• The Korean journal of internal medicine
• /
• 제33권6호
• /
• pp.1039-1049
• /
• 2018

The populations of Asian countries are expected to age rapidly in the near future, with a dramatic increase in the number of heart failure (HF) patients also anticipated. The need for palliative and end-of-life care for elderly patients with advanced HF is currently recognized in aging societies. However, palliative care and active treatment for HF are not mutually exclusive, and palliative care should be provided to reduce suffering occurring at any stage of symptomatic HF after the point of diagnosis. HF patients are at high risk of sudden cardiac death from the early stages of the disease onwards. The decision of whether to perform cardiopulmonary resuscitation in the event of an emergency is challenging, especially in elderly HF patients, because of the difficulty in accurately predicting the prognosis of the condition. Furthermore, advanced HF patients are often fitted with a device, and device deactivation at the end of life is a complicated process. Treatment strategies should thus be discussed by multi-disciplinary teams, including palliative experts, and should consider patient directives to address the problems discussed above. Open communication with the HF patient regarding the expected prognosis, course, and treatment options will serve to support the patient and aid in future planning.

• Journal of Hospice and Palliative Care
• /
• 제24권3호
• /
• pp.154-164
• /
• 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
• /
• 제24권1호
• /
• pp.13-25
• /
• 2021

Purpose: This descriptive study aimed to explore nursing workplace spirituality, end-of-life care stress, and resilience as factors influencing compassion fatigue among nurses working in hospice and palliative care units. Methods: Data were collected using a self-report questionnaire completed by 146 nurses at 14 hospice and palliative care institutions across South Korea who had worked in a hospice and palliative care institution for at least 6 months and had experience providing end-of-life care. Data were collected from February 25, 2019 to April 12, 2019, and analyzed using SPSS for Windows version 18.0. As appropriate, descriptive statistics, the t-test, analysis of variance, the Scheffé test, Pearson correlation coefficients, and stepwise multiple regression were used. Results: The survey results showed that factors influencing compassion fatigue were resilience, subjective health status, current satisfaction with the hospice ward, and end-of-life care stress. Higher levels of resilience, a subjective health status of "healthy", high levels of current satisfaction with the hospice ward, and lower levels of end-of-life care stress were associated with lower levels of compassion fatigue, explaining 42.9% of the total variance. Conclusion: The results of this study suggest that resilience is an important factor mitigating compassion fatigue among nurses at hospice and palliative care institutions. Therefore, intervention programs should be developed to reduce compassion fatigue.

• 한국농촌간호학회지
• /
• 제16권2호
• /
• pp.60-68
• /
• 2021

Purpose: This case report was attempted to present the process of the end of life nursing care provided by the visiting nurse. Methods: The subject was a person who was decided the long-term care Grade 1 and received a visiting nursing service, and the service was terminated on the death, and then was selected as a case with the consent of his family. The data were collected through long-term care benefit provision records and interviews with the visiting nurse. The nursing process was presented by applying the Omaha System. Results: The subject had digestion-hydration problems and respiration problems in the physiological domain, and the problems of role change, caretaking/parenting, spirituality, and grief in the psychosocial domain were identified. Depending on the problem, the end of life nursing care was provided to the subject and family members through activities on physical symptoms/signs, dietary management, end-life care, and coping skills. Conclusion: We expect that if the visiting nurse provides anticipatory guidance on the death process, the subject will be able to prepare for death comfortably with the family at home instead of vague fear of death.

• 가정∙방문간호학회지
• /
• 제30권3호
• /
• pp.276-286
• /
• 2023

Purpose: This study aimed to assess the effect of palliative care practical training for nursing students. Methods: This quasi-experimental study included 38 third-grade nursing students form one university. Practical training, develooed by experts, was provided for 2 weeks (90 h) in a palliative care hospital. Participants received education on palliative care but no clinical practical experience. Collected data were analyzed using independent t-test, χ² test and paired t-test using the WIN SPSS 23.0 program. Results: Students showed significant pretest-posttest differences in attitude toward death (t=-2.43, p=.021), end-of-life nursing attitude (t=3.90, p=<.001) and spiritual nursing competency (t=3.82, p=.001). Conclusion: The study results revealed that palliative care practical training was an effective learning method to improve nursing attitude, toward death, end-of-life nursing attitude and spiritual nursing competency. Further studied are needed to assess the effects of various education programs of palliative care.

• 대한간호학회지
• /
• 제48권1호
• /
• pp.59-69
• /
• 2018

Purpose: The purpose of this study was to investigate variables and construct paths that affect complicated grief. Methods: Participants in this cross-sectional, descriptive study were 164 bereaved spouses of cancer patients at least 12 months before the death. Data were collected from October 2016 to February 2017 using self-report structured questionnaires and were analyzed using IBM SPSS 21.0 and AMOS 20.0. Results: The variables affecting complicated grief of bereaved spouses of cancer patients were the quality of end-of-life care (${\gamma}=.15$, p<.001), preparedness for death (${\beta}=-.06$, p=.005), and coping with bereavement (${\beta}=-.24$, p<.001), whereas the quality of death and dying did not show any effects. Preparedness for death had multiple mediating effects in the relationship between the quality of end-of-life care and complicated grief (z=-2.20, p=.028), and in the relationship between the quality of end-of-life care and coping with bereavement (z=2.11, p=.035). Coping with bereavement had a mediating effect on the relationship between preparedness for death and complicated grief (z=-2.39, p=.017). Conclusion: This study revealed that preparedness for death and coping with bereavement play a prominent role in complicated grief. Therefore, it is important to help in preparing for death and enhancing coping with bereavement of spouses providing end-of-life care to cancer patients. In addition, investigating cultural differences in the relationship between the quality of end-of-life care and complicated grief is recommended.

• 한국공작기계학회논문집
• /
• 제14권3호
• /
• pp.1-7
• /
• 2005

The prediction for tool life is one of the most important factors for increasing reliability, stability, and productivity of manufacturing system. This paper deals with a tool life prediction method in view of reliability assessment for cutting tools. In this study, flank wear was focused among multi-factors deciding the tool wear state. First, tool life was predicted by correlation between flank wear and cutting time, based on the extended Taylor tool life equation of turning, including parameters of cutting speed, feed rate, and cutting depth. Second, each of cutting conditions of end-milling was equivalently converted to apply ball end-mill data to the extended Taylor equation. The web-based prediction program for tool life was developed as one of reliability assessment programs for machine tools.

• Journal of Hospice and Palliative Care
• /
• 제16권4호
• /
• pp.223-231
• /
• 2013

목적: 본 연구는 간호사의 품위 있는 죽음태도와 도덕적 민감성 정도가 임종간호수행에 미치는 영향요인을 파악하여 인간존엄성을 바탕으로 한 임종간호수행의 질적 수준 향상에 도움이 될 기초 자료를 제시하고자 시도되었다. 방법: 1개 도시의 3차 의료기관에서 근무하는 간호사를 대상으로 172명을 편의 표집 하였다. 구조화된 설문지에는 품위 있는 죽음, 도덕적 민감성, 임종간호수행을 포함하였다. 자료는 기술통계, 피어슨 상관계수 및 다중회귀분석을 이용하여 분석하였다. 결과: 주요 결과로서 대상자의 임종간호수행에 영향을 미치는 요인은 도덕적 민감성, 품위 있는 죽음태도, 교육수준의 순으로 나타났다. 이는 간호사의 도덕적 민감성이 높고, 품위 있는 죽음 태도가 긍정적이며, 교육수준이 높을수록 임종간호수행 정도가 높다는 것으로 확인되었다. 결론: 본 연구 결과는 웰빙에서 웰다잉으로 사회적 관심이 옮아가는 시대적 요구에 비추어 볼 때, 임종간호수행의 질적 수준 향상을 위해서는 간호사의 품위 있는 죽음태도와 도덕적 민감성을 배양할 노력이 필요함을 시사한다. 또한 의료현장의 복합적인 의사결정 과정에서 간호사의 옹호자 역할 수행을 위해 의사-간호사간의 상호 역기능적 갈등을 조정하는데 필요한 효율적인 임종교육 프로그램 개발의 기초 자료가 될 것이다.

• Journal of the Korean Wood Science and Technology
• /
• 제36권6호
• /
• pp.59-68
• /
• 2008

본 연구에서는 엔드테이핑(End-taping) 처리가 두께가 20~75 mm이고, 직경이 120~470 mm인 백합나무 원반들의 고주파진공건조중 건조결함 예방 미치는 영향에 대하여 조사하였다. Inside end-taping (Inside-ET)과 Outside end-taping (Outside-ET)의 경우 두께 33 mm, 직경 270 mm 이하 원반에서 할렬의 예방효과가 우수하게 나타났다. 직경이 30 cm 이하이고, 두께 60 mm와 두께 75 mm의 원반에서도 전처리을 통하여 경계할렬을 예방할 수 있을 것으로 기대되었다. 경계할렬의 발생위치는 0.50~0.63 diameter 지점으로서 직경에 따라서 상이하였으며, 따라서 횡단면의 부분 엔드테이핑 처리의 경계선도 원반의 직경 따라 적정하게 선정할 필요가 있는 것으로 조사되었다. 중경재의 경우 0.3 diameter 지점이 경계할렬 예방을 위한 전처리의 경계점일 가능성이 높을 것으로 해석된다. 대경재의 경우 경계할렬과 V형 크랙에 의한 손상이 매우 심하였으며, 이는 방사방향으로의 함수율 분포변이가 극심한 백합나무 고유의 재질특성에 기인한 것으로 해석된다. 따라서 대경재의 경우 원반으로 활용하는 것은 적절하지 않는 것으로 생각된다.

• 대한안전경영과학회지
• /
• 제12권3호
• /
• pp.327-332
• /
• 2010

It is necessary that End-of-life Vehicle (ELV) should be recycled from the point of view of environmental preservation and resource recycling. This paper deals with two issues. The first one is the basic functional construction and plant layout of the ELV dismantling system that can maximize the reusability of parts and the recyclability of materials. The second issue is the development of a simulation model which can be used to estimate the performance of the layout design. The simulator has been interfaced with an interactive layout design system, and used to effectively determine an optimal layout design of the ELV dismantling system.