• 호스피스학술지
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• 제7권1호
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• pp.15-28
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• 2007

This study was focused on figure out what kinds of elements are influencing on job satisfaction with approach of the educational system. It was also to figure out how work characteristics and role conflicts of employees influence on job satisfaction. Objects of study were employeeswho had been working in Hospice and Palliative medical center at least for 6 months, and they were doctors, nurses, ministers, and welfare workers. Collected materials were analyzed by Frequency Analysis, One-way ANOVA, Correlation Analysis, and SimpleRegression Analysis. Results from study can be summarized like below. The first, job satisfaction of workers in Hospice and Palliative medical center were 3.36, and this numerical value is pretty high over all. For saying from the higher to the lower satisfaction level, there were satisfaction with job itself, satisfaction with co-workers, satisfaction with seniors (superiors), and satisfaction with organizations, on the other hands, satisfaction with salaries was turned out as the lowest level among those. The second, role conflict was 2.63, and it is considered as the medium level. after inquiring into it by elements of role conflict, they felt many environmental difficulties compared to other workers in different fields such as environmental difficulty, role ambiguity, insufficient ability, process obscurity, etc. The third, work environment influencing on job satisfaction are as follows. Professional environment among characteristics of work environment was significant statistically. Job satisfaction of ministers was the highest; others were in the order of doctors, welfare workers, and nurses. For employment history, job satisfaction was higher as they have more and longer job experience including whole professional experience both in hospice and palliative medical center. In addition, participating in hospice and palliative programs, intensive training regularly was significantly. Job Motivation was also significant statistically. Especially, job satisfaction was higher when people decided to work in hospice and palliative medical center because of individual desire (self-realization). Lastly, influence of role conflict on job satisfaction is as follows. Environmental difficulty, role ambiguity, insufficient ability, process obscurity, etc showed the significant meaning statistically, and the lower role conflict was related with the higher job satisfaction. Suggestions for next study based on such results are as follows in order to improve or increase job satisfaction of employees in hospice/palliative medical centers. The first, to expand education opportunity of employees is needed to increase job satisfactionof hospice/palliatives medical centers. Participating in intensive programs and seminars by types of occupation and acquiring professional knowledge are very important since employees are motivated by those activities. For that, developing and activating intensive education/programs by professional occupations are suggested. The second, dividing roles of employees and determining each job's limit clearly in hospice/palliative medical centers are required. For that, study developing standard job regulations is suggested for each professional job. Lastly, developing and providing reasonable salaries is needed because low salaries of hospice/palliative medical centers are the absolute reason lowering job satisfaction. Therefore, this paper suggests improving the salary level of employees of hospice/palliative medical centers and developing practical plan for it.

• 대한간호학회지
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• 제30권4호
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• pp.1045-1054
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• 2000

As cost pressures have escalated, policy makers, politicians, health care providers and families have tried to devise ways to reduce health care costs. While originally developed to enhance patient control and to provide better care at the end of life, hospice care has recently received significant attention as a mean of reducing health care costs. As a program providing care for patients who are dying at their homes, hospice has expanded slowly since the opening of the first hospice in Korea in 1963. Therefore, a variety of services that responds to the needs and concerns of many dying people and their families is limited The purpose of this study was to determine the potential cost savings at the end of life among patients who used home hospice compared with the patients who received institutional care in Korea. This study used a retrospective, descriptive design. The sample for this study included 46 patients who died of lung cancer: 25 patients who received home hospice care and 21 patients who received institutional care. Data on patient characteristics, kinds and frequencies of provided treatment and nursing services, and hospice and hospital charges during the last month before death were collected. Cost of care was measured by the average cost per patient per day in the last month of life. The results of the study indicated that there were significant differences in average cost of care between home hospice sample and institutional care sample (t=9.956, p<.001; home hospice sample: M=18,102 won, institutional care sample: M=317,578 won). The cost of the home hospice sample was approximately 6% of the cost of institutional care. The majority of the home hospice nursing services were education (35.7%) and supportive counseling (25.2%), followed by medication management (13.6%), assessment (12.1%), basic nursing (7.2%), treatment (5.5%) and others. In institutional care sample, basic nursing and treatment were more emphasized than education or supportive counseling among the nursing services provided. The results of this study showed the potential for hospice to reduce costs and implications for policymakers and clinicians to incorporate hospice program into the formal health care delivery system in Korea.

• Journal of Hospice and Palliative Care
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• 제11권3호
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• pp.147-155
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• 2008

목적: 본 연구는 국내 호스피스 완화의료 관련 종사자들의 호스피스 완화의료 실무에 대한 자기 효능감, 자기평가 실무수행역량, 그리고 교육 요구도를 파악하여 구조화된 호스피스 완화의료 연수프로그램을 개발의 기초자료를 마련하고자 시도되었다. 방법: 2008년 3월부터 2개월간 9개 대학, 6개의 지역 암센터, 일개 암센터의 6개월 이상의 교육과정 참여자에게 우편 혹은 전자우편을 통해 자료를 수집하였고, 이 중 156부를 분석하였다. 호스피스에 대한 자기효능 감은 Barrington과 Murrie의 The Self-efficacy in Palliative Care (SEPC)를 Mason과 Ellershaw가 수정 보완한 도구를, 호스피스 주제별 자기평가 실무수행역량과 교육 요구 도는 선행연구를 바탕으로 본 연구자가 선정한 22개 항목에 대한 4점 척도 도구를 사용하였다. 결과: 대상자 156명의 평균연령은 37.94세였고 일반간호사가 82.1%이다. 자기 효능감 총점은 $2.67{\pm}.62$로 '보통이다' 보다 낮았고, 자기평가 실무수행역량은 모든 영역에서 3점('알고 있으나 스스로 수행하지 못 한다') 보다 낮았다. 교육 요구도는 모든 항목이 '필요하다' 이상으로 보고되었는데, 이 중 통증관리가 $3.71{\pm}.50$으로 가장 높았고, 통증 및 증상평가($3.67{\pm}.52$), 임종간호($3.67{\pm}.52$), 의사소통과 상담($3.63{\pm}.53$) 순이었다. 6개월 이상의 호스피스 교육과정을 이수한 집단은 그렇지 않은 집단보다 유의하게 높은 자기효능감과 자기평가 실무수행 역량을 보고하였으나, 교육 요구도에서는 차이가 없었다. 결론: 본 연구의 결과는 6개월 이상의 호스피스 교육 수료의 유무와 무관하게 호스피스 실무에서의 낮은 자기효능감과 독립적인 역할수행을 어려워하고 있음을 보여주었다. 또한 호스피스 실무에서 실무능력 향상을 목적으로 하는 연수교육의 필요성과 간호사들의 높은 요구를 보여주었다. 호스피스의 질적 향상을 위해서는 이론 중심의 교육과정과 실무 중심의 훈련과 계속 교육이 요구되고, 이를 실행할 수 있는 교육과정을 개발하는 것이 필요하다.

• 호스피스학술지
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• 제5권1호
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• pp.33-41
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• 2005

Purpose: The purpose of this study was to identify the effects of education of hospice for nurses on concern and coping about death and dying. Methods: The subjects of this study were 33 Korean nurses who participated in the education of hospice which consisted of lectures and practices for 5 months. Data were collected using questionnaire of concern and coping about Death and Dying. Data were analyzed with the mean, SDs and Wilcoxen test. Results: The mean score of concern about death and dying was 7.03. The highest items of concern about death and dying were 'thoughts of physical pain and being, 'thoughts of suffocating and choking, 'fear of darkness', The lowest items of concern about death and dying were. 'thoughts of burglars invading my possessions', 'rejection by God', thoughts of no one attending funeral', 'thoughts of no one paying respect or tribute', The mean score of coping about death and dying was 11.37. The highest items of coping about death and dying were 'call family member(s) into room and ask them ti sit close by, reminisce on happy events of the past, tell myself that there is nothing to be afraid of, look at family picture albums'. The lowest items of coping about death and dying were 'stay up stay up late till ready to fall asleep', 'look at family heirlooms', 'phone a prayer line', 'ask for a snack or something to drink'. In concern and coping about death and dying, significant differences were not found between pre and post test. But there was a tendency to decrease concern and increase coping about death and dying after education of hospice. Conclusion: According to these results, it is needed for nurses not only to do research for concern and coping about death and dying but also to develop an education program.

• 가정간호학회지
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• 제11권1호
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• pp.57-70
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• 2004

Purpose: This study was to develop a cost-effective and efficient curriculum for advanced practice nurse (APN) programs in home health care and hospice. Method: The process was to: (1) compare and analyze the present curriculum in home health care and hospice programs, (2) identify the needs of 7 expert nurses in home health care and hospice, and (3) develop a common curriculum structure and contents between home health care and hospice specialty courses. Result: Out of the 10 credits constituting the home health care and hospice specialty courses respectively, 6 credits were identified the common courses, Common content areas included introduction to hospice, communication skills, pain control. symptom control. teaching methods, and agency management. Conclusion: These results can be utilized in the development of APN programs for home health care and hospice in terms of qualified and cost-effective aspects of education.

• 호스피스학술지
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• 제2권1호
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• pp.41-57
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• 2002

This study was done to examine spiritual well-being of hospice care service volunteers for the purpose of providing them with programs promoting coping skills in response to the wholistic needs of patient effectively, also providing data for professional or nonprofessional hospice training program. Subjects were 123 volunteers serving in 6 hospice centers in Jeonbuk province at present. Data collection were done from 16 Oct. 2000 to 17 Nov. 2000. questionnairs were consisted of activities of hospice care service volunteer and spiritual well-being. The study results were as follows 1.Mean of activities of hospice care service volunteers were 2.433, those activities were divided into 5 categories such as spiritual, activities of volunteer for themselves, psychosocial, physical area and bereavement. The highest mean score was spiritual area 2.578, activities of volunteers for themselves 2.525, psychosocial area 2.456, physical area was 2.359 and the lowest mean score was bereavement area 2.130. 2.Spiritual well-being of hospice care service volunteers was 5.25, the highest mean. In subcategories of spiritual well-being, religious spiritual well-being was higher than existential spiritual well-being, mean score for each one was 5.41, 5.10. 3.Statistically significant relations among demographic characteristics such as gender(t=2.72, P=.008), status of marriage(t=6.067, P=.003), occupation(F=3.795, P=.025), frequency of visiting for volunteered hospice care(F=3.833, P=.024) were noted. 4.Statistically significant demographic characteristics of hospice service volunteers was religion(t=-4.38, p=0.000), status of marriage(F=3.505, p=0.033), frequency of visiting for volunteered hospice care(F=3.107, p=0.048), level of satisfaction from hospice care volunteer service(F=3.610, p=0.030), hospice service volunteers doing more home visiting(5-9times/month) had higher status of spiritual well being than volunteer with less home visiting(1-4times/month) 5.A significant relationship between activities of hospice service volunteers and status of spiritual well-being was noted(r=.236, p=.004), activities of hospice service volunteers was related to both subcategories of spiritual well-being such as religious well-being(r=.210, p=.010) and existential well-being(r=.208, p=.011). From the results of the study It is noted that status of spiritual well-being for hospice volunteers influences on service activities. It means spiritual well-being should be considered as a essential character for hospice service volunteers, it also means that managing and maintaining of status of spiritual well-being for hospice service volunteers is important. On the base of the study recommendation are made as follows: 1.Considering status of spiritual well-being for hospice care service volunteers is needed to promote hospice care activities. 2.It is necessary to develope spiritual well-being programs for hospice care service volunteers and further study for effect validation of them is needed. 3.Further study to sort out effecting variables for hospice care service volunteer activities is needed. 4.It will be desirable to have spiritual well-being information included in the hospice education program.

• Journal of Hospice and Palliative Care
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• 제3권2호
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• pp.136-143
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• 2000

목적 : 본 연구는 호스피스 자원봉사자와 자원봉사를 받은 환자의 특성을 조사하구 호스피스 자원봉사자의 활동내용을 분석하는데 그 목적이 있다. 방법 : 1차적으로 자원봉사자의 특성을 파악하기 위하여 1997년 3월부터 2000년 3월까지 원주의 C.C.C에서 교육수료 후 자원봉사 유경험자의 기록지 총 64개 전수를 분석하였으며, 2차적으로 호스피스 자원봉사자의 활동을 분석하기 위하여 2000년 6월 현재 자원봉사 활동을 하고 있는 30명을 대상으로 하였다. 자원봉사자의 활동에 관한 자료수집은 연구자들이 개발한 도구를 직접배부한 후 즉시 회수하였다. 결과 : 1) 호스피스 자원봉사자들의 특성은 93.1%가 여성이었으며, 이들의 평균연령은 45세였다. 또한 자원봉사자 교육이수후 현재까지 봉사활동을 하고 있는 대상자는 35명으로 32.4%를 차지하였다. 2) 자원봉사를 받은 환자들의 특성은 평균연령이 50.1세였으며, 질병명은 대부분 암으로 그중 폐암환자가 13.6%로 가장 많았다. 3) 자원봉사자들의 환자 1인당 방문한 회수는 평균 10회정도 였으며, 방문기간은 평균 49.4일 이였다. 4) 호스피스 자원봉사자의 활동내용을 영역별로 분석한 결과 영적활동(4점 만점 중 1.97점)이 가장 활발하게 이루어지고 있었으며, 그 다음이 정서적 돌봄(4점 만점 중 1.49점)이였다. 결론 : 본 연구결과는 W시의 호스피스 사업의 발전을 위한 활동가능한 자원봉사자 교육과 제도를 위한 전략을 개발하는데 기초자료를 제시하고 있다.

• Journal of Hospice and Palliative Care
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• 제24권3호
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• pp.154-164
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• 2021

Purpose: The purpose of this study was to examine the effects of a death preparation education program for nurses working in convalescent hospitals on death anxiety, death attitudes, and attitudes toward end-of-life care. Methods: This was a quasi-experimental study with a non-equivalent control group, pre-test and post-test design. Among 53 participants, 26 were assigned to the non-equivalent experimental group and 27 to the control group. The program was performed in the formats of lectures, video-watching, group discussions, and sharing, and consisted of 10 sessions held twice a week, for 5 weeks (90 minutes per session). Data were analyzed using descriptive statistics, the t-test, and the chisquare test in SPSS version 21.0. Results: Significant differences between the experimental and control groups were observed in death anxiety (t=7.62, P<0.001), death attitudes (t=-7.58, P<0.001), and attitudes to end-of-life care (t=-10.30, P<0.001). Conclusion: It was confirmed that the death preparation education program reduced death anxiety and had a positive effect on death attitudes and attitudes toward end-of-life care. Based on the results of this study, it is expected that specialized and systematic education that can increase the implementation and stability of death preparation education in various fields, including nursing, will have a positive effect on both hospice patients and members of society more broadly.

• Journal of Hospice and Palliative Care
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• 제18권1호
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• pp.9-15
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• 2015

말기암환자 관리를 위해서 전문인력 교육은 필수적이다. 정부에서는 암관리법을 통해 호스피스완화의료의 양적 확대를 기반으로 전문 인력을 양성하기 위해 제2기 암정복 10개년 계획에서 전문인력 확충계획을 발표하였다. 그간, 호스피스완화의료 전문인력 훈련을 위한 표준교육 과정과 의사/간호사 e-learning에 이어 이번 사회복지사 e-learning을 개발하여 운영하게 되었다. 호스피스완화의료 현장에서 사회복지사는 호스피스완화의료 대상자들의 심리 사회적 문제를 해결하는 중추적 역할을 수행해왔으며, 우리나라 호스피스완화의료가 정착되고 제도화되기까지 현장에서 전문가의 책임과 역할을 다해오고 있다. 하지만 그간 사회복지사 직종을 위한 체계적인 교육 과정이 없는 실정으로 사회복지 실천 지식과 기술을 충분히 습득하는 데 어려움이 있었다. 이번 호스피스완화의료 사회복지사 e-learning 과정 개발을 통해 말기암환자를 돌보는 사회복지사의 정체성과 전문성, 임상현장에서의 실천능력이 함양되고 교육 접근성이 향상될 것이며, 향후 보수교육 과정을 통한 지속적인 전문성 보장을 위한 교육제도가 제도적으로 도입되어 더욱 발전하길 기대한다.

• Journal of Hospice and Palliative Care
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• 제25권2호
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• pp.66-75
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• 2022

Purpose: The purpose of this study was to examine person-centered care, nursing professionalism, the nursing work environment, and empathy capacity among hospice ward nurses and to identify the factors affecting person-centered care. Methods: Data were collected using a self-report questionnaire completed by 120 nurses at 30 inpatient hospice institutions in South Korea from August 24, 2020 to September 8, 2020. The independent t-test, one-way analysis of variance, and Pearson correlation analysis were conducted using SPSS version 26.0. Results: The scores were 3.76±0.45 for person-centered care, 3.58±0.47 for nursing professionalism, 3.24±0.57 for the nursing work environment, and 4.00±0.46 for empathy capacity. There were positive correlations between the variables. Factors that influenced the person-centered care of hospice nurses were being a manager (β=0.20, P=0.002), high nursing professionalism (β=0.20, P=0.012), a better nursing work environment (β=0.15, P=0.033), and high empathy capacity (β=0.51, P<0.001). The explanatory power was 65.3%. Conclusion: To reinforce the person-centered care competency of hospice nurses, it is necessary to improve nursing professionalism, the nursing work environment, and empathy competency. Opportunities for nurses to practice independently must be expanded for nurses to develop nursing professionalism. Sufficient nursing personnel and material resources must be provided to nurses to cultivate a positive work environment. Empathy should be improved by implementing integrated education programs that include nursing practice situations.