DOI QR코드

DOI QR Code

Self-transcendence, Life Satisfaction and Preference for care near the end of life of the Elderly

재가노인의 자기초월, 삶의 만족도와 임종기 치료 선호도 관련성

  • Lee, Jeong In (Division of Nursing, Daejeon Institute of Science and Technology) ;
  • Kim, Soon Yi (Division of Nursing, Daejeon Institute of Science and Technology)
  • 이정인 (대전과학기술대학교 간호학과) ;
  • 김순이 (대전과학기술대학교 간호학과)
  • Received : 2016.07.05
  • Accepted : 2016.09.09
  • Published : 2016.09.30

Abstract

Purpose: The purpose of this study was to examine self-transcendence, life satisfaction, and preference for end-of-life care in elderly patients. Method: This was a descriptive survey study. The study period was between August 2013 and October 2013 and included 208 elderly patients. Results: The average scores for self-transcendence, life satisfaction, and preference for end-of-life care were 2.79, 9.97, and 3.24, respectively. Statistically significant positive correlations were observed between self-transcendence and life satisfaction, decision making by health care professionals, spiritual area, family area. A positive correlation was observed between: (1) life satisfaction and spiritual area, (2) decision making by health care professionals and family area, and (3) decision making by health care professionals and pain area. Self-transcendence was a significant predictor of PCEOL. Conclusion: This study will provide basic information for use in the development of a program to encourage self- transcendence and life satisfaction, as well as to consider the elder's autonomy, pain control, and spirituality as important factors at the end-of-life care.

본 연구는 재가노인의 자기초월, 삶의 만족도, 임종기 치료선호도 정도를 파악하고 노인의 삶의 질을 향상시키기 위한 기초자료를 제공하기 위하여 시도된 서술적 조사연구이다. 연구대상자는 65세 이상의 노인 208명을 대상으로하고 자료수집은 2013년 8월부터 10월까지 실시하였다. 연구결과, 연구대상자의 자기초월 정도는 2.79점이며, 삶의 만족도 정도는 9.97점, 임종기 치료선호도 정도는 3.24점으로 나타났다. 자기초월은 교육수준이 높은 집단(F=3.38, p=.011)에서와 건강상태가 좋은 집단 (F=13.88 p<.001)에서, 삶의 만족도는 건강상태가 좋은 집단(F=24.42, p<.001)에서 유의하게 높게 조사되었다. 대상자의 자기초월은 삶의 만족도(r=.559, p<.001), 의료인에 의한 의사결정(r=.182, p=.008), 영성요인( r=..324, p<.001), 가족요인(r=.224, p<.001)과 유의한 순상관관계가 있는 것으로 조사되었으며, 삶의 만족도와 영성요인(r=.165, p=.017), 의료인에 의한 의사결정과 가족요인(r=.278, p<.001), 의료인에 의한 의사결정과 통증요인(r=.146, p=.035)이 유의한 순상관관계로 나타났으며, 자기초월이 임종기 치료 선호도에 영향을 미치는 요인으로 나타났다. 따라서 자기초월과 삶의 만족을 높일 수 있는 방안을 구축하고 임종기 대상자 관리를 위한 전략이 구체적으로 계획되어야 할 것이다

Keywords

References

  1. Korea National Statistical Office(KNSO). The autumn of future population. Retrived from http://www.nao.fo.kr, January, 12. 2011.
  2. P. G. Reed, "Demystifying self-transcendense for mental health nursing practice and research", Archives of Psychiatric Nursing, Vol. 23, no. 5, pp. 397-400, 2009. DOI: http://dx.doi.org/10.1016/j.apnu.2009.06.006
  3. D. Baker, "Relationship of self-transcendence and death anxiety to older adult's participation in health promotion behavior", Journal of Nursing Research, vol. 9, no. 2, pp. 1-10, 2009.
  4. J. Neill, "Transcendence and transformation in the life patterns of women living with rheumatoid arthritis", Advances in Nursing Science, vol. 24, pp. 27-47. 2002. DOI: http://dx.doi.org/10.1097/00012272-200206000-00008
  5. B. Nygren, L. Alex, E. Jonsen, Y. Gustafson, A. Norberg, B. Lundman, "Resilence, sense of coherence, purpose in life and self-transcendence in relation to perceived physical and mental health among the oldest old", Aging & Mental Health, vol. 9, no. 4, pp. 354-362, 2005. DOI: http://dx.doi.org/10.1080/1360500114415
  6. J. C. Thomas, M. Burton, M. T. Griffin, J. J. Fitzpatrick, self-transcendence, spiritual well-being and spiritual practice of women with breast cancer", Journal of Holistic care. vol. 28, pp. 116-122, 2010.
  7. E, J. Kim, Y. Kim, "Predictors of successful aging in korean women based on successful aging theory(SAT)", Korean Journal Women Health Nursing, vol. 17, no. 4, pp. 378-387, 2011. DOI: http://dx.doi.org/10.4069/kjwhn.2011.17.4.378
  8. H. K. Kim, "Gender difference of the influencing factors on successful aging among rural community dwelling korean elders", Journal of the Korean Gerontological Society, vol. 32, no. 3, pp. 819-834, 2012.
  9. S. Y, Kim, "The lived experience of self-transcendence of elders", Korean Journal of Adult Nursing, vol. 12, no. 4, pp. 595-605, 2000.
  10. S. Y. Kim, J, I. Lee, "Self-transcendence, spiritual well-being and death anxiety of the elderly", Journal of Korean Public Health Nursing, vol. 27, no. 3, pp. 480-489, 2013. https://doi.org/10.5932/JKPHN.2013.27.3.480
  11. S. Y. Kim, "The effect of self-transcendence and loneliness on quality of life of the elderly", Journal of the Korean Academia-Industrial cooperation Society, vol. 16 no. 10, pp. 6679-6687, 2015. DOI: http://dx.doi.org/10.5762/KAIS.2015.16.10.6679
  12. K. B. Bean, K. Wagner, "Self-transcendence, illness distress, and quality of life among liver transplant recipients", The Journal of theory Construction and Testing, vol. 10 no. 2, pp. 47-53, 2005.
  13. K. H. Kim, H. K. Chung, M. H. Choi, H. J. Kwon, "A study on self-efficacy and quality of life in the elderly patients with chronic pain", Journal of Korean academy of fundamental Nursing. vol. 7, no. 2, pp. 332-344, 2000.
  14. Z. K. Park, "Life satisfaction of people with disabilities : a theoretical model and its empirical test", A doctoral thesis of Sungkyunkwan University of Korea, 2009.
  15. Chosun Il bo, 12. 8, 2015.
  16. S. Kim, S. Y. Kim, K. Kim, "Death Anxiety and preferences regarding end-of-life medical care", Korean Journal of Medical Ethics, vol. 14, no. 4, pp. 413-426, 2011.
  17. Y. Lee, S. Kim, "Validating the korean version of the preference for care near the end of life(PCEOL-K) scale", Korean Journal Medical Ethics, vol. 12, no. 1, pp. 29-42, 2009.
  18. D. S. Kim, A. Y. So, K. S. Lee, J S. Choi, "Comparing the preference for terminal care in nurses and patients, Journal Muscle Joint Health, vol. 20, no. 3, pp. 214-224, 2013. DOI: http://dx.doi.org/10.5953/JMJH.2013.20.3.214
  19. P. G. Reed, "Self-transcendence and mental health in oldest-old adults", Nursing Research, vol. 40, no. 1, pp. 5-11, 1991. DOI: http://dx.doi.org/10.1097/00006199-199101000-00002
  20. P. G. Reed, "Religiousness among terminally ill and health adults", Research in Nursing & Health, vol. 9, no. 1, pp. 35-41, 1986. DOI: http://dx.doi.org/10.1002/nur.4770090107
  21. A. Campbell, "The sense of well-being". American Psychologist, vol. 31. pp. 114-117, 1981.
  22. M. S. Lee, " Factors influencing subjective quality of life of the workers", A doctoral thesis of Yonsei University of Korea, 1998.
  23. D. M Gauthier, R. D. Froman, "Preference for care near the end of life : scale development and validation", Research in Nursing & Health, vol. 24. no. 4, pp. 298-306, 2001. DOI: http://dx.doi.org/10.1002/nur.1031
  24. Y. K. Kim, J. W. Lee, "Influencing factors on life satisfaction in female elderly with degenerative knee arthritis-pain, activity of dailly living(ADL), depression", Journal of the Korean Data Analysis Society, vol. 13. no. 6, pp. 3009-3020, 2011.
  25. H. S.Kim, S. Kim, S. J. Yu, M. Kim, "The preference for care near end of life of Korean nurse", The Korean of Hospice and Palliative Care, vol. 13. no. 1, pp. 41-49, 2010.
  26. S. M. Lee, "Patients and family determination in medical decision making", Korea Journal of Medical Ethics, vol. 12. no. 4, pp. 323-334, 2009.
  27. K.E. Streinhauser, N. A Christakis, E. C. Clipp, M. McNeilly, L. Mclntyre, J. A. Tulsky, " Factors considered important at the end of life by patients, family, physicians, and other care providers", JAMA, vol. 284, pp. 2476-2482, 2000. DOI: http://dx.doi.org/10.1001/jama.284.19.2476
  28. C. M. Cho, "Factors influencing the quality of life in low-income elderly living an home : a literature review",. Journal fo Korean Public Health Nursing, vol. .27, no. 2, pp. 372-383, 2013. https://doi.org/10.5932/JKPHN.2013.27.2.372
  29. U. Jackobson, I. R. Hallberg, "Quallity of life among older adult with osteoarthritis", Journal of Gerontological Nursing, Vo. l, no. 8, pp. 51-60, 2002.
  30. K. O. Chang, M. J. Kim. I-J. Kim, "Effect of perceived health status, self-esteem and quality of life on life satisfaction of elders living at home", Journal of the Korean Academia-Industrial cooperation Society, vol. 16 no. 7, pp. 4723-4733, 2015. https://doi.org/10.5762/KAIS.2015.16.7.4723
  31. S. Kim, M. Lee, S. Y. Kim, "A survey on life sustaining treatment experienced by adults with deceased family member", Journal of the Korea Gerontological Society, vol. 21. no. 3, pp. 15-27, 2002.
  32. K H. Kim, H. J. Kwon, M. H. Choi, Y. J. Park, S. K. Kim, "psychological and spiritual factors associated with death anxiety of elderly people living at home", Journal of Korean academy Psychiatry Mental health Nursing, vol. 19, no. 1, pp. 96-105, 2010. https://doi.org/10.12934/jkpmhn.2010.19.1.96