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의료인의 호스피스가정간호에 대한 지식과 태도 조사연구

  • Kim, Ok-Gyeom
    • Korean Journal of Hospice Care
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    • v.2 no.2
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    • pp.28-48
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    • 2002
  • The advances of medical technologies have not only prolonged human life span, but also extended suffering period for the patients with incurable medical diseases. Hospice movement was developed to help these patients keep dignity and lives peaceful at the end of their life. Since many patients prefer to spend the last moment of life at home with their family, hospice home care has become very popular worldwide. The purpose of this study for a promotion and development of hospice home care in Korea, and features basic research on medical profession's knowledge and attitudes to hospice home care. This study which was used for the research questionnaires developed by the researcher that were answered by 100 physicians and 127 nurses in a general hospital. Data were collected from April 22, 2002 to May 10, 2002. The SPSS was used to make a comparative analysis of the frequency, percentile, ANOVA, and x2-test. The results of the study were as follows; 1.The medical profession showed high level of knowledge of the definition and philosophy of hospice. However, the physician group of the examinees showed insufficient knowledge of the fact that hospice care includes bereavement care, while the nurse group's response to the same question showed a significant difference(x2=10.752, p=.001). 2.For whom the hospice home care is provided, 95.6% of the respondents showed very high level of knowledge as answering that the incurable terminal illness patients and their families are the beneficiaries of hospice care. The respondents counted nurses, volunteers, pastors, physicians and social workers, consecutively, as hospice care providers. More nurse were positive toward pastors than physicians in regarding as a hospice care provider by a significant difference(x2=11.634, p=.001). 3.For when to referral hospice home care to the patients, only 34.2% answered that patients with less than 6 months of survival time are advised to receive hospice care, reflecting very low level of knowledge. 23.0% of the physicians and 48.0% of the nurses answered that hospice care should be provided when death is imminent, making a significant difference between the two groups(x2=6.413, p=.000). 4.To promote hospice activities, 87.2% pointed out that it is crucial to make general people, including those engaging in the medical field, more aware of hospice. 79.7% answered that a national hospice management should be developed, marking a significant difference between the physician group and nurse group(x2=10.485, p=.001). 5.Advantages of hospice home care are 87.2% responded that patients can have better rest at home receiving hospice home care. Economical merit was brought forward as one of the advantages also, where there was a significant difference between the physicians group and nurse group(x2=7.009, p=.008). 6.The medical professions' attitude to hospice home care are 92.8% of the physicians answered that they would advise incurable terminally ill patients to be discharged from hospital, with 44.3% of them advising the patients to receive hospice home care after leaving the hospital. From the nurses' point of view, 20.9% of the terminally ill patients are being referred to hospice home care after discharge, which makes a significant difference from the physicians' response(x2=19.121, p=.001). 7. 30.6% of physicians have referred terminally ill patients to hospice home care, 75.9% of whom were satisfied with their decision. Those physicians who have never referred their patients to hospice home care either did not know how to do it(66.7%) or were afraid of losing trust by giving the patients an impression of giving up(27.3%). 94.9% of the physicians responded that they would refer their last stage patients to a doctor who is involving palliative care. 8.Only 36.2% of nurses have suggested to physicians that refer the terminally ill patients discharged from the hospital to hospice home care. Once suggested, 95.8% of the physicians have accepted the suggestion. Nurses were reluctant to suggest hospice home care to the physicians, as 48.8% of the nurses said they did not want to. From the result of this study the following conclusion can be drawn, the medical profession's awareness of general hospice care has been increased greatly compared to the results of the previously performed studies. However, this study result also shows that their knowledge of hospice home care is not good enough yet. There is a need for high recommended that medical education institute and develop regular courses on various types of hospice care. Medical field training courses for physicians and nurses will be very helpful as well. It is also important to train hospice experts such as palliative physicians and develop a national hospice management urgently in order to improve the hospice care in Korea.

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Comparative Study on Social Support and Perceived Health between Obese Women and Normal Weight Women (비만여성과 정상체중 여성의 사회적지지 및 건강지각의 비교)

  • Kim, Jeong-Ah;Wang, Myoung-Ja
    • Research in Community and Public Health Nursing
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    • v.15 no.4
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    • pp.587-599
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    • 2004
  • Purpose: The purpose of this study is to compare abdomen-fat rate, life style and social-support between normal weight women and obese women. Method: 304 women objectives from their 30 to 59 years of age were selected living in Je-chon city, Chung-Buck province and their height and weight were measured from April 1st to June 30th, 2003. Data were classified into low-weight group ($18.5kg/m^2$), normal-weight group ($18.5{\sim}22.9kg/m^2$), over weight group ($23{\sim}24.9kg/m^2$), and obese group ($25kg/m^2$) following the Korean Conference of Obesity, 2001. in which 119 people in the normal weight group and 91 people in the obese group, i.e. total 210 people were analyzed in sequence. Using SPSS Win 10.1 Program, frequency and percentile, and by ANOVA, $X^2-test$ and t-test were treated. Results: The average age of obese women was 46.68 distributing 40.7% of forties and 39.6% of fifties while normal-weight women were average 41.73-year old distributing 53.8% of forties and 34.5% of thirties, which revealed aged in obese women. The body fat rate of obese women averaged $37.52{\pm}4.17%$, in which 98.9% of obese women and 21.0% of normal weight women with a more than 30% of body-fat rate resulted in a higher body-fat rate in obese women. The waists of obese women averaged $88.37{\pm}8.22cm$, in which more than 85cm showed in obese women of 68.2% and normal weight women of 7.6% indicating a higher waist-fat rate in obese women. The abdomen-fat rate of more than 0.85 of waist vs hip-fat showed 74.7% in obese women and 58.4% in normal weight women, indicating a higher abdomen-fat rate in obese women. Obese women and normal weight women showed significant differences in education level, number of children, religion, menstrual status, and mother's weight. Especially, obese women ate hotter or saltier food than normal weight women preferring meat. However, no significant differences appeared in marital status, social economic status. occupation. eating habits. smoking. drinking and physical exercise. Social support levels showed a lower rate in obese women than in normal weight women, indicating a statistically significant difference (p<.05). Observing areas of social support, obese women showed lower rates in attachment/intimacy, social integrity, opportunity of foster and confidence in value except help and instruction, which indicated a statistically significant difference (p<.05). Social support for obese women showed significant differences in age, education level, social hierarchy, religion and menstrual status. Obese women were more negative than normal weight women in health recognition, indicating a statistically significant difference (p<.01). Normal weight women showed higher health recognition when provided high social support and significantly low (p<.01) health recognition when provided low social support. However, there was no significant difference in health recognition in obese women whether high or low social support was given. The health recognition of obese women showed significant differences in age, education level, social hierarchy, number of children, menstrual status, physical exercise, eating habits, eating taste and preference of food. Conclusion: Obese women showed elder than normal-weight women, higher body-fat rate and abdomen-fat rate, lower social support, and a tendency to more negative health recognition. Therefore, providing weight-control programs for the treatment of obesity and prevention of recurrence for obese women to prevent progressing to adult disease and promote a healthy life, we suggest that better eating habits and the encouragement of regular physical exercise should be included, as well as total approachment on change of health recognition and social support would be needed.

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Safety Assessment of Estimated Daily Intakes of Antioxidants in Korean Using Dietary Survey Approach and Food Supply Survey Approach (식이를 통한 평가방법과 공급량 평가방법을 이용한 산화방지제 일일 추정 섭취량 안전성 평가)

  • Suh, Hee-Jae;Choi, Sung-Hee
    • Korean Journal of Food Science and Technology
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    • v.42 no.6
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    • pp.762-767
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    • 2010
  • This study evaluated daily intakes of BHT, BHA, and TBHQ in Korean. The daily intakes were estimated using both a dietary survey approach and food supply survey approach. In the dietary survey approach, individual dietary intake data from the Korea National Health and Nutrition Survey in 2005, as well as analytical results of BHT in 131 samples, BHA in 134 samples, and TBHQ in 104 samples, were used to assess daily intakes of the antioxidants. In the food supply survey approach, both total production amounts of BHT, BHA and TBHQ and maximum permitted levels of the antioxidants were used to calculate daily intakes. In the dietary survey results, the average daily intakes of BHT, BHA and TBHQ were 0.8, 0.5, and 0.3 ${\mu}g$/kg body weight/day, respectively, and below 0.2% of the ADI (acceptable daily intake) set by JECFA (Joint FAO/WHO Expert committee on Food Additives). In the food supply survey approach, the average daily intakes of BHT, BHA,and TBHQ were all 0.3 mg/kg body weight/day. The ratios of ADI were 97, 60, and 40%, respectively. According to these results, daily intakes of BHT, BHA, and TBHQ in Korean are lower than the ADI.

Effects of interaction between SLC12A3 polymorphism, salt-sensitive gene, and sodium intake on risk of child obesity (소금민감성 SLC12A3 유전자 다형성에 따른 나트륨섭취가 소아비만에 미치는 영향)

  • Jung, Joohyun;Lee, Myoungsook
    • Journal of Nutrition and Health
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    • v.50 no.1
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    • pp.32-40
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    • 2017
  • Purpose: Obesogenic environments in children, in particular excessive intake of sodium, generate hypertension, which is a major risk factor for chronic diseases. Methods: In all, 725 children, 379 boys and 373 girls, aged 8~9 years were recruited from seven elementary schools in Kuro-ku, Seoul. To evaluate whether or not obesity risk was modulated by salt-sensitive genes, Solute Carrier Familiy 12 member 3 (SLC12A3) was used as the target. After children were assigned into obese (BMI > 85 percentile) or non-obese groups, anthropometry, blood biochemistry, and dietary intakes were measured according to the genotypes GG (wild) or GA+AA (hetero+mutant). Results: Without gender differences, high TG and low HDLc were detected in the obese group compared to the non-obese group. Regardless of obesity, weight gain and blood pressure (BP) increased in the SLC12A3 GA+AA genotype rather than in the GG type. HDLc was associated with obesity risk without genotype difference. Odd ratios for risk of obesity were 15.57 (95% CI 2.192~110.654), 22.84 (95% CI 1.565~333.469), and 9.32 (95%CI 1.262~68.817) in boys and girls with GA+AA genotypes as sodium intake increased above 4,000 mg/day. Dietary calcium, sodium, folate, and vit C were associated with obesity risk according to gender or genotype differences. Since high folate intake reduced obesity risk in only boys with GG type. Risk for overweight and obesity increased in boys with GA+AA genotypes and dietary habits with high sodium and cholesterol and low folate. Conclusion: The A allele of SLC12A3 rs11643718 was sensitive to development of obesity in children as sodium intake increased.

Dietary risk assessment for suspected endocrine disrupting pesticides in agricultural products in Busan, Korea (부산지역 유통 농산물의 내분비계 장애추정농약 위해평가)

  • Kwon, Hyeon-Jeong;Ok, Yeon-Ju;Kim, Chan-Hee;Park, Mi-Jung;Hwang, Hye-Sun;Youn, Jong-Bae;Cha, Kyung-Suk;Jo, Hyun-Cheol
    • Korean Journal of Food Science and Technology
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    • v.50 no.1
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    • pp.28-36
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    • 2018
  • Studies on suspected endocrine disrupting pesticide (EDP) residues in agricultural products were carried out in 2016 in Busan, Korea. Twelve different EDPs, ranging in concentration between 0.003-2.049 mg/kg, were detected in 19.5% of 462 samples. About 0.2% of agricultural product samples exceeded the maximum residue limits (MRLs). Risk indices of all of the EDPs were less than 10% of the acceptable daily intake (ADI). The outcomes indicated that the risk groups at highest risk of exposure to diazinon (found in Korean cabbages) and carbendazim (found in apples) were females aged 40 to 49 and young males less than 10 years old, respectively. Based on the stochastic assessment at $95^{th}$ percentile (P95), risk index in these risk groups accounted for 8.38 and 2.98% of ADIs. The results showed that the occurrence of EDP residues in agricultural products could not be considered a public health problem.

Risk Assessment of Operator Exposure During Treatment of Fungicide Dithianon on Apple Orchard (사과 과수원에서 농약살포시 살균제 Dithianon의 농작업자 위해성 평가)

  • Cho, ll Kyu;Kim, Su Jin;Kim, Ji Myung;Oh, Young Goun;Seol, Jae Ung;Lee, Ji Ho;Kim, Jeong Han
    • Korean Journal of Environmental Agriculture
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    • v.37 no.4
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    • pp.302-311
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    • 2018
  • BACKGROUND: Dithianon (75%) formulation were mixed and sprayed as closely as possible by normal practice on the ten farms located in the Mungeong of South Korea. Patches, cotton gloves, socks, masks, and XAD-2 resin were used for measurement of the potential exposure of dithianon on the applicators wearing standardized whole-body outer and inner dosimeter (WBD). This study has been carried out to determine the dermal and inhalation exposure to dithianon during preparation of spray suspension and application with a power sprayer on a apple orchard. METHODS AND RESULTS: A personal air monitor equipped with an air pump, IOM sampler and cassette, and glass fiber filter was used for inhalation exposure. The field studies were carried out in a apple orchard. The temperature and relative humidity were monitored with a thermometer and a hygrometer. Wind speed was measured using a pocket weather meter. All mean field fortification recoveries were between 85.1% and 99.1% in the level of 100 LOQ (limit of quantification), while the LOQ for dithianon was $0.05{\mu}g/mL$ using HPLC-DAD. The exposure to dithianon on arms of the mixer/loader (0.0794 mg) was higher than other body parts (head, hands, upper body, or legs). The exposure to dithianon on the applicator's legs (3.78 mg) was highest in the body parts. The dermal exposures for mixer/loader and applicator were 10 and 8.10 mg, respectively, from a grape orchard. The inhalation exposure during application was estimated as 0.151 mg, and the ratio of inhalation exposure was 11.2% of the dermal exposure (inner clothes). CONCLUSION: The dermal and inhalation exposure on the applicator appeared to be 4.203 mg - 25.064 mg and $0.529{\mu}g-116.241{\mu}g$, respectively. The total exposures on the agricultural applicators were at the level of 2.596 mg - 25.069 mg to dithianon during treatment for apple orchard. The TER showed 3.421 (>1) when AOEL of dithianon was used as a reference dose for the purpose of risk assessment of the mixing/loading and application.

Designing optimized food intake patterns for Korean adults using linear programming (II): adjustment of the optimized food intake pattern by establishing stepwise intake goals of sodium (선형계획법을 이용한 한국 성인의 최적 식품섭취패턴 설계 (II) : 단계적 나트륨 목표섭취량 설정에 따른 최적 식품섭취패턴 조정)

  • Asano, Kana;Yang, Hongsuk;Lee, Youngmi;Kim, Meeyoung;Yoon, Jihyun
    • Journal of Nutrition and Health
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    • v.52 no.4
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    • pp.342-353
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    • 2019
  • Purpose: The Dietary Reference Intakes for Koreans (KDRIs) suggest that the goal for the intake of sodium should be less than 2,000 mg, which is thought to be infeasible to achieve when eating the typical Korean diet. This study aimed to obtain the new intake goals for sodium with improved feasibility to achieve, and also to design optimized food intake patterns for Korean adults by performing linear programming. Methods: The data from a one day 24-hour dietary recall of the 2010 ~ 2014 Korea National Health and Nutrition Survey were used to quantify food items that Korean adults usually consumed. These food items were categorized into seven groups and 24 subgroups. The mean intakes and intake distributions of the food groups and the food subgroups were calculated for eight age (19 ~ 29, 30 ~ 49, 50 ~ 64, and over 65 years old) and gender (male and female) groups. A linear programming model was constructed to minimize the difference between the optimized intakes and the mean intakes of the food subgroups while meeting KDRIs for energy and 13 nutrients, and not exceeding the typical quantities of each of the food subgroups consumed by the respective age and gender groups. As an initial solution of the linear programming, the optimized intake of seasonings, including salt, was calculated as 0 g for all the age and gender groups when the sodium constraint was inserted not to exceed 2,000 mg. Therefore, the sodium constraint was progressively increased by 100 mg until the optimized intake of seasoning was obtained as the values closest to the $25^{th}$ percentile of the intake distribution of seasonings for the respective age and gender groups. Results: The optimized food intake patterns were mathematically obtained by performing linear programming when the sodium constraint values were 3,600 mg, 4,500 mg, 4,200 mg, 3,400 mg, 2,800 mg, 3,100 mg, 3,100 mg, and 2,500 mg for the eight age and gender groups. Conclusion: The optimized food intake patterns for Korean adults were designed by performing linear programming after increasing the sodium constraint values from 2,000 mg to 2500 ~ 4,500 mg according to the age and gender groups. The resulting patterns suggest that current diets should be modified to increase the intake of vegetables for all the groups, milk/dairy products for the female groups, and fruits for the female groups except for the females aged 50 ~ 64 years.

Comparison of the portion sizes of Korean adults across eating places: Korea National Health and Nutrition Examination Survey (2012-2016) (우리나라 성인의 식사 섭취 장소에 따른 1인 1회 섭취 분량 비교: 국민건강영양조사 2012-2016 자료를 중심으로)

  • Hong, Hye-Sook;Park, Seon-Joo;Lee, Do-Kyung;Lee, Hae-Jeung
    • Journal of Nutrition and Health
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    • v.53 no.6
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    • pp.676-687
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    • 2020
  • Purpose: The purpose of this study was to investigate the differences in portion size of 11 types of foods that Korean adults frequently consume, based on the parameters of eating place, gender, and age using the Korea National Health and Nutrition Examination Survey (KNHANES) data. Methods: The dietary survey data from 2012-2016 KNHANES was used. A total of 19,779 subjects (8,034 male [40.6%], 11,745 female [59.4%]) were classified based on gender, three age groups (19-29 years old [15.7%], 30-49 years old [46.9%], 50-64 years old [37.4%]) and three eating places (home, institution, and restaurants/convenient stores etc.). Results: The portion sizes according to the eating places were calculated as per the median intake of Korean adults. Foods that showed the highest median intake in restaurants/convenience stores were boiled rice and kimchi stew. The median intake quantity of kimchi stew was the highest in restaurants/convenience stores in men across most age groups. Women in 30-49 years age group also consumed a lot of kimchi stew in restaurants/convenience stores. Men in the age groups 30-49 and 50-64 years consumed soybean paste stew the most in institutions compared to home and restaurants/convenient stores. Stir-fried pork was consumed the most at institutional meal places across all age groups. Conclusion: The portion sizes of kimchi stew and boiled rice were the highest in restaurants/convenience stores. As kimchi stew and soybean paste stew is high in sodium, the intake should be reduced in institutions and restaurants/convenience stores. Furthermore, it is necessary to reduce sodium intake through consumer nutrition education and the development of low-salt standard recipes for restaurants.

Childhood Obesity and Cardiovascular Health: Using 2010-2012 Data of the Korea National Health and Nutrition Examination Survey (아동기 인구 집단의 비만과 심혈관건강: 제5기 국민건강영양조사 자료 이용)

  • Lee, Go Eun;Choo, Jina
    • Korean journal of health promotion
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    • v.17 no.2
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    • pp.109-118
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    • 2017
  • Background: Abdominal obesity as measured by waist-to-height ratio (WHtR) may have stronger and inverse associations with cardiovascular (CV) health than overall obesity as measured by body mass index (BMI). However, there was some challenges for controversies. We aimed to examine the associations of WHtR and BMI with CV health among Korean children using data of the 2010-2012 Korea National Health and Nutrition Examination Survey. Methods: A cross-sectional study was conducted with the sample of 2,363 children by analyzing by gender and two-age groups (10-12 and 13-18 years). Overall obesity was categorized into 3 groups by BMI percentile: non-overweight (<85), overweight (${\geq}85$), and obesity groups (${\geq}95$). Abdominal obesity was categorized into 2 groups by WHtR: normal (<0.5) and abdominal obesity groups (${\geq}0.5$). The CV health score was defined as a z-score by calculating the sum of 7 CV factors. Results: The overweight/obesity groups had significantly lower CV health scores than the normal group (P<0.05) in boys and girls aged either 10-12 years or 13-18 years after adjusting for covariates. The abdominal obesity group also showed significantly lower CV health scores than the normal group (P<0.05) in all the groups; this significant association remained significant in boys aged 13-18 years even after further adjusting for BMI category (P<0.01). Conclusions: Among boys aged 13-18 years, abdominal obesity as measured by WHtR was significantly and inversely associated with CV health, independent of BMI category. Therefore, it should be considered to assess the level of abdominal obesity as a measure of CV health in late adolescent boys.

Lithium Distribution in Thermal Groundwater: A Study on Li Geochemistry in South Korean Deep Groundwater Environment (온천수 내 리튬 분포: 국내 심부 지하수환경의 리튬 지화학 연구)

  • Hyunsoo Seo;Jeong-Hwan Lee;SunJu Park;Junseop Oh;Jaehoon Choi;Jong-Tae Lee;Seong-Taek Yun
    • Economic and Environmental Geology
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    • v.56 no.6
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    • pp.729-744
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    • 2023
  • The value of lithium has significantly increased due to the rising demand for electric cars and batteries. Lithium is primarily found in pegmatites, hydrothermally altered tuffaceous clays, and continental brines. Globally, groundwater-fed salt lakes and oil field brines are attracting attention as major sources of lithium in continental brines, accounting for about 70% of global lithium production. Recently, deep groundwater, especially geothermal water, is also studied for a potential source of lithium. Lithium concentrations in deep groundwater can increase through substantial water-rock reaction and mixing with brines. For the exploration of lithim in deep groundwater, it is important to understand its origin and behavior. Therefore, based on a nationwide preliminary study on the hydrogeochemical characteristics and evolution of thermal groundwater in South Korea, this study aims to investigate the distribution of lithium in the deep groundwater environment and understand the geochemical factors that affect its concentration. A total of 555 thermal groundwater samples were classified into five hydrochemical types showing distinct hydrogeochemical evolution. To investigate the enrichment mechanism, samples (n = 56) with lithium concentrations exceeding the 90th percentile (0.94 mg/L) were studied in detail. Lithium concentrations varied depending upon the type, with Na(Ca)-Cl type being the highest, followed by Ca(Na)-SO4 type and low-pH Ca(Na)-HCO3 type. In the Ca(Na)-Cl type, lithium enrichment is due to reverse cation exchange due to seawater intrusion. The enrichment of dissolved lithium in the Ca(Na)-SO4 type groundwater occurring in Cretaceous volcanic sedimentary basins is related to the occurrence of hydrothermally altered clay minerals and volcanic activities, while enriched lithium in the low-pH Ca(Na)-HCO3 type groundwater is due to enhanced weathering of basement rocks by ascending deep CO2. This reconnaissance geochemical study provides valuable insights into hydrogeochemical evolution and economic lithium exploration in deep geologic environments.