• Title/Summary/Keyword: Social medicine

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Legal Issues on the Collection and Utilization of Infectious Disease Data in the Infectious Disease Crisis (감염병 위기 상황에서 감염병 데이터의 수집 및 활용에 관한 법적 쟁점 -미국 감염병 데이터 수집 및 활용 절차를 참조 사례로 하여-)

  • Kim, Jae Sun
    • The Korean Society of Law and Medicine
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    • v.23 no.4
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    • pp.29-74
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    • 2022
  • As social disasters occur under the Disaster Management Act, which can damage the people's "life, body, and property" due to the rapid spread and spread of unexpected COVID-19 infectious diseases in 2020, information collected through inspection and reporting of infectious disease pathogens (Article 11), epidemiological investigation (Article 18), epidemiological investigation for vaccination (Article 29), artificial technology, and prevention policy Decision), (3) It was used as an important basis for decision-making in the context of an infectious disease crisis, such as promoting vaccination and understanding the current status of damage. In addition, medical policy decisions using infectious disease data contribute to quarantine policy decisions, information provision, drug development, and research technology development, and interest in the legal scope and limitations of using infectious disease data has increased worldwide. The use of infectious disease data can be classified for the purpose of spreading and blocking infectious diseases, prevention, management, and treatment of infectious diseases, and the use of information will be more widely made in the context of an infectious disease crisis. In particular, as the serious stage of the Disaster Management Act continues, the processing of personal identification information and sensitive information becomes an important issue. Information on "medical records, vaccination drugs, vaccination, underlying diseases, health rankings, long-term care recognition grades, pregnancy, etc." needs to be interpreted. In the case of "prevention, management, and treatment of infectious diseases", it is difficult to clearly define the concept of medical practicesThe types of actions are judged based on "legislative purposes, academic principles, expertise, and social norms," but the balance of legal interests should be based on the need for data use in quarantine policies and urgent judgment in public health crises. Specifically, the speed and degree of transmission of infectious diseases in a crisis, whether the purpose can be achieved without processing sensitive information, whether it unfairly violates the interests of third parties or information subjects, and the effectiveness of introducing quarantine policies through processing sensitive information can be used as major evaluation factors. On the other hand, the collection, provision, and use of infectious disease data for research purposes will be used through pseudonym processing under the Personal Information Protection Act, consent under the Bioethics Act and deliberation by the Institutional Bioethics Committee, and data provision deliberation committee. Therefore, the use of research purposes is recognized as long as procedural validity is secured as it is reviewed by the pseudonym processing and data review committee, the consent of the information subject, and the institutional bioethics review committee. However, the burden on research managers should be reduced by clarifying the pseudonymization or anonymization procedures, the introduction or consent procedures of the comprehensive consent system and the opt-out system should be clearly prepared, and the procedure for re-identifying or securing security that may arise from technological development should be clearly defined.

A Study for The Prognostic Indicators of Korean Alcoholics in Psychological, Social and Biological Aspects (한국인 알코올중독 환자의 예후인자에 관한 연구 : 심리적, 사회적, 생물학적 요인을 중심으로)

  • Sung, Sang-Kyung;Chang, Hwan-Il
    • Korean Journal of Biological Psychiatry
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    • v.2 no.2
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    • pp.218-236
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    • 1995
  • The author studied prognostic indicators of sixty Korean male alcoholics in psychological, social and biological aspects who were divided into abstinent and drinking groups. Thirty patients were assigned to each group. They were controlled in age and sex. Both groups were compared in terms of the demographic characteristics, past drinking history, treatment history, famaily history, ego strength and personality factors differences and distribution of dopamine $D_2$ receptor gene Al allele. Also the author studied relation of clinical course, alcoholic family history and dopamine $D_2$ receptor gene Al allele in both groups. The results were as follows; 1) The abstinent group had higher rate of married state, higher economic status, longer education years and maintained more stable job than the drinking group. But made no differences in occupation and religion. 2) The abstinent group showed higher rate of living with family members than the drinking group, and wives and fellows of the alcoholics anonymous were important factors for maintenance of abstinence. Family loading and parent's characters were not different. 3) The abstinent group had longer maximal length of abstinence but mean amount of alcohol consumption per day were larger than the drinking group. But there were no differences in duration of past drinking, drinking pattern, main drinking time, first drinking age and preference of the kind of alcoholic beverage in the past drinking history. 4) The abstinent group showed stronger treatment motivation, absolute abstinence in treatment goal, more voluntary adimission and maintained longer therapeutic relationship otter discharge than the drinking group. But both groups showed negative attitude toward antabuse therapy. 5) The abstinent group had higher mean score in ego strength scale than the drinking group. 6) In the personality factor questionnaire, the abstinent group showed strong laugh poise and the trait of praxernia, conservatism personality but the drinking group showed tough poise, the trait of weak ego strength(unstableness) and tough mindedness personality. 7) In comparision of dopamine $D_2$ receptor gene A1 allele, the prevalence of A1 allele was seventy percent and the frequency was 0.38 in the abstinent group. The prevalence of A1 allele was sixty percent and the frequency was 0.42 in the drinking group. Both groups were not significantly different in A1 allele prevalence and frequency. 8) In comparision of dopamine $D_2$ receptor gene A1 allele according to alcoholic family history, the prevalence of A1 allele was seventy percent and the frequency was 0.43 in the family history positive group. The prevalence of A1 allele was sixty-one percent and the frequency was 0.38 in the family history negative group. Both groups were not significantly different in A1 allele prevalence and frequency. In comparision of past drinking history according to alcoholic family history, the family history positive group showed earlier first drinking and problem drinking, but the family history negative group hod longer duration of past drinking. The mean amount of alcohol consumption per day, the longest duration of abstinence and Alcoholism Screening Test of Seoul Natoinal Mental Hospital(NAST) results were not significant. In conclusion, the results suggest that successful prognostic indicators of Korean alcoholics are married state, higher economic status, longer education years, stable job, living with family members, longer abstinence during past drinking history, strong treatment motivation, absolute abstinence in treatment goal, voluntary adimission, maintained therapeufic relationship, strong ego strength and the trait of praxernia, conservatism personality. But occupation, religion, alcoholic family history, parent's characters, duration of past drinking, drinking pattern, main drinking time, first drinking age, preference of the kind of alcoholic beverage, attitude to antabuse therapy and distribution of dopamine $D_2$ receptor A1 allele were not significantly related to the prognostic indicators of Korean alcoholics.

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Questions and Answers about the Humidifier Disinfectant Disaster as of February 2017 (가습기살균제 참사의 진행과 교훈(Q&A))

  • Choi, Yeyong
    • Journal of Environmental Health Sciences
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    • v.43 no.1
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    • pp.1-22
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    • 2017
  • 'The worstest environment disaster', 'World's first biocide massacre', 'Home-based Sewol ferry disaster' are all phrases attached to the recent humidifier disinfectant disaster. In the spring of 2011, four of 8 pregnant women including 1 adult man passed away at a university hospital in Seoul due to breathing failure. Epidemiologic investigation conducted by the Korean CDC soon revealed the inhalation of humidifier disinfectant, which had been widely used in Korea during the winter, to be responsible for the disease. As well as lung fibrosis hardening of the lungs, other diseases including asthma, rhinitis, skin disease, liver disease, fetal disease or cancers have been researched for their relation with exposure to the products. By February 9, 2017, 5,342 cases had registered for health problems and 1,131 of them were already dead (20.8% mortality rate). Based on studies by government agencies and a telephone survey of the general population by Seoul National University and civic groups, around 20% of the general public of Korea has used these products. Since the market release of the first product by SK Chemical in 1994, over 7.1 million items from around 20 brands were sold up to 2011. Most of the products were manufactured by well-known large conglomerates such as SK, Lotte, Samsung, Shinsegye, LG, and GS, as well as some European companies including UK-based Reckitt Benckiser and TESCO, the German firm Henkel, the Danish firm KeTox, and an Irish company. Even though this disaster was unveiled in 2011 by the Korean government, the issue of the victims was neglected for over five years. In 2016, an unexpected but intensive investigation by prosecutors found that Reckitt Benckiser manipulated and concealed animal tests for its own brand and brought several university experts and company employees to court. The matter was an intense social issue in Korea from May to June with a surge in media coverage. The prosecutor's investigation and a nationwide boycott campaign organized by victims and environmental groups against Reckitt Benckiser, whose product had been used by more than 70% of victims, led to the producer's official apology and a compensation scheme. A legislative investigation organized after the April 2016 national election revealed the producers' faults and the government's responsibility, but failed to meet expectations. A special law for the victims passed the National Assembly in January 2017 and a punitive system together with a massive environmental epidemiology investigation are expected to be the only solutions for this tragedy. Sciences of medicine, toxicology and environmental health have provided decisive evidence so far, but for the remaining problems the perspectives of social sciences such as sociology and jurisprudence are highly necessary, similar to with the Minamata disease and Wonjin Rayon events. It may not be easy to follow this issue using unfamiliar terminology from medical and chemical science and the long, complicated history of the event. For these reasons the author has attempted to write this article in a question and answer format to render it easier to follow. The 17 questions are: Q1 What is humidifier disinfectant? Q2 What kind of health problems are caused by humidifier disinfectant? Q3 How many victims are there? Q4 What is the analysis of the 1,112 cases of death? Q5 What is the problem with the government's diagnostic criteria and the solution? Q6 Who made what brands? Q7 Has there been a recall? What is still on sale? Q8 Was safety not checked by any producers? Q9 What are the government's responsibilities? Q10 Is it true that these products were sold only in Korea? Q11 Why and how was it unveiled only in 2011 after 17 years of sales? Q12 What delayed the resolution of the victim issue? Q13 What is the background of the prosecutor's investigation in early 2016? Q14 Is it possible to report new victim cases without evidence of product purchase? Q15 What is happening with the victim issue? Q16 How does it compare with the cases of Minamata disease and Wonjin Rayon? Q17 Are there prevention measures and lessons?

Mathematics and Society in Koryo and Chosun (고려.조선시대의 수학과 사회)

  • Joung Ji-Ho
    • The Mathematical Education
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    • v.24 no.2
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    • pp.48-73
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    • 1986
  • Though the tradition of Korean mathematics since the ancient time up to the 'Enlightenment Period' in the late 19th century had been under the influence of the Chinese mathematics, it strove to develop its own independent of Chinese. However, the fact that it couldn't succeed to form the independent Korean mathematics in spite of many chances under the reign of Kings Sejong, Youngjo, and Joungjo was mainly due to the use of Chinese characters by Koreans. Han-gul (Korean characters) invented by King Sejong had not been used widely as it was called and despised Un-mun and Koreans still used Chinese characters as the only 'true letters' (Jin-suh). The correlation between characters and culture was such that, if Koreans used Han-gul as their official letters, we may have different picture of Korean mathematics. It is quite interesting to note that the mathematics in the 'Enlightenment Period' changed rather smoothly into the Western mathematics at the time when Han-gul was used officially with Chinese characters. In Koryo, the mathematics existed only as a part of the Confucian refinement, not as the object of sincere study. The mathematics in Koryo inherited that of the Unified Shilla without any remarkable development of its own, and the mathematicians were the Inner Officials isolated from the outside world who maintained their positions as specialists amid the turbulence of political changes. They formed a kind of Guild, their posts becoming patrimony. The mathematics in Koryo significant in that they paved the way for that of Chosun through a few books of mathematics such as 'Sanhak-Kyemong', 'Yanghwi-Sanpup' and 'Sangmyung-Sanpup'. King Sejong was quite phenomenal in his policy of promotion of mathematics. King himself was deeply interested in the study, createing an atmosphere in which all the high ranking officials and scholars highly valued mathematics. The sudden development of mathematic culture was mainly due to the personality and capacity of king who took anyone with the mathematic talent into government service regardless of his birth and against the strong opposition of the conservative officials. However, King's view of mathematics never resulted in the true development of mathematics perse and he used it only as an official technique in the tradition way. Korean mathematics in King Sejong's reign was based upon both the natural philosophy in China and the unique geo-political reality of Korean peninsula. The reason why the mathematic culture failed to develop continually against those social background was that the mathematicians were not allowed to play the vital role in that culture, they being only the instrument for the personality or politics of the king. While the learned scholar class sometimes played the important role for the development of the mathematic culture, they often as not became an adamant barrier to it. As the society in Chosun needed the function of mathematics acutely, the mathematicians formed the settled class called Jung-in (Middle-Man). Jung-in was a unique class in Chosun and we can't find its equivalent in China or Japan. These Jung-in mathematician officials lacked tendency to publish their study, since their society was strictly exclusive and their knowledge was very limited. Though they were relatively low class, these mathematicians played very important role in Chosun society. In 'Sil-Hak (the Practical Learning) period' which began in the late 16th century, especially in the reigns of Kings Youngjo and Jungjo, which was called the Renaissance of Chosun, the ambitious policy for the development of science and technology called for. the rapid increase of he number of such technocrats as mathematics, astronomy and medicine. Amid these social changes, the Jung-in mathematicians inevitably became quite ambitious and proud. They tried to explore deeply into mathematics perse beyond the narrow limit of knowledge required for their office. Thus, in this period the mathematics developed rapidly, undergoing very important changes. The characteristic features of the mathematics in this period were: Jung-in mathematicians' active study an publication, the mathematic studies by the renowned scholars of Sil-Hak, joint works by these two classes, their approach to the Western mathematics and their effort to develop Korean mathematics. Toward the 'Enlightenment Period' in the late 19th century, the Western mathematics experienced great difficulty to take its roots in the Peninsula which had been under the strong influence of Confucian ideology and traditional Korean mathematic system. However, with King Kojong's ordinance in 1895, the traditional Korean mathematics influenced by Chinese disappeared from the history of Korean mathematics, as the school system was hanged into the Western style and the Western mathematics was adopted as the only mathematics to be taught at the Schools of various levels. Thus the 'Enlightenment Period' is the period in which Korean mathematics shifted from Chinese into European.

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The Hospital Life of the Patient with Femoral Neck Fracture (대퇴경부 골절 환자의 입원 생활)

  • Kim, Kyung-Ja;Chi, Sung-Ai
    • Journal of Korean Academy of Nursing Administration
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    • v.2 no.1
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    • pp.35-56
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    • 1996
  • Nowerdays, the increase of traffic accidents and old age population make the Femoral Neck Fracture(FNF) patients increase. By the improvement of education and standard of living the patients demand better medical service than before. This study is designed to give practical help for the FNF patients by observing their hospital life and establish practical nursing strategies for the FNF patients. For these purposes the Ethnographic Participant Observation was adopted. By this study is focused on the hospital life patient's view. For this end, the field study adopted orthopedic ward in the C University Hospital with 400 beds in Seoul. The object patients of the study were twelve patients. The patients experienced five stages : Embarrassment, Conflict, Stability, Independent, and Extension Stage. The findings and prepared nursing strategies are stated as follows. First, in the Embarrassment Stage they suffered embarrassment, anxiety, pain, they could not do ordinary things. The patients who accidental fractures had anxiety from unfamiliar tests and from hospitalization itself. They lamented that they could not ordinary things, and do nothing but obeying the hospital, and endure the pain. They recognized the changed environment and resigned themselves to life in the ward. In this stage, full openness by the nurses is needed. Second, the attribute of the Conflict Stage were conflict, fear, curiosity, belief, reflection. When they sign the consentment form, they experience conflicts about the possibility of complication, fear of recovery from anesthesia, curiosity about the operation procedure, post - operation state, reflection on their past life, and promise to care for their family members after discharge and keep their religious life faithfully. And they accepted the operation depending on God, believing in modern medicine, and the surgeon. Asking for their changed informations, they expected positive results from the operation. In this stage, an empathic attitude by the nurses is needed. Third, the attribute of the Stability Stage were relief, gratitude, difficulty with excretion, and pain. When they awoke from anesthesia, they felt relief because of a the end of the operation, but they experienced extreme pain, difficulty of excretion in bed. They accepted the changed environment and expected recovery. In this stage, support by the nurses is needed. Fourth, the attributes of the Independence Stage were freedom, exercise, nurturing, anxiety, and discomfort. When they ambulated and exercised, they experienced freedom. They showed exhibited weakness of the digestive organs and discomfort hospital's space, structure, and facilities, the delay of medical certificate issue the lack of prompt response by the medical agents. They ate nurturious food and felt anxiety on the end of hospital life and returning to their ordinary life. They showed the independence of overcoming their environment by increasing exercise and expected their discharges. In this stage, respect by the nurses is needed for the patients to, overcome their environment and prepare for their independence. Fifth, the attributes of the Extension Stage were pessimism, isolation, dissatisfaction, and pain. Accompanied injury and old age made their ward life extend to over seven weeks. They exhibited weariness, melancholy, skeptisis, general pessimistic feeling, and desperation caused by their isolated life. They experienced the digestive discomfort caused by the prolonged medication and psycological pain caused by long-time hospitalization. As a, result, their dissatisfaction on the human, physical, and systematic environments had been increased. They acquired critical power and sought for something to do spending their time. They expected vaguely about the returning of their ordinary life. In this stage, counseling is needed by the nurse to overcome positively their psychological, social, and physical problems. The process of the FNF patient's ward life starts from the dependent state, when they are hospitalized, and gradually progresses to self-fulfillment in order to keep independent life. As a result, the FNF patients showed "Response in Challenge" or "Adaptation in Conflict" through their experiences of social, physical, and psychological difficulties.

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Experimental Models of Schizophrenia (정신분열병의 실험적 모델)

  • Cheon, Jin-Sook
    • Korean Journal of Biological Psychiatry
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    • v.6 no.2
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    • pp.153-160
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    • 1999
  • Animal models can provide a useful tool for the study of some aspects of psychiatric disorders and their treatment. The four criteria for the evaluation of animal models of psychiatric disorders are as following : 1) similarity of inducing conditions 2) similarity of behavioral state 3) common underlying neurobiological mechanisms 4) reversal by clinically effective treatment techniques. Several animal models have been proposed for schizophrenia : phenylethylamine model, L-dopa model, hallucinogen model, cocaine model, amphetamine model, phencyclidine model, noradrenergic reward system lesion model, reticular stimulation model, social isolation model, conditioned avoidance reaction, catalepsy test, paw test, self-stimulation paradigms, latent inhibition paradigms, blocking paradigms, prepulse inhibition of the startle reflex, rodent interaction, social behavior in monkeys, hippocampal damage, high ambient pressure, and models using selective breeding. Among them, animals with bilateral lesion of the hippocampus may provide an adequate animal model for several symptoms of schizophrenia, and ketamine model can reproduce negative symptoms and cognitive deficits as well as positive symptoms of schizophrenia. In conclusion, no model of schizophrenia is entirely representative of the disease, and findings gleaned from model systems must be cautiously interpreted. Furthermore, the process of developing and validating animal models must work in concert with the process to identify reliable measures of human phenomenology.

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CLINICAL CHARACTERISTICS AND TREATMENT COURSES OF THE CHILDREN WITH SELECTIVE MUTISM (선택적 함구증 아동의 임상특성 및 치료경과)

  • Chung, Sun-Ju;Hong, Kang-E
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.6 no.1
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    • pp.74-89
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    • 1995
  • Selective mutism is a childhood condition defined by persisten failure to speak in specific social situation when speaking is expected, dispite preserved ability to comprehend spoken language and speak. Present study is to investigate clinical characteristics, treatment method and outcome of 23 children who were diagnosed as selective mutism by DSM-IV criteria at the child psychiatry ouptatient department of SNUH. The results were as follows : 1) The Sex ratio was 1: 4.8, female dominant Mear age of onset was 33 years old and mean age of first referral was 7.7 years old. 2) 22% of subjects had perinatal problem such as low birth weight, preterm birth, 26% of the subjects have history of delayed language development. There are subjects who had been separated with mam caretaker before 3 years old(26%) and who experienced physical or psychological trauma before 3 years old(26%). A few subjects had enurests(30%) and encoprests(4%). 3) Many subjects(65%) had symbiotic relationship with their mother. These families consist of dominant, verbally aggressive mother and passive father. Parents of 39% of all subjects were judged to have definite psychopathology(social phobic, depression, hysterical trait or alcohol problem) 26% of all subject, were reported physically abused. 4) The personality trait of the subjects were frequently described as follows(in order of frequency) ; Shy(100%), anxious(83%), stubborn(83%)m rigid and tense posture(78%), immature(65%) overdependent(65%), irritable(52%), manipulative(39%), depressive(39%). 5) The mean performance IQ of 16 subjects by KEDI-WISC was 88.3 Among them, the subjects with IQ below 69 were seven and those with IQ above 70 were nine. When comparing these two group(Mental retardation group vs Normal IQ group), we could find some difference in language development, personality trait, family dynamics and treatment outcome. 6) Among several treatment methods for selective mutism, play therapy was the most frequently used method(65%). Other commonly used treatment methods were pharmacotherapy(21%), behavioral therapy(8%), combined therapy(play therapy+pharmacotherapy+family therapy+behavioral therapy)(12%), 7) Regarding the outcome of treatment 8.6% was evaluated as Excellent, 30.4% as Good, 52% as Fair, 8.7% as Poor at the tinic of treatment. At follow up interview 21.7% was evaluated Excellent, 13% as Good, 21.7% as Fair, 34.8% as Poor. 8) We classified all subjects by Havden's 4 subtype. Symbiotic mutism was most common(65%) and other subtypes are Speech phobic mutism(8.6), Reactive mutism(13%) and Passive-aggressive mutism(30%).

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A comparative study of ADL and IADL of residential home and home for the aged dwelling elderly (노인의 거주 형태에 따른 일상생활동작(ADL) 및 도구적 일상 생활 동작(IADL)의 수행능력 비교)

  • Park, Chan-Eui;Chang, Chung-Hoon;Lee, Jae-Hyoung
    • The Journal of Korean Physical Therapy
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    • v.18 no.4
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    • pp.61-70
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    • 2006
  • Purpose: The purpose of this study was to investigate the activities of daily living (ADL) and instrumental activities of daily living (IADL) of residential home dwelling elderly and home for the aged dwelling elderly. In attempt to address medical professional caring the elderly, this comparative study examines the factors associated with dependence in the ADL and IADL in two samples of elderly people living in two different environments. Methods: The instrument of ADL and IADL widely used Katz ADL and IADL. Katz ADL and IADL was not a perfect fit for Korean. In concern with cultural factors Won developed K(Korean)-ADL and K-IADL scale reflecting Korean's own language expression and cultural factors in year of 2002. The assessment tool of this study was K-ADL and K-IADL. Differences of ADL and IADL were tested for statistical significance using group t-test and x2 test for comparisons between the residential home dwelling elderly and the home for the aged dwelling elderly. Results: Comparison of assessment for K-ADL and K-IADL in two different dwelling types was significant. Performance of ADL and IADL depend upon their living environment such as social status, number of children, income, present illness as well as age group. This study also showed significant differences of performance in some activities of ADL and IADL between the elderly who live in their own home and live in home for the aged. Comparison of performance of ADL and IADL in different dwelling types revealed that only one item of ADL was significant but only one item of IADL was not significant. It means that IADL is more difficult activities in the home for the aged dwelling elderly than the residential home dwelling elderly. The coupled elderly has more independent in some ADL and IADL activities compared with the single elderly. Conclusion: Using K-ADL and K-IADL is more convenient for Korean elderly. Medical professional consider some factors like dwelling style, social status, existing diseases and disabilities in order to care the elderly and train him/her activities of daily living as well as instrumental activities of daily living. Medical professional, especially physical and occupational therapist emphasize the training items which are bathing of ADL and grooming, housework, preparing meals, laundry, traveling, public transportation, shopping, using telephone and taking medicine of IADL based on the result of this study.

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Changes of Stress and Coping Strategy in Families of Schizophrenic Patients after Brief Program of Family Education (정신분열병 환자 가족의 단기 가족교육 후 대처전략 및 스트레스 변화에 대한 연구)

  • Seo, Seung-Woo;Yi, Ho-Taek;Paek, Ju-Hee;Lee, Sang-Yeon
    • Korean Journal of Psychosomatic Medicine
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    • v.9 no.1
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    • pp.16-27
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    • 2001
  • Objectives : This study was aimed to investigate stress and coping strategy in the families of schizophrenic patient, and changes of knowledge, stress and coping strategy after brief program of family education compared with control group Methods : The education group consisted of twenty four people who were families with schizophrenic patients and attended the brief program of family education. The control group consisted of twenty two people with schizophrenic inpatients. Self-report questionnaires such as Family Coping Questionnaire(FCQ), Patient Rejection Scale(PRS), Worry Questionnaire, Knowledge Questionnaire, Beck Depression Inventory(BDI), and State-Trait Anxiety Inventory(STAI) were administered to the education group and the control group, twice at the pre-test and post-test. Results : 1) In the education group, scores of worry questionnaire, BDI and STAI-S at the post-test were significantly lower than those at the pre-test. Social interests score of FCQ and knowledge questionnaire score at the post-test were significantly higher than those at the pre-test. In FCQ factors, social interests associated with avoidance strategy score at the post-test was significantly higher than that at the pre-test. However, in the control group, there was no significant difference in all questionnaires. 2) In the education group, significant positive correlation existed between calculated differences of worry questionnaire and STAI-S, and between worry questionnaire and STAI-T, whereas significant negative correlation existed between positive communication of FCQ and PRS, and between knowledge questionnaire and STAI-S. In the control group, significant negative correlation existed between information of FCQ and PRS, and between positive communication of FCQ and PRS. 3) In the education group, significant positive correlation existed between calculated differences of worry questionnaire and age of patient, whereas significant negative correlation existed between knowledge questionnaire and duration of illness. However, in the control group, there was no significant correlation. Conclusion : The brief program of family education was effective in increasing knowledge about schizophrenia, decreasing worry and anxiety about the patients in families with schizophrenic patient. In the education group as knowledge about schizophrenia increased, anxiety about schizophrenic patient decreased, but there was no significant correlation in the control group. As relative's rejection feeling about schizophrenic patient decreased, positive communication strategy increased in both groups. However, the control group was more affected by rejection feeling than the education group.

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A Study on the Care Needs of Family-Caregivers to the Patients with Stroke (뇌졸중환자 가족의 간호요구)

  • Kim Mi-Hee
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.4 no.2
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    • pp.175-192
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    • 1997
  • The purpose of this study was to identify the care needs of family-caregivers to the patients with stroke. Subjects were 115 family-caregivers caring for the patients while they were in-patients or out-patients with stroke in two general hospitals and one oriental medicine hospital located in Seoul and Kwang-Ju. The instrument used for this study was made by the researcher on the basis of results of literature review and interviews with family-caregivers, composed of 35 items. Internal validity by calculation of cronbach's alpha with data of respondents was 0.91, which was regarded as high. The Data were analyzed by SAS program, with percentage, mean, t-test, and ANOVA. Factor structures of care needs of family-caregivers were elicited by factor analysis(PCA, Varimax rotation). Datum collection had been from July 1 to August 14, 1997. The results of this study were as follows : 1. The mean score of the sum of the care needs of family-caregivers was 3.96 and the highest-mean item was 'need for immediate care(M=4.77)', and the lowest-mean item was 'need for chaplian's visit (M=2.82)'. 2. Care needs of the family-caregivers were : Need to be informed of the disease, treatment and care ; need of education and assistance related to physical functional level ; need of social support and consultation ; need of management of nursing problem related to immobility ; need of appreciation ; need of the way to communicate with patients ; need of immediate care and help. The highest mean factor was the 'need for immediate care and help(M=4.74)', and the lowest mean factor was the 'need of appreciation(M=3.58)'. 3. The variables influencing the degree of care needs perceived by family-caregivers to the patients with stroke were as follows : There were significant differences between need to be informed of the disease, treatment and care and general characteristic factors, which were family caregiver's sex (p=.0178), caring period(p=.0223) and patient's suffering period(p=.0244). There were significant differences between need of education and assistance related to physical functional level and general characteristic factors, which were patient's paralysis(p=.0177), patient's ADL dependency(p=.0032). There were significant differences between need of social support and consultation and general characteristic factors, which were family caregiver's sex(p=.0055), occupation(p=.0159), religion(p=.0093) and patient's sex(p=.0134). There was significant difference in the degree of need of management of nursing problem related to immobility, according to the patient's ADL dependency(p=.0493). There were significant differences between need of appreciation and general characteristic factors, which were family caregiver's age(p=.0107), sex(p=.0133), and patient's age(p=.0338). There were significant differences between need of the way to communicate with patient and general characteristic factors, which were patient's paralysis(p=.0002) and aphasia(p=.0001). There were significant differences between need of immediate care and help and general characteristic factors, which were family caregiver's caring period(p=.0162) and patient's suffering period(p=.0116). 4. The mean score of patient's ADL dependency was 3. 38 and the highest-mean item was 'ascending and descending stairs(M=4.12)', and the lowest-mean item was 'drinking(M=2.60)'. There was no significant difference in the degrees of care needs related to the patient's ADL dependency. 5. The highest information source of family-caregivers was from the doctors about the disease, treatment and care(26.1%). The second highest one was from mass media(20.8%), and the third one was from the nurses. The above findings may be used as the basic data to seek more efficient way of elevating nursing practice and quality for family-caregivers to the patients with stroke.

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