• Journal of Hospice and Palliative Care
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• 제21권4호
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• pp.137-143
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• 2018

목적: 가족구성의 특성이 건강에 미치는 영향에 관한 다양한 실증 연구들이 꾸준히 보고되어 왔다. 우리나라에 말기암환자의 가족구성의 특성에 대한 연구가 부족하여 이에 본 연구에서는 호스피스 병동에 입원하고, 사망한 말기암환자의 가족구성의 특징을 파악하고 호스피스 완화의료 이용과의 연관성에 대해 알아보고자 하였다. 방법: 2009년 1월부터 2014년 3월까지 일개 호스피스 병동에 입원 후 48시간 후 사망한 말기암환자의 134명의 의무기록을 후향적으로 분석하였다. 환자들의 인구사회학적 및 임상적인 특성을 확인하여 동거배우자 유무에 따른 차이를 살펴보았으며, 암 진단 후 호스피스 입원까지 기간(개월) 및 입원 후 사망까지의 생존기간(일)을 산출하여 가족구성과의 연관성을 알아보았다. 결과: 암 진단 후 호스피스 입원까지 기간의 중앙값 13개월을 기준으로 나눈 Group B(13개월 이후)에서 배우자 동거군의 비율이 통계적으로 유의하게 높았다(P<0.01). 주의사결정권자는 Group A에서는 자녀인 경우가 59.0%, B에서는 배우자가 52.9%로 많았다(P=0.04). 호스피스 입원 후 사망까지 기간의 중앙값 20일을 기준으로 Group 1(20일 미만)과 Group 2(20일 이상)로 나누어 살펴보았을 때 두 군 간의 가족구성의 특징은 통계적으로 유의한 차이가 없었다. 결론: 가족구성의 특성 중 배우자의 유무가 말기암환자의 호스피스 완화의료 이용 시기에 영향을 미치는 요인으로 나타났으며, 말기암 환자와 가족의 보다 더 효율적이고 적절한 호스피스 완화의료 이용을 위해 가족 구성의 특성을 파악하는 것이 도움이 될 수 있다.

• 기본간호학회지
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• 제13권2호
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• pp.217-224
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• 2006

Purpose: This study was done to investigate the effects of pilocarpine mouth care on the condition and discomfort of the oral cavity in patients with terminal cancer. Method: A quasi-experimental design with a non-equivalent control group, pre- and post-test was used. The participants were 30 patients admitted to the hospice care unit of C university hospital. Fourteen patients received pilocarpine mouth care for 5 days. The other sixteen received general mouth care. Results: Improvement in the condition of the oral cavity was significantly higher in the experimental group compared to the control group. Decrease in oral discomfort scores was significantly higher in the experimental group compared to the control group. The incidence of oral candidiasis was significantly higher in the control group compared to the experimental group. Conclusion: These findings indicate that pilocarpine mouth care could be an effective intervention for relieving oral discomfort, improving the condition of the oral cavity, and decreasing the incidence of oral candidiasis in patients with terminal cancer.

• 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.

• 임상간호연구
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• 제25권2호
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• pp.161-169
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• 2019

Purpose: This study was conducted to examine the effect of a Happiness Self-Coaching program for new graduate nurses working in cancer care units. Methods: A quasi-experimental pretest-posttest, nonequivalent control-group design was applied to conduct the study. Study participants were new graduate nurses employed within 12 months and working as shift employees at G university hospital, located in J city. A total of 21 new graduate nurses participated in the study, 10 in the experimental group, and 11 in the control group. The happiness self-coaching program was conducted weekly for 70 minutes from February 1 to June 6, 2016 for 6 weeks. The experimental group received the Happiness Self-Coaching program through lectures, presentation, group activities, and strength card play. Data were analyzed by using repeated measure ANOVA and paired t-test. Results: The experimental group demonstrated significantly higher happiness (F=6.82, p=.003) and self-efficacy (F=3.38 p=.045) levels compared to the control group. Conclusion: The Happiness Self-Coaching program was effective in enhancing new graduate nurses' happiness and self efficacy. It is recommended that nursing organizations to apply the Happiness Self -Coaching program to facilitate adaption of new graduate nurses in cancer care units.

• Journal of Hospice and Palliative Care
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• 제24권2호
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• pp.109-115
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• 2021

Purpose: This study aimed to investigate the effects of aroma foot baths on stress and sleep in terminally ill cancer patients. Methods: We performed a non-randomized intervention-control study with 30 terminal cancer patients who were admitted to a palliative care unit. Participants responded to questionnaires on stress and sleep before and after a 5-day interval. The intervention group received a daily aroma foot bath for 5 days. We performed multivariate regression analysis to examine the changes in outcomes on stress and sleep for the intervention group compared to the control group. Results: The differences in baseline characteristics between groups, excluding subjective economic status and general weakness, did not show statistical significance. In contrast to the control group, the intervention group showed a statistically significant change in physical stress and psychological stress levels, but significant changes were not observed in quality of sleep. Compared to the control group, the intervention group showed a significant reduction in physical stress (P=0.068) and psychological stress (P=0.021). Conclusion: Aroma foot baths are effective for reducing stress in patients hospitalized with terminal cancer.

• Tuberculosis and Respiratory Diseases
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• 제66권1호
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• pp.27-32
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• 2009

연구배경: 최근 중환자실에 입원하여 기계환기 등의 적극적인 치료를 받는 폐암 환자들이 증가하고 있다. 내과계 중환자실에 입원하는 폐암 환자의 임상적인 특성과 사망률에 영향을 미치는 위험 인자에 대하여 알아보고자 하였다. 방 법: 2004년 4월부터 2008년 3월까지 내과계 중환자실에 입원한 폐암 환자 88명을 후향적으로 조사하였다. 결 과: 대상 환자는 88명(평균 나이, 66세)이었으며 비소세포폐암이 71명(80.7%), 소세포폐암이 17명(19.3%)이었다. 79명(89.8%)에서 전이가 있었으며 중환자실에 입원하는 주된 이유로는 급성호흡부전(77.3%), 패혈증(11.4%), 중추신경계 기능장애(4.5%) 순이었다. 54명(61.4%)이 기계환기 치료를 받았다. APACHE II 점수, 중환자실 입원기간, 입원 경로, 기계환기 등과 중환자실 사망률은 유의한 관계가 있었다. 그러나 조직형, 전이 여부 등은 유의한 관계가 없었다. 결 론: 중환자실 사망률은 65.9%이었으며, 중환자실 사망과 유의한 관계가 있는 인자는 APACHE II 점수, 중환자실 입원 기간, 입원 경로, 기계환기 등이었다.

• 대한후두음성언어의학회지
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• 제33권2호
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• pp.97-102
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• 2022

Background and Objectives Tracheostomy is a relatively safe procedure, and the recent emergence of COVID-19 has raised the need to perform tracheostomy immediately in the bed of an intensive care unit (ICU) rather than an operating room. The purpose of this study was to determine the occurrence of complications related to surgical tracheotomy performed in the ICU by an ENT specialist. Materials and Method From March 2019 to January 2022, a total of 101 patients underwent tracheostomy in the ICU. Demographics and complications were classified according to postoperative period. Results Within 24 hours after the procedure, bleeding events were confirmed in 2 patients (2.0%) with mild bleeding. One case (1.0%) of ventricular fibrillation occurred shortly after the procedure. There were no complications from 24 hours to 1 week after procedure. After one week, 4 patients (4.5%) had a local infection, and 3 patients (3.4%) had a tube obstruction. During all follow-up periods, there were no serious side effects such as death, major vascular injury, pneumothroax. No complications were observed throughout the entire period in 6 COVID-19 patients. Conclusion The number of complications of surgical tracheotomy in the ICU performed by a specialist was lower than in previous studies, and there were no complications that delayed treatment or endangered life. The ENT training hospitals should provide sufficient training opportunities for residents to perform surgical tracheostomy and strive to minimize complications associated with the procedure and pre- and post-operative management under the detailed guidance and supervision of specialists.

• Tuberculosis and Respiratory Diseases
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• 제77권4호
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• pp.193-196
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• 2014

Acute airway obstruction after hemoptysis occurs due to the presence of blood clots. These conditions may result in lifethreatening ventilation impairment. We report a case of obstruction of the large airway by endobronchial blood clots which were removed using bronchoscopic cryotherapy at the bedside of intensive care unit. A 66-year-old female with endometrial cancer who had undergone chemotherapy, was admitted to the intensive care unit due to neutropenic fever. During mechanical ventilation, the minute ventilation dropped to inadequately low levels and chest radiography showed complete opacification of the left hemithorax. Flexible bronchoscopy revealed large blood clots obstructing the proximal left main bronchus. After unsuccessful attempts to remove the clots with bronchial lavage and forceps extraction, blood clots were removed using bronchoscopic cryotherapy. This report shows that cryotherapy via flexible bronchoscopy at the bedside in the intensive of intensive care unit is a simple and effective alternative for the removal of endobronchial blood clots.

• Asian Pacific Journal of Cancer Prevention
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• 제15권13호
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• pp.5349-5353
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• 2014

Statistical methods to analyze and predict the related risk factors of nosocomial infection in lung cancer patients are various, but the results are inconsistent. A total of 609 patients with lung cancer were enrolled to allow factor comparison using Student's t-test or the Mann-Whitney test or the Chi-square test. Variables that were significantly related to the presence of nosocomial infection were selected as candidates for input into the final ANN model. The area under the receiver operating characteristic (ROC) curve (AUC) was used to evaluate the performance of the artificial neural network (ANN) model and logistic regression (LR) model. The prevalence of nosocomial infection from lung cancer in this entire study population was 20.1% (165/609), nosocomial infections occurring in sputum specimens (85.5%), followed by blood (6.73%), urine (6.0%) and pleural effusions (1.82%). It was shown that long term hospitalization (${\geq}22days$, P= 0.000), poor clinical stage (IIIb and IV stage, P=0.002), older age (${\geq}61days$ old, P=0.023), and use the hormones were linked to nosocomial infection and the ANN model consisted of these four factors. The artificial neural network model with variables consisting of age, clinical stage, time of hospitalization, and use of hormones should be useful for predicting nosocomial infection in lung cancer cases.

• Asian Pacific Journal of Cancer Prevention
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• 제15권19호
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• pp.8095-8099
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• 2014

Background: Worldwide, over half a million women died of breast cancer in 2011 alone. Mammography screening is associated with a reduction of 20 to 35% in breast cancer mortality. The aim of this study was to determine the awareness and practice of mammography screening and predictors of its uptake in Malaysian women attending a primary care clinic. Materials and Methods: A cross-sectional study was carried out among women aged 40 to 74 years attending a primary care clinic in Selangor, Malaysia. An assisted structured questionnaire included questions on socio-demography, source of information and level of knowledge. An adapted version of the revised Champion Health Belief Model Scale plus other associated factors for mammography screening up-take were also included as part of the questionnaire. Predictors for mammography screening uptake were only determined in those who were aware about mammography screening. Significant predictors were determined by logistic regression. Results: 447 women were recruited for this study; 99.1% of them (n: 411) were aware about breast cancer. Only 50.1% (n: 206) had knowledge about mammography screening. Prevalence of clinical breast-examination (CBE) was 23.3% (n: 104) and mammography screening up-take was 13.2% (n: 59). The predictors for the latter were those who have had clinical breast-examination (aOR=17.58, 95%CI: 7.68-39.82) and those aged between 50 to 59 years (aOR=3.94, 95%CI: 1.61-9.66) as well as those aged 60 years and above (aOR=6.91, 95%CI: 2.28-20.94). Good knowledge and positive beliefs about mammography screening were not associated with mammography screening uptake. Conclusions: Half of our Malaysian women were aware about mammography screening. However, the uptake of mammography was low. Previous CBE and older age were significant predictors of mammography screening uptake. Increasing CBE services may increase compliance with guidelines.