• Journal of Hospice and Palliative Care
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• v.15 no.4
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• pp.193-204
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• 2012

Purpose: This correlation study was performed to examine Korean adults' perceptions and attitudes towards death with dignity and the withdrawal of life sustaining treatment and to identify factors that predict their attitude towards death with dignity. Methods: The study was conducted using convenience sampling of 291 adults from three towns of a metropolitan city in Korea. Data were collected using structured questionnaires which surveyed people's perception about and attitudes towards withdrawal of life sustaining treatment and scaled their attitude towards death with dignity. Data were analyzed by using descriptive statistics, Pearson correlation coefficients and multiple regression. Results: The attitude towards the withdrawal of life sustaining treatment and death with dignity showed a significant positive correlation (r=0.49, P<0.001). For attitudes towards death with dignity, significant predictors were attitudes towards the withdrawal of life sustaining treatment, age, religion, a proper withdrawal process and advanced medical directives, which explained 49.3% of total variance. Conclusion: The results of this study may contribute to development of a new medical decision-making system including nurses' appropriate roles in the process of withdrawing life sustaining treatment and advanced medical directives.

• Journal of Preventive Medicine and Public Health
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• v.38 no.1
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• pp.9-15
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• 2005

Objectives : To analyze medical expenses by cancer site and survival time among cancer patients in their last year of life. Method : The study subjects were 45,394 people that had died of cancers in 2002, were registered by the Korea Central Cancer Registry and received National Health Insurance benefit in the last year (360 days) of life. Personal identification data, general characteristics, dates of death and cancer incidence, and site of cancer were collected from the National Statistical Office and the Korea Central Cancer Registry, and merged with the data of the individual medical expenses of the Health Insurance Review Agency. Results : Average monthly cost curves were U-shaped with high costs near the time of diagnosis and death, and lower costs in between. Medical expenses in the last year of life were around 30.3, 16.7, 13.0, and 12.1 million won among leukemia, lymphoma, ovarian cancer, and breast cancer patients, respectively. Digestive organ cancers including stomach, esophagus, liver, pancreas, and colorectal cancers had relatively low medical expenses. Medical expenses in the last year of life were inverse U-shaped with high expenses near one year of survival. Average monthly cost in the 12 months before death among the patients who had survived $10{\sim}15$ years were more than two-fold greater than the cost before diagnosis among those who had survived for less than one year. Conclusions : Leukemia was the most expensive cancer. It is possible that once diagnosed as cancer, medical expenses do not return to the level before diagnosis. Further research will be needed to understand the magnitude and change of the medical expenses among cancer patients with long term follow up data.

• Korean Journal of Social Welfare
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• v.62 no.4
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• pp.325-347
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• 2010

To provide a satisfactory life for the elderly females who are the most impoverished among the elderly social strata, this study is geared towards, and focused on, the exploration on their attitudes towards death. For the purpose of this study, in-depth interviews with females aged 65 and over, who are officially classified as the beneficiary of national fundamental livelihood security, have been conducted. Then, the results from these interviews have been compiled and analyzed through qualitative research methods. As a result of this research, the attitudes of the destitute elderly females towards death are categorized into several themes, such as 'Feeling close to the death through a hard life', 'Positive acceptance of the death', 'Relying on funeral services from government and religious organization', 'Hoping for a death with dignity'. The attitudes of death means to them that 'they can get out of a hard life', and elderly female beneficiaries were positive in their acceptance of this meaning. Those who could obtain funeral services as a part of assistance from government and a religious organization did not feel stressful about their funeral arrangements. However, there were individuals who didn't know if their funeral services would be covered by the government. They were unsure if a funeral service would be held for them, or they would have nobody to hold a funeral for them. Accordingly, they were worried about that. The poor elderly females were unhealthy and indigent, and so, they had death anxiety. Therefore, based on the study results above, some ideas regarding elderly welfare are proposed to enable poor elderly females to face their deaths with dignity.

• Journal of Hospice and Palliative Care
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• v.14 no.4
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• pp.204-211
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• 2011

Purpose: This study used a nonequivalent control group pre-post test design to analyze how a death preparation education program helps middle-aged adults deal with life and death anxiety. Methods: We studied 83 adults at the age of 40 to 65 years. An experimental group of 38 people participated in the death preparation education, and a control group of 45 people did not. The death preparation program comprising four sections was given for four hours per week, and the program ran for 11 weeks. Data were analyzed by descriptive statistics, t-test, ${\chi}^2$ test, Fisher's exact test, and ANCOVA using SPSS version 17.0. Results: The death anxiety score of the experimental group was significantly lower than that of the control group (P<0.000). The quality of life did not show significant difference between the experimental and control groups (P=0.188). Conclusion: It was confirmed that the death preparation education program is effective in alleviating death anxiety. Although the program was confirmed as a necessity for the middle-aged adults, repeated observations with a wider range of experimental group is needed to collect objective and solid data. Death preparation education for middle-aged adults is expected to be more widely provided, starting from local health facilities.

• The Research Journal of the Costume Culture
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• v.9 no.3
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• pp.398-411
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• 2001

Funeral rites relate to the last ceremonies involving the process of human beings moving from this world to the other world, becoming part of a life which remarkably reflects the world after death. They can be said to be the best culture created by the conception of death. The ceremonies of mourning, or ubiquitius folk phenomena of all the ages from the ancient times to modern times, represent the mass belief of each nation in spiritual worlds as well as the feelings of individuals facing death. In so far as their methods are concerned, the ceremonies vary in accordance with ages, nations, regions and culture. The practices of today\`s funeral rites conducted in the West have been formed and changed throughout its long history. Now that the ceremonies are a combination of complicated cultures, they serve as an important tool for inquiring into the spiritual life of the people of an age in question and the pictures of the society concerned. Therefore this paper is designed to look into the culture of shrouds showing respect for the dead in the West. With the view of examining death, and grave clothes for them, but also with the spiritual culture of human beings in relation to death represented in their pictures. I resort to literature and materials related to the shrouds of the dead which appeared in a period from the Medieval Age to the 19th century.

• 한국사회정책
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• v.25 no.1
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• pp.99-123
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• 2018

Purpose: This study empirically investigates the utilization and expenditure of health care and long-term care at the last year of life for long-term care beneficiaries in Korea. Methods: This study used National Health Insurance and Long-term Care Insurance claims data of 271,474 LTCI beneficiaries, who died from July 2008 to December 2012. Their cause of death, place of death, health care costs, and the provision of aggressive care were analyzed. Results: Cardio-vascular disease(29.8%) and cancer(15.3%) were reported as their major cause of death, and hospital(64.4%), home(22.0%), social care facility(9.2%) were analyzed as the place of death. 99.3% of subjects used both health care and long-term care during the last 1 year of life. The average survival period were 516.2 days after they were LTCI beneficiaries. The health care expenditure gradually increased near the death, and the last month were three times more rather than the first month. Furthermore, 31.8% experienced some aggressive cares(CPR, blood transfusion, hemo-dialysis, etc.) at the last month of life. Conclusion: The results of this study suggest that it is important to develop the end of life care policies(for example, hospice, advanced care directives) for the LTCI beneficiaries. They might contribute to the improvement of quality of life and the reduction of health care expenditure of the elderly at the end-of-life.

• BMB Reports
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• v.45 no.9
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• pp.496-508
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• 2012

Fas-associated protein with death domain (FADD), an adaptor that bridges death receptor signaling to the caspase cascade, is indispensible for the induction of extrinsic apoptotic cell death. Interest in the non-apoptotic function of FADD has greatly increased due to evidence that FADD-deficient mice or dominant-negative FADD transgenic mice result in embryonic lethality and an immune defect without showing apoptotic features. Numerous studies have suggested that FADD regulates cell cycle progression, proliferation, and autophagy, affecting these phenomena. Recently, programmed necrosis, also called necroptosis, was shown to be a key mechanism that induces embryonic lethality and an immune defect. Supporting these findings, FADD was shown to be involved in various necroptosis models. In this review, we summarize the mechanism of extrinsic apoptosis and necroptosis, and discuss the in vivo and in vitro roles of FADD in necroptosis induced by various stimuli.

• Journal of Korean Clinical Nursing Research
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• v.21 no.3
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• pp.389-400
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• 2015

Purpose: The purpose of the study was to identify and describe illness experiences of men with myocardial infarction. Methods: Data were collected through individual in-depth interviews with 10 male patients. Analysis was done using phenomenological analysis. Results: Five theme clusters including 11 themes emerged. 1) "Unexpected grave disease instantly dividing life and death" describes the great ignorance of symptoms and experience as a survivor narrowly escaping death. 2) "A disease still not considered a disease" illustrates the paradoxical and confusing situation between low level of awareness of the severity of the disease and high level of reflection on their unhealthy lifestyles. 3) "Fighting against me for health" illustrates their resolution and action to maintain health while experiencing helplessness. 4) "Relationships in a no-win situation" contains defensive posture due to social stigma and the dilemma of family breadwinners. And 5) "Introspection of past and future life" describes positive turnings in life through enlightenment in addition to remorseful feeling about the past and persistent worry of death. Conclusion: Health professionals need to support men with myocardial infarction by providing family-oriented and empowerment-based self-management interventions to lead to success in their illness journey and to improve their quality of life.

• Journal of Hospice and Palliative Care
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• v.13 no.2
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• pp.81-88
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• 2010

Purpose: This study was conducted to study the attitude of Korean lawyers toward withdrawal of life sustaining treatment, and compare and analyze different types of their attitudes. Methods: Research design of this project was Q methodology approach. The study population was 24 lawyers, aged from 32 to 69 years. Q sample to investigate the attitude of the lawyers toward withdrawal of life sustaining treatment included 34 statements obtained from literatures, TV debate, and depth interviews of 5 lawyers among the lawyers included. After listening to the purpose and method of the study, the 24 lawyers agreed to fill out a survey asking sociodemographic information, and the information was distributed in 9 scale Q-sample. Results: The collected data were processed through QUANL PC program and sorted into 5 types as follows: The first type was 'Choosing to withdraw life sustaining treatment', the second 'Withholding life sustaining treatment' regardless of the cost, the third is neutral type that claims that humans have the right to decide the death and life, and demands the proper legalization to protect such rights, the fourth type agrees to withdrawal of life sustaining treatment, nevertheless, admits that one has a rigt to withhold one's own life treatment, categorized as self contradiction type. The fifth type believed that 'Life and death are providential' with the faith, therefore, such authority to decide life and death belongs to God, but not human beings. Conclusion: In conclusion, the lawyer's attitudes toward withdrawal of life sustaining treatment were grouped into five different types as follows: 'Choosing to withdraw life sustaining treatment', 'Withholding life sustaining treatment', 'Demanding legalization', 'Self contradiction type', and 'Life and death are providential'.

• International Journal of Oral Biology
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• v.42 no.1
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• pp.9-15
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• 2017

Microglia have multiple functions in regulating homeostasis of the central nervous system. Microglia cells have been implicated as active contributors to neuron damage in neurodegenerative disorders. In this study, medicinal plant extracts (MPEs) were used to evaluate the cell-death induction effect in microglia BV-2 cells. Among 35 MPEs tested in this study, 4 MPEs showed less than a 30% cell survival after 24 hours of incubation. These were Foeniculi Fructus, Forsythiae Fructus, Zingiberis Rhizoma and Hedera Rhombea. The concentration showed that 50% cell death ($IC_{50}$) occurred with 33, 83, 67 Ed highlight: Please confirm wording, and $81{\mu}/ml$, respectively. For further study, we chose Zingiberis Rhizoma (ZR) which showed a reasonably low $IC_{50}$ value and an induction of cell death in a relatively narrow range. Western blot analysis showed that ZR-treated cells showed activation of caspase-3 and cleavage of PARP Ed highlight: When an acronym is first presented it needs to be spelled out in both dose- and time-dependent manners. However, the level of Bcl-2 and Bax were not changed by ZR-treatment in BV-2 cells. These results suggest that ZR-induced apoptosis in BV-2 cells occured through caspase-3 activation. The results also suggested that ZR may be useful in developing treatments for neurodegenerative diseases.