• 제목/요약/키워드: Patient family

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의학적 충고에 반한 퇴원의 특성과 퇴원결정 요인에 관한 연구 - 사회사업가의 개입사례와 역할을 중심으로 - (A Study on the Characteristics of DAMA(Discharge Against Medical Advice) Case and Causal Factors of DAMA - Perspective of Medical Social Worker's Role and Intervention -)

  • 강흥구;이상진;조경기
    • Journal of Korean Neurosurgical Society
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    • 제29권12호
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    • pp.1620-1627
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    • 2000
  • Objectives : DAMA cases were analyzed to examine what the main casual factors of DAMA were and how to deal with these cases effectively in hospital with the DAMA interdisciplinary team including medical social worker whose role is to perform psycho-social assessment, family counsel, to evaluate family's DAMA need. Patients and Methods : The content analysis of medical record and social work record were reviewed in 37 cases referred by medical doctor to DAMA team. These cases were reported by patients' self discharge request or family's request for discharge from September 1998 to February 2000. The DAMA team consists of Assistant Director of Hospital as team leader, medical staff in-charge, social worker, QI nurse, other staff members who are not involved in direct treatment for patient, and administrative clerk. Results : The results of content analysis are as follows : 1) The most causal factors of DAMA consist of combination of more than 2 factors. 2) The major decision-maker is revealed to be son and daughter of patient. 3) In 59.4% of cases, family was not informed of patients' prognosis, alternatives, the consequence of DAMA at all. 4) In cases of DAMA report, the rapid intervention of social worker is carried out. Conclusion : In this study, we propose the interdisciplinary team approach to make decision legitimately and ethically for DAMA. The suggestions from this study are as follows : 1) To deal with DAMA case properly, the interdisciplinary team approach should be considered. 2) The criteria for DAMA case should be formed carefully. For the explicit selection of DAMA case, preliminary system for high-risk patient screening is recommended. 3) The medical social worker is available for the psycho-social problems of the patient once family members. For the effective family counselling, discharge planning and nursing home placement, the participation of medical social worker should be mandatory.

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Experiences of Family Caregivers of Cancer Patients Receiving Chemotherapy

  • Sercekus, Pinar;Besen, Dilek Buyukkaya;Gunusen, Neslihan Partlak;Edeer, Aylin Durmaz
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권12호
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    • pp.5063-5069
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    • 2014
  • Background: Cancer is a disease which affects not only patients but also their families physically and emotionally. The purpose of this study was to determine the needs, challenges and ways of coping of caregivers of cancer patients. Materials and Methods: In the study, a phenomenological approach was used. Data were collected through semi-structured individual interviews. The study sample comprised 16 family members providing care for a cancer patient. Results: The study findings are grouped under four main themes: the impact of caregiving, masking feelings, experienced challenges and expectations, and coping. During the caregiving process, patient relatives are affected physiologically, psychologically and socially. It was determined that patient relatives hid their feelings and avoided talking about the disease for fear that they might upset the patient, and that they had difficulty in coping with the patient's reactions during the treatment process. Family members had difficulties arising from the health system, hospital conditions and treatment in addition to transportation and financial problems. Support is very important in coping, but it was determined that some of the relatives of patients did not receive adequate support. Patient relatives expect that health care professionals should provide them with more information about their patient's condition and the course of the disease that their patients should be dealt with by the physicians specialized in cancer, and that psychological support should be provided both for them and for their patient. Conclusions: During the caregiving process, family members are faced with many difficulties and they exhibit different coping behaviors which health care professionals should take into account.

류마티스 관절염 치료에 대한 고찰 (A Study on Rheumatoid Arthritis Treatment)

  • 최현석
    • 대한물리치료과학회지
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    • 제4권4호
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    • pp.511-518
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    • 1997
  • For the perfect cure of rheumatoid arthritis, the ultimate hope of patients and therapist, it is necessary to find a patient early and treat him properly and to teach him what rheumatoid arthritis is. 1. Although rheumatoid arthritis is a chronic disease and its cause is uncertain matke the patient understand that there are many ways to reduce symptoms and to prevent deformation. 2. Explain the peculiarity and the procedure of rheumatoid arthritis to the patient and encourage him. 3. Teach the patient how to protect his arthrosises by showing him concrete movement. 4. Teach the patient or his family the ways to relieve rheumatoid arthritis easily in his house for continuous remedy. In order to make that remedy most effective for the patient, a complex and balanced treatment, considering medication, surgical teatment and rehabilitative treatment, has to be applied, which needs team work. Team work occurs when doctors, physiotherapists, nurses, nutritionists, clinical psychologists, prosthesis manufacturers, social workers, employment agents and the family of the patient work together. The members of the tern have to onderstand the procedure of the treatment of rheumatoid arthritis and apply proper remedies according to the condition of the patient.

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임종태도와 HOSPICE에 관한 연구 (A study on the attitude toward dying and hospice)

  • 김영욱;이중훈;이종범;박병탁;정성덕;김명세;김후자
    • Journal of Yeungnam Medical Science
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    • 제7권2호
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    • pp.55-66
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    • 1990
  • 1. 임종통고에 대한 반대는 노인군과 환자가족군이 40.2%, 40.9%로 환자군과 의료인군의 23.%, 13.3%보다 유의하게 높았다(p<0.001). 2. 임종환자에 대한 의료인의 회피적 태도에서는 의료인군의 44%가 반대하여 전체평균 28.5%보다 유의하게 높았다(p<0.001). 3. 불치병 환자의 생명 연장에 대한 태도에서는 환자군과 보호자군의 반대율이 33.3%, 22.5%로 노인군과 의료인군의 54.5%, 56.0%보다 유의하게 낮았다(p<0.001). 4. 임종환자를 위한 특수시설 및 교육문제에 있어서는 의료인군의 찬성율이 81.3%로 가장 높았고 환자군이 56.8%로 가장 낮았다. 5. 임종환자에 대한 가족의 회피적 태도에 대해서는 노인군의 찬성율이 81.3%로 가장 높았고 가족군이 34%로 가장 낮았다. 6. 임종에 대한 지각문제에 있어서는 의료인군의 찬성율이 77.3%로 전체평균 58.8%보다 높았다.

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류마티스 관절염 환자의 자가간호역량과 가족지지, 삶의 질과의 관계 (The Relationships among Self-Care Agency, Family Support, Quality of Life in Patients with Rheumatoid Arthritis)

  • 박상연;남영화;백명화
    • 근관절건강학회지
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    • 제7권2호
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    • pp.281-293
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    • 2000
  • This study was conducted to identify the relationships among self-care agency, family support, qualify of life in patients with rheumatoid arthritis. The subjects were 120 rheumatoid arthritis patients who attended RA O.P.D. at a university hospital, located in Daegu city, from 10th of May in 1998 to 30th of July in 1998. Three structure questionnaires were administered for explore three main research variables; 소향숙's self-care agency scale, 강현숙's family support scale, and 김종임's quality of life scale of RA patien. Data analysis was conducted with SPSS program including percentage, mean, standard deviation, mean score, Pearson Correlation Coefficient, multiple regression, and Cronbach's Alpha. Results are summarized as follows; 1. The mean of RA patient's self-care agency was 136.62, the mean of family support 37.38, and the mean of qualify of life 134.41. 2. Subject's self-care agency was positively correlated with family support(r=.2446) and with quality of life(r=.4341). Subject's family support was positively correlated with quality of life(r=.2630). 3. Stepwise multiple regression was used to determine the predictors of subject's quality of life. Significant predictors for subject's quality of life were self-care agency(t=4.873 p=0.0000), family support(t=4.480 p=0.0000) and the severity of arthralgia(t=-3.838, p=0.0002). The number of joints involved and the periods of illness did not show significant contribution to subject's quality of life. Self-care agency, family support, and family support explained 40. 39% of the variance in RA patient's quality of life. Given this results, it is suggested that a repeated study to measure RA patient's self-care practice in their own life may be needed to develope and validate an optimum level of nursing intervention for RA patient with which family support will be encouraged and patient's self-care agency will be facilitated.

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만성요통환자가 지각하는 가족기능과 우울의 관계 (The Relationship between Perceived Family Functioning and Depression in Patients with Chronic Low-Back Pain)

  • 손정태;박현숙
    • 기본간호학회지
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    • 제7권2호
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    • pp.316-331
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    • 2000
  • This study was conducted using a descriptive correlational survey design to identify how patients with chronic low-back pain perceived family function and to examine the relationship between family function and depression. The participants of the study were 116 patients with chronic low-back pain patient who were having follow-up treatment in a local pain clinic, located in Daegu. A structured questionnaire was filled out participants themselves and the structured interview was given during January and February, 2000. The data collection instrument were FACE II-Korean version and Beck's Depression Inventory(1983). The data collected were analysed using mean, standard deviation(SD), t-test, F-test, Duncan test and Pearson correlation coefficient, done with SAS. The results are as follows; 1. The mean of the respondents' perceived family function was 3.47, with emotional bonding at 3.61, acceptability and sharing at 3.61, participation at 3.23, negotiation and satisfaction at 3.24 and responsibility and expectation at 3.76. 2. The mean of the respondents' perceived depression was $17.53{\pm}8.76$. 3. There was significantly negative correlation between family function and depression(r=-0.4817, p=.0001). 4. Research variables included demographic characteristics and showed that subjects who were aged 65 years or older showed significantly lower scores in patient's perceived family function than those who were aged 45 years or below(p=.0502). Perceived family function of females respondents were significantly lower than males(p=.0026). The illiterate showed significantly lower scores than other groups(p=.0001). Respondents with spouse and extended family tended to show significantly higher scores than those who were living with spouse only or by themselves alone(p=.0091). Those who had higher income showed significantly higher scores than in the lower income group(p=.0001). 5. For family function regarding pain characteristics, those who reported severe pain-related daily activity impediments showed significantly lower scores in family function than others with less pain(p=.0357).

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임종환자 및 그 가족의 심리적 간호요구가 충족되지 못하는 이유에 관한 문헌고찰 - American Journal of Nursing을 중심으로 (A Literary Review of Obstacles to Providing Psychological Care for Dying Patient and His Family)

  • 김순용
    • 대한간호
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    • 제19권5호통권108호
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    • pp.55-68
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    • 1980
  • The purpose of this study is to find out most wanted nursing contents (behavior) of the dying patient and his family and to discover the obstacles to helping the dying as analysis of 53 factual reports on the care of dying patients on American Journal of

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두경부암 환자 가족의 돌봄 경험에 관한 현상학적 연구 (A Phenomenological Study of Experiences of Family Care Givers of Patient with Head and Neck Cancer)

  • 임정원;권주연;안손희;윤은지
    • 한국콘텐츠학회논문지
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    • 제18권10호
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    • pp.348-360
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    • 2018
  • 목적 : 본 연구는 두경부암 환자를 돌보는 가족들의 돌봄 경험의 의미와 본질을 탐색하는 것을 목적으로 하고 있다. 방법 : 개인들의 공통된 체험의 본질과 의미를 기술하는데 적합한 현상학적 연구 방법을 이용하여 5명의 두경부암 환자 가족을 대상으로 심층 면담을 실시하였다. 결과 : 자료 분석 결과 24개의 주제, 9개의 주제 모음이 도출되었고, '충격적이고 막막한 미로 같은 현실', '가족구성원의 신체상의 변화로 세상과 단절됨', '가족 탈진', '성숙한 돌봄을 위한 가족의 도약'의 4개의 범주가 드러났다. 결론 : 본 연구를 통해 두경부암 환자 가족의 돌봄 경험을 더 깊이 있게 살펴보고 이해할 수 있었다. 본 연구 결과를 기반으로 두경부암 환자 가족의 어려움을 지지해 줄 수 있는 전문적인 지지 프로그램의 개발이 마련되었으면 한다.

가정전문간호사의 환자·가족교육 수행정도와 저해요인 (Performance and Impediments to Patient and Family Education among Home Health Care Nurses)

  • 서유진;이미경
    • 가정간호학회지
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    • 제26권3호
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    • pp.329-340
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    • 2019
  • Purpose: This study aimed to provide basic data necessary to develop education programs and educational services for home care by investigating the degree of patient and family education among home health care nurses. Methods: Data collection was carried out with 145 people from 47 institutions that agreed to participate in the research. A total of 128 questionnaires were received, of which 122 were analyzed. Data were analyzed using SPSS 12.0. Results: The item on which education was most frequently delivered was intravenous injection speed control (66.4%), whereas the item requiring the longest teaching period was pressure ulcer care. The average degree of impediment perceived by home care nurses was 2.82 out of 5. Conclusion: Medical institutions should develop educational materials and programs that reflect the characteristics and degree of home health care needed. Repeated research, including that by medical institutions, on the degree and impeding factors related to patient and family education performance of home health care nurses should be conducted. Moreover, medical institutions should investigate the nursing and educational needs of patients and families who received home health care service.

투석기간에 따른 투석 환자의 불확실성 요인 (Factors Influencing Uncertainty in Dialysis Patient by Duration of Dialysis)

  • 윤수정;이영희
    • 성인간호학회지
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    • 제24권6호
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    • pp.597-606
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    • 2012
  • Purpose: This study was to describe the uncertainty, depression, physical symptom, and family support among patients undergoing dialysis. Further, the factors that impact uncertainty were also examined. Methods: A convenience sample of 145 patients who received dialysis was selected. A descriptive correlation study was conducted. Data were collected using structured questionnaires and the collected data were analyzed using descriptive statistics and multiple regression analysis. Results: The patient who received more than five years of dialysis reported higher levels on inconsistency of uncertainty than patient with less than five years. These latter patients' reported uncertainty was positively correlated with depression, whereas, patients family support was correlated with uncertainty. The group's uncertainty with less than five years of dialysis explained about 13% of the variance. In contrast, variables of education level, family support, and monthly income were predictors of uncertainty and explained 33% of the variation. Conclusion: These results can provide for nursing intervention to facilitate reduction of uncertainty. To provide dialysis period-sensitive nursing intervention for uncertainty among dialysis patient, depression should be considered below five years. While factors such as education level, family support, and monthly income should be taken into account over five years.