The correlates of unemployment and its association with quality of life in cervical cancer survivors

유신혜,윤영호,박상민,김영애,박상윤,배덕수,남주현,박종택,조치흠,이종민 대한부인종양학회 2013 Journal of Gynecologic Oncology Vol.24 No.4

Objective: Little is known regarding cervical cancer survivors’ employment status, which represents social integration of cancer survivors as a pivotal domain of long-term quality of life. The goal of this study was to assess the correlates of unemployment and evaluate the impact on the comprehensive quality of life in cervical cancer survivors. Methods: We enrolled 858 cervical cancer survivors from the gynecologic oncology departments of multi-centers in Korea. Factors associated with unemployment were identified using multivariate logistic regression analyses. We assessed different health-related quality of life domains with multivariate-adjusted least-square means between cervical cancer survivors who currently work and do not. Results: After diagnosis and treatment, the percentage of unemployed survivors increased from 50.6% to 72.8%. Lower income (adjusted odds ratio [aOR], 1.97; 95% confidence interval [CI], 1.38 to 2.81), medical aid (aOR, 1.58; 95% CI, 1.05 to 2.38), two or more comorbidities (aOR, 1.80; 95% CI, 1.12 to 2.90), current alcohol drinkers (aOR, 2.33; 95% CI, 1.54 to 3.52), and employed at the time of diagnosis (aOR, 10.72; 95% CI, 7.10 to 16.16) were significantly associated with unemployment. Non-working groups showed significant differences with respect to physical functioning, role functioning, depression, and existential well-being. Conclusion: The proportion of unemployed cervical cancer survivors seems to increase, with low-income status and the presence of medical aid negatively being associated with employment, in addition to other comorbidities and previous working status. Effort should be made to secure the financial status of cervical cancer survivors.

노인 암환자 통증의 치료 및 관리

유신혜 대한내과학회 2021 대한내과학회 추계학술대회 Vol.2021 No.2

‘Prison Art’의 유용성에 관한 소고 - 외국의 동향을 중심으로 -

유신혜 아시아교정포럼 2020 교정담론 Vol.14 No.2

Prison Art란 교도소 내 미술프로그램을 통해 익힌 기술로 수 용자 또는 출소자가 창작한 작품을 이르며, 넓은 의미로는 예술 의 한 장르로 분류된다. 교도소 수용자라는 참여자의 특성상 독 특한 심리적, 문화적 경험이 작품에 반영되기에 Prison Art는 타 예술과 확연히 구분되는 특수성을 가진 미술영역의 한 갈래이다. 교도소 수용자들이 미술프로그램을 통해 기술을 배운 후 작품 생산에 직접 참여하고 그 미술품이 유통과 판매까지 이어지는 경우가 다수라는 점에서 교육에만 그치는 기존의 교도소 미술프 로그램, 그리고 작품제작과 취업과의 연계성이 미흡한 교정작품 과도 구분된다. Prison Art를 통해 수용자 교화, 교정작품의 생 산과 판매, 그리고 취업연계까지 목표를 둘 수 있다는 점에서 Prison Art의 활용 가능성은 큰 것으로 평가되고 있다. 이 연구는 국내에서 아직 이론적인 소개가 미흡하고, 교정현 장 및 실무에서도 도입되지 않은 Prison Art의 외국사례를 소개 하여 국내의 관련 연구 및 수용자 처우에의 적용가능성을 탐색 하는데 목적을 두었다. 국내에서는 관련정보가 부족한 만큼 탐색 적 수준에서 외국의 우수사례를 검토하고 유용성을 분석함으로 써 국내에서 미술을 매개로 한 수용자 예술치료와 취업연계로의 활용가능성을 검토하고자 한다. 이를 위하여 외국의 관련논문들을 통해 Prison Art의 개념, 역사, 주된 유형 등에 관한 이론적인 내용을 소개하였다. 아울러 외국 Prison Art의 우수사례를 소개하고 유용성을 분석하였는 데, 주된 내용은 다음과 같다. 첫 번째, 멕시코의 ‘The Prison Art Project’프로젝트는 수용 자에게 멕시코 교도소 내 타 직업군에 비해 월등히 높은 수입을 제공하며, 출소 후 기관에 협력 가능한 취업의 길을 열어주는 것 이 주요한 특징이었다. 두 번째 사례인 미국 뉴욕시에서 열린 전 시 ‘The Pencil Is a Key’는 Prison Art의 예술성을 부각시키고 역사적 흐름을 보여준 전시로, 수용자와 그들의 작품에 대한 대 중 인식 개선에 긍정적인 영향을 준 것으로 본다. 마지막으로 미 국 하와이의 유일한 여성 교도소인 WCCC에서 진행한 ‘CARE Project’는 수용자에게 종이공예의 한 갈래인 퀼트를 가르치고 지역의 갤러리와 온라인 시장에 연계한 성공적인 사례로 꼽을 수 있다. Prison Art is a creative work of art by the inmates or the released prisoners who were practiced through Prison Art Programmes. Prison Art is distinctively and widely classified as one genre of art which reflects unusual psychological characteristics and cultural experiences of inmates. Moreover, Prison Art is different from 'Arts in Prison: educational art program for correctional purpose' and 'Correctional Works. While the other two lack in connectivity between producing art pieces and making a business of it, the inmates participate in production processes after obtaining the art skills from Prison Art Programmes. The usefulness of Prison Art is highly evaluated for having potential as a tool for correcting prisoners, producing and selling correctional works, and activating employment linkage. This paper introduces the overseas cases of Prison Art, which has not yet been academically established and has not been introduced in the domestic fields and practice. This paper also aims to be used in domestic related research and to find a possibility of application on inmate treatment. As relevant informations lack in Korea, this paper intends to review the foreign outstanding practices at an exploratory level and to suggest the applicability of employment linkage and art therapy program for the domestic field. To propose the applicability, this paper reviews the definition, history, and frequent form of Prison Art from the relevant foreign papers. Along with introducing the impressive cases of foreign prison art and analyzing the proposals of applicability, the main points of research are as follows. Among the research results of outstanding cases, 'The Prison Art Project' from Mexico, sales of bags and wallets with tattoo design from inmates, is introduced at first. 'The Prison Art Project' provides an exceptionally high income to the project participants comparing with other Mexican inmates with different occupations and suggests a collaboration of related institution after a discharge. Those two are the significant characteristics of 'The Prison Art Project'. Secondly, ‘The Pencil Is a Key’ from New York City is an exhibition that showed the historical flow of Prison Art and improved the bias on the prisoners and their artworks by regarding inmates as pure artists. Furthermore, 'CARE Project' held by WCCC(Women's Community Correction Center), the only women's prison in Hawaii, is another successful example of connecting inmate's art with local galleries and online markets after educating quilt to the inmates.

The Effect of Hospice Consultation on Aggressive Treatment of Lung Cancer

유신혜,김범석,김미소,김태민,김동완,허대석 대한암학회 2018 Cancer Research and Treatment Vol.50 No.3

Purpose The aims of this study were to investigate trends of aggressive treatment of non-small cell lung cancer (NSCLC) patients at the end-of-life (EOL) during the recent 5 years and examine the relationship between hospice consultation (HC) and aggressive care. Materials and Methods The medical records of 789 patients with stage IIIB-IV NSCLC at Seoul National University Hospital (SNUH) who received palliative chemotherapy and died from 2010 to 2014 were retrospectively reviewed. Indicators of aggressive treatment were evaluated, and the association of HC with these indicators was analyzed. Results During the last 5 years, the frequency of HC increased from 26.7% to 43.6%. The time interval from last chemotherapy to death increased, and the proportion of patients who received palliative chemotherapy, visited an emergency room, were admitted to intensive care unit, during the last month of life, and died in SNUH significantly decreased over time. Referral to HC was significantly associated with lower intensive care unit admission rates, lower out-of-hospital death rates, and less use of the chemotherapy within 1 month prior to death. Overall survival did not differ by HC. Conclusion The pattern of cancer care near the EOL has become less aggressive when HC was provided. The positive association of HC with better EOL care suggests that providing HC at the optimal time might help to avoid futile aggressive treatment.

영어 발음지도에 관한 연구 : 7차 교육과정을 중심으로

유신혜 The English Linguistic Science Association of Kore 2000 English Linguistic Science Vol.4 No.-

Difficulties Doctors Experience during Life-Sustaining Treatment Discussion after Enactment of the Life-Sustaining Treatment Decisions Act: A Cross-Sectional Study

유신혜,최원호,김예진,김민선,박혜윤,김범석,허대석 대한암학회 2021 Cancer Research and Treatment Vol.53 No.2

Purpose This study aimed to investigate difficulties doctors experience during life-sustaining treatment (LST) discussion with seriously ill patients and their families after enactment of the LST Decisions Act in February 2018.Materials and Methods A cross-sectional survey was conducted in a tertiary hospital in the Republic of Korea in August 2019. Six hundred eighty-six doctors who care for seriously ill patients were given a structured questionnaire, and difficulties during the discussion were examined.Results One hundred thirty-two doctors completed the questionnaire. Eighty-five percent answered they treat cancer patients. Most (86.4%) experienced considerable difficulties during LST discussions (mean score, 7.4±1.6/10). The two most common difficulties were communication with patients and family and determining when to discuss LST. Two-thirds of doctors found direct discussions with the patient difficult and said they would initiate LST discussions only with family. LST discussions were actually initiated later than considered appropriate. When medically assessing whether the patient is imminently dying, 56% of doctors experienced disagreements with other doctors, which could affect their decisions.Conclusion This study found that most doctors experienced serious difficulties regarding communication with patients and family and medical assessment of dying process during LST discussions. To alleviate these difficulties, further institutional support is needed to improve the LST discussion between doctors, patients, and family.

의사소통능력 향상을 위한 영어발음 지도방법에 관한연구 : 고등학생을 중심으로 with Korean High School Students

유신혜 The English Linguistic Science Association of Kore 2002 English Linguistic Science Vol.8 No.-

The purpose of the present study is to find out the teaching English pronunciation methods to improve communicative abilities for Korean high school students. The methods of the present study are as follows: (1) to examine the current teaching English pronunciation trends, (2) to develop teaching English pronunciation models, (3) to compare and analyze the effects after having experimental classes based on the teaching English pronunciation models, and (4) to suggest teaching English pronunciation methods for Korean high school students. We develop three kinds of teaching English pronunciation models. The first model is the one which focuses on pronunciation-based listening practice. The second model is the integral one which focuses on teaching pronunciation explanation and rules. The third model is the one which focuses on using pronunciation-based CD-ROM Title. The results of the present study are as follows; (1) The experimental class having pronunciation classes focused on pronunciation-based listening shows higher score than the controlled class on communicative abilities. (2) The experimental class having pronunciation classes focused on teaching pronunciation explanation and rules shows higher score than the controlled class on communicative abilities. (3) The experimental class having pronunciation classes focused on using pronunciation-base CD-ROM Title shows higher score than the controlled class on communicative abilities. (4) Three kinds of experimental classes having pronunciation classes of their own don't show the significant improvement of pronunciation production, but the significant improvement of pronunciation perception compared with the controlled class. (5) Three kinds of experimental classes show the improvement on the English pronunciation attitude than the controlled class. (6) The experimental class having pronunciation classes focused on pronunciation-based listening shows there is positive correlation between English pronunciation attitude and English pronunciation, and the controlled class shows that there is negative correlation between English pronunciation attitude and English pronunciation. (7) The controlled class shows there is a negative correlation between English pronunciation attitude and communicative abilities, but the other experimental classes don’t. In conclusion, the above suggested teaching English pronunciation models are efficient for improving the communicative abilities. The controlled class shows that there are negative correlations between English pronunciation attitude and English pronunciation production, and communicative abilities, which means that the teaching method for the controlled class is not sufficient for the desire and demand of the students. Therefore we suggest the three kinds of teaching English pronunciation models to enhance communicative competence.

Sapir의 음소론 : 그의 논문 Sound Patterns in Language를 중심으로

유신혜 이화여자대학교 외국어교육과 1974 Foreign language teaching Vol.- No.7

Anxiety in Cancer Outpatients before Radiologic Response Assessment: A Cross-sectional Study

유신혜,변자민,박진현,김기환,김진수,최인실 대한내과학회 2018 대한내과학회 추계학술대회 Vol.2018 No.1

Poor prognostic factors in human papillomavirus- positive head and neck cancer: who might not be candidates for de-escalation treatment?

유신혜,옥찬영,김범석,박성준,김태민,김진호,전윤경,정은재,권성근,J. Hun Hah,권택균,정경천,김동완,우홍균,성명훈,허대석 대한내과학회 2019 The Korean Journal of Internal Medicine Vol.34 No.6

Background/Aims: Since patients with human papillomavirus (HPV)-associated head and neck squamous cell carcinoma (HNSCC) have favorable outcomes after treatment, treatment de-escalation for these patients is being actively investigated. However, not all HPV-positive HNSCCs are curable, and some patients have a poor prognosis. The purpose of this study was to identify poor prognostic factors in patients with HPV-positive HNSCC. Methods: Patients who received a diagnosis of HNSCC and tested positive for HPV from 2000 to 2015 at a single hospital site (n = 152) were included in this retrospective analysis. HPV typing was conducted using the HPV DNA chip assay or liquid bead microarray system. Expression of p16 in the tumors was assessed by immunohistochemistry. To determine candidate factors associated with overall survival (OS), univariate and multivariable Cox regression analyses were performed. Results: A total of 152 patients with HPV-positive HNSCC were included in this study; 82.2% were male, 43.4% were current or former smokers, and 84.2% had oropharyngeal cancer. By univariate analysis, old age, performance status ≥ 1, non-oropharyngeal location, advanced T classification (T3–4), and HPV genotype 18 were significantly associated with poor OS. By multivariable analysis, performance status ≥ 1 and non-oropharyngeal location were independently associated with shorter OS (hazard ratio [HR], 4.36, p = 0.015; HR, 11.83, p = 0.002, respectively). Furthermore, HPV genotype 18 positivity was also an independent poor prognostic factor of OS (HR, 10.87, p < 0.001). Conclusions: Non-oropharyngeal cancer, poor performance status, and HPV genotype 18 were independent poor prognostic factors in patients with HPV-positive HNSCC. Patients with these risk factors might not be candidates for de-escalation treatment.