Analysis of the Time Interval between the Physician Order for Life-Sustaining Treatment Completion and Death / 가정의학회지

Background@#This study aimed to explore the time interval distribution pattern between the Physicians Order for Life-Sustaining Treatment (POLST) form completion and death at a tertiary hospital in South Korea. It also examined the association between various independent parameters and POLST form completion timing. @*Methods@#A total of 150 critically ill patients admitted to Korea University Guro Hospital between June 1, 2018 and December 31, 2018 who completed the POLST form were retrospectively analyzed and included in this study. Data were analyzed with descriptive statistics, and group comparisons were performed using the chi-square test for categorical variables. Fisher’s exact test was also used to compare cancer versus non-cancer groups. @*Results@#More than half the decedents (54.7%) completed their POLST within 15 days of death and 73.4% within 30 days. The non-cancer group had the highest percentage of patients (77.8%) who died within 15 days of POLST form completion while the colorectal (39.1%) and other cancer (37.5%) groups had the lowest (P=0.336). @*Conclusion@#Our findings demonstrated a current need for more explicit guidance to assist physicians with initiating more timely, proactive end-of-life discussions.

Clinical Practice Guideline for Care in the Last Days of Life / 한국호스피스완화의료학회지

A clinical practice guideline for patients in the dying process in general wards and their families, developed through an evidence-based process, is presented herein. The purpose of this guideline is to enable a peaceful death based on an understanding of suitable management of patients’ physical and mental symptoms, psychological support, appropriate deci-sion-making, family care, and clearly-defined team roles. Although there are limits to the available evidence regarding medical issues in patients facing death, the final recommendations were determined from expert advice and feedback, considering values and preferences related to medical treatment, benefits and harms, and applicability in the real world. This guideline should be applied in a way that takes into account specific health care environments, including the resources of medical staff and differences in the available resources of each institution. This guideline can be used by all medical institutions in South Korea.

Development and Evaluation of a Hospice and Palliative Care Music Therapy Education Program / 한국호스피스완화의료학회지

Purpose@#This study was conducted to develop a hospice music therapist training program and to evaluate its effects. @*Methods@#The educational program consisted of training on the theory of hospice and the theory and practice of hospice music therapy. The course lasted for 4 weeks, with 8 hours of training per week, and 33 music therapists completed the course. In order to assess the effectiveness of the course, participants’ knowledge and confidence regarding hospice music therapy and readiness for hospice music therapy before and after education were measured. The statistical analysis was done using SPSS version 18.0 and the paired t-test was used to assess the effectiveness of the program. @*Results@#The trainees showed significant improvements in knowledge (P＜0.001) and confidence (P＜0.001) in all areas of this course, as well as in readiness for hospice music therapy (P＜0.001). Participants’ satisfaction with the lectures was assessed using a 5-point Likert scale. The average score for all lecture areas exceeded 4 (yes), and the satisfaction level was mostly high. Students were most satisfied with the lectures on music therapy theory, followed in order by those on music therapy practice and hospice theory. @*Conclusion@#This hospice music therapist training program is considered to be suitable because of its positive educational effects and the high satisfaction of participants with the lectures. In order to provide high-quality music therapy services to patients and their families, this training course should be regularly offered to cultivate competent music therapists, and the content of the education should be standardized and applied in various clinical settings.

Chronic Disease and Health-Related Quality of Life in an Urban Elderlies

BACKGROUND: In Korea, the proportion and absolute number of old people are increasing very rapidly. And the concern about the quality-of-life of elderly is to increase more and more among health care workers. The quality-of-life of elderly is affected by chronic medical conditions in some part. The purpose of this study is to evaluate the association between eight chronic medical conditions and health-related quality of life among the community-based elderly. METHODS: Target areas were 22 dongs in Dong-gu,Kwangju and 2 dongs in Buk-gu. Six hundreds subjects were randomly sampled from target ares. Interview survey was performed for chronic medical conditions by check list and health-related quality of life by COOP chart. Actual subjects were 568 elderlies. RESULTS: The results are followed ; 1) Compared with other domains of health-related quality of life, overall health was the most associated with chronic medical conditions, and social activity the least associated. 2) Stroke were significantly associated with every domain. And also back problems/joint problems were except the domain of social activity. Compared with other disease, stroke was the most associated with health-related quality of life except the domain of pain. 3) Migraine/chronic headache, gastroduodenal problems, and heart conditions were significantly associated with overall health, bodily pain, and one or two domains. 4) Hypertension and diabetes mellitus were signi ficantly associated with only one domain; overall health 5) Asthma and chronic bronchitis was not associated with any domains. CONCLUSION: Generally, health-related quality of life was highly associated with mobility limiting diseases such as back problems/joint problems stroke. And also moderately associated with pain relation disease such ans migraine/chronic headache, gastroduodenal problems, and heart condition.

Clinical Study of Acute Osteomyelitis in Children / 대한정형외과학회잡지

The treatment of acute osteomyelitis has been much improved with the development of better antibiotics, but still a number of problems have remained unsolved. To find out possible problems in our method of management and to help resolve these problems, a clinical study was done of 34 cases of acute childhood osteomyelitis treated from August 1980 to January 1985. The results were as follows: 1. Bone scan helps diagnosis and localization of this disease; blood culture is significant in the selection of relevant antibiotics by sensitivity test. 2. All the causative organisms cultured were staphylococcus aureus which showed 100% sensitivity to cephalosporin and 100% resistant to penicillin: methicillin was not much effective compared with other reports. 3. 22 cases were trcated with decompression operation and 12 cases with conservative method: surgery is considered to be better method of treatment in the viewpoints of clinical process and complications.