• The Journal of the Korea Contents Association
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• v.13 no.9
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• pp.334-343
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• 2013

This study was conducted to examine the readiness for death and death anxiety among hospitalized cancer patients. A convenience sample of 183 cancer patients admitted to four hospitals in Korea was recruited for this study. Data were collected in 2010. Collected data were analyzed with descriptive statistics, independent t-test, one-way ANOVA, and Pearson's correlation coefficient. The mean scores of readiness for death and death anxiety were 1.99(${\pm}0.69$) and 2.21(${\pm}0.59$) out of 4, respectively. 'Psychological readiness' showed the highest mean score among the death anxiety domains, and 'dying process' had the highest mean score among the death anxiety domains. No statistically significant correlation was found between readiness for death and death anxiety. Readiness for death was statistically significantly different according to age, afterlife beliefs, stage of cancer, duration of disease, and number of symptoms. Death anxiety showed significant difference according to faith in God and afterlife beliefs. Distress in the process of dying needs to be managed for cancer patients and spiritual interventions should be considered to relieve death anxiety.

• Journal of the Korea Convergence Society
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• v.10 no.6
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• pp.393-399
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• 2019

This is a descriptive study on the perception and attitude toward DNR in adults. Structured questionnaires were used and 210 subjects were studied. In recognition of DNR, DNR was helpful for 'a comfortable dying(64.3%)'. The need for DNR in situation investigated 'For dignified dying (41.3%)' and 'to alleviate patient suffering(23.9%)'. Respondents who do not agree with DNR are shown 'Because legal issues can arise(61.7%)', 'Because human dignity is the life-sustaining priority(16.7%)'. In the attitude toward DNR, the most significant result was 'I want to know if I have an incurable disease (4.21).' There was no difference in attitudes toward DNR among adults. The DNR is not a method of Withdrawing in lifeprolonging treatment, It should be addressed in a comprehensive context in which human beings exercise autonomy over the process of dying and death.

• The Journal of the Korea Contents Association
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• v.18 no.6
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• pp.180-192
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• 2018

Purpose: This study is aimed to identify the ethical issues and needs for ethical education of nurses in long-term care hospitals. Methods: Data were collected in 2015. Participants were 142 nurses working in nine long-term care hospitals. The Ethical Issues in Clinical Practice Tool was used. Data analysis was performed using SPSS WIN 24.0. Results: The degree of experienced ethical issues was 1.23 out of 3, and 'Providing care with a possible risk to your health' was an ethical problem most frequently experienced in nurses. In addition, the ethical problem that the nurse most disturb was identified by 'Determining when death occurs'. The degree of needs for ethical education was 3.11 out of 4, and the highest ethical topic was 'Legal/ethical issues in the use of restraints'. Ethical issues and needs for ethical education were not statistically significant differences according to the characteristic of participants. Conclusion: In this study, we identified the ethical problems and necessity of ethics education experienced by nurses working in long-term care hospitals. The results of this study can be used as basic data for the development of customized ethical education contents for nurses in long-term care hospitals.

• The Korean Nurse
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• v.23 no.3 s.126
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• pp.44-50
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• 1984

한국여성은 전통적으로 대가족제도 속에서 육아 및 가사활동에만 종사해왔다. 그러나 산업화 및 사회구조의 변화로 여성들도 교육의 기회를 갖게 되었으며 전통적인 역할 수행에 대한 가치변화와 함께 여성의 사회적 역할을 필요로 하게 되었다. 반면에 가족 형태가 핵가족화 함으로서 가족 내에서의 자녀양육을 비롯한 가정적 역할이 더욱 중요시 되게 되었다. 오늘날 한국사회는 여성에게 현재의 사회구조와 핵가족 속에서는 시간적으로 동시에 수행할 수 없는 두 가지 상반된 역할을 강조하고 있는 것이다. 이러한 상반된 역할사이에서는 여성은 갈등과 좌절감을 느끼게 되며 이중적인 부담 속에서 생활하게 되었다. 본 원고에서는 전통적인 한국의 가족가치관을 살펴보고 건강관리 측면에서 여성의 역할을 살펴보고 건강관리 측면에서 여성의 역할을 살펴보고자 한다. 전통적 가족가치관과 여성-우리나라의 전통적 가족은 부계 중심의 혈연 계승을 중요시하는 가부장적 대가족제도라 할 수 있다. 따라서 부계 계승을 통한 가족의 영속성과 가 중심사상에 기반을 둔 철저한 가족주의적 가치관이 전통적 사회를 지배하여 왔다. 그러므로 자연히 개인보다 가족집단이 우의적인 지위에 있을 뿐만 아니라 모든 행동의 결정에도 중요한 준거 집단이 되었다. 이러한 가의 영속 및 번영을 가장 효과적으로 수행하기 위해서는 많은 자녀를 필요로 했으며 부계중심 가족에서 자연히 남아 선호사상이 강할 수밖에 없었으며 이것은 조상에 대한 의무요 책임이라 생각했다. 이러한 가부장권의 확대에 반비례해서 가정 내에서 여성의 지위와 역할은 축소되어갔다. 여성들의 절대적인 예속을 필요로 하여 삼종지도니 칠거지악이니 불경이부등의 도덕률을 만들었으며 여성들 스스로가 이러한 정절과 복종을 미덕으로 생각하도록 교육받음으로서 여성들 자신이 자기희생의 굴레 속에서 인내와 복종의 생활을 운명처럼 받아들이게 되었으며 남편과 자식을 위해서는 목숨까지도 희생하게끔 철저히 사회화되었던 것이다. 그러나 가족 제도 안에서의 남녀의 지위는 동위 항렬 내에서만 해당되고 항렬을 달리할 때는 삼종지도의 이론에 부합된다. 어머니로서의 존장련이 인정되어서 가정 내에서의 여성의 종속적인 지위에 비하여 모의 권한은 절대적이었다. 상례와 제례에서 어머니와 아버지에 대한 의식에는 차이가 없으며 내외 명부제도에 의해서 부인도 남편과 똑같은 대우를 받도록 되어있다. 이러한 존장련에 의한 모의 권리와 더불어 부부유별에 의해서 가사권의 독자적인 결정권도 인정되고 있었다. 건강관리 측면에서 여성의 역할- 전통적으로 건강관리에 관련된 한국여성의 역할은 1. 씨받이로서의 역할로 생명을 잉태하도록 돕고 건강한 아이의 수태를 위해 태교에 힘썼으며 2. 자녀의 의식주를 해결하는 가사 역할만을 담당하는 전통적인 여성의 역할만을 수행하였으며 출산한 생명을 건강하게 자라도록 건강관리를 철저히 하였으나 체계적인 건강관리는 되지 못하였으며 특히 식생활에 유의하였으나 정서, 사회면은 도외시 한 과잉보호현상이었다. 3. 결혼 후에는 남편의 건강관리를 위해 철저하였으며 특히 식생활에 유의하였고 정서적으로 부담을 주지 않도록 유념하였다. 4. 또한, 임종시 평안한 죽음을 맞도록 도왔다. 전통적으로 한국여성의 역할은 돕는 역할이었다.

• Journal of Hospice and Palliative Care
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• v.16 no.2
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• pp.90-97
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• 2013

Purpose: Ten years have passed since the Korean government announced its plan to institutionally support hospice and palliative care in 2002. In line with that, this study aims to suggest future directions for Korea's hospice and palliative care policy. Methods: We conducted a survey on people's perception and acceptance of well-dying. Data were collected from 1,000 participants aged 19~69 years between June 1 and June 11, 2012 via computer-assisted telephone interviews. Results: The most important factor for well-dying was placing no burden of care on others (36.7%) and the second most important factor was staying with their family and loved ones (19.1%). Among nine suggestions of policy support for well-dying, the most popular was the promotion of voluntary care sharing (88.3%), followed by the palliative care training support for healthcare providers (83.7%) and the support for palliative care facilities instead of funeral halls (81.7%). The idea of formulating a five-year national plan for end-of-life care drew strong support (91%). According to the survey, the plan should be implemented by the central government (47.5%), the National Assembly (20.2%) or civic groups (10%). Conclusion: This study demonstrated the public consensus and their consistent direction toward policy support for well-dying. Results of this study may serve as a foundation for the establishment of policy support for people's well-dying and palliative care at the national-level.

• Journal of Hospice and Palliative Care
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• v.11 no.3
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• pp.147-155
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• 2008

Purpose: This study aimed to assess the educational needs for nurses who care for terminal cancer patients and their families. To identify top needs along with key issues in consideration to develope hospice training program and provide specific recommendations. Methods: A cross-sectional design with nurses from nine universities' hospice specialist courses and seven cancer centers was used. Data were collected via e-mail or mail service from March to April in 2008. One hundred seventy three questionnaires were returned (return rate: 73.6%), and 156 questionnaires were eventually analyzed. The questionnaire consisted of Mason and Ellershaw's The Self-efficacy in Palliative Care (SEPC) and self-reporting confidence and educational needs in hospice care. Results: The mean age of the participants was 37.94 years, 82.1% were staff nurses, and 44.9% completed over six months hospice education. Mean$\pm$standard deviation score for total SEPC was $2.67{\pm}.62$, which was lower than average (score 3), with communication score being the lowest ($2.49{\pm}.69$). The lowest self-reporting confidence score was $2.03{\pm}.77$ in hospice administration and management, followed by providing complement therapy ($2.34{\pm}.77$), bereavement care ($2.34{\pm}.71$), lymph edema management ($2.35{\pm}.79$), and care planning ($2.36{\pm}.81$). The participants reported that additional education is needed in all topics, with pain management score being the highest ($3.71{\pm}.50$), followed by pain and symptom evaluation ($3.67{\pm}.52$), care for dying ($3.67{\pm}.52$), and communication and counseling ($3.63{\pm}.53$). There were significant subgroup differences in SEPC and self-reporting confidence between groups who completed 6 months hospice education or not, however, no significant difference in educational need between the groups. Conclusion: This study showed the need for developing hospice training program to improve compentency of nurses in hospice palliative care.

• Journal of Hospice and Palliative Care
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• v.10 no.3
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• pp.137-144
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• 2007

Purpose: The purpose of this study is to identify and assess the needs of the cancer patients and their families and provide basic data to meet with their needs. Methods: This is a descriptive study using questionnaire method. Questionnaire were collected by mail from 76 discharged patients from a hospice ward from May until the end of October, 2004, and data were analyzed by SPSS 10.0. Results: Admitted patients had needs of pain control (85.5%), non-pain symptoms (63.2%) such as vomiting, dyspnea, ascites, etc, and emotional and spiritual problem solving (28.9%, 14.5%). Interests of patients were health care of himself/herself (65.8%), concern for their spouses left alone (32.9%), and future of their children (15.8%). In families' needs of care of 5 areas, "information on patient's status and treatment/nursing care" was shown most high score ($3.48{\pm}0.62$). In detailed questions, they request most 'to inform the prognosis of patients' and the next is 'to inform the reasons that nursing care was required'. The next highest score was to 'inform family roles' ($3.39{\pm}0.64$), and next was spiritual support ($3.11{\pm}0.79$), and emotional support ($3.08{\pm}0.72$). Expectations of family on the treatment were comfortable dying (73.4%) scored the highest. Patients' families were satisfied with volunteer service most in service area (97.4%). The next was pain control (89.5%) and nursing service (77.6%). Conclusion: Health care staff should identify the actual needs of families caring cancer patients and they should operate realistic programme which can give continuous and assistance by reflecting individual needs and characteristics. With these srategies, the quality of life of patients and families can be improved. And then the intervention programme should be developed to measure subjective nursing care needs of terminally ill cancer patients and their families.

• Journal of Hospice and Palliative Care
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• v.2 no.2
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• pp.91-100
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• 1999

Purpose : This study was performed to investigate the satisfaction in the hospice services provided for inpatient families and bereaved families whose members had been admitted to the hospice unit at Kangnam St. Mary's Hospital to improve the quality of care for the terminally ill patients and their families. Methods : This sample consisted of 33 families of hospice patients during the period of April to lune, 1998 and 30 bereaved families whose patients had died from March, 1993 to March, 1998. The data were collected through a self-report questionnaire and analyzed using t-test and ANOVA. Results : 1) The satisfaction level of inpatient families and bereaved families showed the mean value of 3.5 where the highest value is 5.0. 2) According to age, the level of satisfaction of inpatient families had significant differences in the fields of hospice philosophy, support for the family, medical management and nursing management(P=0.0001). The level of satisfaction of bereaved families showed significant differences in the field of support for the family, medical management, nursing management, and facilities of the hospice unit(P=0.0001). 3) By family relationship, the level of satisfaction of inpatient families had significant differences in the fields of hospice philosophy, support for the family, medical management and nursing management (P=0.0001). 4) According to religion, the level of satisfaction of inpatient families had significant differences in the fields of hospice philosophy, support for the family and nursing management (P=0.0001), but there was no significant difference for the bereaved families. Conclusions : The findings of this study showed that hospice services had positive influence on families with terminal disease such as cancer. To improve the level of satisfaction in the hospice services for families with hospice patients, we need to provide care by an interdisciplinary hospice team approach, and to assess needs of the families according to their socio-psychological characteristics. Further studies need to be conducted with large samples.

• Research in Community and Public Health Nursing
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• v.9 no.1
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• pp.143-162
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• 1998

This is a study for the construction of nursing care based upon the Korean attitude toward medicine. Factors which were investigated include the source of nursing care, the reason for choosing care, the type of heath care chosen, the accessability of caregivers, and the desired location of death. The population examined in this study consisted of 517 adults distributed in six large cities and 191 adults from five rural communities. Data was analyzed using frequency, percent, Cronbach alpha, $X^2$ - test, t - test, F - test and scheffe post hoc contrast with an SAS program. The results of this study are summarized as follows: 1. Among sources of nursing care used, first rank rated-pharmacy(54.4), private hospital(18.2), general hospital(8.4), folk remedies in house (5.0), chinese hospital(2.8), prayer(2.8) and others(8.4), and the reasons for choosing nursing care rated 'the easiest method' (63.6), 'the best method'(15.7), 'reliable'(10.8) and 'lower cost burden'(4.6) in order of preference. 2. The type of nursing care chosen rated western medicine(6.80), chinese medicine(6.15), folk remedies(5.46), faith remedies(3.51) and divination remedies (1.41). There were significant differences in the effect recognition degree to various kinds of medicine. 3. The difference of the type of nursing care chosen according to general characteristics showed that urban residents were higher than rural community residents(t=2.15, p=0.0320) in western medicine, and urban residents, women, and singles were higher than rural community residents(t=2.04, p=0.0414), men (t= -2.89, p=0.0039), and married(t=2.50, p= 0.0126) on folk remedies. With repect to age and education those 21-30, under 20 and 31-40, graduated from college and graduate school were higher than above 51, above 61 (F = 7.76, p = 0.0001), graduated from elementary school(F=4.39, p=0.0006) on folk remedies. In other categories, rural community residents, women, younger people. Christians were higher than urban residents ( t = -2.73, p=0.0305), men(t= -4.15, p=0.0001), older people (F=2.48, p=0.0307), Catholic, Buddhist, or atheist (F= 70.18, p=0.0001) on faith remedies. Those graduated from high school and Buddhist were higher than unschooled, graduated from middle school(F=3.18, p= 0.0075), atheist, Catholic or Christian(F=18.32, p=0.0001) on divination redemies. There were significant differences concerning age and education level. 4. The accessibility of caregivers rated 'caregivers should be nearby if the patients need them' (50.0), 'caregivers must be there all day (24 hours)' (39.6), 'caregivers must be there at night only'(5.0), 'caregivers must be there during the day only'(2.6), 'caregivers always should visit during visiting hours' 0.4), 'caregivers don't need to be there at all' (1.2). The frist rank of suitable caregivers were rated as spouse(66.6), mother(24.2), daughter (3.6), daughter-in-law(1.9), and the reasons of thinking thus were rated as 'the most comfortable' (81.5), 'people should correctly with regards to family they'(7.1), 'the easiest' (5.4), 'take good care of the patient' (5.1) and 'lower cost burden' (0.4). 5. The desired location of death rated as the following: his/her house (91. 6) to the hospital(8. 4). A person going to encounter death in the hospital wanted his house(78.5) over the hospital(21.5), and a person dieing in the hospital prefered his house(52.9) over the hospital(47.1) as a funeral ceremony place. The following suggestions are made based on the above results. 1. A sampling method that enhances the re presentativeness should be used in regional and/or national related research and replicated to confirm the result of this study. 2. This study should be used to understand the Korean view of medical centers and to meet the expectations of patients in Korean nursing. 3. Research on the Korean traditional view of humans and expectations of the sick, health and illness, and health behavior, the perception of dying, the decision to heal, and the view of general medicine should continue to be conducted continuosly so that Korean nursing theory can be advanced on these concepts.

• Journal of Korean Academy of Nursing
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• v.4 no.1
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• pp.162-178
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• 1974

The present study is purported to provide a basic information to be utilized by nurses to care and attend effectively for patients nearing the moment of death. Therefore, the primary purpose of the study has been placed upon grasping an understanding of the trends of death in general. For this purpose: 1. By utilizing the schneidman questionnaire, the trend of death has been categorized by 6 parts and analyzed. 2. A search has been conducted to find out dying patient's needs, nurse's attitudes viewed by the patient, and nurse attitudes to dying patient. The followings are itemized results of analysis: 1. Analysis by the schneidman questionnaire. (1) In general concepts of death. the first sighting of the occurrence of death was experienced upon strangers, grandfather and great grandfather. The death is openly discussed among people of all ages and sex. Ages in which the death is mostly feared were from 12 to well over 70 yews old that are evenly distributed regardless of difference in age. (2) As to the attitudes toward death the occurrence of death to most closely associated person influenced most upon the attitude of their own termination of lives. Among the reading materials, the maximum influence was effected by the Bible. In terms of religion, the thoughts of death were Influenced by religions education in case of the believers of the western religions (36%), and by their own health and physical conditions in case of the believers in the oriental religions (35%). In case of non-believer, their attitude toward death were largely determined through their own thinking meditation (45%). People aged 20 or thereunder revealed that they wished to know the day of their own death to be occurred (58%). However, the older the less thor wanted to know. (3) As to the choosing the time of death, 57% preferred senility, and 30% preferred the time in mediately following the prime period of their lives in general. In terms of religion, 85% of the believer in the oriental religion preferred senility, and 67% in the western religion, 58% in others, Therefore. the desiring of their lives to be terminated in earlier stage, not by the natural senility. sequenced as follows : Others, western religions and oriental religions. (4) Referring to the disposal of the corpse under the assumption that it had already occurred, majority desired the burial system. There has been seen a slight tendency to consider the importance of holding funeral services for the sake of survivors. Concerning the life insurance policy, it showed that the nurse had less belief in it than the patient (5) Upon the subject of life-after-death. religion wise, 72% of western religion believers preferred to have an existence of life-after-death: Among the believers of oriental regions, 35% desired this category, 30% did not mind either way. and 35% did not desire the existence of such a life-after-death. In others, 53% did not mind whether or not such a life existed. (6) In general, serious thoughts were not being attended to the commitment of suicide. 37% emphasized that such an act should be prevented. However, 30% insisted that such commitment should not be bothered, and that society possesses no right to prevented it. More male wished to commit suicide (13%) than females (9%). 2. Nurse's attitudes toward terminal patients and patient's needs. In the instance where the patient realized that their death is imminent, most of them showed desire to discuses mainly on the problems of life. When faced a situation of this nature, it is revealed that 40% of nurses could not furnish appropriate care for them.