Rapid progress in modern medical technology has made it possible to sustain life and/or delay death using 'heroic' treatments. The availability of life-sustaining treatment brings several issues in end-of-life care such as 'dying with dignity' and an radical increase in health care costs. The use of Advance Directives(AD) have been widely heralded by health care providers, gerontologists, and advocacy groups as means of protecting patients' right to accept or refuse life-sustaining treatment in end-of-life care. The use of AD can not only improve patients' autonomy and quality of life but also bring efficiency in distributing health care resources. The proportion of older persons in Korean population has been increasing. Those 65 years of age or over were about 7 percent of the population. Death and dying is not limited to older persons, but it is more prevalent among them. In conjunction with an aging population and the increasing prevalence of death, the issues of death and dying will become crucial in near future in terms of 'dying with dignity', 'autonomy', and 'self-control'. This paper attempts to explode and establish the concept of advance directives (AD) based on literature review. Data sources are computer searches with the MEDLINE database. Due to the lack of prior study on AD for a Korean cases, studies abroad are reviewed. This paper suggests the need for future study on the possibility of the use of AD in Korea.
Advance Directives* ; Aging ; Surveys and Questionnaires ; Delivery of Health Care ; Health Care Costs ; Health Personnel ; Humans ; Korea ; Patient Rights ; Prevalence ; Quality of Life

PURPOSE: The purpose of this study is to identify the influence of job stress and empowerment on nursing performance of clinical nurses working in small and medium hospital. METHODS: The empirical data were collected from a self-administered survey using a structured questionnaire with 404 nurses working in 4 medium-sized hospitals (less than 300 beds), located in I-city. The data were analyzed using stepwise multiple regression with the SPSS/WIN 17.0 program. RESULTS: There were significant differences in nursing performance depending on general characteristics (age, marital status, religion, shift work, education level, position, clinical experience, department, and monthly salary). Empowerment correlated with nursing performance. Factors influencing on nursing performance were empowerment, clinical experience, job stress, and marital status with R2 value of 36.3%. The most influencing factor was empowerment (beta=.47), followed by clinical experience (beta=.24), job stress (beta=.20), and marriage (beta=.12). CONCLUSION: It is needed to implement specific empowerment strategy, control job stress, and reward experienced and married nurses working in medium-sized hospital for improving nursing task performance.
Marital Status ; Marriage ; Power (Psychology) ; Surveys and Questionnaires ; Reward ; Task Performance and Analysis

PURPOSE: This study was performed to identify and understand the nature of attitude patterns regarding dying process exhibited in the elderly persons who lived in the community setting. METHOD: Q methodology was applied. Ten elderly were selected from the senior centers and requested to answer open ended questions by using written questionnaires. Additionally, 12 other elderly from different senior centers were interviewed in depth, and their statements were recorded via voice pen by researchers to derive Q-population. From the 120 Q-population, 33 Q-sample were selected. 22 P-sample were rated by 1 to 9 point scale respectively for Q-sorting. For Q-type analysis, pc QUNAL was used. RESULT: Three types of attitude patterns were identified, which were valuing dignity, seeking provision of nature, and avoiding of dying process. CONCLUSION: The significance of this study is as follows : Discovery of 3 attitude patterns of elderly toward dying, better understanding about elderly's perspectives for favorable dying, and informations for possible development of nursing strategies for elderly who is facing death.
Aged* ; Humans ; Nursing ; Q-Sort ; Senior Centers ; Voice ; Surveys and Questionnaires

PURPOSE: This research was to determine the characteristics of dysmenorrhea among girls, identify the factors affecting dysmenorrhea. METHOD: The study subjects were 1653 high school student in Busan Metropolitan city. The data were collected by a self-administered questionnaire between November 1 and November 30, 2002. Descriptive statistics, t-test, one-way ANOVA with Scheffe' test, and stepwise multiple regression analysis in SPSS program were used for data analysis. RESULT: Students suffering from slight dysmenorrhea made up the majority 52.9%, whereas those with serious cases represented 29.8%. Regarding the measures taken to cope with dysmenorrhea, most of the respondents took analgesics 52.8%. A high points of dysmenorrhea was associated with irregular meal habits(p<0.01), unbalanced diet(p<0.05), stress(p<0.01), and health awareness(p<0.01), first menstruation before they reached 13 (p<0.01), heavy bleeding(p<0.01), family history(p<0.01). Factors affecting the dysmennorrhea of the respondents included the extent of bleeding, family history, health awareness, age during the first menstruation, and degree of stress, accounting for 13.1% of the total variance. CONCLUSION: To manage dysmenorrhea among girls, the results of the research indicate that students need to have proper awareness of health and manage stress through health education. Likewise, they need to be given positive follow-up management through a holistic nursing approach.
Adolescent* ; Analgesics ; Busan ; Data Collection ; Dysmenorrhea* ; Female ; Health Education ; Hemorrhage ; Holistic Nursing ; Humans ; Meals ; Menstruation ; Statistics as Topic ; Child Health ; Surveys and Questionnaires

PURPOSE: This study was to prepare the basic data for prevention of colo-rectal cancer and protection against its spread. METHOD: The subjects for the study were 204 patients with colo-rectal cancer from the G.S. wards of five general hospitals in Busan for the period of June 1 to September 1, 2001. The instrument used was a questionaire which was developed by Junho Shin(1995). The data was analyzed by descriptive statistics, McNemar test, x2 test, paired t-test, and ANOVA. RESULT: 1. 57% of the studied subjects were male, 42.7% were more than 60 years old, 54.9% were of standard physique, 49.5% were the Buddhists, 50.5% were the middle or high school graduates, 83.8% were city dwellers, 48% were jobless, 69.6% had no-history of alimentary disease, 44.1% had no-family history of cancer, 82.8% were married. 2. Constipation(x2=36.45, p=0.0001) in clients showed a significant positive association for the pre- diagnosed, but diarrhea(x2=3.947, p=0.047) showed a significant positive association for the post-diagnosed. The preference for high seasonings(t=6.23, p=0.0001) and animal fat (t=8.35, p=0.0001) was higher significantly in the pre-diagnosed, but physical activities(x2= 30.22, p=0.0001), an eutrophic or tonic medicine(x2=30.22, p=0.0001), was of and vegetables(t=-6.20, p=0.0001) was higher significantly in the post-diagnosed. 3. There were significant differences in the life style of the pre-diagnosed according to the general characteristics except religion. CONCLUSION: Results of the above study reveal we should be very sensitive to the change of defecation styles and consider the necessity of improving life styles as regards eating habits. When an education program is developed, the general characteristics of the subjects need to be considered.
Animals ; Busan ; Defecation ; Eating ; Education ; Hospitals, General ; Humans ; Life Style* ; Male ; Middle Aged

OBJECTIVES: This study aimed to report the incidence of chronic posttraumatic stress disorder (PTSD), to identify psychosocial risk factors posttraumatically affecting the severity of PTSD symptoms, to compare the pattern of symptom changes over time, and to find early self-rated measures for the prediction of chronic PTSD in the patients physically injured by motor vehicle accident. METHOD: One-hundred-and-four motor vehicle victims, who were systematically recruited for the study of Kim et al(1998), were reevaluated through interview and questionnaire after twenty-four months. Clinician Administered PTSD Scale(CAPS), Beck Depression Inventory(BDI), Spiel-berger State Trait Anxiety Inventory(STAI), Impact of Event Scale(IES), questions about socioen-vironmental experiences after accident, and The Ways of Coping Checklist(WCC) were included in follow-up assessment. Of these subjects, 68 victims participated in CAPS interview and only 54 victims finished CAPS Interview, and questionnaire. The subjects with PTSD at initial and follow-up assessment were classified as the chronic PTSD group, subjects who recovered from PTSD at follow-up assessment were classified as the recovered group, and subjects who did not meet criteria for PTSD at initial and follow-up assessment were classified as the non-PTSD group. RESULTS: The prevalence of PTSD in motor vehicle victims was 39.8% in follow-up assessment. Compensation of disabilities, return to previous job and financial difficulty were associated with chronicity and poor psychological adjustment of PTSD. In total group of victims, PTSD symptoms that appeared at initial assessment were improved or disappeared at follow-up assessment. However, avoidance and numbing symptoms significantly increased in chronic PTSD group and "acting or feeling as if event were recurring" and "exaggerated startle response" were not recovered over time in recovered group. Only IES at initial assessment showed significant differences among Non-PTSD, PTSD and recovered group. BDI, STAI-II, active coping and passive coping at follow-up assessment showed significant differences among three groups. IES at initial assessment contributed 18.6% to CAPS variance at follow-up. CONCLUSION: This study showed a high risk of developing PTSD among physically injured victims after motor vehicle accident. Risk factors such as event severity, compensation of disabilities, return to previous job and financial difficulty were identified. High IES score at initial assessment was regarded as major factor affecting chronic PTSD.
Emotional Adjustment ; Anxiety ; Compensation and Redress ; Depression ; Follow-Up Studies ; Humans ; Incidence* ; Motor Vehicles* ; Prevalence ; Prospective Studies* ; Surveys and Questionnaires ; Risk Factors ; Stress Disorders, Post-Traumatic*

No abstract available.

Overwhelming evidences supports the idea that inflammatory bowel disease (IBD) is caused by a complex interplay between genetic alterations of multiple genes and an aberrant interaction with environmental factors. There is growing evidence that epigenetic factors can play a significant part in the pathogenesis of IBD. Significant effort has been invested in uncovering genetic and epigenetic factors, which may increase the risk of IBD, but progress has been slow, and few IBD-specific factors have been detected so far. It has been known for decades that DNA methylation is the most well studied epigenetic modification, and analysis of DNA methylation is leading to a new generation of cancer biomarkers. Therefore, in this review, we summarize the role of DNA methylation alteration in IBD pathogenesis, and discuss specific genes or genetic loci using recent molecular technology advances. Here, we suggest that DNA methylation should be studied in depth to understand the molecular pathways of IBD pathogenesis, and discuss epigenetic studies of IBD that may have a significant impact on the field of IBD research.
Biomarkers ; DNA Methylation ; Epigenomics* ; Genetic Loci ; Inflammatory Bowel Diseases*

Overwhelming evidences supports the idea that inflammatory bowel disease (IBD) is caused by a complex interplay between genetic alterations of multiple genes and an aberrant interaction with environmental factors. There is growing evidence that epigenetic factors can play a significant part in the pathogenesis of IBD. Significant effort has been invested in uncovering genetic and epigenetic factors, which may increase the risk of IBD, but progress has been slow, and few IBD-specific factors have been detected so far. It has been known for decades that DNA methylation is the most well studied epigenetic modification, and analysis of DNA methylation is leading to a new generation of cancer biomarkers. Therefore, in this review, we summarize the role of DNA methylation alteration in IBD pathogenesis, and discuss specific genes or genetic loci using recent molecular technology advances. Here, we suggest that DNA methylation should be studied in depth to understand the molecular pathways of IBD pathogenesis, and discuss epigenetic studies of IBD that may have a significant impact on the field of IBD research.
Biomarkers ; DNA Methylation ; Epigenomics* ; Genetic Loci ; Inflammatory Bowel Diseases*

We produced two murine monoclonal antibodies designated S2E1 and S2C11, which recognize S antigen of hepatitis B virus (HBsAg). S2E1 could bind to denatured form of recombinant HBsAg as well as native form of HBsAg, but S2C11 could bind only to native form of HBsAg. Both antibodies reacted with HBsAg in the hepatocyte of patient infected with hepatitis B virus. Analyses of the nucleotide sequences encoding the variable regions of these antibodies revealed that S2E1 and S2C11 utilize variable gene segment which belong to V4/5 gene family and utilize the J5 and Jk4 gene segments, respectively. In addition, the heavy chain of S2E1 express a member of V14 gene family and a member of DSP2.9 and Jh3 gene families. S2C11 is related to the V1 gene family and expresses DFL16.1 gene regions in conjunction with the Jh3 gene segment.
Antibodies ; Antibodies, Monoclonal* ; Base Sequence ; Clone Cells* ; Cloning, Organism* ; Hepatitis B Surface Antigens ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis* ; Hepatocytes ; Humans