• Journal of Hospice and Palliative Care
• /
• v.5 no.1
• /
• pp.17-23
• /
• 2002

Purpose : The prevalence of symptoms in patients with terminal cancer varies considerably and these symptoms are very difficult to control. However, patients can spend their last days or hours of life without suffering pain with appropriate care. One of the major concerns during last days of life is to predict the time of death. We would like to investigate symptom prevalence during terminal cancer patients' last 48 hours in Korea, and therefore contribute to predict the time of death and to help to determine appropriate treatments. Methods : The data for this study was recorded from 92 of 132 patients who died with terminal cancer at the hospital between February 1 and October 31, 2000. We investigated the symptom prevalence during the last 48 hours through medical obligation record and analyzed the changes of symptom prevalence at the admission, $48{\sim}24$ hours and $24{\sim}0$ hours before death. Results : The predominant symptom prevalence was pain (57.6%), followed by confusion (55.4%), dyspnea (48.9%), voiding difficulty (42.4%) in the last 48 hours before death. From the statistical analysis for the changes of symptom prevalence in time, pain, nausea and vomiting were decreased but noisy and moist breathing, sweating, groan, restlessness and agitation, and loss of consciousness were increased (P<0.05). Conclusion : The results from this study show the tendency to increase of prevalence of noisy and moist breathing, sweating, groan, restlessness and agitation as well as loss of consciousness in 48 hours before death. Therefore the symptoms above can be used for the important indicators to predict the imminent death.

• Journal of Oral Medicine and Pain
• /
• v.31 no.4
• /
• pp.347-354
• /
• 2006

Most patients suffering from TMD appear to have unsatisfactory masticatory function and compromised values of bite force. The purposes of this study were to investigate and compare bite force between affected and unaffected sides of patients with unilateral TMD and to evaluate its relation with duration of TMD. 42 patients with unilateral TMD, from Department of Oral Medicine, Dankook University Dental Hospital, were selected for this study. The ratio of men to women was 9:33 and their mean age of $27.2{\pm}10.4$ years. The bite forces were measured over both canines (for anterior bite force) and $1^{st}$ molars (for posterior bite force) using a bite force recorder while all the subjects were asked to clench successively for 3 seconds not until pain was felt. They were compared with those measured from bilateral TMD patients(N=6, M:F=1:5, mean age: $23.0{\pm}27.3$ years). The unilateral TMD patients were divided into time groups according to duration of TMD on the basis of 1 and 6 months, respectively. Paired and unpaired t-tests were used for statistical analysis. Unilateral TMD patients in this study showed that the affected sides had significantly lower bite force than the unaffected sides(force difference of about 7-8 kgf, p<0.05) while there was no significant sides difference in the bilateral patients. Nor did bite force on the affected sides reveal significant difference between unilateral and bilateral TMD patients. With regards to TMD duration, there was significant difference between the patients with TMD < 6 months and $\geq$ 6 months (p<0.05) while no significant difference existed between < 1 month and $\geq$ 1 month. The results of this study indicated that unilateral TMD patients can exhibit more reduced bite force on the affected sides compared with that on the unaffected sides and that bite force on the unaffected sides might be deteriorated more as longer did TMD last.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.7 no.1
• /
• pp.54-60
• /
• 2004

Purpose: Henoch-$Sch{\ddot{o}}nlein$ purpura (HSP) is a small-vessel vasculitic disease that most often affects the skin. Abdominal symptoms precede the typical purpuric rash of HSP in 14~36%. It is a challenge to diagnose HSP in the absence of a rash, because there are no biologic tests that can identify HSP with certainty, so we tried to find out the characteristic features of HSP gastroenteropathy without purpura before diagnosis. Methods: This study included 82 children with HSP who had been admitted or visited outward of the Department of Pediatrics, Pusan National University Hospital from 1995 to 2000. The cases that the onset of purpura preceded or coincided that of abdominal pain were defined as purpura-positive group. The cases that the onset of abdominal pain preceded purpura more than 1 week and purpura was not presented till diagnosed as HSP gastroenteropathy were defined as purpura-negative group. We compared and analyzed the clinical features of the two groups by reviewing the medical records retrospectively. To ensure the diagnosis of HSP gastroenteropathy, we conducted upper GI series, abdominal ultrasonogram, abdominal CT, endoscopy and/or skin biopsy. Results: The number of cases of purpura-positive group and purpura-negative group were 72 and 10, respectively. There is no difference between two groups in the incidence of clinical symptoms and laboratory findings. Children with HSP gastroenteropathy had characteristic erosive or ulcerative lesions in the stomach or duodenum on esophagogastroduodenoscopy, or mural thickening of the small bowel on abdominal ultrasonogram, CT or upper GI series. Skin biopsy revealed leukocytoclastic vasculitis in 3 of them, although biopsy specimen was taken from any areas of normal- appearing skin. In purpura-negative group, 9 patients improved by steroid therapy. Conclusion: In purpura-negative group, there is no diagnostic feature on the laboratory findings and clinical features. Therefore, to diagnose HSP gastroenteropathy in patients with abdominal pain in the absence of the characteristic rash, careful observation of clinical features and laboratory data, and prompt application of available diagnostic tools such as gastrointestinal endoscopy, radiologic study and skin biopsy are recommended. Early use of corticosteroid may reduce the suffering in these patients.

• Journal of Korean Academy of Nursing
• /
• v.25 no.3
• /
• pp.510-537
• /
• 1995

Human health is an integral part of experience in the process of Human Becoming. Through continual interaction with the environment human beings freely choose experience and develop as responsible beings. The process of the health experience of patient with terminal cancer is a unique. he objective of this study is to understand the lived experience of patients with terminal cancer in order to provide basic information for nursing care in the clinical setting and to develop a theoretical background for clinical practice. This study is to de-scribe and define the lived experience of patients with terminal cancer in order to provide a foundation for nursing research and education. Data collection has been done between December 1993 and November 1994. The subjects included five persons -four females and one male : one who was in her sixties, one in his fifties, two in their forties, and one who was in her thirties. The researcher has met with these patients 35 times, but at eight times the patient was in a stuporous condition and not able to participate, so these were not included in the data analysis. Parse's "Human Becoming Methodology", an existential phenomenological research methodology is used for this study. Data has been collected using he dialogical engagement process of "I and You", the participant researcher and the participant subject. Dialogical engagement was discontinued when the data was theoretically saturated. Data was analyzed using the extraction - synthesis and heuristic interpretation. The criteria of Guba and Lincoln(1985). and Sandelo wski(1986) : credibility, auditability, fitness and objectivity were used to test the validity and reliability of the data. The following is a description of the structure of the lived experience of patients with terminal cancer as defined by this study : 1. Structure : 1) Suffering through the reminiscence of past experience 2) The appearance of complex emotions related to life and connectedness 3) The increasing importance of significant people and of the Absolute Being 4) The increasing realization of the importance of health and belief 5) Desire for a return to health and a peaceful life or for acceptance of dying and a comfortable death In summary the structure of the lived experience of these patients can be said to be : suffering comes through reminiscence of past experience, and there are complex emotions related to life and connectedness. Significant people and the Absolute Being become increasingly important along with a realization of the importance of health and faith. And finally there is a desire for either a return to health and a peaceful life or for the acceptance of dying and a comfortable death. 2. Heuristic Interpretation : Using Parse's Human Becoming Methodology, the structure of the lived experience of patients with terminal cancer identified in this research is interpreted as. The lived experience of patients with terminal cancer involves the solving of past conflicts, and the experience of the healing and valuing of sorrow and pain. Through the relation of life and health, and the complex emotions that arise, the lived experience of revealing - concealing is of paradoxical emotions. The increasing importance of significant others and of the Absolute Being shows Connecting and Separating an on- going process of nearness and farness. Revision of thoughts about health and faith is interpreted as transforming and desire for restoration to health and a peaceful life or acceptance of dying and a cowfortable death, as powering. In summary, it is possible to see, in the lived experience of patients with terminal cancer, the relationship of the five concepts of Parse's theory : valuing, revealing -concealing, connecting-separating, transforming, and powering. From Parse's theory, the results of this study show that meaning is related to valuing, rhythmicity to revealing-concealing and connect-ing-separating, and cotranscendence to transforming and powering.

• Journal of Chest Surgery
• /
• v.40 no.5 s.274
• /
• pp.369-375
• /
• 2007

Background: Patients suffering with pectus carinatum complain of cosmetic problems when they stand and this in spite of wearing cloths. The standard surgical treatment of pectus carinatum is resection of the deformed cartilages, but the wide operative scar, post-operative pain and complications related with such an operation can occur. Therefore, we have peformed compressive brace therapy as a non-operative treatment for pectus carinatum and we observed the effects and the efficiency of this treatment. Material and Method: From January, 2001 to December, 2006, 109 patients wore the compressive brace for all day. The degree of satisfaction was evaluated after $6\sim9$ months of wearing the compressive brace. The degree of satisfaction was evaluated by a score of from $1\sim4$. A score of 1 was assigned when the status was worse, 2 when it was the same, 3 when there was partial improvement and 4 when remarkable improvement was observed. The degree of satisfaction was assessed subjectively by the parent if the patient was a child younger than middle school age, and the patients older than middle school age assessed the score themselves. Result: The mean score of the overall degree of satisfaction was $3.93{\pm}0.33$. Recurrence of pectus carinatum after removal of compressive brace occurred in 6 patients (5.5%) of the total 109 patients. But 4 patients of the total 6 recurred patients stopped wearing of compressive brace against our advice. The 6 recurred patients were re-corrected by re-wearing the compressive brace within 3 months after they originally removed the compressive brace. The complications were discomfort with initially wearing the compressive brace, which occurred in all patients, skin rash due to the compressive brace for 76 patients (69.7%) and skin discolorization with excessive compression for f6 patients (5.5%). The skin rash and discolorization returned to normal within a few months after removal of the compressive brace. Conclusion: This study demonstrated that non-surgical treatment with using the compressive brace for patients with pectus carinatum was effective, and especially for children and teenagers. Non-surgical treatment with using a compressive brace would be helpful for the patients suffering with pectus carinatum and who dislike surgical operations because of their fear about general anesthesia and operation-related complications. Yet long-term follow up is necessary to accurately evaluate the effectiveness of this compressive brace and the recurrences after removal of the compressive brace.

• Korean Journal of Hospice Care
• /
• v.7 no.1
• /
• pp.29-45
• /
• 2007

People in the end of life and their families suffer in their physical disease and other aspects as a whole person. They need hospice care to palliate their total suffering in physical, emotional, social and also spiritual aspect through professional hospice team. To care their whole personal needs, hospice team must be a multi-discipline team which consists of medical doctors, nurses, social workers, pastors and volunteers. Recently those who die in hospice palliative care unit have trend to increase more than in home year by year. So it is necessary to develop the nursing intervention program to be performed by multi-discipline team approach for in-patient of hospice palliative care unit. The purposes of this study were to develop of wholistic hospice nursing intervention program for inpatient of hospice palliative care unit. The subjects of study were collected from 30 patients those who were over 18 years old and admitted in hospice palliative care unit of S hospital in P city with agreement in hospice palliative care in their terminal disease. The period of data collection was from December 15, 2003 to March 15, 2004. The result were as follows : 1. The result of Wholistic Hospice Nursing Program's development was as follow : A Wholistic Hospice Nursing Program was developed by me in this study is one of the service program for hospice palliative care unit. It was named as ‘Rainbow Program’ to be approached easily by hospice patients. The purposes of it are to improve the quality of life of the terminal patients with their dignity, to help them live in abundant and meaningful in their lives, to care them in peaceful in dying process with understanding them in whole personal, and also to palliate the grief and suffering of the bereaved. It was provided by hospice professionals(nurses, medical doctors, social worker, pastors, art therapists) and volunteers those who were educated in hospice for multi-diciplinary team approach to collaborate with each role play I 20-30 minuters of each through visiting their rooms individually and a place of hospice palliative care unit of S hospital in P city. The subjects of it were the terminal patients those who admitted hospice palliative care unit and their familes. with agreement in hospice palliative care in their terminal disease. The characteristics of it were multi-disciplinary team approach, whole personal care, individual care and total care according to their needs in their condition. The contents of it were pain control, symptom control, counseling patient, counseling family, hair cutting, hair shampooing, bed bath, recreation, taking a walk, event of culture(screen, recital, festival of praises, exhibition and so on), pastoral counseling, ritual service in bed, praying, service in bed, sing a worship praise, listening to the music, sharing remembrance of life, individual visiting music service(sing and praying), meditation Bible, art therapies(dance and drawing), social worker's counselling, confessing and sharing love and thanksgiving. The experimental group subjects participated in Wholistic Hospice Nursing Program which takes 120 minutes per session, total 10 sessions(total 1,200 minutes) altogether. In conclusion, this Wholistic Hospice Nursing Intervention can be used actively for whole personal well-being of the patients in hospice palliative in hospice palliative care unit and also applied in hospice practice as an useful model of multi-disciplinary team approach by hospice professionals.

• Journal of Hospice and Palliative Care
• /
• v.2 no.1
• /
• pp.16-22
• /
• 1999

Purpose : Today, people usually die in hospitals and institution-sterile and strange, and equipped with a complex range of technology capable of supporting and prolonging life, frequently only biological one, when a return to health and vitality is no longer possible. Consequently, 'dying with dignity' has become a slogan of opposition to useless and degrading prolongation of life when a patient's organ, though still minimally functional, can no longer support or permit the exercise of self-fulfilling personal control over life's events. Dying with dignity, however, means entirely different things to different people. This study is to investigate the college students' attitude on terminal care and passive euthanasia. Methods : During June 1997, 337 college students participated in this study by responding to the pre-made questionnaire. It deft with the attitude to passive euthanasia, hospice, the most suffering fear facing the death, the preferred place and person to be with if dying. Results : 63.2% of subjects agreed to passive euthanasia. Only 14.2.% of college students can explain the concept of hospice, exactly They got the information about hospice by TV(43%), book(33.5%), religious group(12%) in order. The preferred death place was home(76.6%) and hospital(11.9%) in order. The Most suffering fear facing the death were about unknown(41.5%), loosing colleague(13.6%), pain(11%), isolation(6.5%) in order. Conclusion : About two-thirds of college students agreed to passive euthanasia. But euthanasia is dangerous and unnecessary. We should vigorously promote programmes of education in hospice and palliative medicine and care.

• Journal of Venture Innovation
• /
• v.1 no.1
• /
• pp.129-143
• /
• 2018

When consulting with senior service user or his or her family members, employees of senior welfare facilities face a vertical relationship due to age rather than a horizontal relationship. Despite few cases reported, service users and the families afflict physical and mental pain on the employees through irrational demands, physical abuses, and verbal abuses. In particular, the Korean society has advocated the notion of respecting elders and thus emphasized members of society to provide unconditional support to those of old age. In reality, however, people who work at senior welfare facilities report the difficulty of providing supports to heavy demands in selfish complaints that are often impossible to fulfill. Starting from May 2018, there has been a petition to the Korean Blue House, seeking protective measures for 'Senior welfare facility professions who are exposed to violence'. The study conduct researches on the effect of job stress on the organizational commitment for senior welfare facility employees from suffering emotional labor. Furthermore, it also aims to point the difficulties that the professions face and the solutions that alleviate the conflicts between the rights of services users of senior welfare facilities and its staffs. The study surveyed 178 staffs who work in senior welfare facilities in Seoul and Gyeonggi Province as its research method. The collected data was analyzed by using IBM SPSS Statistics 24.0 to derive the general characteristics of the sample, reliability, feasibility analysis, correlation analysis, and verification of the research hypothesis. The study was able to conclude the following: First, the frequency of emotional expression of senior welfare facility staffs had negative(-) influences on job stress. Second, the incongruity of emotions of senior welfare facility staffs had negative(-) influences on job stress. Third, the incongruity of emotions of senior welfare facility staffs had negative (-) influences on job stress. Fourth, the job stress showed mediating effects between emotional labor factors and organizational commitment

• Journal of Korean Public Health Nursing
• /
• v.9 no.2
• /
• pp.17-32
• /
• 1995

The purpose of this study is to promote health for young female workers. It is based on questionnaires collected from 215 female workers in Incheon area. This study includes health condition (fatigue scores), occupational disease, knowledge of abused drugs and the actual condition of drug use. The results are summerized as follows: - $47.4\%$ visited their health center and were treated with diseases like cold and headache $(34.9\%)$, gastroenteric disease $(6.5\%)$, trauma $(7.9\%)$ and chronic disease such as diabetes and hypertension $(3.3\%)$ - $44.7\%$ received regular health education and $4.7\%$ among them received education on abused drugs. - $20.5\%$ were suffering from work related diseases such as gastroenteric disease, headache, trauma, repiratory disease, skin problem, arthritis, low back pain, shortsightness and tuberculosis. - Total mean fatigue score as an indication of health status was $9.0\pm5.4$ points out of 30 points. Physical mean score (group I) was $3.92\pm2.2$ points and psychological mean score was $2.5\pm2.3$ points and neurosensory mean score was $2.6\pm2.1$ points out of each 10 points. - They recognized analgesics $(55.0\%)$ and the next are laxatives $(49.8\%)$, inhalants $(40.0\%)$, narcotics $(24.2\%)$, stimulants $(24.0\%)$, antihistamines$(5.9\%)$, diuretics $(3.0\%)$, tranquilizer $(2.4\%)$ and sedatives $(1.4\%)$ - They used analgesics $(37.2\%)$ the most and then laxatives $(6.0\%)$, stimulants$(5.6\%)$, diuretics $(1.9\%)$, antihistamines$(0.5\%)$, And nobody used tranquilizer, sedatives, narcotics and inhalant. - The relationship between career, drug abuse education, health center utilization and and the actual condition of drug using was examined. The longer the career and the more educated with drug abuse, the less drug used. And those who utilized health center rarely used more drugs. - The relationship between career, health center utilization, the score of fatigue and use of analgesics was also examined. Those group who have a longer career above 3 years and the group who have never used health center used more analgesics. And the group of fatigue score above 11.0 points used a little more analgesics than the other group. These results indicate that analgesics are the most frequent used drugs among female workers. Those analgesics such as geborin, penzal, saridon, aspirin, tyrenol should be used properly. These basic data is submitted for the education and consultation which are carried out by industrial nurses for promoting health of industrial workers.

• Journal of Acupuncture Research
• /
• v.24 no.4
• /
• pp.209-223
• /
• 2007

Objectives : Facial Nerve Paralysis is one kind of common diseases and it can be treated by natural therapy and the efficiency of treatment is relatively high. In clinical trial, it is not difficult to find patients who were not completely recovered from Facial Nerve Paralysis, so the symptoms are fixed permanently. This leads many doctors and patients to have interests in the progress and prognosis of the disease, so this study was to analyze clinical prognosis factors and verify the effects of Electrodiagnostic Test. Methods : The 378 subjects were chosen from 987 patients who were suffering from Peripheral Facial Palsy, diagnosed with Bell's palsy and Ramsay Hunt Syndrome and had admission treatment. They got Oriental-Western Medicine Treatment within two weeks after outbreaks of the disease and treated at least over 3 weeks using Oriental-Western Medicine Treatment. Results : 1. There was a significant difference in the results of treatment according to gender, age, types of Facial Palsy, existence of Post Auricular Pain, existence of Labyrinth Symptom, HBGS, and existence of onsets of recovery as clinical prognosis factors of Peripheral Facial Palsy, However, a statistically significant difference was not shown in the results of treatment according to the position of Facial Palsy(left or right), existence of a relapse, and diabetes, hypertension. 2. As a result of overall treatment, 77.2% of patients were recovered almost entirely and 22.8% were not, and the quelae of incomplete recovery were Synkinesis, facial contracture, facial spasm, crocodile tears and scheroma in order of frequency. 3. The results of electrodiagnostic test represented useful correlation to predict the final effects of treatment. Conclusion : Based on the above results, the prognosis factors, the degree of recovery, and the sequelae of incomplete recovery were analysed and the effects of electrodiagnostic test was verified.