• Title/Summary/Keyword: 돌봄대상자

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Factor affecting Unplanned Readmissions after Cardiac Valve Surgery: Analysis of Electric Medical Record (심장판막수술 환자의 비계획적 재입원 영향요인: 전자의무기록분석)

  • Lee, Jung Sun;Shin, Yong Soon
    • The Journal of the Korea Contents Association
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    • v.22 no.2
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    • pp.794-802
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    • 2022
  • This retrospective study was to investigate the characteristics of unplanned readmission and factors affecting readmission within 30 days of discharge in patients who underwent heart valve surgery through electronic medical records. The participants were 423 unplanned re-hospitalization within 30 days after heart valve surgery at a tertiary hospital in Seoul from January 2018 to August 2019. A total of 48 patients (11.3%) were unplanned readmissions, and the most common causes were atrial fibrillation in 13 cases (27.1%) and pain at the surgical site in 13 cases (27.1%). Other causes were: 10 cases (20.8%) of warfarin inappropriate treatment concentration, 7 cases of general weakness (14.6%), 5 cases of hypotension (10.4%), 4 cases of pericardial effusion (8.3%), 3 cases of surgical wound infection (6.3%), 3 cases of hemorrhage (6.3%), 3 cases of high fever (6.3%), and 1 case of cerebral infarction (2.1%). Variables influencing readmission were history of cancer (OR = 2.60, 95% CI 1.13-6.03, p = .025) and the patients who went to a home rather than a hospital after discharge (OR = 2.91, 95% CI 1.33-6.36, p = .008), as a type of valve surgery, mitral valve valvuloplasty had a higher readmission rate than aortic valve replacement (OR = 1.21, 95% CI 1.21-4.98, p = .012). In order to reduce unplanned readmissions, an tailored education program is needed to enable patients and caregivers to manage their comorbid chronic diseases before discharge and assess risk factors for readmission in advance.

A Study on the Burden of Hospice Volunteers (호스피스 자원봉사자의 부담감에 관한 연구)

  • Choi, Euy-Soon;Han, Ji-Eun
    • Journal of Hospice and Palliative Care
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    • v.8 no.2
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    • pp.173-182
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    • 2005
  • Purpose: This study was carried out to provide the basic information for developing intervention programs for volunteers by identifying the burdens felt by hospice volunteers and the factors related to such burdens. Methods: The subjects were 243 hospice volunteers at 8 hospitals of The Catholic University of Korea. A questionnaire was carried out: 25 questions about the burdens to the participants and 47 questions about the quality of life. The data obtained was analyzed using the SAS program to conduct t-test, ANOVA, Duncan test, and Pearson's correlation coefficient test. Results: 1. The mean total score of the burdens felt by the hospice volunteers was $53.3{\pm}10.4$. There was no significant difference in the level of burden depending on the demographic characteristics of the hospice volunteers. But the burden in care of high education and low quality of life increased significantly. 2. The level of burden to the hospice volunteers decreased significantly as their families more favored their volunteer activities. The subjects felt the highest burden in: family care, physical care spiritual care, emotional care, and after-death care, in this order. 3. The level of burden related to each factors was high in the burden due to patient care, sense of achievement, and volunteer activities, in this order. 4. There was a reverse correlation between the level of burden to hospice volunteers and their quality of life. Conclusion: In order to reduce the burdens to hospice volunteers and to help them tate care of patients more effectively, it would be necessary to provide the education programs about practical patient care problems and to develop measures for improving their quality of life, taking into account their level of education, family's support, and difficulties in their volunteer activities.

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Factors for the Prediction of Pain in Terminally Ill Cancer Patients in Hospice Units (호스피스 병동에 입원한 말기 암환자의 통증 예측요인)

  • Yong, Jin-Sun;Han, Sung-Suk;Ro, You-Ja;Hong, Hyun-Ja
    • Journal of Hospice and Palliative Care
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    • v.5 no.2
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    • pp.125-135
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    • 2002
  • Purpose : The purpose of this study was to investigate the impact of depression, discomfort, spirituality, physical care, and opioid use on pain with terminally ill cancer patients in the hospice units. Method : The convenient sample of this study consisted of 58 terminally ill cancer patients at three hospice units in university-affiliated hospitals. Patients were interviewed with structured questionnaires. The data was analyzed using ANOVA, Pearson correlation coefficient, and multivariate multiple regression. Result : The results of this study were as follows : 1) The mean age of the participants was approximately 57 years. Regarding diagnosis, stomach cancer showed the highest frequency (24.1%), followed by lung cancer (17.2%) and rectal cancer (13.8%). Regarding motivation for admission to the hospice unit, the majority of the participants indicated pain control (67.2%), followed by spiritual care (39.7%), and symptom relief (27.6%). 2) The mean pain level measured by VAS was 5.13 (${\pm}2.61$). Regarding pain type, the highest pain frequency the participants experienced was deep pain (53.4%), followed by multiple pain (20.7%), intestinal pain (17.3%), and neurogenic (5.2%) and superficial pain (3.4%). 3) Regarding the factors influencing pain, the pain level was significantly affected by the depression level (P<0.01) and the opioid use (P<0.01). Conclusion, In summary, the higher the level of pain the terminally ill cancer patents had the higher the depression level as well as the opioid use. Thus, health care professionals need to continuously provide holistic care for them to die comfortably.

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Quality of Life Changes in Patients Admitted to the Hospice Unit (호스피스 병동 입원 환자의 삶의 질 변화)

  • Park, Theresia;Song, Hae-Hiang;Seo, In-Ok;Cho, Young-Yee;Park, Myung-Hee;Heo, Jeong-Hee;Kim, Eun-Kyung;Park, Sun-Ju;Ra, Jeong-Ran
    • Journal of Hospice and Palliative Care
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    • v.3 no.1
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    • pp.18-27
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    • 2000
  • Purpose : This study aims to find out the quality of life of patients admitted to the hospice unit at Kangnam St. Mary's Hospital, at admission and after weeks hospice service and to assess the effects of hospice service on the quality of life of terminal cancer patients. Methods : This study subjects were 100 patients admitted to the hospice unit at Kangnam St. Mary's Hospital, Catholic University between October 1999 and March 2000, and their primary caregivers. Quality of life data were collected using a questionnaire revised by the authors and were analyzed by means of repeated measures ANOVA. Results : 1) Patient's quality of life as perceived by the primary caregiver was significantly improved and the mean score was 3.31, 3.68, 3.56, 3.73, 3.75 at admission and week 1, 2, 3, 4. With the detailed item analysis, the following items were shown to be significantly improved: "clean bodies"(F=6.50, P=0.0001) "pain control"(F=18.01, P=0.0001) constipate"(F=2.96, P=0.0237) "sleep"(F=3.99, P=0.0048) "nausea/vomiting"(F=4.50, P=0.0022) "medical team's comfortable care" (F=3.95, P=0.0051) "family's care"(F=2.76, P=0.0317) "anxiety" (F=3.14, P=0.0177) "comfort"(F=3.63, P=0.0085) "treat with dignity"(F=3.32, P=0.0136). The item of "death is not the end of life rather the beginning" was significantly decreased(F=2.54, P=0.0450). 2) Patient's quality of life as perceived by the patient showed an improvement but statistically insignificant and the mean score was 3.63 and 3.83 at admission and week 1. With the detailed item analysis, the item of "pain control" was shown to be significantly improved(F=9.19, P=0.0251). 3) The quality of score in the last week of life of patient were 3.48, 3.51, 3.44, 3.46, 3.50, respectively, from 5 week prior to 1 week prior to death and these changes were insignificant. Conclusion : The findings of this study showed a positive effect of hospice service on quality of life of the terminal cancer patients admitted to the hospice unit. To improve the quality of life, we need first of all to develop hospice interventions with a particular emphasis on the spiritual aspect of patient. Secondly, measurement instruments need to be developed to collect the quality of life of the hospice patients who become weakened especially in the last weeks of their life and with this effort more representative data of hospice patients may be collected.

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The Analysis of Activities of Volunteers for Hospice Care (일 지역 호스피스 자원봉사자의 활동분석)

  • Choi, Sang-Soon;Hur, Hye-Kyoung;Park, So-Mi
    • Journal of Hospice and Palliative Care
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    • v.3 no.2
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    • pp.136-143
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    • 2000
  • Purpose : The purpose of this study was to identify the characteristics of hospice volunteers and care-takers and analyze activities of volunteers. Methods : First, to identify the characteristics of hospice volunteers and care-takers, 87 records that registered in for the hospice volunteer education program in Wonju C.C.C from 1997 to 2000 were analyzed. Second, to analyze activities of volunteers, 30 volunteers were participated in this study. The data were collected through a self reporting questionnaire developed by research team. Results : 1) Hospice volunteers were mostly female(93.1%) with an average age of 45 years. 32.4% of persons who completed the hospice volunteer education program has been participated hospice care continuously. 2) The care-takers average age was 50 years and mostly with cancer. The majority(13.6%) of cancers was lung cancer. 3) The mean frequency for visiting was 10 and the mean duration for offering hospice care was 49.4 days. 4) The highest score of activity was spiritual area(mean=1.97) and next activity was emotional area(mean=1.49). Conclusion : The findings in this study have an important basic data to develope program for hospice volunteers in W city.

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Nurturing Experience of Mothers of Children with Disabilities Admitted to a Group-Home (장애아동을 그룹홈에 입소시킨 어머니의 양육경험)

  • Hwang, Yeon-Hwa;Im, Jong-Ho
    • The Journal of the Korea Contents Association
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    • v.16 no.8
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    • pp.257-267
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    • 2016
  • The research subject is 8 mothers who put their physical/mentally impaired children in a group home, as the research method, this study conducted an in-depth interview survey. The participants of this study collected data from the in-depth interview on 8 mothers who put their disabled children to the group home. In the result of open coding, total 34 concepts, 28 subcategories and 13 categories were derived. The core category in the selective coding was 'establishing restorative relationship through entering a group home after encountering the limit of nurture.' Practical Strategies include the following; first, it's necessary to provide psychology counselling consequent on a mother's nurturing phase, and this study proposes a program for a father having a child with disability; in addition, there is the necessity of having to arrange the differentiated facility for physically/mentally impaired people, which meets the needs of the relevant people. At a level of policy, this study suggested the necessity of having to take into account the minimization of poverty problem facing a family having a disable child through the caring card, necessity of the use of good-natured card, and medical-social-welfare-based intervention, expansion of facility-touring class installation, and use of adult guardianship system, and differential payment of disabled child nurturing allowance consequent on income quantile, etc.

A Comparative Study on the Attitude toward Caring for Alcoholics of Nursing Students according to the Degree of Parents' Drinking Problem (부모의 음주문제정도에 따른 간호대학생의 알코올중독자 돌봄에 대한 태도 차이)

  • Kim, Ji-Seon;Kweon, Young-Ran
    • The Journal of the Korea Contents Association
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    • v.17 no.11
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    • pp.632-640
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    • 2017
  • Purpose: This study was to investigate the difference of attitude toward caring for alcoholics of nursing college students according to degree of parents' drinking problem. Methods: The subjects of this study were 281 students in the second and fourth grade students in nursing departments of 4 Universities located in G city. Data were analyzed by the mean and standard deviation, t-test. and ANOVA using SPSS 22.0 program.. Results: Parents' problem drinking perceived by the subjects was $3.70({\pm}5.85)$, $1.25({\pm}1.71)$ in the social drinking group(n=225), $8.59({\pm}2.07)$ in the alcohol abuse group(n=29), and alcohol dependence group (n=27) was $18.85({\pm}5.17)$ points. The average attitude toward caring for alcoholics was $45.25({\pm}6.49)$. The attitude toward caring for alcoholics showed a statistically significant difference depending on whether or not-they participated in the nursing practice of alcoholics. The attitude toward caring for alcoholics in nursing college students was negative as the parents' problem drinking was severe. Conclusion: The results of this study can be used as basic data for the development of psychiatric nursing education and counseling program for nursing college students whose parental drinking problems are serious in the future.

The Evaluation of the Korean Advance Directives (K-AD) (한국형 사전의료의향서 평가)

  • Kim, KiSook;Kim, Shinmi;Hong, Sunwoo;Kim, JinShil
    • Journal of Hospice and Palliative Care
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    • v.19 no.2
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    • pp.109-118
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    • 2016
  • The purpose of this study was to evaluate Korean advance directives (K-AD) by examining the degree of adults' acceptance and reliability of the directive itself. Methods: Survey was performed with 181 adults aged 20 or older who were recruited from three regions. A questionnaire used to examine the participants' acceptance of their K-AD in terms of visual analogue scale score of complexity, difficulty, necessity, satisfaction, recommendation. Then, a retest was carried out by asking participants to write up a K-AD again to confirm the reliability of the directives. Results: On a scale of 100, the average acceptance score was 70 or above, which represents rather high level of acceptance in all five categories. The test-retest reliability kappa values ranged from 0.592 to 0.950, and the conformity degree was moderate or high. Regarding K-AD components such as values, treatment preference, proxy appointment, differences among age groups were observed in each component. Conclusion: The results of this study suggest that K-AD is a feasible instrument to analyze its acceptability and reliability for adult population. K-AD could be utilized to help people make their own decision on their end-of-life care. Further studies are needed to confirm this study results and promote widespread use of K-AD.

Development of a CD Program Applied Logotherapy for Psycho.Spiritual Care of Late Adolescents with Terminal Cancer (청소년 후기 말기 암 환자의 정서적.영적 돌봄을 위한 의미요법 CD 프로그램 개발)

  • Kang, Kyung-Ah;Kim, Shin-Jeong;Song, Mi-Kyung
    • Journal of Hospice and Palliative Care
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    • v.12 no.2
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    • pp.61-71
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    • 2009
  • Purpose: The purpose of this study was to develop a CD program of applied logotherapy for psycho spiritual care of late adolescents with terminal cancer. Methods: Keller & Song's ARCS theory and a model for developing learning materials was applied to develop this program composed four distinct phases: planning, designing, developing, and evaluation stages. Results: This program was entitled 'Finding meaning in my life' and consisted of 5 sessions and its educational contents were made up as follows: "First Secret" is 'learning three natures of the human mind', "Second Secret" is 'learning creative values first method to find meaning of life', "Third Secret" is 'learning experiential value as second method to find meaning of life', "Fourth Secret" is 'learning attitudinal value as third method to find meaning of life', and "Fifth Secret" is 'Becoming the master of my life'. The sub-menu was made up of 'Beginning', 'Opening mind', 'Learning'. 'Laughing Song', 'Experiencing'. Conclusion: This CD program applied logotherapy with flash animation technique as an emotional and spiritual nursing intervention program for easier and more scientific application in pediatric oncology and hospice care area.

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Experience in Widow's Bereavement: Q Methodology - Widow Below 2 Years Bereavement - (배우자 사별여성들의 경험: Q 방법론 적용 - 2년 미만의 사별여성을 중심으로 -)

  • Yang, Soo;Hong, Jin-Ui
    • Journal of Hospice and Palliative Care
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    • v.12 no.2
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    • pp.80-87
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    • 2009
  • Purpose: The purposes of this study were to identify the types of widow's bereavement experience and understand the nature of it's bereavement by using Q-methodological approach. Methods: Contents Q sample included 46 statements obtained from literatures and interviews with 5 widows. P sample consisted of 13 widows who bereaved within 2 years. The data were collected from October 2004 to December 2006 and analyzed using Quanal program. Results: Two types of widow's experience were found. Type 1 was characterized by loss suffering, and type 2 was characterized by acceptance and adaptation Conclusion: Widows were found to experience different types of bereavement. Therefore, bereavement care team should assess the types of suffering pain and provide appropriate care to the widows. Also, need to be developed programs to relieve or prevent suffering of bereavement.

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