• Title/Summary/Keyword: 완화의료

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A Convergence Study on Stress, Peer Relationships, and Depression according to Differences in Academic Performance and household Income of Youth in Coal Mine Areas (탄광지역 청소년의 학업성적 및 가구소득 차이와 스트레스, 교우관계 및 우울의 융복합 상관 연구)

  • Kim, Seon-Jo;Lee, Seong-Ae;Lee, Ye-Eun;Park, Hyoung-Ryul;Jeong, Jung-Woo;Song, Bo-Kyoung
    • Journal of the Korea Convergence Society
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    • v.13 no.2
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    • pp.123-129
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    • 2022
  • This study investigated a differences in grade (G), academic performance (AP), and household income (HI) on adolescents' stress (S), peer relationship (PR), and depression (D) in the coal mine area. The study method was to measure S, PR and D according to different of G, AP, HI for 87 middle school students located in Taebaek and Samcheok Dogye area. As a result, there were significant differences in PR in the 2nd G, and significant differences were shown in PR and D according to HI and AP. Based on these results, it is necessary to expand the support program for PR of middle school students in the coal mine area, and to develop and support active health promotion programs in the community for stress relief and academic activities, especially for low HI.

Perceptions of Caregivers and Medical Staff toward DNR and AD (Do Not Resuscitate (DNR)와 Advance Directives (AD)에 대한 환자 보호자와 의료인의 인식)

  • Lee, Sun Ra;Shin, Dong-Soo;Choi, Yong-Jun
    • Journal of Hospice and Palliative Care
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    • v.17 no.2
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    • pp.66-74
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    • 2014
  • Purpose: This study is aimed to investigate perceptions of caregivers and medical staff toward do not resuscitate (DNR) and advance directives (AD). Methods: Participants were 141 caregivers and 272 medical staff members from five general hospitals. A questionnaire used for the study consisted of 20 items: 14 about DNR perceptions, three about AD, one each for age, gender and employment. Results: Both medical staff and caregivers strongly recognized the need for DNR and AD, and the level of recognition was higher with medical staff than caregivers (DNR ${\chi}^2=44.56$, P=0.001; AD ${\chi}^2=16.23$, P=0.001). The main reason for the recognition was to alleviate sufferings of patients in the terminal phase. In most cases, DNR and AD were filled out when patients with terminal conditions were admitted, and patients made the decisions by consulting with their guardians. Medical staff better recognized the need and for growing demand for guidelines for the DNR and AD decision making process than caregivers (${\chi}^2=7.41$, P=0.0025). Conclusion: This study showed that patients highly rely on their caregivers when making decisions for DNR and AD. Thus, it is important that patients and caregivers are provided with objective information about the decisions. Since participants' strong support for DNR and AD was mainly aimed at alleviating patients' suffering, further study is needed in the association with hospice care. Medical staff also needs to understand the different views held by caregivers and fully consider the disparity when informing patients/caregivers to make the DNR and AD decisions.

Malignant Bowel Obstruction in Terminal Cancer Patients (말기암 환자의 악성 장 폐색)

  • Moon, Do-Ho;Choe, Wha-Sook
    • Journal of Hospice and Palliative Care
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    • v.7 no.2
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    • pp.214-220
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    • 2004
  • Purpose: As for the malignant bowel obstruction of terminal cancer patient, a prognosis is relatively bad. Physicians consider palliative procedures or surgery for the quality of life, but sometimes it is hard to decide. After diagnosis of a malignant bowel obstruction in terminal cancer patients, we investigated the clinical characteristics, the prognostic factors and the survival of patients with palliative procedures or surgery. Methods: we retrospectively reviewed the medical records in 40 malignant bowel obstruction patients who had been diagnosed as terminal cancer from May in 2002 to May in 2004. Results: There were 21 males (53%) and 19 females (47%), and median age of patients was $64.1{\pm}1.58$ years. The most common cause of malignant bowel obstruction was colorectal cancer (18 patients, 45%), followed by stomach cancer (11, 28%), pancreatic cancer (4, 10%), others (7, 19%). Metastases were carcinomatosis peritonei (14 patients, 35%), liver (13, 33%). During a bowel obstruction, symptoms were vomiting (15 patients, 38%), abdominal pain (10, 25%), constipation (6, 15%), abdominal distension (5, 13%). Performance status (ECOG) was 2 score (16 patients, 40%), 3 score (20, 50%), 4 score (4, 10%). Palliative procedure group were 30 patients, the others 10. Median survival in palliative procedure group was 142 days, that of no palliation group 30. Median survival time of palliative procedure group from palliative procedures or surgery were significantly higher than that of no palliation group from diagnosis of malignant bowel obstruction. Prognostic factors of palliative procedure group were PS, site of obstruction and primary cancer. Median survival in PS 2, lower GI obstruction and colorectal cancer was higher than PS 3, upper GI obstruction and others, respectively. Conclusion: we recommend aggressively palliative procedures or surgery in malignant bowel obstruction patients diagnosed with terminal cancer if palliative procedures or surgery could be performed effectively.

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Suffering and Hospice Care (고통과 호스피스 케어)

  • Kim, Myung-Ja;Jung, In-Sook
    • Journal of Hospice and Palliative Care
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    • v.10 no.1
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    • pp.21-28
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    • 2007
  • Although hospice care includes palliative care technology in terminally ill person for pain, it is much more holistic including emotional, spiritual and other life dimension. Human suffering that experiencing the hospice client must be reconsidered whether one starts with an objective side or a subjective side of suffering, the strategies about the expanded consciousness is important. In the hospice caring perspectives, the body, mind and spirit are integrated so the objectivity and subjectivity can merge; the extended awareness with inner resource or energy, and the positive thinking about the God is meaningful especially dying person, family member, and the hospice team.

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Efficient Maximum Intensity Projection using SIMD Instruction and Streaming Memory Transfer (단일 명령 복수 데이터 연산과 순차적 메모리 참조를 이용한 효율적인 최대 휘소 투영 볼륨 가시화)

  • Kye, Hee-Won
    • Journal of Korea Multimedia Society
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    • v.12 no.4
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    • pp.512-520
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    • 2009
  • Maximum intensity projection (MIP) is a volume rendering method which extracts maximum values along the viewing direction through volume data. It visualizes high-density structures, such as angio-graphic datasets so that it is frequently used in medical imaging systems. We have proposed an efficient two-step MIP acceleration method that uses the recent CPUs. First, we exploited SIMD instructions to reduce conditional branch instructions which take up a considerable part of whole rendering process, so that we improved rendering speed. Second, we proposed a new method, which accesses volume and image data successively by modifying the shear-warp rendering. This method improves memory access patterns so that cache misses are reduced. Using the current CPUs, our method improved the rendering speed by a factor of 7 than that of the shear-warp rendering.

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A Study on the Effect of Energy Voucher Program on the Consumption and Expenditure of User Households (에너지바우처제도가 수급자 가구의 소비·지출에 미친 영향 연구)

  • Lee, Hyunjoo;Kim, Ji-hyun
    • Journal of the Korea Convergence Society
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    • v.12 no.12
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    • pp.331-338
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    • 2021
  • This study used data from the 10rd and 15th year of the Korean Welfare Panel to evaluate the effects of the Energy Voucher Program(EVP) on the consumption and expenditure of EVP users' households. The study consisted of program group using EVP and control group not using. Chi-square and t-test were used for the characteristic differences among the groups, and the difference of consumption expenditure was identified by multiple regression analysis. As a result, EVP had a statistically significant effect on the health care costs of EVP users' households, resulting in an increase in health care costs(𝛽=3.06). However, there was no statistically significant effect on the total cost of living, basic cost, education cost, and recreation/entertainment cost. Therefore, in order to increase the effectiveness of the EVP system, it is required to improve the EVP system by expanding the level of benefits and easing the qualification standards for the eligibility for benefits.

Neutrophil-Lymphocyte Ratio as a Prognostic Factor in Terminally Ill Cancer Patients (말기 암 환자에서 호중구-림프구 비가 예후인자로서 생존기간에 미치는 영향)

  • Cho, Wan-Je;Hwang, Hee-Jin;Lee, Yong-Jae;Son, Ga-Hyun;Oh, Seung-Min;Lee, Hye-Ree;Shim, Jae-Yong
    • Journal of Hospice and Palliative Care
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    • v.11 no.4
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    • pp.181-187
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    • 2008
  • Purpose: In order to establish efficient palliative treatment plans. It is important to estimate the survival time of a terminally ill cancer patient as accurate as possible. Proper estimation of life expectancy aids not only in improving the quality of life of the patient, it also promotes productive communication between the medical staff and the patient. The aim of this study is to determine the efficacy of neutrophil-lymphocyte ratio as a predictor of survival time in terminally ill cancer patients. Methods: Between January 2004 and June 2007, 67 terminally ill cancer patients who were admitted or transferred for palliative care, were included. Patients were categorized into three groups by Neutrophil-Lymphocyte Ratio. Demographic characteristics, clinical characteristics and blood samples were analyzed. Results: In univariate analysis, survival time of the highest Neutrophil-Lymphocyte Ratio group (${\geq}12.5$) was significantly shorter than that of the others (hazard ratio (HR)=3.270, P=0.001). After adjustment for low performance status (ECOG score 4) and dyspnea, high Neutrophil-Lymphocyte Ratio (${\geq}12.5$) was significantly and independently associated with short survival time (HR=2.907, P=0.007). Neutrophil-Lymphocyte Ratio was also significantly increased before death (P=0.001). Conclusion: Neutrophil-Lymphocyte Ratio can be useful in predicting life expectancy in terminally ill cancer patients.

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Analysis on the Income Gap Between Urban and Rural Areas Among the Three Major Areas in China (중국(中國) 3대(3大) 지역(地域) 도농(都農) 간(間) 소비격차(所得隔差) 현황(現況) 및 형성원인(形成原因)에 관(關)한 실증연구(實證硏究))

  • Nan, Xuefeng;Jin, Shizhu
    • Journal of the Korean association of regional geographers
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    • v.16 no.5
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    • pp.537-548
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    • 2010
  • As the rapid development of economy in China, the problem in income gaps become a tough and sensitive social problem. Under this social background, this research try to find the main reasons of the income gap among the East China, West China, and the central China, basing on the analysis of its actuality and forming, and then put forward some solution plans. The research shows that in different development levels of China influencing factor of urban-rural income gap is also different. Take East China for example, the education support plays an important part of narrowing income gap. The influence of education support on urban-rural income gaps more significant than industrialization, what is more, its influence has the more reinforce trend, while in the less developed central and western part in China, what can narrowing income gap significantly is industrialization and the support for agriculture. Therefore, in order to solve the problem of income gap between urban and rural areas in China radically, it is not enough to perform medical insurance reform and social insurance reform in the whole county. Besides this, we should perform other kinds of reformation countermeasures which have their regional characteristics. For example, in eastern, the regional governments should reinforce the education system; in central china, they should focus on developing industry; in western, the regional governments should increase the expense to support the agricultural development, and so on. With these countermeasures, they could not only relieve the gap between urban and rural areas in China, but also ensure to develop economy substantially and stably in the whole country.

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Analysis of Pain Records for Cancer Patients Complaining of Moderate or Severe Pain (중등도 이상의 통증을 호소하는 암환자의 통증간호기록 분석)

  • Park, Ran Hee;Cho, Ok Hee;Yoo, Yang Sook
    • Journal of Hospice and Palliative Care
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    • v.17 no.4
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    • pp.270-277
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    • 2014
  • Purpose: This is a retrospective study that investigated cancer patients' complaints of moderate or severe pain to analyze pain characteristics, pain relief interventions and their effects. Methods: The participants of this study were 363 patients who were hospitalized in the cancer ward for three to 30 days and scored 4 points or higher on the pain severity assessment. Results: The most frequent region of pain was the abdomen. The most frequent factor that exacerbated pain was movement. The most frequent pain alleviating factor was administration of analgesics. The most frequent pain type was breakthrough pain, and the most frequent non-pharmaceutical intervention for pain control was heat therapy. Among all, analgesics were routinely prescribed for 52.2% of the participants. Morphine sulfate was the most frequently used analgesic while Gabapentin was the most frequently used non-narcotic analgesic. At the time of discharge, 82.5% of the participants marked their pain intensity as 3 points or lower. Conclusion: For cancer patients complaining of moderate or severe pain, it is important to actively control pain from the beginning of admission. Thus, it is necessary to educate not only cancer patients using narcotic analgesic for pain control and their families but nurses about the effects and side-effects of drugs. Moreover, patients and their families need to learn how to assess and record pain at home to collect data that can be referred for future treatment.

Factors Related to Fatigue in Cancer Patients Receiving Chemotherapy (항암 화학요법 환자의 피로 관련 요인)

  • Jung, Eun-Ja;Jung, Young;Park, Mi-Young
    • Journal of Hospice and Palliative Care
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    • v.7 no.2
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    • pp.179-188
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    • 2004
  • Purpose: The purpose of this study was to investigate the degree of fatigue and its related factors in cancer patients during chemotherapy. Methods: The subjects of this study consisted of 90 patients over 20 years old who were receiving chemotherapy at the injection room of the o.p.d. and ward admission care unit in a University hospital located in Gwang-ju city and data were collected from August 8th to October 2nd, 2002. Collected data were analysed using SPSS v 10.0. to obtain summary statistics for the descriptive analysis, t-test, ANOVA, pearson correlation, and multiple regression. Results: 1. Fatigue of the subjects was significantly correlated with physical distress score. and 6 items of subscale those were nausea, vomiting, anorexia, pain, and immobility, showed statistically significant correlation. 2. Fatigue of the subjects showed statistically significant differences according to a nap satisfaction. Fatigue of the subjects was significantly correlated with mood state, Also, all 5 items of subscale, which are those were anxiety, confusion, depression, energy, and anger showed statistically significant correlations. 3. Fatigue of the subjects showed statistically significant differences according to metastasis, chemotherapy cycle, post operation existence, post radiation therapy existence. There were significant negative correlation between fatigue and hematocrit and fatigue and weight change. There was no significant correlation between fatigue and spiritual well-being state. With the result to multiple regression, Immobility, Anorexia, Anger explained fatigue by, pain, and immobility showed statistically significant correlation.

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