• Journal of Hospice and Palliative Care
• /
• v.21 no.3
• /
• pp.92-103
• /
• 2018

Purpose: This descriptive study was conducted to examine factors that affect hospital workers in their decision to withdraw from life-sustaining treatment, such as knowledge, attitude, and perception of organ donation, transplantation, death and hospice palliative care. Methods: A questionnaire was completed by 228 workers of a tertiary general hospital, and data were analyzed using t-test, ANOVA, and Pearson's correlation by using SPSS 21.0. Results: The subjects' knowledge of biomedical ethics awareness differed by age, education level, occupation, affiliated department, and biomedical ethics education. Their knowledge of brain death, organ donation and transplantation was positively correlated with attitudes toward tissue donation and transplantation, knowledge of hospice palliative care, and perception of hospice palliative care. Their attitudes toward tissue donation and transplantation were significantly correlated with knowledge of hospice palliative care, perception of hospice palliative care, and withdrawal of life-sustaining treatment. Their awareness of death was significantly correlated with knowledge of hospice palliative care, perception of hospice palliative care and withdrawal of life-sustaining treatment. The perception of hospice palliative care was significantly correlated with withdrawal of life-sustaining treatment. Factors associated with their withdrawal of life-sustaining treatment were work at the hospice ward (32.5%), attitudes toward tissue donation and transplantation and perception of hospice palliative care. Conclusion: This study has shown that work at the hospice ward, attitudes toward tissue donation and transplantation and perception of hospice palliative care were related to attitudes toward withdrawal of life-sustaining treatment. More research is needed to further develop various curriculums based on biomedical methods.

• Journal of Life Science
• /
• v.30 no.2
• /
• pp.211-220
• /
• 2020

The activity of CAR can be regulated not only by ligand binding but also by phosphorylation of regulatory factors involved in extracellular signaling pathways, cross-talk interactions with transcription factors, and the recruitment, degradation, and expression of coactivators and corepressors. This regulation of CAR activity can in turn have effects on the control of diverse physiological homeostasis, including xenobiotic and energy metabolism, cellular proliferation, and apoptosis. CAR is phosphorylated by the ERK1/2 signaling pathway, which causes formation of a complex with Hsp-90 and CCRP, leading to its cytoplasmic retention, whereas phenobarbital inhibits ERK1/2, which causes dephosphorylation of the downstream signaling molecules, leading to the recruitment to CAR of the activated RACK-1/PP2A components for the dephosphorylation, nuclear translocation, and the transcriptional activation of CAR. Activated CAR cross-talks with FoxO1 to induce inhibition of its transcriptional activity and with PGC-1α to induce protein degradation by ubiquitination, resulting in the transcriptional suppression of PEPCK and G6Pase involved in gluconeogenesis. Regulation by CAR of lipid synthesis and oxidation is achieved by its functional cross-talks, respectively, with PPARγ through the degradation of PGC-1α to inhibit expression of the lipogenic genes and with PPARα through either the suppression of CPT-1 expression or the interaction with PGC-1α each to induce tissue-specific inhibition or stimulation of β-oxidation. Whereas CAR stimulates cellular proliferation by suppressing p21 expression through the inhibition of FoxO1 transcriptional activity and inducing cyclin D1 expression, it suppresses apoptosis by inhibiting the activities of MKK7 and JNK-1 through the expression of GADD45B. In conclusion, CAR is involved in the maintenance of homeostasis by regulating not only xenobiotic metabolism but also energy metabolism, cellular proliferation, and apoptosis through diverse cross-talk interactions with extracellular signaling pathways and intracellular regulatory factors.

• Journal of the Korean Society of Radiology
• /
• v.1 no.1
• /
• pp.17-23
• /
• 2007

Background: Cerebrovascular diseases are known to show different patterns of incidence among regions and races. Therefore, it is very important to determine the incidence pattern of a specific area in order to diagnose, treat and prevent cerebrovascular diseases. The objective of the present study is to analyze quantitatively the incidence ratios of hemorrhagic and ischemic cerebrovascular diseases by season, by gender and by age. Methods: The subjects of this study were 1603 patients hospitalized for hemorrhagic or ischemic cerebrovascular diseases at the Department of Neurosurgery or the Department of Neurology of a University Hospital. Statistical analysis of data used Excel 2003 of Microsoft, and t-test was conducted using ORIGIN 6.0 of MICROCAL. Results: In the subjects, the incidence ratios of hemorrhagic and ischemic cerebrovascular diseases for four years, the period of this research, were 38.55% and 61.45%, respectively. The mean and standard deviation of age when hemorrhagic cerebrovascular diseases occurred were 58.20 and 12.60, respectively, and the percentages of subjects in their 40s, 50s, 60s and 70s were all around 20%. On the contrary, the mean and standard deviation of age when ischemic cerebrovascular diseases occurred were 65.01 and 13.59, respectively. The average age of patients with ischemic cerebrovascular diseases was older than that of patients with hemorrhagic brain diseases, and the percentages of those in their 60s, 70s and 80s were 15.53%, 37.06% and 27.72%, respectively. The season when hemorrhagic cerebrovascular diseases appeared most frequently was winter, which was followed by summer, spring and autumn. The season when hemorrhagic cerebrovascular diseases appeared most frequently was spring, which was followed by summer, winter and autumn. Conclusions: In this study, the incidence rates of hemorrhagic and ischemic cerebrovascular diseases were 38.55% and 61.45%, showing the rising percentage of ischemic cerebrovascular diseases. For making adequate prevention and disease control plans, it is considered necessary to make a long-term epidemiological investigation of cerebrovascular diseases.

• Journal of the Korean Society of School Health
• /
• v.10 no.2
• /
• pp.157-167
• /
• 1997

This study was conducted to investigate follow up tests and related factors in students who tested positive for in urine tests. For the purpose of this study, the authors analysed a self-administered questionnaire collected from 316 middle school students and 451 high school students who had positive urinalysis results in Kyungpook province during the month of February, 1996. The major findings of this study were as follows : The proportion of follow up tests among students was 39.2% in middle school students and 34.1% in high school students. There was a significant relation among a number of factors : parents' environment, health concern, and knowledge of urinalysis results, existence of nursing teachers, education concerning urinalysis, medical facility visits, and notification methods. In a multiple logistic regression analysis a higher economic level, parents' concern, knowledge of urinalysis results, medical facility visits, anti direct notification of parents were all significantly related with the follow up tests. On consideration of the above findings, in order to perform practical and effective follow-up management of students who have a positive result in urine test, direct notification of urine test result to parents as well as active health guidance in school are required.

• Journal of Hospice and Palliative Care
• /
• v.3 no.1
• /
• pp.39-48
• /
• 2000

Purpose : The purpose of the study is to disclose the spiritual needs of hospice patients. Method : The questionaire survey was carried out on 49 hospice patients and 40 caregivers who were in the 9 hospice institutions from lune to August in 1999. Results : In the patients, mean scores of the spiritual needs were significantly higher in the group with stomach cancer, college education, christians, $8{\sim}14$ days of hospice care and the group thinking that religion was important, and in the caregivers in the group of religions besides christianity and lives under $3{\sim}5$ years of medical treatment. In the total average of the spiritual needs, the patients's average was significantly lower than the caregiver's. Among the different categories, the patient's needs were highest in the area of meaning of life and the hope, the caregiver's needs in the love and the concern. However, both groups were low in the religion area. In the items of the love and the concern, the patient was highly responding to the 'wanting someone to give warm concern in conversation' and the caregiver was highly responding to the 'giving a warm response to questions on the sad and hard time'. And also, the patient was lowly responding to the 'wanting more concerns to him than other patients', and the caregiver was low responding to the 'patients wanting warm response in conversation'. In the categories of religious area both group were highly responding to the 'wanting to be helped to relax out of all'. And they gave lowest response to the 'wanting to introduce a book to know God'. In the area of meaning of life and hope, the both groups gave highest response to the 'wanting to be guided to have the hope' and lowest to the 'wanting to have opportunity to reconcile the person with bad relationship'. Conclusion : Summing up the above results, personal in-depth conversation is necessary to understand more deeply the spiritual needs of hospice patient. Moreover the hospice team needs to have more systematic approach to find out the spiritual needs of hospice patients.

• Journal of Hospice and Palliative Care
• /
• v.13 no.3
• /
• pp.153-160
• /
• 2010

Purpose: The purpose of the present study was to investigate needs and satisfaction on the medical services of cancer patients in Jeju Special Self-Governing Province. Methods: Total 174 cancer patients, who visited at the clinic of Jeju National University Hospital, submitted informed consent and participated in this study from July 13 to July 30, 2009. Self questionnaire was used and data were analyzed with Kolmogorov-Smirnov test, Mann-Whitney U test, ANOVA, and Kruskal-Wallis test. Results: Participants expressed the needs of most economical support (3.38 out of 4), followed by counseling of treatment plan (3.22), information of disease (3.07), and disease management except cancer (2.97). Participants were satisfied most with religious counseling (3.41), followed by nursing service support (3.39), employment counseling (3.26), and counseling for family or interpersonal relationships (3.26). The satisfaction of economical support was the lowest (1.98). Satisfaction of men was higher than women, and needs in patients who were living with children was the highest. Patients who were living alone or with children showed the lowest satisfaction about the medical services. There were no significant differences in the general characteristics, however, participants who were older than 60 years of age or had higher income showed lower needs and higher satisfaction. There were no significant differences in the medical characteristics, however, thyroid cancer patients and patients who were treated with radiation therapy or transarterial embolization showed low satisfaction. Conclusion: Cancer patients seemed to need more economical support, information of treatment or disease, and symptom management. Furthermore, there were various needs about the services, depending on family formation or economical support of patients. Therefore, it is certain that patients who were suffering from other cancers, except the 5 major cancers, needed more services. In conclusion, continuous and systemic policy to consider patient's characteristics and needs are needed in community as well as health care system.

• Journal of Hospice and Palliative Care
• /
• v.16 no.1
• /
• pp.10-19
• /
• 2013

Purpose: Home-based care providers were surveyed to assess the effect of collaborative service between Gyeongnam Regional Cancer Center (GRCC) and public health centers (PHCs) in Gyeongnam province. Methods: Twenty home-based care providers who had previously participated in the GRCC-PHC care project were recruited from nine PHCs and were surveyed using a questionnaire developed by specialists. Questions were rated using the 5-point Likert scale ranging from "strongly disagree (-2)" to "strongly agree (+2)" and each score was multiplied by the corresponding number of respondents (n=20) with the maximum score of 40. Results: Between January 2008 and December 2011, 73 patients were registered to the collaborative service: 72 by GRCC and one by PHC. Home-based care providers marked the highest score (23 points) to "The collaborative service contributed to patients and their family's psychological stability" and the lowest score (11 points) to "The collaborative service was generally helpful for home-based cancer management." For possible suggestions to improve the service, the highest score (35 points) was given to "Simplification of the hospitalization process" followed by "Substantial benefits for patients at their visit to the hospital" (34 points). Conclusion: The results revealed several limitations of the GRCC-PHC collaborative care service for terminal cancer patients. The service could be further improved by developing measures to address the limitations and a service model tailored to region-specific needs.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.17 no.4
• /
• pp.188-198
• /
• 2016

This study examined the effects of a smoking cessation coaching program based on the motivation stage applying the Transtheoretical Model to stop the smoking of patients in terms of the amount of smoking, nicotine dependence, CO level, and urine cotinine. The study design was a multi-repeat multiple repeat intermittent time series study with one-group, a pre-post design. The participants were 47 smoking patients (44 males and 3 females), who were treated at a public hospital in N city. The participants were 4 (8.51%) subjects in the action stage and 43 subjects (91.49%) in the preparation stage of the motivation stage. The coaching program intervention was conducted at the first day, second week, and 6th week. The smoking cessation maintenance of the subjects was checked at the 12th week. A chi-square test and t-test were used to analyze the data. The subjects in the action stage were kept under the condition of no smoking and nicotine dependence. After the program of subjects in the preparation stage, the amount of smoking, nicotine dependence, and CO level were significantly lower compared to the pre-test (p<.001). The findings suggest that the coaching program based on the motivation stage was effective in improving the smoking cessation for patients who smoke. On the other hand, the patients in the smoking cessation program may require much more financial assistance than those of healthy people. A greater workforce and budget will be needed for patients to stop smoking.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.13 no.5
• /
• pp.2189-2198
• /
• 2012

This study was designed to measure the difference in health-related quality of life (HRQOL) among social classes and explore the factors that may explain it. Study subjects were 7,992 Korean adults aged 20-69 from the 4th (2007-2009) Korea National Health and Nutrition Examination Surveys data. We described mean value of EQ-5D index as a HRQOL by class and performed hierarchical multiple regression analysis to find the factors. The result was as follows. In the distribution of EQ-5D index level among social classes, new middle class (class II) had the highest score (0.966 in men and 0.955 in women); upper and middle-upper class (class I) 0.965 in men and 0.936 in women; working class (class IV) 0.958 in men and 0.936 in women; old middle class (class III) 0.955 in men and 0.932 in women; low class (class VI) 0.941 in men and 0.908 in women; and rural self-management class (class V) the lowest score (0.918 in men and 0.866 in women). In men, chronic disease, job stress, education and income level were found to make the difference in the health-related quality of life among social classes; in women, those factors and health behavior explained the difference. In conclusion, the lower social class has lower HRQOL. Except for education and income level, chronic disease may be the major factor to explain the difference in the health-related quality of life among social classes.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.15 no.8
• /
• pp.5159-5168
• /
• 2014

The study examined the relationship among metal health, metabolic syndrome and nutrient acceptance according to gender. Implemented until 2010-2012, the 5th Korean National Health and Nutrition Examination Survey, as an original document, was used for the study. The target was problem drinkers with more than 12 points under AUDIT. Regarding mental health, it was classified into stress, depression and suicidal impulse. Metabolic syndrome was defined when three causes of BMI, waist circumference, FBS, HDL and BP were out of the normal range. The nutrient intake was obtained to confirm the energy intake of nine non-nutrients (Nutrient adequacy ratio: NAR) and the proper intake of the average non-nutrient (Mean adequacy ratio: MAR). These variables were analyzed by frequency, cross analysis and multiple regression analysis through SPSS18.0. In the general features, there was a significant difference according to age, occupation and marital status. In mental health, stress, depression and suicidal impulse were examined. Metabolic syndrome was dependant on FBS, HDL and BP. The nutrient acceptance depended on calcium, vitamin A, thiamine, riboflavin, niacin, vitamin C, and MAR. Logistic regression analysis performed on the variables showed significant differences. Stress, depression, and thoughts of suicide was significantly higher in men aged 19-29 years, and women aged 30-49 years. In the case of the male, those who employed have metabolic syndrome more than those who unemployed. In terms of female, those who were belonged into the middle - low economic level have undergone with metabolic syndrome. In the part of a Mean adequacy ratio(MAR), the male who unmarried, employed, were in the middle low economic levelwere higher. In the case of the female, it was higher for those who were in the middle - low economic level. Overall, an effective way of planning the solution regarding mental health, metabolic syndrome and nutrient intake can be found by considering these features.