• 한국간호교육학회지
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• 제20권3호
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• pp.402-412
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• 2014

Purpose: This study was to investigate the importance of nurses' caring behaviors as perceived by nurses and patients at emergency departments, and to determine the differences between the two groups. Methods: The subjects of this study were 159 nurses working at emergency departments in 9 general hospitals in B Metropolitan City and 153 in-patients in 6 general hospitals, who were transferred to a general ward after being admitted to an emergency room. Research tool was a self-report questionnaire, which was a translated version of Caring Behavior Assessment(CBA). In this study, Cronbach's ${\alpha}$ was ranged from .83 to .93 in the seven subscale's reliability of CBA. Results: In terms of caring behaviors at emergency departments, both nurses and patients perceived that the most important subscale was . The subscale which showed the least importance from both groups was . Conclusion: The results of this study have demonstrated that nurses' caring behaviors can meet the patient's needs if the gap in perceptions between nurses and patients would be reduced.

• 대한간호학회지
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• 제42권5호
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• pp.749-758
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• 2012

Purpose: The purpose of this study was to develop a tool for measuring the intra-operative caring as perceived by regional anesthesia patients. Methods: A preliminary instrument with 54 questions, based on a literature review and semi-structured interviews with 11 regional anesthesia patients, was developed. A group of experts revised individual questions, and 34 questions were finally selected. This tool was tested with 137 regional anesthesia patients admitted to D university hospital in B city from August to October 2008. Results: The validity and reliability of the tool were tested using factor analysis. After item analysis, one question with a correlation coefficient under .30 was discarded After performing factor analysis on the final 33 questions, 7 factors were identified; holistic needs fulfillment, consideration, protective environment, cautiousness, concern, information, physical comfort. The total variance shown in the test was 73.5%. A Cronbach alpha of 0.96 showed the reliability of the instrument. Conclusion: Results of this study indicate that the tool is statistically reliable and valid to measure the intra-operative caring perceived by regional anesthesia patients. This tool can be utilized usefully in assessing the effects of nursing interventions for regional anesthesia patients.

• 대한간호학회지
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• 제42권2호
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• pp.280-290
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• 2012

Purpose: This study done to identify the experiences of families caring for patients with terminal cancer. The question was, "What is the caregiving experience of a family who has a member with terminal cancer?" Methods: Grounded Theory was applied and in-depth interviews were done with 11 family members. Interviews were recorded with the interviewees' consent and were transcribed and analyzed. Participants' relationships to patients were 6 spouses, 4 daughters, and 1 mother. The ages of the participants were between 32 and 62, with an average of 47.5. Results: The study showed "enduring with bonds" as the main category and the main factor affecting this category was the "patients' diagnosis of terminal cancer." The caregiving experience was divided into four stages: shock, confusion, struggle, and acceptance. Mediating factors were relationship with the patient, intimacy with the patient, social support, communication, and trust. Conclusively, participants underwent internal maturity, and changes occurred in family and social and personal life. Conclusion: The families took care of the patients with responsibility and love. The study results should help with the understanding of a family with a member with terminal cancer and should be used to develop nursing, mediating, and consulting programs for these caregivers.

• 대한간호학회지
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• 제26권3호
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• pp.653-667
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• 1996

It is important to find indicators of quality nursing care to establish the excellence of nursing practice and for the development of nursing as a profession. Caring is one of the indicators which can represent professional nursing care. The purpose of this study was to develop a measurement tool of caring that could be used as an instrument for the evaluation of quality of nursing care. The Target population for the developed tool of caring is the adult patient. The mearsurement tool of caring was developed through the following steps. (1) A list of caring behaviors was made using qualitative researches on caring that has been done in Korea. (2) Caring behaviors in nurses were selected using the list of caring behaviors developed from Watson's 10 factors of caring. (3) Items for the measurement tool of caring were developed using the caring behaviors of nurses (4) Content validity of the developed items was evaluated by an expert panel. (5) The mearsurement tool of caring was developed after a pilot study (6) Internal consistency, and construct validity of the developed tool were verified. (7) The mearsurement tool of caring with the items verified for the internal consistency and construct validity was confirmed. As a result of the study, a mearsurement tool of caring, composed of 27 items with 3 factors, was developed. The Reliability coefficient of the tool was. 9578. The tool is a 5 point Likert scale. The factors of the tool and the number of items for each factor are, 1) accessibility and availablility, 15 items ; 2) emotional support and giving information, 8 items ; 3) providing a protective environment, 4 items.

• 한국직업건강간호학회지
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• 제28권2호
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• pp.114-123
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• 2019

Purpose: The aims of this study were to identify the effects of caring burden and the way of coping on burnout in caregivers of cancer patients. Methods: One-hundred and forty family caregivers of cancer patients who visited the cancer center at one tertiary hospital in metropolitan city B were included. The data collection was conducted from August 1st to October 1st, 2018, using a structured, self-reported questionnaire. The collected data were analyzed using descriptive statistics, t-test, one-way ANOVA, Pearson correlation coefficients, and multiple regression. Results: In the multiple regression analysis, the subject's gender (${\beta}=.12$, p=.028) and caring burden (${\beta}=.74$, p<.001) had a significant effect on burnout. The explanatory power of the subject's gender, education level, religion, caring time, number of family caregivers, monthly income, economic burden, expectation for treatment, caring burden, the way of aggressive coping, and the way of passive coping with burnout was 63.8% (F=23.28, p<.001). Conclusion: Reducing the caring burden in family caregivers of cancer patients will ultimately contribute to reducing burnout, thereby contributing to an improvement in the psychological well-being and quality of life of family members, as well as positively contributing to the recovery of patients.

• 가정간호학회지
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• 제30권3호
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• pp.243-251
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• 2023

Purpose: The aim of this descriptive study was to identify factors influencing quality of life among family caregivers of non-cancer patients at the end-of-life stage. Methods: A cross-sectional survey was conducted using a questionnaire. Participants included 172 family caregivers caring for non-cancer patients. Data were collected from April to May 2016 and analyzed with descriptive statistics, an independent t-test, one-way ANOVA, Pearson's correlation coefficient, and a hierarchical regression analysis using the SPSS/WIN 24.0 program. Results: The mean of the participants' quality of life was 51.70±9.98. Factors influencing quality of life among family caregivers were spiritual care (𝛽=-.45, p=.021), coordination among family members or relatives (𝛽=-.27, p=.029), and psychological support (𝛽=-.04, p=.031). The explanatory power of the model was 21.0%. Conclusion: The findings of this study suggest that care needs; spiritual care, coordination among family members or relatives, and psychological support are important factors for family caregivers' quality of life. To improve quality of life among family caregivers who are taking care of non-cancer patients at the end-of-life stage, national systems establishing comprehensive support considering the respective care needs of patients are crucial.

• Journal of Hospice and Palliative Care
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• 제15권1호
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• pp.1-9
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• 2012

목적: 본 연구는 희망은 개인화된 유일하며 주관적이고 역동적인 경험이라는 가정 하에서 개인 경험에 근거한 희망 찾기 중재를 하는 데 도전해야할 문제점들을 토의하는 것을 목적으로 하였다. 방법: 연구자는 개인 경험에 근거한 희망을 향하여 가는 데 도전하여야 할 제한점과 요구되는 방안을 확인하기 위하여 비판적인 분석과 토의가 포함된 문헌 고찰을 사용하였다. 결과: 도전 과제들은 1. 개념화 문제로 대표되는 것들로서 종종 희망이 다양한 속성을 가진 표준화된 단일 구조나 현실적인 희망만이 강조되는 단일 구조로 또는 한 문헌에서 두 가지 오리엔테이션(상대주의 대 단일주의)의 혼합 속에서 기술되거나 사용되었다. 2. 완화돌봄을 받고 있는 환자들에 의하여 고유하게 경험되는 다양한 희망의 패턴이나 경험들에 대한 연구가 거의 없다. 3. 개인 경험에 근거한 희망 중재와 그 방법에 대하여 다룬 문헌이 거의 없다. 결론: 개념화 문제는 오랫동안에 걸쳐서 관련 학문 학자와 전문가에 내재되어온 고정된 오리엔테이션과 관계가 있는 것으로 보여진다. 따라서 이 문제는 우리들의 고정된 생각의 변화와 고정된 생각으로부터의 해방을 요구한다. 두 번째 도전 과제는 효과적이고 적절한 개인 경험에 근거한 희망 중재에 사용될 수 있도록 완화 간호 세팅에 있는 환자들의 다양한 희망 경험에 대한 다문화적 연구를 필요로 한다. 세 번째 도전 과제는 개인경험에 근거한 희망 중재를 위한 효과적인 방법을 찾을 것을 요구한다.

• Journal of Hospice and Palliative Care
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• 제21권2호
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• pp.51-57
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• 2018

목적: 임종기 환자의 연명의료 결정은 환자와 가족, 의료진에게 당면과제이나 실제 의료현장에서 합의된 연명의료 제한의 정의와 시기는 결정하기 어려운 실정이다. 이에 본 연구는 단일 의료기관에서 심폐소생술 금지 동의 후 사망한 환자를 조사하여 임종기환자의 연명의료의 실태를 확인하여 보고자 한다. 방법: 2016년 1월부터 2016년 12월까지 한 대학병원에서 '회복불능 예상 환자 제한 치료 동의서(DNR 동의서)'에 동의 후 사망한 환자의 의무기록을 후향적으로 분석하였다. 결과: 전체 대상환자의 DNR 동의 후 사망까지 기간은 중앙값 2일(1일 미만~51일)이었다. 전체 사망의 45.3%(170명)은 암환자였으며, 54.6%(205명)은 비 암환자로 주요 사망원인은 뇌혈관계(19.2%), 호흡기계(14.7%)가 많았고, 순환기계(6.7%), 감염(6.4%), 신장질환(5.1%), 간질환(2.7%) 등이었다. 암환자군과 비 암환자군을 비교했을 때 DNR 동의 후 사망까지 기간의 중앙값은 암환자에서 3일(range 1일 미만~51), 비 암환자에서 2일(range 1일 미만~50)로 통계적 차이는 없었다(P=0.629). 대상 환자 중 205명은 DNR 동의 전기계호흡 등 특수 연명의료를 시행받았으며 특수 연명의료 유보군(170명)과 비교하였을 때, 특수 연명의료 시행군의 76.1%가 비 암성질환이었으며, 특수 연명의료 유보군의 71.1%가 암질환이었다(P<0.05). 결론: DNR 동의 후 사망한 환자 대부분이 임종에 임박하여 연명의료를 결정하였으며 DNR 동의 후 사망한 환자의 절반 이상이 비 암환자였으나 연명의료를 받던 중에 중단 또는 유보로 결정되는 경우가 더 많았다. 바람직한 연명의료 결정을 위해 의료진은 말기 환자 및 가족과 좀 더 빠른 시점에서 이에 대한 논의가 필요하겠다.

• Journal of Hospice and Palliative Care
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• 제18권3호
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• pp.179-187
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• 2015

환자가 죽음에 임박했을 때 환자, 보호자, 의사 사이에서 심폐소생술에 대한 논의는 피할 수 없는 주제이다. 환자가 회복 불가능한 말기의 암환자인 경우에는 환자의 품위 있는 죽음을 고려하여 심폐소생술을 시행하지 않음(Do-not-resuscitate, DNR)을 결정하게 된다. 그러나 DNR에 대한 선택은 환자와 보호자의 심폐소생술과 DNR의 의미 및 그 결과에 대한 이해를 바탕으로 한다. DNR에 대하여 환자, 보호자, 의료진이 상담을 할 때는 환자의 질환이 더 이상 치료가 불가능하며, 심폐소생술이 환자의 생명을 연장시키는 것이 아니라 죽음의 과정을 연장시키는 것이며, 심폐소생술 이후에 삶의 질이 급격히 나빠질 수 있는 상황이라는 합의가 필요하다. 충분한 이해는 환자 또는 보호자가 품위 있는 죽음을 위한 DNR을 선택하도록 한다. 국내에서는 DNR 자체 보다는 이미 생명유지장치를 가지고 있는 환자에서의 생명유지장치의 제거에 대한 법적인 문제가 2차례 발생하면서 사회적으로 품위 있는 죽음에 대한 일반 대중의 관심이 이전보다 증가하였다. 환자와 의료진을 대상으로 한 설문에서는 DNR에 대한 인식과 의지가 80년대에 비해 2000년대 초반에 이르러 상당히 증가하였으나, 실제 의료 현장에서는 DNR의 결정에 있어 환자가 직접 관여를 하는 경우는 많지 않았고 DNR 작성 시점과 사망 시점과의 시간 간격이 1주 이내로 환자가 관여를 하거나 임종시기의 의료를 결정하기에는 너무 짧은 문제가 있었다. 이러한 문제는 조기 완화의료의 확산을 통하여 개선이 가능할 것으로 생각된다. 일부에서는 DNR이라는 용어보다는 자연적인 죽음을 허용함(Allow-Natural-Death)이라는 용어로 바꾸어서 설명하는 것이 이해를 돕고 선택의 갈등을 줄인다는 보고를 하여 DNR 논의와 결정에 있어서 적절한 시기 이외에도 환자와 보호자에게 많은 어려움이 있다는 것을 보여 주고 있다. DNR은 말기암환자에서 품위 있는 죽음을 위해 고려해야 하는 사항이며, 임상에서 DNR이 잘 시행되도록 임상적, 제도적 노력이 필요하다.

• 중환자간호학회지
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• 제11권2호
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• pp.1-10
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• 2018

Purpose : This study aimed to develop an in-depth and comprehensive understanding of the experiences of critical care nurses caring for dying patients. Method : Eleven critical care nurses with experience in caring for dying patients were recruited from four tertiary hospitals. Semi-structured face-to-face interviews were conducted between November 2016 and March 2017. The transcribed data were analyzed using qualitative content analysis to identify major themes and sub-themes that represented the experiences of critical care nurses. Results : The following six themes, and twelve sub-themes, were identified: (1) the gap between expectation and reality, (2) a distorted meaning of death, (3) repeated emotional pain and stress, (4) finding a solution alone, (5) sublimation into mission and calling, and (6) integration into one's own life. Conclusion : This study found that critical care nurses experience various psychological difficulties while caring for dying patients, and they made efforts on their own to overcome them. These findings are expected to inform the development of specialized programs to support critical care nurses to tackle these challenges, create guidelines on caring for dying patients, and help promote death education.