• The Korean Journal of Legal Medicine
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• 제42권4호
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• pp.159-163
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• 2018

Progressive muscular dystrophy (PMD) is a primary muscle disease characterized by progressive muscle weakness and wasting, which is inherited by an X-linked recessive pattern and occurs mainly in males. There are several types of muscular dystrophies classified according to the distribution of predominant muscle weakness including Duchenne and Becker, Emery-Dreifuss, facioscapulohumeral, oculopharyngeal, and limb-girdle type. Clinical manifestations of PMD are clumsy, unsteady gait, pneumonia, heart failure, pulmonary edema, hydropericardium, hydrothorax, aspiration, syncopal attacks, and sudden cardiac death. The deceased was a 34-year-old man, and the onset of the first clinical symptom, gait disturbance, was in his late teens. His elder brother had the same disease and experienced brain death after a head trauma and died after mechanical ventilation was discontinued. After an autopsy, we found contracture of the joints, pseudohypertrophy of the calf, wasting and fat replacement of the thigh muscle, pericardial effusion (80 mL), fibrosis and fat replacement of the cardiac ventricular wall, pulmonary edema, and froth in the bronchus. The cause of death was heart failure and dyspnea due to muscular dystrophy. There was no sign or suspicion of foul play in his death.

• 한국콘텐츠학회논문지
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• 제18권8호
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• pp.379-391
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• 2018

본 연구의 목적은 배우자를 사별한 결혼이주여성들의 경험을 심층적으로 이해하는데 있으며, 또한 결혼이주여성의 배우자 사별에 대해 처음으로 그들의 관점에서 경험적 인식을 살펴보았다는 점에서 의의가 있다할 것이다. 이를 위해 배우자 사별 경험을 한 결혼이주여성 7명을 심층면담하고 Colaizzi의 현상학적 방법으로 분석한 결과, 결혼이주여성의 배우자 사별 경험은 20개의 주제묶음과 5개의 범주로 도출되었으며 5개의 범주는 '행복했던 결혼생활', '참고 살았던 결혼생활', '남편의 사별', '혼자 살아내야 하는 삶', '희망이 있어 견딜 수 있는 삶'으로 나타났다. 결혼이주여성들의 배우자 사별 경험은 모든 것을 남편에게 의존하던 삶에서 사별 후 스스로 삶의 변화에 적응해 가며 주체적인 삶을 살아내기 위해 노력하는 경험인 것으로 나타났다. 이를 토대로 배우자 사별 결혼이주여성이 사별 후 한국사회에서 더 나은 삶을 살아갈 수 있는 실질적 방안 마련과 사회복지 지원의 기초자료가 될 것이다.

• Journal of Hospice and Palliative Care
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• 제26권2호
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• pp.80-94
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• 2023

Purpose: This study aimed to identify attitudes toward advance directives (ADs) among female cancer patients and factors related to ADs. Methods: The study was conducted at a university hospital in Seoul from September 19, 2020, to January 20, 2021. The participants were 153 patients diagnosed with gynecological cancer or breast cancer. Data were collected using questionnaires and included general characteristics, disease- and AD-related characteristics, knowledge and attitudes about ADs, and attitudes about dignified death. Data were analyzed using the t-test, analysis of variance, and multiple regression analysis. Results: Only 2% of the participants completed ADs. The mean score for attitudes toward ADs was 3.30, indicating a positive knowledge and attitude toward dignified death. The factors related to attitudes toward ADs were attitudes toward dignified death (𝛽=0.25, P=0.001), experience discussing life-sustaining treatment (𝛽=0.17, P=0.037), preferred time to have a consultation about ADs (𝛽=0.19, P=0.046), intention to write ADs (𝛽=0.15, P=0.038), and Eastern Cooperative Oncology Group Performance Status (𝛽=-0.37, P<0.001). The explanatory power of these variables for attitudes toward ADs was 38.5%. Conclusion: Overall, patients preferred to have a consultation about ADs when they were still active, mentally healthy, and able to make decisions. Education about ADs should be provided to patients on the first day of hospitalization for chemotherapy or while awaiting treatment in an outpatient setting so patients can write ADs and discuss them with family and friends.

• 대한간호학회지
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• 제28권2호
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• pp.479-489
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• 1998

This work was done for 9 patients having experience of a herb medical treatment after being diagnosed as CVA during a year from January, 1996 to December, 1996 by using an ethnographic research method. The summarized results of this research are following. Ⅰ. THE EXPERIENCE OF THE ILLNESS First, the falling-ill phase is the time that they have the first stroke of paralysis and the decision pattern of medical institution' comes out. The emotional experience in the period is something like 'flustration', 'anxiety', 'despair', and 'expectation'. Second, the active-treatment phase is the time that the patients as well as their family or care giver not only show the positive attitude and actively participate in the illness treatment but also show a lot of interest in medical institutions and activities of health recovery. There is a primary factor of the continuation of treatment as an experience of treatment and being crushed and sensitivity as an experience of the illness. Third, the rehabilitation phase is the time that the patients or their family become tired and insensitive to the treatment and recuperation, and then reduce the treatment activity. There is a primary influence factor of the discontinuance of treatment as an experience of treatment and physical experience and emotional experience as an experience of the illness. The physical experience is divided into 'personal-hygiene care', and 'the sphere of activity' The emotional experiences are 'blaming someone', 'contempt' and 'despair' as a negative experience and 'hope' as a positive experience. Ⅱ. COPING STRATEGY There are a physical coping, an emotional and mental coping, a social coping, and a spiritual coping as a coping strategy used for the patients to overcome their illness and adjust themselves to their altered life. First, the physical coping comes out as 8 categories, 'using an auxiliary tool', 'doing exercise', 'protecting', 'improving their diet', 'taking care of something', 'using subsidiary medicines', 'trying a folk remedy', and 'having interest in their health'. Second, for the emotional and mental coping, there are 'accepting' and 'trying' as a positive coping and a failure of control as a negative coping. Third, the social coping is appeared as 'being supported'. Fourth, the spiritual coping is recognized as' recourse to God' and 'preparation of death'. After all, the elderly CVA patients in an agricultural area choose the act of treatment based on the traditional belief and the relationship with a caretaker. A personal health can be maintained by taking care of themselves and controling their mind, and the overcome of the illness is decided on the basis of traditional concepts and cultural principles in which the patients as well as the family, neigbors and take carers should work out together and cooperate with each other in order to achieve that.

• 호스피스학술지
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• 제5권2호
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• pp.75-85
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• 2005

The objective of this research is to provide the basic material for effective hospice care by analyzing the recognition of families who have terminally ill patients over death. To do so, this research is designed to investigate the general tendency toward death and changes after hospice care. To analyse the initial status of the recognition about the death, questionnaires were provided to the families of the terminally ill patients who were taken hospice care from June 1st, 2005 to September 10th, 2005 at Saemmul Hospice. The same questionnaires were distributed to research some changes of the recognition of the death after 3 weeks. As the Data Analysis Methodology, SPSS v.10.0 statistics program were utilized. The summary of this research is as follows. First, by gender, it is analyzed that women have more fear than men in terms of incompetence sense after death. By religion, Christians have less fear than other religious people in terms of fear toward after death and general sense of death. Second, those who experienced deaths of close family members, relatives, friends for the past 3 years have more fear toward the moment of death than those who did not experience it. Third, statistically valid difference was found in terms of fear toward the moment of death, fear toward incompetence, fear toward after death, and fear toward death before and after the hospice care was taken. Based on the result of this research, terminally ill patients' families facing death have shown significant differences on fear and incompetence before and after hospice care was offered. It is necessary that the hospice care should be settled more professionally by expanding the opportunities of hospice care and institutionalizing the system. In addition, hospice activities which are focused on providing hope after death and facing death with dignity and peace should be expanded increasingly as the family members who experienced deaths showed higher degree of fear and powerlessness and Christians have less fear toward death with the help of biblical influence. It is also required that hospice care specialized in recognizing the importance of terminal cancer patients and their families at the same time.

• 호스피스학술지
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• 제5권2호
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• pp.54-63
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• 2005

The purpose of this study is to examine the requirement for child life support specialist and fetal education for children with cancer. This research presented was composed with three chapters : First chapter, I presented the purpose, scope and definitions of this research. Second chapter, I defined about hospice care service for children with cancer and kind of pediatric cancer. And general characteristics of children with cancer, a understanding character of death and dietary therapy. Lastly, I defined and investigated about spiritual care. Third chapter, I concluded with some of findings and final suggestions based on the results. According to the developmental stages children with cancer are disability of communication competence and more dependence on their parents, therefore parents' decision making were more difficulty. And parents with a child who suffers from a cancer needs a counseling in order to discover the meaning of life. Parents' psychological experience about the caring for their child suffering from pediatric cancer was equal to broken hearts due to shadow of the child's death from time to time. In other words a parents with a child who suffers from a cancer needs comprehensive services such as hospice, consultor as well as wide experienced pediatrician and nurse. Child life support specialist can help them recover and improve their o주 potential strength in behalf of overcoming their difficulties. And pastoral counseling can help them reduce the fear and anxiety about unknown world and death. The systematically developed a school-based counseling program would help children adjust to the difficulties after a perfect cure because of children adjusted to school well when they have good peer relationships.

• 대한간호학회지
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• 제32권2호
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• pp.243-253
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• 2002

The purpose of this study was to develop Nurse's Suffering Experience Scale and to test the reliability and validity of the instrument. Method: The subjects used to verify the scale's reliability and validity were 220 nurses who were taking care of the end stage cancer patients, while working at university and general hospitals in Daegu and Kyungbuk province from April 20. to July 10, 2001. The data was analyzed by the SPSS/WIN 8.0 program. Results: A factor analysis was conducted, and items that had a factor loading more than .40, and an eigen value more than 1.0. were selected. The factor analysis classified a total of seven factors statistically, and it's communality was 44%. The explanation of factors based on the conceptual framework and item content are as follows: The first factor was expanding self consciousness, the second factor was forming empathy with family, the third factor was professional challenge, the fourth factor was change of values, the fifth factor was spiritual sublimation, the sixth factor was helplessness, and finally the seventh factor was rejection to death. Cronbach's coefficient to test reliability of the scale was .8665 for total of 44 items. The Scale for Nurse's Suffering Experience developed in the study was identified as a tool with a high degree of reliability and validity. Therefore this scale can be effectively utilized for the evaluation of the degree of nurse's suffering experience in clinical settings.

• 지역사회간호학회지
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• 제28권1호
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• pp.98-106
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• 2017

Purpose: To understand the meaning of the lived experience with Person under train (PUT) for train or subway operators. Methods: The study was built on hermeneutic phenomenological themes from individual interviews of present-day train or subway operators in South Korea. Eight participants were selected to participate in the study. All qualitative data were analyzed using the heuristic guides of Van Manen. Results: Four fundamental lifeworld themes and eight sub themes emerged in the findings. The first theme of spatiality had'the place pressed by the darkness' and 'the train drags me there'. The second theme, corporeality had 'a foreboding fear', and 'debris of death that gets stuck in the whole body'. The temporality theme had'distorted time in chaos', and 'memory trapped in time'. Finally the last existential theme of relationality had 'intrapersonal encounter' and 'resentment and guilt'. Conclusion: The four existential lifeworld themes provided a framework for in-depth investigation of the operator's "lived experience." This leads to clear understanding of effects of PUT experience on related individuals. The findings imply that specific active nursing intervention strategies are necessary in order to treat affected train operators, and to prevent further issues in their work and private life.

• 한국노년학
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• 제36권3호
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• pp.785-808
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• 2016

본 연구는 노년 죽음과 관련해 노년 스스로의 죽음 준비 모습과 주변인들의 돌봄 의미 및 가치를 조경란의 소설 을 통해 분석해 보았다. 먼저, 작가는 죽음에 이른 노년을 돌보는 여성들의 고통이나 내적 갈등을 그려나가는 한편, 오랜 돌봄 경험을 통해 죽음에 대한 긍정적 수용 자세와 자아발견의 모습을 형상화 하였다. 이런 작가의 시각은 생태여성주의자들이 고령사회에서 여성의 돌봄 행위 가치를 긍정적으로 평가는 주장과 연결된다. 작품 속 젊은 여성들의 돌봄 행위를 유교 문화적 성역할 규범의 내면화로 파악하기보다, 현대사회 죽음의 개인화 현상 속에서 노년의 삶과 죽음을 공유해 나간 공동체적 삶의 자세로 파악할 수 있다. 또한 노년 인물들의 투병생활과 죽음에 이르는 과정은 젊은 세대에게 유년시절 죽음의 트라우마를 극복하고 삶과 죽음에 대한 존재론적 물음을 던지며 진정한 자아성찰의 계기가 되었다. 이렇게 조경란은 고령화 사회에서 불가역적 노화현상에 따른 죽음 문제를 노년 주체의 죽음 준비 모습과 주변인의 돌봄 행위를 통해 세대 간 소통의 의미를 보여주었다. 특히 젊은 세대의 시선에 비친 노년의 질병과 죽음을 통해 삶과 죽음의 윤리적 계기를 마련해 나가는 데 집중하였다.

• 한국응급구조학회지
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• 제6권1호
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• pp.39-53
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• 2002

This descriptive study was conducted to identify the attitude toward euthanasia of EMT and nursing students and to compare their attitude before and after clinical practice. The convenience sample was comprised of 40 first grade and 40 second grade EMT students attended at G college in G-city, and 40 first grade and 40 third grade nursing students attended at C college in C-province. The variable was tested with an euthanasia attitude scale developed by Kim Ae Kyoung(2001). The valid responses were obtained and analyzed by using SPSS PC+ from November 25 to December 6, 2002. The results showed that most of the respondents agreed to have positive attitude toward euthanasia in terms of client's right and client's quality of life. Also, they thought that euthanasia should be legalized and the right to die with dignity should be guaranteed. The EMT respondents having a clinical experience showed significantly higher score than respondents having no experience in the subarea of medical ethics, and nursing respondents who had a clinical practice showed significantly higher score than others no experience in the subarea of quality of life. But, the other sub-areas had no significant difference between the respondents before and after clinical practice. The attitude toward euthanasia composed of sub-areas such as being after the quality of life, having a high regard for a life and recognizing client's right was not affected by the single factor of clinical practice. Therefore, much supportive intervention need to be done for the students about the significant affecting factors found in this study like a religion, values, education and observing experience of someone's death.