• Journal of Preventive Medicine and Public Health
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• v.1 no.1
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• pp.25-36
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• 1968

Introduction In order to improve medical education through the introduction of a concept of comprehensive health care of a community, an area surrounding the University Campus was chosen for the Community Health Service Project. It has been on operation for last 4 years with its major emphasis on family planning services, and maternal and child health care. The major objectives of this survey at the area are to obtain: 1) The demographic data, 2) The health need and trend of medical care, 3) The attitude and practice in maternity care to be used for further improvement of the planning and the services of the project. Population and Survey Method Out of three Dongs of the Community Health Service Area, only two Dongs namely Changchun and Yonhee were selected for the survey. Total number of households and population in the area studied was 3,683 and 21,857 respectively. An interview was performed with questionnaire schedule which was recorded by interviewers. This includes the degree of utilization of health services provided by the Community Health Service Program such as family planning, prenatal care during their last pregnancy, delivery history and complications of the delivery as well as the incidence of illnesses in general. Prior to the interview, all interviewers were trained for interviewing technique for two days. The survey was carried out during the period from October December 1967. Results 1) Demographic Data : 41.3% of the population studied were children under age 15 and only 3.5% were over 60 years of age. Crude birth rate and crude death rate of this area studied during the period of November 1966-October 1967 were 20.5 and 7.7 respectively. Infant mortality rate during the same period was 35.9. 50.4% of the 2,832 households fell into the category of middle class, 39.8% to the lower class and 9.5% to the upper class in economic condition. 19.8% of 2,832 householders had no formal education, 22.7% primary school, and 57.5% middle or higher school education. 2) Health Status and Utilization of the Community Health Service: Those who suffered from many illnesses during the month of October, 1967 were 690(4.6% of 14,891 persons). Classification of these patients into the type of disease shown respiratory diseases 27.4%, gastrointestinal diseases 18.1%, tuberculosis 10.9%, skin and genitourethral diseases 4.5% and gynecologic patients 4.5%. Only 55.9% of the patients received medical care at hospital or doctor's clinic. But among TB and gynecologic patients, 70.7% and 72.4% were treated at medical facilities. 10.6% of 2,832 householders interviewed has ever utilized the Community Health Service Program provided by the Yonsei Medical School, Classifying these clients into the type of service, 35.9% utilized the wellbaby clinic, 31.0% the family planning clinic, 14.7% the home delivery care, and the rest utilized other services such as the premarital guidance cinlic and the sanitary inspection service. 3) Maternity Care: 23.6% of 2,151 deliveries were done at medical facilities such as hospital, private clinic, while 76.4% were done at home. Acceptance rate of prenatal care was 32.6% as whole, but 49.6 of 774 women who had the prenatal care service had their deliveries at medical facility. 45.1% of total deliveries were attended by medical and or paramedical personnel. 75.8% of the deliveries of those received prenatal care were attended by medical and or paramedical personnel while only 27.8% of the deliveries of those who did not have prenatal care attended by medical and or paramedical personnel. 49.8% of deliveries of the upper class, 29.8% of the middle class and 9.9% of the lower class were attended by medical and or paramedical personnel. 6.2, 3.3% and 24.8% of mothers reported about their xeperience of edema, coma and fever during the period of trimester of pregnancy and puerperium. 4) Family Planning: The rate of practice of family planning was 27.9%. 31.7% of them were by IUD, 2.9% by oral pill, 15.2% by sterilization and the rest by traditional methods. Those women who had 3 to 4 children had highest(30.2%). Practice rate among the various methods of family planning, oral pill was the most popular method to whom had 2 or less children. In relation between the practicing rate of family planning and living standard, the upper, middle and lower class practiced 37.5, 29.4 and 19.9% respectively.

• Journal of Hospice and Palliative Care
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• v.16 no.2
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• pp.90-97
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• 2013

Purpose: Ten years have passed since the Korean government announced its plan to institutionally support hospice and palliative care in 2002. In line with that, this study aims to suggest future directions for Korea's hospice and palliative care policy. Methods: We conducted a survey on people's perception and acceptance of well-dying. Data were collected from 1,000 participants aged 19~69 years between June 1 and June 11, 2012 via computer-assisted telephone interviews. Results: The most important factor for well-dying was placing no burden of care on others (36.7%) and the second most important factor was staying with their family and loved ones (19.1%). Among nine suggestions of policy support for well-dying, the most popular was the promotion of voluntary care sharing (88.3%), followed by the palliative care training support for healthcare providers (83.7%) and the support for palliative care facilities instead of funeral halls (81.7%). The idea of formulating a five-year national plan for end-of-life care drew strong support (91%). According to the survey, the plan should be implemented by the central government (47.5%), the National Assembly (20.2%) or civic groups (10%). Conclusion: This study demonstrated the public consensus and their consistent direction toward policy support for well-dying. Results of this study may serve as a foundation for the establishment of policy support for people's well-dying and palliative care at the national-level.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.4
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• pp.2691-2703
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• 2015

This research aims to provide basic materials for assisting DNR patient cares by understanding ICU nurses' awareness and ethical attitude regarding DNR. A total of 154 results were analyzed which were collected from Aug. 1st to Sep. 5th in 2014 by surveying nurses working in ICU (from 1 advanced general hospital in G metropolitan city and other general hospitals of more than 700 beds in Cheolla provinces). (1) For the decision attitudes of DNR, there were both consent and objection. Consent for the patient's opinion of rejecting further treatment and life extension despite of bad prognosis. And objection for no conducting DNR in the case of the patient's wish, treatment requested by the guardian, and CPR for the patient who has no chance. (2) Objection for artificial respirator and other treatment requested by the patient's family and the entrance of guardians into ICU. Consent for the passive use of artificial respirator by the doctor and the decrease of basic care to stabilize patients physically and mentally. No specific opinion for treatment not following aseptic techniques. Objection for frequent reports to primary care physician requested by the family. (3) Acknowledging less interest by the doctor, while supporting the health care team in the case of the guardian's complaint, objection for the DNR decision mede by the primary care physician. Objection for the DNR decision by the guideline. Objection or neutrality for straightforward explanation to the patient of bad prognosis. Objection for straightforward explanation of the patient's status (even near to death) to the patient him/herself or the guardian. In conclusion, the subject of DNR is the patient and the patient's opinion should be fully reflected. The conflict arising from the scope of medical practice and decision processes should be minimized. The standard and guideline for DNR decision is required for the ethical decision making for the patient along with agreements based on full explanations.

• Korean Journal of Hospice Care
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• v.2 no.2
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• pp.28-48
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• 2002

The advances of medical technologies have not only prolonged human life span, but also extended suffering period for the patients with incurable medical diseases. Hospice movement was developed to help these patients keep dignity and lives peaceful at the end of their life. Since many patients prefer to spend the last moment of life at home with their family, hospice home care has become very popular worldwide. The purpose of this study for a promotion and development of hospice home care in Korea, and features basic research on medical profession's knowledge and attitudes to hospice home care. This study which was used for the research questionnaires developed by the researcher that were answered by 100 physicians and 127 nurses in a general hospital. Data were collected from April 22, 2002 to May 10, 2002. The SPSS was used to make a comparative analysis of the frequency, percentile, ANOVA, and x2-test. The results of the study were as follows; 1.The medical profession showed high level of knowledge of the definition and philosophy of hospice. However, the physician group of the examinees showed insufficient knowledge of the fact that hospice care includes bereavement care, while the nurse group's response to the same question showed a significant difference(x2=10.752, p=.001). 2.For whom the hospice home care is provided, 95.6% of the respondents showed very high level of knowledge as answering that the incurable terminal illness patients and their families are the beneficiaries of hospice care. The respondents counted nurses, volunteers, pastors, physicians and social workers, consecutively, as hospice care providers. More nurse were positive toward pastors than physicians in regarding as a hospice care provider by a significant difference(x2=11.634, p=.001). 3.For when to referral hospice home care to the patients, only 34.2% answered that patients with less than 6 months of survival time are advised to receive hospice care, reflecting very low level of knowledge. 23.0% of the physicians and 48.0% of the nurses answered that hospice care should be provided when death is imminent, making a significant difference between the two groups(x2=6.413, p=.000). 4.To promote hospice activities, 87.2% pointed out that it is crucial to make general people, including those engaging in the medical field, more aware of hospice. 79.7% answered that a national hospice management should be developed, marking a significant difference between the physician group and nurse group(x2=10.485, p=.001). 5.Advantages of hospice home care are 87.2% responded that patients can have better rest at home receiving hospice home care. Economical merit was brought forward as one of the advantages also, where there was a significant difference between the physicians group and nurse group(x2=7.009, p=.008). 6.The medical professions' attitude to hospice home care are 92.8% of the physicians answered that they would advise incurable terminally ill patients to be discharged from hospital, with 44.3% of them advising the patients to receive hospice home care after leaving the hospital. From the nurses' point of view, 20.9% of the terminally ill patients are being referred to hospice home care after discharge, which makes a significant difference from the physicians' response(x2=19.121, p=.001). 7. 30.6% of physicians have referred terminally ill patients to hospice home care, 75.9% of whom were satisfied with their decision. Those physicians who have never referred their patients to hospice home care either did not know how to do it(66.7%) or were afraid of losing trust by giving the patients an impression of giving up(27.3%). 94.9% of the physicians responded that they would refer their last stage patients to a doctor who is involving palliative care. 8.Only 36.2% of nurses have suggested to physicians that refer the terminally ill patients discharged from the hospital to hospice home care. Once suggested, 95.8% of the physicians have accepted the suggestion. Nurses were reluctant to suggest hospice home care to the physicians, as 48.8% of the nurses said they did not want to. From the result of this study the following conclusion can be drawn, the medical profession's awareness of general hospice care has been increased greatly compared to the results of the previously performed studies. However, this study result also shows that their knowledge of hospice home care is not good enough yet. There is a need for high recommended that medical education institute and develop regular courses on various types of hospice care. Medical field training courses for physicians and nurses will be very helpful as well. It is also important to train hospice experts such as palliative physicians and develop a national hospice management urgently in order to improve the hospice care in Korea.

• (The)Study of the Eastern Classic
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• no.35
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• pp.387-414
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• 2009

This paper looks into the Confucius customs of Yiphu and Seungjung, that is respectively a problem of deciding the successor of the family and a matter of establishing Jongtong (宗統: the proper inheritance line of the family), especially concerning the funerary and ancestor memorial services through Seongho Lee Ik's discussion on proprieties, whose Yeahak (禮學: Studies on Proprieties) is representative of the eighteenth century Yeahak. Seongho Lee Ik sees that there is one penetrating principle that should apply the same concerning Jongtong, regardless whether it is for the state or for a family or whether it is for the royal family or for the gentry in or out of the state service. To establish this one penetrating principle, he emphasizes the manners that fit one's circumstance and social standing, proposed as the theory and practice of 'Seoin-garyea (庶人家禮: Proper customs that even common people with no official titles can practice in marking their important life events like coming-of-age, marriage, and death)'. These two aspects of Seongho seem at odds with each other at a glance. Yet given that he considers that keeping proprietary manners for their own social standings would help secure the fundamental social order, which is of supreme importance to him, it makes sense. Next, the most problematic issues about Seongjung and Yiphu are the timing when one can declare the 'absence of the patriarch' and the manner how one substitutes oneself for the absent patriarch. Seongho sees that it is one thing to 'inherit the Jongtong' and it is another to 'become a next patriarch'. Basically, he does not separate the problem of Jongtong by one's social standings. The real situation involved can be different based on one's social standing, he readily acknowledges. Yet, 'the unchangeable ethical principle between the father and the son' would prevail over the same regardless of classes, he insists. This attitude of his is in line with his philosophy of proprieties and his practical guidance that proposes 'Seoin-Garyea' with an appeal to establish fundamental social order based on the practice of proper manners in accordance of one's social standing as he philosophizes the rules of Jongtong on the base of the one penetrating principle.

• Journal of Korean Classical Literature and Education
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• no.34
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• pp.41-74
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• 2017

This study aimed to investigate the narrative strategy and meaning of fantasy in classic novels and to derive the educational meaning from the fantasy of Sukhyangjeon. This study selected Sukhyangjeon because is considered a suitable literary text that embodies characteristics of fantasy inherent in classical novels through its successful portrayal of the fantasy genre and its high popularity during its time. Specifically, this study observed that the "notice of hardships" which repeatedly appears in the narration of Sukhyangjeon reinforces the fantasy of the novel as it serves as an advance notice of intervention from heaven. Therefore, this study investigated the relationship between the notice of hardships and fantasy by focusing on Sukhyang's life. The way in which the "notice of hardships" is a form of illusion realized it evident in the plot when heaven saves Sukhyang from her hardship even though it was heaven that had granted her those forms of hardship. Firstly, the "notice from heaven" constitutes the macro structure of Sukhyangjeon. Through it, readers realize the enormous power of heaven by seeing how Sukhyang's life has been realized in accordance with heaven's notice with that, it evokes a sense of respect to heaven. In addition, heaven saves Sukhyang from different forms of danger. It enhances a miraculous feeling, which the omnipotent power of heaven shows, against the innocent appearance of Sukhyang during her times of danger. Meanwhile, when heaven notifies Sukhyang and the surrounding people of their fate and subsequently realizes it through dreams, this act creates a mysterious atmosphere and improves the probability of the narrative. If so, the narrative meaning in reinforcing the fantasy of the novel by the use of "notice of hardships" could be revealed through Sukhyang's real life. First, the hardship in which Sukhyang has gone through is so realistic and detailed that the readers' feelings of empathy are evoked with the fear of the coming hardship, wailing together, and trying to resolve the inner anxiety through Sukhyang's happiness. Second, the heavenly beings who are touched by the good behaviors of Sukhyang save her from the dangers of death. This creates the belief in readers that heaven intervenes for the good people. Third, the active attitude that Sukhyang and Leesun show in the process of marriage helps them overcome their earthly hardship and preserve their relationship in heaven. This gives readers hope that they could go to a "higher life" after going through suffering. This fantasy of Sukhyangjeon helps readers overcome their anxieties of reality through fantasy and recognizes the importance of relationships to enhance a sense of unity and solidarity with others. Because of these elements, it is expected that the fantasy of Sukhyangjeon will have a meaningful value to modern readers.

• (The)Study of the Eastern Classic
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• no.55
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• pp.223-264
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• 2014

Yeoncheon Hong Seok-joo(淵泉 洪奭周: 1774-1842) faithfully followed a policy of restoration of literary style of king Jeongjo. He was an young vassal after 1794 and influenced by Jeongjo because Yeoncheon was around the king. Furthermore, he had comparatively favorable working period as a vassal(仕宦期, 1795-1836) after death of Jeongjo(1800) while establishing his own academic viewpoint. Therefore, a study about art theory of Yeoncheon Hong Seok-joo is one about logical system to accept various desires for change of then while not getting rid of scope of Neo-Confucianism after Jeongjo. It is catched that exchange of Hong Seok-joo and Jeong Yak-yong was made relating to study of Sangseo. Hong Seok-joo and Jeong Yak-yong absorbed in study of Sangseo, which is come from putting importance on 6 scriptures (經) among studies of scriptures by both of them. Through this, they aimed to re-discover ideology of original Confucian studies as one for cultivating oneself and governing people (修己治人之學). Dasan and Yeoncheon have something in common that they were young vassals who were cultivated as a guarding power for Jeongjo centered on Gyujanggak. They were largely fit to view of literature(文體觀) of Jeongjo. Hong Seok-joo distinguished function of prose(文) and poetry(詩) into teaching moral(明敎) and moving people(感人) in the category of Mun-yi-jae-do(文以載道) based on thoughts of 'literature is linguistic device for Taoism '(道本文末)' which is a core concept of literature theory based on Neo-Confucianism. He gave a careful attention on instructional and social function in prose while on emotional understanding that puts importance on temper and the secrets of nature in poetry. Hong Seok-joo regarded moral impression and edification through this as a core of artistic creation based on Segyoseol(世敎說). Furthermore, expressions such as 'Heunggwangunwon(興觀群怨)' or 'Yeohangguyo(閭巷謳謠) which are mentioned as important elements in his artistic works put importance on actual existence of objective things in artistic activity and this is connected to an attitude to require description fit to fact. So, it is assumed that such expression style aimed for features of genre painting in painting arts. Understanding of the study of ancient documents by Yeoncheon developed from critical perspective. He criticized the study of ancient documents, saying it as first, Pasoijisul(破碎之術), second, Dotaekjisul(塗澤之術), third, Hoimojisul(毁侮之術). Jeong Yak-yong criticized ' theory on the Odes' from viewpoint of theory of Mun-yi-jae-do(文以載道) based on Neo-Confucianism. He stressed political and social function of Sipeon and general poetry in "the Odes" and reinterprets discourses about poetry of Zhu Xi based on his own opinion. He says that poems of national fashion do political and social criticism. The theory of national fashion by Jeong Yak-yong clearly discloses his thoughts that stress practical role of noblemen in the social and political context.