• Journal of Hospice and Palliative Care
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• v.14 no.1
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• pp.28-33
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• 2011

Purpose: Recognition of impending death is crucial not only for efficient communication with the caregiver of the patient, but also determination of the time to refer to a separate room. Current studies simply list the events 'that have already occurred' around 48 hours before the death. This study is to analyze the predictability of each event by comparing the time length from 'change' to death. Methods: Subjects included 160 patients who passed away in a palliative care unit in Incheon. The analysis was limited to 80 patients who had medical records for the last week of their lives. We determined 9 symptoms and 8 signs, and established the standard of 'significant change' of each event before death. Results: The most common symptom was increased sleeping (53.8%) and the most common sign was decreased blood pressure (BP) (87.5%). The mean time to death within 48 hours was 46.8% in the case of resting dyspnea, 13.6% in the ease of low oxygen saturation, and 36.9% in the case of decreased BP. The symptom(s) which had the highest positive predictive value (PV) for death within 48 hours was shown to be resting dyspnea (83%), whereas the combination of resting dyspnea and confusion/delirium (65%) had the highest negative PV. As for the most common signs before death within 48 hours, the positive PVs were more than 95%, and the negative PV was the highest when decreased BP and low oxygen saturation were combined. The difference in survival patterns between symptoms and signs was significant. Conclusion: The most reliable symptoms to predict the impending death are resting dyspnea and confusion/delirium, and decline of oxygen saturation and BP are the reliable signs to predict the event.

• Journal of Hospice and Palliative Care
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• v.13 no.3
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• pp.153-160
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• 2010

Purpose: The purpose of the present study was to investigate needs and satisfaction on the medical services of cancer patients in Jeju Special Self-Governing Province. Methods: Total 174 cancer patients, who visited at the clinic of Jeju National University Hospital, submitted informed consent and participated in this study from July 13 to July 30, 2009. Self questionnaire was used and data were analyzed with Kolmogorov-Smirnov test, Mann-Whitney U test, ANOVA, and Kruskal-Wallis test. Results: Participants expressed the needs of most economical support (3.38 out of 4), followed by counseling of treatment plan (3.22), information of disease (3.07), and disease management except cancer (2.97). Participants were satisfied most with religious counseling (3.41), followed by nursing service support (3.39), employment counseling (3.26), and counseling for family or interpersonal relationships (3.26). The satisfaction of economical support was the lowest (1.98). Satisfaction of men was higher than women, and needs in patients who were living with children was the highest. Patients who were living alone or with children showed the lowest satisfaction about the medical services. There were no significant differences in the general characteristics, however, participants who were older than 60 years of age or had higher income showed lower needs and higher satisfaction. There were no significant differences in the medical characteristics, however, thyroid cancer patients and patients who were treated with radiation therapy or transarterial embolization showed low satisfaction. Conclusion: Cancer patients seemed to need more economical support, information of treatment or disease, and symptom management. Furthermore, there were various needs about the services, depending on family formation or economical support of patients. Therefore, it is certain that patients who were suffering from other cancers, except the 5 major cancers, needed more services. In conclusion, continuous and systemic policy to consider patient's characteristics and needs are needed in community as well as health care system.

• The Korean Society of Law and Medicine
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• v.16 no.2
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• pp.159-193
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• 2015

Owing to causes such as population aging, increased use of various medical devices, long-term hospitalization of various patients with reduced immune function such as cancer, diabetes, and organ transplant patients, and the growing size of hospitals, hospital infections are continuing to increase. As seen in the MERS crisis of 2015, hospital infections have become a social and national problem. In order to prevent damage due to such hospital infections, it is necessary to first strictly implement measures to prevent hospital infections, while, on the other hand, providing proper relief of damage suffered due to hospital infections. However, the mainstream attitude of judicial precedents relating to hospital infection cases has been judged to in fact shift responsibility over damages due to hospital infections on the patient. In light of the philosophy of the damage compensation system, whose guiding principle if the fair and proper apportionment of damages, there is a need to seek means of drastically relaxing the burden of proof on the patient's side relative to conventional legal principles for relaxing the burden of proof, or the theory of de facto estimation. In relation to such need, the German civil code (Burgerliches Gesetzbuch), which defines contracts of medical treatment as typical contracts under the civil code, and has presumption of negligence provisions stipulating that, in cases such as hospital infections which were completely under the control of the medical care providers, if risks in general medical treatment have been realized which cause violations of the life, body, or health of patients, error on the part of the person providing medical care is presumed, was examined. Contracts of medical treatment are entered into very frequently and broadly in the everyday lives of the general public, with various disputes owing thereto arising. Therefore, it is necessary to, by defining contracts of medical treatment as typical contracts under the civil code, regulate the content of said contracts, as well as the proof of burden when disputes arise. If stipulations in the civil code are premature as of yet, an option may be to regulate through a special act, as is the case with France. In the case of hospital infection cases, it is thought that 'legal presumption of negligence' relating to 'negligence in the occurrence of hospital infections,' which will create a state close to equality of arms, will aid the resolution of the realistic issue of the de facto impossibility of remedying damages occurring due to negligence in the process of occurrence of hospital infections. Also, even if negligence is presumed by law, as the patient side is burdened with proving the causal relationships, such drastic confusion as would occur if the medical care provider side is found fully liable if a hospital infection occurs may be avoided. It is thought that, alongside such efforts, social insurance policy must be improved so as to cover the expenses of medical institutions having strictly implemented efforts to prevent hospital infections in the event that they have suffered damages due to a hospital infection accident, and that close future research and examination into this matter will be required.

• Journal of the Society of Cosmetic Scientists of Korea
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• v.44 no.4
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• pp.363-373
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• 2018

In recent years, parabens used as preservatives in cosmetics have become a problem of human safety. Therefore, in this study, we tried to evaluate the preservative efficacy of 1,3-butylene glycol, 1,2-hexanediol, and 1,2-pentanediol as a preservative system to replace parabens. 1,3-Butylene glycol was added to cosmetic creams at a concentration of between 5 and 25%. The preservative efficacy of 1,3-butylene glycol was determined using a M-3 challenge test, as recommended by the Personal Care Products Council (formally CTFA). The alkane diols, such as 1,2-hexanediol and 1,2-pentanediol, were assessed in a similar manner. An evaluation of the preservative efficacy of 1,3-butylene glycol revealed that it was effective against all tested microbial strains at a concentration of 25%. We also investigated the efficacy of combinations of 0.3% phenoxyethanol and 0.1% ethylhexylglycerin. Finally, we tested the alkane diols, including 1,2-hexanediol and 1,2-pentanediol, as an alternative to the preservative 0.3% phenoxyethanol. Both 1% 1,2-hexanediol and 1% 1,2-pentanediol demonstrated preservative efficacy. Taken together, our study demonstrated that the formulation of 25% 1,3-butylene glycol and 0.1% ethylhexylglycerin, 1% 1,2-hexanediol, and 1% 1,2-pentanediol had the best preservative efficacy of the compositions tested. Thus, this study suggests that the formulation is a possibility of substituting parabens preservatives, which has been used in cosmetics and has become a safety issue.

• 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.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.5
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• pp.84-99
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• 1998

The objectives of this study are to identify the actual educational contents of management for head nurse and to propose the educational subjects according to identity the needs of head, charge, and staff nurses. The subjects were investigated the actual Management Development Programs and educational needs of head nurses and prospective nurse manager(charge nurse, staff nurse with a lot of clinical experiences) in general hospitals. The tools were composed of two questionnaires: One was developed from the literature review for making items to measure actual situation. The other was revised Katz's model for measurement of educational needs. The first respondents of actual situation were 27 general hospitals with over 400 beds in Seoul and the second respondents were 89 head nurses, 67 charge nurses and 136 nurses at 3 hospitals by convenient sampling out of 27 general hospitals. Data were collected by telephone interview, mail questionnaire and visiting from 7th of October through 30th of November in 1997. In data analysis, general characteristics of the respondents and actual status of Management Development Programs were analyzed by frequency and percentage. Educational needs according to general characteristics were analyzed by ANOVA The results were as follows: 1. Actual situation of Management Development Program 1) Seven hospitals(26%) had Management Development Program for prospective managers and 14 hospitals (52%) for head nurses. 2) Education Department existed in 14 hospitals (52%). 3) One hospital(4%) had top level managers took part in the Management Development. 4) Two hospitals selected head nurse, who had finished courses of Management Development. Eight hospitals(30%) assessed educational needs. The assessment tools consisted of making a question via questionnaire(75%), determining at department meeting(12%) and interview(13%). 5) Educational programs had 3 types: 10 lecture type, 7 discussion type and 4 role play type programs. 6) One hospital evaluated the change of learner's attitude. 7) Four hospitals scored educational point, but that was measured only by attending. 8) Actual Management Development Programs were as follows. parenthesis indicates the number of hospitals. (1) Management Development Programs for Prospective manager. Role perception of Middle level Manager (1) . Role reconstruction of Nurse Manager (1). Workshop for Charge Nurse (1). Nursing Delivery System and Nursing Process (1). Communication (1). Motivation (1) (2) Management Development Programs for Head nurse.. Head nurse's Role (5). Administrative Work (7). Service Education (4). Prevention and Countermeasure of Nursing Incidence (3). Appraisal (3) 2. The results of needs on Management Development subject 1) The educational needs of all respondents on 3 skill domains showed positive agreement to strongly positive agreement. 2) High priority(more than 4.5) items were 12 of 24 Human skill items(50%), 1 of 6 Technical skill items(16%), and 2 of 13 Conceptual skill items (15%). 3) Out of high priority items, 8 items were instituted. 4) All respondents showed high needs on 3 skill domains regardless of 3 positions (head nurse, charge nurse, and nurse). Educational needs of Human skill domain, according to position were 108. S, 108.7, 106.8 (mean score = 72) , needs of Technical skill domain were 26.5, 26.6, 26.I(mean score=18), and needs of Conceptual skill domains were 56.9,56.7, 55.1(mean score=39). 5) Needs of 3 skill domains according to clinical career showed significant difference. Out of respondents, nurses with career of over 16years showed lowest degree of needs in Human skill domains(F=4.47, P=.004) and Conceptual skill domain(F=2.93, P=.034). 6) Educational needs according to educational background were not significant difference. But out of respondents, nurses educated at 3-year junior college relatively showed lowest needs in all of the 3 skill domains. With the above-mentioned findings, further study is necessary for generalization of this study at hospitals with different bed size and location. Also it is needed to study about management skill of nurse and charge nurse, and effective educational method.

• Journal of the Korean Society of Clothing and Textiles
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• v.39 no.3
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• pp.369-378
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• 2015

Various forms of wearable bio-signal monitoring systems have been developed recently. Acquisition of stable bio-signal data for health care purposes needs to be unconscious and continuous without hindrance to the users' daily activities. The garment type is a suitable form of a wearable bio-signal monitoring system; however, motion artifacts caused by body movement degrade the signal quality during the measurement of bio-signals. It is crucial to stabilize the electrode position to reduce motion artifacts generated when in motion. The problems with motion artifacts remain unresolved despite their significant effect on bio-signal monitoring. This research creates a foundation for the design of garment-type wearable systems for everyday use by finding a method to reduce motion artifacts through modular design. Two distinct garment-type wearable systems (tee-shirt with a motion artifact-reducing module (MARM) and tee-shirt without a MARM) were designed to compare the effects of modular design on the measurement of heart activity in terms of electrode position displacement, signal quality index value, and morphological quality. The tee-shirt with MARM showed superior properties and yielded higher quality signals than the tee-shirt without MARM. In addition, the tee-shirt with MARM showed a better repeatability of the heart activity signals. Therefore, a garment design with MARM is an efficient way to acquire stable bio-signals while in motion.

• Journal of Digital Convergence
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• v.14 no.4
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• pp.101-110
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• 2016

With the result of Korean national senior's real life state survey analysis that is triennially conducted based on Article 5 of Welfare of the Aged Act, this study categorized the senior according to age norm cognition, and figured out the characteristic of each category, and analyzed their needs for life satisfaction and hoping activities. Because the senior at present are on higher level of health, education, and economy than 20 to 30 years ago, it is about time to repeat discussion about the policies established in the past in terms of society, culture, industry, welfare, employment, and participation as a convergence approach. As a result of analysis study, the senior divided into three groups:, resignation type, progressiveness type, and saving appearances type. Their life satisfaction level and hoping activities by senior segment groups are different. By results of this study, the preservation of income for senior will be needed, and they don't want volunteer activities so that there are another policy system will be needed to vitalize senior's social participation for their healthy physical and mental life. Korean senior were satisfied with family members relationship, -although Korean senior's life satisfaction level is not higher so that the new policy to care senior by senior system will be reviewed more actively.

• Korean Journal of Child Studies
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• v.1
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• pp.94-106
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• 1980

The issue presented in this paper are as follows: 1. Legislative actions of welfare-related law for the exceptional children. The legislative base for the evolution has been yet weak and ambigous at best for a formalization of what should be considered accepted practice and effective action in providing handicapped child and their parents educational rights and equal protection of the law. And they are under remote control of partial factor subject to social welfare law for children, and public law for education, promotion law for the exceptional child education, protection law for public aids. 2. Organization of government for the welfare services for the exceptional children. There is no sing of a push toward consolidation of effort for the welfare service of the exceptional children in this country that seeks to recapture a sense of unity, of coherence, of completeness from a reality made up of discontinuous fragments of humanitarian effora This presently that. as for the education of the exceptional child, by the section of the exceptional education in MOE (Ministry of Education), and/or as for welfare services and promotion actions, by the section of child welfare in MHSA (Ministry of Health and Social Affairs). One door type operation rooted in the specialization, and limited resources to evolve multi-purpose agencies that undertake to provide a broad range of tangible and concrete services, as well as supportive counselling and assessment, under a single management which plans and directs the allocations of resources, should be followed. 3. Facilities and recruitment of teachers for the exceptional children. In this country there are 54 facilities for special services, 56 schools for the exceptional education, and 3 colleges and equavalents that provide teacher training services leading to certification with IIO annual graduates. However, curriculum for exceptional children should be rearranged and reconstructed. Conclusion; Only as for social welfare institutions in community, this country produced a succession of specific purpose activities, over period of time, that accumulated to form the present network of hundreds of social welfare organizations and facilities Periodically major efforts were launched to revitalize or to improve the help-giving system. But they lack specialization to be effective, and the nature of multi-purpose center tends to be vague for the classified handicapped. Therefore, there, should be linkage between policy maker and community services to maintain some coherenty in preventive care, treatment, and after cares. At last, the effects of the current concept "the exceptional child" involved with their families, and their neighborhood should be considered in view of the people who consist about 25% of the total population.

• The Journal of the Korea Contents Association
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• v.22 no.10
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• pp.445-459
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• 2022

This study presented a plan to improve the life satisfaction and leisure status of the elderly in the With COVID-19 era, and the life satisfaction of the elderly. For this purpose, we investigated life satisfaction and leisure life for 107 senior citizens at the Gyeonggi Senior Welfare Center, and the following results were obtained. First, it can be seen that overall life satisfaction was relatively lower after Corona than before. Second, in the correlation between leisure activity and life satisfaction, there was no significant correlation between the level of leisure activity and life satisfaction before Corona, and a significant positive correlation was found between the level of leisure activity and life satisfaction after Corona. seemed If alternative measures are proposed according to these results, first, it is necessary to seek ways to improve and manage the environment for the elderly in the with Corona era in the local community. In particular, in order to reduce the adaptation gap among the elderly due to the many changes in digital technology, institutions related to the elderly are providing education on how to use smartphones and kiosks, but it needs to be expanded as a community-wide measure. Second, a systematic system for health care for the elderly in the era of With Corona must be provided. Third, the old-age income security system and support are required so that the minimum living security is guaranteed for the elderly who are experiencing economic difficulties due to the corona virus. Fourth, it is necessary to revitalize programs related to talking to the elderly and counseling for the improvement of relationships and location satisfaction due to social distance and relationship atrophy due to Corona.