• Title/Summary/Keyword: 말기환자

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Case Report of Terminal Cancer Patient by Community Health Practitioner (보건진료소에서의 말기 암 환자 간호사례)

  • Jeong, Migyung
    • Journal of Korean Academy of Rural Health Nursing
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    • v.15 no.1
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    • pp.30-40
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    • 2020
  • Purpose: This study was done to describe a community health practitioner's nursing case management for a terminal cancer patient registered in the public health post. Methods: For this purpose, data were collected through the patient and family through home visits, health clinic offices, and phone calls. The nursing process was carried out from August to November 2019. Results: The patient suffered the most from anorexia and lack of energy. Also he expressed psychologically uncertainty about disease and death anxiety caused by long-term treatment. In order to reduce the death anxiety, Community Health Practitioner (CHP) asked him to express his life stories and listened to him. CHP provided information of appropriate medications and alternative foods for symptoms such as gastrointestinal disorders and anorexia to the patient and family. Observing the situation of the patient and family, CHP guided the patient and family to prepare for death and has confirmed to them that the process was not with the patient alone. Conclusion: CHP's this experience has shown the possibility for CHP to help the terminal cancer patient and family to prepare peaceful death in their communities.

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

  • Kim, Kyung Ah
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.30 no.3
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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.

Quality of Life Changes in Patients Admitted to the Hospice Unit (호스피스 병동 입원 환자의 삶의 질 변화)

  • Park, Theresia;Song, Hae-Hiang;Seo, In-Ok;Cho, Young-Yee;Park, Myung-Hee;Heo, Jeong-Hee;Kim, Eun-Kyung;Park, Sun-Ju;Ra, Jeong-Ran
    • Journal of Hospice and Palliative Care
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    • v.3 no.1
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    • pp.18-27
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    • 2000
  • Purpose : This study aims to find out the quality of life of patients admitted to the hospice unit at Kangnam St. Mary's Hospital, at admission and after weeks hospice service and to assess the effects of hospice service on the quality of life of terminal cancer patients. Methods : This study subjects were 100 patients admitted to the hospice unit at Kangnam St. Mary's Hospital, Catholic University between October 1999 and March 2000, and their primary caregivers. Quality of life data were collected using a questionnaire revised by the authors and were analyzed by means of repeated measures ANOVA. Results : 1) Patient's quality of life as perceived by the primary caregiver was significantly improved and the mean score was 3.31, 3.68, 3.56, 3.73, 3.75 at admission and week 1, 2, 3, 4. With the detailed item analysis, the following items were shown to be significantly improved: "clean bodies"(F=6.50, P=0.0001) "pain control"(F=18.01, P=0.0001) constipate"(F=2.96, P=0.0237) "sleep"(F=3.99, P=0.0048) "nausea/vomiting"(F=4.50, P=0.0022) "medical team's comfortable care" (F=3.95, P=0.0051) "family's care"(F=2.76, P=0.0317) "anxiety" (F=3.14, P=0.0177) "comfort"(F=3.63, P=0.0085) "treat with dignity"(F=3.32, P=0.0136). The item of "death is not the end of life rather the beginning" was significantly decreased(F=2.54, P=0.0450). 2) Patient's quality of life as perceived by the patient showed an improvement but statistically insignificant and the mean score was 3.63 and 3.83 at admission and week 1. With the detailed item analysis, the item of "pain control" was shown to be significantly improved(F=9.19, P=0.0251). 3) The quality of score in the last week of life of patient were 3.48, 3.51, 3.44, 3.46, 3.50, respectively, from 5 week prior to 1 week prior to death and these changes were insignificant. Conclusion : The findings of this study showed a positive effect of hospice service on quality of life of the terminal cancer patients admitted to the hospice unit. To improve the quality of life, we need first of all to develop hospice interventions with a particular emphasis on the spiritual aspect of patient. Secondly, measurement instruments need to be developed to collect the quality of life of the hospice patients who become weakened especially in the last weeks of their life and with this effort more representative data of hospice patients may be collected.

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Perceptions of Caregivers and Medical Staff toward DNR and AD (Do Not Resuscitate (DNR)와 Advance Directives (AD)에 대한 환자 보호자와 의료인의 인식)

  • Lee, Sun Ra;Shin, Dong-Soo;Choi, Yong-Jun
    • Journal of Hospice and Palliative Care
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    • v.17 no.2
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    • pp.66-74
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    • 2014
  • Purpose: This study is aimed to investigate perceptions of caregivers and medical staff toward do not resuscitate (DNR) and advance directives (AD). Methods: Participants were 141 caregivers and 272 medical staff members from five general hospitals. A questionnaire used for the study consisted of 20 items: 14 about DNR perceptions, three about AD, one each for age, gender and employment. Results: Both medical staff and caregivers strongly recognized the need for DNR and AD, and the level of recognition was higher with medical staff than caregivers (DNR ${\chi}^2=44.56$, P=0.001; AD ${\chi}^2=16.23$, P=0.001). The main reason for the recognition was to alleviate sufferings of patients in the terminal phase. In most cases, DNR and AD were filled out when patients with terminal conditions were admitted, and patients made the decisions by consulting with their guardians. Medical staff better recognized the need and for growing demand for guidelines for the DNR and AD decision making process than caregivers (${\chi}^2=7.41$, P=0.0025). Conclusion: This study showed that patients highly rely on their caregivers when making decisions for DNR and AD. Thus, it is important that patients and caregivers are provided with objective information about the decisions. Since participants' strong support for DNR and AD was mainly aimed at alleviating patients' suffering, further study is needed in the association with hospice care. Medical staff also needs to understand the different views held by caregivers and fully consider the disparity when informing patients/caregivers to make the DNR and AD decisions.

IPAA의 효과를 고찰하기 위한 분류분석방법들의 비교연구

  • Lee, Seung-Yeon;Lee, Eun-Ju;Choe, Ho-Sik
    • Proceedings of the Korean Statistical Society Conference
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    • 2005.05a
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    • pp.291-298
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    • 2005
  • 지속성 외래 복막투석은 말기 신부전 환자들에게 널리 시행하는 신 대체 요법으로, 복막투석 환자에게서 주된 합병증으로 일어나는 단백질-열량 영양실조를 치료하기 위하여 아미노산을 복강 내로 주입하는 치료방법이다. 이현석 등(2004)의 연구에서는 아미노산 복막 투석액(IPAA)이 영양실조 환자들에게 실제로 영양상태에 미치는 영향을 평가하기 위하여 지속성 외래 복막투석 환자 43명을 12개월 동안 3개월 주기로 관측하여 얻어낸 반복측정자료를 바탕으로 IPAA의 효과 여부에 따라 반응군과 비반응군을 분류하였다. 본 논문에서는 이러한 두 그룹을 효과적으로 분류할 수 있는 분류기준변수들을 찾아내고 이 분류기준변수의 값을 바탕으로 새로운 환자에게 IPAA의 투여 여부를 진단할 수 있는 여러 분류방법들을 고찰하여 비교 연구하였다. 모수적인 방법으로 선형판별분석, 이차판별분석 및 로지스틱 판별분석을 소개하고 비모수적인 방법으로 support vector machine(SVM)을 소개하여 분류분석의 결과를 비교하여 두 그룹을 최소한의 오류로 분류하는 방법을 제안하였다.

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Nurses호 Painful Experiences through Terminal Patient (말기환자를 간호하는 간호사의 고통 경험)

  • 조계화;한희자
    • Journal of Korean Academy of Nursing
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    • v.31 no.6
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    • pp.1055-1066
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    • 2001
  • The Purpose of this study is to understand the meaning and the essence of suffering as viewpoint and to find the meaning and structure of the experience from encounters with patients in their terminal stages of illness. Method: A descriptive design based on the phenomenological approach model developed by Collaizzi was used. The period of data collection was from August to November of 2000. Data collection was conducted by open-ended and audio-taped interviews. The participants were nine female nurses who were willing to take part in this study. Results: Results of this study were classified into five main categories. The main category clusters were "difficulty in experiencing suffering," "professional challenges to expert nurses," "formation of empathic relationships," "expanding consciousness through suffering," and "alleviation of the patient's suffering." Conclusion: In conclusion, the implications for providing nursing care to end-stage patients in the throes of suffering is both rewarding and stressful. However, sharing these research results may help other nurses discover and experience deeper meanings in their own practice and careers.deeper meanings in their own practice and careers.

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말기환자의 전인적 돌봄에 있어서 포괄적 평가개념의 중요성

  • Yun, Uk-Hui;Lee, Gwi-Han;Yu, Seon-Hui;Gwak, Won-Yeong;Jin, Seon-Gyeong
    • Korean Journal of Hospice Care
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    • v.3 no.1
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    • pp.12-30
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    • 2003
  • We all human beings, should be reached the terminal of life in the world. There is the only difference between that comes suddenly or slowly. Persons who should be come the terminal stage suddenly due to disease, especially, malignancy, are Hospice patients. Hospice work is the work of all of us because anyone, anywhere, whenever can be suffered in terminal stage. The characters of Hospice-care are total care of wholistic human beings, comprehensive total assessment of the life and the team work composed of diverse team-members, for example, doctors, nurses, social workers, physical therapists, psychologists, ministers & volunteers. The care manager of the total care(the coordinator of Hospice care), should be worked systemically and, rationally. The comprehensive assessment concept should be entered to the infra-consultant of terminal care-program. The care manager should be have the ability of comprehensive assessment for terminal patients. It will also help standardization of Hospice, and application of medical insurance and social security.

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A Study on the Architectural Characteristics of the German Stationary Hospice Facility (독일 입원형 호스피스 시설의 건축 계획적 특성에 관한 연구)

  • Kim, Cheol-Hwan
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.14 no.1
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    • pp.39-48
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    • 2008
  • Well-dying is as important as Well-Being because dying is also a natural part of life. Recently, due to the change of lifestyles, cancer, AIDS and other chronic diseases cause drastic increase of mortality rate. Needs for hospice services are growing as many terminal patients interested in quality of life during their end of life period. They want calm and dignity in case process as well as pain-relieving. However, there is not many researches on the architectural planning of hospice facilities and their service system as well as government regulations. This study focuses on the German hospice facilities which have developed advanced models through researches on service contents and architectural planning. The purpose of this study is to provide fundamental data for designing hospice facilities through analyzing 7 cases of German hospice facilities with different characteristics.

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Transcatheter Arterial Embolization for Palliation of Uterine Body Cancer Bleeding (자궁체부암 출혈에 대한 보존적 치료로써의 경카테터 동맥 색전술)

  • Jaeyeon Choi;Ji Hoon Shin;Hee Ho Chu
    • Journal of the Korean Society of Radiology
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    • v.84 no.3
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    • pp.606-614
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    • 2023
  • Purpose This study aimed to evaluate the efficacy and safety of transcatheter arterial embolization (TAE) for bleeding due to uterine body cancer. Materials and Methods In this retrospective study, six patients with varying types of uterine body cancer who underwent TAE for bleeding control were investigated. Angiographic findings, cross-sectional images, TAE details, and clinical outcomes were studied. Technical and clinical success rates were calculated. Results The identified patients had endometrioid adenocarcinoma, sarcoma, and gestational trophoblastic neoplasia, and most were patients with advanced-stage cancer. In four patients, tumor bleeding presented as vaginal bleeding. Technical success was achieved in all seven TAE procedures in six patients. Two patients with recurrent masses who had undergone hysterectomy presented with hematochezia, and TAE was able to provide technical success in these patients as well. The clinical success rate was 50%, indicating bleeding control for > 1 week. Rebleeding was directly associated with death in one patient. On the following day, mild fever was observed in one patient. Conclusion TAE can be considered an effective and safe method of bleeding control for uterine body cancer, especially during critical periods throughout the disease course of patients with inoperable, advanced-stage cancer.

회원병원 소개 - 온세상을 건강한 미소로... - 창원파티마병원 -

  • 한국가톨릭의료협회
    • Health and Mission
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    • s.17
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    • pp.24-27
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    • 2009
  • 지난 6.29일자 중앙일보에 보도에 의하면 창원파티마병원은 2005년에 이어 2008년에도 보건복지가족부 주관 전국의료기관평가서 최우수병원으로 선정되었다. 의료서비스 및 환자만족도 등 20개 부문 중 19개 부문에서 A등급을 받아 평가 대상 의료기관 중 최고의 성적을 거두었다. 창원파티마병원은 1969년 마산시 대성동에서 4개 진료과, 10개 병상의 마산파티마병원에서 출발하여 2002년 창원으로 이전, 진료를 시작한 이래 응급환자의 진료에 만전을 기하기 위해 응급의료센터를 개설하고, 보건복지가족부 지정 중증외상 및 응급뇌질환 특성화후보센터를 운영하고 있다. 말기 암 환자를 위한 호스피스 병동을 지역최초로 개설하였고, 전신 암 조기진단장비인 PET-CT 등 첨단 장비를 지속적으로 보강하여 보다 질 높은 의료서비스 제공을 위해 노력하고 있다. 또한 온생명 Care 캠페인을 통해 지구의 환경을 보전하기 위한 환경 운동을 전개하는 한편 다문화 가정 지원사업, 환자와 보호자를 위한 사랑의 음악회, 찾아가는 시민강좌 등 다양한 사회공헌 활동을 하고 있다.

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