• 제목/요약/키워드: life-and-death problems

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학령기 아동의 스트레스와 대응전략에 관한 연구 (A Study of Stress and Coping Strategies in School-Age Children)

  • 신희선
    • 대한간호학회지
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    • 제26권4호
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    • pp.808-819
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    • 1996
  • The purpose of this study was to examine the stressors and coping strategies of school -age children and to explore the relationship between stressful life events and health symptoms and the effects of coping and trait anxiety which is theoretically considered to mediate the relationship between stress and health symptom. The study subjects consisted of 639 elementary school children in the fourth to sixth grade living in Seoul. Of the 639 subjects, 348 were boys and 291 were girls. The mean age was 11.35 (SD=.86). The Feel Bad Scale(FBS), Schoolager's Coping Strategy Inventory(SCSI), Spielberger's Trait Anxiety Scale for Children(STAIC), and Health Symptom Questionnaire (HSQ) were adapted for this study. A pilot study was undertaken to ascertain the reliability and validity of the instruments. The Cronbach alphas of FBS, SCSI, STAIC and HSQ were from .81 to .92. The Researcher and a research assistant visited the school and data were collected in the class using the questionnaire method after an explanation of the purpose and procedures was given to the children. Data collection was done during the period between Nov.25 to Dec.19, 1995. Using the SAS statistical program, percentages, t-test, ANOVA, correlation analysis, and multiple regression were used for data analysis. The result are as follows : 1. The mean score for the FBS was 204.79(range : 48-472) and there was a significant difference according to grade. The most severe stressors perceived by children were parental divorce and death or illness of family members. The most frequently experienced stressful life events were conflict with siblings and being home alone. 2. The mean score for the SCSI was 57.36(range : 9-118) and there was a significant difference according to grade. The most frequently used, and perceived as helpful, coping strategies were distraction and cognitive activities. 3. The mean score for the HSQ were 20.7(range : 0-81) and there were significant differences according to grade and sex. The percentage of the children answering that they perceived their health state as not good was 3.9%. 4. The mean score for the STAIC was 33.76 and there were significant differences according to grade and sex. 5. There was a significant relationship between stressful life events and health symptoms ( r=.53, p<.01). Also, Stressful life events were postively related with coping strategies(r=.39, p<.01). Trait anxiety was highly correlated with health symptoms(r=.72, p<.01). 6. To examine the multivariate effects of the variables to health symptoms, multiple regression was performed. Stressful life events, coping, trait anxiety, and health concerns were identified as significant variables. Explanation of the health symptoms by these variables was 56.78%. The study revealed that stressful life events correlated with health symptoms in school-age children and coping and trait anxiety had mediating effects on this relationship. The implication for nursing is that there is a need to develop supportive interventions for high risk population to decrease health problems due to stress. Also, it is recommended that a study be conducted to explore protective factors for the prevention of health problems in children.

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연명(延命)치료적 인공기계호흡요법의 보류(保留)/중지(中止)를 전후한, 법의학적 및 윤리적 문제들과 그 대처방안 (The Medico-Legal and Ethical Problems of Withholding / Withdrawing of Futile Life-Sustaining Mechanical Respirator treatment)

  • 김건열
    • Tuberculosis and Respiratory Diseases
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    • 제58권3호
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    • pp.213-229
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    • 2005
  • The first and the longest criminal indictment case of Korean medico-legal battle, so called BORAMAE Hospital Incident, was finally on its end by Korean Supreme Court's decision on June 24, 2004, after 7 years long legal dispute via Seoul District Court and Seoul Superior Appeal Court's decision. Boramae Hospital case was the first Korean legal case of Withdrawing Life-sustaining treatment of mechanical respirator on 58 years old Extradural Hematoma victim who was on Respirator under Coma after multi-organ failure postoperatively(APACHE II score: 34-39). Two physicians who have involved patient's care and had helped to make discharge the Near-death patient to home after repeated demand of patient's wife, due to economic reason, were sentenced as homicidal crime. This review article will discuss the following items with the review of US cases, Quinlan(1976), Nancy Cruzan(1990), Barber (1983), Helen Wanglie(1990), Baby K (1994) and Baby L cases, along with Official Statement of ATS and other Academic dignitaries of US and World.: [1] Details of Boramae Hospital incident, medical facts description and legal language of homicidal crime sentence. [2] The medical dispute about the legal misinterpretation of patient's clinical status, regarding the severity of the victim with multi-organs failure on Respirator under coma with least chance of recovery, less than 10% probability. [3] Case study of US, of similar situation. [4] Introduction of ATS official Statement on Withdrawing/ Withholding Life sustaining treatment. [5] Patient Autonomy as basic principle. [6] The procedural formality in Medical practise for keeping the legitimacy. [7] The definition of Medical Futility and its dispute. [8] Dying in Dignity and PAS(Physician Assisted Suicide)/and/or Euthanasia [9] The Korean version of "Dying in Dignity", based on the Supreme Court's decision of Boramae Hospital incident (2004.6.24.) [10] Summary and Author's Note for future prospects.

윤심덕과 김우진 소재 영상물 비교 및 영화 <사의 찬미>(1991) 재론 (Comparison of the Video Dramas Based on Yoon Sim-duk, Kim Woo-jin and Reconsidering the Movie Praise of Death(1991))

  • 정우숙
    • 대중서사연구
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    • 제26권4호
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    • pp.43-76
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    • 2020
  • 이 논문은, 윤심덕과 김우진 소재의 영상물 세 편을 비교한 후, 그 중 가장 소재 구현의 복합성이 살아 있는 영화 <사의 찬미>(1991)에 대해, 감독 및 연기자의 이전 작품과의 관계 중심으로 집중적으로 그 특성을 탐색한다. 영화 <윤심덕>(1969)은 삼각관계 및 본처와 혼외 여성 중심의 멜로 서사에 주력하고, 드라마 <사의 찬미>(2018)는 일제 강점기의 고통까지 관습적 이미지로 포장하면서 청춘남녀의 이상적 애정물을 추구한다. 이에 비해 1991년 영화 <사의 찬미>는 영상미에 치중하는 동시에, 두 인물이 선구적 예술인으로 겪은 고뇌를 좌절된 사랑의 서사와 겹쳐 놓는다. 이 과정에서 이 영화는 다른 두 편에 비해, 특히 여주인공 중심의 모순적 특성을 드러낸다. 그녀는 남성의 구원을 위한 수동성과 자기 삶의 추락마저 스스로 선택하는 능동성 사이에서 균열을 보인다. 이 특성을 살피기 위해 영화 <사의 찬미>에 영향을 미친 이전 작품들에 대해 고찰해본다. 김호선 감독과 연기자 장미희의 1970년대 영화들, 또한 그녀가 1980년대에 배창호 감독과 함께 한 영화에서 구축해온 인물상의 맥락이 그 고찰의 대상이다. 대중영화의 장 안에 부분적으로 고급문화를 지향하는 태도를 담아내며, 섹슈얼리티를 포함한 욕망의 문제와 정신적·지성적 문제를 중첩시키는 경향은, 이전 작업에서부터 영화 <사의 찬미>에 이어져 윤심덕 구현의 배경을 이룬다. 이 연구는 1991년 영화 <사의 찬미>를 두 가지 맥락에서 살피는 결과를 낳는다. 그 하나는 윤심덕과 김우진 소재 영상물의 맥락이고, 또 하나는 김호선 감독이나 연기자 장미희가 지속해온 작업의 맥락이다. 지금까지도 윤심덕과 김우진을 소재로 한 작품들은 계속 나오고 있다. 이런 상황에서, 해당 소재 작품의 대표 사례인 이 영화를 입체적 맥락에서 살핌으로써, 윤심덕과 김우진 소재가 제공하는 허구화의 효과와 난점을 재확인할 수 있다.

노년기의 의식구조에 관한 연구 (Ego Structure in Life Process of the Aged in Korea)

  • 유숙자
    • 대한간호학회지
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    • 제10권2호
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    • pp.95-115
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    • 1980
  • Current statistics reveal remarkable prolongation of the average longevity in this country for the past decade. Welfare of the aged is no longer sole concern of the person or/and family. but has aroused social concern on the community and national level. This study was designed to assess social, economic and emotional needs of the aged. and to identify problems they are confronting. Data were gathered through questioning 273 subjects living in Seoul from July 25, to August 31. 19 80. Frequencies and percentile scores were analysed to describe the fact. and the significance of int or-variable differences was tested by Chi-square method. Results are : 1. Majority of the subjects (male : 65.38%). (female : 62.13%)“talk about past experiences”to re-collect their past days, the difference between male and female respondents was not significant. 2. Except few who earn their pocket money (4.21%). majority were doing household errands (34.52% ) and looking after their garnd children (29.26 %). Main sources of their pocket money revealed to be their children (84.02%) and their own savings (24.64% ). Except few (15%)engaged with social activities directly or indirectly. leisure hours are spent in chatting with aged neighbors (44.81%). Highest in the rank order on the joyous moments for the aged revealed to be when the members of family living apart paying a visit (male : 37.5%, female : 63.72%)difference of male and female was significant ( P<0.05). Among female respondents. significant difference between age group was revealed (p<0.05). 3. Majority prefered sin91e houses (84.30% ). as residential environment. the suburban (36.26% ) area was the filet in the rank order : difference between age group and the educational status were not significant. Majority of respondents revealed to have their own room in the house. The first preference was given to live with their children (68.86%). Memory of the past (37.36% )revealed to be the highest in the rank order among the reasons why they dislike moving the house. 4. Majority favored current welfare benefts provided for the old age. however. the ideal way to live at their old age they responded was to live on their own savings (50.54%). 5. Majority revealed to be daunted occasionally (62.27%) by not being less active (34.16%) socially and by poor physical health(29.75%). Male and female differ in the causes of loneliness significantly (P <0.001) : retirement (37.89%) in ale and helpessness (43.05%) in female revealed the highest in the rank order. Majority talk over their feelings with aged neighbors to overcome the loneliness. 6 Majority were in favor of planting and looking after pet animal in the house. however. male and female differ in the kind significantly (p <0.001), 7. Majority think about death and dying occasionally or more (84.11% ). Many of the respondents believes in the life after life (53.49%) : female revealed to be significantly higher (p <0.01). and subjects with christian belief were significantly higher than non-christians (P<0.001). Attitude towards death and dying differs significantly between male and female (P <0. 001) and between christians ans and nonchristians (p <0.001). Highest preference was given to simple funeral (69.85%). Precious heritage that they would pass on to their descendants was onoscience and ethical value(57. 51%) : christian response as the first value was christian belief (52.38%).

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Health-promoting Lifestyle Behaviour for Cancer Prevention: a Survey of Turkish University Students

  • Ay, Semra;Yanikkerem, Emre;Calim, Selda Ildan;Yazici, Mete
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권5호
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    • pp.2269-2277
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    • 2012
  • Background: Health risks associated with unhealthy behaviours in adolescent and university students contribute to the development of health problems in later life. During the past twenty years, there has been a dramatic increase in public, private, and professional interest in preventing disability and death through changes in lifestyle and participation in screening programs. The aim of the study was to evaluate university students' health-promoting lifestyle behaviour for cancer prevention. Method: This study was carried out on university students who had education in sports, health and social areas in Celal Bayar University, Manisa, Turkey. The health-promoting lifestyles of university students were measured with the "health-promoting lifestyle profile (HPLP)" The survey was conducted from March 2011 to July 2011 and the study sample consisted of 1007 university students. T-test, ANOVA and multiple regression analyses were used for statistical analyses. Results: In the univariate analyses, the overall HPLP score was significantly related to students' school, sex, age, school grades, their status of received health education lessons, place of birth, longest place of residence, current place of residence, health insurance, family income, alcohol use, their status in sports, and self-perceived health status. Healthier behaviour was found in those students whose parents had higher secondary degrees, and in students who had no siblings. In the multiple regression model, healthier behaviour was observed in Physical Education and Sports students, fourth-year students, those who exercised regularly, had a good self-perceived health status, who lived with their family, and who had received health education lessons. Conclusion: In general, in order to ensure cancer prevention and a healthy life style, social, cultural and sportive activities should be encouraged and educational programmes supporting these goals should be designed and applied in all stages of life from childhood through adulthood.

The Art Therapy Experiences of Patients and Their Family Members in Hospice Palliative Care

  • Park, Sungeun;Song, Hyunjoo
    • Journal of Hospice and Palliative Care
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    • 제23권4호
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    • pp.183-197
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    • 2020
  • Purpose: In this study, the researchers closely investigated the psychosocial problems faced by terminal cancer patients and their family members in hospice palliative care units. Methods: The investigators conducted four sessions of art therapy intervention programs for the terminal cancer patients and their family members, carried out in-depth interviews about the influence of the cancer experience on their family function and quality of life, and analyzed their experiences using grounded theory methodology. Results: After providing autonomous written informed consent, six pairs of terminally ill cancer patients and their family members, accounting for a total of 17 participants with the inclusion of additional family members who took part sporadically, took part in the art therapy intervention and interviews. The raw data, in the form of verbatim records, were analyzed according to the procedures of grounded theory (open, axial, and selective coding). Through these processes, a total of 154 concepts, 56 subcategories, and 13 categories were identified. Families were classified into four types according to their family function, quality of life, and attitude toward death. Though the art therapy intervention, patients and their family members experienced three stages over time. Conclusion: This research focused on essential aspects of the family relationships and the art therapy experiences of terminal cancer patients and their family members through an art therapy intervention in the context of hospice palliative care. Based on these observations, the researchers constructed a theoretical rationale for art therapy interventions delivered to patients and their family members in the process of hospice palliative care.

입원한 암환자와 재가 암환자의 가족지지, 희망, 삶의질 정도에 관한 연구 (A Study on the Quality of Life, Family Support and Hope of Hospitalized and Home Care Cancer Patients)

  • 조계화;김명자
    • 대한간호학회지
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    • 제27권2호
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    • pp.353-363
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    • 1997
  • With the occurrence of cancer, most cancer patients experience various emotional changes such as anxiety, depression, and emotional shock. Especially in our country, cancer has been recognized as an incurable disease resulting in death. The number of cancer patients increases daily. But as the survival rate of cancer patients is also increasing, there is a need to find the better methods of nursing care for cancer patients. The purposes of this paper are as follows : 1) To understand family support and hope and quality of life for the cancer patient both during hospitalization and at home. 2) To determine the relationship between family support, hope and quality of life. To examine the problems. we used a questionnaire and obtained data form the records of 45 home care and 90 hospitalized (in 3 university hospitals) patients in Taegu area from the period of June 15 to August 15, 1996. SPSS /PC was used for the data analysis and the statistical methods used were the T-test and ANOVA. The results of this paper are as follows : 1) In the aspect of family support, there is no difference between hospitalized and home care cancer patients(t=1.63, P>0.01). 2) In the aspect of hope, hospitalized cancer patients have a higher score than home care cancer patients(t=3.08, P>0.01). 3) In the aspect of quality of life, hospitalized cancer patients have a higher score than home care patients(t=2.96, P<.01). 4) There is a correlation between quality of life and hope with a correlation coefficient r=0.5195 and P=0.000. In addition, the correlation coefficient between quality of life and family support is 4179 with P=0.000. 5) The family support of the cancer patient is influenced by sex(F=9.1863, P<0.01), education(F=4.3641, P<0.01) and the level of life (F=5.5002, P<0.01), 6) The hope of cancer patients is influenced by the number of hospitalizations(F=3.6413, P<.05), education(F=6.0113, P<.01). and the level of life(F=5.0649, P<.01). 7) The quality of life of cancer patients is influenced by the number of hospitalization(F=5.1167, P<0.05), education(F=3.1590, P<0.01) and the level of life(F=5.6942, P<0.01).

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김해지역 호스피스 보건복지연계 모형개발에 관한 연구 (Development of Hospice Model Networked with the Existing Welfare Systems in Gimhae City)

  • 조현
    • Journal of Hospice and Palliative Care
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    • 제5권2호
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    • pp.101-110
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    • 2002
  • Purpose : With the elongation of the average life span, the main causes of death are chronicle illness including cancers resulting in a large amount of medical resources. And there are still many patients to whom a sufficient medical care is not given. All these bring on the uneven distribution of medical resources together with the increase of medical cost. Hence, an efficient system should be set up to solve these problems. Methods : The hospice draws a great attention as a resolution of high medical cost and uneven medical resource distribution, and has been proved to be an alternative to the existing medical system. So, the characteristics of the hospice has been reviewed, particularly with respect to its scopes and related resources. And by tracking the actual cases, the necessary services and supports are investigated. Results : The intrinsic characteristics of hospice is that it executes not only the medical exercise but also all the subjects related with patients and their families. And the hospice is performed not only by the medical experts but also by all the disciplines including social and spiritual affairs. This indicates that the hospice requires the integrated system comprised of medical, social and other welfare entities. Conclusion : To establish the actual hospice, an efficient and systematic integration of all the existing medical and other welfare resources in the local society is necessary. The most practical way is the networking of resources, which practices the hospice more efficiently without additional investment.

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안면 색윤(色潤) 분석을 통한 신장 기능 측정 방법 제안 (A Novel Method of Measuring the state of Kidney by Analysing the Color and Gloss of the Patient's Face)

  • 이세환;조동욱;강응택
    • 한국통신학회논문지
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    • 제35권7C호
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    • pp.634-641
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    • 2010
  • 말기신부전의 경우 당뇨병, 고혈압 등의 4대 사망 요인의 합병증으로 이로 인한 의료비 지출과 삶의 질의 저하가 큰 사회적 문제로 작용하고 있다. 신장의 경우 이상이 생겨도 자각증상이 거의 없기 때문에 진단이 어렵고 질환 발병시 완치 및 기능회복이 어렵기 때문에 예방 및 조기 진단이 매우 중요하다. 본 논문은 신장 기능의 이상 여부를 측정하는 하나의 방법으로 한의학의 망진법에서 진단의 지표가 되는 색윤을 활용하고자 한다. 안면 영상에서의 반사도 즉 색윤의 변화와 신장 기능과의 상관성을 분석하기 위해 편광필터를 사용하여 색윤을 측정하는 방법을 제안하고 이를 통한 실험을 진행하였다.

Medetomidine과 Ketamine을 사용한 그물무늬 기린마취에 대한 고찰 (Chemical Immobilization of Reticulated Giraffe (Giraffa camelopardalis reticulata) Using Medetomidine and Ketamine)

  • 김규태;김종부;장경철;이일범
    • 대한수의학회지
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    • 제43권3호
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    • pp.501-505
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    • 2003
  • The chemical immobilization in giraffes (Giraffa camelopardalis reticulata) remains a challenge because of their size, behavior, and anatomic and physiologic characteristics that commonly create life threatening problems during immobilization. The drug combination medetomidine (MED) and ketamine (KET) was administered by remote injection. The dosages of MED and KET were correlated to the giraffe's shoulder height (SH), become recumbent with a dosage of $114{\mu}g$ of MED and 2.1 mg of KET, $320{\mu}g$ of atipamezole per cm of SH, respectively. After injection of the drugs, initial signs of sedation including ataxia were noticed at 3 minutes followed by lateral recombency at 12 minutes. The mean heart rate, respiratory rate and rectal temperature recorded during the procedures were 55 beats per minute, 48 breaths per minute and $36.6^{\circ}C$, respectively. Atipamezole was administered, after 33 minutes result in death. Assuming that 24 hours fasting times were short and light esteemed of atipamzole adverse effects like vomiting, passive regurgitation.