• Title/Summary/Keyword: 완화의료

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The Design of the Self-diagnosis Algorithm for the Efficient Control of Sudden Cancer Pain (효율적인 돌발성 암 통증 관리를 위한 자가 진단 알고리즘 설계)

  • Jung, Eun-Young;Eun, Sung-Jong;Jeong, Byoung-Hui;Lee, Yong-Joon;Park, Dong-Kyun
    • The Journal of the Korea Contents Association
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    • v.14 no.5
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    • pp.458-467
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    • 2014
  • Pain is one of the most common and painful symptoms that cancer patients suffer from. Pain seriously affects 30-50% of the patients at the early cancer diagnosis stage or who receive active anticancer treatments, 60-70% of the patients with progressive cancer, and 80-90% of the patients at the late stage of cancer. However, there is no systematic and easy pain control program for the cancer patients. In this study, an algorithm is proposed to provide quick pain relief service upon the occurrence of sudden pain, for the purpose of controlling the sudden pain that cancer operation survivors experience. In developing the algorithm, questionnaires, evaluation forms and National Comprehensive Cancer Network (NCCN) guideline were considered, and a trial service was provided to a group of 20 cancer patients for a month to evaluate the designed algorithm. The results of the trial service were examined by expert medical workers to evaluate the proposed algorithm, and a 90% compatibility decision was derived, which verified the effectiveness of the proposed algorithm. In the case of incompatibility decision, the management of the pain diary did not have compatible results. Therefore, the further study will additionally address the customized pain diary algorithm.

Factors Associated with Burnout of Nurses Working for Cancer Patients (말기 암 환자 간호사의 직무소진 관련 요인 분석)

  • Leou, Chung-Soon;Kim, Kwang-Kee;Kim, Jeoung-Hee
    • Journal of Hospice and Palliative Care
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    • v.8 no.1
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    • pp.45-51
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    • 2005
  • Purpose: The purpose of this study is to examine the factors surrounding burnout of nurses caring for cancer patients. Methods: The sample of this study was conveniently selected among nurses who had hospice care experiences working in General Hospitals located in Seoul. This study was conducted by a self-administered questionnaire. Two hundred forty four questionnaires were retrieved and the response rate was 81.3%. The period of data collection was from February 25th to March 5th in 1994. Mean, standard deviation, T-test ANOVA, and multiple regression analysis were performed for statistical analysis. Results: The data showed that respondents reported to have burnout as many as 2.71 out of a 5.0 score. Bivariate analyses indicated that those who had hospice education reported to have a lower burnout than those without hospice education. Multivariate regression analyses revealed factors associated with burnout the nurses have had. They include being a Christian, higher job satisfaction, and experiences of hospice education. Hospice education reducing burnout for the nurses was observed by hierarchial multiple regression analyses, after controlling out the effect of coping methods, sociodemographic characteristics, job satisfaction, and job-related stresses on experience of burnout. This observation was not hue for physical and psychological burnout but for burnout in general and emotional one. But this was not confirmed among the nurses with type A personality. Conclusion: The findings of this study have a weakness in generalizability due to the sampling methodology used in this study. However, for the better hospice care further research with a probability sampling method are necessary.

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Deep Vein Thrombosis in Advanced Cervical Cancer Patient after Taking Cyclooxygenase-2 Selective Inhibitors (Cyclooxygenase-2 선택적 억제제를 복용 중 자궁암 환자에 발생한 심부정맥혈전증 1예)

  • Ko, Byung-Joon;Kim, Su-Hyun;Kim, Jeong-A;Hong, Jeong-Ik;Yoon, Do-Kyoung;Kim, Jung-Hwan;Sohn, Keun-Ju;Choi, Youn-Seon
    • Journal of Hospice and Palliative Care
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    • v.8 no.1
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    • pp.57-64
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    • 2005
  • Cyclooxygenase-2 (COX-2) selective inhibitors were specifically developed to reduce the risks of gastrointestinal bleeding associated with other NSAID drugs. However, the APPROVe (Adenomatous Polyp Prevention on VIOXX) trials revealed that rofecoxib sometimes exerts prothrombotic effects. Meanwhile, cancer patients, who also carry a risk of thrombosis due to a variety of mechanisms, are often treated with COX-2 selective inhibitors, due to their relative gastrointestinal safety. This report concerns the case of a 46-year old woman with advanced cervical cancer, who had been treated with opioids and a COX-2 selective inhibitor (celecoxib) for 2 months, for the relief of pain associated with her cancer. The patient was admitted due to swelling of the left leg, which was also accompanied by pain. A computerized tomography scan revealed deep vein thrombosis occurring in multiple veins of both legs. After the administration of low-molecular weight heparin and oral warfarin, the patient's symptoms were relieved initially. However, her prothrombin time was found to be prolonged, necessitating the discontinuation of anticoagulation therapy. The patient's dyspnea worsened, ultimately resulting in her death. In conclusion, the administration of cox-2 selective inhibitors should be carefully considered in patients with a number of different risk factors, and assessed on a case-by-case basis.

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Quality of Sleep in Hospitalized Patients with Lung Cancer (입원 폐암환자의 수면의 질)

  • Han, Young-In;Sohn, Sue-Kyung
    • Journal of Hospice and Palliative Care
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    • v.8 no.1
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    • pp.1-7
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    • 2005
  • Purpose: The purpose of this study was to identify the quality of sleep in hospitalized patients with lung cancer. Methods: The data were collected from January to April 2001. Study subjects were 50 lung cancer patients hospitalized at K University and G hospital in Busan, Korea. Quality of sleep was measured using the Quality of Sleep Scale (range $15{\sim}60$) developed by Oh et al (1999). The data were analyzed with the SPSS 10.0 program using frequency and percentage, mean, standard deviation, t-test, ANOV4 and Post-hoc test (Scheffe's test). Results: The results of this study were as follow; 1) The mean quality of sleep score was $35.64{\pm}7.59$ (range: $21{\sim}52$). 2) There was 3 Significant difference in 'ongoing pain' (t=-1.943, P=.046), 'major caregiver' (F=B863, P=.047), 'change of weight' (F=5.906, P=.019), according to general characteristics in the quality of sleep in hospitalized patients with lung cancer. Conclusion: As a results, the level of the quality of sleep in hospitalized patients with lung cancer was moderate. And, the study results indicate that ongoing pain, major caregiver, change of weight impact the quality of sleep of lung cancer patients. Therefore, nurses should consider those factors in providing nursing care for hospitalized patient with lung cancer.

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The Changes of Quality of Life in Cancer Patients Treated with Chemotherapy (화학치료를 받는 암 환자 '삶의 질'의 변화에 관한 연구)

  • Kim, Byung-Soo;Choi, In-Keun;Park, Kyeung-Hwa;Yoon, So-Young;Oh, Sang-Chul;Seo, Jae-Hong;Choi, Chul-Won;Shin, Sang-Won;Kim, Yeul-Hong;Kim, Jun-Suk
    • Journal of Hospice and Palliative Care
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    • v.4 no.2
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    • pp.130-136
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    • 2001
  • Purpose : It is very important to endow the cancer patients underwent chemotherapy with satisfactory quality of life (QOL). However, little is known about the factors influencing QOL during chemotherapy. Therefore, we designed this study to find out the factors influencing QOL in the cancer patients who underwent chemotherapy. Methods : Ninety-seven cancer patients were studied, prospectively. The patients' characteristics were as follows; median age(range): 48(19{\sim}83) years, male:female; 57:40, PS:0,1/2,3;55/42 patients, diagnosis(number): lymphoma (28), lung cancer (22), gastrointestinal cancer (18), sarcoma (12), breast cancer (12), gynecological cancer (5), Stage: I,II/III.IV;37/60 patients. We used EORTC QLQ-C30 questionnaires to evaluate QOL. EORTC QLQ-C30 scores were performed before the onset of chemotherapy and after the end of 3 cycles of chemotherapy. The correlation of these scores with performance status (PS), diagnosis, disease stage, response to chemotherapy, and regimen related toxicity was evaluated. Results : The responder group (CR, PR) demonstrated marked improvement of social functional and emotional scales to non-responder group (SD,PD) (P=0.024, 0.045). Non-hematologic regimen related toxicity such as mucositis, nausea and vomiting was significantly correlated with pain scale change (P=0.043). Other factors had no notable correlation with QOL changes. Conclusion : Our preliminary study results may suggest as follows. The response to chemotherapy is associated with the change of social functional and emotional scales and the severity of non-hematologic regimen related toxicity is associated with pain scale change.

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The Comparison of Physicians' and Nurses' Knowledge and Attitudes Toward Cancer Pain Management (통증 관리에 대한 의사와 간호사의 지식과 태도 비교)

  • Lee, Eun-Ok;Heo, Dae-Seok;Kim, Soon-Ja;Kim, Yeul-Hong;Yoon, Sung-Soo;Kwon, In-Gak;Cho, Seok-Goo;Park, Myung-Hee;Park, Jung-Yoon
    • Journal of Hospice and Palliative Care
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    • v.2 no.1
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    • pp.7-15
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    • 1999
  • This survey was designed to evaluate knowledge and attitudes of physicians and nurses toward cancer pain management in South Korea and to compare physicians' knowledge and attitudes with nurses' Ninety-nine physicians and 152 nurses working at four major institutions in South Korea were included for the study. With the 30 items of the knowledge with true and false answers about cancer pain such as pain assessment(6 items), pharmacokinetics of opioids(8 items), analgesics classification(11 items), and drug administration(5 items), total score of knowledge answered by physicians was 21.40, which was not significantly higher than 20.87 answered by nurses. Rates of the correct answer were more than 70% in both physicians and nurses. Physicians were more knowledgeable in pharmacokinetics and analgesics classification than nurses, while nurses higher only in pain assessment than physicians. Since physicians and nurses could not effectively manage the cancer pain because of inappropriate knowledge, it is important to provide intensive education to physicians and nurses about cancer pain management.

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Development of a Community-Based Management System of Home-Stay Cancer Patients (지역사회 재가 암환자 관리 체계 구축 - 일 시 지역을 중심으로 -)

  • Kim, Boon-Han;Jung, Yun
    • Journal of Hospice and Palliative Care
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    • v.4 no.2
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    • pp.154-160
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    • 2001
  • Purpose : This study, as the first year project of setting up a community based management system, was attempted for the cancer patients and their family to improve their quality of life; investigating and managing the cancer patients, educating volunteers and connecting the patients with the volunteers were performed. Method and result : The education of managing cancer patients for the volunteers was done once in lune for 2 days to the 80 volunteers. Questions about education effect, volunteer motivation and so on were made up. The survey showed, generally, education satisfaction level was high and a longer education and an intensive course were needed and was suggested that organizing a volunteer community be needed for the continuous further education and systematic management. As the result, after the public health center and volunteers deliberated, a volunteer community consisting of 4 teams, 28 members was organized, launched in Oct. and operated for the cancer patients and their family. For investigating and enrolling the patients, advertising on a local information paper, recommending of local doctors, publicizing by educating the heads of a subdivision of the city, the heads of a neighborhood association and the people in charge of the related local communities such as women's society, and surveying the community by volunteers were performed and the total, 41 patients were registered. Management of cancer patients was carried out by volunteers in a community and in a nursing school. A regional volunteers' community is composed of 23 members and they have worked 87 times, that is 3.8 times per capita on an average. The content of duties is attending the education (41.1%) the most. A volunteers' community of nursing students composed of 12 members have worked 135 times, that is 11.3 times per capita on an average. The content of duties - consulting with patients and home visiting (37.8 %) were the most and survey for investigating the cancer patients was the second. Conclusion : This study has the meaning that this is the guiding attempt in building a community based management system, and especially the achievement of this study is that a regional society organized a volunteer community for the cancer patients by itself and went into action for the cancer patients and their family. Furthermore, to activate this volunteering, it is necessary to keep managing volunteers and running continuing education or the intensive course of the volunteers. Indeed we should let the patients have good impression on this program through publicity and education for the residents to keep track of more cancer patients. For that, systematic and powerful cooperation of a self-administrative organization is required.

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Information Needs and Satisfaction among Family Members of Terminal Cancer Patients through Phone Cancer Information Services (말기 암 환자 가족의 전화상담을 통한 정보요구와 만족도 조사)

  • Kwon, Kyeung-Eun;Kim, Boon-Han;Chang, Yoon-Jung;Kim, Hee-Jung;Jung, Yun
    • Journal of Hospice and Palliative Care
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    • v.12 no.1
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    • pp.5-13
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    • 2009
  • Purpose: This exploratory study was undertaken to analyze the information needs of family members of terminal cancer patients, collected through the telephone counselling service by National Cancer Information Center. Methods: The study included 113 family members of terminal cancer patients who had enrolled at the National Cancer Information Center for the period from June, 2007 through March, 2008 and had agreed to the survey. Results: The subjects (n=113) consisted of grown-up children (n=82) and spouses (n=8) of patients'. Those in their 40's (n=40) and 30's (n=36) accounted for the majority of the sample. The questions raised most were about the information on treatment methods (n=117), management of terminal cancer patients (n=46), terminal cancer patients' life (n=27), deathbed and prediction of remaining life (n=18), hospitalization (n=16), and financial support (n=15). Most of the subjects were satisfied with the telephone counseling services, and 69% of the subjects had come to know about the telephone counseling service via Internet, and 10.6% of them stated that the PR for the service was poor. Conclusion: It is deemed essential for the government to use the mass media for PR of the hospice services, since family members of terminal cancer patients' are less aware of the hospice conducive to enhancement of patients' remaining quality of life, being involued too deeply in their treatment.

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A Research of the Spiritual Well-Being and Spiritual Needs of HIV/AIDS Patients (HIV/AIDS 환자의 영적 안녕과 영적 요구도 조사)

  • Gwak, Ji-Hyun
    • Journal of Hospice and Palliative Care
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    • v.12 no.1
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    • pp.14-19
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    • 2009
  • Purpose: The purpose of this study was to provide basic data to assess spiritual health of HIV/AIDS patients and devise spiritual nursing mediation plans in practical nursing work by examining the levels of spiritual wellbeing (SWB) and spiritual needs of HIV/AIDS patients'. Methods: A correlation survey study was conducted on HIV/AIDS patients age ranging from 20 to 70 years to investigate the relationship between their SWB and spiritual needs. Results: 1. Average scores of HIV/AIDS patients' related to SWB were found to be higher than the intermediate level: 54.59 in SWB; more specifically, 27.78 in existential well-being and 26.80 in religious well-being. 2. Average score of for HIV/AIDS patients' spiritual needs was 108.67: More specifically, 37.80 in the needs of love and interest, 42.35 in the needs of seeking meanings and purposes, and 28.51 in the needs of wanting to be forgiven. 3. Concerning the correlation between SWB and spiritual needs, the total SWB and total spiritual needs of HIV/AIDS patients' showed a weak positive correlation (r=0.344, P=0.013). Conclusion: The result of the study showed that SWB and spiritual needs of HIV/AIDS patients' are higher than the average scores, and these two parameters have a weak positive correlation, indicating that HIV/AIDS patients have strong spiritual needs of seeking meanings and purposes. Therefore, more studies on the spiritual nursing mediation plans are needed in order to raise their spiritual well-being levels and meet their spiritual needs through precise assessment.

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Nurse's Experience of Changing Role in the Hospice Unit of Medical Ward (호스피스병동 간호사의 역할 변화 경험)

  • Kim, Hyun-Joo;Ku, Jeong-Il;Byun, Jun-Hye;Kim, Su-Mi;Choe, Wha-Sook
    • Journal of Hospice and Palliative Care
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    • v.11 no.1
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    • pp.30-41
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    • 2008
  • Purpose: This study was designed to investigate various role changes of nurses who have cared both medical cases and hospice patients and what they experienced. Methods: Focus group interviews were done 3 times and participants were 12 nurses who have worked in the hospice unit of medical ward. Results: Role changes in 4 areas such as holistic care, end-of-life care, care fur rare givers, and coordination of hospice team were reported by the participants. What they felt were as follows : fear, confusion, maturation, increasingly labor, regret, accomplishment, sympathy and depression. Conclusion: Although hospice care in general medical ward added extra tasks, it helped clinical nurses recover professional identity and led to growth of nursing by acquiring new knowledge and skill in hospice care.

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