• Journal of Hospice and Palliative Care
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• v.1 no.1
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• pp.56-64
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• 1998

Purpose : Seoul National University Hospital developed a group counseling program for the terminal cancer patients and their family members. This program consists of each of doctor, nutritionist, nurse, pharmacist, and social worker to provide them with the information and to enhance their ability to cope with terminal cancer. This research aims to introduce this new program per se, and to appreciate its validity and applicability to the terminal cancer patients and their family members by analyzing the concerns and specific questions of the participants. Methods : The methodological approach employed in this research is 1996 content analysis of the group counseling reports, and interview of the 312 participants. The analysis includes the general characteristics of the subjects, family relationship to the patients, times of attendance to the group session, source of information to the program. Results : The participants consist of 261 family members(84%) and 51 patients(16%). Majority responded to the program with a single-attendance. Diagnosis are mainly lung cancer, stomach cancer, liver cancer. The ratio of participants by family members is decreased in the order of spouse, children, daughter-in-law, brothers and sisters, and parents. The source of information to the program is largely through medical staff(69%) as compared with posters in the hospital (26%). The participants are interested primarily in the medical information. Their interests are various, such as pain control, patient care, nutrition, psychosocial problem and etc. Conclusion : This program is characterized largely as a family-supporting program which primarily offers information for terminal cancer. This program is a sort of a hospice program, which maximizes the present quality of living of the terminal cancer patients as long as life continues by encouraging them to live with terminal cancer. Thus, this group program can be employed as an active support network for the patients and their family. In order to develop comprehensive care-giving services, it is required to have 24-hour telephone service, hospice facilities, home care service, and communication between the referral hospitals and the primary care physicians, in particular. Such a development of services is the ultimate goal for improving care. But the immediate goal of the program is to make possible better education for the patients and their family to live with terminal cancer.

• The Journal of Internal Korean Medicine
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• v.28 no.1
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• pp.47-67
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• 2007

Objectives : This study was aimed to investigated the warning signs and its relationship with the other characteristics in acute stroke patients. Methods : 225 acute stroke patients were recruited at the Department of Cardiovascular and Neurologic Diseases (Stroke Center) of Kyung Hee University Oriental Hospital from October 2005 to September 2006. We evaluated their stroke type with brain MRI, their warning signs, and general characteristics such as age, sex, past history, risk factors, etc. Results : 225 subjects were included in the final analysis. In the subjects' general characteristics, the most common etiology of stroke was small vessel occlusion. In the assessment of the subjects' warning signs, the frequency of tension felt at the cervical area was highest followed by blepharospasm, sensory dysfunction (one side of numbness, tingling sensation, dead sensation), one side paralysis or weakness, etc. After analyzing etiology, cerebral hemorrhage had more facial spasm sign and hypertension than cerebral infarction. On the other hand, cerebral infarction had more diabetes and sensory dysfunction (one side of numbness, tingling sensation, dead sensation) than cerebral hemorrhage. Among stroke locations, subjects with their brain lesion in the cortex had more warning sings of motor dysfunction such as one side paralysis, or weakness. Multiple lesions showed a close relationship with smoking habit and were more common in males than in females. The under 65 years old group were more commonly associated with alcohol consumption, accidental mental stress and blepharospam than the over 65 years old group. In the group of under 65 years old, males more commonly had lesions in occipital lobe, alcohol consumption and smoking habit than females. Otherwise, females more commonly had vision dysfunction and blepharospasm than males. In the group of over 65 years old, males more commonly had cortex lesion than females. On the other hand, Females more commonly had accidental mental stress than males. Conclusions : We observed various warning signs and their distribution in acute stroke patients. The subjects' brainlesions and their etiology seemed to affect the features of the warning signs. Hypertension, diabetes and hyperlipidemia were also related to etiology of stroke and some habitual problems such as smoking and drinking seemed to reduce the age of stroke ictus. Although a concrete conclusion can hardly be drawn from this study, it reminds physicians of the importance of warning signs which appear among their patients.

• Radiation Oncology Journal
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• v.22 no.3
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• pp.184-191
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• 2004

Purpose: In order to improve the proper use of radiotherapy and breast-conserving treatment (BCT) in the management of breast cancer, current status of breast cancer treatment in Korea was surveyed nationwide and the use of BCT were evaluated. Materials and Methods: Patients characteristics and treatment pattern of 1048 breast cancer patients from 27 institutions diagnosed between January, 1998 and June, 1998 were analyzed. The incidence of receiving BCT was analyzed according to the stage, age, geography, type of hospital, and the availability of radiotherapy facility. Results: Radical mastectomy was peformed in 64.8$\%$ of total patients and 26$\%$ of patients received breast- conserving surgery (BCS). The proportions of patients receiving BCT were 47.5$\%$ in stage 0, 54.4$\%$ in stage I, and 20.3$\%$ in stage II, Some of the patients (6.6$\%$ of stage I, 10.1$\%$ of stage II and 66.7$\%$ of stage III) not received radiotherapy after BCS. Only 45$\%$ of stage III patients received post-operative radiotherapy after radical mastectomy. The proportion of patients receiving BCT was different according to the geography and availability of radiotherapy facilities. Conclusion: Radiotherapy was not fully used in the management of breast cancer, even in the patients received breast-conserving surgery. The proportion of the patients who received BCT was lower than the report of western countries. To improve the application of proper management of breast cancer, every efforts such as a training of physicians, public education, and improving accessibility of radiotherapy facilities should be done. The factors predicting receipt of BCT were accessibility of radiotherapy facility and geography. Also, periodic survey like current research is warranted.

• Journal of the Korean Society of Radiology
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• v.17 no.2
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• pp.257-265
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• 2023

The purpose of this study was to vaccinate every year according to the general characteristics of COVID-19, whether to vaccinate every year according to the vaccination experience, whether to vaccinate every year according to knowledge/attitude about vaccination, and negative responses to the vaccinate every year In order to understand the factors affecting the vaccination physician every year by identifying the factors of Statistical analysis is based on general characteristics, variables based on vaccination experience, and knowledge/attitudes related to vaccination. The doctor calculates the frequency and percentage, A square test (-test) was performed, and if the chi-square test was significant but the expected frequency was less than 5 for 25% or more, a ratio difference test was performed with Fisher's exact test. Through multiple logistic regression analysis using variables that were significant in simple analysis, a predictive model for future vaccination and the effect size of each independent variable were estimated. As statistical analysis software, SAS 9.4 (SAS Institute Inc., Cary, NC, USA) was used, and because the sample size was not large, the significance level was set at 10%, and when the p-value was less than 0.10, it was interpreted as statistically significant. In the simple logistic regression analysis, the reason why they answered that they would not be vaccinated every year was that they answered 'to prevent infection of family and hospital guests' rather than 'to prevent my infection' as the reason for the vaccination. It was 11.0 times higher and 3.67 times higher in the case of 'for the formation of collective immunity of the local community and the country'. The adverse reactions experienced after the 1st and 2nd vaccination were 8.42 times higher in those who did not experience pain at the injection site than those who did not, 4.00 times higher in those who experienced swelling or redness, and 5.69 times higher in those who experienced joint pain. There was a 5.57 times higher rate of absenteeism annually than those who did not. In addition, the more anxious they felt about vaccination, the more likely they were to not get the vaccine every year by 2.94 times.

• Journal of Korean Medical classics
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• v.6
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• pp.89-130
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• 1993

Huh-joon's medical thoughts shown on his medical book of the Doog-Eui-Bo-Kham can be summerized as follows. 1. The general trend of medical science in Koryo dynasty is that much more interests were concentrated upon the books about curative means rather than upon the books about theoretical knowledge of medical science. With the development of Hyang Yak(鄕樂) (the term referring either various kinds of domestic medical stuffs such as herbs or the curative methods using those stuffs) and the writing of books on Hyang Yak, independent medical science of the nation's own was established in late Koryo dynasty. And the national medical science was continuously further developed until early Choson dynasty. Briskly-expanded mutual exchanges with China in early Choson dynasty provided Choson opportunities to import Chinese medical science and to examine it. Under this circumstances, he wrote the Dong-Eui-Bo-Kham. 2. As we look over the preface and Chip-Rae-Muo(集例文), we can find the characterstic of Doog-Eui-Bo-Kham is that the philosophical theory of Taoism was quoted in explaining the principles of his medical science and that the main idea of Naekyuog is the basis in explaining the way of curing diseases. 3. 83 kinds of medical books were quoted in the Doog-Eui-Bo-Kham. Besides, as many as 200 kinds of books including Tao-tzu's teaching books(道書), history books(史書), almanac(曆書), and Confucius' teaching books(儒家書籍) were quoted in total. Naekyuog and Eue-Hak-Ip-Mun, Dan-Kye-Sim-Bup were the most frequently quoted books among them. 4. Huh-Joon's medical thoughts about health care were like these. 1) The reason why Huh-Joon regarded the idea of health care as of great importance was that he laid much more emphasises on the preventive medicines rather than on the remedial medicines. The direct reason was that he was greatly influenced by profound knowledge of Taoist's study of discipline and who participated in the editing the books from the beginning. 2) Huh-Joon's outlook on human body started from the theory of "Unity of Heaven and Man"(天人合一論), which implied man was a kind of miniature universe. In addition to that, he largely theory of essence(精), vital force(氣), and spirit(神) which were regarded very important as the three most valuable properties in Taoism. However, he took his medical ground on practical and pragmatic idea that he did not discuss fundamental essence(元精), fundamental vital force(元氣), and fundamental spirit(元神) which were given by Heaven from the received only the theory of essence, vital force, and spirit which were acquired after birth and worked mainly on realistic activity of life. 3) Huh-loon accepted Do-In-Bup(導引法) sharply as a method to prevent and cure diseases. 5. Huh-loon's medical thoughts on remedial aspects are as 1) Naekyung was considered so important in Dong-Eui-Bo-Kham that not only each paragraph was begun with the Quotations from Nackyung but also the edited order of the content of the book the same with that of Naekyung. And differently from the former korean medical books he accepted at large and recorded the theories of the four noted physicians of the Geum-Won era(金元四大家) by Dong-Eui-Bo-Kham. 2) For the first time, Huh-Joon introduced the theory of Un-Ki (運氣論) in the Dong-Eui-Bo-Kahm. However, he accepted it as a pathological function of human body but he did not apply physical constitution, physiological function, pathological function, and remedial methods. 3) Huh-loon liked to use Hyang Yak that he recorded korean name of Hyang Yak(鄕名), places of the production(産地), the time of collecting(採取時月), and the way of drying herbs(陰陽乾正法) in the remedial method of a single medicine prescription for diseases at the end of each paragraph. By doing so, he developed, arranged, and revived Hyang Yak. 4) He believed that since the natural features of China were different from those of Korea the reasons of being attacked with its remedial methods couldn't be the same with different from Chinese medical books which primarily focused on paralysis and the injury of the cold has his own structure in his book that he founded independent science of this nation. He consulted enormous documents He discovered and wrote the theory and therefore concrete methods for diseases so that the book hadthe principles of outbreak of diseases(理), methods of cure(法), prescription(方), and a single medicine prescription(藥) and set system of medical science in a good order. By doing so, he and pragmatic development of medical science.

• Tuberculosis and Respiratory Diseases
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• v.80 no.2
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• pp.169-178
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• 2017

Background: The purpose of this study was to assess the effect of our new video-assisted asthma education program on patients' knowledge regarding asthma and asthma control. Methods: Adult asthmatics who were diagnosed by primary care physicians and followed for at least 1 year were educated via smart devices and pamphlets. The education sessions were carried out three times at 2-week intervals. Each education period lasted at most 5 minutes. The effectiveness was then evaluated using questionnaires and an asthma control test (ACT). Results: The study enrolled 144 patients (mean age, $56.7{\pm}16.7years$). Half of the patients had not been taught how to use their inhalers. After participating in the education program, the participants' understanding of asthma improved significantly across all six items of a questionnaire assessing their general knowledge of asthma. The proportion of patients who made errors while manipulating their inhalers was reduced to less than 10%. The ACT score increased from $16.6{\pm}4.6$ to $20.0{\pm}3.9$ (p<0.001). The number of asthmatics whose ACT score was at least 20 increased from 45 (33.3%) to 93 (65.3%) (p<0.001). The magnitude of improvement in the ACT score did not differ between patients who received an education session at least three times within 1 year and those who had not. The majority of patients agreed to the need for an education program (95.8%) and showed a willingness to pay an additional cost for the education (81.9%). Conclusion: This study indicated that our newly developed education program would become an effective component of asthma management in primary care clinics.

• Journal of Korean Academy of Nursing
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• v.11 no.2
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• pp.23-32
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• 1981

The purpose of the study was to evaluate the educational content which had been given by midwifery training program. It was hoped that this result would help. It was sponsored by com-munity health worker plan effective health education. College of Nursing Ewha Womans University and The Korean Nurses Academic Society during the November 19 thru 24, 1979. It was carried out on July through on September 1980, and involved 22 community health workers. The results were as follows: 1. Most of the community health workers came from Seoul ＆ Pusan areas and have been working at the hospitals. There were 31.82% of Head Nurses, 27.2% of Staff Nurses, 22.73% Nurse Supervisons, 13.6% of Nurse Directors and 4.5％ of educational coordinator for Nurses. These participant had nurse-midwifery lincences by 63.64%. None of there had just midwifery lincences. 2, Age structures of the study population shows 31.82% of whom are.26-30 years and 22.73% of whom are 36. 40 years of age. This shown that seniority proportion is higher than the younger. There are 31.82% of 1-5 years, 27.27% of 6-10 year and 11-15 years, respectively by work career. 3. There are 54.55% of the institutions have opened their own midwifery training course for their nursing staff members. Because of lack of the facilities, shortage of instructors, and problems of administrative process. 4. According to the institution which opened for midwifery training courses, the participant was responsible for “midwifery”“Infant care”“MCH”“practice of midwifery”“Nursing adjustment”and“F. P.”5. During the midwifery couse, there were 8 institution who used the textbook and 4 institution who did not. Least of there referned to content matinals which was given by the sponsored. 6. There are 7 insititues who kept their training courses with other professional helps such as physicians., professiors and nurses. Some problems are pointed out by respondents such as“conflict with residents”“poor suportive administration”and“lake of manpower”. 8. The participant showed that they learned new knowledge as trends during this programs for there quality work so it need (one or twice times) a year. But they suggested that it needed more emphasis on the“maternal health care”and“role of the nurse-midwifery”. 9. The analysis of the results are as follows within the 6 areas which are given by the sponsored: There are highest ranks between“basic theory & family planning”“role of midwifery & nursing practice”. In the prenatal care the highest rank ware related to“health risk”on“idenify of risk symtoms”. In the health care areas which related to delivery, the responsers were related to“general conditions”or“high risk criteria”. In the health care area which related to high risk maternity care. In the neonatal health care, the highest rank was related to”health assessment of normal infant”. In the infant health care the responses was related to“abnormal symptoms”and“risk symptoms”. Actually, the participants show that they are more interested in“role of midwifery”“health assessment”and “high risk maternity care”are which emphasised on health promotion, health maintenance & disease preventive. 1) The midwifery training program need higher education for midwifery on a regular basis. 2) Within the open institution of midwifery training program, the nurses must be supported by their own institution and administry of social welfare must give systematic support. Also non-open institution must be open very soon. 3) All health workers including the residents & other workers, must cooperate for their phased common good of impovement of the maternity health. 4) Administration agonies & education institutions must provide the curriculum facilitis and administration systems which are needed for training of nurse-midwifery.

• Clinical and Experimental Pediatrics
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• v.51 no.4
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• pp.415-419
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• 2008

Purpose : Herbal medicine is thought to be widely used by children with epilepsy, but there have been few studies. This study aimed to investigate the perceptions and the actual conditions of usage of herbal medicine by children with epilepsy. Methods : From July to August 2007, three hundred seventy eight questionnaires were completed by parents of epileptic children who visited pediatric neurology clinic of Korea University hospital and Kwangmyung-Sungae hospital. Demographic data and patterns of usage of herbal medicine were investigated. Results : Among 378 patients, sixty five (17.2%) reported using herbal medicine. Major reasons for using herbal medicine were 'to enhance general health' and 'belief that it has fewer side effects'. Majority of respondents did not notify their physician about using herbal medicine because 'they did not need to share this with doctor' and 'they thought their doctor would disapprove'. After taking herbal medicine, 33.3% of patients reported that it did not benefit their seizure but they felt healthier. Usage of herbal medicine was significantly related to number of AEDs (antiepileptic drugs), duration of AED treatment, association with psychosomatic disorders and motivation by other people or by mass media. Conclusion : Considerable numbers of epileptic children were using herbal medicine during treatment with AED and did not inform their physician about usage of it. Physicians should be aware of benefits and harms of herbal medicine and actively intervene in the usage of herbal medicine by epileptic patients.

• Journal of Preventive Medicine and Public Health
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• v.31 no.2 s.61
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• pp.310-322
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• 1998

In order to reinforce the role of primary care physician and o improve doctor-patient relationship, the Korean government tried to introduce 'Family Doctor Registration Program' into Seocho-Gu in Seoul, Ansung-Gun and Paju city in Kyunggi-Do in Oct. 1996. Community residents and doctors in those area did not show much interest in this project because of low incentives. We have done this study to see how much people know 'Family Doctor Registration Program' and what is people's real needs about 'Family Doctor Registration Program'. We selected 1,800 telephone numbers in Seoul, Chongju city, and Ansung-Gun by multi-stage stratified random sampling. Three trained survey personnels called them and got answers to the premade questionnaire until they completed the questionnaires of 200 persons in each community. The calling time was 7-9 p.m. from Monday to Friday, 3-9 p.m. on Saturday, and 9 a.m. to 9 p.m. on Sunday. We dropped out the persons who did not respond 3 times. The subjects consisted of 222 male and 367 female residents. Their ages ranged from 20 to 78: 24.8% in their 30s, 23.4% in their 20s, 22.5% in their 40s in male, and 35.2% in theirs, 22.5% in their 40s, 18.5% in their 20s in female. 9.9% of male and 13.2 % of female had their Family Doctors. The specialties of their Family Doctors were internists in 56.2%, general surgeons in 11.0%. The persons who did not have their family doctors were asked which doctors they would prefer if they had choices of family doctor. The results were internists in 50.3%, family physicians in 13.0%, pediatricians in 4.8%. Only 16.0% residents knew that government tried to introduce Family Doctor Registration Program. The 'Family Doctor Registration Program' was not well known to people. The results of our study showed that more effective incentives and public notifications are needed to activate this program.

• Journal of Hospice and Palliative Care
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• v.15 no.1
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• pp.10-17
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• 2012

Purpose: This study was conducted to identify the perception regarding palliative care among Korean doctors and referral barriers toward palliative care for terminal cancer patients. Methods: Between May and June 2010, 477 specialists mainly caring cancer patients using a web-based, self-administered questionnaire. Results: A total of 128 doctors (26.8%) responded. All respondents (100%) deemed palliative care a necessary service for terminal cancer patients. More than 80% of the respondents agreed to each of the following statements: all cancer centers should provide palliative care service (80.5%); all terminal cancer patients should receive concurrent palliative care along with anti-cancer therapies (89.1%) and caring for terminal cancer patients requires interdisciplinary approach (96.9). While more than 58% of the respondents were satisfied with their performance of physical and psychological symptoms management and emotional support provided by patient's family members, 64% of the responded answered that their general management of the end-of-life care was less than satisfactory. Doctors without prior experience in referring their patients to palliative care specialists accounted for 26.6% of the respondents. The most common barrier to hospice referral, cited by 47.7% of the respondents, was "refusal of patient or family member", followed by "lack of available palliative care resources" (46.1%). Conclusion: Although most doctors do recognize the importance of palliative care for advanced cancer patients, comprehensive and sufficient palliative medicine, including interdisciplinary cooperation and end-of-life care, has not been put into practice. Thus, more active palliative consultation or referral is needed for effective care of terminal cancer patients.