• 지역사회간호학회지
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• 제16권3호
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• pp.270-281
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• 2005

Purpose: The objective of this study was to understand the caring experience of families with terminal cancer patients. Method: This was designed to be an inductive and descriptive study. Forty-seven families with terminal cancer patients were interviewed in depth and collected data were examined through content analysis. Result: The main categories of difficulties found in this study were 'suffering of patient', 'emotional suffering of family', 'bereavement of patient', 'difficulties in coping', 'problems in treatment', 'incurable situation', 'family problems', 'relationship with other people', 'economic problems', 'spiritual problems', 'problems in the future', 'informing patients of their condition', 'preparing death', 'emotional unstability', 'meaninglessness', 'unkindness of medical teams', 'poor environment for treatment', 'difficulties in hospital environment' and 'economic burden'. Conclusion: The main point found from this result was that families taking care of terminal cancer patients are suffering emotionally from watching the patients' pains and had difficulties in coping with the patients' situation and treatment. In addition, they had negative experiences in medical teams' attitude and hospital environment. This result can be used as an important guide for nurses to assess families' needs in the terminal care setting.

• Asian Pacific Journal of Cancer Prevention
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• 제14권12호
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• pp.7309-7314
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• 2013

Aim: To investigate factors that affect the place of death (POD) of terminal cancer patients. Materials and Methods: We recruited 702 consecutive patients (${\geq}18$ years) from 12 centers during July 2005 to October 2006, and 481 completed the questionnaire. In April 2011, we linked the data for 96.0% (n=462) of the deceased patients to the POD using the 2005-2009 death certificate data of Korea's National Statistical Office. The primary outcome variable was POD, and the predictive value of variables pertaining to patients and caregivers was evaluated using univariate and multivariate analyses. Results: Most patients died in a hospital (91.5%, n=441) and age, education, preference for place of terminal care, wish to use hospice/palliative care services, terminal cancer awareness, time between diagnosis and death, and global quality-of-life subscale of the EORTC QLQ-C30 of patients, and education and preference for place of terminal care of caregivers were significant predictors in univariate analyses. On multivariate analysis, patients and caregivers who preferred hospital/palliative care as the terminal care option over home care [adjusted odds ratio (aOR), 2.68; 95% confidential interval (CI), 1.18-7.04 and aOR: 2.65; 95%CI: 1.15-6.09 for patient and caregiver preferences, respectively] and caregivers who were highly educated (aOR, 3.19; 95%CI, 1.44-7.06) were predictors of POD. Conclusions: Most of the terminal cancer patients died in a hospital. Our findings indicate that major predictors of hospital deaths are preference of both the patient and caregiver for hospital/palliative care as the terminal care option and higher education of the caregiver.

• 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.

• 대한간호학회지
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• 제42권2호
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• pp.280-290
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• 2012

Purpose: This study done to identify the experiences of families caring for patients with terminal cancer. The question was, "What is the caregiving experience of a family who has a member with terminal cancer?" Methods: Grounded Theory was applied and in-depth interviews were done with 11 family members. Interviews were recorded with the interviewees' consent and were transcribed and analyzed. Participants' relationships to patients were 6 spouses, 4 daughters, and 1 mother. The ages of the participants were between 32 and 62, with an average of 47.5. Results: The study showed "enduring with bonds" as the main category and the main factor affecting this category was the "patients' diagnosis of terminal cancer." The caregiving experience was divided into four stages: shock, confusion, struggle, and acceptance. Mediating factors were relationship with the patient, intimacy with the patient, social support, communication, and trust. Conclusively, participants underwent internal maturity, and changes occurred in family and social and personal life. Conclusion: The families took care of the patients with responsibility and love. The study results should help with the understanding of a family with a member with terminal cancer and should be used to develop nursing, mediating, and consulting programs for these caregivers.

• Journal of Hospice and Palliative Care
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• 제23권2호
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• pp.55-70
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• 2020

Purpose: This study was conducted to examine differences in Spiritual Interests Related to Illness Tool (SpIRIT) scores and the degree of spiritual needs (SNs) between patients with terminal cancer and their primary family caregivers and to compare spiritual needs between them. Methods: The study participants were inpatients with terminal cancer and their primary family caregivers at 40 national hospice centers. The final analysis included 120 SpIRIT surveys from patients and 115 from family members, and 99 SNs questionnaires from patients and 111 from family members. Data analysis was conducted using descriptive statistics, the t-test, one-way analysis of variance, and Pearson correlation coefficients. Results: There were no significant between-group differences in SpIRIT scores or SNs. The SpIRIT sub-dimensions that ranked high for both patients and primary family caregivers were "maintaining positive perspective", "loving others", and "finding meaning". The SNs sub-dimensions were ranked identically in both groups, in the order of "love and connection", "hope and peace", "meaning and purpose", respectively. In both groups, the recognition of the importance of spiritual matters and religion were major factors influencing SpIRIT scores and SNs. Conclusion: The SpIRIT scores and degree of SNs of patients with terminal cancer and their primary family caregivers were found to be very closely related, and the needs for coherence and meaning were greater than religious needs. When providing spiritual care for patients with terminal illness, family members should also be considered, and their prioritization of spiritual needs and the importance of spiritual matters and religion shall be taken into account.

• 호스피스학술지
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• 제4권2호
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• pp.1-8
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• 2004

Purpose: This research aims to assess the effect of group education of hospice and palliative care program on recognition of home hospice care for terminal cancer patients and their family members. Methods: The terminal cancer patients or their family members who have visited Sam Anyang Hospital from January to September in 2004 participated in group education of hospice and palliative care program on one time a week. Of those, 32 patients or family members who were called education group has participated in group education more than 4 times and responded to a questionnaire. Sixty three patients or family members who were called non-education group have never participated in group education of hospice and palliative care program during the same period. Data were collected and done comparative analysis about both group. Results: A knowledge difference on definition of hospice and palliative care come out 29 people(91%) in education group and 26 people(41%) in non-education group. The recognition of home hospice care in education group(32 people, 100%) was significantly higher than non-education group(15 people,24%). A intention to home hospice care in education group(23 people, 72%) was significantly higher than non-education group(10 people,16%) and practically number of home hospice care was 15 people(50%) in education group and 8(13%) in non-education group. The recognition about cancer of patients was not significant differences in both group. People that the response to the question about 'Did you let your patient know to be the terminal cancer patient?' is 'yes' was 12 people(38%) in education group and 13(21%) in non-education group. Patients in education group had insight about terminal cancer significantly higher than non-education group. Conclusion: If we educated effective hospice and palliative care program in terminal cancer patients or their family members, we think the recognition of cancer and hospice and palliative care improve, and the home hospice care be activated more and more.

• 사상체질의학회지
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• 제12권2호
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• pp.195-200
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• 2000

For many patients suffered from a terminal cancer, the best care is to extend a period and improve a quality of life. So that the pain, a major symptom of patients with terminal cancer, should be effectively controled. Otherwise it causes anorexia, nausea, vomiting, general weakness, loss of body weight, insomnia and becomes worse the condition of patients. The case is a report about a patient diagnosed as terminal gastric cancer and suffered abdominal pain. The patient was treated by Taeumin Chongsim Yonja Tang and the abdomnal pain decreased. This report described the process and contents about the way the patient was cured.

• The Korean Journal of Pain
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• 제12권2호
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• pp.221-226
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• 1999

Background : Validity of WHO guideline of cancer pain management has been proven and many trials have been done to derive solutions for inadequate cancer pain management. We assessed the severity of pain of terminal cancer patients in a few different ways and patients' characteristics influencing inadequate pain management. Methods : This study was based on 100 adult oncological patients who were confirmed as terminal stage in our institution from 3/1998 to 11/1998. Medical records were reviewed and individual patients were interviewed to obtain demographic information and medical characteristics such as: daily activity performance, metastasis, and drug-adjusted pain severity. Adequacy of prescribed analgesics in accordance with WHO guidelines of pain management and patients' characteristics influencing adequacy of pain management were assessed. Results : Among those cancer patients diagnosed as terminal stage, 85% complained of pain, and 68% of those patients reported pain above moderate severity. 38% of those patients received inadequate pain management resulting in greater severity of pain; the less adequate pain relief was(p<0.01). Sex, age, primary cancer site metastasis, symptoms such as depression and anxiety, and daily activity performance were not significantly related. Conclusions : Despite WHO guidelines for pain management, majority of the terminal cancer patients received inadequate pain management. There is a necessity for education on proper pain evaluation and strict implimentation for WHO guidelines of pain management.

• Journal of Hospice and Palliative Care
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• 제22권4호
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• pp.156-165
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• 2019

목적: 본 연구는 임상실습을 경험한 간호대학생의 말기환자에 대한 주관적 태도 유형을 확인하고, 유형별 특성을 분석하기 위해 Q 방법론을 적용한 조사연구이다. 방법: 75개의 Q 모집단 중 최종 34개의 Q표본을 선정하고 임상실습을 경험한 간호대학생 43명의 P표본을 대상으로 9점 척도의 Q-분류를 하도록 하였다. 수집된 자료는 PC QUANAL Program으로 주요인분석을 하였다. 결과: 임상실습을 경험한 간호대학생의 말기환자에 대한 주관적 태도는 모두 3개 유형으로 나타났으며, 이들의 전체변량은 49.96%였다. 제1유형인 '생명의료 희망형'은 말기환자가 자신의 상태를 정확히 알고 생명을 연장하기를 원한다고 생각하였다. 제2유형인 '서비스 제공 요구형'은 말기환자가 미리 죽음을 준비할 수 있도록 다학제적인 간호와 이에 대한 제도가 마련되어야 한다고 생각하였다. 제3유형인 '죽음 수용 인식형'은 호스피스 병동에 입원하여 품위 있게 죽기를 원한다고 생각하였다. 결론: 본 연구를 통해 임상실습을 경험한 간호대학생의 말기환자에 대한 다양한 주관적 태도를 파악했으며, 이를 토대로 유형별 맞춤형 교육 프로그램이 개발된다면 말기환자에 대한 교육이 체계적으로 이루어질 것이다.

• 성인간호학회지
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• 제14권4호
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• pp.543-553
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• 2002

Purpose: The purpose of the study was to compare symptoms, medical therapies, and nursing interventions with terminal cancer patients during the last four weeks of their lives in a hospice unit and general units. Method: For the descriptive survey study, data were collected by reviewing the medical records of 243 patients who died of terminal cancer at K hospital in Seoul. The data was analyzed by using Chi-square test and t-test. Result: The study findings are summarized as follows: There were higher frequencies in physical symptoms of constipation, itching sensation, pain, sleeping disturbance, soreness and dysuria for those patients in the hospice unit than those patient in general units. All emotional symptoms were recorded significantly higher for those patients in the hospice unit than those in general units. Regarding the major medical interventions, pain management was used more significantly for those patients in the hospice unit, but antibiotic therapy and resuscitation were used more significantly for those patients in general units. Conclusion: The hospice unit provided more comprehensive nursing interventions including psychological, spiritual, and family cares as well as physiological care for terminal cancer patients. The facts showed that those patients who would need hospice care in general units should be referred to the hospice unit at an appropriate time.