Malignant mesothelioma is a common, primary tumor that can invade pleura, and is associated with previous exposure to asbestos. However, it poses considerable difficulties regarding its diagnosis and treatment, and thus, accurate history taking with respect to exposure to asbestos, and radiologic and pathologic examinations are essential. In addition, the involvement of a multidisciplinary team is recommended in order to ensure prompt and appropriate management using a framework based on radiotherapy, chemotherapy, surgery, and symptom palliation with end-of-life care. Because lymphocyte-dominant, exudative pleural effusion can occur in malignant mesothelioma, adenosine deaminase values may be elevated, which could be mistaken for tuberculous pleurisy, and lead to an incorrect diagnosis and suboptimal treatment. The authors describe a case of malignant mesothelioma initially misdiagnosed as tuberculous pleurisy. As evidenced by the described case, malignant mesothelioma should be considered during the differential diagnosis of patients with lymphocyte-dominant, exudative pleural effusion with a pleural lung lesion.
Cancer is a disease which has the huge burden in worldwide, and cancer is the number one cause of death in Korea. At this point, the new framework for cancer monitoring index is required for regional cancer monitoring. Especially, cancer survivors are the important target which is rapidly increasing recently, also cancer survivor's quality of care should be considered in the cancer monitoring index framework. To develop the Multidimensional Cancer Monitoring Index considering cancer survivor's quality of care, we took into account cancer continuum which including prevention, detection, diagnosis, treatment, survivorship, assessment of quality of care and monitoring cancer patient, and end-of life care for stage. For target, components of health care delivery system such as patient, family, provider, payer, and policy maker are included. Also, Donabedian model which is a framework for examining health services and evaluating quality of health care such as structure, process, and outcome is applied to contents. This new cancer monitoring framework which includes multidimensional components could help to develop regional cancer monitoring index, and to make national cancer management and prevention policy in the future.
This study was a descriptive research study conducted to determine how nursing students' good death awareness and nursing attitudes toward dying patients affect their empathy. The subjects of the study were 155 nursing students, and data were collected using an online survey method. Data analysis was performed using descriptive statistics, independent t-test, one-way ANOVA, and multiple regression using the IBM SPSS Statistics 26. Higher attitude toward care of dying (B=.312) had a statistically significant positive effect on empathy capacity (p<.010). The variables that affected nursing students' empathy capacity were end-of-life experiences of relatives (𝛽=.226) and attitude toward care of dying (𝛽=.220). The regression model was statistically significant (F=6.968, p<.001), explained 10.4% of empathy. This study is expected to be used as basic data for the development of programs to strengthen the empathy capacity of nursing students in the future.
In this study, wearable ECG measurement system was implemented for health monitoring during daily life. A wearable belt-type ECG electrode worn around the chest by measuring the real-time ECG is produced in order to minimize the inconvenience in wearing. The measured ECG signal is transmitted via an ultra low power consumption wireless data communications unit to personal computer using Zigbee-compatible wireless sensor node. The ECG monitoring program is developed at end user which is personal computer. The measured ECG contains many noises mainly due to motion artifacts. For ECG signal processing, adaptive filtering process is proposed which can reduce motion artifacts efficiently and accurately than digital filter. The experimental results show that a reliable performance with high quality ECG signal can be achieved using this wearable ECG monitoring system.
Yoon, SeokJoon;Choi, YoungSim;Jung, Jin Gyu;Kim, Jong-Sung;Ryu, Hyewon
Journal of Hospice and Palliative Care
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v.20
no.4
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pp.226-234
/
2017
Purpose: With the implementation of the Act on Life Sustaining Treatment, hospice-palliative care will be extended to non-cancer diseases including the acquired immunodeficiency syndrome (AIDS). However, there are concerns about negative perceptions and prejudice toward AIDS patients. The purpose of this study was to investigate factors related with willingness to volunteer (WV) for patients with end-stage AIDS among hospice volunteers. Methods: Participants were 326 hospice volunteers from 19 institutions. A self-administered questionnaire was employed to investigate the participants' WV for end-stage AIDS patients, and the questions were answered using an 11-point rating scale. Demographics, volunteer activity, satisfaction with hospice volunteering, knowledge of AIDS, and attitudes towards AIDS patients (i.e., fear AIDS patients, negative attitude towards AIDS patients, personal stigmatization and stigmatizing attitude) were also investigated. A multiple regression analysis was performed to examine factors associated with WV for patients with end-stage AIDS. Results: WV for patients with end-stage AIDS was 2.82 points lower than that for cancer patients (P<0.001). The multiple regression analysis showed that the higher the level of satisfaction with hospice volunteering (P=0.002) and the lower the level of "personal stigmatization" (P<0.001), participants showed greater WV for end-stage AIDS patients. Conclusion: The level of satisfaction with hospice volunteering and "personal stigmatization" were factors associated with participants' WV for patients with end-stage AIDS.
This study was conducted to evaluate the effects of dietary supplementation with shrimp soluble extract (SSE) on growth performance, feed utilization, innate immunity and digestibility of Pacific white shrimp Litopenaeus vannamei. A basal diet (Con) was formulated and three other diets were prepared with SSE supplementation at different levels of 1, 2 and 4% (designated as SSE1, SSE2 and SSE4, respectively). Triplicate groups of shrimp (1.20±0.01 g) were fed one of the experimental diets for 6 weeks. At the end of the feeding trial, growth performance and feed utilization of the shrimp were significantly improved by dietary supplementation of SSE4 compared to those of shrimp fed the Con diet. Shrimp fed SSE4 diet had significantly higher phagocytic activity than shrimp fed the Con diet. Dietary supplementation of SSE improved the protein and dry matter digestibility of shrimp. These results indicate that SSE can be used as a functional additive in the diets for Pacific white shrimp.
The purpose of the study is to explore how parenting attitudes, ego resilience, and care affects adolescents' adjustment to school so as to provide a necessary basic guideline needed to seek various intervention methods. To achieve this end, the study referred to the 2014 Annual Report of the Korean Children and Youth Panel Survey. By using both SPSS 19.0 and AMOS 19.0, the study yielded the following results. First, the study showed that parenting attitudes, ego resilience, care, and school adjustment all have a positive correlation. Second, by conducting path analysis in order to verify the mediating effect of ego resilience and care with regards to the relationship between parenting attitudes and school adjustment, the direct influence that parenting attitudes had on school adaptation was shown to be relevant. Third, adolescents' ego resilience and care have a partial mediating effect on the relationship between parenting attitudes and school adaptation. Therefore, together with intervention in actual school settings, assessing various factors that would aid the recovery of adolescents' characters and pursuing a positive reinforcement of character by finding protective factors would enable this study to be used as a basic guideline that would prevent adolescents' maladjustment to school and social deviance as well as aid the growth of their characters.
The problem of care of patients and families with Alzheimer's disease has become a conscious raising social policy issue in Korea. The government of the Republic of Korea has become cognizant of the situation and has begun searching for ways to remedy it. Thus, there is a need for a comprehensive under-standing of the situation in which patients and their families are struggling and the enormous problems of care. With a realization of the urgent need, this study was done to investigate the situation and the care needs of families with patients with Alzheimer's Disease, and to compare the effectiveness of services utilized by the families in terms of cost and effects on patient's conditions and on family live. The Subjects for the study were 29 families with hospitalized patients, 25 families utilizing hospital outpatient clinics, 14 families utilizing day care facilities, and 16 families with homebound patients. A total of 84 families were interviewed by four trained interviewers using structured and semistructured questionnaires. The data produced from these interviews included : the patient's stage of Alzheimer's disease, patient's bizarre behavior, hours spent on patient care per day, family burden and quality of life, direct and indirect costs encountered in the care of patients, and the families' evaluation of the effectiveness of the services received. The data were analyzed to determine the relationships between family charactersistics, patient's conditions and services utilization. The effectiveness of each of the service entities was assessed through families evaluation and hoped for service and comparisons were made between services in terms of the cost-effectiveness ratios. After initial comparison of cost-effectiveness ratios, further analysis was done to compare between groups for incremental effectiveness for each incremental unit of cost to determine the most cost-effective service entities. The findings of the study are as fellows : 1. The choice of living arrangement and the types of services are a function of the stage of Alzheimer's condition and the economic status of the family. 2. Comparision of the cost of care showed that most expenses were encountered in by families with hospitalization, families using outpatient services, and families using day care services in that order. The least expense was involved in the care of homebound patients. The economic burden felt by families was in the same order as expenses. 3. The average number of hours spent on daily patient care was 9.9 hours for the outpatient clinic users, 9.7 hours for homebound patients, and 5.4 hours for day care users. 4. There were significant differences in the patient's conditions (CDRL), bizarre behaviors and the families's burden by living arrangement and /or types of service. However, no significant difference was found between groups in the family's quality of life. 5. The families rated the services of day care center as most effective for the care of the patients and families, except for a few families who had experienced some improvement in the patient's conditions. The outpatient clinic users expressed psychological comforts mainly in that the patient was being taken care of. For those hospitalized patients, families expressed the comfort of being relieved of the burden of care and that the patient is being professionally cared for. Form the analysis of the costs, hours of patient care, patient's bizarre behaviors, family's quality of life and burdens, and family's evaluation of services, it is concluded that up to the mid stage of Alzheimer's condition, the utilization of day care center services is found to be the most cost-effective, and toward the end stage of the Alzheimer's disease, it is hoped that there will be a establishment of long term or short term in-patient facilities for the protection of patients and preservation of the integrity of families for less cost. Thus. it was concluded that the family centered system of care is the most effective for Korea with systematic support systems developed for the care of patients and their families according to the needs of families as the patient's condition deteriorates.
This study explores experiences of male siblings without disability who are caring for their adult siblings with intellectual disability. To this end, in-depth interviews were conducted based on phenomenological qualitative research methods, and documents such as newspaper articles and broadcasting documentaries covering the care of participants were also used as materials. Data collection took place from August to October, 2017, and four brothers without disability participated in this study. Findings are presented as five themes: a sibling with a disability-centered life, living with complex emotions including emotional ambivalence, cautious life at all times, life to receive consolation, and life trying to achieve balance and harmony. Based on the results, political and practical considerations for brothers without disability and their families who support their adult siblings with intellectual disability are discussed. Implications for social workers are suggested.
Seo, Min-Jeong;Kim, Jung Yeon;Kim, Sanghee;Lee, Tae Wha
Journal of Hospice and Palliative Care
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v.16
no.2
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pp.108-117
/
2013
Purpose: The objectives of this study were to 1) explore nurses' attitudes toward death, coping with death, understanding and performance regarding end-of-life (EOL) care, 2) describe correlations among the above factors, and 3) determine the factors affecting nurses' EOL care performance. Methods: Study participants were 187 nurses stationed at departments that post higher mortality than others such as the oncology department, intensive care unit (ICU) and emergency department (ED). Data were collected from three urban university-affiliated hospitals. Multi-dimensional measure was performed for study instruments such as "attitude toward death", "coping with death" and "understanding and performance regarding EOL care". Data were analyzed by using descriptive statistics, correlation, and multiple regressions. Results: First, nurses showed significantly different attitudes toward death by age, religion, work unit and EOL care education. Younger nurses tend to score low on the understanding of EOL care, and ED nurses' score was lower than their peers at the oncology department and ICU. Second, EOL care performance was positively correlated with attitude toward death (P<0.001), coping with death (P=0.003) and understanding of EOL care (P<0.001). Third, nurses' EOL care performance was affected by work unit (P<0.001) and understanding of EOL care (P<0.001). Conclusion: Because nurses' performance was influenced by their work unit and understanding of EOL care, they should be provided with appropriate training to improve their understanding of death and EOL care according to work unit.
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