• Title/Summary/Keyword: End-of-life Care

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A Ethnographic Field Study for a Model Development of the Chronic Bed-ridden Patient s Home-ward (만성 재가 기동장애자의 가정병실 모델 개발을 위한 현장 연구)

  • 김태연;정연강
    • Journal of Korean Academy of Nursing
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    • v.24 no.4
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    • pp.597-615
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    • 1994
  • This study is designed to facilitate the creation of home environment conducive to the family taking care of chronic bed-ridden patients with more effective method. The need for this study has emerged against the background of marked changes in the structure of ailments and causes of death, resulting in the number and plights of chronic bed-ridden patients as well as of a rapid increase in demand for medical care and resulting premature discharge. Keeping these in mind, this study focused on home-wards where the majority of chronic bed-ridden patients are being cared for. Despite. their overriding importance, home-words are less than efficient in caring (or chronic bed-ridden patients. These circumstances require the designing of home-wards that can offer greater comfort to patients and at the same time make things easier for caregivers, on the basis of an overall analysis of patients' life and home - ward situation. According1y this study adopted a Participant Observation Method derived cultural anthropology, Toward this end, 3 patients were chosen as subjects of this study for intensive interviewing and participant observation. In the process of this field re-search efforts were made to collect emprical data, that is, to faithfully record the words of the subjects and their caregivers for analysis and interpretation. The findings of these analyses are as follows. Firstly, the chronic bed-ridden patients are mostly being taken care by close family members. Secondly, a room for the exclusive use of the patient, floor, kitchen, bathroom and multipurpose space were found to be necessary for proper caring of the patient. These spaces were respectively used with a view to 1) accomodating the patient as well as caregivers' activities, 2) keeping general and medical supplies and other appliances for patient's care and drying the patient's washing, 3) preparing and keeping the patient's foods and beverages, 4) keeping the supplies necessary for cleaning the patient's body and treating the patient's eliminations, 5) washing the patient's clothes, underwears and bedclothes. The patient's room in turn is subdivided into six portions in terms of uses : specifically the places for accomodating 1) the patient, 2) medical supplies, 3) medicines, 4) linens St clothes, 5) bedclothes and, 6) diapers. Thirdly, the activities of the caregiver are subdivided into seven key areas : hygiene, exercise, diet, elimination, therapeutic nursing, prevention of sore, and other activities. Each area is further classified into several different activities of caring. These activities we mainly carried out in the patient's room. Fourthly, the supplies for caring the chronic bed-ridden patient is divided into two large domains : medical and general supplies. Finally, three main problems areas were found in this study on the part of caregivers, that is, sore prevention, hygiene problem related frequent urination / defecation, the caregiver's physical, psych ological and emotional burden. In consideration of the aforesaid problem areas, a model home-ward was developed in this study. The newly-developed model has been found to have the following six advantages. Firstly, the time and effort required for maintaining the patient's hygiene are reduced, thus relievins the caregiver's physical and psychological bur-den. Secondly, the patient's hygiene can be maintained in satisfactory conditions, because the patient's eliminations are more easily removed. Thirdly, skin irritations caused by the patient's eliminations were remarkably reduced and so were the patient's sores due to moisture and bacteria. Fourthly, the home-ward have a tilt-table ef-fect thanks to the inclining room floor. This improves the patient's cardiovascular function as well as constantly changes pressed skin areas and thus prevents sores. Fifthly, improved shelf arrangements help make the best use of patient's supplies. Sixthly, the trouble of continuously changing clothes, underwears, diapers & bedclothes is remarkably reduced simply by covering the patient with cotton sheets when laid in bed. This is espected to cut down expenses by reducing the comsumptions of diapers and other disposable supplies.

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Application of the Extract of Zanthoxylum piperitum DC to Manufacturing Eco-friendly Nosocomial Infection Control Protective Materials (초피의 항균 활성을 이용한 원내 감염 제어 친환경 방호 소재 개발)

  • Shin Young Park;Ki Yun Kim;Do Youn Jun;Sung Chul Kim;Hyo-Il Jung;Young Ho Kim
    • Journal of Life Science
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    • v.33 no.10
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    • pp.820-827
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    • 2023
  • Since COVID-19 began at the end of 2019, the wearing time of protective clothing used to prevent pathogenic bacteria and virus infection has increased, and the development of safe protective materials that are human-friendly and have antibacterial and antiviral functions has been required. In this study, we investigated the possibility of developing natural antibacterial protection materials using ethanol extract of the medicinal plant Zanthoxylum Piperitum DC. The antibacterial activity assay of the 80% ethanol extract of Z. piperitum DC leaves against various nosocomial infectious bacteria, using the disk diffusion method, showed that Staphylococcus aureus ATCC 25923, Klebsiella pneumoniae ATCC 13883, Salmonella typhimurium, and Aeromonas hydrophila are sensitive to the inhibitory action of the extract. The IC50 values of the ethanol extract against S. aureus, K. pneumoniae, P. vulgaris and A. hydrophila were about 0.59 mg/ml, 0.50 mg/ml, 1.06 mg/ml, and 0.06 mg/ml, respectively. To determine whether the ethanol extract of Z. piperitum DC leaves can be applied to the development of antibacterial protective fabric, the ethanol extract was tested using a protective fabric from the KM Health Care Corp. using the JIS L1902-Absorption method. As a result, the bacteriostatic and bactericidal activity values of S. aureus ATCC 25923 and K. pneumoniae ATCC 13883 appeared to be more than 2.0 when treated with the ethanol extract at a concentration of 1% (w/v). Together, these results suggest that Z. piperitum DC leaves can be applied to develop natural antibacterial functional protective fabrics.

Association of diet-related quality of life with dietary regimen practice, health-related quality of life, and gastrointestinal symptoms in end-stage renal disease patients with hemodialysis (혈액투석을 실행중인 말기 신부전 환자의 식사관련 삶의 질(Diet-Related Quality of Life)과 식사요법 실천도, 건강관련 삶의 질 및 위장관 증상과의 관련성 연구)

  • Lee, JinJu;Kim, Ji-Myung;Kim, Yuri
    • Journal of Nutrition and Health
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    • v.46 no.2
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    • pp.137-146
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    • 2013
  • The purpose of this study was to evaluate diet-related Quality of Life (QOL) and to analyze the relationship among diet-related QOL, dietary regimen practice, health-related QOL, and gastrointestinal symptoms in hemodialysis patients. Subjects were recruited from an artificial kidney center in Seoul. The self-report questionnaire consisted of socio-demographic characteristics, diet-related QOL, compliance with dietary regimen practice, health-related QOL, and gastrointestinal symptoms was distributed. Diet-related QOL includes a 'Quality of Life and Related to Dietary Change Questionnaire', 'Satisfaction Survey', and 'Dietary Impact Survey'. According to their responses, participants had experienced the greatest difficulty with 'Dietary Impact'. In particular, the mean score for general health was low. Association of dietary regimen practice showed a positive association with 'Cost' and 'Self-care' score. In addition, diet-related QOL showed positive correlation with health-related QOL, particularly in 'taste'. Scores for 'Taste', 'Convenience', and 'Dietary Impact' were lower for subjects with constipation compared to those of subjects without constipation. Scores for 'Taste' and 'Dietary Impact' were lower in subjects with irritable bowel syndrome compared to those of subjects without the syndrome (p < 0.05). Diet-related QOL showed a positive association with health-related QOL (p < 0.05), whereas it showed a negative association with constipation (p < 0.01). In conclusion, hemodialysis patients in Korea suffer from burden of dietary regimen practice and most scores for diet-related QOL and health-related QOL from patients with gastrointestinal symptoms were low. Therefore, appropriate nutrition education considering gastrointestinal symptoms is necessary for improvement of patients' QOL during dietary regimen practice.

Analysis of Household Textbooks for MiddleㆍHigh School in Colonial Age (식민지 시대 '가사교과서'에 관한 연구: 1930년대를 중심으로)

  • Jun Mi-Kyung
    • Journal of Korean Home Economics Education Association
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    • v.16 no.3
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    • pp.1-25
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    • 2004
  • This study analyzes the external forms of the household textbooks and also the contents of them used at girls' middleㆍhigh schools during the period of Japanese ruling over Korea. To this end, 8 household textbooks published from 1928 to 1937 were analyzed. The results of the study are summarized as follows. 1. The household subject had become the one of the most important subjects to girl students as the practical uses were emphasized in educational area during the period. As a result. the classes of the household were the second in hours, following the class of Japanese (the national language) to girl students. 2. The contents of the household textbooks were intended to contain 'the modern' and 'the newest'. The students were also suggested to apply the contents of the textbooks to real home life. Many pictures, photos and illustrations were included in household textbooks to help students to understand the contents of the subject. 3. The purposes of the household class were the reformation of the living conditions and home economics. 4. The external characteristics of the household textbooks during the period were as follows. - Written in Japanese vertically and the size of the textbook was A5 (150/210) with pulp paper of good quality - The type style of the body of the textbooks was Ming-style type- The sequent order of the textbooks was the outer cover, the title page, pictorial, introduction, table of contents, the body, appendix and the back cover. 5. The household textbooks consisted of the first volume and the second volume. The first volume contained clothing and textiles, food and nutrition and housing. Taking care of the aged. nursing. child care, household economy and home management were included in the second volume. 6. The household textbooks were designed to make women the housewives.

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The Role of ROS-NF-κB Signaling Pathway in Enhancement of Inflammatory Response by Particulate Matter 2.5 in Lipopolysaccharide-stimulated RAW 264.7 Macrophages (RAW 264.7 대식세포에서 지질 다당류에 의한 미세먼지(PM2.5) 유발 염증 반응 증진에 미치는 ROS-NF-κB 신호 전달 경로의 역할)

  • Kwon, Da Hye;Kim, Da Hye;Kim, Min Yeong;Hwangbo, Hyun;Ji, Seon Yeong;Park, Seh-Kwang;Jeong, Ji-Won;Kim, Mi-Young;Lee, Hyesook;Cheong, JaeHun;Nam, Soo-Wan;Hwang, Hye-Jin;Choi, Yung Hyun
    • Journal of Life Science
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    • v.31 no.12
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    • pp.1110-1119
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    • 2021
  • The purpose of this study was to investigate whether the inflammatory response in lipopolysaccharide (LPS)-treated RAW 264.7 macrophages could be promoted by particulate matter 2.5 (PM2.5) stimulation. To this end, the levels of inflammatory parameters, reactive oxygen species (ROS) and inflammation-regulating genes were investigated in RAW 264.7 cells treated with PM2.5 in the presence or absence of LPS. Our results showed that the production levels of pro-inflammatory mediators (nitric oxide and prostaglandin E2) and cytokines (interleukin-6 and -1β) were significantly increased by PM2.5 stimulation in LPS-treated RAW 264.7 cells, which was correlated with increased expression genes involved in their production. In addition, when LPS-treated RAW 264.7 cells were exposed to PM2.5, nuclear factor-kappaB (NF-κB) expression was further increased in the nucleus, and the expression of inhibitor of NF-κB as well as NF-κB in the cytoplasm was decreased. These results suggest that the co-treatment of PM2.5 and LPS further increases the activation of the NF-κB signaling pathway compared to each treatment alone, thereby contributing to the promotion of transcriptional activity of inflammatory genes. Furthermore, although the generation of ROS was greatly increased by PM2.5 in LPS-treated RAW 264.7 cells, the NF-κB inhibitor did not reduce the generation of ROS. In addition, when the generation of ROS was artificially suppressed, the production of inflammatory mediators and the activation of NF-κB were both abolished. Therefore, our results suggest that the increase in the NF-κB-mediated inflammatory response induced by PM2.5 in LPS-treated RAW 264.7 macrophages was a ROS generation-dependent phenomenon.

Recognition of Advance Directives by Advanced Cancer Patients and Medical Doctors in Hospice Care Ward (호스피스병동 말기 암 환자 및 내과의사의 사전의료지시(서)에 대한 인식)

  • Sun, Der-Sheng;Chun, Yeon-Joo;Lee, Jeong-Hwa;Gil, Sang-Hyun;Shim, Byoung-Yong;Lee, Ok-Kyung;Jung, In-Soon;Kim, Hoon-Kyo
    • Journal of Hospice and Palliative Care
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    • v.12 no.1
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    • pp.20-26
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    • 2009
  • Purpose: We undertook this study to find out the recognitions of terminal cancer patients and doctors about advance directives (ADs), of how they would do in non-response medical conditions and whether ADs could be one of medical options for their dying with dignity. Methods: One hundred thirty four cancer patients in the Hospice Unit, St. Vincent's Hospital, and 97 medical doctors in the Department of Internal Medicine, Catholic Medical Center, were asked about ADs, including Do-Not-Resuscitate (DNR), medical power of attorney, living will and medical options. Results: One hundred thirty patients (97%) and 38 doctors (39.2%) were unfamiliar with ADs, however, 128 patients (95.5%), 95 doctors (97.9%) agreed with it. Seventy nine patients (59.0%) and 96 doctors (99.0%) wanted DNR rather then intensive treatments if they were in non-response medical conditions. Eighty four patients (62.7%) and 75 doctors (77.3%) were agreeable to medical power of attorney. One hundred Thirty four patients (100.0%) and 94 doctors (96.9%) did not want medical options to be in terminal conditions, and hoped to die in peace. Conclusion: Most of patients did not know about ADs and how to make it. However, they showed positive attitudes about it. If we advertise it properly, it is highly likely that a large number of cancer patients would make their living wills easily by ADs. Nevertheless, many legal and ethical problems have to be solved. Doctors should engage their patients in an ongoing communication about the end-of-life. Therefore, let the patients have opportunities to plan their own deaths.

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Protective Effect of Plantago asiatica L. Leaf Ethanolic Extract Against Ferric Nitrilotriacetate-Induced Prostate Oxidative Damage in Rats (랫드에서의 Fe-NTA 유발 산화스트레스에 대한 차전초 에탄올 추출물의 전립선보호 효과)

  • Hong, Seung-Taek;Hong, Chung-Oui;Nam, Mi-Hyun;Ma, Yuan-Yuan;Hong, Yun-Jin;Son, Da-Hee;Chun, Su-Hyun;Lee, Kwang-Won
    • Journal of Food Hygiene and Safety
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    • v.26 no.3
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    • pp.260-265
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    • 2011
  • Plantago asiatica L. (P. asiatica) has been used as one of the popular folk medicines in Asia for human health care practices. Various activities of P. asiatica have been reported, such as anti-oxidant, anti-glycation, anti-inflammatory and hepatoprotective activity. Therefore, the potential of P. asiatica to reduce oxidative stress has been studied in several ways for over 20 years, especially at liver and kidney. However no investigation has been reported revealing its protective effect on prostate. Method: Treatment of P. asiatica leaf ethanolic extract (PLE) (1 g/kg body weight (b.w.), 2 g/kg b.w., or 4 g/kg b.w.) were given separately to animals for pretreatment once per day for 7 days, and on the seventh day ferric nitrilotriacetate (Fe-NTA; 0.24 mmol Fe/kg b.w.), which is known as an oxidative stress-inducer at prostate, was administrated by i.p to negative control group. At the end of the study period, dissection was carried out for detecting the prostate protective effect of PLE. Result: Fe-NTA-treated animals produced reactive oxygen species (ROS) resulting in depletion of antioxidant biomaker, such as glutathione (GSH), glutathione reductase (GR), and glutathione s-transferase (GST) and increase of lipid peroxidation in prostate. However, PLE pretreatment resulted in an increase in the GSH, GST and GR levels concentration dependent manner and in an significant decrease in the levels of lipid peroxidation. Conclusion: Our data suggest that PLE may be effective in protecting oxidative stress-induced damage of prostate, and PLE may be an chemopreventive agent against Fe-NTA-mediated prostate oxidative damage.

A Study on the Social Welfare Needs of the Aged Chronic Patients and Their Family (만성질환노인 및 가족의 사회복지적 욕구에 대한 연구)

  • Wang, Kyeng Hi
    • The Korean Journal of Health Service Management
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    • v.1 no.1
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    • pp.59-74
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    • 2007
  • Considering the characteristics of the Korean family which maintain a close connection with their patients from the moment of their falling sick to hospitalization to discharge, the family is the most important environmental factor of the social supporting system, and is the important object of the client as well as activity system. The medical social work intends to meet the practical needs of aged chronic patients, providing them and their family with a professional human service. The end of this study is to find out the hardships of both the aged chronic patients and their family as well as their needs for the social welfare service, and to search out the way of comprehensive social work service. The summary of the analysis of the survey is as follows: 1. The needs of aged chronic patients are divided into those of the solution of the problems of falling ill, social welfare program and discharge. Those needs arc affected by the various factors of the types of hospitals, the patients' age, the kinds of insurance, and the supporting systems, etc. Accordingly, the assessment of the needs of the patients are asked to be done comprehensively in accordance with the kinds of diseases and social environments. 2. The importance of the family to the aged chronic patients is evident. The family plays a decisive role in the patients' hospitalization and discharge, the family being an important supporting system and making it necessary to take an approach to client system. The family has difficulty in getting connection of community resources, in adapting to social life after the patient's discharge, and in paying the treatment. The family suffers the secondary hardships more than the burden of the treatment expenses. 3. For this reason various interventions are needed to reduce the stress caused by supporting and nursing patients. Thus the social welfare service for the aged chronic patients and their family needs the following prepositions: 1. It is the characteristics of the aged chronic patients that they need continuous care and that the strengths of the patients and their family cannot be too much emphasized, and that comprehensive assessment based on the connection 'with the community and the mutual interchange 'with the environment, is much emphasized. 2. The family of the aged chronic patient is a resources system as well as a client one. 3. Another characteristic of the aged chronic patients is that with the resources connection in mind, it needs an active intervention of social workers in the community. With these prepositions considered, the development of practical social work service for the aged chronic patients is thought urgently needed.

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The Journal of Targeted at the general public for the Modeling of Well-dying Program Development (일반인 대상 웰 다잉 교육프로그램 개발을 위한 모델링에 관한 연구)

  • Kim, Kwang-Hwan;Kim, Yong-Ha;Ahn, Sang-Yoon;Lee, Chong Hyung;Lee, Moo-Sik;Kim, Moon-Joon;Park, Arma;Hwang, Hye-Jeong;Shim, Moon-Sook;Song, Hyeon-Dong
    • Journal of Digital Convergence
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    • v.12 no.8
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    • pp.369-376
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    • 2014
  • Death education the subject of interest is the subject of the medical staff for the death of stress degree and acceptable approach to analyze the death centered on the hospital space education in order to take advantage of From April 2014 until April 30, 281 people who lived Daejeon were surveyed. Analysis of the results, if they are taken the death education, it was considered more important than none education. If Patient in an unrecoverable state, to the question of who to notify, guardian had the highest score. Suitable for end-of-life include home, healthcare, social welfare facilities in order. When you take advantage of the results, In order to understand and take care of the phenomenon of death, we accommodate health and medical treatment perspective, humanity perspective, social perspective. It is Study for Death education program that can be applied to public. It is significant as a basis material to popularize and generalize death education program.

Biological Potential of Enzymatic and Polyphenol Extracts from Ecklonia cava (감태 효소 추출물 및 폴리페놀 추출물의 생리활성에 관한 연구)

  • Lee, Su Min;Kim, Jin Eun;Oh, Myoung Jin;Lee, Joo Dong;Jeon, You-Jin;Kim, Bora
    • Journal of the Society of Cosmetic Scientists of Korea
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    • v.39 no.1
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    • pp.19-24
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    • 2013
  • To investigate the efficacy of enzymatic extract of Ecklonia cava and its polyphenol extract (AG-DK) as cosmetic ingredients, the anti-oxidative effect, anti-glycation effect, anti-melanogenic effect, and anti-inflammatory effect of the extracts were evaluated in vitro. The enzymatic extract of E. cava ($SC_{50}$ 42.9 ppm) and AG-DK ($SC_{50}$ 6.4 ppm) showed a strong DPPH free radical scavenging activity. The anti-glycation ability of the enzymatic extract of E. cava and AG-DK was tested using bovine serum albumin (BSA), which inhibited the formation of advanced glycation end-products (AGEs) in the BSA/glucose system. The enzymatic extract of E. cava ($IC_{50}$ 97.2 ppm) and AG-DK ($IC_{50}$ 7 ppm) had inhibitory effects on tyrosinase activity. Moreover, the enzymatic extract of E. cava and AG-DK had an anti-inflammatory effect through the inhibition of nitricoxide (NO) and prostaglandin E2 ($PGE_2$). These findings suggest that the enzymatic extract of E. cava and AG-DK can be applied to skin-care products as cosmetic ingredients.