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Experiences of Spousal Bereavement in Middle Aged Men (중년남성의 배우자 사별경험)

  • Park, Kyung-Bok;Kim, Boon-Han
    • Asian Oncology Nursing
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    • v.4 no.2
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    • pp.143-153
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    • 2004
  • Death of spouse is the most heartbreaking stressful and inevitable tragic life event. In middle aged men who belong to the social middle class and accomplished their occupational success, experiences of spousal bereavement are great shock. The aim of this study was to find out how they overcome their mental and physical pain and to obtain the basic materials to develop suitable nursing care programs for them. The methodological approach of this study is Giorgi's phenomenological analysis meaning unit. This method also makes theme focal meaning, situated structural description and create general structural description grasped by participator's experience through situated structure description. This study performed from November 2002 to May 2004, and participators were four men. Data collected through in-depth personal interviews. which had been tapped and analysed the Giorgi's method. Finally, the five focal meaning below have been abstracted. Theme 1. Physical symptom loss of appetite, fatigue, insomnia. outbreak of illness, weight loss. Theme 2. life of spiritless lack of desire, sense of emptiness, unstableness, prosaic life. wandering. indifference of appearances, avoidance of meeting people. Theme 3. life of retrospction reflection for his wife, yearning, grief, muttering to himself, never-to-be forgotten wife, leading a lonely life. Theme 4. negative emotion reproaching, feeling hurt, marriage of daughter, feeling heavy, getting angry, sexual desire, awareness of his sinfulness. loneliness Theme 5. social support and adjustment getting his wife off his mind, curring favor with children, support and consolation by his daughter-in-law, appreciation for hospice nurse, considering remarriage, taking care of himself, good relation with his children. The result of this study showed that middle aged men bereaved of their wife by cancer need other's concern. And we have to study further to understand their experience. Until now hospice nursing is concentrated on cancer patients But from now we have to provide their families suitable nursing care programs to adjust themselves to social life before and after death of patients.

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Development of Construction Model of Disease Classification on Clinical Diagnosis in Ophthalmology (임상진단명에 따른 질병분류체계 구축모형 개발 - 안과를 대상으로 -)

  • Suh, Jin-Sook;Shin, Hee-Young;Kee, Chang-Won
    • Quality Improvement in Health Care
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    • v.10 no.2
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    • pp.204-215
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    • 2003
  • Background : ICD-10 Classification, which is used domestically as well as internationally, has limited use in the clinical practice since it is developed for at disease statistics and epidemiology. Therefore, the purposes of this study were to improve the quality of diagnosis by constructing a new disease classification based on the diagnoses doctors currently make in the clinical setting and connecting this classification with OCS and EMR, and to meet the demands of doctors for high quality medical study data in medical research. Methods : The specialists in each ophthalmic subfield collected clinical diagnoses and abbreviations based on the ophthalmology textbooks and confirmed the classifications. Total number of clinical diagnoses collected was totaled 672, for which ideal diagnoses had been selected and a new model of disease classification model in connection with ICD-10 was constructed. The constructed classification of clinical diagnoses consisted of six steps: the first step was the classification by ophthalmic subspecialty field; the second to fifth steps were the detailed classification by each specialty field; the sixth step was the classification by site. Results : After introducing the new disease classification, research on the use and a pre-post comparison was conducted. The result from the research on the use of the clinical diagnoses in inpatient and outpatient care has shown a gradually increasing tendency. From the pre-post comparison of EMR discharge summary diagnoses, the result demonstrated that the diagnosis was stated correctly and in detail. Since the diagnosis was stated correctly, code classification became correct as well, which makes it possible to construct high quality medical DB. Conclusion : This construction of clinical diagnoses provides the medical team with high quality medical information. It is also expected to increase the accuracy and efficiency of service in the department of medical record and department of insurance investigation. In the future, if hospitals wish to construct a classification of clinical diagnosis and a standard proposal of clinical diagnosis is presented by a medical society, the standardization of diagnosis seems to be possible.

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Clinical Study about Patients in Intensive Care Unit at an Oriental Medical Hospital - Focused on Main Disease and Complications - (한방병원 중증치료실 입원 환자의 임상적 분석 - 주 질환 및 합병증 위주로 -)

  • Noh, Hyun-In;Lee, Jee-Sook;Yoon, Da-Rae;Yi, Seo-Ra;Ryu, Jae-Hwan
    • The Journal of Internal Korean Medicine
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    • v.33 no.2
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    • pp.172-179
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    • 2012
  • Objectives : This study was designed to quantify the characteristics, main diagnosis and complications in the intensive care unit (ICU) at an Oriental Medical Hospital. Methods : The medical records of 44 patients admitted to the ICU at Kyunghee Oriental Medical Hospital between January 1, 2011 and December 31, 2011 were reviewed. Basic characteristics of patients, admission channel, main diagnosis, east-western medical therapy, mortality, and complications were investigated retrospectively based on medical notes. Results : 1. The total number of patients was 44. Males were 63.6%, females 36.3%. Average admission days was 15.9. 2. The most frequent age group is eighties, 38.6%. 3. The most frequent disease is cerebrovascular disease, 61.3%. 4. The medical therapy done after admission to ICU was intubation. Central vein insertion was performed next, followed by Foley's catheter insertion, ventilator, tracheostomy, nasogastric intubation, and thoracentesis in order. The proportion of Oriental medical treatment provided to the patients of ICU was as follows: herbal medication only 6.8%; herbal medication plus acupuncture 31.8%; herbal medication, acupuncture electro-acupuncture, plus subcutaneous acupuncture 2.3%; and none 27.3%. 5. The number of cases of complications occurred since ICU admission was 18. The most frequently observed complication was infection, including 6 cases of pneumonia and 4 cases of urinary tract infection. Conclusions : We suggest that ICUs of Oriental medical hospitals need to be managed effectively to treat diseases including cerebrovascular disease and prevent complications.

Observational Study on Patient's Satisfactions and Quality of Life (QoL) Among Cancer Patients Receiving Treatment with Palliative Care Intent in a Tertiary Hospital in Malaysia

  • Sharifa Ezat, Wan Puteh;Fuad, Ismail;Hayati, Yaakub;Zafar, Ahmed;Wanda Kiyah, George Albert
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.2
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    • pp.695-701
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    • 2014
  • The main objective of palliative treatment for cancer patients has been to maintain, if not improve, the quality of life (QoL). There is a lack of local data on satisfaction and QoL among cancer patients receiving palliative treatment in Malaysia. This study covers patients with incurable, progressive cancer disease receiving palliative treatment in a teaching hospital in Kuala Lumpur, comparing the different components of QoL and correlations with patient satisfaction. A cross-sectional survey using Malay validated SF36 QoL and PSQ-18 (Short Form) tools was carried out between July 2012 -January 2013 with 120 cancer patients receiving palliative treatment, recruited into the study after informed consent using convenient sampling. Results showed that highest satisfaction were observed in Communication Aspect ($50.6{\pm}9.07$) and the least in General Satisfaction ($26.4{\pm}5.90$). The Mental Component Summary ($44.9{\pm}6.84$) scored higher when compared with the Physical Component Summary ($42.2{\pm}7.91$). In this study, we found that patient satisfaction was strongly associated with good quality of life among cancer patients from a general satisfaction aspect (r=0.232). A poor significant negative correlation was found in Physical Component (technical quality, r=-0.312). The Mental Component showed there was a poor negative correlation between time spent with doctor (r=-0.192) and accessibility, (r=-0.279). We found that feeling at peace and having a sense of meaning in life were more important to patients than being active or achieving good physical comfort. More studyis needed to investigate patients who score poorly on physical and mental component aspects to understand their needs in order to achieve better cancer care.

Radiotherapy in prostate cancer treatment: results of the patterns of care study in Korea

  • Chang, Ah Ram;Park, Won
    • Radiation Oncology Journal
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    • v.35 no.1
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    • pp.25-31
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    • 2017
  • Purpose: The purpose of this study was to describe treatment patterns of radiotherapy (RT) for prostate cancer in Korea. Materials and Methods: A questionnaire about radiation treatment technique and principles in 2013 was sent to 83 radiation oncologists and data from 57 hospitals were collected analyzed to find patterns of RT for prostate cancer patients in Korea. Results: The number of patients with prostate cancer treated with definitive RT ranged from 1 to 72 per hospital in 2013. RT doses and target volumes increased according to risk groups but the range of radiation doses was wide (60 to 81.4 Gy) and the fraction size was diverse (1.8 to 5 Gy). Intensity-modulated radiation therapy was used for definitive treatment in 93.8% of hospitals. Hormonal therapy was integrated with radiation for intermediate (63.2%) and high risk patients (77.2%). Adjuvant RT after radical prostatectomy was performed in 46 hospitals (80.7%). Indications of adjuvant RT included positive resection margin, seminal vesicle invasion, and capsular invasion. The total dose for adjuvant RT ranged from 50 to 72 Gy in 24-39 fractions. Salvage RT was delivered with findings of consecutive elevations in prostate-specific antigen (PSA), PSA level over 0.2 ng/mL, or clinical recurrence. The total radiation doses ranged from 50 to 80 Gy with a range of 1.8 to 2.5 Gy per fraction for salvage RT. Conclusion: This nationwide patterns of care study suggests that variable radiation techniques and a diverse range of dose fractionation schemes are applied for prostate cancer treatment in Korea. Standard guidelines for RT in prostate cancer need to be developed.

Clinical Study of Antibiotic-associated Diarrhea Treatment in Intensive Care Unit Patients at an Oriental Hospital (한방병원 중증치료실 입원 중 항생제 연관성 설사를 진단받은 환자에 대한 임상적 고찰)

  • Yang, Ga-Eun;Kim, Seul-Ji;Park, Young-Ju;Lee, Mi-Jung;Lee, Jee-Sook;Ryu, Jae-Hwan
    • The Journal of Internal Korean Medicine
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    • v.31 no.2
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    • pp.298-307
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    • 2010
  • Objectives : This study was designed to investigate the effectiveness of adjunctive herbal therapy combined with conventional therapy on antibiotic-associated diarrhea (AAD) treatment. Methods : The medical records of 25 patients admitted to the Intensive Care Unit at Kyunghee Oriental Medical Center between January 1, 2009 and January 30, 2010 were reviewed. The charts were analyzed for the general characteristics, site of infection, predominant bacteria, antibiotic treatment, herbal medicine treatment, effect on liver and kidney functions, and the effect of therapy on diarrheal duration. Results : 48% of the 25 patients were male while 52% were female. The average age was 67.2 years old. The most commonly used antibiotic was fluoroquinolone (40.0%) and the most commonly used herbal medicine was Samchulkunbi-tang (24.0%). The average diarrheal duration was 8.9 days. No significant change in hepatic and renal function was discovered before and after treatment with herbal medicine. Conclusions : The results suggest that herbal therapy would be a safe and effective treatment for AAD. Further study investigating the usage of herbal medicine in AAD treatment is anticipated.

The experimental study of oral care for early radiation therapy in the head and neck cancer patients (두경부 악성종양 환자에서 조기 방사선치료를 위한 구강관리법에 대한 실험적 연구)

  • Moon, Won-Kyu;Cha, In-Ho;Kim, Hyung-Jun;Jung, Young-Soo;Lee, Chun-Ui;Lee, Jong-Young;Ryu, Mi-Heon;Yoo, Jae-Ha
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.37 no.3
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    • pp.169-175
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    • 2011
  • Background: Teeth requiring extraction before radiotherapy in head & neck cancer patients should be removed as long as possible before the initiation of radiation therapy. Conventionally, a minimum 2-week waiting primary healing period is recommended. Although the above 2-week period is ideal, it was not uncommon for the radiotherapist and cancer patient to feel an urgent need to process with radiotherapy despite the need for dental care. Therefore, alternative approaches for early radiotherapy, including conservative endodontic treatment and a 1-week waiting primary healing period after dental extraction at the time of radiotherapy, were considered and applied based on the experimental study Materials and Methods: Eighteen dogs were processed for histopathologic wound healing. The effect of the primary endodontic treatment and extraction before early radiotherapy was examined. Results: No specific complication, such as, post-extraction wound infection, radiation osteitis and osteoradionecrosis, were encountered despite the early radiotherapy. Conclusion: Based on the experimental study, a minimum 1-week waiting primary healing period for oral care before radiotherapy is suitable for the early radiotherapy in head and neck cancer patients.

Perceptions of primiparas of their Newborns : A Comparision of Koreans and Americans (한국과 미국 초산모의 신생아에 대한 지각 비교)

  • 박문희;이애란
    • Journal of Korean Academy of Nursing
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    • v.25 no.3
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    • pp.431-440
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    • 1995
  • The purpose of this study was to compare Korean and American women as to the perception of their newborns, and to assess factors contributing to a positive mother-infant relationships. American mothers were with their own newborns in the same rooms and could feed and take care of them if they wanted, but Korean mothers were separated from their babies. The subjects of this study were 86 Korean and 86 American primiparas within two-three days after delivery. Data were collected from May to August 1993, using the Neonatal Perception Inventory (NPI) devised by Broussard(1963) with additions by Lee, Ja Hyung(1986). The results of this study are as follows : 1. There was a significant difference in the mothers' perceptions of their babies according to mothers' age(P<0.05, P0.01). Mothers of 20 years and downward had negative perceptions of their babies. 2. There was no difference in the methers' perceptions of their babies according to whether they had a job or not. 3. There was a significant difference in the mothers' perceptions of their newborns according to mothers' education level(P<0.01). Mothers graduated from a junior high school had negative perceptions of their babies. 4. There was no difference in the mothers' perceptions according to their feeding pattern. 5. There was a significant difference between Korean mothers' perceptions and American mothers' perceptions of their babies(P<0.01). 69.7% of Korean mothers and 44. l% of American mothers had positive perceptions. But Korean mothers perceived that it would be more difficult for them to take care of their babies. As seen above, Korean primiparas evaluated their babies higher than Americans. But they perceived that it would be more difficult for them to take care of their babies. The results suggest that there needs a rooming-in system and systematic prenatal educations for the primiparas in Korea.

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Factors Influencing Readmission of Convalescent Rehabilitation Patients: Using Health Insurance Review and Assessment Service Claims Data (회복기 재활환자의 재입원에 영향을 미치는 요인: 건강보험 청구자료를 이용하여)

  • Shin, Yo Han;Jeong, Hyoung-Sun
    • Health Policy and Management
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    • v.31 no.4
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    • pp.451-461
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    • 2021
  • Background: Readmissions related to lack of quality care harm both patients and health insurance finances. If the factors affecting readmission are identified, the readmission can be managed by controlling those factors. This paper aims to identify factors that affect readmissions of convalescent rehabilitation patients. Methods: Health Insurance Review and Assessment Service claims data were used to identify readmissions of convalescent patients who were admitted in hospitals and long-term care hospitals nationwide in 2018. Based on prior research, the socio-demographics, clinical, medical institution, and staffing levels characteristics were included in the research model as independent variables. Readmissions for convalescent rehabilitation treatment within 30 days after discharge were analyzed using logistic regression and generalization estimation equation. Results: The average readmission rate of the study subjects was 24.4%, and the risk of readmission decreases as age, length of stay, and the number of patients per physical therapist increase. In the patient group, the risk of readmission is lower in the spinal cord injury group and the musculoskeletal system group than in the brain injury group. The risk of readmission increases as the severity of patients and the number of patients per rehabilitation medicine specialist increases. Besides, the readmission risk is higher in men than women and long-term care hospitals than hospitals. Conclusion: "Reducing the readmission rate" is consistent with the ultimate goal of the convalescent rehabilitation system. Thus, it is necessary to prepare a mechanism for policy management of readmission.

A Study on the Changes in the Oil and Moisture Condition of Facial Skin in Women in their 20s and 30s (20-30대 여성의 안면 피부 유·수분 상태 변화 연구)

  • Choi, Ji-woo;Lee, Yoo-jeong;Shin, Sae-young
    • Journal of Fashion Business
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    • v.25 no.4
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    • pp.1-13
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    • 2021
  • As interest in skin care increases, this study aims to contribute to the development of the beauty self-care market by providing basic data through the measurement of the oil and moisture skin condition of women in their 20s and 30s. The study was conducted from November 27, 2020 to January 31, 2021, with 20 women in their 20s and 30s divided into 4 groups, A~D, by age, 5 per group. Skin measurements were taken four times at 4 hour intervals at 0H, 4H, 8H, and 12H based on the first measurement that was taken within 30 minutes after waking up, and the oil and moisture indices were observed over time. As a result, both T and U zones showed significant differences in moisture levels over time, with no difference between groups for both T and U zones. Moisture decreased the most between 0H to 4H, and moisture changed the least between 4H to 8H. Changes in moisture increased the similar at 0H and 12H. The oil condition changed more irregularly compared to moisture over time, but all groups showed lower oil content in the U-zone compared to the T-zone. Overall, the facial oil and moisture conditions of women in their 20s and 30s changed over time, indicating that the skin changes in real time. The fact that the skin data, which was measured in the primary activity living environment, can be used as basic research data in the beauty self-care market is meaningful.