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Lived Experience of patients with Terminal Cancer : Parses Human Becoming Methodology (말기 암환자의 체험에 관한 현상학적 연구)

  • 이옥자
    • Journal of Korean Academy of Nursing
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    • v.25 no.3
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    • pp.510-537
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    • 1995
  • Human health is an integral part of experience in the process of Human Becoming. Through continual interaction with the environment human beings freely choose experience and develop as responsible beings. The process of the health experience of patient with terminal cancer is a unique. he objective of this study is to understand the lived experience of patients with terminal cancer in order to provide basic information for nursing care in the clinical setting and to develop a theoretical background for clinical practice. This study is to de-scribe and define the lived experience of patients with terminal cancer in order to provide a foundation for nursing research and education. Data collection has been done between December 1993 and November 1994. The subjects included five persons -four females and one male : one who was in her sixties, one in his fifties, two in their forties, and one who was in her thirties. The researcher has met with these patients 35 times, but at eight times the patient was in a stuporous condition and not able to participate, so these were not included in the data analysis. Parse's "Human Becoming Methodology", an existential phenomenological research methodology is used for this study. Data has been collected using he dialogical engagement process of "I and You", the participant researcher and the participant subject. Dialogical engagement was discontinued when the data was theoretically saturated. Data was analyzed using the extraction - synthesis and heuristic interpretation. The criteria of Guba and Lincoln(1985). and Sandelo wski(1986) : credibility, auditability, fitness and objectivity were used to test the validity and reliability of the data. The following is a description of the structure of the lived experience of patients with terminal cancer as defined by this study : 1. Structure : 1) Suffering through the reminiscence of past experience 2) The appearance of complex emotions related to life and connectedness 3) The increasing importance of significant people and of the Absolute Being 4) The increasing realization of the importance of health and belief 5) Desire for a return to health and a peaceful life or for acceptance of dying and a comfortable death In summary the structure of the lived experience of these patients can be said to be : suffering comes through reminiscence of past experience, and there are complex emotions related to life and connectedness. Significant people and the Absolute Being become increasingly important along with a realization of the importance of health and faith. And finally there is a desire for either a return to health and a peaceful life or for the acceptance of dying and a comfortable death. 2. Heuristic Interpretation : Using Parse's Human Becoming Methodology, the structure of the lived experience of patients with terminal cancer identified in this research is interpreted as. The lived experience of patients with terminal cancer involves the solving of past conflicts, and the experience of the healing and valuing of sorrow and pain. Through the relation of life and health, and the complex emotions that arise, the lived experience of revealing - concealing is of paradoxical emotions. The increasing importance of significant others and of the Absolute Being shows Connecting and Separating an on- going process of nearness and farness. Revision of thoughts about health and faith is interpreted as transforming and desire for restoration to health and a peaceful life or acceptance of dying and a cowfortable death, as powering. In summary, it is possible to see, in the lived experience of patients with terminal cancer, the relationship of the five concepts of Parse's theory : valuing, revealing -concealing, connecting-separating, transforming, and powering. From Parse's theory, the results of this study show that meaning is related to valuing, rhythmicity to revealing-concealing and connect-ing-separating, and cotranscendence to transforming and powering.

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Study on Influence of Water Fluoridation Program on the Economic Benefit (상수도수불화사업의 경제적 편익에 대한 조사연구)

  • Park, Myung-Suk;Yoo, Wang-Keun
    • Journal of dental hygiene science
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    • v.6 no.2
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    • pp.133-138
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    • 2006
  • To find out influence of water fluoridation program on the economic benefit effect, this study analyzed comparatively dental treatment indicators obtained from dental clinics at Sangdang-gu in Chenongju City, fluoridated community and Manan-gu in Anyang City, non-fluoridated community, from January 1, 2003 to the end of June, and the results are as follows: 1. If water fluoridation program is carried out in Anyang, non-fluoridated community, the number of treatment from caries and disease of tissues around dental pulp and root apex from age 6 to 18 for the first half of year 2003 is expected to decrease by 1,272, 636 for low estimation, and 1,908 for high estimation. And the treatment cost is expected to decrease by 40,888,000 Wons, 20,444,000 Wons for low estimation, and 61,333,000 Wons for high estimation. 2. Assuming that water fluoridation program is spread to all over the country, the number of treatment per year is expected to decrease by 2,492,018, 1,246,009 for low estimation, and 3,738,027 for high estimation. And the treatment cost is expected to decrease by 80,105,075,000 Wons, 40,052,537,000 Wons for low estimation and 120, 157,612,000 Wons for high estimation respectively. 3. For Yeong-un water supply management office which has 48,925 water supply personnel, the benefit/cost rate was 2.9 times, and for Jibuk water supply management office which has 239,751 water supply personnel, the benefit/cost rate was 9.0 times. As the water supply personnel increased, the cost increase of water fluoridation program was little and as the scale got large, the economic effect was very large. Improving national oral health is thought to be associated with expense retrenchment of oral health insurance financial. So it may need to extend using tap water to all the area of the country and additionally establish confidence through an active public relations and education of water fluoridation program.

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Management Plan for Humanistic and Ecological Characteristics of Suweol Village Forest in Tongyoung (통영 수월숲의 인문학적 특성 및 생태적 특성을 고려한 관리방안)

  • Lim, Eui-Jea;Lee, Soo-Dong;Kim, Mi-Jeong
    • Korean Journal of Environment and Ecology
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    • v.27 no.1
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    • pp.85-98
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    • 2013
  • In order to propose effective conservation management plan, this study verified ecological characteristics, humanities and Social characteristics. The research site is private property which is owned belonging to the Kim's of Gimhae that have long history. The study site is more than a thousand years old and was created for protecting from typhoon. There held the religious ritual what is called Dongsinje until 1960s. There have been protected and managed by the villagers. As the results of analysis, the area of windbreak are $12,392.69m^2$. The windbreak is dominated old years deciduous broad-leaved tree such as Zelkova serrata, Celtis sinensis, Aphananthe aspera. Around there were farmlands(52.1%), urbanized area(26.3%), forest area(16.6%). The vegetation communities of windbreak were classified by considering the dominant species and current status of forest. The forest types are following as; A. aspera community(I) which is using less pressure, Platycarya strobilacea-Carpinus coreana-Z. serrata community(II). Z. serrata community(III) which is using high pressure, Z. serrata-A. aspera community(IV), Z. serrata community(V) which is damaged under canopy trees. The windbreak was in good condition whereas, there were concerns the some wrong status was being undermined such as the wrong forest restoration projects in the past, the trails that is penetrating inside the forest, building up education facilities. Therefore, in order to restore the value of windbreak what is so called Suwol forest, we should improve the problems of forest ecosystem such as wrong management, forest fragmentation by facilities and decline in forest by lack of growing the next generation trees. In addition, we should remove excessive resting facilities and lead to passive use of forest. to improve the way of wrong management, moreover, we should close off he trails that is penetrating inside the forest for improving fragmentation. We should restore vegetation restoration and fostering the next generation trees for forest ecosystem. In order to restore unique of histo-cultural and ecological forest landscape, the next generation trees should be grown up that is the dominant species in Suwol forest. Moreover, as a results of comparing the between good vegetation communities and damaged vegetation communities, it is necessary to complementary planting for demeged vegetation communities, therefore there needs to 10.8 under canopy trees, 79.7 shrubs.

Need Assessment for Enlargement of Oriental Medical Care Service Room in Rural Community Health Center (농촌지역 보건소 한방진료실 확대설치 요구도 및 관련요인 - 일개 군 보건소 한방진료실 내소자를 대상으로 -)

  • Kim, Dae-Feel;Song, Mi-Sook;Song, Hyun-Jong
    • Journal of agricultural medicine and community health
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    • v.28 no.1
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    • pp.39-51
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    • 2003
  • Objectives: The oriental medical care has been getting popular in community health centers because of uniqueness, changing of disease patterns, and increasing of elderly population. From 1998, oriental medical doctors has been working in several rural community health centers for their military obligations. At this point of time, it is necessary to evaluate the oriental public health doctors system. This study was performed to investigate the utilization patterns, the degree of satisfactions, needs of oriental medical care service provided by community health center in a designated Gun area. This study focused on the need for extending over Myun area of community health center's oriental medical care services. Methods: Person-to-person interview survey method through a structured questionnaire was done by a personnel at a oriental medical care service room in a Gun community health center. The major statistical method used for the analysis were the t-test, ANOVA, and logistic analysis. Results: The total number of responded subjects in this study was 163 residents. Among these 65.0% were aged 61 or over, and only 13.5% recognized themselves were healthy. 73.7% of the respondents demanded establishment of more oriental medical care services provided by community health center to other Myun area. Factors affecting the need for enlargement of oriental medical care service room were education level, subjective awareness of access to community health center, and cost satisfaction of oriental medical service provided by community health center. Thus, a resident who had graduation of middle school achievement or above(OR=3.35), had a long way to center(OR=2.47), satisfied with oriental medical service cost(OR=2.78) had demonstrated increased chance of need by logistic regression analysis.

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Needs Assessment for the Beneficiaries of Home-Based Cancer Patients Management Project (보건소 재가암환자관리사업 대상자의 서비스 요구도 분석)

  • Lee, Ju-Hyung;Park, Jung-Im;Kang, Ji-Hoon;Youm, Jung-Ho;Koh, Dai-Ha;Kwon, Keun-Sang
    • Journal of agricultural medicine and community health
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    • v.36 no.4
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    • pp.238-250
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    • 2011
  • Objectives: This study was performed to investigate the service needs of the beneficiaries who had enrolled in home-based management programs for cancer patients. Methods: From March to May 2009, 676 cancer patients who were registered in home-based cancer patient management programs were selected as subjects for this study. The data were collected using a questionnaire along with a face-to-face interview performed by officers in charge of the home-based care programs of 47 regional health centers. Fifteen patients were excluded due to incomplete data, leaving 661 subjects who were ultimately enrolled in the study. Results: The mean age of subjects was $64.0{\pm}2.5$ years, and males comprised 45.1% (298/661) of the sample. The results of factor analysis for service needs showed that there were five main categories and Cronbach's alpha ranged from 0.593 to 0.890 for each factor. The service needs categories in order of importance were social support, information and education, psychological problems, physical symptoms and household chores. The service needs scores were significantly different when subjects were stratified by age, habitation, religion and disease classification. When we divided the subjects into complete remission, under treatment and terminally ill groups, the needs scores of the terminally ill patient group were significantly higher than those of the other groups (p<0.001). Conclusions: Service provision based on patient and beneficiary needs could be an effective intervention to reduce the economic burden of cancer management and to improve the quality of life of cancer patients receiving home-based care. Therefore, it is recommended that individual cancer patient care programs be developed and administered according to patient age, habitation and disease severity.

A Study on Pregnancy, Delivery, and Infant Rearing Knowledge and Educational Need of Marriage Immigrant Women (국제결혼 이주여성의 임신·출산 및 영유아 양육 지식과 교육요구도)

  • Jeon, Mi-Soon;Kang, Ki-Jung;Park, Sung-Hee
    • Journal of agricultural medicine and community health
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    • v.36 no.3
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    • pp.179-190
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    • 2011
  • Objectives: This study was performed to understand pregnancy, delivery, and infant rearing knowledge and educational need of marriage immigrant women to be utilized as a basic data for developing a suitable educational program. Methods: The subject of the study was composed of one hundred twenty two married immigrant women who live in South Korea. The method used in determining the population was the convenience sampling method. The data were gathered by means of personal interviews using questionnaires. Results: The mean score of pregnancy and delivery knowledge was 3.35, educational need was 3.64 out of 5, and infant rearing knowledge was 3.16, educational need was 3.66 out of 5. The pregnancy and delivery knowledge of the subject showed significant differences based on their present residential location and presence of children and their educational need varies according to their country of origin. The infant rearing knowledge on the other hand, showed notable differences according to presence of children while homeland and existence of children were the two major factors that greatly influenced the significant variation for educational need. Conclusions: The score of pregnancy, delivery and infant educational need were higher than knowledge. The score of pregnancy, delivery, and infant rearing educational need garnered similar results. Thus it is suggested that further researches should be conducted for the development, application, and verification of pregnancy, delivery, and infant rearing education programs that consider knowledge and educational need of immigrant married women in South Korea.

An Experimental study on the Engineering Properties of Concrete with Rice-Husk Ash (왕겨재를 혼입(混入)한 콘크리트의 공학적(工學的) 특성(特性)에 관(關)한 실험적(實驗的) 연구(硏究))

  • Sung, Chan Yong;Yoo, Byong In;Kim, Kyung Tae;Jung, Hyun Jung;Kim, Young Ik
    • Korean Journal of Agricultural Science
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    • v.24 no.2
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    • pp.207-217
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    • 1997
  • This study was performed to evaluate the engineering properties of rice-husk ash concrete using normal portland cement, natural aggregates and rice-husk ash. The following conclusions were drawn; 1. The unit weight was in the range of $2,216{\sim}2,325kgf/m^3$, the weights of those concrete were decreased 1~6% than that of the normal cement concrete, respectively. 2. The highest strength was achieved by 10% rice-husk ash filled rice-husk ash concrete, it was increased 8% by compressive strength, 17% by tensile strength and 18% by bending strength than that of the normal cement concrete, respectively. 3. The ultrasonic pulse velocity was in the range of 3,252~4,016 m/s, which was showed about the same compared to that of the normal cement concrete. The highest ultrasonic pulse velocity was showed by 10% rice-husk ash filled rice-husk ash concrete. 4. The dynamic modulus of elasticity was in the range of $242{\times}10^3{\sim}306{\times}10^3kgf/cm^2$, which was showed about the same compared to that of the normal cement concrete. The highest dynamic modulus was showed by 10% rice-husk ash filled rice-husk ash concrete. 5. The static modulus of elasticity was in the range of $185{\times}10^3{\sim}275{\times}10^3kgf/cm^2$, which was showed about the same compared to that of the normal cement concrete. The poisson's number of rice-husk ash concrete was less than that of the normal cement concrete. The dynamic modulus was increased approximately 11~30% than that of the static modulus. 6. The durability was increased with increase of the content of rice-husk ash. The durability was increased 1.3 times by 10% rice-husk ash, 1.6times by 20% rice-husk ash filled concrete than that of the normal cement concrete. respectively.

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Study the impact on job satisfaction in the care facility of the empowerment of the members of the organization (요양시설의 조직구성원의 임파워먼트가 직무만족에 미치는 영향에 관한 연구)

  • Kim, Chang-Tae;Gwak, Gyeong-Ja
    • Management & Information Systems Review
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    • v.31 no.4
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    • pp.57-82
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    • 2012
  • The purpose of the study is to suggest the measure for the improvement of job satisfaction and level of empowerment of sanatoriums' social workers by analyzing factors of empowerments' effect on the job satisfaction, and investigating level of empowerment and job satisfaction of social workers of sanatoriums for the elderly and the handicapped. The result of investigation and analysis on subjects of 420 social workers of sanatoriums for the elderly and the handicapped in Youngnam area for this is as follows: First, job characteristic that is empowerments' influence factor of sanatoriums' social workers is appeared in order of feedback, and function variety, and in organization characteristic is appeared in order of leadership, reward, and employee development. Second, level of empowerment that is recognized by sanatoriums' social workers is appeared a little higher than normal level and significance is appeared highest, and next are capability, self-determination ability, and influence. Third, features that showed significant difference with significance in general characteristic of sanatoriums' social workers were 'sex', 'marital status', and 'religion', and features that showed significant difference with capability were sex, age, marital status, academic background, and employment history. And features that showed significant difference with self-determination ability were sex, age, marital status, and employment history, and features that showed significant difference with influence were sex, age, employment history and types of facilities. Fourth, the whole average of job satisfaction of sanatoriums' social workers was 3.82 out of 5, which is generally high, features that showed significant difference statistically were age, marital status, academic background, employment history, and types of facilities. Thus, job satisfaction was appeared as high as 'more than age of thirty' in age, 'married' in marital status, 'under graduates of colleges' in academic background, and 'less than three years' in employment history. Fifth, as for factors that had influence on job satisfaction, the indirect effect with empowerment was appeared that had significant effect in organization characteristic, and had few effect in organization features. On these results, practical measures to increase job satisfaction of sanatoriums' social workers are as follows: First, political approach is required to standardize duty system(by various types of facilities and clients' characteristic) of social workers of sanatoriums for elderly and the handicapped, and help to do the role as professionals with giving better treatment and building self-respect by enough reward. Second, to suggest chances to perform the responsibility for the duty of the scenes by the regular supervision, establish regular supervision system of social workers of sanatoriums for the elderly and the handicapped, and the extension of duty to increase the functional varieties. Third, it is required to motivate to have self confidence for the work and to use potential ability with transforming leadership, and to have more chances of education for the self-development. To increase job satisfaction of sanatoriums' social workers who give direct services in sanatoriums for the elderly and the handicapped, more active and positive empowerment's level improvement is in need by improvement of empowerment for them.

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A Case Study on High and Low Performance Areas for Family Planning (가족계획 우수.부진지역 사례연구)

  • 홍성열;김태일
    • Korea journal of population studies
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    • v.4 no.1
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    • pp.105-130
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    • 1981
  • This study was conducted to compare the characteristics of high performane areas for family planning with that of low performance areas and to find factors which strongly affected contraceptive practice behavior. For the study, eight areas were selected from 274 rural family planning canvassing areas of Korean Population Policy and Program Evaluation Study, which was an action study operated in all areas of Cheju Island from July 1, 1976 until December 31,1979. As a first step of the action study, Cheju Island was devided up 318 family planning canvasser areas Each area was consisted of 200 households in rural district and 300 households in urhan one Duriog the period of project, each canvassing area had been managed by a female family planning canvasser, selected by director of health center considering several individual conditions needed for family planning activities Basic activities of canvassers were to counsell all the eligihie couples in own charged area about family planning methods and also to distribute contraceptives such as condoms and oral pills. In case couples desire to accept sterilization including vasectomy and tubal-ligation, the canvassers played a linking role connecting potential client with family planning field workers. Canvassng areas shows significant differentce in performance for family planning, nevertheless they are supposed to have almost the same conditions regarding family planning distribution channel. Because the purpose of the Cheju project was to eliminate all the problems that existed in governmental distribution system, that is to remove geographic, economic, cognitive and administrative barriers Accumulated performances of family planning methods accepted by residents in each area were calculated by eligible women aged 14-49. And then canvassing areas were ranked according to performance score. Consequently, 4 areas in extremely high and low family planning performance areas were selected respectively. Major results were obtained by comparing characteristics of high performance area with that of low performance areas, which are as follows: 1. The mean number of living children was about the same both in high and low performance areas for family planning. But respondents' mean age (38.5) in high performance areas was higher than that (37.0) in low performance areas 2. Respondents' perception in the expectant educational level of others' children in high performance areas was higher than that in low performance areas, although respondents educational level, monthly expenditure and ratio of children in high school and above was not different. 3. Ratio of ownerships of TV and newspaper in high performance areas was highen than that in low performance areas 4. The duration of canvasser' charge in high performance areas was longer than that of low performance areas, showing the fact that canvassers didn't move cut in high performance areas 5. In high performance areas, canvassers' houses were relatively located in the center part of the village. And so villagers resided in near distances from the anvasser's house 6. 4H clubs' activities in high performance areas were more active than those in low performance areas Therefore it was assumed that cohesiveness of community in high performance areas were stronger than that in low areas. 7. Canvassers' family planning practice rate was higher than that in low performance areas, and also canvassers' human relationship was more sociable than that of canvassers in low performance areas. 8. Fourteen variables which showed relatively high significance level in $X^2$ and F test were selected as independent variables for stepwise regression analysis. According to the results of regression analysis. five of 14 variables-distributors education level ($R^2$=.4439), duration of distributor's charge ($R^2$=.6166), 4H club activities ($R^2$=.6697), canvasser's contraceptive practice ($R^2$=.7377) and location of distributions house ($R^2$=.8010) explained 80.1 percent of total variance.

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A Study on the Gene Expression of Adipogenic Regulators by an Herbal Composition (생약복합물에 의한 지방세포형성 조절자의 유전자 발현 연구)

  • Lee, Hae-Yong;Kang, Ryun-Hwa;Bae, Sung-Min;Chae, Soo-Ahn;Lee, Jung-Ju;Oh, Dong-Jin;Park, Suk-Won;Cho, Soo-Hyun;Shim, Yae-Jie;Yoon, Yoo-Sik
    • Journal of Life Science
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    • v.20 no.5
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    • pp.729-735
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    • 2010
  • In our previous study, it was reported that an herbal mixture, SH21B, inhibits fat accumulation and adipogenesis both in vitro and in vivo models of obesity. SH21B is a mixture composed of seven herbs: Scutellaria baicalensis Georgi, Prunus armeniaca Maxim, Ephedra sinica Stapf, Acorus gramineus Soland, Typha orientalis Presl, Polygala tenuifolia Willd, and Nelumbo nucifera Gaertner (Ratio 3:3:3:3:3:2:2). The aim of this study was to investigate the detailed molecular mechanisms of the effects of SH21B on various regulators of the adipogenesis pathway. During the adipogenesis of 3T3-L1 cells, SH21B significantly decreased the expression levels of central transcription factors of adipogenesis, such as peroxisome proliferator-activated receptor (PPAR)$\gamma$ and CCAAT/enhancer binding protein (C/EBP)$\alpha$. To elucidate the detailed molecular mechanism of the anti-adipogenic effects of SH21B, we examined the expression levels of the various pro-adipogenic or anti-adipogenic regulators of adipogenesis upstream of $PPAR{\gamma}$ and C/$EBP{\alpha}$. The mRNA levels of Krox20 and Kruppel-like factor (KLF) 15, which are pro-adipogenic regulators, were significantly down-regulated by SH21B treatment, whereas the mRNA levels of C/$EBP{\gamma}$ and KLF5 were not changed. KLF2 and C/EBP homologous protein (CHOP), which are anti-adipogenic regulators, were significantly up-regulated by SH21B treatment. These results suggest that the molecular mechanism of the anti-adipogenic effect of SH21B involves both the down-regulations of pro-adipogenic regulators, such as Krox20 and KLF15, and the up-regulations of anti-adipogenic regulators, such as KLF2 and CHOP, which results in the suppression of central transcription factors of adipogenesis including $PPAR{\gamma}$ and C/$EBP{\alpha}$.