• Journal of Hospice and Palliative Care
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• 제26권2호
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• pp.95-100
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• 2023

With the implementation of Act on Hospice and Palliative Care and Decisions on Life-Sustaining Treatment for Patients at the End of Life, interests of the general public on self-determination right and dignified death of patients have increased markedly in Korea. However, "self-determination" on medical care is misunderstood as decision not to sustain life, and "dignified death" as terminating life before suffering from disease in terminal stage. This belief leads that physician-assisted suicide should be accommodated is being proliferated widely in the society even without accepting euthanasia. Artificially terminating the life of a human is an unethical act even though there is any rational or motivation by the person requesting euthanasia, and there is agreement thereof has been reached while there are overseas countries that allow euthanasia. Given the fact that the essence of medical care is to enable the human to live their lives in greater comfort by enhancing their health throughout their lives, physician-assisted suicide should be deemed as one of the means of euthanasia, not as a means of dignified death. Accordingly, institutional organization and improvement of the quality of hospice palliative care to assist the patients suffering from terminal stage or intractable diseases in putting their lives in order and to more comfortably accept the end of life physically, mentally, socially, psychologically and spiritually need to be implemented first to ensure their dignified death.

• 한국노년학
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• 제41권1호
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• pp.85-105
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• 2021

본 연구는 활동적 노화의 관점을 적용하여 장기요양시설에서의 돌봄 유형에 관한 다양한 인식유형을 분석하는 데 목적을 둔다. 이를 위해 Q방법론을 적용하였다. WHO의 활동적 노화를 위한 건강, 안전, 참여 세 영역에서 장기요양시설의 돌봄에 관한 다양한 생각을 파악하기 위해 심층면접을 진행하였다. 면접조사에는 장기요양시설 거주 노인, 거주 노인의 성인자녀, 지역사회 거주 노인, 서비스 제공자, 장기요양 전문가 등 35명이 참여하였다. 451개의 Q모집단 중 63개의 Q표본을 추출하였으며, 최종 자료분석에는 43개의 P표본 자료가 활용되었다. QUANL 프로그램을 활용하여 자료를 분석한 결과, 3개의 요인구조(4개 유형)가 적합하며 이는 전체 변량의 30.15%를 설명하는 것으로 나타났다. 현재 장기요양시설의 돌봄은 보호 중심 돌봄(1유형), 참여 중심 돌봄(2유형), 의료연계 중심 돌봄(3유형), 인간 중심 돌봄(4유형)으로 유형화할 수 있다. 본 연구결과를 바탕으로 장기요양시설에서 돌봄의 질적 변화를 위한 제도적, 실천적 함의를 제시하였다.

• 대한기관윤리심의기구협의회지
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• 제4권1호
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• pp.16-22
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• 2022

Purpose: The traditional ethical study only suggests a blurred insight on the research using medical big data, especially in this rapid-changing and demanding environment which is called "4th Industry Revolution." Current institutional/ethical issues in big data research need to approach with the thoughtful insight of past ethical study reflecting the understanding of present conditions of this study. This study aims to examine the ethical issues that are emerging in recent health care big data research. So, this study aims to survey the public perceptions on of health care big data as part of the process of public discourse and the acceptance of the utility and provision of big data research as a subject of health care information. In addition, the emerging ethical challenges and how to comply with ethical principles in accordance with principles of the Belmont report will be discussed. Methods: Survey was conducted from June 3th August to 6th September 2020. The online survey was conducted through voluntary participation through Internet users. A total of 319 people who completed the survey (±5.49%P [95% confidence level] were analyzed. Results: In the area of the public's perspective, the survey showed that the medical information is useful for new medical development, but it is also necessary to obtain consents from subjects in order to use that medical information for various research purposes. In addition, many people were more concerned about the possibility of re-identifying personal information in medical big data. Therefore, they mentioned the necessity of transparency and privacy protection in the use of medical information. Conclusion: Big data on medical care is a core resource for the development of medicine directly related to human life, and it is necessary to open up medical data in order to realize the public good. But the ethical principles should not be overlooked. The right to self-determination must be guaranteed by means of clear, diverse consent or withdrawal of subjects, and processed in a lawful, fair and transparent manner in the processing of personal information. In addition, scientific and ethical validity of medical big data research is indispensable. Such ethical healthcare data is the only key that will lead to innovation in the future.

• 지역사회간호학회지
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• 제19권2호
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• pp.196-204
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• 2008

Purpose: To examine factors affecting long-term care hospital patients' intention of transfer to a nursing home. Method: A questionnaire survey was conducted in Aug. 2007 that included 655 patients from 49 long-term care hospitals. The survey aimed to assess the patients' health status, family status, cost and intention of transfer to a nursing home. Institutional characteristics were analyzed from the nationwide database of Health Insurance Review & Assessment Service. The affecting factors were examined by employing chi-square test and logistic regression using SAS 8.2. Result: Of the subjects, 32.4% had intention of transfer to a nursing home. The intention of transfer to a nursing home was affected by moderate or severe pain, living together with the primary carer, high cost uncovered by insurance, and recognition of nursing home. Conclusion; For appropriate service utilization. a higher level of care is needed to satisfy patients at nursing homes and a balanced fee schedule is needed between long term care hospitals and nursing homes. It is desirable to encourage transfer to a nursing home at which nurses support patients and their families by giving information, coordination, and to make efforts to establish a reference system.

• 한국융합학회논문지
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• 제8권11호
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• pp.193-201
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• 2017

본 연구는 보건복지계열 예비졸업생들의 노인장기요양보험에 대한 전반적 인식도를 파악하기 위해 시도하였다. 일개 4년제 대학의 보건복지계열 예비졸업생 총 207명의 설문조사에 대해 SPSS ver 22.0을 이용하여 분석하였다. 연구결과 보건복지계열 예비졸업생의 노인장기요양보험에 대한 관심도와 지식 수준은 낮았으나, 태도는 긍정적인 것으로 나타났다. 또한, 노인장기요양보험에 대한 지식과 태도는 대상자의 노인시설 봉사 경험에 따라 차이가 있는 것으로 나타났다. 향후 보건복지계열 대학생의 노인장기요양보험에 대한 인식과 관심도를 증진시킬 수 있는 교육과정 개선과 함께 능동적 봉사활동 프로그램 개발이 필요할 것이다.

• Perspectives in Nursing Science
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• 제10권1호
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• pp.52-64
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• 2013

Purpose: The purpose of this study was to explore the utilization of health care of patients with lung cancer in Korea and identify determinants of these patients' health care utilization. Methods: This was a descriptive analytical study. The national medical fees claims data of patients with lung cancer were used. Using SPSS Statistics 20, the ${\chi}^2$-test and logistic regression were performed to determine the factors influencing health care utilization. Results: There were significant differences by sex, age, disease type, stage, comorbidity index, region of institutions, and type of institutions in the utilization of surgical procedures; by age, disease type, stage, comorbidity index, region of institutions, and type of institutions in the utilization of chemotherapy; and by age, stage, comorbidity index, region of institutions, and type of institutions in the utilization of radiotherapy. Conclusion: The findings of this study suggest that democratic and clinical characteristics of patients as well as institutional characteristics affect health care utilization of patients with lung cancer. Additional research is needed to determine the factors influencing health care utilization of patients with lung cancer.

• Human Ecology Research
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• 제55권6호
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• pp.581-592
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• 2017

This study investigated the occupational experiences of social workers in child care facilities. The participants of the study were six social workers in child care facilities. This qualitative research used a Consensual Qualitative Research (CQR) method that and classified the main findings into five categories and twelve sub-themes. This study revealed that child care professionals define themselves as "caregivers" and "role models." Positive effects of institutional life on a child were forming peer relationships and being able to use diverse services while negative effects included acquiring a social stigma, having problems in developing attachment between a child and a surrogate caregiver, developing passive attitude and weak will power from communal living. Meanwhile, conflicts with children and poor working conditions led to burnout for caregivers. Our recommendations on the direction of change for the facilities are: categorizing admitted children, supporting restoration of family functions, reinforcing support for children's preparation for an independent life, and developing expertise. This paper provides a better understanding of child care facilities as well as encourages further social discourse on institutionalized children in order to promote policy making and implementation.

• 가족자원경영과 정책
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• 제22권2호
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• pp.1-24
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• 2018

Communal places for parents to take child-care are very important in activating cooperative child-care(CCC). Therefore, Jeju Special Self-Governing Province has been operating Cooperative-Childcare-Places(CCPs) since 2016. This study analyzed the operational status of the CCPs and presented the model type to provide data for the activation of CCC. Qualitative analyses were applied to the results of interviews with 10 staff members. The common task they considered difficult was recruitment, and there was a big difference in the operation of the regular program depending on the competence of the staff in charge. The lack of support systems, such as education and consulting, has made it difficult for the staff to do their work. Additionly, four models of CCPs were found, a resident self-governing type, a workplace type, an institutional type, and a rural complex type. In conclusion, CCP spaces should be planned and facilities created with a focus on the needs of child-care activities. Second, the role of staff in helping to organize the parents' self-governing committee is crucial. Third, it needs to establish a support system to strengthen the capacity of the staff members.

• 동의생리병리학회지
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• 제31권5호
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• pp.294-303
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• 2017

The purpose of this study was to investigate self care, depression, and Yangsaeng and to confirm the factors related to Yangsaeng of diabetes mellitus patients. The survey was conducted on 116 subjects who consented to Institutional Review Board for diabetes mellitus patients in the area and data were collected by self-report questionnaire. The questionnaires consisted of self care, depression, and Yangsaeng. Date analysis was done by SPSS 22.0 with T-test, ANOVA, $Scheff{\acute{e}}$ test, Pearson correlation coefficient, and multiple regression. Yangsaeng was significantly related to the educational level, partner, income, perceived health status, depression, and admission for diabetes mellitus. Yangsaeng and self care showed positive correlation, on the other hand Yangsaeng and depression showed negative correlation. Yangsaeng was found to be related to education level, self care, and depression through the multiple regression. In conclusion, the Yangsaeng score increased with improving of blood glucose level and depression. Based on these results, we considered various characteristics such as patient's age and illness characteristics, therefore it is necessary to develop a method to measure Yangsaeng.

• 가정∙방문간호학회지
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• 제28권3호
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• pp.295-306
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• 2021

Purpose: This study aims to compare and analysis job stress, patient safety culture, and patient safety management activities of nurses in comprehensive nursing care service wards and general wards. Methods: Through an online survey conducted on nurses with more than three months of working experience at five general hospitals in the metropolitan area, 156 participants's data were used for 𝜒²-test, t-test, ANOVA using SPSS ver. 26.0. Result: There were no significant differences in the nurses' job stress and patient safety management activities between the comprehensive nursing care service wards and general wards. However, the patient safety culture of nurses in the comprehensive nursing care service ward was significantly lower than that of general ward. Conclusion: Patient safety culture should be promoted through continuous regular patient safety education, training, and organizational support to increase patient safety management activities. Additionally, institutional programs should be prepared to reduce job stress of nurses at the frontline of patient safety.