• 한국간호교육학회지
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• 제9권2호
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• pp.329-339
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• 2003

The purpose of this study is to consider of meaning in life based on Frankl's theory and to propose of hospice nursing according to conceptual framework of meaning in life. The conceptual framework of meaning in life is composed of 4 phases. According to the first phase, acceptance & awareness of self and life, hospice nurse should helps dying patient to accept limitedness of human existence and death. and according to the second phase, actualization of creative value, hospice nurse can helps dying patient to discover meaning in life through doing a deed for last time before his death. According to the third phase, actualization of experiential value, hospice nurse can helps them to discovery of meaning by experiencing of love through meetings with other people, nature, and god. According to the forth phase, actualization of attitudinal value, hospice nurse can helps them to discovery of meaning by realizing meaning in suffering and death through exercising of the inner freedom to choose bravery and acceptance in the face of death and misfortune. As mentioned above, the Frankl's theory accords with the core of hospice nursing that helps people to accomplish human essence in suffering and death. therefore we accepted Frankl's point of view, asserted that one of the most important roles of a hospice nurse as a supporter and sustainer for dying patients is to help patients to find meaning in life even in the course of death. To achieve the goal, hospice nurses should try to have a firm faith through philosophical introspection about life, death, human existence and meaning in life what the most important goal of life is to discover meaning in life and human have the duty and responsibility of recognizing and pursuing meaning up to the last moment of life.

• Journal of Hospice and Palliative Care
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• 제26권2호
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• pp.95-100
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• 2023

With the implementation of Act on Hospice and Palliative Care and Decisions on Life-Sustaining Treatment for Patients at the End of Life, interests of the general public on self-determination right and dignified death of patients have increased markedly in Korea. However, "self-determination" on medical care is misunderstood as decision not to sustain life, and "dignified death" as terminating life before suffering from disease in terminal stage. This belief leads that physician-assisted suicide should be accommodated is being proliferated widely in the society even without accepting euthanasia. Artificially terminating the life of a human is an unethical act even though there is any rational or motivation by the person requesting euthanasia, and there is agreement thereof has been reached while there are overseas countries that allow euthanasia. Given the fact that the essence of medical care is to enable the human to live their lives in greater comfort by enhancing their health throughout their lives, physician-assisted suicide should be deemed as one of the means of euthanasia, not as a means of dignified death. Accordingly, institutional organization and improvement of the quality of hospice palliative care to assist the patients suffering from terminal stage or intractable diseases in putting their lives in order and to more comfortably accept the end of life physically, mentally, socially, psychologically and spiritually need to be implemented first to ensure their dignified death.

• 호스피스학술지
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• 제6권2호
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• pp.55-68
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• 2006

In Korea, there are constantly increasing number of cancer patients with reaching 65,000 deaths and it was 26.3% of the total number of death in 2004. Many cancer patients suffer from surgery, chemotherapy, and radiotherapy after being diagnosed as cancer. And many of them are facing fear of death because they can't be perfectly cured. Due to patients' physical, psychological, and spiritual pain, quality of life drops dramatically. Patients' families also suffer from huge medical expenses while they have to take care of patients's suffering from pain. At the same time, family's attitude can influence on the quality of patients' life. The purpose of this study is to investigate the relationship between the death orientation of first care giver and the quality of life of hospice patient. The subjects of the study were 80 hospice patients registered at ten hospice institutions with hospice team and medical practitioners in six cities including Seoul as well as their first care givers. This study used 13 questions for the hospice patients and nine questions for the first care givers to recognize general characteristic. To measure death orientation of the first care giver the tool developed by Noh, Soon-hee (2003) was used. And to measure quality of life of the hospice patients Yoo, Seung-yeon's structured tool was used. The data were collected for a month through interview method. SPSS win 12.0 was used to analyze the data by using frequency, percentage, t-test, Pearson correlation. The study result is as follows. In relationship between general characteristic of hospice patient and quality of life, the highest suffering was pain (60%) and the second suffering was anorexia (23.8%). There was no significant relationship between physical pain and general characteristics of hospice patient. In psychological aspects, religion (p=.044) showed significant difference (p<.05). In existential aspects, age (p=.035) showed significant difference (p<.05). There was no significant difference variable in support aspects. And religion (p=.000) was statistically significant variable in spiritual aspects (p<.001). Age (p=0.025) and religion (p=.050) were the variable showed significant difference according to general characteristics of first care giver's death orientation. Although the relation between death orientation of first care giver and quality of life of hospice patient was not statistically significant correlation. In conclusion, while death orientation of first care giver and hospice patient's quality of life are not statistically significant in correlation analysis.

• 여성건강간호학회지
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• 제7권2호
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• pp.121-130
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• 2001

Although the general concept of suffering care includes palliative care technology for terminally ill person to alleviate his pain, it is much more holistic including emotional, spiritual and other life dimension. This inclusive concept of caring can be possible with the fundamental reflection on the human suffering. Far from the concept of pain understood in the context of materialist medical approach, human suffering has many dimensions including aesthetic, psychological, and religious: its meaning is holistic. With this perspective, the experience of the suffering client must be reconsidered before one starts with an objective side or a subjective side of suffering. Indeed, the actual strategies of suffering care can be different depending on the definition of human suffering accepted by practicians. In this caring perspective, the body, mind and spirit are integrated so the objectivity and subjectivity can merge; the extended awareness with inner resource or energy, and the positive thinking about the God is meaningful especially for dying person, his family members and the caring team. Despite this impending importance of the inclusive understanding of human suffering, the actual nursing practice still does not reflect this growing understanding of human suffering. This approach, which tried to pursuit the more fundamental meaning of human suffering, can contribute to the development of nursing education and practice which pay attention to the more inclusive view of human suffering.

• Clinical and Experimental Pediatrics
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• 제52권8호
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• pp.843-850
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• 2009

A recent High Court's decision regarding the withdrawal of life supporting medical treatment (artificial ventilator) from an elderly female patient in the terminal stage has opened up a new era of the "euthanasia dispute" in Korea. With this decision, the legitimate withdrawal of life supporting treatment became possible under certain conditions and the Korean Medical Association is working toward the establishment of practical guidelines for the terminal-stage patients. However, there are still very few debates on the cases of pediatric patients in the terminal stage or suffering from fatal diseases. For pediatric patients, the core principle of autonomy and following procedure of "advance directives" are hardly kept due to the immaturity of the patients themselves. Decisions for their lives usually are in the hands of the parents, which may often bring out tragic disputes around "child abuse", especially in Korea where parents have exclusive control of the destiny of their children. Some developed countries such as the U.S.A., the U.K. and Canada have already established guidelines or a legal framework for ensuring the rights of the healthcare system regarding children suffering from severe illness, permitting the withdrawal of Life supporting medical treatment (LSMT) in very specific conditions when the quality of life of the children is severely threatened. For the protection of the welfare and interest of the children, we should discuss this issue and develop guidelines for the daily practice of pediatricians.

• 대한간호학회지
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• 제47권1호
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• pp.110-120
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• 2017

Purpose: The purpose of this study was to describe the lived experience of patients with heart transplantation in Korea. Methods: Individual indepth interviews and a focus group interview were used to collect the data from nine patients who had heart transplantations in 2015. All interviews were audio-taped and verbatim transcripts were made for the analysis. Data were analyzed using Colaizzi's phenomenological method. Results: Among the nine participants, eight were men. Mean age was 57.30 years. Six theme clusters emerged from the analysis. 'Joy of rebirth obtained by good luck' describes the pleasure and expectation of new life after narrow survival. 'Suffering from adverse drug effects' illustrates various psychosocial difficulties, such as low self-esteem, helplessness, alienation, and burnout, arising from the side effects of medications. 'Body and mind of being bewildered' illustrates disintegrated health and haunting fear of death. 'Alienation disconnected with society' describes isolated feeling of existence due to misunderstandings from society. 'Suffering overcome with gratitude and responsibility' includes overcoming experience through various social supports and suitable jobs. Finally, 'acceptance of suffering accompanied with new heart' illustrate changed perspective of life itself. Conclusion: The findings in this study provide deep understanding and insights of the lived experience of heart related illness for these patients and should help in the development of tailored-interventions for patients with heart transplantation.

• 호스피스학술지
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• 제5권2호
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• pp.54-63
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• 2005

The purpose of this study is to examine the requirement for child life support specialist and fetal education for children with cancer. This research presented was composed with three chapters : First chapter, I presented the purpose, scope and definitions of this research. Second chapter, I defined about hospice care service for children with cancer and kind of pediatric cancer. And general characteristics of children with cancer, a understanding character of death and dietary therapy. Lastly, I defined and investigated about spiritual care. Third chapter, I concluded with some of findings and final suggestions based on the results. According to the developmental stages children with cancer are disability of communication competence and more dependence on their parents, therefore parents' decision making were more difficulty. And parents with a child who suffers from a cancer needs a counseling in order to discover the meaning of life. Parents' psychological experience about the caring for their child suffering from pediatric cancer was equal to broken hearts due to shadow of the child's death from time to time. In other words a parents with a child who suffers from a cancer needs comprehensive services such as hospice, consultor as well as wide experienced pediatrician and nurse. Child life support specialist can help them recover and improve their o주 potential strength in behalf of overcoming their difficulties. And pastoral counseling can help them reduce the fear and anxiety about unknown world and death. The systematically developed a school-based counseling program would help children adjust to the difficulties after a perfect cure because of children adjusted to school well when they have good peer relationships.

• 디지털융복합연구
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• 제15권5호
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• pp.241-251
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• 2017

본 연구는 보건계열 대학생들의 죽음인식 태도와 관련 요인을 조사하여 죽음의 태도에 대한 기초자료로 활용하고자, 2015년 12월 1일부터 30일까지 G지역 대학생 314명을 대상으로 조사하였다. 분석결과 죽음인식 수준은 2.04점으로 보통수준이며, 평균점수는 고통불안 2.49점, 죽음불안 1.95점, 내세불안 1.86점으로 나타났다. 죽음인식 하위영역은 연령, 학년, 건강상태, 생활정도에서 유의한 차이를 보였다. 고통불안, 죽음불안, 내세불안은 각각 상관관계가 있는 것으로 나타났다. 여성은 죽음불안과 내세불안에 영향을 미치며, 2학년은 고통불안과 내세불안, 건강상태는 고통불안, 생활정도는 고통불안, 죽음불안, 내세불안에 영향을 미치는 것으로 나타났다. 죽음이 현실과는 멀게만 느껴져 죽음에 대한 두려움이 크지 않았다. 그러나 죽음에 대한 올바른 인식은 보다 평화로운 죽음으로 이끌 수 있으며, 현재의 삶을 더욱 보람되게 살 수 있다. 죽음과는 거리가 먼 대학생들에게도 의미 있는 삶을 살아갈 수 있도록 죽음 준비교육이 필요할 것으로 사료된다.

• 가정과삶의질연구
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• 제32권6호
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• pp.1-18
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• 2014

This study explored the sandplay therapy case of a middle school-aged boy having severe conflicts with his mother, from the viewpoints of initiation. The goal of the therapy was to lessen the boy's conflicts with his mother within the free and protected space in sandplay therapy. Thirty-seven therapy sessions were held. The client showed the scene of having fun in the water in the most unconscious part of the tray in the initial phase of therapy (1, descending into the unconscious). In the intermediate phase of therapy (2~33, a period of suffering, confrontation with death and trials), he showed suffering, was confronted with death and underwent trials. In the final phase of therapy (34~37, seeking masculine principles and rebirth), he began to seek masculine principles instead of having conflicts with his mother and was reborn. Using sandplay therapy in a free and protected space, this study showed the effectiveness of sandplay therapy since the boy's severe conflicts with his mother were lessened. This study also confirmed the existence of an archetypal pattern in the male adolescent's psyche.

• 대한간호학회지
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• 제41권2호
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• pp.214-224
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• 2011

Purpose: Understanding daily life experiences of patients admitted to hospital with recurrent breast cancer. Methods: The grounded theory method was used for this study. Results: Consistent comparative analysis was used throughout the study to obtain the results. Results showed that inpatients with recurrent breast cancer experience 'a co-existence of life suffering and fear of death'. The causal condition of this result was determined to be 'patient's response to cancer recurrence (acceptance/despair)', including contextual conditions such as, 'previous experience with cancer treatment', 'patient's current physical condition', and 'treatment methods for recurrent cancer'. Intervening conditions, such as 'a strong will to live', 'family support', 'moral support providers', and action/interaction strategies were found to provide patients with 'a strength to live'. Shown in these results, inpatients with recurrent breast cancer were seen to have a simultaneous 'hope for life and fear of death'. Conclusion: When providing nursing services to inpatients with recurrent breast cancer, people must recognize there is a notable difference between individual patients' contextual conditions and interactive strategies. Henceforth, proper cognitive nursing must be provided which encourages patients to maintain a strong will to overcome the many hardships of treatment as well as physical nursing, such as management of side effects caused by chemotherapy.