The Change of the Status of Joseon Medical Bureaucrats in the 15th and 16th Centuries / 의사학

In the 15th century, Joseon dynasty's goal for the stabilization of the ruling system, the ideological freedom of the era, and the necessity of medicine due to the introduction of Jin and Yuan dynasty's medicine led to the increased interest in medicine by the nobility along with tolerant practice. The practice of reading medical books is a good example of this institutional demonstration. However, by the end of the 15th century, a noticeable change had taken place. Within the nobility, there was an ideological rigidity regarding technology other than those of Confucianism, as the nobility became concentrated on the principles of Neo-Confucianism. In addition, as the publication of large-scale editions such as Ŭibangyuch'wi (the Classified Collection of Medical Prescriptions) came to an end, they have become less inclined to nurture talent at the level of the central government as in the previous period. In addition, as the discrimination against illegitimate children became stronger, technical bureaucrats such as medical officials, which were open to illegitimate children, came to be seen in increasingly disdainful and differentiated manners. From the late Sejong period to the early Seongjong period, the entrance of illegitimate sons into the medical bureaucracy solidified the negligence of medicine by the nobility. After then, the medical bureaucracy came to be monopolized by illegitimate sons. As for illegitimate sons, they were not allowed to enter society through Confucian practices, and as such, the only way for them to enter the government was by continuing to gain experience as technical bureaucrats. Technical posts that became dominated by illegitimate sons became an object of contempt by the nobility, and the cycle reproduced itself with the social perception that legitimate sons of the nobility could not become a medical official. Medical officials from the Yi clan of Yangseong had been legitimate sons and passers of the civil service examination in the 15th century. However, in the 16th century, only illegitimate sons became medical officials. The formation of Jungin (middleclass) in technical posts since the middle of the Joseon period is also related to this phenomenon. The Yi clan of Yangseong that produced medical officials for 130years over four generations since Yi Hyoji, a medical book reading official, is an exemplary case of the change in the social perception in the early Joseon period regarding medical bureaucrats.

Subjectivity About Turnover Intention Among Male Nurses in South Korea: A Q-Methodological Study

PURPOSE: Around the world, male nurses face a variety of difficulties within clinical settings; accordingly, a large number of male nurses consider changing their occupation. In particular, male nurses in a number of Asian countries with a Confucian heritage experience difficulties. Thus, the purpose of this study was to explore individual differences in turnover intention among male nurses in one such country, South Korea, and on that basis to suggest concrete strategies for reducing turnover among male nurses in Confucian cultures. METHODS: Q methodology, which is used to analyze human subjectivity, was applied. Q statements were derived from 207 candidate statements gathered from various documents and interviews; 40 statements were finalized. A purposive sample of 41 male nurses was selected as likely to have diverse opinions on turnover intention of male nurses. The collected data were analyzed using PQMethod software. RESULTS: Four distinct types of subjectivity about turnover intention among male nurses were identified: (1) “Pursuing occupational values,” (2) “Dissatisfaction with treatment,” (3) “Seeking a relaxed and stable life,” and (4) “Conflict related to organizational culture.” CONCLUSION: This study suggests various ways of reducing turnover and increasing retention among male nurses based on the four identified perspectives, especially in Confucian heritage regions.

Drawing method can improve musculoskeletal anatomy comprehension in medical faculty student / 대한해부학회지

The Chinese philosophy of Confucianism said “What I heard I forgot, what I see, I remember, what I do, I understand.” During this time, most of the teaching and learning process relies on viewing and listening modalities only. As a result, much information does not last long in memory as well as the material understanding achieves became less deep. In studying anatomy science, drawing is one of effective important methods because it is an integration of ideas and knowledge of vision thereby increasing comprehension and learning motivation of college students. The purpose of this research is to know the musculoskeletal anatomy comprehension by drawing learning method in Medical Faculty student. This research uses observational analytic design with the cross-sectional design. Total sampling was done to the entire student of Physiotherapy Study Program in 2012, 2013, and 2014, Medical Faculty of Udayana University. The average value of musculoskeletal anatomy of the student in 2012, 2013, and 2014 sequentially are 31.67, 33.57, and 45.00, respectively. Normality test with Shapiro-Wilk and homogeneity with Levene's test showed normal results and homogeneous. One-way ANOVA test between groups showed a significant result that is 11.00 (P < 0.05). It is concluded that the drawing method can improve the musculoskeletal anatomy comprehension in Medical Faculty student.

Selection and Management of Medical Official during the Yuan Dynasty / 의사학

Although the healthcare system of the Yuan Dynasty followed that of the Song Dynasty, there are certain differences between these two dynasties in terms of practices. Including appointing ‘Yihus’ in ‘Zhusehuji’ and setting up ‘Guanyitijusi’ to oversee Yihus, the Yuan Dynasty developed an effective management system for their physicians and, soon after the coronation of Khubilai, built ‘Yixue (Medical school)’ all over its territories in order to establish an organized and substantial medical training system. Moreover, the Yuan Dynasty not only revived the civil service examination system system between 1314 and 1320 as well as the medical examination system, but also increased the quota for qualification to twice that of Confucian examination in Song. These changes resulted in producing many brilliant people at the time. In the second half of the reign of Emperor Chengzong it was decided that the incompetence of the government healthcare organizations and the abundance of charlatans could not be neglected any longer. Existing policies and systems was limited in educating and training proper physicians, and this problem was not restricted to the field of medicine. The need for new systems that could reform the social order led to the restoration of the civil service examination system. The civil service examination system for Confucianism and for medicine began in 1314 and 1316, respectively. The purpose of the medical examination system was to select medical officials. The medical examination system which started in 1316 had a significant impact on the medicine of the Yuan dynasty for many reasons. Firstly, the qualification to apply to the medical examination did not remain constricted to ‘Yixue’ but opened to all ‘Zhusehuji’; and secondly, the examination system did not have a restriction on the number of applicants was not restricted. The most important aspect of the examination system was that the number of test takers that passed the first test was one hundred and the number of passers of the second test were thirty, which were not low compared to the number of passers of the Confucianism examination. As such, the impact of the medical examination on the Yuan society was substantial. The Confucian examination selected 300 persons to pass the first test. The second test had 100 test takers which was equally divided among the four social classes at 25 percent each. The medical system selected 100 persons in the first test and 30 in the second. What is important is that unlike the Confucian examination system, the medical system was not divided into four classes. Hypothetically, the 30 qualified persons could all be South Chinese. In terms of the number of passers, it was much more promising for the South Chinese to flourish through the medical test than through Confucian examination test. Such facts support the claim that the Yuan Dynasty emphasized the field of medicine compared to the Song Dynasty. Although the Song Dynasty implemented the civil service examination system early on, the medical system was not implemented until 1115, which started with the founding of ‘Yixue’ across the country and assigning student capacity. During the Song Dynasty, the number of students in the medical system was 15 percent of that in the Confucianism system, and compared to that in Yuan, it raised to 30 percent, which is twofold. The indications of the Yuan Dynasty valuing medicine and making an effort to educate and train medical experts can be seen in the ‘Yihu system’, ‘Guanyitijusi’, Yixuetijusi’, and medical school as well as the ratio of the medical system capacity.

The Influence of Traditional Culture and the Interpersonal Psychological Theory on Suicide Research in Korea

Korea has the highest suicide rate amongst the OECD countries. Yet, its research on suicidal behaviors has been primitive. While the Interpersonal Psychological Theory of Suicide has gained global attention, there has only been a few researches, which examined its applicability in Korea. In this article, we review the previous studies on suicide and examine the association between the Interpersonal Psychological Theory of Suicide and traditional Korean culture, with an emphasis on Collectivism and Confucianism. We propose that pathways to suicide might vary depending on cultural influences. Clinical implications and suggestions for future research will be discussed.

Applying the Methodology and Practice of Microhistory: The Diary of a Confucian Doctor, Yi Mun-gon (1495-1567) / 의사학

Since microhistory's approach to the past is based on an understanding of and a sympathy for the concrete details of human lives, its area of interests overlaps with the history of medicine and medical humanities, which examine illness and health. If we put a specific region and society in a specific period under a microscope and increase the magnifying power, we can understand the numerous network connections among the body, illness management, and medicine and how multilayered were the knowledge and power applied to them. And this approach of using microhistory to illuminate medical history can be more effective than any other historical approach. This article focuses on Yi Mun-gon's extensive volumes of Mukchaeilgi (Mukchae's diary) in approaching medical history from the perspective of microhistory. Simply defined, this work is a Confucian scholar-doctor's diary. Its author, Yi Mun-gon, played the role of a Confucian doctor, although not professionally, during his 23-year exile, after serving in a high governmental office on the senior grade of the third court rank. Thanks to this extensive and detailed diary, we can now get adetailed andthorough picture of his medical practice in the Songju region, 270 kilometers southeast of Seoul, where he was exiled. This article aims to understand the state of medical practice in the Songju region in the 16thcentury through the"zoom-in" method adopted by microhistory. In particular, I will focus on the following three aspects: 1)Yi Mun-gon's motivation for and method of medical study, 2)the character of Yi Mun-gon'spatient treatment as hwarin (the act of life-saving), and 3) the plural existence of various illness management methods, including pyongjom (divination of illness), sutra-chanting, exorcism, and ch'oje (ritual toward Heaven). All three aspects are closely related to Confucianism. First, Yi Mun-gon decided to acquire professional-level medical knowledge in order to practice the Confucian virtue of filial piety. He sharpened his medical knowledge during the process of caring for his ill mother. In Confucian Choson society, a patient was encouraged to be deeply involved in the process of his or her medical treatment and the space of clinical treatment was not an exclusive domain for the doctor, but for public discussion, where both doctor and patient participated in making the best medical choices. In this atmosphere, a patient's family members would also naturally learn the clinical process, not unlike today's interns learning from renowned doctors. Second, after studying medicine up to a professional level, Yi Mun-gon administered the "life-saving" medicine to many people, yet he did not open his doors to all individuals. His medicine was practiced within his social network of blood, regional, and intellectual relations, where priority was established according to the level of closeness to himself, according to Confucian ideology. Nevertheless, because he did partially accept patients outside of these networks, his practice setin motion the symbolic system of Confucian ideal of universal "life-saving." Third, in the Songju region during the 16thcentury, various methods of treating illnesses-such as medicine, divination, sutra-chanting, exorcism, and kumyongsisik (life-saving, food-offering ritual)-co-existed and were selected according to individual conditions. Confucianism did not want to either acknowledge or outright reject most of these methods, except for officially acknowledged medicine, at that time. In fact, this co-existence was inevitable because there was not one entirely effective means of curing illness at that time. Also, the system of Confucian ideology was not powerful enough to enforce what it championed. On the contrary, behind the outer austerity of Confucian society, people sought out unorthodox methods, such as exorcism, Buddhism, and Taoism-ironically, in order to practice the important Confucian values of filial piety and patrilineage in the face of their parents' or sons'illnesses. It was only after the emergence of modern ideology and methodology of hygiene, which had the ability to control epidemics and prioritize the preservation of the life of individuals and the population, following the opening of the port in the late 19th century, that this pluralistic culture for illness management became much less prevalent.

Takeki Kudoh's Research on Modern Medical Science and Japanized Confucianism in Colonial Korea (Choson) / 의사학

This paper reviews Kudoh Takeki's activity critically during the colonial Korea period, regarding his research on Medical Science and Japanized Confucianism. He managed 'The Seoul Gynecological Hospital'for approximately 35 years in the Choson period as a Japanese resident with Choson status. He published medical knowledge about obstetrics through more than 280 articles, and attempted to improve the hygiene and health of 'Korean Women'. He tried to complete his will toward 'One Unity of Choson and Japan'by terminating the Choson culture 'gene'as an intention. The purpose would enlighten Choson by Japanese blessing. This paper aims to confirm his intention by two aspect of analysis by 'Medical Science'as an occupation and 'Confucianism'and the background of his thought. The content of Kudoh Takeki's research in Choson regarding Medical Science-Confucianism is described as below. First, the purpose and mission of Kudoh Takeki regarding Choson was analyzed. The papers revealed the Kudoh Takeki mentioned only the 'HusbandMurders of Corean Women', which was defined by Kudoh Takeki as 'A Special Crime of Corea'. This paper examined his intensions. Second, writings by Kudoh Takeki were listed to verify the 'medical'field and 'non-medical'field according to the subject. No list of contents was found for his more than 280 articles or essays in magazines/newspapers/publications, and these papers only described the Kudoh paper "A Special Crime of Corea"and studied the separate book publication by Kudoh THE GYNAECOLOGICAL RESEARCH OF HUSBANDMURDERS OF COREAN WOMEN, A SPECIAL CRIME OF COREA. Third, the genealogy of Confucianism of Kudoh Takeki was analyzed as his background of mental.thought by his hometown and the school he graduated from. The people from Kumamoto and Seiseiko school who were influenced by 'Yi Toegye'of Choson Confucianism were more active than general Japanese. Fourth, the practical activity of Kudoh Takeki in Choson was described. The paper revealed that his brother Tadaske and Shigeo also stayed in Choson to act as an important assistants for the Colonial Choson Government-general. Kudoh was an important man in Japanese society in Choson, acting as a member of [Group of Same Origin] and 'Choson Association of great Asia'which was an important organization assisting Colonial Choson Government-general and was a representative position in Seoul district of Bukmichang-jeong(now Bukchang-dong). Fifth, Kudoh Takeki's precise activity to terminate Choson cultural 'gene'and lead to enlightenment was analyzed by an examination of his Medical Science as an occupation and Confucianism as a background of his thought. Even he attempted to enlighten the brutal Choson people in cultural aspects but it was only a tool to assist the colonial policy of Japan by emphasizing 'Kyoikuchokugo(Imperial Rescript on Education)'to implant the Kodo-Seishin(Imperial Spirit). Analyzing the relationship of Kumamoto Practical Party with Yi Toegye, the intention of a deep connection toward 'One Unity of Japan and Choson'by colonial policy was revealed. In conclusion, the paper revealed the Japanese modernization frame to complete 'One Unity of Japan and Choson'and 'Make people to obey the Japan Emperor'by enlightening the dark Choson and merging them with Japan as Kudoh intended.

Obstetric Medical Book and Women's Childbirth in Qing Dynasty: The Case of the Treatise on Easy Childbirth / 의사학

Ye Feng composed what was to become one of the most famous and widely-circulating medical works of the late imperial period, the Treatise on Easy Childbirth(1715). Ye Feng proposed the idea of natural childbirth, When the correct moment for birth had arrived, the child would leave its mother's body as easily as "a ripe melon drops from the stem". He argued attempts to facilitate birth were therefore not only unnecessary, and female midwives artificial intervention was not required. However, this view is to overlook the pangs of childbirth, and women bear responsibility for the failure of delivery. So his views reflect the gender order in male-dominated. Also he constructed the negative image of the midwife and belittle her childbirth techniques. As a result, midwife are excluded from the childbirth field, male doctors grasp guardianship rights of the female body. Ye Feng declared that the key to safe and successful delivery could be summed up in just a few words: "sleep, endure the pain, delay approaching the birthing tub". This view must be consistent with the Confucian norms, women to export to equip the 'patience' and 'self-control'. These norms were exposed desire men want to monitor and control the female body, effect on consolidation of patriarchal family order. In sum, the discourse of "a ripe melon drops from the stem" and "sleep, endure the pain, delay approaching the birthing tub" comprised an important intellectual resource that male doctors drew on to legitimate themselves as superior overseers of women's gestational bodies.

Koreans' Traditional View on Death / 한국호스피스완화의료학회지

Koreans' traditional view on death has been much influenced by Confucianism, Taoism, Buddhism, and shamanism since ancient times. Confucianism emphasizes the importance of the real life in this world and highly praises doing good deeds for the family and the community. It also praises people who are enlightened by education and self-discipline. Confucian scholars admit that death cannot be understood by rational thinking although it is unavoidable as a cosmic order. Taoism sees life as the same entity as death; Both are two different aspects of the same cosmos or the wholeness. However, the disciples of Taoism became much interested in a long life and well being that may be achieved by harmonizing with the cosmic order. Buddhism thinks that death and life are an "illusion". It says that people can be enlightened by recognizing the fact that "Nothing is born and nothing is dying in this world. Everything is the product of your mind occupied with false belief." However, secular Buddhists believe in the afterlife and metempsychosis of the soul. This belief is sometimes connected with the view of the traditional shamanism. Shamanism dichotomizes the world between "this world" and "that world". After death, the person's soul travels to "that world", where it may influence life of people who reside in "this world". And shamans who are spiritual beings living in "this world" mediate souls and living people. In conclusion, there are various views and beliefs regarding death, which are influenced by a number of religions and philosophies. They should be seriously considered when making a medical decision regarding the end of patients' life.

YI Suki's Yoksimanpil and the Professional Identity of a Chung'in Medical Official in Eighteenth Century Choson Korea / 의사학

About one hundred years after the publication of Tonguibogam (1613), a physician at the court YI Suki (1664-?) wrote a medical manuscript titled Yoksimanpil (Miscellaneous Jottings on Medical Experiences and Tests, 1734). As indicated in its title, Yoksimanpil was a medical essay composed of 130 medical case histories, drawing on what YI Suki himself had experienced in his medical practices. This paper examines the messages YI Suki in Yoksimanpil tried to address to his fellow Korean doctors, and by doing so illuminates an aspect of the medicine in the late Choson period. The argument goes that YI Suki wrote Yoksimanpil as a vehicle for promulgating his professional identity as a bureaucratic physician who belonged to the network of the chung'in technical officials-a group of government technical functionaries in late Choson Korea. Throughout the late Choson period, the chung'in technical officials had been discriminated, institutionally and socioculturally, against the yangban literati, while their promotion to honored higher positions was blocked. It was in the late 17th and early 18th century that a group of chung'in officials tried to secure their sociocultural places for their professional activity, thus bringing to light their social and professional identity in Choson society. A member of the network of the chung'in technical officials in the early 18th century, YI Suki was in an effort to position himself as a doctor somewhere between the medical tradition and the Confucian literary tradition. In these sociocultural contexts, we can see more clearly what YI Suki tried to speak of in his book and the historical meaning of the medical writing Yoksimanpil. First, the way he practiced medicine was testing and confirming what the received medical textbooks had asserted (Chunghomkobang). This style of practicing medicine could be viewed as a reflection of the comprehensivity trait of bureaucratic court physicians network YI Suki belonged to. Also this type of practice has the implication that YI Suki himself was a well-versed practitioner following the medical textual tradition, which was closely associated with the medical officials network. The emergence of the practice Chunghomkobang could be better understood in the backdrop of over 100 years of maturation process of Tonguibogam in the clinical practices. Second, he formulated the professional identity of physicians only in terms of medical proficiency without recourse to the Confucian literary tradition. In other words, in promoting the social status of medicine, he did not resort to Confucian morality. He instead emphasized his dexterity or resourcefulness in dealing with millions of ever-changing diseases (Imsikwonbyon). Conceivably, this way of characterizing his own medical practice-by way of strongly combining the textual tradition and the experiential tradition while keeping distance with the Confucian literary tradition-reflected the complexity of the ambivalent identity of the technical chung'in officials, especially in regard to Confucianism, between Confucian physicians and hereditary doctors. All in all, YI Suki presented himself as an ideal image of the physician, which arguably reflected the sociocultural and academic context of the network of the chung'in technical officials in early 18th century Choson Korea.

Perception of aging among Korean undergraduate nursing students

OBJECTIVE: To explore perceptions of aging among Korean undergraduate nursing students. METHODS: The participants for the study were 102 undergraduate nursing students, selected from two universities in Korea. The questions were non-structured, open-ended in order for the students to make sufficiently complete statements regarding their experiences with aging. RESULTS: The collected materials were classified into 4 themes, 13 sub-themes and 30 meaning units. Four themes emerged: fullness, emptiness, transference, and desirability. Most nursing students perceived aging positively as fullness and desirability, which are influenced by Confucianism. CONCLUSION: In conclusion, Confucianism as a cultural context should be considered to develop strategies for promoting a positive perception of aging in Korea.

OBJETIVO: Explorar a percepção sobre envelhecimento entre alunos de graduação em Enfermagem de duas universidades da Coréia do Sul. MÉTODOS: Pesquisa de abordagem qualitativa, do tipo descritivo com amostra de 102 graduandos em Enfermagem, selecionados com base em duas universidades desse país. As cinco questões utilizadas na pesquisa foram abertas, não estruturadas para possibilitar que os estudantes relatassem de modo completo suas experiências sobre envelhecimento; os relatos, obtidos entre os meses de setembro e novembro de 2010, foram submetidos à análise de conteúdo. RESULTADOS: Os materiais coletados foram classificados em quatro temas: plenitude, vazio, transferência e conveniência. A maioria dos estudantes de enfermagem percebeu o envelhecimento de forma positiva em relação à plenitude e conveniência, que são influenciados por valores do confucionismo. CONCLUSÃO: O confucionismo deve ser considerado como um contexto cultural para desenvolver estratégias de promoção de percepção positiva do envelhecimento na Coréia do Sul.

OBJETIVO: Explorar la percepción sobre el envejecimiento entre alumnos de pregrado en Enfermería de dos universidades de Corea del Sur. MÉTODOS: Investigación con abordaje cualitativo, de tipo descriptivo realizado con una muestra de 102 graduandos en Enfermería, seleccionados en dos universidades de ese país. Las cinco preguntas utilizadas en la investigación fueron abiertas, no estructuradas para posibilitar que los estudiantes relaten de modo completo sus experiencias sobre envejecimiento; los relatos, obtenidos entre los meses de setiembre y noviembre del 2010, fueron sometidos al análisis de contenido. RESULTADOS: Los materiales recolectados fueron clasificados en cuatro temas: plenitud, vacío, transferencia y conveniencia. La mayoría de los estudiantes de enfermería percibió al envejecimiento de forma positiva en relación a la plenitud y conveniencia, que son influenciados por valores del confucionismo. CONCLUSIÓN: El confucionismo debe ser considerado como un contexto cultural para desarrollar estrategias de promoción de percepción positiva del envejecimiento en Corea del Sur.

Influence of Compendium of Materia Medica on the Materia Medica in the late period of the Chosun Dynasty / 의사학

In this paper, I investigated the influence of Compendium of Materia Medica (CM) on Records for Rural Life of Chosun Gentlemen (RRC), and refuted Miki Sakae's opinion, CM did not have much impact on the Materia Medica in the late period of the Chosun Dynasty. When Li Shizhen published CM, it resulted in a shift of mainstream of Materia Medica in Eastern Asia from Classified Emergency Materia Medica to CM and a new categorizing system of Materia Medica by CM led to the division of Materia Medica into medicine and natural history. It is obvious that doctors of the Chosun Dynasty also adopted the latest achievements of Materia Medica by CM, but so far there have been few studies to clarify this. Seo yugu was a scholar of the Realist School of Confucianism during the late period of the Chosun Dynasty, and RRC is his representative work. RRC is a massive encyclopedia of natural history that covers vast areas of science from agriculture, floriculture, writing and drawing, architecture, diet, and medicine, among others which absorbed the achievements of CM, the best Materia Medica book at that time. Miki Sakae also highly regarded the encyclopedic knowledge of RRC, but devalued the results of Materia Medica. He only described a part of RRC's Materia Medica, nurturing volume, on the view of life nurturing and mentioned that it had been strongly influenced by China. According to this study, a large portion of RRC, especially regarding Materia Medica, depends on CM. Seo yugu had accepted the categorizing system and new medicinal information of CM, at the same time he modified the categorizing system of CM practically by the subject of each volume of RRC. We can find many quotations of CM except the nurturing volume, but other books, Treasured Mirror of Eastern Medicine, Materia Medica for Relief of Famines are also quoted. Furthermore, Seo yugu emphasized the differences of natural environments between Chosun and China, and specified the editing criteria, "to be useful in Chosun." This is the most obvious evidence that Materia Medica of Chosun had not remained in the framework of Treasured Mirror of Eastern Medicine which succeeded Classified Emergency Materia Medica, but had been developed into medicine and natural history based on CM.

Who Takes Care of Patients with Dementia in Korea: A Study on the Present State of Patients with Dementia Living Alone and Primary Caregivers

BACKGROUND: Cultural characteristics of taking care of patients with dementia in Korea are based on the influence of Confucianism on the lifestyle of Koreans. In addition, as the family size has been getting smaller, the number of old persons who live alone has been increasing. The purpose of this study is to examine the proportion of the elderly with dementia who live alone and demographics of caregivers when such patients live with their family. METHODS: From the multiple hospital-based cohort, 973 elderly patients with very mild dementia (Clinical Dementia Rating [CDR]=0.5), 1,056 patients with mild dementia (CDR=1) and 359 patients with moderate dementia (CDR=2) were recruited. We analyzed the proportion of the patients with dementia who live alone and the demographics of the caregivers if such patients live with and are taken care of by such caregivers depending upon the severity of dementia. RESULTS: The proportion of the patients with dementia who live alone accounts for about 40% of all elderly patients with dementia. Major age groups of caregivers are of 40s and 50s. Sons, daughters, and spouses were ranked in the said order in the proportion of caregivers according to their relationship to patients. CONCLUSIONS: Up to now, family members care for about 60% of elderly patients with dementia, which may suggest that from the objective viewpoint, direct burden borne by caregivers for old patients with dementia would be considerably high. On the other hand, about 40% of dementia patients live alone, implying that the social care system is needed for them.

Who Takes Care of Patients with Dementia in Korea: A Study on the Present State of Patients with Dementia Living Alone and Primary Caregivers

BACKGROUND: Cultural characteristics of taking care of patients with dementia in Korea are based on the influence of Confucianism on the lifestyle of Koreans. In addition, as the family size has been getting smaller, the number of old persons who live alone has been increasing. The purpose of this study is to examine the proportion of the elderly with dementia who live alone and demographics of caregivers when such patients live with their family. METHODS: From the multiple hospital-based cohort, 973 elderly patients with very mild dementia (Clinical Dementia Rating [CDR]=0.5), 1,056 patients with mild dementia (CDR=1) and 359 patients with moderate dementia (CDR=2) were recruited. We analyzed the proportion of the patients with dementia who live alone and the demographics of the caregivers if such patients live with and are taken care of by such caregivers depending upon the severity of dementia. RESULTS: The proportion of the patients with dementia who live alone accounts for about 40% of all elderly patients with dementia. Major age groups of caregivers are of 40s and 50s. Sons, daughters, and spouses were ranked in the said order in the proportion of caregivers according to their relationship to patients. CONCLUSIONS: Up to now, family members care for about 60% of elderly patients with dementia, which may suggest that from the objective viewpoint, direct burden borne by caregivers for old patients with dementia would be considerably high. On the other hand, about 40% of dementia patients live alone, implying that the social care system is needed for them.

A Study on How Young Doctors and Patients Perceive the Doctor-patient Relationship / 한국의학교육

PURPOSE: We specifically investigated the young doctor (residents) patient doctor-patient relationship in Korea. A society built on Confucianism, age is expected to affect even the doctor-patient relationship. METHODS: 57 residents participated and answered 6 open-ended questions. 90 patients of various age participated and answered 3 open-ended and 6 close-ended questions. RESULTS: It seems that the general problem of the doctor-patient relationships was related to attitudes and communication skills. Over 80% of the residents felt uncomfortable and received inappropriate verbal expressions and attitudes from their patients simply because they were young or younger than the patients. This negative experience resulted mostly from the residents' self-perceived lack of experience and clinical competence and the patients' distrust of young doctors. As for the patients, over 80% preferred middle-aged doctors to young doctors. Middleaged doctors were thought to be easier to understand, better mannered, more humane, and clinically competent. Most residents expected professional respect from their patients, while patients expected kindness and humility from the young doctors. This shows a gap in the reciprocal expectations between residents and patients. CONCLUSION: Young doctors are perceived as inexperienced and incompetent and, consequently, not trusted by patients in Korea. To improve the resident-patient relationship, improvement in attitude and communication skills is needed.

The Past, Present, and Future of Xenotransplantation

No abstract available.

A Study on Knowledge and Attitude of Housewives toward Health Care and Antibiotics in a Rural Area / 예방의학회지

A study was conducted during the period of August 13 to August 18, 1974 to obtain information on knowledge and attitude of the rural area housewife toward health care and antibiotics using. Interviewed 242 housewives dwelling in Soodong and Hwado Myun, Yangju Gun, Kyunggi Do, a typical rural area in Korea and the following results are obtained: 1. Of 242 housewives interviewed, 20.2% were illiteracy, 68.2% was graduated from primary school, 9.1% from middle school and 2.5% from high school. 2. Of those interviewed, 8.7% were Christian, 5.0% Bueldist, 2.9% Confucianism, and 83.4% of those were no religious preference. 3. Utility rate according with the kind of mass media in home was 85.1% of respondents possessed radio, 16.1% of magazine, 12.8% of newspaper, and 4.1% of television. 4. In the case of patients occur in a family, 13.0% out of 242 respondents had chosen physician's clinics for initial medical care place, 58.4% drug stores, 0.9% herb medicine and 27.7% of those had chosen folk medicine at home. 5. Antibiotics effective complaints listed by the respondents were skin diseases with 43.8%, suppureated wound 30.0%, URI like symptoms 18.2%, diarrhea 14.5%, low back pain 12.9%, fever 6.2%, loss of appetite 3.3%, all kind of diseases 2.5%, urethral discharge 2.1% and tuberculosis 0.8% respectively. 6. Only 14.7% of respondents had obtained antibiotics for medical care from physician's clinics and 85.3% of the respondents had obtained antibiotics from drug store (70.7%), village shop (10.4%), and salesmen in street market without any physician's prescription. 7. Eight-nine percent of the respondents were understanding on patient care activity as the local health subcenter but only 11.0% of those on M.C.H., 29.0% of those on family planning, 21% on vaccination, and only 6.6% on tuberculosis control activity. 8. Utility rate of the local health subcenter was 71.9% out of the patients indicated medical care of medical facilities.