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• The Effect of Hospice Patients' Pain, Anxiety, Depression, Perception of Dignity, and Spiritual Well-Being on their Attitudes toward Dignified Death
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• Development of a One-item Screening Question to Assess Spiritual Well-Being for Advanced Cancer Inpatients in Korea
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PURPOSE: The purpose of this study was to investigate the effects of cardiac rehabilitation teaching program on knowledge level and compliance of health behavior for the patients with myocardial infarction.
METHOD
The subjects were 47 patients 23 were assigned to the experimental group and 24 were for the control. The cardiac rehabilitation teaching program is a individualized teaching program which was delivered to the experimental group during hospitalization period by present researcher. Data were collected through questionnaire surveys for knowledge level and compliance of health behavior from September 15, 1999 to December 31, 2000. The collected data was analyzed by using the SAS program.
RESULTS
1. With regard to the knowledge scores 1) The total knowledge level in the experimental group was significantly higher than in the control group. 2) As to the knowledge domains, nature of disease, risk factors, diet, medication, exercise, and daily activities were significantly higher in score in the experimental group than in the control group. 2. With regard to the compliance of health behavior 1) The average compliance with good health behavior was significantly higher in the experimental group than in the control group. 2) As to the health behavior domains smoking cessation, diet, stress management, regular exercise, and other measures for lifestyle modification were significantly higher in score in the experimental group than in the control group. 3. The pre-treatment knowledge score was positively correlated to the post-treatment knowledge score and post-treatment knowledge score was positively correlated to the post-treatment compliance of health behaviors.
CONCLUSION
The above findings indicate that the cardiac rehabilitation teaching program for the experimental group was effective in increasing level of knowledge and improvement f compliance with good health behavior of patients with myocardial infarction.

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This study was conducted to draw out prevalence and the risk factors of diabetes mellitus and impaired fasting glucose for adults,(age 30-69). The subjects were 2096 adults, who had regular health examinations between January and December of 1999 at K Hospital in Seoul. The data was analyzed using chi-square test, unpaired t-test and logistic regression. Diabetes Mellitus and impaired fasting glucose were diagnosed by ADA (American Diabetes Association, 1997) criteria. The results were as follows: 1. Mens' prevalence of Diabetes Mellitus was 7.9% and womens' prevalence of Diabetes Mellitus was 3.8%. Mens' prevalence of impaired fasting glucose was 10.4% and womens' prevalence of impaired fasting glucose was 6.5%. Prevalences of Diabetes Mellitus and impaired fasting glucose increased with age. 2. Prevalence of Diabetes Mellitus and impaired fasting glucose of obese subjects (relative body weight>=162) was higher than that of overweight subjects (110<=relative body weight<=119) in men and women. 3. The diagnoses of Diabetes Mellitus and impaired fasting glucose increased with systolic blood pressure and triglyceride. 4. Significant factors associated with diabetes in the logistic regression best gut model were age, relative body weight, systolic blood pressure, triglyceride in men, and systolic blood pressure in women. In conclusion, as age, weight, systolic blood pressure and triglyceride get higher, Diabetes Mellitus and impaired fasting glucose prevalence also increases, porportionally.

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The study was aimed at developing an independent hospice center model that would be best suited for Korea based on a literature review and the current status of local and international hospices. For the study, five local and six international hospice organizations were surveyed. Components of the hospice center model include philosophy, purpose, resources (workers, facilities, and equipment), allocation of resources, management, financial support and hospice team service. The following is a summary of the developed model: Philosophies for the hospice center were set as follows: based on the dignity of human life and humanism, help patients spend the rest of their days in a meaningful way and accept life positively. On the staff side, to pursue a team-oriented holistic approach to improve comfort and quality of life for terminally ill persons and their families. The hospice center should have 20 beds with single, two, and four bed rooms. The center should employ, either on a part-time or full-time basis, a center director, nurses, doctors, chaplains, social workers, pharmacists, dieticians, therapists, and volunteers. In addition, it will need an administrative staff, facility managers and nurses aides. The hospice should also be equipped with facilities for patients, their families, and team members, furnished with equipment and goods at the same level of a hospital. For the organizational structure, the center is represented by a center director who reports to a board and an advisory committee. Also, the center director administers a steering committee and five departments, namely, Administration, Nursing Service, Social Welfare, Religious Services, and Medical Service. Furthermore, the center should be able to utilize a direct and support delivery systems. The direct delivery system allows the hospice center to receive requests from, or transfer patients to, hospitals, clinics, other hospice organizations (by type), public health centers, religious organizations, social welfare organizations, patients, and their guardians. On the other hand, the support delivery system provides a link to outside facilities of various medical suppliers. In terms of management, details were made with regards to personnel management, records, infection control, safety, supplies and quality management. For financial support, some form of medical insurance coverage for hospice services, ways to promote a donation system and fund raising were examined. Hospice team service to be provided by the hospice center was categorized into assessment, physical care, emotional care, spiritual care, bereavement service, medication, education and demonstrations, medical supplies rental, request service, volunteer service, and respite service. Based on the results, the study has drawn up the following suggestions: 1. The proposed model for a hospice center as presented in the study needs to be tested with a pilot project. 2. Studies on criteria for legal approval and license for a hospice center need to be conducted to develop policies. 3. Studies on developing a hospice charge system and hospice standards that meet local conditions in Korea need to be conducted.

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• Hospice and Hospice Care in Korea: Evolution, Current Status, and Challenges
  Bok Yae Chung, Yu Xu, Chanyeong Kwak
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The purpose of this study was to identify the effect on improvement of the Activity of Daily Living (ADL) and decrease the cognitive function and agitation behaviors by reminiscence with audio-visual stimulation for senile dementia. The quasi-experimental design was used in this study. Subjects were 26 with mild senile dementia who were cared for at a Day Care Center for Dementia in Seoul. The data were collected from March to July, 1999. Subjects were divided into three groups: Control I group with 10 subjects, reminiscence group(Control II group with 8 subjects), and reminiscence with audio-visual stimulation group(experimental group with 8 subjects). The Control I group got routine care as usual. Control II group participated in reminiscence sessions for one hour a day, five times a week, for a period of 4 weeks. The experimental group participated in reminiscence with audio-visual stimulation sessions for one hour a day, five times a week, for a period of 4 weeks. Instruments of this study were color photography with sound that was developed through an open questionnaire about events, objects, humans in action and animals that 100 Korean elderly over 60 would like to memorize. This was referred from the Sensory Stimuli Package by Namazi and Haynes(1994). The effects of treatment was evaluated through MMSE-K by Kwon & Park(1989). Also the Brief Cognitive Rating Scale(BCRS) by Reisberg et al(1983) for the cognitive function, through Agitation Inventory by Cohen- Mansfield and Colleague(1989) for behavioral response and through the Rapid Disability Rating Scale-2(RDRS-2) by Linn & Linn(1982) for the activity of daily living respectively. Data analysis was done using SPSS for X2-test, ANOVA, repeated measures ANOVA. The results were as follows : 1. Reminiscence with audio-visual stimulation did not improve cognitive function for senile dementia, but significantly improved verbal expression, the subscale of cognitive function. 2. Reminiscence with audio-visual stimulation reduced agitation behavior of experimental group significantly, but there was no significant difference between groups. 3. Reminiscence with audio-visual stimulation did not significantly effect the activity of daily living after treatment. In conclusion, it was shown that the reminiscence with audio-visual stimulation was an effective therapy to improve verbal expression and to reduce agitation behaviors of senile dementia. Further research with more indepth approach is needed, considering characteristic and level individualized for each senile dementia.

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• Effect of an educational tooth-brushing program using priming in an elderly population with dementia residing in nursing homes
  Gwi-Ryung Son Hong, Jung-Soo Woo
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  S.R. Sok
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This study was undertaken to identify optimal head elevation and position in the care of the neurosurgical patient with a cerebral aneurysm. The effects of 0degree, 15degrees and 30degrees head elevation and three positions(supine, side lying position opposite to the operation site, and side lying position on the same side as the operation site) on ICP was studied in fourteen neurosurgical patients with cerebral aneurysms. The results are as follows : 1. The mean intracranial pressure was significantly lower when the patient's head was elevated at 30degrees as compared to 0degree and 15degrees. 2. The mean intracranial pressure was significantly lower when the patient was positioned in the supine as compared to side lying positioned in the supine as compared to side lying position opposite to the operation site and side lying position on the same side as the operation site. The data indicate the head elevation to 30degrees and the supine position reduce ICP in neurosurgical patients with cerebral aneurysm.