• Journal of Hospice and Palliative Care
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• v.8 no.2
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• pp.173-182
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• 2005

Purpose: This study was carried out to provide the basic information for developing intervention programs for volunteers by identifying the burdens felt by hospice volunteers and the factors related to such burdens. Methods: The subjects were 243 hospice volunteers at 8 hospitals of The Catholic University of Korea. A questionnaire was carried out: 25 questions about the burdens to the participants and 47 questions about the quality of life. The data obtained was analyzed using the SAS program to conduct t-test, ANOVA, Duncan test, and Pearson's correlation coefficient test. Results: 1. The mean total score of the burdens felt by the hospice volunteers was $53.3{\pm}10.4$. There was no significant difference in the level of burden depending on the demographic characteristics of the hospice volunteers. But the burden in care of high education and low quality of life increased significantly. 2. The level of burden to the hospice volunteers decreased significantly as their families more favored their volunteer activities. The subjects felt the highest burden in: family care, physical care spiritual care, emotional care, and after-death care, in this order. 3. The level of burden related to each factors was high in the burden due to patient care, sense of achievement, and volunteer activities, in this order. 4. There was a reverse correlation between the level of burden to hospice volunteers and their quality of life. Conclusion: In order to reduce the burdens to hospice volunteers and to help them tate care of patients more effectively, it would be necessary to provide the education programs about practical patient care problems and to develop measures for improving their quality of life, taking into account their level of education, family's support, and difficulties in their volunteer activities.

• Journal of Hospice and Palliative Care
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• v.5 no.2
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• pp.155-162
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• 2002

Purpose : The purpose of this study is to provide preliminary information on the hospice care needs of hospice volunteers. Methods : The sample of this study was obtained from those who completed the hospice volunteer education program in three different areas in Korea. This study was conducted by a self-administered questionnaire. The sample analyzed for this study contained 88 hospice volunteers. Frequency, percentage, mean, standard deviation, and logistic regression analysis were performed to produce the findings of this study. Results : The characteristics of the study sample were $40{\sim}49$ aged, middle class, christianity, married women with high school diplomas. They attended at the hospice center with less than 1 year experience. Majority of them had no family members who received a hospice care. The hospice care was strongly required in the field of information, particularly regarding their diseases and treatments. The identified hospice care needs were the prevention and treatment of gangrene in the field of physical needs, the maintenance of closer relationship with their doctors in the field of emotional needs, and the support of supporting medical insurance in the field of socioeconomic needs. The significant predictors were 'having hospice care taker among family members' in the field of the total hospice care needs and physical needs. Two predictable variables were found in the field of emotional needs. However, none were found to be a predictable variable in the field of information and socioeconomic needs. Conclusion : The findings or this study have a weekness of generalizability due to the sampling methodology used in this study. Thus, further research should be designed in relation to this topic with a probability sampling method.

• Journal of Hospice and Palliative Care
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• v.13 no.4
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• pp.216-224
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• 2010

Purpose: The purpose of this study was to evaluate a community-based cancer patient management program (CBPCMP) which was collaborated between a hospice center and public health centers. Methods: The CBPCMP proceeded on four steps; 1) Signing agreements with three public health centers, 2) Enrolling the domiciliary terminal cancer patients, 3) Providing home hospice service, and 4) Inquiring patient's level of satisfaction. From February 1 to December 31 in 2009, 43 terminal cancer patients were referred and provided with home hospice service. The hospice team made a total of 605 visits. Medical records for each visit and data from satisfaction surveys were analyzed. Results: 76.7% of patients were older than 60 years, and 90.7% of the patients were alert. The level of functional status for 76.7% of patients rated as lower than ECOG grade 1. 62.8% of the patients or their caregivers signed hospice service agreements. On the initial evaluation, the most frequent reasons for referral were general weakness (86.0%), followed by anorexia (72.1%). Nurses visited the patients' most frequently (371 visits), followed by volunteers (216 visits). Nurses provided emotional support and health promotion counseling on 95.1% and 22.9% of visits, respectively. The mean satisfaction score rated by patients and their family was 4.45 out of 5. Conclusion: This study tested CBPCMP in collaboration with hospice centers and public health centers. CBPCMP showed a possibility to improve the quality of end of life care. To insure the quality care, however, the guidelines for home hospice service should be developed.

• Journal of Hospice and Palliative Care
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• v.17 no.2
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• pp.66-74
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• 2014

Purpose: This study is aimed to investigate perceptions of caregivers and medical staff toward do not resuscitate (DNR) and advance directives (AD). Methods: Participants were 141 caregivers and 272 medical staff members from five general hospitals. A questionnaire used for the study consisted of 20 items: 14 about DNR perceptions, three about AD, one each for age, gender and employment. Results: Both medical staff and caregivers strongly recognized the need for DNR and AD, and the level of recognition was higher with medical staff than caregivers (DNR ${\chi}^2=44.56$, P=0.001; AD ${\chi}^2=16.23$, P=0.001). The main reason for the recognition was to alleviate sufferings of patients in the terminal phase. In most cases, DNR and AD were filled out when patients with terminal conditions were admitted, and patients made the decisions by consulting with their guardians. Medical staff better recognized the need and for growing demand for guidelines for the DNR and AD decision making process than caregivers (${\chi}^2=7.41$, P=0.0025). Conclusion: This study showed that patients highly rely on their caregivers when making decisions for DNR and AD. Thus, it is important that patients and caregivers are provided with objective information about the decisions. Since participants' strong support for DNR and AD was mainly aimed at alleviating patients' suffering, further study is needed in the association with hospice care. Medical staff also needs to understand the different views held by caregivers and fully consider the disparity when informing patients/caregivers to make the DNR and AD decisions.

• Journal of Hospice and Palliative Care
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• v.17 no.4
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• pp.216-222
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• 2014

Purpose: This study was performed to identify the symptoms and care needs of home-based cancer patients in Korea and to add to the scarce literature on this topic. Methods: Data were collected from patients who subscribed to home-based cancer care services in Jinju. Assessments were performed by nurses at the local public health center. The Edmonton Symptom Assessment System with a numeric rating scale (NRS) was used to identify symptoms, and a four-point Likert scale was used to assess psychological, social, and spiritual needs. Results: Cross-sectional data were collected in October 2013. A total of 209 patients participated and their median age was 65 years (range, 17~89 years). Most patients were diagnosed in the early stage of cancer (n=188); only 19 patients were diagnosed in the advanced stage. More than half the patients lived alone (n=115, 55.0%) and took care of themselves (n=128, 61.2%). Anorexia and fatigue were the most common symptoms (median NRS, 5 and 4, respectively). Patients needed economic support the most, whereas spiritual care was least needed (n=138 [67.3%] vs. n=128 [62.1%], respectively). Conclusion: Patients who signed up for home-based cancer care services in Jinju are struggling with a financial issue and physical symptoms. A customized approach is needed to improve the quality of the home-based care services.

• Journal of Science Education
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• v.38 no.2
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• pp.302-316
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• 2014

The purpose of this study is to devise a Small-Scale Chemistry (SSC) lab program for primary school learners and to examine its effects on science learning achievement. In addition, it will be examined whether the type of learning groups affects the achievement or not. The participants in the current study were 173 6th graders from 6 classes of Y elementary school in Changwon city, Gyeongnam. Three classes(86) were assigned to the experimental group and the other three, the comparative group after checking the pre-homogeneity between the two groups through t-test on the scores of the science mid-term exam. We conducted five experimental sessions on the Acid and Base in the science textbook for the sixth graders. The students of one experimental class worked in pairs and another class worked individually, but the students of the comparative classes were divided into groups of six(one group with pair, another group with individual work in the SSC program, and the other group conducting the traditional experiment with groups of six students). The data were analyzed by t-test and ANOVA. The results showed that experimental learning using individual work in the SSC program compared to traditional experimental learning was effective in improving science learning achievement. also it was indicated that the teachers could reduce their burden of preparing for classes and of school hours when they utilized the SSC laboratory learning program. Teachers could also actively support students' experimental activities in employing the program. Based on the results, we suggest that the development of the SSC laboratory learning program is meaningful in the sense that this program can help elementary schoolers to improve science learning achievements more than the existing traditional experimental methods.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.8 no.2
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• pp.117-121
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• 2005

Purpose: Elevated AST/ALT level in rotavirus gastroenteritis have been reported. We found elevated creatine kinase (CK) in those children. This study was carried out to define the relationship of major clinical presentation, laboratory findings, and level of creatine kinase. Methods: A retrospective analysis was made for thirty patients who were diagnosed rotavirus gastroenteritis from Jan 2001 to Mar 2005 in Department of Pediatrics, Gyeongsang National University Hospital. Serum creatine kinase was checked for the evaluation of high aminotransferase level among the patients. Results: Fourteen patients (8 males, 6 females) with high creatine kinase activity were included in this study. The mean age was $1.46{\pm}1.24year$ of age. The mean level of AST, ALT and CK were $127.5{\pm}136.2IU/L$, $126.1{\pm}154.3IU/L$, and $542.8{\pm}624.6IU/L$, respectively. Electrophoresis of CK isoenzyme was performed in four of them and the results revealed elevated CK-MM fraction (96~100%). Three of them revealed high serum creatine kinase acitivity (>1,000 IU/L) without acute renal failure and other symptom. However, none of them had muscular pain or trauma history. Elevated creatine kinase activity did not correlate with clinical implications (age, sex, vomiting, diarrhea, fever, symptom of URI, degree of dehydration or seizure) or laboratory findings. Conclusion: In this study, we found that serum creatine kinase acitivity also was elevated in infants with rotavirus gastroenteritis. This data support muscular damage due to rotavirus, but could not prove the mechanism of increased serum creatine kinase activity.

• Journal of architectural history
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• v.19 no.3
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• pp.7-29
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• 2010

The form of the Wangheungsa Temple's wooden pagoda site is that of the traditional form of the wooden pagodas constructed during the Baekjae Period. Likewise, it is an important ruin for conducting research on the form and type of the wooden pagodas constructed during the Baekjae Period. In particular, the method used for the installation of the central pillar's cornerstone is a new technique. The purpose of this research is to restore the ruin of the Wangheungsa Temple's wooden pagoda of the Baekjae Period that remains at the Wangheungsa Temple's wooden pagoda site. Until now, research conducted on the wooden pagoda took place mostly centered on the Hwangryongsa Temple's wooden pagoda. Meanwhile, the reality concerning Baekjae's wooden pagoda is one in which there were not many parallel cases pertain to the design for restoration. This research paper wants to conduct academic examination of the Wangheungsa Temple's wooden pagoda to organize the intention of design and design process in a simple manner. This research included review of the Baekjae Period's wooden pagoda related ruins and the review of the existing wooden pagoda ruin to analyze the wooden pagoda construction technique of the era. Then, current status of the Wangheungsa Temple's wooden pagoda site is identified to define the characteristics of the wooden pagoda, and to set up the layout format and the measure to estimate the size of the wooden pagoda in order to design each part. Ultimately, techniques and formats used for the restoration of the wooden pagoda were aligned with the wooden pagoda of the Baekjae Period. Basically, conditions that can be traced from the current status of the Wangheungsa Temple site excavation using the primary standards as the standard. Wangheungsa Temple's wooden pagoda was designed into the wooden pagoda of the Baekjae's prosperity phase. The plane was formed into $3{\times}3$ compartments to design into three tier pagoda. The height was decided by factoring in the distance between the East-West corridors, size of the compartment in the middle, and the view that is visible from above the terrace when entering into the waterway. Basically, the origin of the wooden structure format is based on the Goguryeo style, but also the linkage with China's southern regional styles and Japan's ancient wooden pagoda methods was factored in. As for the format of the central pillar, it looks as if the column that was erected after digging the ground was used when setting up the columns in the beginning. During the actual construction work of the wooden pagoda, central pillar looks as if it was erected by setting up the cornerstone on the ground. The reason that the reclaimed part of pillar that use the underground central cornerstone as the support was not utilized, was because the Eccentric Load of the central pillar's cornerstone was factored in the state of the layers of soil piled up one layer at a time that is repeated with the yellow clay and sandy clay and the yellow clay that were formed separately with the $80cm{\times}80cm$ angle at the upper part of the central pillar's cornerstone was factored in as well. Thus, it was presumed that the central pillar was erected in the actual design using the ground style format. It is possible to presume the cases in which the reclaimed part of pillar were used when constructed for the first time, but in which central pillar was installed later on, after the supplementary materials of the underground column is corroded. In this case, however, technique in which soil is piled up one layer at a time to lay down the foundation of a building structure cannot be the method used in that period, and the reclamation cannot fill up using the $80cm{\times}80cm$ angle. Thus, it was presumed that the layers of soil for building structure's foundation was solidified properly on top of the central pillar's cornerstone when the first wooden pagoda construction work was taking place, and that the ground style central pillar was erected on its upper part by placing the cornerstone once again. Wangheungsa Temple's wooden pagoda is significant from the structure development aspect of the Korean wooden pagodas along with the Hwangryongsa Temple's wooden pagoda. Wangheungsa Temple's wooden pagoda construction technique which was developed during the prosperity phase of the Baekjae Period is presumed to have served as a role model for the construction of the Iksan Mireuksa Temple's wooden pagoda and Hwangryongsa Temple's wooden pagoda. With the plan to complement the work further by excavating more, the basic wooden pagoda model was set up for this research. Wangheungsa Temple's wooden pagoda was constructed as at the Baekjae Kingdom wide initiative, and it was the starting point for the construction of superb pagoda using state of the art construction techniques of the era during the Baekjae's prosperous years, amidst the utmost interest of all the Baekjae populace. Starting out from its inherent nature of enshrining Sakyamuni's ashes, it served as the model that represented the unity of all the Baekjae populace and the spirit of the Baekjae people. It interpreted these in the most mature manner on the Korean peninsula at the time.

• Journal of agricultural medicine and community health
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• v.28 no.2
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• pp.1-14
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• 2003

Objectives: This paper introduces need and supply level of rural mental health care service and especially focuses on the evaluation for the community mental health programs of Public Health Centers(PHCs) in rural areas as the facilities for primary mental health care. Methods: We defined the need as prevalance rate and service utilization rate, for which reviewed the results of the epidemiological study of mental disorders using Korean Composite International Diagnostic Interview surveyed on a nationwide scale in 2001. Supply was appraised in terms of psychiatric beds and primary mental heath care facilities such as private psychiatric clinics, facilities for social rehabilitation, PHCs running community mental health programs. For this, we reveiwed a variety of annual reports related mental health published by Ministry of Health and Welfare. To evaluate the community mental health programs of PHCs in rural areas, we selected. randomly samples out of the 3rd community health plans including the contents of community mental health programs, which submitted by 89 rural counties and 44 cities mixed with rural areas, and used the program's guideline established by central government as a standard. Results: Prevalence rates of major psychiatric diseases such as schizophrenia, alcoholism, major depression, anxiety disorder were higher in rural area than in urban area and 8.9% of psychiatric patients in both areas stayed at homes contacted with mental health manpower more than one time during the last year. Psychiatric beds were sufficiently supplied, but urban area had less beds than rural area contrary to general health care service. Psychiatric clinics were supplied very insufficiently in rural areas and PHCs bridged the gap instead. However rural PHCs got less financial support for community mental health programs from higher positioned agencies than urban PHCs. Rural community health programs not supported hardly worked out. Conclusions: Central government should consider a special policy for rural primary mental health care, because private psychiatric clinics can't be introduced in rural areas due to demand-deficiency and the financial independence of rural counties was very vulnerable.

• Journal of agricultural medicine and community health
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• v.35 no.2
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• pp.151-164
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• 2010

Objective:Korea has 3,170 islands with about 188,000 inhabitants. These inhabitants' needs for health services might go unmet because of geographic isolation, slimmer availability of health services, and higher proportion of the elderly compared with the mainland population. Unmet health service needs might result in serious health problems for these island residents. Therefore, the purpose of this study was to investigate their unmet health service needs and related factors from population of Nowha island. Methods: The survey was conducted from July 30 to August 1 by trained interviewers. Target population were residents in Nohwa island and the sampling method was incomplete quota sampling. General characteristics, socioeconomic status, utilization of health service, and unmet medical service needs were investigated. First univariate and then multivariate logistic analyses were done for the statistical analysis. Results: 324 residents were surveyed and the proportion of unmet health services needs was 26.5%. People living alone and of female sex had increased health services needs based on univariable analysis. From the multivariate analysis, those living alone increased the health services needs. Self-determined low socioeconomic status and medical aid increased the proportion of unmet medical needs, but these were not statistically significant. Conclusion:In Nowha island, those who are elder, and of lower socioeconomic status had much higher unmet medical needs. The results suggest the need for more social support by qualified health services to solve this unmet medical needs problem.