• Title/Summary/Keyword: 영적 중재

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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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Effect of Supportive Nursing Intervention on Hopelessness, Self-Esteem, Self-Concept of Operative Patient with Head and Neck Cancer (전인적 지지간호중재가 두경부암 수술환자의 절망감, 자아존중감 및 자아개념에 미치는 효과)

  • Seok, Jung-Hee;Kang, Eun-Sil;Choi, Hwa-Sook
    • Journal of Hospice and Palliative Care
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    • v.7 no.2
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    • pp.189-199
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    • 2004
  • Purpose: Despite the small incidence, head and neck cancer may cause a wide range of physical transformation by surgical operation, damage to active functions such as eating and speaking. It may provoke hopelessness, change self-esteem and self-concept after its operation, influencing the quality life of head and neck cancer patients. Thus nursing intervention should be developed to provide supportive nursing for head and neck cancer patients and play roles as competent supporters. Methods: This study was a nonequivalent, control group, pretest-posttest, non-synchronized quasi-experimental research designed to determine how supportive nursing intervention effects on hopelessness, self-esteem and self-concept of head and neck cancer patients. Subjects of the study included 40 adult inpatients of K University hospital in Pusan who were diagnosed as having head and neck cancer and operated. They were divided into experimental and comparison groups, each consisting of 20 members. The data were collected during the period from December 1, 1999 to April 11, 2000. Tools of the study included the protocol of supportive nursing intervention which was developed by researcher by means of reference, literal review and expert's advice. The measurement tool of hopelessness was translated by Won was the device of hopelessness self-evaluation from Beck, the tool for self-esteem measurement was developed by Rosenberg and translated by Kim, and the device of self-concept used by Lee et al, modified by Lee were used respectively. Data were analyzed using the SPSS/PC 9.0 program. The homogeneity of the subjects were tested using $x^2-test$ and t-test. 3 hypotheses were tested using t-test. Results: The results of the study can be summarized as follows. 1. The third hypothesis that the experimental group receiving supportive nursing intervention showed a little hopelessness than the control group not receiving supportive nursing intervention was supported (t=4.550, P=.000). 2. The third hypothesis that the experimental group receiving supportive nursing intervention showed more self-esteem than the control group not receiving supportive nursing intervention was supported (t=-6.40, p=.000). 3. The third hypothesis that the experimental group receiving supportive nursing intervention showed more self-concept than the control group not receiving supportive nursing intervention was supported (t=-6.065, P=.000). Conclusion: Supportive nursing intervention was effective nursing intervention strategy for reducing hopelessness and increasing self-esteem and self-concept of head and neck cancer patients. Then the quality of life of head and neck cancer patients can be enhanced by providing supportive nursing intervention in nursing practice.

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Effects of Wholistic Hospice Nursing Intervention Program on Pain and Anxiety for In-patient of Hospice Palliative Care Unit (전인적 호스피스간호중재 프로그램이 입원한 호스피스환자의 통증과 불안에 미치는 효과)

  • Choi, Sung-Eun;Kang, Eun-Sil;Choe, Wha-Sook
    • Korean Journal of Hospice Care
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    • v.8 no.1
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    • pp.55-67
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    • 2008
  • Purpose: This study was to test the effects of wholistic hospice nursing intervention program on pain and anxiety for in-patient of hospice palliative care unit. This study's design was one-group pre-post test quasi- experimental research. Methods: The subjects of study were 27 patients who were over 18 years old and admitted in hospice palliative care unit of S hospital in P city with agreement in hospice palliative care in their terminal disease. The experimental group subjects participated in holistic hospice nursing program took 120 minutes per session, a total of 1,200 minutes altogether for 10 sessions. The period of data collection was from April 6, 2004 to April 20, 2005. The collected data were analyzed by Paired t-test with SPSS/WIN 12.0 program. A Wholistic Hospice Nursing Intervention Program (named ‘Rainbow Program’) was used as a experimental tool in this study. This was developed by the authors. It was provided by interdisciplinary hospice team (nurses, medical doctors, social worker, pastors, art therapists, and volunteers). In addition, Korean Version of Brief Pain Inventory (BPI-K) by Young-Ho Yun(1998) was used to test degree of pain in physical aspect. And State-Anxiety Inventory was developed by Spielberger(1975) and translated by Kim, Jung-Tack & Shin, Dong-Gyun(1978) was used to test the degree of state-anxiety in emotional aspect. Results: (1) Hypothesis No. 1 "The experimental group which received Wholistic Hospice Nursing Program will have a lower degree of pain than before" was supported (t=-10.585, P= .000). (2) Hypothesis No. 2 "The experimental group which received Wholistic Hospice Nursing Program will have a lower degree of state-anxiety than before" was supported (t=-8.234, P= .000). Conclusion: Our results testified that this Wholistic Hospice Nursing Intervention Program was effective to decrease pain and state-anxiety of the in-patients of hospice palliative care unit. Therefore it can be used and applied actively in practice as a useful model of interdisciplinary team approach by hospice professionals in hospice palliative care unit.

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Effects of the Comfort Promotion Program for Prevention of Delirium among Elderly Patients Hospitalized in Long-term Care Hospital (요양병원 입원 노인환자의 섬망예방을 위한 안위증진 프로그램 개발 및 효과 검증)

  • Hwang, Hye-Jeong;Shin, Yeonghee;Kim, Gaeun
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.9
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    • pp.203-215
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    • 2017
  • Delirium is an acute confused state associated with poor outcomes among hospitalized long-term care hospital elderly patients. This study was conducted to examine the effects of acomfort promotion program based on Kolcaba's comfort theory for prevention of delirium among elderly patients who have been hospitalized in long-term care hospitals. The study used was a quasi-experimental type, with two groups of patients; those who received their usual care plus comfort nursing intervention (n=34) and those who only received usual care methods. Using the IBMSPSS/PC (Version 21), the homogeneity of the control and intervention group wereevaluated by the chi-squared test and an independent t-test, and all collected data wereanalyzed. Hypotheses were tested by independent t-tests and repeated measures of ANOVA. Delirium occurred at a rate of 2.9% (1/34) in the intervention group and 14% (5/34) -in the control group ($x^2=3.98$, p=0.047). The severity of the delirium in theintervention group was lower than that of the control (t=2.27, p=.027). The duration of delirium was 2days in the intervention group and 2-10days in the control group, indicating delirium in the intervention group lasted for a significantly shorter period ($x^2=3.22$, p=0.048). According to the change of time, the intervention group showed improvement in all areas including comfort scores (F=108.85, p<0.001), anxiety scores (F=63.39, p<0.001), depression scores (F=89.78, p<0.001), quality of sleep scores (F=63.63, p<0.001), and pain scores (F=93.64, p<0.001). In conclusion, elderly patients who were admitted to nursing homes were advised to participate in nursing intervention,which effectivelyprevented delirium based on the Kolcaba's comfort theory of physical, psychological, spiritual, social, cultural and environmental approaches to prevent delirium. Therefore, it is necessary to extend the program for prevention of delirium in the physical, psychological, spiritual, social, cultural, and environmental contexts to prevent delirium in geriatric hospitalized elderly patients.

Needs of Hospice Care and Quality of Life for Cancer Patients (암환자의 호스피스 간호 요구와 삶의 질)

  • Seo, In-Sun;Shin, Mi-Hwa;Hong, Se-Hwa
    • Journal of Hospice and Palliative Care
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    • v.13 no.2
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    • pp.89-97
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    • 2010
  • Purpose: This study investigated the relationship between the needs for hospice care and quality of life in cancer patients. Methods: Data were collected from 127 cancer patients hospitalized at a university hospital in Chonbuk between October, 2006 to March, 2007. Two instruments were used: cancer patients' need for hospice care, developed by Kang and Kim and quality of life developed by Tae et al. Results: The mean scores were 3.11 out of 4 for hospice care needs, and 5.25 out of 10 for quality of life. The correlation between needs for hospice care and quality of life was moderate and negative (r=-0.395, P<0.01). Among the four groups of needs, physical need was the most strongly correlated with quality of lifer (r=-0.388, P<0.01). The need for hospice care was significantly different according to participants' religion (t=6.02, P<0.05), and duration of disease (F=3.45, P< 0.05). Quality of life was significantly different according to participants' monthly income (F=3.38, P<0.05). cancer stage (F=8.10, P<0.01) and chemotherapy (t=6.09, P=0.015). Conclusion: The results suggested that the cancer patients' hospice care needs should be answered in order to improve their quality of life. While doing so, participants' characteristic need should also be considered.

Total Pain of Patient with Terminal Cancer (말기 암환자의 총체적 고통)

  • Lee, Won-Hee
    • Journal of Hospice and Palliative Care
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    • v.3 no.1
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    • pp.60-73
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    • 2000
  • Purpose : The purpose of this study was to describe a total pain model in patients with terminal cancer and to identify factors relating to total pain using the Twycross Pain Management Model, which included physical, psycho-social and spiritual pain. Method : The study was a retrospective descriptive study. The first stage included 87 patients who received hospice service at Y hospital in 1997. The second stage included five model patients who suffer severe pain as selected by the four hospice nurses. Data collection was from 1) chart analysis and 2) in-depth interviews with the hospice nurses about their selected patients. Data analysis was performed using SPSS-WIN and content analysis. Result : 1) The main problems of 3 patient with terminal cancer were pain(77%), constipation (25.3%), family coping(35.6%), psycho-spiritual distress(17.2%)and other symptoms. 2. The Twycross model was a useful model. However, new items were added; loneliness, depression, and no improvement in condition as depression factors. In anger, new items were anger due to family neglect, at God and in relationships. The case studies identified the followsing; 1) Patient suffer from physical pain as well as multiple other symptoms when cancer is advanced. 2) Body concept, role change, threat to self concept, fear of pain, fear of death, anxiety, family conflict, financial burden, spiritual distress, hope for a cure, are all affected. Conclusion : 1) It is believed that the Twycross model is useful but further tests and revisions are necessary for deciding priorities in the care plan. 2) Pain management must improve culturally appropriate and family support, psychological, spiritual care are imperative for patient with terminal cancer. 3) Further study is recommended to test correlations of depression, anxiety, spiritual distress and family coping using valid instruments. A qualitative study on the spiritual journey of the patient with terminal cancer is also recommended.

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The Quality of Life Analysis in Patients with Cervical Cancer (자궁경부암 환자의 삶의 질 분석)

  • Kim, Yoon-Sook;Kim, Boon-Han
    • Journal of Hospice and Palliative Care
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    • v.7 no.1
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    • pp.8-16
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    • 2004
  • Purpose: The porpose of this descriptive study was grasp the QOL (Quality of Life) of cervix cancer patient and to analysis QOL (Quality of Life) by stage of disease, type of treatment and de me graphic characteristics Methods: Data were collected from 67 patients with cervical cancer from 3 General Hospitals from March 15 to June 4 using The "QOL (Quality of Life)-Cancer Version" inventory made by Ferrell et al (1995). The data were analysed by using SPSS $PC^+$ program including t-test, ANOVA, and Scheffe test. Results: Progressing stage of disease and QOL, the significant between the progressing stage of disease and QOL was significant (F=5.06, P=.003). The degree of difference between the progresstion of the stage of the disease and each item in the test was physical well-being (F=3.97 P=.012), the items of psychological well-being (F=3.91, P=.013), the items of social well-being (F=4.96, P=.004). It show a significant difference, but the item of spiritual well-being (F=1.36, P=.262) was not significant difference. The significance between the type of treatment and QOL was insignificant. The degree of difference between each area of life was the psychological well-being (t=-2.14, P=.037), the social well-being (t=-2.15, P=.036). But the physical well-being (t=-.93, P=.356), the spiritual well-being (t=.73, P=.469) was insignificant. Conclusion: As a result, The QOL of patients with cervical cancer is differentiated by the stage of disease, the type of treatment, and the demographic data. Therefore, there is a need to apply nursing intervention to patients with cervical cancer by considering the stage of disease, the type of treatment, and the demographic data.

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Factors Influencing Death Anxiety in Community-Dwelling Elderly: Based on the Ecology Theory (재가 노인의 죽음불안에 영향을 미치는 요인: 생태학 이론을 바탕으로)

  • Kim, Yeonha;Kim, Minju
    • Journal of Hospice and Palliative Care
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    • v.22 no.1
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    • pp.30-38
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    • 2019
  • Purpose: This study analyzed a path through which factors influencing death anxiety in the community-dwelling elderly, assuming personal organismic factors and microsystemic factors based on the ecology model purported by Belsky (1980). Methods: This study was performed with 189 elderly people. Data were collected through a self-report questionnaire. The data were analyzed using the SPSS and AMOS programs. Results: The factors influencing death anxiety in the elderly were depression, family support, social network, and familism value, and the explanatory power of these variables was 22%. Death anxiety increased with higher depression, higher familism value, larger social network, and lower family support. Spiritual well-being and elderly discrimination experience had indirect effects on death anxiety, and these effects were mediated by depression. Conclusion: Depression, family support, social network, and familism value were found to influence death anxiety in the elderly, and the strongest effect came from depression. To reduce death anxiety in the elderly, it is important to improve their relationship with their family and friends. Moreover, support should be provided by establishing local systems, and intervention should be provided to alleviate depression.

Physiologic Health Status and Health Promotion in Older Adults (건강검진행사에 참여한 노인의 생리적 건강상태 및 건강증진생활양식)

  • Kang, Hee Sun;Park, Yeon Hwan
    • 한국노년학
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    • v.25 no.2
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    • pp.95-108
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    • 2005
  • This study was done to explore the level of physiologic health status and health promotion lifestyle, and its contributing factors of Korean older adults. A total of 209 older adults participated in this study that ran from July 2 to July 6, 2004 in the waiting area of the subways of Seoul. The average age of the respondents was 67 years old with 39.2% considering themselves as healthy, 71.3% stating they regularly exercised and 71.8% knowing their own blood pressure. Among the participants 44% were classified as having high or low blood pressure and 44.5% showing abnormal blood sugar. The mean score of health promotion lifestyle was 2.75 and the order of its subcategories was interpersonal relationship, nutrition, stress management, spiritual growth, physical activities, and health responsibilities. This score was altered by exercise and knowing personal blood pressure. As a result of this study, it is important for older adults to know their own blood pressure and to exercise regularly to promote good health. In addition, health promotion programs should be developed and implemented based on the influencing factors.

Factors Influencing the quality of life in thyroid cancer patients after thyroidectomy (갑상선암 수술환자의 삶의 질에 영향을 미치는 요인)

  • Jeong, Jeong-Sook;Kim, In-Sook;Lee, Eun-Seon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.8
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    • pp.5442-5451
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    • 2015
  • The purpose of this study was to examine the affection factors of quality of life in thyroid cancer patients after thyroidectomy. The subject of this study were 125 patients with thyroid cancer who were receiving operation and outpatient medical examination in general hospital in Gwangju city. Data were analysed using descriptive statistics, t-test, one-way ANOVA, Sheffe test, Pearson correlation analysis and stepwise multiple regression analysis using SPSS 21.0 program. The significant factors influencing quality of life were depression(${\beta}=-0.39$, p<.001), spiritual fatigue(${\beta}=-0.30$, p<.001) and physical fatigue(${\beta}=-0.24$, p<.001), which explained 57.2% of the quality of life. Therefore, it is necessary to develop nursing intervention program reducing fatigue and depression for thyroid cancer patients after thyroidectomy.