The purpose of this study was to explore and describe the experience of caregivers with mentally ill children. The sample consists of 4 participants who care for their children with mentally ill. They were asked open-ended questions in order for them to talk about their experiences. With permission of the subjects, the interviews were recorded and transcribed. The methodology utilized was the Colaizzi's phonomenological approach. The interview data was organized by themes into 5 categories anguish, positive emtion, maturation, acceptance of the disease, and seeking information. These 5 themes were further categorized into 4 main groups : emotional impact, spiritual maturation, adapting to the illness, and seeking support needs. The results of this study have clinical and theoretical implications not only for psychiatric nursing in Korea but also for all clinicians working with the families of the mentally ill.
Purpose: This study was done to develop a bereaved family care program by identifying characteristics of a grief healing process in a child loss. Method: The subjects were five bereaved mothers who have lost their children with cancer. Data was collected with in-depth interviews using grief phase assessment tool and grief reaction assessment tool from 1, February, 2001 to 31 August, 2002. Data was analyzed on the basis of two tools. Result: Process of grief in general was as follows: evading phase was within one week - one month, confrontation phase was 5 - 12 months, and reconciliation phase was after 9 months and still going on when the study was finished. Grief reaction in five (physical, cognitive, emotional, social, and spiritual) dimensions was stabilized when the phase moved into reconciliation phase. Influencing factors were intimacy and expectation towards child, social support, personality, prior loss experience, coping style, religion, culture, family cohesion, openness of communication, and stress events. Conclusion: These results suggest that a bereaved family care program considering characteristics of Korean culture should be developed and activated.
The purpose of this descriptive study was to identify the nursing needs of patients with chronic illness. Method: The subjects of this study were 636 patients with chronic illness, 323 general nurses, and 106 public health nurses. The instruments used for this study were questionnaires including perceived functions of nursing from the center for chronic illness, preference to placement, intention to use, needs to receive services from the center for chronic illness, strategies management for nursing, and nursing needs of chronically ill patients. Results: The mean of perceived functions for nursing from the center were 3.1(0.5) in public health nurses, 2.9 (0.59) in general nurses, and 2.4(1.33) in chronically ill patients. Regards of needs to receive on services of the nursing centers were, the regularly physical examination, for health educational services which was perceived highest request amongst chronically ill patients. We found the means of each specific need as 2.2(0.6), for physical health, 2.1(0.7), for psychosocial health, and 1.8(0.6) for spiritual health. Conclusion: From the results of this study, it is suggested that establishing a nursing center for chronically ill patients consider physical, psychosocial, for spiritual health needs of chronically ill patients. It is also a consideration that direct care for symptom management and health education in the nursing center be implemented.
Purpose: The purpose of this study was to understand the meaning of prayer in Christian patients with breast cancer. Methods: Data collection and analysis were conducted by the Colaizzi analysis of phenomenological method. Data were collected by in-depth interviewing the participants and by further follow-up observations. Sixteen patients participated in this study. Results: The significant statements (188), formulated meanings (42), themes (38), clusters of theme (10), and categories (5) were emerged. The 5 categories were as follows: communication with God, healing and peace, spiritual growth, distrust in prayer, and method of prayer. Conclusion: Further studies need to consider the period of faith, comparison between christian and other religions, and length of diagnosis. A better understanding of the meaning of prayer will lead to a more comprehensive view of the spiritual care for patients with breast cancer, and can lead to guidelines for assessment and intervention to reduce suffering from cancer.
Care for the human spirit is a core component of quality end-of-life care. Logotherapy, based on the premise that the primary motivation of human beings is to find meaning and purpose in life, can be helpful in providing care for patients, families, and loved ones in hospice care. The use of Socratic dialog in posing questions about one's life experiences, values, and attitudes is a useful method of evoking reflection. Guidance for finding meaning, even until one's last moments, can be found in the three categories: (a) tasks or deeds, (b) experiences of love and beauty, and (c) attitudes chosen in spite of a fate that cannot be changed. Self-transcendence, defined as getting outside the self for the good of others, can add meaning to life. A growing body of research concerning meaning-centered therapy is promising for improving spiritual well-being and a sense of meaning and purpose in life.
Purpose : This study aims to explore nursing activities after the decision to discontinue life-sustaining treatment, awareness of a good death, and perception of life-sustaining treatment decisions among nurses in intensive care units (ICUs) at tertiary general hospitals. Methods : Participants were 173 nurses working in two tertiary general hospitals. The data were collected using structured questionnaires and analyzed using an independent t-test, paired t-test, one-way ANOVA, Scheffé's test, and Pearson's correlation coefficient. Results : Participants were 173 nurses working in two tertiary hospitals. The nursing activity increase was the greatest in the spiritual domain, and the physical domain was where the activities decreased the most. There were significant associations between Awareness of good death (Clinical) and Perception of life-sustaining treatment decision(r=.26, p <.001), Awareness of good death (Closure) and Perception of life-sustaining treatment decision(r=.36, p <.001), and Awareness of good death (Personal control) and Perception of life-sustaining treatment decision(r=.49, p <.001). Conclusion : Based on the results, systematic education programs and job training are required to improve the awareness regarding good death and perception of life-sustaining treatment decision for nurses in ICUs where discontinuing life-sustaining treatment decisions are made.
This study was conducted to examine the present state, types of services, difficulties, education programs, motivation, satisfaction and attitude of hospice volunteers and also to suggest supporting programs for the volunteer. For these purposes, a questionnaire was distributed among the 200 hospice volunteers in ten hospice organizations in Daejeon and Chungcheong province. In this research, 85.5% of the respondents were women and most of them were housewives in their forties and fifties. The majority of hospice volunteers had an education background of more than high school. Christianity (94%) was the dominant religion of volunteers. Among the service area of the hospice, emotional caring, such as listening closely and establishing empathy were the most frequently done by the respondents and the next one was spiritual care. Hospice volunteers who had started with altruistic motivation show more dynamic activities in emotional, spiritual, physical caring and so on, than those with non-altruistic motivation. Most of the respondents expressed that they felt a hospice volunteer was valuable. However they had a hard time to overcome the sorrow coming from sharing empathy with the dying patients. Those who had started with altruistic motivation usually took part in two times per a week and had more positive attitude. Volunteers who had been working more than five years showed better attitude than those who had been working less than three years. The longer the voluntary services, the more positive attitude experienced by volunteers. Hospice volunteers encountered the most considerable difficulty with lack of background knowledge and their actual capability. Insufficiency of time was the next reason for the considerable difficulty of the hospice volunteer. On the other hand, those who served more than twice per week replied that lack of background knowledge and their capability were the least considerable difficulty. Insufficiency of time was the reason of difficulty for male volunteers, as well as for females under thirty and those in their forties and fifties respectively. Generally most of the hospice volunteers (70%) were satisfied with their services and they usually satisfied with physical caring, spiritual caring, hospice's family caring. The less difficulty in voluntary services, more satisfaction for the volunteers in the end. There is a positive correlation between a attitude of the hospice volunteer and frequency of voluntary services while the volunteers' difficulty affect negatively their attitude as well as the frequency of voluntary services. Most of the hospice volunteers want to have more education about basic skills, volunteer's attitude and role, spirituality, the way of attending on the hospice and so on. Most of them considered discussion and sharing different cases as the most effective method. They also wish to had more supporting programs for the hospice volunteers(in the order of their needs) such as regular events, newsletters, personal concern, social meetings among the volunteers, insurance and minimum expenses. Based on the study results, more programs should be run in order to activate the voluntary services regardless of their gender and education background. A continuous practical supporting policy and education programs are required in order to provide special education and training courses considering every field of voluntary services. Expanding the role of the volunteers allows them more opportunities to take part in voluntary services and th activate participation. It is necessary to establish a new hospice system as a part public medical system, which can not only facilitate the voluntary services for a hospice but also enhance professional hospice volunteers. Finally, experts are needed to operate the voluntary services effectively.
Purpose: The objective of this study was to provide an understanding of the difficulties for facing parents of children with terminal cancer. Method: The design of this study was an inductive and descriptive study. Thirty???]one parents of children with terminal cancer participated in???]depth were interviewed s. C in depth and content analysis was used for analyzing the data. Results: The main categories in the findings were 'difficulties in coping', 'physical and psychological suffering of children', 'suffering of family', 'bereavement with children', 'economic problems', 'incurable situation', 'preparation of death', 'social isolation', 'coping after a child dies', 'spiritual problems', receiving active treatment', 'informing children of their condition', 'a sense of meaninglessness', 'emotional iunstability', and 'giving up hope'. Conclusion: The main point identified from this result in this study was that parents who have a child with terminal cancer don't never give up the hope of recovery for their child even when the child is in by the terminal stage of their children, even though and they are unwillingly to prepare for their child's death. This is a unique characteristic in the attitude of the families' attitude in child hospice care and differs from that found in adult hospice care. This result can be used as an important guide for nurses to in assessing the parents' needs in the terminal care setting.
The purpose of this study is to examine the requirement for child life support specialist and fetal education for children with cancer. This research presented was composed with three chapters : First chapter, I presented the purpose, scope and definitions of this research. Second chapter, I defined about hospice care service for children with cancer and kind of pediatric cancer. And general characteristics of children with cancer, a understanding character of death and dietary therapy. Lastly, I defined and investigated about spiritual care. Third chapter, I concluded with some of findings and final suggestions based on the results. According to the developmental stages children with cancer are disability of communication competence and more dependence on their parents, therefore parents' decision making were more difficulty. And parents with a child who suffers from a cancer needs a counseling in order to discover the meaning of life. Parents' psychological experience about the caring for their child suffering from pediatric cancer was equal to broken hearts due to shadow of the child's death from time to time. In other words a parents with a child who suffers from a cancer needs comprehensive services such as hospice, consultor as well as wide experienced pediatrician and nurse. Child life support specialist can help them recover and improve their o주 potential strength in behalf of overcoming their difficulties. And pastoral counseling can help them reduce the fear and anxiety about unknown world and death. The systematically developed a school-based counseling program would help children adjust to the difficulties after a perfect cure because of children adjusted to school well when they have good peer relationships.
This work was done for 9 patients having experience of a herb medical treatment after being diagnosed as CVA during a year from January, 1996 to December, 1996 by using an ethnographic research method. The summarized results of this research are following. Ⅰ. THE EXPERIENCE OF THE ILLNESS First, the falling-ill phase is the time that they have the first stroke of paralysis and the decision pattern of medical institution' comes out. The emotional experience in the period is something like 'flustration', 'anxiety', 'despair', and 'expectation'. Second, the active-treatment phase is the time that the patients as well as their family or care giver not only show the positive attitude and actively participate in the illness treatment but also show a lot of interest in medical institutions and activities of health recovery. There is a primary factor of the continuation of treatment as an experience of treatment and being crushed and sensitivity as an experience of the illness. Third, the rehabilitation phase is the time that the patients or their family become tired and insensitive to the treatment and recuperation, and then reduce the treatment activity. There is a primary influence factor of the discontinuance of treatment as an experience of treatment and physical experience and emotional experience as an experience of the illness. The physical experience is divided into 'personal-hygiene care', and 'the sphere of activity' The emotional experiences are 'blaming someone', 'contempt' and 'despair' as a negative experience and 'hope' as a positive experience. Ⅱ. COPING STRATEGY There are a physical coping, an emotional and mental coping, a social coping, and a spiritual coping as a coping strategy used for the patients to overcome their illness and adjust themselves to their altered life. First, the physical coping comes out as 8 categories, 'using an auxiliary tool', 'doing exercise', 'protecting', 'improving their diet', 'taking care of something', 'using subsidiary medicines', 'trying a folk remedy', and 'having interest in their health'. Second, for the emotional and mental coping, there are 'accepting' and 'trying' as a positive coping and a failure of control as a negative coping. Third, the social coping is appeared as 'being supported'. Fourth, the spiritual coping is recognized as' recourse to God' and 'preparation of death'. After all, the elderly CVA patients in an agricultural area choose the act of treatment based on the traditional belief and the relationship with a caretaker. A personal health can be maintained by taking care of themselves and controling their mind, and the overcome of the illness is decided on the basis of traditional concepts and cultural principles in which the patients as well as the family, neigbors and take carers should work out together and cooperate with each other in order to achieve that.
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