• 제목/요약/키워드: Education for hospice

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죽음준비교육이 간호학생들의 생의 의미, 죽음과 웰다잉, 호스피스에 대한 인식에 미치는 효과 (Effects of Death Preparation Education on Nursing Students' Perceptions about the Meaning of Life, Death and Well-dying and Hospice)

  • 변도화;박미현
    • 한국산학기술학회논문지
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    • 제18권5호
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    • pp.169-176
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    • 2017
  • 본 연구는 죽음준비교육을 실시하여 간호대학생들의 생의 의미, 죽음과 웰다잉, 호스피스에 대한 인식의 변화 정도를 파악하고 효과를 규명하기 위한 비 동등성 대조군 전 후 유사실험 연구이다. 연구대상자는 A시의 C대학 간호학과에 재학 중인 38명을 실험군으로, P시의 P대학 간호학과에 재학 중인 36명을 대조군으로 선정하였다. 연구기간은 2016년 2월 29일부터 4월 20일까지 주 1회 90분씩 8회기에 걸쳐 죽음준비교육을 실시하였고, 자료 분석은 $x^2-test$, t-test로 분석하였다. 죽음준비교육은 죽음교육의 중심적인 4가지 영역인 인지적, 정서적, 실천적, 가치 영역의 구분에 맞추어 생의 의미를 부여하고 죽음과 웰다잉, 호스피스에 대한 인식에 중점을 두면서 내용을 구성하였다. 연구결과 죽음준비교육은 간호학생들의 생의 의미, 웰다잉 인식, 호스피스에 대한 인식을 높이는 것으로 나타나 간호학생들 자신의 생이라는 의미 부여와 함께 올바른 삶의 가치관 정립에 도움을 주며 긍정적으로 살아갈 수 있는 원동력이 되고, 웰다잉과 호스피스에 대한 올바른 인식 함양을 돕는 유용한 교육으로 활용될 수 있을 것으로 기대된다. 반면 죽음에 대한 인식은 유의한 차이가 없는 것으로 나타나 죽음에 대한 인식에 대한 효과를 검증하는 반복 연구와 적용기간에 따라 웰다잉 인식 변화의 차이가 있는지를 확인하는 후속 연구가 필요함을 제언한다.

말기환자 돌봄 교육 후 의과대학생의 인식과 태도 변화 (Awareness and Attitude Change after End-of-Life Care Education for Medical Students)

  • 김현경;남은미;이경은;이순남
    • Journal of Hospice and Palliative Care
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    • 제15권1호
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    • pp.30-35
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    • 2012
  • 목적: 우리나라에서는 의과대학에서 말기환자 돌봄에 대한 교육이 충분치 못하다. 이 연구는 의과대학생에서 말기환자 돌봄 교육이 학생들의 말기환자의 돌봄에 관한 인식과 태도에 미치는 영향을 평가하고 교육에 대한 요구도를 파악하고자 하였다. 방법: 이화여자대학교 의학전문대학원 의학과 4학년 학생 166명을 대상으로 말기환자의 호스피스 완화의료에 관한 설문조사를 교육 전과 후에 조사하여 분석하였다. 결과: 사전의료의향서 작성시기에 관한 질문에 교육 전에는 '임종이 가까운 말기'가 33.6%로 가장 빈도가 높았으나 교육 후에는 '건강할 때'가 58.7%로 가장 많았다. 무의미한 연명치료의 유보나 중지에 관하여는 수업 전과 후에 심폐소생술은 48.1% 대 92.5%, 기관삽관이나 인공호흡기 38.3% 대 92.5%, 혈압상승제 39.1% 대 85.8%, 혈액투석 60.9% 대 94.8%, 총정맥영양공급 27.8% 대 56.0%로 유의한 변화를 보였다. 안락사에 대한 반대 의사는 46.6%에서 82.1%로 현저히 증가하였다. 모든 학생이 말기환자 돌봄 교육이 필요하다고 동의하였다. 결론: 대부분의 의과대학생은 임종환자관리 교육과정을 통해 죽음의 의미에 대해 성찰하는 시간을 갖고 말기환자의 호스피스 완화의료 교육의 필요성을 인식하였다. 또한 말기환자의 돌봄에 관한 인식과 태도의 변화가 컸다. 향후 이러한 교육과정이 모든 의과대학에서 정규교육과정으로 포함되어야 할 것이다.

암 환자 가족의 호스피스 요구도 (The Need for Hospice Care in Families of Patients with Cancer)

  • 김신정;김영순;강경아
    • 지역사회간호학회지
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    • 제15권4호
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    • pp.639-647
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    • 2004
  • Purpose: The purpose of this study was to analyze the need for hospice care programs in families of patients with cancer. Method: The study surveyed 98 families who were taking care of patients with cancer. This survey was conducted from August 2004 to October 2004 at two general hospitals in Seoul. The data were collected through a self-reporting questionnaire of 22 items. The items were classified into five areas by factor analysis to identify the construct validity. The reliability of the tool was established by Cronbach's alpha as .93 and the data collected were analyzed by descriptive statistics, t-test and ANOVA. Results: 1) The degree of need for hospice care of the subjects showed a high average of $3.26({\pm}3.7$). The need for 'emotional care of patients showed the highest mean' (M=3.47), 'management of terminal physical symptoms' (M=3.34), 'control of secondary physical problems' (M =3.26), 'acceptance of the family's difficulty' (M=3.12), 'spiritual care for preparing for death' (M=2.96), respectively. 2) With respect to the demographic characteristics of the subjects, there were statistically significant differences in hospice care needs, according to the onset of diagnosis (F=3.110, p=.030). Conclusion: Hospice care must be provided considering the needs of families of patients with cancer. In this sense, this country's needs as well as hospice nurses' higher concern and support for hospice care of patients require further education and program development to meet the current demands.

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Development and Evaluation of an Education Program for Professional Palliative Care Nursing

  • Yeun, Young-Ran;Kwon, Min;Lee, Kyoung-Soon
    • 대한간호학회지
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    • 제45권1호
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    • pp.139-146
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    • 2015
  • Purpose: This study aimed to develop a "Palliative Care Professional" education program and evaluate its effects on the recognition of good death, palliative care, and the meaning of life for nurses. Methods: It was developed based on the hospice care program for volunteers being used in the Hospice Palliative Care Research Center of S University in Seoul. It was also based on the studies which investigated the educational needs of nurses in palliative care. This program consisted of 5 sessions and 16 content items for 2 weeks. A non-equivalent control group non-synchronized design was utilized and participants were assigned to the experimental group (n=42) or the control group (n=44). Results: The recognition of a good death (F=11.44, p=.001), palliative care (F=4.15, p=.045), and the meaning of life (F=5.12, p=.026) increased more significantly for participants in the experimental group than in the control group. Participants felt that they gained further knowledge in palliative patient management and refined their clinical practice. Conclusion: The results of the study indicate that this program could serve as a practical program for palliative care nursing in the nursing field and suggests that more attention should be directed to the diverse educational needs of nurses.

의료인의 호스피스가정간호에 대한 지식과 태도 조사연구

  • 김옥겸
    • 호스피스학술지
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    • 제2권2호
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    • pp.28-48
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    • 2002
  • The advances of medical technologies have not only prolonged human life span, but also extended suffering period for the patients with incurable medical diseases. Hospice movement was developed to help these patients keep dignity and lives peaceful at the end of their life. Since many patients prefer to spend the last moment of life at home with their family, hospice home care has become very popular worldwide. The purpose of this study for a promotion and development of hospice home care in Korea, and features basic research on medical profession's knowledge and attitudes to hospice home care. This study which was used for the research questionnaires developed by the researcher that were answered by 100 physicians and 127 nurses in a general hospital. Data were collected from April 22, 2002 to May 10, 2002. The SPSS was used to make a comparative analysis of the frequency, percentile, ANOVA, and x2-test. The results of the study were as follows; 1.The medical profession showed high level of knowledge of the definition and philosophy of hospice. However, the physician group of the examinees showed insufficient knowledge of the fact that hospice care includes bereavement care, while the nurse group's response to the same question showed a significant difference(x2=10.752, p=.001). 2.For whom the hospice home care is provided, 95.6% of the respondents showed very high level of knowledge as answering that the incurable terminal illness patients and their families are the beneficiaries of hospice care. The respondents counted nurses, volunteers, pastors, physicians and social workers, consecutively, as hospice care providers. More nurse were positive toward pastors than physicians in regarding as a hospice care provider by a significant difference(x2=11.634, p=.001). 3.For when to referral hospice home care to the patients, only 34.2% answered that patients with less than 6 months of survival time are advised to receive hospice care, reflecting very low level of knowledge. 23.0% of the physicians and 48.0% of the nurses answered that hospice care should be provided when death is imminent, making a significant difference between the two groups(x2=6.413, p=.000). 4.To promote hospice activities, 87.2% pointed out that it is crucial to make general people, including those engaging in the medical field, more aware of hospice. 79.7% answered that a national hospice management should be developed, marking a significant difference between the physician group and nurse group(x2=10.485, p=.001). 5.Advantages of hospice home care are 87.2% responded that patients can have better rest at home receiving hospice home care. Economical merit was brought forward as one of the advantages also, where there was a significant difference between the physicians group and nurse group(x2=7.009, p=.008). 6.The medical professions' attitude to hospice home care are 92.8% of the physicians answered that they would advise incurable terminally ill patients to be discharged from hospital, with 44.3% of them advising the patients to receive hospice home care after leaving the hospital. From the nurses' point of view, 20.9% of the terminally ill patients are being referred to hospice home care after discharge, which makes a significant difference from the physicians' response(x2=19.121, p=.001). 7. 30.6% of physicians have referred terminally ill patients to hospice home care, 75.9% of whom were satisfied with their decision. Those physicians who have never referred their patients to hospice home care either did not know how to do it(66.7%) or were afraid of losing trust by giving the patients an impression of giving up(27.3%). 94.9% of the physicians responded that they would refer their last stage patients to a doctor who is involving palliative care. 8.Only 36.2% of nurses have suggested to physicians that refer the terminally ill patients discharged from the hospital to hospice home care. Once suggested, 95.8% of the physicians have accepted the suggestion. Nurses were reluctant to suggest hospice home care to the physicians, as 48.8% of the nurses said they did not want to. From the result of this study the following conclusion can be drawn, the medical profession's awareness of general hospice care has been increased greatly compared to the results of the previously performed studies. However, this study result also shows that their knowledge of hospice home care is not good enough yet. There is a need for high recommended that medical education institute and develop regular courses on various types of hospice care. Medical field training courses for physicians and nurses will be very helpful as well. It is also important to train hospice experts such as palliative physicians and develop a national hospice management urgently in order to improve the hospice care in Korea.

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호스피스 간호사의 생명윤리의식과 환자중심간호가 임종간호태도에 미치는 영향 (The Effect of Bioethics Awareness and Patient-Centered Care on Attitude of Terminal Care of Hospice Nurses)

  • 서가원
    • 실천공학교육논문지
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    • 제15권2호
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    • pp.475-484
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    • 2023
  • 본 연구는 호스피스 간호사의 생명윤리의식과 환자중심간호가 임종간호태도에 미치는 영향을 파악하기 위해 수행된 서술적 조사연구이다. 대상자는 국내 병원의 호스피스 병동에서 근무하는 간호사 145명이다. 자료는 2018년 5월 1일부터 6월 30일까지 수집되었다. 자료의 분석은 SPSS 24.0 프로그램을 이용하여 서술적 통계, t-test, one way-ANOVA, Pearson 상관관계분석과 위계적 다중회귀분석을 실시하였다. 임종간호태도에 영향을 미치는 요소로는 호스피스 전문간호사 자격증(β=.15, p=.031), 생명윤리의식(β=-.24, p=.003)과 환자중심간호(β=.36, p<.001)가 나타났으며, 이 변수들은 임종간호태도를 39.6% 설명하였다. 본 연구의 결과를 토대로 호스피스간호사의 임종간호 향상을 위해서는 생명윤리의식을 포함한 환자중심간호 능력을 향상시키기 위한 프로그램이 제공되어야 한다.

간세포암 환자의 호스피스 완화 의료 (Hospice and palliative care for the terminal patients with hepatocellular carcinoma)

  • 길현자;문도호
    • 호스피스학술지
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    • 제7권2호
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    • pp.6-14
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    • 2007
  • Purpose: Hepatocellular carcinoma is the 3rd leading cause of cancer death in Korea and its prognosis is very poor. We aimed to investigate the clinical characteristics of terminal patients with hepatocellular carcinoma on admission into a hospice unit, and to know if they had received appropriate hospice and palliative care. Methods: We retrospectively reviewed the medical records in 62 patients with hepatocellular carcinoma who had admitted, received palliative care, and died in a hospice unit between January 2003 and December 2005. Results: The median age of patients was 56.5 years with 50 men(80.65%) and 12 women(19.35%) and gender ratio(male to female) was 417. Child-Pugh class A, B, and C were 6(9.68%), 22(35.38%), and 34(58.84%) respectively. We divided the patients into two groups and compared, the terminal HCC patients with class C as group I and those with class A & B as group 2. The median time from hospice referral to death was significantly short in group 1 with 15.5 days compared to group 2 with 53 days. Statistically more prevalent symptoms in group I were ascites, dyspnea, peripheral edema, and hepatic encephalopathy with abnormal laboratory findings (jaundice, hypoalbuminemia, or renal insufficiency). There, however, was no significant difference in complications and managements during admission between group 1 and 2. Conclusion: Most terminal HCC patients were often accompanied with chronic liver disease. The length of hospice and palliative care for above patients was not enough to attend them. Therefore, we suggest that proper education and information should be provided to physicians, patients, and their family members for effective hospice and palliative care.

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전인적 호스피스 간호중재 프로그램이 호스피스완화의료병동 입원 환자의 자아존중감과 영적안녕에 미치는 효과 (Effects of Holistic Hospice Nursing Intervention Program on Self Esteem and Spiritual Well-being for Inpatients of Hospice Palliative Care Unit)

  • 최성은;강은실
    • Journal of Hospice and Palliative Care
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    • 제12권4호
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    • pp.209-219
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    • 2009
  • 목적: 본 연구는 단일군 사전 사후 원시실험설계 연구로서 호스피스완화의료병동 입원 환자를 위한 전인적 호스피스간호중재 프로그램("무지개 프로그램")의 자아존중감과 영적안녕에 대한 효과를 검증하고자 하였다. 방법: 2004년 4월 6일부터 2005년 4월 20일까지 경북포항시 소재 선린병원의 호스피스완화의료병동에 입원한 만18세 이상의 성인 환자로서 의사소통이 가능하여 연구참여에 서면 동의한 27명을 대상으로 사전조사 후 2주간, 총 10회(회당 120분)로 구성된 전인적 호스피스 간호중재 프로그램 제공 후, 사후 조사를 실시하였다. 효과 검정을 위해 자아존중감 측정 도구로는 성인용으로 수정보완된 Self Esteem Questionnaire (SEQ), 영적안녕 측정도구로는 Spiritual Well-being Questionnaire를 사용하였으며, 자료분석은 SPSS/WIN 12.0 프로그램을 이용하여 Paired t-test로 분석하였다. 결과: 1. 가설 1 '전인적 호스피스 간호중재 프로그램을 제공받은 호스피스완화의료병동 입원환자(이하 실험군)는 실험 전보다 실험 후의 자아존중감 정도가 높을 것이다'는 지지되었다(t=11.554, P<0.000) 2. 가설 2 '전인적 호스피스 간호중재 프로그램을 제공받은 실험군은 실험 전보다 실험 후의 영적안녕 정도가 높을 것이다'는 지지되었다(t=6.387, P<0.000). 결론: 전인적 호스피스간호중재 프로그램은 호스피스완화의료병동 입원환자의 자아존중감과 영적안녕을 증진시키는 데 효과적이므로, 호스피스완화의료 병동에 입원한 말기환자를 위해 임상 실무에서 적용 가능하며, 호스피스 전문직의 다학제적 팀 접근 모델로 연구, 교육 측면에서도 유용하리라 생각한다.

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호스피스 자원봉사자 지망생들의 암에 대한 인식도

  • 문도호;최화숙
    • 호스피스학술지
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    • 제5권2호
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    • pp.15-21
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    • 2005
  • Purpose: This study was designed to evaluate the perception of cancer in aspirants for hospice volunteer. Methods: Aspirants for hospice volunteer were surveyed by questionnaire before education of hospice program in September 2005 at Pyongan Hospice Center of Sam Anyang Hospital. The questionnaire was composed of total 28 items. Ten items were general characteristics and the remaining 18 items knowledge, attitude and practice of cancer and cancer pain. The data were analyzed by SPSS WIN 11.0 program using frequency, mean, percentage. Results: Eighty nine questionnaires were returned. There were 6 males and 83 females, and median age of aspirants was 46 years. Forty five aspirants(51%) had a cancer patient in th family or relatives and the others 44(49%) not. Forty eight(54%) had favorable attitude about modern clinical medicine for cancer treatment and the others 39(44%) unfavorable. Fifty eight(65%) had favorable attitude about complementary and alternative medicine for cancer treatment and the others 20(23%). In response to the question about 'How illness is a cancer', 25 aspirants(25%) responded to chronic disease, 42(47%) suffering incurable disease, the others 17(19%) death sentence, respectively. A number of aspirants had wrong knowledge and understanding of cancer, cancer pain and opioid analgesics. Seventy one percent aspirants feared cancer pain. Conclusion: The credibility to modern clinical medicine for cancer treatment was relatively low in aspirants for hospice volunteer compared with complementary and alternative medicine. They recognized a cancer as suffering incurable disease and death sentence than chronic disease. A number of aspirants had wrong knowledge of cancer, cancer pain and opioid analgesics. Therefore, further studies and trial will be warranted to evaluated the causes of these results and improve the credibility of modern clinical medicine for cancer treatment in general population.

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호스피스자원봉사자가 지각한 호스피스자원봉사자 활동의 중요도 및 수행도 (The Importance and Performance of Hospice Volunteer's Activities Perceived by Hospice Volunteers)

  • 전명화;이병숙
    • Journal of Hospice and Palliative Care
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    • 제12권3호
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    • pp.122-131
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    • 2009
  • 목적: 본 연구는 호스피스자원봉사자가 지각한 자원봉사자 활동의 중요도 및 수행도를 파악하고자 수행되었다. 방법: 연구대상은 대구와 경북지역 소재 6개 종합병원의 호스피스 병동 및 호스피스 팀에서 활동하고 있는 자원봉사자 259명이다. 대상자가 지각한 자원봉사자 활동에 대한 중요도 및 수행도 조사를 위해 문헌고찰 및 호스피스자원봉사자 면담을 기초로 작성된 호스피스자원봉사자 활동 목록이 사용되었다. 자료수집 기간은 2007년 9월부터 10월까지였다. 수집된 자료는 SPSS WIN 12.0을 이용하여 서술통계, T-test, One-way ANOVA와 사후검정으로 Scheffe test, Pearson's product-moment correlation 등으로 분석 하였다. 결과: 호스피스자원봉사자가 지각한 자원봉사활동 중요도의 평균은 3.09점, 수행도는 2.31점으로서 중요도에 비해 수행도가 상대적으로 낮았다. 대상자가 지각한 자원봉사자 활동의 중요도와 수행도에는 유의한 상관관계가 있었다(r=.487, P=.000). 대상자의 종교, 교육수준 및 자원봉사활동 기간에 따라 자원봉사자 활동에 대한 중요도 지각에 유의한 차이가 있었다. 대상자의 연령, 종교 및 자원봉사활동 기간에 따라 자원봉사활동 수행도에 유의한 차이가 있었다. 결론: 호스피스자원봉사자가 지각한 자원봉사자 활동의 중요도는 높은 수준이었으나 수행도는 여기에 미치지 못하고 있었으며, 일부 자원봉사자의 특성이 호스피스자원봉사자 활동에 대한 중요도 지각과 수행도에 영향을 미치고 있음을 알 수 있었다. 이상과 같은 본 연구의 결과는 호스피스자원봉사자 교육 프로그램 개발 시에 기초 자료로 활용될 수 있을 뿐 아니라 자원봉사자에 대한 효율적 관리에도 활용될 수 있을 것으로 사료된다.

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