• Journal of Hospice and Palliative Care
• /
• 제24권1호
• /
• pp.26-35
• /
• 2021

Purpose: The purpose of this study was to determine the effects of awareness of good death and end-of-life care attitudes on end-of-life care performance in long-term care hospital nurses. Methods: This study used a cross-sectional study design. The participants were 147 nurses working at six long-term care hospitals with more than 200 beds in B city, South Korea. Data were collected using self-reported questionnaires, and analyzed with descriptive statistics, the t-test, analysis of variance, Pearson correlation coefficients, and multiple stepwise regression analysis using IBM/SPSS 26.0 for Windows. Results: The participants' awareness of good death, end-of-life care attitudes, and end-of-life care performance were positively correlated. The factors affecting end-of-life care performance were age, education level, awareness of good death, and end-of-life care attitudes; these variables explained 19.0% of end-of-life care performance. Conclusion: In order to improve long term care hospital nurses' end-of-life care performance, continuing education and training should be provided regarding awareness of good death and end-of-life care attitudes.

• Asian Pacific Journal of Cancer Prevention
• /
• 제13권5호
• /
• pp.2405-2408
• /
• 2012

This descriptive study was performed to determine levels of the death anxiety levels of relatives of patients who being treated in a public hospital located in the Asian side of Istanbul and influencing factors. The sample was 106 patient relatives of patients from oncology or chemotherapy units of the hospital. Data were collected between May-June 2011 with the 15-item Death Anxiety Scale developed by Templer (1970) and adapted to Turkish by Senol (1989) and evaluated by number-percentage calculations, the Kruskal Wallis, Anova and t tests. Some 36.8% of the included group were aged 45 years and over, 57.5% were female and 65.1% were married. A statistically significant difference was found between the age groups, genders of the patient relatives, the period of cancer treatment regarding the death anxiety levels (p<0.05). The death anxiety levels of the patient relatives who were in the 17-39 age group, female and had a patient who was under treatment for less than 6 months were found to high as compared to others.

• 임상간호연구
• /
• 제20권3호
• /
• pp.384-394
• /
• 2014

Purpose: To improve professional intensive care by analyzing admission causes, causes of death, disease conditions, and treatment processes in patients with hematological malignancies admitted to intensive care units (ICUs) in South Korea. Methods: This was a retrospective study approved by IRB, and conducted on admission with 559 adults, in the hematology ICU of a hospital located in Seoul. The study was carried out from April 2009 to March 2012. Data were analyzed using SAS. Results: Pneumonia was the most frequent cause of ICU admission and death, followed by sepsis. The condition at discharge was death (53.6%), recovery (39.9%), or hopeless (5.1%). Mortality of patients in states of incomplete remission was higher than that of patients with complete remission and of patients with multiple myeloma, severe aplastic anemia, and lymphoma. Conclusion: Results show that pneumonia and sepsis are the most frequent causes of ICU admission and for the death of patients with hematological malignancies. The most frequent status at discharge of patients with hematological malignancies was death (53.6%), with mortality of patients at Incomplete Remission status, of mechanically ventilated patients, and of patients on continuous renal replacement therapy (CRRT) being higher than others.

• 보건행정학회지
• /
• 제16권3호
• /
• pp.37-51
• /
• 2006

This study evaluates the reliability of the discharge status variable m health insurance claims for identifying in-hospital patient deaths. This study used 2002 national health insurance claims and the cause of death statistics from Korean national statistical office. The Study data set included acute myocardial infarction (AMI) and coronary artery bypass graft (CABG) surgery patients in 133 general and tertiary hospitals. The gold standard containing patient death information was made and then compared with that of claims data. The hospitals were classified into four groups based on the number of deaths in each hospital. Simple kappa coefficients were calculated to evaluate the agreements of patient deaths between the gold standard and the insurance claims. CABG (83.9%) showed higher agreements than AMI(73.0%) in matched in-hospital patient death information between data sets. Simple kappa coefficients of CABG (0.63) and AMI (0.59) showed moderate or good agreements. The agreements, however, varied depending on the disease or hospital types. The fact that the agreements are only moderate to good indicates that the accuracy of in-hospital death information in claims is not high. n the variable is used to identify patient deaths, it may mislead people. Therefore, efforts should be made to improve the reliability of the discharge status variable in health insurance claims.

• 대한간호학회지
• /
• 제45권4호
• /
• pp.513-522
• /
• 2015

Purpose: The purpose of this study was to identify and understand nurses' experiences of the death of patients in geriatric hospitals. Methods: Van Manen's hermeneutic phenomenological analysis was applied in the interpretation of experiential descriptions of seven nurses who had experienced the death of patients in a geriatric hospital. Results: The essential subjects derived from the experience of the nurses on the death of patients in a geriatric hospital are covered in the following 7 themes. 'Placed in death site', 'Difficult repetition of death and farewell', 'Emotional waves that rushes in after farewell', 'Dilemmas in a place with no preparation to greet expected death', 'Getting dull from continually being struck with sorrow', 'Being together with living death', and 'Showing courtesy for a good farewell and living well'. Conclusion: The results of this research will contribute to the development of policy on all the deaths of patients in geriatric hospitals and suggest basic data that need to be applied in real practice and directions to introduce plans for realistic improvements in nursing care of deathbed patients in geriatric hospitals.

• 한국콘텐츠학회논문지
• /
• 제21권4호
• /
• pp.688-698
• /
• 2021

본 연구의 목적은 대학병원 간호사의 좋은 죽음에 대한 인식과 사전연명의료의향서 지식이 연명의료 중단에 미치는 영향을 파악하기 위해 시도되었다. 연구대상자는 J도와 G시에 소재하고 있는 3개 대학병원에 근무하는 간호사 207명이었다. 연구결과 연명의료 중단에 대한 태도에 가장 강력한 예측인자는 좋은 죽음에 대한 인식(𝛽=-.32, p<.001)이었고, 좋은 죽음에 대한 교육 경험(𝛽=.15, p=.024), 사전연명의료의향서 지식(𝛽=.14, p=.036)이 영향요인으로 파악되었으며, 모형의 설명력은 14.2%였다. 본 연구결과를 토대로 대학병원 간호사가 연명의료 중단에 대한 긍정적 태도를 가지고 정확한 정보 제공과 상담자로서 제 역할을 할 수 있도록 좋은 죽음에 대한 인식, 사전연명의료의향서 지식을 향상시키기 위한 좋은 죽음과 연명의료에 대한 교육 프로그램의 개발을 제언한다.

• Annals of Clinical Neurophysiology
• /
• 제19권2호
• /
• pp.118-124
• /
• 2017

Electroencephalography (EEG) is frequently used to assist the diagnosis of brain death. However, to date there have been no guidelines in terms of EEG criteria for determining brain death in Korea, despite EEG being mandatory. The purpose of this review is to provide an update on the evidence and controversies with regarding to the utilization of EEG for determining brain death and to serve as a cornerstone for the development of future guidelines. To determine brain death, electrocerebral inactivity (ECI) should be demonstrated on EEG at a sensitivity of $2{\mu}V/mm$ using double-distance electrodes spaced 10 centimeters or more apart from each other for at least 30 minutes, with intense somatosensory or audiovisual stimuli. ECI should be also verified by checking the integrity of the system. Additional monitoring is needed if extracerebral potentials cannot be eliminated. Interpreting EEG at high sensitivities, which is required for the diagnosis of brain death, can pose a diagnostic challenge. Furthermore, EEG is affected by physiologic variables and drugs. However, no consensus exists as to the minimal requirements for blood pressure, oxygen saturation, and body temperature during the EEG recording itself, the minimal time for observation after the brain injury or rewarming from hypothermia, and how to determine brain death when the findings of ECI is equivocal. Therefore, there is a strong need to establish detailed guidelines for performing EEG to determine brain death.

• 디지털융복합연구
• /
• 제12권8호
• /
• pp.369-376
• /
• 2014

죽음교육의 주체이자 대상인 의료진의 죽음에 대한 스트레스 정도와 수용방식을'병원 공간을 중심으로'분석하여 죽음교육에 활용하고자, 2014년 4월부터 동년 4월30일까지 대전지역 일반인 281명을 대상으로 조사했다. 분석 결과 죽음교육의 필요성에 대해, 죽음교육을 받은 경우 더 중요하다고 생각하였다. 환자가 회불 불가상태인 경우 의료진은 누구에게 알리는가의 물음에 전체적으로는 보호자가 가장 높았으며, 임종하기 적합한 장소로는 살던집이 가장 많았고, 의료기관, 사회복지시설 순으로 나타났다. 이상과 같은 결과를 활용하면 죽음이라는 현상을 이해하고 다룸에 있어 보건의료적 시각과 인문학적 시각, 사회적 시각을 동시에 수용하여 일반인에게 적용할 수 있는 죽음 교육 프로그램 개발을 위한 연구로 죽음준비프로그램을 대중화 일반화를 위한 기초자료로써 의의가 있다고 할 수 있다.

• 임상간호연구
• /
• 제25권3호
• /
• pp.323-332
• /
• 2019

Purpose: This study aimed to identify the factors affecting the terminal care stress of nurses in intensive care units in terms of their death perception, attitude toward terminal care, and mental health. Methods: This descriptive study collected data from 118 nurses in intensive care units in one tertiary referral hospital and three general hospitals. The instruments used in the study were the Terminal Care Stress Assessment Tool, the View of Life and Death Scale, the Frommelt Attitudes toward Nursing Care of the Dying Scale (FATCOD), and the Mental Health Assessment Tool. The data were analyzed by t-test, ANOVA, Pearson's correlation coefficient, and multiple regression. Results: There was a significant positive correlation between terminal care stress and death perception (r=.31, p<.001). The factors significantly influencing the terminal care stress of the participants included gender (β=.33, p<.001), religion (β=.24, p=.004), and death perception (β=.35, p<.001), and the overall explanatory power was 23.1% (F=12.73, p<.001). Conclusion: To decrease terminal care stress among nurses, establishing the death perception of nurses based on value clarification about death may be necessary. Furthermore, this study suggests an intervention study examining the effect of an education program on terminal care stress among ICU nurses.

• 한국산학기술학회논문지
• /
• 제15권10호
• /
• pp.6234-6241
• /
• 2014

이 연구의 목적은 의료진의 죽음에 대한 스트레스 정도와 수용 방식을 병원 중심으로 조사하여 의료인 대상 죽음교육프로그램 개발의 기초자료로 활용하는 것이다. 연구기간은 2014년 4월부터 동년 4월30일까지이며, 대전지역 K 대학병원 의료진 353명을 대상으로 조사했다. 분석방법은 빈도분석과 카이스퀘어 검정이며, 연속변수는 독립표본 t-검정을 실시하였다. 분석결과 죽음교육의 내용 중 중요하게 다뤄야 할 것은 시간의 소중함 및 의미 있는 미래 삶 준비였으며(p<0.05), 죽음교육 필요 이유는 죽음에 대한 인식과 태도를 바꿔보기 위해서였다(p<0.05). 죽음교육 방법은 사례연구 문제 기반학습이었으며(p<0.05), 죽음 목격 후 가장 큰 스트레스는 보호자의 의료진에 대한 부정적 반응(p<0.05)으로 나타났다. 이상과 같은 결과를 볼 때 의료진의 죽음에 대한 이해와 죽음교육 필요성 제고는 의료진 자신은 물론 환자에 대한 이해와 감수성 향상에도 기여할 것으로 판단되었다. 죽음에 대한 의료 인문적 시각을 동시에 포함한 본 조사는 병원 공간과 의료진 대상의 특성화된 '죽음교육프로그램 개발'에 기여할 것이다.