• The Korean Society of Law and Medicine
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• v.10 no.2
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• pp.309-341
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• 2009

According to a case of Supreme Court's Sentence No. 2009DA17417 (May 21, 2009), the Supreme Court judges that 'the right to life is the ultimate one of basic human rights stipulated in the Constitution, so it is required to very limitedly and conservatively determine whether to discontinue any medical practice on which patient's life depends directly.' In addition, the Supreme Court admits that 'only if a patient who comes to a fatal phase before death due to attack of any irreversible disease may execute his or her right of self-determination based on human respect and values and human right to pursue happiness, it is permissible to discontinue life-sustaining treatment for him or her, unless there is any special circumstance.' Furthermore, the Supreme Court finds that 'if a patient who is attacked by any irreversible disease informs medical personnel of his or her intention to agree on the refusal or discontinuance of life-sustaining treatment in advance of his or her potential irreversible loss of consciousness, it is justifiable that he or she already executes the right of self-determination according to prior medical instructions, unless there is any special circumstance where it is reasonably concluded that his or her physician is changed after prior medical instructions for him or her.' The Supreme Court also finds that 'if a patient remains at irreversible loss of consciousness without any prior medical instruction, he or she cannot express his or her intentions at all, so it is rational and complying with social norms to admit possibility of estimating his or her own intentions on withdrawal of life-sustaining treatment, provided that such a withdrawal of life-sustaining treatment meets his or her interests in view of his or her usual sense of values or beliefs and it is reasonably concluded that he or she could likely choose to discontinue life-sustaining treatment, even if he or she were given any chance to execute his or her right of self-determination.' This judgment is very significant in a sense that it suggests the reasonable orientation of solutions for issues posed concerning withdrawal of meaningless life-sustaining medical efforts. The issues concerning removal of medical instruments for meaningless life-sustaining treatment and discontinuance of such treatment in regard to medical treatment for terminal cases don't seem to be so much big deal when a patient has clear consciousness enough to express his or her intentions, but it counts that there is any issue regarding a patient who comes to irreversible loss of consciousness and cannot express his or her intentions. Therefore, it is required to develop an institutional instrument that allows relevant authority to estimate the scope of physician's medical duties for terminal patients as well as a patient's intentions to withdraw any meaningless treatment during his or her terminal phase involving loss of consciousness. However, Korean judicial authority has yet to clarify detailed cases where it is permissible to discontinue any life-sustaining treatment for a patient in accordance with his or her right of self-determination. In this context, it is inevitable and challenging to make better legislation to improve relevant systems concerning withdrawal of life-sustaining treatment. The State must assure the human basic rights for its citizens and needs to prepare a system to assure such basic rights through legislative efforts. In this sense, simply entrusting physician, patient or his or her family with any critical issue like the withdrawal of meaningless life-sustaining treatment, even without any reasonable standard established for such entrustment, means the neglect of official duties by the State. Nevertheless, this issue is not a matter that can be resolved simply by legislative efforts. In order for our society to accept judicial system for withdrawal of life-sustaining treatment, it is important to form a social consensus about this issue and also make proactive discussions on it from a variety of standpoints.

• Journal of Korean Academy of Nursing
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• v.22 no.2
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• pp.207-226
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• 1992

This study was designed to develop a conceptual framework for the curriculum and develop the details of the learning content for the education of Community Health Practitioners (CHPs). Since education programs for CHPs started 10 years ago, concepts related to CHP services have changed because of changes in society. The objectives of the study were as follows : 1) to analyse the usefulness of the present education program for CHPs, 2) to analyse the Job performance and self -confidence of the CHPs, 3) to identify the health needs of the clients served by the CHPs and the community problems related to health. 4) to develop a conceptual framework for the curriculum, for the education of CHPs, 5) to develops details for the learning content of the education program for CHPs. Phase I of the study was conducted by questionnaires to 150 CHPs who have worked in remote rural areas for more than 2 years. Among them, 147 responded. Data was collected from August 16, to August 25, 1990. In order to identify the health needs of the community people, research within the last five years was reviewed and analyzed. The data on 1, 842 communities gathered by the WHO Nursing Collaborations Center of the College of Nursing, Yonsei University was utilized to identify community problems related to health and the self - confidence in job performance of the CHPs. Psase II of the study consisted of a workshop with 13 professionals including Community Health Practitioners to evaluate the existing education program and a conceptual framework of the curriculum for the job education of CHPs. The results of the study are Summariged below : 1. The only 26 among 45 content items of the education program related to job skills was used by 80% of the responding CHPs. The knowledge of $\ulcorner$Networking community organization$\lrcorner$ was used by only 53.7% of the respondents. Educational content about $\ulcorner$Mental disease$\lrcorner$ was used by less than 50% of CHPs because of a knowledge deficit. 2. The CHPs reported that their activities concentrated on clinical services during the last six months. The survey showed that they seemed to neglect the activities for health promotion and disease prevention. Thus, $\ulcorner$Education for community loaders$\lrcorner$(15.9%), $\ulcorner$Activity for eavironmental health$\lrcorner$(16.3%) and $\ulcorner$Social work for needey people$\lrcorner$(23.3%) were done by less than 30% of CHPs. 3. More than 90% of CHPs reported being self - confident for the activities of $\ulcorner$Health education and counselling$\lrcorner$, $\ulcorner$Medicine prescription$\lrcorner$ and $\ulcorner$Immunization$\lrcorner$. But 50% of CHPs reported that they were not have self - confident in $\ulcorner$Management of water and environmental health$\lrcorner$ and only 25.6% of CHPs could insert an IUD independently. 4. It was identified that respiratory diseases and the gastrointestinal diseases were most common problems for the community people, followed by musculoskeletal and skin problems. 5. The community problems were classified into eight categories : physical environmental problems, environmental hygiene, health problems, health behavior, social problem, lack of resources, financial problem and the problems of the cultural and value system. 6. The conceptual framework consisted of the target population and their health status, nursing process working site and primary health care services such as health promotion, disease prevention, treatment and rehabilitation. 7. The contents of curriculum of education program for CHPs were formulated from the results of this study.

• Korean Journal of Health Education and Promotion
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• v.17 no.1
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• pp.131-154
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• 2000

This study was conducted to provide basic data for development of public information program and public policy which could prevent the medicine abuse in Korea, examining the level of knowledge of medicine and its related factors. Data were collected from the 2,011 residents who live in mtropolitan cities, large-sized cities, small and medium cities, and small towns The results of this study are summarized as follows. 1) In case of purchasing of medicines in pharmacy, 67.3％ of the respondents chose the medicines through recommendations of the professionals such as pharmacists and doctors, while 32.7％ of the respondents chose the medicine through self-judgement, advertizing, or recommendation of relative. 2) 64.7％ of the respondents obtained the information on medicines through TV. It appeared to be higher in the groups of female of the twenties, the unmarred, a brother and sister threesome, highschool graduates, housewives, residents in small and medium cities, atheists, and the middle class, displaying the significant difference from the other groups. 3) 40.5％ of the respondents recognized the side effect of the medicine when they took the medicine, while 34.4％ did not recognize it. The rate of experience in the side effect was 39.7％. The informations on the medicine abuse and the risk of addiction were obtained through broadcast media (47.9％), publications (12.1％), and health professionals (11.6％). 4) 81.1％ of the respondents experienced taking of the fatigue relieving medicine. The experience in taking of the fatigue relieving medicine appeared to be higher in the groups of the forties. the married. a brother and sister threesome. highschool graduates. persons engaging in farming, livestock raising, and forestry, the residents in small towns, and Christians. Each group displayed the significant difference from the other groups. 5) According to the level of knowledge of medicines, the respondents marked average 11.7 ± 3.76 points on the base of 24 points. It appeared to be higher in the groups of female of the twenties, a brother and sister foursome, college graduates, teachers, Catholics, and the middle class, displays the significant difference from the other groups. 6) According to the experience in taking of health medicine and health food, 81.1％ of respondents had the experience in taking ‘the fatigue relieving medicine’; 72.4％ ‘carrot or vegetable juice’; 69.5％ ‘ginseng’; 63.0％ ‘mushroom’; 42.5％ ‘dog meat’; 38.0％ ‘aloe’; 36.4 ‘deer antlers’; 11.4％ ‘snake’; 2.0％ ‘the penis of a fur seal’. 7) The factors influencing the level of knowledge of medicine include experiences in taking of the tonic, the fatigue relieving medicine, and the nutritive medicine, economic status, the number of brothers and sisters, education level, marital status, father's education level, and age. The factors influencing the experience in side effect of medicine are experiences in taking of the fatigue relieving medicine, the nutritive medicine, and the tonic, sex, age, education level, father's education level, marital status, economic status, religion, and the number of brothers and sisters. In conclusion, it is estimated that the level of knowledge of medicines is significantly low in Korea. Especially, it is found out that workmen, students, the upper class, the class of low education level, and persons engaging in farming, livestock raising, and forestry neglect importance of knowledge of medicine. Therefore, it is necessary for public authority, associations related, and health professionals to develop programs for public information and education to help people obtain basic knowledge of medicine.

• Journal of Hospice and Palliative Care
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• v.3 no.1
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• pp.60-73
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• 2000

Purpose : The purpose of this study was to describe a total pain model in patients with terminal cancer and to identify factors relating to total pain using the Twycross Pain Management Model, which included physical, psycho-social and spiritual pain. Method : The study was a retrospective descriptive study. The first stage included 87 patients who received hospice service at Y hospital in 1997. The second stage included five model patients who suffer severe pain as selected by the four hospice nurses. Data collection was from 1) chart analysis and 2) in-depth interviews with the hospice nurses about their selected patients. Data analysis was performed using SPSS-WIN and content analysis. Result : 1) The main problems of 3 patient with terminal cancer were pain(77%), constipation (25.3%), family coping(35.6%), psycho-spiritual distress(17.2%)and other symptoms. 2. The Twycross model was a useful model. However, new items were added; loneliness, depression, and no improvement in condition as depression factors. In anger, new items were anger due to family neglect, at God and in relationships. The case studies identified the followsing; 1) Patient suffer from physical pain as well as multiple other symptoms when cancer is advanced. 2) Body concept, role change, threat to self concept, fear of pain, fear of death, anxiety, family conflict, financial burden, spiritual distress, hope for a cure, are all affected. Conclusion : 1) It is believed that the Twycross model is useful but further tests and revisions are necessary for deciding priorities in the care plan. 2) Pain management must improve culturally appropriate and family support, psychological, spiritual care are imperative for patient with terminal cancer. 3) Further study is recommended to test correlations of depression, anxiety, spiritual distress and family coping using valid instruments. A qualitative study on the spiritual journey of the patient with terminal cancer is also recommended.

• Journal of Preventive Medicine and Public Health
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• v.53 no.2
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• pp.89-97
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• 2020

Objectives: The quality of life (QoL) of the elderly and elder abuse are growing public health concerns. This study aimed to evaluate the prevalence of abuse and the association between QoL and abuse in older adults. Methods: Multistage random cluster sampling, along with valid QoL (LEIPAD: LEIden, the Netherlands; PADua, Italy; Helsinki, Finland) and abuse questionnaires, were used to assess QoL and elder abuse. Path analysis was performed using Mplus. SPSS and AMOS were used for the other analyses. Results: A total of 386 elderly individuals with a mean age of 68.00±6.10 years were interviewed, of whom 200 (51.8%), 289 (74.9%), and 376 (97.4%) were women, educated, and married, respectively. Moreover, 167 (43.2%) had low-to-moderate QoL, and 108 (27.9%) had experienced a moderate level of abuse. QoL and abuse were inversely associated (r=-0.253), with men (β=-0.24) more affected than women (β=-0.21). Musculoskeletal disorders were also strong determinants of QoL in the elderly. QoL was strongly associated with emotional abuse, while abuse was highly related to the social component of QoL. Furthermore, emotional abuse was the type of abuse most significantly associated with the self-care, depression/anxiety, cognitive, and social components of QoL. Sexual abuse, violation of personal rights, and neglect were the main determinants of the physical functioning, life satisfaction, and sexual domains of QoL, respectively. Conclusions: Nearly half of the elderly individuals lacked a high QoL, and at least one-fourth had experienced some form of abuse. Elder abuse was correlated inversely with QoL. Therefore, preventive interventions are recommended to decrease elder abuse in the family, community, and other settings.

• Journal of Distribution Science
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• v.12 no.8
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• pp.43-54
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• 2014

Purpose - This study was based on a theoretical consideration of the structural relationship between the support and control of the franchisor and the satisfaction and strategic response (voice, loyalty, exit, neglect) of the franchisee. First, based on the preceding research, this study systematically organized the type of support and control of the franchisor. Second, the study examined the effects of a franchisor's support and control on the expectancy disconfirmation between affiliated franchisees' expectations before a franchise agreement and performance after operating an affiliated store. Third, the study looked into the effects of expectancy disconfirmation relating to a franchisor's support and control on an affiliated franchisees' general satisfaction. Fourth, this study examined the influence of the general satisfaction of a franchisee on affiliated franchisees' response strategies. Research design, data, and methodology - In this study, the population comprised the nation's franchisors, and the sample comprised franchisees conducting business in Seoul and Gyeonggi-do. A self-administered questionnaire was used; the author and examiner explained the study's parameters to the interviewees in advance, to lessen the rate of rejection of the answers and to maintain reliability. The author distributed 350 copies of the questionnaire and collected 327 copies (93.4%). The author removed 54 copies of the sample, as these copies belonged to franchisees that were not registered by the Fair Trade Commission and/or were thought to have either defects or inadequate answers. The author selected an effective sample of 273 copies to enter data and to do the statistical analysis. Results - Both a reliability analysis and a confirmatory factor analysis were performed to measure reliability and validity, and a structural equation model was used to conduct the hypothesis test and investigate the models. The hypothesis was tested (Table 5). The models had a suitable fit, for instance, χ² = 447.663(df = 212, p = .000), χ²/df = 2.112, GFI = .881, AGFI = .858, RMR = .083, RMSEA = .067, NFI = .932, and CFI = .961. The hypothesis test results were as follows. Hypothesis 1 was accepted (C.R. = -2.339, p = .019). Hypothesis 2 was accepted (C.R. = 15.213, p = .000). Hypothesis 3 was accepted (C.R. = -2.631, p = .006). Hypothesis 4 was accepted (C.R. = 16.271, p = .000). Hypothesis 5 was accepted (C.R. = 2.391, p = .017). Hypothesis 6 was accepted (C.R. = 5.777, p = .000). Hypothesis 7 was accepted (C.R. = 17.153, p = .000). Hypothesis 8 was accepted (C.R. = 24.746, p = .000). Hypothesis 9 was accepted (C.R. = -10.150, p = .000). Hypothesis 10 was accepted (C.R. = -12.124, p = .000). Conclusions - The research results showed that expectations for a franchisor's support and control had a significant influence on expectation disconfirmation in a negative way, whereas the performance of support and control were found to have a significant influence on expectation disconfirmation in a positive way. In addition, the expectation disconfirmation of support and control was found to have a significant influence on satisfaction of franchisees in a positive way. Generally, regarding the research on control, control is found to have a negative influence on the satisfaction of franchisees, but this study proves that control is found to affect it in a positive way through conformity.

• Journal of The Korean Association For Science Education
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• v.39 no.2
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• pp.307-320
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• 2019

This study explores how an elementary school homeroom teacher who continued to lecture, can use diversified science teaching methods for learner-centered instruction. Using an auto-ethnographic approach over the course of a year, self-memory data, facebook diaries, class diaries, and interview data of an elementary teacher's day-to-day preparations and practice of elementary science, in the context of a Korean elementary school, were collected. The data was analyzed through cultural historical activity theory, examining how the interplay of key elements (i.e., the subject as a homeroom teacher with instructional expertise, norms, community, division of labor, tools, and goals) was characterized within and across distinct two-activity systems, and how these elements shaped the teacher's teaching methods into either lecture format or diversified teaching. The study revealed that a non-cooperative community, lack of division of labor, and norms that neglect preparation for science class were the elements that perpetuated the lecture format, and that a contradiction between goals and tools occurred in the activity system. However, these elements were able to be transformed into a cooperative community, shared labor, and norms that saved preparation time for both science class and diversified teaching methods, and those changed elements facilitated the teacher in using diversified teaching methods (e.g., experiments, subject-integrated classes, field work), thereby mitigating the contradiction. This study also discusses that diversified teaching methods can be facilitated when dealing with norms, community, and division of labor elements in an elementary school context as well as improving individual teachers' instructional expertise.

• Korean Journal of Social Welfare Studies
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• v.47 no.1
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• pp.29-56
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• 2016

The purpose of this study is first, to explore the level of codependency among social work related professionals since codependency of professionals in the field has not been explored much in Korea. Second purpose is to examine whether codependency affects the level of burnout. Last purpose is to examine moderating effects of the Sex-role attitude on the relationship between codependency and burnout. Data were collected from the 11th of December in 2014 until the 28th of February in the following year. Self-administered questionnaires were distributed to care professionals practicing in social work institutions in Daejeon City and Choongcheong province, via email and mail. In addition, surveys were administered at several continuing education training venues. Instruments used for this study include CODAT(Codependency Assessment Tool) developed by Hughes-Hammer and colleagues in 1998, MBI(Maslach Burnout Inventory) developed by Maslach and Jackson in 1981, and SRA(Sex Role Attitude) developed by Osmond and Maryin in 1975. In total, 368 surveys were used for final analysis. The results include that gender did not have statistically significant relationship with the overall codependency, however, male showed statistically higher score than female in one of subscales of codependency called hiding oneself. Workers in the residential settings showed higher level of codependency than those in non-residential settings, especially in the subscale of Other focus or Self-neglect. Codependency showed a strong relationship with Burnout. Among the five-factor structure of the CODAT, Medical problem, Low Self-worth and Family of Origin showed strong relationship with the Burnout score. And the moderating effects of Sex-role Attitude showed a statistically significant relationship between codependency and burnout. Conservative sex-role attitude amplified the level of burnout on the relationship between codependency and burnout. Based on the result, educational and policy implications were made in order to prevent burnout among social work related professionals.

• Korea Journal of Hospital Management
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• v.11 no.1
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• pp.1-30
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• 2006

According to the available data, in these days, the number of medical accidents and disputes have significantly increased since 1990 in Korea. From this aspect, a variety of approaches and efforts to solve these problems is needed before it is too late. This study intended to identify the thoughts of patients who are directly connected with medical accidents and disputes and then to consider reasonable settlement methods of the increasing disputes. For achieving the purpose of this study, the self-administerd questionnaire was conducted with 450 out-patients who visited three university hospitals, five small and medium-sized hospitals, and ten clinics in Seoul from June 13 to 17, 2005. Incomplete questionnaires were omitted and 410 respondents(91%) were included for the analysis of this study. Each section of the survey was composed of six categories such as the recognition of malpractice, a compensation system about no-fault medical accidents, the recognition of the judgement of medical accidents in court, reasonable settlement of medical accidents, reasons of lawsuit, and the need of the medical dispute settlement organization. The major results of this study were as follows. First, more than half of the respondents, 51.9 percent, worry about malpractice. And many respondents think malpractice causes their symptoms to persist or become worse, and also some respondents think that the doctor's prescription changed too frequently. Second, as for a compensation system about no-fault medical accident, 55.7 percent of the respondents insist that a proper compensation for suffering patients or their families should be provided. And also as for the responsibility of compensation, respondents think joint compensation of both the medical institution and the government is needed foremost, followed by the medical insurance company and finally by the medical institution. The government as well as the related institutions should take responsibility for malpractice accidents for which the doctor is not responsible. Third, as for the acknowledgment of medical accident judgements by the court, 32.8 percent of respondents think that it is best to compromise with a medical institution, followed by lawsuit(26.2%), the assistance of civil organization(23.2%), and a powerful physical protest(7.6%). Fourth, as for the lawsuit of medical accidents, 62.9 percent of respondents think that patients and their families would be in a disadvantageous position in relation to medical institutions and doctors mentioning the lack of professional medical and lawful knowledge, experience and know-how as the reason. So many people have given up appeals owing to the difficulties involved in defending themselves through evidence. Fifth, about a half share of the respondents indicated that the medical institution's neglect of the responsibility of medical accidents is one of the most important reasons of lawsuit. And next respondents mentioned the lack of the medical dispute settlement organization and a general distrust of medical institutions and doctors. Sixth, a majority of respondents consented to the introduction of the need of the medical dispute settlement organization, And about a half of the respondents mentioned a readiness to accept the mediation of the organization, but the rest did not express a clear opinion. It seems that conflict among the parties concerned have existed in relation to the medical dispute settlement organization and related legislation for many years. But as this study has shown, the needs of the medical dispute settlement organization is in desperate demand. Therefore, more negotiation efforts from all interest groups should be considered for the birth of the medical dispute settlement organization and related legislation.

• Korean Journal of Comparative Education
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• v.27 no.4
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• pp.187-209
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• 2017

The purpose of this study was to highlight the necessity of a conceptual reestablishment of world university evaluations. The hitherto most well-known and validated world university evaluation systems such as Times Higher Education (THE), Quacquarelli Symonds (QS) or Academic Ranking of World Universities (ARWU) primarily assess big universities with quantitative evaluation indicators and performance results in the rankings. Those Systems have instigated a kind of elitism in higher education and neglect numerous small or local institutions of higher education, instead of providing stakeholders with comprehensive information about the real possibilities of tertiary education so that they can choose an institution that is individually tailored to their needs. Also, the management boards of universities and policymakers in higher education have partly been manipulated by and partly taken advantage of the elitist ranking systems with an economic emphasis, as indicated by research-centered evaluations and industry-university cooperation. To supplement such educational defects and to redress the lack of world university evaluation systems, a new system called 'U-Multirank' has been implemented with the financial support of the European Commission since 2012. U-Multirank was designed and is enforced by an international team of project experts led by CHE(Centre for Higher Education/Germany), CHEPS(Center for Higher Education Policy Studies/Netherlands) and CWTS(Centre for Science and Technology Studies at Leiden University/Netherlands). The significant features of U-Multirank, compared with e.g., THE and ARWU, are its qualitative, multidimensional, user-oriented and individualized assessment methods. Above all, its website and its assessment results, based on a mobile operating system and designed simply for international users, present a self-organized and evolutionary model of world university evaluation systems in the digital and global era. To estimate the universal validity of the redefinition of the world university evaluation system using U-Multirank, an epistemological approach will be used that relies on Edgar Morin's Complexity Theory and Karl Popper's Philosophy of Science.