Purpose: This study aimed to describe nurses’ perceived needs and barriers to pediatric palliative care (PPC). Methods: Mixed methods with an embedded design were applied. An online survey was conducted for nurses who participated in the End-of-Life Nursing Education Consortium- Pediatric Palliative Care (ELNEC-PPC) train-the-trainer program, of whom 63 responded. Quantitative data were collected with a survey questionnaire developed through the Delphi method. The 47 items for needs and 15 items for barriers to PPC were analyzed with descriptive statistics. Qualitative data were collected through openended questions and analyzed with topic modeling techniques. Results: The mean scores of most subdomains of the PPC needs were 3.5 or higher out of 4, and those of PPC barriers ranged from 3.22 to 3.56, indicating the items in the questionnaire developed in this study properly reflect each factor. The needs for PPC were divided into 4 categories: “children and adolescents,” “families,” “PPC management system,” and “community-based PPC.” Meanwhile, PPC barriers were divided into 3 categories: “healthcare delivery system,” “healthcare provider,” and “client.” The keywords derived from the topic modeling were perception, palliative, children, and education for necessities and lack, perception, medical care, professional care providers, service, and system for barriers to PPC. Conclusion In this study, by using mixed-methods, items of nurses’ perceived needs and barriers to PPC were identified, categorized, and weighted, and their meanings were explored. For the stable establishment of PPC, the priority should be given to improving perceptions of PPC, establishing an appropriate system, and training professional care providers.

A resolution adopted by the World Health Assembly in 2014 stated that all nurses should be equipped with palliative care skills in order to integrate palliative care into a day-to-day healthcare system. This article introduces the palliative nursing competency that was developed for the Korean environment by the Korean Hospice Palliative Nursing Research Network based on its study of overseas cases where this competency and competency-based training were developed. This is the first step towards the development of competency-based palliative nursing education, and active efforts should be made to integrate this competency into the undergraduate nursing curriculum.
Clinical Competence ; Curriculum ; Delivery of Health Care ; Education ; Global Health ; Hospice and Palliative Care Nursing ; Hospices ; Humans ; Korea ; Nursing ; Palliative Care ; Students, Nursing

Although the prognosis of papillary thyroid cancer (PTC) is extremely good, locoregional recurrences after initial treatment occur. Thyroglobulin (Tg) is a reliable tumor marker to detect recurrence or persistence of PTC. However, occasionally serum Tg may miss the detection of a recurrence. We report a 54-year-old female presented with hoarseness due to cervical recurrence without concomitant elevation of serum Tg and anti-Tg antibody, in contrast to extremely increased needle-washout Tg, who had undergone a total thyroidectomy and radioiodine ablation as initial therapies for PTC. Several factors causing such discrepancy between needle-washout Tg and serum Tg can be suggested including site of recurrence, volume of tumor, interference by some kind of plasma antibodies other than anti-Tg antibody, and any conformational defect of Tg protein. Among them, the most convincing explanation is that any conformational defect of Tg may lead to impaired secretion of Tg to blood. We suggest that more studies are needed to find the cause for potential mechanisms involved in PTC recurrences without increased serum Tg.
Antibodies ; Female ; Hoarseness ; Humans ; Middle Aged ; Plasma ; Prognosis ; Recurrence ; Thyroglobulin* ; Thyroid Neoplasms* ; Thyroidectomy

PURPOSE: The aim of this research was to explore nurses' knowledge of and attitudes toward pediatric palliative care (PPC) in Korea. METHODS: A descriptive cross-sectional design was used. A total of 196 participants were recruited from the ELNEC-PPC course held in Seoul, Korea. All participants completed a 20-item survey questionnaire which assessed knowledge of and attitudes toward PPC using a 7-point Likert scale. RESULTS: Nurses' knowledge of PPC correlated with their educational level and work experience in the pediatric unit and hospice care unit. The work experience in the pediatric unit, career length in PPC and completion of palliative education course made differences in the attitudes toward PPC. Married nurses scored significantly higher on the parental rights in determining palliative care service for their child, and nurses with master's degree or higher showed a higher level of understanding of and attitudes toward the differences between PPC and adult palliative care. CONCLUSION: The factors influencing nurses' knowledge of and attitudes toward PPC need be considered to develop a pediatric palliative training program.
Adult ; Child ; Education ; Hospice Care ; Human Rights ; Humans ; Korea ; Palliative Care* ; Parents ; Seoul ; Surveys and Questionnaires

PURPOSE: This study was conducted to identify the caring experience of the mothers of childhood burn patients. METHODS: Data were collected from 28 mothers of childhood burn patients, through semi-structured in-depth interviews. Data were categorized and coded by using content analysis. RESULTS: 27 categories and 102 statements were drawn from 4 domains. The analyzed domains were psychological sufferings, confronted harsh reality, coping method, and future concerns. Psychological sufferings were categorized heartache, sense of guilt, confusion, regret, depression, sorriness, getting hurt, frustration and upset feeling. Confronted harsh nature were categorized economic difficulty, physical burn-out, lack of caring other children and family troubles. Coping method were categorized positive thinking, having hope, ventilating feelings, accepting the situations, demanding help from family members, changing patterns of the burned child rearing, collecting information for burn treatment, refusing accept the condition of burned child, avoiding personal and social relationship, and reliance on religion. Concerns were categorized concerns of growth and adaptation of the burned child, anxiety for scar, concerns of adapting school life and vague future concerns. CONCLUSION: The nursing interventions for early assessing psychological problems and providing social supports for caring both burn patients and other siblings should be provided to the mothers of childhood burn patients.
Adaptation, Psychological ; Anxiety ; Burns ; Child ; Child Rearing ; Cicatrix ; Depression ; Frustration ; Guilt ; Humans ; Mothers ; Siblings ; Thinking

OBJECTIVES: Adoption of hospital information systems offers distinctive advantages in healthcare delivery. First, implementation of consolidated hospital information system in Seoul National University Hospital led to significant improvements in quality of healthcare and efficiency of hospital management. METHODS: The hospital information system in Seoul National University Hospital consists of component applications: clinical information systems, clinical research support systems, administrative information systems, management information systems, education support systems, and referral systems that operate to generate utmost performance when delivering healthcare services. RESULTS: Clinical information systems, which consist of such applications as electronic medical records, picture archiving and communication systems, primarily support clinical activities. Clinical research support system provides valuable resources supporting various aspects of clinical activities, ranging from management of clinical laboratory tests to establishing care-giving procedures. CONCLUSIONS: Seoul National University Hospital strives to move its hospital information system to a whole new level, which enables customized healthcare service and fulfills individual requirements. The current information strategy is being formulated as an initial step of development, promoting the establishment of next-generation hospital information system.
Adoption ; Confidentiality ; Delivery of Health Care ; Electronic Health Records ; Hospital Information Systems ; Information Systems ; Management Information Systems ; Quality of Health Care ; Radiology Information Systems ; Referral and Consultation

OBJECTIVE: To investigate the activities of upper trapezius and deltoid muscles in shoulder abduction in full can and empty can position in rotator cuff tear patients. METHOD: Twelve subjects with right rotator cuff tear patients participated in this study. Each subject performed scapular plane abduction with humeral external rotation (full can position) and with humeral internal rotation (empty can position). Electromyography (EMG) was recorded with surface electrodes at the both upper trapezius, anterior, lateral, and posterior deltoid muscles during shoulder abduction. The EMG activity of each muscle was normalized according to the highest EMG activity during a maximum manual muscle test for the corresponding muscle. RESULTS: Muscle activities of the lesion side's upper trapezius and lateral deltoid were significantly greater than those of the normal side in full can position. In empty can position, the activities of upper trapezius, anterior, and lateral deltoid increased in lesion side. In comparison between full can and empty can exercises, over 30degrees abduction arcs, empty can exercise showed increased muscle activities of upper trapezius and all deltoid muscle in lesion side. In contrast, anterior and lateral deltoid only showed increased in the muscle activities under empty can exercise in sound side. CONCLUSION: Rotator cuff tear is involved in changed the activities of upper trapezius and deltoid muscles. And these results suggested that in rotator cuff tear patients, the changed pattern of muscle contraction should be considered in shoulder exercise.
Anesthetics, Local ; Deltoid Muscle ; Electrodes ; Electromyography ; Exercise ; Humans ; Lidocaine ; Muscle Contraction ; Muscles ; Rotator Cuff ; Shoulder ; Tears

Yellow fever is the original viral hemorrhagic fever (VHF), a pansystemic viral sepsis with viremia, fever, prostration, hepatic, renal, and myocardial injury, hemorrhage, shock, and high lethality. Yellow fever was one of the most feared lethal diseases before the development of an effective vaccine. Yellow fever (YF) can be prevented by an attenuated vaccine. The yellow-fever 17D vaccine developed in the 1930s has been regarded as one of the most successful live attenuated vaccines, with few side effects or adverse events. The adverse effects associated with yellow-fever vaccine are generally mild and include headache, myalgia, and low-grade fever. Recently, however, some cases of severe neurologic disease and multi-organ system disease have been described in individuals who received yellow-fever vaccine. We report the case of a 39-year-old female with meningitis following vaccination with 17D yellow-fever vaccine.
Adult ; Female ; Fever ; Headache ; Hemorrhage ; Hemorrhagic Fevers, Viral ; Humans ; Meningitis ; Sepsis ; Shock ; Vaccination ; Vaccines, Attenuated ; Viremia ; Yellow Fever

BACKGROUND: Smoking prevention and anti-smoking education in schools must be designed and planned according to age and sex as well as the type of schools and their smoking status. But the current education programs do not consider these factors. This study, therefore, aims to evaluate the actual status of the smoking prevention and anti-smoking education in Korea and to find present recommendations for an effective and, systematic education. METHODS: We surveyed 15,310 teen-age students attending middle schools and high schools in such cities as Seoul, Incheon, Bucheon, Mokpo, and Pohang and smaller areas in the vicinity of these cities from June 1 to 15, 2005. Self-survey was done by the health education teacher of each school. It contained questions about the general disposition of respondents, their smoking habits, and awareness programs on prevention and cessation of smoking. We used SPSS 12.0 for chi-square-test to analyze the collected data. RESULTS: The most prevailing form of anti-smoking education was "video". Most of the students surveyed said that the fourth or fifth grade of elementary school will be a good starting point for anti-smoking education. Only 39.6% of students who were educated by the current smoking prevention and anti-smoking program answered that it was "helpful" and 29.6% was "satisfied". Higher percentage of middle school students said that they either tried to quit smoking ('pre-contemplation') or had no intention of doing it ('termination-fail') after having been involved in the anti-smoking education program, while high school students turned out to be more oriented towards 'contemplation' and 'termination-success'. CONCLUSION: Some students were found to begin smoking even at an early grade in elementary school. Most adolescents knew about the danger of smoking, but current smokers had a low educational satisfaction. The real target of such education programs, however, should be focused on higher grade students in elementary schools and middle school students, because data show that smoking rate increases explosively among these students.
Adolescent ; Surveys and Questionnaires ; Education* ; Gyeonggi-do ; Gyeongsangbuk-do ; Health Education ; Humans ; Incheon ; Intention ; Jeollanam-do ; Korea ; Seoul ; Smoke* ; Smoking Cessation ; Smoking*

PURPOSE: We wished to develop the web based Picture Archiving and Communication System in the emergency room for early decision making in emergency treatment planning at a full PACS Hospital. MATERIALS AND METHODS: The program tools were Microsoft Visual Studio 6.0 - Visual C++ 6.0, and the Microsoft SQL 7.0 under the Microsoft Windows 2000 server(R) operation system. The achievement of images was performed by an auto transport program installed in the ER and the radiology department. RESULTS: The average compression rates were 5:1 for CT and MR, and 20:1 for CR with JPEG 2000 lossy compression. All the images were stored on hard disk for 3 months. The patients' information was displayed for 2 weeks for reducing the security risk. For interdepartmental consultation, patient query by patient hospital number was available. CONCLUSION: Our Web based ER PACS could be useful system for early decision making for treatment planning in the emergency room because it reduces the risk factors for the security of the Web PACS by using a system independent from PACS in the hospital and minimizing the information patients.
Decision Making ; Emergencies* ; Emergency Service, Hospital* ; Emergency Treatment ; Humans ; Risk Factors