• Title/Summary/Keyword: 호스피스간호

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A Study of Intensive Care Unit Nurses' Understanding of the Meaning of Death, Death Anxiety, Death Concern and Respect for Life (중환자실 간호사의 죽음의미, 죽음불안, 죽음관여도 및 생명존중의지에 관한 연구)

  • Kang, Jeong Hwa;Han, Suk Jung
    • Journal of Hospice and Palliative Care
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    • v.16 no.2
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    • pp.80-89
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    • 2013
  • Purpose: We investigated how intensive care unit (ICU) nurses understand the meaning of death, death anxiety, death concern and respect for life. Methods: From November 2009 through February 2010, a survey was conducted on 230 nurses working at the ICU of 10 general hospitals located in Seoul and Gyeonggi province. Participants were asked to answer a questionnaire consisted of 67 questions under four categories of the meaning of death, death anxiety, death concern and respect for life. Results: Participants scored 4.27 points on their understanding of the meaning of death, 4.43 on death anxiety, 4.12 on death concern and 4.18 on respect for life. Participants' meaning of death was negatively correlated with death anxiety and death concern and positively with respect for life. Participants' positive meaning of death was negatively correlated with death anxiety and death concern and positively with respect for life. Participants' negative meaning of death was negatively correlated with death anxiety and death concern and positively with respect for life. Participants' death anxiety was positively correlated with death concern and negatively with respect for life. Participants' death concern was negatively correlated with respect for life. Conclusion: Compared with nurses who served at ICU for a long time, nurses with less ICU experience scored lower on the meaning of death and respect for life, while they presented high anxiety and concern about death. A training course may help nurses develop their view on the meaning of death, which in turn would enhance their performance in caring dying patients.

The Prayer Experiences of Patients with End-Stage Cancer (말기암환자의 기도 경험)

  • Park, SoonBok Esther;Lee, Won Hee;Oh, Kyong Hwan
    • Journal of Hospice and Palliative Care
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    • v.20 no.1
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    • pp.26-36
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    • 2017
  • Purpose: To explore the meaning of prayer in Korean patients with end-stage cancer who profess Christianity or Buddhism, given the significant differences between these religions. Methods: The Colaizzi (1978) analysis method was employed. In-depth interview were performed with 13 participants (seven Christians and six Buddhists) who were admitted to a University-affiliated hospital in Korea. Results: The six categories emerged: 1) communication with God, 2) mind discipline, 3) spiritual growth, 4) mysterious experiences, 5) perception of death and after-life, and 6) various forms of prayers. Conclusion: The participants' prayer experiences were described in a religious context. Christians believed that prayer is communication with God while Buddhists regarded it as disciplining of minds. Despite some differences between the religious groups, a general meaning of prayer was a desperate desire to solve their health issues by relying on God or someone who is more powerful than themselves. They also experienced personal and spiritual growth through prayer. This study explains the phenomenon of prayer experiences and shows that prayer is an important coping mechanism.

Development of a CD Program Applied Logotherapy for Psycho.Spiritual Care of Late Adolescents with Terminal Cancer (청소년 후기 말기 암 환자의 정서적.영적 돌봄을 위한 의미요법 CD 프로그램 개발)

  • Kang, Kyung-Ah;Kim, Shin-Jeong;Song, Mi-Kyung
    • Journal of Hospice and Palliative Care
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    • v.12 no.2
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    • pp.61-71
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    • 2009
  • Purpose: The purpose of this study was to develop a CD program of applied logotherapy for psycho spiritual care of late adolescents with terminal cancer. Methods: Keller & Song's ARCS theory and a model for developing learning materials was applied to develop this program composed four distinct phases: planning, designing, developing, and evaluation stages. Results: This program was entitled 'Finding meaning in my life' and consisted of 5 sessions and its educational contents were made up as follows: "First Secret" is 'learning three natures of the human mind', "Second Secret" is 'learning creative values first method to find meaning of life', "Third Secret" is 'learning experiential value as second method to find meaning of life', "Fourth Secret" is 'learning attitudinal value as third method to find meaning of life', and "Fifth Secret" is 'Becoming the master of my life'. The sub-menu was made up of 'Beginning', 'Opening mind', 'Learning'. 'Laughing Song', 'Experiencing'. Conclusion: This CD program applied logotherapy with flash animation technique as an emotional and spiritual nursing intervention program for easier and more scientific application in pediatric oncology and hospice care area.

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The Quality of Life Analysis in Patients with Cervical Cancer (자궁경부암 환자의 삶의 질 분석)

  • Kim, Yoon-Sook;Kim, Boon-Han
    • Journal of Hospice and Palliative Care
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    • v.7 no.1
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    • pp.8-16
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    • 2004
  • Purpose: The porpose of this descriptive study was grasp the QOL (Quality of Life) of cervix cancer patient and to analysis QOL (Quality of Life) by stage of disease, type of treatment and de me graphic characteristics Methods: Data were collected from 67 patients with cervical cancer from 3 General Hospitals from March 15 to June 4 using The "QOL (Quality of Life)-Cancer Version" inventory made by Ferrell et al (1995). The data were analysed by using SPSS $PC^+$ program including t-test, ANOVA, and Scheffe test. Results: Progressing stage of disease and QOL, the significant between the progressing stage of disease and QOL was significant (F=5.06, P=.003). The degree of difference between the progresstion of the stage of the disease and each item in the test was physical well-being (F=3.97 P=.012), the items of psychological well-being (F=3.91, P=.013), the items of social well-being (F=4.96, P=.004). It show a significant difference, but the item of spiritual well-being (F=1.36, P=.262) was not significant difference. The significance between the type of treatment and QOL was insignificant. The degree of difference between each area of life was the psychological well-being (t=-2.14, P=.037), the social well-being (t=-2.15, P=.036). But the physical well-being (t=-.93, P=.356), the spiritual well-being (t=.73, P=.469) was insignificant. Conclusion: As a result, The QOL of patients with cervical cancer is differentiated by the stage of disease, the type of treatment, and the demographic data. Therefore, there is a need to apply nursing intervention to patients with cervical cancer by considering the stage of disease, the type of treatment, and the demographic data.

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Utilization and Expenditure of Health Care and Long-term Care at the End of Life: Evidence from Korea (장기요양 인정자의 사망 전 의료 및 요양서비스 이용 양상 분석)

  • Han, Eun-jeong;Hwang, RahIl;Lee, Jung-suk
    • 한국사회정책
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    • v.25 no.1
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    • pp.99-123
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    • 2018
  • Purpose: This study empirically investigates the utilization and expenditure of health care and long-term care at the last year of life for long-term care beneficiaries in Korea. Methods: This study used National Health Insurance and Long-term Care Insurance claims data of 271,474 LTCI beneficiaries, who died from July 2008 to December 2012. Their cause of death, place of death, health care costs, and the provision of aggressive care were analyzed. Results: Cardio-vascular disease(29.8%) and cancer(15.3%) were reported as their major cause of death, and hospital(64.4%), home(22.0%), social care facility(9.2%) were analyzed as the place of death. 99.3% of subjects used both health care and long-term care during the last 1 year of life. The average survival period were 516.2 days after they were LTCI beneficiaries. The health care expenditure gradually increased near the death, and the last month were three times more rather than the first month. Furthermore, 31.8% experienced some aggressive cares(CPR, blood transfusion, hemo-dialysis, etc.) at the last month of life. Conclusion: The results of this study suggest that it is important to develop the end of life care policies(for example, hospice, advanced care directives) for the LTCI beneficiaries. They might contribute to the improvement of quality of life and the reduction of health care expenditure of the elderly at the end-of-life.

Effects of Death Education on Attitude toward Death and Depression in Older Adults (죽음준비교육이 노인의 죽음에 대한 태도와 우울에 미치는 효과)

  • Oh, Chin-Tak;Kim, Chun-Gill
    • 한국노년학
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    • v.29 no.1
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    • pp.51-69
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    • 2009
  • The purpose of this study was to identify the effects of death education on attitudes toward death and depression for older adults. A death education program consisted of needs of death education, alternatives for dignity on death, not ending death(I, II), hospice(I, II), and 9 patterns of death(I, II, III). Participants in this study were 38 older adults aged 60 years or older. Attitudes toward death and depression scales for Korean elders were employed. The data collection and intervention were performed from January to June, 2008. The subjects participated in a death education program for 1 time per week during 10 weeks. The data were analyzed with t-test, and Pearson correlation coefficients with SPSS/Window 14.0. After the intervention, the subjects showed significant difference in attitudes toward death compared to that of pre-intervention. The subjects after the intervention showed no statistical differences in change of depression compared to that of pre-intervention. Also, attitudes toward death were negatively related with depression both before and after interventions, but the change of relation was not significant. The findings of this study contributed to extend the base of program developments on death education enhancing attitudes toward death among Korean older adults.

Development of Needs Assessment Instrument for the Patients with Cancer (암환자의 요구 조사 도구 개발)

  • Kim, Gi-Yon;Choi, Sang-Soon;Pak, So-Mi;Song, Hee-Young;Hur, Hea-Kung
    • Journal of Hospice and Palliative Care
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    • v.5 no.2
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    • pp.136-145
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    • 2002
  • Purpose : This study was designed to develop an instrument that could be used for comprehensive and effective need assessment for patients with cancer. Methods : In the first phase, a conceptual framework for the instrument was established by Wingate & Lackey (1989). In the second phase, the preliminary instrument was drawn up through a review of the literature and in consultation with three professors in Nursing. In the third phase validity and reliability of the preliminary instrument were tested as follows; 1) an expert validity test of the preliminary instrument was done by nine head nurses and charge nurses who had over ten years experience caring for patients with cancer at Wonju Christian Hospital. 2) A construct validity test and reliability test was done for the instrument by 116 staff nurses selected by convience sampling from hospitals located in Kang-Won, Kyoung-Ki, and Choong-Chung Provinces. The collected data were analyzed using SPSS 10.0 WIN program. For the factors of the instrument, factor analysis was used. The reliability of the scale was analyzed by Cronbach's alpha. Results : The results of the experts' test of validity, showed that, of 32 items, only one item had less than 55.4%. It was then deleted and a total of 31 items was selected. On the basis of the results of the factor analysis, the following six components were identified: physiological, informational, spiritual, and emotional needs, available resources, and legal/financial needs. These factors explained 61.8% of the variance. In the factor analysis, the first factor (physiological needs) and the second factor (informational needs) explained 25.4% and 10.9% of the variance respectively, which were major factors for the needs of patients with cancer in Korea. Cronbach' alpha for the scale was .90 indicating internal reliability. Conclusion : This instrument can be effectively utilized for assessment of needs of patients with cancer in Korea. Use of the needs assessment instrument developed in this study will allow nurses to develop nursing interventions that provide comprehensiveness and continuity in meeting the needs of patients with cancer.

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Types of Perception toward End-of-Life Medical Decision-making of Clinical Nurses: Q-Methodological Approach (말기환자의 의료적 의사결정에 관한 임상간호사의 인식: Q 방법론적 접근)

  • Jo, Kae-Hwa;Kim, Yeon-Ja;Sohn, Ki-Cheul
    • Journal of Hospice and Palliative Care
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    • v.15 no.1
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    • pp.18-29
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    • 2012
  • Purpose: We analyzed how clinical nurses in Korea perceive terminally ill patients' medical decision-making. Methods: The Q-methodology which analyzes the subjectivity of each item was used. We selected 34 Q-statements among those provided by each of 37 subjects and grouped them into a shape of normal distribution using a 9 point scale. The collected data were analyzed using a QUANL PC program. Results: Four types of perception toward medical decision-making were identified. Type I focuses on patient participation, and Type II emphasizes the role of health professionals. Type III is characterized by an open-minded culture toward death, and Type IV values the role of family members. Conclusion: The results of this study indicate the need for development of a multi-disciplinary curriculum medical decision-making and death for medical and nursing students.

A Study on the Influence of Business performance on the Adoption Factors of Information Systems in Information and Communications Industries (정보시스템 도입 요인이 기업 성과에 미치는 영향에 관한 연구 - 정보통신산업 중심으로-)

  • Yi, Seon-Gyu;Kim, Woo-Bong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.8 no.3
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    • pp.576-592
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    • 2007
  • We, in this study, tried to examine the influence of business environment, organization structure and information technology characteristics used on the performance of the information systems in Information and Communications Industries. The result shows that frequency of system usage and users' satisfaction are positively affected by the factors of business environment, organizational structure and information-technology. The user satisfaction of the system is affected by the frequency of system usage. Both financial performance and non-financial performance are affected by the frequency of the systems usage and user satisfaction of the system. With path analysis, we verified the overall model goodness-of-fit verified for the research model. The result shows that organization structureand technological factors are positively related to the frequency of usage and user satisfaction of the system, while the environmental factors are not. The frequency of system usage is not linked to both financial and non-financial performance. The user satisfaction of the system does not affected to the financial performance. In conclusion, the usage frequency and user satisfaction of the system are the moderating variables affecting business performances. These two variables are affected by the environment, organization structure and information technology. The Path analysis also supports the relationships among these variables.

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Determination of Cost and Measurement of nursing Care Hours for Hospice Patients Hospitalized in one University Hospital (일 대학병원 호스피스 병동 입원 환자의 간호활동시간 측정과 원가산정)

  • Kim, Kyeong-Uoon
    • Journal of Korean Academy of Nursing Administration
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    • v.6 no.3
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    • pp.389-404
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    • 2000
  • This study was designed to determine the cost and measurement of nursing care hours for hospice patients hostpitalized in one university hospital. 314 inpatients in the hospice unit 11 nursing manpower were enrolled. Study was taken place in C University Hospital from 8th to 28th, Nov, 1999. Researcher and investigator did pilot study for selecting compatible hospice patient classification indicators. After modifying patient classification indicators and nursing care details for general ward, approved of content validity by specialist. Using hospice patient classification indicators and per 5 min continuing observation method, researcher and investigator recorded direct nursing care hours, indirect nursing care hours, and personnel time on hospice nursing care hours, and personnel time on hospice nursing care activities sheet. All of the patients were classified into Class I(mildly ill), Class II (moderately ill), Class III (acutely ill), and Class IV (critically ill) by patient classification system (PCS) which had been carefully developed to be suitable for the Korean hospice ward. And then the elements of the nursing care cost was investigated. Based on the data from an accounting section (Riccolo, 1988), nursing care hours per patient per day in each class and nursing care cost per patient per hour were multiplied. And then the mean of the nursing care cost per patient per day in each class was calculated. Using SAS, The number of patients in class and nursing activities in duty for nursing care hours were calculated the percent, the mean, the standard deviation respectively. According to the ANOVA and the $Scheff{\'{e}$ test, direct nursing care hours per patient per day for the each class were analyzed. The results of this study were summarized as follows : 1. Distribution of patient class : class IN(33.5%) was the largest class the rest were class II(26.1%) class III(22.6%), class I(17.8%). Nursing care requirements of the inpatients in hospice ward were greater than that of the inpatients in general ward. 2. Direct nursing care activities : Measurement ${\cdot}$ observation 41.7%, medication 16.6%, exercise ${\cdot}$ safety 12.5%, education ${\cdot}$ communication 7.2% etc. The mean hours of direct nursing care per patient per day per duty were needed ; 69.3 min for day duty, 64.7 min for evening duty, 88.2 min for night duty, 38.7 min for shift duty. The mean hours of direct nursing care of night duty was longer than that of the other duty. Direct nursing care hours per patient per day in each class were needed ; 3.1 hrs for class I, 3.9 hrs for class II, 4.7 hrs for class III, and 5.2 hrs for class IV. The mean hours of direct nursing care per patient per day without the PCS was 4.1 hours. The mean hours of direct nursing care per patient per day in class was increased significantly according to increasing nursing care requirements of the inpatients(F=49.04, p=.0001). The each class was significantly different(p<0.05). The mean hours of direct nursing care of several direct nursing care activities in each class were increased according to increasing nursing care requirements of the inpatients(p<0.05) ; class III and class IV for medication and education ${\cdot}$ communication, class I, class III and class IV for measurement ${\cdot}$ observation, class I, class II and class IV for elimination ${\cdot}$ irrigation, all of class for exercise ${\cdot}$ safety. 3. Indirect nursing care activities and personnel time : Recognization 24.2%, house keeping activity 22.7%, charting 17.2%, personnel time 11.8% etc. The mean hours of indirect nursing care and personnel time per nursing manpower was 4.7 hrs. The mean hours of indirect nursing care and personnel time per duty were 294.8 min for day duty, 212.3 min for evening duty, 387.9 min for night duty, 143.3 min for shift duty. The mean of indirect nursing care hours and personnel time of night duty was longer than that of the other duty. 4. The mean hours of indirect nursing care and personnel time per patient per day was 2.5 hrs. 5. The mean hours of nursing care per patient per day in each class were class I 5.6 hrs, class II 6.4 hrs, class III 7.2 hrs, class IV 7.7 hrs. 6. The elements of the nursing care cost were composed of 2,212 won for direct nursing care cost, 267 won for direct material cost and 307 won for indirect cost. Sum of the elements of the nursing care cost was 2,786 won. 7. The mean cost of the nursing care per patient per day in each class were 15,601.6 won for class I, 17,830.4 won for class II, 20,259.2 won for class III, 21,452.2 won for class IV. As above, using modified hospice patient classification indicators and nursing care activity details, many critical ill patients were hospitalized in the hospice unit and it reflected that the more nursing care requirements of the patients, the more direct nursing care hours. Emotional ${\cdot}$ spiritual care, pain ${\cdot}$ symptom control, terminal care, education ${\cdot}$ communication, narcotics management and delivery, attending funeral ceremony, the major nursing care activities, were also the independent hospice service. But it is not compensated by the present medical insurance system. Exercise ${\cdot}$ safety, elimination ${\cdot}$ irrigation needed more nursing care hours as equal to that of intensive care units. The present nursing management fee in the medical insurance system compensated only a part of nursing car service in hospice unit, which rewarded lower cost that that of nursing care.

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