• 제목/요약/키워드: 호스피스간호

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일 지역 보건소 등록 호스피스 완화돌봄 대상자의 특성 및 증상 분석 (Analysis of Characteristics and Symptoms in Home-Based Hospice-Palliative Care Patients Registered at Local Public Health Centers)

  • 최순옥;김숙남
    • Journal of Hospice and Palliative Care
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    • 제18권4호
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    • pp.329-334
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    • 2015
  • 목적: 본 연구는 보건소에 등록된 재가 호스피스 완화돌봄 대상자의 특성과 증상을 분석하는 것이다. 방법: 부산광역시 소재 6개구 보건소에 등록된 호스피스 완화돌봄 대상자 144명의 초기 방문기록지(호스피스대상자 등록카드, 초기 통증평가지, 초기 통증 외 증상평가지)를 후향적으로 분석하였다. 결과: 대상자의 평균 연령은 67.7세이었으며, 혼자 사는 대상자가 46.2%, 교육정도는 중졸 이하가 65%였다. 종교는 불교가 36.3%로 가장 많았고, 47.5%가 의료급여 대상자였다. 진단명은 폐암, 위암, 간암의 순이었고, 기능 상태는 일상생활이 어려운 경우가 48.9%로 나타났다. 등록 당시 암 치료 중인 대상자는 39.6%이었고, 84.5%가 말기상태를 인지하고 있었다. 대상자들의 83.6%에서 통증을 호소하였으며, 그 중 36.5%에서 중간정도 이상의 통증을 호소하였다. 통증 외 증상에서 가장 많은 대상자가 호소하는 증상으로는 피로(84.7%)였으며, 피로를 호소하는 대상자의 49.3%가 중증의 증상을 호소하는 것으로 나타났다. 결론: 본 연구결과 재가 호스피스 완화돌봄 대상자들은 사회경제적 취약군으로, 중간정도 이상의 통증과 통증 외 증상을 호소하는 대상자가 많았다. 따라서 재가 호스피스 완화돌봄 대상자의 효율적인 관리를 위해서는 대상자 특성에 따른 차별화된 통합적 전략이 필요하다.

호스피스 병동 입원 환자의 삶의 질 변화 (Quality of Life Changes in Patients Admitted to the Hospice Unit)

  • 박테레지아;송혜향;서인옥;조영이;박명희;허정희;김은경;박순주;라정란
    • Journal of Hospice and Palliative Care
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    • 제3권1호
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    • pp.18-27
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    • 2000
  • 목적 : 본 연구는 강남성모병원 호스피스 병동에 입원한 환자들의 입원 시 삶의 질과 간호서비스를 받는 동안 삶의 질 변화와 호스피스 간호서비스가 말기환자의 삶의 질에 미치는 영향을 알아보고자 시도하였다. 방법 : 1999년 10월부터 2000년 3월 사이에 가톨릭 대학교 강남성모병원 호스피스 병동에 입원한 환자와 가족 100명을 대상으로 연구자가 수정, 보완하여 개발한 설문지를 통해 자료를 수집하였고, 수집된 자료는 repeated measures ANOVA로 분석하였다. 결과 : 1) 간호제공자에 의해 인지된 환자의 삶의 질 평점은 입원시, 입원 1, 2, 3, 4주에 각각 3.31, 3.68, 3.56, 3.73, 3.75로 입원 당시보다 시간이 지남에 따라 유의하게 향상되었고, 입원시점에 따라 항목별로 살펴 볼 때 "신체적 청결"(F=6.50, P=0.0001) "통증조절"(F=18.01., P=0.0001) "대변상태"(F=2.96, P=0.0237) "수면상태"(F=3.99, P=0.0048) "메스꺼움/구토"(F=4.50, P=0.0022) "의료진의 편안한 돌봄"(F=3.95, P=0.0051) "가족들의 돌봄"(F=2.76, P=0.0317) "불안감"(F=3.14, P=0.0177) "마음이 편안함"(F=3.63, P=0.0085) "인간적인 대우"(F=3.32, P=0.0136) "죽음이 끝이 아니라 새로운 시작이라고 생각함"(F=2.54, P=0.0450) 등의 항목에서 유의한 차이가 있었다. 2) 환자 자신에 의해 인지된 삶의 질 평점은 입원 시와 입원 1주에 각각 3.63, 3.83으로 향상되었지만 유의한 차이는 보이지 않았다. 입원시점에 따라 항목별로 살펴볼 때 "통증조절" 항목만이 유의한 변화를 보였다. 3) 사망시점으로부터 삶의 질 평점은 사망 5주전, 4주전, 3주전, 2주전, 1주전에 각각 3.48, 3.51, 3.44, 3.46, 3.50이었으며 유의한 차이는 없었다. 결론 : 본 연구의 결과 호스피스 서비스는 말기 환자의 삶의 질에 긍정적인 영향을 주는 것으로 보여졌다. 따라서 호스피스 서비스의 질 향상을 위해 호스피스 환자들을 지지해 줄 중재방안을 모색해야 하며, 특히 간호의 영적 영역에 초점을 두어야 하겠다. 또한 말기 환자의 주관적인 삶의 질 측정을 위해 도구개발이 이루어져야 하며 대상자를 확대하여 계속적인 연구가 있어야 할 것으로 생각된다.

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가정 호스피스 대상자와 일반 가정간호 대상자에게 제공된 간호중재 비교 (A Comparison between Home Care Nursing Interventions for Hospice and General Patients)

  • 용진선;노유자;한성숙;김명자
    • 대한간호학회지
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    • 제31권5호
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    • pp.897-911
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    • 2001
  • The purpose of the study was to compare home care nursing intervention activities analyzed by the Nursing Intervention Classification (NIC) system for hospice and general patients. Method: For the descriptive survey study, data was collected by reviewing charts of 151 hospice patients and 421 general patients who registered in the department of home health care nursing at K Hospital. Results: According to the NIC system application, there were 2380 total nursing interventions used for the hospice patients and 8725 for the general home care patients. For both sets of patients (hospice vs. general), the most frequently used nursing intervention in level 1 was the Physiological: Complex domain (40.13 vs. 31.06 percent), followed by the Safety domain; in level 2, the Risk Management class (28.4 vs. 27.70 percent), followed by Tissue Perfusion Management; and in level 3, Vital Sign Monitoring (6.18 vs. 4.84 percent), followed by Health Screening. Conclusion: The study showed that there was a lack of specialized hospice nursing interventions such as emotional, family and spiritual support, and care for dying hospice patients.

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가정호스피스 간호중재 표준서에 의한 임상간호활동 분석 (Analysis of Clinical Nursing Activities Using Home Hospice Nursing Intervention Standards)

  • 용진선
    • 성인간호학회지
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    • 제20권6호
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    • pp.960-972
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    • 2008
  • Purpose: The purpose of this study was to validate the nursing intervention standards of home care to home care setting for a guide in giving quality care to home hospice patients. Methods: The developed nursing standards were applied to 79 home hospice patients at K hospital, C university. Data were collected through the developed nursing intervention standards of home care with 19 selected nursing interventions and 418 associated nursing activities from January to June in 2006. Results: The performance frequency was 509 times for total nursing interventions and 7,815 times for total associated nursing activities. The most frequently used nursing activity was 722 times(9.24%) on teaching prescribed medication, followed by surveillance(718 times, 9.18%), and vital signs & neurologic monitoring nursing intervention(701 times, 8.97%). The highest mean nursing activity performance rate showed on Intravenous therapy(82%), followed by dying care(81%), and vital signs & neurologic monitoring (80%). Among 418 nursing activities, there were three classifications: 168 as core activities, 165 as major, and 85 as accessory activities. Conclusion: The final validated nursing intervention standards can guide home care nurses to perform quality care and contribute to computerized nursing services and request of nursing fees.

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아동간호사의 호스피스·완화의료에 대한 지식, 인식과 임종간호 스트레스 (The relationship between Terminal Care Stress and Knowledge and Perception of Hospice-Palliative Care among Pediatric Nurses)

  • 박은영;방경숙
    • Perspectives in Nursing Science
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    • 제16권2호
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    • pp.55-64
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    • 2019
  • Purpose: This study examined the knowledge and perception of hospice-palliative care and terminal care stress among pediatric nurses, and the relationships among these variables. Methods: In this descriptive research study, 154 pediatric nurses who experienced terminal care at least once were surveyed. This study used three scales, including the Palliative Care Quiz for Nursing (PCQN), Perception of Hospice-Palliative Care, and Terminal care stress. Data analyses using SPSS 22.0 included descriptive statistics, independent t-test, one-way ANOVA, Mann-Whitney U test, Pearson's correlation coefficient, and stepwise multiple linear regression. Results: Terminal care stress experienced by the pediatric nurses was significantly related to the perception of hospice-palliative care; the hospice-palliative care education program enhanced the knowledge and perception of hospice-palliative care. Conclusion: Hospice-palliative care education programs should be developed and provided for pediatric nurses to improve pediatric hospice-palliative care. Additionally, further research on this topic is required because the present results are inconsistent with previous and current researches.

호스피스 자원봉사자의 삶의 질 정도와 관련요인 (Quality of Life and Related Factors in Hospice Volunteers)

  • 한지은;최의순
    • 종양간호연구
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    • 제6권2호
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    • pp.143-151
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    • 2006
  • Purpose: This study was to explore the degree of quality of life (QOL) in hospice volunteers and identify related factors Methods: A total of 243 subjects was recruited from eight hospitals of the Catholic University in Korea. Research tool used to measure QOL was questionnaires developed by You-Ja, Ro in 1988. The data obtained was analyzed using the SAS program to compute a t-test, ANOVA, and Stepwise multiple regression. Results: The mean score of QOL was $3.65{\pm}0.39$. The QOL was significantly increased with perceived health status, satisfaction to the hospice volunteer activity, family response on volunteer activity, qualification as a hospice volunteer, and needs of education. Among six domains of QOL, self-esteem had the highest score. Conclusions: It would be necessary for hospice volunteers to provide an program considered health status, satisfaction to the hospice volunteer activity, family response on their activity, qualification as a hospice volunteer, and needs of education to increase their QOL.

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호스피스환자 가족을 위한 지지적 교육프로그램의 효과 (Effect of Supportive Education Program for Hospice Patients's Family)

  • 이태연;권윤희
    • 한국간호교육학회지
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    • 제20권2호
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    • pp.175-183
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    • 2014
  • Purpose: The aim of this study was examine effects of fatigue, anxiety, depression, social support, and spiritual well-being of supportive education program for hospice patients's family. Method: Using a non-equivalent control group pre-post quasi-experimental design, 70 study subjects were assigned into two groups, experimental group (n=35) and the control group (n=35). Measures were fatigue, state-anxiety, depression, social support, and spiritual well-being to test for the effects of supportive education program for hospice patients's family. Data analyzed using $x^2$ test, t-test with SPSS/WIN 19.0 version. Results: The experimental group receiving supportive education program for hospice patients's family had a significant changes of fatigue, state-anxiety, depression, social support, and spiritual well-being. Conclusion: The supportive education program for hospice patients's family is an effective intervention to enhance social support and spiritual well-being and to decrease fatigue, anxiety and depression.

호스피스 자원 봉사자들의 암 환자 돌봄에 대한 경험 (Hospice Volunteer's Experiences in Caring for Cancer Patients)

  • 김분한;김윤숙;정연
    • 종양간호연구
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    • 제5권2호
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    • pp.79-86
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    • 2005
  • Purpose: This study was explored the meaning of hospice volunteer's experience in caring for cancer patients and tried to understand their experiences. Method: The data was collected from 7 participants living in Seoul and Gyeonggi province from Jan. to Apr. 2005. Collection of data was by means of in-depth interviews. The analysis of the data was made the phenomenological analytic method suggested by Colaizzi(1978). Result: The result is consisted of nine theme-cluster; experienced a fear, limitation of activity, experienced social care, experienced physical care, good death, experienced necessity of recharging, experienced bereavement care. Conclusion: The result above indicated that health professionals must develop the management and education of volunteer of hospice care for various hospice care. Also, We should to encouraged the continuous education and efficient management. And support system should be developed.

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입원한 말기 암환자 가족의 호스피스 요구 (Needs of Hospice Care in Families of the Hospitalized Terminal Patients with Cancer)

  • 손수경
    • 종양간호연구
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    • 제9권1호
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    • pp.1-6
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    • 2009
  • Purpose: The purpose of this study was to identify the needs of hospice care in families of the hospitalized patients with terminal cancer. Method: The data were collected from April to July, 2008. The participants were 100 family caregivers of hospitalized terminal patients with cancer recruited from two general hospitals in 2 cities in Korea. Needs of hospice care were measured using the 'Needs Assessment Instrument for Hospice Care in Families of the Patients with Cancer'. Results: The mean of needs score was 76.6, which meant degree of the needs was very high. Among the categories of the needs, the mean of category 'emotional care' was the highest. There were significant differences in the needs of hospice care according to sex and type of present therapy. Conclusion: Health care providers in hospital and hospice facilities must assess the needs of families as well as the patients in order to meet their specific needs. Additionally, they need to have deeper understanding of the need of emotional care and to apply emotional care to hopice patients and their families.

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암환자의 심리사회영적 간호

  • 최화숙;김수지
    • 호스피스학술지
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    • 제6권1호
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    • pp.24-31
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    • 2006
  • Psycho-social-spiritual care should be included with comprehensive nursing care of cancer patient. Because of human being have four dimensions as physical, psychological, social and spiritual dimension and they do interactional relationship with themselves, others and God. So caregivers of cancer patient have to recognize what they have psycho-social-spiritual needs and have to consider how caregivers can combine these in comprehensive nursing care. Cancer patient will be experienced shock, feeling of crisis and fear of death and will be showed denial, anger, bargaining, depression, accept or give-up, hope, spiritual distress and spiritual needs to which help them to do some rituals or interactions according their religion. Loving attitude is essential of cancer patient care especially of psycho-social-spiritual care. Dr. Kim and her some colleques investigated about this and find out 10 concepts(Caring Behaviors) by Graunded Theory Methodology. They are Noticing, Participating, Sharing, Active Listening, Complimenting, Companioning, Comforting, Hoping, Forgiving, Accepting.

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