통합 검색 | Korea Science

호스피스 완화의료 연구에서의 윤리적 고려사항 (Ethical Considerations in Hospice and Palliative Care Research)

윤가현
- Journal of Hospice and Palliative Care
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- 제22권2호
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- pp.49-66
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- 2019
의료기술 발달 및 경제개발 수준 상승 등으로 호스피스 완화의료(hospice & palliative care) 서비스를 받는 말기 환자들이 점점 늘어나고 있다. 이와 더불어 최근 호스피스 완화의료 분야 임상전문가들은 환자나 가족 대상 호스피스 완화의료 서비스의 질을 향상시킬 목적으로 하는 연구에도 많은 관심을 보이고 있다. 한편 정부의 연구대상자 보호 정책이 강화되면서 IRB(생명윤리심의위원회)에서도 호스피스 완화의료 연구의 연구계획서를 심의할 때 환자의 취약성과 관련된 다양한 윤리적 사안들을 더 엄밀하게 점검하고 있다. 그러나 말기 환자들의 삶의 질 향상 및 유지를 위해서는 질적으로 보장된 호스피스 완화의료 서비스가 제공되어야 한다. 이를 위해서 윤리적으로 안전한 호스피스 완화의료 연구의 시도가 지지되어야 한다. 이에 필자는 호스피스 완화의료 연구의 윤리지침을 종설 논문 형식으로 제안했다. 이는 윤리적으로 안전하고 과학적으로 가치가 있는 연구계획서를 준비해야 하는 연구자 및 그 연구계획서를 심의하는 IRB가 적절하게 참조할 수 있도록 해주기 위함이다.
https://doi.org/10.14475/kjhpc.2019.22.2.49 인용 PDF KSCI

Barriers to Effective Communication about Advance Care Planning and Palliative Care: A Qualitative Study

Hyosin Kim;Signe Peterson Flieger
- Journal of Hospice and Palliative Care
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- 제26권2호
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- pp.42-50
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- 2023
Purpose: The purpose of this study was to identify barriers to effective conversations about advance care planning (ACP) and palliative care reported by health care and community-based service providers in Massachusetts, USA. Methods: This qualitative research analyzed open-ended responses to two survey questions, inquiring about perceived barriers to having conversations about ACP and palliative care with patients and consumers. Data were collected between November 2017 and June 2019 from nine organizations in Massachusetts, including health care provider organizations, health insurers, community-based organizations, and a nursing education institution. Two researchers reviewed and coded the responses and identified common themes inductively. Results: Across 142 responses, primary barriers to ACP included hesitation and lack of understanding and knowledge, discomfort and resistance among service providers, lack of staff knowledge, difficulties with followup, and differences in ACP policies across regions. Common barriers to palliative care were misconceptions about palliative care and lack of knowledge, service providers' lack of preparedness, and limited policy support and availability. Challenges relevant to both ACP and palliative care were fear and discomfort around serious illness discussions, lack of knowledge and awareness, discussions that occur too late, and cultural and language barriers. Conclusion: Health care practitioners and community-based professionals reported consumer-, service provider-, and system-level barriers to facilitating conversations about ACP and palliative care with patients experiencing serious illness. There is a need for more tools and support to strengthen service providers' ACP and palliative care competencies and to promote a structured approach to health care planning conversations.
https://doi.org/10.14475/jhpc.2023.26.2.42 인용 PDF

중환자실 완화의료 모델과 간호사의 역할 (Palliative Care Models in Intensive Care Units and Nurses' Roles in the Models)

고진강
- 중환자간호학회지
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- 제7권1호
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- pp.40-46
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- 2014
Purpose: In Korea, about 30,000 people die in intensive care units annually. However, their quality of life at the end-of-life seems very low. The purpose of this study was to describe palliative care models that could be applied in intensive care units and examine nurses' roles in the models. Methods: A conventional literature review was performed focusing on palliative care in intensive care units and nursing roles in the approaches identified. Results: There are two different models regarding the implementation of palliative care approaches in the intensive care unit. Those are the consultative model and the integrative model. Each model has advantages and disadvantages. Therefore, an appropriate model must be chosen according to the setting. Nurses' roles could vary depending on the setting. Conclusion: Palliative care in the intensive care unit is important to improve patients' quality of life. Moreover, nursing roles are important in providing comprehensive palliative care in intensive care units.
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