• Title/Summary/Keyword: 말기간호

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Dignity Therapy for End-stage Patients: Concept Analysis (말기 환자의 존엄요법 개념분석)

  • Chung, Bokyae;Oh, Eunhee
    • Journal of Hospice and Palliative Care
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    • v.19 no.3
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    • pp.211-221
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    • 2016
  • Purpose: Dignity therapy is a very effective intervention to improve the dignity of end-stage patients. A concept analysis by Walker and Avant (2005) was adopted to define, describe, and delimitate the concept of dignity therapy. Methods: Nursing literature in the National Digital Science Links (NDSL) and Medline database were searched for the definitions of "dignity" and "dignity therapy". Definitions, uses, and defining attributes of dignity therapy were identified; model and contrary cases were developed; and antecedents, consequences, and empirical references were determined. Results: Through dignity therapy patients and their families share their stories, and that in turn improves the quality of life and death. Five attributes were identified: higher quality of life and death, therapeutic conversation, respect of human dignity and worth, expressing thoughts about life and death and systematic process. Conclusion: Patients at the end of their lives feel more comfortable about death. Hospice care providers should try to protect dignity of patients in their care. The attributes of the dignity therapy clarified in this study should be applied for terminally ill patients to improve their quality of life and death.

Community Based Nursing Service As An Alternative Background Forces and Current Practice (지역사회에 기반을 둔 간호사업 그 배경과 실태에 관한 고찰)

  • Hong Yeo-Shin;Rhee Seon-Ja
    • The Korean Nurse
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    • v.19 no.1 s.104
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    • pp.68-84
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    • 1980
  • 간호사업은 1970년대 후반부터 이제까지의 병원중심-환자중심의 간호사업을 수행해 오다가 지역사회에 기반을 둔 간호사업인 건강간호사업으로 전환되기 시작하였다. 세계보건기구에서도 지역사회에 기반을 둔 간호사업인 일차건강관리사업을 중점적으로 지원하기 시작한 것이다. 이러한 역사적 전환의 배경과 실태에 관하여 문헌고찰을 하여 앞으로 국민건강사업 체계에 대한 논의에 참고자료가 되게 하고자 본 논문을 시도하였다. 본 논문에서 얻어진 결과를 다음과 같이 요약한다. 고도의 과학문명의 발달과 물질적 풍요로 특징짓는 현대사회속에서도 인류의 건강문제는 영원히 충족되지 못한 상태로 대두되고 있는 실정이다. 전통적으로 60년대 중반까지는 의료지식 및 기계공업의 발달과 이를 뒷받침할 재정적 지원속에 세계적으로 치료의학분야에 획기적인 발전을 가져왔다. 다른 한편으로는 건강을 태생의 권리라고 규정하여 여러나라에서 사회보장제대로써 의료시해의 균점을 위한 각가지 방도를 마련하기에 이르렀다. 그리하여 60년대말기부터 70년대로 넘어오면서 치료의학의 발달만으로는 의료수가가 앙등되어 모든 국민이 이용할 수 없을 뿐만 아니라 나아가서는 모든 국민의 건강문제를 해결하기는 어렵다는 사실을 발견하기 시작하였다. 또한 지역사회의 건강문제를 요인별로 따져보면 복잡하여 사회경제적, 문화적, 환경적, 유전적 제요인과도 밀접한 관계를 맺고 있기 때문에 신체적인 질병의 치료만이 지역사회 건강문제를 해결하는 길이 아님을 알게 되었다 그리고 지역사회의 건강문제를 해결하기 위해서는 일차보건의료사업에 중점을 두어 노력하는 것이 가장 합리적인 개선방안이라는 의견이 경험적으로 이론적으로 뒷받침되기 시작하였다. 이러한 사조는 지역사회 건강문제가 복잡한 것과 같이 그 접근방법에 있어서도 여러보건요원이 팀이 되어 임해야만 하며 그중에서도 간호팀의 활동이 중추적인 역할을 담당해야 한다고 여러 전문가들은 주장하고 있다. 따라서 앞으로의 간호사업의 방향은 지역 사회에 기반을 둔 간호사업이 실시되어야만 국민건강문제 해결에 기여하게 될 것으로 고찰되었다.

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Effects of Oral Care with Essential Oil on Improvement in Oral Health Status of Hospice Patients (정유를 이용한 구강간호가 호스피스 대상자의 구강상태에 미치는 효과)

  • Kang, Hee-Young;Na, Song-Sook;Kim, Yun-Kyung
    • Journal of Korean Academy of Nursing
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    • v.40 no.4
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    • pp.473-481
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    • 2010
  • Purpose: This study was done to examine the effects of oral care with essential oil in improving the oral health status of hospice patients with terminal cancer. Methods: The participants were 43 patients with terminal cancer admitted to K hospital in G city, Korea. Twenty-two patients were assigned to the experimental group and 21 to the control group. Participants in the experimental group received special mouth care with essential oil (application of essential oil mixture consisting of geranium, lavender, tea tree, and peppermint). The control group received special mouth care with 0.9% saline. The special mouth care was performed twice daily for one week in both groups. The scores for subjective oral comfortness, objective oral state, and numbers of colonizing Candida albicans were measured before and after the treatment. Results: The score for subjective oral comfortness and objective oral state were significantly higher in the experimental group compared to the control group. The numbers of colonizing Candida albicans significantly decreased in the experimental group compared to the control group. Conclusion: Oral care with essential oil could be an effective oral health nursing intervention for hospice patients with terminal cancer.

Pilocarpine Mouth Care for Patients with Terminal Cancer (필로카르핀을 이용한 구강간호가 말기 암환자의 구강 상태와 불편감에 미치는 효과)

  • Park, Myung-Hee;Yoo, Yang-Sook
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.13 no.2
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    • pp.217-224
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    • 2006
  • Purpose: This study was done to investigate the effects of pilocarpine mouth care on the condition and discomfort of the oral cavity in patients with terminal cancer. Method: A quasi-experimental design with a non-equivalent control group, pre- and post-test was used. The participants were 30 patients admitted to the hospice care unit of C university hospital. Fourteen patients received pilocarpine mouth care for 5 days. The other sixteen received general mouth care. Results: Improvement in the condition of the oral cavity was significantly higher in the experimental group compared to the control group. Decrease in oral discomfort scores was significantly higher in the experimental group compared to the control group. The incidence of oral candidiasis was significantly higher in the control group compared to the experimental group. Conclusion: These findings indicate that pilocarpine mouth care could be an effective intervention for relieving oral discomfort, improving the condition of the oral cavity, and decreasing the incidence of oral candidiasis in patients with terminal cancer.

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Factors Affecting Life respect and will of Korean Nursing Students (한국 간호대학생의 생명존중의지에 영향을 미치는 요인)

  • Park, Younghee
    • The Journal of the Convergence on Culture Technology
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    • v.5 no.4
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    • pp.243-249
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    • 2019
  • The purpose of this study is to investigate the factors affecting the respect for life of nursing students and to prepare the basic data for developing educational programs to establish proper awareness of the life of nursing students and nurturing it. This is a descriptive research study. A total of 146 nursing students were included in this study. Data analysis was performed using t-test, ANOVA, Pearson correlation coefficients, and multiple regression. The results of this study confirmed the meaning of life, spiritual wellbeing, and attitude toward death as factors influencing respect and will for life. The explanatory power of these three factors was 26.3%. Therefore, nursing students will be able to cultivate respect for life by increasing their understanding of the meaning of life, improving their level of spiritual well-being, and reducing their negative attitudes about death. Also, in order to improve the respect for life of nursing students, it will be possible to develop an intervention program to improve life respect including the factors identified in this study. Ultimately, it is expected to grow into a nurse who can provide real help to patients who are at the end of life or who are dying.

Experience of Visiting Nurse's End-of-life Care: A Qualitative Contents Analysis (방문간호사의 생애말기 간호에 대한 경험: 질적 내용분석)

  • Bang, Misung;Lee, Insook;Yang, Juhyeon;Kim, Sohee
    • Journal of Home Health Care Nursing
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    • v.29 no.2
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    • pp.143-152
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    • 2022
  • Purpose: This study aims to describe and explore the experiences of visiting nurses so as to providing high-quality end-of-life care at home. Methods: Data was collected and recorded through in-depth interviews with 11 visiting nurses and transcribed verbatim. The data were analyzed with qualitative contents analysis. Data were collected from April 8 to July 30, 2021. Results: The results revealed the following four themes and ten sub-themes: The main themes were 'Dignified end-of-life caring practice at home', 'Providing integrated support of end-of-life family caregivers', 'Confronting the limits of visiting nursing at the end of life' and 'Reflection on life and feeling rewarded'. Visiting nurses have performed dignified end-of-life care at home and integrated support for family caregivers. Although the visiting nurse sometimes faced the limits of visiting nursing during end-of-life care, it was surveyed that they rewarded on their lives and felt rewarding through the end-of-life nursing experience. Conclusion: Practical and systematic training is needed to positively change the end-of-life care of visiting nurses. We propose programs, such as expert counseling, to improve coping skills in end-of-life care practice at home. Additionally, we propose various institutional supports which can support the limitations of end-of-life care provision.

Activities of a Home Hospice Organization (가정호스피스기관의 활동에 관한 연구)

  • Kim, Jung-Hee;Choi, Young-Soon
    • Journal of Hospice and Palliative Care
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    • v.3 no.1
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    • pp.28-38
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    • 2000
  • Purpose : This study examined characteristics of, problems of and services provided to hospice recipients and their family members at a home hospice organization. Methods : The subjects were 113 people who were discharged from one free-standing home hospice organization between November, 1994 and lune, 1999. Since the opening of the organization in November of 1994, it has provided hospice services at patients' homes with no charge. Data were collected from those subjects' records. Results : The average age of the subjects was 57.1 years; those aged 60 and over were 54%. Spouse was the most frequent(50.9%) primary caregiver followed by daughter-in-law and daughter. All the subjects were diagnosed as having cancer. Of those 41 subjects who did not know their terminal stage in the beginning, 31 subjects came to know their states. Of the subjects, 72.7% were referred from their physicians. On the average, the service duration and the number of home visits were 6.8 weeks and 7.2 times, respectively. Pain was the most prevalent problem of the subjects(89.4%). Medication management was the most frequently provided service followed by psychological supports. The reasons for discharge were death(88.5%) and refusal(8%). Home was the most frequent place of death(60%). Conclusion Home hospice service providers should be trained particularly in working with elders and in managing cancer pain. People need to be referred at an appropriate time for achieving goals of hospice. Community recognition of hospice services needs to be promoted.

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Development of a CD Program Applied Logotherapy for Psycho.Spiritual Care of Late Adolescents with Terminal Cancer (청소년 후기 말기 암 환자의 정서적.영적 돌봄을 위한 의미요법 CD 프로그램 개발)

  • Kang, Kyung-Ah;Kim, Shin-Jeong;Song, Mi-Kyung
    • Journal of Hospice and Palliative Care
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    • v.12 no.2
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    • pp.61-71
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    • 2009
  • Purpose: The purpose of this study was to develop a CD program of applied logotherapy for psycho spiritual care of late adolescents with terminal cancer. Methods: Keller & Song's ARCS theory and a model for developing learning materials was applied to develop this program composed four distinct phases: planning, designing, developing, and evaluation stages. Results: This program was entitled 'Finding meaning in my life' and consisted of 5 sessions and its educational contents were made up as follows: "First Secret" is 'learning three natures of the human mind', "Second Secret" is 'learning creative values first method to find meaning of life', "Third Secret" is 'learning experiential value as second method to find meaning of life', "Fourth Secret" is 'learning attitudinal value as third method to find meaning of life', and "Fifth Secret" is 'Becoming the master of my life'. The sub-menu was made up of 'Beginning', 'Opening mind', 'Learning'. 'Laughing Song', 'Experiencing'. Conclusion: This CD program applied logotherapy with flash animation technique as an emotional and spiritual nursing intervention program for easier and more scientific application in pediatric oncology and hospice care area.

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Needs of Hospice Care in Families of the Hospitalized Terminal Patients with Cancer (입원한 말기 암환자 가족의 호스피스 요구)

  • Sohn, Sue-Kyung
    • Asian Oncology Nursing
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    • v.9 no.1
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    • pp.1-6
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    • 2009
  • Purpose: The purpose of this study was to identify the needs of hospice care in families of the hospitalized patients with terminal cancer. Method: The data were collected from April to July, 2008. The participants were 100 family caregivers of hospitalized terminal patients with cancer recruited from two general hospitals in 2 cities in Korea. Needs of hospice care were measured using the 'Needs Assessment Instrument for Hospice Care in Families of the Patients with Cancer'. Results: The mean of needs score was 76.6, which meant degree of the needs was very high. Among the categories of the needs, the mean of category 'emotional care' was the highest. There were significant differences in the needs of hospice care according to sex and type of present therapy. Conclusion: Health care providers in hospital and hospice facilities must assess the needs of families as well as the patients in order to meet their specific needs. Additionally, they need to have deeper understanding of the need of emotional care and to apply emotional care to hopice patients and their families.

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Effects of a Short-term Life Review on Spiritual Well-being, Depression, and Anxiety in Terminally Ill Cancer Patients (단기 생애회고요법이 말기 암 환자의 영적 안녕, 우울 및 불안에 미치는 효과)

  • Ahn, Sung-Hee;An, Young-Lan;Yoo, Yang-Sook;Ando, Michiyo;Yoon, Soo-Jin
    • Journal of Korean Academy of Nursing
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    • v.42 no.1
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    • pp.28-35
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    • 2012
  • Purpose: This study was done to evaluate the effects of a short-term life review on spiritual well-being, depression, and anxiety in patients with terminal cancer. Methods: The study used a pre posttest quasi experimental design with a nonequivalent control group. Measurement instruments included the Functional Assessment of Chronic Illness Therapy-Spiritual scale (FACIT-Sp12) and the Hospital Anxiety and Depression Scale (HADS). Participants were 32 patients with terminal cancer who were receiving chemotherapy or palliative care at hospitals or at home. Eighteen patients were assigned to the experimental group and 14 to the control group. A sixty minute short-term life review session was held twice a week as the intervention with the experimental group. Results: There was a statistically significant increase in spiritual well-being in the experimental group compared to the control group. There were also significant decreases in depression and anxiety in the experimental group compared to the control group. Conclusion: The results indicate that a short-term life review can be used as a nursing intervention for enhancing the spiritual well-being of patients with terminal cancer.