• The Korean Nurse
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• v.29 no.4
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• pp.51-72
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• 1990

The purpose of this study was to determine whether Severance Hospice Home Care Pro gram was able to meet its objectives. This was done in order to show in detail the effects of hospice home care on the quality of life of terminally ill patients and to provide rationale for setting up more hospice home care programs in korea. The results of the study were as follows: The subjects of the study were 100 terminally ill patients who hnd died 'while in the hospice program and 64 family members who were registered with Severance Hospice Home Care Program between march 1988 and Feb. 1990. The nursing needs of these terminally ill patients were assessed by the nursing records of these patients. The need for pain control(82%) was the highest nursing need so far as the physical aspects were concerned. This was followed by poor appetite(37%), 8 dyspnea(34%), nausea and vomiting(30%) in that order of frequency. In reqard to spiritual needs, the need for religious' support was also high at 72%. Their main psychological symptoms were anxiety and fear(34% ). Burn-out was a major problem for 44% of the family members. The psychological process experiencel by the terminal ill patients was compared to the dying process, described by Kiibler Ross. In comparison of the five stages outlined by kubler Ross with the dying process of the subjects it was found that the subjects not only experienced the five stages but also experienced denial and doubt-fulness or denial with acceptance or acceptance with the expectation of a miracle. But rather than acceptance of the dying process, giving up was a frequent end point of the psychological process, of the subjects. However, when the combination of states was observed, most of the patients reached the state of acceptance in the dying process. It was difficult to identify a definite pattern of change in the psychological process of the subjects. Also it was difficult to identify the factors that influenced the psychological process. The symptoms of the terminally j]] subjects just before dying, that is, 3-4 days before dying included apparent signs of dying. These were a reduction of intake(77%), reduction of the amount of urination(63%), increase in sleeping time (64%) and acceptance of dying by patients and their families who had been unaccepting be before that time(66%). The primary care givers(family member's) degree of satisfaction with the care given to the patient by the hospice was 88.7%. The results of this study show that Severance Hospice Home Care Program had a positie effeet on the quality of life of the terminally ill patients and their family members as they faced the death of the patient. It can be seen from this study that there is an urgent need to extend hospice programs - in order to provide quality of care for terminally ill patient and their families. Based upon the reesults of this study several suggestions are presente as follows: 1) A follow up study should be carried out to identify the dying process as it is unique to Korea. 2) A comparison should be made of other hospice care programs. 3) A comparison study should- be made with subjects who do not receive any hospice care as compared to those who do by use of an experimental and control group methodology. 4) There is a need to determine a scientific method to adequeto measure the interventions carried out to meet the hospice patients nursing care needs. 5) A study should be made using quality research methodology to evaluate effects of hospiec care from the patients, their family members and the nurrse's perspective.

• Progress in Medical Physics
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• v.22 no.1
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• pp.18-27
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• 2011

The purpose of this study was to identify different cerebral areas of the human brain associated with rural and urban picture stimulation using a 3.0 Tesla functional magnetic resonance imaging (fMRI) and further to investigate the human suitability for rural and urban environments. A total of 27 right-handed participants (mean age: $27.3{\pm}3.7$) underwent fMRI study on a 3.0T MR scanner. The brain activation patterns were induced by visual stimulation with each rural and urban sceneries. The participants were divided into two groups as 26 subjects favorable to rural scenery and 14 subjects unfavorable to urban scenery based on their filled-in questionnaire. The differences of the brain activation in response to two extreme types of pictures by the two sample t-test were characterized as follows: the activation areas observed in rural scenery over urban were the insula, middle frontal gyrus, precuneus, caudate nucleus, superior parietal gyrus, superior occipital gyrus, fusiform gyrus, and globus pallidus. In urban scenery over rural, the inferior frontal gyrus, parahippocampal gyrus, postcentral gyrus, superior temporal gyrus, amygdala, and posterior cingulate gyrus were activated. The fMRI patterns also clearly show that rural scenery elevated positive emotion such as happiness and comfort. On the contrary, urban scenery elevated negative emotion, resulting in activation of the amygdala which is the key region for the feelings of fear, anxiety and unpleasantness. This study evaluated differential cerebral areas of the human brain associated with rural and urban picture stimulation using a 3.0 Tesla fMRI. These findings will be useful as an objective evaluation guide to human suitability for ecological environments that are related to brain activation with joy, anger, sorrow and pleasure.

• Cartoon and Animation Studies
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• s.43
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• pp.321-342
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• 2016

The "uncanny valley" curve describes the measured results of the negative emotion response which depends on the similarity between the artificially created character and the real human shape. The "uncanny valley" effect that usually appears in the animation character design induces negative response such as fear and hatred feeling, and anxiety, which is not expected by designers. Especially, in the case of the commercial animation which mostly reply on public response, this kind of negative response is directly related to the failure of artificially created character. Accordingly, designers adjust the desirability of the character design by avoiding or utilizing the "uncanny valley" effect, inducing certain character effect that leads to the success in animation work. This manuscript confirmed the "uncanny valley" coefficient of the positive emotion character design which was based on the actual character design and animation analysis. The "uncanny valley" concept was firstly introduced by a medical scientist Ernst Jentsch in 1906. After then, a psychologist Freud applied this concept to psychological phenomenon in 1919 and a Japanese robert expert Professor Masahiro Mori presented the "uncanny valley" theory on the view of the recognition effect. This paper interpreted the "uncanny valley" effect based on these research theory outcomes in two aspects including sensation production and emotion expression. The mickey-mouse character design analysis confirmed the existence basis of the "uncanny valley" effect, which presented how mickey-mouse human shape image imposed the "uncanny valley" effect on audience. The animation work analysis investigated the reason why the produced 3D animation character should not be 100% similar to the real human by comparing the animation baby character produced by Pix company as the experimental subject to the data of the real baby with the same age. Therefore, the examples of avoiding or utilizing the "uncanny valley" effect in animation character design was discussed in detail and the four stages of sensation production and emotional change of audience due to this kind of effect was figured out. This research result can be used as an important reference in deciding the desirability of the animation character.

• The Korean Society of Law and Medicine
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• v.15 no.1
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• pp.335-373
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• 2014

According to one Medicare report, in the US, total federal spending on health care expends almost 18 percent of the nation's GDP, about double what most industrialized nations spend on health care. And in 2011, Medicare spending reached close to $554 billion, which amounted to 21 percent of the total spent on U.S. health care in that year. Of that $554 billion, Medicare spent 28 percent, or about $170 billion, on patients' last six months of life. So what are the reasons of this high cost in EOL care and its possible solutions? Much spendings of Medicare on End-of-Life care for the terminally ill/chronically ill in the US has led health economics experts to assess the characteristics of the care. Decades of study shows that EOL care is usually supply-sensitive and poor in cost-effectiveness. The volume of care is sensitively depending on the supply of resources, rather than the severity of illness or preferences of patients. This means at the End-of-Life care, the medical resources are being overused. On the other hand, opposed to the common assumption, "The more care the better utility", the study shows that the outcome is very poor. Actually the patient preference and concerns are quite the opposite from what intense EOL care would bring about. This study analyzes the reasons for the supply-sensitiveness of EOL care. It can be resulted from the common misconception about the intense care and the outcome, physicians' mission for patients, lack of End-of-Life Care Decision which helps the patients choose their own preferred treatment intensity. It also could be resulted from physicians' fear of legal liabilities, and the management strategy since the hospitals are also seeking for financial benefits. This study suggests the possible solutions for over-treatment at the End-of-Life resulting from supply-sensitiveness. Solutions can be sought in two aspects, legal implementation and management strategy. In order to implement advance directive properly, active ethics education for physicians to change their attitude toward EOL care and more conversations about end-of-life care between physicians and patients is crucial, and incentive system for the physicians who actively have the conversations with patients will also help. Also, the general education towards the public is also important in the long run, and easy and official advance directive registry system-such as online registry-has to be built and utilized more widely. Alternative strategies in management are also needed. For example, the new strategic cost management and management education, such as cutting unnecessary costs and resetting values as medical providers have to be considered. In order to effectively resolve the problem in EOL care for the terminally ill/chronically ill and provide better experience to the patients, first of all, the misconception and the wrong conventional wisdom among doctors, patients, and the government have to be overcome. And then there should be improvements in systems and cultures of the EOL care.

• Journal of Hospice and Palliative Care
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• v.10 no.4
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• pp.184-189
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• 2007

Purpose: This study was to explore barriers to effective pain management in general population. Methods: Total 163 Participants completed the Barrier Questionnaire-II (BQ-II), a 27-item on a six point scale, from May to June in 2007. BQ-II consisted of four subscales which were 1) physical effects (PE) addressing beliefs that side effects of analgesics are inevitable and concerns about tolerance, fatalism (Fa) addressing fatalistic beliefs about cancer pain and its management, Communication (Co) addressing the beliefs of 'good patient' and concerns of distracting physician from underlying disease, and harmful effects (HE) addressing fear of addiction and harmful effect to immune system of pain medicine. Results: The BQ-II total had an internal consistency of 0.877 in this study. HE was the biggest barrier (3.03) followed by PE (2.73), Fa (2.15), and Co (1.71). Items appeared as great concerns were 'there is a danger of becoming addicted to pain medication'(3.58), 'using pain medicine blocks your ability to know if you have any new pain' (3.18), 'pain medicine is very addictive' (3.09), 'when you use pain medicine your body becomes used to its effects and pretty soon it won't work any more' (3.09), and 'drowsiness from pain medicine is difficult to control' (3.09). Only 12 respondents (7.4%) reported that they took any type of pain education, however, those who took pain education represented significantly lower barriers to pain management than who did not (P=.029). Conclusion: This result suggests the strategies for public education to surmount cancer pain.

• Journal of Hospice and Palliative Care
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• v.20 no.4
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• pp.226-234
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• 2017

Purpose: With the implementation of the Act on Life Sustaining Treatment, hospice-palliative care will be extended to non-cancer diseases including the acquired immunodeficiency syndrome (AIDS). However, there are concerns about negative perceptions and prejudice toward AIDS patients. The purpose of this study was to investigate factors related with willingness to volunteer (WV) for patients with end-stage AIDS among hospice volunteers. Methods: Participants were 326 hospice volunteers from 19 institutions. A self-administered questionnaire was employed to investigate the participants' WV for end-stage AIDS patients, and the questions were answered using an 11-point rating scale. Demographics, volunteer activity, satisfaction with hospice volunteering, knowledge of AIDS, and attitudes towards AIDS patients (i.e., fear AIDS patients, negative attitude towards AIDS patients, personal stigmatization and stigmatizing attitude) were also investigated. A multiple regression analysis was performed to examine factors associated with WV for patients with end-stage AIDS. Results: WV for patients with end-stage AIDS was 2.82 points lower than that for cancer patients (P<0.001). The multiple regression analysis showed that the higher the level of satisfaction with hospice volunteering (P=0.002) and the lower the level of "personal stigmatization" (P<0.001), participants showed greater WV for end-stage AIDS patients. Conclusion: The level of satisfaction with hospice volunteering and "personal stigmatization" were factors associated with participants' WV for patients with end-stage AIDS.

• Pediatric Infection and Vaccine
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• v.13 no.2
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• pp.155-162
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• 2006

Purpose : Appropriate use of antimicrobials is an essential factor to treat infectious diseases and prevent acquisition of antimicrobial resistant pathogens. This study was undertaken to search that application of computerized management program for restriction of antimicrobials use in a hospital is helpful to decrease antimicrobial use density. Methods : Antibiotics utilization committee decided to restrict the use of 16 antimicrobials(14 expensive drugs having fear of drug resistance by pathogens and additional two drugs with inappropriate using tendency). Retrospective evaluation of antimicrobial user numbers between May and July of 2004 and 2005(study group) was conducted to compare with previous use density during same period of 2002 and 2003(control group). Results : Inpatients number of control group($823.5{\pm}37.1$ persons) was more than study group($809.2{\pm}39.3$ persons, P<0.001), but, outpatients number and hospitalized duration were equal in two groups. Antimicrobial user number/100 inpatients per day of glycopeptides and antifungal agents was equal in two groups, and study group was significantly higher density than control group in the use of carbapenems, piperacillin-tazobactam and quinolones(P<0.001). But study group was significantly lower density than control group in the use of drugs with inappropriately using tendency and expensive cephalosporins having broad antimicrobial spectrum(P<0.001). Conclusion : Application of computerized management program for restriction of antimicrobials use in a hospital is effective to decrease the use density of antimicrobials with inappropriately using tendency, but it is an insufficient measures for the restricted use of other antimicrobials on the whole.

• Korean Journal of Ecology and Environment
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• v.38 no.1 s.110
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• pp.45-53
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• 2005

The environmental change of Yong-nup in Mt. Dae-Am, which is located at the northern part of Kangwon-Do, Korea, was assesed with peat sedimentary carbon and nitrogen isotope analysis. The surface layer of the peat (0 ${\sim}$ 5 cm) was 190 year BP, and the middle layers (30 ${\sim}$ 35 cm and 50 ${\sim}$ 55 cm) were 870 year BP and 1900 year BP, respectively. Bulk sedimentation rate was estimated to be about 0.4 mm $year^{-1}$ for 0 cm to 30 cm and 0.15 mm $year^{-1}$ for 35 cm to 50 cm. The $^{14}C$ age of the bottom sediment (75 ${\sim}$ 80 cm) collected and measured in this study was about 1900 year BP, although it was measured that the $^{14}C$ of the lowest bottom sediment in Yong-nup was 4105 ${\pm}$ 175 year BP (GX-23200). Since the $^{14}C$ ages for 50 ${\sim}$ 55 cm and 75 ${\sim}$ 80 cm layers were almost the same as 1890 ${\pm}$ 80 fear BP (NUTA 5364) and 1850 ${\pm}$ 90 year BP (NUTA 5462), respectively, we have estimated that the deep layers (55 ${\sim}$ 80 cm) in the high moor were the original forest soil. The low organic C and N contents in the deeper layers supported the inference. The sediment of 50 ${\sim}$ 55 cm layer contains much sandy material and showed very low organic content, suggesting the erosion (flooding) from the surrounding area. In this context, the Yong-nup, high moor, of Mt. Dae-Am, might have developed to the sampling site at about 1900 year BP. The ${\delta}^{13}C$ values of organic carbon and the ${\delta}^{15}N$ values of total nitrogen in the peat sediments fluctuated with the depths. The profile of ${\delta}^{13}C$ may indicate that the Yong-nup of Mt. Dae-Am have experienced the dry-wet and cool-warm period cycles during the development of the high moor. The ${\delta}^{15}N$ may indicate that the nitrogen cycling in the Yong-nup have changed from the closed (regeneration depending) system to the open (rain $NO_3\;^-$ and $N_2$ fixation depending) system during the development of the high moor.

• Journal of Hospice and Palliative Care
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• v.15 no.4
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• pp.212-221
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• 2012

Purpose: This study was performed to compare nursing students' attitudes toward death among South Korea, Japan and Indonesia, and to confirm the need for death education in nursing. Methods: A total of 294 nursing students completed a questionnaire titled as the Death Attitude Profile-Revised (Wong, Recker, Gesser. 1994). Participating students were from two nursing schools in South Korea, two in Japan and one in Indonesia. Data were analyzed by using descriptive statistics and inferential statistics including, ${\chi}^2$-test, ANOVA and multiple comparison analysis. Results: The total mean score of the DAP-R for the three countries combined was $3.84{\pm}0.73$. By country, the mean was the highest for Indonesian students ($4.32{\pm}0.71$), followed by Korean ($3.75{\pm}0.57$) and Japanese ($3.56{\pm}0.70$) respectively. In relation to subcategories, Indonesian students showed the highest mean score for death avoidance ($3.67{\pm}1.38$) and approach acceptance ($5.37{\pm}1.00$). Korean students marked the highest ($5.51{\pm}0.91$) in neutral acceptance and Japanese students scored the best ($3.63{\pm}1.46$) in escape acceptance. Nursing students who had an experience of caring terminally ill patients tended to be affirmative in approach acceptance (P=0.047). There were significant differences in each of the four subcategories except fear of death among the three countries (P<0.001). Conclusion: The above results indicate it is necessary to develop education programs based on each country's social and cultural background to help nursing students form desirable attitudes toward death.

• Journal of Hospice and Palliative Care
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• v.13 no.3
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• pp.169-180
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• 2010

Purpose: This study was to identify the death recognition, meaning in life, and death attitude of participants in the death education program. Methods: A survey was conducted, and 205 data were collected. Descriptive statistics, ${\chi}^2$-test, ANOVA, and Duncan test were used. Results: 1) The followings were the characteristics of death recognition shown by the participants. Over half of the participants said that they had given some thoughts on their deaths, that they had agreeable view on death acceptance, and that diseases and volunteer works made them think about their deaths. Moreover, suffering, parting with family and concerns for them, etc. were the most common reasons for the difficulty of accepting death. As for 'the person whom I discuss my death with', spouse, friend, and son/daughter were the most chosen in this order. Lastly, the funeral type that most of the participants desired was cremation. 2) The means of meaning in life and death attitude were $2.92{\pm}0.29$ and $2.47{\pm}0.25$, respectively. There were significant differences between health status, meaning in life and death attitude. 3) A significant positive corelationship was found between meaning in life and death attitude (r=0.190, P=0.001). Conclusion: For an effective death education program that would fit each individual's situation, an educational content that can make a person understand the meaning of his or her life and death, includes knowledge to lessen the fear and anxiety of death, and helps a person heal from the loss of a family member is absolutely necessary.