• The Monthly Diabetes
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• s.216
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• pp.19-23
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• 2007

신장내과를 전문 과목으로 선택하여 대학병원에서 10여년 가까이 환자를 진료하면서 아침에 회진을 할 때면 저는 전공의 들에게 "어제 입원한 환자는 당뇨병성 신증 환자인가"라고 먼저 묻는 경우가 많습니다. 그 이유는 당뇨병으로 합병된 신장병, 혹은 당뇨병환자에서 혈관질환과 감염 질환이 동반될 경우 치료도 어렵고 임상 경과가 악성 경과를 밟으며 예후가 좋지 않기 때문입니다. 또한 당뇨병으로 인한 말기 신부전증이 최근 무섭게 증가되고 있기 때문이기도 합니다. 따라서 당뇨병성 신증의 조기 발견과 적절한 치료는 아무리 강조해도 지나침이 없습니다. 저는 여기서 최근 가장 가슴이 아팠던 사례를 간단히 소개하고 당뇨병성 신증의 원인, 예방과 치료를 서술하고자 합니다.

• Journal of Hospice and Palliative Care
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• v.19 no.4
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• pp.296-302
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• 2016

Purpose: This study examined the effectiveness of a hand massage combined with analgesics on pain control in hospice patients with terminal cancer. Methods: This study is a quasi-experimental study with a single group time series design. The study included 25 terminal cancer patients who were admitted to a hospice ward. Each patient's pain level was measured after analgesics use only (control group). When patients complained of pain again, the pain level was assessed after administering a combination of hand massage and analgesics (experimental group). As for the experimental treatment, the participants were provided with oil hand massage on each hand for 5 minutes. Results: The experimental group and the control group showed no significant differences in the changes of pain score (F=0.74, P=0.3939). Conclusion: Although the pain level of the experimental group did not significantly improve compared with the control group, their pain levels tended to be low to begin with. Thus, a complementary utility value of hand massage cannot be completely excluded in terminal cancer patients. Since the pain level significantly changed according to the dosage of analgesic, nurses need more education and research on analgesic drug therapy for terminal cancer patients.

• Journal of Music and Human Behavior
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• v.2 no.1
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• pp.35-46
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• 2005

Older adults in the hospice care experience difficulties in expressing their emotional and psychological issues, which has detrimental effect in their well-being. The purpose of this study is to examine how music can be used to facilitate self-expression both verbally and nonverbally in order to decrease negative influences of self-concealment. Four cases were referred from hospice personnel at the hospital, and received music therapy sessions for four month. The total number of session varied from 9 to 11 depending on the conditions of each case. Both qualitative and quantitative data were collected from pre and post test of Self-Concealment Scale and Personal Descriptive Essays. The results indicated that the use of music, especially programed songs were effective in evoking emotional responses with various life-related issues and themes. The posttest indicated that the level of self-concealment has decreased, and also the Personal Descriptive Essays involved increased statements of emotional content after music therapy implementation. The study indicates that music can be used as an significant communicative and expressive medium when working with older adults in the hospice or palliative care, since they experience many difficulties to be engaged in the active expression. Music provide both passive and active experience through listening and participating, and programed music therapy intervention will increase the quality of life through expressive music activities.

• Proceedings of the KAIS Fall Conference
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• 2010.11b
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• pp.980-983
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• 2010

본 연구는 말기콩팥질환자의 대체요법 이용에 영향을 미치는 요인을 파악하기 위해 시도하였다. 자료수집은 2010년 4월 13일부터 5월 13일까지 서울의 한 종합병원 신장내과에 내원한 201명을 대상으로 설문 및 면접조사를 실시하였다. 연구결과 첫째, 이용기간과 연령과는 양의 상관관계를 보였다(r=0.159, p<0.05). 둘째, 만성콩팥병의 대체요법 이용에 영향요인은 연령이 많을수록(${\beta}$=1.64), 대체이용기간이 길수록(${\beta}$=0.059), 월비용이 높을수록(${\beta}$=0.003), 질병이환기간(${\beta}$=2.147)이 길수록 대체요법 이용은 증가하였다. 따라서 초기에는 말기 콩팥질환자들에게 대체요법의 효과와 한계를 지도해야 하며 환자들에게 영향을 주는 가족들에게도 올바른 정보를 제공해야 할 것이다.

• Journal of Home Health Care Nursing
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• v.16 no.2
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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.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.8 no.1
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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.

• Journal of Korean Academy of Nursing
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• v.26 no.3
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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.

• Journal of The Korea Institute of Healthcare Architecture
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• v.3 no.5
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• pp.107-122
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• 1997

According as the aging procese have been high, last stage patient become more important. Therefore, todays hospice ward of hospital is glandized, specified too. However, its study is few performed in domestic and its architectural planning data is few obtained. Therefore, this study aims to represent the standard of the architectural planning of the hospice ward in hospital. As its method, the present conditions, the interview with staffs, space programs of 4 hospice ward were investigated and analyzed, add to 2 free standing hospice were selected, theirs architectural space programing were studied.

• Journal of Hospice and Palliative Care
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• v.5 no.1
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• pp.17-23
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• 2002

Purpose : The prevalence of symptoms in patients with terminal cancer varies considerably and these symptoms are very difficult to control. However, patients can spend their last days or hours of life without suffering pain with appropriate care. One of the major concerns during last days of life is to predict the time of death. We would like to investigate symptom prevalence during terminal cancer patients' last 48 hours in Korea, and therefore contribute to predict the time of death and to help to determine appropriate treatments. Methods : The data for this study was recorded from 92 of 132 patients who died with terminal cancer at the hospital between February 1 and October 31, 2000. We investigated the symptom prevalence during the last 48 hours through medical obligation record and analyzed the changes of symptom prevalence at the admission, $48{\sim}24$ hours and $24{\sim}0$ hours before death. Results : The predominant symptom prevalence was pain (57.6%), followed by confusion (55.4%), dyspnea (48.9%), voiding difficulty (42.4%) in the last 48 hours before death. From the statistical analysis for the changes of symptom prevalence in time, pain, nausea and vomiting were decreased but noisy and moist breathing, sweating, groan, restlessness and agitation, and loss of consciousness were increased (P<0.05). Conclusion : The results from this study show the tendency to increase of prevalence of noisy and moist breathing, sweating, groan, restlessness and agitation as well as loss of consciousness in 48 hours before death. Therefore the symptoms above can be used for the important indicators to predict the imminent death.

• The Monthly Diabetes
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• s.184
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• pp.19-23
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• 2005

당뇨병성 신증은 초기에 진단하여 이를 치료하는 것이 중요하다. 일단 알부민뇨가 300mg/day 이상이면 일반뇨 검사시 단백뇨로 검출되는데, 이러한 환자는 결국 말기 신부전증으로 진행되기 때문이다.