords of 'nursing' and 'hospice on an academic research information service. Also reviewed were all articles published in the Korean Journal of Nursing Science and its 8 subcategory journals, the Korean Journal of Hospice and Palliative Care and the Korean Hospice Association from 1998 through 2017, except thesis papers. Results: In 2013~2017, 79 articles (31.0%) were relevant, up over 7% from 61 articles (23.9%) in 2008~2012. The most studied field was psychology (92 papers, 36.2%) in the Korean Journal of Hospice and Palliative Care. Enrolled in most papers were patients with end-stage cancer (75, 29.5%), which is overwhelmingly high. Most studies used quantitative methods (183, 72.0%). Recognition was the most studied theme (62, 24.4%), and 16 of them focused on recognition of death (6.3%). Intervention studies totaled 34 (13.4%), and most of them (7, 2.8%) were conducted for palliative education. Conclusion: Most hospice nursing studies were quantitative studies, conducted with patients, and hospice nursing intervention programs were similar to each other. Thus, more studies with hospice patients and their families are needed. And more experimental and qualitative studies are needed to build an evidence-based nursing study environment. Considering how most studies examined psychological factors, physiological factors such as pain, a major issue in hospice care, should be analyzed in experimental studies to construct a pain intervention program for hospice patients.

Retrospective Cohort Study on the Administration of Sedative for Delirium in Terminally Ill Cancer Patients and Survival Time (말기암환자의 섬망으로 인한 진정제 투약과 생존기간에 관한 후향적 코호트 연구)

  • Park, Hyoung Sook;Kim, Dae Sook;Bae, Eun Hee;Kim, Jung Rim;Seo, Jung Hwa;Yun, Jung Mi
    • Journal of Hospice and Palliative Care
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    • v.19 no.2
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    • pp.119-126
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    • 2016
  • Purpose: This study analyzed the difference in survival time of patients with delirium according to sedative medication. Methods: From January 2012 through December 2013, a retrospective cohort study was performed using the electronic medical records (EMR) of Pusan National University Hospital. Among 900 patients who died from cancer, we selected 240 who suffered delirium based on the EMR. The Nu-DESC delirium screening test was used to diagnose delirium. Results: The median length of delirium period was five days. Delirium characteristics were dominated by inappropriate behaviors (35.0%). Sedatives were administered in 72.1% of the cases. The most frequently used sedative was haloperidol which was used in 59.6% of cases. The delirium period significantly differed by patients' age (F=3.96, P=0.021), cancer type (F=3.31, P=0.010), chemotherapy (t=-3.44 P=0.001). The average survival time was 16.85 days for the sedative medication group and 9.37 days for the non-medication group, which, however, was not significant (t=1.766, P=0.079). Conclusion: In this study, the use of sedatives did not affect patients' survival time. Thus, appropriate sedative medication can be positively recommended to comfort terminal cancer patients and their families.

Hospice and Palliative Care for the Terminal Patients with Colorectal Cancer (말기 대장직장암 환자의 호스피스 완화의료)

  • Hong, Young-Hwa;Lee, Choon-Sub;Lee, Ju-Ri;Lee, Jung-Ho;Kim, You-Jin;Lee, Tae-Kgyu;Moon, Do-Ho
    • Journal of Hospice and Palliative Care
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    • v.10 no.1
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    • pp.35-42
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    • 2007
  • Purpose: Colorectal ranter is the 4th leading cause of cancer death in Korea and the prevalence is increasing continuously. This study was aimed to figure out the problems through the clinical consideration about terminal colorectal ranter patients who had died in hospice unit. Methods: We retrospectively reviewed the medical records in 78 patients with colorectal ranter who had admitted, received palliative care, and died in a hospice unit between April 2003 and November 2006. Results: The median age of patients was 59.6 years with 45 men (58%) and 24 women (42%). The median survival in hospice and palliative care was 36 days. The median hospitalization was 22 days. The most prevalent reason for admission was pain (38 patients, 49%), and the most common symptom was also pain (70 patients, 90%). Forty eight patients (62%) took analgesics before hospice referral. Twenty seven patients (65%) of 45 patients with intestinal obstruction have been performed palliative procedures. Median survival of patients with palliative procedure was higher than that of no palliative procedure group (47 days vs 19 days, P-value=0.005). Conclusion: The duration of hospice and palliative care was not enough to care the terminal colorectal cancer. Therefore, we suggest that proper education and information should be provided to physician, patients and their family members for effective hospice and palliative care.

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The Current Status of Utilization of Palliative Care Units in Korea: 6 Month Results of 2009 Korean Terminal Cancer Patient Information System (말기암환자 정보시스템을 이용한 우리나라 암환자 완화의료기관의 이용현황)

  • Shin, Dong-Wook;Choi, Jin-Young;Nam, Byung-Ho;Seo, Won-Seok;Kim, Hyo-Young;Hwang, Eun-Joo;Kang, Jina;Kim, So-Hee;Kim, Yang-Hyuck;Park, Eun-Cheol
    • Journal of Hospice and Palliative Care
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    • v.13 no.3
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    • pp.181-189
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    • 2010
  • Purpose: Recently, health policy making is increasingly based on evidence. Therefore, Korean Terminal Cancer Patient Information System (KTCPIS) was developed to meet such need. We aimed to report its developmental process and statistics from 6 months data. Methods: Items for KTCPIS were developed through the consultation with practitioners. E-Velos web-based clinical trial management system was used as a technical platform. Data were collected for patients who were registered to 34 inpatient palliative care services, designated by Ministry of Health, Welfare, and Family Affairs, from $1^{st}$ of January to $30^{th}$ of June in 2009. Descriptive statistics were used for the analysis. Results: From the nationally representative set of 2,940 patients, we obtained the following results. Mean age was $64.8{\pm}12.9$ years, and 56.6% were male. Lung cancer (18.0%) was most common diagnosis. Only 50.3% of patients received the confirmation of terminal diagnosis by two or more physicians, and 69.7% had an insight of terminal diagnosis at the time of admission. About half of patients were admitted to the units on their own without any formal referral. Average and worst pain scores were significantly reduced after 1 week when compared to those at the time of admission. 73.4% faced death in the units, and home-discharge comprised only 13.3%. Mean length of stay per admission was $20.2{\pm}21.2$ days, with median value of 13. Conclusion: Nationally representative data on the characteristics of patients and their caregiver, and current practice of service delivery in palliative care units were obtained through the operation of KTCPIS.