PURPOSE: This study was to identify the role of general hospice palliative nurse through job analysis (duties, task, and task elements). METHODS: The sample consisted of 136 nurses or professors who were performing duties related to hospice care areas in Korea. A survey method was used, and the questionnaire included frequencies, criticality, and difficulties of task elements in job description by the DACUM method. Descriptive statistics were performed by using SPSS WIN 17.0. RESULTS: The job description of general hospice palliative nurse was identified 8 duties, 36 tasks, and 137 task elements. As for the 8 duties, the average scores of frequency, criticality, and difficulty were 2.94, 3.66, and 2.80, respectively. The role of 'pain assessment' was the most important task element among frequency and criticality. The lowest score at the frequency and criticality were 'manage public finance' and 'collect datum through diagnostic test & lab', respectively. Furthermore, the role of 'identify spiritual needs of patients and family' was the most difficult task, whereas the role of 'manage documents and information' was the least. CONCLUSION: In this study, we could recognize the reality of general hospice palliative nurse's performances. For general hospice palliative nurse, therefore, concrete practice guide lines of psychosocial and spiritual care, communication skills, and bereavement care with qualifying system are critically needed.
Surveys and Questionnaires ; Diagnostic Tests, Routine ; Hospice Care ; Hospices ; Humans ; Job Description ; Korea ; Nurse's Role ; Nursing Staff ; Task Performance and Analysis

PURPOSE: Authors evaluated results of palatoplasty by speech analysis in bilateral, unilateral complete, and unilateral incomplete and submucous cleft palate patients. METHODS: The speech outcomes were studied in 15 bilateral, 28 unilateral complete, and 46 unilateral incomplete and submucous cleft palate patients who underwent push-back palatoplasties from January 1998 to July 2004. The patients were divided into 2 groups as 3 to 6, 7 to 10-year-old and compared with 20 normal children(control groups were divided into 10 children on each side). Nasal emission test, hypernasality test, and articulation test were done by speech evaluation table which was composed of 39 different words. RESULTS: In all speech evaluation tests, the group of bilateral cleft palate patients got the worst score. And 7 to 10-year-old groups got better score when compared to the same type cleft palate. CONCLUSION: Bilateral cleft palate patients have many more speech problems than other patients. In cleft palate patients, the speech problem was improved with ages, postoperatively. And the speech therapy can improve the operative outcomes.
Child ; Cleft Palate ; Humans ; Speech Therapy

BACKGROUND: Carcinoma of the ampulla of Vater is rare and its pathogenesis is unclear. The role of epigenetic changes in the APC or CDH1, in the Wnt pathway, has not been reported in ampullary carcinomas. METHODS: We performed immunohistochemistry on 73 sporadic ampullary carcinomas to identify Wnt-related molecules (APC, beta-catenin, E-cadherin, c-erbB2, cyclin D1) and examined mutations in the CTNNB1, loss of heterozygosity of 5q21, and the methylation status of the CpG island of APC and CDH1. RESULTS: Thirteen tumors (17.8%) showed abnormal nuclear localization of beta-catenin; this was more prominent in the intestinal type than in the pancreaticobiliary type (p=0.01). The loss of APC correlated with the loss of beta-catenin or c-erb B2 (p<0.01). The prognosis was worse in the group with APC loss than when APC was maintained (p<0.05). There was no mutation identified in CTNNB1. Six (24%) out of 25 informative cases had 5q21 allelic loss. CpG island methylation in APC and CDH1 was detected in 33 (45.2%) and 29 (31.5%) cases, respectively. CONCLUSIONS: The absence of mutations in CTNNB1 and the epigenetic alteration of APC and CDH1, might be characteristic changes in the Wnt/beta-catenin signaling pathway during the carcinogenesis of ampullary carcinomas.
Ampulla of Vater* ; beta Catenin ; Cadherins ; Carcinogenesis ; CpG Islands ; Cyclins ; Epigenomics* ; Immunohistochemistry ; Loss of Heterozygosity ; Methylation ; Prognosis ; Wnt Signaling Pathway

BACKGROUND: CDX1 and CDX2 are members of the caudal-type homeobox gene family and control the proliferation and differentiation of intestinal mucosal cells. Their expressions are commonly reduced in colorectal cancer, but reports about the relationships between their expressions and clinicopathologic features are rare. The aim of this study was to examine the expressions of CDX1 and CDX2 mRNAs in colorectal cancers and to assess the relationships between their expressions and clinicopathologic features. METHODS: CDX1 and CDX2 mRNA expressions were analyzed by real-time polymerase chain reaction in 48 colorectal cancers and in adjacent non-tumorous normal mucosal tissue. RESULTS: CDX1 and CDX2 mRNA expressions were significantly reduced in colorectal cancer tissues versus normal mucosal tissues (p=0.001, p=0.042, respectively). As compared with paired normal mucosal tissues, colorectal tissues showed reduced CDX1 mRNA expression in 64.6% (31/48) and reduced CDX2 mRNA expression in 66.7% (32/48) of cases. A statistically significant positive correlation was found between the expressions of CDX1 mRNA and CDX2 mRNA in colorectal cancer (r=0.543, p< 0.001). However, the expressions of CDX1 and CDX2 mRNAs were not related to age, sex, cancer location, differentiation, lymphatic or vascular invasion, lymph node metastasis, stage or serum carcinoembryonic antigen level. CONCLUSIONS: CDX1 and CDX2 mRNA expressions were found to be significantly reduced in colorectal cancers, but these expressional changes were not found to be related to clinicopathologic features.
RNA, Messenger/*metabolism ; Polymerase Chain Reaction ; Middle Aged ; Male ; Humans ; Homeodomain Proteins/*metabolism ; Female ; Colorectal Neoplasms/*metabolism

BACKGROUND: CDX1 and CDX2, members of the caudal-type homeobox gene family, control proliferation and differentiation of intestinal mucosal cells. Their expression is reduced commonly in colorectal cancers, but reports about the relationship between their expression and the clinicopathologic features are rare. The aim of this study was to examine CDX1 mRNA and CDX2 mRNA expression in colorectal cancers and to assess the relationship between their expression and the clinicopathologic features. METHODS: CDX1 mRNA and CDX2 mRNA expression were analyzed by real-time polymerase chain reaction in 48 colorectal cancers and their adjacent non-tumorous normal mucosas. RESULTS: CDX1 mRNA and CDX2 mRNA expression were decreased significantly in colorectal cancers than in normal mucosas (p=0.001, p=0.042, respectively). In comparison with paired normal mucosas, colorectal cancers showed decreased CDX1 mRNA expression in 64.6% (31/48) and decreased CDX2 mRNA expression in 66.7% (32/48). There was a statistically significant correlation between CDX1 mRNA and CDX2 mRNA expression in colorectal cancers (r=0.543, p<0.001). CDX1 mRNA and CDX2 mRNA expression were not related to age, sex, location of cancer, differentiation, lymphatic or vascular invasion, lymph node metastasis, stage and serum carcinoembryonic antigen level in colorectal cancers. CONCLUSION: CDX1 mRNA and CDX2 mRNA expression were decreased significantly in colorectal cancers, but were not related to the clininopathologic features.
Carcinoembryonic Antigen ; Colorectal Neoplasms* ; Genes, Homeobox ; Humans ; Lymph Nodes ; Mucous Membrane ; Neoplasm Metastasis ; Real-Time Polymerase Chain Reaction ; RNA, Messenger*

Hepatocellular carcinomas (HCCs) show genomic alterations, including DNA rearrangements associated with HBV DNA integration, loss of heterozygosity, and chromosomal amplification. The genes most frequently involved are those encoding tumor suppressors. The p16INK4A tumor suppressor gene frequently displays genetic alteration in HCC tissues. The present study was performed to examine the incidence of methylated p16INK4A in the sera of liver cirrhosis (LC) and HCC patients, and to evaluate its role as a tumor marker of HCC. The sera of 23 LC patients and 46 HCC patients were examined in this study. The methylation status of p16INK4A was evaluated by methylation-specific PCR of serum samples. Methylated p16INK4A was detected in 17.4% (4/23) of LC patients and in 47.8% (22/46) of HCC patients. No association was demonstrated between p16INK4A methylation and serum AFP level. As the status of p16INK4A methylation was not associated with serum AFP level, it may have a role as a tumor marker of HCC.
Aged ; Carcinoma, Hepatocellular/*genetics ; DNA/metabolism ; *DNA Methylation ; Female ; Fibrosis ; *Genes, p16 ; Human ; Liver/pathology ; Liver Cirrhosis/*genetics ; Liver Neoplasms/*genetics ; Male ; Middle Aged ; Polymerase Chain Reaction ; Predictive Value of Tests ; Protein p16/*blood ; Sensitivity and Specificity ; Time Factors ; Tumor Markers, Biological

The purpose of this study is to identify and classify the different types of cancer patients who use alternative therapies, to understand their subjective frameworks in using such alternative therapies. The results of this study provided the subjective information on five types of attitudes towards alternative therapies and described characteristics of five types from 30 cancer patients. The "Dependent to Others" (the first type) decided to use alternative therapy because they were influenced by the experiences of others and invocations of the family (especially spouse) or close relatives. In general, they did not believe that it will cure the diseases but generally thought it was not harmful and it may be better than doing nothing. There were a group of patients who chose to use alternative therapy with vague hope and belief. These patients decided to try alternative methods with their own convictions and confidences because they have personally seen or heard about some people who had been cured miraculously. This group of patients was grouped as "Belief in Effects (second type)." Although, there is a very little chance for miracles, "Expecting for Effects (third type)" believed alternative therapy will strengthen immune systems, help with feces and urine, change physical constitutions, slow down the progression of cancerous cell, have no side-effects, and expects to have practical effects and uses. The fourth group of patients thought foods in alternative therapies were same as general foods, therefore, it was easy to take, did not expect miracles to happen but considered the alternative therapy as supplementary treatments. This "Supplementary for Effects (fourth type)" patients thought it was their duty to do everything possible. The last type was "Expecting for Miraculous Effects (fifth type)." The patients in this group were devastated and thought of alternative treatments as the last hope for miracles. They thought it would relieve their physical pains, reduce the chance of side effects from chemical treatments, help them for comfortable and painless death, and considered it as the last possible option with expecting for miracles. The result of this study has implications to provide practical and concrete guidelines for caring and nursing cancer patients using alternative therapies. It will be used as a tool to work on independent for nursing intervention. Furthermore, the result of study will provide practical guidelines to help develop better tools and nursing intervention strategies to nurse cancer patients.
Complementary Therapies ; Constitution and Bylaws ; Feces ; Hope ; Humans ; Immune System ; Nursing

The purpose of this study was to develop an education program for hospice care and to examine the effect of program. The education program for hospice care was developed based on the philosophy and principle of Hospice and integrated with various professional areas related to the problems with witch terminal patients and their family might be associated. The program was continued for 16 weeks and consisted of lectures and practices. The courses of this program were The Concept and Principle of Hospice, The Role of the Hospice Nurse, The Characteristics of Terminal Disease, Physical Care in Terminal Patients, Death Orientation, Psychological care for Terminal Patients, Spiritual care for Terminal Patients, and Care for the Family. To identify the effect of the education program for hospice care, the difference in death orientation of subjects between the pre and post performance of the education program was examined using the t-test. The finding of this statistic indicated that this education program for hospice care was effective in terms of changing the death orientation of subjects with positive direction. The education program for hospice care was performed several times at Kwangrim Hospice Missionary, Chungbuk University Hospital, and Wooam Church. Case studies were reported for a description after the performance of education. put this at the beginning 8 the sentence. In conclusion, the education program for hospice care was developed effectively. Therefore, this program should be used to educate and activate the subjects in community to be participants in hospice care.
Chungcheongbuk-do ; Education* ; Hospice Care* ; Hospices* ; Humans ; Lectures ; Missions and Missionaries ; Philosophy

The purpose of this descriptive correlational study was to understand and find the relationships among the degree of the stress, anxiety, and depression of pre-operational patients, and to describe strategies for pre-operational patient care through exact assessment. The Stress Inventory which was made by researcher, Spielberger's(1972) State-Trait Anxiety Inventory, and Beck's(1967) Depression Inventory were used as research instruments. Subjects were seventy-five patients who hospitalized in general hospital located in Seoul and Inchun. Data was collected from April 12th to April 24th 1998 using questionnaire. Data analysis consisted of Pearson correlation coefficiency, Multiple regression analysis, t-test, one-way ANOVA using SPSS PC+ program. The results were summarized as follows: 1. The average score for the stress was 73.87, for the state-anxiety was 57.05, for the trait-anxiety was 57.59, and for the depression was 37.41. The degree of stress, anxiety and depression were above moderate level. 2. The degree of pre-operational stress and anxiety(r=.692, p=.000), stress and depression (r=.644, p=.000), anxiety and depression (r=.647, p=.000) had significant relationships in statistically. 3. Pre-operational stress was significantly explained by anxiety and depression. 4. The relationships among general characteristics and stress, anxiety, and depression were significantly defferent in education and experience of operation. In conclusion, pre-operational stress, anxiety and depression had high relationships with each other. Because significant differences exist in degree of patients' pre-operational stress, anxiety, and depression on education and experience of operation, these characteristics are needed to be applicated in nursing intervention on pre-operational care. The importance of this study is that the stress inventory predict pre-operative anxiety and depression of patients, so it is valid instrument for mesuring pre-operational stress. I suggest that the necessity of studies involving physical, environmental, spiritual aspect, etc. include emotion aspect in mesuring the degree of stress. Because the effect of pre-medication was not controled in research design, I suggest that repeated studies are needed include the pre-medication, furthermore the studies which combine the self-report method and the physiological maker of mesuring the degree of stress are necessary for the future study.
Anxiety* ; Depression* ; Education ; Hospitals, General ; Humans ; Incheon ; Nursing ; Patient Care ; Research Design ; Seoul ; Statistics as Topic ; Surveys and Questionnaires

This study was undertaken to investigate the casual perceptions and health seeking behaviors of Rheumatoid arthritis patients, define and understand the typology, and find the relationship between causal perceptions and health seeking behavioral types. There were six types(Physical Fatigue, Dispensation of Nature, Causality to Environment, Conscience of Guilty, Rationally perceiving, Psychological Stress) of subjective opinion about Causal Perceptions of Rheumatoid Arthritis Patients. And there were four types(Oriental medical Treatment, Information Seeking Dietary Control, Western Medical Treatment) of subjective opinion about Health Seeking Behaviors. In the relationship between types of the causal perceptions and health seeking behaviors, oriental medical treatment and information seeking type were common health seeking behaviors of all six causal perception types, Only difference for internal causal perception types was related to hospital instructions and external causal perception types were related to dietary control. The result of this study can help health care provides, especially nurses to understand the types of causal perceptions and health seeking behaviors of Rheumatoid arthritis patients to gain treatment educational nursing intervention to aid health care.
Arthritis, Rheumatoid* ; Conscience ; Delivery of Health Care ; Fatigue ; Humans ; Nursing