• Title/Summary/Keyword: health related symptoms

Search Result 1,186, Processing Time 0.034 seconds

Water-Blooms (Green-Tide) Dynamics of Algae Alert System and Rainfall-Hydrological Effects in Daecheong Reservoir, Korea (대청호 조류경보제의 녹조현상 동태와 강우-수문학적 영향)

  • Shin, Jae-Ki;Kang, Bok-Gyoo;Hwang, Soon-Jin
    • Korean Journal of Ecology and Environment
    • /
    • v.49 no.3
    • /
    • pp.153-175
    • /
    • 2016
  • Daecheong Reservoir has suffered eutrophication and water-blooms by blue-green algae from initial impoundment, and algae alert system (AAS) was introduced in 1997. The purpose of this study was to investigate the effect of rainfall and hydrological factors in increase or decrease variability of green-tide and prolonged AAS, studied and analyzed the current situation of AAS has been operating for 19 years (1997~2015) in Daecheong Reservoir. The total issued number of AAS was 46 times, the most frequent period in August and September were 22 times (752 days) and 16 times (431 days), respectively, it accounted for 82.6%. Many number and frequency during this period were significantly associated with rainfall, various discharge and water level. Rainfall and hydrological events are associated with the rainy season of monsoon-Changma and the typhoon, it was concentrated in June~September, total rainfall in this period accounted for 69.9% of the annual rainfall. An increase in inflows was dependent on the intensity, frequency and the amount of rainfall. Accounted for 68.4% of the total annual inflow, it was a time when the most rapidly changing hydrological variability in the reservoir. The total outflow was closely related to rainfall, and compared the distinctive characteristics of hydropower generation and watergate-spillway discharge. In addition, the upreservoir zone of Daecheong Reservoir could be vulnerable to green-tide by regulating discharge of the upstream dam. The issue of AAS was strongly related to the with and without of watergate-spillway discharge. The watergate-spillway discharge had a total of 25 times, it was maximum 17 days from July to September in the year. And the opening times and each duration of the watergate were 1~4 times and the range of 3~37 days, respectively. When the watergate opened, the issue of AAS was maintained to 13 years and the movement of water bodies and green-tide was great about five times than that of non-open, had a profound effect on prolonged AAS within reservoir. In Daecheong Reservoir, Chusori (CHU) area of the So-ok Stream was still showing serious symptoms green-tide levels in the summer, but Janggye (JAN) waters of the main reservoir was pointed out that more important. AAS will be operated by an absolutely consider the rainfall and hydrological effects around the watergate-spillway discharge. The measures of green-tide will be included in the limnological studies more suited to the characteristics of the watershed and reservoir of the our country. Finally, from now on, we will prepare the systematic management and guidelines for vulnerable zone water-blooms that are the source within the reservoir before the monsoon rather than waiting for the arrival of green-tide on the operating stations of AAS.

Investigating Research on the Degree of Frequency and Importance of Tasks for Framing the EMTs Occupational Description (응급구조사 직무기술서 작성에 따른 일의 요소별 빈도 및 중요도 조사 연구)

  • Kim, Tae Min;Kim, Hyo Sik;Yoou, Soon Kyu
    • The Korean Journal of Emergency Medical Services
    • /
    • v.5 no.1
    • /
    • pp.199-212
    • /
    • 2001
  • This research, aiming at analyzing the Emergency Medical Technicians' duties prior to establishing a baseline for question development in the national exams to qualify for the EMTs, investigated the importance and frequency per unit specified in the description with the EMTs to be subjects working on the task spot by means of questionnaires. The EMT duties were classified into 9 items like 1) the notification and response, 2) the scene size-up, 3) the patient assessment, 4) the emergency care, 5) the patient transport, 6) the duties at hospital clinics, 7) the operational management, 8) the receiving and responding to a call, 9) the self-development, and put the functional tasks into 52 items, describing the task elements into 177 items, and then questioned 112 EMTs working on the spot from July 21 through August 30, 2000, which showed the following results. 1) The distribution of subjects' career showed the highest rate with 33.9% for those who careered "less than a year", only 13.4% for those with more than 4 years and the highest rate with 43.8% for those who aged at 20-25. And 70.5% of all those who were questioned was the junior college graduates, 58.9% for those working at fire station and 29.5% working at hospital clinics. 2) Looking at the distribution of frequency and importance for each task element, questioning 'the patients main symptoms', 'accidental type', 'place of the patients identification' showed the highest rate in both frequency and importance in the field of "notification and response". 3) In the "scene size-up", identifying the patients showed the highest rate of frequency and importance, compared to other field of tasks, among which "identifying the patients' state" showed the highest rate of frequency (2.66) and importance (2.81). 4) In the "patient assessment", "identifying the patients" showed the high rate of frequency and importance in most elements of task, especially the importance showed the highest rate with 2.83 for the task of airway management and the cervical immobilization during "the primary assessment", and the frequency showed the highest rate for questioning the past case of the task of grasping the patients' history. 5) In the "emergency care", "the management of the heart attacked patients" and "the advanced cardiac life support" showed a high rate in the importance, whereas the frequency showed a very low rate. The high rate of frequency during the emergent task was the management of "musculoskeletal system injury patients" and of "the gastro-intestinal and urinary genital system injury patient support." In care of the patients with heart attack, the management of the airway showed the highest rate with 2.95, whereas the management of alcoholic abused patients and of dying patients, showed comparatively lower rate of assessment in the importance. The frequency of tasks showed the highest rate with 2.69 in the control of bleeding and the lowest with 0.47 in the management of abnormal delivery of child. 6) As to the patient transport, "the emergency transport" showed the highest rate with 2.74 and the unemergent transport with 2.55 in the importance, and the task importance at hospital showed the highest rate with 2.89 in managing the cardio-pulmonary resuscitation and with 2.60 in identifying the patient state. 7) Of all the tasks related with "operational task", the high importance was to "educate for the management of the first responder", but the frequency of tasks mostly showed a low rate and "receiving and responding to a call" showed relatively a high rate of importance and frequency. And related with "the self-development", "the health care management" and "the stress control" on working spot showed a high rate, but the frequency mostly showed a low rate.

  • PDF

Psychosocial Factors Predicting Delayed Diagnosis of Breast Cancer : The Role of Marital Relationship Functioning (지연된 유방암 진단을 예측하는 정신사회적 요인 : 부부관계기능의 역할)

  • Kim, Ji Young;Woo, Jungmin;Lee, Sang Shin;Kim, Hea Won;Khang, Dongwoo;Rim, Hyo-Deog
    • Korean Journal of Psychosomatic Medicine
    • /
    • v.22 no.1
    • /
    • pp.13-22
    • /
    • 2014
  • Objectives : Breast cancer has been the most prevalent female cancer in South Korea since 2001. Early detection of this disease is the most effective strategy for reducing mortality. The objective of this study was to identify factors which could predict advanced stage at diagnosis of breast cancer. Methods : Participants who were initially diagnosed with breast cancer and referred to the Stress Clinic of the Breast Cancer Center at Kyungpook National University Hospital were included. Through a semi-structured interview, the authors investigated psychosocial variables such as the extent of marital and family functioning and emotional-economic family burden as well as sociodemographic and health behavior-, health characteristic- and cancer-related variables. Results : Data were collected from 219 participants. One hundred and twenty(54.8%) subjects were diagnosed with advanced-stage breast cancer. Variables that were significantly different between the advanced-stage and early-stage groups included : monthly breast self examination(p<0.000), annual mammographic screening(p<0.000), mode of tumor detection(p<0.000), nature of the first symptoms(p<0.000), time to treatment after diagnosis(p<0.000), overloaded economic and family burden(p=0.018), marital functioning(p<0.000) and family functioning(p<0.00). Logistic regression analysis indicated that irregular annual mammography screening(OR=7.431 ; 95% CI 2.407-22.944) or a lack of screening(OR=25.299 ; 95% CI 7.855-81.482) and a dysfunctional marital relationship(OR=4.772 ; 95% CI 2.244-10.145) were significantly associated with advanced stage at diagnosis of breast cancer. Conclusions : We reconfirmed screening behavior to be a risk factor for delayed diagnosis of breast cancer. Our findings also emphasized the importance of psychosocial factors such as marital functioning in early detection of breast cancer. Psychiatric consultation in the area of martial functioning could be beneficial for increasing early detection in breast cancer.

  • PDF

Clinical review of Typhoid Fever Patients (장티브스에 관한 임상적 관찰)

  • 최정신
    • Journal of Korean Academy of Nursing
    • /
    • v.6 no.1
    • /
    • pp.60-71
    • /
    • 1976
  • The author reviewed the medical records of 96 typhoid fever patients who were diagnosed, admitted, and treated at Sea grave Memorial Hospital from January 1 , 1973 through August 31, 1975. Diagnosis was determined by clinical observation, aerology and bacteriology, eighty patients were treated medically, the remaining 16 patients required surgical intervention. The following results were obtained: 1) The age distribution of the patients revealed that 33.3% wert between 10 and 19 years old 21.9% were between 20 and 29, and 19.8% were between 30 and 39. The majority of patients were from these more active age groups. Male to female sex ratio was 1.3 : 1 2) Seasonal distribution was observed. Most illness occurred in the summer and autumn month 5. 3) 84. 3%of the patients came from farm families. 4) Duration between onset and admission averaged 16.0 days. The group without compilations was admitted after an average of 15. 1 days; The group with complications was ad-matted after an average of 19.4 days. 5) Methods of treatment before admission were as follows: 10.4% at medical clinics, 61, 5% at pharmacies (antibiotics 47.9%, other. drugs 13.5%), 7.3% by herb medications, 20.8% had no treatment. 6) Main clinical symptoms were as follows: fever 93.8%, headache 47.9%, abdominal pain 47.9%, chills 38.5%, cough 36.5%, general weakness 26.0%, nausea e vomiting 24.0% and generalized pain 21.9%. 7) Temperature of patients on admission: 22.9% were 39f or more, 67.6% were between 37℃ and 38℃, and 9.4% were 37℃ or less. 8) Occurrence of intensional bleeding after onset of disease averaged 9.3 days; perforation occurred at an average of 19. 1 days. 9) Interval between onset of major complication and surgical intervention averaged 2.8 days. 10) Among the 68 patients who underwent the bacteriological test the positive rate was 44.1% (30). The positive ,ales to, each separate culture method were as follows: 20.4% in the blood culture, 40.4% in the stool culture and 6.7% in the urine culture. Among these bacteriological positive patients 15 patients had a negative results or less than 160 titer of vidal reaction. 11) The initial vidal test of the total group showed a counts of 160 titer or more in 60.4% and less than 160 titer in 39.6%, 12) W. B. C. Counts in the uncomplicated group indicated that 32.5% were 6,000/㎣ or less, 47.5% were between 6,000 and 10,000, arid 20.0% were 10,000/㎣ or more. In the complicated group, 37.6% were 6,000/㎣ or less, 25,0% were 6,000-10,000/㎣ and 37.6% were 10,000/㎣ or more. 13) Duration of hospital stay of the patients averaged 6.4 days in the uncomplicated group and 12.7 days in the complicated group. 14) Subdiaphragmatic free air simple X-ray was found in 91.7% of the perforated cases. 15) Duration of antibiotic therapy until an febrile state was attained averaged 4.8 days in the uncomplicated group and 6.5 days in the complicated group. 16) Operative procedures were as follows: one layer simple closure of their perforation with or without debasement in 56.3%, drainage only in 6.3%, small bowel resection with primary anastomosis in 18.8% , externalization in 6.3%, cholecystectomy in 6.3%, The clinical findings of this study suggest the following recommendations. According to Top's report; 1% of typhoid fever patients treated with chlorarnphenicol and 2% of patients treated with other drugs become chronic carriers. Therefore, importance should be given to the strict control of these carriers. Immunization, improvement of sanitation and living standards are all needed for the prevention and treatment of disease, but a more serious problem is a lack of knowledge on the part of patients and their families. Thus it is most urgent to enlighten the citizens about the transmission and hygiene related to contagious disease. Legal restriction of sale of antibiotics at drug stores without a physician's prescription is an urgent matter for public health administrators. An even more important nursing responsibility is the reemphasis on health education both in the clinical setting and in the home.

  • PDF

Distribution of Depressive Disorders among the Aged People by the Type of Residence (일개 중소도시의 거주형태별 노인 우울장애 분포 양상)

  • Hwang, Sung-Min;Lee, Jun;Lee, Eun-Jun;Cho, Ki-Hyun;Yoo, Ha-Na;Chon, Kyung-Hun;Hur, Tae-Hun;Lim, Hyun-Sul;Min, Young-Sun;Lee, Kwan;Bae, Geun-Ryang;Jung, Cheoll;Cheong, Hae-Kwan
    • Journal of agricultural medicine and community health
    • /
    • v.31 no.1
    • /
    • pp.1-8
    • /
    • 2006
  • Objectives: We studied to find out the relevant relationship between the type of residence and the level of mental depression among aged people. Methods: The authors surveyed 156 people who are over 65 in a small city. Here are three groups: 50 persons who live in the facility for the aged. 72 persons who live with their family and 34 persons who live alone. We developed the questionnaire and the severity of depressive symptoms was measured using Korean Form of Geriatric Depression Scale (KGDS) score. Results: Positive rate of depressive disorders among the aged people was 43.6%. Positive rate of depressive disorders among the aged who live in the facility for the aged was 42.0% and that persons who live with their family was 9.7%. It's more likely to be their gender, the marital status, schooling, going out and pocket money that affect on their mental depression. According to the multiple logistic regression, the odds ratios of the persons who live in the facility for the aged versus persons who live with their family and pocket money in a month were significant (p<0.05). Conclusions: The research shows that the mental depression in the aged people is more serious in the facility for the aged and also significantly related to their pocket money.

  • PDF

The Relation of Maternal Stress with Nutrients Intake and Pregnancy Outcome in Pregnant Women (임신부의 스트레스와 영양상태 및 임신결과와의 관련성)

  • Kim, Yi-Jung;Lee, Sang-Sun
    • Journal of Nutrition and Health
    • /
    • v.41 no.8
    • /
    • pp.776-785
    • /
    • 2008
  • Maternal stress was one of the common symptoms that pregnant women could have experienced during pregnant period. The purpose of this study was to investigate the relation of maternal stress with maternal nutrients intake and pregnancy outcome. Subjects were 248 pregnant women and were recruited at two hospitals in Seoul area. Individual stress levels were divided by the stress scores (total 41 scores), as low stressed group (< 12) and high stressed group (${\geqq}12$). The social characteristics, nutrient intake, anthropometric measurements and pregnancy outcome were compared between low stressed group (LSG) and high stressed group (HSG) to recognize risk factor of maternal stress. We found that subjects experience stress by various factors which were concern about newborn (40.4%), concern about health (28.8%), economic difficulties (13.2%), depress (10.1%), family relationship (2.9%), concern of house work (2.5%), human relationship (2%). In HSG, unemployed rate (p < 0.05) and pre-pregnancy BMI (p < 0.05) were higher than in LSG. Family size in HSG was larger than that in LSG (p < 0.01). Doing regular exercise with the light activity level was significantly higher in LSG (p < 0.05). The nutrient intake in LSG was slightly higher than that in HSG, but not statistically significant. Pregnancy outcome was not significantly affected by the maternal stress. In conclusion, the risk of maternal stress may be related with a life style during pregnancy. Therefore, life style for maternal stress control, such as weight control and regular exercise is recommended to prevent maternal stress.

Chronic pain control in patients with rheumatoid arthritis (만성통증 환자의 통증 조절)

  • Eun, Young
    • Journal of muscle and joint health
    • /
    • v.2 no.1
    • /
    • pp.17-40
    • /
    • 1995
  • Rheumatoid arthritis is the one of the chronic diseases, one of its major symptoms is a chronic pain. Despite developing medical treatment and surgical techniques, it is suggested that to control the pain is the goal of the treatment. But pain is an inner experience and even those closest to the patient cannot truly observe its progress or share in its suffering. The National Academy of Sciences Institute of Medicine's report on Pain and Disability concluded that there is no objective measure of pain-(exactly) no pain thermometer-nor can there ever be one, because the experience of pain is inseparable from personal perception and social influence such as culture. To explore chronic pain experience is to understand the process and property of the patient's perception of pain through the response to pain, the coping with pain, and the adaptation to pain. Therefore a qualitative study was conducted in order to gain an understanding of pain experience of patients with RA in korea. I used naturalistic inquiry as a research methodology, which had 5 axioms, the first is that realities are multiple, constructed, and holistic, the second is that knower and known are interactive, inseparable, the third is only time and context bound working hypotheses(idiographic statements) are possible, the forth is all entities are in a state of mutual simultaneous shaping, so that it is impossible to distinguish causes from effects and the last is that inquiry is value-bound. Purposive sampling was conducted as a sampling. 20 subjects who experienced pain over 10 years, lived in middle-sized city and big city in Korea, and 17 women and 3 men. The subject's age was from 32 to 62 (average 48.8), all were married, living with their spouse and children, except two-one divorced and the other widow before they became ill. I collected data using In depth structured interview. I had interviews two or three times with each subject, and the interviews were conducted at each subject's home. Each interview lasted about two hours an average. A recording was taken with the consent of the subject. I used inductive data analysis-such as unitizing and categorizing. unitizing is a process of coding, whereby raw data are systematically transformed and aggregated into units. Categorizing is a process wherby previously unitized data are organized into categories that provide descriptive or inferential information about the context or setting from which the units were derived. This process is used constant comparative method. The pain controlling process is composed of behavior of pain control. The behaviors of pain control are rearranging of ADL, hiddening role conflict, balancing treatment, and changing social relation. Rearranging of ADL includes diet management, sleep management, and the adjustment of daily life activities. The subjects try to rearrange their daily activities by modified style of motions, rearranging time span & range of activities, using auxillary facilities, and getting help in order to keep on the pace of daily life. Hiddening role conflict means to reduce conflicts between sick role and their role as a family member. In this process, the subjects use two modes, one is to control the pain complaints, and the other is to internalize the value which is to stay home is good for caring her children and being a good mother. To control pain complaints is done by 'enduring', 'understanding' the other family members, or making them undersood in order to reduce pain. Balancing treatment is composed of two aspects. One is to keep the pain within the endurable level, the other is to keep in touch with medical personnel in order to get the information of treatment and emotional support. Changing social relation is made by information seeking and sharing, formation of mutual support relation, and finally simplification of social relationships. The subjects simplify their social relationships by refraining from relations with someone who makes them physically and psychologically strained. In particular the subjects are apt to avoid contact with in-laws, and the change of relation to in-laws results in lessening the family boundary. In the course of this process, they confront the crisis of family confict result in family dissolution. This crisis is related to the threat of self-existence. Findings from this study contribute to understanding the chronic pain experience. To advance this study, we should compare this result with other cases in different cultural contexts. I think to interpret these results, korean cultural background should be considered. Especially the different family concept, more broader family members and kinship network, and the traditional medical knowledge influences patients' behavior.

  • PDF

Survey of Knowledge on Insomnia for Sleep Clinic Clients (수면클리닉을 방문한 환자들의 불면증에 대한 인식조사)

  • Soh, Minah
    • Sleep Medicine and Psychophysiology
    • /
    • v.26 no.1
    • /
    • pp.23-32
    • /
    • 2019
  • Objectives: Insomnia is not only the most common sleep-related disorder, but also is one of the most important. Knowledge of the comorbidities of insomnia is essential for proper treatment including pharmacological and non-pharmacological methods to prevent disease chronification. This study aimed to determine sleep clinic patients' knowledge of insomnia. Methods: This study recruited 44 patients (24 males and 20 females; mean age $54.11{\pm}16.30years$) from the sleep clinic at National Center for Mental Health. All subjects were asked to complete a self-report questionnaire about their reasons for visiting a sleep clinic and about their knowledge of treatment and comorbidities of insomnia. Results: The reasons for visiting the sleep clinic were insomnia symptoms of daytime sleepiness, irregular sleeping time, nightmares, snoring, and sleep apnea, in that order. Of the responders, 72.7% had a comorbidity of insomnia, and 22.7% showed high-risk alcohol use. In addition, 70.5% of responders chose pharmacological treatment of insomnia as the first option and reported collection of information about treatment of insomnia mainly from the internet and medical staff. More than half (52.3%) of the respondents reported that they had never heard about non-pharmacological treatments of insomnia such as cognitive behavioral treatment (CBT-I) or light therapy. The response rate about comorbidities of varied, with 75% of responders reporting knowledge of the relation between insomnia and depression, but only 38.6% stating awareness of the relation between insomnia and alcohol use disorder. Of the total responders, 68.2% were worried about hypnotics for insomnia treatment, and 70% were concerned about drug dependence. Conclusion: This study showed that patients at a sleep clinic had limited knowledge about insomnia. It is necessary to develop standardized insomnia treatment guidelines and educational handbooks for those suffering from insomnia. In addition, evaluation of alcohol use disorders is essential in the initial assessment of sleep disorders.

A Study on the Psychosocial Characteristics and Quality of Life in Functional Gastrointestinal Disorders (기능성위장질환 환자들의 정신사회적 특성 및 삶의 질의 관계에 관한 연구)

  • Kim, So-Won;Jang, Seung-Ho;Ryu, Han-Seung;Choi, Suck-Chei;Rho, Seung-Ho;Lee, Sang-Yeol
    • Korean Journal of Psychosomatic Medicine
    • /
    • v.27 no.1
    • /
    • pp.25-34
    • /
    • 2019
  • Objectives : This study aimed to compare the psychosocial characteristics among patients with functional gastrointestinal disorder (FGID), adults with functional gastrointestinal symptoms, and normal control group and investigate factors related to quality of life (QoL) of FGID patients. Methods : 65 patients diagnosed with FGID were selected. 79 adults were selected as normal control group based on the Rome III diagnostic criteria, and 88 adults who showed functional gastrointestinal symptoms were selected as "FGID positive group". Demographic factors were investigated. Psychosocial factors were evaluated using the Korean-Beck Depression Inventory-II, Korean-Beck Anxiety Inventory, Korean-Childhood Trauma Questionnaire, Multi-dimensional Scale of Perceived Social Support, Connor-Davidson Resilience Scale and WHO Quality of Life Assessment Instrument Brief Form. A one-way ANOVA was used to compare differences among groups. Pearson correlation test was used to analyze correlations between QoL and psychosocial factors in patients with FGID. Results : There were group differences in the education level. Depression (F=29.012, p<0.001), anxiety (F=27.954, p<0.001) and Childhood trauma (F=7.748, p<0.001) were significantly higher in FGID patient group than in both FGID-positive and normal control group. Social support (F=5,123, p<0.001), Resilience (F=9.623, p<0.001) and QoL (F=35.991, p<0.001) were significantly lower in the FGID patient group than in others. QoL of FGID patients showed a positive correlation with resilience (r=0.475, p<0.01), and showed a negative correlation with depression (r=-0.641, p<0.01), anxiety (r=-0.641, p<0.01), and childhood trauma (r=-0.278, p<0.05). Conclusions : FGID patients have distinctive psychosocial factors compared to the both FGID-positive and normal control group. Therefore, the active interventions for psychosocial factors are required in the treatment of patients with FGID.

Inappropriate Care of Oncologic Emergency in Korea (암환자 응급진료의 현황 및 문제점)

  • Heo, Dae-Seog;Yun, Young-Ho;Jeong, Joo-Young;Kim, Hong-Soo;Kim, Sung-Hye;Shin, Sang-Do;Rhee, Joong-Eui;Oh, Eun-Kyung;Yoo, Chul-Gyu;Bang, Yung-Jue;Kim, Noe-Kyeong
    • Journal of Hospice and Palliative Care
    • /
    • v.1 no.1
    • /
    • pp.14-22
    • /
    • 1998
  • Purpose : Cancer is a common cause for admission to emergency room(ER). Cancer patient present to ER with undiagnosed cancer, acute vague problem of cancer, or treatment related complication. But there is little information on the magnitute of the problems in the Korea. The purposes of our study were to evaluate the appropriateness of care for oncologic emergencies in Korea. Materials and Methods : This study was undertaken of all cancer patients above 15 years old presenting to the Seoul National University Hospital ER, who visited during the period from Oct. 16 to Nov. 15, 1997. ER record was reviewed and ER doctors evaluated patients' reason for visiting ER, appropriateness in patients' utilization of ER, oncology emergency Results : 266 cancer patients(17.4% of total patients) visited ER during this period and 166 cancer patients(62.4%) utilized inappropriately ER. Their average stay is 32.0 hours and 65.8% of them stayed for 6 hours. There were complaints of patients such as pain(44.8%), abdomen distension(9.4%), and dyspnea(7.5%). The most common oncologic emergency in ER during this study were gastrointestinal(34.0%), neurologic(21%), hematologic(8.0%), infectious(7.0%), respiratory(6.0%), and genitourinary(5.0%). Conclusion : For the care of symptoms like pain, most of cancer patients utilize ER inappropriately due to lack of attention from primary health delivery system. For the better care, the palliative medicine should be established in Korea.

  • PDF