• Journal of Hospice and Palliative Care
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• 제19권4호
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• pp.292-295
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• 2016

목적: 대만의 호스피스와 완화 의료는 지속적으로 증가하고 있다. Economist Intelligence Unit에서 평가한 2015년 죽음의 질 지수 등급에서 대만은 아시아 국가 중에서 1위, 세계에서 6위를 기록했다. 이 리뷰 기사에서 우리는 성공에 기여한 것으로 보이는 세 영역, 즉 법률 및 규정, 영적 치료, 연구 네트워크에 주목하였다. 마지막으로 대만 사람에게 적용을 위한 미래의 도전과 전망에 대해 논의하기로 한다. 방법: PubMed에서 "대만의 호스피스 완화의료" 검색어를 이용해 체계적인 검토를 수행하였다. 결과: 2000년에 "자연사법"의 통과로 아시아에서 환자의 자기결정권에 대한 획기적인 본보기가 만들어지고 확립되었다. 이는 의료진에게 연명치료중지(DNR, do not resuscitate)를 요청할 수 있고 삶의 마지막에 기타 무의미한 의료 행위를 거부할 수 있는 환자의 권리를 보장하며 더불어 정책적 관점에서 완화의료의 중요성을 반영하는 것이다. 2015년에 대만은 "환자의 자기결정권 특별법"이라는 선구적인 법률을 통과시켰다. 이 법은 환자가 그/그녀의 자기의지에 따라 의료 행위를 거부할 수 있다는 것을 규정한다. 대만 고유의 영적 치료는 2000년에 도입되었는데, 불교 수행을 죽음에 직면한 환자에 적용하기 이전의 임상실습뿐 아니라 강의들로 구성된 훈련 프로그램을 성공적으로 이수하기 위해서는 불교 사제가 필요하다. 일본-한국-대만 연구 네트워크는 죽음의 과정을 자세히 설명(EASED, Elucidate the Dying process)하기 위한 동아시아 공동의 비교 문화 집단 연구를 위해 설립되었다. 결론: 대만에서의 호스피스와 완화의료는 정부와 사회의 우선적 합의에 따라 꾸준하게 성장하고 있다.

• Child Health Nursing Research
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• 제21권1호
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• pp.74-81
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• 2015

목적 본 연구의 목적은 백혈병 경험 청소년들의 영적 안녕과 생의 의미 정도를 알아보고 영향을 미치는 요인을 파악하기 위함이다. 방법 백혈병으로 진단받고 C대학병원에서 관해유도요법을 마친 후 외래에서 추후관리를 받고 있는 11-21세 청소년 102명을 대상으로 자료를 수집하였다. 영적 안녕은 Paloutzian과 Ellison (1983)의 영적 안녕 측정 도구를, 생의 의미는 Kang 등(2007)의 청소년 생의 의미 측정도구를 사용하였고, 관련 요인을 파악하기 위해 자아존중감과 사회적 지지를 측정하였다. 수집된 자료는 SPSS를 이용하여 영적 안녕과 생의 의미 영향요인은 stepwise multiple regression analysis로 분석하였다. 결과 백혈병 경험 청소년들의 영적 안녕은 중간 수준이었고 생의 의미는 높은 수준을 나타냈으며 자아존중감, 사회적 지지, 영적 안녕은 생의 의미와 양의 상관관계를 보였다. 회귀분석 결과 영적 안녕에 영향을 미치는 요인은 자아존중감과 가족의 지지였으며, 생의 의미에 영향을 미치는 요인은 자아존중감, 실존적 안녕, 가족의 지지, 친구의 지지였다. 결론 백혈병 경험 청소년들이 질병과정을 성공적으로 이겨내고 생의 의미를 찾도록 돕기 위해서는 자아존중감과 실존적 안녕을 높이고 가족 및 친구 지지를 촉진시켜줄 수 있는 간호중재 프로그램의 개발과 실행이 필요하다고 본다.

• 대한간호
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• 제33권4호
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• pp.86-98
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• 1994

We have examined the development and conceptual definition of shamanism and divination through significant characteristics of various illnesses. However, the terrminology has been inconsistent and its real conceptual meaning is not well defined. Divination is a historically dominant religious practice which represents the core of Korean folk culture. Despite prevalent prejudice toward its primitive nature, we cannot deny its profound relationship to our unconscious, especially our reliance on its religious role whenever we face crisis or conflict. It is therefore appropriate to use the term divination in this context. Shamanism originated as humanity's oldest mode of communication with divine - a religion, The shaman is not a sorceress but a priestess, a healer, a spritual guide, a leader, a mystic, traditionally having a different significance from that of the contemporary diviner or "shaman". The traditional concept of illness has been profoundly altered to serve new functions: while the shamanistic view is based upon spiritual abduction, divination on the other hand invokes concepts of spiritual invasion phenomena such as spirit intrusion, taboo violations, soul loss, object instrusion, deviations from the appropriate spiritual path besiegement, and curess or predestination (the idea that the sufferer is born with his fate), We should therefore try to understand divination from a more holistic point of view, rather than attempting to fit it into the standrd medical illness. We must recognize divination as a phenomenon within our culture, since most people have a mixed conception of illness arising from a combination of divinational and modem concepts, Since divination's humanistic approach is ingrained in our people, to irresponsibly ignore the spiritual aspects of treatment would exert a negative influence on our culture, Especially now, while attraction is focused on Korean culture and its influence on every aspect of our livies, it is important for nurses to expand our horizons in order to create a way of nursing more suitable to Korean culture. Increased importance is now being given to the opinions of patients themselves about their own illness and health, so nurses should seek to understand how patients accept their illness and what particular kinds of help they expect to receive. Consequently, an understanding of traditional divinations will enable us to utilize these characteristics on the job in order to enhance nursing care.

• 한국산학기술학회논문지
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• 제17권9호
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• pp.212-220
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• 2016

본 연구는 재가노인의 자기초월, 삶의 만족도, 임종기 치료선호도 정도를 파악하고 노인의 삶의 질을 향상시키기 위한 기초자료를 제공하기 위하여 시도된 서술적 조사연구이다. 연구대상자는 65세 이상의 노인 208명을 대상으로하고 자료수집은 2013년 8월부터 10월까지 실시하였다. 연구결과, 연구대상자의 자기초월 정도는 2.79점이며, 삶의 만족도 정도는 9.97점, 임종기 치료선호도 정도는 3.24점으로 나타났다. 자기초월은 교육수준이 높은 집단(F=3.38, p=.011)에서와 건강상태가 좋은 집단 (F=13.88 p<.001)에서, 삶의 만족도는 건강상태가 좋은 집단(F=24.42, p<.001)에서 유의하게 높게 조사되었다. 대상자의 자기초월은 삶의 만족도(r=.559, p<.001), 의료인에 의한 의사결정(r=.182, p=.008), 영성요인( r=..324, p<.001), 가족요인(r=.224, p<.001)과 유의한 순상관관계가 있는 것으로 조사되었으며, 삶의 만족도와 영성요인(r=.165, p=.017), 의료인에 의한 의사결정과 가족요인(r=.278, p<.001), 의료인에 의한 의사결정과 통증요인(r=.146, p=.035)이 유의한 순상관관계로 나타났으며, 자기초월이 임종기 치료 선호도에 영향을 미치는 요인으로 나타났다. 따라서 자기초월과 삶의 만족을 높일 수 있는 방안을 구축하고 임종기 대상자 관리를 위한 전략이 구체적으로 계획되어야 할 것이다

• 대한간호학회지
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• 제44권6호
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• pp.726-734
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• 2014

Purpose: The purpose of this study was to evaluate the effects of the Spirituality Promotion Program(SPP) for young nurses working in the stressful university hospital environment. Methods: The study included 41 nurses in the experimental group, nurses who had worked less than 5 years and completed 8 weeks of SPP between June and July in 2011. The control group, 44 nurses, also received the same program after the study was completed. For the study, a survey was conducted of all participants concerning spirituality, perceived stress, positive and negative affect, empathy, job satisfaction, and leadership practice. Results: No significant difference was found between the two groups on study variables. Perceived stress decreased significantly in the experimental group (p=.012). Spirituality (p=.019), positive affect (p=.014), empathy (p=.004), job satisfaction (p=.016), and leadership practice (p=.021) increased significantly in the experimental group. Conclusion: The results show that the Spirituality Promotion Program has positive effects on the spiritual and psychosocial aspect of young nurses. Continuation of this program for nurses is recommended in order to help them develop their self-care ability and improve nursing competency.

• Asian Pacific Journal of Cancer Prevention
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• 제15권21호
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• pp.9307-9312
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• 2014

Background: Hope is an important coping resource for cancer patients. Types and sources of hope and hope-inspiring strategies are not well investigated among Iranian cancer patients. The aims of present study were therefore to investigate the nature of hope and some demographic predictors of hope among Iranian cancer patients. Materials and Methods: This descriptive-correlational study was undertaken among 200 cancer patients admitted to an educational center affiliated to Ardabil University of Medical Sciences, Iran. Participants were selected using a convenience sampling method. The Herth Hope Index and other validated questionnaires were used to investigate level of hope and types and sources of hope, as well as hope-inspiring strategies. Data were analyzed using SPSS statistical software. Results: The overall score for hope was 31 from total scores ranging between 12 and 48. Some 94% of patients mentioned 'return to normal life' and 'complete healing of disease by drugs and physicians' as their main hopes. The most important sources of hope reported by patients include spiritual resources, family members, healthcare workers, and medicines and treatments available for the disease. Relationship with God, praying/blessing, controlling the signs and symptoms of the disease, and family/health care workers' support were the main hope-inspiring strategies. Patients who had a history of metastasis, or who were older, illiterate, divorced/widowed and lived with their children reported lower levels of hope. On the other hand, employed patients and those with good support from their families had higher levels of hope. Conclusions: The study findings showed moderate to high levels of hope among Iranian cancer patients. Accordingly, the role of spiritual/religion, family members and health care workers should be considered in developing care plans for these patients.

• 호스피스학술지
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• 제2권1호
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• pp.75-86
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• 2002

Prupose: The purpose of this study was to identify signs and symptoms of hospice patients during their dying processes. Method: The subjects of this study were 76 patients who received hospice care services in 2 different hospice care programs in Seoul area. Data was obtained from January, 1999 to June, 2001 by hospice nurse's observation, interviews with patient's primary caregiver and hospice volunteers, patient's self report, nursing records and questionnaires which had been developed by selecting from various references and refining them based on the result of preliminay studies. The collected data were analyzed with the SPSS PC+ program and content analysis. Results: Mean lengths of hospice patient's dying process were 3.6 days. Physical signs and symptoms of hospice patients during their dying processes were 'increased sleep'(89.5%), 'decreased oral intake of food'(88.2%) and 'liquids'(86.8%), 'change of respiration'(82.9%), 'decreased urine output'(80.3%), 'cold extremities'(69.7%), 'death rattle'(67.1%), 'cyanosis'(57.9%), 'restlessness'(55.3%), etc. And psychological, spiritual and social signs and symptoms were 'decreased interpersonal relationships'(61.8%), 'panorama of memories from childhood'(60.5%), 'experiences as like hallucination'(56.5%), 'saying bye with family'(69.7%), 'forgiveness', 'make a will', etc. Experiences as like hallucination were seemed not as dream but reality were shown by 43 dying patients. They had experienced to see and to talk with their deceased mother(18.6%) and/or relatives(30.2%), angels(20.9%), heaven(11.6%), old house in which they had lived, someone from the world beyond with black clothes, etc. Conclusion: The above results indicate that death of hospice patients is ongoing process with dying signs and symptoms during several days contains not only in physical aspects but also among psychological, spiritual and social aspects including family dynamics.

• 기본간호학회지
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• 제13권2호
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• pp.172-181
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• 2006

Purpose: This study was done to identify observation and performance of nursing role activities by student nurses graduating from 3 year junior colleges or 4 year universities. Method: A descriptive design was used and the participants were 295 student nurses who were graduating. Data were collected using a structured questionnaire. Results: The average score for observation of nursing role activity was $2.16{\pm}0.29$, and for performance $1.61{\pm}0.29$. Among the college students, the mean item score for observation was highest for medication administrator and lowest for provider of spiritual & bereavement care, while for the university students the highest was for provider of care during surgery and lowest for provider of spiritual & bereavement care. The college students had higher scores for observation, and the university students for performance. Conclusion: It is concluded that standardized practice learning programs need to be designed in schools and in clinical practice areas, in order to further develop adaptability to nursing roles.

• 대한간호학회지
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• 제31권5호
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• pp.897-911
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• 2001

The purpose of the study was to compare home care nursing intervention activities analyzed by the Nursing Intervention Classification (NIC) system for hospice and general patients. Method: For the descriptive survey study, data was collected by reviewing charts of 151 hospice patients and 421 general patients who registered in the department of home health care nursing at K Hospital. Results: According to the NIC system application, there were 2380 total nursing interventions used for the hospice patients and 8725 for the general home care patients. For both sets of patients (hospice vs. general), the most frequently used nursing intervention in level 1 was the Physiological: Complex domain (40.13 vs. 31.06 percent), followed by the Safety domain; in level 2, the Risk Management class (28.4 vs. 27.70 percent), followed by Tissue Perfusion Management; and in level 3, Vital Sign Monitoring (6.18 vs. 4.84 percent), followed by Health Screening. Conclusion: The study showed that there was a lack of specialized hospice nursing interventions such as emotional, family and spiritual support, and care for dying hospice patients.

• Journal of Hospice and Palliative Care
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• 제19권1호
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• pp.45-60
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• 2016

목적: 본 연구는 한국 호스피스의 실천 현장에서 자원봉사자들의 세밀한 봉사활동 경험과 호스피스 팀 활동에 따른 상호작용에 대한 깊이 있는 이해를 도모하고자 시행되었다. 보다 구체적으로, 호스피스 정책 입안자들과 행정가들 그리고 관리자들에게 호스피스 자원봉사자의 의미와 자원봉사자 역할의 중요성에 대한 인식을 제고함으로써 향후 한국 호스피스의 발전을 위한 정책적 기여를 행하고자 한다. 방법: 한국 호스피스의 제도화된 4가지 유형(분산형 가정형 병동형 독립형)에 대해 심층 인터뷰와 참여관찰을 시행하였다. 질적 접근의 엄격한 연구방법 중 하나인 "사례 분석"과 관련해서, 연구 참여자들을 선정한 후 심층 인터뷰를 행하였고, 인터뷰 결과는 '사례 내분석'과 '사례 간 분석'으로 정리하였다. 결과: 분석 결과, 호스피스 자원봉사자들은 '종교적 신앙심'에 의해 이 일을 시작하였고, 그토록 힘든 봉사활동을 지속시키는 힘 또한 '신앙심'이라고 했다. 따라서 호스피스 자원봉사자 활동 경험의 본질은 "종교적 신앙심에 의한 일 나를 위한 일"로 분석되었다. 또한 이들의 봉사활동 경험의 특성은 "아무런 대가 없이 행하는 진정한 봉사 아무나 할 수 없는 전문적인 봉사"로 나타났다. 덧붙여서, 호스피스 자원봉사 활동을 통해 스스로가 달라진 점으로는 "내적 성장 - '좋은 죽음'의 의미에 대한 자기 성찰 -과 영적 다양성 존중의 중요성인식"이라고 했다. 결론: 본 연구는 한국 호스피스의 실천가들과 정책 전문가들에게 호스피스 팀의 일원으로서 호스피스 자원봉사자의 의미와 그 중요성에 대한 인식 제고를 위해 시행되었다. 이러한 연구 결과를 토대로, 한국 호스피스의 성공과 한국인들의 좋은 죽음 성취를 위한 실천적 제언을 하고자 한다.