• Journal of Hospice and Palliative Care
• /
• 제23권3호
• /
• pp.126-138
• /
• 2020

Purpose: In Korea, since the Act on Hospice and Palliative Care and Decisions on Life-Sustaining Treatment for Patients at the End of Life was implemented in February 2018, advance directives (ADs) have become legally effective and should be documented after sufficient explanation by a registered counselor. However, little is known regarding the adequacy of current AD counseling. This qualitative study aimed to explore the barriers to AD counseling based on counselors' experiences. Methods: We conducted focus group interviews using purposive sampling. Seven counselors working at hospitals, community health institutions, and non-profit organizations participated in this study. They were asked about the challenges and problems they encountered during AD counseling. Results: Three themes emerged from this study; 1) issues regarding consistency in AD counseling, 2) issues regarding AD counselors' competency and work environment, and 3) issues regarding the adequacy of the service system. The interviewees stated that the lack of a manual for standardized service made AD counseling inconsistent. The limited competency and poor work environment of counselors were pointed out as major barriers. The interviewees also stated that a proper service system considering individual circumstances is absent. Conclusion: The goals of AD counseling should be clarified and guidance should be implemented for providing standardized services. Further efforts to enhance the competency of AD counselors and to improve their working conditions are needed. Establishing an integrated framework for an adequate service system is also essential to overcome systematic barriers to AD counseling.

• Journal of Genetic Medicine
• /
• 제5권2호
• /
• pp.89-93
• /
• 2008

"Personalized medicine," the goal of which is to provide better clinical care by applying patient's own genomic information to their health care is a global challenge for the $21^{st}$ century "genomic era." This is especially true in Korea, where provisions for clinical genetic services are inadequate for the existing demand, let alone future demands. Genomics-based knowledge and tools make it possible to approach each patient as a unique biological individual, which has led to a paradigm-shift in medical practice, giving it more of a predictive focus as compared with current treatment oriented approach. With recent advancements in genomics, many genetic tests, such as susceptibility genetic tests, have been developed for both rare single gene diseases and more common multifactorial diseases. Indeed, genetic tests for presymtomatic individuals and genetic tests for drug response have become widely available, and personalized medicine will face the challenge of assisting patients who use such tests to make appropriate and wise use of genetic risk assessment. A major challenge of genomic medicine lies in understanding and communicating disease risk in order to facilitate and support patients and their families in making informed decisions. Establishment of a health care system with provisions for genetic counseling as an integral part of health care service, in addition to genomic literacy of health care providers, is vital to meet this growing challenge. Realization of the promise of personalized medicine in the era of genomics for improvement of health care is dependent on further development of next generation sequencing technology and affordable sequencing test costs. Also necessary will be policy development concerning the ethical, legal and social issues of genomic medicine and an educated and ready medical community with clinical practice guidelines for genetic counseling and genetic testing.

• 대한지역사회영양학회지
• /
• 제28권6호
• /
• pp.480-494
• /
• 2023

Objectives: This study sought to assess the effectiveness of community-based nutrition counseling on improving nutritional status, managing complex chronic diseases, and enhancing the quality of life for elderly individuals with chronic conditions, particularly in older adults with high levels of food insecurity and multiple chronic illnesses. Methods: Thirty elderly subjects with diabetes and hypertension who were registered at local Senior Welfare Center received individualized nutrition counseling, based on their Nutrition Quotient for the Elderly (NQ-E) index. Over a 16-week period, they received tailored counseling and underwent various health and nutritional assessments. The final analysis included 28 participants after two dropped out. Data analysis was conducted using the SPSS v28.0. Results: The subjects were over 70, with multiple chronic diseases including diabetes and hypertension and predominantly female. After 16 weeks, significant improvements were observed in the subjects' grip strength, and HbA1c levels, as well as in their NQ-E scores, indicating improved dietary balance and diversity. There were no significant improvements in the 'Moderation' subdomain of the NQ-E index, suggesting that this aspect requires further attention in nutritional counseling. The subjects' nutritional risk scores (NSI) were also significantly decreased, indicating less nutritional risk. Lastly, as measured by the SF-36K, the subjects' quality of life showed significant improvement in several domains including physical role performance and social function. Conclusions: This study demonstrates that tailored nutrition counseling, based on the NQ-E index, can improve elderly health, manage chronic diseases, and enhance quality of life. This approach potentially broadens the scope of community nutritionists' roles within an aging society. However, additional research is necessary to evaluate these interventions' long-term effects and sustainability.

• 여성건강간호학회지
• /
• 제12권2호
• /
• pp.87-96
• /
• 2006

Purpose: This study was conducted to provide fundamental information for a system establishment of advanced practice nursing for gynecological cancer patients (APN-GCP). Method: Data was collected by focus group and individual interviews and analyzed in the framework of the Grounded theory method mapped by Strauss and Corbin (1990). There were 13 subjects in this study (nurses, doctors, patient and her family). Result: We identified 87 concepts, 22 sub-categories, and 10 categories. Categories for role expectation were arrangement of diagnosis and treatment process, giving information of treatment course, support of treatment process, patients' right toward making a decision of treatment, counseling and teaching after discharge from hospital, medical insurance and financial problems, counseling about sexual problems and use of family and community resources. All subjects perceived the necessity of an APN-GCP. An APN-GCP requires over 2$\sim$7 years clinical experience and a master's degree. Services would be performed from initial registration to termination of treatment or death, and accomplished on an outpatient clinic basis. Conclusion: The nursing delivery system and curriculum should be developed for a women's health nurse practitioner including APN-GCP. As a further step, cost-effectiveness and projected estimation of manpower of APN-GCP should be studied in the future.

• 대한간호학회지
• /
• 제42권7호
• /
• pp.1095-1104
• /
• 2012

Purpose: The purpose of this study was to investigate the contribution of actual cardiovascular disease (CVD) risk, as well as, individual, psychosocial, and work-related factors as predictors of CVD risk perception among Korean blue-collar workers. Methods: The participants were 238 Korean blue-collar workers who worked in small companies. Data were collected through a survey; anthropometric and blood pressure measures; and blood sampling for lipid levels. Results: Blue-collar workers had high actual CVD risk and low CVD risk perception. The significant predictors of risk perception included perceived health status, alcohol consumption, knowledge of CVD risk, actual CVD risk, decision latitude, and shift work. The model explained 26% of the variance in CVD risk perception. Conclusion: The result suggests when occupational health nurses are giving routine health examination in small companies, they can enhance CVD risk perception in blue-collar workers by providing essential information about CVD risk factors and personal counseling on the individual worker's CVD risk status.

• 스트레스연구
• /
• 제26권4호
• /
• pp.277-289
• /
• 2018

본 연구는 일반인이 경험하는 일상우울 상태를 손쉽게 판단할 수 있는 개인선별용 검사를 제작하고 신뢰도와 타당도를 조사하는데 목적이 있다. 이를 위해 원척도인 일상우울 집단연구용 척도(17문항)를 바탕으로 5문항으로 된 단축형 척도를 개발하였다. 연구 결과, 집단연구용 척도와 단축형 척도 간 상관은 .94로 높았으며, 검사-재검사 신뢰도(60일 이내 .73) 또한 양호한 수준이었다. 검사의 내적 구조는 1요인으로 확인되었다. 끝으로 기준점수를 구하였는데, 단축형 5개 문항의 총점이 18점 이상이면 일상우울 수준을 넘어 역기능우울의 가능성이 있으므로 역기능우울척도를 실시하는 것을 권고한다.

• 지역사회간호학회지
• /
• 제32권1호
• /
• pp.107-115
• /
• 2021

Purpose: The purpose of this study is to identify factors associated with smoking relapse within six months after quit attempts among workers in small and medium-sized enterprises in South Korea. Methods: The analysis was conducted for a total of 194 people who attempted to quit smoking by applying for a smoking cessation support service at the Regional Tobacco Control Center. The data used in the study were extracted from the Smoking Cessation Service Integrated Information System. Kaplan-Meier estimator and Cox proportional hazards regression model were used to identify variables associated with smoking relapse within six months' time period. Results: Smoking relapse rate within six months was 66.0%, and variables associated with relapse included the cases such as carbon monoxide (CO) at the time of registration (HR: 2.15, 95% CI: 1.10~4.22 for CO ≥20 ppm or more vs.CO <10 ppm), the average number of cigarettes smoked per day (HR: 1.04, 95% CI: 1.00~1.07), and the number of counseling(HR: 0.60, 95% CI: 0.54~0.67). Conclusion: Smoking characteristics and counseling showed one of the strongest correlations with relapse within six months. This implies that it is necessary to understand the smoking characteristics and patterns of workers and to provide continuous smoking cessation counseling tailored to individual characteristics for effective smoking relapse prevention.

• Journal of Nutrition and Health
• /
• 제22권4호
• /
• pp.275-289
• /
• 1989

The purpose of this study is to develop a computer system with data file and computerized programs for nutrition counseling. In this research, a 16 / XT personal computer (word : COBOL) compatible with IBM-PC/XT was used. Computer system developed for this study was as follows: Data files(food composition list, food exchange list, nutrition management comment, special diet therapy) were used for analysis the nutritional status and the ntrition education comment. (1) Programs for the nutritional status assessment 1) General information a) Name, age, sex, higher, weight, activity, disease and special diet b) Ideal body weight and Obesity assessment(Kaup index and Broca index) c) Rest and athletics status d) Biochemical data comparision with standard 2) Food Intakes 3) Nutrient Intakes a) Comparison of the amounts intaked with the recommended dietary allowances for present weight. b) Comparison of the energy composition rate intaked with the recommended dietary allowances for present weight. b) Comparison of the energy composition rate intaked with the recommended for present weight and ideal weight. c) Nutrient analysis by each meal and snack. 4) Food intakes from each food group and comparison with recommended 5) Special nutrient analysis. (2) Programs for the nutrition education based on nutritional status assessment. 1) Suggestion of number of food exchange group 2) Nutritional assessment and advise comments 3) Nutritional management comments 4) Special diet therapy In the study, the nutritioal status and nutrition education comments are based on individual data from nutrition counseling.

• Tuberculosis and Respiratory Diseases
• /
• 제82권1호
• /
• pp.1-5
• /
• 2019

Quitting smoking helps smokers maintain their health and extend their lifespan by 10 or more years. Treatment strategies for smoking cessation should be tailored to individual smokers with special needs based on their specific circumstances. It is recommended that pregnant women adopt smoking cessation through counseling and behavioral interventions because the safety of medications has yet to be established. Counseling is the main strategy for smoking cessation in adolescents and nicotine replacement therapy can be used with caution in individuals with serious nicotine dependence. It is important for smokers with psychiatric diseases to quit smoking following accurate assessment of their depression status. Nicotine replacement therapy, varenicline, and bupropion can be used for smoking cessation in smokers with psychiatric disorders. The incidence of cardiovascular disease decreased according to the smoking status and the duration of smoking cessation. In smokers with chronic obstructive pulmonary disease (COPD) who used a combination of counseling and pharmacotherapy the quitting rate was more than twice as high as subjects who used behavioral interventions alone. Varenicline can be used as the most effective anti-smoking drug by most smokers including those with psychiatric disorders, cardiovascular disease, and COPD.

• 한국학교ㆍ지역보건교육학회지
• /
• 제23권4호
• /
• pp.63-79
• /
• 2022

Objectives: The purpose of this study is to reveal the phenomenological meaning and experience of alcohol craving experienced by alcoholics through qualitative research. Methods: From November 8, 2020 to October 10, 2022, in-depth interviews were conducted with four recovering alcoholics within two years of a single week who were diagnosed with alcoholism in the past and had been hospitalized for alcoholism problems. The data were analyzed using phenomenological qualitative research methods. Results: The alcohol craving experienced by alcoholics worked in connection with the life of alcoholics. Alcohol intensity was not entirely determined by external factors, but varied by the individual's internal state and circumstances surrounding the individual, and cravings were found to be classified into when control and intervention were possible. Also, the power to neutralize alcohol cravings was a warm 'self-compassion' mind. Conclusion: This study presented a new perspective on alcohol craving, and based on this perspective, the necessity of developing an alcohol addiction prevention program and a recurrence prevention program was presented. In addition, the basis for emphasizing the necessity of complete abstinence in health education services for preventing alcohol and preventing recurrence in the community was presented.