BACKGROUND: This study investigated the current status of communication about death and confidence levels concerning death-related issues among Korean adults.METHODS: A survey was conducted to ascertain the frequency of death related communication, factors promoting and impeding such communication, and confidence levels concerning death-related issues. Data of 112 participants who completed the survey were analyzed using descriptive statistics, a chi square test, and multiple logistic regression.RESULTS: More than half of the participants (52.7%–84.0%) appeared to have infrequent (never/at least one) conversations about death or death-related issues. Owing to socio-cultural aspects, death-related communication was considered a taboo or an unpleasant topic of conversation. Additionally, indifference toward death inhibited people from communicating; however, personal experiences of death or morbidity and favorable social contexts promoted communication. Overall, the confidence levels concerning death-related issues was low. Only 17.9%–32.2% of the participants were confident/very confident about their preferences concerning death-related issues. The more people talked about death, the more likely they were to develop a confident attitude toward death-related issues (odds ratio, 3.45; 95% confidence interval, 1.37–8.69).CONCLUSION: This study confirmed that communication about death is being withheld among Koreans, and this could possibly lower their level of confidence regarding death-related issues. To achieve death with dignity, a ‘death culture’ needs to be promoted alongside legislation and infrastructure.
Adult ; Advance Care Planning ; Attitude to Death ; Humans ; Logistic Models ; Personal Autonomy ; Right to Die ; Taboo ; Terminal Care

Heo Joon is one of the best-known physicians of the Chosun Dynasty, the last imperial dynasty (1392~1910) of Korea. He had served King Seonjo during his practice, and has produced many publications on medicine. Then, how did he actually treat the patients? So far, other than the case when he treated Gwanghaegun's smallpox, it is not clearly known how and when he attended and treated the ill. In his most famous book, the Treasured Mirror of Eastern Medicine (TMEM), he details the physiopathological mechanisms, diagnoses, treatments or prescriptions, and treatment cases, however, it is not clear if they're from his own clinical experiences. Nevertheless, based on the written method, the original information is reconstituted according to its respective editors of the TMEM, a particular case being included may be considered as an agreement and acceptance of an actual treatment executed. This research analyzes what type of medicinal theory that the main writer Heo Joon employed in his real treatments, as well as how he diagnosed and treated diseases. After analyzing the complete series of the TMEM, we found a total of 301 clinical cases. Here, one may wonder, why does the Section of Inner and External Bodily Elements, that deal with diseases and the structure of the body, have far outnumber cases than the Section of Miscellaneous Disorders? Why does the TMEM introduce the various types of disease experiences and treatment cases, medical cases, simple treatments, nurturing life, materia medica, and also include supernatural phenomena? Why does the TMEM include the experiences and cases from the book published in the Song, Jin, Yuan dynasty of China, moreover in the Ming Dynasty of its time. These questions can be answered to the extent that Heo Joon and the others who participated in completing the book sought to justify the new clinical medicine practices, and because it had to be acceptable to the Confucius beliefs which dominated the society, and also because the book came to light in a time when tensions between the pre-existing Chosun medicine and the newly introduced Chinese medicine were evident. Among the clinical cases in the TMEM, there are only 41 cases that can be considered as Medical Cases which include the pathology and treatment mechanism. After analyzing these mechanisms, we were able to discover that they cover not only the theories of the 4 great physicians of Jin-Yuan Dynasty, but also the theories of the Danxi's Medical Current, a big trend in the Early Ming Dynasty, and some of the most recent clinical cases that had been just reported at the time. However, Heo Joon did not lean towards a particular theory of medicine; rather, he insisted on establishing a classical medicine based on the traditional medicinal scriptures such as the Yellow Emperor's Inner Canon or Shennong's Classic of Materia Medica, and had created his own Body-Viscera medicine, as Shin Dongwon's recent research. Moreover, he successfully secured his own right to be a clinical physician by customizing the amount of medication in prescriptions for the people of Chosun. Heo Joon was one of the chief physicians for the Royal Family of the Chosun Dynasty. Despite the tendency of traditional medicine to lean towards Taoism or Fangshu, for him the most important thing was the actual treatment of diseases. As a result, Heo Joon successfully treated smallpox by utilizing traditional medicinal methods, by breaking the taboo of not using medication on such diseases, as well as he was able to treat an unknown disease, scarlet fever, by discovering the pathological mechanism of the illness. Also he made bold decisions on altering existing prescriptions to treat diseases more efficiently. The TMEM consists of not only justified methods that integrate the different and scattered medicinal and clinical practices, which many insisted their originality, but also was backed with Heo Joon's such credible and endeavored clinical medicine.
Asian Continental Ancestry Group ; China ; Clinical Medicine ; Diagnosis ; Humans ; Korea ; Materia Medica ; Medicine, Traditional ; Music ; Pathology ; Prescriptions ; Religious Philosophies ; Scarlet Fever ; Smallpox ; Taboo

OBJECTIVES: This study was conducted to investigate knowledge, attitude, and experience regarding suicidal behavior among mental health workers in Gangwon province of Korea to use as a basis for development of suicide prevention and education programs. METHODS: Questionnaires consisted of 31 questions including general knowledge regarding suicide statistics and suicide related legislation, attitude toward suicide, awareness of suicide, and individual experiences of suicidal behaviors. Chi-square and binary logistic regression analyses were used to determine differences and association among attitude toward suicide, individual experience of suicide, and sociodemographic characteristics. RESULTS: Taboo attitude toward suicide showed association with age and male. Males thought that social responsibility for suicide is necessary. Religiously non-affiliated group and people who had previous suicidal ideation and attempts showed a more permissive attitude toward suicide. CONCLUSION: The findings of this study suggest that demographic characteristics and previous individual experience of suicidal behaviors might influence attitude toward suicide. These personal characteristics should be considered in development of suicide prevention programs for mental health workers.
Education ; Gangwon-do ; Humans ; Korea* ; Logistic Models ; Male ; Mental Health* ; Social Responsibility ; Suicidal Ideation ; Suicide ; Taboo

OBJECTIVES: This study was conducted to investigate knowledge, attitude, and experience regarding suicidal behavior among mental health workers in Gangwon province of Korea to use as a basis for development of suicide prevention and education programs. METHODS: Questionnaires consisted of 31 questions including general knowledge regarding suicide statistics and suicide related legislation, attitude toward suicide, awareness of suicide, and individual experiences of suicidal behaviors. Chi-square and binary logistic regression analyses were used to determine differences and association among attitude toward suicide, individual experience of suicide, and sociodemographic characteristics. RESULTS: Taboo attitude toward suicide showed association with age and male. Males thought that social responsibility for suicide is necessary. Religiously non-affiliated group and people who had previous suicidal ideation and attempts showed a more permissive attitude toward suicide. CONCLUSION: The findings of this study suggest that demographic characteristics and previous individual experience of suicidal behaviors might influence attitude toward suicide. These personal characteristics should be considered in development of suicide prevention programs for mental health workers.
Education ; Gangwon-do ; Humans ; Korea* ; Logistic Models ; Male ; Mental Health* ; Social Responsibility ; Suicidal Ideation ; Suicide ; Taboo

What if the angel of death suddenly came knocking on your door? Death and aging are inevitable. However, since investigations usually assume that death unanimously provokes anxiety, death is often termed the last taboo which makes it painful for most people to talk about, think about, or even plan for it. This study was conducted to determine the philosophies and attitudes of the elderly in terms of the physical, psychosocial, and spiritual aspects of death preparation. The study also sought to determine importance of a support system for the elderly faced or are facing neardeath experiences and/or terminal illnesses. The study utilized phenomenology as its research design. Eight informants from the different cities and municipalities of Pangasinan were chosen through purposive sampling. All of them have been involved in a near-death experience and/or are in a dying state. Data was gathered in the form of a semi-structured interview. The study found that the informants' respective concepts of death, the grieving process, their cultivated philosophies, and support system played major roles in helping them prepare for death.

 

Human ; Male ; Female ; Aged 80 And Over ; Aged ; Taboo ; Cities ; Grief ; Death ; Aging ; Spiritualism ; Attitude ; Anxiety

Recent developments in medicine in our society have drawn attention to various phenomena related to death, such as brain death, cardiac death, vegetative death, euthanasia, death with dignity, near-death experiences, hospice, and suicide. The definition and conception of death is significant because its reductionist determination may bring about a denial or taboo of death and a certain limitation on the modes of life and death. As religious traditions like Christianity and Buddhism and life and death studies show, human death cannot and should not be explained by physical and biological criterion of death like brain death or cardiac death alone. In a society with such a reductionist definition of death there can be no space for a mature culture of death and only a colossal number of miserable deaths like suicide. Therefore, as Kubler Ross argues, death should be defined in terms of considering the continued existence of certain realities as to psyche, spirit, and the meaning of life beyond physical and biological aspects. The medical and legal approach to death is greatly incomplete and restricted in taking into account the physical and biological aspect of death. Thus, it is necessary to precisely and deeply reconsider the definition and understanding of death from a broader and more comprehensive perspective rather than concentrating solely on the physical and biological criterion of death such as brain death or cardiac death.
Brain Death ; Buddhism ; Christianity ; Death ; Denial (Psychology) ; Euthanasia ; Fertilization ; Hospices ; Humans ; Right to Die ; Spirituality ; Suicide ; Taboo ; Thanatology

PURPOSE: The aims of this study were to describe and interpret the nature of the experience inherent in the sex life of female breast cancer patients after treatment and understand the meaning behind it. METHODS: The participants were 10 female breast cancer patients who were married. Data were collected from March to September 2010. Van Manen's hermeneutic phenomenology was adopted in this qualitative study as a research method. RESULTS: There were 4 essential topics in the participants' experience of sex life; 'Sex life alert' was a result of negative changes in sexual relationships with spouse that they had never experienced before the breast cancer diagnosis; 'Precarious situation for pending divorce' was an experience of deteriorated sex life because of the failure to overcome 'sex life alert'; 'Sublimation of the difficulties by discovering an alternative solution' was an experience of discovering a solution to overcome the 'sexlife alert'. 'Leaving it as unsettled' was an experience of a condition in which the participants did not have any intension to resolve the difficulties in sex life due to the lack of appropriate support, thus tried to ignore the challenges faced. CONCLUSION: This study illustrates the necessity to develop proper nursing intervention on the issues related to sex life among breast cancer patients. Given the fact that the sexual topics are often considered taboo in day to day nursing practice, special attention and efforts need to be given in this area to build up nursing knowledge and evidence-based practice.
Breast ; Breast Neoplasms ; Evidence-Based Practice ; Female ; Humans ; Qualitative Research ; Sexual Behavior ; Spouses ; Taboo

Patients should be treated with dignity and respect toward the end of their lives, being freed from unnecessary and painful life-sustaining therapy in hospitals. In Korea, the quality of endof-life (EOL) care has been variable, a major factor being the physicians' perception to the care. A firm consensus of EOL care decision-making has not yet explicitly stated in Korean law and ethics until recently. However, movements to make a law of so-called "the death with dignity act" are presently making its way to the National Assembly, initiated by a law case that allowed the hospital to withdraw mechanical ventilator support per request by the patients' family of a permanently vegetative patient. Socially agreed guidelines for EOL care can facilitate clinical decision process and communication between health service provider and the patient or his/her family. At the same time, EOL care should be individualized also in the same line of guideline to meet patient' and patient' family wish regarding the withdrawal of life-sustaining therapy. The painful EOL care experience of the loved one remains in the memory of the relatives who live on. Physicians should identify, document, respect, and act on behalf of the hospitalized patients' needs, priorities, and preference for EOL care. It has been advocated that competent patients can express their right of self-determination on EOL care through advance directives in Western countries. Advance directives are considered as a tool to facilitate EOL decision making. However, there are barriers to adopt the advance directives as a legitimate tool for an EOL decision making in Korea. For one thing, the reality of death and dying is rarely discussed in our society. In addition, the discussion about EOL care with chronically and critically ill patients has been considered as a taboo in the hospitals. In spite of these difficulties, physicians could do better EOL care by the open communication with patients or with their surrogates. Through the communication, physician should set a goal how to manage the EOL patient. The set goal should be shared among the caregivers to achieve the maximum benefit of the patient. The lack of open discussion with patient prior to EOL care results in inappropriate protraction of a patient's dying process. In summary, physicians, who know the clinical significance of delivering treatments to EOL patients, should play a central role in assisting patients' and their families' to make the best decision on EOL care. Moreover, the concerted actions to improve EOL care in our society among general public, professionals, stakeholders for EOL care, and governmental organizations are required to address ongoing social requests, although a policy or a guideline is made in this time.
Advance Directives ; Caregivers ; Complement Factor B ; Consensus ; Critical Illness ; Decision Making ; Ethics, Medical ; Health Services ; Humans ; Jurisprudence ; Korea ; Love ; Memory ; Physician's Role ; Right to Die ; Taboo ; Ventilators, Mechanical

PURPOSE: The purpose of this study was to investigate differences in Korean child-rearing practices between the generations of young mothers and grandmothers. METHOD: The participants were 98 mothers who were 20 to 39 years old and had raised one-year-old child and 103 grandmothers who were over 60 years old and had raised their children in a small city. Data were collected through self-report questionnaire based on the Korean traditional child-rearing practice from Yoo(1986). The data were analyzed using the SPSS Win 10.0 program. RESULTS: Of 37 items in the categories of feeding and weaning, health management and taboo matters, play, and baby celebrations, the grandmothers practiced 13 items (35%) more frequently than the young mothers. However, no generation differences were found in 21 items (57%), and 3 items were practiced more frequently by the young mothers. For the young mothers, there were 15 items (41%) which were practiced over 70%, 7 items (19%) which were practiced less than 30%. CONCLUSION: It seems that some Korean traditional child-rearing practices were transferred to modern child-rearing practices. Therefore pediatric nurses need to pay attention to traditional child-rearing practices for the best health, growth and development of children.
Adult ; Child ; Family Characteristics* ; Growth and Development ; Humans ; Middle Aged ; Mothers* ; Taboo ; Weaning ; Child Health ; Surveys and Questionnaires

Child abuse and neglect refers to any act or failure to act that violates the rights of children and affects their overall optimal health, survival or development. Also sexual abuse in children is defined as engaging a child in sexual acts that the child does not understand, to which the child cannot give informed consent, or which violate the taboos of our society. Sexual abuse may involve direct acts perpetrated against children as well as other non-touching abuses, which include exhibitionism, voyeurism, or the use of children for pornographic purposes. Although precise incidence and prevalence rate data are lacking, sexual abuse of children is common in our country and throughout the world. Child sexual abuse is a universal problem that has frequently passed unrecognized and its victims (both children and perpetrators) untreated. Child sexual abuse results in significant social damage. The physical and psychological consequences of child sexual abuse may result in trauma and has implications throughout the lifespan. Experiencing sexual abuse as a child also has the consequence of contributing to an increased risk of violent victimization, perpetration, self-directed violence and suicide later in life. Despite the importance of the issues, information about sexual abuse in children and amongst adults has not been commonly shared by health professionals. The purpose of this review article is to assist the physician in their investigation of child sexual abuse by exploring the important topics.
Adult ; Child Abuse ; Child Abuse, Sexual ; Child* ; Crime Victims ; Exhibitionism ; Health Occupations ; Humans ; Incidence ; Informed Consent ; Prevalence ; Sex Offenses* ; Suicide ; Taboo ; Violence ; Voyeurism