• Journal of Hospice and Palliative Care
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• v.1 no.1
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• pp.65-68
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• 1998

The neuropathic pains are not well controlled by common analgesics and opioid drugs in terminal cancer patients. The types of these pains are divided within the two cages, one is due to continuous central sensitization and the other is due to paroxymal peripheral sensitization. The mechanism of continuous central sensitization is the activity of dorsal horn neurones that are activated by C-fiber input. The tricyclic antidepressants, non-tricyclic antidepressants, and oral local anaesthesia probably produce analgesic effects in neuropathic pains through suppression of this activity. The mechanism of paroxymal peripheral sensitization is the hyper-excitability of peripheral neurones. The neuropathic pains due to peripheral sensitization respond relatively the anticonvulsants and baclofen that stabilize membranes and suppress paroxymal electrical discharge. The patients was a 38-year-old female who complained of hyperthemia on upper right extremity. The symptom of this patient was improved with anticonvulsant(dilantin 600mg).

• Journal of Korean Academy of Nursing
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• v.51 no.1
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• pp.15-26
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• 2021

Purpose: This study aimed to distinguish and describe the types of perceptions of do not resuscitate (DNR) proxy decisions among families of elderly patients in a long-term care facility. Methods: This exploratory study applied Q-methodology, which focuses on individual subjectivity. Thirty-four Q-statements were selected from 130 Q-populations formed based on the results of in-depth interviews and literature reviews. The P-samples were 34 families of elderly patients in a long-term care hospital in Busan, Korea. They categorized the Q-statements using a 9-point scale. Using the PC-QUANL program, factor analysis was performed with the P-samples along an axis. Results: The families' perceptions of the DNR proxy decision were categorized into three types. Type I, rational acceptance, valued consensus among family members based on comprehensive support from medical staff. Type II, psychological burden, involved hesitance in making a DNR proxy decision because of negative emotions and psychological conflict. Type III, discreet decisions, valued the patients' right to self-determination and desire for a legitimate proxy decision. Type I included 18 participants, which was the most common type, and types II and III each included eight participants. Conclusion: Families' perceptions of DNR proxy decisions vary, requiring tailored care and intervention. We suggest developing and providing interventions that may psychologically support families.

• Journal of the Korea Safety Management & Science
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• v.15 no.2
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• pp.135-141
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• 2013

As the country's elderly people who are 65 years or older recently exceeded 10% of the total population with development of medical technology and improvement of living standards, Korea has turned into an aging society. Especially in Gyeonggi-do, as of late December 2012, elderly people who were 65 years or older were 1,135,242 persons, taking up 18.98% of the region's population and registering the largest number of elderly people in the nation's cities or provinces. Due to such a sharp rise in elderly population, support for the elderly is increasing the burden on families and communities. The study aims to take as its subjects elderly people staying at authorized elderly welfare facilities, who are weak in mind and body and have difficulty in daily life with disabilities, or adult day care facilities that take care of elderly people during the day or at night, examine the concept of adult day care facilities and instances in foreign countries, and study the status of the adult day care facilities located in Gyeonggi-do, their services, and safety by figuring out space arrangement based on program implementation. Spacial arrangement in program operation should satisfy fuction and purpose from the manager and user's perspective, and a desirable program operation should provide separate spaces for the elderly with Alzheimer's and those without Alzheimer's. Compared to residential care facilities, adult day care facilities incur less financial burden and, compared to other authorized services, have many right functions that can upgrade the quality of users and satisfy their desires. Major countries like Japan, the UK, and Sweden recognize the right functions of day and night care services and aggressively support and utilize adult day care facilities. For adult day care facilities, quality services should be developed and use and choices should be enhanced as regards services. Development of special programs for the elderly with dementia and stroke, instead of simple protective functions of a program, must be actively promoted, while manpower training is required for program operation, conveniences, and safety. By developing and providing space arrangement models that focus on efficiency, convenience, and safety of program operation, adult day care operation can be revitalized, while quality of elderly care may be enhanced and welfare budget can be saved.

• Journal of Hospice and Palliative Care
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• v.19 no.4
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• pp.292-295
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• 2016

Hospice and palliative care in Taiwan has been growing continuously. The 2015 Quality of Death index, as rated by the Economist Intelligence Unit, ranked Taiwan first among Asian countries and sixth in the world. In this review article, we highlight three particular areas that might have contributed to this success; the laws and regulations, spiritual care and research network. Finally, we discuss the future challenges and prospects for Taiwanese encounters. A systemic review was conducted with the keywords "hospice palliative care Taiwan" using PubMed. The passing of the "Natural Death Act" in 2000 set the example and established a landmark for patient autonomy in Asia; it guarantees the patient's right to request that medical staff do not resuscitate (DNR) them and to reject other futile medical treatments at the end of their life, thus reflecting the importance of palliative care from the policy perspective. In 2015, Taiwan passed another pioneering law entitled the "Patient Autonomy Act". This law states that a patient may decline medical treatment according to his/her own will. Taiwanese indigenous spiritual care was launched in 2000. It requires a Buddhist Chaplain to successfully complete a training program consisting of lectures, as well as bedside practicum before applying Buddhist practices to end-of-life care. The Japan-Korea-Taiwan research network was established for the purpose of enabling collaborative research for the East-Asian collaborative cross-cultural Study to Elucidate the Dying process (EASED) cohort. With consensus from the government and society to make it a priority, hospice and palliative medicine in Taiwan has been growing steadily.

• Journal of the Korean Home Economics Association
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• v.33 no.5
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• pp.51-62
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• 1995

The purpose of this study is to prevent unwed mothers from the view of home-welfare. The main causes of unwed mothers should be reviewed part. The concrete reactions to solve this problem are possible by these studies even though this problem is very complicated related with the matters of individuals, families and our societies. The conclusion to prevent the unwed mothers is : (ⅰ) to establish the right sex morality through the education in families; (ⅱ) the society's role to share the responsibilities and care in single-parent families; (ⅲ) the right sex education in schools and society ; (ⅳ) the governmental aids to enlarge the number of consultation facilities and accomodation places for youths and women. Besides these attempts, the unwed mothers should be aware of the importance and responsibilities of their own and the baby's lives. The responsibility of society also should be focused from the point of family welfare.

• Research in Community and Public Health Nursing
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• v.12 no.3
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• pp.620-626
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• 2001

Purpose: This study was aimed at investigating the recognition and attitude of inpatients for the purpose of facilitating the implementation of the home health care program in relation to the opening of the Home Care Department in P University Hospital in Pusan. Method: Data were collected from the questionnaires returned by 293 patients, who were admitted at P University Hospital. from May 1 to May 15, 2001 and analyzed using descriptive statistics and the Fisher exact test. Results: In regard to the previous information about the home health care program, 55.6% of the inpatients heard about the name through the advertisement in the hospital. the mass communication, and from acquaintances. The percentage of right answers regarding the knowledge of home health care program was 43.9%. In regard to the acceptance of the home health care program, 97.1 % of patients agreed with the implementation of the home care program. The reasons for acceptance were: the maintenance of the continuity of care, the alleviation of the family burden of time. Conclusion: For the stabilization and successful implementation of a home health care system, it should be accompanied not only by advertisement but also education for patients about the home health care program, and a post-evaluative study after the implementation.

• Journal of Korean Ophthalmic Optics Society
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• v.18 no.4
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• pp.373-383
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• 2013

Purpose: In this study, we analyzed refractive power of school children in low income family. Methods: We have done a comparative analysis with 112 subjects of low-income of 17 elementary schools in the Yeongcheon area and low-income children less than -6 D of refractive errors from the Korean National Health and Nutrition Examination Survey Report 2010. Results: Spherical equivalent (SE) with low-income group of nation was -1.99 D for right eye and -1.81 D for left eye, while high income group of nation showed -1.26 D and -1.21 D for right eye and left eye respectively. The SE with low income group in Yeongcheon area was -1.85 D for right eye and -1.81 D for left eye. The SE with orphan was -2.75 D and -2.42 D. Single parent family was -2.10 D and -1.96 D, and two parent family was -1.75 D and -1.73. Conclusions: The lack of attention to children eye care may be one of cause for myopia, so the role of the parents and teacher is very important. However, limited role of parents to children due to low income, it is necessary to provide an institutional strategy and social interest to prevent children vision' in low income family.

• Quality Improvement in Health Care
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• v.6 no.1_2
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• pp.80-91
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• 1999

Background : With the CQI concepts, which emphasize doing the right things right the first time, we tried to enhance the timely completion of medical records by changing the review process from retrospective method to concurrent one. Methods : Against the current retrospective QA activity, Medical record administrator did the concurrent QA of the inpatient medical records with the deficiency sheets. One general surgery ward was chosen as a trial one. The deficiency rate of the medical records of the discharged patients was compared before and after the enforcement of the system. Job analysis of the medical record departments was done about four tertiary care hospitals located in Seoul to estimate the cost and the time consumed by current system. Results : There was a little improvement in the completion rate of the medical records after the trial. The new system was effective. And job analysis showed that much money and time were wasted by current retrospective feedback system. Conclusion : Though the result was not so satisfactory, it should be considered that this test was a voluntary one and the interns and residents were not forced to complete the medical records during this trial period. If there be any strong motivation to complete the medical record in time, this system is sure to be succeed. As the DRG system requires the concurrent review of the medical records to confirm severity of the patient's illness and to assure the timely discharge, it is desirable to enforce this method with the DRG system together. DRG coding and reducing deficiency rate of the medical records can be accomplished simultaneously.

• Journal of Hospice and Palliative Care
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• v.18 no.3
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• pp.179-187
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• 2015

For patients who are near the end of life, an inevitable step is discussion of a do-not-resuscitate (DNR) order, which involves patients, their family members and physicians. To discuss DNR orders, patients and family members should know the meaning of the order and cardiopulmonary resuscitation (CPR) which includes chest compression, defibrillation, medication to restart the heart, artificial ventilation, and tube insertion in the respiratory tract. And the following issues should be considered as well: patients' and their families' autonomy, futility of treatment, and the right for death with dignity. Terminal cancer patients should be informed of what futility of treatment is, such as a low survival rate of CPR, unacceptable quality of life after CPR, and an irremediable disease status. In Korea, two different law suits related to life supporting treatments had been filed, which in turn raised public interest in death with dignity. Since the 1980s, knowledge of and attitude toward DNR among physicians and the public have been improved. However, most patients are still alienated from the decision making process, and the decision is often made less than a week before death. Thus, the DNR discussion process should be improved. Early palliative care should be adopted more widely.

• Women's Health Nursing
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• v.1 no.1
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• pp.81-96
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• 1995

This study was intended to provide women who are supposed to experience childbirth with effective nursing care exploring the childbirth experience. The purpose of this paper is to give an answer to the question of what the childbirth experience is, and phenomenological method has been used for that purpose. 17 primiparous mothers right after delivery in one university hospital of J city were served as subjects for this research. Data were collected June to October, 1993 through in depth interview with subjects using unstructured and open questions about the childbirth experience. Van Kaam's phenomenological analysis method was used for the analysis of the data. The results of the study are summarized as follows : The contents of the experience which primiparous mothers had undergone through childbirth were pain, fear, worry, relief, lightness, thankfulness, unsatisfactory, unreality, holiness for a new life, identifying the meaning of life, becoming a mother. 1. Experience before delivery Mothers experienced pain, fear, worry, unsatisfactory, relief, and thankfulness before delivery. Subjects' descriptions about the pain appeared to be various ; unbearable pain, bearable pain, anticipated pain. And their reactions were also various ours ; some endured pain, sought alternative method i.e., surgery, didn't want to reexperience it, or accepted it as women's fate. Subjects experienced fear for anticipated pain, suffering pain, and possible delayed delivery progress and were worried about delivery progress and baby wellbeing. Also, Subjects were unsatisfied with professionals' unfaithful attitude, their spouses' absence, and the ignorance of their pain. But subjects became relieved at the accustomed surroundings, good progress of delivery, support of family, care of professionals and support of other family. And they expressed their thanks to the professionals and family members for doing their best and also to their mothers who gave birth to them. 2. Experience after delivery Subjects experienced lightness, thankfulness, unsatisfactory, worry, unreality, holiness for a new life, identifying the meaning of life, becoming a mother after delivery. Mothers experienced lightness from the fact that it is over, and freshness right after delivery. They were thankful that they delivered vaginally and had an easy delivery. Subjects who delivered female baby were unsatisfied and some were worried about rearing the baby. By confessing, "I have no specific feeling, I am very confused, It is unrealistic, I feel strange", they expressed the unrealistic aspect of childbirth experience. Subjects felt holiness for a new life for novelty and birth of life. They identified the meaning of life from the fact that they felt worthy, fulfilled their duty, had their own baby, accomplished an important affair. After they experienced what it is to be a mother, they realized with it is being a mother and had a rearing expectation for the baby. The results of the study will provide basic data for caring the childbearing women.