• Title/Summary/Keyword: 완화의료

Search Result 907, Processing Time 0.022 seconds

Prognostic Value of Leptin in Terminally Ill Cancer Patients (말기암환자의 여명 예측 요인, 혈중 렙틴 농도의 효과)

  • Hong, Ji-Hyun;Lee, So-Jin;Kwak, Sang-Mi;Choi, Youn-Seon;Lee, June-Yeong
    • Journal of Hospice and Palliative Care
    • /
    • v.15 no.2
    • /
    • pp.99-107
    • /
    • 2012
  • Purpose: Most terminally ill cancer patients die from cancer anorexia-cachexia syndrome. This study evaluated a prognostic role of plasma leptin levels in terminally ill cancer patients. Methods: This study enrolled 69 terminally ill cancer patients who were aged above 20 years old from July 2009 to July 2010. For univariate analysis, an association between leptin levels and patient's characteristics or other variables was examined using Spearman's correlation analysis, Wilcoxon's rank-sum test or Kruskal-Wallis test, as appropriately. For multivariable analysis, Cox's proportional hazard regression model was used to evaluate a clinical significance of plasma leptin levels as a prognostic factor and to determine factors which affect the risk of death in terminally ill cancer patients. Results: A statistically significant positive correlation between plasma leptin levels and survival time was found. Univariate Cox's proportional hazard regression analyses also showed a moderately significant association between plasma leptin levels and survival time. However, after adjusting variables for sex, white blood cell counts, total bilirubin, AST, ALT, albumin and CRP levels, plasma leptin levels were not significantly associated with survival time. Conclusion: No significant association was found between plasma leptin levels and survival time in terminally ill cancer patients. However, this study suggested a prognostic value of plasma leptin levels in gastrointestinal cancer patients.

Macro Analysis of Factors Impacting on the Elderly's Suicide Rates in the Republic of Korea (노인자살률에 영향을 미치는 요인에 대한 거시적 분석)

  • Kim, Ki-Won;Kim, Han-Gon
    • Korea journal of population studies
    • /
    • v.34 no.3
    • /
    • pp.31-54
    • /
    • 2011
  • The main purposes of this study are to describe regional differentials of the rate and to explore factors impacting on the regional differentials among the elderly's suicide rate in the Republic of Korea. Suicide data among 16 provinces from 2000 to 2008 were used for the statistical analyses. Six independent variables, such as crude divorce rate, GRDP per capita, welfare budget proportion, number of leisure facilities, number of medical and housing welfare facilities, and number of sports facilities are introduced for the multiple regression analyses. Elderly suicide rate, female elderly's suicide rate, and male elderly's suicide rate are used for the dependent variables. The findings of this study are as follows: Elderly's suicide rate has been increased constantly since 2000 and regional differentials of the elderly's suicide have been existed over time. According to the multiple regressions analyses, number of sports facilities(${\beta}$=-521), welfare budget proportion, and number of leisure facilities(${\beta}$=-219) have shown statistically significant negative relationships with the elderly's suicide rate. On the other hand, number of medical facilities(${\beta}$=0.550), crude divorce rate(${\beta}$=0336) have shown statistically significant positive relationships with the elderly's suicide rate in the Republic of Korea. Finally, some policy implications for alleviating the elderly's suicide rate are introduced and discussed.

Changes of Recognition to Death Before and After Observation on the Cadaver Dissection to Paramedical Students (해부용시신을 이용한 참관 해부실습 후 죽음에 대한 인식의 변화)

  • Cho, Keun-Ja;Kim, Sooil
    • Anatomy & Biological Anthropology
    • /
    • v.31 no.4
    • /
    • pp.159-165
    • /
    • 2018
  • The aim of this study is to identify changes of recognition to death before and after observation on the cadaver dissection to paramedical students. This study was done on 472 freshmen using questionnaire survey. Recognition to death questionnaire was consisted of 36 items. Data were collected before and after observation on the cadaver dissection with agreement of subjects. The data were analyzed using SPSS win 24.0. This study showed that recognition to death was significantly increased after observation on the cadaver dissection (3.19 points) than before observation on the cadaver dissection (3.06 points) (p=.000). Especially, anxiety on death was significantly increased (p=.000), and interest in death was significantly increased, too (p=.000). The results of this study suggest that we need positively to encourage observation on the cadaver dissection for paramedical students with providing program to decrease anxiety on death because of not only improving anatomy knowledge but also increasing recognition to death.

Analysis of ROX Index, ROX-HR Index, and SpO2/FIO2 Ratio in Patients Who Received High-Flow Nasal Cannula Oxygen Therapy in Pediatric Intensive Care Unit (고유량 비강 캐뉼라 산소요법을 받은 소아중환자실 환아의 ROX Index와 ROX-HR Index 및 SpO2/FIO2 Ratio분석)

  • Choi, Sun Hee;Kim, Dong Yeon;Song, Byung Yun;Yoo, Yang Sook
    • Journal of Korean Academy of Nursing
    • /
    • v.53 no.4
    • /
    • pp.468-479
    • /
    • 2023
  • Purpose: This study aimed to evaluate the use of the respiratory rate oxygenation (ROX) index, ROX-heart rate (ROX-HR) index, and saturation of percutaneous oxygen/fraction of inspired oxygen ratio (SF ratio) to predict weaning from high-flow nasal cannula (HFNC) in patients with respiratory distress in a pediatric intensive care unit. Methods: A total of 107 children admitted to the pediatric intensive care unit were enrolled in the study between January 1, 2017, and December 31, 2021. Data on clinical and personal information, ROX index, ROX-HR index, and SF ratio were collected from nursing records. The data were analyzed using an independent t-test, χ2 test, Mann-Whitney U test, and area under the curve (AUC). Results: Seventy-five (70.1%) patients were successfully weaned from HFNC, while 32 (29.9%) failed. Considering specificity and sensitivity, the optimal cut off points for predicting treatment success and failure of HFNC oxygen therapy were 6.88 and 10.16 (ROX index), 5.23 and 8.61 (ROX-HR index), and 198.75 and 353.15 (SF ratio), respectively. The measurement of time showed that the most significant AUC was 1 hour before HFNC interruption. Conclusion: The ROX index, ROX-HR index, and SF ratio appear to be promising tools for the early prediction of treatment success or failure in patients initiated on HFNC for acute hypoxemic respiratory failure. Nurses caring for critically ill pediatric patients should closely observe and periodically check their breathing patterns. It is important to continuously monitor three indexes to ensure that ventilation assistance therapy is started at the right time.

Factors Influencing mHealth Use in Older Adults with Diabetes (당뇨병 노인의 mHealth 이용에 영향을 미치는 요인)

  • Minjin Kim;Beomsoo Kim;Sunhee Park
    • Knowledge Management Research
    • /
    • v.23 no.4
    • /
    • pp.113-132
    • /
    • 2022
  • The development of information and communication technologies (ICT) and changes in medical services centering on daily life have ushered in an era of self-management through the smartphone health management app (mHealth). This study identified the factors affecting mHealth use among older adults with diabetes. A structured survey was conducted using online and offline channels for 252 older adults who were over 65 and had diabetes. The collected data were subjected to hierarchical multiple regression analyses, and subjective health status, e-health literacy, and interaction terms of social support were inputted to verify moderating effect. The main results of this study are as follows. First, mHealth use among older adults with diabetes was higher in the male, type 2 diabetes, and younger age groups. Second, the higher was the e-health literacy, the higher was the mHealth use. Third, a negative moderating effect of social support was found in the relationship between subjective health status and mHealth use. We expect this study to provide researchers and managers interested in mHealth and older adults with diabetes, with valuable theoretical and practical implications. Furthermore, this study contributes to improving mHealth use among older adults with diabetes and building a digitally inclusive society.

Loss and Grief in Asian Culture (아시아 문화권에서의 상실과 슬픔)

  • Hong, Young-Seon;Yeom, Chang-Hwan;Lee, Kyung-Shik
    • Journal of Hospice and Palliative Care
    • /
    • v.1 no.1
    • /
    • pp.1-5
    • /
    • 1998
  • Grief is the ordinarily self-limited complex of symptoms and processes that constitute the acute reaction to a significant loss. And it is the reaction of the dying as well as the bereaved. Every culture has had its own ways of grief and mourning. The definition of healthy grief and mourning, in terms of both emotional expression and the length of time it should continue, mostly depend upon the type of culture as well as the type of religion. So the manner of grief and mourning greatly differs from culture to culture. In the most of the Asian countries, influenced by Confucianism, Taoism, and Buddhism, death is traditionally considered the most significant life cycle transition. In Chinese culture, many rituals have evolved to help family members deal with their loss, over the past five thousand years. Confucianism taught the virtues of filial piety and righteousness. These rules and many customs added since the time of Cofucius, have been loyally followed and practiced by many Asian people. However, Buddhists have different ideas. They believe in karma and reincarnation and in predetermination of one's present life by good or bad deeds in the present life and past lives. Display of uncontrollable emotion is not encouraged. Continuity of family relations after death is very important. The ancient practice of the ancestor worship is still followed in many Asian households. Many Buddhist do not practice ancestor worship; family members honor the deceased by placing a memorial plate in the temple for continued chanting purposes. The mourning rituals have been dramatically curtailed in the past 50 years. For example, political, social and economic forces have shaped the current mourning practices of Chinese in different countries. There are many clinical implications in helping Asian to deal better with the emotional strains of the experience of loss. The therapiest must respect the cultural framework through which the client perceives family losses.

  • PDF

Koreans' Traditional View on Death (한국인의 전통 죽음관)

  • Kwon, Ivo
    • Journal of Hospice and Palliative Care
    • /
    • v.16 no.3
    • /
    • pp.155-165
    • /
    • 2013
  • Koreans' traditional view on death has been much influenced by Confucianism, Taoism, Buddhism, and shamanism since ancient times. Confucianism emphasizes the importance of the real life in this world and highly praises doing good deeds for the family and the community. It also praises people who are enlightened by education and self-discipline. Confucian scholars admit that death cannot be understood by rational thinking although it is unavoidable as a cosmic order. Taoism sees life as the same entity as death; Both are two different aspects of the same cosmos or the wholeness. However, the disciples of Taoism became much interested in a long life and well being that may be achieved by harmonizing with the cosmic order. Buddhism thinks that death and life are an "illusion". It says that people can be enlightened by recognizing the fact that "Nothing is born and nothing is dying in this world. Everything is the product of your mind occupied with false belief." However, secular Buddhists believe in the afterlife and metempsychosis of the soul. This belief is sometimes connected with the view of the traditional shamanism. Shamanism dichotomizes the world between "this world" and "that world". After death, the person's soul travels to "that world", where it may influence life of people who reside in "this world". And shamans who are spiritual beings living in "this world" mediate souls and living people. In conclusion, there are various views and beliefs regarding death, which are influenced by a number of religions and philosophies. They should be seriously considered when making a medical decision regarding the end of patients' life.

The Preference for Care Near the End of Life of Korean Nurses (일 지역 간호사의 임종기 치료 선호도)

  • Kim, Hyun-Sook;Kim, Shin-Mi;Yu, Su-Jeong;Kim, Moung-Ok
    • Journal of Hospice and Palliative Care
    • /
    • v.13 no.1
    • /
    • pp.41-49
    • /
    • 2010
  • Purpose: This study was performed to explore the preference for care near the end-of-life of nurses who had been working in an acute hospital. Methods: Data were collected by using PCEOL-K which was originally developed in U.S. and standardized into Korean version. Two hundred nurses from one acute hospital who agreed to participate in the study filled out questionnaires and 177 questionnaires were analyzed for the study results. Results: Relatively positive preference toward spirituality and pain control and negative preference toward decision making by health care professional were uncovered. Conclusion: Nurses consider patient's autonomy, pain control and spirituality as important factors at the end-of-life care. Further studies regarding the preference for the care near the end-of-life of diverse groups such as patients, doctors, and family members are called for.

Reliability and Validity of the Evaluation of Korean Cancer Pain Assessment Tool(K-CPAT) (표준형 성인 암성 통증 평가 도구(K-CPAT): 설문조사의 신뢰도 및 타당도 평가)

  • Choi, Youn-Seon;Park, Jin-No;Lee, Myung-Ah;Yeom, Chang-Hwan;Jang, Se-Kwon;Lee, June-Young
    • Journal of Hospice and Palliative Care
    • /
    • v.6 no.2
    • /
    • pp.152-163
    • /
    • 2003
  • Pupose : The Korean cancer pain assessment tool (K-CPAT) was developed in 2003 is consisted of questions concerning the pain location, quality of pain, present pain intensity, symptoms associated with pain, and psychosocial/spiritual pain assessments. This study was done to evaluate the reliability and validity of K-CPAT. Methods : A Stratified, proportional-quota, clustered, systematic sampling has been employed. Study population (903 cancer patients) was 1% of the target population (90,252 cancer patients). A total of 314 (34.8%) questionnaires have been collected. Results : Average pain score (5 Likert scale) by cancer type and at-present average pain score (VAS, $0{\sim}10$) were correlated (r=0.56, P<0.0001), and showed a moderate agreement (kappa=0.364). Mean score of satisfaction was 3.8 ($1{\sim}5$). The average time of completion of the questionnaire was 8.9 minutes. Conclusions: The K-CAPT is a reliable and valid instrument for the assessment of Cancer Pain for Korean.

  • PDF

Physical Function and Fatigue in Mastectomy Patients (유방절제술 환자의 신체기능과 피로)

  • Yoo, Yang-Sook
    • Journal of Hospice and Palliative Care
    • /
    • v.6 no.2
    • /
    • pp.164-171
    • /
    • 2003
  • Purpose : The purpose of this study was to provide information for developing a rehabilitation intervention that improves adaptation and the quality of life after mastectomy by investigating the level of physical function and fatigue in mastectomy patients. Methods : The subjects were 63 patients selected from St. Mary's Kangnam hospital Data were collected from March to June, 2003. Physical function was measured by the range of motion of the shoulder joint, shoulder function, and physical symptoms. fatigue was measured by using the Brief Fatigue Inventory (BFI). Results : The range of motion on the affected side was significantly lower than that in the healthy side. Shoulder function score was highest in the item of 'pull on pants', and lowest in the item of 'back zipper'. Physical symptom score was highest in the item of 'numbness', and lowest in the item of 'Itching sensation'. The highest item interfered by fatigue was 'normal work (includes both work outside the home and daily chores)'. Conclusion : The result of this study suggests that effective rehabilitation intervention for mastectomy patients should be needed to improve physical function, and reduce fatigue.

  • PDF