• 대한간호
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• 제28권3호
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• pp.52-67
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• 1989

True nursing care means total nursing care which includes physical, emotional and spiritual care. The modern nursing care has tendency to focus toward physical care and needs attention toward emotional and spiritual care. The total nursing care is mandatory for patients with terminal cancer and for this purpose, hospice care became emerged. Hospice case originated from the place or shelter for the travellers to Jerusalem in medieval stage. However, the meaning of modem hospice care became changed to total nursing care for dying patients. Modern hospice care has been developed in England, and spreaded to U.S.A. and Canada for the patients with terminal cancer. Nowaday, it became a part of nursing care and the concept of hospice care extended to the palliative care of the cancer patients. Recently, it was introduced to Korea and received attention as model of total nursing care. This study was attempted to assess the efficacy of hospice care. The purpose of this study was to prove a difference in terms of physical, emotional a d spiritual aspect between the group who received hospice care and who didn't receive hospice care. The subject for this study were 113 patients with advanced cancer who were hospitalized in the S different hospitals. 67 patients received hospice care in 4 different hospitals, and 46 patients didn't receive hospice care in another 4 different hospitals. The method of this study was the questionaire which was made through the descriptive study. The descriptive study was made by individual contact with 102 patients cf advanced cancer for 9 months period. The measurement tool for questionaire was made by author through the descriptive study, and included the personal religious orientation obtained from chung(originated R. Fleck) and 5 emotional stages before dying from Kubler Ross. The content ol questionaire consisted in 67 items which included 11 for general characteristics, 10 for related condition with cancer, 13 for wishes far physical therapy, 13 for emotional reactions and 20 for personal religious orientation. Data for this study was collected from Aug. 25 to Oct. 6 by author and 4 other nurse's who received education and training by author for the collection of data. The collected data were ana lysed using descriptive statistics, $X^2-test$, t-test and pearson correlation coefficient. Results of the study were as follows: "H.C Group" means the group of patient with cancer who received hospice care. "Non H.C Group" means the group of patient with cancer who did not receive hospice care. 1. There is a difference between H.C Group and Non H.C Group in term of the number of physical symptoms, subjective degree of pain sensation and pain control, subjective beliefs in physical cure, emotional reaction, help of present emotional and spiritual care from other personal, needs of emotional and spiritual care in future, selection of treatment method by patients and personal religious orientation. 2. The comparison of H.C Group and Non H.C Group 1) There is no difference in wishes for physical therapy between two groups(p=.522). Among Non H.C Group, a group, who didn't receive traditional therapy and herb medicine was higher than a group who received these in degree of belief that the traditional therapy and herb medicine can cure their disease, and this result was higher in comparison to H.C Group(p=.025, p=.050). 2) Non H.C Group was higher than H.C Group in degree of emotional reaction(p=.050). H.C Group was higher than Non H.C Group in denial and acceptant stage among 5 different emotional stages before dying described by Kubler Ross, especially among the patient who had disease more than 13 months(p=.0069, p=.0198). 3) Non H.C Group was higher than H. C Group in demanding more emotional and spiritual care to doctor, nurse, family and pastor(p=. 010). 4) Non H.C Group was higher than H.C Group in demanding more emotional and spiritual care to each individual of doctor, nurse and family (p=.0110, p=.0029, P=. 0053). 5) H.C Group was higher th2.n Non H.C Group in degree of intrinsic behavior orientation and intrinsic belief orientation of personal religious orientation(p=.034, p=.026). 6) In H.C Group and Non H.C Group, the degree of emotional demanding of christians was significantly higher than non christians to doctor, nurse, family and pastor(p=. 000, p=.035). 7) In H.C Group there were significant positive correlations as following; (1) Between the degree of emotional demandings to doctor, nurse, family & pastor and: the degree of intrinsic behavior orientation in personal religious orientation(r=. 5512, p=.000). (2) Between the degree of emotional demandings to doctor, nurse. family & pastor and the degree of intrinsic belief orientation in personal religious orientation(r=.4795, p=.000). (3) Between the degree of intrinsic behavior orientation and the degree of intrinsic: belief orientation in personal religious orientation(r=.8986, p=.000). (4) Between the degree of extrinsic religious orientation and the degree of consensus religious orientation in personal religious orientation (r=. 2640, p=.015). In H.C. Group there were significant negative correlations as following; (1) Between the degree of intrinsic behavior orientation and extrinsic religious orientation in personal religious orientation (r=-.4218, p=.000). (2) Between the degree or intrinsic behavior orientation and consensus religious orientation in personal religious orientation(r=-. 4597, p=.000). (3) Between the degree of intrinsic belief orientations and the degree of extrinsic religious orientation in personal religious orientation(r=-.4388, p=.000). (4) Between the degree of intrinsic belief orientation and the degree of consensus religious orientation in personal religious orientation(r=-. 5424, p=.000). 8) In Non H.C Group there were significant positive correlation as following; (1) Between the degree of emotional demandings to doctor, nurse, family & pastor and the degree of intrinsic behavior orientation in personal religious orientation(r= .3566, p=.007). (2) Between the degree of emotional demandings to doctor, nurse, family & pastor and the degree of intrinsic belief orientation in personal religious orientation(r=.3430, p=.010). (3) Between the degree of intrinsic behavior orientation and the degree of intrinsic belief orientation in personal religious orientation(r=.9723, p=.000). In Non H.C Group there were significant negative correlation as following; (1) Between the degree of emotional demandings to doctor, nurse, family & pastor and the degree of extrinsic religious orientation in personal religious orientation(r= -.2862, p=.027). (2) Between the degree of intrinsic behavior orientation and the degree of extrinsic religious orientation in personal religious orientation(r=-. 5083, p=.000). (3) Between the degree of intrinsic belief orientation and the degree of extrinsic religious orientation in personal religious orientation(r=-. 5013, p=.000). In conclusion above datas suggest that hospice care provide effective total nursing care for the patients with terminal cancer, and hospice care is mandatory in all medical institutions.

• 한국산학기술학회논문지
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• 제13권5호
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• pp.2178-2188
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• 2012

본 연구는 건강한 사람보다는 불건강한 즉 질병에 노출될 가능성이 많은 사람들을 간호의 대상으로 하는 간호 대학생과 간호사의 영적 요구도를 비교 파악하기 위한 목적으로 수행하였다. 2011년 9월부터 10월까지 부산 경남지역의 간호사 총 153명과 간호 대학생 총 147명을 대상으로 설문 조사 수집하였으며 최종 200부를 분석하였다. 본 연구에서는 영적 케어 요구도 수준을 '사랑과 유대감', '희망과 평화'. '삶의 의미와 목적', '죽음의 수용', '신과의 관계'에 대한 5가지 영역으로 구분하여 조사한 결과 간호사 집단에서는 사랑과 유대감이 가장 수준이 높았으며(r=3.82), 신과의 관계 영역이 가장 낮은 수준이었다(r=2.73). 이에 비하여 간호 대학생의 집단에서도 5개의 영역 중 사랑과 유대감 영역의 수준이 가장 높았고(r=3.92), 신과의 관계 영역의 수준이 가장 낮았다(r=2.99). 간호사와 간호 대학생간에 통계적으로 유의한 차이를 보인 것은 '죽음의 수용'과 '신과의 관계'였으며 간호 대학생이 간호사에 비해 '죽음의 수용'과 '신과의 관계'에 대한 요구도 높은 것으로 나타났다(p<0.05). 간호사의 영적요구도 영역간의 상관관계를 살펴보면 '삶의 의미와 목적'이 '희망과 평화' 영역과의 관련성이 가장 높았고(r=.699), '신과의 관계' 영역과 '희망과 평화'간의 관련성이 가장 낮았다(r=.247). 간호 대학생의 영적요구도 영역간의 상관관계 분석결과, '삶의 의미와 목적'이 '희망과 평화' 영역과의 관련성이 가장 높았고(r=.660), '죽음의 수용'과 '신과의 관계' 영역간의 관련성이 가장 낮은 것으로 조사되었다(r=.277). 따라서 향후 연구에서는 본 연구의 결과에서 도출된 영적 간호 제공자인 간호 대학생과 간호사의 영적 요구도를 바탕으로 더욱 효율적이고 체계화된 영적 간호 교육 프로그램 개발이 필요한 것으로 사료된다.

• 대한간호
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• 제27권1호통권144호
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• pp.21-27
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• 1988

• Journal of Hospice and Palliative Care
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• 제18권1호
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• pp.25-34
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• 2015

목적: 본 연구의 목적은 입원 암환자의 영적건강, 불안과 통증과의 관계를 규명하여 입원 암환자의 통증감소를 위해 영적건강을 증진시키고 불안을 감소시키는 간호중재 프로그램을 개발하기 위한 기초자료를 제공하는 것이다. 방법: 대상자는 B광역시 소재 대학병원에서 입원 치료중인 암환자 167명이고, 자료수집기간은 2012년 4월 27일부터 동년 5월 11일까지였다. 연구도구로 영적건강은 Highfield(1992)의 SHI (Spiritual Health Inventory)를 이원희 등(2001)이 번안한 것을, 불안은 Spielberger(1975)의 STAI (State-Trait Anxiety Inventory)를 김정택과 신동균(1978)이 번안한 것을, 통증은 국가암정보센터(2010)의 VAS (Visual Analogue Scale) 척도를 사용하였다. 자료분석은 SPSS 20 프로그램을 이용하여 분석하였다. 결과: 본 연구의 결과는 다음과 같다. 1. 입원 암환자의 영적건강과 불안은 중간 정도, 통증은 약한 정도로 나타났다. 2. 입원 암환자의 일반적 특성에 따른 영적건강은 종교, 교육, 평균월수입, 질병상태, 건강상태, 전이, 일상생활, 지지정도에 따라 차이가 있었다. 3. 입원 암환자의 일반적 특성에 따른 상태불안은 종교, 교육, 질병상태, 건강상태, 전이, 일상생활, 지지정도, 진통제에 따라 차이가 있었다. 4. 입원 암환자의 일반적 특성에 따른 통증은 질병상태, 건강상태, 전이, 일상생활, 지지정도, 진통제에 따라 차이가 있었다. 5. 입원 암환자의 영적건강과 상태불안의 관계는 중간 정도의 역상관관계(r=-0.627, P<0.001), 영적건강과 통증의 관계는 약한 역상관관계(r=-0.255, P=0.001), 상태불안과 통증의 관계는 약한 순상관관계(r=0.306, P<0.001)로 나타났다. 결론: 입원한 암환자의 영적건강, 불안 및 통증을 관리하기 위해 본 연구에서 규명한 관련 요인을 고려한 프로그램 개발 및 효과검증 연구가 필요할 것으로 생각된다.

• 호스피스학술지
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• 제5권2호
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• pp.64-74
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• 2005

Purpose : This study is non-equivalent control group pre-post design attempted to see 'The effect of spiritual nursing intervention on the meaning of life and spiritual distress of the terminal cancer patients.' Method : The data collection was performed from June to October, 2004. The subjects were 41 terminal cancer patients of one general hospital in Jeon Ju city. They are formed two groups, 20 experimental group and 21 control group. Experimental treatment provided spiritual nursing intervention 3 times per a week, the mean 45 minutes each, for 4 weeks for experimental group with the contents of therapeutical use of oneself, use of bible, use of hymn, use of prayer, depend on the priest in the spiritual need assessment of 6 kinds. Study tools was used the thing which Kim(1990) developed about purpose inspection of life which Crumbaugh(1968) developed to measure the meaning of life. The measure of spiritual distress was used the tool which Kim(1990) developed, spiritual nursing intervention was developed by researcher of this thesis. Data was analyzed by descriptive statistics of real number, percentage, the mean etc. and x2-test, t-test, ANCOVA. Result: The 1st hypothesis, 'spiritual the meaning of life score in the experimental group, who received the spiritual nursing intervention, will be higher than the control group who did not receive it' was supported(F=157.09, P=0.000) The 2nd hypothesis, 'spiritual distress score in the experimental group, who received the spiritual nursing intervention, will be lower than the control group who did not receive it' was supported(F=36.48, P=0.000) Conclusion: Spiritual nursing intervention was verified as an effective program to improve the meaning of life and decrease spiritual distress for the terminal cancer patients. Thus, it was confirmed with an effective nursing intervention which helps them in order to spend the rest time of life meaningfully and meet the peaceful death.

• 지역사회간호학회지
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• 제26권2호
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• pp.69-78
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• 2015

Purpose: This study was conducted in order to investigate changes in the physical, psychosocial and spiritual health of people with mental disorder in community participating in the Integrated Health Care Program (IHCP). Methods: This study applied the non-equivalent control group pretest-posttest quasi-experimental design. The participants were 37 chronic psychiatric patients who had been clinically diagnosed with mental disorder and visiting a mental rehabilitation center located in S City (17 in the experimental group, and 20 in the control group). The experimental group participated in the IHCP consisting of 24 sessions for eight weeks. Results: After the intervention, only the participants in the experimental group reported significant improvement in physical (body mass, triglyceride), psychosocial (mental symptoms, depression, self-esteem, ability of problem solving), and spiritual wellbeing when compared with those in the control group. Conclusion: These results indicate that IHCP is effective in improving the physical, psychosocial, and spiritual wellbeing of people with mental disorder. Therefore, IHCP developed in this study is considered a useful nursing intervention for raising the comprehensive health level of people with mental disorder in community.

• 한국보건간호학회지
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• 제17권2호
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• pp.255-265
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• 2003

This study was conducted to provide a baseline data for hospice nurses to improve their practices for the spiritual wellbeing of their clients. Analysis of the spiritual wellbeing status of hospice patients was conducted from April 20 to June 20, 2002. A total of 59 cancer patients who admitted to hospice care units of one university medical center, and who have alert mental status were recruited for the study. Paloutzian and Ellison (982) spiritual wellbeing scale and Jungho Kang (996) scale, which was modified for the cancer patients, were used as the study instruments, ANOVA and T-test were applied using SPSS win 10.0 for statistical analysis. The results are as follows : 1. The mean spiritual wellbeing score of the hospice patients was $49.76(SD\pm7.95)$. When it was converted into 4 point scale, the mean score for the spiritual wellbeing was 2.49. The mean religious wellbeing score was $24.17 (SD\pm5.56)$ and that of the existential wellbeing was $25.59 (SD\pm3.10)$. 2 The mean score for the total spiritual wellbeing was $52.54 (SD\pm8.12)$ for female, and $47.86 (SD\pm6.95)$ for male and the difference was statistically significant (t=-2.305, p=.025), 3. In testing the spiritual wellbeing, there was significant difference according to the religion (F=28.931, p=.000). 4. In testing the religious wellbeing, the mean score was $22.77 (SD\pm5.35)$ for male, and $26.20 (SD\pm5.32)$ for female and the difference was statistically significant (t=-2.430, p=.019). 5. In testing the religious wellbeing, there was significant difference according to the religion (F=37.522, p=.000). However, the religious wellbeing was not different according to the age, occupation, marital status and education level. 6. In testing the existential wellbeing. there was significant difference according to the religion (F=8.147, p=.000). However, mean score for the existential wellbeing was not significantly different according to sex, age, occupation, marital status and education level. 7. In testing the existential wellbeing, there was significant difference according to the level of vigor (F=3.662, p=.032), while no difference was observed in the existential wellbeing according to the general health status, degree of pain, and diagnosis. From the results described above it can be concluded that : To improve the spiritual wellbeing status of hospice patients, hospice nurses should identify spiritual needs of the patients according to the religion. gender and the level of vigor.

• 대한간호학회지
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• 제41권3호
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• pp.374-381
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• 2011

Purpose: The purpose of this study was to develop and validate a hospice palliative care performance measure which would cover more than just physical symptoms or quality of life. Methods: Through an intensive literature review, the author chose questions that measured aspects of physical, emotional, spiritual, social, or practical domains pertinent to hospice palliative care for inclusion in the scale. Content validation of the questions was established by 15 hospice palliative care professionals. A preliminary Hospice Palliative Care Performance Scale (HPCPS) of 20 questions was administered to 134 pairs of terminal cancer patients from 5 hospice palliative care units and their main family caregiver. A validation study was conducted to evaluate construct validity and internal consistency. Results: Factor analysis showed 14 significant questions in five subscales; Physical, Emotional, Spiritual, Social, and Patient' rights. There were no significant differences between the ratings by patients and family members except for three out of the 14 questions. The measure demonstrated construct validity, and Cronbach's ${\alpha}$ of the subscales ranged from .73 to .79. Conclusion: The HPCOS demonstrated acceptable validity and reliability. It can be used to assess effectiveness of hospice palliative care for terminal cancer patients in practice and research.

• 가정간호학회지
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• 제30권3호
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• pp.243-251
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• 2023

Purpose: The aim of this descriptive study was to identify factors influencing quality of life among family caregivers of non-cancer patients at the end-of-life stage. Methods: A cross-sectional survey was conducted using a questionnaire. Participants included 172 family caregivers caring for non-cancer patients. Data were collected from April to May 2016 and analyzed with descriptive statistics, an independent t-test, one-way ANOVA, Pearson's correlation coefficient, and a hierarchical regression analysis using the SPSS/WIN 24.0 program. Results: The mean of the participants' quality of life was 51.70±9.98. Factors influencing quality of life among family caregivers were spiritual care (𝛽=-.45, p=.021), coordination among family members or relatives (𝛽=-.27, p=.029), and psychological support (𝛽=-.04, p=.031). The explanatory power of the model was 21.0%. Conclusion: The findings of this study suggest that care needs; spiritual care, coordination among family members or relatives, and psychological support are important factors for family caregivers' quality of life. To improve quality of life among family caregivers who are taking care of non-cancer patients at the end-of-life stage, national systems establishing comprehensive support considering the respective care needs of patients are crucial.

• 한국간호교육학회지
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• 제4권2호
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• pp.331-342
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• 1998

Nurses evaluate the physical, emotional, and spiritual well-being of a person when conducting an assessment and forming a plan of care. Nursing is a holistic approach to health and well-being. Implication for Nursing Practice : nurses must assess and support intrinsic religiosity and promote spiritual well-being in peoples coping with severe diseaser. The purpose of this study was to investigate spiritual well-being, hope and self-esteem of nursing students, and to identify spiritual well-being, hope and self-esteem the differences between nursing students of christian university and nursing students of non-christian university. The measurment tools for spiritual well-being, hope anf self-esteem were a self-report questionnaire. The collected data was prepared for computer analysis and analyzed using appropriate statistical methods. General characteristics, spiritual well-being, hope and self-esteem are analyzed by descriptive statistical methods. For hypothesis testing t-test, Pearson correlation are used. The result of this study can be summarized as follows ; 1. The mean score for spiritual well-being in the nursing students was 79.52 of a possible range of 20-120. And the mean score for hope was 58.18 of a possible range of 29-116, the mean score for self-esteem was 112.29 of a possible range of 30-150. 2. 'Nursing students of christian university will demonstrate higher spiritual well-being than the nursing students of nonchristian university' was rejected(t=1.01, p=.96). 3. 'Nursing students of christian university will demonstrate higher hope than the nursing students of nonchristian university' was rejected(t=1.71, p=.05). 4. 'Nursing students of christian university will demonstrate higher self-esteem than the nursing students of nonchristian' was rejected(t=1.53, p=.12). 5. 'The higher spiritual well-being, the higher hope' was rejected(r=-.664, p=.000). 6. 'The higher spiritual well-being score, the higher self-esteem' was supported(r=.487, p=.000).