• Title/Summary/Keyword: 완화의료

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Development and Effects of Death Preparation Education for Middle-aged Adults (중년층을 위한 죽음준비교육 프로그램 개발 및 효과)

  • Kang, Kyung-Ah
    • Journal of Hospice and Palliative Care
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    • v.14 no.4
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    • pp.204-211
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    • 2011
  • Purpose: This study used a nonequivalent control group pre-post test design to analyze how a death preparation education program helps middle-aged adults deal with life and death anxiety. Methods: We studied 83 adults at the age of 40 to 65 years. An experimental group of 38 people participated in the death preparation education, and a control group of 45 people did not. The death preparation program comprising four sections was given for four hours per week, and the program ran for 11 weeks. Data were analyzed by descriptive statistics, t-test, ${\chi}^2$ test, Fisher's exact test, and ANCOVA using SPSS version 17.0. Results: The death anxiety score of the experimental group was significantly lower than that of the control group (P<0.000). The quality of life did not show significant difference between the experimental and control groups (P=0.188). Conclusion: It was confirmed that the death preparation education program is effective in alleviating death anxiety. Although the program was confirmed as a necessity for the middle-aged adults, repeated observations with a wider range of experimental group is needed to collect objective and solid data. Death preparation education for middle-aged adults is expected to be more widely provided, starting from local health facilities.

The Relationship of Plasma Visfatin Level and Anorexia in Terminal Cancer Patients (말기암환자의 혈중 Visfatin 농도와 식욕부진의 관계)

  • Lee, So Jin;Lee, Joon Yong;Choi, Youn Seon;Lee, June Young
    • Journal of Hospice and Palliative Care
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    • v.17 no.1
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    • pp.18-26
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    • 2014
  • Purpose: Anorexia is a common symptom in terminal cancer patients. Some data have suggested a role of visfatin in regulating feeding behavior. We studied the relationship of a serum visfatin level and anorexia in cancer patients provided with hospice care. Methods: After informed consent was obtained, 69 cancer patients over 20 years old at a hospice center were enrolled in the study from July 2009 to July 2010. We characterized patients by age, sex, body mass index, primary cancer site, and Eastern Cooperative Oncology Group (ECOG) performance status, etc. Also, blood tests were performed to measure the level of hemoglobin, white blood cell (WBC), C-reactive protein (CRP), total cholesterol, albumin, lymphocyte count, glucose, blood urea nitrogen (BUN), creatinine, tumor necrosis factor-alpha (TNF-${\alpha}$), interukin-6, leptin and visfatin. Results: The mean age of subjects was 65.5 years old, According to univariate analysis, pulse, ECOG performance scale, opioid use and visfatin level were different between the anorexia and non-anorexic group (P<0.05). The median visfatin level was higher in the anorexia group than the good appetite group (P=0.0323). Serum visfatin concentrations were not related with either body mass index or serum leptin or total cholesterol levels, but it was negatively correlated with serum albumin levels (P=0.0198) and lymphocyte counts (P=0.0013). Conclusion: This study did not identify a novel link between visfatin levels and anorexia in cancer patients at a hospice.

Study of Subjective View on the Meaning of Well-dying Held by Medical Practitioners and Nursing Students: Based on Q-Methodology (의료인과 간호학생의 웰다잉 의미에 관한 주관성 연구)

  • Kim, Seon Young;Hur, Sung Soun;Kim, Boon Han
    • Journal of Hospice and Palliative Care
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    • v.17 no.1
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    • pp.10-17
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    • 2014
  • Purpose: This study was conducted to examine understanding of the meaning of well-dying and types of such views held by medical practitioners and nursing students. Methods: The Q-methodology was used to analyze the subjectivity of each item. The P-sample was made up of 22 medical practitioners or nursing students. The P-sample was instructed to rate 33 statements using a 7-point scale to obtain forced normal distribution. They were asked to make extra comments on the statements that were placed on both ends of the distribution curve. The PC-QUANL Program was used for the factor analysis of the collected data. Results: The participants had three types of meaning of well-dying. Total variance explained by these types was 57.97%" where type 1 was "reality-oriented", type 2 "relationship-oriented" and type 3 "obeying-the-nature". Conclusion: The participants' subjective views on well-dying influences their medical practice on patients who are facing death. Therefore, medical practitioners should have profound insights concerning life and death. To that end, a training program is needed to help medical practitioners develop a proper view on well-dying by subjectivity type.

Current Status and Prospects for the Hemp Bioindustry (대마 생물산업의 현황과 전망)

  • Sohn, Ho-Yong;Kim, Mun-Nyeon;Kim, Young-Min
    • Journal of Life Science
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    • v.31 no.7
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    • pp.677-685
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    • 2021
  • Cannabis sativa L. belongs to the Cannabaceae family and is an annual herbaceous flowing plant. The plants can be classified into narcotic marijuana and nonnarcotic hemp. Different parts of C. sativa L. have been used as food, medicine, cosmetics, fiber and textile. However, the use of leaf, flower, and seed of C. sativa L was forbidden in Korea in January 1977 as a result of the Cannabis Control Act due to the narcotic properties. The plant's mature stems have limited uses for the production of fiber and sheets. Recently, various cannabinoids, terpenes and essential fatty acids were identified from C. sativa L., and their safety and useful bio-activities, such as neuroprotective, anti-inflammation, antithrombosis, antiepileptic, and antimicrobial activities, and the relief of pain, have been highlighted. Furthermore, the process of reduction of tetrahydrocannabinol, a representative narcotic compound, and the isolation of cannabidiol, a nonnarcotic active compound in C. sativa L., have been determined. These findings resulted in the legalization of C. sativa L. in Korea for medical use in December 2018 and the exclusion of C. sativa L. from the narcotic list of the UN Commission on Narcotics Drugs (UNCND) in December 2020. Therefore, developments of various high-value added products have commenced worldwide. Additionally, in 2021, the Korean government deregulated special zones based on hemp. In this study, the current status and the prospect of the hemp industry, as well as essential techniques for developing new hemp products, are provided for the activation of the Korea Green-Rush.

A Study on the Problems and Improvement of Long-Term Care Insurance for the Elderly (노인장기요양보험제도의 문제점 및 개선방안에 관한 고찰)

  • Ahn, Myung-Sun;Park, Joo-Hyun
    • The Journal of the Korea Contents Association
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    • v.19 no.8
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    • pp.525-534
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    • 2019
  • Korea is facing one of the fastest aging population problems in the world due to the extension of life expectancy and low birth rates due to economic development and the development of health care. It has become difficult to take care of elderly people in need of long-term care at home, and social problems such as dementia and the increase in stroke cases are serious problems. The government is enacting and implementing the Long-Term Care Insurance Act for the purpose of improving the quality of life for senior citizens subject to long-term care and alleviating the burden of family support in order to solve such social structure and problems for senior citizens. However, as a result of the implementation of the long-term care insurance system for the elderly, the privatization of the facilities and the disorder are causing widespread requests for public accountability of the services and the enhancement of the quality of the facilities. In addition, various arrangements are needed for the production of low-wage medical care workers, tasks for quality improvement, problems regarding financing methods, and so on. In order to maintain and develop the long-term care insurance system for the elderly, the government will consider seeking ways to improve the legal and institutional aspects according to changes in the social environment of the age, as well as seeking mental and psychological measures for the stabilization of old life as well as physical health.

Factors Influencing Death Anxiety in Community-Dwelling Elderly: Based on the Ecology Theory (재가 노인의 죽음불안에 영향을 미치는 요인: 생태학 이론을 바탕으로)

  • Kim, Yeonha;Kim, Minju
    • Journal of Hospice and Palliative Care
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    • v.22 no.1
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    • pp.30-38
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    • 2019
  • Purpose: This study analyzed a path through which factors influencing death anxiety in the community-dwelling elderly, assuming personal organismic factors and microsystemic factors based on the ecology model purported by Belsky (1980). Methods: This study was performed with 189 elderly people. Data were collected through a self-report questionnaire. The data were analyzed using the SPSS and AMOS programs. Results: The factors influencing death anxiety in the elderly were depression, family support, social network, and familism value, and the explanatory power of these variables was 22%. Death anxiety increased with higher depression, higher familism value, larger social network, and lower family support. Spiritual well-being and elderly discrimination experience had indirect effects on death anxiety, and these effects were mediated by depression. Conclusion: Depression, family support, social network, and familism value were found to influence death anxiety in the elderly, and the strongest effect came from depression. To reduce death anxiety in the elderly, it is important to improve their relationship with their family and friends. Moreover, support should be provided by establishing local systems, and intervention should be provided to alleviate depression.

Difficulties in End-of-Life Care and Educational Needs of Intensive Care Unit Nurses: A Mixed Methods Study (중환자실 간호사의 임종간호 어려움과 임종간호 교육요구 조사: 혼합연구방법)

  • Kim, Hyun Sook;Choi, Eun Kyoung;Kim, Tae Hee;Yun, Hye Young;Kim, Eun Ji;Hong, Jin Ju;Hong, Jeong A;Kim, Geon Ah;Kim, Sung Ha
    • Journal of Hospice and Palliative Care
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    • v.22 no.2
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    • pp.87-99
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    • 2019
  • Purpose: This study aimed to identify the difficulties with end-of-life care (EOLC) experienced by intensive care unit (ICU) nurses and to investigate their educational needs for EOLC. Methods: Mixed methods were used to survey ICU nurses at a university hospital. Quantitative data (N=106) were collected through a questionnaire and analyzed using an independent samples t-test, ANOVA, Mann-Whitney U test and $Scheff{\acute{e}}$ test. Qualitative data (N=19) were collected through focus group interviews and analyzed through qualitative content analysis. Results: The mean score on the difficulty of EOLC was 3.41 out of 5. The education needs derived from the qualitative analysis was categorized into four themes: 1) guidelines on professional EOLC, 2) spiritual care, 3) a program to take care of feelings of patients, families and nurses, and 4) activities to think about death. Conclusion: This study confirmed that ICU nurses were experiencing an extreme difficulty in providing EOLC. In addition, a qualitative analysis confirmed that they needed an EOL nursing program. To mitigate the difficulties experienced by nurses involved in EOLC, there is an urgent need to develop an education program for EOLC tailored to nurses' needs.

Housing Choice Determinants of the Youth and Newlyweds Households: A Case Study of Incheon (청년·신혼부부의 주거선택요인에 관한 연구: 인천시를 중심으로)

  • Key, Yunhwan
    • Land and Housing Review
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    • v.13 no.4
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    • pp.13-26
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    • 2022
  • This study analyzes housing choice determinants of the youth and newlyweds households by using housing survey data in Incheon. A multinomial logit model is employed for analysis with the following variables: housing characteristics, housing market characteristics, and residential and neighborhood environment characteristics. The findings from the analysis are as follows. First, for the continued residence of the youth, the important factors were the relief assistance of housing maintenance costs. For the newlyweds, the important factors were the quality improvement of residential environments to ensure residential stability. Second, the housing choice factors to attract the youth were residential support for rent, maintenance costs, and relocation, and the improvements of residential environments such as security, noise levels, and medical facilities. For the newlyweds, the important factors were housing loan assistance for a home purchase or a cheonsei deposit and residential quality improvements for air pollution and parking facilities. Third, the youth were likely to move out due to high rental costs, and the newlyweds were likely to move out for the purchase of a new apartment or higher-quality housing.

Exploring Social Service Demand and Policy Implications of the Vulnerable in Rural Areas (농어촌 취약계층의 사회서비스 수요탐색과 정책함의)

  • Kim, Yun-Yong;Lee, Seok-Hwan
    • The Journal of the Korea Contents Association
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    • v.20 no.12
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    • pp.332-345
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    • 2020
  • This study sought to explore the demand in the social service sector and present policy implications, focusing on the vulnerable in rural villages exposed to worse conditions amid the Covid-19 crisis. To this end, the social service needs of vulnerable groups by household type were analyzed by utilizing the raw data of the 2018 Survey on Rural Well-Being. Analysis showed that the greatest demand social services for all rural villages, the elderly, the disabled, one-person, one elderly and low-income households were income support services, while in household that included children the demand was for childcare and education-related services. The second-highest social services in terms of demand were cultural leisure vacation support services for all rural villages, healthcare-related services for the elderly, the disabled, one elderly and low-income households, cultural leisure vacation support services for households including children and daily life support services for single-person households. Based on these results, a measure was proposed to support social services, tailored to vulnerable groups in rural villages. In addition, the government's lack of a consultation system between urban and rural welfare policies, such as a basic plan for health and welfare in rural villages, led this paper to discuss the need for a feedback function and dedicated formulation of mid- to long-term policies in rural villages. It also proposed the establishment of conditions for providing customized social services for rural villages.

Awareness of Doctors' Shared Decision-Making in Life-Sustaining Care Decisions

  • Kim, Dalyong;Lee, Hyun Jung;Yu, Soo-Young;Kwon, Jung Hye;Ahn, Hee Kyung;Kim, Jee Hyun;Seo, Seyoung;Maeng, Chi Hoon;Lim, Seungtaek;Kim, Do Yeun;Shin, Sung Joon
    • Journal of Hospice and Palliative Care
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    • v.24 no.4
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    • pp.204-213
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    • 2021
  • Purpose: At the end of life, communication is a key factor for good care. However, in clinical practice, it is difficult to adequately discuss end-of-life care. In order to understand and analyze how decision-making related to life-sustaining treatment (LST) is performed, the shared decision-making (SDM) behaviors of physicians were investigated. Methods: A questionnaire was designed after reviewing the literature on attitudes toward SDM or decision-making related to LST. A final item was added after consulting experts. The survey was completed by internal medicine residents and hematologists/medical oncologists who treat terminal cancer patients. Results: In total, 202 respondents completed the questionnaire, and 88.6% said that the decision to continue or end LST is usually a result of SDM since they believed that sufficient explanation is provided to patients and caregivers, patients and caregivers make their own decisions according to their values, and there is sufficient time for patients and caregivers to make a decision. Expected satisfaction with the decision-making process was the highest for caregivers (57.4%), followed by physicians (49.5%) and patients (41.1%). In total, 38.1% of respondents said that SDM was adequately practiced when making decisions related to LST. The most common reason for inadequate SDM was time pressure (89.6%). Conclusion: Although most physicians answered that they practiced SDM when making decisions regarding LST, satisfactory SDM is rarely practiced in the clinical field. A model for the proper implementation of SDM is needed, and additional studies must be conducted to develop an SDM model in collaboration with other academic organizations.