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

The purpose of this pilot study was to identify the effects of hand moxibustion therapy to decrease pain and relieve coldness of the body in women who had a hysterectomy. The conceptual framework of this study was derived from Ying-Yang, Khi and other corresponding theories. The data were collected from February to May 1997. A Graphic Rating scale was used to measure the degree of pain and Digital Infrared Thermographic Imaging(D.I.T.I) was used to examine the degree of coldness. The subjects were women who resided in Seoul and had a hysterectomy within five years. An experimental group was composed of five women who received moxibustion and a control group was composed of five who did not. The research procedure began with having both the experimental group and control group describe their general characteristics and the degree of pain they perceived. Then, Digital Infrared Thermographic Imaging(D.I.T.I) was conducted. Moxibustion was only given to the experimental group on both hands twice every day for a total of five weeks. Their perception of pain and D.I.T.I were examined weekly. The control group received no therapy. After finishing therapy, the perception of pain and D.I.T.I for both groups were also measured. According to this study, moxibustion therapy resulted in a change of body temperature on the right shoulder joint(p=0.00074), abdomen(p= 0.0047), waist(p=0.0068) and hands(p=0.0317) respectively. Also, the study results showed significant decrease (p=0.0001) in pain over time and significant improvement over body coldness.
Body Temperature ; Female ; Hand* ; Humans ; Hysterectomy* ; Moxibustion* ; Pilot Projects ; Seoul ; Shoulder

No abstract available.
Aneurysm, Dissecting* ; Paraplegia*

No abstract available.
Knee Joint* ; Knee* ; Torque*

No abstract available.
Pregnancy*

The purpose of nursing education is to prepare the professional practitioner as nurse who will be interested in the health and the related aspects of community and will assume responsibility for contributing toward the improvement of the health for the all. This means that nursing education must provide opportunities for the development of knowledge, skills, and attitudes which make this possible. Consequently, this approach has relevance for nursing education. Faculty engaged in endless debates about what is to be included, and to what death, and what will be given short shrift as a result. Thus, it can be seen why there is so much confusion and lack of agreement between the emphasis and objectives in nursing. This study attempted to review and identify the curriculum content of child nursing in Korea to build and develop the standard curriculum contents for national board examination for nurses and child's health needs for the coming 21st century. The questionnaire was consisted of items for selection and organization of the knowledge components and type of unit with weigh to be attained in child nursing. Response of 34% of nursing program in university and junior college. Content analysis was done by using consensual validation of essential knowledge for curriculum content to identify what is obvious or trivial. This study pointed out that it is not yet apparent that demographic fact has greatly influenced child nursing curriculum content. In a similar vein the majority of content of child nursing devote little time and weigh to social and epidemically significant to child health. It seems to be needed that the content of child nursing may push the paradigm shift in nursing education such as health promotion and prevention for postretinal roles of child and family. In conclusion, it is time to convoke and content and standardization on job analysis for national board exam for nurses in Korea.
Child* ; Curriculum* ; Education, Nursing ; Health Promotion ; Humans ; Korea* ; Nursing* ; Veins ; Child Health ; Surveys and Questionnaires

Chronotype is an important moderator of psychiatric illnesses, which seems to be controlled in some part by genetic factors. Clock genes are the most relevant genes for chronotype. In addition to the roles of individual genes, gene-gene interactions of clock genes substantially contribute to chronotype. We investigated genetic associations and gene-gene interactions of the clock genes BHLHB2, CLOCK, CSNK1E, NR1D1, PER1, PER2, PER3, and TIMELESS for chronotype in 1293 healthy Korean individuals. Regression analysis was conducted to find associations between single nucleotide polymorphism (SNP) and chronotype. For gene-gene interaction analyses, the quantitative multifactor dimensionality reduction (QMDR) method, a nonparametric model-free method for quantitative phenotypes, were performed. No individual SNP or haplotype showed a significant association with chronotype by both regression analysis and single-locus model of QMDR. QMDR analysis identified NR1D1 rs2314339 and TIMELESS rs4630333 as the best SNP pairs among two-locus interaction models associated with chronotype (cross-validation consistency [CVC] = 8/10, p = 0.041). For the three-locus interaction model, the SNP combination of NR1D1 rs2314339, TIMELESS rs4630333, and PER3 rs228669 showed the best results (CVC = 4/10, p < 0.001). However, because the mean differences between genotype combinations were minor, the clinical roles of clock gene interactions are unlikely to be critical.

Chronotype is an important moderator of psychiatric illnesses, which seems to be controlled in some part by genetic factors. Clock genes are the most relevant genes for chronotype. In addition to the roles of individual genes, gene-gene interactions of clock genes substantially contribute to chronotype. We investigated genetic associations and gene-gene interactions of the clock genes BHLHB2, CLOCK, CSNK1E, NR1D1, PER1, PER2, PER3, and TIMELESS for chronotype in 1293 healthy Korean individuals. Regression analysis was conducted to find associations between single nucleotide polymorphism (SNP) and chronotype. For gene-gene interaction analyses, the quantitative multifactor dimensionality reduction (QMDR) method, a nonparametric model-free method for quantitative phenotypes, were performed. No individual SNP or haplotype showed a significant association with chronotype by both regression analysis and single-locus model of QMDR. QMDR analysis identified NR1D1 rs2314339 and TIMELESS rs4630333 as the best SNP pairs among two-locus interaction models associated with chronotype (cross-validation consistency [CVC] = 8/10, p = 0.041). For the three-locus interaction model, the SNP combination of NR1D1 rs2314339, TIMELESS rs4630333, and PER3 rs228669 showed the best results (CVC = 4/10, p < 0.001). However, because the mean differences between genotype combinations were minor, the clinical roles of clock gene interactions are unlikely to be critical.

PURPOSE: This study was done to examine relationships between nurse staffing level and postsurgical patient outcomes using inpatient database from the National Health Insurance. METHODS: Records of 111,491 patients who received one of 12 types of surgery between January and December, 2009 were identified and analyzed in this study. Nurse staffing level was measured using adjusted nurse staffing grades from 0 to 7. Patient outcomes were defined as in-hospital mortality, or pneumonia, sepsis, or urinary tract infection after surgery. Logistic regression analyses estimated by Generalized Estimation Model, were used to analyze the association between nurse staffing level and patient outcomes. RESULTS: An inverse relationship was found between nurse staffing and patient mortality. Compared with patients who were cared for in hospitals with the highest nurse staffing (Grades 0-1), increases in the odds of dying were found in those with Grades 6-7 [OR (odds ratio)=2.99, 95% CI (confidence interval)=1.94-4.60], those with Grades 4-5 (OR=1.78, 95% CI=1.24-2.57) and those with Grades 2-3 (OR=1.57, 95% CI=1.25-1.98). Lower nurse staffing level was also associated with higher number of cases in pneumonia and sepsis. CONCLUSION: Policies for providing adequate nurse staffing is required to enhance quality of care and lead to better perioperative patient outcomes.
Adult ; Aged ; Aged, 80 and over ; Female ; *Hospital Mortality ; Hospitals ; Humans ; Logistic Models ; Male ; Middle Aged ; Nursing Staff, Hospital/*supply & distribution ; Odds Ratio ; Outcome Assessment (Health Care) ; Pneumonia/etiology/*mortality ; Sepsis/etiology/*mortality ; Severity of Illness Index ; Surgical Procedures, Operative/adverse effects ; Urinary Tract Infections/etiology/*mortality

PURPOSE: The purpose of this study was to develop an educational program for parents of children with epilepsy. METHOD: The first step was to survey the need for information and social support for these parents. The second step was to design the educational program based on the survey results, literature review, and the theory of chronic sorrow that provided a framework for understanding and working with people suffering a loss of health. RESULT: The information which these parents were most anxiously seeking was information on the causes of seizures, appropriate steps deal with seizures, and appropriate and supportive parental role for their children. The educational program for parents of children with epilepsy included understanding the responses to loss, increasing the parents' knowledge about how to care for their children, managing their stress, enhancing the psychosocial adaptation of children, and encouraging the participation of the family. CONCLUSION: The educational program developed by the researcher can used with parents of children with epilepsy, and is expected to enhance the psychosocial adaptation of these children.
Child* ; Epilepsy* ; Humans ; Parents* ; Program Development ; Seizures