• Journal of Hospice and Palliative Care
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• v.25 no.2
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• pp.76-84
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• 2022

Purpose: We compared cost-effectiveness parameters between inpatient and home-based hospice-palliative care services for terminal cancer patients in Korea. Methods: A decision-analytic Markov model was used to compare the cost-effectiveness of hospice-palliative care in an inpatient unit (inpatient-start group) and at home (home-start group). The model adopted a healthcare system perspective, with a 9-week horizon and a 1-week cycle length. The transition probabilities were calculated based on the reports from the Korean National Cancer Center in 2017 and Health Insurance Review & Assessment Service in 2020. Quality of life (QOL) was converted to the quality-adjusted life week (QALW). Modeling and cost-effectiveness analysis were performed with TreeAge software. The weekly medical cost was estimated to be 2,481,479 Korean won (KRW) for inpatient hospice-palliative care and 225,688 KRW for home-based hospice-palliative care. One-way sensitivity analysis was used to assess the impact of different scenarios and assumptions on the model results. Results: Compared with the inpatient-start group, the incremental cost of the home-start group was 697,657 KRW, and the incremental effectiveness based on QOL was 0.88 QALW. The incremental cost-effectiveness ratio (ICER) of the home-start group was 796,476 KRW/QALW. Based on one-way sensitivity analyses, the ICER was predicted to increase to 1,626,988 KRW/QALW if the weekly cost of home-based hospice doubled, but it was estimated to decrease to -2,898,361 KRW/QALW if death rates at home doubled. Conclusion: Home-based hospice-palliative care may be more cost-effective than inpatient hospice-palliative care. Home-based hospice appears to be affordable even if the associated medical expenditures double.

• Journal of Hospice and Palliative Care
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• v.26 no.3
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• pp.145-148
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• 2023

Preserving dignity is a significant concern for individuals approaching the end of their lives, as they face an increasing number of conditions that can potentially compromise their dignity. This article discusses dignity therapy as one intervention method aimed at enhancing the psychological and spiritual well-being of patients with terminal illnesses. Dignity therapy is an empirically supported therapeutic intervention that interviews patients with nine questions about what is important to them and what they want to remember, culminating in the production of a document based on these conversations. This intervention serves as a valuable tool and framework, enabling clinical professionals to reflect on dignity. It also provides clinicians with a medium to connect with patients on a deeply human level.

• Journal of Hospice and Palliative Care
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• v.27 no.2
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• pp.82-86
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• 2024

Purpose: This study examined the quality of life (QoL) and quality of care (QoC) in inpatient hospice settings in Korea before and during the coronavirus disease 2019 (COVID-19) pandemic. Methods: Data were obtained from three institutions that participated in two prospective cohort studies. The primary outcomes measured were the QoL of patients with terminal cancer and their family caregivers (FCs), as well as the QoC as perceived by the FCs. Results: Multivariable regression analysis revealed that during the COVID-19 pandemic, both patients and FCs experienced better QoL than before the pandemic, and FCs reported a higher QoC. Conclusion: Health policymakers should consider our findings when planning for future pandemics.

• Journal of Home Health Care Nursing
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• v.19 no.2
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• pp.183-194
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• 2012

Purpose: The purpose of this study was to compare the quality of life(QOL) between middle-aged women and men. Method: In this study, we surveyed 482 middle-aged women and men living in Seoul aged between 40 and 64. Data were analyzed t-test, ${\chi}^2$-test, and 2-way ANOVA. Results: There was no significant difference between satisfaction and importance of the life of middle-aged women and men of the overall. However, while the case of middle-aged women showed a significant difference in the emotional support from people who are not family members, middle-aged men showed significant differences between the importance and satisfaction of the life with spouse, the ability to take care of family responsibilities, sex life, energy(fatigue), personal appearance, and pain. In addition, the overall quality of life scores showed no gender difference between the middle-aged women and men but in the quality of life both genders, the family area of the sub-area showed high scores. Conclusion: It is suggested that further repetitive studies for middle-aged women and men are needed by using the same tool of this study and various health promotion programs based on the result of this study should be developed for middle-aged.

• Journal of Korean Critical Care Nursing
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• v.12 no.1
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• pp.1-12
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• 2019

Purpose : It is widely accepted that addressing multiple symptoms together is the preferred approach in assessment and intervention and results in reduced negative patient outcomes. Yet, there are few studies examining symptom clusters and their impacts on quality of life longitudinally in patients after heart valve surgery. Methods: A total of 101 patients were recruited from a tertiary hospital and were administered questionnaires (at 3, 6, and 10 weeks after the surgery) assessing participants' characteristics, cardiac symptoms, and quality of life. Factor analysis was used to identify symptom clusters. Hierarchical multiple linear regression was used to predict quality of life. Results: Participants were predominantly 70-years old or more with a mean age of 64.34. The two symptom clusters at 3 weeks after the surgery with education, gender, and occupation accounted for 76.3% of variance in quality of life. Conclusion: Symptom clusters containing various physical and psychological symptoms in patients after the surgery affected quality of life, and the relationship was significant at 3 weeks after the surgery. Because symptom clusters were identified in all three recovery periods, nurses need to acknowledge these clusters, rather than each symptom separately, and to utilize these in providing care and education and in promoting quality of life in these patients.

• Korean Medical Education Review
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• v.22 no.3
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• pp.146-152
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• 2020

Hospice and palliative care (HPC) education is an essential component of undergraduate medical education. Since February 4th, 2018, withholding and withdrawing life-sustaining treatment at the end of life (EOL) has been permitted in Korea as put forth by law, the "Act on Hospice and Palliative Care and Decisions on Life-Sustaining Treatment for Patients at the End of Life." Therefore, Korean medical schools have faced a challenge in providing comprehensive HPC education in order to better prepare medical students to be competent physicians in fulfilling their role in caring for patients at the EOL. There have been considerable variations in the evolution and organization of HPC education across Korean medical schools for the past 20 years. In 2016, all medical schools taught HPC curriculum as a separate course or integrated courses, with the most frequently taught topics including: delivering bad news, pain management, and the concept of palliative medicine. However, the content, time allocation, learning format, and clinical skills practice training of HPC education have been insufficient, inconsistent, and diverse. For this reason, we propose a HPC curriculum containing seven domains with 60 learning objectives in a course duration of over 20 hours based on the Palliative Education Assessment Tool (PEAT) as standard HPC curriculum. Furthermore, we recommend development of a national curriculum for HPC/EOL care education to be organized by the HPC board and managed under the accreditation criteria of the Korea Institute of Medical Education and Evaluation.

• Korean Journal of Adult Nursing
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• v.20 no.1
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• pp.163-175
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• 2008

Purpose: This study aimed to define the relationship among self-care, symptom experiences, and health-related quality of life(HRQoL) according to the severity of disease in chronic obstructive pulmonary disease(COPD) patients. Methods: The participants, 195 COPD patients, were recruited at a pulmonology clinic of a universityaffiliated medical center in B metropolitan city. Inclusion criteria were patients who were diagnosed as COPD and had less than 0.7 of $FEV_1$/FVC(Forced Expiratory Volume for 1 second/Forced Vital Capacity) ratio. The severity was classified with GOLD(Global initiative for Obstructive Lung Disease) stages, $FEV_1%$ predicted value from mild to very severe. The data were gathered by the medical records and self-reported questionnaires. Results: The self-care, symptom experience, and HRQoL were all significantly different by COPD severity based on pulmonary function(p<.05). There were significant moderate negative relationships between symptom experiences and self-care(r=-.54, p<.001) and between symptom experiences and HRQoL(r=-.64, p<.001). There was a moderate positive correlation between self-care and HRQoL(r=.63, p<.001). Conclusion: It suggests that the assessment of disease severity based on pulmonary function and subjective symptom experience in patients with COPD may be a key component to develop a tailored self-management program and to improve their quality of life.

• Journal of Families and Better Life
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• v.33 no.4
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• pp.83-104
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• 2015

The purpose of this study is to provide diverse points of view to understand the low fertility issue of Korean society. For this phenomenological qualitative study, in-depth interviews were conducted with 14 married couples(28 persons) all raising three children. Participants were asked about overall family and work life, child care role performance, thoughts about child rearing, and their sociocultural context. Interview data were explored based on 6 analyzing steps offered by S, J, Talyor and R. Bogdan(1984). Most participants of this study were formed positive perceptions about having three children. Parents' positive perception was closely related with their attitude of not worrying too much about their children's future as well as child caring contexts around them. Parents' perception about having three children was also linked with their child care role construction process. In detail, parents with more positive perceptions tended to increase their level of child care involvement. This was particularly true for fathers. Mother and father's job situation emerged as an important factor to shape their child care involvement. In addition, child care attitude of people around them explained father's child care involvement. Applying these qualitative results, we first expect to provide detailed ideas about lives with three children in Korea. Second, based on our study findings, a more realistic and helpful policy to help the low fertility problem could be developed. Lastly, we also hope to provide helpful phenomenological qualitative research about low fertility issues of Korea.

• Journal of the Korean Dietetic Association
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• v.30 no.2
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• pp.125-139
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• 2024

This study assessed the beauty care behavior and the dietary attitudes, eating behaviors, and dietary quality related to beauty care in accordance with the level of interest in beauty care by examining 558 female high school subjects in the Incheon area. The study aimed to identify the interest in beauty care on the part of adolescent girls that impacts their dietary life and provide basic data for nutrition education forming desirable dietary habits. The interest in beauty care on the part of female high school students is relevant to dietary life and dietary attitude, with the high-level interest group attempting to use diet foods more frequently and attempting weight control because of their low satisfaction with their body type. On the other hand, a high level of interest in appearance failed to lead to the practice of a varied and balanced dietary life. Therefore, nutritional education is necessary to avoid a high level of interest in beauty care, leading to an incorrect perception of body shape and excessive weight control. Furthermore, nutrition education is necessary to link interest in appearance to the beauty of a healthy body based on nutritional balance by connecting the interest in appearance to a varied and balanced dietary life that goes beyond the category of practice.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.9
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• pp.6152-6159
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• 2015

The purpose of the study was to explore job stress, coping strategies and life satisfaction, and to identify related factors in long-term care workers. A cross-sectional study was used to study 111 long-term care workers in Gyeonggi-do. Questionnaires were given to the workers, and data were collected between 1 February and 30 March 2015. The data were analyzed using a stress scale, and a life-satisfaction index. The major findings were: 1) The type of facility was a significant factor in life satisfaction of long-term care workers (F=4.11, p=.020). 2) A statistically significant relationship existed between job stress(r=-.46, p<.001), coping strategies(r=.21, p=.040) and life satisfaction. 3) The results of the regression analyses showed that job stress, coping strategies, and type of facility were statistically significant in predicting the life satisfaction level of long-term care workers. The result of this study provides a better understanding of job stress, coping strategies, and life satisfaction in long-term care workers.