• Asian Pacific Journal of Cancer Prevention
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• v.14 no.1
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• pp.373-379
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• 2013

Background: Although caregiving to patients with terminal illness is known to be a stressful burden to family members, little attention has been focused on work-related problems. We aimed to investigate employment status and work-related difficulties of family caregivers of terminal cancer patients, comparing with the general population. Methods: Using structured questionnaires, we assessed family caregivers of 481 cancer patients determined by physicians to be terminally ill, from 11 university hospitals and the National Cancer Center in Korea. Results: Among 381 family caregivers of terminal cancer patients (response rate, 87.6%), 169 (43.9%) were not working before cancer diagnosis, but currently 233 (63.7%) were not working. Compared with the general population (36.5%), the percentage of not working among the family caregivers was higher (OR=2.39; 95%CI=1.73-3.29). A major reason for not working was to provide assistance to the patients (71.6%). 40.6% of those who continued working and 32.3% of those who not working family members reported extreme fatigue. Caregivers of old age, those who were female, those with a lower household income, and those caring for patients with a low performance status were not working at a more significant rate. Conclusion: Family caregivers of terminal cancer patients suffer job loss and severe work-related difficulties, probably due to caregiving itself and to fatigue. We need to develop supportive programs to overcome the burden of caregivers of the terminally ill.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.1
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• pp.209-215
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• 2013

Objectives: Terminal cancer patients and their caregivers often experience traumatic stress and need many types of assistance. In the present study we interviewed terminally ill cancer patients and caregivers to determine how much burden they experienced and to find out what factors are most important for satisfaction. Design: We constructed a questionnaire including overall care burden and needs experienced, and administered it to 659 terminal cancer patients and 659 important caregivers at 11 university hospitals and 1 national cancer center in Korea. Results: Finally, 481 terminal cancer patients and 381 caregivers completed the questionnaire. Care burden was not insubstantial in both and the caregiver group felt more burden than the patient group (P<0.001). While the patient group needed financial support most (39.0%), the caregiver group placed greatest emphasis on discussion about further treatment plans (44.8%). Stepwise multiple logistic regression analyses showed that in the patient group, patient's health status (OR, 2.03; 95%CI, 1.16-3.56) and burden (OR, 2.82; 95%CI, 1.76-4.50) influenced satisfaction about overall care, while in the caregiver group, high education level (OR, 1.84; 95%CI, 1.76-4.50), burden (OR, 2.94; 95%CI, 1.75-4.93) and good family function (OR, 1.94; 95%CI, 1.24-3.04) were important. Conclusions: Our study showed that burden was great in both terminal cancer patients and their caregivers and was perceived to be more severe by caregivers. Our study also showed that burden was the factor most predicting satisfaction about overall care in both groups.

• Journal of Korean Academy of Nursing
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• v.29 no.4
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• pp.880-891
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• 1999

The purpose of this study was to describe nursing decision tasks, their characteristics, and problems associated with decision making. The subjects were 32 nurses who had at least one-year nursing experience and worked on medical-surgical units or intensive care units(ICU). They were asked to describe their decision making experiences in patient care situations and to identify the characteristics of each decisions. They were also asked to describe perceived problems associated with decision making in nursing. The responses on nursing decision tasks and problems were analyzed with content analysis and the decision characteristics were identified by statistical analysis of variance. It was found that there were 16 nursing decisions which are as follows : decisions related to interpreting and selecting appropriate strategies for pain management(6.6%) ; decisions related to providing emotional support (0.7%) ; decisions related to explaining the patient's condition and rationale for procedures(1.1%) ; decisions related to assisting patients to integrate the implications of illness and recovering into their lifestyles(2.9%) ; decisions related to detecting significant changes In patients and selecting appropriate intervention strategies (17.2%) ; decisions related to anticipating problems and selecting preventive measures(4.2%) ; decisions related to identifying emergency situations(0.4%) ; decisions related to effective management of patient crisis until physician assistance becomes available(2.8%) ; decisions related to starting and maintaining intravenous therapy(2.6%) ; decisions related to administering medications(8.1%) ; decisions related to combating the hazards of immobility(7.3%) : decisions related to treating wound management strategies(5.5%) ; decisions related to relieving patient discomfort(13.9) ; decisions related to selecting appropriate strategy according to the changing situation of the patient(18.2%) ; decisions related to selecting the best strategy for patient management(5.3%) ; and decisions related to coordinating, ordering, and meeting the various needs of the patient (3.1%). The nurses reported the fellowing problems in decision making : difficulties due to lack of knowledge and experience (18.6%) ; uncertainty and complexity of decision tasks(15.2%) ; lack of time to make decisions(2.9%) ; personal values which conflict with other staff(15.7%) ; lack of selection autonomy(30.0%) ; and organizational barriers(7.6%). Continuing education programs and decision support systems for frequent nursing decision tasks can be established on the basis of these results. Then decision ability in nurses will increase through the education programs and decision support systems, and then quality of nursing service will be better.

• Journal of Korean society of Dental Hygiene
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• v.11 no.5
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• pp.671-683
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• 2011

Objectives : The purpose of this study was to examine the oral health knowledge and actual oral health care of the selected subjects, their decision making about prosthetic treatment, the state and characteristics of their prosthetic treatment and their satisfaction with prosthetic treatment in an attempt to provide some information on the improvement of the quality of life related to oral health and the promotion of oral health. Methods : The subjects in this study were 250 people who received education in two different lifelong education institutions in the city of Busan. After a survey was conducted from May 23 to June 15, 2011, the answer sheets from 217 respondents were analyzed. Results : 1. As for the general characteristics of the respondents, the men(52.1%) outnumbered the women. Those who were in their 60 and up(47.5%) made up the largest age group, and the married people(65.4%) outnumbered the unmarried ones. By occupation, the company employees(20.3%) made up the biggest group. By education, the greatest group was high-school graduates(36.1%). By monthly mean income, the biggest group gained an income of 2.01 million won or more(36.9%). As to medical security, community-based insurance was most prevailing (36.9%). In terms of health promotion, the largest group worked out to stay fit(52.4%). 2. Regarding oral health knowledge, they had a good knowledge about the cause of dental caries(56.7%), but they weren't well aware of the right time for regular dental checkup(47.9%). In relation to oral health care, regular scaling wasn't prevailing(16.9%). 3. Regarding connections between the general characteristics and satisfaction with prosthesis, the less-educated respondents expressed significantly more dissatisfaction(p=0.015). By monthly mean income, those who had a smaller income were dissatisfied in general(p=0.028). Conclusions : The findings of the study illustrated that it's required to spread awareness of the importance of oral health among people in general, and that differentiated incremental oral health care should be provided for different age groups. In order to raise the satisfaction of patients with prosthesis, how to relieve their pain and anxiety and how to adjust prosthetic treatment cost properly should carefully be considered. In addition, the government should take measures to offer assistance for the low-income classes in preparation for an increase in the elderly population.

• Journal of Hospice and Palliative Care
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• v.18 no.4
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• pp.329-334
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• 2015

Purpose: This study was aimed at analyzing the characteristics and symptoms in home-based hospice-palliative care (HBHPC) patients registered at local public health centers. Methods: A retrospective study was performed; Data of 144 HBHPC patients registered at six public health centers in Pusan City were analyzed, including their initial visit records (registration cards, initial pain evaluation and symptom evaluation). Results: The average age of the patients was 67.7 years old. Among all, 46.2% of the patient lived alone, and 65% had middle school education or lower. The most popular (36.3%) religion was Buddhism, and 47.5% received medical assistance from the government. The most frequent diagnosis was lung cancer followed by stomach cancer and liver cancer in that order. Of all, 48.9% were functionally too weak to lead a daily life, 39.6% were under cancer treatment when registered at the public health center, and 84.5% were aware of the fact that they have reached the terminal phase. Moreover, 83.6% complained about pain, and the pain level was moderate or severe in 36.5% of them. Besides pain, fatigue was the most complained symptom (84.7%), and 49.3% of them rated their fatigue as moderate or severe. Conclusion: Most of the HBHPC patients were socio-economically underprivileged and complained about moderate or worse pain and symptoms. Therefore, it appears necessary to develop an integrated strategy that is tailored for each patient reflecting their characteristics.

• The Journal of Korean Academic Society of Nursing Education
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• v.7 no.2
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• pp.264-274
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• 2001

About the patients who visited the emergency department of a hospital, investigative study was performed to assess and to classify them with triage tool, and to estimate the characteristics of them. 210 patients older than 15 years were investigated. Among them 11 patients who had responded inappropriately were excluded and remaining 210 patients were chosen as study subjects. Investigation had been performed for 30 days from Jan. 10, 2001 to Feb. 9, 2001. The triage tool was designed through the modification of triage tools developed by Kim and Choi. The data were analyzed with the SPSS program using mean, standard deviation, frequency, percentage, ANOVA and Scheffe's test. The results were as follows: 1. Of the characteristics of the study subjects, mean age of patients were 55.76 years and 70-79 years group which included 41 patients(20.6%) were most numerous. 101 (51.8%) patients visited emergency room by 119 emergency service and 91(45.7%) patients walked with assistance. 127 patients were cared in internal medicine department. 2. The distribution of triage scores were from minimum 6 points to maximum 18 points with mean $13.76{\pm}2.58$ points. 3. Triage scores had significant relationship with age(F=13.349,P=0.000), visiting method (F=8.832, P=0.000), walking status(F=28.185, p=0.000), care department(F=2.596, P=0.019), and preexisting disease(F=12.012, P=0.000). 4. After trage there were no urgent patient, 35 emergent patients(17.6%),109 subemergent patients(54.8%), and 55 nonemergent patients (27.6%). The result of emergency care were 80 admission(40.2%), 59 discharge (29.6%), 34 ICU admission(17.1%), 14 transfer to other hospital(7%), 10 operation (5%), and 2 death (2%). 5. About the time required for triage, mean duration to triage were $7.54{\pm}2.28$ mins in emergent patients, mean $7.23{\pm}2.50$ mins in subemergent patients and mean $6.49{\pm}2.19$ mins in nonemergent patients. There were no differences in duration to triage according to the severity of triage. 6. Time required in emergency treatment were mean $116.23{\pm}88.10$ in emergent patients mean $101.61{\pm}73.27$ in subemergent patients and mean $81.56{\pm}61.01$ in nonemergent patients. There were no significant difference among groups. This study depicted that triage scores were below the middle level and there were many geriatric patients in this hospital. Among the characteristics of patients, age, visiting method, walking status, care department, and accompanying disease could be data for triage of emergency patients. With triage score of a patient, the outcome of emergency care of a patient could be anticipated and this could be basal data in determining the priority of emergency nursing.

• The Journal of the Korea Contents Association
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• v.15 no.5
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• pp.200-218
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• 2015

The purpose of the present study was to examine daily lives of elderly welfare recipients and their experiences with social welfare services. Researchers collected and analyzed data through individual interviews with 11 elderly welfare recipients. A major theme in the time context was "Daily lives enduring physical and mental sufferings alone and mismatches of social welfare services": 'Starting same tedious days: trading diligent work for basic living assistance', 'Forced ritual of having meals', 'Struggle with depressing night: not attentive welfare services at closing hours', 'Welfare services suspended in holidays', 'Mind and body withered by economic hardship in winter', 'Social support for enduring weary lives'. In the space context, a major themes was "Inadequate welfare services and social interaction in the context of social isolation": 'Unhygienic and unsafe living environment', 'Hiding places: spending tedious days in vacant lots', 'Community welfare centers useful only for healthy elderly', 'Differences and similarities of elderly in urban and rural areas', 'Receiving restricted medical services at hospitals', 'Hard-to-reach public institutions', 'ambivalence about living as welfare recipients'. Based on the findings, the researchers proposed implications for policy and practice to improve elderly welfare recipients' quality of life.

• Advances in pediatric surgery
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• v.16 no.2
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• pp.162-169
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• 2010

The aim of this study is to review our clinical experience with patients with Hirschsprung's disease (HD) Medical records of 39 children who underwent definitive surgery for HD at Inha University Hospital from September 1996 to June 2008 were analyzed by age at presentation, sex, gestational age, birth weight, clinical presentation, diagnostic tools, level of aganglionosis, surgical procedures, postoperative complications, and postoperative bowel function. Twenty-five patients (64.1 %) were males and 14 (35.9 %) were females. Thirty patients (76.9 %) were diagnosed and treated in the neonatal period. The transitional zone was at the rectosigmoid region in 89.7 %. Twenty-seven patients (69 %) were treated by preliminary colostomy or ileostomy. Twenty-four patients had the Duhamel operation, 6 patients anorectal myectomy, and 9 patients had transanal endorectal pull-through (TEP). Five of 9 patients who had the TEP procedure did laparoscopic assistance. Postoperatively, seventeen patients (83 %) passed stool once or more times per day and 3 patients had stool soiling. This study demonstrated that the majority of the patients had good results. To determine which treatment is most effective comparative review by operation method would be required.

• Journal of muscle and joint health
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• v.4 no.2
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• pp.221-237
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• 1997

In an attempt to measure effects of the Programmed Resistance Exercise on the daily performance of patients with rheumatoid arthritis, a quasi-experiment ; non-synchronised control group pre-post-test, was carried out for 8 weeks : from June 3 to November 29, 1996. 25 for the experimental group and 26 for the control group were conveniently sampled among registered out-patients on rheumatoid arthritis clinic of Anam Hospital, Korea University Medical Center. The programmed experimental resistance exercises were carried out by the experimental group five times a week for eight weeks. Before and after experiments, level of functional task performance, functional disability, joint mobility, ESR, CRP, self-efficacy and family support were measured and statistically analysed. The results of the analysis of the effects on the Programmed Resistance Exercise are as follows : 1. A statistically significant post-test effects on functional task performance were revealed : 1) the experimental group climbed up and down the 10 steps of the stairs significantly faster than the control group(P=0.0001). 2) the experimental group walked 100 m significantly faster than the control group (P=0.0000). 3) After the experiment, the experimental group could sit down and get up from chairs with no armrest as low as 30cm, 40cm, 50cm on their on, with no assistance as opposed to the control group who could not sit down and get up from such low chairs (P=0.0084). 4) the experimental group lifted 0-15 kg object up to their own heights with no specific strain than the control group (P=0.0000). 2. A significant reduction in the functional disabilities was revealed in the experimental group(P=0.0017). 3. A notable incresement of the joint mobility was revealed in the experimental group. 4. A decrease in the ESR in both the experimental and the control groups was noticed, however, the difference was not statistically significant (P=0.9546). 5. The CRP of both the experimental and control groups decreased with no significant difference (P=0.6022). 6. The self-efficacy increased significantly in the experimental group(P=0.0042), however, no significant effect of self-efficacy on the actual practice of the program was noticed. 7. The family support revealed to be significantly higher in the experimental group (P=0.0013), however, the effect of the family support on actual practice of the program revealed not significant. Judging from the results of these experiments, the resistance exercise program not only improves the functional capacity of rheumatoid arthritis, but also diminishes their functional disabilities and has a great influence on increasing their joint mobility, self-efficacy, and family support. Concluding, in promoting the daily performance of rheumatoid arthritis, the resistance exercise program would be an appropriate nursing intervention.

• Korean Journal of Digital Imaging in Medicine
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• v.13 no.4
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• pp.171-175
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• 2011

Server and Pi view management, external image and internal image Copy Import business in PACS room is through the medical assistance. Import and Copy, and in particular the number of cases is increasing the number of import is a fast growing trend. Although the increase in workload With limited human resources to increase business efficiency so Remote system is using PACS room. This remote system will want to evaluate the effectiveness of using the service. Amount of data each 437.5 MB, Copy and Import time is to compare and evaluate sees by use 1 PC. 4 PC, 4 PC+ remote system. The use of the remote system before the January 2010 to June daily average waiting time and the use of the remote system after the January 2011 to June compared to a daily average patient waiting time, evaluate. Using the remote system in January 2011 to June Find out the average remote utilization. The biggest difference on the four copy and eight continued, Were performed two times faster by use 4 PC+ remote system than use 4 PC and four times faster than use 1 PC. Before using the remote system, the daily average wait time is 14.5 minutes after using the daily average 10.2 minutes, waiting time 30% of the existing waiting time was 4.3 minutes, to reduce. Using the remote system in January 2011 to June the average daily number of cases is 107 number and The number of remote and on average 35 cases with 32% in a day remote usage. The use of the remote system to Import, CD Copy and greatly increase the efficiency of their time could be. Hours due to efficiency could also reduce customer waiting time. As a result, the manpower and the use of a remote system over time to maximize efficiency in business hours, work was evaluated by.