Although hospice care includes palliative care technology in terminally ill person for pain, it is much more holistic including emotional, spiritual and other life dimension. Human suffering that experiencing the hospice client must be reconsidered whether one starts with an objective side or a subjective side of suffering, the strategies about the expanded consciousness is important. In the hospice caring perspectives, the body, mind and spirit are integrated so the objectivity and subjectivity can merge; the extended awareness with inner resource or energy, and the positive thinking about the God is meaningful especially dying person, family member, and the hospice team.
Although the general concept of suffering care includes palliative care for the terminally ill that is designed to alleviate pain, it is much more holistic and encompasses emotional, spiritual and other life dimensions. Human suffering is multi-dimensional including spiritual and religious aspects, which diverge from the concept of pain understood in the context of materialistic medical approach. In this caring perspective, the body, mind and spirit are integrated so that objectivity and subjectivity can merge. The extended awareness with inner source or energy, and positive thinking about the personally-relevant God can be meaningful the dying person, family members and the caring team. Despite the importance of an inclusive understanding of human suffering, actual nursing practice still does not fully embrace the full understanding of human suffering. A more fundamental meaning of human suffering from the nursing perspective may fruitfully adopt a more inclusive view of human suffering.
The arthritis patients suffer from psychological, social and spiritual problems as well as physical problems because the arthritis is not curable and has chronic pain, joint deformity, limitation of activity and physical dysfunction for all of his life. Especially if they do not find the meaning in their lives, they will experience spiritual distress seriously. Therefore, it is important that nurses help the patients to find the meaning in their lives and to reduce spiritual distress. The purpose of this study is to provide a basis for nursing intervention strategies to minimize the arthritis patients' spiritual distress and understand the relationship between the meaning of life and the spiritual distress in arthritis patients. The samples were composed of 157 arthritis patients. Data collection was carried out from October 1, 1998 to February 28, 1999. Data were analyzed using a SAS program for descriptive statistic, Pearson correlation, t-test, ANOVA, linear regression. The results were as follow; 1. The scores on the meaning of life scale ranged from 51 to 130 with a mean of 93. 2. The scores on the spiritual distress scale ranged from 26 to 91 with a mean of 60. 3. There were significant correlations between the meaning of life and the spiritual distress(r=.53, p=.00). 4. The linear regression analysis showed that the meaning of life explained 13% of the spiritual distress. 5. In the degree of the meaning of life and the spiritual distress according to the general characteristics, the level of the meaning of life in arthritis patients was different by the duration of incidence(F=2.71, p=.03). In conclusion, the nursing intervention strategies to reduce the spiritual distress in arthritis patients must take into account the meaning of life.
Although the general concept of suffering care includes palliative care technology for terminally ill person to alleviate his pain, it is much more holistic including emotional, spiritual and other life dimension. This inclusive concept of caring can be possible with the fundamental reflection on the human suffering. Far from the concept of pain understood in the context of materialist medical approach, human suffering has many dimensions including aesthetic, psychological, and religious: its meaning is holistic. With this perspective, the experience of the suffering client must be reconsidered before one starts with an objective side or a subjective side of suffering. Indeed, the actual strategies of suffering care can be different depending on the definition of human suffering accepted by practicians. In this caring perspective, the body, mind and spirit are integrated so the objectivity and subjectivity can merge; the extended awareness with inner resource or energy, and the positive thinking about the God is meaningful especially for dying person, his family members and the caring team. Despite this impending importance of the inclusive understanding of human suffering, the actual nursing practice still does not reflect this growing understanding of human suffering. This approach, which tried to pursuit the more fundamental meaning of human suffering, can contribute to the development of nursing education and practice which pay attention to the more inclusive view of human suffering.
Purpose : The purpose of this study was to describe a total pain model in patients with terminal cancer and to identify factors relating to total pain using the Twycross Pain Management Model, which included physical, psycho-social and spiritual pain. Method : The study was a retrospective descriptive study. The first stage included 87 patients who received hospice service at Y hospital in 1997. The second stage included five model patients who suffer severe pain as selected by the four hospice nurses. Data collection was from 1) chart analysis and 2) in-depth interviews with the hospice nurses about their selected patients. Data analysis was performed using SPSS-WIN and content analysis. Result : 1) The main problems of 3 patient with terminal cancer were pain(77%), constipation (25.3%), family coping(35.6%), psycho-spiritual distress(17.2%)and other symptoms. 2. The Twycross model was a useful model. However, new items were added; loneliness, depression, and no improvement in condition as depression factors. In anger, new items were anger due to family neglect, at God and in relationships. The case studies identified the followsing; 1) Patient suffer from physical pain as well as multiple other symptoms when cancer is advanced. 2) Body concept, role change, threat to self concept, fear of pain, fear of death, anxiety, family conflict, financial burden, spiritual distress, hope for a cure, are all affected. Conclusion : 1) It is believed that the Twycross model is useful but further tests and revisions are necessary for deciding priorities in the care plan. 2) Pain management must improve culturally appropriate and family support, psychological, spiritual care are imperative for patient with terminal cancer. 3) Further study is recommended to test correlations of depression, anxiety, spiritual distress and family coping using valid instruments. A qualitative study on the spiritual journey of the patient with terminal cancer is also recommended.
Purpose: A quantitative descriptive study aimed to identify the relationships between spiritual well-being and perception attitudes of death in nursing students. Methods: A survey was conducted and 175 data were collected. Collected data were computed and analyzed using SPSS10.0 for Win. 1) Descriptive statistics were used to identify demographic data, and 2) both t-test and ANOVA statistics were used to figure out the relationships between spiritual well-being /or perception attitudes of death and demographic data of the participants. 3) Pearson's correlation coefficient was used to identify the relationships between the two main variables. Results: 1) The mean of spiritual well-being score of the participants was $50.9943{\pm}10.7235$. Significant relationships between religion /or doing economic activity and spiritual well-being were found. 2) The mean of perception attitudes of death was $20.4914{\pm}2.6280$. There were significant relationships between gender /or age and perception attitudes of death among participants. 3) A strong positive relationship between spiritual well-being and perception attitudes of death of participants was also found(r=.261, P=.000). Conclusion: The study results shows that spiritual well-being of nursing students as caregivers of terminal patients is important when the perception of death of terminal patients is considered. Previous studies indicate that caregivers' perception attitudes impact on those of terminal patients. Therefore, it is suggested that not only perception attitudes of death and spiritual well-being in terminal patients, but also those of caregivers are importantly required to consider in educational programs in relation to spiritual care of terminal patients.
Purpose: This study was to investigate relationships among distress, depression, anxiety, and spiritual needs of hospitalized patients with stomach cancer. Methods: The participants were 120 in-patients with stomach cancer for surgery or chemotherapy at C University in Seoul from December 2010 to February 2011. To measure emotional and spiritual states was used Distress management version 1 (National Comprehensive Cancer Network, NCCN), the Hospital anxiety and Depression Scale (HADS), and the Spiritual Needs Scale. The data were analyzed using SPSS 19.0, specifically descriptive statistics, t-test, ANOVA, Scheffe's test, and Pearson's correlation coefficients. Results: Distress showed positive correlations with anxiety (r=.49, p<.001), and depression (r=.44, p<.001). Anxiety showed positive correlations with depression (r=.59, p<.001). While, depression showed negative correlations with spiritual needs (r=-.25, p<.001). Conclusion: This study's findings show that hospitalized patients with stomach cancer experienced distress, anxiety, depression and high spiritual needs. Distress, anxiety, and depression of patients with stomach cancer were positively correlated with each other. While the level of depression was negatively correlated with the level of spiritual needs, indicating the higher the level of depression, the lower the spiritual needs. Therefore, nursing interventions for emotional and spiritual support need to be developed for stomach cancer patients.
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.
For hospice palliative care that provides comprehensive and general care, it is necessary to use assessment tools to objectively list issues and detail care plans. The initial assessment is a process of establishing an overall direction of care by identifying the patient's symptoms, social and spiritual issues and palliative care needs on the admission day or within one day of admission. This process is also used to identify the patients' and families' awareness of the illness, prognosis, treatment options and if the Physician Orders for Life-Sustaining Treatment (POLST) has been drafted. Consisting of 13 simple questions regarding the physical, mental, social, and spiritual domains, the Needs at the End-of-Life Screening Tool (NEST) is recommended as an initial assessment tool. Using specific assessment tools, a care plan is established for the issues identified in the initial assessment within three days of admission. A multidisciplinary assessment tool can be helpful in the physical domain. The psychosocial domain evaluates psychological distress, anxiety and depression. The social domain examines an ability to make decisions, understanding of the socioeconomic circumstance, family relationship, and death preparedness. A spiritual evaluation is also important, for which the Functional Assessment of Chronic Illness Therapy-Spiritual WellBeing Scale (FACIT-Sp) or the Spiritual Health Inventory (SHI) can be used. The use of an assessment tool could not only contribute to pain mitigation a better quality of life for patients, but also provide systematic training for a multidisciplinary team; And the process itself could be a stepping stone for the better care provision.
Purpose : This study is non-equivalent control group pre-post design attempted to see 'The effect of spiritual nursing intervention on the meaning of life and spiritual distress of the terminal cancer patients.' Method : The data collection was performed from June to October, 2004. The subjects were 41 terminal cancer patients of one general hospital in Jeon Ju city. They are formed two groups, 20 experimental group and 21 control group. Experimental treatment provided spiritual nursing intervention 3 times per a week, the mean 45 minutes each, for 4 weeks for experimental group with the contents of therapeutical use of oneself, use of bible, use of hymn, use of prayer, depend on the priest in the spiritual need assessment of 6 kinds. Study tools was used the thing which Kim(1990) developed about purpose inspection of life which Crumbaugh(1968) developed to measure the meaning of life. The measure of spiritual distress was used the tool which Kim(1990) developed, spiritual nursing intervention was developed by researcher of this thesis. Data was analyzed by descriptive statistics of real number, percentage, the mean etc. and x2-test, t-test, ANCOVA. Result: The 1st hypothesis, 'spiritual the meaning of life score in the experimental group, who received the spiritual nursing intervention, will be higher than the control group who did not receive it' was supported(F=157.09, P=0.000) The 2nd hypothesis, 'spiritual distress score in the experimental group, who received the spiritual nursing intervention, will be lower than the control group who did not receive it' was supported(F=36.48, P=0.000) Conclusion: Spiritual nursing intervention was verified as an effective program to improve the meaning of life and decrease spiritual distress for the terminal cancer patients. Thus, it was confirmed with an effective nursing intervention which helps them in order to spend the rest time of life meaningfully and meet the peaceful death.
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