• Title/Summary/Keyword: 말기 환자

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Doctor's Attitudes toward Hospice and Palliative Care for Terminal Cancer Patients (말기 암 환자의 호스피스 완화의료에 대한 의사들의 태도)

  • Moon, Do-Ho;Lee, Myung-Ah;Koh, Su-Jin;Choi, Youn-Seon;Kim, Su-Hyun;Yeom, Chang-Hwan
    • Journal of Hospice and Palliative Care
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    • v.9 no.2
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    • pp.93-100
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    • 2006
  • Purpose: This study was designed to understand the doctor's attitude toward hospice and palliative care for terminal cancer patients. Methods: Specialists who work at general hospital were surveyed with questionnaires about hospice and palliative care for terminal cancer patients. The questionnaires comprise 17 items. The data were statistically analyzed. Results: Eighty one doctors responded. Their median age was 35 years old. Thirty six doctors (44.4%) were from internal medicine. The median of specialist's experience was 4 years. Forty three respondents (53.2%) have rarely examined and treated cancer patients even a week. Thirty seven respondents (45.6%) knew the exact definition of hospice and palliative care. Eighty respondents (98.8%) felt that hospice and palliative care is necessary, and 91.2% of them responded the necessity of palliative medicine specialist. As to the question 'Do you positively referred terminal cancer patient to hospice and palliative care?', 55 respondents (67.9%) responded 'Yes' and 22 (27.2%) 'No'. Among the 'Yes' respondents 17 (30.9%) had an experience of hesitation for referring patients to hospice and palliative care; the most common reason was the disagreement of family members (6, 35.3%). As for the reasons of responding 'No', 6 doctors (27.2%) did so because of their 'feeling of abandoning the patients' and the other f for the 'lack of information on the referral procedure for hospice and palliative care'. Thirty seven specialists (45.7%) thought it is most desirable for the patients to have hospice and palliative care for 3 months before death. Fifty eight specialists (71.6%) responded that hospice and palliative care help controlling the patient's psychological symptoms before all. Conclusion: While most doctors recognize the need of hospice and palliative care for patients with terminal ranter, their attitude toward hospice and palliative care was rather reserved. We suggest that continuing education, information and promotion for hospice and palliative care should be provided for doctors.

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Single Lung Transplantation in the Patient with End-stage Lymphangioleiomyomatosis -Report of 1 case- (말기 폐림프관 평활근종증 환자에서의 단측 폐이식술)

  • 양희철;최용수;김진국;심영목;김관민
    • Journal of Chest Surgery
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    • v.37 no.12
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    • pp.1015-1018
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    • 2004
  • Lymphangioleiomyomatosis (LAM) is a rare disease in women in childbearing age leading to progressive respiratory failure. LAM is characterized by an abnormal harmartomatous proliferation of smooth muscle cells surrounding the blood vessels, lymphatics and airways in the lung. This proliferation leads to airway obstruction, cystic alveolar change and lymphatic obstruction. Patients present with dyspnea, pneumothorax, cough, chest pain, hemoptysis, and chylous effusion. Although lung transplantation is the only therapeutic modality in end-stage LAM with respiratory failure, there has not been any report of successful treatment in Korea. We report one case of successful left single lung transplantation in a 40 year old woman suffering from end-stage LAM.

The Single Lung Transplantation for End-Stage Emphysema by Functional Criteria (말기 폐기종 환자에서 기능적 기준에 의한 일측 폐이식술)

  • 조현민;백효채;김도형;강두영;이두연
    • Journal of Chest Surgery
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    • v.36 no.2
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    • pp.101-104
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    • 2003
  • Although lung transplantation has been accepted as the most effective treatment for end-stage pulmonary emphysema, it is not only very hard to find a donor but also to obtain a relatively healthy lung. Furthermore, it is more difficult to match the size of the allograft, considering the height, the weight, and the size of the thoracic cage. The single lung transplatations for the end-stage emphysema have been more commonly performed than bilateral lung transplantation due to the shortage of the donors and the long-term survival rate of the single lung transplantations has shown no reasonable difference compared with that of the bilateral lung transplantationh. Recently, the functional criteria based on a comparison of predicted TLCs(Total Lung Capacities) of the donor and recipient according to height, sex and age, have been accepted at a more suitable.

A Clinical Observation of Oriental Medicine-Based Long Care for Terminal Rectal Cancer Patient with Multiple Metastasis

  • Bang, Sun-Hwi;Son, Chang-Gue
    • The Journal of Internal Korean Medicine
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    • v.29 no.3
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    • pp.567-573
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    • 2008
  • Cancer is now the leading fatal disease in every developed country. Due to very low efficiency of conventional cancer therapeutics and important aspect of quality of life (QOL), complementary/alternative medicine (CAM) has been accepted worldwide, especially by late-staged cancer patients. Oriental medicine traditionally has stressed not only the tumor itself but the body having cancer, improving cancer-related immunity and extending survival period. Herein, we report one case of a terminal staged rectal cancer patient having spread-metastasis but showing a meaningful clinical course of around four years with Oriental medicine therapies. This study aimed to report the clinical capacity of Oriental medicine for patients with cancerous disease, to help development of Oriental medicine-derived anticancer treatments.

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특집 : 올바른 신장합병증 관리를 위해 - 신장합병증의 치료 I - 혈액투석과 복막투석으로 치료

  • Kim, Min-Ok
    • The Monthly Diabetes
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    • s.261
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    • pp.22-23
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    • 2011
  • 당뇨병은 전 세계적으로 급격하게 증가하면서 심각한 대혈관 및 미세 혈관 합병증들의 원인이 되고 있으며 대다수 선진국에서 당뇨병은 만성 신질환 및 말기 신부전의 가장 중요한 원인으로 알려져 있다. 당뇨병성 신증은 단백뇨를 특징으로 하며 30% 정도의 환자에서는 혈뇨도 관찰된다. 그래서 당뇨병성 신증의 발병 검진은 미세알부민뇨 검사로 하는 것이 가장 이상적이며 제 1형 당뇨병환자는 일반적으로 당뇨병 발병 5년 이후에 하며 위험인자가 있는 환자는 더 조기에 한다. 제 2형 당뇨병환자는 당뇨병 진단 시점부터 매년 하는 것을 원칙으로 한다.

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특집 - 당뇨의 대표적 합병증, 신증

  • O, Dong-Jin
    • 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.

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Effectiveness of Hand Massage Combined with Analgesics on Pain Control in Patients with Terminal Cancer (진통제와 병용한 손 마사지가 말기 암환자의 암성통증 조절에 미치는 효과)

  • Lee, Yunmi;Yoon, Hosoon;Lee, Sungwoon;Kim, Young Mi
    • 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.

Use of music to facilitate verbal and nonverbal expression for older adults in the hospice care (호스피스 환자들의 언어적·비언어적 표현 증진을 위한음악적 활용)

  • Chong, Hyun Ju;Choi, Sung Yoon
    • 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.

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Factors Influencing on Chronic Renal Disease Patients' Use of Alternative Therapies (만성콩팥병 환자의 대체요법 이용에 영향을 미치는 요인)

  • Lee, Seong-Ran
    • 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.

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