• Journal of Hospice and Palliative Care
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• v.26 no.2
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• pp.95-100
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• 2023

With the implementation of Act on Hospice and Palliative Care and Decisions on Life-Sustaining Treatment for Patients at the End of Life, interests of the general public on self-determination right and dignified death of patients have increased markedly in Korea. However, "self-determination" on medical care is misunderstood as decision not to sustain life, and "dignified death" as terminating life before suffering from disease in terminal stage. This belief leads that physician-assisted suicide should be accommodated is being proliferated widely in the society even without accepting euthanasia. Artificially terminating the life of a human is an unethical act even though there is any rational or motivation by the person requesting euthanasia, and there is agreement thereof has been reached while there are overseas countries that allow euthanasia. Given the fact that the essence of medical care is to enable the human to live their lives in greater comfort by enhancing their health throughout their lives, physician-assisted suicide should be deemed as one of the means of euthanasia, not as a means of dignified death. Accordingly, institutional organization and improvement of the quality of hospice palliative care to assist the patients suffering from terminal stage or intractable diseases in putting their lives in order and to more comfortably accept the end of life physically, mentally, socially, psychologically and spiritually need to be implemented first to ensure their dignified death.

• Korean Journal of Adult Nursing
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• v.24 no.6
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• pp.647-658
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• 2012

Purpose: This study was to analyzed the types of subjectivity that elderly who live alone caregivers have about the lonely death. Methods: This study objectified the subjective area by applying the Q methodology. It studied 24 caregivers in H region, who responded to 34 Q sample statements. The method of forced distribution was practiced regarding the results on a 9 points Q sample distribution chart. The collected data was analyzed using PC QUANL program. Results: The caregivers' perception of lonely death has been classified into four types: Type 1 ('type of fate-receptive invitation of lonely death'), Type 2 ('type of afterlife-expectantly invitation of lonely death'), Type 3 ('type of death preparation invitation of lonely death'), and type 4 ('type of rejection of lonely death due to attachment with life'). Conclusion: The present study attempts to provide basic resources for the development of nursing-intervention program to solve the problems with lonely death by grasping and understanding the types of the caregivers' perception of lonely death through which it also aims to yield information necessary to improve the quality of life in their remaining years.

• Journal of Korean Academy of Nursing
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• v.31 no.2
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• pp.279-291
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• 2001

Rapid progress in modern medical technology has made it possible to sustain life and/or delay death using 'heroic' treatments. The availability of life-sustaining treatment brings several issues in end-of-life care such as 'dying with dignity' and an radical increase in health care costs. The use of Advance Directives(AD) have been widely heralded by health care providers, gerontologists, and advocacy groups as means of protecting patients' right to accept or refuse life-sustaining treatment in end-of-life care. The use of AD can not only improve patients' autonomy and quality of life but also bring efficiency in distributing health care resources. The proportion of older persons in Korean population has been increasing. Those 65 years of age or over were about 7 percent of the population. Death and dying is not limited to older persons, but it is more prevalent among them. In conjunction with an aging population and the increasing prevalence of death, the issues of death and dying will become crucial in near future in terms of 'dying with dignity', 'autonomy', and 'self-control'. This paper attempts to explode and establish the concept of advance directives (AD) based on literature review. Data sources are computer searches with the MEDLINE database. Due to the lack of prior study on AD for a Korean cases, studies abroad are reviewed. This paper suggests the need for future study on the possibility of the use of AD in Korea.

• Journal of Hospice and Palliative Care
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• v.13 no.3
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• pp.169-180
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• 2010

Purpose: This study was to identify the death recognition, meaning in life, and death attitude of participants in the death education program. Methods: A survey was conducted, and 205 data were collected. Descriptive statistics, ${\chi}^2$-test, ANOVA, and Duncan test were used. Results: 1) The followings were the characteristics of death recognition shown by the participants. Over half of the participants said that they had given some thoughts on their deaths, that they had agreeable view on death acceptance, and that diseases and volunteer works made them think about their deaths. Moreover, suffering, parting with family and concerns for them, etc. were the most common reasons for the difficulty of accepting death. As for 'the person whom I discuss my death with', spouse, friend, and son/daughter were the most chosen in this order. Lastly, the funeral type that most of the participants desired was cremation. 2) The means of meaning in life and death attitude were $2.92{\pm}0.29$ and $2.47{\pm}0.25$, respectively. There were significant differences between health status, meaning in life and death attitude. 3) A significant positive corelationship was found between meaning in life and death attitude (r=0.190, P=0.001). Conclusion: For an effective death education program that would fit each individual's situation, an educational content that can make a person understand the meaning of his or her life and death, includes knowledge to lessen the fear and anxiety of death, and helps a person heal from the loss of a family member is absolutely necessary.

• Korea journal of population studies
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• v.13 no.1
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• pp.3-25
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• 1990

Life table of Korean population for years 1983 1985 1987 and 1989 were constructed byt the National Bureau of Statics. The ago specific death rates were calculated froom the death registral ion for numerators and the estimated population by age and sex for denominators. In the course of constructing life tables, we have maole some adjustments for deficiencies in regist rat ion olata as follows. First, the non-registered portion oof infant deaths especially for neo-natal deaths was estirnateol and added too the original data. The main reason is that deaths occorring in the neo-natal period and prior to the registrat ion of birth leave little incentive for the registration of either the birth or the death. Second. t he do~hayed p(ortioon of deaths registering after one year of occurrence was estimated and added too the original data. Third t the ptortioon haying in, occuracies in ,~oge reporting was also estimated. Fourth the moving average methood was finally employed in an effort too remove the random error. The major fin(hings are as foolloows. 1. the average life expectancy at birth in 1989 is calculateol as 70.8 years in 1989, 2. a gap netween the male and female life expectancies is widened to more than 8 years toorm 1.8 years in 1906 10. It means that the female life expectancy has increased substantially, 3. the death rates of the middle - aged men starting age 40 are found to he relatively higher than those of females and younger age groups. This peculiar pattern was also found with the comparison of those of other countries.

• BMB Reports
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• v.37 no.2
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• pp.192-198
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• 2004

The hepatitis C virus (HCV) core protein is believed to be one of viral proteins that are capable of preventing virus-infected cell death upon various stimuli. But, the effect of the HCV core protein on apoptosis that is induced by various stimuli is contradictory. We examined the possibility that the HCV core protein affects the ceramide-induced cell death in cells expressing the HCV core protein through the sphingomyelin pathway. Cell death that is induced by $C^2$-ceramide and bacterial sphingomyelinase was analyzed in 293 cells that constitutively expressed the HCV core protein and compared with 293 cells that were stably transfected only with the expression vector. The HCV core protein inhibited the cell death that was induced by these reagents. The protective effects of the HCV core protein on ceramide-induced cell death were reflected by the reduced expression of $p21^{WAF1/Cip1/Sid1}$ and the sustained expression of the Bcl-2 protein in the HCV core-expressing cells with respect to the vector-transfected cells. These results suggest that the HCV core protein in 293 cells plays a role in the modulation of the apoptotic response that is induced by ceramide. Also, the ability of the HCV core protein to suppress apoptosis might have important implications in understanding the pathogenesis of the HCV infection.

• Journal of Industrial Convergence
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• v.22 no.5
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• pp.107-116
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• 2024

This study is a descriptive research study to determine the extent to which end-of-life care stress, death awareness, and prior decision-making attitudes of nurses at a hospice and palliative nursing institution have an impact on end-of-life care performance. The subjects of this study were 200 nurses working at a hospice and palliative nursing institution. Data collection for this study was conducted from August 9 to September 30, 2021, using two methods: written questionnaire and internet survey. The data analysis method used Pearson's correlation coefficient to analyze the relationship between the subjects' end-of-life care stress, death awareness, prior decision-making attitude, and end-of-life care performance. Hierarchical Regression was used to identify factors affecting the subject's end-of-life care performance. The results of this study showed a significant correlation between end-of-life care performance and death awareness (r=.22, p=.002), and end-of-life care performance and prior decision-making attitude (r=.20, p=.004). And prior decision-making attitude and death awareness had a significant impact on end-of-life care performance. As death awareness and prior decision-making attitudes increased, end-of-life care performance increased, and end-of-life care stress did not appear to be a statistically significant factor influencing end-of-life care performance. In order to improve hospice nurses' ability to provide end-of-life care, intervention that takes into account the influencing factors is required.

• The Korean Society of Law and Medicine
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• v.23 no.2
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• pp.67-96
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• 2022

"Aid in Dying" means that when a decision-making patient suffers from an incurable disease, a drug that can speed up death is prescribed by a doctor and used to lead to death. Since the suspension of life-sustaining treatment was institutionalized based on human dignity and patient autonomy, the question of whether assisted death can be legally justified in relation to the right to receive medical help to shorten one's life to die with dignity has recently been actively discussed. In Korea, since the suspension of life-sustaining treatment was institutionalized by the enactment of the Life-sustaining Treatment Decision Act in 2016, an amendment to the Life-sustaining Treatment Act was recently proposed to legalize Aid in Dying. The global trend is that human "Right to Die" is discussed in the division of life and death, from the suspension of life-sustaining treatment to assisted death, and again in the order of euthanasia. In this paper, we started discussing dignified death and institutionalized patients' right to self-determination, looked at the controversy in the United States, which legislated assisted death in many states since the 2000s, and analyzed the main contents of California's End of Life Option Act and the data after enforcement. The strict requirements for Aid in Dying, such as voluntary confirmation of patients' intentions and doctors' obligation to provide information, and the results of California's Aid in dying system, composed of relatively diverse races, were reviewed.

• Journal of the Korean Society of School Health
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• v.19 no.1
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• pp.1-15
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• 2006

Purpose : This study was to identify the incidence, trend, and situation of the unexpected sudden death of elementary, middle, and high school students in school for 17 years from 1988 to 2004 in seoul. Methods : We used the data of The Seoul Safety Mutual aid Association in seoul. Subjects were 53 unexpected sudden death in school from elementary, middle, and high school students, and we explored the gender, month, a day of the week, year, contents of situation, and medical certificate of death. Statistic analysis were chi-square test, Cochran-Armitage trend test, and the tool was SAS 9.1.Results : There were 53 unexpected sudden death students(male 42 and female 11). The incidence of male students was higher than that of female during 16 years except in 1995. The incidence occurred in middle school students were 31 (58.5%) of 53 and were also most frequent in middle school students in both of male and female students. In 1990, the incidence was 8(15.1%) students, 6(11.3%) in 1992 , and 5(9,4%) in 2000 respectively. The frequency of unsuspected sudden death in March was 11(20.8%) of 53 students, 11 (20.8%) in September, 7(13.2%) in October. In Thursday, it was 12(22.6%) of 53 students. Only 14(26.4%) students of 53 died during general life, but 39(73.6%) were related to excercise. The diagnosis of 14 students died during general life were cardiac arrest 7(50.5%), brain disorder 3(21.4%) which were based on medical certificate. But the diagnosis of 39 students died during or after excercise were brain disorder including cerebral hemorrhage 9(23.1%), heart disease 9(23.1%), cardiac arrest 8(20.5%), and unknown 6(15.4%), respectively. Conclusion : The incidence of unexpected sudden death were more frequent in male students, in middle school, and in excercise-related situation and the trend was similar for 17 years. Therefore, to prevent the unexpected sudden death, it needs to further study substantially the risk factors of unexpected sudden death including past history, life-style, nutrition and development, family history, and learning environment.

• Child Health Nursing Research
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• v.25 no.1
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• pp.38-47
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• 2019

Purpose: The purpose of this study was to investigate the influence of perceptions of death, end-of-life (EOL) care stress, and emotional intelligence on attitudes toward EOL care among nurses in the neonatal intensive care unit (NICU). Methods: The participants were 111 nurses working in a NICU who had experienced EOL care at least once. Data were analyzed using the t-test, Pearson correlation coefficient, and stepwise multiple regression analysis in SPSS for Windows. Results: The mean score for perceptions of death was 3.16 out of 5, the mean score for EOL care stress was 3.61 out of 5, the mean emotional intelligence score was 4.66 out of 7, and the average score for EOL care attitudes was 2.77 out of 4. The factors affecting attitudes towards EOL care were academic degree, anxiety regarding death, negativity towards death, experiences of patient death, and emotional intelligence. The explanatory power of these variables for attitudes towards EOL care was 24.7%. Conclusion: The results of this study are expected to serve as a basic reference for the development of nursing education programs and EOL care protocols to improve attitudes toward EOL care among NICU nurses.