• 문화기술의 융합
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• 제5권1호
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• pp.119-125
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• 2019

종래 헌법학계의 공화국에 관한 정의는 왕의 존재여부로만 구별하여 소극적 형식적 의미에 머물러 왔다. 하지만 이는 정확한 이해가 아니다. 오늘날 우리는 신자유주의의 비정한 침습을 경험하고 있다. 그에 따라 헌법 제1조 제1항에 규정된 공화국의 공적 질서와 시민적 덕성을 잃어가고 있다. 이러한 시점에서 공화국의 의미를 재해석해보는 것은 신자유주의의 부작용을 완화하는 역할을 기대함에 있다. 공화국의 의미를 재음미하는 일에서 무엇이 공화국인지 구체적인 상을 정립하는 것이 그 어떠한 것보다 중요하다. 따라서 본 논문의 주요 내용은 공화국의 요건을 제시함으로써 그것을 구체화하는 것이다. 그 요건은 바로 공공물로서의 국가, 국가의 의사결정에 국민의 개입을 실질적으로 허용하지는 여부, 경제적 가치보다 국민의 정치적 결정이 우선하는 국가, 평등을 지향하는 국가, 자의적인 지배권력이 없는 국가 등이다. 다만, 이러한 공화국의 개념정립과 강조에서 매우 주의할 것이 있다. 그것은 공화국의 개념정립과 강조의 과정에서 국가가 국가에 유리한 추정의 근거로 확장할 경우(개인보다 공동체를 우선시하는 논거를 오남용할 경우), 과거 군사정권에서 공화국을 오용하였던 시절로 회귀될 수도 있음을 반드시 유념하여야 한다. 공화국의 현대적 의미가 올바르게 정립 이해 강조 정착됨으로써 오늘날 신자유주의의 폐단이 극복하고, 우리나라 국민들이 명시적으로 헌법에 규정된 공화국의 가치를 누릴 수 있는 날을 기대해본다.

• Journal of Hospice and Palliative Care
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• 제22권2호
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• pp.77-86
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• 2019

목적: 본 연구는 혈액종양내과 병동에 근무하는 간호사를 대상으로 긍정심리자본과 죽음인식을 확인하고 임종간호 수행에 미치는 영향을 파악하여 임종간호 수행의 질적 수준 향상을 위한 근거자료를 제공하고자 하였다. 방법: 서울시에 소재한 일 상급종합병원에서 근무하는 혈액종양내과 병동에 근무하는 간호사 127명을 대상으로 자가보고 설문지를 통해 긍정심리자본, 죽음인식, 임종간호수행을 조사하였고, 기술 통계, 피어슨 상관관계 및 다중회귀분석을 이용하여 분석하였다. 결과: 긍정심리자본과 죽음인식, 임종간호 수행 간에는 모두 양의 상관관계가 나타났다. 임종간호 수행에 미치는 영향요인은 긍정심리자본의 하위 영역 중 희망, 회복탄력성, 지난 1년 이내 가족, 친척 또는 친구의 죽음 경험이었으며 임종간호 수행에 대한 설명력은 32.1%로 나타났다. 결론: 혈액종양내과 병동에 근무하는 간호사의 임종간호 수행의 질적 수준 향상을 위하여 희망과 회복탄력성을 포함한 교육 프로그램 개발이 필요하다.

• 한국정보통신학회논문지
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• 제23권11호
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• pp.1420-1427
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• 2019

초고령 사회 일본은 다양한 사회문제 해결 방법 중 하나로 정보통신기술의 활용을 적극적으로 추진하고 있다. 특히 머지않아 초고령 사회에 진입할 우리나라로서는 고령자 지원과 관련한 ICT활용에 대한 일본의 정책 및 현황을 살펴보는 것은 의미가 있을 것이다. 본 연구에서는 문헌조사를 통하여 일본의 고령자 지원관련 ICT정책 및 활용 현황을 살펴보고 우리나라 고령자 지원과 관련하여 다음과 같은 사항을 제안하였다. 고령자 지원관련 현장에서 ICT기술이 실질적으로 활용될 수 있는 기회가 넓혀져야 하며, 일본의 경우처럼 고령자 지원에 있어서 개호와 의료의 연계가 중요하기 때문에 이러한 기관간의 정보연계네트워크 구축을 위한 노력이 필요하다. 또한 다양한 로봇의 개발 및 보급을 통해 개호자와 관련 인력의 서류업무의 간소화 및 개호 부담의 완화를 모색해야 한다. 그리고 ICT활용을 통한 고령자를 위한 정서지지 및 안정을 위한 기술의 보급도 적극 추진되어야 한다.

• Journal of Hospice and Palliative Care
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• 제24권2호
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• pp.74-84
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• 2021

Purpose: This study investigated knowledge of and attitudes toward advance directives (ADs) among middle-aged women in South Korea, their willingness to write ADs in the future, and the factors related to knowledge of and attitudes toward ADs. Methods: Data were collected using a self-administrated questionnaire completed by 154 middle-aged women aged 50 to 64 from February to March 2020. The questionnaire asked about participants' knowledge of and attitude toward ADs, willingness to write ADs in the future, experiences with life-sustaining treatment within their families, experience making decisions about life-sustaining treatment, and demographic characteristics. Results: Scores for both knowledge of and attitude toward ADs were relatively high. About 60% of participants gave wrong answers when asked if attorneys were required for writing ADs. A higher knowledge score was significantly associated with a higher attitude score (r=0.227, P<0.01). The women were more likely to be willing to write ADs in the future when they reported a middle income level rather than a lower income level (odds ratio [OR]=5.952, P<0.01), considered themselves unhealthy (OR=5.873, P<0.01), and graduated college or higher (OR=4.096, P<0.05). Furthermore, women who thought that ADs would have an impact on treatment (OR=1.869, P<0.05) and on their families (OR=1.447, P<0.05) were more likely to be willing to write an AD. Conclusion: This study shows that wrong information about ADs persists among middle-aged women, and significant factors associated with knowledge of and attitude toward ADs were identified. Targeted education programs about ADs need to be developed for middle-aged women.

• Journal of Hospice and Palliative Care
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• 제24권2호
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• pp.116-129
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• 2021

Purpose: The purpose of this study was to examine the knowledge, caregiving performance, stress levels, and mental health of family caregivers of terminal cancer patients with delirium, insofar as these characteristics are relevant for delirium. Methods: Between May 1, 2019, and June 1, 2020, 96 family caregivers of terminal cancer patients with delirium completed a structured survey, the results of which were analyzed. Results: The average correct answer rate for delirium-related knowledge was 53.2% across all subcategories, which included knowledge of causes (41.5%), symptoms (65.4%), and caregiving (51.7%). The average score for family caregivers' performance of caregiving for delirium was 2.60±0.5, with subcategories including caregiving for patients without delirium (2.16±0.95), caregiving for patients with delirium (2.84±1.01), and stress related to caregiving for delirium (39.88±16.55), as well as categories such as patient-related caregiving (44.32±28.98), duty-related caregiving (44.21±30.15), and interpersonal relationship-related caregiving (22.35±25.03). For mental health, the average score among family caregivers was 1.96±0.70, with the highest score being for the category of additional items (2.28±0.84). Family caregivers of patients with hyperactive delirium as the delirium subtype had higher scores for caregiving performance than caregivers of patients with mixed delirium. Conclusion: Scores for the delirium-related knowledge and caregiving performance of family caregivers were low, while their caregiving stress levels were high due to their lack of knowledge and experience. This indicates the importance of delirium-related education for family members of patients with delirium and the necessity of developing nursing intervention programs to help manage stress and promote mental health among family caregivers.

• Journal of Hospice and Palliative Care
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• 제24권2호
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• pp.130-134
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• 2021

In the era of coronavirus disease 2019 (COVID-19), social distancing and strict visitation policies at hospitals have made it difficult for medical staff to provide high-quality end-of-life (EOL) care to dying patients and their families. There are various issues related to EOL care, including psychological problems of patients and their families, difficulties in EOL decision-making, the complicated grief of the bereaved family, moral distress, and exhaustion of medical staff. In relation to these issues, we aimed to discuss practical considerations in providing high-quality EOL care in the COVID-19 pandemic. First, medical staff should discuss advance care planning as early as possible and use the parallel planning strategy. Second, medical staff should play a role in facilitating patient-family communication. Third, medical staff should actively and proactively evaluate and alleviate dying patients' symptoms using non-verbal communication. Lastly, medical staff should provide care for family members of the dying patient, who may be particularly vulnerable to post-bereavement problems in the COVID-19 era. Establishing a system of screening high-risk individuals for complicated grief and connecting them to bereavement support services might be considered. Despite the challenging and limited environment, providing EOL care is essential for patients to die with dignity in peace and for the remaining family to return to life after the loved one's death. Efforts considering the practical issues faced by all medical staff and healthcare institutions caring for dying patients should be made.

• Journal of Hospice and Palliative Care
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• 제23권4호
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• pp.212-227
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• 2020

Purpose: This study presents the process of designing workbooks for advance care planning appropriate for the Korean cultural setting and describes actual case studies. Methods: This study focused on single inductive case studies of the utilization of an advance care planning workbook and recruited individual participants. Results: The workbook for adolescents contained six sessions and the workbook for children contained seven sessions. The workbook sessions led to four major discoveries: 1) considering the Korean cultural context, discussions on life and death must be held indirectly; 2) the role of the counselor as a supporter is crucial for the workbook to be effective; 3) the workbook must be accessible regardless of the seriousness of the illness; and 4) patients must be able to make their own choice between the workbook versions for children and adolescents. Six facilitating factors improved engagement: 1) the role of the counselor as a supporter; 2) building trust with the patient; 3) affirming freedom of expression on topics the patient wished to avoid talking about; 4) having discussions on what private information to keep secret and to whom the information can be disclosed; 5) discovering and regularly discussing relevant topics; and 6) regular communication and information-sharing with the patient's medical service providers. Conclusion: It is necessary to build on actual case studies regarding workbooks for children and adolescents in order to expand the usage of these workbooks to all relevant medical institutions in Korea.

• Journal of Hospice and Palliative Care
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• 제23권4호
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• pp.183-197
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• 2020

Purpose: In this study, the researchers closely investigated the psychosocial problems faced by terminal cancer patients and their family members in hospice palliative care units. Methods: The investigators conducted four sessions of art therapy intervention programs for the terminal cancer patients and their family members, carried out in-depth interviews about the influence of the cancer experience on their family function and quality of life, and analyzed their experiences using grounded theory methodology. Results: After providing autonomous written informed consent, six pairs of terminally ill cancer patients and their family members, accounting for a total of 17 participants with the inclusion of additional family members who took part sporadically, took part in the art therapy intervention and interviews. The raw data, in the form of verbatim records, were analyzed according to the procedures of grounded theory (open, axial, and selective coding). Through these processes, a total of 154 concepts, 56 subcategories, and 13 categories were identified. Families were classified into four types according to their family function, quality of life, and attitude toward death. Though the art therapy intervention, patients and their family members experienced three stages over time. Conclusion: This research focused on essential aspects of the family relationships and the art therapy experiences of terminal cancer patients and their family members through an art therapy intervention in the context of hospice palliative care. Based on these observations, the researchers constructed a theoretical rationale for art therapy interventions delivered to patients and their family members in the process of hospice palliative care.

• Journal of Hospice and Palliative Care
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• 제24권1호
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• pp.36-45
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• 2021

Purpose: This study examined the relationship between Knowledge of Life-sustaining Treatment Plans and Attitudes toward Withdrawal of Life-sustaining Treatment among nursing college students, and attempted to identify the mediating effect of Role Perception on Life-sustaining Treatment in that relationship. It is hoped that the findings will ultimately contribute to the development of active nursing strategies. Methods: The participants were 142 nursing college students in the third and fourth years of study who had experienced clinical practice at two universities in cities Y and C. Data were collected from November 1 to 30, 2019. For data analysis, SPSS for Windows version 22.0 was used to calculate descriptive statistics, the t-test, Pearson's correlation coefficients, and multiple regression. To analyze the mediating effect, the Baron and Kenny bootstrapping method was used. Results: Attitudes toward Withdrawal of Life-sustaining Treatment of nursing college students had a significant positive correlation with Knowledge of Life-sustaining Treatment Plans (r=0.34, P<0.001) and Role Perception on Life-sustaining Treatment (r=0.44, P<0.001). Role Perception on Life-sustaining Treatment partially mediated the relationship between Knowledge of Life-sustaining Treatment Plans and Attitudes toward Withdrawal of Life-sustaining Treatment (95% CI, 0.446~1.055). Conclusion: Based on the results of this study, improving nursing college students' Role Perception on Life-sustaining Treatment could be used as a coping strategy to establish positive Attitudes toward Withdrawal of Life-sustaining Treatment.

• Journal of Hospice and Palliative Care
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• 제25권1호
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• pp.25-41
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• 2022

Purpose: This study investigated trends of nursing research on life-sustaining treatment in South Korea. Methods: The period for data search was set from January 2018 to December 2020. The major search terms used were advance directives and life-sustaining treatment. Of the 492 records identified in the initial search, 461 articles were excluded for various reasons. A total of 31 records were included in the final qualitative analysis. Results: Sixteen studies had nursing students as study subjects, while nine studies had nurses as study subjects. The majority of the studies employed cross-sectional descriptive surveys as their research design. The major themes that emerged from the studies were as follows: attitudes toward withdrawal of life-sustaining treatment, knowledge of and attitudes toward advance directives, perceptions of a good death, and nurses' attitude toward life support care. Most of the studies reviewed concluded that attitudes toward withdrawal of life-sustaining treatment significantly impacted both knowledge of and attitudes toward advance directives and perceptions of a good death. Conclusion: To date, Korea still lacks extensive nursing research concerning life support care. Further research is needed to provide systematic education for nursing ethics and life support care, as well as the introduction of a specialist course. Furthermore, a multidisciplinary approach is necessary to provide diverse support systems and policy measures. In particular, since nurses are directly responsible for providing life support care, nurses' roles should be expanded in accordance with the Act on Decisions on Life-Sustaining Treatment.