• Title/Summary/Keyword: life support

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A Study on Home Visiting Hospice Care of the Terminally Ill Patients (가정 호스피스케어환자 방문간호 조사분석)

  • Lee, So-Woo;Lee, Eun-Ok;Park, Hyun-Ae;Oh, Hyo-Sook;Ahn, Hyo-Seop;Huh, Dae-Suk;Yun, Young-Ho;Kim, Dal-Sook;Rho, Yoo-Ja
    • Journal of Hospice and Palliative Care
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    • v.1 no.1
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    • pp.39-46
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    • 1998
  • Purpose : Hospice Care is considered as one of the most perfect solutions for the problems brought up as the number of chronically ill patients are increasing rapidly and most of social welfare oriented countries are seeking the quality of life. Our former studies(1996, 1997) were to find out the current status of the hospice care in Korea by surveying terminally ill patients and their family members as well as medical professionals. The former study was also to conduct the operation research by developing an information service system for training of hospice care teams and volunteers, and hospice patients management. The purpose of this study was that hospice information service system was tested by home visiting hospice care through visiting nurses. Methods : From October 1, 1997 to March 31, 1998, Twenty six terminal cancer patients were included in this study from Seoul National University Hospital and other hospital. Databases and homepage, hospice information service system were designed and developed for the information needed for the hospice care before this study by our research team and this services were available through the internet. Visiting nurses were trained about this system and they visited the patients with PC notebook and provided them hospice care with hospice information system. They collected physical, psychiatric, social data of the subjects at the first visit and during hospice care at home. Results : Sixteen subjects(61.5%) died during the study and the mean survival was 20.7 days. Anorexia(96.2%), immobility(88.5%) and pain(84.6%) were the major symptom in the 26 subjects, Altered nutrition(26.1%) and pain(12.4%) were the most frequent diagnoses in 226 nursing diagnoses of the subjects. Families understood and demanded the hospice care more than patients. And most patients and families didn't demand spiritual or social care. Conclusion : Through this demonstration study, it was found that we have to provide the information of pain management and nutritional support for patients by the nurses and visiting hospice nurse. The information service system needs to be upgraded with information and manpower of spiritual and social care according to the findings.

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The Application of Customer Relationship Management for the Effective Prenatal Care (효과적인 산전관리를 위한 고객관계관리(CRM)의 도입)

  • Shin, Sook;Paik, Soo-Kyung;Kang, Sung-Hong;Kim, Yu-Mi
    • Korea Journal of Hospital Management
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    • v.10 no.1
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    • pp.93-114
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    • 2005
  • The prenatal care is the preventive medical service to help the pregnant mother deliver the healthy baby. It's regular examines give some chances to check-up the healthy conditions. This thesis concentrates on the CRM system to support an effective prenatal care system and prove the effectiveness of it. As CRM is the adapted management related to the customer's own information, it is important to develop the CRM model classified by the patients characteristics. A general hospital in Busan operated the CRM system to carry out the effective prenatal care and there is an analysis to ensure the effectiveness of CRM system for the pregnant women in our maternity ward. The results can be summarized as follows: 1) According to the comparisons with the CRM system, we can conclude the system is desirable. (1) Maternal Age : In the age distribution, the prenatal visit frequency, triple marker freqency, oral GTT and targeted ultrasonography in the experimental group in 30 to 34 years old is higher on the whole. For over 35 years old group, the higher frequency comes out in the oral GTT and targeted ultrasonography and for 25 to 29 years old group the different figure shows just in the targeted ultrasonography. (2) Area of residence: There is a clear difference in all the items in Busan and near area but no sign of difference in prenatal visits and oral GTT in other residencial area. Especially in the targeted ultrasonography the higher figure shows in the experimental group located in the both areas. The targeted ultrasonography is known as the specific examination which should be examined by the specialists, on the contrary the other examinations can be operated in the small clinic. So the public information and seminars related with ultrasonography increases the check-up frequency. The clinic requests some ultrasonographical examinations to the specialists in general hospital. (3) Parity: The clear difference shows that the CRM system causes the prenatal visit frequency to become higher in experimental group. The figure is 9.7 times and 8.6 times each. This is opposite that the past study said multiparity reduced the average prenatal visits. But the result of CRM is considered as the method to help the multiparity understand the importance of the prenatal care. (4) Obstetrical history: In the experimental group of the spontaneous delivery group, the figure is higher in the prenatal visit frequency, triple marker, oral GTT and targeted ultrasonography but the Caesarean section delivery group has higher figure in targeted ultrasonography. (5) In the first check-up, the rate of targeted ultrasonography in under 16 week pregnancy, in the 16 week pregnancy to 32 week pregnancy and the over 32 week pregnancy in the experimental group is upper than the compared one. For the oral GTT, there is a difference in under 16 week pregnancy but no difference in prenatal visits and triple marker. 2) The analysis of characteristics of prenatal care through the decision tree resulted in the fact that the most important variable is the residential area. After the delivery frequency is following, the obstetrical history and maternal age are in order. It is the same result in the triple marker and oral GTT. Consequently it is the same order of important variables in CRM system. The effectiveness of CRM system is proved in this study. The CRM system is a marketing method to control and lead the customers through the segmentation of customer data. It increases the new customer aquisition, maintenance of loyal customers, augmentation of customers value, activation of potential customers and creation of life time customers. So eventually it can enlarge the customers value. The medical institution should make efforts to establish the data base enforced by the customer's information on the underlying ordinary data system to carry out the CRM system effectively. In addition, it should develop the a variety of marketing strategy in order to set up one to one marketing satisfying the needs of individual patients.

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Ethical Dilemma and Empowerment among Dental Hygienists in Some Regions (일부 지역 치과위생사가 경험하는 윤리적 딜레마와 임파워먼트)

  • Kim, Mi-Jeong;Park, In-Suk
    • Journal of dental hygiene science
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    • v.12 no.4
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    • pp.383-391
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    • 2012
  • The purpose of this study was to examine the ethical dilemma of dental hygienists and the level of empowerment among them in an attempt to provide some information on how to alleviate the ethical dilemma of dental hygienists to boost their empowerment. The findings of the study were as follows: The dental hygienists got a mean of 1.58 out of possible four points in ethical dilemma. Among the subfactors of ethical dilemma, they scored highest in ethical dilemma about dental hygienists and profession (1.79), followed by dental hygienists and patients (1.53), life reverence and respect for human rights (1.51) and dental hygienists and cooperators (1.49). As for the general characteristics of the dental hygienists, those who were better educated and who intended to temporarily work just until marriage fell into a more ethical dilemma. The dental hygienists got a mean of 3.05 out of possible five points in empowerment. Among the subfactors of it, they scored highest in support structure (3.52), opportunity structure (3.18), information structure (3.08) and resources structure (3.04). There were significant gaps among the dental hygienists in empowerment according to their attitude toward the dental hygienist job as a profession. There was a significant negative correlation between ethical dilemma and empowerment. Regarding influential factors for the ethical dilemma of the dental hygienists, marital status and empowerment were identified as significantly influential factors, and empowerment had a significant relationship to age, academic credential and ethical dilemma. Given the findings of the study, the development of various intervention programs and empowerment-boosting strategies is required to relieve dental hygienists of ethical dilemma.

Effects of Baby Boomers' Stress and Depression on Their Psychological Well-being : Moderation Effects of Social Supports - A Comparative Study of the 1st- and 2nd-Generation Baby Boomers - (베이비붐 세대의 스트레스, 우울이 심리적 안녕감에 미치는 영향 : 사회적 지지의 조절효과 - 1차·2차 베이비 붐 세대의 비교연구)

  • Lee, Yon-Sil;Seo, In-Kyun
    • The Journal of the Korea Contents Association
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    • v.16 no.8
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    • pp.292-309
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    • 2016
  • The purpose of the present paper is to investigate the effects of stress and depression experienced by the first (1955-1964) and second (1968-1974) generations of baby boomers on their psychological well-being as well as the moderation effects of social supports for them. For this purpose, 369 who come under the category of the first- and second-generation baby boomers were selected by convenient sampling from among the participants in the programs of the life-long educational institutes in Seoul metropolitan area and questionnaires of self-administered type were distributed to them. Frequency analysis, t-test, ANOVA, correlation analysis and hierarchial regression analysis which used input of mean-centered variables and interaction term were conducted to determine the moderating effects of social supports based on the replies to the questionnaires. The major outcomes of the analyses could be summed up as follows: first, the stress and depression suffered by the first and second generations of baby boomers turned out to have negative (-) influence upon their psychological well-being; second, the social supports for those two generations were found to exercise positive (+) effects upon their psychological well-being; and third, a survey of difference in the moderating effects of social supports between the first- and second-generation baby boomers showed that, in case of the first generation, the worse their economic status and the higher their stress and depression were, the lower their psychological well-being tended to be and that social supports functioned to hike their psychological well-being but had moderating effects only in connection with stress. In case of the second generation, however, it was shown that the higher their stress and depression got, the lower their psychological well-being developed and that social supports might increase their psychological well-being but without any moderating effects on the part of relationship with their stress and depression. A practical and political method was discussed to improve baby boomers mental health.

The Feminine Factor of the Therapeutic Landscape by Water from a Perspective of the Japanese Hot Spring (일본 온천을 중심으로 본 물을 매개로 하는 치유의 경관에서의 여성적 요소)

  • Park, Sookyung
    • Journal of the Korean association of regional geographers
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    • v.22 no.3
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    • pp.529-552
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    • 2016
  • The purpose of this study is to examine the matter as to how the meaning of the physical therapeutic landscape by water, which is associated with physical, cultural, spatial, and economical aspects, appears in the space centering on women and is to look into the feminine factors in term of a rest area, consideration, and imagery for women. From a perspective of a rest area for women, the meaning of a physical aspect is remarkable and is materialized in thermal waters and bathing, atmosphere, subsidiary facilities and safe nightlife. According to these phenomena, female visitors are able to feel freedom, power, which can return themselves to the best condition by thermal waters, therapeutic equipments provided in a watering place continuously, safe protection and exchange with strangers with an open mind. And the cultural aspect of the therapeutic landscape by water is discovered in consideration for women. It is the fact that joins the Japanese culture based on consideration towards others to the traditional culture of hot springs by itself. For example, women can feel various pleasure, experience the protection or the support by someone and pursuit not only physical beauty but also mental or spiritual one through welcome bus, service of Okami san and Nakai san, decorations, funny installments and secure of private space. Lastly, the imagery of women can be identified in cultural, spatial, and economical aspects extensively somewhat and is embodied by advertising mediums, signs of hot springs, shrines, objets and products variously. It is made into healthiness, relaxation, comfort, familiarity and image that are realized to love or are connected to a happy marriage life. To sum up the results, the healing or therapeutic elements for women appearing in hot springs are gathered to some abstraction such as freedom, safe, effect beyond the body, pleasure, durability of healing or therapy, beauty and hope; furthermore, if these abstraction are combined each other closely, the effect of healing or therapy, which transforms anxiety into a stable condition, can be exposed externally.

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Jeongjo's Enjoyment of the Palace Garden (정조(正祖)의 궁원(宮苑) 유락(遊樂))

  • Hong, Hyoung-Soon
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.33 no.4
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    • pp.10-25
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    • 2015
  • The purpose of this research is to investigate the reality behind Jeongjo's enjoyment of the palace garden. If I were to summarize the results of this research, they are as follows: First, The 'Sanghwajoeoyeon(賞花釣魚宴)' has the differentiation which decided and regularized the rules and the regulations with the annual meetings for the Kyujanggak(奎章閣). Jeongjo had held the events five times. Second, The 'Seshimdae(洗心臺) Excursion' is based on the tragic personal history of Jeongjo. There were four events. Third, Jeongjo had enjoyed the 'viewing of the waterfall(觀瀑)' of the Okryucheon(玉流川) where a lot of the water overflows right after it rains. This is worth the special mention with regard to the point that it is a temporary landscape and not an usual landscape. Fourth, As an event for the military officers, the 'Seoljungryonghohwe(雪中龍虎會)' was held seven times. This event had been held in the middle of the winter. And each of the attendees skewered a pheasant and roasted and ate it. Also, it emphasized the sovereign and the subjects being the partners of the joys and the sorrows by giving the alcoholic drinks and the music. Fifth, Jeongjo had consoled the hard work by the civilian subjects either by holding the brazier feast(煖爐會) in the winter or by granting the alcoholic drinks and the foods according to the historical facts of the brazier feasts. Sixth, Jeongjo was good at archery and enjoyed it. During the period of his reign, Jeongjo held twice Yeonsarye(燕射禮). Seventh, Jeongjo soothed his desire to get out of the busy everyday life at the royal palace garden. While appreciating the natural landscape of the backyard, he was awakened of the meaning of the Book of Changes(周易) in which all the things had been created and changed. Eighth, At the royal palace garden, Jeongjo actively prepared the place for enjoyment by the sovereign and the subjects together. It is judged that this is because, in order to materialize his political ideals, the support by all the subjects who had been close was needed. The limitation of this research is the fact that the research had been proceeded with limited to the translations, among the many old writings related to Jeongjo. With the accumulation of the excavations of the new thoughts and of the results of the translations, the researches that are deeper will be needed.

Comparison of Wetting and Drying Characteristics in Differently Textured Soils under Drip Irrigation (점적관개 시 토성별 습윤.건조 특성 비교)

  • Kim, Hak-Jin;Son, Dong-Wook;Hur, Seung-Oh;Roh, Mi-Young;Jung, Ki-Yuol;Park, Jong-Min;Rhee, Joong-Yong;Lee, Dong-Hoon
    • Journal of Bio-Environment Control
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    • v.18 no.4
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    • pp.309-315
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    • 2009
  • Maintenance of adequate soil water content during the period of crop growth is necessary to support optimum plant growth and yields. A better understanding of soil water movement for precision irrigation would allow efficient supply of water to crops, thereby resulting in minimization of water drainage and contamination of ground water. This research reports on the characterization of spatial and temporal variations in water contents through three different textured soils, such as loam, sandy loam, and loamy sand, when water is applied on the soil surface using an one-line drip irrigation system and the soils are dried after the irrigation stops, respectively. Water contents through each soil profile were continuously monitored using three Sentek probes, each consisting of three capacitance sensors at 10, 20, and 30cm depths. Spatial variability in water content for each soil type was strongly influenced by soil textural class. There were big differences in wetting pattern and the rate of downward movement between loam and sandy loam soils, showing that the loam soil had a wider wetting pattern and a slower rate of downward movement than did the sandy loam soil. The wetting pattern in loamy sand soil was not apparent due to a low variability in water content (< 10%) by a lower-water holding capacity as compared to those measured in the loam and sandy loam soils, implying that the rate of water drainage below a depth of 30cm was high. When soils were dried, there were highly exponential relationships between water content and time elapsed after irrigation stops ($r^2$${\geq}$0.98). It was estimated that equilibrium moisture contents for loam, sandy loam, and loamy sand soils would be 17.6%, 6.2%, and 4.2%, respectively.

The Analysis of Research Trend about Hospice in Korea ($1991{\sim}2004$) (국내 호스피스 논문 분석($1991{\sim}2004$))

  • Kim, Sang-Hee;Choi, Sung-Eun;Kang, Sung-Nyun;Park, Jung-Suk;Sohn, Sue-Kyung;Kang, Eun-Sil;Lee, Young-Eun
    • Journal of Hospice and Palliative Care
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    • v.10 no.3
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    • pp.145-153
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    • 2007
  • Purpose: This study was to analyze the research trend centering on the theses to hospice released in Korea. Methods: The researcher collected the academic degrees and theses published on the book of the academic society from 1991 to 2004, and examined 110 domestic papers of hospice. Results: 1) The number of articles increased 3 years after 1997, 52 (47%) theses were published in $2000{\sim}2002$. 97 (88%) articles were quantitative studies, and 13 (12%) were qualitative studies. 2) As for the subject, the results were: patients with end stage 44 (40%), nurse 18 (16%), hospice care system, facilities, and literature review 12 (10%). 3) As for main concepts of correlational studies 15 (13%), the results were: quality of life, activities of volunteers, suffering experience of nurse, and so on. 4) The subjects and contents of survey, the results were: pain control and need for nursing care in patients, need for spiritual and physical care in family, and so on. 5) The treatment of experimental research, the results were: hospice nursing, educational program, informational support, spiritual nursing, supportive nursing intervention, home hospice care, information services for control of cancer pain, and so on. 6) In the theme of the qualitative studies, the results were: experience of dying patients, perceive of hospice care and death, experience of family of terminal ill patients, meaning of dying in Korean. 7) In the instrument in studies, the results were: MQOL, EQOL, QOL, NIC, Need Scale, Spiritual Well-being Scale, Spiritual Perspective Scale, Coping for Grief Scale, K-CPAT, VAS, BPI, Depression Scale, Strait-anxiety Scale, Care-giver Burden Inventory, Burnout Inventory, Mental quality. Conclusion: More research needs to be encouraged in experimental and qualitative research fields. Researches should be conducted for the establishment of the basis of practical and theoretical framework and hospice polices.

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Concerning the Constitution Court's constitutional decision and the direction of supplemental legislation concerning Article 33 paragraph 8 of the Medical Service Act - With a focus on legitimacy of a system that prohibits multiple opening of medical instituion, in the content of 2014Hun-Ba212, August 29, 2019, 2014Hun-Ga15, 2015Hun-Ma561, 2016Hun-Ba21(amalgamation), Constitutional Court of Korea - ('의료법 제33조 제8항 관련 헌법재판소의 합헌결정'에 대한 평가 및 보완 입법 방향에 대하여 -헌법재판소 2019. 8. 29. 2014헌바212, 2014헌가15, 2015헌마561, 2016헌바21(병합) 결정의 내용 중 의료기관 복수 개설금지 제도의 당위성 및 필요성을 중심으로-)

  • KIM, JOON RAE
    • The Korean Society of Law and Medicine
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    • v.20 no.3
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    • pp.143-174
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    • 2019
  • Our Constitution obliges the state to protect the health of the people, and the Medical Law, which embodied Constitution, sets out in detail the matters related to open the medical institution, and one of them is to prohibit the operation of multiple medical institutions. By the way, virtually multiple medical institutions could be opened and operated because the Supreme Court had interpreted that several medical institutions could be opened if medical activities were not performed directly at the additional medical institution which was opened under the another doctor's license. However, some health care providers opened the several medical institutions with another doctor's license for the purpose of the maximization of profit, and did illegal medical cares like the unfair luring of patients, over-treatment, and commission treatment. Also, realistic problems such as the infringed health rights have arisen. Accordingly, lawmakers had come to amend the Medical Law to readjust the system of opening for medical institution so that medical personnel could not open or operate more than one medical institution for any reason. For this reason, the Constitutional Court recently declared a constitutional decision through a long period of in-depth deliberation because the constitutional petition and the adjudication on the constitutionality of statutes had been filed on whether Article 33 paragraph 8 of the revised medical law is unconstitutional. The Constitutional Court acknowledged the "justice of purpose" in view of the importance of public medical institutions, of the prevention from seduction of for-profit patients and from over-treatment, and of the fact that health care should not be the object of commercial transactions. Given the risk that medical personnel might be subject to outside capital, the concern that the holder of the medical institution's opening certificate and the actual operator may be separated, the principle that the human body and life should not be just a means, and the current system's inability to identify over-treatment, it also acknowledged the 'minimum infringement'. Furthermore, The Constitutional Court judged it is constitutional in compliance with the principle of restricting fundamental rights, such as 'balance of legal interests'. In this regard, legislative complements are needed in order to effectively prevent the for-profit management and the over-treatment the Constitutional Court is concerned about. In this regard, consumer groups actively support the need for legislation, and health care providers groups also agree on the need for legislation. Therefore, the legislators should respect the recent Constitutional Court's decision and in the near future complete the complementary legislation to reflect the people's interests.

A Study on the recognition and Attitude of Home Health Nursing System (가정간호사 제도에 대한 인식 및 태도 조사연구)

  • Lee Sung Ja
    • Journal of Korean Public Health Nursing
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    • v.12 no.1
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    • pp.132-146
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    • 1998
  • This Study was attempted to provide the basic data necessary in the development and introduction of Home Health Nursing System by investigating the recognition and attitude level of Home Health Nursing System. The data were collected by means of questionaires presented to 74 patients who had been admitted in C general hospital in Chon Ju, from June 30, 1997. As the tool for this study, the questionares developed by Kim Yong. Soon, et al (1990) and Han Bok Hee(1993) were modified and supplemented for the aim of this study. The computer was used for data analysis. The items about the charateristics of the subjects and the attitude to the management plan of Home Health Nursing System were represented as the frequency and percentage. The standard deviation and calculation average were produced on the items related to definition, recognition, necessity, expected effect of the attitude of Home Health Nursing System and the items related to admission. The ANOVA test was .used according to the characteristics of variables to analyze the necessity and difference of Home Health Nursing System. The results of this study were as follows 1) The general characteristics of the subjects were as follows ; for sex, man, $58.1\%$ ; for age, 50-59 years, $29.7\%$ ; for the level of education, high school, $51.4\%$ ; $79.7\%$ of them were married; for the family forms, small family, $73.0\%$ ; and $68.9\%$ of them take the monthly income over 100 million won. 2) The characteristics related to admissions of the subjects were as follows ; for clinic, surgical department, $78.4\%$ ; addmission not more then 7days, $47.3\%$ ; for the operation-performance $71.6\%$ of them were experienced; for the admission route, via outpatients clinic, $54.1\%$ ; for waiting period to the admission day, 1-2 days, $71.6\%$. 3) The difficulties comming from the hospitalization were related mostly to the factor that they felt hospital life more inconvenient than home.(3.66) The reasons for the difficulties in the admission which was due to insufficient beds in the hospital was related to the concentration to the general hospital because of 'The Whole National Medical Insurance System'(4.05). 4) On the previous informations about the Home Health Nursing System, those who have heard of only the name were 42 $(56.8\%)$, and on the recognition of it, they thought that it is periodic treatment by the licenced nurses for the recovering pateints after early discharge(3.73). On the attitude about the necessity of Home Health Nursing System, they thought that it is necessary because of the increasing trend of a psychological disease by the change of environment and complexity of the social structure(4.24). On the expected effect of Home Health Nursing System, they answered that it is convinient for the family of the patient to take care of them(4.l8). 5) On the attitude to the management plan of the Home Health Nursing System, those who had intention to participate in the system in the case of systemic support were 42(56.8). In the visiting time, 'visit periodically' and 'visit when the patient needs' were $28(37.8\%)$ respectively. For the application of medical insurance, if possoble, they will use $(91.9\%)$; for the method of payment for the treatment, 'pay by the time required' was $23(31.1\%)$, for the subject of management, 'National public institute must operate' was $33(44.6\%)$. 6) The relationship between the general characteristics of the subjects and the necessity of Home Health Nursing System showed the notable difference in the age (F=3.508, P<0.05) and marrage state (F=5.402, P<.023).

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