• 제목/요약/키워드: Bereavement Experience

검색결과 24건 처리시간 0.019초

Palliative Care Education in Gynecologic Oncology: a Survey of Gynecologic Oncologists and Gynecologic Oncology Fellows in Thailand

  • Ratanakaaew, A;Khemapech, N;Laurujisawat, P
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권15호
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    • pp.6331-6334
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    • 2015
  • Background: The main purpose of this study was to survey the education and training of certified gynecologic oncologists and fellows in Thailand. A secondary objective was to study the problems in fellowship training regarding palliative care for gynecologic cancer patients. Materials and Methods: A descriptive study was conducted by sending a questionnaire regarding palliative care education to all certified gynecologic oncologists and gynecologic oncology fellows in Thailand. The contents of the survey included fellowship training experience, caring for the dying, patient preparation, attitudes and respondent characteristics. Statistics were analyzed by percentage, mean and standard deviation and chi-square. Results: One hundred seventy completed questionnaires were returned; the response rate was 66%. Most certified gynecologic oncologists and fellows in gynecologic oncology have a positive attitude towards palliative care education, and agree that "psychological distress can result in severe physical suffering". It was found that the curriculum of gynecologic oncology fellowship training equally emphasizes three aspects, namely managing post-operative complications, managing a patient at the end of life and managing a patient with gynecologic oncology. As for experiential training during the fellowship of gynecologic oncology, education regarding breaking bad news, discussion about goals of care and procedures for symptoms control were mostly on-the-job training without explicit teaching. In addition, only 42.9 % of respondents were explicitly taught the coping skill for managing their own stress when caring for palliative patients during fellowship training. Most of respondents rated their clinical competency for palliative care in the "moderately well prepared" level, and the lowest score of the competency was the issue of spiritual care. Conclusions: Almost all certified gynecologic oncologists and fellows in gynecologic oncology have a positive attitude towards learning and teaching in palliative care. In this study, some issues were identified for improving palliative care education such as proper training under the supervision of a mentor, teaching how to deal with work stress, competency in spiritual care and attitudes on responsibility for bereavement care.

요양병원 간호사의 생애말 환자간호 역량과 임종간호 스트레스 (End of Life Care Competencies and Terminal Care Stress of Nurses in Long Term Care Hospitals)

  • 정영희;전경자
    • Journal of Hospice and Palliative Care
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    • 제22권3호
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    • pp.125-133
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    • 2019
  • 목적: 요양병원 간호사의 생애말 환자간호 역량과 임종간호 스트레스 수준을 파악하고 상관관계를 확인하여 요양병원 간호서비스의 질 향상을 위한 기초자료를 제공하고자 하는 것이다. 방법: 충청남도 A시, C시 소재 요양병원에서 근무하고 있는 6개월이상 경력의 임종간호 경험이 있는 간호사 140명을 대상으로 하였고 설문지는 2018년 1월 17일부터 3월 3일까지 수집되었다. 수집된 자료는 연구 목적에 따라 SPSS WIN ver. 21.0 프로그램을 이용하여 기술통계 및 t-test, One way ANOVA, Scheffe-test, Pearson's correlation coefficient, multiple stepwised regression을 실시하였다. 결과: 연구 대상 간호사의 생애말 환자간호 역량은 5점 척도의 평균 $3.54{\pm}0.46$점이며 임종간호스트레스는 평균 $3.77{\pm}0.50$점으로 보통 수준 이상이었다. 연령, 총임상경력, 죽음교육 또는 호스피스 완화의료 교육, 직계가족의 임종경험 여부에 따라 생애말 환자간호 역량에 유의한 차이가 있었다. 생애말 환자간호 역량과 임종간호 스트레스 수준과의 상관관계를 분석한 결과 총점평균의 상관관계는 유의하지 않았으나 생애말 환자간호 역량은 임종간호 스트레스 중 전문지식과 기술부족으로 인한 스트레스와 음의 상관관계가 있는 것으로 나타났다(r=-0.260, P=0.002). 결론: 이상의 연구결과를 볼 때, 요양병원 간호사의 임종간호 스트레스는 보통 수준 이상으로 높으며 생애말 환자간호 역량이 높을수록 전문지식과 기술부족으로 인한 스트레스는 낮아지므로 간호사의 특성에 맞춘 생애말 환자간호 교육프로그램이 실시되어야 한다.

암으로 자녀를 잃은 가족의 경험에 대한 질적연구 (The Experience of the Family Whose Child Has Died of Cancer)

  • 이정섭;김수지
    • 대한간호학회지
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    • 제24권3호
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    • pp.413-431
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    • 1994
  • The purpose of this study was to build a substantive theory about the experience of the family whose child has died of cancer The qualitative re-search method used was grounded theory. The interviewees were 17 mothers who had cared for a child who had died of cancer Traditionally in Korea, mothers are the care givers in the family and are considered sensitive to the family's thoughts, feelings. The data were collected through in-depth interviews by the investigator over a period of nine months. The data were analyzed simultaniously by a constant comparative method in which new data are continuously coded into categories and properties according to Strauss and Corbin's methodology. The 16 concepts which were found as a result of analyzing the grounded data were, -left over time, the empty place, meaninglessness, inner sadness, situational sadness, heartache, physical pain, guilt, resentment, regret, support / stigmatization, finding meaning in the death, changing attitudes about life and living, changing attitudes about health, changing religious practice and changing family relations. Five categories emerged from the analysis. They were emptiness, consisting of left over time, the empty place and meaninglessness ; sadness, consisting of inner sadness and situational sadness ; pain, consisting of heartache and physical pain ; bitterness, consisting of guilt, resentment, regret, sup-port / stigmatization and finding meaning in the death : and transition, consisiting of changing attitudes about life and living, changing attitudes about health, changing religious practice and changing family relations. These categories were synthesized into the core concept, -the process of filling the empty space. The core phenomenon was emptiness. Emptiness varied with the passing of time, was perceived differently according to support / stigmatization and finding meaning in the death, was followed by sad-ness, pain, and bitterness, and finally resulted in changes in attitudes about life and living and about health, and in changes in religious practice and family relations. The process of filling the empty space proceeded by ① accepting realty, ② searching for the reason for the child's death, ③ controlling the bitter feelings, ④ reconstructing the relationships ameng death, illness and health and ⑤ filling the emptiness by resolving causes of child's death, adopting, having another child or with work. Six hypotheses were derived from the analysis. ① The longer the bereavement, the mere the empty space becomes filled. ② The longer the hospitalization, the more sup-port the family needs. ③ The more the sadness, pain and bitterness are expressed, the mere positive changes emerge. ④ Family support faciliates the process of filling the empty space. ⑤ Higher family cohesiveness faciliates the process of filling the empty space. ⑥ The greater the variety of reasons attributed to the child's death, the greater the variety of patterns of change. Four propositions related to emptiness and bitter-ness were developed. ① When the sense of emptiness is great and bitterness is manifested by severe feelings of guilt and resentment, the longer the process of fill-ing the empty space. ② When the sense of emptiness is great and the family is highly motivated to get rid of the bitterness, the shorter the process of filling the empty space. ③ When the sense of emptiness is less and bitter-ness is manifested by severe feelings of guilt and resentment, the process of filling the empty space is delayed. ④ When the sense of emptiness is less and the family is highly motivated to get rid of the bitterness, the process of filling the empty space goes on to completion. Through this substantive theory, nurses under-stand the importance of emptiness and bitterness in helping the family that has lost a child through cancer fill the empty space. Further research to build substantive theories to explain other losses may con-tribute to a formal theory of how family health is restored after human tragedies are experienced.

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재미 한인 여성노인의 빈곤경험에 관한 연구 (A study of poverty experiences among Korean elderly women in the United States)

  • 염지혜
    • 한국노년학
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    • 제40권4호
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    • pp.801-821
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    • 2020
  • 한국 노인의 중요 문제 중 하나는 빈곤의 여성화다. 한국 여성의 빈곤 경험에 대해서는 다수의 선행연구가 존재하지만 재미 한인 여성노인의 빈곤 경험에 대해서는 거의 알려진 바가 없다. 따라서 본 연구는 미국으로 이주한 한인 여성노인들의 빈곤 경험을 살펴보고 그러한 경험을 맥락적으로 이해하는데 목적이 있다. 이러한 연구목적을 달성하기 위하여 질적 사례연구 방법을 사용하였다. 캘리포니아주 오클랜드시에 거주하는, 미국 연방정부로부터 생활보조금(SSI)을 지원받는 한인 노인 중 미국 거주 10년이상, 65세 이상, 여성노인, 자녀와 비동거 중인 3명의 연구참여자를 선정하였다. 자료는 각 참여자 당 총 6회의 면담을 실시해 수집하였으며 연구자가 참여자에게 동의서를 직접 읽어주고 동의서에 자필로 서명을 받았다. 분석과 해석은 면담 전사본을 수차례 반복해서 읽는 것으로 시작하여, 반복적으로 나타나는 키워드를 재미 한인 여성노인들의 경험의 측면에서 시간, 공간, 사람들과의 관계를 중심으로 맥락적으로 이해하고자 했다. 재미 한인 여성노인의 빈곤화 경험에 관한 맥락적 이해로 모국에서의 빈곤 연장, 여성 이민자라는 이중고, 노화와 질병으로 인한 노동의 제한 세 가지 차원으로 해석되었다. 미국 이주 이전의 삶도 농사로 생계를 이어가는 어려운 살림살이 였고 남편과의 사별로 생계부양노동을 짊어졌던 빈곤한 삶이었는데 이주 이후에도 빈곤한 삶은 이어졌다. 낮은 교육수준과 특별한 기술이 없는 여성이민자로서 산업화된 미국에서 노동시장 주변부에 편입되어 낮은 임금으로 생계를 이어나갈 수밖에 없었다. 이주 당시 이미 노년기에 접어들었던 재미 한인 여성노인들은 노화와 질병으로 인해 주변부 노동시장으로 돌아갈 수도 없었고 정부 생활보조금에 의지하는 빈곤한 삶을 이어가고 있었다. 이러한 연구결과로부터 재미 한인 여성노인의 삶의 질을 향상시킬 수 있는 방안으로 한인 커뮤니티의 역할에 대해 논의했다.