• Title/Summary/Keyword: Graduate medical education

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Hospice and Palliative Care for Cancer Patients with Brain Metastases (전이성 뇌암 환자의 호스피스 완화의료)

  • Moon, Do-Ho;Choe, Wha-Sook
    • Journal of Hospice and Palliative Care
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    • v.8 no.1
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    • pp.30-36
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    • 2005
  • Purpose: Regardless of treatment, brain metastases are associated with a poor prognosis. We aimed to investigate the clinical characteristics of cancer patients with brain mestastases they after admission into a hospice unit and knowing they have received appropriate hospice and palliative care. Methods: We retrospectively reviewed the medical records in 40 cancer patients with brain metastases they after admission into a hospice unit from March in 2003 to March in 2005. Results: There were 20 males (50%) and 20 females (50%), and the median age of the patients was 64 years. The most common cause of brain metastases was lung cancer (22 patients, 55%), followed by stomach cancer (5, 13%) and breast cancer (3, 8%). Sixteen patients (40%) have never been teated and 20 patient have received the chemotherapy for the primary cancer. The most common symptom of cancer patients with brain metastases is headache (12 patients, 30%), followed by mental change (10, 25%), focal weakness (9, 23%) and convulsion (4, 10%). The most prevalent cause for admission was mental change (13 patients, 33%), followed by pain (9 patients, 23%). The reasons for hospice and palliative care were through recommendation of physician (1 patient, 3%), patient and family self (14, 35%) and the others (25, 62%). Twenty five of the others has been referred to hospice and palliative care during conservative management after referral and enrolled at hospice unit. The median hospitalization was 19 days and median survival in hospice and palliative care was 41 days. The median survival was 87 days from the day when the cancer patients have been diagnosed as brain metastases to death. Conclusion: The duration of hospice and palliative care was not enough to care the cancer patients with brain metastases. We suggest physicians, patients and family need the education and promotion for effective hospice and palliative care.

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Relationship between health behaviors and nutrient supplement intake (건강행태와 영양제 복용 유무의 관련성)

  • Lee, Jong-suk;Kim, In-tae
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.11
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    • pp.498-508
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    • 2017
  • Purpose: The present study investigated nutrient supplement intake to examine the relationship between the health behaviors of nutrient supplement users and nonusers and nutrient supplement users and other drug users. The results provide baseline data to understand whether nutrient supplements actually perform as expected in view of the fact that healthy people that take nutritional supplements may become healthier, but may also develop nutritional supplement abuse problems. Among 7,006 household heads of 24,614 household members from the Korea Health Panel data in 2008, a total of 6,009 household heads were the respondents of the Korea Health Panel Survey (appendix) in 2009. Method: The subjects of the present study were targeted household heads. The respondents who reported that they had taken (planned to take) life/health promotion-related drugs (01. vitamins/nutritional supplements) for more than three months that were purchased at pharmacies during the past one year at the time of the survey were defined as nutritional supplement users. Those who took other drugs (05. hair-loss treatments, 06. obesity treatments, 10. others) were regarded as other drug users. A chi-squared test was performed to analyze the sociodemographic characteristics of the subjects and differences between groups. Multiple regression analyses were conducted to analyze health behaviors according to nutrient supplement intake. Result: Comparison of (A) nutritional supplement users and nonusers revealed that those who were women, 50 years or older, and spent more than average living expenses were more likely to take nutritional supplements, which was not significant in health behavior variables. Analysis of nutritional supplement users and other drug users (B) revealed that those who were high school graduates or above, had a spouse, were non-smokers, took drugs, ate regular meals, and were not stressed by economic or family conflicts were more likely to take nutritional supplements. Conclusion: The results of the present study indicated that people take nutritional supplements because of their psychological desire to be healthy, not because they are not healthy, have problems, or believe supplements will make them healthier.

Norm-referenced criteria for strength of the elbow joint for the korean high school baseball players using the isokinetic equipment: (Focusing on seoul and gyeonggi-do) (등속성 장비를 이용하여 한국고교야구선수 주관절 근력 평가기준치 설정: (서울 및 경기도 중심으로))

  • Kim, Su-Hyun;Lee, Jin-Wook
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.10
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    • pp.442-447
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    • 2017
  • The purpose of this study was to establish norm-referenced criteria for the isokinetic strength of the elbow joint in Korean high school baseball players. Two hundred and one high school baseball players participated in this study, none of whom had any medical problem with their upper limbs. The elbow flexion/extension test was conducted four times at a speed of $60^{\circ}/sec$. The HUMAC NORM (CSMI, USA) system was used to obtain the values of the peak torque and peak torque per body weight. The results were presented as norm-referenced criterion valuesusing the 5-point scale of Cajori which consists of five stages (6.06%, 24.17%, 38.30%, 24.17%, and 6.06%). In the results of this study, the peak torques of the elbow (flexor and extensor?) at an angular velocity of $60^{\circ}/sec$ were $37.88{\pm}8.14Nm$ and $44.59{\pm}11.79Nm$, and the peak torque per body weight of the elbow (flexor and extensor?) were $50.06{\pm}8.66Nm$ and $58.28{\pm}12.84Nm$, respectively. The reference values of the peak torque and peak torque per body weight of the elbow flexor and extensor were setat an angular velocity of $60^{\circ}/sec$. On the basis of the results analyzed in this study, the following conclusions were drawn. There is a lack of proper studies on the elbow joint strength, even though the most common injury in baseball players occurs in the elbow joint. Therefore, we need to establish a standard muscle strength in order to prevent elbow joint injuries and improve their performance. The criteria for the peak torque and peak torque per body weight established here in will provide useful information for high school baseball players, baseball coaches, athletic trainers and sports injury rehabilitation specialists in injury recovery and return to rehabilitation, which can beutilized as objective clinical assessment data.

Factors Affecting to the Instrumental Ability of Daily Living(IADL) in the Urban Elderly (도시지역 노인들의 도구적 일상생활 수행능력(IADL)에 영향을 미치는 요인)

  • Lee in hak;Moon Seng ki;Kim kun joo;Park Jae-Young
    • The Journal of Korean Physical Therapy
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    • v.14 no.3
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    • pp.238-272
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    • 2002
  • This study was intended to find out the factors affecting to the IADL, allowing objective assessment of physical function status of increasing elderly populations. The subjects of 635 elderly persons aged over 65 years old who live in Taejon metropolitan city were interviewed during the two-month period from June to July of 2000. The IADL of Older American Resources and Services(OARS), developed in Duke medical college of USA, was interpreted for use. The study results were statistically processed using SPSSWIN(ver 10.0) and conferred the following results: 1. Among the seven items of IADL, the women showed higher rates of 'yes' in items about using the telephone, getting to the places out of walking distance, going shopping for groceries, taking their own medicine while outnumbered by the men only in the item about managing their own money, without significant differences between them in items about preparing their own meals and doing their own housework. 2. In terms of IADL scores, $82.0\%$ of subjects showed the normal range of scores and $18.0\%$ were under the normal range, meaning dysfunction IADL. Specifications of general characteristics revealed that more dysfunctional were the male subjects, the higher age groups who are more than 75 years old, the higher educated groups, the groups who live in nursing homes, the groups without a spouse. 3. Based on daily activities, lower scores of IADL were found in the subjects who don't go out, who don't have recreational activities, who don't attend elderly gatherings in their neighborhood, who don't hold social meetings. Specifications of psychological traits revealed that more dysfunctional were IADL in the subjects who don't feel satisfied with their lives of the past or the present, who have a deep feeling of isolation, and who don't have the will to live. 4. Among 7 items of health habits, only the subjects who don't regular exercise had lower scores of IADL than those who do. According to HPI, the lower HPI, the more dysfunctional. 5. Based on the factors associated with IADL, the odds ratio of the subjects who don't live together with their families were 1.53 times that of the ones who do, who are educated 3.22 times that of the ones who are not, who don't have spouses 2.09 times that of the ones who do, who don't go out 4.35 times that of the ones who frequently go out, who don't recreational activities for an interest 2.64 times that of the ones who do, who don't attend elderly gatherings in their neighborhood 1.47 times that of the ones who do, who don't hold social meetings 2.23 times that of the ones who do, who don't feel satisfied with their present living 1.43 times that of the ones who do, who have a feeling of isolation 1.53times that of the ones who don'1, who have the weak will to live 3.21 times that of the ones who have the strong one, and who don't regular exercise 2.45 times that of the ones who do. 6. Logistic regression analysis of the study results found that such factors are significantly related as the degree of education, with/without spouse, social meetings, the will to live, and regular exercise, and that higher rates of dysfunctional subjects were in the more educated group, in the group without spouse, in the group who don't frequently go out, who don't have social meetings, who have the weak will to live, and who don't exercise.

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A Study of the Relationship to the Student's Health Behavior, Belief, Value and Health Service Utilization -With Emphasis on Family Structure and Other Variables- (학생(學生)의 건강행위(健康行爲), 신념(信念), 가치(價値) 및 보건의료(保建醫療) 이용(利用)에 미치는 영향(影響)에 관(關)한 연구 -가족(家族)의 형태(形態) 및 제특성(諸特性)을 중심(中心)으로-)

  • Chung, Yeon Kang
    • Journal of the Korean Society of School Health
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    • v.6 no.1
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    • pp.9-44
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    • 1993
  • An explorative and descriptive study in order to determine the effect of family structure and other socio-demographic variables on health behavior, belief, locus, and value and utilization of public health service was carried out. Data were collected from 1,653 subjects randomly sampled in three areas, Seoul, Kyunggi province, and Cheju province. From Seoul 849 subjects were selected, 397 subjects Kyunggi, and 407 subjects from Cheju, respectively. Self-reporting questionaires were administered during the period from March to June, 1992. The major findings were as follows: 1) The subjects visited herb-doctor's at irregular intervals mainly to have tonic medicine prepared. They preferred herb-doctor's rather than with doctors at clinics and hospitals. Statistically significant difference was found among the regions studied (p<0.05). 2) The reason for visiting hospitals was primarily for treatment of diseases. They preferred hospital because they felt that the hospitals offer much highly reliable treatment services as well as medical accessibility. For the purpose of hospital utilization, statistically significant differences existed among sex, educational level, family type and region. However, no significance was found among sex, educational level, and region (p<0.05). 3) The subjects utilized general hospitals mainly for diagnosis and treatment of diseases. They preferred general hospitals because of their much better facilities and reliability. Statistical significance was found among sex, educational level, and region (p<0.05). 4) The subjects visited dentist at irregular intervals basis. They visited once half a year or three to four months. their purpose of visit was mainly for diagnosis and treatment of diseases. Statistical significance differences were found among educational level, region and economic standard (p<0.05). 5) Whenever their illnesses were mild and the pharmacies was located in nearby they visited to pharmacies. They visited once a month and patient medicines. Statistically significant differences were found among sex, educational level and region (p<0.05). 6) The subjects believed that herb medicine was quite efficacious for treatment of some diseases, particularly by information handed down through time-honored tradition and experience. However, they recognized that the efficacy of folk medicine can vary with type and severity of diseases. Statistical significance was among sex, educational level, region and economic standard (p<0.05). 7) The reason why subjects believed that pray and superstition are effective for treatment of certain type of diseases, particularly in neuropathy, was the belief in God's almighty. Statistically significant differences were found among sex, educational level, regions and economic standard (p<0.05). 8) Most of subjects under same condition preferred western medicine because they believed that it is more scientific and prompts in showing therapeutic effect. Statistical significance was not found in the choice of type of public health service among, regions. But significant differences were found among sex, educational level and region (p<0.05). 9) The subjects looked for pharmacy if they thought the symptom was mild. However, they visited hospitals for chronic disease and general hospitals for emergency treatment. Statistical significances were found among educational level, region and economic standard (p<0.05). 10) Although most of students wanted to have a healthy life as for the component of health standard and value, they think that they are not healthy (p<0.05). As for the health behavior, significant difference was found in the proportion of smoking and drinking between educational level and region (p<0.05). The health locus was affected by educational level, and health behavior was influenced by region, sex and educational level. The utilization of type of public health service was influenced by family type and region, and health belief by region and educational level, and the health values by region and economic standard respectively, most of correlation showed statistical significance. Among them, the highest correlation was seen between locus of control and external/internal locus of control, which is quite obvious. The correlation between health belief and behavior was the next highest, but still low (0.343). All the other variables are low but significant except only a few of those. These findings indicate that health education should be incorporated into the curriculum so as to develop desirable health habit, and ability of self-control in accordance with their growth stages. A systematic and scientific understanding on the herb/folk medicine is needed, and greater reliability of the utilization of public health services are is still required. Health policy for equal distribution of health service throughout the country along the hierarchical health service system and complementary mutual assistance and cooperation among various health organizations are also required.

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Spiritual Needs of Hospice Patients (호스피스 환자의 영적 요구)

  • Han, Young-Mi
    • Journal of Hospice and Palliative Care
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    • v.3 no.1
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    • pp.39-48
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    • 2000
  • Purpose : The purpose of the study is to disclose the spiritual needs of hospice patients. Method : The questionaire survey was carried out on 49 hospice patients and 40 caregivers who were in the 9 hospice institutions from lune to August in 1999. Results : In the patients, mean scores of the spiritual needs were significantly higher in the group with stomach cancer, college education, christians, $8{\sim}14$ days of hospice care and the group thinking that religion was important, and in the caregivers in the group of religions besides christianity and lives under $3{\sim}5$ years of medical treatment. In the total average of the spiritual needs, the patients's average was significantly lower than the caregiver's. Among the different categories, the patient's needs were highest in the area of meaning of life and the hope, the caregiver's needs in the love and the concern. However, both groups were low in the religion area. In the items of the love and the concern, the patient was highly responding to the 'wanting someone to give warm concern in conversation' and the caregiver was highly responding to the 'giving a warm response to questions on the sad and hard time'. And also, the patient was lowly responding to the 'wanting more concerns to him than other patients', and the caregiver was low responding to the 'patients wanting warm response in conversation'. In the categories of religious area both group were highly responding to the 'wanting to be helped to relax out of all'. And they gave lowest response to the 'wanting to introduce a book to know God'. In the area of meaning of life and hope, the both groups gave highest response to the 'wanting to be guided to have the hope' and lowest to the 'wanting to have opportunity to reconcile the person with bad relationship'. Conclusion : Summing up the above results, personal in-depth conversation is necessary to understand more deeply the spiritual needs of hospice patient. Moreover the hospice team needs to have more systematic approach to find out the spiritual needs of hospice patients.

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Factors associated with Electronic Cigarettes Use in Korean Adults (한국 성인의 전자담배 사용 관련요인)

  • Park, Eui-Cheol;Bae, Seok-Hwan;Lee, Moo-Sik
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.8
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    • pp.47-55
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    • 2019
  • This study was conducted to investigate the factors associated with electronic cigarette use by Korean adults. To accomplish this, data collected from 228,477 individuals during a community health survey conducted by the Korean Centers for Disease Control and Prevention in 2015 were analyzed by descriptive analysis, the Chi-squared test, and logistic regression analysis. The lifetime prevalence of electronic cigarette smoking was 11.1% for men and 0.8% for women. The current prevalence for electronic cigarettes smoking was 24.2% for men and 26.1% for women among lifetime users of electronic cigarettes. The lifetime experience rate of electronic cigarette smoking was significantly associated with age, educational attainment, occupation, income status and current smoking status, respectively. The current universal smoking e-cigarette is significantly related to the current smoking status, which shows a significantly higher number of current smokers than groups that have smoked in the past. The preference for electronic cigarette smoking was high. E-cigarettes were perceived by those who aimed to quit smoking as having a smoking cessation effect compared to regular cigarettes while also providing the pleasure of smoking and addressing the addiction. Therefore, e-cigarettes were highly favored because they were reflected as a solution to the dilemma of smoking. In 2014, electronic cigarette imports tripled from the previous year, and interest in electronic cigarettes is increasing worldwide. Accordingly, measures related to the prevention and discontinuation of e-cigarettes should be considered. Strengthening anti-smoking education and active promotion of anti-smoking risks is needed to improve smokers' wrong perception of smoking-related health. The WHO also reports that there is a lack of grounds to ensure or acknowledge that e-cigarettes are effective. Accordingly, it is important to identify environmental factors influencing the use of electronic cigarettes and explore the relationship between electronic cigarette recognition and use.

Research on the Measures and Driving Force behind the Three Major Works of Daesoon Jinrihoe in North Korea in Case of the Respective Types of Unification on the Korean Peninsula (한반도 통일 유형별 북한지역의 대순진리회 3대 중요사업 추진 여건과 방안 연구)

  • Park, Young-taek
    • Journal of the Daesoon Academy of Sciences
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    • v.39
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    • pp.137-174
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    • 2021
  • The main theme of this paper centers on how to promote Three Major Works of Daesoon Jinrihoe, charity aid, social welfare, and education projects, during the unification period. Determining the best methods of promotion is crucial because the Three Major Works must be carried out after unification, and the works must remain based on the practice of the philosophy of Haewon-sangsaeng (the Resolution of Grievances for Mutual Beneficence). The idea of Haewon-sangsaeng is in line with the preface of the U.N. Charter and the aim of world peace. North Korean residents are suffering from starvation under their devastated economy, which is certain to face a crisis of materialistic deficiency during reunification. In this study, the peaceful unification of Germany, unification under a period of sudden changes in Yemen, and the militarized unification of Vietnam were taken as case studies to diagnose and analyze the conditions which would affect the implementation of the Three Major Works. These three styles of unification commonly required a considerable budget and other forms of support to carry out the Three Major Works. Especially if unification were to occur after a period of sudden changes, this would require solutions to issues of food, shelter, and medical support due to the loss of numerous lives and the destruction of infrastructure. On the other hand, the UNHCR model was analyzed to determine the implications of expanding mental well prepared and sufficiently qualified professionals, reorganizing standard organizations within complex situations, task direction, preparing sufficient relief goods, budgeting, securing bases in border areas with North Korea, and establishing networks for sponsorship. Based on this, eight detailed tasks in the field of system construction could be used by the operators of the Three Major Works to prepare for unification. Additionally, nine tasks for review were presented in consideration of the timing of unification and the current situation between South and North Korea. In conclusion, in the event of unification, the Three Major Works should not be neglected during the transition period. The manual "Three Major Works during the Unification Period" should include strategic points on organizational formation and mission implementation, forward base and base operation, security and logistics preparation, public relations and external cooperation, safety measures, and transportation and contact systems.

Presenteeism in Agricultural, Forestry and Fishing Workers: Based on the 6th Korean Working Conditions Survey (농업, 임업 및 어업 종사자에서의 프리젠티즘: 제6차 근로환경조사를 바탕으로)

  • Sang-Hee Hong;Eun-Chul Jang;Soon-Chan Kwon;Hwa-Young Lee;Myoung-Je Song;Jong-Sun Kim;Mid-Eum Moon;Sang-Hyeon Kim;Ji-Suk Yun;Young-Sun Min
    • Journal of agricultural medicine and community health
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    • v.49 no.1
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    • pp.1-12
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    • 2024
  • Objectives: Presenteeism is known to be a much more economically damaging social cost than disease rest while going to work despite physical pain. Since COVID-19, social discussions on the sickness benefit have been taking place as a countermeasure against presenteeism, and in particular, farmers and fishermen do not have an institutional mechanism for livelihood support when a disease other than work occurs. This study attempted to examine the relationship between agricultural, fishing, and forestry workers and presenteeism using the 6th Korean Work Conditions Survey. Methods: From October 2020 to January 2021, data from the 6th working conditions survey conducted on 17 cities and provinces in Korea were used, and a total of 34,981 people were studied. Control variables were gender, age, self-health assessment, education level, night work, shift work, monthly income, occupation, working hours per week, and employment status. Results: As a result of the analysis, farmers and fishermen showed the characteristics of the self-employed and the elderly, and as a result of the regression analysis, when farmers and fishermen analyzed the relationship with presenteeism tendency compared to other industry workers, farmers and fishermen increased by 23% compared to other industry groups. Conclusion: This study is significant in that it has representation by utilizing the 6th working conditions survey and objectively suggests the need for a sickness benefit for farmers and fishermen who may be overlooked in the sickness benefit.

Patient Satisfaction with Cancer Pain Management (암성통증관리 만족도)

  • Lee, So-Woo;Kim, Si-Young;Hong, Young-Seon;Kim, Eun-Kyung;Kim, Hyun-Sook
    • Journal of Hospice and Palliative Care
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    • v.6 no.1
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    • pp.22-33
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    • 2003
  • Purpose : The purpose of this study was to evaluate the present status of patients' satisfaction and the reasons for any satisfaction or dissatisfaction in cancer pain management Methods : A cross-sectional survey was used to obtain the feedback about pain management. The results of the survey were collected from 59 in- or out-patient who had cancer treatment at two of the teaching hospitals in Seoul from July, 2002 to November, 2002. The data was obtained by a structured questionnaire based on the American Cancer Society Patient Outcome Questionnaire(APS-POQ) and other previous research. The clinical information for all patients were compiled by reviewing their medical records. Resuts : 1) The subjects' mean score of the worst pain was 6.77, the average pain score was 3.80, and the pain score after management was 2.93 for the past 24 hours. The mean score of total pain interference was $25.03{\pm}12.82$. Many of the subjects had false beliefs about pain such as 'the experience of pain is a sign that the illness has gotten worse', 'pain medicine should be 'saved' in case the pain gets worse' and 'people get addicted to pain medicine easily'. 2) 66.1% of the subjects were properly medicated with analgesics. 33.9% of the subjects reported use of various methods in controlling pain other than the prescribed medication. Only 33.9% of the subjects had a chance to be educated about pain management by doctors or nurses. 3) The mean score of patients' satisfaction with pain management was $4.19{\pm}1.14$. 72.9% of the subjects answered 'satisfied' with pain management. The reasons for dissatisfaction were 'the pain was not relieved even after the pain management', 'I was not quickly and promptly treated when I complained of pain', 'doctors and nurses didn't pay much attention to my complaints of pain.', and 'there was no appropriate information given on the methods of administration, effect duration and side effects of pain medicine.' The reasons for satisfaction were: 'the pain was relieved after the pain management.', 'doctors and nurses quickly and promptly controlled my pain.', 'doctors and nurses paid enough attention to my complaints of pain.' and 'trust in my physician'. 4) In pain severity or pain interference, no significant difference was found between the satisfied group and dissatisfied group. On the belief 'good patients avoid talking about pain', a significant difference was found between the satisfied group and dissatisfied group. Conclusions : The patients' satisfaction with cancer pain management has increased over the years but still about 30% of patients reported to be 'not satisfied' for various reasons. The results of this study suggest that patients' education should be done to improve satisfaction in the pain management program.

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