가정∙방문간호학회지 (Journal of Home Health Care Nursing)

한국가정∙방문간호학회 (Korean Academic Society of Home Health Care Nursing)
권호 표지

일 지역 요양시설의 임종돌봄서비스

Terminal Care in Nursing Homes

  • 투고 : 2015.10.30
  • 심사 : 2015.12.07
  • 발행 : 2015.12.31
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Purpose: This study aimed at understanding terminal care provided in nursing homes. Method: An interview survey with staff in charge of terminal care was conducted in 97 nursing homes using questionnaires. The questionnaire was reviewed by 3 experts and pretested at 5 facilities. Data were analyzed using descriptive statistics, chi-square test, and Fisher's exact test. Result: Dyspnea was the most prevalent symptom predicting death. The most prevalent services were vital sign check for physical care, providing services by talking despite an unconscious state for psychosocial care, and respecting the faith of the elder for spiritual care. Employment of a registered nurse showed a significant difference in tube feeding (p=.035), analgesic administration (p=.022), informing the elder of end-of-life state (p=.020), helping an elderly person say good-byes through a visit with friends and acquaintances (p=.023), and helping express feelings related to death (p=.002). Lack of service was noticed for elderly resident, family, and staff after death of an elder. Problems related to terminal care were indifference of family members, difficulty in obtaining medical prescription, difficulty in predicting death, and so forth. Conclusion: Terminal care must be improved by making specific guidelines and it must become a part of nursing home evaluation.

키워드

참고문헌

  1. Ahn, S. Y., Kim, H. K., Kong, E. S., Kim, N. C., Kim, C. G., Song, M. S.. Lee, Y. W., Chan, S. O., Cho, M. O., & Choi, K. S. (2014). Nurses' experience of end-of-life care for older adults. Journal of Korean Gerontological Nursing. 16(2), 118-129. https://doi.org/10.17079/jkgn.2014.16.2.118
  2. An, M. S., & Lee, K. J. (2014). Awareness of good death and attitudes toward terminal care among geriatric hospital nurses. The Korean Journal of Hospice and Palliative Care. 17(3), 122-33. https://doi.org/10.14475/kjhpc.2014.17.3.122
  3. Brazil, K., Krueger, P., Bedard, M., Kelley, M. L., McAiney, C., Justice, C., & Taniguchi, A. (2006). Quality of care for residents dying in Ontario long-term care facilities: findings from a survey of directors of care. Journal of Palliative Care. 22(1), 18-25.
  4. Brazil, K., McAiney, C., Caron-O'brien, M., Kelley, M. L, A., O'krafka, P., & Sturdy-Smith, C. (2004). Quality end-of-life care in long-term care facilities: service providers' perspective. Journal of Palliative Care. 20(2), 85-92.
  5. Catholic University Hospice Education Research Institute (2006). Hospice and palliative care, Seoul : Koonja Publishing Company.
  6. English, D., & Gong, J. (2001). Why hospice care belongs in nursing homes, Part 1. Nursing Homes. 50(4), 46-50.
  7. Goodridge, D.. Bond, J. B., Cameron, C., & McKean, E. (2005). End-of-life care in a nursing home: a study of family, nurse and healthcare aide perspectives. International Journal of Palliative Nursing. 11(5), 226-232 https://doi.org/10.12968/ijpn.2005.11.5.226
  8. Hall, P., Schroder, C., & Weaver, L. (2002). The last 48 hours of life in long-term care: a focused chart audit. Journal of the American Geriatrics Society. 50(3), 501-506. https://doi.org/10.1046/j.1532-5415.2002.50117.x
  9. Hanson, L., & Henderson, M. (2000). Care of the dying in long-term care settings. Clinics in Geriatric Medicine. 16(2), 225-237. https://doi.org/10.1016/S0749-0690(05)70054-9
  10. Israel, G. D. (2013). Determining sample size. University of Florida IFAS Extension1-5. http://edis.ifas.ufl.edu/pdffiles/PD/PD00600.pdf.
  11. Ji, S. I., & You, H. S. (2014). The impact of clinical nurses' terminal care attitude and spiritual health on their terminal care stress. The Korean Journal of Hospice and Palliative Care. 17(4), 232-240. https://doi.org/10.14475/kjhpc.2014.17.4.232
  12. Katz, J. S., Sidell, M., & Komaromy, C. (2001). Dying in long-term care facilities: Support needs of other residents, relatives, and staff. American Journal of Hospice & Palliative Care. 18(5), 321-326. https://doi.org/10.1177/104990910101800507
  13. Kim, B. H. (2011). Current and future of hospice and palliative care in South Korea. The Korean Journal of Hospice and Palliative Care. 14(4), 191-196.
  14. Kim, H. (2013). Attitudes toward death and end-of-life care among nurses in nursing homes. Master's thesis. Seoul National University, Seoul.
  15. Lee, M. (2009). The present and the improving way of the senior recuperation facility in service field. Master's research report. Ulsan University, Ulsan.
  16. Lim, S. H., Chang, S. O., & Kim, M. S. (2010-a). Nurses' perceptions regarding sign & symptom management in end of life care in nursing homes. Journal of Korean Academy of Fundamentals of Nursing. 17(2), 209-219.
  17. Lim, S. H., Chang, S. O., Seo, K. H., & Lee, S. J. (2010-b). Nurses' perceptions regarding identification and management of change in the condition of residents at risk in nursing homes. Journal of Korean Gerontological Nursing. 12(1), 81-94.
  18. Maitland, J., Brazil, K., & James-Abra, B. (2012). "They don't just disappear": acknowledging death in the long-term care setting. Palliative and Supportive Care. 10(4), 241-247. https://doi.org/10.1017/S1478951511000964
  19. Ministry of Health & Welfare. (2012). 2012 Welfare Facilities for the Aged.
  20. Seo, Y. S., & Sung, K. W. (2012). Influence of nurses' spirituality on hospice nursing intervention in long-term care facilities. Journal of Korean Gerontological Nursing. 14(1), 12-20.
  21. Statistics Korea. (2015). 2015 Statistics on the Aged.
  22. Welch, L. C., Miller, S. C., Martin, E. W., & Nanda A. (2008). Referral and timing of referral to hospice care in nursing homes: the significant role of staff members. The Gerontologist. 48(4), 477-484. https://doi.org/10.1093/geront/48.4.477
  23. Woo, Y. W., Kim, K. H., & Kim, K. S. (2013). Death anxiety and terminal care stress among nurses and the relationship to terminal care performance. The Korean Journal of Hospice and Palliative Care. 16(1), 33-41. https://doi.org/10.14475/kjhpc.2013.16.1.033
  24. Ye, M. J., & Lee, J. S. (2015). Nurses' experiences of the death of patients in geriatric hospitals. Journal of Korean Academy of Nursing. 45(4), 513-522. https://doi.org/10.4040/jkan.2015.45.4.513
  25. Yong J. J., Kim, J. Han, S. S., & Puchalski C. M. (2008). Development and validation of a scale assessing spiritual needs for Korean patients with cancer. Journal of Palliative Care. 24(4), 240-246.
  26. Yoo, H. S. (2008). A study on the hospice service in the elderly welfare facilities. Master's thesis. Sahmyook University, Seoul.
  27. Yoon, E. (2002). A study on the actual condition of hospice service in nursing home. Journal of Welfare for the Aged Institute. 15(0), 91-120.
  28. Yoon, M. (2009). The spiritual well-being and the spiritual nursing care of nurses for cancer patients. The Korean Journal of Hospice and Palliative Care. 12(2), 72-79.