• Title/Summary/Keyword: 임종기 치료

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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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Legislation on Aid in Dying in France (조력사망에 관한 프랑스의 입법 동향)

  • Jieun Lee
    • The Korean Society of Law and Medicine
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    • v.25 no.1
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    • pp.193-222
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    • 2024
  • From a global trend, discussions on the patient's death with dignity are gradually progressing from the issue of withdrawal of life-sustaining treatment to the issue of whether to allow assisted death and its requirements. Several states in the United States and Western European countries such as Canada, Belgium, and the Netherlands have institutionalized treatment to accelerate the time of death through the assistance of doctors. In France, after a long period of raising and reviewing issues, discussions on related legislation are taking place at a slower pace than in other European countries. In France, social discussions and legislative attempts on death with dignity have been actively conducted since the late 20th century. The Leonetti Act of 2005 prohibited the continuation of meaningless treatment against the will of patients, and after the Clay-Leonetti Act of 2016, it was legalized to administer intensive and continuous sedatives to patients until death. However, unlike many neighboring European countries, treatment that speeds up the time of death itself is still prohibited in France, even if the patient wants. As the existential and universal question of whether to allow dying patients to die painlessly with the help of a doctor has recently emerged as an important issue, a number of lawmakers have submitted legislation to legalize assisted death. This paper examines the legislative process developed in relation to patients' rights to dignified death in France, and compares and reviews French legislation that attempts to legalize assisted death with the amendment to the Korean Life-Sustaining Treatment Act.

Convergence of Acupoint and Electrical Stimulation Therapy for Blood Flow and Pain Threshold (혈류량과 통증역치에 대한 경혈과 전기자극치료의 융합연구)

  • Yi, Dong-Hyun;Kim, Beom-Ryong;Hur, Yoon-Jung;Kim, Dong-Hoon;Shim, Su-Young;Yim, Jong-Eun
    • Journal of the Korea Convergence Society
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    • v.10 no.6
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    • pp.79-87
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    • 2019
  • This study examined how the application of silver spike point (SSP) and acupuncture-like transcutaneous electrical nerve stimulation (A-TENS) on acupoints affects blood flow and pain threshold, using laser Doppler blood fluxes and the Commander algometer. Our study included 32 healthy men and women who were randomly divided into the SSP group (n=18) and the A-TENS group (n=14). The pain threshold and blood flow were measured at the Neiguan (PC6) of the Jueyin Pericardium Meridian of the hand. SSP was performed with a 2.8cm electrode at a fixed frequency of 3 Hz for 15 minutes. The change in blood flow and pain threshold after the intervention significantly differed between the two groups (p<0.05). We found that the application of SSP and A-TENS on an acupoint altered their blood flow and pressure pain threshold, with SSP resulting in significantly greater change than A-TENS. Based on these results, the convergence of acupoint and electrical stimulation therapy can be usefully applied as a method for various patients. Continued development of convergence interventions is necessary.

End-of-Life Care Practice in Dying Patients with Do-Not-Resuscitate Order: A Single Center Experience (심폐소생술 금지 동의 후 사망한 환자의 현황과 연명의료 실태 조사: 단일 의료기관 경험)

  • Yoon, Sang Eun;Nam, Eun Mi;Lee, Soon Nam
    • Journal of Hospice and Palliative Care
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    • v.21 no.2
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    • pp.51-57
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    • 2018
  • Purpose: End-of-life (EoL) decisions are challenging and multifaceted for patients and physicians. This study was aimed to explore how EoL care is practiced for patients with a do-not-resuscitate (DNR) order. Methods: We retrospectively analyzed medical records of patients who died after agreeing to a DNR order in 2016 at a university hospital. Characteristics including cause of death, intensity of EoL care, and other factors were reviewed and statistically analyzed. Results: Of total 375 patients, 170 patients (45.3%) died with malignancies, and 205 patients (54.6%) with other causes involving the central nervous system (19.2%), pulmonary (14.7%), cardiologic (6.7%) and infectious (6.4%) conditions. Both the cancer and non-cancer patient groups showed a short duration from DNR to death (median 3 days vs 2 days, P=0.629). An intensive care group comprising patients who received one or more intensive treatments such as ventilator (n=205) showed a higher number of non-cancer patients and a shorter duration from DNR to death than a group that withheld treatment before DNR (P<0.05). Conclusion: EoL decisions were made very late by both cancer and non-cancer patients. About half of the patients did not have cancer, and two-thirds of them decided DNR during intensive treatment. To make a good EoL decision, a shared decision making with patients should be done at an earlier stage.

Hospice-Palliative Care Activities of personnel in a Long-Term Care Hospital; a retrospective chart review (일개요양병원 호스피스·완화의료의 서비스의 직종별 행위 분석; 후향적 의무기록 중심으로)

  • Cho, Hyun;Lim, Heeyoung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.4
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    • pp.570-577
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    • 2017
  • The purpose of this study was to provide a basis for the development of a health insurance payment system by exploring inpatient hospice & palliative care activities in a long-term care hospital by occupational personnel. The contents and frequency of inpatient hospice-palliative care activities were obtained retrospectively from the chart review of 12 terminally ill patients who died during the 6 months before their deaths. According to their occupational personnel, doctors were doing blood transfusion, family counseling, and medication guidance. Nurses' main activities were airway suction, oxygen supply, EKG monitoring, observing patient's status, helping medication and tube feeding. Other workers' activities are as follows: social workers were applying individualized programs, physical therapists were doing electrostimulation, nutritionists were giving nutrition evaluation and meal rounding, and careworkers were assisting with meals and nutrition. Although certain nursing activities, like emotional support, were performed by nurses, the hospice-palliative activities from doctors, social workers and physical therapists were largely unavailable for terminally ill patients in a long-term care hospital. And some terminally ill patients were receiving too intensive and invasive medical cares for end end-of-life care. The results highlight the importance of valid measures of hospice-palliative care quality and the need for establishing an adequate reimbursement system for ensuring and improving end-of-life care.

Residue Depletion of the Sulfaquinoxaline and Trimethoprim Combination in Broilers (육계에서 설파퀴녹살린 및 트리메토프림 합제의 잔류분석)

  • Lim, Jong-Hwan;Hwang, Youn-Hwan;Kim, Myoung-Seok;Song, In-Bae;Park, Byung-Kwon;Yun, Hyo-In
    • Journal of Veterinary Clinics
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    • v.27 no.5
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    • pp.565-568
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    • 2010
  • Sulfaquinoxaline (SQX) and trimethoprim (TMP) are chemotherapeutics that are extensively used in various animal species for the treatment or prevention of coccidia and coccidia-like parasites. Little information about the depletion kinetics of these compounds in chickens exists in the literature. In this study, a new commercial liquid concentrate of SQX in combination with TMP (100 g/l of SQX and 33.4 g/l of TMP) was administered with drinking water at a dose of 0.75 ml/l or 1.5 ml/l. The edible tissue concentrations of the drugs were determined by the validated high-performance liquid chromatography/mass spectrometric method. Residue concentrations of SQX and TMP were lower than their maximum residual limits (MRLs) in all tissues from both dose groups at 5 days after the treatment. The optimal withdrawal time of SQX/TMP combination was suggested to be over 5 days after cessation of medication in broilers.

Burden, Job Satisfaction and Quality of Life of Nurses Caring for Cancer Patients (암 환자를 돌보는 간호사의 부담감, 직무 만족도 및 삶의 질)

  • Park, Mi-Sun;Yoo, Yang-Sook
    • Journal of Hospice and Palliative Care
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    • v.8 no.1
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    • pp.8-17
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    • 2005
  • Purpose: This study was performed to investigate burden, job satisfaction and quality of life of nurses who take care of cancer patients. Methods: The subjects were 237 nurses working at the oncology unit of hospitals with over 500 beds in Seoul and Gyeonggi-do. Data were collected using questionnaire from the February to March, 2005. Data were analyzed through t-test, ANOVA, Pearson's correlation coefficient and stepwise multiple regression using SAS. Results: 1. The item that showed the highest level of burden was 'I feel limited even if I make efforts to reduce patients' pain. 'Burden was high in those group both who were younger than 35 years old and who had clinical experiences caring cancer patients for $3{\sim}4$ years. 2. The item that showed the lowest level of job satisfaction was 'the possibility of promotion'. Job satisfaction was high in those group both who had a spouse and were head nurses or incharge nurses. 3. The item that showed the lowest level of quality of life was 'I am physically exhausted'. Over 35 years old who had a spouse, and over 2,000,000 won monthly income made a high score in the quality of life. 4. There were negative correlations among burden, iob satisfaction and the quality of life. 5. The major factor affecting the quality of life was burden. Conclusion: The results of this study are expected to be utilized as basic data for developing support system to improve nurses' work conditions and quality of life.

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