• Title/Summary/Keyword: pain and suffering

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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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Oral Health Status and Dental Treatment Need of Liver Transplant Candidates (간 이식 예정 환자의 구강건강상태 및 치과치료 요구도에 관한 연구)

  • Park, Tae-Jun;Kho, Hong-Seop
    • Journal of Oral Medicine and Pain
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    • v.34 no.1
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    • pp.1-9
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    • 2009
  • Liver transplantation is definitive treatment for the patients suffering from hepatitis, severe liver cirrhosis and liver cancer. In these patients, systemic infections under immunosuppression may occur easily. Therefore, primary object of dental treatments before liver transplantation is absolute removal of oral infection source. In addition, comprehensive dental management plan is essential for success of liver transplantation. The present study has been performed to investigate decayed, missing and filled permanent teeth index(DMFT index), degree of oral hygiene, past medical history, need of dental treatment, completion of dental treatment need and time interval between dental visit and operation date of liver transplantation in liver transplant candidates. Obtained results were as follows; 1. Decayed teeth of the patients were 2.68, missing teeth were 4.02 and filled teeth were 3.42. DMFT index was 10.12. 2. Twenty percents of patients showed moderate to severe food impactions, 42.2% of patients had moderate to heavy calculus and 37.8% of patients displayed gingival inflammation with swelling. 3. Patients needed periodontal treatments more than any other dental treatments. Periodontal treatments were needed for 88.9% of patients, operative & endodontic treatments were 46.7% of patients and 33.3% of patients needed for oral & maxillofacial surgical treatments. 4. Among 90 patients, time interval between scheduled operation date of liver transplantation and dental visit was within 2 weeks for 32.2% of patients, within 1 week for 20.0% of patients. In conclusion, most liver transplant candidates needed dental treatments for removal of potential infection sources. However because of insufficient interval between dental visit and operation date, they had taken liver transplantation procedures without comprehensive dental management. Development of preventive and comprehensive dental management program is mandatory for these patients. Cooperative interdisciplinary management will play a positive role for successful liver transplantation.

Usefulness of a Alvarado Scoring System for the Diagnosis of Acute Appendicitis in Children (소아 충수돌기염 진단에서 Alvarado Scoring System의 유용성)

  • Yang, Eun Seok;Yoon, Sung Kwan;Kim, Eun Young;Rho, Young Il;Park, Sang Kee;Park, Yeong Bong;Mun, Gyeong-Rae
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.7 no.1
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    • pp.1-7
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    • 2004
  • Purpose: Alvarado scoring system was evaluated regarding its usefulness for the early diagnosis of acute appendicitis in adult and in reduction of the incidence of negative appendicectomies. To evaluate the accuracy of diagnosing appendicitis using the Alvarado score in children. Methods: Prospectively, we surveyed 122 patients (male 67, female 55) suffering from abdominal pain, who had visited to the emergency department of Chosun University Hospital from June 2002 to May 2003. The Alvarado score has been computed from the white blood cell count, neutrophil count, body temperature, resistance in the right lower quadrant, length of symptoms, nausea and vomiting. Each patient was evaluated by a pediatric resident and then by a general surgeon independently. Results: Out of 170 total children who visited to the emergency department due to abdominal pain, 122 patients were associated with appendicitis. A total of 122 patients (67 male and 55 female) were visited to the emergency room with suspected appendicitis. From 105 operated patients, 92 (87.6%) were diagnosed acute appendicitis and erronous diagnostic rate was 12.4%, pathologically. Mean alvarado score of appendicitis group was $5.40{\pm}1.24$ whereas those of non-appendicitis group was $3.73{\pm}1.82$ (p<0.05). From 6 Alvarado score high sensitivity (86.4%) and high specificity (80.0%) were observed. Sensitivity of ultrasonography or computed tomography was 92.5%. Conclusion: We found that Alvarado score system is a noninvasive, safe diagnostic method, which is simple, reliable and repeatable. Alvarado score is useful system for a first, rapid and economic evaluation for the appendicitis in children.

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A Study on the Ethics of Reproduction in Alain Resnais's Film -Focusing on , , and (알랭 레네 영화로 본 재현의 윤리 연구 -<밤과 안개>, <히로시마 내 사랑>, <뮤리엘>을 중심으로)

  • Choi, Eun-Jeong
    • Journal of Popular Narrative
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    • v.25 no.1
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    • pp.393-425
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    • 2019
  • This paper focuses on Alain Resnais's representative works (1955), (1959), and (1963), and analyzes how he implements a representation of memory though cinematic apparatus. These three films deal with horrific memories that seem impossible to reproduce aesthetically such as the Holocaust, the Hiroshima Atomic Bomb, World War II, and the war in Algeria. The reappearance of events that stripped humans of even their minimum dignity can naturally be associated with ethical issues. These events can never be reproduced because they cannot be explained in the human language. It is also impossible to reproduce in a way that doesn't invade other peoples' sufferings, nor displays the pain of others as spectacles. Alain Resnais was a director who realized that if factual representation was not possible from the beginning, truthfulness would have to be approached through cinematic form. Therefore, he tries to overcome these problems through cinematic forms. First, he shifts to action films to avoid the obscenity of documentary. shows the records of camps captured by German forces in the past, while shows the pain of others in a fictional form of representation. Next, he describes how the trauma affects the identity of the main character through a flashback in , but also shows a main character who is experiencing trauma without a flashback in Flashbacks have the effect of showing the effects of trauma on the main character, but at the same time they involve the obscenity of enjoying the suffering of others. Nonetheless, the absence of flashbacks highlights the impossibility of representation. This is because it is not silent in the impossibility of representation but is constantly approaching. The attitude that repeatedly circles around impossibility is an ethical form that maximizes the impossibility of representation. In conclusion, this is the ethics of representation that Alain Resnais showed in his films.

Epidemiology and Clinical Manifestations of $Henoch-Sch\"{o}nlein$ Purpura in Children (소아 $Henoch-Sch\"{o}nlein$ 자반증의 역학 및 임상양상)

  • Kim Se-Hun;Lee Chong-Guk
    • Childhood Kidney Diseases
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    • v.7 no.2
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    • pp.166-173
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    • 2003
  • Purpose : The cause and pathogenesis of $Henoch-Sch\"{o}nlein$ purpura has been studied for many years but the results are disappointing. Recently the hypothesis that abnormalities involving the glycosylation of the hinge region of immunoglobulin Al(IgAl) may have an important role in the pathogenesis of $Henoch-Sch\"{o}nlein$ purpura is being approved. $Henoch-Sch\"{o}nlein$ purpura is the most common vasculitis Ihat affects children and the prognosis is good. But if kidney invovement occurs, the course may be chronic and troublesome. So we evaluated children with $Henoch-Sch\"{o}nlein$ purpura especially from the point of epidemiology and clinical manifestations. Methods : Investigation of 124 children who were diagnosed with $Henoch-Sch\"{o}nlein$ purpura at Inje University Ilsan Paik Hospital from December 1999 to July 2003 was performed retrospectively through chart review. Efforts were made to get informations about the profile, epidemiology, clinical manifestations, progress of the disease and recurrence rate of patients. Results : The patients were 69 boys and 55 girls, with a mean age of $6.1{\pm}2.7$ years at the time of data collection. The male to female ratio was 1.25 : 1. The occurrence rate was much higher in autumn(from September to November, 31.5%) and winter(from December to February, 28.2%) than in spring and summer, with a peak in November. Joint involvement was shown in 66.9% of patients mostly on the foot/ankle(75.9%), knee(39.8%). Seventy(56.5%) out of 124 patients had abdominal pain and 10 patients(8.1%) showed bloody stools. Renal involvement was observed in 24 patients(19.4%) after 21.1 days on the average. IgA was elevated in 10 of 21 patients(47.6%). $C_3$ and $C_4$ levels were normal in 40 of 49 patients (81.7%) and 47 of 48 patients(97.9%), respectively Antistreptolysin-O(ASO) titer was elevated over 250 Todd units in 29 of 62 Patients(46.8%). Mycoplasma antibody titer was elevated in 21 of 49 patients(42.9%) equal or greater than 1:80. Radiologic studies were peformed in 23 patients. Seven patients(30.4%) showed bowel wall thickening and one of them received intestinal resection and anastomosis operation due to terminal ileum necrosis. Eighty four patients took steroid 1.4 mg/kg/day in average. Recurrence rate was 2.5 in 37 patients(29.8%). Conclusion : $Henoch-Sch\"{o}nlein$ purpura in childhood appears most in about 6 years of age. The occurrence rate is much higher in autumn and winter relatively. Diagnosis can be made through the perspective history taking and the inspection of clinical manifestations, but the laboratory findings are not of great help. A small portion of the patients might show abdominal pain or arthritis before purpura develops, therfore various diagnosis can be made. Radiologic evaluation should be performed to avoid surgical complications in cases accompanying abdominal pain, and long term follow up should be needed especially in patients suffering from kidney involvement. In about 30% of the patients $Henoch-Sch\"{o}nlein$ purpura would recur. Steroid can be used safely without side effects.

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A Study on the Blood-Letting Therapy in Elementary Questions (("황제내경소문(黃帝內經素問)" 중(中) 사혈(瀉血)에 관한 연구(硏究))

  • Lee, Jun-Geun
    • Journal of the Korean Institute of Oriental Medical Informatics
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    • v.14 no.1
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    • pp.19-42
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    • 2008
  • Blood-Letting Therapy is a rational and ecological medical treatment by which we can heal most of the diseases by removing the static blood which precipitates in the blood vessel and blocks the flowing of blood. And the static blood is the generic term for the injurious, bad, dead and precipitated blood which is blocked the capillary vessel. The Yellow Emperor's Canon of Internal Medicine says that "the patient is treated with drugs internally and stone acupuncture externally. "In the old texts, the blood-letting therapy is mentioned as blood-letting, network vessel pricking, bloodletting, pricking, and arousing pulses etc and it is noted down as the method of network vessel pricking in 'On the Application of Needles' of Spiritual Pivot. Nine-pricking therapy, twelve-pricking therapy and five-pricking therapy are recorded in the methods of network vessel pricking and among them, the method of squeezing blood after pricking the affected part is explained as the network vessel pricking. There are four methods of network vessel pricking, pricking, picking, cluster needling and scatter-pricking and they are fluidly applied to the various symptoms of diseases. In 'On Discriminative Treating for Patients of Different Regions' in Elementary Questions, Ki-baek emphasizes "most of the local people, there are black in skin and loose in striate, and their diseases are mostly of carbuncle kind. It is suitable to treat the disease with stone therapy to prick with stone, so the stone therapy is transmitted from the east. "And in 'On the Corresponding Relation Between the Eum and Yang of Man and All Things' in Elementary Questions, when the Emperor asked Ki-Back, he answered "sthenia means the sthenia of evil, and deficiency means the deficiency of healthy energy. When the blood is sthenic, the evil should be discharged by pricking when out letting the blood; deficiency of vital energy is the asthenia of channels and network vessels, so the energy should drain from the channel which is not deficient, to replenish. "And in this case we can use the methods of 'Breaking out the static bloods', 'driving out the static bloods', blood-letting'. With this we can infer that the blood-letting therapy is made use of the important medical treatments from the ancient times. Especially in referring to the principles of treatment in The Yellow Emperor's Canon of Internal Medicine, it mostly alluded to acupuncture therapies and only eleven times to medicinal treatments. This is to verify that the blood-letting therapy formed the foundation of the medical art. In Dong's Therapy of Acupuncture-Moxibustion and Bloodletting, Dong Kyeong-Chang gave emphasis on the points that there must be extravasated bloods without exception in the serious illnesses which is old, unnatural, accompanying acute pains and so we can revive our body‘s sprit by circulating 'gi' and static blood piled up in the network vessel, regulating the weakness and strength, and controling the disharmony of the internal organs. The blood-letting therapy has effect on the orifice in emergency, such as fore draining, freeing network vessels, harmonizing gi and blood, relieving pain, dispersing swelling and concretion, sedation, resolving toxin as well as strengthening the heart, relieving itching. So it has distinguished effect on all kinds of medical treatment to the modern people. But by the change of social customs and the confucianism of confucius - it is widely spread on the period of North and South Dynasties, 'Wi' and 'Jin' in china and the period of the Three States in korea - The blood-letting therapy which was regarded as the most important medicinal treatment withered rapidly. And Confucius accentuated the importance of our body and all its members, loyalty and filial piety and banned any damage of our body under no circumstances. As a result of it, the therapy of blood-letting had a rapid decrease and barely kept itself in existence in both countries. What is worse, at the period of Japanese colonial rule of korea and our nation's founding of early stage, it has been withered by the high-handed policy to change Oriental Medicine into modern medical science. So the therapy of blood-letting barely kept itself in existence in some Buddhist temples. Another case, it has handed down as a old-fashioned quick fix in folk remedies. But all kinds of the contamination of heavy metals and the misuses of antibiotics are widely spread nowadays, which increased diseases of adult people and incurable diseases as modern society unavoidably made its way into a highly industrial society. To make us more miserable, the western medical science - the antibiotics and surgical operation medical science - already reveals itself into a limit. The necessity of a new medical science which can give a security to the patients who are suffering from the diseases of adult people and the incurable diseases is especially come into the force nowadays. In view of the results after bibliographically studying on the blood-letting Therapy in Elementary Questions of the Yellow Emperor's Canon of Internal Medicine, the blood-letting therapy has acted for the important Oriental medicinal science and has been clarified the prominent effects on the diseases of adult people and the incurable diseases. So it is regarded as an appropriate thing that we lay out a determined theory of the blood-letting therapy and of course prevent the unwanted side effects from inappropriate medicinal treatments, and make full use of clinic by elevating the curative value and that we win back our self-respect of medical treatment which is dominated from the western medical science and ultimately contribute to national medical welfare.

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The Legitimate and Eldest Son Complex in Changseongameirok (<창선감의록>의 적장자 콤플렉스)

  • Jo, Kwangkuk
    • Journal of Korean Classical Literature and Education
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    • no.38
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    • pp.65-101
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    • 2018
  • In the late Joseon Dynasty, patriarchal ideology became central to the family and the clan, and once again became acutely felt with "the familism of clan rules that centered around a legitimate and eldest son." The establishment of the family-clan system, though somewhat complex, was largely aimed at the family line of "a paternalist-a legitimate and eldest son." The trend was not limited to a particular family, but rather, was a historical and social trend. Changseonggameirok showed how to solve the family crisis by setting up a problem for the next generation's patriarch. This paper tries to explain the issue of Hwachun's complex as the legitimate and eldest son complex. First, it suggests that Hwachun's complex is as universal as the Cain complex, also known as the eldest son complex, and that Hwachun's complex is a special instance of the legitimate and eldest son complex in Changseonggameirok. Next this paper studies the aspects of Hwachun's legitimate and eldest son complex combined with Mrs. Sim's complex, as well as her daughter-in-law's complex, and eventually tracks the development of the family-clan complex. As a result, we've come to a new conclusion that the legitimate and eldest son complex was found in Changseonggameirok for the first time in Korean literary history. This paper also examines the fact that when the legitimate and eldest son complex was transferred to Hwajin, it became a family complex that Hwajin had to contend with; this paper tracks the process wherein Hwajin's filial piety solved the legitimate and eldest son complex. As a result, we realized that Hwajin's filial duty and brotherly love went beyond his feelings for Mrs. Sim and Hwachun, and supported the substantiation for "the familism of a clan that is based on rules of the legitimate and eldest son" in the course of public opinion. However the familism of these rules was not embodied in the absolute; in the royal family, for example, it was rather flexibly implemented when the characters admitted to breaking the law. In addition, this paper provides the room for a critical reading of Changseonggameirok, reflecting back on the underlying guilt and psychological pain of the characters who are affected by the particular rules, and concluding that guilt and suffering are fundamentally insoluble. This is because the two ideas, "the legitimate and eldest son complex" and "the familism of a clan rules centered on a legitimate and eldest son" are two sides of the same coin.

Disaster : Concepts and Responses in Prehistoric Times from the Viewpoint of Analytical Psychology (선사시대 원시인의 재난과 대처양식에 대한 분석심리학적 연구 : 신화와 암각화를 중심으로)

  • Chan-Seung Chung
    • Sim-seong Yeon-gu
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    • v.32 no.2
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    • pp.73-121
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    • 2017
  • Disaster is externally an incident that causes enormous damage to society and humanity. Disaster also internally stimulate a variety of personal and collective complexes in the human mind. The sinking of Sewol Ferry in 2014 was a disaster that took away countless lives. People not only in South Korea but around the world were deeply affected by the incident. While directly taking part in disaster mental health support and meeting with people who were sunk in sorrow and helplessness and feeling the collapse of conceit against modern technological civilization, I realised the need to conduct study and research on the conscious and unconscious response from the viewpoint of analytical psychology. This research investigates the response and management of disaster in prehistoric times mainly through myths and petroglyphs. This study aims to consider the problems and improvements of disaster response in the modern times by finding the distinct cultural characteristics and the universal, fundamental, and archetypal human nature inherent in the concepts of disaster and responses to disaster and discovering their meaning and wisdom. Creation myths around the world show that in the beginning there was a disaster as part of the universal creation. Humanity has understood disaster as a periodic renewal of the world by the oppositeness between destruction and creation and had the idea that violation of taboo to be the cause of disaster since prehistoric times. Disaster could be interpreted as the intention of the Self that renews the fundamental consciousness through the externally appearing destructive action. Various rituals performed by man on earth renovates the human consciousness during a mental crisis situation, such as a disaster, and corresponds with the unconscious to create an opportunity for psychological regeneration that seeks harmony. Modern society has neglected the importance of internal dealing and the suffering human soul and concentrated on the external, technological and administrative actions related with disaster response. We cannot determine the occurrence of a disaster, but we can determine how to deal with the disaster. While developing external disaster response, we need to ponder on the meaning of disaster and conduct internal disaster response that care for human mind. Through this, we will understand the meaning of pain and have renewed mature psyche.

The Effect of Intradermal Acupuncture on The Patients suffering from Insomnia after Stroke (중풍환자(中風患者)의 불면증(不眠症)에 피내침(皮內針)의 유효성(有效性) 및 적응증(適應證) 평가(評價))

  • Lee Sang-Ho;Kim Eun-Ju;Kim Lee-Dong;Yun Sang-Pil;Lee Cha-Ro;Hong Jin-Woo;Jeong Dong-Won;Moon Sang-Kwan;Cho Ki-Ho;Kim Young-Suk
    • The Journal of Internal Korean Medicine
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    • v.25 no.1
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    • pp.138-148
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    • 2004
  • Objective : Insomnia is the disorder of initiation or maintenance in sleeping that results in daytime sleepiness and dysfunction, and it arises from multiple psychological, physiological and environmental factors. A number of stroke patients suffer from insomnia are classified as sleep disorder patients with physical illness. In addition, insomnia may have profound deleterious effects on the natural course of stroke. We are to assess the effectiveness of intradermal acupucture on stroke combined with insomnia. Methods : We recruited hospitalized patients with insomnia after stroke. Then, the subjects were allocated into a treatment group and a control group by randomization. The treatment group received intradermal acupuncture therapy at He-7(神門), EH-6(內關) correctly. However in control group, intradermal acupuncture were just attached to He-7(神門), EH-6(內關) without insertion. Treatment over time at first day and second day a various indexes were repeatedly checked such as sleep latency, total sleep time, sleep quality, condition on awakening, ability of concentration, morning sleepiness, Insomnia Severity Index, and Athens Insomnia Scale. In the second analysis, we divided the treatment group into a response and a non-response group by their response to intradermal acupuncture. With the acupuncture treatment, accompanied symptoms were checked Results : Among thirty two subjects, two of them were dropped out: One complained the pain from needle insertion, and the other underwent the change of his herbal medication. At baseline investigation with the residual 30 subjects, the control and the treatment group were assessed to have an equal comparability. In the treatment group, sleep latency, total sleeping time, a number of awakenings, sleep quality and ability of concentration showed improvement significantly compared with the control group. The non-response Group showed symptoms such as nausea and halitosis, belching and acid regurgitation, abundant expectoration, while Responder Group showed palpitation, oppressed feelings in chest and sleep disorder. Conclusions: The result of this clinical study suggests that the intradermal acupuncture at He-7(神門), EH-6(內關) is one of the effective treatments for the insomnia after stroke.

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Problems of the Current Referral System of the Terminal Cancer Patients in Korea (말기 암 환자의 완화 의료 연계 시스템의 문제점과 개선 방안)

  • Yun, Cho-Hee;Lee, Ju-Young;Kim, Mi-Ra;Heo, Dae-Seok
    • Journal of Hospice and Palliative Care
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    • v.5 no.2
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    • pp.94-100
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    • 2002
  • Purpose : The system to refer terminally ill patients to palliative or hospice care which ultimately give them emotional, psychological, and social support hasn't been fully developed and organized yet in Korea. The controversies concerning the current referral system are being analyzed to present the improvements. Methods : The questionnaires were asked to be filled out by family members of the 76 patients by phone interview, who were referred from the Seoul National University Hospital between April, 2001 to March, 2002. They were referred to the 35 palliative and hospice care-giving institutes and hospitals which were given questionnaires by mail. Results : Of the 76 patient's family members, 47 family members accepted to answer the questionnaire. The first thing that influence to family to determine the referral of patient was solicitation of doctors or nurses (44%). And they were influenced by allowance for the other things such as convenience of patients (32%), convenience of caring family members (24%). In the course of determining of referred institutes, responders had considered at first their dwelling area, and then fame of institutes, the place which patent had wanted to spend last hours or which is suitable for patient's funeral service, and their financial condition. Thirty-eight the 47 responders answered that they had experienced difficulties in referral procedure. The worst among difficulties was unwanted discharge, and followings were lack of information about the referred institutes, concern about patient's suffering, resistance of patient and opposition of other family members, etc. Although they expressed dissatisfaction in referral procedure, most of them answered they had been satisfied with hospice care at referred institute after referral. Merits of referral which responders counted were patient's peace, caring family's comfort and reduced cost in order. Of the 35 referred institutes, 24 institutes' staffs responded mail questionnaires and sent to us in return. Except one responder, the rest approved the referral system and thought that referred patients had been satisfied with their hospice care. And they claimed that systemic support of the government is definitely necessary. The most difficult thing which responders experienced in care of referred patients was lack of information about patients. Besides, there were patient's financial problems, lack of understanding about their institutes of patients or family, and inconvenience of terminal cancer patient's pain control. Conclusion : The development and support of the organized referral system is needed to alleviate the troubles which patients, family members, and palliative or hospice institutes and hospitals have to face through the procedure of the referral.

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