• 호스피스학술지
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• 제2권1호
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• pp.21-40
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• 2002

Cancer is the second leading cause of the death in Korea. Family caregivers of dying patients manifest many psychological and physical symptoms of stress, and they often seek for informational support from health care providers. Unfortunately, however, few systematic studies identify the actual effect of such support on family caregivers. This study, thus, intends to evaluate the effect of informational support for hospice care. One group pretest-posttest design was used, employing the stress-coping model by Cohen and Wills as a conceptual framework. This research was conducted from July 1 to November 15, 1998, initially with 32 subjects sampled from hemato-oncology department of two general hospitals in Seoul, but reduced to 18 at the end due to the untimely death of patients or caregiver's refusal during the course of study. Informational supports were programmed to provide the family caregivers with 8 times of education and counseling as well as 24-hour hot-line for 4 weeks. A booklet that explains the various problems of hospice care was also prepared and distributed to all subjects. Data were collected by using self-report questionnaires and reviewing medical records. The tools used in this study were based on the Weinert's PRQ-II(scale of perceived social support), Spielberger's state anxiety inventory, and CES-D. Also included in the data collection were the general characteristics of family caregivers and patients, and the pain intensity and the performance status of patients. The data were analyzed with descriptive statistics, Wilcoxon sign rank test and paired t-test using SPSSWIN program. The results of the study were as follows: 1.The perceived social support of family caregivers was not significantly increased with informational support for hospice care(t=1.64, one tailed p=.060). 2.The anxiety of family caregivers was significantly reduced following informational support for hospice care(t=3.48, one tailed p=.002). 3.The depression of family caregivers was significantly reduced following informational support for hospice care(t=-2.18, one tailed=.022). 4.The pain intensity of patients with terminal cancer was significantly reduced following informational support for hospice care(t=-2.41, two tailed p=.027). The results suggest that the informational support provided to family caregivers of patients with terminal cancer reduced not only their anxiety and depression but also the pain intensity of patients. Further study is necessary to consolidate the conceptual framework of this study with expanded number of subjects. Nevertheless, it was certain that the informational support program for hospice care was very helpful to both caregivers and patients. Thus, the informational support program is strongly recommended for the hospitals which have no hospice unit yet.

• Child Health Nursing Research
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• 제24권4호
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• pp.475-483
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• 2018

Purpose: This study aimed to identify stress levels due to end-of-life care, coping strategies, and psychological well-being among nurses in neonatal intensive care unit, and to investigate the effect of stress levels and coping strategies on their well-being. Methods: A total of 128 nurses in the neonatal intensive care units of general hospitals in B city participated. The data were collected using a self-report questionnaire. The collected data were analyzed using descriptive statistics, the t-test, ANOVA, the Pearson correlation coefficient, and hierarchical regression with SPSS version 22.0. Results: The coping strategy that nurses most often used was seeking social support. The factors affecting the well-being of the participants were wishful thinking, problem-focused coping and seeking social support, in order. Those 3 variables explained 21 % of the total variance in psychological well-being. Problem-focused coping and seeking social support were positively associated with psychological well-being, while wishful thinking showed a negative association. Conclusion: In order to improve the psychological well-being of nurses in neonatal intensive care units, it is necessary to provide nurses with a program to build a social support system and to improve their problem-based coping skills.

• 한국콘텐츠학회논문지
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• 제22권10호
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• pp.374-382
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• 2022

본 연구는 2003년부터 1월부터 2022년 7월까지 국내 학술지에 게재된 임종간호 연구의 동향을 파악하는데 목적이 있다. 자료수집을 위해 '한국학술지인용색인'을 이용하였으며 총 115편의 논문을 분석하였다. 연구 결과, 임종간호 논문은 2008년 이후 꾸준히 증가하는 추세를 보였으며, 2017년에서 2019년에 가장 많은 논문이 출판된 것으로 확인되었다. 이들 연구는 주로 간호사와 간호대학생을 대상으로 수행되었고, 간호사의 경우 주로 상급종합병원, 요양병원, 종합병원에서 근무하는 것으로 파악되었다. 논문의 주요 주제로는 임종간호 태도, 수행, 임종간호 스트레스와 관련된 연구가 많았으며 연구 방법으로는 양적연구가 78.3%로 다수를 차지하였다. 논문의 IRB 승인 여부를 분석한 결과, IRB 승인을 받은 논문은 64.3%로 확인되었다. 이처럼 본 연구는 국내 학술지에 게재된 임종간호 연구의 동향을 분석하여 향후 연구방향을 제시했다는 점에서 연구의 의의가 있다.

• Journal of Hospice and Palliative Care
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• 제15권4호
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• pp.205-211
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• 2012

목적: 본 연구는 암병동 간호사의 임종간호에 따른 스트레스와 인지정도 및 교육요구도를 파악하고자 수행되었다. 방법: 본 연구는 서울과 경기도에 소재한 4개 종합병원 암병동에 근무하는 간호사 151명이었으며, 자가보고식 설문지로 자료를 수집하였다. 스트레스 측정도구는 40문항, 인지정도와 교육요구도 측정도구는 각각 27문항으로 구성되었으며, 수집된 자료는 서술적 통계방법으로 분석하였다. 결과: 암병동 간호사의 임종간호에 따른 스트레스 정도는 5점 만점에 평균 3.96점으로 높았으며, 영역별 스트레스는 업무량 과중이 가장 높았고, 임종환자에게 시간할애의 어려움, 임종환자와의 인간적 갈등의 순이었다. 임종간호에 대한 인지정도는 5점 만점에 평균 2.64점이었으며, 인지정도가 가장 낮은 문항은 죽음에 대한 아동의 이해였으며, 법적 측면, 진실통고에 대한 윤리적 근거의 순이었다. 임종간호에 대한 교육요구도는 5점 만점에 평균 3.25점으로 높았으며, 스트레스와 소진관리, 임종 전 관리, 의사소통 방법, 임종준비에 대한 의사소통, 마약성 진통제 관리에 대한 교육요구도가 높았다. 간호사의 일반적 특성에 따른 임종간호에 대한 스트레스는 유의한 차이가 없었으며, 임상경력이 길수록, 호스피스 교육기간이 길수록, 임종간호 횟수가 많을수록 임종간호에 대한 인지정도가 높았고, 암병동 근무기간이 길수록 임종간호에 대한 교육요구도가 높음을 알 수 있었다. 결론: 본 연구의 결과에서 임종간호에 대한 스트레스가 높고, 인지정도는 낮으며, 교육요구도가 높았던 내용을 토대로 하여 교육 프로그램을 개발, 적용하는 것이 필요하다.

• Asian Pacific Journal of Cancer Prevention
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• 제14권1호
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• pp.209-215
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• 2013

Objectives: Terminal cancer patients and their caregivers often experience traumatic stress and need many types of assistance. In the present study we interviewed terminally ill cancer patients and caregivers to determine how much burden they experienced and to find out what factors are most important for satisfaction. Design: We constructed a questionnaire including overall care burden and needs experienced, and administered it to 659 terminal cancer patients and 659 important caregivers at 11 university hospitals and 1 national cancer center in Korea. Results: Finally, 481 terminal cancer patients and 381 caregivers completed the questionnaire. Care burden was not insubstantial in both and the caregiver group felt more burden than the patient group (P<0.001). While the patient group needed financial support most (39.0%), the caregiver group placed greatest emphasis on discussion about further treatment plans (44.8%). Stepwise multiple logistic regression analyses showed that in the patient group, patient's health status (OR, 2.03; 95%CI, 1.16-3.56) and burden (OR, 2.82; 95%CI, 1.76-4.50) influenced satisfaction about overall care, while in the caregiver group, high education level (OR, 1.84; 95%CI, 1.76-4.50), burden (OR, 2.94; 95%CI, 1.75-4.93) and good family function (OR, 1.94; 95%CI, 1.24-3.04) were important. Conclusions: Our study showed that burden was great in both terminal cancer patients and their caregivers and was perceived to be more severe by caregivers. Our study also showed that burden was the factor most predicting satisfaction about overall care in both groups.

• 중환자간호학회지
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• 제13권1호
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• pp.27-43
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• 2020

Purpose : This integrative review aimed to synthesize studies on intensive care unit (ICU) nurses' attitude, perceptions, and experiences toward end-of-life care decision-making. Methods : Using Whittermore and Knafl (2005)'s methods, we identified and synthesized research articles published in domestic journals between the years 2003 and 2019 and evaluated the quality of selected articles using the Mixed Methods Appraisal Tool. Results : In the 13 studies reviewed, 12 were published prior to enactment of the "The Act for Hospice and Palliative Care and Decision-Making about Life-Sustaining Treatment (2018)." All nine quantitative studies identified were based on cross-sectional descriptive survey. In four qualitative studies, content analysis (n=2) and phenomenology (n=2) were used. Overall, ICU nurses were well-aware of the necessity of communicating and limiting life-sustaining treatments. Many ICU nurses had positive attitude towards limiting life-sustaining treatments to promote patients' comfort and dignity. Although nurses were willing to take active roles, they also reported having experienced high stress in the process of decision-making and implementation. Conclusions : It is important to prepare ICU nurses with proper knowledge and attitude regarding the topic area. It is also equally important to develop systems to support nurses' emotional stress and moral distress during communication, decision-making, and implementation.

• 종양간호연구
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• 제11권1호
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• pp.49-57
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• 2011

Purpose: The purpose of this study was to test the reliability and validity of an instrument to measure suffering of family of patients with terminal cancer. Methods: This research was a methodological study processed as follows: 1) The preliminary 32 items were developed based a conceptual framework of suffering for patients with cancer. 2) The content was validated by an expert panel (n=24) and the family of patients with terminal cancers (n=33). 3) The instrument was validated by survey (n=92). Finally, 29 items were selected in developing final version of the scale. Results: Seven factors were extracted through factor analysis: 'economical distress', 'loss of meaning in life', 'feeling of social isolation', 'emotional distress', 'burnout', 'guilty feeling', and 'physical discomfort'. These factors explained 66.94% of the total variance. Cronbach's alpha and Guttman Split-half coefficient of the 29 items were .93 and .92. respectively. Conclusion: This scale identified as a valid and reliable tool with a high degree of reliability and validity. It can be effectively utilized to assess the degree of suffering of family in palliative care settings.

• 한국호스피스완화의료학회:학술대회논문집
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• 한국호스피스완화의료학회 2004년도 정기총회 및 하계학술대회
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• pp.100-102
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• 2004

Under the current medical system, a terminal patient and his/her family who are neglected inevitably face various aspects of crises including not only physical, but also psychological, social, economic, spiritual and legal problems. Nurses often look after many terminal patents with these types of complicated problems. Therefore, educating the nurses who will take care of such patents would greatly reduce stress so the patents end could their lives in peace and without losing their dignity. This research is a quasi experimental study of nonequivalent control group. A pretest-posttest design where a basic education program is developed for nurses, who frequently treat terminal patents, to understand the importance of the role of hospice and to apply their understandings to treat terminal lancer patents. A sample of the nurses were taken from those who were working in general wards at two general hospitals in Seoul during October, 2003${\sim}$December 2003. The study was composed of 46 experimental group and 43 control group. A basic hospice education program was developed by taking emphasized and overlapping parts from advanced practice hospice nurses education course, short-term education course, an extensive literature survey and by consulting three professionals as well. With the group of 5 professors with vast experiences in oncolgy, 5 nursing administrator, 3 nursing practitioner, the tentative first version of the program was developed and reviewed. Afterwards, by utilizing person to person interviews with 2 head nurses experienced with terminal patients, 1 nurse in charge of hospice, 1 nurse on the contents of the program, and a person to person rating on the educating medium by a nurse were performed. The final version of a basic education program was developed after the second revision. The hospice basic education program consists of introduction to hospice, hospice and commucation, management of pain for terminal cancer patients, physical management for terminal cancer patients, socio-psycological caring of terminal cancer patients and management of death and separation. Total education time was four hours organized into 50 minutes of instruction and 10 minutes of break. $Powerpoint^{(R)}$ software was used as the education medium. As research tools, "Knowledge on Hospice" was developed by the author after receiving a review from one expert. "Attitude of Hospice Nursing" was revised Kim(2001)'s attitude measuring tool which was based on Wang(1998), Kwon(1989), Park and Sung(1991)'s tool. "Liability on nursing terminal patients" was used as developed by Zarits(1980) and Mongomory(1985) translated by Lee(1985). For collecting data, preliminary investigation prior to 1 week of the hospice basic education program and post-investigations after 1 week and 4 weeks of the education were carried out for the nurses at a general ward who understood and agreed on the purpose of the program. Collected data were analyzed throughout t-test, $x^2-test$, Manova test and Bonferroni correction in $SAS^{(R)}$ program. The summary of the investigation is as follows: Hypothesis 1: "Educated experimental group would possess more knowledge on hospice compared to the un-educated control group" was supported after 1 (F=12.14, p=.00) and 4 (F=5.3, p=.02) weeks of education. Hypothesis 2: "Educated experimental group would take a positive attitude toward hospice nursing compared to the un-educated control group" was supported after 1(F=3.92, p=.05) and 4(F=5.05, p=.02) weeks of education. Hypothesis 3: "Educated experimental poop would feel less liability compared to the un-educated control group in nursing terminal cancer patients' was rejected. In this study, it was found that knowledge on hospice was significantly important. By applying hospice basic education programs to nurses, the education program helped nurses to take a positive attitude toward terminal patients. It was, however, seen that the education program had no effect on alleviating liability in nursing terminal patients. Therefore, it is expected that this educational program would help hospices and nurses at general wards to understand the concept and the role of hospice so that terminal patents, now neglected under current medical system, would be able to end their lives in peace.

• 한국간호교육학회지
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• 제26권1호
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• pp.56-66
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• 2020

Purpose: The purpose of this study was to explore nursing students' experiences with patient deaths during clinical practice. Methods: The participants were ten nursing students who had experienced patient deaths during clinical nursing practice at a university hospital in Korea. Individual in-depth interviews were conducted, and the data were analyzed using the content analysis method suggested by Graneheim and Lundman (2004). Results: The participants' experience was structured into six categories: experiencing various emotions in facing patient deaths, viewing oneself as a nursing student at the scene of a patient's death, thinking about death again, finding a pathway of understanding and support for patient death experiences, impressions and regret felt while actually observing terminal care, and picturing oneself as a future nurse dealing with a patient's death. Conclusion: Based on this study, stress management and self-reflection programs are suggested for nursing students who have experienced patient deaths. Practical nursing education for patient death and end of life care is also needed.

• 대한암한의학회지
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• 제13권1호
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• pp.1-11
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• 2008

Objectives: To grasp the traditional stream of cancer treatment inherited from the previous doctors. Methods: The author's research has been performed cancer treatment based on JIJU(積聚) taking the original text as a reference. Results & Conclusion: The general three outlines and five detailed rules of cancer treatment have been obtained as follows. The first outline of cancer treatment is that reinforced vital function makes cancer reduce naturally. the second is that Harmless cancer can coexist in human beings and aging with them. and the third is that Elimination and reinforcing therapies should be executed in appropriate era and those therapies should utilize appropriate methods. The first detailed rule of cancer treatment is when using reinforcing therapy, it must applicate mildly and when using elimination therapy, it must applicate calmly. The second detailed rule is that the methods of cancer treatment are different from each cancer stage. The concentration should be made on reinforcing therapy at early stage while reinforcing and elimination therapies must be conducted together at middle stage. At terminal stage reinforcing therapy is the sole method to be taken. The third detailed rule is that the basis property of cancer drug is warm nature and extremely biased property should be avoided and when complication arises (eg. inflamatory disease, cancer fever, etc), cold or cool nature can be applied. The fourth detailed rule is that Cancer drug must have the effect eliminating the blood stasis, phlegm and excessive fluid, all together. The fifth detailed rule is that Physicians have to control patient's stress or stress related symptom and teach patients about right way of taking care of themselves and patients should take hygienic rules with their free will by themselves (eg diet, exercise, stress, etc)