• 제목/요약/키워드: 말기간호

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말기 환자간호 실습교육이 간호대학생의 죽음에 대한 태도, 임종간호 태도, 영적간호역량에 미치는 효과 (Effect of palliative care practical training on nursing students' attitudes toward death, end-of-life care nursing attitude, and spiritual nursing competency)

  • 김경아
    • 가정간호학회지
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    • 제30권3호
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    • pp.276-286
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    • 2023
  • Purpose: This study aimed to assess the effect of palliative care practical training for nursing students. Methods: This quasi-experimental study included 38 third-grade nursing students form one university. Practical training, develooed by experts, was provided for 2 weeks (90 h) in a palliative care hospital. Participants received education on palliative care but no clinical practical experience. Collected data were analyzed using independent t-test, χ2 test and paired t-test using the WIN SPSS 23.0 program. Results: Students showed significant pretest-posttest differences in attitude toward death (t=-2.43, p=.021), end-of-life nursing attitude (t=3.90, p=<.001) and spiritual nursing competency (t=3.82, p=.001). Conclusion: The study results revealed that palliative care practical training was an effective learning method to improve nursing attitude, toward death, end-of-life nursing attitude and spiritual nursing competency. Further studied are needed to assess the effects of various education programs of palliative care.

영적 간호중재가 노인 말기 암환자의 삶의 의미와 영적 안녕에 미치는 효과 (Effect of Spiritual Nursing Care on Meaning of Life and Spiritual Well-Being of Terminal Cancer Older Adult Patients)

  • 윤매옥
    • 가정간호학회지
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    • 제16권2호
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    • pp.135-144
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    • 2009
  • Purpose: This study was to analysis the effect of spiritual nursing care on meaning of life and spiritual well-being of terminal cancer older adult patients. Method: The study was a one group pre-posttest design. Data collection and intervention were performed from May 10 to December 20, 2007. The participants were 28 older adults in Jeonju city. Data was analyzed with paired t-test and Pearson correlation coefficient using the SPSS/WIN 12.0 program. Result: Meaning of life, spiritual well-being, religious well-being and existential well-being scores were significantly higher than before spiritual nursing care (all p<.001). Meaning of life and the spiritual well-being were significantly correlated before and after spiritual nursing care, but it was not highly correlated after than before the spiritual nursing care. Conclusion: The study verified spiritual nursing care the improvement of the meaning of life and spiritual well-being for the terminal cancer older adult patients.

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간호대학생의 말기환자에 대한 생명의료윤리 인식과 죽음에 대한 태도 (Nursing Students' Awareness of Biomedical Ethics and Attitudes toward Death of Terminal Patients)

  • 김영희;유양숙;조옥희
    • Journal of Hospice and Palliative Care
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    • 제16권1호
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    • pp.1-9
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    • 2013
  • 목적: 본 연구는 간호대학생의 말기환자에 대한 생명의료윤리 인식과 죽음에 대한 태도를 파악하기 위한 서술적 조사연구이다. 방법: 대상자는 D광역시에 소재한 일개 전문대학의 3년제 간호과에 재학 중인 660명이었다. 자료는 2011년 10월부터 11월까지 수집하였다. 생명의료윤리 인식은 본 연구자가 선행연구를 근거로 개발한 도구로, 죽음에 대한 태도는 Collett와 Lester(1969)의 FODS (Fear of Death Scale)로 측정하였다. 수집된 자료는 서술통계, Wilcoxon rank sum test와 Kruskall Waills test로 분석하였다. 결과: 생명의료윤리에 대한 문제로 갈등 경험이 있고, 심폐소생술 금지가 필요하다고 생각하며, 종교가 없는 학생이 그렇지 않은 학생에 비해 죽음에 대해 부정적인 태도를 가지고 있었다. 대상자 중 말기환자의 연명치료중단이 필요하다고 생각하는 경우는 81.2%였고, 말기환자의 심폐소생술 금지가 필요하다고 생각하는 경우는 76.4%로서, 심폐소생술 금지가 필요한 이유는 '평안하고 품위있는 죽음을 위해서'가 가장 많았다. 결론: 죽음에 대한 긍정적인 태도의 형성을 위해 확고한 생명의료윤리 가치관의 확립이 요구되며, 가능하면 임상실습을 시작하기 전에 교육이 실시될 필요가 있다. 교육 프로그램을 구성할 때 종교, 학년, 생명의료윤리 갈등 경험, 심폐소생술 금지 찬성 여부가 포함되어야 하며, 말기환자 간호를 미리 경험할 수 있도록 표준화 환자를 이용한 시뮬레이션 실습의 기회를 제공하는 것이 필요하다.

간호일지 상의 간호중재와 지각된 간호중재의 수행빈도 비교 -말기 암환자를 중심으로- (Comparison of Cancer Nursing. Interventions Recorded in Nursing Notes with Nursing Interventions Perceived by Nurses of an Oncology Unit - Patients with Terminal Cancer -)

  • 최윤자;장금성
    • 대한간호학회지
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    • 제35권3호
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    • pp.441-450
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    • 2005
  • Purpose: The purposes of this study were to determine the core nursing interventions in nursing notes and the practice which was perceived by nurses of an oncology unit with patients with terminal cancer. Also, comparing interventions in nursing notes with interventions in perceived practice was done. Method: Subjects were 44 nursing records of patients with terminal cancer who had died from Jan. to Dec. 2002 at C University Hospital and 83 nurses who were working on an oncology unit for more than one year. Data was collected using a Nursing Interventions Classification and analyzed by means of mean and t-test. Results: The most frequent nursing intervention was 'nausea management' in the nursing note and was 'medication administration: oral' in perceived practice. The frequency of nursing interventions in the nursing record was lower than in perceived practice. Conclusion: This study finds that nurses actually practice nursing care, but they may omit records. To correct for omitted nursing records, development of a systematic nursing record system, continuous education and feedback is recommended.

재가 비암 환자의 생의 말기 단계별 신체적, 영적 간호요구도 - 간호요구의 중요도와 난이도를 중심으로 - (Physical and Psychospiritual Care Need by End-of-life Stages among Non-cancer Patient at Home: Based on the Importance and Difficulty of Care Need)

  • 이종은;김순례
    • 지역사회간호학회지
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    • 제23권2호
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    • pp.127-133
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    • 2012
  • Purpose: This study was conducted to assess needs at each end-of-life care stage and to analyze importance and difficulty of care needs for home care nursing among non-cancer patients. Methods: We used a retrospective design. Total eligible patients were 117 at the ages of 40 and over, who continuously received home care nursing throughout beginning, stable, and near death stages, and finally died at home from January 1, 2006 to December 31, 2006. Descriptive statistics, Cochran's Q test, Friedman's test were used for data analysis. Results: In the area of physical care, the care need for 'assistance for activities in daily life' was significantly highest in the beginning stage. The care need for 'aggravation or adverse changes in physical symptoms' was significantly increased in the near death stage. In the area of psychospiritual care, 'family's psychological burden' was revealed as having the highest rate of care needs in the every stage. Conclusion: Future intervention should consider assessing care needs in end-of-life care for non-cancer patients who are provided with home care nursing.

간호사를 위한 말기 환자 존엄간호 측정도구 개발 (Development and Validation of a Dignity in Care Scale of Terminally Ill Patients for Nurses)

  • 안윤실;오복자
    • 대한간호학회지
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    • 제53권3호
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    • pp.340-358
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    • 2023
  • Purpose: This study aimed to develop an instrument to showcase Dignity in Care of Terminally Ill Patients for Nurses and to examine its validity and reliability. Methods: A total of 58 preliminary items on dignity in care of terminally ill patients for nurses were selected using content validity analysis and expert opinions on 97 candidate items derived through a literature review and qualitative focus group interviews. Questionnaires were administered to 502 nurses caring for terminally ill cancer patients at hospice and palliative care institutions. The data were analyzed using item analysis, exploratory and confirmatory factor analysis, convergent and discriminant validity, and Pearson correlation for criterion validity, reliability was tested using Cronbach's alpha. Results: The final instrument consisted of 25 items, with four factors identified through confirmatory factor analysis. Four factors-ethical values and moral attitudes, interaction-based communication, maintaining comfort, professional insight and competence-accounted for 61.8% of the total variance. Cronbach's α for total items was .96, and test-retest reliability of intraclass correlation coefficient was .90. Conclusion: Since its validity and reliability have been verified through various methods, the Dignity in Care Scale of Terminally Ill Patients for Nurses can be used for develop nursing interventions and improve dignity in care of terminally ill patients.

말기의 의료적 의사결정에 관한 임상간호사의 갈등경험 (Nurse's Conflict Experience toward End-of-life Medical Decision-making)

  • 조계화
    • 성인간호학회지
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    • 제22권5호
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    • pp.488-498
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    • 2010
  • Purpose: The purpose of this study was to explore clinical nurse's reported conflict experience toward end-of-life medical decision making. Methods: Data were collected by in-depth interviews with eight nurses from three different wards of university hospital in D city of Korea. Conventional qualitative analysis was used to analyze the data. Results: Results were three major themes and twelve categories from the analysis. The three major themes were prioritization of treatment, non-disclosure of diagnosis, and hierarchical and power relations. Conclusion: The results of this study suggest that shared decision making in end of life among patient, family members, physician, and nurse may contribute to improve end-of-life care performance as well as dignified dying of patient in end of life.

말기 암환자를 간호하는 간호사의 고통 인식에 관한 태도 : Q-방법론 적용 (The Perception of Suffering by Hospice Nurses)

  • 조계화;김명자
    • 기본간호학회지
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    • 제8권1호
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    • pp.35-50
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    • 2001
  • The purpose of this study was to identify the perception of hospice nurses on suffering, the type of stracture and characteristics of suffering. The research process is followed : First, the researcher selected 35 statements on suffering using content analysis of in-depth interviews and a literature search Second, the researcher asked 38 hospice nurses to classify the statement cards. The result of the research showed that the hospice nurse's perception of suffering can be divided into 4 types (Self-recognition, Suffering-elimination, Relation-restoration, and Meaning-endowment). The total explained variance was 46 percent. In relation to this, nursing intervention skills could be presence, listening touch, hope, reassurance, and comforting which result in positive effects between nurse and hospice client.

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호스피스 간호시 말기 암환자의 임종 현상 연구 -독립형 호스피스 센타를 중심으로- (A Study of the Experience of Patients with Terminal Cancer Who are in an Independent Hospice Center)

  • 김분한;탁영란;전미영
    • 대한간호학회지
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    • 제26권3호
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    • pp.668-677
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    • 1996
  • This study is a phenomenological study done to promote understanding of the dying process in patients with terminal cancer who were in an independent hospice center. The purpose of study was to explore and understand indepth information on the dying process in order to provide data for holistic hospice care in nursing and to give insights in to practical applications in the nursing care In-depth interviewing was done from may, through November, 1995 with 11 patient with cancer who were being cared for at K Hospice Care Center. Experiences in the dying process were discussed as they expressed feelings about death including (a) feeling of isolation because family members try to hide the diagnosis of cancer. (b) hopelessness, (c) guilt, anger, and hostility, (d) suffering from pain, (e) fear of death. However, subjects did not deny death itself and were developing peace of mind and acceptance of death through religion.

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만성 심폐질환을 가진 말기 노인 환자의 연명의료 의사결정의 번복 및 관련 요인 (Reversals in Decisions about Life-Sustaining Treatment and Associated Factors among Older Patients with Terminal Stage of Cardiopulmonary Disease)

  • 최정자;김수현;김신우
    • 대한간호학회지
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    • 제49권3호
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    • pp.329-339
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    • 2019
  • Purpose: The purpose of this study was to investigate the frequency, patterns, and factors of reversals in decisions about life-sustaining treatment (LST) among older patients with terminal-stage chronic cardiopulmonary disease. Methods: This was a retrospective correlational descriptive study based on medical chart review. De-identified patient electronic medical record data were collected from 124 deceased older patients with terminal-stage cardiopulmonary disease who had made reversals of LST decisions in an academic tertiary hospital in 2015. Data were extracted about the reversed LST decisions, LST treatments applied before death, and patients' demographic and clinical factors. Multivariate logistic regression analysis was used to identify the factors associated with the reversal to higher intensity of LST treatment. Results: The use of inotropic agents was the most frequently reversed LST treatment, followed by cardiopulmonary resuscitation, intubation, ventilator therapy, and hemodialysis. Inconsistency between the last LST decisions and actual treatments occurred most often in hemodialysis. One-third of the reversals in LST decisions were made toward higher intensity of LST treatment. Patients who had lung diseases (vs. heart diseases); were single, divorced, or bereaved (vs. married); and had an acquaintance as a primary decision maker (vs. the patients themselves) were significantly more likely to reverse the LST decisions to higher intensity of LST treatment. Conclusion: This study demonstrated the complex and turmoil situation of the LST decision-making process among older patients with terminal-stage cardiopulmonary disease and suggests the importance of support for patients and families in their LST decision-making process.