• Journal of Hospice and Palliative Care
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• 제19권3호
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• pp.233-239
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• 2016

목적: 말기암환자 가족간병인의 사별가족 연구참여와 관련된 요인에 대해서는 알려진 바가 적다. 본 연구에서는 사별가족 연구에 실제 참여를 예측하는 임종 전 요인에 대해 살펴보고자 한다. 방법: 임종 전과 사별 후에 시행된 다기관 조사연구 자료를 이용하여, 전향적 관찰연구를 진행하였다. 사별가족 연구 참여와 관련된 요인을 추출하기 위해, 단계적 다변량 로지스틱 회귀분석을 이용하였다. 결과: 185명의 사별가족 중, 30명이 사후조사에 참여하였다(응답률: 16.2%). 사후조사 참여군과 비참여군은, 종교, 경제적 상태 그리고 임종 전 인지되었던 돌봄의 질에서 차이를 보였다. 최종 다변량 모델에 의하면, 종교를 가지고 있던 가족(adjusted odds ratio [aOR]=5.01, P=0.008), 높은 경제수준을 가진 가족(aOR=4.86, P=0.003) 그리고 가족 내 관계형성에 대한 돌봄에 만족했던 가족(aOR=4.49, P=0.003)이 그렇지 않은 가족에 비해 더 사후 연구에 참여를 하였다. 결론: 본 연구에 의하면, 임종기 돌봄의 질을 향상시키는 것은 사후 고통을 줄임으로써 사별가족연구에의 참여를 촉진시킨다. 사별가족 연구참여를 망설이는 사별가족들의 특성에 관심을 가질 필요가 있다.

• 호스피스학술지
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• 제5권1호
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• pp.42-49
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• 2005

To determine which are the culturally specific factors of Korean bereavement, this chapter focuses on the view of death and the traditional mourning process which reflect Korean values and norms. The formation of the Korean view and understanding of death has been strongly influenced by three of its major traditional religions: Shamanism, Buddhism, and Confucianism (Park:1994: Hao:1999) and Christianity more recently. Each religion has a different view of death and the appropriate expression of mourning. Korea accommodates funeral customs and rules strictly as a cultural system and has retained these traditions over a long period; hence, some of the traditional funeral rituals still remain in modern Korean life, although some of the rites have been simplified. We have looked at the various ways in which grief and mourning is displayed and shared in a collective manner over a long period of time. This fits in well within the other Eastern cultures that are collectively organized, and contrary to the Eurocentric models do not hastily seek to detach the living from the dead and recognize that grief is a long process, and different individuals may take different amounts of time to recover from the grief. The view of death and bereavement in Korea has sprung from the roots of three Korean religions, together with the recent addition of Christianity, although they mainly result from the three earlier religions. The beliefs of these religions are still closely linked together in the rituals of Korean bereavement on both conscious and unconscious levels. The influence of these religions is evident in practice through the bereaved family's mourning reactions, funeral rites and customs and its views about death. Korea used to have a period of mourning for three years, following traditional mourning rites; then the chief mourner and the bereaved families could return to their normal life. In spite of this long mourning process for the bereaved family, once the funeral ceremony is finished, people expect the bereaved family not to express their grief in public; even the bereaved family does not like to talk about death. The process for bereaved people is related to mourning processes in terms of detachment from the deceased in order to start a new life. Relatives and the community recommend the performance of the kut ceremony for relieving the grief of the bereaved. When one family member dies in an unlucky way, the bereaved family may have some fear or other psychological reactions of grief such as pain, depression, insomnia and nightmares, hallucinations or other physical reactions. Unlucky deaths give the bereaved a very painful time and these types of reactions are often more serious than reactions to natural death. But through the kut ceremony, the bereaved family can start to make a new relationship with the deceased. The taboo of this type of death and death generally remains a crucial aspect of the isolation that bereaved people might face and the collective nature of mourning(even where it is still present) is unable to address this aspect of the privatization of grief.

• 대한간호학회지
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• 제33권6호
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• pp.847-855
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• 2003

Purpose: This study was done to develop a bereaved family care program by identifying characteristics of a grief healing process in a child loss. Method: The subjects were five bereaved mothers who have lost their children with cancer. Data was collected with in-depth interviews using grief phase assessment tool and grief reaction assessment tool from 1, February, 2001 to 31 August, 2002. Data was analyzed on the basis of two tools. Result: Process of grief in general was as follows: evading phase was within one week - one month, confrontation phase was 5 - 12 months, and reconciliation phase was after 9 months and still going on when the study was finished. Grief reaction in five (physical, cognitive, emotional, social, and spiritual) dimensions was stabilized when the phase moved into reconciliation phase. Influencing factors were intimacy and expectation towards child, social support, personality, prior loss experience, coping style, religion, culture, family cohesion, openness of communication, and stress events. Conclusion: These results suggest that a bereaved family care program considering characteristics of Korean culture should be developed and activated.

• Journal of Hospice and Palliative Care
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• 제26권2호
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• pp.27-41
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• 2023

Purpose: Pediatric palliative care is a rapidly developing multidisciplinary approach that supports children with life-limiting conditions and their families. However, there is limited evidence on how to effectively support bereaved parents and siblings. The purpose of this study is to explore the therapeutic impact of art therapy for bereaved families, in accordance with John Bowlby's four-stage theory of mourning. Methods: This single-case study employed the consensual qualitative research method. Art therapy records of bereaved families were reviewed individually, and records from one case were selected. Verbal statements made during the art therapy sessions and photocopies of the artworks were analyzed to understand the mourning process of the family. Results: A total of 113 statements and 12 artworks from 19 art therapy sessions were analyzed. As the art therapy progressed, each family member exhibited a pattern of engaging in more positive and healthy conversations in daily life, demonstrating the final stage of mourning: reorganization and recovery. The family dynamics also revealed that they reconstructed their inner world and redefined the meaning of loss, which is the final stage of mourning. The art therapy provided a safe environment for the family, allowing them to fulfill their wishes and regain the strength needed for recovery. Conclusion: This study suggests that art therapy supports bereaved families in alleviating their psychological difficulties, engaging in a healthy mourning process, and functioning as members of society. Further research is needed to better understand the effect of art therapy as a bereavement support tool in pediatric palliative care.

• Journal of Hospice and Palliative Care
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• 제17권3호
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• pp.134-141
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• 2014

목적 : 본 연구는 문헌연구방법을 통해 지금까지 국내에서 진행된 사별 가족 연구 동향을 살펴봄으로써 이후 연구의 방향성을 제시하는 데 그 목적을 두었다. 방법 : 국내에서 1994년부터 2013년 상반기까지 사별 가족을 대상으로 발표된 학위논문과 학술지 총 97편을 연구대상으로 설정하고, 시기별, 대상별, 목적별로 구분한 후 주요 특징을 제시하였다. 결과 : 첫째, 이전 시기에 비해 2010년 이후부터 사별 가족 연구의 증가 추세가 뚜렷하게 나타난다. 둘째, 가족 전체를 대상으로 하는 연구 빈도가 가장 높았으며, 남편과 사별한 중년 여성 배우자를 대상으로 하는 연구들이 활발하게 진행되고 있다. 셋째, 관련 변인간 관계를 검증한 연구가 가장 많은 것으로 확인되었다. 결론 : 후속 연구를 통해서 사별 가족에게 영향을 미치는 것으로 보고되고 있는 다양한 변수들을 통합적으로 이해하기 위한 노력이 필요하며, 체계적 검토방법을 활용한 개입 효과성 평가가 이루어져야 하고, 배우자를 사별한 중년 남성, 자녀를 사별한 부모, 부모를 사별한 자녀들을 대상으로 하는 질적 연구가 시행되어야 함을 제시하였다.

• 융합정보논문지
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• 제12권3호
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• pp.259-269
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• 2022

본 연구는 배우자 사별을 경험한 여성 노인을 대상으로 우울이 삶의 만족도에 미치는 영향에서 가족기능의 매개효과를 파악하기 위한 서술적 조사연구이다. 본 연구는 2021년 3월부터 4월까지 A시에 거주하는 배우자 사별경험이 있는 60세 이상 여성 노인 192명을 대상으로 자료 수집하였다. 자료 분석은 SPSS 27.0 Statistics Program을 이용하였으며, 우울과 삶의 만족도와의 관계에서 가족기능의 매개효과를 분석하기 위하여 계층적 다중회귀분석(Hierarchical Multiple Regression) 방법으로 분석하였다. 연구결과 배우자 사별을 경험한 여성 노인의 우울이 삶의 만족도에 미치는 영향에서 가족기능이 완전매개 효과가 있음을 확인하였다. 본 연구결과를 바탕으로 배우자와의 사별을 경험한 여성 노인의 원만한 적응을 돕기 위해 가족기능을 향상 시킬 수 있는 다양한 프로그램 개발과 적용이 필요하다.

• 가정과삶의질연구
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• 제26권5호
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• pp.39-49
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• 2008

This research reports on a qualitative analysis of email facilitated reflective dialogue with seven college students whose parent dies. The study was exploratory in considering cultural values on intact family and asked the question: What do children experience after parental death in terms of the relationships with intra and extrafamily systems? Young adult children of single parent family expressed that they felt social pressure to practice filial piety toward their single parent. They made efforts to fulfill the social expectation and to achieve social desirability. Social stigma from extrafamily systems affected the experiences of the bereaved children. In terms of intrafamily system, young adult children tend to idealize their deceased parent. Single parents depended on the young adult children, which made parent-child relationship enmeshed or conflicting. The holistic view of the study highlights the importance of interactions between individuals and the intra and extra family systems when understanding family loss experience of the bereaved young people.

• 대한간호
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• 제31권2호
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• pp.51-69
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• 1992

Grief that is not acknowledged and worked through may manifest itself in some emotional, mental or physical problem. In recent years much has been learned about coping with grief which the hospice program can utilize to help family members cope with their grief. This study was carried out to determine the helpfulness of the bereavement care of Severance Hospice and to learm more about the grief response of the bereaved. The tools used to collect data were an assessment form used in the bereavement program and the Grief Experience Inventory developed by Sanders and revised and translated 'by the researcher. Data was obtained from bereaved family members(54 for the final grief assessment and 39 for the grief response assessment) receiving bereavement follow-up, from July 1989 to March 1991. Results of the study were as follows: 1. Final Grief Assessment Regarding the resolution of their grief the majority of the bereaved accepted the reality of the death of their family member, while slightly more than three-quarters were able to express their feelings toward their loss. A large majority had returned to activities of daily living well or fairly well and had reinvested their energy in a person other than the deceased. In addition, the physical condition of the majority was good or fairly good. A majority of the bereaved considered the bereavement care to be helpful and almost three-quarters were not considered to be in need of more follow-up. 2. Grief Response Assessment Age was found to have a modoerately positive correlation to appetite disturbance(r=.41, P<.Ol) and loss of vigor(r=.37, P<.Ol) A moderately positive correlation was found between the number of contacts and sleep disturbance(r=2.38, P<.01) Significant differences were found between men and women in regard to guilt(t=2.38, P<.05), social isolation(t=2.44, P<.05) and depersonalization(t=2.07, P<.05) with men having the more intense grief. Significant differences were found in the grief responses of somatization(F=5.82, P<.001), physical symptoms(F=5.87, P<.OOl), appetite disturbance(F=4.40, P<.Ol), despair(3.79, P<,Ol), anger(Fp2.83, P<.05), social isolation(F=3.61, P<.05), guilt(F=3.62, P<.05) and depersonalization (F = 2.58, P <.05). In the first six of these grief responses mothers scored highest, followed by husbands and then wives, In the grief response of guilt, daughters scored highest and on the grief response of depersonalization sons scored highest. Only one grief response, that of sleep disturbance(t= -2.19, P<.05) was found to be statistically significant, with those family members who died at home having the higher scores. Based on the results of this study several suggestions are presented as follows: 1. Since unresolived grief can have a detrimental effect on the bereaved person's mental and phys. ical health it would be good for the nurse, to include questions related to death of family members and the bereaved person's response to the grief, in her nursing assessment. And in the case of unresolved grief the nurse should encourage the person to talk with a trusted friend or counselor and express their fellings of grief. 2. A study to determine the degree of resolution of the grief of those in the bereavement program could be carried out by use of the Grief Experience Inventory early in their bereavement and again 13 months after the death of their family member. 3. A comparison of the grief response of the bereaved in the bereavement program and bereaved not in the program could be carried out using the Grief Experience Inventory. 4. After bereavement programs have been started in other hospice programs it would be good to carry out a joint study of bereavement outcomes of those in the bereavement programs.

• Journal of Hospice and Palliative Care
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• 제2권2호
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• pp.91-100
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• 1999

목적 : 본 연구는 강남성모병원 호스피스 병동에 입원한 환자 가족과 사별 가족을 대상으로 호스피스 병동에 입원하여 돌봄을 받았던 내용에 대한 만족도를 조사하는데 그 목적이 있다. 방법 : 1998년 4월에서 6월까지 강남성모병원 호스피스 병동에 입원한 환자 가족 33명과 1993년 3월에서 1998년 3월까지 입원하여 임종한 사별 가족 30명을 대상으로 하였고, 본 연구의 자료수집은 QI(Quality Improvement)의 조사원이 시행하였으며 입원 환자 가족은 입원 $1{\sim}2$주 가족에게 질문지를 직접 배부하였고 사별 가족은 주소 화인을 통해 설문지를 우편으로 발송하여 회수하였다. 결과 : 1) 입원 환자 가족과 사별 가족의 만족도는 평점 최대 5.0에 비하여 평점 3.50 이상이었다. 2) 연령에 따른 만족도는 입원 환자 가족에서 호스피스 철학, 가족지지, 의사 진료, 간호사 돌봄 영역에서 유의한 차이가 있었고(P=0.0001) 사별 가족에서는 가족지지, 의사 진료, 간호사 돌봄, 병동 시설 영역에서 유의한 차이가 있었다(P=0.0001). 3) 가족관계에 따른 만족도는 입원 환자 가족에서 호스피스 철학, 가족 간호, 의사 진료, 간호사 돌봄 영역에서 유의한 차이가 있었다(P=0.0001). 4) 종교에 따른 만족도는 입원 환자 가족에서 호스피스 철학, 가족 간호, 간호사 돌봄 영역에서 유의한 차이가 있었고(P=0.0001) 사별 가족에서는 유의한 차이가 없었다. 결론 : 호스피스 돌봄은 말기 암 환자의 가족에게 몇 가지 측면에서 긍정적인 영향을 미치는 결과를 보였다. 가족의 만족도를 높여주기 위해서는 각 분야의 호스피스 팀 접근을 통한 간호가 필요하며 사회경제적 특성에 따라 다양하게 요구되는 가족의 요구를 살펴보아야 하겠다. 또한 추후 대상자를 확대하여 연구할 필요가 있음을 제언한다.

• 한국콘텐츠학회논문지
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• 제8권12호
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• pp.256-263
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• 2008

본 연구는 범죄로 인한 사망의 원인을 수사하는 최일선 국가기관인 수사경찰관의 사법부검에 대한 인식을 분석하여 문제점을 파악하고, 정책적 함의를 제시하였다. 본 연구에서는 다음과 같은 정책대안을 도출하였다. 첫째, 유족의 부검동의를 이끌어 내기 위하여 검안의사와 수사경찰이 합동으로 수사 상황과 검안의 결과를 유족의 대표 등에게 설명하는 합동설명의 기회와 사전 유족의 의견수렴의 절차가 필요하다. 둘째, 부검 참관인을 최소화하고, 여성변사자에 대한 특별한 배려가 있어야 할 것이다. 부검의 견학은 반드시 유족의 동의를 얻도록 하고, 외부인의 부검실 출입을 금지하여야 한다. 셋째, 부검절차의 신속을 기하기 위하여 일정한 범위내의 변사체의 경우 사후 영장이 가능한 가이드 라인을 설정하는 것이 필요하다. 또한 유족이 적극적으로 부검을 원하는 경우 가칭 ‘부검요청서’ 등으로 부검이 가능토록 하여야 할 것이다. 끝으로, 부검시행여부에 대하여 현장에서 변사사건을 직접 수사한 경찰과 검찰의 의견이 다른 경우, 검사와 수사경찰이 합동으로 현장 수사 후 부검을 결정하는 절차가 필요하며, 부검은 유족의 의사를 가능한 존중하여 필요한 경우에 한하여 실시해야 할 것이다.