• 한국보건간호학회지
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• 제30권3호
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• pp.420-433
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• 2016

Purpose: This study was performed to identify the nursing needs of home-dwelling breast cancer patients based on counseling contents. Methods: Descriptive research was conducted with content analysis. This study included 185 patients who underwent treatment for breast cancer in a tertiary hospital. The data were collected using personal counseling via telephone or face-to-face between March 2011 and July 2013. A total of 536 counseling contents were used in the analysis. Inductive content analysis was used to analyze the contents related to nursing counselling. Results: According to the results. the most frequently reported nursing needs was symptom management, followed by information needs and supportive intervention needs; symptom management needs included symptoms related to chemotherapy, daily living, surgery, and medication side effects; information needs included treatments, medication, clinical tests, and alternative therapies; and supportive intervention needs were related to emotional and social aspects. Conclusion: Our findings suggest that nursing interventions for home-dwelling breast cancer patients should be designed and provided with a consideration to these relevant nursing needs.

• Journal of Hospice and Palliative Care
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• 제4권2호
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• pp.154-160
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• 2001

Purpose : This study, as the first year project of setting up a community based management system, was attempted for the cancer patients and their family to improve their quality of life; investigating and managing the cancer patients, educating volunteers and connecting the patients with the volunteers were performed. Method and result : The education of managing cancer patients for the volunteers was done once in lune for 2 days to the 80 volunteers. Questions about education effect, volunteer motivation and so on were made up. The survey showed, generally, education satisfaction level was high and a longer education and an intensive course were needed and was suggested that organizing a volunteer community be needed for the continuous further education and systematic management. As the result, after the public health center and volunteers deliberated, a volunteer community consisting of 4 teams, 28 members was organized, launched in Oct. and operated for the cancer patients and their family. For investigating and enrolling the patients, advertising on a local information paper, recommending of local doctors, publicizing by educating the heads of a subdivision of the city, the heads of a neighborhood association and the people in charge of the related local communities such as women's society, and surveying the community by volunteers were performed and the total, 41 patients were registered. Management of cancer patients was carried out by volunteers in a community and in a nursing school. A regional volunteers' community is composed of 23 members and they have worked 87 times, that is 3.8 times per capita on an average. The content of duties is attending the education (41.1%) the most. A volunteers' community of nursing students composed of 12 members have worked 135 times, that is 11.3 times per capita on an average. The content of duties - consulting with patients and home visiting (37.8 %) were the most and survey for investigating the cancer patients was the second. Conclusion : This study has the meaning that this is the guiding attempt in building a community based management system, and especially the achievement of this study is that a regional society organized a volunteer community for the cancer patients by itself and went into action for the cancer patients and their family. Furthermore, to activate this volunteering, it is necessary to keep managing volunteers and running continuing education or the intensive course of the volunteers. Indeed we should let the patients have good impression on this program through publicity and education for the residents to keep track of more cancer patients. For that, systematic and powerful cooperation of a self-administrative organization is required.

• Journal of Hospice and Palliative Care
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• 제25권2호
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• pp.76-84
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• 2022

Purpose: We compared cost-effectiveness parameters between inpatient and home-based hospice-palliative care services for terminal cancer patients in Korea. Methods: A decision-analytic Markov model was used to compare the cost-effectiveness of hospice-palliative care in an inpatient unit (inpatient-start group) and at home (home-start group). The model adopted a healthcare system perspective, with a 9-week horizon and a 1-week cycle length. The transition probabilities were calculated based on the reports from the Korean National Cancer Center in 2017 and Health Insurance Review & Assessment Service in 2020. Quality of life (QOL) was converted to the quality-adjusted life week (QALW). Modeling and cost-effectiveness analysis were performed with TreeAge software. The weekly medical cost was estimated to be 2,481,479 Korean won (KRW) for inpatient hospice-palliative care and 225,688 KRW for home-based hospice-palliative care. One-way sensitivity analysis was used to assess the impact of different scenarios and assumptions on the model results. Results: Compared with the inpatient-start group, the incremental cost of the home-start group was 697,657 KRW, and the incremental effectiveness based on QOL was 0.88 QALW. The incremental cost-effectiveness ratio (ICER) of the home-start group was 796,476 KRW/QALW. Based on one-way sensitivity analyses, the ICER was predicted to increase to 1,626,988 KRW/QALW if the weekly cost of home-based hospice doubled, but it was estimated to decrease to -2,898,361 KRW/QALW if death rates at home doubled. Conclusion: Home-based hospice-palliative care may be more cost-effective than inpatient hospice-palliative care. Home-based hospice appears to be affordable even if the associated medical expenditures double.

• 융합정보논문지
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• 제9권2호
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• pp.65-74
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• 2019

본 논문은 재가암환자를 위한 융합적 통합지지 프로그램의 적용 및 효과를 검증하기 위한 단일군 전 후 실험설계 연구이다. 연구 대상은 J시 재가암환자 33명을 대상으로 주 3회, 10주, 총 30회기 동안 암 관련 지식 교육, 스트레스 관리, 인지 행동적 접근, 활력 충전 운동으로 구성된 융합적 통합지지 프로그램을 제공받았다. 연구 결과 재가암환자를 위한 융합적 통합지지 프로그램은 대상자의 스트레스를 감소시키고, 희망과 자아존중감을 향상시키는 효과가 있는 것으로 나타났다. 이에 본 프로그램은 재가암환자에게 적합한 융합적 통합지지 프로그램으로 사료되며 향후 각 지역 보건소나 암생존자를 위한 중재 프로그램을 수행하는 지역사회 기관으로 확대하여 대상자들이 지속적으로 프로그램에 참여할 수 있는 간호중재 전략의 모색이 필요하다고 사료된다.

• Journal of Hospice and Palliative Care
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• 제17권4호
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• pp.223-231
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• 2014

목적: 본 연구의 목적은 말기암환자로서 가정호스피스 돌봄을 받고 있는 대상자의 삶의 경험에서 얻어지는 현상을 이해하고 경험의 본질을 이해하고자 함이다. 방법: 가정호스피스 돌봄을 받고 있는 말기암환자 10명으로부터 심층면담을 통해 자료를 수집하였고 Colaizzi의 현상학적 방법을 사용하여 분석하였다. 결과: 의미 있는 진술에서 구성된 의미가 도출되고, 구성된 의미에서 주제 및 주제모음을 확인하여 범주화 한 결과, '삶의 질 저하', '남은 삶의 수용', '신앙으로 준비된 죽음', '고마움', '부정적 대처'의 범주가 도출되었다. 결론: 가정호스피스 돌봄을 받고 있는 말기암환자들의 삶의 경험을 이해하고, 호스피스 간호를 통해 대상자가 부정적인 삶의 경험을 극복하고, 긍정적인 삶의 경험을 할 수 있도록 체계화된 호스피스 간호의 제공이 필요하다.

• 지역사회간호학회지
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• 제23권2호
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• pp.127-133
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• 2012

Purpose: This study was conducted to assess needs at each end-of-life care stage and to analyze importance and difficulty of care needs for home care nursing among non-cancer patients. Methods: We used a retrospective design. Total eligible patients were 117 at the ages of 40 and over, who continuously received home care nursing throughout beginning, stable, and near death stages, and finally died at home from January 1, 2006 to December 31, 2006. Descriptive statistics, Cochran's Q test, Friedman's test were used for data analysis. Results: In the area of physical care, the care need for 'assistance for activities in daily life' was significantly highest in the beginning stage. The care need for 'aggravation or adverse changes in physical symptoms' was significantly increased in the near death stage. In the area of psychospiritual care, 'family's psychological burden' was revealed as having the highest rate of care needs in the every stage. Conclusion: Future intervention should consider assessing care needs in end-of-life care for non-cancer patients who are provided with home care nursing.

• 가정간호학회지
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• 제14권2호
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• pp.65-75
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• 2007

Purpose: This study was conducted to provide fundamental information for policy integration of the home health care system. Methods: Focused review was performed from 8 studies out of 48 literature related to home care needs. Results: Females utilized home care based on hospital and public health centers at a higher rate than males. While there had been more rate of the elderly above 60 year-old at hospital and community based home care, on the other hand below 45 year-old at public health center. The most common disease amongst users in all three types was cerebrovascular disease, the second was cancer based at hospitals, hypertension and arthritis at public health centers. There were more needs for those using artificial respiratory equipment, cancer patients, and puerpera. However, the needs for hospital and community based home care were very similar. Conclusions: Due to similar disease characteristics but varied severity at the three home care based settings, they should be managed with flexibility. Home care curriculum should be developed according to common disease type, and home care services should be strengthened for its expertise.

• 임상간호연구
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• 제19권3호
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• pp.443-454
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• 2013

Purpose: The purpose of this study was to evaluate the effects of periodic reminding interventions on medication adherence, self-efficacy, and pain intensity for home-based lung cancer patients. Methods: A quasi-experimental nonequivalent control group, pretest and posttest design was used. The intervention comprised of individual education by tailored image-combined medication instructions, daily reminding text message, and weekly telephone calls for four weeks. The subjects in this study consisted of 62 lung cancer patients (31 in the experimental group, and 31 in the control group). Mann-Whitney U-test was applied to analyze the data. Results: Experimental group who received periodic reminding intervention program better adhered to prescribed medication compared to the control group (z=-6.14, p<.001). Experimental group demonstrated higher level of self-efficacy compared to the control group (z=-6.74, p<.001). Experimental group experienced less intense average pain compared to the control group (z=-6.29, p<.001). Conclusion: The findings suggest that periodic reminding interventions can be applied as an effective nursing intervention to promote medication adherence and self-efficacy to improve and pain management for home-based lung cancer patients.

• 가정간호학회지
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• 제15권2호
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• pp.99-105
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• 2008

Purpose: We evaluated patient nutritional status in a home care setting. Method: We recruited 81 patients who received in-home care using a screening sheet. The level of nutrition-related serum marker (albumin) was checked via medical records and data analyzed using descriptive analysis, t-tests, and $X^2$-test. Results: Nutritional status varied according to the primary medical diagnosis. Poor nutritional status was significantly higher in cancer patients than in other diseases. Serum albumin levels were significantly lower in the malnutrition group than the good nutrition group. Conclusions: Nutrition screening can determine the nutritional status in home care patients. Home care nurse practitioners should consider nutritional status when assessing patient health.

• Journal of Hospice and Palliative Care
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• 제10권4호
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• pp.195-201
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• 2007

목적: 본 연구에서는 전국의 시 군 구 보건소 재가 암환자 관리사업의 객관적 실태분석의 일환으로 재가 암환자 관리 사업의 주 대상자인 재가 암환자를 대상으로 개발된 조사도구를 이용하여 그들의 재가 암환자 관리 요구도와 제공정도를 파악하는데 목적이 있다. 방법: 재가암환자 관리사업의 요구도 및 제공정도로 구성된 설문지를 개발 조사하고 수집된 자료는 SPSS WIN 12.0을 이용하여 빈도와 백분율을 중심으로 분석하였다. 결과: 현재 재가 암환자 관리사업을 통해 제공되고 있는 서비스를 신체적, 정서적, 영적, 교육정보적 서비스로 나누어 재가 암환자들을 대상으로 조사한 결과 요구도와 제공정도는 정서적 서비스에서 가장 높고 다음으로 교육 정보적 서비스, 영적 서비스, 신체적 서비스 순으로 조사되었다. 각 서비스별 주요 항목을 살펴보면 신체적 서비스의 경우 통증조절은 요구도에 비해 그 제공정도가 낮았고 반면 배설장애조절과 개인위생은 요구도에 비해 그 제공정도가 높은 것으로 나타났다. 또한 정서적 서비스의 경우 전반적으로 요구도와 제공정도가 높았고 영적 서비스의 경우 요구도에 알맞게 서비스가 제공되고 있는 것으로 나타났다. 결론: 본 연구는 보건소 재가암환자 관리사업에 대한 환자의 서비스 요구도와 실제 제공받은 서비스 정도를 분석한 연구로서 향후 재가 암환자의 요구도에 근거한 효율적 프로그램 개발의 기초자료로 활용이 가능할 것으로 사료된다.