• Title/Summary/Keyword: 완화의학

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호스피스 완화요법으로서의 미술치료

  • An, Jeong-Hui
    • 한국호스피스완화의료학회:학술대회논문집
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    • 2003.12a
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    • pp.217-227
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    • 2003
  • 신체적 질병의 심리적이고 신체적인 측면을 위한 미술치료의 사용은 여러 가지 이유로 확대되었다. 그 이유로는 대체의학에 대한 관심과 이미지를 제작하는 창조적인 과정이 심각한 질병과 싸우는 사람들에게 효과적인 치료라는 인식의 확산을 들 수 있다. 미술치료는 사람들이 고통과 몸을 쇠약하게 하는 그 밖의 증상들과 대결하도록 도와 감정과 신체적 증상들의 정체를 밝히고 그들이 의학적 치료에 능동적으로 참여하게 한다(1998, Cathy A. Malchiodi), 완화의학이 삶이 제한된 질환을 가진 환자 삶의 질을 최대한 높이는데 목적을 두고 연구하며 치료하는 의학의 한 전문분야로서 질환의 초점을 완치에 두는 것이 아니라 통증과 증상 조절 등 완화에 두고 의학적 문제뿐만 아니라 정신사회적, 영적인 문제까지 해결하는데 관심을 둔다면 예술치료의 한 분야인 미술치료는 그 대안이 될 수 있다.

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호스피스와 완화의료

  • Hong, Yeong-Seon
    • Health and Mission
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    • s.3
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    • pp.21-26
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    • 2005
  • 정부 당국이 정책적으로 호스피스 제도를 완비하고 문제점을 보완하는 노력이 필요한 때가 도래했다. 말기암 환자의 삶을 편안하게 하고 인간 존엄성을 끝까지 유지하기 위한 호스피스 및 완화의학의 필요성이 절실히 요청되는 의료환경을 직시해야 한다.

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Panperitonitis with Advanced Gastric Cancer - Based on Seminar of Korean Family Medicine Palliative Medicine Research Group - (진행된 위암 환자에게 발생한 범복막염 치료의 완화의학적 접근 - 대한가정의학회 완화의학연구회 세미나를 기초로 하여 -)

  • Jung, Yun-Joo;Kim, Dae-Kyun;Choi, Youn-Seon;Korean Palliative Medicine Research Group, Korean Palliative Medicine Research Group;Shim, Jae-Yong
    • Journal of Hospice and Palliative Care
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    • v.9 no.1
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    • pp.35-39
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    • 2006
  • A 77-year-old female presented panperitonitis due to advanced gastric ranter during palliative care. In the case of panperitonitis following obstruction or perforation, surgical treatment is vital to avoid fatal sepsis and dehydration. However, the risk of surgery and the residual life of a patient must be carefully considered because of high mortality and complication rate in those patients with advanced disease due to the poor condition. The therapeutic value of aggressive hydration, nasogastric tube insertion, and the use of antibiotics is also questionable. Palliative surgery was not performed on this case, and she passed away peacefully in the presence of family after 4 days of palliative medical care. Here is the appropriate management for this kind of patients we would like to recommend through review of relevant references and long discussions. Firstly, we need to predict survival time using clinical variables. Secondly, considering patient status and risk of surgery, non surgical palliative care such as pain control, transient nasogastric tube insertion, and parenteral hydration is recommended. Minimal use of fluid is desirable to minimize complications such as edema and dyspnea if massive hydration in the beginning of treatment is not proved to be effective. Even though started earlier in the course of disease, discontinuation of antibiotics could be discussed with patients and their caregiver if patient status is not improved.

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The Assessment Tools in Palliative Medicine (완화 의학에서의 평가도구)

  • Gwak, Jung-Im;Suh, Sang-Yeon
    • Journal of Hospice and Palliative Care
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    • v.12 no.4
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    • pp.177-193
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    • 2009
  • The assessment of patient status in palliative medicine is essential for determining treatments and for clinical outcomes. The objective of assessment tools is to raise the quality of care for individual patients and their families. There are a number of tools available to assess pain, non-pain symptoms and quality of life. The tools are either uni-dimensional or multi-dimensional measures. Unfortunately, however, no single tool is recommended to be a superior to others in symptoms or quality of life assessment. Therefore, to select an appropriate assessment tool, one should consider the time frame and unique characteristics of tools depending on purpose and setting. The combination of prognostic index is highly recommended in prognostication, and web-based prognostic tools are available. Recently, a new objective prognostic score has been constructed through multicenter study in Korea. It does not include clinicalestimates of survival, but includes new objective prognostic factors, therefore, anyone can easily use it. For beginners in palliative medicine, relatively easy-to-use tools would be convenient. We recommend Eastern Cooperative Oncology Group performance status to assess functional status, numeric rating scale for pain assessment and the Korean version of brief pain inventory for initial pain assessment. Asking directly with numeric rating scale or the Korean version of MD Anderson Symptom Inventory would be desirable to assess various symptoms together. We think that European Organization Research and Treatment Quality of Life Questionnaire Core 15 for Palliative Care is good to assess the quality of life, while Objective Prognostic Score is convenient as prognostic index for beginners.

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