• Asian Pacific Journal of Cancer Prevention
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• 제15권18호
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• pp.7653-7664
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• 2014

Background: Colorectal ranked first among cancers reported in males and ranked second amongst females in Jordan, accounting for 12.7% and 10.5% of cancers in males and females, respectively. Colorectal cancer patients can suffer several consequences after treatment that include pain and fatigue, constipation, stoma complications, sexual problems, appearance and body-image concerns as well as psychological dysfunction. There is no published quantitative data on the health-related quality of life and psychological wellbeing of Jordanian colorectal cancer survivors. Method: This project was a cross-sectional study of colorectal cancer survivors diagnosed in 2009 and 2010. Assessment was performed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), the colorectal cancer specific module (EORTC QLQ-CR 29) and the Hospital Anxiety and Depression Scale (HADS). Data on potential predictors of scores were also collected. Results: A total of 241 subjects completed the study with mean age of $56.7{\pm}13.6$. Males represented 52.3% of study participants. A majority of participants reported good to high overall health; the mean Global health score was $79.74{\pm}23.31$ with only 6.64% of study participants scoring less than 33.3%. The striking result in this study was that none of the study participants participated in a psychosocial support group; only 4 of them (1.7%) were even offered such support. The mean scores for HADS, depression score, and anxiety score were $8.25{\pm}9$, $4.35{\pm}4.9$ and $3.9{\pm}4.6$, respectively. However, 77.1% of study participants were within the normal category for the depression score and 81.7% were within this category for anxiety score; 5.4% of participants had severe anxiety and 5.4% of them had severe depression. Discussion: Patients with colorectal cancer in Jordan have a good quality of life and psychological wellbeing scores when compared with patients from western countries. None of the colorectal cancer patients managed at the Ministry of Health received any formal counselling, or participated in psychological or social support programmes. This highlights the urgent need for a psychosocial support programme, psychological screening and consultations for patients diagnosed with colorectal cancer at the Ministry of Health Hospitals.

• Asian Pacific Journal of Cancer Prevention
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• 제14권11호
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• pp.6833-6838
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• 2013

The purpose of this descriptive study was to determine the hopelessness and depression levels of parents of children diagnosed with cancer and undergoing cancer treatment and factors affecting these levels. The study was carried out with parents of 44 children receiving treatment in a paediatric haematology clinic of a university hospital. Data were collected using a survey form, the Beck Hopelessness Scale (BHS) and the Beck Depression Scale (BDS). The mean BDS score of the mothers and fathers was $18.3{\pm}11.30$ and $15.2{\pm}11.33$, respectively. The mean BHS score of the mothers was $6.45{\pm}4.40$, whereas the mean BHS score of the fathers was $5.88{\pm}4.27$. The results showed that the levels of hopelessness and depression among the mothers were higher than among the fathers (p<0.001). There was a positive relationship between the hopelessness and depression scores of the mothers and the fathers (p<0.05), and the levels of hopelessness and depression scores of the fathers increased as those of the mothers increased. A weak financial situation of the family increased the hopelessness and depression levels of the fathers. The hopelessness and depression levels of the mothers who were supported by their families and relatives were decreased compared to those without such support (p<0.05). The results show that the parents of children with cancer face many psychosocial and spiritual problems. Using simple screening tools, nurses can identify at-risk parents and direct them to support services. We conclude that actively encouraging families to avail themselves of support resources and supporting them financially would positively affect the levels of depression and hopelessness of parents of children with cancer.

• 한국융합학회논문지
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• 제13권1호
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• pp.313-323
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• 2022

본 연구에서는 COVID-19시대에 비대면 서비스가 확대되고 있는 상황에서 마비말장애의 재활을 위한 디지털 치료제 기반의 커뮤니티케어 방안을 모색하고자 하였다. 이를 위하여 병원, 언어치료기관, 사회복지기관에서 근무하는 전문가들을 대상으로 질적연구를 수행하였고, 연구 결과 3개의 주제와 9개의 하위주제, 18개의 의미단위가 도출되었다. 분석결과에 근거한 디지털 치료제 기반의 커뮤니티케어 모델은 원격진단, 원격치료, 재활훈련 프로그램 제공, 동료지원가들의 지지, 임상적 지원, 의사소통 지원, 심리사회적 중재, 케어플랜 서비스 등 9가지 유형으로구성되었다. 본 연구는 디지털 치료제를 활용한 보건-복지 연계서비스를 위한 기초자료와 다학제간 협력에 기반한 공유케어 계획 수립의 가이드라인을 제공할 수 있을 것이다.

• Journal of Hospice and Palliative Care
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• 제26권2호
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• pp.51-59
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• 2023

Purpose: We evaluated the status of patients enrolled in South Korea's pediatric palliative care pilot project based on the experience of a single center. This study examined factors related to end-of-life services and differences in medical costs. Methods: The medical records of 120 patients referred by a pediatric palliative care team were analyzed retrospectively. Data from July 1 to February 28, 2022 were collected and analyzed using the chi-square test and the Mann-Whitney U test. Results: Volunteer programs and psychological support (100%), family support and education (99.2%), and financial support through institutional linkage (62.5%) were provided to the participants. In the deceased group, there were no significant differences in general characteristics, which included age, gender, primary disease, religion, duration of hospitalization in an intensive care unit (ICU) and non-intensive care unit (non-ICU). However, the ICU group had fewer opportunities to access individual pain and physical symptom management than the non-ICU group and there were limitations in linking with external resources. Medical expenses were significantly different for the ICU group, with a 3-times higher average cost than the non-ICU group. Conclusion: Although an individualized approach is needed for each patient in pediatric palliative care, psychosocial care is essential. In addition, if early intervention for end-of-life pediatric patients is available from a palliative care team, the cost burden of medical care for patients and their families should be minimal.

• 한국아동복지학
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• 제56호
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• pp.165-193
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• 2016

본 연구는 체계적 문헌고찰과 메타분석을 활용하여 아동의 심리사회적 부적응에 영향을 미치는 상관요인을 생태체계적 관점으로 개인, 가족, 학교, 지역사회 수준에서 고찰하였다. 1999년부터 2016년 6월 30일까지 국내에서 수행된 연구 중 선정기준에 따라 총 36편이 선정되었고, 외현화 문제관련 21개변인 65개 데이터, 내재화 문제관련 22개변인 70개의 데이터가 최종 메타분석에 사용되었다. 분석결과 아동의 외현화 문제 관련 아동 개인요인 중 스트레스 대처방식, 가족요인 중에는 가족의사소통, 학교요인 중에서는 학교적응, 지역사회요인 중에서는 사회복지서비스 만족정도가 가장 큰 효과크기로 나타났다. 반면, 내재화 문제와 관련해서는 아동 개인요인 중 아동의 기질, 가족요인 중 부모가족과의 관계, 학교요인 중 또래와의 관계, 지역사회요인 중 사회적 지지가 가장 큰 효과크기를 보이는 것으로 나타났다. 각 요인군별 평균효과크기를 살펴본 결과 외현화, 내재화 문제 모두 개인 > 가족 > 학교/지역사회 요인군 순으로 평균효과크기가 나열 되었다. 또한 요인군별 이질성에 대해 조절효과 분석을 실시한 결과를 제시하였다.

• 한국인구학
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• 제34권1호
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• pp.73-97
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• 2011

본 연구는 '2008년 노인생활실태조사'를 토대로 손자녀를 돌보는 조부모의 심리적 복지감에 영향을 미치는 요인을 살펴본 것이다. 특히 양육 상황, 양육지각, 자원 등을 손자녀 양육경험의 주요 차원으로 설정하여, 매개모형분석을 통해 이들 요인 간의 상호복합적 관련성을 검토하였다. 본 연구결과를 요약하면 다음과 같다. 첫째, 조사대상자들의 손자녀 양육동기의 대부분이 맞벌이가정의 자녀양육을 돕기 위함이었으며, 조사대상자의 대다수가 양육에 대한 대가를 받지 않았다. 둘째, 돌봄 상황 자체가 직접적으로 조부모의 심리적 복지감의 차이를 유발하지 않고, 돌봄 상황의 차이가 가져온 양육지각과 자원의 차이가 매개역할을 하면서 간접적으로 조부모의 심리적 복지감에 영향을 미쳤다. 셋째, 자원 중 경제형편과 이웃도움은 양육지각을 긍정적으로 높이는 것과 관련되었으며 자녀지지는 양육지각과 관련이 없었다. 결국, 본 연구는 현대 사회에서 조부모가 손자녀 양육을 통해 성인자녀세대의 경제활동을 지원함으로써 사회의 생산성을 유지하는 중요한 서비스 제공자임을 보여준다. 또한 손자녀 양육경험은 관련요인들이 서로 복잡하게 연결된 복합적 과정이며, 특히 손자녀 양육 조부모의 심리적 복지감에 작용하는 개인, 가족, 사회적 자원의 유용성을 주목할 필요가 있다. 이것은 조부모의 손자녀 양육이 더 이상 개인과 가족차원의 논의에 머무르지 않고 지역사회차원 이상의 관심사로 다루어짐으로써, 이들의 외적자원을 강화시키는 구체적인 방안이 강구되어야 함을 시사한다.

• 한국노년학
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• 제40권1호
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• pp.111-130
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• 2020

본 연구는 중·고령 초기 유방암 생존자를 위한 가족들의 돌봄 경험에 대해 이해하고자 한 질적 연구이다. 총 4명의 유방암 생존자 가족들을 대상으로 초점집단면접(FGI)을 실시하였고 추가로 1명의 가족에 대해 개별심층면접을 실시하였다. 초점집단면접과 개별심층면접 내용을 주제 분석한 결과, 다음 4가지 주제가 나타났다: 첫째, 살얼음 위를 걷는 듯한 일상의 감정들 (치료시기마다 서로 뒤얽히는 감정들, 생존자의 고통을 지켜볼 수밖에 없는 안타까움, 암 재발과 죽음에 대한 두려움, 관계 변화에 대한 걱정, 딸로서 겪는 다양한 감정), 둘째, 생활의 중심이 된 돌봄 (낯설고 서툴렀던 돌봄, 내 생활을 잃어감), 셋째, 회복의 시작, 생존자와 가족이 느끼는 온도 차이 (생존자가 느끼는 심연의 고통을 헤아리지 못함, 생존자가 아직 환자라는 사실을 잊고 소홀히 대함), 넷째, 앞으로 나아가기 (나아질 것이라는 희망, 지치지 않기 위한 나를 위한 돌봄). 본 연구 결과를 토대로 유방암 생존자 가족의 심리사회적 욕구를 반영하고 돌봄 과정에서 가족 지지를 지원하기 위한 사회복지서비스 및 정책 방안에 대해 제언하였다.

• 여성건강간호학회지
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• 제5권1호
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• pp.133-145
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• 1999

The purposesof the study are to analyze the community nursing center in U.S.A and to develop the model of nursing care system based on nurse-midwifery clinic in community for women's health in Korea. 1. In America nursing center is defined as nurse-anchored system of primary care delivery or neighborhood health center. Nursing centers are identified the following four types: (1) community outreach centers, which are similar to traditional public health clinics: (2) institutional-based centers following the mission of a large institution, such as a hospital or university: (3) wellness/health promotion centers, which offer screening, education, counseling, triage, and health maintenance services: and (4) independent practice. Nursing centers are a concept of services provided by nurses in practice arrangements in a community. Nursing centers offer a variety of services, ranging from primary care provided by advanced practice nurses with medical acute management and nursing care to the more traditional education, health promotion, screening wellness and coordination services. Some services, such as the care provided by advanced practice nurses are reimbursed under various insurance plan in some instances and states, where as others, such as preventive and educational services, are not. Thus, lack of reimbursement has threatened the survival of some centers. Licensing of nursing centers varies by state and program and accreditation of nursing centers is also limited. 52% of centers are affiliated with another facility and 48% are freestanding centers. The number of registered nurse at the nursing centers ranges from just one to 115, with a mean of eight RNs peragency and a median of three. Nursing centers avail ability varies: 14% are open 24 hours, 27% have variable short hours, 23% are open 6-7 days per week, and 36% are open Monday- Friday. As the result of my visiting three health centers in Seattle and San Francisco, the women's primary care nurse practitioners focus on a systematic and comprehensive assessment of the health status of women and diagnosis and management of common physical and psychosocial health concerns of women in ambulatory settings. Therapeutic nursing strategies are directed toward self-care, risk reoduction, health surveillance, stress reduction, healthy nutrition, social support, healthy coping, psychological well-being, and pharmacological therapy. They function as primary care providers for the well ness and illness care of women from adolescence through the older adult years and pregnant families. 2. In Korea a nurse-midwife practices independently for pregnant women's health including childbearing family at her own clinic in community. Her services are reimbursed under national health insurance but they are not paid on a fee-for-service schedule covering items. Analyzing the nursing centers in America, I suggest that nurse-midwifery clinics offer primary care for women and home care for chronic ill patients. The health law and health insurance policy should be reovised in order to expand nurse-midwife's and home care nurse's roles at nurse-midwifery clinic.

• Asian Pacific Journal of Cancer Prevention
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• 제15권14호
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• pp.5927-5936
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• 2014

Introduction: Breast cancer is the most common cancer among Jordanians. Breast cancer patients suffer from several negative consequences after treatment and these include pain, fatigue, sexual problems, appearance and body image concerns, with psychological dysfunction. This could affect the patient quality of life and psychological well-being. To the best of our knowledge, there is no published quantitative data on the quality of life and psychological well-being of breast cancer patients in Jordan. The objective of this study was to obtain such data and assess predictors with calculated scores. Methods: In this cross-sectional study conducted among breast cancer patients in Jordan diagnosed in 2009 and 2010, assessment was performed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), the Breast Module (QLQ-BR23) and the Hospital Anxiety and Depression Scale (HADS). Clinical, demographic and psychosocial indicators that could predict patient quality of life scores were collected. Results: The number of patients interviewed was 236 (mean age=$50.7{\pm}10.7$ years). The mean Global Health score for the QLQ-C30 was $63.7{\pm}20.2$ SD. Among functional scales, "social functioning" scored the highest ($mean=78.1{\pm}28.6$ SD), whereas "emotional functioning" scored the lowest ($mean=59.0{\pm}SD\;33.5$). For the QLQ-BR23, the worst scores within the functional scales were for "body image" ($mean=52.1{\pm}36.8$ SD) and "future perspective" ($mean=52.9{\pm}38.5$ SD). The worst symptom was "upset by hair loss" ($mean=69.8{\pm}43.0$). The mean HADS scores was $18.{\pm}9.0$ SD. Out of study participants, 53% scored abnormal on the anxiety scale and 45% on the depression scale. Severe depression and severe anxiety were detected among 8% and 14% of study participants, respectively. Statistically significant predictors for individual scores were similar to those reported in published studies, such as the presence of recurrence since baseline, family history of cancer, low educational status, current social problems, extent of the disease, presence of financial difficulties, and employment status. Conclusions and Recommendations: Breast cancer survivors in Jordan have overall good quality of life scores when compared with patients from Western countries. However, their psychological wellbeing is more impaired. There is an urgent need for psychosocial support programs and psychological screening and consultation for breast cancer patients at hospitals of the Ministry of Health in Jordan.

• 보건행정학회지
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• 제4권2호
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• pp.27-57
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• 1994

The objective of running a long-term care institution is to provide services helpful for maintaining, supporting, and improving elderlies' optimum level of physical, mental, and psychosocial functioning. For the purpose of analyzing the current situations of institutional long term care facilities in Korea, 27 facilities were selected proportionately from each of the cities and provinces, out of the total 152 facilities. About 20% of those who were institutionalized during 25 August through 2 Qctober 1993, the 391 elderlies were chosen on a systematic random basis. The instrument of this study was developed by modifying the tools of CARE, MAI and PCTC. A multivariate approach of discriminant analysis and clustering technique were employed for this study. The Stiudy reveals that there is no clear differentiation of goals and functions among the longterm care institutions in Korea. Staffing patte군 of long-term care facilities shows a shortage of nurses, physical therapists, and dieticians. The linkage between acute care facilities and long-term care is weak, and administration of long-term care faciltiy is carried out by non-professionals. They are responsible for assessing health status before entering the facility, and evaluating elderlies' care. Therefore, it is not surprising to find that most of the facilities have accommodated agede regardless of their real needs and health status. Based upon findings of the analysis, this study has classified long-term care facilities into four types : Type I is to help elderlies maintain independence in daily living activities. Type II facilities have the objective of maintaining and improving the current level of elderlies' function. Type III is to maintain maximum independence of elderlies in activities of daily living. And Type IV is identified for the group of facilities designed to restore or improve functional abilities of elderlies. In conclusion, the following suggestions are made : the need for long-term care should be assessed by multidimensional measurement. Institutional long-term care facilities should be classified and developed in response to type of type of care and service need. Both acute and long-term care facilities should be linked together in order to support the evaluation of service operation and program development.