• 문화기술의 융합
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• 제4권4호
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• pp.67-75
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• 2018

장례문화는 화장위주의 장례방법 개선에서 죽은 자의 복지적 차원의 접근이 필요하다. 장례문화는 미래지향적으로 재조명해 보고, 웰엔딩(well-ending)과 연계한 발전방향을 모색할 필요성이 있다. 본고에서는 장례문화 변화과정과 서울시 장례문화의 문제점 진단을 통해 웰엔딩의 실천과제를 모색하는 것을 목적으로 하고 있다. 이를 위해 서울 시민 500명을 대상으로 조사한 장례문화 의식조사 결과를 활용하였다. 웰엔딩은 생의 마지막 순간까지 인간의 존엄성을 보장해 주고 죽음문화를 질적으로 향상시키는 과정이다. 웰엔딩 문화의 체계적인 접근은 죽음의 질적 개선을 달성할 수 있을 것으로 판단된다. 고령사회에 부응하는 장례문화 정착을 위해서는 장례문화에 대한 패라다임의 전환이 필요하다. 웰엔딩 준비 교육은 죽음을 맞이하는 당사자 뿐 만 아니라 살아있는 가족들에도 삶의 의미를 깨달을 수 있다. 그리고 장사시설은 모든 세대가 공유할 수 있는 문화 복지시설로 확충될 수 있도록 우리의 지혜를 모아야 한다.

• 한국환경보건학회지
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• 제49권3호
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• pp.149-158
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• 2023

Background: Injury is one of the major health problems in South Korea. Few studies have evaluated both intentional and unintentional injury when investigating the association between exposure to air pollutants and injury. Objectives: We aimed to explore the association between short-term exposure to ambient air pollution and years of life lost (YLLs) due to injury. Methods: Data on daily YLLs for 2002~2019 were obtained from the the Death Statistics Database of the Korean National Statistical Office. This study estimated short-term exposure to particulate matter with an aerodynamic diameter of <10 ㎛ (PM₁₀), particulate matter with an aerodynamic diameter of <2.5 ㎛ (PM_2.5), sulfur dioxide (SO₂), nitrogen dioxide (NO₂), carbon monoxide (CO), and ozone (O₃). This time series study was conducted using a generalized additive model (GAM) assuming a Gaussian distribution. We also evaluated a delayed effect of ambient air pollution by constructing a lag structure up to seven days. The best-fitting lag was selected based on smallest generalized cross validation (GCV) value. To explore effect modification by intentionality of injury (i.e., intentional injury [self-harm, assault] and unintentional injury), we conducted stratified subgroup analyses. Additionally, we stratified unintentional injury by mechanism (traffic accident, fall, etc.). Results: During the study period, the average daily YLLs due to injury was 307.5 years. In the intentional injury, YLLs due to self-harm and assault showed positive association with air pollutants. In the unintentional injury, YLLs due to fall, electric current, fire and poisoning showed positive association with air pollutants, whereas YLLs due to traffic accident, mechanical force and drowning/submersion showed negative associations with air pollutants. Conclusions: Injury is recognized as preventable, and effective strategies to create a safe society are important. Therefore, we need to establish strategies to prevent injury and consider air pollutants in this regard.

• The Korean journal of internal medicine
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• 제33권6호
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• pp.1039-1049
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• 2018

The populations of Asian countries are expected to age rapidly in the near future, with a dramatic increase in the number of heart failure (HF) patients also anticipated. The need for palliative and end-of-life care for elderly patients with advanced HF is currently recognized in aging societies. However, palliative care and active treatment for HF are not mutually exclusive, and palliative care should be provided to reduce suffering occurring at any stage of symptomatic HF after the point of diagnosis. HF patients are at high risk of sudden cardiac death from the early stages of the disease onwards. The decision of whether to perform cardiopulmonary resuscitation in the event of an emergency is challenging, especially in elderly HF patients, because of the difficulty in accurately predicting the prognosis of the condition. Furthermore, advanced HF patients are often fitted with a device, and device deactivation at the end of life is a complicated process. Treatment strategies should thus be discussed by multi-disciplinary teams, including palliative experts, and should consider patient directives to address the problems discussed above. Open communication with the HF patient regarding the expected prognosis, course, and treatment options will serve to support the patient and aid in future planning.

• 대한간호학회지
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• 제30권6호
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• pp.1437-1454
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• 2000

This study was designed to identify the attitudes of the people on organ donation and transplantation. The purpose of this study was to provide data to help inspire organ donation, and promote registration yield so donor candidates will have more favorable recipients through Q-methodology. A Q-sample was developed through a review of the literature and interviews. Thirty-three statements made up the final Q-sample. The P-sample consisted of twenty-eight subjects, excluding chronic organic disorder. The Q-sorts by each subject were coded and analyzed with the QUNAL computer program. The results were as follows: This study discovered five different types of organ donation and transplantation of twenty- eight subjects. Type I is 'utilitarian.' The people of this type consider human life very valuable and they recognize that organ transplantation is an affirmative medicine that should be performed to extend human life. They believe that are saving others' lives by donating organs. Type II is 'sardonist.' The people of this type approve of organ transplantation usefulness, but they have no intention of participating in the program because of it may trample on human rights. Type III is 'individualist.' The people of this type consider it proper for the activation of organ transplantation by the legal system. They believe that organ donation a valuable too, but needs support through social benefits to donors. Yet, they have not intention of doing what they propose. Type IV is 'familist.' The people of this type have strong attachments to life but they think that organ donation and transplantation should be done between within a family. Type IV is disposition of family intensive consideration rather than altruistic and utilitarianism. Type V is 'deontologist.' The people of this type recognize the benefits of transplantation, but have a negative opinion of activation. They worry about ethical and social problems occurring in the development of modern medicine. They believe that death is the only natural end to life, so they have strong negative opinions of euthanasia and brain death compared to other types. They regard transplantation to be a non-human behavior, because it involves a removing organs and breaking the boundary of death. The findings of this study are only preliminary and serve as a baseline to understanding the subjectivity of individuals on organ donation and transplantation. Therefore, the subjectivity of the five types will be applied to formulate the educational programs and public relations strategies for organ donation because the public's awareness toward organ donation is closely related to their values, beliefs, and attitudes.

• 호스피스학술지
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• 제7권2호
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• pp.26-41
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• 2007

There are three things that are not known to the human being. That is when, where and how one will die. Most people live ignoring death. However, elements of death linger everywhere. The purpose of this treatise is investigates about justification Deciding for Other directions. First, I will investigate about Deciding for Other directions, when patient can not decide own, I will do investigate agent's decision's problem. Second, These four principles provide the common ground for biomedical ethics. Principlism argue that a method using four principles can resolve controversies in bioethics. The method holds that there are four principles-respect for autonomy, nonamleficence, beneficence, justice- that articulate the necessary conditions of common morality for health care and bioethics. Beauchamp and Childress respond by arguing that the two problems are nc the meaning or interpretation but the process of specification. Third, So, Supplement four principles' problem to Levinas concept of the Other theory. Levinas concept of the Other is very resemblant with 'Love your neighbour as yourself." Christians believe that Love is above all and they act accordingly. They base this faith mainly upon the motto of "love your neighbour as yourself." Fourth. difficult part of Levinas concept of the Other is that there is no human to equal infinite sense of responsibility. Can be supplemented about this through cooperation of community. Four principles can be brought to bear on moral choices. And they asserts that each principles has weigh but they do not assign a priority weighting of ranking. All the principles are equal in moral decision making.

• 대한예방한의학회지
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• 제16권3호
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• pp.15-26
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• 2012

Objective : Only a few studies have investigated the life expectance and health related quality of life (HRQOL) about stroke patients. The purpose of this study is to analyze the life expectancy, preference based quality of life(QOL) and quality adjusted life years(QALYs) of stroke patients. Methods : We used data of 10,533 adults from 4th Korean national health and nutritional examination survey 2009 for evaluating HRQOL of stroke patients. We also analyzed the life expectancy for stroke patients using life table from national public health data. Finally we calculated the QALYs with and without stroke conditions and assumed the difference of QALYs. Results : The mean age of stroke patients was assumed to be 65. Lower income and less educated groups were prone to be exposed to the stroke conditions. Common comorbidities of stroke patients were ischemic heart attack, hypertension, diabetes and hyperlipidemia. The proportions of participants who reported problems in each of the five EQ-5D dimensions increased significantly at chronic stroke group. Participants with chronic stroke conditions had an almost 6-fold higher risk of impaired health utility(the lowest quartile of EQ-5D utility score) compared with non stroke participants, after adjustment of age, gender, income, education, comorbidity variables. The differences of life expectancy and QALYs between non-stroke and stroke group from the age of 65 till death were assumed to be 0.767 year and 3.103 QALYs. Conclusions : Although the authors analyzed the affecting factors of QOL and assumed the differences of life expectance and QALYs about stroke patients using domestic national data and statistic references, well designed cohort studies should be needed to prove the causal effects of affecting factors and to assume more correct QALY differences.

• 가정과삶의질연구
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• 제29권5호
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• pp.51-73
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• 2011

Korean society with low fertility rate and high aging rate crisis has been tried very hard to find out alternatives to solve these social problems. These efforts resulted in increasing the development of education programs for the elderly. The education for the elderly have been development in various different academic fields. Therefore, this is the time to establish database for education programs which developed so far. The purpose of this study is to examine research trend in the field of education programs for the elderly in Korea. For this purpose, 62 education programs for the elderly which developed so far were analyzed. The results of this study were as followed. The topics of education programs for the elderly were divided into the following : a marriage enrichment programs for the elderly married couples, leisure programs, death education programs, health education programs, economic education programs, education programs for grandparents raising their grandchildren, etc. Based on the results of this analysis, the tasks of future research about education programs for the elderly were presented.

• 대한한의학원전학회지
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• 제19권3호
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• pp.228-254
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• 2006

1. King Hyeonjong(1641-1674) mainly suffered from eye disease and abscess. He specially took a hot spring bath for cure of eye and skin problems. He probably died of septicemia and the following gastro-intestinal infection at the age of 34, quite early for his age. 2. King Sukjong(1661-1720) was not very well all through his life, but lived quite longer than other Kings in the Joseon Dynasty. He suffered from various diseases like heart-based heat, abscess, edema, upper respiratory infections, etc. He frequently took the treatments of acupuncture and moxibustion. He presumably died of dysfunction of liver and kidney at the age of 60. 3. King Gyeongjong(1688-1724) suffered from political problems from birth to death, so he may have had excessive mental stress for his poor health. He mainly suffered from heart-based heat and abscess. It is quite not sure why he died in only one month from the onset of his symptoms, so many people thought that he was poisoned to death. He probably died of septicemia and the following gastro-intestinal infection at the age of 37. 4. King Yeongjo(1694-1776) lived for 83 years, which is the longest of all the Kings in the Joseon Dynasty. He mainly suffered from hypofunction of gastro-intestinal system with cold symptoms, coughs, uneasiness. He took various kinds of herbal medicine, of which he took ginseng the most. He is supposed to be dead due to his old age at 83.

• Journal of Preventive Medicine and Public Health
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• 제31권3호
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• pp.481-489
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• 1998

Injuries and infectious diseases have been the most important public health problems since the beginning of human life. Injuries result in death of about 30,000 people each year in South Korea. In terms of years of life lost, injuries are considerably more costly than either heart disease or cancer. In terms of cost - both the direct costs of care and the indirect costs to individuals, families, and societies of a diminished life-injuries are among the most expensive of all social problems. The main purposes of this study are (1) to describe the outcomes as well as treatment process of brain injured patients and (2) to identify the factors impacting on length of stay during hospitalization and hospital fees. The research method used in this study was to review the medical records of five hundreds brain injured cases using systemic random sampling. The multiple logistic regression was administered to identify the factors impacting on the outcomes. The results are as follow : (1) the consultation .ate was found to be 72.9% while referral rate was 11.2%; (2) nearly 30% of the respondents were hospitalized over 30 days; (3) multiple logistic regression analyses revealed that the determinants influencing LOS were number of consultations, number of lab tests, and surgery; (4) the determinants of hospital fee were severity of brain injury, gender of patients, number of consultations, number of lab tests, and surgery.

• Journal of Hospice and Palliative Care
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• 제25권1호
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• pp.1-11
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• 2022

The Act on Decisions on Life-Sustaining Treatment has been in effect since 2018 for end-of-life patients. However, only 20~25% of deaths of terminally ill patients comply with the law, while the remaining 75~80% do not. There is significant confusion in how the law distinguishes between those in the terminal stage and those in the dying process. These 2 stages can be hard to distinguish, and they should be understood as a single unified "terminal stage." The number of medical institutions eligible for life-sustaining treatment decisions should be legally expanded to properly reflect patients' wishes. To prevent unnecessary suffering resulting from futile life-sustaining treatment, life-sustaining treatment decisions for terminal patients without the needed familial relationships should be permitted and made by hospital ethics committees. Adult patients should be permitted to assign a legal representative appointed in advance to represent them. Medical records can be substituted for a patient's judgment letter (No. 9) and an implementation letter (No. 13) for the decision to suspend life-sustaining treatment. Forms 1, 10, 11, and 12 should be combined into a single form. The purpose of the Life-sustaining Medical Decisions Act is to respect patients' right to self-determination and protect their best interests. Issues related to the act that have emerged in the 3 years since its implementation must be analyzed, and a plan should be devised to improve upon its shortcomings.