The objective of this study was to compare the cost of illness of amyotrophic lateral sclerosis (ALS) in the Korean population based on the staging system for ALS from the perspective of both patients and the government. Direct medical costs, care-related costs, and loss of productivity in patients with ALS were measured based on medical records and face-to-face interviews. The patients were divided into groups according to the staging system for ALS, and the cost of illness was analysed. A total of 151 patients with ALS were enrolled in the study. The mean monthly cost of ALS was US $7902 per patient and increased according to the disease stage (stage 2, US $5181; stage 3, US $7089; stage 4, US $10,557). Of direct medical costs (US $3436), 44.8% of the cost burden was carried by patients, and the remaining costs were paid by the government. In conclusion, although the current coverage rate of the National Health Insurance (NHI) system for rare and intractable diseases including ALS is 90%, the rate of direct medical costs paid by patients and out-of-pocket costs remain high. Moreover, coverage rates and cost of illness are closely related with disease severity.

The results of this study suggest that levels of depression and caregiving burden are high among family members caring for patients with ALS. As depression is associated with caregiving burden, screening and emotional supports should be provided to reduce the burden of care for these family. Support programs to alleviate the care burden are also needed, considering family demographics, time per day in caring giving and K-ALSFRS-R.

No abstract

Purpose: The purpose of this study was to examine effects of enneagram group counseling program on self-identification and depression in nursing college students. Three groups, categorized by how the students solve their conflicts, were selected to identify changes from the program. Methods: A quasi-experimental study with a non-equivalent control group and pre posttest design was used. Participants were assigned to the experimental group (n= 30) or control group (n= 33). The experimental group participated in enneagram group counseling program for 38 hours through eight sessions covering four different topics. Collected data were analyzed using Chi-square test, Fisher's exact test, t-test, and Wilcoxon signed rank test. Results: Total self-identity score for the experimental group was significantly higher than the control group. However, there was no significant difference between the two groups for depression scores. The Assertive and Compliant groups demonstrated significant change in self-identification while the Withdrawn groups did not reveal any change. Conclusion: Results indicate that the enneagram group counseling program is very effective in establishing positive self-identification for nursing college students who face developmental crisis and stressful situations. It is also expected that this program would be useful to enhance the students' confidence through a deeper understanding and acceptance of themselves.Key words: Enneagram, Group counseling, Nursing college student, Self-identity, Depression

Purpose: The purpose of this study was to identify and understand nurses' experiences of the death of patients in geriatric hospitals. Methods: Van Manen's hermeneutic phenomenological analysis was applied in the interpretation of experiential descriptions of seven nurses who had experienced the death of patients in a geriatric hospital. Results: The essential subjects derived from the experience of the nurses on the death of patients in a geriatric hospital are covered in the following 7 themes. 'Placed in death site', 'Difficult repetition of death and farewell', 'Emotional waves that rushes in after farewell', 'Dilemmas in a place with no preparation to greet expected death', 'Getting dull from continually being struck with sorrow', 'Being together with living death', and 'Showing courtesy for a good farewell and living well'. Conclusion: The results of this research will contribute to the development of policy on all the deaths of patients in geriatric hospitals and suggest basic data that need to be applied in real practice and directions to introduce plans for realistic improvements in nursing care of deathbed patients in geriatric hospitals. If the original work is properly cited and retained without any modification or reproduction, it can be used and re-distributed in any format and medium.