• 한국산업보건학회지
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• 제29권3호
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• pp.375-382
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• 2019

Objectives: This study was to examine the features of work and posture analysis outputs in assessment of exposure to musculoskeletal disorder (MSD) risk factors in general hospital nurses. Methods: Work and posture analyses were carried out using observational approaches for nurses at general hospitals across Korea. With development of a taxonomy for assessing exposure to MSD risk factors, nursing tasks were documented in frequency (%time) for 8 hours a day in work analyses. Rapid Entire Body Assessment (REBA) scores were obtained for mode and maximum risk levels, respectively, during posture analyses. Results: A total of 27 nurses were observed while conducting 7 nursing tasks at 6 general hospitals. For both the work analyses and posture analyses, the taxonomy was developed and used. In the work analyses, 'Video display terminal task' and 'Nursing examination/ treatment' were the highest as 25%time for 8 hours a day, followed by 'Patient care' and 'Room rounding' as 13%time in order. In the posture analyses, the mode REBA scores were 2 or less for all nursing tasks while the maximum REBA scores were 7 for upper limbs at 'Room rounding' and 6 for trunk/neck/legs at 'Patient care'. Conclusions: The results showed the study nurses are occasionally at a risk for MSD, a medium level as designated in the REBA risk level, suggesting that it is important to control awkward posture at the nursing tasks such as 'Room rounding' and 'Patient care', in priority, for preventing MSD in the hospital sector including the study general hospitals.

• 의료법학
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• 제9권1호
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• pp.385-411
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• 2008

The goal of medicine is to contribute to promoting national health by preventing diseases and providing treatment. The scope of modern medicine isn't merely confined to disease testing, treatment and prevention in accordance to that, and making experiments by using the human body is widespread. The advance in modern medicine has made a great contribution to valuing human dignity and actualizing a manly life, but there is a problem that has still nagged modern medicine: treatment and healing for terminal patients including cancer patients. In advanced countries, pain care and hospice medicine are already universal. Offering a helping hand for terminal patients to lead a less painful and more manly life from diverse angles instead of merely focusing on treatment is called the very hospice medicine. That is a comprehensive package of medical services to take care of death-facing terminal patients and their families with affection. That is providing physical, mental and social support for the patients to pass away in peace after living a dignified and decent life, and that is comforting their bereaved families. The National Hospice Organization of the United States provides terminal patients and their families with sustained hospital care and home care in a move to lend assistance to them. In our country, however, tertiary medical institutions simply provide medical care for terminal patients to extend their lives, and there are few institutional efforts to help them. Hospice medicine is offered mostly in our country by non- professionals including doctors, nurses, social workers, pastors or physical therapists. Terminal patients' needs cannot be satisfied in the same manner as those of other patients, and it's needed to take a different approach to their treatment as well. Nevertheless, the focus of medical care is still placed on treatment only, which should be taken seriously. Ministry for Health, Welfare & Family Affairs and Health Insurance Review & Assessment Service held a public hearing on May 21, 2008, on the cost of hospice care, quality control and demonstration project to gather extensive opinions from the academic community, experts and consumer groups to draw up plans about manpower supply, facilities and demonstration project, but the institutions are not going to work on hospice education, securement of facilities and relevant legislation. In 2002, Ministry for Health, Welfare & Family Affairs made an official announcement to introduce a hospice nurse system to nurture nurse specialists in this area. That ministry legislated for the qualifications of advanced nurse practitioner and a hospice nurse system(Article 24 and 2 in Enforcement Regulations for the Medical Law), but few specific plans are under way to carry out the regulations. It's well known that the medical law defines a nurse as a professional health care worker, and there is a move to draw a line between the responsibilities of doctors and those of nurses in association with medical errors. Specifically, the roles of professional hospice are increasingly expected to be accentuated in conjunction with treatment for terminal patients, and it seems that delving into possible problems with the job performance of nurses and coming up with workable countermeasures are what scholars of conscience should do in an effort to contribute to the development of medicine and the realization of a dignified and manly life.

• Journal of Hospice and Palliative Care
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• 제25권1호
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• pp.12-24
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• 2022

Purpose: This descriptive study compared the perceptions, determinants, and needs of patients, family members, nurses, and physicians regarding life-sustaining treatment decisions for patients with hematologic malignancies in the hematology-oncology department of a tertiary hospital in Seoul, Korea. Methods: In total, 147 subjects were recruited, gave written consent, and provided data by completing a structured questionnaire. Data were analyzed using analysis of variance, the chi-square test, and the Fisher exact test. Results: Nurses (F=3.35) and physicians (F=3.57) showed significantly greater familiarity with the Act on Decisions on Life-Sustaining Treatment than patients (F=2.69) and family members (F=2.59); (F=19.58, P<0.001). Many respondents, including 19 (51.4%) family members, 16 (43.2%) physicians, and 11 (29.7%) nurses, agreed that the patient's opinion had the greatest effect when making life-sustaining treatment decisions. Twelve (33.3%) patients answered that mental, physical, and financial burdens were the most important factors in life-sustaining treatment decisions, and there was a significant difference among the four groups (P<0.001). Twenty-four patients (66.7%), 27 (73.0%) family members, and 21(56.8%) nurses answered that physicians were the most appropriate people to provide information regarding life-sustaining treatment decisions. Unexpectedly, 19 (51.4%) physicians answered that hospice nurse practitioners were the most appropriate people to talk to about life-sustaining treatment (P<0.001). Conclusion: It is of utmost importance that the patient and physician determine when life-sustaining treatment should be withdrawn, with the patient making the ultimate decision. Doctors and nurses have the responsibility to provide detailed information. The goal of end-of-life planning is to ensure patients' dignity and respect their values.

• 중환자간호학회지
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• 제14권1호
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• pp.1-13
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• 2021

Purpose : Based on Quint's theory and the relevant literature, this study constructed a structural equation model for explaining and predicting end-of-life care performance in clinical nurses. Methods : A self-administered questionnaire was used to collect data from 265 nurses between September 1 and September 30, 2016. The data were analyzed using SPSS ver. 21 and AMOS ver. 21. Results : The goodness of fit of the modified model was found to be relatively satisfactory (χ2=114.82, Nomed χ2(χ2/df)=2.44, SRMR=.06, GFI=.94, AGFI=.89, CFI=.95, TLI=.91, RMSEA=.07). End-of-life care performance was affected by the attitudes toward nursing care of the dying, working unit, and death anxiety. The attitudes toward such care had the highest effect on end-of-life care performance. Conclusion : The results suggest that end-of-life care performance is directly and indirectly affected by attitudes toward nursing care of the dying, participation in end-of-life care education, working unit, death perception, and death anxiety. To improve clinical nurses' end-of-life care performance, effective programs to promote death anxiety and attitudes toward nursing care of the dying need to be developed. In addition, hospital nursing organizations should attempt to produce concrete measures for death anxiety and terminal care attitudes in clinical nurses.

• 기본간호학회지
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• 제23권2호
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• pp.172-183
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• 2016

Purpose: The purpose of this study was to explore the subjective experience of life-sustaining treatment care among nurses in intensive care units. Method: A phenomenology was used for the study. Data were collected from October to December, 2015 using open-ended questions during in-depth interviews. Participants were nurses working in intensive care units and were contacted through purposive techniques. Eight nurses participated in this study. Results: Four categories emerged from the analysis using Colaizzi's method: (a) difficulties due to life-sustaining treatment care, (b) dilemma of extension or cessation of life-sustaining treatment, (c) repressed feelings and emotional exhaustion, and (d) forming values for life-sustaining treatment from nursing experience. Conclusion: Provision of clearer guidelines on life-sustaining treatment which reflect a family-oriented culture is important for nurses in ICU and will promote nurses involvement in the decision-making process of life-sustaining treatment of patients.

• 임상간호연구
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• 제14권1호
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• pp.33-44
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• 2008

Purpose: This study was performed to determine the effects of foot reflexology on pain and quality of sleep in patients with terminal cancer. Method: Quai-experimental research design was used. The subjects of this study were consisted of 19 for experimental group and 18 for control group. Visualue Scale(VAS) was used as the measurement tool of pain in this study, Verra & Snyder-Halpern Sleep Scale(VSH) and Visual Analogue Scale(VAS) were used as the measurement tool of perceived quality of sleep. Data were analyzed using statistical methods such as frequency, percent, $x^2$-test, t-test using SPSS WIN 12.0 program. Results: The hypothesis 1 that the experimental group with reflexology has less degree of pain than the control group without reflexology was supported (t=5.41, p<.001). The hypothesis 2 that the experimental group with reflexology has higher degree of VSH Scale than the control group without reflexology was supported(t=2.37, p=.02). The hypothesis 3 that the experimental group with reflexology has the difference among the mean of sleep VAS Scale during the 12 measurement periods was not supported(F=1.63, p=.08), and no significant interactions between group and time. Conclusion: It is considered that reflexology is effective for reducing cancer pain and improving quality of sleep in patients with terminal cancer.

• 임상간호연구
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• 제14권2호
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• pp.103-114
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• 2008

Purpose: The purpose of this study was to investigate the level of QoL of the terminal cancer patients at home and to identify any influencing factors on QoL. Method: Subjects of this study consisted of 72 terminal cancer patients who were receiving home care nursing for more than 2 weeks in 6 general hospitals. Data were collected by a self-reporting questionnaire on QoL, pain, physical functioning, and symptom experience from Feb, 2006 to Dec, 2006. Data were analyzed by t-test, one way ANOVA, Pearson correlation coefficients, and multiple regression using SPSS Win 14.0. Results: Mean score of QoL was 98.6(230 in total). Except the level of family coping, general characteristics and disease related variables did not show significant difference in QoL. QoL was higher in the family with better coping, and QoL showed negative correlation with three types of pain, physical functioning, and symptom experiences. Least pain, physical functioning, and level of family coping explained QoL up to 26.7%. Conclusion: The QoL was closely related with pain, physical functioning, symptom experience, and family coping. And the least pain, physical functioning and level of family coping were important factors influencing on QoL of terminal cancer patients. However, some other variables influencing the QoL need to be investigated in the future.

• 근관절건강학회지
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• 제20권3호
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• pp.197-206
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• 2013

Purpose: The purpose of this study was to investigate end-of-life care preferences of employees working in a university hospital. Methods: Of 650 eligible employees that were approached, 607 employees (386 nurses, 93 physicians, and 128 general staff) completed the Korean version of Preferences for Care Near the End of Life (PCEOL-K). Results: Among 5 dimensions of the PECOL-K, "Pain" was the most preferred care dimension and "Decision making by health care professional" was the least preferred care dimension. The item that received the highest mean score was "I want to let nature guide my dying and I do not want my life to be artificially prolonged in any way", and the lowest item was "I want health care providers to make all decisions about my care". As preferred care near the end of life, nurses gave lower scores to the life sustaining treatment and decision making by health care profession than physicians and general staff. Compared to physicians and nurses, general staff preferred the decision making by health care professional and by family. Conclusion: The results show that adequate pain relief is the most preferred care at the end of life among hospital employees and non-medical personnel preferred decision making by others.

• 임상간호연구
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• 제18권2호
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• pp.205-214
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• 2012

Purpose: The purposes of this study were to develop the constipation assessment tool for identifying their bowel movement patterns, and to provide basic information for the assessment and intervention protocol on constipation for patients with terminal cancers. Methods: The study followed the steps: the first step was to build a conceptual framework based on literature review; the second step was to develop a tentative instrument by analyzing the conceptual framework and existing instruments; the third step was to test content validity and reliability; and the final step was to apply the tool to patients with terminal cancers (N=112). Results: The constipation assessment tool was consisted of total nine items; under the categories of subjective and objective data for diagnosis had 4 items, and under the initial assessment category which includes stool type, physical examination, and abdomen X-ray had 5 items. Conclusion: The constipation assessment tool developed in this study is very easy to use and useful in nursing practice, especially in hospice and palliative care setting. Particularly this tool has items on patient assessment which would be considered as an evidence for choosing nursing interventions. Based on the constipation assessment tool, the development and application of intervention protocol on constipation for patients with terminal cancers is warranted in future research.

• 디지털융복합연구
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• 제18권9호
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• pp.307-315
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• 2020

본 연구의 목적은 현상학적 방법을 통해 말기 암 환자를 돌보는 호스피스 병동 간호사의 경험의 의미 가 무엇인지 이해하여 본질을 추구하고 그 현상의 의미를 심층적으로 기술하고자 함이다. 본 연구의 대상자는 C시에 위치한 일종합병원의 호스피스 병동에서 1년 이상 근무하고 있는 간호사 9명을 선정하였다. 연구 방법은 심층 인터뷰로 2019년 7월부터 2019년 9월까지 자료를 수집하였다. 인터뷰 자료는 Giorgi의 현상학적 방법으로 분석하였다. 분석 결과는 '업무의 부담감' '성숙해짐', '밀착된 관계형성', '호스피스에 대한 지원 부족'으로 나타났다. 결론적으로 말기 암 환자를 돌보는 호스피스병동 간호사의 경험에 대하여 그들의 입장에서 포괄적이고 총체적인 이해를 제공함으로써 말기 암 환자 돌봄에 대한 통찰력을 제공 할 것이며, 그들의 경험에 근거하여 효과적인 지지체계 및 행정적 지원체계의 개발에 기여할 수 있으리라 생각된다.