• Title/Summary/Keyword: Personal autonomy

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Decision and Practice of End-of-Life Care in Lung Disease Patients with Physicians Orders for Life Sustaining Treatment

  • Yu Mi Oh;Yoon Na Kang;Soo Jung Han;Jeong Hye Kim
    • Journal of Hospice and Palliative Care
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    • v.26 no.1
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    • pp.7-17
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    • 2023
  • Purpose: The purpose of this study was to analyze end-of-life care practices in lung disease patients with physician orders for life-sustaining treatment (POLSTs). Methods: We retrospectively analyzed data from medical records regarding the end-of-life care practices of POLST decisions for patients with lung disease hospitalized at a tertiary hospital in Seoul, South Korea. Data were collected from January 1 to June 30, 2021. Results: Of 300 total patients, 198 had lung cancer (66.0%) and 102 had non-malignant lung diseases (34.0%). A POLST was written for 187 patients (62.3%), and an advance directive was written for 20 patients (6.7%). Subsequent treatments were hemodialysis in 13 patients (4.3%), surgery in 3 patients (1.0%), and cardiopulmonary cerebral resuscitation in 1 patient (0.3%). Among cancer patients, chemotherapy was performed in 11 patients (3.7%), targeted therapy in 11 patients (3.7%), immunotherapy in 6 patients (2.0%), and radiation therapy in 13 patients (4.3%). Depending on the type of lung disease, types of treatment differed, including hemodialysis, ventilators, bilevel positive airway pressure, high-flow nasal cannulas, nebulizers, enteral nutrition, central line, inotropic agents, and opioids. Conclusion: Although the goals of hospice care are the same whether a patient has lung cancer or a non-malignant lung disease, because the characteristics of the respective diseases differ, end-of-life care practices and hospice approaches must be considered differently.

The Qualitative Study for User Needs and Acceptance of Smart Clothing: Focused on Women Aged 56 and Over (스마트 의류의 인식과 수용에 관한 질적 연구 : 56세 이상 여성을 대상으로)

  • Paek, Kyung-Ja;Cross, Meghan;Ashdown, Susan
    • Journal of the Korean Home Economics Association
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    • v.47 no.3
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    • pp.55-65
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    • 2009
  • By definition, smart clothing describes a garment whose functionality is enhanced by technological advancements in order to ease one’'s lifestyle. To know user’'s understanding and needs, the research had consisted of brainstorming sessions, personal interviews, focus group meeting, and a series of content analyses. Ten of the interview subjects and focus group panel were found by contacting women aged 56-64 in the Ithaca community, NY. They were prompted with general questions on style choices for their lifestyles and age group and then presented with two examples of smart clothing to discuss and critique. Meanwhile, the other three interview subjects, located outside of the Ithaca community, were aged either above or below the targeted bracket. These subjects were interviewed as a method of comparison on multiple levels. Findings had shown that there was indeed a need for smart clothing amongst the increasingly populated demographic of older women: devices to help one’'s body temperature regulation and vision problem, and well-designed clothing. However, the functionalities must be carefully constructed and conveyed in order to be taken seriously by the mainstream consumer market. Once successfully designed, the smart clothing will ideally create a greater sense of autonomy for older women.

The effects subjective fatigue symptoms to job satisfaction in Daejon city and south Chungcheong province of dental hygienists (대전·충남지역 치과위생사의 피로자각증상이 직무만족도에 미치는 영향)

  • Shin, Min-Woo;Kim, Young-Suk
    • Journal of Korean society of Dental Hygiene
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    • v.8 no.1
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    • pp.73-91
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    • 2008
  • In order to investigate the complaint rates of subjective fatigue symptoms and the degree of job-satisfaction among dental hygienists based on their socio-demographic and job characteristics and to find out the factors related with subjective fatigue symptoms and job satisfaction. The study subjects were recruited from 274 dental hygienists who worked at dental hospitals and clinics in Daejon city and South Chungcheong Province during the period between Jan. 5 and Feb. 11, 2008. They were asked to complete the self-administered questionnaires asking about their socio-demographic characteristics. job characteristics. daily life styles, job satisfaction and subjective fatigue symptoms, and the major finding of the results were as follows : 1. The mean scores of job satisfaction were 3.12V0.47 of the total full scores(5.00). and the highest scores were in the sub-domain of interpersonal relationship. and the lowest scores were pay. The scores of job satisfaction by socio-demographic characteristics and daily life styles were not significantly differences, but in job characteristics, significantly increased with those feeling satisfied with their job. those with appropriate amount of duty amount, those free of jop autonomy, those feeling satisfied with their monthly income. satisfactory personal relations at work. 2. The mean scores of subjective fatigue symptoms were 27.6V10.9 of the total full scores(60.0), and the highest scores were in the sub-group of bodily projection of fatigue(Group III), and they were followed by difficulty in concentration(Group II). dullness and sleepness(Group I) in their decreasing order of magnitude. The scores of job satisfaction by socio-demographic characteristics and daily life styles were significantly increased with the group of lower age, the group of irregularly breakfast habit and the worse subjective health status. Based on job characteristics. the score of subjective fatigue symptoms were significantly increased with those group of lower clinical career and monthly income, those feeling unsatisfied with their job, those with inappropriate amount of duty amount. those satisfactory personal relations at work 3. The correlation of subjective fatigue symptoms with job satisfaction showed a negative correlation with rM-0.198(pM0.000), and job satisfaction were higher according to the lower subjective fatigue symptoms. The correlation among the scores of sub-domain of job satisfaction and the sub-group of subjective fatigue symptoms were significantly positive correlation. 4. The affecting factors of significance on job satisfaction included clinical career, duty amount salary satisfaction, with the explanatory power of 32.9%. Those on subjective fatigue symptoms included the eucation and the subjective health statuts, with the explanatory power of 20.8%. When considering these results, the job-satisfaction and the subjective fatigue symptoms were significantly correlated with the job related factors than factors of socio-demographic characteristics and daily life styles. In addition. if job environments of dental hygienist can improved. their job-satisfaction and subjective fatigue symptoms are suggested to be betters.

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Design and Analysis of Ubiquitous Social Network Management Service Model: u-Recruiting Service Model (유비쿼터스 사회연결망관리 서비스 모델 설계 및 분석: u-구인 구직 서비스 모델을 중심으로)

  • Oh, Jae-Suhp;Lee, Kyoung-Jun;Kim, Jae-Kyeong
    • Information Systems Review
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    • v.13 no.1
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    • pp.33-59
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    • 2011
  • Although online social network services widely used in human networking and recruiting industries, it is showing off its limitations in followings-it's hard to reach the status of seamless connection between offline and online; the incompletion and low credibility of the information came from non-face-to-face profile exchange; and the restraint of user autonomy due to centralized control. This paper defines the ubiquitous social network management which enables the seamless real-time face-to-face social interactions of the users based on WPAN (Wireless Personal Area Network) who share the same interest in real word and deduces a ubiquitous social network management framework based on it. As an instance of ubiquitous social network management, u-Recruiting service model will be designed and analyzed. The Analysis using the business model will be followed by the possible scenario of service model. The role, value proposition and potential benefits of the each participants in this service model and will be given as well. In order to evaluate relative advantages of the model suggested by this study, 6 cases will be compared.

Relationship between Job Stress contents, Depression in dental hygienists in D City (D도시에 종사하는 일부 치과위생사의 직무스트레스 및 우울과의 관련성)

  • Han, Se-Young
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.10 no.11
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    • pp.3487-3493
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    • 2009
  • The degree of depression of dental hygienist was analyzed to reveal the various factors related to them. The self-administered between June 1st, and 30st, 2009, questionnaires were filled out from 221 dental hygienist in D City. 1.The distribution for depression degree has shown the rate as 79.1% in normal range group, 15.4% in mild depression group, 4.1% in moderate depression group and 1.4% in severe depression group, 2.As for depression, junior college, lower salary, poor sense satisfaction in work, not fit to the job, low personal relation with peer works or supervisors, poor subjective condition of health, without regular eating habits, without alcohol drinking, without regular exercise, in the group with higher level of job demand, lower job autonomy and lower supervisor support than their respective counterparts. 3.Concerning correlation between depression and various factors, while level of depression correlated with was negatively sense satisfaction, fit to the job, personal relation with peer works or supervisors, subjective condition of health, spervisor support, coworker support, it was positively correlated with job demand. Resulting from these results, in order to resolve depression properly, implementation and maintenance of program should be renewed to improve various kinds of factors.

A Study on the Infusion of Public Administrative Information Systems: Focusing on the Social Security Information System (공공행정 정보시스템의 내재화에 관한 연구: 사회보장정보시스템을 중심으로)

  • Park, Sun-Mi;Hwang, K.T.
    • Informatization Policy
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    • v.25 no.2
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    • pp.46-66
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    • 2018
  • This research explores the factors affecting infusion of public administrative information systems(IS) and analyzes its impact on work performance. For this purpose, the factors affecting the infusion of IS are classified into voluntary and involuntary motivations based on the self-determination theory that explains individual motivations. As factors for voluntary motivation, performance expectancy, personal innovativeness, and organizational citizenship behavior are proposed, while government influence, competitor influence, and the top-level management influence are proposed as factors for involuntary motivation. The analysis shows the voluntary motivation factors-performance expectancy, personal innovativeness, and organizational citizenship behavior-do affect infusion of IS, whereas the involuntary motivation factors-government influence, competitor influence, and the top-level management influence-have no statistically significant impact on the infusion of IS. The relationship between infusion of IS and work performance is found significant. While individuals are unable to decide on the adoption of IS in an involuntary environment such as in the case of using the public administrative IS, the results show that the factors related to individual autonomy have an important role in extended, active usage of IS beyond the mandatory level.

Manifest Weeds and Self-Actualization of Patients with Essential Hypertension (본태성 고혈압 환자의 자기실현 및 욕구구조에 관한 연구)

  • 강익화
    • Journal of Korean Academy of Nursing
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    • v.8 no.1
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    • pp.163-180
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    • 1978
  • Much of a person's energy is spent in the effort of becoming a productive member of to-day's complex society. This activity may cause tension, and chronic unrelieved tension is an influential factor in blood pressure elevation. The problem of this study was to identify manifest needs and self-actualization of patients with essential hypertension, and to analyse and compare their manifest needs and selt-actualization with the selected general characteristics of We, sex, religion, occupation and level of education with a control group of patients with normal blood pressure readings. The purpose was to contribute to the planning of nursing interventions toward reducing the impact of complex psycho-somatic factors on the anxiety of patients with essential hypertension. The instruments used included selected items from the Edwards (1959) Personal Preference Schedule (EPPS) as adapted by Hwang (1965) and from the Personal Orientation Inventory (POI) (Shostrom 1964, 1974) adapted by Kim and Lee (1977) to measure manifest needs and self-actualization. The convenience sample was chosen from 149 persons who presented themselves for general physical examinations at Ewha University Medical Centre and 41 patients diagnosed with essential hypertension at three general hospitals in Seoul during June 1 and August 31, 1977. Forty-nine persons from the Ewha group with blood-pressure readings exceeding 150/90 were added to the experimental group. Data were analysed by the S.P.S.S. computer programme using t-test and tests for statistical significance. Statistically significant findings were as follows: A. Blood Pressure and Manifest Needs. 1. with the exception of Autonomy, patients with hypertension had significantly high scores on all variables Abasement, Achievement, Affiliation, Aggression, Dominance, Emotionality, Exhibitionism and Sex. 2. When mean scores of normal persons were compared by age groups, normal persons had higher scores in the following order on Abasement (50's, 40's, 20's, 30's), Achievement (50's, 30's, 40's, 20's), Affiliation (50's, 40's, 30's, 20's), Dominance (50's, 40's, 40's, 20's) and Exhibitionism (30's, 50's, 40's, 20's). In each case, there was a significant difference between the first and last age group scores. 3. When the mean scores of normal persons were compared by sex, normal men had higher scores than women on Achievement, Affiliation, Aggression, Dominance, Exhibitionism and Sex. Male patients had higher scores than female patients on Achievement, Dominance, Exhibitionism and Sex, but female patients scored higher in Emotionality. 4. Normal persons had higher scores related to religion in the following order on Achievement (Buddhism, no religion, Christianity). Hyper tensive patients had higher scores on. Exhibitionism (no religion, Christianity, Buddhism). 5. Normal persons had higher scores related to occupation in the following order on Achievement and Exhibitionism (unemployed, office workers, teachless, businessmen), Emotionality (office workers, unemployed, businessmen, teacher) and Sex (office workers, unemployed, teachers, businessmen). Hypertensive patients had higher scores on Achievement and Aggression (teachers, businessmen, office worker, unemployed), Dominance and Exhibitionism (businessmen, teacher, of ace workers, unemployed) and Sex (teachers, office worker, businessmen, unemployed). 6. Normal persons had higher scores related to level of edification in the following order on Abasement, Emotionality and Autonomy (secondary school graduation, university). Hypertensive patients had higher scores on Abasement (no education, primary, university, secondary), Achievement (no education, secondary, university, primary) , Dominance (university, no education, secondary, primary), Exhibitionism (university, secondary, no education, primary), and Sex (university, secondary, primary, no education). B. Blood Pressure and Self_Actualization 1, Patients with hypertension had significantly lower scores on all variables. 2. Normal persons had higher scores related to age groups in the following order on Existentiality (20's, 30's, 40's, 50's). Hypertensive patients showed no significantly different scores. 3. Normal women had higher scores than men on Time Competence. Normal men had higher scores on Feeling Reactivity. Male patients had higher scores than women on Self-Actualizing Value and Self-Regard. 4. Normal persons ha 1 higher scores related to religion on spontaneity (Buddhism, no religion, Christianity). Hypertensive patients had higher scores on Time Competence and Nature of Man (Buddhism, Christianity, no religion). 5. Normal persons had higher scores related to occupation in the following order on Existentiality (teachers, office workers, businessmen, unemployed) and Self-Regard (unemployed, office workers, teachers, businessmen). Hypertensive patients showed no significantly different scores. 6. Normal persons had higher scores related to level of education in the following order on Existentiality and Self-Acceptance (university, secondary). Hypertensive patients had higher scores on inner-Director (university, secondary, no education, primary) and Existentiality (university, secondary, primary, no education). Recommendations for nursing interventions with hypertensive patients with emotional problems or low self-actualization were made. 1. The nurse should encourage the patient through her interactions with other members of the medical team to accept counselling and health education. 2. Through her therapeutic interpersonal relationships with the patient, the nurse should help him discover the causes of his emotional tension. 3. Through her health teaching with the family, the nurse should encourage them to participate with the medical team in the patient's therapeutic plan and in providing him with the minimum possible emotional support. 4. Through frequent counselling with the obsessive-thinking and inflexible patient, the nurse should reevaluate the patient's behaviour and her interventions. 5. Seriously ill patients should be given needed reeducation by members of the professional medical team.

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Exploration of the Relationship Structure of Personal and Social Cognitive Factors Affecting Professional Help-seeking Decisions for Distress among People in Low-income (저소득층의 디스트레스에 따른 전문가 도움추구의 결정에 영향을 미치는 개인 및 사회인지 요인들의 관계구조 탐색)

  • Park, Sunyoung
    • Korean Journal of Social Welfare
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    • v.67 no.2
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    • pp.85-112
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    • 2015
  • This study examined the relationship structure among personal and social cognitive factors contributing to professional help-seeking decisions to relieve distress of those in low-income, then suggested an appropriate model to inform knowledge for better social work practice. Using data of a purposive sampling from 331 low-income people, covariance structural analyses were conducted in two stages of model exploration, one for TPB model and another for its extended model including the level of distress, family support, and willingness. As results, in the path analyses with the observed variables of the basic components of the TPB, subjective norm showed the strongest effect on the intention, following by attitudes towards help-seeking, then behavioral control the least; in turn both the intention, positively, and behavioral control, negatively, contributed to help-seeking decisions. In the second stage of the path analyses with the extended model of the TPB, each of distress and family support demonstrated direct positive effect on each of attitudes, subjective norm, and behavioral control; each of the attitudes, subjective norm, and behavioral control showed positive effect on both intention and willingness; in turn, while intention showed strong positive effect on help-seeking decisions, willingness had no significant effect and behavioral control had negative effect on decisions. There were significant indirect effects of behavioral control on intention through willingness and of willingness on decisions through intention. These results suggested that the TPB model is useful for modeling help-seeking decisions through personal and social cognitions, especially the significance of subjective norm implied the importance of social cognition for the people in low-income with distress. Further, it was implied that the extended model needs to address particularity of those people in low-income and the mechanism shown by behavioral control and willingness implied the importance of practicing respect for the client's autonomy and will for self-support in social work practice.

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Occupational Stress of Hospital Workers (병원종사자의 직업성 스트레스에 관한 연구 - 서울시내 500병상 이상 병원종사자를 중심으로 -)

  • Lee, Woo-Cheon
    • Korea Journal of Hospital Management
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    • v.3 no.1
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    • pp.1-33
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    • 1998
  • The purpose of this thesis is to study theoretical access to the methods that have been used for the research of occupational stress, thereby providing management methods of occupational stress of hospital workers. With a stress model of hospital workers set up from the viewpoint of organization management, 929 sets of questionnaires were collected from intern doctors, resident doctors, nurses, nursing aides, pharmacists, medical technicians, workers in patient affairs(reception and medical insurance workers), administrators and clerks from the 8 hospitals in Seoul with more than 500 beds. Upon variance analysis, correlation analysis and regression analysis of the collected questionnaires, this work examined how differences in stress caused by specific occupations and formulated a method of stress management for the hospital workers. The results are as follows. 1) If some duties of the nurses suffering from role-overloaded stress are transferred to the nursing aides dissatisfied with insufficient role, the two grunting groups can be satisfied at the same time. It is also necessary to transfer some jobs of the overloaded workers in patient affairs to the administrators, or the other way around. To reduce stress of conflict and ambiguity of role caused by the obscure division of roles between the workers, the role of each occupation should be delineated and the clear division of roles should be translated into action strictly according to that delineated. 2) Stress of inefficiency of organization from which the student doctors suffer can be relieved by management of participation. If they have access to the process of decision-making in general hospital affairs and consequently their understanding and the autonomy of job performance are promoted, such stress will be reduced. 3) To cope with stress of career development from which nurses, medical technicians, administrators, workers in patient affairs suffer, it is necessary to establish whether they have a chance to revive their careers, whether there are any ways of remotivation for less contributive workers, and whether they encourage each other to develope their careers. If they are given a chance to develope their careers, such stress will be relieved. 4) Pharmacists, suffering from stresses of living and personal relations, have strong cohesive power among themselves and organize a well-integrated team; thereby reducing the stress of personal relations and increasing productivity. 5) For administrators and student doctors confined to lesser social supports and for nurses and workers in patient affairs whose recognition of stress and job satisfaction are affected by social supports, emotional and informational supports for job performance help alleviate an individual's mental, and physical stress. 6) In addition to the above-mentioned stress-management methods, if an organizational coping strategy is provided according to the types of stress from the general viewpoint of the whole group of hospital workers, it would be of great help to managing stress. For example, the redesign of jobs, the management of objective, the improvement of working environment, the formation of an autonomous working group and various working plans can be set up for those who suffer from stress related to inappropriate role, while career counseling and development of career process can be provided for those dissatisfied with career development. Participation in the process of decision-making and the restructuring of the organization are needed for those who suffer from stress of malfunctioning organization, whereas creation of a supportive organizational atmosphere is desired for those who feel stressed due to personal relations. As well, such organizational coping strategies. as the increase of welfare facilities, seminars and educational programs and provision of health-promotion facilities can be provided.

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Influence of Empowerment and Job Satisfaction of Private Day Care Center Teachers on Infant's Right Respect Care (민간어린이집 교사의 임파워먼트와 직무만족도가 영유아 권리존중보육에 미치는 영향)

  • Cho, Sin Sook;Kim, Jung Hee
    • Korean Journal of Child Education & Care
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    • v.18 no.3
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    • pp.1-20
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    • 2018
  • Objective: The purpose of this study is to provide practical data to effectively implement day care that respects the rights of infants in day care centers by investigating the relationship between private day care center teachers' empowerment, job satisfaction, infant's right respect care, and examining the influence of empowerment and job satisfaction of private day care center teachers on Infant's right respect care. Methods: The 228 day care teachers who work in private daycare centers located in Seoul and Gyeonggi province were the investigated subjects. For the analysis of questionnaire, frequency, percentage, reliability, t-test, ANOVA, correlation, and regression were used as SPSSWIN 20.0 program. Results: First, the difference of empowerment according to the individual variables of teachers was different to career, monthly salary, marital status, and turnover intentions. The difference of job satisfaction according to personal variables showed difference to age, career, marital status, type of work organization, and number of teachers and classes. There was a difference in infant's right respect care to age and marital status. Second, in the relationship between empowerment and job satisfaction and between empowerment and infant's right respect care, there was a positive correlation. The relationship between job satisfaction and infant's right respect care showed there is a positive correlation between infant's right respect care and all other factors except for the pay and promotion factors of job satisfaction. Third, Expert extension, autonomy, fellow relationship and job self have a positive influence on infant's right respect care. Conclusion/Implications: This study suggests that specific efforts should be made at the daycare center to raise the level of expertise and autonomy of private daycare teachers and to give satisfaction to their fellow relationship and their job self factors to effectively implement infant's right respect care.