• Journal of Korean Academy of Nursing
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• v.9 no.2
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• pp.73-83
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• 1979

The objectives of this study have been conducted to establish effective clinical teaching program to I.C.U in terms of proper assignment of the clients for the students, proper rotation schedule, priorities in critical nursing problems and selection of the teaching and learning. We have analyzed statistically 1,850 patients who have been admitted during a period from January 1977 to October 31 1979 in Ewha Woman's University Hospital. The results are as follows: 1. The proportion to the total inpatients number was 6.5% and mortality rate was 16.3%. 2. The average hospitalized days were 5.8 days in I.C.U and the total death was occured from 1 st hospital day to 5th hospital day. So it shows a certain difficulties for clinical experiences of the senior students in I.C.U. 3. In the age of the death, 41.3% of the patients were in the 41-60 year age group. It shows highest mortality rate in socially active and productive age groups. 4. The mortality rates of the departments of the medicine was 18.7%, general surgery 18.5%, and neurosurgery 14.7%. 5. The number of patients admitted to the department of neurosystem was 30.6%, cardiovascular system 22.6%, respiratory system 11.1 ％ and urinary system 2.9%. 6. On utilizing instruments and machine for diagnosis and client's assessment in I.C.U, they have utilized everything a usual. But they never utilize angiogram and cardiac catheterization in cardiovascular system, and retroperitoneal pneumography in the urologic system. Further more we would recommend as follows 1. In consideration of the average hospital days and the date of death, the rotation program for clincal experience need to be adjusted as continuing practice program in apposite to current alternative practice program for comprehensive nursing care. 2. Socioeconomic needs for the patient's families and himself should be emphasized by the students in addition to physical needs. 3. Course content for critical care might be built up in considering of core disease centered nursing problems. 4. The diagnostic procedures and client's assessment items which could not experience in our university hospital by the students might be considered and refilled as filled trips to another hospital and visual aids.

• Korean Circulation Journal
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• v.48 no.11
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• pp.989-999
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• 2018

Background and Objectives: We aimed to compare outcomes of complete revascularization (CR) versus culprit-only revascularization for ST-segment elevation myocardial infarction (STEMI) and multivessel disease (MVD) in the $2^{nd}$ generation drug-eluting stent (DES) era. Methods: From 2009 to 2014, patients with STEMI and MVD, who underwent primary percutaneous coronary intervention (PCI) using a $2^{nd}$ generation DES for culprit lesions were enrolled. CR was defined as PCI for a non-infarct-related artery during the index admission. Major adverse cardiovascular event (MACE) was defined as cardiovascular (CV) death, non-fatal myocardial infarction, target lesion revascularization, or heart failure during the follow-up year. Results: In total, 705 MVD patients were suitable for the analysis, of whom 286 (41%) underwent culprit-only PCI and 419 (59%) underwent CR during the index admission. The incidence of MACE was 11.5% in the CR group versus 18.5% in the culprit-only group (hazard ratio [HR], 0.56; 95% confidence interval [CI], 0.37-0.86; p<0.01; adjusted HR, 0.64; 95% CI, 0.40-0.99; p=0.04). The CR group revealed a significantly lower incidence of CV death (7.2% vs. 12.9%; HR, 0.51; 95% CI, 0.31-0.86; p=0.01 and adjusted HR, 0.57; 95% CI; 0.32-0.97; p=0.03, respectively). Conclusions: CR was associated with better outcomes including reductions in MACE and CV death at 1 year of follow-up compared with culprit-only PCI in the $2^{nd}$ generation DES era.

• The Korean Journal of Rehabilitation Nursing
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• v.17 no.1
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• pp.18-26
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• 2014

Purpose: To improve the family functioning, fear of death and depression among the terminally ill cancer patients, the effects of letter as an independent nursing intervention were identified. Methods: Non-equivalent control group pre and post test design was used. Subjects were 60 patients and their family members who were hospitalized at hospice units of an university-affiliated hospital. Patients and their family members were encouraged to write a letter to each other at least 4 times for 2 weeks. Results: Family functioning, fear of death and depression in the experimental group were significantly more improved after intervention than those of control group, even depression of experimental group before intervention was worse than that of control group. Conclusion: Writing a letter to family members is worth to use as an independent nursing intervention for terminally ill patients. It is recommended that further study to identify the potential of letters as an independent nursing intervention is implemented for various patients.

• The Journal of Korean Academic Society of Nursing Education
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• v.26 no.4
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• pp.383-392
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• 2020

Purpose: This study was a descriptive study to identify factors affecting the attitude toward life-sustaining treatment of nurses working at long-term care hospitals. Methods: Data were collected through structured questionnaires from August 2nd to 27th, 2019. Study participants consisted of 163 nurses who were working for at least 6 months from 7 long-term care hospitals in B and K city. Data were analyzed using t-test, ANOVA, Scheffe' test, Pearson's correlation coefficients, and hierarchical regression with SPSS WIN v 21.0. Results: There were significantly positive correlations between awareness of good death (r=.46, p<.001) and perception of patients' rights (r=.32, p<.001). The factors affecting participants' attitude toward life-sustaining treatment were awareness of good death (β=.35, p<.001) and their own view of death (β=.24, p=.001), which explained about 27.0% of the attitude toward life-sustaining treatment. Conclusion: Based on these results, it is necessary to develop nursing educational materials that can establish values for deaths, and cultivate legal and ethical knowledge related to attitude toward life-sustaining treatment. In addition, since the severity of a patient's condition varies and the characteristics of the institution vary depending on the type of hospital, a study is needed on the relevance of variables considering the hospital environment.

• Journal of East-West Nursing Research
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• v.27 no.2
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• pp.124-133
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• 2021

Purpose: This study examined the effects of death perception, terminal care stress, and resilience on the terminal care performance of clinical nurses. Methods: As a correlational study, this study conducted a survey total of 189 nurses working at K university hospital and a P university hospital in B metropolitan city for six months or more. The data was collected from August 20th, 2020 to September 15th, 2020. Data were analyzed using the SPSS, Windows version 25.0, according to the purpose of the analysis by descriptive statistics, t-test, ANOVA, Scheffe test, Pearson's correlation coefficient, and hierarchical multiple linear regression. Results: The factors having effects on the terminal care performance of subjects were resilience, perception of death, and the experience of terminal care education. The total explanatory power of those variables on the terminal care performance was 21.0%. Conclusion: For the improvement of terminal care performance, it would be necessary to develop a systematic and professional terminal care education program that could increase the positive perception of death and resilience, and also include knowledge and skills necessary for terminal care. Also, the efficiency of terminal care performance should be increased through periodic terminal care-related nursing education.

• Journal of Hospice and Palliative Care
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• v.23 no.4
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• pp.172-182
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• 2020

Purpose: This study aimed to identify the relationships among attitudes towards death, perceptions of hospice care, and hospice care needs as perceived by family members of patients in the intensive care unit (ICU). Methods: This study used a descriptive correlational method. A structured questionnaire was used to collect data from 114 participating families in the ICU at Dong-A University Hospital, from October 10 to November 1, 2019. The data were analyzed in terms of frequency, percentage, and mean and standard deviation. The t-test, one-way analysis of variance, and Pearson correlation coefficients were also conducted. Results: Perceptions of hospice care showed significant differences according to age (F=3.06, P=0.031) and marital status (t=3.55, P=0.001). However, no significant differences in attitudes towards death or hospice care needs were found. A significant positive correlation was found between perceptions of hospice care and hospice care needs (r=0.49, P<0.001). Conclusion: In order for families to recognize the need for hospice care and to receive high-quality palliative care at the appropriate time, it is necessary to increase public awareness of hospice care through various educational and awareness-raising efforts, thereby providing opportunities for families of terminally ill patients to request hospice care.

• Journal of Hospice and Palliative Care
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• v.26 no.2
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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.

• Journal of Korean Academy of Nursing
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• v.42 no.5
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• pp.680-688
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• 2012

Purpose: The purposes of this study were to explore the effects of family cohesion and subjective happiness on death anxiety of Korean elders and to identify other factors contributing to death anxiety. Methods: The participants were 280 elders who lived in P metropolitan city. Data were collected between November 5, 2011 and January 12, 2012 using the Short Portable Mental Status Questionnaire (SPMSQ), Family Cohesion Evaluation Scale, Subjective Happiness Scale, and Fear of Death Scale (FODS). Data were analyzed using the SPSS/WIN 19.0 program. Results: Family cohesion, marital status, religious activity, perceived health status, and subjective happiness were included in the factors affecting death anxiety of Korean elders. These variables explained 50.1% of death anxiety. Conclusion: The results of the study indicate that these variables should be considered in developing nursing intervention programs to decrease death anxiety and increase family cohesion and subjective happiness for life integration in Korean elders.

• BMB Reports
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• v.35 no.1
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• pp.67-86
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• 2002

Three routes have been identified triggering neuronal death under physiological and pathological conditions. Excess activation of ionotropic glutamate receptors cause influx and accumulation of $Ca^{2+}$ and $Na^+$ that result in rapid swelling and subsequent neuronal death within a few hours. The second route is caused by oxidative stress due to accumulation of reactive oxygen and nitrogen species. Apoptosis or programmed cell death that often occurs during developmental process has been coined as additional route to pathological neuronal death in the mature nervous system. Evidence is being accumulated that excitotoxicity, oxidative stress, and apoptosis propagate through distinctive and mutually exclusive signal transduction pathway and contribute to neuronal loss following hypoxic-ischemic brain injury. Thus, the therapeutic intervention of hypoxic-ischemic neuronal injury should be aimed to prevent excitotoxicity, oxidative stress, and apoptosis in a concerted way.

• Journal of Korean Critical Care Nursing
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• v.9 no.2
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• pp.61-70
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• 2016

Purpose: The purpose of this study was to identify the influences of death perception, terminal care attitude on clinical nurses' terminal care performance for cancer patients. Methods: Data were collected through self-reported questionnaires filled by 526 nurses at a General Hospital in Seoul. Data were analyzed using a multiple regression analysis. Results: Death perception showed a positive correlation with terminal care attitude (r = .45, p < .001), while there was no correlation with terminal care performance. Additionally, terminal care attitude had a positive correlation with terminal care performance (r = .18, p < .001). The explanatory power of nurses' death perception and terminal care attitude toward terminal care performance was 14%. Conclusions: The study results imply that nurses' death perception and terminal care attitude are significant variables affecting terminal care performance.