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The Study on the Medical and Nursing Service Needs of the Terminal Cancer Patients and Their Caregivers (말기암 환자와 가족의 의료 및 간호 서비스 요구)

  • 이소우;이은옥;허대석;노국희;김현숙;김선례;김성자;김정희;이경옥
    • Journal of Korean Academy of Nursing
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    • v.28 no.4
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    • pp.958-969
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    • 1998
  • In this study, we attempted to investigate the needs and problems of the terminal cancer patients and their family caregivers to provide them with nursing information to improve their quality of life and prepare for a peaceful death. Data was collected from August 1, 1995 to July 31, 1996 at the internal medicine unit of S hospital in Seoul area with the two groups of participants who were family members of terminal cancer patients seventy four of them were in-patients and 34 were out-patients who were discharged from the same hospital for home care. The research tool used in this study has been developed by selecting the questionnaires from various references, modifying them for our purpose and refining them based on the results of preliminary study. While general background information about the patients was obtained by reviewing their medical records, all other information was collected by interviewing the primary family caregivers of the patients using the questionnaire. The data collected were analyzed with the SPSS PC/sup +/ program. The results of this study are summarized as follows ; 1) Most frequently complained symptoms of the terminal cancer patients were in the order of pain(87%), weakness(86.1%), anorexia(83.3%) and fatigue (80.6%). 2) Main therapies for the terminal cancer patients were pain control (58.3%), hyperalimentation(47.2%) and antibiotics(21.3%). 3) Special medical devices that terminal cancer patients used most were oxygen device (11.1%), and feeding tube(5.6%). Other devices were used by less than 5% of the patients. 4) The mobility of 70.4% of the patients was worse than ECOG 3 level, they had to stay in bed more than 50% of a day. 5) Patients wanted their medical staffs to help relieve pain(45.4%), various physical symptoms(29.6%), and problems associated with their emotion(11.1%). 6) 16.7% of the family caregivers hoped for full recovery of the patients, refusing to admit the status of the patients. Also, 37% wished for the extension of the patient's life at least for 6 months. 7) Only 38.9% of the family members was preparing for the patient's funeral. 8) 45.4% of family caregivers prefer hospital as the place for the patient's death, 39.8% their own home, and 14.8% undetermined. 9) Caregivers of the patients were mostly close family members, i.e., spouse(62%), and sons and daughters or daughter-in-laws(21.3%). 10) 43.5% of the family caregivers were aware of hospice care. 46.8% of them learned about the hospice care from the mass media, 27.7% from health professionals, and the rest from books and other sources. 11) Caregivers were asked about the most difficult problems they encounter in home care, 41 of them pointed out the lack of health professionals they can contact, counsel and get help from in case of emergency, 17 identified the difficulty of finding appropriate transportation to hospital, and 13 stated the difficulty of admission in hospital as needed. 12) 93.6% of family caregivers demanded 24-hour hot line, 80% the visiting nurses and doctors, and 69.4% the volunteer's help. The above results indicate that terminal patients and their family caregivers demand help from qualified health professionals whenever necessary. Hospice care system led by well-trained medical and nursing staffs is one of the viable answers for such demands.

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Practice Rate of Breast Self- examination and Its Related Factors among Women in a Rural Area (일부 농촌지역 여성의 유방자가검진 실천율과 관련요인)

  • Lee, Eun-Il;Kang, Pock-Soo;Yun, Sung-Ho;Kim, Seok-Beom;Lee, Kyeong-Soo
    • Journal of agricultural medicine and community health
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    • v.26 no.2
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    • pp.147-159
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    • 2001
  • A questionnaire survey of 568 women over the age of 30 in 11 dongs of Goryeong- gun was performed to identify the practice rate of breast self- examination and its related factors. It was found that the practice rate of breast self- examination was 28.2%, with 9.7% of those surveyed performing breast self- examinations more than once a month. The practice rate of breast self- examination showed significant differences according to factors, such as age, presence of spouse, educational level, occupation, economic status, smoking, regular exercise and chronic disease. According to age, the highest practice rate of breast self-examination was between the ages of 40-49 and the lowest over the age of 60. The practice rate increased with higher the educational level and presence of spouse. According to occupation, administrative and managerial occupations presented the highest practice rate of breast self- examination. Higher economic status, regular exercise and positive family history of breast cancer each presented high practice rates of breast self- examination. The practice rate revealed higher in those who did not smoke and who had no chronic diseases than others. The greatest reason for performing breast self- examination was decided by myself for health reasons, followed by effect of mass media and promotion by health center. The most common reasons for not performing breast self- examination were don't feel the need, followed by don't know how to perform the exam and don't know about the exam itself. Multiple logistic regression analysis showed that factors, such as over the age of 60, less education, and no experience with mammography all lowered the practice rate of self-breast examination. Inconclusion, the rates of breast self- examination and regular check-ups of people in rural areas, who are characteristically older and have low educational backgrounds, were 28.2% and 9.7%. These results show the immediate need for the education of the methods for breast self- examination to be carried out by health centers in these areas. Such efforts and programs could increase the practice rate of breast self- examination and thereby improve health and enhance the quality of life of women in rural areas.

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Therapeutic Compliance for Calcium Supplements and Its Related Factors in Rural Osteoporotic Women (일부 농촌지역 여성 골다공증 환자의 칼슘보조제 치료순응도와 결정요인)

  • Chun, Byung-Yeol;Kam, Sin;Lee, Young-Ja;Lee, Sang-Won;Lee, Kyung-Eun;Lee, Young-Seok;Kim, Bong-Kee
    • Journal of agricultural medicine and community health
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    • v.26 no.2
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    • pp.111-132
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    • 2001
  • This study was conducted to examine the therapeutic compliance and its related factors in rural women with osteoporosis. A questionnaire survey was performed from April to May in 2000 for 140 osteoporotic patients who were diagnosed from April to June in 1999 through community health program. The study employed the health belief model for predicting and explaining sick role behavior. The analysis techniques employed included contingency table analysis and path analysis using LISREL. The major results of this study were as follows: Of the subjects, 12.1% were continuously complaint, 53.6% were intermittently compliant, and 34.3% were non- compliant to calcium supplement therapy. As the result of path analysis, the therapeutic compliance was significantly higher(${\mid}T{\mid}$ >2.0) as patients had higher perceived severity of disease, lower perceived barriers of treatment, and when patients thought their disease status as severe. As the patients had higher educational level, more experience of mass media contact or health education about osteoporosis, and when family had more concern for patient treatment, they had higher perceived susceptibility of complication(bone fracture)${\mid}T{\mid}$ >2.0). The patients had higher perceived severity(${\mid}T{\mid}$ >2.0) as they had more educational level, more advice for treatment from their doctors, and when family had more concern for their treatment. As the patients had more advice for treatment from their doctors and when family had more concern for their treatment, they had higher perceived benefit of treatment and lower perceived barriers to treatment(${\mid}T{\mid}$ >2.0). In order to improve the therapeutic compliance in rural osteoporotic women, it would be necessary that the patient should recognize their disease severity properly. And the perceived barriers should be removed through supportive environments for osteoporosis treatment such as doctor 's more advice and family 's more concern for treatment. In addition, effective and continuous management system for osteoporotic patients should be established.

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Appraisal of the Special Production Area Development Project in Rural Area and Countermeasures for Off-farm Income Increase (The Case of Chungnam Province) (농어촌(農漁村) 특산단지개발사업(特産團地開發事業)의 평가(評價)와 농외소득증대방안(農外所得增大方案) (충청남도(忠淸南道)를 중심(中心)으로))

  • Lim, Jae Hwan
    • Korean Journal of Agricultural Science
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    • v.18 no.2
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    • pp.164-179
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    • 1991
  • Korean agriculture has encountered two problems. One is internal income disparity between rural and urbarn area and the other is external Uruguay Round trade problems as an abolition of direct and indirect import barriers, reduction in export subsidies and to reduce internal price supports. These problems will be brought severe farm problems such as decreasing farm household income and repressing agricultural growth in the near future. Considering the above inevitable facts Korean government has implemented several development projects such as rural industrial area development project, rural special production area development project, leisuresight seeing farm development project, traditional food development project, unskilled labor training project for off-farm employment and so on, to increase farm household income through off-farm income increase. This study was mainly concentrated on the identification of operational problems and post evaluation of the rural special production area development projects which aimed at increasing non-farm incomes and giving employment opportunity for rural farmers in small factories processing regional special farm products and mine products. The main findings and problems to be solved for the successful project implementation are as followed ; 1. Total number of the special production area development projects as of the end of 1991 was amount to 138, and total number of farm household participated were estimated at 2,079, and total amount of off-farm income per farm household was reached to 3,011 thousand won. 2. The total number of processed special products have increased from 21 items in 1981 to 56 items in 1991. On the other hand the total number of farm household participated in the projects have decreased from 2,518 to 2,079 during same period. 3. Total amount of investment for the projects has increased from 1,429 million won in 1981 to 24,760 million won in 1991 but the rate of G'T loan of the total investment has reduced from 24.5% to 5.2% during same period. 4. 138 special production area development project are classified into 6 kinds of commodity groups such as 19 of general industrial good production areas, 52 of folks-industrial art objects production areas, 39 of food processing areas, 9 of fiber and texstile processing areas, 18 of agricultural and fishery inputs processing areas and 1 of stone processing area. 5. The total production value in 1990 was estimated 20,169 million won of which export was amount to 2,627 million won. 6. The finacial rate of return of the UNGOK KUGIJA Tea processing Project operated by UNGOK coops and BAKSAN ginseng tea processing project were estimated at 45.4% (B/C Ratio=1.17, NPV=152.5 million won) and 17.7% (B/C Ratio=1.12, NPV=120.2 million won) respectively. 7. More favorite terms and condition of the loan including collateral problems have to be given to farmers participated. Heavy investment and G'T subsidy policies should be started for the successful project implementation anf farm household income increase. 8. To expand market demand of the rural special goods G'T have to provide special program of TV or other mass media for commodity propaganda and the total cost concerned must be supported by G'T subsidy. 9. The special farm products as GUGUJA,MOSI'Ramie', Ginseng. SOGOKJU,HEMP,Mushroom.DUGYUNJU and Chesnut processing projects have to be propelled and expanded for off-farm income increase in Chung Nam Province. 10. Direct operational pattern of the special production area by coops is more favorable to farmers and recommendable considering with off-farm income increase and market demand creation throughout Korea. 11. In rural area, special organizations for project appraisal are not exist. Accordingly special training program, project appraisal, formulation and preparation for civil servants concerned have to be prepared for project selection and sound implementation under limited budget and financial support.

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A Study on Dental Health Awareness of High School Students (고교생들의 구강보건의식 행태에 관한 연구 -경기 이천시 소재 고교-)

  • Yoo, Su-Min;Ahn, Geum-Sun
    • Journal of dental hygiene science
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    • v.3 no.1
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    • pp.23-31
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    • 2003
  • In this research, dental health awareness of 3rd graders of high schools in Icheon-city was investigated in order to use the result of this research as the basic data for school dental health program, education direction, and educational purpose. The research was done from Sep. 23. to Oct. 5 and the followings are the results of survey. (1) 85.0% of the students brush their teeth once or twice a day and more female students brush their teeth 3 times a day than male students. (2) 77% of the students had experienced dental caries and 38.0% of the students have periodontal disease, which has lower percentage than cavity. (3) Most of the students can not go to the dentists because they do not have time and 84.0% of the students have been treated in dental clinics so this tells that most of the students had experienced dental treatment. (4) 46.8% of the students had interests in dental health and male students showed more interests than female students and the difference was statistically significant(p<0.05). (5) Most of the students hear the importance and information of dental health from mass media such as TV and radio or from people around. The research shows that most of the students do not get periodic dental checkups. (6) 80.8% of the students had never taught dental health education for improvement of dental health and 76.2% of the students think that the dental health education is needed. There was no difference according to the gender. (7) Most of the students think that the dental health education is needed to prevent cavity and gingiva disease and it shows that more students tend to attend the dental health education. (8) 69.3% of the students think that brushing your teeth is important to maintain good dental health and there was no difference according to the gender. Most of the students weren't aware that periodic dental checkups, right brushing, and using fluoric toothpaste is effective for cavity protection. (9) After looking into the knowledge of the students on dental health, it shows that the knowledge is low and there is no difference according to the gender.

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The Perceptions of Pre-service Science Teachers Regarding Ethics Education Related to Science and Technology (초중등 예비과학교사의 과학기술 윤리교육에 대한 인식)

  • Choi, Kyung-Hee
    • Journal of The Korean Association For Science Education
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    • v.30 no.5
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    • pp.576-593
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    • 2010
  • The purpose of this study was to identify the current status of ethics education in science and technology for pre-service science teachers and find out their recognition on the needs for ethics education at school. A survey was administered for this study and a total of 594 pre-service science teachers studying in college/university of education participated. The survey was organized to examine participants' 1) experience in ethics education in science and technology, 2) recognition on the needs of ethics education in science and technology, and 3) the need for it in elementary and secondary school. Each item was responded using either 1 to 5 Likert type scale, multiple choices, or open questionnaires. The results showed that 37.4% of participants obtain science technology information from the mass media, and 23.5% from the school education. Only 8.4% of the participants had the experience of taking class on ethics in science and technology. In terms of level of confidence in understanding the ethical issues in science and technology, the average response was 2.73. However, their perception on the needs of the ethics education ranges from 3.34 to 4.58, which is much stronger than other responses on average. This strong perception on the needs was much higher for pre-service science teachers for elementary school, than those of the secondary school(p<.05). All participants recognized the need for ethics education in science and technology at both elementary and secondary school. In responses for which subject should provide ethical issues on science and technology, science class was most frequently suggested (62.4%), followed by ethics class (29.1%). In responses for the most efficient form of learning, they suggested that case studies (43.5%), followed by discussions (41.4%) would be an efficient way to learn. Even in the responses of open questionnaires asking for efficient ways of learning ethical issues, participants suggested that discussions on various ethical issues on the cases in the science and technology would provide practical and substantial learning.

Gastric-cancer-related Inquiries and Questionnaires through an Internet Homepage (인터넷 홈페이지를 통한 위암 관련 질의 및 설문조사)

  • Ahn Dae Ho;Shin Dong Woo;Cheong Jae Ho;Hyung woo Jin;Choi Seung Ho;Noh Sung Hoon
    • Journal of Gastric Cancer
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    • v.4 no.4
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    • pp.219-224
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    • 2004
  • Purpose: Through a survey on an Internet homepage, we conducted research concerning the need of patients and their families for information on gastric cancer. We also assessed their interest in gastric cancer. Materials and Methods: We analyzed 619 inquiries presented from June 2002 to September 2003 and 524 replies submitted to a questionnaire survey delivered by the Internet homepage (www.gastriccancer.co.kr) from August to October 2003 to gastric cancer patients and their families. Results: Analysis of Inquiries: The classified inquiries listed in order of frequency are as follows: treatment, prognosis, stages, symptoms, pathophysiology, diagnostic modalities, favorable food, etiology, follow-up, etc. Among the inquiries about treatment, the most frequent subgroup was about the scope of surgery or perioperative implications. Next came questions concerning chemotherapy. Among the questions from patients yet to be operated, on those about operability and the prognosis were most frequent. Among the patients who had undergone a resection, questions on complications and the corresponding prognosis were most frequent. The concern from patients with inoperable or recurrent cancers was related to terminal care and/or chemotherapy. Analysis of Questionnaires: The respondents acquired information on gastric cancer from the Internet ($40\%$), doctors ($32\%$), the mass media ($15\%$) and acquaintances ($13\%$). Only $6\%$ of the respondents were sufficiently satisfied with the information provided by doctors. Among the respondents, $89.9\%$ were interested in complementing treatment with folk remedies while only $5\%$ were not. Conclusion: Patients and their families were eager to get information about gastric cancer. However, many of them found the doctors' information to be insufficient. Our suggestion is that the public health, academic societies, medical institutions, and public organizations should endeavor to provide through an activated Internet network correct information on gastric cancer. (J Korean Gastric Cancer Assoc 2004;4:219-224)

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A Study on the Decisive Factors in Personal Health Maintenance Practice of Housewives Living in Younhi Area Apartments (연희지역 아파트주부의 건강관리실천의 결정요인분석에 관한 조사연구)

  • 김인숙
    • Journal of Korean Academy of Nursing
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    • v.8 no.2
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    • pp.89-102
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    • 1978
  • Owing to the development of modern science, prolonging man's life, the sudden increase of population and betterment of the standard of living has increased health needs. In order to fulfill these health needs, more active plans for developing health should be made. Health education is one of the methods at hand that can improve the health behavior of the community and the individual through the contact of individuals with their groups. Proper understanding of the characteristics of the sampled group and participation of individuals within the community for the development of their health plan are needed for efficient health education. This study was attempted for the purpose of presenting some data helpful for pre-paring the fundamentals of a health education plan that can improve personal health maintenance practice of a community through efficient health education by investigating the relationship between the response of subjects to personal health maintenance practice and selected decisive factors in personal health maintenance practice. The subjects for this study were a systematic sample of 120 housewives selected from 600 housewives from B Zone Apt. Younhi-3-Dong in Seoul. Data was collected for 4 days from May 16th to May 19th, 1578 through personal interviews with questionnaires by well trained interviewers. Percentage, t-test and stepwise multiple regression analysis by use of EDPS were employed for statistical analysis. Results of this study can be summarized : 1. General characteristics of subjects Subjects over 20 and below 40 years of age formed 62.5% of the toed and the rest were subjects of 40 years and upward. 76.7% of the subjects have less than 4 children. 51.3% of the subjects had completed at least the senior high school course. 2. The response of subjects to personal health maintenance practice. Ratios of personal health maintenance practice to the maximum score for each category are as follows; 84.1% in the category of population and family planning, which was the highest ratio; 82.4% in the prevention of accidents; 68.0% in control of communicable disease; 67.8% in personal health care and habits of daily life, 64.3% in mental health and 52.5% in control of parasites, which was the lowest. 3. The response of subjects to selected decisive factors. in personal health maintenance practice. The arithmetic mean of the score for each decisive factor was as follows: the mutual relation between family members marked 18.33, which is under 73,3% of the maximum score; the degree of interest in health marked 34.48, 70.0% of the maximum score: the degree of utilization and demand for health care facilities marked 25.79 or 64.5% of the maximum score and health maintenance of the family marked 11.58, 43.6% of the maximum score. 4. The relationship between personal health maintenance practice and general characteristics of subjects. 1) There was a significant difference in the numbers of children. (t = 1.83, d.f. =117, p< 0.1) 2) There was a significant difference in the contact rates with mass-media, (t = 5.02, d.f. = 118, p< 0,05) 5. The multiple correlation between personal health maintenance practice and their selected decisive factors. 1) The factor“the degree of interest in health”could account for personal health maintenance practice in 43.6% of the sample. (R = 0.6602, R²= 0,4359, F = 91.1678, p< 0.001) 2) When the factor,“health maintenance of family”is added to this, it accounts for 51.2% of personal health maintenance practice. (R = 0.7158, R²= 0.5124, F = 61.4653, p< 0.001) 3) When the factor,“mutual relations between family members”is also included, it accounts for 53.7% of personal health maintenance practice. (R = 0.7324, R²= 0.5365, F = 44.7509, p< 0.001) 4) When the factor, “the degree of utilization and demand for health care facilities”is included, it accounts for 55.1% of personal health maintenance practice. (R = 0.7421, R²= 0.5507, F = 35.2430, p< 0.001).

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A Study on the Care Needs of Family-Caregivers to the Patients with Stroke (뇌졸중환자 가족의 간호요구)

  • Kim Mi-Hee
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.4 no.2
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    • pp.175-192
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    • 1997
  • The purpose of this study was to identify the care needs of family-caregivers to the patients with stroke. Subjects were 115 family-caregivers caring for the patients while they were in-patients or out-patients with stroke in two general hospitals and one oriental medicine hospital located in Seoul and Kwang-Ju. The instrument used for this study was made by the researcher on the basis of results of literature review and interviews with family-caregivers, composed of 35 items. Internal validity by calculation of cronbach's alpha with data of respondents was 0.91, which was regarded as high. The Data were analyzed by SAS program, with percentage, mean, t-test, and ANOVA. Factor structures of care needs of family-caregivers were elicited by factor analysis(PCA, Varimax rotation). Datum collection had been from July 1 to August 14, 1997. The results of this study were as follows : 1. The mean score of the sum of the care needs of family-caregivers was 3.96 and the highest-mean item was 'need for immediate care(M=4.77)', and the lowest-mean item was 'need for chaplian's visit (M=2.82)'. 2. Care needs of the family-caregivers were : Need to be informed of the disease, treatment and care ; need of education and assistance related to physical functional level ; need of social support and consultation ; need of management of nursing problem related to immobility ; need of appreciation ; need of the way to communicate with patients ; need of immediate care and help. The highest mean factor was the 'need for immediate care and help(M=4.74)', and the lowest mean factor was the 'need of appreciation(M=3.58)'. 3. The variables influencing the degree of care needs perceived by family-caregivers to the patients with stroke were as follows : There were significant differences between need to be informed of the disease, treatment and care and general characteristic factors, which were family caregiver's sex (p=.0178), caring period(p=.0223) and patient's suffering period(p=.0244). There were significant differences between need of education and assistance related to physical functional level and general characteristic factors, which were patient's paralysis(p=.0177), patient's ADL dependency(p=.0032). There were significant differences between need of social support and consultation and general characteristic factors, which were family caregiver's sex(p=.0055), occupation(p=.0159), religion(p=.0093) and patient's sex(p=.0134). There was significant difference in the degree of need of management of nursing problem related to immobility, according to the patient's ADL dependency(p=.0493). There were significant differences between need of appreciation and general characteristic factors, which were family caregiver's age(p=.0107), sex(p=.0133), and patient's age(p=.0338). There were significant differences between need of the way to communicate with patient and general characteristic factors, which were patient's paralysis(p=.0002) and aphasia(p=.0001). There were significant differences between need of immediate care and help and general characteristic factors, which were family caregiver's caring period(p=.0162) and patient's suffering period(p=.0116). 4. The mean score of patient's ADL dependency was 3. 38 and the highest-mean item was 'ascending and descending stairs(M=4.12)', and the lowest-mean item was 'drinking(M=2.60)'. There was no significant difference in the degrees of care needs related to the patient's ADL dependency. 5. The highest information source of family-caregivers was from the doctors about the disease, treatment and care(26.1%). The second highest one was from mass media(20.8%), and the third one was from the nurses. The above findings may be used as the basic data to seek more efficient way of elevating nursing practice and quality for family-caregivers to the patients with stroke.

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Exploring Changes in College Students' Perceptions of Science and Scientists through a Documentary Focused on Their Daily Lives and Research (과학자들의 일상과 연구과정을 다룬 다큐멘터리를 통한 대학생들의 과학 및 과학자에 대한 인식변화 탐색)

  • Lee, Hyunok;Mun, Jiyeong
    • Journal of The Korean Association For Science Education
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    • v.38 no.2
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    • pp.293-304
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    • 2018
  • In spite of a growing number of recent studies that indicate students are coming to view scientists with more varied images, the stereotypical image of scientists remains in many students' minds. In this study, the authors explore how college students change their perceptions of science and scientists through the use of a documentary that focuses on scientists' daily lives, including laboratory life, and their emotional ups-and-downs. We analyzed 109 college students' essays on perceptions about scientists after watching the documentary. As a result, 64.2% of the college students declared that there was a change in their perception of scientists. The students' new perceptions of science and scientists are as follows: 1) scientists undergo emotional ups-and-downs just like any normal person; 2) scientists experience numerous failures while researching; 3) science does not have a fixed answer and scientists undertake research with creativity; 4) scientists conduct research in collaboration, but also in highly competitive environments; 5) scientists are often frustrated with their socio-economic status. The students' previous perceptions on science and scientists were mainly stereotypical ones that have been reported in previous studies. In addition, of the other college students who did not change their perceptions, the majority declared that they have new perceptions such as 1) - 5). Only a small percentage of students (7.3%) had unchanged stereotypical perceptions. These results are interpreted as that college students relatively easily change their stereotypical images of scientists after watching the documentary but, alternatively, the results can be interpreted that the most stereotypical images of college students are not perceptions that form a deep impression, but rather they are simply depictions of representative images of scientists given from outside sources (e.g. the mass media and school).