• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.4
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• pp.570-577
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• 2017

The purpose of this study was to provide a basis for the development of a health insurance payment system by exploring inpatient hospice & palliative care activities in a long-term care hospital by occupational personnel. The contents and frequency of inpatient hospice-palliative care activities were obtained retrospectively from the chart review of 12 terminally ill patients who died during the 6 months before their deaths. According to their occupational personnel, doctors were doing blood transfusion, family counseling, and medication guidance. Nurses' main activities were airway suction, oxygen supply, EKG monitoring, observing patient's status, helping medication and tube feeding. Other workers' activities are as follows: social workers were applying individualized programs, physical therapists were doing electrostimulation, nutritionists were giving nutrition evaluation and meal rounding, and careworkers were assisting with meals and nutrition. Although certain nursing activities, like emotional support, were performed by nurses, the hospice-palliative activities from doctors, social workers and physical therapists were largely unavailable for terminally ill patients in a long-term care hospital. And some terminally ill patients were receiving too intensive and invasive medical cares for end end-of-life care. The results highlight the importance of valid measures of hospice-palliative care quality and the need for establishing an adequate reimbursement system for ensuring and improving end-of-life care.

• The Korean Nurse
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• v.37 no.2
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• pp.53-62
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• 1998

ursing as a profession is characterized by its holistic, mind-body-spirit approach to the patient. Also, nurses have historically been the leaders in health education and promotion. Parish nursing has a great potential for providing primary preventive health care. services as well as assisting people to access the health care system. While working in the community, parish nurses see the church as the new arena for delivering health care services. The parish nurse program was introduced by Granger Westberg in 1984. The concept of parish nursing is based on several beliefs; health is multidimensional and affects all aspects of an individual-physical, psychological, social, and spiritaul being. Parish nursing is one model in which churches can cooperatively work with health care institutions to address the needs of their parishioners. The role of the parish nurse is emphasized in four basic area: a) health education, b) health counseling, c) referal services, and d) facilitation and organization of support groups within the congregation. The parish nurse programs work chiefly in congregation or commuity where a certain language of faith is ready at hand. This means that the parish nurse works in an ecology of meanings and care which encourages the drawing on the message of God's grace, the practices and habits it encourages. The parish nurse may be involved in the church's health ministries and may work on either paid or volunteer basis; however, one of the most important qualification of the parish nurse is to have the nursing knowledge and skills to practice within the standards of Nursing Practice Act. The completion of standards of practice for professional nurses practicing as parish nurses had been identified as a priority by the HMA Executive Board (1996, HMA). In conclusion, parish nursing promotes health and healing by empowering the faith community, family, or individual to incorporate health and healing practices. There are several preconditions that should proceed to establish the foundation for successful development of the parish nursing program in Korea. First, reciprocal relationship with home health nursing should be considered. Second, correct terms and concepts of parish nursing should be studied and understood. Third, systematic study and investigation should be followed for further development of parish nursing. Fourth, strengths and weaknesses of different models should be studied to develop proper model of parish nursing for Korean situation. Finally, consensus of standardized education program and corporation with various religious communities as well as health institutions should be established. When these preconditions are met, the role of parish nursing as a new program for the promotion of holistic health will be established.

• Korean Journal of Social Welfare
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• v.51
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• pp.93-118
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• 2002

The objective of this study was to determine the effect of a psycho-educational group intervention in reducing psychologic distress and enhancing coping in Korean breast cancer patients. The patient selection criteria were age younger than 70 years, having any postoperative adjuvant therapy, and surgery undergone within the previous 12 months as of the start of the study and there were 70 patients eligible for this criteria. They were randomized into three groups; experimental group(24 patients), wait-list control group(24 patients) and wait-list group(36 patients). We conducted a 8-week, structured, psychosocial group intervention, which used psycho-educational strategies combining education and psychological support. Subjects were assessed for psychological distress and coping by administering the Beck Depression Inventory(BDI) and the Ways of Coping Checklist-Revised(WCCL-R) at the baseline and after 8 weeks. Forty eight patients were participated and thirty five patients completed the study. The experimental group had significantly lower scores than the controls for depression on the BDI(p=.012) after 8-week intervention. However, coping did not show a significant difference on WCCL-R after the intervention. Despite of some limitations, the results of this study suggest that a short term psychosocial group intervention produces a significant improvement in the quality of life of patients with primary breast carcinoma in Korea in terms of managing depression.

• Experimental and Molecular Medicine
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• v.50 no.11
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• pp.8.1-8.14
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• 2018

We previously demonstrated that the direct transplantation of human umbilical cord blood-derived mesenchymal stem cells (hUCB-MSCs) into the dentate gyrus ameliorated the neurological symptoms of Niemann-Pick type C1 (NPC1)-mutant mice. However, the clinical presentation of NPC1-mutant mice was not fully understood with a molecular mechanism. Here, we found 14,15-epoxyeicosatrienoic acid (14,15-EET), a cytochrome P450 (CYP) metabolite, from hUCB-MSCs and the cerebella of NPC1-mutant mice and investigated the functional consequence of this metabolite. Our screening of the CYP2J family indicated a dysregulation in the CYP system in a cerebellar-specific manner. Moreover, in Purkinje cells, CYP2J6 showed an elevated expression level compared to that of astrocytes, granule cells, and microglia. In this regard, we found that one CYP metabolite, 14,15-EET, acts as a key mediator in ameliorating cholesterol accumulation. In confirming this hypothesis, 14,15-EET treatment reduced the accumulation of cholesterol in human NPC1 patient-derived fibroblasts in vitro by suppressing cholesterol synthesis and ameliorating the impaired autophagic flux. We show that the reduced activity within the CYP system in the cerebellum could cause the neurological symptoms of NPC1 patients, as 14,15-EET treatment significantly rescued cholesterol accumulation and impaired autophagy. We also provide evidence that the intranasal administration of hUCB-MSCs is a highly promising alternative to traumatic surgical transplantation for NPC1 patients.

• Korean Journal of Psychosomatic Medicine
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• v.24 no.2
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• pp.133-139
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• 2016

Objectives : As the prevalence of elderly depression increases, it becomes urgent problem to provide preventive and management measures. But in practice, it is difficult to detect depression in early stage. The purpose of this study is to evaluate the association between sociodemographic factors and depression in elderly welfare facility users in a city. Methods : In this research, the severity of depression and sociodemographic factors(gender, age, education, co-morbid disease, housing type, number of children, number of family members living with the subjects) was evaluated through PHQ-9 and interview. Using the data, the associations of depression and sociodemographic factors were analyzed. Based on PHQ-9 depression cut-off value(10 points), the subjects were divided into two groups, and the difference of the variables between groups were analyzed statistically. Results : 'Own house'(YES/NO), education(less than elementary school graduation/more than elementary school graduation) were sociodemographic factors which showed significance difference in mean PHQ-9 scores. Group with Over PHQ-9 10 points showed less 'having their own house' and less education level than group with less PHQ-9 10 points. Conclusions : With this research, it is expected that the risk factors for the elderly depression can be understood and the measures for early detection and invention of elderly depression would be provided.

• PNF and Movement
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• v.16 no.3
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• pp.485-493
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• 2018

Purpose: This study provides a treatment for central nervous system development in patients with chronic stroke by investigating changes in the upper limb function over time. The correlations among the activities, participation, and environmental factors of the international classification of functioning (ICF), disability and health are also examined. Methods: The subjects of this study are 18 patients with chronic stroke who were hospitalized and treated at 00 hospital in the Chungcheongbuk-do province. Their upper extremity functions are evaluated using the manual function test (MFT). The activities, participation, and environmental factors are evaluated using the ICF generic form. The correlations between the total scores of the affected and unaffected sides and the ICF items are analyzed using the Pearson correlation analysis. The significance level is p<0.05. Results: When the correlations between the activities and participation areas of ICF and the total score of the affected side of MFT were examined, significant correlations (p<0.05) were found in the following items: changing basic body position (D410), lifting and carrying objects (D430), moving around using equipment (D465), using transportation (D470), washing oneself (D510), caring for body parts (D520), and dressing (D540). When the correlations between the activities and participation areas of ICF and the total score of the unaffected side of MFT were examined, significant correlations (p<0.05) were found among writing (D170), speaking (D330), eating (D550), and drinking (D560). In addition, when the correlation between the environment area of ICF and the total score of the unaffected side of the MFT were examined, significant correlations (p<0.05) were found between products and technology for personal use in daily living (E115) and immediate family (E310). Conclusion: The MFT of patients with chronic stroke is closely correlated with the activities, participation, and environmental factors of ICF. This result suggests that ICF can be used as a useful tool to comprehensively evaluate the abilities of the patient, including the upper extremity function.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.20 no.7
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• pp.589-598
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• 2019

This study was conducted to build a structural equation model explaining factors that affect hemodialysis patients' quality of life to test the goodness of fit of the model and identify directly and indirectly significant paths. To accomplish this, 230 patients receiving hemodialysis registered at study hospitals in G Metropolitan City and M City were randomly selected, and 201 were used in the final analysis. Data were collected using a self reporting questionnaire from February 1 to March 31, 2014. SPSS WIN 18.0 was used for descriptive statistics and correlation analysis of the general characteristics and for reliability analysis of the research tools. In addition, AMOS 18.0 was used for confirmatory factor analysis of latent variables, to determine the goodness of fit of the hypothetic model, and hypotheses testing. The results of this study were as follows: the fit of the modified model was 41.32, GFI = .96, AGFI = .92, RMR = .04, NFI = .96, CFI = .91 and TLI = .95. Twelve out of the 22 research hypotheses that were improved and improved were statistically significant. The results indicated that hemodialysis patients' quality of life was influenced directly by self-efficacy, depression, and self-care behavior, and indirectly by sleep disturbance, stress, fatigue, and family support. These variables explained 58.6% of the variation in quality of life. Overall, these findings suggest that nursing interventions for hemodialysis patients require strategies for managing patient depression and for increasing self-efficacy and self-care behavior to improve quality of life.

• Korea Journal of Hospital Management
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• v.25 no.4
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• pp.94-102
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• 2020

Purposes: The purpose of this study was to analyze the trends of hospitalization and emergency room visits of asthma patients over the three years in 25 districts of Seoul. And analyzed the relationship between preventable hospital service uses and number of clinics for asthma patients. Methods: Data was collected from a customized database of the NHI(National Health Insurance) for 2016 to 2018. The number of clinics means Internal Medicine, Pediatrics, Ear-Nose-Throat, and Family Medicine clinics. The hospital service means the number of adults admission for asthma and the number of total asthma emergency visits. This study used kappa analysis to assess the agreements of indicators between years, and structural equation modeling analysis was applied to analyze the relationship. Findings: The kappa value of the number of adults admission for asthma was compared between 2016 and 2017(kappa score=0.68), and was lowered when compared between 2016 and 2018(kappa score=0.26). And the value of kappa in the number of total asthma emergency visits due to asthma between 2016 and 2017(kappa score=0.51) was lower than that of between 2016 and 2018(kappa score=0.60). And the results showed that the number of clinics significantly negatively related to the uses of hospital services in asthmatic patients(β=-0.5, p=0.005). Practical Implication: This research could provide policy implications for strengthening primary care services that can contribute to the reduction of preventable hospital services.

• Journal of Digital Convergence
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• v.18 no.12
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• pp.389-399
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• 2020

Diverse official policies in community are available for caregivers to take care of the elderly in the US and the UK. This study aims to examine the recent changes in government supports based on The Recognize, Assist, Include Support and Engage (RAISE) in the US, and those by Carer Act 2014 in the UK, to take any good lessons for Korean policy. Caregivers will play a new role to develop innovative treatment for patient-centered care. The UK strengthens to provide various efforts for working carers while assuring economic efficiency in labor market with empirical evidence. The major four ways to support carers were developed agreed with the acknowledge of caregiving value and their human right; financial support, direct services for carers, flexible work time, and advocacy. Korean supports policies for carers in long-term care and social welfare will be more effective in community care system if more evidence based policies are prepared.

• Journal of Korean Neurosurgical Society
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• v.64 no.4
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• pp.644-664
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• 2021

Objective : Since the enactment of the Special Act on Korean Medical Residents, neurosurgeons working at training hospitals have been performing the duties of residents, in addition to their existing patient care responsibilities, which include surgery, education, and research. This study explores the relationships between work intensity, work-life balance, and burnout experienced by Korean neurosurgeons. Methods : The participants (n=451) were neurosurgeons working at training hospitals throughout Republic of Korea. Data on socio-demographic characteristics (including objective and subjective work environment), work intensity, work-life balance, and burnout were gathered using self-report questionnaires completed between March 1 and December 20, 2019. The data were analyzed using descriptive statistics, independent samples t-tests, one-way analysis of variance, Pearson's correlations, and multiple regression analysis. IBM SPSS Statistics for Windows, version 25 (IBM Corp., Armonk, NY, USA) was used for the analyses. Results : The work intensity, work-life balance, and burnout levels of neurosurgeons were 3.95, 3.57 (on a scale from 1 to 5) and 4.60 (on a scale from 1 to 7); and 280 (62.1%) of 451 neurosurgeons were found to be experiencing burnout. By controlling for the socio-demographic characteristics, the effects of work intensity and work-life balance on burnout were analyzed. Work intensity (B=0.314), work-life balance-family and leisure (B=0.216), work-life balance-growth (B=0.147), job stress (B=0.133), and satisfaction with human relationships (B=-0.069) were shown to be significant (all p<0.05), and they were found to affect burnout in the abovementioned order. The overall explanatory power was 58.3% (p<0.05), and the explanatory power with the addition of independent variables such as work intensity and work-life balance was 14.5% (p<0.05). Conclusion : This study showed that Korean neurosurgeons working at training hospitals experienced a high level of work intensity and job stress, and low work-life balance. Additionally, nearly half of the neurosurgeons were found to experience burnout related to factors such as work intensity, work-life balance, job stress, and satisfaction with human relationships. In particular, these factors seem to have deteriorated further after the implementation of the Special Act on Korean Medical Residents. These very high levels of burnout among Korean neurosurgeons who care for patients with both brain and spinal diseases may have a very important impact on patients' health. Therefore, it is recommended that the Korean Neurosurgical Society and the Korean government make efforts to improve the factors that affect burnout among Korean neurosurgeons.