• Title/Summary/Keyword: End-of-life care stress

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Investigation of the Relationships Between Death Recognition, Terminal Care Stress, and Terminal Care Performance in Terminal Hospital Nurses (요양병원간호사의 죽음인식, 임종간호스트레스와 임종간호수행간의 관계 조사)

  • Jung, Ji Soo;Lee, Kyung-Sun
    • Science of Emotion and Sensibility
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    • v.23 no.1
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    • pp.79-88
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    • 2020
  • The purpose of this study is to investigate the relationships between death recognition, terminal care stress, terminal care performance, and other influencing factors of terminal care performance in terminal care hospital nurses. Two hundred forty nurses working in 11 hospitals for the elderly located in G, N, C city were surveyed. They were asked to complete three questionnaires: one on death recognition, one on terminal care stress, and a final one on terminal care performance. The data collected were analyzed using descriptive statistics, Pearson's correlation, and stepwise regression using SAS 9.1. The findings suggest that the nurses' own mental and occupational stress was the cause of many difficulties in the practice of end-of-life care, where the nurse will often experience the death patients, which results in increased dysentery stress. There was a negative correlation between species stress and terminal care performance. Death recognition and terminal care stress were correlated with terminal care performance. The results suggest that the longer the clinical experience, the higher the quality of terminal care performance. Therefore, it is suggested that terminal care should be performed considering the longevity of the careers career and their death tendency. Further to this study, it is necessary to find out how to reduce stress and to evaluate other variables affecting the care of the patient.

The Theory of Meaning in Hospice Care

  • Starck, Patricia L.
    • Journal of Hospice and Palliative Care
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    • v.20 no.4
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    • pp.221-225
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    • 2017
  • Care for the human spirit is a core component of quality end-of-life care. Logotherapy, based on the premise that the primary motivation of human beings is to find meaning and purpose in life, can be helpful in providing care for patients, families, and loved ones in hospice care. The use of Socratic dialog in posing questions about one's life experiences, values, and attitudes is a useful method of evoking reflection. Guidance for finding meaning, even until one's last moments, can be found in the three categories: (a) tasks or deeds, (b) experiences of love and beauty, and (c) attitudes chosen in spite of a fate that cannot be changed. Self-transcendence, defined as getting outside the self for the good of others, can add meaning to life. A growing body of research concerning meaning-centered therapy is promising for improving spiritual well-being and a sense of meaning and purpose in life.

Palliative Care Education in Gynecologic Oncology: a Survey of Gynecologic Oncologists and Gynecologic Oncology Fellows in Thailand

  • Ratanakaaew, A;Khemapech, N;Laurujisawat, P
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.15
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    • pp.6331-6334
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    • 2015
  • Background: The main purpose of this study was to survey the education and training of certified gynecologic oncologists and fellows in Thailand. A secondary objective was to study the problems in fellowship training regarding palliative care for gynecologic cancer patients. Materials and Methods: A descriptive study was conducted by sending a questionnaire regarding palliative care education to all certified gynecologic oncologists and gynecologic oncology fellows in Thailand. The contents of the survey included fellowship training experience, caring for the dying, patient preparation, attitudes and respondent characteristics. Statistics were analyzed by percentage, mean and standard deviation and chi-square. Results: One hundred seventy completed questionnaires were returned; the response rate was 66%. Most certified gynecologic oncologists and fellows in gynecologic oncology have a positive attitude towards palliative care education, and agree that "psychological distress can result in severe physical suffering". It was found that the curriculum of gynecologic oncology fellowship training equally emphasizes three aspects, namely managing post-operative complications, managing a patient at the end of life and managing a patient with gynecologic oncology. As for experiential training during the fellowship of gynecologic oncology, education regarding breaking bad news, discussion about goals of care and procedures for symptoms control were mostly on-the-job training without explicit teaching. In addition, only 42.9 % of respondents were explicitly taught the coping skill for managing their own stress when caring for palliative patients during fellowship training. Most of respondents rated their clinical competency for palliative care in the "moderately well prepared" level, and the lowest score of the competency was the issue of spiritual care. Conclusions: Almost all certified gynecologic oncologists and fellows in gynecologic oncology have a positive attitude towards learning and teaching in palliative care. In this study, some issues were identified for improving palliative care education such as proper training under the supervision of a mentor, teaching how to deal with work stress, competency in spiritual care and attitudes on responsibility for bereavement care.

Conceptual Model for Women s Health (여성건강을 위한 개념적 모형)

  • 이경혜
    • Journal of Korean Academy of Nursing
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    • v.27 no.4
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    • pp.933-942
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    • 1997
  • There has recently been an increased interest in women's health from, various disciplines, with different perspectives presented according to each profession's academic background. This has led to many instances of incorrectly defining, or misinterpretation, of the issues even among professionals. Nurse scholars as well as practitioners who work in women's health care need to have a clear conceptual understanding of women's health in order to build a body of knowledge, delineate curricular activities, and set directions for professional nursing interventions. In addition, a conceptual model that may be directly utilized in practice is needed to maintain and promote women's health issues. The purpose of this study was to apply a Hybrid model, analyzing conceptual definitions and discussions related to women's health gathered from review of the literature. Further to compare analyticals the concepts and properties observed from field work, so as to present a final definition of women's health and, build a conceptual framework for a united comprehensive perspective on the concept as well as on nursing practice. Data collection and analysis consisted of a theoretical stage, field work stage, and final analysis. A heterogeneous group of professionals and lay persons, 39 in all, participated in the field work. Study findings Include several subconcepts under the concept of women's health : a woman's whole life, holistic health, quality of life, awareness of being a woman, individual nursing, self care ability, reproductive health, and family health. Thus, a comprehensive definition was built, 1. e., "Women's health care be defined as improvement in the quality of life of women through attainment of holistic health throughout the life span. With reproductive health at the core, the concept is directly related to family and national health, and includes taking care of one's own health based on awareness of being a woman and utilizing self care activities. Women's health care issues are unique and allow various responses, therefore women's health professionals need to apply individual approaches to reach solutions in attaining holistic health and improving quality of life." The constructual factors of women's health were found to be reproductive functions, diseases more common in woman, self actualization, mental health, women's health policies, sexuality, midlife changes, and marital relations, with each factor having more than three properties. Positive factors affecting women's health were found to be a normal childbearing process, a healthy lifestyle, active health management, health information, support, and resources, and interpersonal relationships. Negative factors were found to be overwhelming role stress, cultural oppression, gender inequality, distorted sexual identity, economic difficulties, misuse and/or abuse of substances, and stress. The model of women's health may be visualized as a balance scale set upon a woman's life, supporting 4 concentric circles. The innermost circle and second circle incorporate conceptual definitions of women's health, and the outer two circles represent the constructional factors and properties of women's health. Each circle has its own color that symbolizes the conceptual meaning. Positive and negative factors are represented as weights at either end of the scale, and are affected by nursing intervention, i. e., health and wellness increase when positive factors are stronger, whereas disease and illness increase when negative factors are stronger. This model is only a preliminary effort and requires much discussion and testing to be further developed. Continuous research is also required.

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Mediating Effects of Empathy and Resilience on the Relationship between Terminal Care Stress and Performance for Nurses in a Tertiary Hospital (일 상급종합병원 간호사의 임종간호스트레스와 임종간호수행 간의 관계에 미치는 공감역량과 극복력의 매개효과)

  • Kim, Heui Yeoung;Nam, Keum Hee;Kwon, Su Hye
    • Journal of Hospice and Palliative Care
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    • v.20 no.4
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    • pp.253-263
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    • 2017
  • Purpose: To develop end-of-life care training programs for nurses who provide in a tertiary hospital, we examined the mediating effects of empathy and resilience on the relationship between their stress and job performance. Methods: This study was conducted with 218 participants at a hospital in B city in South Korea from August 15 through August 30, 2017. Data collected from the participants were analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlation coefficients, and multiple regression using the IBM SPSS/WIN 21.0 software. Results: Terminal care stress was found to be negatively correlated with empathy competence (r=-0.345, P<0.001), resilience (r=-0.223, P=0.001) and terminal care performance (r=-0.260, P<0.001), whereas empathy (r=0.467, P<0.001) and resilience (r=0.358, P<0.001) were positively correlated with terminal care performance. Empathy had a complete mediating effect (${\beta}=0.409$, P<0.001) on the relationship between terminal care stress and performance, and resilience a partial mediating effect (${\beta}=0.294$, P<0.001). Conclusion: Based on the findings of this study, development of training programs with a focus on empathy and resilience are highly recommended to improve job performance of nurses who provide terminal care in a tertiary hospital.

Development of Job Burnout and Job Stress Relife Program for the Nursing Care Workers based on Acceptance and Commitment Therapy(ACT) (수용전념치료(ACT) 기반 요양보호사 직무 소진, 직무스트레스 완화 프로그램 개발과 적용)

  • Lee, OkJoo;Kim, Mooyoung
    • The Journal of the Korea Contents Association
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    • v.21 no.7
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    • pp.222-237
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    • 2021
  • The purpose of this study is to develop an ACT group counseling program for the purpose of alleviating and healing the job stress and burnout of nursing care workers and to verify the effectiveness of the ACT group counseling program. To this end, the goal and theoretical model, content, operation and evaluation of the program were composed and applied according to the procedure. The main research results are as follows. First, as a result of measuring the job stress of the study subjects, there was a positive change in the group participating in the program. Second, as a result of measuring the level of job burnout of the study subjects, there was a positive change in the group participating in the program. Third, as a result of measuring the level of role conflict of the study subjects, there was a positive change in the group participating in the program. Fourth, as a result of measuring the level of over-role of the study subjects, there was a positive change in the group participating in the program. Fifth, as a result of measuring the level of role ambiguity of the study subjects, there was a positive change in the group participating in the program. As a practical implication, by including the ACT theory and practice plan in various nursing care providers training courses, the ability to respond to job burnout and job stress is increased, and ultimately, by increasing the psychological flexibility of nursing care workers, the opportunity for essential change in attitude toward work and life describe what to provide.

Nursing Students' Experiences with Patient Deaths during Clinical Practice (간호학생의 임상실습 중 환자의 죽음 경험)

  • Kang, Hyun-Ju;Choe, Hye Jeong
    • The Journal of Korean Academic Society of Nursing Education
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    • v.26 no.1
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    • pp.56-66
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    • 2020
  • Purpose: The purpose of this study was to explore nursing students' experiences with patient deaths during clinical practice. Methods: The participants were ten nursing students who had experienced patient deaths during clinical nursing practice at a university hospital in Korea. Individual in-depth interviews were conducted, and the data were analyzed using the content analysis method suggested by Graneheim and Lundman (2004). Results: The participants' experience was structured into six categories: experiencing various emotions in facing patient deaths, viewing oneself as a nursing student at the scene of a patient's death, thinking about death again, finding a pathway of understanding and support for patient death experiences, impressions and regret felt while actually observing terminal care, and picturing oneself as a future nurse dealing with a patient's death. Conclusion: Based on this study, stress management and self-reflection programs are suggested for nursing students who have experienced patient deaths. Practical nursing education for patient death and end of life care is also needed.

New Graduate Nurses' Satisfaction with Transition Programs and Experiences in Role Transition (신규간호사의 실무적응지원 교육 만족도 및 역할 이행 경험에 관한 조사)

  • Kwon, In Gak;Cho, Yong Ae;Cho, Myung Sook;Yi, Young Hee;Kim, Mi Soon;Kim, Kyeong Sug;Choi, Ae Seon
    • Journal of Korean Clinical Nursing Research
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    • v.25 no.3
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    • pp.237-250
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    • 2019
  • Purpose: The aim of this study was to investigate the satisfaction of newly graduated nurses with educational programs and their experiences in role transition. Methods: Data were collected from November 1 to December 15, 2018 and 483 new graduate nurses working at 15 tertiary hospitals and 10 general hospitals participated. For data collection, self-report questionnaires including the Casey-Fink Graduate Nurse Experience Survey tool and satisfaction with education were used. Data were analyzed using descriptive statistics, t-test, and one-way analysis of variance. Results: Satisfaction with education ranged from 3.09 to 3.27, and satisfaction with preceptors was 3.45(maximum 4). The skill that new nurses ranked as most difficult during the first 3 months was charting/documentation, and throughout a whole year, the top 4 difficult skills were cardiopulmonary resuscitation/emergency response, ventilator care, end-of-life care, and prioritization/time management. In comfort/confidence, new graduates felt most comfortable with support and least comfortable with patient safety. More than 50 percent of new graduates experienced stress during role transition, and the most frequently experienced stressors were related to job performance and personal life. Levels of satisfaction with education and comfort/confidence differed according to the hospital type and number of preceptors for new nurses. Conclusion: In order to facilitate the transition of new graduate nurses to professional nurse, an extended period of education, systematic and standardized transition programs, and continuous support during the first year of practice are required.

Protective Effect of Plantago asiatica L. Leaf Ethanolic Extract Against Ferric Nitrilotriacetate-Induced Prostate Oxidative Damage in Rats (랫드에서의 Fe-NTA 유발 산화스트레스에 대한 차전초 에탄올 추출물의 전립선보호 효과)

  • Hong, Seung-Taek;Hong, Chung-Oui;Nam, Mi-Hyun;Ma, Yuan-Yuan;Hong, Yun-Jin;Son, Da-Hee;Chun, Su-Hyun;Lee, Kwang-Won
    • Journal of Food Hygiene and Safety
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    • v.26 no.3
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    • pp.260-265
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    • 2011
  • Plantago asiatica L. (P. asiatica) has been used as one of the popular folk medicines in Asia for human health care practices. Various activities of P. asiatica have been reported, such as anti-oxidant, anti-glycation, anti-inflammatory and hepatoprotective activity. Therefore, the potential of P. asiatica to reduce oxidative stress has been studied in several ways for over 20 years, especially at liver and kidney. However no investigation has been reported revealing its protective effect on prostate. Method: Treatment of P. asiatica leaf ethanolic extract (PLE) (1 g/kg body weight (b.w.), 2 g/kg b.w., or 4 g/kg b.w.) were given separately to animals for pretreatment once per day for 7 days, and on the seventh day ferric nitrilotriacetate (Fe-NTA; 0.24 mmol Fe/kg b.w.), which is known as an oxidative stress-inducer at prostate, was administrated by i.p to negative control group. At the end of the study period, dissection was carried out for detecting the prostate protective effect of PLE. Result: Fe-NTA-treated animals produced reactive oxygen species (ROS) resulting in depletion of antioxidant biomaker, such as glutathione (GSH), glutathione reductase (GR), and glutathione s-transferase (GST) and increase of lipid peroxidation in prostate. However, PLE pretreatment resulted in an increase in the GSH, GST and GR levels concentration dependent manner and in an significant decrease in the levels of lipid peroxidation. Conclusion: Our data suggest that PLE may be effective in protecting oxidative stress-induced damage of prostate, and PLE may be an chemopreventive agent against Fe-NTA-mediated prostate oxidative damage.

A Study on the Factors Affecting Health Promoting Lifestyles of Workers in the Small Scale Industries (소형 사업장 근로자들의 건강증진 생활양식에 영향을 미치는 요인)

  • Jang Yong-Nam;Lee Eun-Kyoung;Chong Myong-Soo;Jun Sun-Young;Kim Sang-Deok;Jeoung Jae-Yul;Jahng Doo-Sub;Song Yung-Sun;Lee Ki-Nam
    • Journal of Society of Preventive Korean Medicine
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    • v.5 no.1
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    • pp.10-30
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    • 2001
  • Oriental medicine needs to be armed with theories on health-improvement concept under it and basic data matching its views, in order to participate in the health-improvement service in industrial work places. The Orient medicine health-improvement program defines factors that determine individuals' lifestyle, and provides information and technologies for workers to practice in life. To that end, this research compares and analyzes health-improvement concept and health care, defines relations between individuals' health state and their lifestyle as the basic data needed to perform health-improvement business for workers. 1. The subjects employed for this research is categorized into; by gender, males 52.1% and females 47.9% with no big difference between them; and by age, 20s, 6.1%, 30s. 33.9%, 40s, 34.1%, and 50s, 24.8% with 30-50 accounting for most of it. By marriage status, unmarried represents 7.1%, and married 79.1% with most of them married; by revenue, under one million won represents 3.0%, 1-2 million won 26.4%, 2-2.49 million won 11.2%, above 2.5 million won 11.2%, and 1-2.5 million won a majority. By living location, owned houses represents 65.4%, rented houses 14.7%, monthly-rented 9.5%; and by education, elementary and middle school represent 16.9%, high school and its dropouts 22.6%, and junior college and higher 51.6%, with high school and higher occupying most of the group. 2. By job, office workers and managerial workers represent 12.3%, part-timers 21.0%, manual workers 11.4%, jobless 0.6%, professionals 35.6%, service 0.6%, housewives 8.4%, and equipment/machinery operation/assemblers 10.1%. Of this, jobless and part-timers, totaling three, are dropped from this research. By years worked, 0-3.9 years represents 9.7%, 4-7.9 years 6.7%, 8-14.9 years 18.4%, above 15 years 28.7%, and no respondents 36.5%. 3. The degree of the subjects practicing life-improvement lifestyle, on a scale of 1 to 4, is an average of 2.69, personal relations 3.04, self-realization 2.92, stress management 2.76, nutritional state 2.73, responsibility for health 2.47, and athletic activities 2.18, with personal relations earning the highest points and athletic activities the lowest. As for factors influencing health-improvement lifestyle, there is no significant difference between gender, age, and marriage status. Meanwhile, there is significant difference between revenue, dwelling pattern, education level, etc. That is, higher income-bracket, owned houses, rented houses, monthly-rented houses, and higher-educated, in this order, show higher average in health-enhancement lifestyle. By job, housewives, manual workers, office workers, professionals, equipment/ machinery operation/ assemblers, and part-timers, in this order show higher points, while there is no difference with significance by years worked. 4. Factors that affect health-improvement lifestyle are shown below. Self-realization is influenced by age, marriage status, type of dwellings, and level of education; responsibility for health by type of dwellings; athletic activities by gender and age; nutrition by age, marriage status and type of dwellings; personal relations by marriage status; and stress management by type of dwellings. 5. Areas with high points by job show this: in self-realization, office workers, manual workers, housewives, professionals, equipment/ machinery operation/ assemblers, in this order, show difference with significance; in the area of responsibility for health, manual workers, housewives, equipment/ machinery operation/ assemblers, professionals, office workers and part-timers, in this order, do. In athletic activities, manual workers, housewives, office workers, professionals, equipment/ machinery operation/ assemblers, and part-timers, in this order, show difference with significance; in nutrition, housewives, office workers, manual workers, professionals, equipment/ machinery operation/ assemblers, and part-timers, in this order do; and in stress, housewives, office workers, manual workers, professionals, equipment/ machinery operation/ assemblers, part-timers, in this order do. By years worked, more years showed higher points in the area of responsibility for health and nutrition; in the area of athletic activities, above 15 years, 4-8 years, below 4 years and 8-14 years, in this order, show higher points; and no difference shows in realization, personal relation, and stress area. 6. To look at correlation between overall and divisional health-improvement practice degree, this researcher has analyzed it using Person's correlation coefficient. Self-realization, responsibility for health, athletic activities, nutrition, support for personal relations, and stress management show significant correlation with the sub-divisions, while all health-improvement lifestyle shows significant correlation with the six sub-divisions.

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