• Journal of Hospice and Palliative Care
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• v.11 no.3
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• pp.147-155
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• 2008

Purpose: This study aimed to assess the educational needs for nurses who care for terminal cancer patients and their families. To identify top needs along with key issues in consideration to develope hospice training program and provide specific recommendations. Methods: A cross-sectional design with nurses from nine universities' hospice specialist courses and seven cancer centers was used. Data were collected via e-mail or mail service from March to April in 2008. One hundred seventy three questionnaires were returned (return rate: 73.6%), and 156 questionnaires were eventually analyzed. The questionnaire consisted of Mason and Ellershaw's The Self-efficacy in Palliative Care (SEPC) and self-reporting confidence and educational needs in hospice care. Results: The mean age of the participants was 37.94 years, 82.1% were staff nurses, and 44.9% completed over six months hospice education. Mean$\pm$standard deviation score for total SEPC was $2.67{\pm}.62$, which was lower than average (score 3), with communication score being the lowest ($2.49{\pm}.69$). The lowest self-reporting confidence score was $2.03{\pm}.77$ in hospice administration and management, followed by providing complement therapy ($2.34{\pm}.77$), bereavement care ($2.34{\pm}.71$), lymph edema management ($2.35{\pm}.79$), and care planning ($2.36{\pm}.81$). The participants reported that additional education is needed in all topics, with pain management score being the highest ($3.71{\pm}.50$), followed by pain and symptom evaluation ($3.67{\pm}.52$), care for dying ($3.67{\pm}.52$), and communication and counseling ($3.63{\pm}.53$). There were significant subgroup differences in SEPC and self-reporting confidence between groups who completed 6 months hospice education or not, however, no significant difference in educational need between the groups. Conclusion: This study showed the need for developing hospice training program to improve compentency of nurses in hospice palliative care.

• Journal of Preventive Medicine and Public Health
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• v.27 no.4 s.48
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• pp.711-734
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• 1994

Among chemical agents in herbicides, dioxin (2, 3, 7, 8-tetrachloro dibenzo-$\rho$-dioxin : TCDD), a chemical contaminant in herbicides sprayed during the Vietnam War has been known to be the major agent causing toxic effects. Approximately 320,000 korean soldiers participated the Vietnam War from 1964 to 1974. Although the potential hazards of the herbicides among Korean veterans exposed were implicated, the problem had not been a public issue until 1991 when Korean veterans were informed U.S. companies, the herbicides manufacturer payed fund, from which a trust fund for New Zealand and Australian Class members were established in 1985. After a series of appeals and demonstration by the Korean Veterans demanding medical care and compensation for their serious health damages, a bill of medical care and compensation for herbicides victims was promulgated in March 1993 and become effective from May 1993, This study was carried out with two major objectives : the first to understand the health problems caused from the herbicides by reviewing literatures published, and the second to examine the nature and extent of health impacts among Korean veterans exposed and to develop valid study methods for the major study by interviewing and reviewing records on a part of veterans (638 persons) registered and completed medical examination in Seoul Veterans Administration Hospital from June to October 1993. The results obtained are as followings: 1. The literature review of 107 papers revealed that 1) Dioxin is teratogenic, carcinogenic and affects almost all organs including nervous, endocrine, and reproductive systems in animal experiments. 2) The diseases showing evidence of causal association were Hodgkin's disease, non-Hodgkin's disease, lung cancer, lymphoma, soft tissue sarcoma, chloroacne and polyneuropathy when judged on the basis of consistency in study results and biological plausibility. 2. Interview and medical record review study on 638 veterans, though limited validity owing to lack of control group, crude estimates of dioxin exposure levels (no biomarkers measurable), and uncertainty of diagnosis, showed that: 1) Most of the study subject's were in their 40's of age and had been dispatched to Vietnam during the period from $1965{\sim}1970$ around one year. 2) Most frequently complained symptoms in medical examination were motor weakness (32%), sensory abnormalities in extremities (23%), skin diseases (22%), and pain in extremities (20%) whereas in Interview they were more frequent in order of skin problem (44%), motor weakness (38%), sensory abnormalities and pain in extremities(17% and 19% each). Kappa indices on the same category of complaints between two sources of information were variable and relatively low. 3) On medical examination, only a part of the 638 subjects had initial impression (442 pts) and final diagnosis (218 pts) suggesting decision making on diagnosis appeared to be difficult even with all available modern medical technologies: in initial impression disorders from peripheral and central neuropathy were predominant whereas in final diagnosis various types of skin disorder were most frequent 4) When dose-response relationship between several conditions (from questionnaire) and arbitrary exposure scores were examined by CMH linear trend test, spontaneous abortion, sexual problems and health problem of offsprings showed statistically significant linear trends. However, pregnancy, accident and suicidal attempts did not show any relationship in this study capacity. 5) Among complaints, psychosis and neurosis (anxiety, phobia) in interview study, and memory disorder and psychosis in medical record study revealed linear trend. 6) Skin disorder was the only condition showing linear trend in initial impression and none in final diagnosis on medical examination. Even though objective to select out dioxin-related disease or group of diseases from this study was not achieved the research experiences provided firm basis for developing various methodological approaches. 3. From this preliminary study we concluded that a larger scale major epidemiologic study on health impacts of herbicides among Korean veterans exposed is not only Indispensible but also well designed study with more valid exposure information and diagnosis may be able to establish causal relationship between certain groups of diseases and exposure to the herbicides among Korean veterans.

• Journal of Korean Physical Therapy Science
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• v.2 no.3
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• pp.653-666
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• 1995

This study was conducted to investigate factors related to experience rate of low back pain(LBP) in the high school students, a questionnaire survey was carried out for 778 high school students in Andong city Kyungsang Pook province from 28th June to 10th July, 1993. The results were as follows: The experience rate of LBP for 778 high school students who were interviewed was 27.1 %. Unknown(47.4 %) was the highest in the cause of LBP. The experience rate of a academical high school students (57.8 %) was higher than the technical high school students(42.7 %) in association according to LBP and school division(P = 0. 001). The experience rate of 18 years old above students (60.2 %) was higher than 17 years old below school students(39.8 %%) in association between LBP and age(P = 0.031). The experience rate of students who go to bed at the hot floored bed (80.1 %) was higher than students who go to bed at the bed room (11.8 %) in association between LBP and room type(P = 0.012). The statisticaly significant variables related to LBP were school division, age and stress. It was revealed by this survey that independent variables related to LBP experience rate of high school students were important health problem. So the prospective research is need by those variables.

• Journal of Oral Medicine and Pain
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• v.33 no.1
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• pp.75-83
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• 2008

There was a research to make it sure that among the contributing factors, the cognitive factor affects on TMD(temporomandibular disorders) or not, we used a questionnaire on new TMD patients who visited the Department of Oral Medicine at Pusan National University of Hospital(PNUH). Research was to identify the patients' understanding of the TMD. 120 patients who visited PNUH from 2007 June to August were tested and following are the results. 1. Those who were in Jr. college or had higher scholarship showed higher understanding than those with final graduation of high school or had lower scholarship(p=0.129). 2. Percentage of high scorers(score of $16{\sim}20$) were in Jr. college or had higher scholarship than those with final graduation of high school or had lower scholarship(p=0.098). 3. Both in those who scored higher than average and in those scored lower than average, there was no difference in the rate of previsit to local dental clinic, selection of special treatment(by professor), and attendance to next visit after their conservative treatment. 4. Patients who claimed that their symptom did not change after conservative treatment showed higher rate of pre-visit to local dentist(p=0.107) and selection of special treatment(by professor)(p=0.101) and many of them were in Jr. college or had higher scholarship(p=0.005). 5. The fact the patients who claimed their symptoms did not changed or got worsen had a tendency of higher scholarship showed that understanding of the TMD has little to do with the improvement of symptom and that TMD is a very complicated disease.

• Journal of the Ergonomics Society of Korea
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• v.36 no.3
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• pp.183-196
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• 2017

Objective: The purpose of this research was to assess the agreement between job physical risk factor analysis by ergonomists using ergonomic methods and physical examinations made by occupational physicians on the presence of musculoskeletal disorders of the upper extremities. Background: Ergonomics is the systematic application of principles concerned with the design of devices and working conditions for enhancing human capabilities and optimizing working and living conditions. Proper ergonomic design is necessary to prevent injuries and physical and emotional stress. The major types of ergonomic injuries and incidents are cumulative trauma disorders (CTDs), acute strains, sprains, and system failures. Minimization of use of excessive force and awkward postures can help to prevent such injuries Method: Initial data were collected as part of a larger study by the University of Utah Ergonomics and Safety program field data collection teams and medical data collection teams from the Rocky Mountain Center for Occupational and Environmental Health (RMCOEH). Subjects included 173 male and female workers, 83 at Beehive Clothing (a clothing plant), 74 at Autoliv (a plant making air bags for vehicles), and 16 at Deseret Meat (a meat-processing plant). Posture and effort levels were analyzed using a software program developed at the University of Utah (Utah Ergonomic Analysis Tool). The Ergonomic Epicondylitis Model (EEM) was developed to assess the risk of epicondylitis from observable job physical factors. The model considers five job risk factors: (1) intensity of exertion, (2) forearm rotation, (3) wrist posture, (4) elbow compression, and (5) speed of work. Qualitative ratings of these physical factors were determined during video analysis. Personal variables were also investigated to study their relationship with epicondylitis. Logistic regression models were used to determine the association between risk factors and symptoms of epicondyle pain. Results: Results of this study indicate that gender, smoking status, and BMI do have an effect on the risk of epicondylitis but there is not a statistically significant relationship between EEM and epicondylitis. Conclusion: This research studied the relationship between an Ergonomic Epicondylitis Model (EEM) and the occurrence of epicondylitis. The model was not predictive for epicondylitis. However, it is clear that epicondylitis was associated with some individual risk factors such as smoking status, gender, and BMI. Based on the results, future research may discover risk factors that seem to increase the risk of epicondylitis. Application: Although this research used a combination of questionnaire, ergonomic job analysis, and medical job analysis to specifically verify risk factors related to epicondylitis, there are limitations. This research did not have a very large sample size because only 173 subjects were available for this study. Also, it was conducted in only 3 facilities, a plant making air bags for vehicles, a meat-processing plant, and a clothing plant in Utah. If working conditions in other kinds of facilities are considered, results may improve. Therefore, future research should perform analysis with additional subjects in different kinds of facilities. Repetition and duration of a task were not considered as risk factors in this research. These two factors could be associated with epicondylitis so it could be important to include these factors in future research. Psychosocial data and workplace conditions (e.g., low temperature) were also noted during data collection, and could be used to further study the prevalence of epicondylitis. Univariate analysis methods could be used for each variable of EEM. This research was performed using multivariate analysis. Therefore, it was difficult to recognize the different effect of each variable. Basically, the difference between univariate and multivariate analysis is that univariate analysis deals with one predictor variable at a time, whereas multivariate analysis deals with multiple predictor variables combined in a predetermined manner. The univariate analysis could show how each variable is associated with epicondyle pain. This may allow more appropriate weighting factors to be determined and therefore improve the performance of the EEM.

• Journal of agricultural medicine and community health
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• v.28 no.2
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• pp.171-182
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• 2003

Objectives: This study was conducted to analyze the dental care utilization patterns and related factors of the rural residents. Methods: The data collected by interview and self-administered questionnaire survey of 524 peoples of Seongju county in Gyeongsanbuk-do. The summarized results are as follows. Results: The rate of persons who experienced the oral disease was 52.5% during 1 year and it was at most in the age group of 40-49. The rate of persons who had experienced the oral disease were investigated according to general characteristics, perception of oral health, being of regular treatment facility. Therefore the rate of persons who had experienced the oral disease was significantly higher the younger peoples, worse oral health status and being of the regular treatment source than the other groups. During 1 year period, 64.0% of the cases had treated the perceived oral disease, 36.0% did no action at all during last year. Among respondents, 49.4% had treated their oral disease at dental clinics, 8.0% had treated at community health center or subcenter and remains did not treated at all. The results of logistic regression analysis suggested that statistically significant factors in dental health care utilization were educational level, degree of pain, oral health status and regular treatment facility. Therefore the dental health care utilization rate was higher at groups with the high educational level, serious pain, better oral health status and being of the regular treatment source than other groups. 45.5% of the rural residents did not treat their oral disease immediately due to the no identified need, limitation of time(19.2%), economic limitation(19.2%), and geographical limitation(9.0%). Conclusions: In consideration of above findings, we may conclude that oral health community program to prevent oral diseases should be intensified, oral health education to raise oral health knowledge should be performed periodically.

• Journal of agricultural medicine and community health
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• v.33 no.1
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• pp.27-36
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• 2008

=Objectives: This study was conducted to evaluate the diferences in Farmer's syndrome between greenhouse-melon farmers and rice farmers. Methods: The study included 160 residents, who lived in rural community. Of those subjects, 73 and 87 from June 1 to July 30, 2006. Respondents were interviewed by means of a structured questionnaire. Results: This study showed that greenhouse-melon farmers had a lower average age, shorter experience of farming, more working hours per day than rice farmers (p<0.05). n farmers was 38.4% respectively, the prevalence in rice farmers was 22.6%. There was statistically significant diference in the prevalence of Farmer's syndrome between greenhouse-melon and rice farmers (p<0.05). The most frequent symptoms among eight symptoms that constitute the Farmer's syndrome were lumbago, shoulder pain and nocturnal urination regardless of type of farming. But greenhouse-melon farmers had higher prevalence of muskuloskeletal symptoms, such as lumbago and shoulder pain, than rice farmers (p<0.05).Conclusions: These results showed that prevalence of Farmer's syndrome was more common in the tools which reduce physical burden and take a rest and exercise periodically during work in the greenhouse-melon farmers.

• Journal of Hospice and Palliative Care
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• v.10 no.4
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• pp.195-201
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• 2007

Purpose: As a part of the analysis of home-based cancer patients management of public health renters in cities, counties and districts across the nation, this study is to understand the degree of patient demands for that management and the degree and scope of the supply for the patient's demand. Methods: Developed the questionnaire which was constituted of degree of demand and supply for home-based cancer patient management and analyzed data centering on the frequencies and percentages by utilizing SPSS WIN 12.0. Results: The services provided through the home-based cancer patients management project include physical, emotional, spiritual and education/informative services. A survey was conducted for home-based cancer patients about these services, and its result showed that the degree of demand and supply was highest for emotional service, followed by education/informative service, spiritual service and physical service in the order of the demand-supply degree. When main items for each service were examined, it was found that: in the case of physical service, pain control was provided murk lower than its demand, while excretion disorder control and individual hygiene is provided murk more than its demand. In the case of emotional service, the degree of demand was overall higher than that of supply; spiritual service was provided appropriately to the degree of demand. Conclusion: This study examines the home-based canter patients management project of public health centers and compares and analyzes the degree of demand for patient services and the degree of services that are actually provided. The findings could be used as based data for the development of effective programs in future on the basis of actual demands of home-based cancer patients.

• Journal of Hospice and Palliative Care
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• v.3 no.1
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• pp.18-27
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• 2000

Purpose : This study aims to find out the quality of life of patients admitted to the hospice unit at Kangnam St. Mary's Hospital, at admission and after weeks hospice service and to assess the effects of hospice service on the quality of life of terminal cancer patients. Methods : This study subjects were 100 patients admitted to the hospice unit at Kangnam St. Mary's Hospital, Catholic University between October 1999 and March 2000, and their primary caregivers. Quality of life data were collected using a questionnaire revised by the authors and were analyzed by means of repeated measures ANOVA. Results : 1) Patient's quality of life as perceived by the primary caregiver was significantly improved and the mean score was 3.31, 3.68, 3.56, 3.73, 3.75 at admission and week 1, 2, 3, 4. With the detailed item analysis, the following items were shown to be significantly improved: "clean bodies"(F=6.50, P=0.0001) "pain control"(F=18.01, P=0.0001) constipate"(F=2.96, P=0.0237) "sleep"(F=3.99, P=0.0048) "nausea/vomiting"(F=4.50, P=0.0022) "medical team's comfortable care" (F=3.95, P=0.0051) "family's care"(F=2.76, P=0.0317) "anxiety" (F=3.14, P=0.0177) "comfort"(F=3.63, P=0.0085) "treat with dignity"(F=3.32, P=0.0136). The item of "death is not the end of life rather the beginning" was significantly decreased(F=2.54, P=0.0450). 2) Patient's quality of life as perceived by the patient showed an improvement but statistically insignificant and the mean score was 3.63 and 3.83 at admission and week 1. With the detailed item analysis, the item of "pain control" was shown to be significantly improved(F=9.19, P=0.0251). 3) The quality of score in the last week of life of patient were 3.48, 3.51, 3.44, 3.46, 3.50, respectively, from 5 week prior to 1 week prior to death and these changes were insignificant. Conclusion : The findings of this study showed a positive effect of hospice service on quality of life of the terminal cancer patients admitted to the hospice unit. To improve the quality of life, we need first of all to develop hospice interventions with a particular emphasis on the spiritual aspect of patient. Secondly, measurement instruments need to be developed to collect the quality of life of the hospice patients who become weakened especially in the last weeks of their life and with this effort more representative data of hospice patients may be collected.

• Radiation Oncology Journal
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• v.23 no.1
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• pp.32-42
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• 2005

Purpose : To evaluate the incidence of arm morbidity following breast cancer surgery including axillary dissection and to identify related factors. Materials and Methods : One hundred and fifty nine patients were studied using a self-report questionnaire and a clinical examination. Lymphedema, reduction of range of motion in shoulder joint and subjective symptoms (pain, impaired arm movement, numbness, stiffness) were evaluated. As related factors, demographic, oncologic characteristics and types of treatment were analysed. Results : The incidence of lymphedema ($\geqq$2 cm difference comparing to unaffected arm) was $6.3\%$, $10.7\%$, $22.5\%$ and $23.3\%$ at each 10 cm, 20 cm, 30 cm, and 40 cm from wrist. Reduction of range of motion in shoulder joint ($\geqq$ 20 degree difference comparing to unaffected arm) was noted In more than 1/3 patients for flexion, abduction and internal rotation. Especially the reduction of range of motion in internal rotation was severe ($>50\%$ reduction) in 1/3 patients. Approximately 50 to $60\%$ of patients complained impaired arm movement, numbness, stiffness and pain. Body mass index (BMI) was the significant risk factor for lymphedema. Conclusion : Lymphedema was present in 1/3 of patients and the common sites of edema were 30 cm 40 cm proximal from the wrist. Also most severe reduction of range of motion in shoulder joint was with internal rotation. There needs weight control for lymphedema because BMI was the significant risk factor for lymphedema. Also rehabilitation program for range of motion especially internal rotation In shoulder joint should be developed.