• 제목/요약/키워드: Dying Process

검색결과 91건 처리시간 0.027초

노인 장기요양기관에 종사하는 사회복지사의 임종 케어 경험과 역할에 관한 질적 연구 (Qualitative Study on Social Workers' Experiences and Roles during End-of-Life Care in Elderly Long-Term Care Facilities)

  • 김은경
    • 한국콘텐츠학회논문지
    • /
    • 제22권5호
    • /
    • pp.503-517
    • /
    • 2022
  • 본 연구는 노인 장기요양 서비스를 제공하는 기관에서 종사하는 사회복지사들이 임종 케어 과정에서 겪는 심리·사회적 경험 및 역할에 대해 알아보았다. 심층 면접을 통한 자료 분석 결과 사회복지사들은 임종 케어 과정에서 빈번한 죽음 경험으로 인해 기가 빠지고 소진됨을 경험하였으며 돌아가신 노인분들에게 더 잘해드리지 못한 것에 대해 아쉬움과 정든 분에 대한 그리움을 나타냈다. 그리고 갑작스러운 죽음이 발생하면 가족들의 비난과 불평을 겪기도 하였다. 임종 케어시 사회복지사들의 주된 역할로 죽음 징후가 나타나면 가족들에게 수시로 연락하여 소통하였고 임종 후 주 부양자 가족들을 위로하고 지지하였다. 응급상황 대처를 위한 사전준비와 응급조치에 대한 법적 안전망, 사회복지사들의 소진을 막기 위한 재충전 프로그램 및 지지 모임, 임종 케어를 위한 표준화된 매뉴얼과 교육의 필요성이 제시되었다. 또한 노인분의 존엄한 죽음을 위하여 죽음 준비교육, 호스피스 케어, 사전 의료의향서 등의 필요성도 강조되었다.

에너지 절감형 염색기용 직접냉각수세장치에 대한 연구 (A Study on Direct Cooling and Washing Machine for Energy Saving-Type Dyeing Machine)

  • 한승철;김진호;김제훈;이성규
    • 한국산학기술학회논문지
    • /
    • 제13권2호
    • /
    • pp.485-491
    • /
    • 2012
  • 최근 국내 섬유산업의 생산량이 증가함에 따라 섬유산업에서 에너지 소비는 계속 증가되고 있는 실정이다. 기존의 염색기는 고온 고압의 특성을 가지고 있기 때문에 염색 후 냉각을 하기 위하여 열교환기를 통한 간접냉각방식을 채택하고 있다. 이러한 간접냉각방식은 물의 소모량이 많으며 작업 시간 또한 오래 걸리는 문제점이 있고 냉각시 염액의 고착으로 인해 냉각 후 환원세정 및 수세를 수차례 하므로 에너지가 많이 소비된다. 따라서 본 논문에서는 고온 고압 액류 염색기의 열교환기에 의한 간접냉각방식을 염색기내에 냉수를 직접 공급하는 직접냉각방식으로 대체하기 위한 장치를 개발하여 기존의 염색기에 적용하여 냉각과 동시에 환원세정공정을 생략하고 수세공정을 단축시키면서 전공정을 마무리함으로써 전체 작업공정을 줄이고 에너지 소비를 절감하는 등의 생산성을 획기적으로 향상시킬 수 있는 직접냉각수세장치를 제안하며, 시제작품을 제작하고, 실제 염색기에 적용하여 기존의 간접 냉각 방식의 염색기와 성능, 자원 및 에너지 절감율을 비교하였다. 또한 시제작품을 적용한 염색기의 염색성 실험을 하였다.

인터페론감마에 의한 A549 폐암세포주 세포독성의 기전 (The Mechanism of Interferon-$\gamma$ Induced Cytotoxicity on the Lung Cancer Cell Line, A549)

  • 오연목;유철규;정화순;김영환;한성구;심영수
    • Tuberculosis and Respiratory Diseases
    • /
    • 제43권1호
    • /
    • pp.63-68
    • /
    • 1996
  • 연구배경: 인터페론감마-(interferon-$\gamma$)는 항바이러스 효과, 암세포의 형증식 효과, 대식세포 및 B 림프구의 활성화, 주면역복합체(MHC) 항원 발현의 증가 등의 생물학적 효과를 나타낸다. 특히, 인터페론감마의 항암 효과는 이미 생체 내외에서 입증되어 실제 폐암 환자에 대한 임상 연구가 시도되고 있다. 그러나, 인터페론감마의 항암효과 기전은 여러가지 가설이 제시되기는 하고 있지만 아직 확립된 것이 없다. 세포의 괴사(necrosis)는 심한 외부의 스트레스에 의해서 발생하는 세포 사망의 형태로 잘 알려져 있다. 생명현상 중 괴사와는 전혀 다른 세포 사망의 과정으로 아포프토시스(apoptosis)가 있다. 아포프토시스는 조직의 항상성(homeostasis of tissue volume), 개체의 발생과정, 장기의 퇴행(regression), tolerance 등의 여러 생명 활동 과정에서 발생하는 세포 사망의 과정으로서, 세포질 및 핵이 분절화(fragmentation)되어 죽어가는 능동적 사망과정으로 알려져 있다. 아포프토시스에서는 수동적으로 죽어가는 괴사에서 볼 수 없는 DNA 분절화(DNA ladder pattern)가 특징적으로 관찰된다. 인터페론감마의 암세포에 대한 세포독성 기전을 연구하기 위해서 인터페론감마를 폐암세포주인 A549세 처치한 후 현미경(inverted microscope)로 A549의 변화를 관찰하였는데 A549세포가 분절화되면서 죽어가는 것을 관찰할 수 있었다. 저자들은 인터페론감마의 항암기전으로서 아포프토시스의 가능성을 평가하고자 본 연구를 시행하였다. 방법: 폐암세포주인 A549세포를 대상으로 하였다. A549세포에 여러 농도의 인터페론감마를 투여하고 24시간, 72시간, 120시간 후에 MTT(dimethylthiazolyl diphenyltetrazolium bromide) bioassay법으로 세포독성을 정량화하였다. 그리고, 100 unit/ml의 인터페론감마를 A549 세포에 120시간 처치 후, 광학 현미경으로 세포 사망의 양상을 관찰하였다. 또한, 100 unit/ml의 인터페론감마를 투여하고 120시간이 경과한 후 사망 세포의 DNA를 추출하여 1.5% agarose gel에서 전기 영동을 시행하고 ethidium bromide로 염색 후 DNA ladder pattern 유무를 관찰하였다. 결과: 1) 인터페론감마에 의한 A549 폐암세포주의 세포독성 효과는 24시간에는 거의 없다가 72시간부터 120시간 사이에 나타나기 시작하여 120시간에는 더 증가하였다. 2) 인터페론감마에 의한 A549 세포의 사망 양상은 광학현미경상 A549 세포들이 작은 분절로 나뉘면서 사망하였다. 3) 인터페론감마를 A549 폐암세포주에 처치 후 죽어기는 세포의 DNA를 추출하여 전기영동시킨 결과 아포프토시스(apoptosis)에서 특징적으로 보이는 DNA ladder pattern을 관찰할 수 있었다. 결론: 인터페론감마(interferon-$\gamma$)의 A549 폐암세포주에 대한 세포독성의 기전은 아포프토시스 과정을 통해서 일어난다.

  • PDF

부산시민이 인식하는 좋은 죽음과 호스피스에 대한 연구 (A Study on the Perception of Hospice Palliative Care and what Constitutes a Good Death of the Citizenry of Busan)

  • 백정원;김숙남;최순옥;류지선
    • 보건의료산업학회지
    • /
    • 제10권3호
    • /
    • pp.85-97
    • /
    • 2016
  • Objectives : In this study, the awareness of hospice and the perceptions on the need for visiting palliative care and what constitutes a good death of the citizens of Busan were investigated. The purpose of this study was to develop a hospice system based on the needs of the citizenry of Busan by seeking solutions for current hospice strategies. Methods : One thousand Busan citizens from 20 to 80 years of age were surveyed in this study. Results : Busan citizens defined a good death as spending less than one month of time in the actual process of dying at home between the ages of 80-89 years. They knew about hospice a little and were aware of its necessity. They also knew about the necessity of visiting palliative care and were interested in receiving it when appropriate but did not know much about it. Conclusions : First, there is a large difference between Busan citizens' expectations on what constitutes a good death and what a good death really is. Second, Hospice palliative care should be provided to the community. Third, the older the patient is, the more palliative care visits are necessary. Fourth, 40s and 50s must make preparations for hospice palliative care in their future.

Human Embryonic Stem Cells Experience a Typical Apoptotic Process upon Oxidative Stress

  • Lee, Gun-Soup;Lee, Young-Jae;Kim, Eun-Young;Park, Se-Pill;Lim, Jin-Ho
    • 한국발생생물학회:학술대회논문집
    • /
    • 한국발생생물학회 2003년도 제3회 국제심포지움 및 학술대회
    • /
    • pp.97-97
    • /
    • 2003
  • Embryonic stem (ES) cells, derived from preimplantation embryos, are able to differentiate into various types of cells consisting the whole body, or pluripotency. In addition to the plasticity, ES cells are expected to be different from terminally differentiated cells in very many ways, such as patterns of gene expressions, ability and response of the cells in confronting environmental stimulations, metabolism, and growth rate. As a model system to differentiate these two types of cells, human ES (hES, MB03) cells and terminally differentiated cells (HeLa), we examined the ability of these two types of cells in confronting a severe oxidative insult, that is $H_2 O_2$. Ratio of dying cells as determined by the relative amount of dye neutral red entrapped within the cells after the exposures. Cell death rates were not significantly different when either MB03 or HeLa were exposed up to 0.4 mM $H_2 O_2$. However, relative amount of dye entrapped within the cells sharply decreased down to 0.12% in HeLa cells when the cells were exposed to 0.8 mM $H_2 O_2$, while it was approximately 54% in MB03. Pretreatment of cells with BSO (GSH chelator) and measurement of GSH content results suggest that cellular GSH is the major defensive mechanism of hES cells. Induction of apoptosis in hES cell was confirmed by DNA laddering, induction of Bax, and chromatin condensation. In summary, hES cells 1) are extremely resistant to oxidative stress, 2) utilize GSH as a major defensive mechanism. and 3) experience apoptosis upon exposure to oxidative stress.

  • PDF

존엄사에 대한 한국 중년층의 인식유형과 특성 (The Subjective Perception and Characteristics of the Middle-aged on Death with Dignity)

  • 신선호;신원식
    • 디지털융복합연구
    • /
    • 제13권12호
    • /
    • pp.413-422
    • /
    • 2015
  • 이 연구의 목적은 존엄사에 대한 한국 중년층의 인식유형을 파악하고 그 특성을 분석함으로써 존엄사에 대한 제도마련 및 정책을 구성하는데 필요한 기초적인 자료를 제공하고자 하는 것이다. 존엄사에 관한 30개의 진술문을 가지고, 32명의 중년층을 대상으로 Q 분류를 하였다. 분석결과 존엄사에 대한 주관적인 인식유형과 그 특성은 허용형, 반대형, 제한적 허용형으로 나타났다. 허용형은 환자의 자기결정권에 의한 존엄사는 수용되어야 하며, 극심한 고통을 동반하는 환자에게 존엄사는 필요하다고 생각한다. 반대형은 존엄사가 허용되면 부당하게 죽음을 맞이하는 이들이 늘어나며, 인간의 생명경시 풍조가 만연해질 것이라고 생각한다. 제한적 허용형은 존엄사를 허용하기에 앞서 구체적인 법과 제도가 마련되어야 한다고 생각한다. 존엄사라는 주제 자체가 국민들의 온전한 합의를 이끌어낼 수 없는 것일 수 있지만, 존엄사제도 추진과정에서 국민의 의견이 반영되어야 할 것이다.

국내의 암관련 간호연구논문 분석 (An Integrative Review of Oncology Nursing Research : 1980-1998)

  • 최선혜;남영화;류은정;백명화;서동희;서순림;최귀윤;최경숙
    • 대한간호학회지
    • /
    • 제28권3호
    • /
    • pp.786-800
    • /
    • 1998
  • The purposes of this study were to describe systemically 18 years of oncology nursing research in Korea and suggest it's direction in future. 149 nursing studies published from 1980 to 1998 were selected for the present study. There were examined the source and the design of study, type of subjects, measurement variables, the intervention outcome of experimental research, and theme of qualitative research. The results were as follows : 1. 121 of 149 studies were composed of master thesis and dissertation of graduate school. There were 55 correlations, 30 descriptions, 19 comparisons, 19 qualitative studies and 2 Q-methods as the type of research design. 2. Cancer patients without describing specified diagnosis as subjects' characteristic were 44 of total studies. The others had various diagnoses such as gastric cancer, uterine cancer, breast cancer, leukemia, lymphoma, colorectal cancer, and lung cancer. According to treatment type, patients receiving chemotherapy were the highest number distribution as 53 of all researches. 3. Most measurement instruments used for research were translated it into Korean that developed by foreigners, such as Zung's depression, Spielberg's anxiety, and Wallston's locus of control. 4. Quality of life was shown the most frequently among correlational researches. the next one was depression, the third was hope, and so on. 5. There was the most frequent comparison between cancer and non-cancer patients in comparative researches. It was surveyed those variables as diet habits, risk factors, stressful life events, anxiety and depression, and self-care capacity between two groups. 6. The subjects were mostly chemotherapy patients as 15 of 24 experimental studies. Oral care and education were respectively the highest experimental interventions. 7. Qualitative researches about cancer were reported since 1991. Their themes were illness experience, adaptation process, dying experience, family experience, hope, caring, experience of health behavior, meaning of chemotherapy and experience of cancer survivor. Phenomenologic methodology was designed above 50% of qualitative researches. According to the above findings, cancer research had increased since 1990 and done mostly by descriptive design but a few experimental studies. As recommendations for the future, It is necessary to study the comparison of oncology nursing research internationally, the replication to establish the effect of nursing intervention, and the family care of cancer patient.

  • PDF

중독 관련 사망에서의 사망진단서 오류 (Errors of Death Certificate for Poisoning Related Death)

  • 박찬혁;김선휴
    • 대한임상독성학회지
    • /
    • 제18권1호
    • /
    • pp.11-17
    • /
    • 2020
  • Purpose: This study examines errors in death certificates (DCs) issued to cases of poisoning. Methods: DCs issued in poisoning cases were retrospectively reviewed. Errors in the DC were classified as major and minor errors, and were evaluated in accordance with their impact on the process of selecting the cause of death (COD). Results: A total of 79 DCs were evaluated; 43 (54.4%) DCs were issued in the emergency department (ED), and 36 (45.6%) DCs were issued outside the ED. The average major and minor errors per DC were determined to be 0.4 and 3.3, respectively. Moreover, an average of 3.0 errors were discovered in DCs issued at the ED, and 4.4 errors in DCs issued outside the ED. The most common major errors were incorrect manner of death (11.4%, 9/79), followed by unacceptable COD (7.6%, 6/79), and the mode of dying as an underlying COD (5.1%, 4/79). The common minor errors most frequently encountered were incorrect time interval (86.1%, 68/79), followed by incorrect other significant conditions (73.4%, 58/79), and no record for date of onset (62.0%, 49/79). Conclusion: Our results indicate that the total numbers of major errors, minor errors and cases of misjudged cause of death were greater in DCs issued outside the ED than in DCs issued at the ED. The most frequently quoted major error of DCs related to poisoning was determined to be the incorrect manner of death.

분산형캐티온염료/산성염료에 의한 CDP(cation dyeable polyester)/견 교편물의 염색에 관한 연구 (A Study on the Dyeing of CDP(cation dyeable polyester)/Silk Knitted Fabrics With Disperse Type Cation Dyes/Acid Dyes)

  • 성우경
    • 한국의류산업학회지
    • /
    • 제13권5호
    • /
    • pp.797-805
    • /
    • 2011
  • This study was carried out to investigate dyeing characteristics of CDP(cation dyeable polyester)/silk knitted fabrics with disperse type cation dyes/acid dyes by one bath dyeing method in comparison with two bath dyeing method in the interests for rationalization of the dyeing process. The apparent color depth(K/S) of the disperse type cation dyes with CDP and that of acid dyes with silk decreased slowly with increasing pH values of dyebath with the exception of sharp decrease at alkali region for CDP. The contamination behavior of CDP by the acid dyes and that of silk by the disperse type cation dyes decreased with progressing of dyeing. The migration ratio(%) of the disperse type cation dyes with CDP is low compared with that of acid dyes with silk. The sediment in mixed dying solution of disperse type cation dyes and acid dyes remarkably less compared with that of regular type cation dyes and acid dyes at $100^{\circ}C$ regardless applying of preventer agent of precipitation. When CDP/silk knitted fabrics was dyed with by with mixtures of disperse type cation dyes/acid dyes one bath or two bath dyeing method, the characteristic of reflectance spectra of CDP components were greatly influenced by disperse type cation dyes and that of silk components by acid dyes. It was confirmed that K/S values of each components of CDP/silk knitted fabrics dyed by one bath dyeing method decreased slightly compared with two bath dyeing method.

HIV 감염자의 생활 경험에 관한 현상학적 연구 (The Experience of People with HIV/AIDS : A Phenomenological Study)

  • 김은영;이명선
    • 성인간호학회지
    • /
    • 제12권4호
    • /
    • pp.497-506
    • /
    • 2000
  • The purpose of this phenomenological study was to explore and describe the experience of people with HIV/AIDS. Three men and three women with HIV/AIDS participated in the study. They were asked open-ended and descriptive questions in order for them to talk about their experience in their own terms. Interviews were audiotaped and transcribed to maintain data integrity and to reduce perceptual bias. The transcripts were analyzed by the Colaizzi method. Member checks from the participants were used to validate the emergent themes. Seven themes emerged from the analysis. 1. People with HIV/AIDS have a strong impact and emotional reaction when receiving positive HIV test results. 2. All people with HIV/AIDS attempt to conceal HIV infection because of fear of stigma or rejection. 3. After the initial brief traumatic reaction to HIV/AIDS diagnosis, all participants feel lonely because they had no one to express or share their own experiences. 4. People with HIV/AIDS reflect on their life, think about the death and dying process and they become depressed. 5. Most participants feel that the family members who know his/her diagnosis are a big source of support. 6. According to the normativeness of infection route of HIV, the degree of guilty feeling differs among participants. 7. Although all participants think medication is a lifeline, the adherence to medication is not maintained because of side effects, denial and concealment of HIV/AIDS. The results of this study may help nurses and other health care workers to implement more efficient nursing strategies for people with HIV/AIDS by more deeply understanding their experience.

  • PDF