• 대한간호학회지
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• 제28권2호
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• pp.479-489
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• 1998

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.

• 대한간호
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• 제29권4호
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• pp.51-72
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• 1990

The purpose of this study was to determine whether Severance Hospice Home Care Pro gram was able to meet its objectives. This was done in order to show in detail the effects of hospice home care on the quality of life of terminally ill patients and to provide rationale for setting up more hospice home care programs in korea. The results of the study were as follows: The subjects of the study were 100 terminally ill patients who hnd died 'while in the hospice program and 64 family members who were registered with Severance Hospice Home Care Program between march 1988 and Feb. 1990. The nursing needs of these terminally ill patients were assessed by the nursing records of these patients. The need for pain control(82%) was the highest nursing need so far as the physical aspects were concerned. This was followed by poor appetite(37%), 8 dyspnea(34%), nausea and vomiting(30%) in that order of frequency. In reqard to spiritual needs, the need for religious' support was also high at 72%. Their main psychological symptoms were anxiety and fear(34% ). Burn-out was a major problem for 44% of the family members. The psychological process experiencel by the terminal ill patients was compared to the dying process, described by Kiibler Ross. In comparison of the five stages outlined by kubler Ross with the dying process of the subjects it was found that the subjects not only experienced the five stages but also experienced denial and doubt-fulness or denial with acceptance or acceptance with the expectation of a miracle. But rather than acceptance of the dying process, giving up was a frequent end point of the psychological process, of the subjects. However, when the combination of states was observed, most of the patients reached the state of acceptance in the dying process. It was difficult to identify a definite pattern of change in the psychological process of the subjects. Also it was difficult to identify the factors that influenced the psychological process. The symptoms of the terminally j]] subjects just before dying, that is, 3-4 days before dying included apparent signs of dying. These were a reduction of intake(77%), reduction of the amount of urination(63%), increase in sleeping time (64%) and acceptance of dying by patients and their families who had been unaccepting be before that time(66%). The primary care givers(family member's) degree of satisfaction with the care given to the patient by the hospice was 88.7%. The results of this study show that Severance Hospice Home Care Program had a positie effeet on the quality of life of the terminally ill patients and their family members as they faced the death of the patient. It can be seen from this study that there is an urgent need to extend hospice programs - in order to provide quality of care for terminally ill patient and their families. Based upon the reesults of this study several suggestions are presente as follows: 1) A follow up study should be carried out to identify the dying process as it is unique to Korea. 2) A comparison should be made of other hospice care programs. 3) A comparison study should- be made with subjects who do not receive any hospice care as compared to those who do by use of an experimental and control group methodology. 4) There is a need to determine a scientific method to adequeto measure the interventions carried out to meet the hospice patients nursing care needs. 5) A study should be made using quality research methodology to evaluate effects of hospiec care from the patients, their family members and the nurrse's perspective.

• Journal of Hospice and Palliative Care
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• 제22권4호
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• pp.185-197
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• 2019

목적: 호스피스 자원봉사자는 환자와 가족의 곁에서 보이지 않는 손의 역할을 하며 호스피스 완화의료팀 내에서 중추적인 역할을 수행하고 있다. 본 연구는 호스피스 자원봉사자 역량강화를 위한 지속교육과정의 효과를 혼합연구방법을 통해 파악하고자 하였다. 방법: 본 연구는 G도 J시에 소재한 G대학교의 매주 4시간씩 총 20시간의 호스피스 자원봉사자 지속교육 과정에 참여한 호스피스 자원봉사자 30명을 대상으로 하였다. 자료의 양적연구를 위해 대상자의 교육 전후 호스피스 태도, 의미 있는 삶, 자기효능감, 자원봉사활동 만족도를 조사하였다. 자료는 SPSS Window 20.0을 사용하여 기술통계, paired t-test, Wilcoxon signed-rank test로 분석하였다. 질적 연구를 위해 교육 참여자들에게 포커스그룹 인터뷰를 시행하였으며, 수집된 자료는 내용분석하였다. 결과: 호스피스 자원봉사자 지속교육 과정의 효과에 대한 양적연구 결과, 호스피스 자원봉사자의 호스피스 태도(t=-2.52, P=0.018)와 자기효능감(z=-2.06, P=0.40)을 향상시키는 것으로 나타났다. 질적 연구 결과, 참여자들은 자신의 신체를 다치지 않으면서 효과적으로 환자들을 돌볼 수 있는 방법과 영적 돌봄을 제공할 수 있는 실제적인 방법을 알기 원하였다. 참여자들은 삶의 마무리를 돕는 봉사에 대한 자부심과 베푸는 기쁨이 나의 삶에 감사로 돌아오기 때문에 지속적으로 봉사활동을 하고 있었으며, 개인시간 할애가 많음에도 불구하고 환자를 잘 돌보고 싶은 열정으로 지속적 배움에 대한 열의를 나타냈다. 결론: 호스피스 자원봉사자들은 지속교육 과정을 통해 환자와 가족을 돌보기 위한 역량 강화를 원하였으며, 이러한 교육은 호스피스 태도와 자기효능감을 높이는 것으로 나타났다. 자원봉사자들의 역량강화를 위해서는 대상자들의 신체적·사회적·영적인 접근을 모두 강화시키는 지속교육이 필요하다. 효율적이고 체계화된 지속교육을 위해서는 웹기반 교육과정 개발 및 지역별 컨소시엄 형성이 도움이 될 수 있다.

• Journal of Hospice and Palliative Care
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• 제13권1호
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• pp.13-23
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• 2010

목적: 말기 환자와 가족을 돌보는 호스피스 완화 간호사의 정의와 직무내용을 파악하고, 직무기술서를 작성하여, 호스피스 완화 간호사의 역할을 제시하는 데 있다. 방법: 호스피스 완화 간호사의 직무를 분석하기 위해 데이컴 직무분석 기법을 적용하였으며 직무분석의 빈도, 중요도, 난이도 조사를 위한 대상은 ELNEC project Korea에 참석한 간호사 136명의 설문자료를 대상으로 하였다. 직무분석을 위한 설문지는 8개의 임무와 36개의 일 내용으로 구성되었다. 36개의 일 내용에 해당되는 일의 요소는 137개 문항으로서 각 일의 요소에 대한 중요도, 빈도, 난이도는 각각 4점 척도로 측정하였다. 수집된 자료는 일반적 특성과 직무내용에 대한 빈도, 중요도, 난이도를 백분율, 평균, 표준편차로 분석하였다. 결과: 호스피스 완화 간호사는 '간호사 면허 소지자로서 호스피스 완화의료 영역에서 신체적(신체사정, 통증 및 증상관리 포함), 심리사회적, 영적 간호 돌봄에 대한 임상경험과 실무능력을 갖춘 간호사'로 정의하며, 호스피스 완화 간호사 직무 기술서 임무 8개, 일 36개, 일의 요소 137개로 구성되었다. 호스피스 완화 간호사의 임무에 대한 빈도, 중요도, 난이도 평균은 각각 2.94, 3.66, 2.80점이었고, 가장 빈도가 높은 임무는 자료수집(평균 3.23), 빈도가 가장 낮은 임무는 환경 및 자원관리(평균 2.74)이었다. 각 임무에 대한 중요도는 모두 평균 3.50점 이상(평균범위 3.53~3.72)으로 모두 중요한 임무라고 응답하였다. 난이도는 의뢰/조정/협동(평균 2.63)과 환경 및 자원관리(평균 2.65)를 제외한 모든 임무 영역에서 비슷한 난이도(2.73~2.77)를 보였다. 호스피스 완화 간호사 직무의 일에서 가장 빈도가 높은 역할은 통증 사정(평균 3.64)이었고 빈도가 가장 낮은 역할은 재정관리하기 (평균 2.36)이었다. 중요도 수준에서 가장 높은 점수를 보인 일은 통증 사정(평균 3.92)이었고 가장 점수가 낮은 일은 진단 검사를 통한 자료수집하기(평균 3.43)이었다. 난이도 항목에서 가장 점수가 높은 일은 말기환자와 가족의 영적 상태 사정하기(평균 3.11)였고 난이도가 가장 낮은 일은 문서/정보관리하기(평균 2.31)이었다. 결론: 이상의 호스피스 완화 간호사의 역할은 호스피스 전문 간호사에 비해 직접간호 실무 영역에서 더욱 활발한 역할을 수행하고 있으나 보다 체계적인 통증 및 신체증상 관리에 대한 계속교육이 요구되며 치료적 관계를 형성하기 위한 심리사회적, 영적 요구사정 및 중재, 의사소통 및 상담, 사별관리 영역의 실무지침 및 심화교육이 절실히 필요한 것으로 파악되었다. 이를 통해 호스피스 완화의료 대상자(환자와 가족)의 요구에 맞는 변화되고 진보된 호스피스 완화 간호사의 역할을 수행할 수 있다고 본다. 또한 호스피스 완화 간호사의 직무분석 결과를 토대로 이들도 호스피스 관련 자격인증을 받을 수 있는 호스피스 완화의료학회와 호스피스 완화간호사회 및 대한간호협회 차원의 노력이 조속히 진행되어야겠다.

• 종양간호연구
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• 제11권1호
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• pp.74-82
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• 2011

Purpose: This study was performed to systematically review the recently published nursing intervention studies. Methods: The literature was identified through the Korean Education and Research Information Service (KERIS), the Korean Information Service System (KISS), and National Assembly Library websites. Key words such as breast cancer, nursing, and intervention were used. The factors analyzed are as follows: 1) the characteristics of studies and study populations, 2) the classification of interventions, 3) outcome indicators and their effects, and 4) effective interventions. Results: Thirty two studies were included. Seventeen studies used a single intervention such as aerobic dance, TaiChi, foot massage, aromatherapy, or a stress-reduction method. Fifteen studies used combined interventions, including education, exercise, counseling, support, yoga or meditation. The data on 47 outcome indicators and their effects were segregated into psycho/spiritual outcomes, stress coping, physical outcomes, cardiorespiratory function, symptom management, arm and shoulder functions, fatigue, and quality of life. Some interventions had positive effects on stress, fatigue, and functions of shoulder. Conclusion: Various interventions are available for breast cancer patients, and some have had positive effects. However, more studies are required to develop evidence-based practice guidelines for nursing interventions.

• 근관절건강학회지
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• 제29권2호
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• pp.100-112
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• 2022

Purpose: This study is a qualitative analysis of Korean-American (K-A) women's cancer prevention in the US. Methods: Qualitative research was conducted. Fifteen K-A women in four states were interviewed. Content theme analysis was used to analyze verbatim transcriptions of interviews. Results: Participants experienced difficulties in utilizing cancer screening programs. Factors include unfamiliarity with the US health care system, high health care costs or lack of health insurance, language barriers, and irregular and sporadic cancer screening participation. Participants also actively pursued non-institutional approaches to cancer prevention. They engaged in word-of-mouth informational exchanges in K-A communities, sought cancer screening in hospitals in Korea, conducted internet searches, autonomously decided on their health issues, and adopted healthy practices including better diets, physical exercise, and spiritual practices. Conclusion: It is necessary to implement measures to increase K-A women's utilization of the US cancer screening services and to encourage their active engagement in hands-on cancer prevention practices. K-A women should be empowered through increased familiarity with US cancer screening services and through the establishment of improved K-A community social services.

• 성인간호학회지
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• 제12권4호
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• pp.741-757
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• 2000

This study was undertaken to develop an instrument to be used for measuring the concept of quality of life of Korean patients with cancer multidimensionary and correctly. It can contribute in holistic nursing care for Korean cancer patients and also provide and validate basic data to help oncology nurses measure the outcome of nursing intervention correctly. To develop this instrument, the researchers first estabilished a conceptual framework based on the results of qualitative data analysis and indepth interview method Development of the scale was conducted using a method in which 31 items were assessed by subjects' self report using linear analogue scales. The subjects were 79 D.M. patients, 103 patients with acute illness, and 91 cancer patients residing in Busan, Korea. Data were collected during the period from July, 24 to August 14, 2000. This instrument consisted of 31 items with a self report scale. This instrument covered 4 dimensions of cancer patients : 1) physical wellbeing 2) psychological wellbeing 3) social wellbeing and 4)spiritual wellbeing. Each item had a possible score of 10. The reliability of the scale was tested with Cronbach's alpha. Validity was evaluated by examining the relationships of this scale, Youn's Quality of Life Questionnare scores and the Simple Quality of Life scale. Two separate runs of multiple regression were used to predict scores on the Simple Quality of Life measurement. Further validation was obtained by examining the correlation between the instrument subscores and Youn's Quality of Life measurement subscore for convergence of this scale. Examination of the discriminant. power of the instrument was done using ANOVA test. The results are summarized as follows: 1. The reliability of the instrument for the quality of life was 0.8321(Cronbach's alpha.), physical wellbeing dimension 0.6343, psychological wellbeing dimension 0.6501, spiritual wellbeing dimension 0.5883. 2. This instrument had a high correlation with Youn's Quality of Life measurement(r= 0.636) in cancer patients, whereas it had a low correlation with Simple Quality of Life measurement(r=0.455) in cancer patients. In the D.M. patients, the instrument correlated with both the Youn's Quality of Life measurement and Simple Quality of life measurement(r=0.313, r= 0.407) and in the acute stage patients, the instrument had no correlation. 3. Multiple regression of individual items on the Simple Quality of Life scores accounted for 56.8% of the variance in the Simple Quality of Life measurement, whereas, Youn's Quality of Life measurement scores accounts for 31.7%. 4. The correlations collected from the three group had the same patterns of variations but especially the instrument developed in this study had higher disciminant power than that of Youn's Quality of Life Measurement.

• 대한간호학회지
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• 제30권5호
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• pp.1156-1169
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• 2000

The study was aimed at developing an independent hospice center model that would be best suited for Korea based on a literature review and the current status of local and international hospices. For the study, five local and six international hospice organizations were surveyed. Components of the hospice center model include philosophy, purpose, resources (workers, facilities, and equipment), allocation of resources, management, financial support and hospice team service. The following is a summary of the developed model: Philosophies for the hospice center were set as follows: based on the dignity of human life and humanism, help patients spend the rest of their days in a meaningful way and accept life positively. On the staff side, to pursue a team-oriented holistic approach to improve comfort and quality of life for terminally ill persons and their families. The hospice center should have 20 beds with single, two, and four bed rooms. The center should employ, either on a part-time or full-time basis, a center director, nurses, doctors, chaplains, social workers, pharmacists, dieticians, therapists, and volunteers. In addition, it will need an administrative staff, facility managers and nurses aides. The hospice should also be equipped with facilities for patients, their families, and team members, furnished with equipment and goods at the same level of a hospital. represented by a center director who reports to a board and an advisory committee. Also, the center director administers a steering committee and five departments, namely, Administration, Nursing Service, Social Welfare, Religious Services, and Medical Service. Furthermore, the center should be able to utilize a direct and support delivery systems. The direct delivery system allows the hospice center to receive requests from, or transfer patients to, hospitals, clinics, other hospice organizations (by type), public health centers, religious organizations, social welfare organizations, patients, and their guardians. On the other hand, the support delivery system provides a link to outside facilities of various medical suppliers. In terms of management, details were made with regards to personnel management, records, infection control, safety, supplies and quality management. For financial support, some form of medical insurance coverage for hospice services, ways to promote a donation system and fund raising were examined. Hospice team service to be provided by the hospice center was categorized into assessment, physical care, emotional care, spiritual care, bereavement service, medication, education and demonstrations, medical supplies rental, request service, volunteer service, and respite service. Based on the results, the study has drawn up the following suggestions: 1. The proposed model for a hospice center as presented in the study needs to be tested with a pilot project. 2. Studies on criteria for legal approval and license for a hospice center need to be conducted to develop policies. 3. Studies on developing a hospice charge system and hospice standards that meet local conditions in Korea need to be conducted.

• 대한간호학회지
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• 제45권6호
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• pp.890-899
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• 2015

Purpose: The purpose of this study was to identify the level of distress and posttraumatic growth in fathers of chronically ill children and also, to identify the relation between characteristics of the fathers and children and their posttraumatic growth and to investigate factors that influence posttraumatic growth. Methods: In this study, 48 fathers who visited a university hospital in Seoul, Korea and who gave written consent completed the questionnaire between September 23 and November 19, 2013. Data were analyzed using Mann-Whitney U test, Kruskal-Wallis test, Pearson correlation coefficient and stepwise multiple regression. Results: The level of distress in fathers of chronically ill children was relatively high and the majority of them were experiencing posttraumatic growth. Models including the variable (deliberate rumination, religiousness, optimism) explained 64.3% (F=26.38, p <.001) of the variance for posttraumatic growth. Deliberate rumination (${\beta}=.59$, p <.001) was the most influential factor. Conclusion: The findings demonstrate that it is essential for nurses to intervene and facilitate continuously so as to promote posttraumatic growth and relieve distress in fathers of chronically ill children. Furthermore, it is also necessary for nurses to find ways to develop ideal interventions to activate deliberate rumination and offer spiritual care and help maintain optimism in these individuals.

• 성인간호학회지
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• 제16권1호
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• pp.49-59
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• 2004

Purpose: This study is a descriptive research study to measure the quality of life of those who suffer from breast cancer and take the chemotherapy. Method: The Subjects were 70 breast cancer patients who took the chemotherapy from September 2 to October 31, 2003. Quality of life was measured by Ferrell's measurements. Result: Quality of life indicators were spiritual domain=6.44, physical domain=5.45, social domain=4.15, and mental domain=3. 95. Whole quality of life was 4. 68 out of 10 points. The quality of life of those with a practicing religion was significantly higher than those without(F=3.88, P=0.026). Subjects who were less than 2 months post-operation had higher points in the physical domain than those who were more than 2 months post-operation (t= 2.76, p=0.007). Subjects who had less than 4 treatments of chemotherapy had higher points in the physical domain than those who had more than 4 treatments of chemotherapy (t=2.03, p=0.046). Conclusion: The results of this study serve as a meaningful source to promote quality of life of breast cancer patients who undergo chemotherapy. The results can also be applied to the development of education programs and counseling materials for chemotherapy patients. Health care strategy can also raise the quality of life of brest cancer patients.