• 서비스연구
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• 제13권3호
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• pp.70-81
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• 2023

장사 방법의 선택은 생의 마지막 순간에 필요한 결단이며, 이를 위해 우리는 몇 가지를 판단기준으로 삼는다. 우리의 장례방법에는 자연이 아닌 조상숭배 문화와 종교가 지배적이었다. 인간적인 시각에서 자연을 수단화하여 이용했을 뿐 자연에 대한 배려나 자연과의 공생과 같은 자연장의 방법이 등장한 건 최근이다. 최근 자연장의 국민 선호도가 높은 것은 오늘날의 강력한 시대정신, 자연 친화적 가치이다. 2021년 통계 기준, 우리나라 전국 화장률 92%를 상회 했으며, 불과 20년 전 화장률 20% 미만에 견주면 우리의 장사방법은 급변했다. 90년대 초반부터 시작된 화장장려 운동과 정부시책이 체계적으로 전개되면서 봉안시설이 우리 곁에 자리 잡았다. 하지만 이 또한 국토훼손이라는 비난의 굴레를 면하지 못하던 중, 2008년 자연장이라는 장법이 제도권에 도입되었고, 약 15년이 흘렀지만 자연장 활성화는 예상보다 더디다. 발전 정체의 원인 중 하나는 "(한번 숲으로 돌아가면) 숲에 영원히 잠든다"라는 자연장의 기본 정신을 잊고, 마치 묘지의 분묘처럼 생각(改葬을 인정)한 데서 출발했다고 본다. 이에, 본 연구에서는 자연장의 도입배경과 현재 운영실태를 파악하고 자연장이 국민들로부터 사랑받는 추모 공간으로 거듭기 위한 추모서비스 개선을 위한 발전방안을 제시하고자 한다, 또한 국내외 우수 사례와 고품격이면서도 친환경적인 선진국 자연장의 조성사례를 통해 시사점과 적용 가능성을 검토한다.

• 수완나부미
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• 제2권1호
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• pp.55-94
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• 2010

Even Faxian(法顯)'s Gaosengfaxianchuan (『高僧法顯傳』) and Iching(義淨)'s Nanhaijiguineifachuan (『南海寄歸內法傳』) are regarded as very important and useful documents to study the southeast asian buddhist culture, it is very difficult to grasp the contemporary state of those area because their descriptions are very brief and implicit. Therefore this essay aimed an in-depth reading their documents as original texts of modern understanding of those area, and tried to make a new views to approach the southeast asian buddhist culture by some more historically and concretely. At the early 5th century when Faxian(法顯) arrived, Buddhism was flourished in Sri Lanka. Because already a long time passed since the Saṇgha was schismatized into conservative and progressive at around the dominical year, he mentioned nothing about the conflict or disharmony of two orders. And the faith of Buddha tooth relic, which had been uprisen at 50 years ago from Faxian's visiting, was concretely established as a representative religion of Sri Lanka. According to his record, the carrying ritual of this Buddha tooth was performed very magnificently as similar with recent Korean Youngsan ceremony(靈山齋). In the mean time, it looks there were many sculptures of Buddha image made of precious stone of special product from Sri Lanka. The faith of Buddha-pāda(the Buddha's foot-prints) was also generalized at that time. The most famous monk of his contemporary Sir Lanka was Buddhaghosa, the author of Visuddhi-magga, but it is not sure that Faxian had met him. It can be suspected that the funeral in which Faxian participated could be belonged to him, or the Visuddhi-magga was writing at the peak during Faxian's staying. On the way to return to China, Faxian embarked an indigenous ship around Indonesia. It means there were no chinese trade ship which he can use. So the trade between china and southeast asia was advanced by south asian ships, and the chinese ships were not yet joined at that time so activity. And at least until that time, it looks there were no any remarkable buddhist movement in the southeast asian countries by where he stopped. In contrast, the southeast asian world which be seen by Iching had already experienced a lot of changes. He was impressed by the high quality buddhist culture of those area, and insisted to accept it to china. Further, he analyzed the sects of buddhism which were prevalent around the southeast asia in his contemporary time, and tried to make a good relationship with each native monks for learning from them. It looks the center of those exchanges may be Śrīvijaya of Indonesia. He also mentioned the situation of the late 7th century's Funan(扶南) in Cambodia. At that time, the buddhist Saṇgha was oppressed by newly rising Khmer(眞臘). On the other hand, he described the points of sameness and difference in detail between Indian and southeast asian buddhist culture in the field of ritual as like the practical use of garments, buddha images, and daily recited scriptures. There must be a lot of another aspects which this essay couldn't gather up or catch from these documents. Nevertheless, I hope this essay can help the researchers of this field and will wait for any advices and comments from them.

• 대한화장품학회지
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• 제42권4호
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• pp.421-432
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• 2016

본 연구에서는 화장품 신소재 개발을 위해 한의약적 포제법을 적용하여 흰점박이꽃무지 추출물을 제조하고 포제방법에 따른 항염 및 미백활성을 평가하였다. 모든 실험은 생(生), 1회 초법(炒法), 2회 초법(炒法), 3회 초법(炒法), 증법(蒸法)을 적용한 흰점박이꽃무지를 이용하였다. 각 포제법을 적용한 흰점박이꽃무지의 용매별 (80% 에탄올, 50% 에탄올, 에틸아세테이트, 헥산) 추출물에 대한 1,1-diphenyl-2-picrylhydrazyl (DPPH) 라디칼 소거 활성은 각각 85.5, 22.4, 37.0 및 19.4%의 효과를 나타내었다. 따라서 이후의 실험은 항산화 활성이 가장 큰 80% 에탄올 추출물을 이용하였다. 포제법을 적용한 흰점박이꽃무지 추출물과 포제법을 적용하지 않은 추출물 모두 농도 의존적으로 항산화능을 나타냈으며, $500{\mu}g/mL$ 농도에서 포제법을 적용한 3회 초법 및 증법은 superoxide dismutase (SOD)-like 활성이 각각 62.9 및 55.9%를 나타냈다. Lipopolysaccharide (LPS)로 염증이 유도된 RAW 264.7 세포에 포제법을 적용한 흰점박이꽃무지 추출물을 처리하였을 때, LPS를 단독으로 처리한 양성 대조군보다 포제법을 적용하지 않은 흰점박이꽃무지 추출물(38.0%), 1회 초법(41.0%), 2회 초법(69.8%), 3회 초법(70.1%), 증법(78.5%) 순으로 염증 매개물질인 $NO{\cdot}$ 생성이 유의적으로 감소하였다. 세포 내 tyrosinase 저해 활성 및 멜라닌 생합성 저해 효과를 확인한 결과, 농도 의존적으로 tyrosinase 저해 활성 및 멜라닌 생성 억제 활성을 나타내었다. 포제하지 않은 흰점박이꽃무지 추출물은 $500{\mu}g/mL$ 농도에서 ${\alpha}$-MSH만 처리한 대조군과 비교하여 멜라닌 생합성을 90.7% 감소시켰다. 이상의 결과들은 항염이나 미백활성이 있는 화장품 소재 개발에 포제법을 적용할 수 있음을 시사한다.

• Journal of Preventive Medicine and Public Health
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• 제32권3호
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• pp.383-394
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• 1999

공 교의료보험 적용대상자들 중 1992년 건강검진 수검 피보험자와 1993년 건강검진 수검 피부양자를 대상으로 사망에 영향을 미치는 요인에 관한 코호트내 환자-대조군 연구를 실시한 결과는 다음과 같다. '93-'97년도 자료의 분석에서 사망과 정상관 관계를 보인 변수는 수축기 혈압, 이완기 혈압, 혈당, AST, 요당, 요단백, 음주('자주 마신다'), 흡연, 건강인지, 영양제 복용, 수혈이었다. 사망과 역상관 관계를 보인 변수는 커피 음용이었다. 비만도와 혈중 콜레스테롤은 사망과 J형의 상관관계를 보였다. '96-97년 자료만을 이용하여 분석한 경우도 '93-'97년 자료와 관련성의 방향은 동일하였으나, 비만$(25-30kg/m^2)$과 콜레스테롤(240 mg/dL이상)의 사망 예방효과는 '93-'97년 자료에 비해 '96-'97년 자료에서 감소함으로써 '93-'94년 자료에 결과-원인 관계가 일부 개재되었을 가능성을 배제할 수 없었다.

• 복식
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• 제16권
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• pp.221-229
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• 1991

This thesis aims at reviewing the wearing aspect and formation of Chosun ceremonial dresses for meal and finding out the thought reflected by them from the standpoint that dresses themselves should be taken as one of the phenomena in culture. That is men's ceremonial costumes and confucian costumes of the royal family and the gentry family in Chosun is reviewed focused on the formation and the wearing aspect of Po, Which is a kind of them. And in the context of the phase of the times. I also considered the thoughts reflected on the clothes such as confucianism, Ying & Yang Theory, and the symbol and the thoughts of patterns in relation to the clothes. Confucian influence was the main force for the Chosun prohibitions for clothes. The major reasons for the prohibitions for clothes were as follows. First, they reflected confucian Chung myoung chooui(the principle that everything should be where it belongs). That is the prohibitions for clothes were used in the means to maintain feudalistic social order. influenced by social rank system. Second, they reflected confucian ethics in the means to recover social disciplines with the maintenance of traditional customs. This shows well in the restriction of luxurious items in dressing included the prohibitions for clothes. Third, they reflected Chosun's toadysm toward China. With the influx of Chinese style of dressing then government even changed the style of uniforms for public officials into that of Chinese resulting in dual styles of dressing. Ying & Yan Theory greatly affected the colors of Korean clothes and reflected toadysm toward China. too. The theory was embodied by prohibition of such colors for clothes as white, gray, and jade green. I reviewed the twelve patterns on Myunpok, Ten-Longivity patterns and Four-Gracious plants patterns in order to analyze the symbolism and thoughts of patterns for clothes. Nansam, Dopo, and Shimui worn by confucian scholars ensures that those clothes bears confucianism and philosopical factors. As shimui was worn by many people it appears in Chosun scholars' studies and a Chinese book called "Yeki". I reviewed the origin, procession, and ornaments of four ceremonial clothes and tried to find out the confucianism in them. First, In Kwanrei (the coming-of-age ceremony) remained ancestor worship and respect for manners. The clothes for this ceremony granted the rights and responsibilities of and adult to the wearer. The royal Kwanreipok had different dresses for each rank. As Samgapok, the crown prince wore Iksunkwan and Konryongpo for the first ritual, Wonryukwan and Kangsapo for the second, and Myunrukwan and Konpok for the third. The rank of the King's grandson was lower than the crown prince's. This example shows that Chosun people respected manners and thought the basic confucianism "God and people are equal." at the Royal court. Second, as Honreipok(wedding gown), the crown prince wore Myunrukwan and Konpok for Daereipok, Wonyukwan and Kangsapo for Napjing and Tongwoo, and Iksunkwan and Konryongpo for Chekbinui. But common people were allowed to wear an official outfit only for wedding in the means of congratulation on the most important day of their life. Wedding gowns which reflected Ying and Yang Theory emphasized the thought that union of a man and a wife is the most important event in life. Third, Sangrei(funeral) was the last ritual of a human being to send off the deceased. The mourning dresses expressed lamentation of the people left behind. Five-Dress-System for each the relative degree of familarity showed the solemnity and formality, which represented the formality of confucianism and ancestor worship. I reviewed the mourning dresses by dividing them into royal, Yangban's, and commons. They were featured by the fact that there was only one style for every walk of life. It is construed that anyone in mourning can wear the same clothes since he feels the same way regardless of his social rank. Fourth, Chereipok(sacrificial rite dresses) had different styles for each social rank. The King wore Myunpok(Kuryumyun and Kujangpok) were recorded to be worn first in the fourth year of King Taecho's ruling. The crown prince wore Palryumyun and Chiljangpok for sacrificial rite dress which was finally settled when King Sejong was in power. Common people wore Dopo, Shimui for the rite dress in the beginning of the Chosun Era and wore Dopo after Japanese invasion of Korea in 1592. In conclusion, confucianism played the main role in ceremonial dress system of Chosun and that was because it emphasized the ethics of action in life, which was different from other religions. It is true that cause-oriented thoughts and Chung myoung chooui in confucianism drove all ceremonies to extreme manners, discriminating the people who belonged to the lower social rank, and resulting in extremly luxurious life style. However, they also created a unique trend and clothes culture in the Chosun Era. I wish that this thesis provieds important information and direction for furthur studies in the future.

• 대한간호학회지
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• 제28권4호
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• pp.958-969
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• 1998

In this study, we attempted to investigate the needs and problems of the terminal cancer patients and their family caregivers to provide them with nursing information to improve their quality of life and prepare for a peaceful death. Data was collected from August 1, 1995 to July 31, 1996 at the internal medicine unit of S hospital in Seoul area with the two groups of participants who were family members of terminal cancer patients seventy four of them were in-patients and 34 were out-patients who were discharged from the same hospital for home care. The research tool used in this study has been developed by selecting the questionnaires from various references, modifying them for our purpose and refining them based on the results of preliminary study. While general background information about the patients was obtained by reviewing their medical records, all other information was collected by interviewing the primary family caregivers of the patients using the questionnaire. The data collected were analyzed with the SPSS PC/sup +/ program. The results of this study are summarized as follows ; 1) Most frequently complained symptoms of the terminal cancer patients were in the order of pain(87%), weakness(86.1%), anorexia(83.3%) and fatigue (80.6%). 2) Main therapies for the terminal cancer patients were pain control (58.3%), hyperalimentation(47.2%) and antibiotics(21.3%). 3) Special medical devices that terminal cancer patients used most were oxygen device (11.1%), and feeding tube(5.6%). Other devices were used by less than 5% of the patients. 4) The mobility of 70.4% of the patients was worse than ECOG 3 level, they had to stay in bed more than 50% of a day. 5) Patients wanted their medical staffs to help relieve pain(45.4%), various physical symptoms(29.6%), and problems associated with their emotion(11.1%). 6) 16.7% of the family caregivers hoped for full recovery of the patients, refusing to admit the status of the patients. Also, 37% wished for the extension of the patient's life at least for 6 months. 7) Only 38.9% of the family members was preparing for the patient's funeral. 8) 45.4% of family caregivers prefer hospital as the place for the patient's death, 39.8% their own home, and 14.8% undetermined. 9) Caregivers of the patients were mostly close family members, i.e., spouse(62%), and sons and daughters or daughter-in-laws(21.3%). 10) 43.5% of the family caregivers were aware of hospice care. 46.8% of them learned about the hospice care from the mass media, 27.7% from health professionals, and the rest from books and other sources. 11) Caregivers were asked about the most difficult problems they encounter in home care, 41 of them pointed out the lack of health professionals they can contact, counsel and get help from in case of emergency, 17 identified the difficulty of finding appropriate transportation to hospital, and 13 stated the difficulty of admission in hospital as needed. 12) 93.6% of family caregivers demanded 24-hour hot line, 80% the visiting nurses and doctors, and 69.4% the volunteer's help. The above results indicate that terminal patients and their family caregivers demand help from qualified health professionals whenever necessary. Hospice care system led by well-trained medical and nursing staffs is one of the viable answers for such demands.

• 지역사회간호학회지
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• 제9권1호
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• pp.143-162
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• 1998

This is a study for the construction of nursing care based upon the Korean attitude toward medicine. Factors which were investigated include the source of nursing care, the reason for choosing care, the type of heath care chosen, the accessability of caregivers, and the desired location of death. The population examined in this study consisted of 517 adults distributed in six large cities and 191 adults from five rural communities. Data was analyzed using frequency, percent, Cronbach alpha, $X^2$ - test, t - test, F - test and scheffe post hoc contrast with an SAS program. The results of this study are summarized as follows: 1. Among sources of nursing care used, first rank rated-pharmacy(54.4), private hospital(18.2), general hospital(8.4), folk remedies in house (5.0), chinese hospital(2.8), prayer(2.8) and others(8.4), and the reasons for choosing nursing care rated 'the easiest method' (63.6), 'the best method'(15.7), 'reliable'(10.8) and 'lower cost burden'(4.6) in order of preference. 2. The type of nursing care chosen rated western medicine(6.80), chinese medicine(6.15), folk remedies(5.46), faith remedies(3.51) and divination remedies (1.41). There were significant differences in the effect recognition degree to various kinds of medicine. 3. The difference of the type of nursing care chosen according to general characteristics showed that urban residents were higher than rural community residents(t=2.15, p=0.0320) in western medicine, and urban residents, women, and singles were higher than rural community residents(t=2.04, p=0.0414), men (t= -2.89, p=0.0039), and married(t=2.50, p= 0.0126) on folk remedies. With repect to age and education those 21-30, under 20 and 31-40, graduated from college and graduate school were higher than above 51, above 61 (F = 7.76, p = 0.0001), graduated from elementary school(F=4.39, p=0.0006) on folk remedies. In other categories, rural community residents, women, younger people. Christians were higher than urban residents ( t = -2.73, p=0.0305), men(t= -4.15, p=0.0001), older people (F=2.48, p=0.0307), Catholic, Buddhist, or atheist (F= 70.18, p=0.0001) on faith remedies. Those graduated from high school and Buddhist were higher than unschooled, graduated from middle school(F=3.18, p= 0.0075), atheist, Catholic or Christian(F=18.32, p=0.0001) on divination redemies. There were significant differences concerning age and education level. 4. The accessibility of caregivers rated 'caregivers should be nearby if the patients need them' (50.0), 'caregivers must be there all day (24 hours)' (39.6), 'caregivers must be there at night only'(5.0), 'caregivers must be there during the day only'(2.6), 'caregivers always should visit during visiting hours' 0.4), 'caregivers don't need to be there at all' (1.2). The frist rank of suitable caregivers were rated as spouse(66.6), mother(24.2), daughter (3.6), daughter-in-law(1.9), and the reasons of thinking thus were rated as 'the most comfortable' (81.5), 'people should correctly with regards to family they'(7.1), 'the easiest' (5.4), 'take good care of the patient' (5.1) and 'lower cost burden' (0.4). 5. The desired location of death rated as the following: his/her house (91. 6) to the hospital(8. 4). A person going to encounter death in the hospital wanted his house(78.5) over the hospital(21.5), and a person dieing in the hospital prefered his house(52.9) over the hospital(47.1) as a funeral ceremony place. The following suggestions are made based on the above results. 1. A sampling method that enhances the re presentativeness should be used in regional and/or national related research and replicated to confirm the result of this study. 2. This study should be used to understand the Korean view of medical centers and to meet the expectations of patients in Korean nursing. 3. Research on the Korean traditional view of humans and expectations of the sick, health and illness, and health behavior, the perception of dying, the decision to heal, and the view of general medicine should continue to be conducted continuosly so that Korean nursing theory can be advanced on these concepts.

• 대한간호학회지
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• 제4권1호
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• pp.162-178
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• 1974

The present study is purported to provide a basic information to be utilized by nurses to care and attend effectively for patients nearing the moment of death. Therefore, the primary purpose of the study has been placed upon grasping an understanding of the trends of death in general. For this purpose: 1. By utilizing the schneidman questionnaire, the trend of death has been categorized by 6 parts and analyzed. 2. A search has been conducted to find out dying patient's needs, nurse's attitudes viewed by the patient, and nurse attitudes to dying patient. The followings are itemized results of analysis: 1. Analysis by the schneidman questionnaire. (1) In general concepts of death. the first sighting of the occurrence of death was experienced upon strangers, grandfather and great grandfather. The death is openly discussed among people of all ages and sex. Ages in which the death is mostly feared were from 12 to well over 70 yews old that are evenly distributed regardless of difference in age. (2) As to the attitudes toward death the occurrence of death to most closely associated person influenced most upon the attitude of their own termination of lives. Among the reading materials, the maximum influence was effected by the Bible. In terms of religion, the thoughts of death were Influenced by religions education in case of the believers of the western religions (36%), and by their own health and physical conditions in case of the believers in the oriental religions (35%). In case of non-believer, their attitude toward death were largely determined through their own thinking meditation (45%). People aged 20 or thereunder revealed that they wished to know the day of their own death to be occurred (58%). However, the older the less thor wanted to know. (3) As to the choosing the time of death, 57% preferred senility, and 30% preferred the time in mediately following the prime period of their lives in general. In terms of religion, 85% of the believer in the oriental religion preferred senility, and 67% in the western religion, 58% in others, Therefore. the desiring of their lives to be terminated in earlier stage, not by the natural senility. sequenced as follows : Others, western religions and oriental religions. (4) Referring to the disposal of the corpse under the assumption that it had already occurred, majority desired the burial system. There has been seen a slight tendency to consider the importance of holding funeral services for the sake of survivors. Concerning the life insurance policy, it showed that the nurse had less belief in it than the patient (5) Upon the subject of life-after-death. religion wise, 72% of western religion believers preferred to have an existence of life-after-death: Among the believers of oriental regions, 35% desired this category, 30% did not mind either way. and 35% did not desire the existence of such a life-after-death. In others, 53% did not mind whether or not such a life existed. (6) In general, serious thoughts were not being attended to the commitment of suicide. 37% emphasized that such an act should be prevented. However, 30% insisted that such commitment should not be bothered, and that society possesses no right to prevented it. More male wished to commit suicide (13%) than females (9%). 2. Nurse's attitudes toward terminal patients and patient's needs. In the instance where the patient realized that their death is imminent, most of them showed desire to discuses mainly on the problems of life. When faced a situation of this nature, it is revealed that 40% of nurses could not furnish appropriate care for them.

• Journal of Hospice and Palliative Care
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• 제5권2호
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• pp.94-100
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• 2002

목적 : 말기 암 환자가 삶의 마지막 시간 동안 정서적, 사회적으로 안정을 취할 수 있는 곳은 대형화된 3차 의료기관이 아니라, 거주지에서 가까운 1, 2차 의료기관이나 호스피스 기관, 혹은 가정일 것이다. 그러나 현재 우리 나라는 말기 암 환자들을 3차 의료기관에서 1, 2차 의료기관, 호스피스 시설 등으로 연계(referral)하여 주는 시스템이 매우 미약한 상태이다. 본 연구는 현재 연계 상황의 문제점을 파악하여 이에 대한 개선점을 제시해 보고자 한다. 방법 : 2001년 4월부터 2002년 3월까지 서울대학교 병원으로부터 각 기관으로 연계된 말기 암 환자 76명의 보호자와 이 환자들을 연계 받은 35개의 의료기관을 대상으로 하여 설문 조사를 실시하였다. 환자의 보호자에게는 직접 전화를 하여 조사하였고, 의료기관에 대해서는 우편으로 설문지를 발송하였다. 결과 : 환자 보호자를 대상으로 한 47부의 설문지 분석 결과는 다음과 같다. 연계를 결정하는 데 있어서 의료진의 권유가 44%로 가장 큰 영향을 미쳤으며, 32%가 환자의 편의, 24%가 가족의 편의를 주로 고려하여 결정하였다. 연계 결정 과정에서는 가족의 생활권, 연계 기관의 인지도, 환자가 마지막으로 지내고 싶어하는 곳, 가족의 경제 상황, 장례 장소가 순서대로 영향을 많이 미치는 것으로 나타났다. 연계 과정에서는 47명 중 38명이 어려움을 겪었다고 응답했으며, 이들은 원하지 않는 퇴원의 종용을 가장 큰 어려움으로 꼽았다. 이 외에도 연계 기관에 대한 정보 부족, 환자의 고통에 대한 염려, 환자 및 가족의 거부 등으로 인해서도 어려움을 겪은 것으로 나타났다. 이와 같이 연계 과정에서는 어려움을 표현하였지만, 실제로 연계된 기관에서는 47명 중 35명이 완화 의료에 대해 대체로 만족스러웠다고 응답하였다. 그 이유로 환자가 안정과 평안함을 찾았고, 가족들도 편안하였으며 경제적 부담이 감소하였다는 점을 꼽았다. 그러나 15명은 연계 전후에 별 차이가 없다고 응답하였다. 연계된 기관을 대상으로 한 24부의 설문지 분석 결과는 다음과 같다. 24명의 응답자 중 1명을 제외한 23명이 완화 의료 연계 시스템에 대해 찬성하였고, 좀더 활발한 연계가 이루어질 수 있는 제도적 뒷받침의 필요성을 절실히 표현하였다. 의뢰된 환자를 돌보는 데 있어서 경험하는 어려움으로는 가장 큰 것으로 환자에 대한 정보 부족을 꼽았고, 그 외에도 환자의 경제적인 어려움이나 완화 의료 연계 기관에 대한 이해 부족, 통증 조절의 어려움 등을 호소하였다. 대부분(96%)의 기관 종사자들은 환자들이 연계된 이후의 보살핌에 만족하고 있다고 생각하는 것으로 나타났다. 결론 : 3차 기관으로부터 1, 2차 의료기관 및 호스피스로 말기 암 환자들이 연계되는 과정에서 환자, 보호자 뿐만 아니라 연계 기관도 많은 어려움을 겪고 있다. 향후 완화 의료의 연계 시스템 개발과 제도적 뒷받침이 절실히 필요하다.

• Journal of Hospice and Palliative Care
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• 제16권2호
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• pp.90-97
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• 2013

목적: 본 연구는 정부가 호스피스완화의료를 제도적으로 지원하겠다고 발표한 2002년 이후 10년이 지난 현시점에서 일반 대중들의 웰다잉에 대한 인식과 수용도가 어떤 방향성을 띄는지 알아보고자 하였다. 이를 통해 향후 한국 호스피스 완화의료 정책이 나아갈 길을 제시하는 것을 목표로 하였다. 방법: 2012년 6월 1일부터 6월 11일까지 전국 만 20~69세 성인 남녀 1,000명을 대상으로 Computer-Assisted Telephone Interviewing (CATI)를 이용하여 웰다잉에 대한 인식 및 수용도에 관한 설문을 실시하였다. 조사 항목은 인구학적 특성 전반과 신체적, 정신적, 사회적, 영적 건강상태 등 건강에 대한 인식, 그리고 아름다운 삶의 마무리에 대한 정책적 선호도로 구성하였다. 결과: 아름다운 삶의 마무리를 위한 제1 중요 요소로는 다른 사람에게 부담을 주지 않음이 36.7%로 가장 많았다. 제2 중요 요소로는 가족이나 의미 있는 사람과 함께 있는 것이 19.1%로 가장 높은 비율을 차지하였다. 죽음과 관련하여 삶의 아름다운 마무리를 위한 9가지 전략의 선호도를 조사한 결과, 간병 품앗이 활성화에 대해 찬성하는 의견이 88.3%로 가장 많았으며 의료인의 임종환자 관리 교육 실시(83.7%), 장례식장 대신 가족들을 편하게 해주고 의료진이 환자를 돌볼 수 있는 시설을 병원/집에서 가까운 곳에 마련(81.7%)이 그 뒤를 이었다. 삶의 아름다운 마무리를 위한 5개년 국가 전략을 수립하는 것에 찬성한 비율은 전체의 91%로 매우 높은 수준이었으며 그 수행 주체로는 정부(47.5%), 국회(20.2%), 시민 단체(10%)순인 것으로 조사되었다. 결론: 일반 국민 1,000명을 대상으로 조사한 본 연구결과는 국가적 차원의 웰다잉 정책과 완화의료의 제도적 지원책을 마련하는데 초석이 될 수 있을 것이다.