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The Attitude of the Bereaved Family Attending a Bereavement Memorial Service (사별가족모임과 관련된 사별가족 태도 연구)

  • Jung, In-Soon;Shim, Byoung-Yong;Kim, Young-Seon;Lee, Ok-Kyung;Han, Sun-Ae;Shin, Ju-Hyun;Lee, Jong-Ku;Hwang, Su-Hyun;Ok, Jong-Sun;Kim, Hoon-Kyo
    • Journal of Hospice and Palliative Care
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    • v.8 no.2
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    • pp.143-151
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    • 2005
  • Purpose: Bereavement Memorial Service has been held every year by the hospice team at St. Vincent's Hospital for the purpose of supporting the bereaved family who feel grief and mourning. The purpose of this study is to find out the attitude of the bereaved attending at bereavement memorial service (BMS) and to find out the areas needing improvements to set up better memorial service. Methods: Hospice team sent invitation card to 180 families of patients who admitted and passed away at hospice ward Nov., 2003${\sim}$Oct., 2004. Among them 22 families attended the BMS meeting, which was held on 26th Nov., 2004. The researcher collected data from 22 families with 'Questionnaire' survey. Except identifying data and 2 dichotomy questions, we used open-ended questionnaire. 1 researcher conducted a telephone interview survey in 18 families who couldn't attend at BMS meeting. Results: The median age was 56 (range $16{\sim}19$) and there were 37 females and 3 males. They were patient's wife (22), mother (4), husband (5), daughter (4), mother-in-law (1), siblings (1), brothers wife (1). Duration after bereavement, $1{\sim}3$ months (17) was the highest frequency. 36 families agreed 'the dead experienced the death with dignity'. The reason of agreement to the death with dignity was 'the patient died in preparation' (16). 'the patient died in well-being condition spiritually' (9), 'the patient died in comfort physically (7). 4. persons thought the dead died with indignity. The bereaved defined 'the death with dignity' as follows: 'acceptance of death & death in spiritual well-being' (9), 'death in physical comfort condition' (7), 'the death in psycho-social well-being' (3), non-respondents (10). Most families (21) were still in difficulty to overcome bereavement grief. The answer regarding the method to overcome the difficulty was 'with spiritual sublimation' (13), 'with devotion of oneself in daily life' (10), 'with devotion to mourning as it is' (3). With regard to their attitude to invitation, 'having joy and thanks from hospice team' (21), 'grief' (4), 'suffering' (4). Toward the existence of hesitation about attendance at BMS meeting, the result as follows. Nonexistence of hesitation respondent (34), existence respondent (6), the reason for hesitation was various; 'the meeting reminds me of the suffering times', 'the meeting makes me to recall, and it will be likely to cry', and so on. The needs and feelings to memorial service meeting were various; 'it was meaningful time', 'it was good to recall about the dead', 'more meeting annually' and so on. In respect of the most difficulty after bereavement, in attendant family, 'depression' (10) was the highest frequency, whereas, in non-attendant family, the most difficult thing was 'financial problem/role difficulty (6). Conclusion: This study shows the rate of attendance was high in bereaved whose bereavement duration $1{\sim}3$ month. Most of bereaved were still suffering from bereavement grief within 1 year. Although most families didn't hesitate and felt positive mood to invitation, the rate of attendance was low. Comparing with two groups between attendant family and non-attendant, the latter felt more difficulty in 'financial problem/role difficulty, on the other hand, the former felt difficulty in 'depression'. Hereafter, the additional study about the factor relating to these attitude and needs of the bereaved relating to memorial service will be necessary.

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Pre-operative Concurrent Chemoradiotherapy for Stage IlIA (N2) Non-Small Cell Lung Cancer (N2 병기 비소세포 폐암의 수술 전 동시화학방사선요법)

  • Lee, Kyu-Chan;Ahn, Yong-Chan;Park, Keunchil;Kim, Kwhan-Mien;Kim, Jhin-Gook;Shim, Young-Mog;Lim, Do-Hoon;Kim, Moon-Kyung;Shin, Kyung-Hwan;Kim, Dae-Yong;Huh, Seung-Jae;Rhee, Chong-Heon;Lee, Kyung-Soo
    • Radiation Oncology Journal
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    • v.17 no.2
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    • pp.100-107
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    • 1999
  • Purpose: This is to evaluate the acute complication, resection rate, and tumor down-staging after pre-operative concurrent chemoradiotherapy for stage IIIA (N2) non-small cell lung cancer. Materials and Methods Fifteen patients with non-small cell lung cancer were enrolled in this study from May 1997 to June 1998 in Samsung Medical Center. The median age of the patients was 61 (range, 45~67) years and male to female ratio was 12:3. Pathologic types were squamous cell carcinoma (11) and adenocarcinoma (4). Pre-operative clinical tumor stages were cT1 in 2 patients, cT2 in T2, and cT3 in 1 and all were N2. Ten patients were proved to be N2 with mediastinoscopic biopsy and five had clinically evident mediastinal Iymph node metastases on the chest CT scans. Pre-operative radiation therapy field included the primary tumor, the ipsilateral hilum, and the mediastinum. Total radiation dose was 45 Gy over 5 weeks with daily dose of 1.8 Gy. Pre-operative concurrent chemotherapy consisted of two cycles of intravenous cis-Platin (100 mg/m$^{2}$) on day 1 and oral Etoposide (50 mg/m$^{2}$/day) on days 1 through 14 with 4 weeks' interval. Surgery was followed after the pre-operative re-evaluation including chest CT scan in 3 weeks of the completion of the concurrent chemoradiotherapy if there was no evidence of disease progression. Results : Full dose radiation therapy was administered to all the 15 patients. Planned two cycles of chemotherapy was completed in 11 patients and one cycle was given to four. One treatment related death of acute respiratory distress syndrome occurred In 15 days of surgery. Hospital admission was required in three patients including one with radiation pneumonitis and two with neutropenic fever. Hematologic complications and other acute complications including esophagitis were tolerable. Resection rate was 92.3% (12/l3) in 13 patients excluding two patients who refused surgery. Pleural seeding was found in one patient after thoracotomy and tumor resection was not feasible. Post-operative tumor stagings were pT0 in 3 patients, pTl in 6, and pT2 in 3. Lymph node status findings were pN0 in 8 patients, pN1 in 1, and pN2 in 3. Pathologic tumor down-staging was 61.5% (8/13) including complete response in three patients ($23.7%). Tumor stage was unchanged in four patients (30.8%) and progression was in one (7.7%). Conclusions : Pre-operative concurrent chemoradiotherapy for Stage IIIA (N2) non-small cell lung cancer demonstrated satisfactory results with no increased severe acute complications. This treatment shceme deserves more patinet accrual with long-term follow-up.

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Evaluation for Rock Cleavage Using Distributional Characteristics of Microcracks and Brazilian Tensile Strengths (미세균열과 압열인장강도의 분포 특성을 이용한 결의 평가)

  • Park, Deok-Won
    • Korean Journal of Mineralogy and Petrology
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    • v.33 no.2
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    • pp.99-114
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    • 2020
  • The characteristics of the Brazilian tensile strengths(σt) parallel to the rock cleavages in Jurassic granite from Geochang were analysed. The evaluation for the six directions of rock cleavages was performed using the parameter values on microcrack length and the above strength. The strength values of the five test specimens belonging to each direction were classified into five groups. The strength values of these five groups increase in order of group A < B < C < D < E. The close dependence between the above microcrack and strength was derived. The analysis results of this study are summarized as follows. First, the chart showing the variation and characteristics of strength among the three rock cleavages were made. In the above chart, the strength values of six directions belonging to each group were arranged in order of rift(R1 and R2), grain(G1 and G2) and hardway(H1 and H2). The strength distribution lines of the five groups concentrate in the direction of R1. And the widths among the above five lines indicating strength difference(Δσt) are the most narrowest in R1 direction. From the related chart, the variation characteristics among the two directions forming each rock cleavage were derived. G2(2)-test specimen shows higher value and lower value of the difference in strength compared to the case of G1(1)-test specimen. These kinds of phenomena are the same as the case between the test specimen H2(2) and H1(1). The strength characteristics of the above test specimens (2) suggest lower microcrack density value and higher degree of uniformity in the distribution of microcracks arrayed parallel to the loading direction compared to those of test specimens (1). The six strength values belonging to each group were arranged in increasing order in the above chart. The strength values of the test specimens belonging to both group D and E appear in order of R1 < R2 < G1 < H1 < G2 < H2. Therefore, the strength values of group D and E can be indicator values for evaluating the six directions of rock cleavages. Second, the correlation chart between slope angle(θ) and strength difference(Δσt) were made. The values of the above two parameters were obtained from the five strength distribution lines connecting between the two directions. From the chart related to rift plane(G1-H1, R'), grain plane(R1-H2, G') and hardway plane(R2-G2, H'), the slope values of linear functions increase in order of R'(0.391) < G'(0.470) < H'(0.485). Among three planes, the charts related to hardway plane show the highest distribution density among the five groups. From the related chart for rift(R1-R2, R), grain(G1-G2, G) and hardway(H1-H2, H), the slope values of linear functions increase in order of rift(0.407) < hardway(0.453) < grain(0.460). Among three rock cleavages, the charts related to rift show the highest frequency of groups belonging to the lower region. Taken together, the width of distribution of the slope angle among the three planes and three rock cleavages increase in order of H' < G < R' < R < G' < H. Third, the correlation analysis among the parameters related to microcrack length and the tensile strengths was performed. These parameters may include frequency(N), total length(Lt), mean length(Lm), median length(Lmed) and density(ρ). The correlation charts among individual parameters on the above microcrack(X) and corresponding five levels of tensile strengths for the five groups(Y) were made. From the five kinds of correlation charts, the values of correlation coefficients(R2) increase along with the five levels of strengths. The mean values of the five correlation coefficients from each chart increase in order of 0.22(N) < 0.34(Lt) < 0.38(ρ) < 0.57(Lmed) < 0.58(Lm). Fourth, the correlation chart among the corresponding maximum strength for group E(X) and the above five parameters(Y) were made. From the related chart, the values of correlation coefficient increase in order of 0.61(N) < 0.81(Lt) < 0.87(ρ) < 0.93(Lm) < 0.96(Lmed). The two parameters that have the highest correlations are median length with maximum strength. Through the above correlation analysis between microcrack and strength, the credibility for the results from this study can be enhanced.