• 제목/요약/키워드: Funeral Information System

검색결과 24건 처리시간 0.019초

말기 암 환자의 완화 의료 연계 시스템의 문제점과 개선 방안 (Problems of the Current Referral System of the Terminal Cancer Patients in Korea)

  • 윤초희;이주영;김미라;허대석
    • Journal of Hospice and Palliative Care
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    • 제5권2호
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    • pp.94-100
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    • 2002
  • 목적 : 말기 암 환자가 삶의 마지막 시간 동안 정서적, 사회적으로 안정을 취할 수 있는 곳은 대형화된 3차 의료기관이 아니라, 거주지에서 가까운 1, 2차 의료기관이나 호스피스 기관, 혹은 가정일 것이다. 그러나 현재 우리 나라는 말기 암 환자들을 3차 의료기관에서 1, 2차 의료기관, 호스피스 시설 등으로 연계(referral)하여 주는 시스템이 매우 미약한 상태이다. 본 연구는 현재 연계 상황의 문제점을 파악하여 이에 대한 개선점을 제시해 보고자 한다. 방법 : 2001년 4월부터 2002년 3월까지 서울대학교 병원으로부터 각 기관으로 연계된 말기 암 환자 76명의 보호자와 이 환자들을 연계 받은 35개의 의료기관을 대상으로 하여 설문 조사를 실시하였다. 환자의 보호자에게는 직접 전화를 하여 조사하였고, 의료기관에 대해서는 우편으로 설문지를 발송하였다. 결과 : 환자 보호자를 대상으로 한 47부의 설문지 분석 결과는 다음과 같다. 연계를 결정하는 데 있어서 의료진의 권유가 44%로 가장 큰 영향을 미쳤으며, 32%가 환자의 편의, 24%가 가족의 편의를 주로 고려하여 결정하였다. 연계 결정 과정에서는 가족의 생활권, 연계 기관의 인지도, 환자가 마지막으로 지내고 싶어하는 곳, 가족의 경제 상황, 장례 장소가 순서대로 영향을 많이 미치는 것으로 나타났다. 연계 과정에서는 47명 중 38명이 어려움을 겪었다고 응답했으며, 이들은 원하지 않는 퇴원의 종용을 가장 큰 어려움으로 꼽았다. 이 외에도 연계 기관에 대한 정보 부족, 환자의 고통에 대한 염려, 환자 및 가족의 거부 등으로 인해서도 어려움을 겪은 것으로 나타났다. 이와 같이 연계 과정에서는 어려움을 표현하였지만, 실제로 연계된 기관에서는 47명 중 35명이 완화 의료에 대해 대체로 만족스러웠다고 응답하였다. 그 이유로 환자가 안정과 평안함을 찾았고, 가족들도 편안하였으며 경제적 부담이 감소하였다는 점을 꼽았다. 그러나 15명은 연계 전후에 별 차이가 없다고 응답하였다. 연계된 기관을 대상으로 한 24부의 설문지 분석 결과는 다음과 같다. 24명의 응답자 중 1명을 제외한 23명이 완화 의료 연계 시스템에 대해 찬성하였고, 좀더 활발한 연계가 이루어질 수 있는 제도적 뒷받침의 필요성을 절실히 표현하였다. 의뢰된 환자를 돌보는 데 있어서 경험하는 어려움으로는 가장 큰 것으로 환자에 대한 정보 부족을 꼽았고, 그 외에도 환자의 경제적인 어려움이나 완화 의료 연계 기관에 대한 이해 부족, 통증 조절의 어려움 등을 호소하였다. 대부분(96%)의 기관 종사자들은 환자들이 연계된 이후의 보살핌에 만족하고 있다고 생각하는 것으로 나타났다. 결론 : 3차 기관으로부터 1, 2차 의료기관 및 호스피스로 말기 암 환자들이 연계되는 과정에서 환자, 보호자 뿐만 아니라 연계 기관도 많은 어려움을 겪고 있다. 향후 완화 의료의 연계 시스템 개발과 제도적 뒷받침이 절실히 필요하다.

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말기암 환자와 가족의 의료 및 간호 서비스 요구 (The Study on the Medical and Nursing Service Needs of the Terminal Cancer Patients and Their Caregivers)

  • 이소우;이은옥;허대석;노국희;김현숙;김선례;김성자;김정희;이경옥
    • 대한간호학회지
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    • 제28권4호
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    • pp.958-969
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    • 1998
  • In this study, we attempted to investigate the needs and problems of the terminal cancer patients and their family caregivers to provide them with nursing information to improve their quality of life and prepare for a peaceful death. Data was collected from August 1, 1995 to July 31, 1996 at the internal medicine unit of S hospital in Seoul area with the two groups of participants who were family members of terminal cancer patients seventy four of them were in-patients and 34 were out-patients who were discharged from the same hospital for home care. The research tool used in this study has been developed by selecting the questionnaires from various references, modifying them for our purpose and refining them based on the results of preliminary study. While general background information about the patients was obtained by reviewing their medical records, all other information was collected by interviewing the primary family caregivers of the patients using the questionnaire. The data collected were analyzed with the SPSS PC/sup +/ program. The results of this study are summarized as follows ; 1) Most frequently complained symptoms of the terminal cancer patients were in the order of pain(87%), weakness(86.1%), anorexia(83.3%) and fatigue (80.6%). 2) Main therapies for the terminal cancer patients were pain control (58.3%), hyperalimentation(47.2%) and antibiotics(21.3%). 3) Special medical devices that terminal cancer patients used most were oxygen device (11.1%), and feeding tube(5.6%). Other devices were used by less than 5% of the patients. 4) The mobility of 70.4% of the patients was worse than ECOG 3 level, they had to stay in bed more than 50% of a day. 5) Patients wanted their medical staffs to help relieve pain(45.4%), various physical symptoms(29.6%), and problems associated with their emotion(11.1%). 6) 16.7% of the family caregivers hoped for full recovery of the patients, refusing to admit the status of the patients. Also, 37% wished for the extension of the patient's life at least for 6 months. 7) Only 38.9% of the family members was preparing for the patient's funeral. 8) 45.4% of family caregivers prefer hospital as the place for the patient's death, 39.8% their own home, and 14.8% undetermined. 9) Caregivers of the patients were mostly close family members, i.e., spouse(62%), and sons and daughters or daughter-in-laws(21.3%). 10) 43.5% of the family caregivers were aware of hospice care. 46.8% of them learned about the hospice care from the mass media, 27.7% from health professionals, and the rest from books and other sources. 11) Caregivers were asked about the most difficult problems they encounter in home care, 41 of them pointed out the lack of health professionals they can contact, counsel and get help from in case of emergency, 17 identified the difficulty of finding appropriate transportation to hospital, and 13 stated the difficulty of admission in hospital as needed. 12) 93.6% of family caregivers demanded 24-hour hot line, 80% the visiting nurses and doctors, and 69.4% the volunteer's help. The above results indicate that terminal patients and their family caregivers demand help from qualified health professionals whenever necessary. Hospice care system led by well-trained medical and nursing staffs is one of the viable answers for such demands.

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조선시대(朝鮮時代) 유교사상(儒敎思想)과 의예복연구(儀禮服硏究) - 남자(男子) 포(袍)를 중심(中心)으로 - (A study on ceremonial costume and Confucianism is Chosun Dynasty - Focusing on Men's Po -)

  • 이선재
    • 복식
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    • 제16권
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    • pp.221-229
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    • 1991
  • This thesis aims at reviewing the wearing aspect and formation of Chosun ceremonial dresses for meal and finding out the thought reflected by them from the standpoint that dresses themselves should be taken as one of the phenomena in culture. That is men's ceremonial costumes and confucian costumes of the royal family and the gentry family in Chosun is reviewed focused on the formation and the wearing aspect of Po, Which is a kind of them. And in the context of the phase of the times. I also considered the thoughts reflected on the clothes such as confucianism, Ying & Yang Theory, and the symbol and the thoughts of patterns in relation to the clothes. Confucian influence was the main force for the Chosun prohibitions for clothes. The major reasons for the prohibitions for clothes were as follows. First, they reflected confucian Chung myoung chooui(the principle that everything should be where it belongs). That is the prohibitions for clothes were used in the means to maintain feudalistic social order. influenced by social rank system. Second, they reflected confucian ethics in the means to recover social disciplines with the maintenance of traditional customs. This shows well in the restriction of luxurious items in dressing included the prohibitions for clothes. Third, they reflected Chosun's toadysm toward China. With the influx of Chinese style of dressing then government even changed the style of uniforms for public officials into that of Chinese resulting in dual styles of dressing. Ying & Yan Theory greatly affected the colors of Korean clothes and reflected toadysm toward China. too. The theory was embodied by prohibition of such colors for clothes as white, gray, and jade green. I reviewed the twelve patterns on Myunpok, Ten-Longivity patterns and Four-Gracious plants patterns in order to analyze the symbolism and thoughts of patterns for clothes. Nansam, Dopo, and Shimui worn by confucian scholars ensures that those clothes bears confucianism and philosopical factors. As shimui was worn by many people it appears in Chosun scholars' studies and a Chinese book called "Yeki". I reviewed the origin, procession, and ornaments of four ceremonial clothes and tried to find out the confucianism in them. First, In Kwanrei (the coming-of-age ceremony) remained ancestor worship and respect for manners. The clothes for this ceremony granted the rights and responsibilities of and adult to the wearer. The royal Kwanreipok had different dresses for each rank. As Samgapok, the crown prince wore Iksunkwan and Konryongpo for the first ritual, Wonryukwan and Kangsapo for the second, and Myunrukwan and Konpok for the third. The rank of the King's grandson was lower than the crown prince's. This example shows that Chosun people respected manners and thought the basic confucianism "God and people are equal." at the Royal court. Second, as Honreipok(wedding gown), the crown prince wore Myunrukwan and Konpok for Daereipok, Wonyukwan and Kangsapo for Napjing and Tongwoo, and Iksunkwan and Konryongpo for Chekbinui. But common people were allowed to wear an official outfit only for wedding in the means of congratulation on the most important day of their life. Wedding gowns which reflected Ying and Yang Theory emphasized the thought that union of a man and a wife is the most important event in life. Third, Sangrei(funeral) was the last ritual of a human being to send off the deceased. The mourning dresses expressed lamentation of the people left behind. Five-Dress-System for each the relative degree of familarity showed the solemnity and formality, which represented the formality of confucianism and ancestor worship. I reviewed the mourning dresses by dividing them into royal, Yangban's, and commons. They were featured by the fact that there was only one style for every walk of life. It is construed that anyone in mourning can wear the same clothes since he feels the same way regardless of his social rank. Fourth, Chereipok(sacrificial rite dresses) had different styles for each social rank. The King wore Myunpok(Kuryumyun and Kujangpok) were recorded to be worn first in the fourth year of King Taecho's ruling. The crown prince wore Palryumyun and Chiljangpok for sacrificial rite dress which was finally settled when King Sejong was in power. Common people wore Dopo, Shimui for the rite dress in the beginning of the Chosun Era and wore Dopo after Japanese invasion of Korea in 1592. In conclusion, confucianism played the main role in ceremonial dress system of Chosun and that was because it emphasized the ethics of action in life, which was different from other religions. It is true that cause-oriented thoughts and Chung myoung chooui in confucianism drove all ceremonies to extreme manners, discriminating the people who belonged to the lower social rank, and resulting in extremly luxurious life style. However, they also created a unique trend and clothes culture in the Chosun Era. I wish that this thesis provieds important information and direction for furthur studies in the future.

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죽음의 태도에 관한 조사연구 -임종환자의 간호를 위하여- (A Study On The Attitudes Toward Death -For Nursing Care of The Terminally Ill-)

  • 유계주
    • 대한간호학회지
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    • 제4권1호
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    • pp.162-178
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    • 1974
  • The present study is purported to provide a basic information to be utilized by nurses to care and attend effectively for patients nearing the moment of death. Therefore, the primary purpose of the study has been placed upon grasping an understanding of the trends of death in general. For this purpose: 1. By utilizing the schneidman questionnaire, the trend of death has been categorized by 6 parts and analyzed. 2. A search has been conducted to find out dying patient's needs, nurse's attitudes viewed by the patient, and nurse attitudes to dying patient. The followings are itemized results of analysis: 1. Analysis by the schneidman questionnaire. (1) In general concepts of death. the first sighting of the occurrence of death was experienced upon strangers, grandfather and great grandfather. The death is openly discussed among people of all ages and sex. Ages in which the death is mostly feared were from 12 to well over 70 yews old that are evenly distributed regardless of difference in age. (2) As to the attitudes toward death the occurrence of death to most closely associated person influenced most upon the attitude of their own termination of lives. Among the reading materials, the maximum influence was effected by the Bible. In terms of religion, the thoughts of death were Influenced by religions education in case of the believers of the western religions (36%), and by their own health and physical conditions in case of the believers in the oriental religions (35%). In case of non-believer, their attitude toward death were largely determined through their own thinking meditation (45%). People aged 20 or thereunder revealed that they wished to know the day of their own death to be occurred (58%). However, the older the less thor wanted to know. (3) As to the choosing the time of death, 57% preferred senility, and 30% preferred the time in mediately following the prime period of their lives in general. In terms of religion, 85% of the believer in the oriental religion preferred senility, and 67% in the western religion, 58% in others, Therefore. the desiring of their lives to be terminated in earlier stage, not by the natural senility. sequenced as follows : Others, western religions and oriental religions. (4) Referring to the disposal of the corpse under the assumption that it had already occurred, majority desired the burial system. There has been seen a slight tendency to consider the importance of holding funeral services for the sake of survivors. Concerning the life insurance policy, it showed that the nurse had less belief in it than the patient (5) Upon the subject of life-after-death. religion wise, 72% of western religion believers preferred to have an existence of life-after-death: Among the believers of oriental regions, 35% desired this category, 30% did not mind either way. and 35% did not desire the existence of such a life-after-death. In others, 53% did not mind whether or not such a life existed. (6) In general, serious thoughts were not being attended to the commitment of suicide. 37% emphasized that such an act should be prevented. However, 30% insisted that such commitment should not be bothered, and that society possesses no right to prevented it. More male wished to commit suicide (13%) than females (9%). 2. Nurse's attitudes toward terminal patients and patient's needs. In the instance where the patient realized that their death is imminent, most of them showed desire to discuses mainly on the problems of life. When faced a situation of this nature, it is revealed that 40% of nurses could not furnish appropriate care for them.

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