• Journal of Korean Academy of Nursing
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• v.36 no.1
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• pp.159-168
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• 2006

Purpose: The purpose of this study was to examine the effects of music therapy on state anxiety and pain among patients undergoing burn dressing changes. Method: A convenience sample of 32 adult burn patients who were eligible and provided consent were included in the study which was a quasi-experimental study of a nonequivalent control group pretest-posttest design. Fifteen patients in the control group received the routine burn dressing changes but 17 patients in the experimental group listened to self-selected music through headphones connected to a CD player during burn dressing changes for three days. All subjects of the music group chose the type of music that would relax them. Before and after burn dressing changes, subjects completed the State Anxiety Inventory and self-report of pain scores. Result: There was a significant reduction in state anxiety before and after burn dressing changes in those who received music therapy in contrast to those who did not receive music therapy. The music group reported lower pain scores before and after burn dressing changes than did the non-music group. Conclusion: These findings indicate that music therapy composed of self-selected music is a valuable intervention for the treatment of pain and anxiety in patients undergoing burn dressing changes.

• The Korean Society of Law and Medicine
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• v.17 no.1
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• pp.209-279
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• 2016

The Korean Mental Health Act was amended 2016 overall. This paper examines and evaluates the old Korean Mental Health Act since 1995 and the new Korean Mental Health Promotion Act 2016 from the Perspective of Human Rights and Inclusion of Persons with Psychosocial Disabilities. The persons with mental disabilities was separated and ruled out from society by the enactment of the Mental Health Act in 1995 and five times amendment. That has been justified and institutionally supported by medical viewpoint. The medical approach which reconsider the persons with mental disabilities as patients conceal that the aims of the involuntary admission in Mental Hospital are protection of society and the relief of the family member's duty of support for person with mental disabilities. This is institutionally supported in the 1995 Korean Mental Health Act by involuntary admission through the consent of family members as protectors. According to the old Act, the family members as protectors are authorized to consent to involuntary admission of persons with mental disabilities. Also, the psychiatrist that diagnoses the person with mental disabilities and evaluates the need for treatment by admission is not impartial in this decision. Family members as protectors may want to lighten their burden of support for the person with mental disabilities in their home by admitting them into a mental hospital, and the psychiatrist in the mental hospital can be improperly influenced by demand of hospital management. Additionally, Article 24 of the Korean Mental Health Act for the Involuntary Admission by the Consent of Family Members as Protector might violate personal liberty, as guaranteed in the Korean Constitution. The Mental Health Promotion Law was amended to reduce the scope of the persons with mental illness which are subject to forced hospitalization and to demand that a second diagnosis is made by another psychiatrist and screening by the committee concerning the legitimacy of admission in the process of the involuntary admission by the consent of family members as a method of protection. The amended Mental Health Promotion Law will contribute to reducing the number of the involuntary admissions and the inclusion of persons with mental disabilities. But if persons with mental disabilities are not providing some kind of service to the community, the amended Mental Health Promotion Law does not work for Inclusion of them.

• The Korean Society of Law and Medicine
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• v.23 no.4
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• pp.29-74
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• 2022

As social disasters occur under the Disaster Management Act, which can damage the people's "life, body, and property" due to the rapid spread and spread of unexpected COVID-19 infectious diseases in 2020, information collected through inspection and reporting of infectious disease pathogens (Article 11), epidemiological investigation (Article 18), epidemiological investigation for vaccination (Article 29), artificial technology, and prevention policy Decision), (3) It was used as an important basis for decision-making in the context of an infectious disease crisis, such as promoting vaccination and understanding the current status of damage. In addition, medical policy decisions using infectious disease data contribute to quarantine policy decisions, information provision, drug development, and research technology development, and interest in the legal scope and limitations of using infectious disease data has increased worldwide. The use of infectious disease data can be classified for the purpose of spreading and blocking infectious diseases, prevention, management, and treatment of infectious diseases, and the use of information will be more widely made in the context of an infectious disease crisis. In particular, as the serious stage of the Disaster Management Act continues, the processing of personal identification information and sensitive information becomes an important issue. Information on "medical records, vaccination drugs, vaccination, underlying diseases, health rankings, long-term care recognition grades, pregnancy, etc." needs to be interpreted. In the case of "prevention, management, and treatment of infectious diseases", it is difficult to clearly define the concept of medical practicesThe types of actions are judged based on "legislative purposes, academic principles, expertise, and social norms," but the balance of legal interests should be based on the need for data use in quarantine policies and urgent judgment in public health crises. Specifically, the speed and degree of transmission of infectious diseases in a crisis, whether the purpose can be achieved without processing sensitive information, whether it unfairly violates the interests of third parties or information subjects, and the effectiveness of introducing quarantine policies through processing sensitive information can be used as major evaluation factors. On the other hand, the collection, provision, and use of infectious disease data for research purposes will be used through pseudonym processing under the Personal Information Protection Act, consent under the Bioethics Act and deliberation by the Institutional Bioethics Committee, and data provision deliberation committee. Therefore, the use of research purposes is recognized as long as procedural validity is secured as it is reviewed by the pseudonym processing and data review committee, the consent of the information subject, and the institutional bioethics review committee. However, the burden on research managers should be reduced by clarifying the pseudonymization or anonymization procedures, the introduction or consent procedures of the comprehensive consent system and the opt-out system should be clearly prepared, and the procedure for re-identifying or securing security that may arise from technological development should be clearly defined.

• 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.

• Journal of Gastric Cancer
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• v.21 no.4
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• pp.368-378
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• 2021

Purpose: When patients with early gastric cancer (EGC) undergo non-curative endoscopic submucosal dissection requiring gastrectomy (NC-ESD-RG), additional medical resources and expenses are required for surgery. To reduce this burden, predictive model for NC-ESD-RG is required. Materials and Methods: Data from 2,997 patients undergoing ESD for 3,127 forceps biopsy-proven differentiated-type EGCs (2,345 and 782 in training and validation sets, respectively) were reviewed. Using the training set, the logistic stepwise regression analysis determined the independent predictors of NC-ESD-RG (NC-ESD other than cases with lateral resection margin involvement or piecemeal resection as the only non-curative factor). Using these predictors, a risk-scoring system for predicting NC-ESD-RG was developed. Performance of the predictive model was examined internally with the validation set. Results: Rate of NC-ESD-RG was 17.3%. Independent pre-ESD predictors for NC-ESD-RG included moderately differentiated or papillary EGC, large tumor size, proximal tumor location, lesion at greater curvature, elevated or depressed morphology, and presence of ulcers. A risk-score was assigned to each predictor of NC-ESD-RG. The area under the receiver operating characteristic curve for predicting NC-ESD-RG was 0.672 in both training and validation sets. A risk-score of 5 points was the optimal cut-off value for predicting NC-ESD-RG, and the overall accuracy was 72.7%. As the total risk score increased, the predicted risk for NC-ESD-RG increased from 3.8% to 72.6%. Conclusions: We developed and validated a risk-scoring system for predicting NC-ESD-RG based on pre-ESD variables. Our risk-scoring system can facilitate informed consent and decision-making for preoperative treatment selection between ESD and surgery in patients with EGC.

• Journal of Hospice and Palliative Care
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• v.20 no.2
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• pp.93-99
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• 2017

Purpose: This study investigated changes in life-sustaining treatments in terminally ill cancer patients after consenting to a do-not-resuscitate (DNR) order. Methods: Electronic medical records were reviewed to select terminally ill cancer patients who were treated at the oncology unit of the Asan Medical Center, a tertiary hospital in South Korea and died between January 1, 2013 and December 31, 2013. Results: The median (range) age of the 200 patients was 59 (22~89) years, and 62% (124 persons) were male. Among all patients, 83.5% were aware of their medical condition, and 47.0% of the patients had their DNR order signed by their spouses. The median of the patients' hospital stay was 15 days, and time from admission to DNR decision was 10 days. After signing a DNR order, 35.7~100% of the life-sustaining treatments that had been provided at the time of the DNR decision making were administered. The most commonly discontinued interventions were transfusion (13.5%), blood test (11.5%) and parenteral nutrition (8.5%). Conclusion: It is necessary to define the scope of life-sustaining treatments for DNR patients. Treatment guidelines should be established as well to secure terminal patients' death with dignity after their consent to a DNR order, thereby avoiding meaningless life-sustaining treatments and allowing administration of active terminal care interventions.

• The Journal of Korean Obstetrics and Gynecology
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• v.36 no.2
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• pp.85-100
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• 2023

Objectives: To evaluate stress patterns and coping abilities in women with infertility by conducting in-depth interviews. Methods: Ten women with infertility who visited the Korean Medicine Hospital and provided consent after being informed of the purpose and method of the study were selected after meeting the inclusion/exclusion criteria. They were requested to complete a preliminary questionnaire developed by the researchers, the Infertility Stress Scale, and the Korean version of the Fertility Problem Inventory (FPI). Subsequently, each participant was interviewed individually. Results: The preliminary questionnaire was used to evaluate sensitivity to each type of infertility-related stress and ability to express and resolve it. Among all infertility stress types, the largest proportion, accounting for an average of 47.5±26.95%, was that felt by the patient herself. Considering stress awareness intensity, the stress felt by the patient was the highest, with an average score of 4.30±0.64. Relative stress sensitivity due to infertility was the highest, with an average score of 3.90±0.94. Compared with general work stress, the average ability to relieve stress related to problems with spouses was the highest, with a score of 2.50±1.20. The average Infertility Stress Scale score was 2.88±1.35 and FPI score was 2.87±2.52. Conclusions: The highest stress scores were observed for the following items: meaning of children, need for parenthood, and stress due to the diagnosis of infertility. The lowest stress scores were allocated to the item concerning relationships with friends and co-workers. Based on the in-depth interviews conducted after the survey, stress in women with infertility may be classified as emotional, physical, and economic. Thus, the requirement for providing appropriate psychological and emotional support depending on the stress type in addition to general medical treatment for infertility treatment was confirmed.

• Fire Science and Engineering
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• v.19 no.4 s.60
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• pp.47-56
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• 2005

The regulation on organization and operation of rescue and aid party was amended. This Regulation is designed to provide legal formality in order to protect not only the patients' right but also 119 rescuers from liability, which is due to treatment refusal by patient and the discretionary refusal of transfer by 119 rescuers on the non-emergency situation. This study looked over the constitute of violation of emergency medical service act related to the discretionary refusal of 119 rescuers, the criminal liability owing to omission and the possibility of national indemnities on the damage of patients. This study also analyzed the courts' decision and attitude by exploring overseas judicial precedents and examined what should be considered on the execution of the newly enacted law. Finally, this study put emphasis on the importance of medical director's control, documentation of every procedure, 119 rescuer's authorization on the refusal of transfer by securing patient's informed consent.

• Journal of Acupuncture Research
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• v.25 no.1
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• pp.199-209
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• 2008

Objectives : To explore the adverse events and safety following facial cosmetic acupuncture treatment (Miso-Acupuncture). Subjects and methods : This study was a retrospective survey of practitioner's reports. The practitioners worked as facial cosmetic acupuncturists, gave informed consent, and completed a case report form between July and November of 2007. On this form, practitioners were asked to report the degree of adverse events relating to the Miso-Acupuncture, the total safety of the treatment, and reasons patients gave for quitting treatment. The practitioners in this study were all Oriental Medicine Doctors(OMD) who had trained at the Miso-Acupuncture Academy for 40 hours we received 23 final report cases. Results : In this study, adverse events following Miso-Acupuncture treatment were mild bruising(15 ; 65.2%), bleeding(12 ; 52.2%), pain(8 ; 34.8%), fatigue(7 ; 30.4%), headache(5 ; 21.7%), and others(10 ; 43.5%). The average degree of adverse events was between mild and moderate, which needs no extra treatment. The total safety of treatment for 16 weeks was between safe and nearly safe, and there was no need to quit treatment in spite of mild adverse events. Eight patients(34.8%) quit treatment, almost all for personal reasons unrelated to the Miso-Acupuncture. Conclusions : These results suggest that the Miso-Acupuncture has no serious adverse events and is a relatively safe treatment.

• The Korean Journal of Pain
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• v.10 no.1
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• pp.21-27
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• 1997

Background : Previous studies have proven beneficial in labor analgesia to use subarachnoid sufentanil(alone or with adjuvant) on parturients in early first stage of labor. We designed this prospective study to evaluate analgesic efficacy and side effects of subarachnoid sufentanil plus bupivacaine in women with cervical dilatation of 7 cm greater. Methods : This was an open-label, nonrandomized trial of 32 parturients in late first stage labor who requested labor analgesia. After signing the consent form each patient received subarachnoid sufentanil (10 ${\mu}g$) and bupivacaine (2.5 mg). Patients were asked to rate their verbal pain score (0-10 scale) before regional anesthesia and 5 minutes after subarachnoid injection, and every 20 minutes thereafter until delivery or request for additional analgesia. Blood pressure, pruritus, Bromage motor block score, mode of delivery and need for supplemental analgesics were recorded. Results : Thirty women were included in the study. Mean pain scores (mean${\pm}$SD) were $8.7{\pm}1.0$ pre-spinal, $0.7{\pm}1.5$ 5 minutes post-injection, and remained less than 5 for 130 minutes after spinal injection. Of 30 patients, 24 had unassisted vaginal delivery, 4 instrumental vaginal delivery (vacuum), and 2 cesarean delivery. Of 28 patients who delivered vaginally, 19 did not require supplemental analgesics and had a delivery pain score of 5 or lower. Blood pressure decreased in three patients after spinal analgesia (p<0.05), which necessitated treatment. The Bromage motor block score was 0 in 26 patients and 1 in 4 patients. Pruritus was noted in 22 patients. Conclusion : Subarachnoid sufentanil-bupivacaine provides rapid analgesia for an effective duration of approximately 130 minutes in parturients in late first stage of labor.