Purpose: This study was conducted to develop a scale to measure spiritual distress in cancer patients. Methods: A total of 69 preliminary items for the spiritaul distress assessment tool (SDAT) were compiled, based on a literature review, selection of empirically relevant items through concept analysis of hybrid models, confirmation of content validity by experts, cognitive interviews, and a pretest. Self-administered questionnaires were collected between April 1 and July 31, 2018, from 225 cancer patients at four medical institutions and one nursing home. The data were analyzed using item analysis, exploratory factor analysis, convergent and discriminant validity, and Pearson correlation for criterion validity. Reliability was tested by Cronbash’s α coefficient. Results: The final version of the SDAT consisted of 20 items. Five-factors, loss of peace, burden of family, avoidance of confronting death, guilt and remorse, regret for not being able to apololgize and forgive were extracted, and showed 62.8% of total variance. The factors were confirmed through convergent and discriminant validity. Criterion validity was confirmed by functional assessment chronic illness therapy spiritual well-being scale 12 (FACIT-Sp12). The overall Cronbach’s α was .91, and the coefficients of each subscale ranged from .78~.83. Conclusion The SDAT for cancer patients is valid and reliable. It is suggested that the tool can be used to measure spiritual distress in cancer patients.

Severe sepsis and septic shock are the main causes of death in critically ill patients. Early detection and appropriate treatment according to guidelines are crucial for achieving favorable outcomes. Endotoxin is considered to be a main element in the pathogenic induction of gram-negative bacterial sepsis. Polymyxin B hemoperfusion can remove endotoxin and is reported to improve clinical outcomes in patients with intra-abdominal septic shock, but its clinical efficacy for pneumonic septic shock remains unclear. Here, we report a case of a 51-year-old man with pneumonic septic shock caused by Pseudomonas aeruginosa, who recovered through polymyxin B hemoperfusion.
Cause of Death ; Critical Illness ; Gram-Negative Bacteria* ; Hemoperfusion* ; Humans ; Middle Aged ; Polymyxin B* ; Polymyxins* ; Pseudomonas aeruginosa ; Sepsis ; Shock, Septic*

PURPOSE: The purpose of this study was to explore the main prerequisite for Korean Advance Directives [KAD] to ensure their better use. METHODS: Data were collected from two focus group interviews and individual email responses. Study participants were 5 doctors and 6 nurses. All interview data were transcribed and analyzed using qualitative content analysis. RESULTS: Three main themes emerged; establishing a philosophy of KAD, protocol to practice KAD, and the KAD document itself. A philosophy is needed to ensure individual needs, consensus to practice AD and identify principle agents. The core of protocol was found to be as follows; 1) process, 2) premise, 3) procedure, 4) contextual preparation, 5) timing, 6) feasibility. Component and feasibility need to be established for the document itself. CONCLUSION: For a positive acceptance of KAD in Korean society, a culture sensitive, reality based, and user friendly AD needs to be developed.
Adult ; *Advance Directives ; Asian Continental Ancestry Group ; Female ; Focus Groups ; Health Personnel/*psychology ; Humans ; Interviews as Topic ; Male ; Middle Aged ; Qualitative Research ; Questionnaires ; Republic of Korea

BACKGROUND: The purpose of this study was to evaluate the historical anesthetic trends for last 35 years at Chonnam National University Hospital (CNUH). METHODS: The anesthetic records of total 101,637 anesthetic cases performed at CNUH from January 1961 to December 1996 were reviewed and analyzed according to age, sex, department, operation site, physical status, preoperative findings, anesthetic methods and agents, duration of operation, etc. RESULTS: Annual anesthetic cases was increased remarkably year by year; annual surgical patients increased 19 times for 35 years. The ratio of male to female was 1.18:1. The percent of geriatric anesthesia was increased year by year. In preoperative physical status from ASA definitions, 83.6 % of total patients was assigned class I and II. The average departmental distributions in descending order were surgery, orthopedic surgery, obstetrics and gynecology, neurosurgery, urology, ENT, thoracic surgery, ophthalmology, plastic surgery, oral and maxillofacial surgery, and others. The distributions of operation site in descending order were lower abdomen, neck, upper abdomen, lower extremities, head, chest, spine, upper extremities, and breast. Inhalational anesthesia was the most frequent used methods. Ether was abandoned from 1983, and major volatile anesthetics was halothane from 1981 to 1991. The use of enflurane has steadily increased and isoflurane has also been used with increasing frequency since 1992. CONCLUSIONS: Anesthetic cases are markedly increased year by year, and major volatile anesthetics and neuromuscular blocker were changed from halothane to enflurane and from pancuronium to vecuronium, respectively.
Abdomen ; Anesthesia ; Anesthetics ; Breast ; Enflurane ; Ether ; Female ; Gynecology ; Halothane ; Head ; Humans ; Isoflurane ; Jeollanam-do* ; Lower Extremity ; Male ; Neck ; Neuromuscular Blockade ; Neurosurgery ; Obstetrics ; Ophthalmology ; Orthopedics ; Pancuronium ; Retrospective Studies* ; Spine ; Surgery, Oral ; Surgery, Plastic ; Thoracic Surgery ; Thorax ; Upper Extremity ; Urology ; Vecuronium Bromide

For hospice palliative care that provides comprehensive and general care, it is necessary to use assessment tools to objectively list issues and detail care plans. The initial assessment is a process of establishing an overall direction of care by identifying the patient's symptoms, social and spiritual issues and palliative care needs on the admission day or within one day of admission. This process is also used to identify the patients' and families' awareness of the illness, prognosis, treatment options and if the Physician Orders for Life-Sustaining Treatment (POLST) has been drafted. Consisting of 13 simple questions regarding the physical, mental, social, and spiritual domains, the Needs at the End-of-Life Screening Tool (NEST) is recommended as an initial assessment tool. Using specific assessment tools, a care plan is established for the issues identified in the initial assessment within three days of admission. A multidisciplinary assessment tool can be helpful in the physical domain. The psychosocial domain evaluates psychological distress, anxiety and depression. The social domain examines an ability to make decisions, understanding of the socioeconomic circumstance, family relationship, and death preparedness. A spiritual evaluation is also important, for which the Functional Assessment of Chronic Illness Therapy-Spiritual WellBeing Scale (FACIT-Sp) or the Spiritual Health Inventory (SHI) can be used. The use of an assessment tool could not only contribute to pain mitigation a better quality of life for patients, but also provide systematic training for a multidisciplinary team; And the process itself could be a stepping stone for the better care provision.
Anxiety ; Chronic Disease ; Depression ; Family Relations ; Hospice Care ; Hospices ; Humans ; Mass Screening ; Pain Measurement ; Palliative Care ; Prognosis ; Quality of Life

Abstract Tumor of the accessory parotid gland is frequently mistaken as a cheek subcutaneous tumor because of its location and rarity. Preoperative tissue diagnosis is imperative for proper treatment of this rare tumor. In technical point of view, the parotidectomy approach with wide facial nerve dissection and careful elevation of cheek flap is the key to safe resection of the tumor without complication of facial nerve injury. We report one case each of primary and metastatic cancer of accessory parotid gland with a brief review of literature.
Cheek ; Diagnosis ; Facial Nerve ; Facial Nerve Injuries ; Parotid Gland* ; Parotid Neoplasms

Ideal charateristics of soft tissue fillers include longevity, biocompatibility, low adverse event profile and a reasonable cost. Radiesse(R) have many advantage as the desirable properties of facial filler. Authors introduce Radiesse(R) was recently introduced as a facial filler agent. Radiesse(R) was injected to 81 male and female patients in the study, using 27G fine needle. The age range of the patients was 22 to 48 years. The injected areas were nasal root, tip, nasolabial folds and jaw. We measured patient satisfaction scale during the period of follow up 2 to 6 months. The scale of satisfaction was good to excellent in 69 cases of 81 cases and fair in 9 cases of 81 cases. Patients satisfaction was poor in only 3 cases. Patients were observed no systemic effects but minimal adverse events which are leakage, nodule and subclinical inflammation. Radiesse(R) was highly effective, long lasting material for facial soft tissue augmentation. If a precise injection technique were applied, Radiesse(R) can be a very good option for real volumetric facial soft tissue augmentation.
Female ; Male ; Humans

PURPOSE: The tension-free vaginal tape SECUR(R) (TVT-S) is a new, minimally invasive sling procedure for treating female stress urinary incontinence (SUI). However, results of comparisons of the TVT-S with the transobturator tape (TOT) sling are lacking. Therefore, we investigated outcome and satisfaction of the TVT-S procedure compared with the TOT procedure. MATERIALS AND METHODS: We included 64 patients with SUI who underwent the TVT-S (n=31) or TOT (MONARC(R), n=33) procedure and were followed up for more than 1 year. The preoperative evaluation included history taking, pelvic examination, consecutive 3-day voiding diary, and urodynamic study including Valsalva leak point pressure. Postoperatively, continence status and subjective patient satisfaction were evaluated. Cure was defined as the absence of any episodes of involuntary urine leakage during stressful activities and a stress cough test. RESULTS: The TVT-S group (71.0%) showed a slightly lower cure rate than did the MONARC group (84.8%); however, there was no significant difference between the 2 groups (p=0.179). Nine of the patients who underwent the TVT-S showed incontinence postoperatively. Among them, the H approach was used in 7 patients and the U approach was done in 2 patients. Following TVT-S and MONARC, the patients' reported satisfaction was 80.6% and 78.8%, respectively. Patient satisfaction did not differ significantly between the two groups (p=0.854). CONCLUSIONS: Our results showed that the TVT-S and MONARC procedures may be comparable in terms of cure rate and patient satisfaction after more than 1 year of follow-up.
Cough ; Female ; Follow-Up Studies ; Gynecological Examination ; Humans ; Patient Satisfaction ; Suburethral Slings ; Surgical Procedures, Minimally Invasive ; Treatment Outcome ; Urinary Incontinence ; Urinary Incontinence, Stress ; Urodynamics

PURPOSE: Analyzing of the causes of childhood death will provide us with the basis to understand prevalent diseases and to make the best possible health plan according to the studies. The National Statistical Office (NSO) of Korea has released an annual report of nationwide death. However, it could have underestimated the death toll of children because of delayed or missing reports of infants who died during the neonatal period. The death reports by pediatricians at hospitals could compensate for the dropped number of infantile death reported by the NSO. METHODS: We collected the death records for children under 15 years of age from the 136 secondary or tertiary referral hospitals over the country from January 1 through December 31, 1995. Then we tried to make a compilation of the records from both the NSO and our committee to finalize the cause of death. RESULTS: According to the records of the 136 hospitals, the total number of childhood death was 3,900 in 1995, including 1,790 deaths in the first 28 days of life. Most deaths occurred in the hospital (89.0%), which were confirmed either by a pediatrician (6.2%) or by a pediatric resident (58.8%). We were compiling 6,735 deaths according to the NSO and 3,415 of our own, with 846 overlaps. Seventeen deaths recorded by the NSO occurred in the first 6 days of life, compared to 1,292 from our own. After the first year, 4,762 deaths recorded by the NSO and 790 of ours were observed. CONCLUSION: The death records from hospitals could be enough to compensate for the dropped number of neonatal deaths recorded by the NSO, depicting more accurately the real pattern of death for Korean children in 1995.
Cause of Death* ; Child* ; Death Certificates ; Humans ; Infant ; Korea ; Tertiary Care Centers

PURPOSE: Analyzing of the causes of childhood death will provide us with the basis to understand prevalent diseases and to make the best possible health plan according to the studies. The National Statistical Office (NSO) of Korea has released an annual report of nationwide death. However, it could have underestimated the death toll of children because of delayed or missing reports of infants who died during the neonatal period. The death reports by pediatricians at hospitals could compensate for the dropped number of infantile death reported by the NSO. METHODS: We collected the death records for children under 15 years of age from the 136 secondary or tertiary referral hospitals over the country from January 1 through December 31, 1995. Then we tried to make a compilation of the records from both the NSO and our committee to finalize the cause of death. RESULTS: According to the records of the 136 hospitals, the total number of childhood death was 3,900 in 1995, including 1,790 deaths in the first 28 days of life. Most deaths occurred in the hospital (89.0%), which were confirmed either by a pediatrician (6.2%) or by a pediatric resident (58.8%). We were compiling 6,735 deaths according to the NSO and 3,415 of our own, with 846 overlaps. Seventeen deaths recorded by the NSO occurred in the first 6 days of life, compared to 1,292 from our own. After the first year, 4,762 deaths recorded by the NSO and 790 of ours were observed. CONCLUSION: The death records from hospitals could be enough to compensate for the dropped number of neonatal deaths recorded by the NSO, depicting more accurately the real pattern of death for Korean children in 1995.
Cause of Death* ; Child* ; Death Certificates ; Humans ; Infant ; Korea ; Tertiary Care Centers