• 근관절건강학회지
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• 제15권2호
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• pp.140-154
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• 2008

Purpose: The purpose of this study was to describe the adjustment process of patients with Amyotrophic Lateral Sclerosis(ALS). Method: The data were collected from May 2007 to February 2008 through individual in-depth interviews with 4 ALS patients. The data collection and analysis were performed according to grounded theory methodology, as suggested by Strauss and Corbin. Results: 'Accepting the sick role' was the central phenomenon, which was derived from 'perceiving an intial symptom'. Therefore, the adjustment pattern was represented by using the different strategies, which were 'raising hope' and 'hoping to dye comfortably'. For taking a view of the future, ALS patients adopted the strategies of 'living positively', 'being treated hardly', 'joining in the experience', 'depending on the absolute being', 'recognizing the dying process'. Conclusion: This study provides guidance for the development of nursing interventions for patients with ALS.

• Journal of Hospice and Palliative Care
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• 제17권1호
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• pp.10-17
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• 2014

목적: 본 연구는 의료인과 간호학생의 웰다잉 의미와 주관성 유형을 확인하고, 유형별 특성을 분석하기 위해 Q 방법론을 적용한 조사연구이다. 방법: 간호학과 학생 8명, 호스피스전문병원 임상간호사 3명을 대상으로 심층면담과 선행연구고찰을 통해 102개의 Q-모집단을 구성하였으며, 이후 Q-방법론의 전문가인 간호학과 교수 1명과 간호학과 박사과정 중인 2명의 의견 교환 및 재조정을 통하여 총 33개의 Q-표본을 선정하였다. 4년제 간호학과 학생 11명과 경기도 일개 3차 종합병원의 간호사 9명과 의사 2명을 대상으로 총 22명의 P-표본을 대상으로 하였다. P-표본은 선정된 33개의 진술문을 강제 정상분포가 되도록 7점 척도 상에 분류하도록 하였고, 양극단에 분류한 진술문과 관련하여 추가 진술문을 작성하도록 하였다. 수집된 자료는 PC-QUANL Program으로 요인 분석하였다. 결과: 분류된 의료인의 웰다잉 의미 유형은 모두 3가지로 나타났으며 이들 유형에 의해 설명된 전체 변량은 57.97%였다. 제1형은 '현실중시형'으로 부담 없이 아름다운 모습으로 임종하는 것에 의미를 두었다. 제2형은 '관계중시형'으로 죽기 전 자선을 베풀고 주변인들과 화해와 용서의 시간을 갖는 것에 의미를 두고 있었다. 제3형은 '자연순응형'으로 살만큼 살다 가족의 간호를 받으며 임종하는 것에 의미를 두었다. 결론: 웰다잉에 관한 의료인과 간호학생의 주관성은 임종을 맞이하는 환자간호에 영향을 미친다. 따라서 의료인과 간호학생은 삶과 죽음에 대한 깊은 통찰을 가져야 하며, 이를 위해 웰다잉에 대한 주관성 유형별 특징에 맞는 죽음교육이 필요하다.

• 한국콘텐츠학회논문지
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• 제22권8호
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• pp.628-639
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• 2022

본 연구는 환자와 환자 가족에게 최상의 임종간호를 제공하기 위해 간호사가 인식하는 최상의 임종간호와 웰다잉 간의 관계를 조사하였다. 연구대상은 서울 소재 종합병원에 근무하는 간호사 121명을 대상으로 2021년 4월 28일부터 5월 12일까지 수집된 자료를 분석하였다. SPSS/WIN 27.0을 이용하여 t-test, ANOVA, Pearson correlation coefficients로 분석하였다. 본 연구의 결과 대상자의 최상의 임종간호에 대한 인식의 총 평균은 5점 척도상 4.04±0.82점으로 최상의 임종간호에 전반적으로 '동의한다' 수준을 나타냈다. 웰다잉에 대한 인식의 총 평균은 5점 척도상 3.63±1.14점으로 평화롭게 죽는 것을 가장 중요하게 인식하였다. 대상자의 일반적 특성 중 연령에 따른 최상의 임종간호에 유의한 차이를 나타내(t=-.97, p=.013) 30대 간호사군이 20대 간호사군에 비해 최상의 임종간호에 더 높은 동의수준을 나타냈다. 최상의 임종간호와 웰다잉의 상관관계를 분석한 결과 유의한 상관관계는 없는 것으로 나타났다. 본 연구의 결과는 경력이 낮은 젊은 간호사들의 임종간호 인식을 높이기 위한 교육이 제공되어야 함을 시사한다.

• 미래기술융합논문지
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• 제3권1호
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• pp.1-11
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• 2024

본 연구는 간호대학생의 좋은 죽음에 대한 인식과 임종환자에 대한 간호태도가 공감능력에 어떤 영향을 미치는지 알아보기 위해 실시한 서술적 조사연구이다. 연구대상자는 연구목적을 이해하고 참여에 동의한 간호대학생 155명으로, 온라인 설문조사법을 활용하여 자료를 수집하였다. 자료수집 기간은 2023년 4월 11일부터 총 34일이 소요되었다. 자료분석은 IBM SPSS Statistics 26 통계 패키지를 사용하여 기술통계, 독립 t-검정, 일원배치 분산분석, 다중회귀분석을 사용하여 수행되었다. 더미변수인 '지인의 죽음 경험'을 통제한 결과, 임종간호태도가 높을수록(B=.312) 공감능력에 통계적으로 유의한 긍정적인 영향을 미치는 것으로 나타났다(p<.01). 간호대학생의 공감능력에 영향을 미치는 변인은 지인의 임종경험(𝛽=.226), 임종간호태도(𝛽=.220)였으며, 회귀모형은 통계적으로 유의하였다(F=6.968, p<.001). 하나의 더미변수(지인의 임종경험)와 2개의 독립변수(임종간호태도, 좋은 죽임 인식)는 공감능력을 10.4% 설명하였다. 본 연구는 간호대학생의 공감능력에 미치는 영향을 분석함으로써 향후 간호대학생의 공감역량 강화를 위한 프로그램 개발의 기초자료로 활용될 수 있을 것으로 기대된다.

• 호스피스학술지
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• 제2권2호
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• pp.1-16
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• 2002

Hospice can not only help the dying persons to maintain the high quality of life and facing the death in comfortable and peaceful state, but also the bereaved family to relieve the grief and sufferings. We investigated the work of hospice performed by church base from March 2000 until recently and reported the results dividing them into three parts. 1)The application of resources in church to administration, education, nursing delivery of hospice in the aspects of management. 2)Spiritual and postmortal management relating hospice nursing and funeral in hospice practice. 3)Case report of hospice and the patients situation(5 in average a month). The expected effects of hospice practice using the resources in church are as follows. 1)Hospice practice can provide the highly qualified persons with the opportunities to do voluntary services and find their lives worth living. Consequently hospice contributes to the spreading of the volunteering culture. 2)The volunteers in hospice can grow mature spiritually and get interpersonal relationships among the volunteers. Doyle. D., Geoflrey.W.C., & Macdonald. N.(1988). Oxford Textbook of Palliative Medicine(2nd ed). New York :Oxford University Press. Woodruff. R.(1996). Palliative Medicine(2nd ed). Melburn: Asperula Pty Ltd. 3)Through the hospice activity, church can practice and show the moral. 4)The volunteers in hospice can make a organization with a hope to be a beautiful community in church. 5)The patients and their families can enjoy the high quality of life through the holistic care provided by 33 nursing practical items of hospice. 6)'Hospice newsletter' can be a useful vehicle to provide readers with hope and encouragement through the stories of the patient and the volunteers. The persons unaware of the hospice can be contacted with hospice by this 'Hospice newsletter'. 7)Irrespective of the economic status, all patients are served equally that hospice can contribute to dying with dignity and the equality of human being.

• Journal of Hospice and Palliative Care
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• 제26권1호
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• pp.22-25
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• 2023

Although most patients prefer dying at home, patients whose condition rapidly becomes critical need care in the intensive care unit (ICU), and it is rare for them to die at home with their families. Therefore, interest in hospice and palliative care for patients in the ICU is increasing. Hospice and palliative care (PC) is necessary for all patients with life-threatening diseases. The following patients need palliative care in the ICU: patients with chronic critical illnesses who need tracheostomy, percutaneous gastrostomy tube, and extracorporeal life support; patients aged 80 years or older; stage 4 cancer patients; patients with specific acute diseases with a poor prognosis (e.g., anoxic brain injury and intracerebral hemorrhage requiring mechanical ventilation); and patients for whom the attending physician expects a poor prognosis. There are two PC models-a consultative model and an integrative model-in the ICU setting. Since these two models have advantages and disadvantages, it is necessary to apply the model that best fits each hospital's circumstances. Furthermore, interdisciplinary decision-making between the ICU care team and PC specialists should be strengthened to increase the provision of hospice and palliative care services for patients expected to have poor outcomes and their families.

• 종양간호연구
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• 제12권2호
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• pp.186-193
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• 2012

Purpose: The purpose of this narrative study was to understand how family caregivers interpreted themselves life during caring for dying patients with gliobalstoma, and how they integrated these experiences into their personal biographies. Methods: Three family caregivers were recruited for the study. Data were collected through a series of audio-taped unstructured interviews and conversations with participants. The interviews and observation were conducted between October and November, 2011. Data were analyzed using psychosocial analytical methods that combined case based, in-depth staged analysis of narratives. Results: The life experiences of the family caregivers with a dying family member were summarized as, in their own voices, 'the repetition of gliobalstoma,' 'a smart patient,' 'being obsessed with rehabilitation treatment,' 'the frustration from nothing but just looking at the suffering of the patient,' and 'a stubborn son'. Conclusion: Caregiving was characterised by various roles and life changes from the moment of diagnosis. Family caregivers of brain tumor reported experiences similar to those described by caregivers of people with other cancers. What differed for this group was the rapidity of change and the need for immediate information and support to assist with caring for a person with high-grade glioma.

• Asian Pacific Journal of Cancer Prevention
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• 제13권12호
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• pp.6023-6026
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• 2012

The incidence of hepatocellular carcinoma (HCC) in Malaysia for the year 2001 was 2.8 per 100,000 people. The mortality rate is increasing. A retrospective cohort study measuring the survival of HCC patients who received treatment in Selayang Hospital was conducted from 1 January 2003 to 31 December 2006. The main objectives of the study were to measure the survival of the patients and to understand the influencing factors, especially ethnicity. The subjects were newly diagnosed cases of HCC by CT scan and histopathological assessment who underwent futher investigations and treatments in Hospital Selayang (inception cohort). The survival time was measured from the date of diagnosis until the subjects died, or failed to follow-up at the end of the study period (31 December 2007). A total of 299 patients were selected with 95 patients dying, the majority among Chinese (39.1%). Subgroup analysis according to ethnicity proved significantly that Chinese patients who had smaller tumor, less number of nodules, low AFP level, Child Pugh Class A and received surgical treatment had a better median survival rate compared to other ethnic groups. Malay (cHR: 1.3, 95%CI; 0.89-1.85) and Indian (cHR: 1.3, 95%CI; 0.74-2.26) patients had a poor survival compared to Chinese patients, but not in the final model. Therefore ethnicity may play a role in survival of HCC patients, but not as a main hazard prognostic factor.

• 대한간호학회지
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• 제31권5호
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• pp.897-911
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• 2001

The purpose of the study was to compare home care nursing intervention activities analyzed by the Nursing Intervention Classification (NIC) system for hospice and general patients. Method: For the descriptive survey study, data was collected by reviewing charts of 151 hospice patients and 421 general patients who registered in the department of home health care nursing at K Hospital. Results: According to the NIC system application, there were 2380 total nursing interventions used for the hospice patients and 8725 for the general home care patients. For both sets of patients (hospice vs. general), the most frequently used nursing intervention in level 1 was the Physiological: Complex domain (40.13 vs. 31.06 percent), followed by the Safety domain; in level 2, the Risk Management class (28.4 vs. 27.70 percent), followed by Tissue Perfusion Management; and in level 3, Vital Sign Monitoring (6.18 vs. 4.84 percent), followed by Health Screening. Conclusion: The study showed that there was a lack of specialized hospice nursing interventions such as emotional, family and spiritual support, and care for dying hospice patients.

• 대한간호학회지
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• 제30권4호
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• pp.1045-1054
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• 2000

As cost pressures have escalated, policy makers, politicians, health care providers and families have tried to devise ways to reduce health care costs. While originally developed to enhance patient control and to provide better care at the end of life, hospice care has recently received significant attention as a mean of reducing health care costs. As a program providing care for patients who are dying at their homes, hospice has expanded slowly since the opening of the first hospice in Korea in 1963. Therefore, a variety of services that responds to the needs and concerns of many dying people and their families is limited The purpose of this study was to determine the potential cost savings at the end of life among patients who used home hospice compared with the patients who received institutional care in Korea. This study used a retrospective, descriptive design. The sample for this study included 46 patients who died of lung cancer: 25 patients who received home hospice care and 21 patients who received institutional care. Data on patient characteristics, kinds and frequencies of provided treatment and nursing services, and hospice and hospital charges during the last month before death were collected. Cost of care was measured by the average cost per patient per day in the last month of life. The results of the study indicated that there were significant differences in average cost of care between home hospice sample and institutional care sample (t=9.956, p<.001; home hospice sample: M=18,102 won, institutional care sample: M=317,578 won). The cost of the home hospice sample was approximately 6% of the cost of institutional care. The majority of the home hospice nursing services were education (35.7%) and supportive counseling (25.2%), followed by medication management (13.6%), assessment (12.1%), basic nursing (7.2%), treatment (5.5%) and others. In institutional care sample, basic nursing and treatment were more emphasized than education or supportive counseling among the nursing services provided. The results of this study showed the potential for hospice to reduce costs and implications for policymakers and clinicians to incorporate hospice program into the formal health care delivery system in Korea.