No abstract available.

As cost pressures have escalated, policy makers, politicians, health care providers and families have tried to devise ways to reduce health care costs. While originally developed to enhance patient control and to provide better care at the end of life, hospice care has recently received significant attention as a mean of reducing health care costs. As a program providing care for patients who are dying at their homes, hospice has expanded slowly since the opening of the first hospice in Korea in 1963. Therefore, a variety of services that responds to the needs and concerns of many dying people and their families is limited The purpose of this study was to determine the potential cost savings at the end of life among patients who used home hospice compared with the patients who received institutional care in Korea. This study used a retrospective, descriptive design. The sample for this study included 46 patients who died of lung cancer: 25 patients who received home hospice care and 21 patients who received institutional care. Data on patient characteristics, kinds and frequencies of provided treatment and nursing services, and hospice and hospital charges during the last month before death were collected. Cost of care was measured by the average cost per patient per day in the last month of life. The results of the study indicated that there were significant differences in average cost of care between home hospice sample and institutional care sample (t=9.956, p<.001; home hospice sample: M=18,102 won, institutional care sample: M=317,578 won). The cost of the home hospice sample was approximately 6% of the cost of institutional care. The majority of the home hospice nursing services were education (35.7%) and supportive counseling (25.2%), followed by medication management (13.6%), assessment (12.1%), basic nursing (7.2%), treatment (5.5%) and others. In institutional care sample, basic nursing and treatment were more emphasized than education or supportive counseling among the nursing services provided. The results of this study showed the potential for hospice to reduce costs and implications for policymakers and clinicians to incorporate hospice program into the formal health care delivery system in Korea.
Administrative Personnel ; Cost Savings ; Counseling ; Delivery of Health Care ; Education ; Health Care Costs ; Health Personnel ; Hospice and Palliative Care Nursing ; Hospice Care* ; Hospices* ; Hospital Charges ; Humans ; Korea ; Lung Neoplasms ; Nursing Services* ; Nursing* ; Retrospective Studies ; Terminally Ill*

No abstract available.
Wilms Tumor*

No abstract available.
Anemia, Hemolytic* ; Humans ; Infant, Newborn ; Infant, Premature* ; Vitamin E* ; Vitamins*

Spiritual health is an important indicator in the quality of life of patients with cancer. The purpose of this study was to validate a Spiritual Health Inventory (SHI) for patients with cancer developed by Highfield (1989). The SHI was translated into Korean, back-translated into English. The study sample was 96 patients with cancer. The data were collected from September, 1999 to February, 2000 for 6 months. Statistic analysis was done with the SPSS PC+ (Version 10.0) program: descriptive statistics, factor analysis, Pearson correlation coefficient, and one-way ANOVA. The results are as follows: 1. The reliability score was examined using Cronbach's alpha and found to be .79. 2. Construct validity was examined using factor analysis. Four factors were identified and named: Peace of mind (19.1% of variance), Hope (9.7%), Self-esteem (6.4%), Trust (6.0%). The total of 41.2 percent of the variance. 3. The Pearson correlation coefficient score of 4 factors was between r = .24~ .42. 4. SHI was identified as multidimension, that is The relationship with GOD, as absolute being, the relationship with others, the relationship within oneself. 5. There were differences in response in items especially related to GOD. The following recommendations can be made on the above findings: 1. Replicate with a minimum sample of 150 and test for concurrent validity. 2. Since spirituality is a dynamic concept, longitudinal study is also necessary. 3. Concept analysis using a qualitative study based on religious preference is recommended. 4. The items such as 12, 13, 15, 17, 19, 22, 24, 26 indicated conceptual ambiguity for Korean populations and further study is needed on item deletion or new items.
Hope ; Humans ; Quality of Life ; Reproducibility of Results* ; Spirituality

No abstract available.
Female* ; Humans ; Krukenberg Tumor*

The purpose of this study was to investigate the relationship among percieved social support, hope and quality of life of the cancer patients and to gain the baseline data for development of nursing intervention program for promoting quality of life in cancer patients. The design of this study was a cross sectional correlational survey. The subjects were 20 out and in-cancer patients in 5 general hospitals in Pusan The data were collected from July 2 to August 1. 2001. The instruments were the Percieved social support scale(16 items, 5 point scale) had developed by Tae(1986), Hope scale(12 items, 4point scale) developed by Nowotny(1989) and Quality of life scale(31 items, 10 point scale) developed by Tae et al.(2000). The data was analyzed by the SPSS/PC+ program using frequency & percentage, item mean & standard deviation, t-test, ANOVA & Scheffe test, Pearson's correlation coefficient. The results of this study was as follows: 1) The item mean score of quality of life was 6.05+/-1.16 (range 0-10). The heighest score of subarea of the quality of life was the spiritual wellbeing area (7.09+/-1.63) and the lowest score was social wellbeing area(5.53+/-1.65), The mean score of perceived social support was 52.65+/-10.32 (the lowest 1, the highest 80). The mean score of family support was32.71+/-6.66 (range 1- 40) and the mean score of medical team support was 19.93+/-5.95 (range 1- 40), The mean score of Hope was 37.02+/-5.64 (range 1- 48). 2) There were statistically significant difference in the score of quality of life according to the life effect of religion(F=3.97, p=0.00), treatment method(F=2.94, p=0.01), area of diagnosis (F=3.48, p=0.01), stage of disease (F=13.74, p= 0.00). 3) There was significant correlation between perceived social support(r=0.44, p=0.000 ; family support: r=0.334, p=0.000, medical support; r=0.395, p=0.000), hope(r=0.563, p= 0.000) and quality of life. In conclusion, there was a significant relationship among perceived social support, hope and quality of life. Therefore perceived social support, hope intervention programs should be developed to improve the quality of life in cancer patients.
Busan ; Diagnosis ; Hope* ; Hospitals, General ; Humans ; Nursing ; Quality of Life*

BACKGROUND & OBJECTIVE: We did this study to evaluate the sensitivity of ictal SPECT in the presurgical evaluation of medically intractable TLE patients and 1,o know the variables to affect the results of ictal SPECT. METHODS: Ictal SPECT studies were performed in 49 medically intractable TLE patients and the results compared to the final anterior temporal lobectomy sites. Also, we have evaluated the effect of injection time of 99m7c-HMPAO and the presence of secondary generalization on the result of ictal SPECT. Results : In 43/49 (87.8%) patients, increased temporal perfusion of ictal SPECT was concordant to the estimated side of seizure origin. But in 6/49 (12.2%) patients, ictal SPECT studies were incorrect (2 patients - contralateral temporal increased perfusion, 1 patient - bilateral temporal increased perfusion, 1 patient ipsilateral but frontal increased perfusion, 2 patients - no significant perfusion change) Forty-two of forty-four (95.5%) patients in whom true ictal studies were done showed increased temporal perfusion in the final surgery sites. But only one of five patients with postictal injection correctly identified the site of focus. In all eight patients with secondary generalized convulsion and ictal injection, the ictal SPECT studies showed Increased temporal perfusion concordant to the final surgery site. Conclusions : Ictal SPECT studies were very sensitive and useful in the presurgical evaluation of medically intractable TLE patients especially when they were done during the ictal state. Whether generalization occurred or not did not seem to affect the ictal SPECT findings. And this study suggests that if ictal SPECT are used appropriately along with video-EEG monitoring, brain MRI, and other noninvasive studies, many patients can avoid invasive studies.
Anterior Temporal Lobectomy ; Brain ; Generalization (Psychology) ; Humans ; Magnetic Resonance Imaging ; Perfusion ; Seizures ; Tomography, Emission-Computed, Single-Photon*

Neuroacanthocytosis is a rare dosorder characterized by various neurological manifestations and the presence of abnormal red blood cells called acanthocytes which have a disturbed morphology showing spiky, knobby end projections. Acanthocytosis associated with neurological involvements includes 3 major syndromes ; Bassen-Korzweig syndrome, choreoacanthocytosis (or Levine-Critchley syndrome), and Mcleod syndrome. Here, we report two cases of familial choreoacanthocytosis. A 40 years old man presented with orofacial dyskinesia, involuntary vocalization, dysarthria, dysphagia, generalized choreic movements, hyporef lexia, and amyotrophy of the bilarteral anterior tibilais muscles. Serum creatine phosphokinase was increased. Scanning electronmicroscopic examination of the fresh peripheral blood smear film showed acanthocytes, corresponding to about 6% of all red blood cells. His one of two daughter had high arched foot, bradykinesia, and hypoactive deep tendon reflexes. A 70 years old woman showed head and hand tremor, bilateral eye brow choreic movements, torticollis and bradykinesia. Her mother and two younger sisters had head termor. Serum creatine phosphokinase level was normal. Scanning electronmicroscopic examination of the fresh peripheral blood smear showed acnthocytes, corresponding to 9% of the examined red blood cells.
Abetalipoproteinemia ; Acanthocytes ; Adult ; Aged ; Chorea ; Creatine Kinase ; Deglutition Disorders ; Dysarthria ; Erythrocytes ; Female ; Foot ; Hand ; Head ; Humans ; Hypokinesia ; Mothers ; Movement Disorders ; Muscles ; Neuroacanthocytosis* ; Neurologic Manifestations ; Nuclear Family ; Reflex, Stretch ; Siblings ; Torticollis ; Tremor

The purpose of this study is to examine how nutritionists, principals and parents evaluated the importance and priorities of different selection factors for food materials suppliers in an attempt to suggest how to ensure the best supplier choice, since the selection of the best supplier was mandatory for the successful TQM of school food services. This study especially aims to develop priority alternatives based on relative rather than absolute assignments on selection of suppliers for school food service materials. To apply AHP, the selection factors of a food materials suppliers were grouped into five categories, which included quality, service, reliability, hygiene and price. And the five categories involved 28 elements. As the result, quality was considered most crucial on the whole, followed by service, reliability, hygiene and price; and food labeling in the category of quality evaluated as that of first priority in the totality evaluation elements.
Dietary Sucrose ; Food Labeling ; Food Services ; Humans ; Hydroxyproline ; Hygiene ; Parents