• 성인간호학회지
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• 제16권3호
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• pp.378-387
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• 2004

Purpose: The study was undertaken to examine the degree of nurse's suffering experience and to identify the influencing factors on nurses' suffering experience in Korea. Method: Data were collected using a questionnaire for 271 nurses working at 5 general hospitals in Daegu and Kyung-book province from Sep. 1, to Sep. 30, 2003. The questionnaire consists of 54 items, general characteristics(10) and nurse's suffering experience(44). All surveys were sorted and studied by frequency analysis, mean score, standard deviation, range, independent t-test, one way ANOVA, Pearson's correlation coefficient and Multiple regression. Result: The findings of this survey indicate 1) The degree of suffering experienced by nurses caring for terminal cancer patients was 2.96; 2) Demographic variables affecting the degree of nurses' suffering experience were age(F=5.62, p=.000), marital status(F=20.53, p=.000), religion(F=5.44, p=.020), career of clinical experience(F=6.96, p=.000), and feelings of end-life care(F=3.11, p=.016); 3) There were slight correlation between the subitem of nurse's suffering experience and general characteristics of subjects. For 'expanding self consciousness', age, career duration, and position; for 'forming empathy with family', age and career duration ; for 'spiritual sublimation', age, and career duration were affected variables. 4) As a result of the multiple regression analysis for predictable variables affecting nurses' suffering, it was found that 'career of clinical experience' was most significant(F=23.100, p=.000). The explanatory power of this regression formula was 17.6%. Conclusion: This study can provide the basic data useful towards improvement of nursing services for terminal cancer patients and the health of the nurse.

• 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.

• 디지털융복합연구
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• 제18권9호
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• pp.307-315
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• 2020

본 연구의 목적은 현상학적 방법을 통해 말기 암 환자를 돌보는 호스피스 병동 간호사의 경험의 의미 가 무엇인지 이해하여 본질을 추구하고 그 현상의 의미를 심층적으로 기술하고자 함이다. 본 연구의 대상자는 C시에 위치한 일종합병원의 호스피스 병동에서 1년 이상 근무하고 있는 간호사 9명을 선정하였다. 연구 방법은 심층 인터뷰로 2019년 7월부터 2019년 9월까지 자료를 수집하였다. 인터뷰 자료는 Giorgi의 현상학적 방법으로 분석하였다. 분석 결과는 '업무의 부담감' '성숙해짐', '밀착된 관계형성', '호스피스에 대한 지원 부족'으로 나타났다. 결론적으로 말기 암 환자를 돌보는 호스피스병동 간호사의 경험에 대하여 그들의 입장에서 포괄적이고 총체적인 이해를 제공함으로써 말기 암 환자 돌봄에 대한 통찰력을 제공 할 것이며, 그들의 경험에 근거하여 효과적인 지지체계 및 행정적 지원체계의 개발에 기여할 수 있으리라 생각된다.

• 호스피스학술지
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• 제5권2호
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• pp.64-74
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• 2005

Purpose : This study is non-equivalent control group pre-post design attempted to see 'The effect of spiritual nursing intervention on the meaning of life and spiritual distress of the terminal cancer patients.' Method : The data collection was performed from June to October, 2004. The subjects were 41 terminal cancer patients of one general hospital in Jeon Ju city. They are formed two groups, 20 experimental group and 21 control group. Experimental treatment provided spiritual nursing intervention 3 times per a week, the mean 45 minutes each, for 4 weeks for experimental group with the contents of therapeutical use of oneself, use of bible, use of hymn, use of prayer, depend on the priest in the spiritual need assessment of 6 kinds. Study tools was used the thing which Kim(1990) developed about purpose inspection of life which Crumbaugh(1968) developed to measure the meaning of life. The measure of spiritual distress was used the tool which Kim(1990) developed, spiritual nursing intervention was developed by researcher of this thesis. Data was analyzed by descriptive statistics of real number, percentage, the mean etc. and x2-test, t-test, ANCOVA. Result: The 1st hypothesis, 'spiritual the meaning of life score in the experimental group, who received the spiritual nursing intervention, will be higher than the control group who did not receive it' was supported(F=157.09, P=0.000) The 2nd hypothesis, 'spiritual distress score in the experimental group, who received the spiritual nursing intervention, will be lower than the control group who did not receive it' was supported(F=36.48, P=0.000) Conclusion: Spiritual nursing intervention was verified as an effective program to improve the meaning of life and decrease spiritual distress for the terminal cancer patients. Thus, it was confirmed with an effective nursing intervention which helps them in order to spend the rest time of life meaningfully and meet the peaceful death.

• Journal of Hospice and Palliative Care
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• 제23권1호
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• pp.11-16
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• 2020

Purpose: D-dimer levels are known to be associated with poor outcomes in patients with various cancers, but their significance at the end of life remains unclear. This study investigated D-dimer levels as a prognostic indicator for terminal cancer patients in the last hours of life. Methods: The retrospective study was conducted at a palliative care unit of a tertiary cancer center, using a database to analyze the records of patients treated from January 1, 2010 to December 31, 2018. In total, 67 terminal cancer patients with available data on D-dimer levels were included. Patients' demographic data, clinical information, and laboratory values, including D-dimer levels, were collected. Survival was analyzed using the Kaplan-Meier method and the log-rank test. A Cox proportional-hazards model was used to identify prognostic factors of poor survival. Results: The most common site of cancer was the lung (32.8%) and the median survival time was 5 days. Most laboratory results, particularly D-dimer levels, deviated from the normal range. Patients with high D-dimer levels had a significantly shorter survival time than those with low D-dimer levels (4 days vs. 7 days; P=0.012). In the Cox regression analysis, only a high D-dimer level was identified as a predictor of a poor prognosis (hazard ratio, 1.83; 95% confidence interval, 1.09~3.07). Conclusion: Our results suggest that at the very end of life, D-dimer levels may serve as a prognostic factor for survival in cancer patients.

• The Korean Journal of Pain
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• 제18권1호
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• pp.19-22
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• 2005

Background: Most terminal cancer patients suffered from intractable pain. For the treatment of these patients, opioids, via various routes, are usually administered. Continuous epidural opioid, especially morphine, administration is a good method for the management of intractable cancer pain. Methods: We retrospectively analyzed 347 terminal cancer patients, who had been treated with continuous epidural morphine infusion, between 1999 and 2004. For the epidural infusion, an epidural catheter was inserted, tunneled subcutaneously and exited from the anterior chest or abdomen. Multiday $Infursor^{(R)}$ (Baxter, 0.5 ml/h) was used for the continuous infusion. Results: Of the 347 patients studied, there were 211 males and 136 females. The mean treatment time was 54.7 days, ranging from 5 to 481 days. The mean starting and termination doses of morphine were 32.4 (for 5 days) and 100.0 mg, respectively. The doubling time of the morphine dose was 26.3 days, corresponded to a 3.8 percent increase per day. Incidental catheter removal was the most common side effect, which occurred 130 times in 61 cases. Conclusions: The procedure of epidural catheterization, with subcutaneous tunneling, was simple and inexpensive. Despite the disadvantages, such as incidental catheter removal, it is a useful method for the control of terminal cancer pain.

• The Korean Journal of Pain
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• 제26권1호
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• pp.32-38
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• 2013

Background: Intrathecal opioid administration has been used widely in patients suffering from severe cancer pain that is not managed with conventional modalities. However, the potential serious neurological complications from the procedure and the side effects of intrathecal opioids have made many clinicians reluctant to employ continuous intrathecal analgesia as a first-line therapeutic option despite its dramatic effect on intractable pain. We retrospectively investigated the efficacy, side effects, and complications of intrathecal morphine administration through intrathecal catheters connected to a subcutaneous injection port (ICSP) in 22 Korean terminal cancer patients with successful intrathecal morphine trials. Methods: Patient demographic data, the duration of intrathecal opioid administration, preoperative numerical pain rating scales (NRS) and doses of systemic opioids, side effects and complications related to intrathecal opioids and the procedure, and the numerical pain rating scales and doses of intrathecal and systemic opioids on the $1^{st}$, $3^{rd}$, $7^{th}$ and $30^{th}$ postoperative days were determined from medical records. Results: Intrathecal morphine administration for $46.0{\pm}61.3$ days significantly reduced NRS from baseline on all the postoperative days. A significant increase in intrathecal opioids with a nonsignificant decrease in systemic opioids was observed on the $7^{th}$ and $30^{th}$ postoperative days compared to the $1^{st}$ postoperative day. The most common side effects of intrathecal opioids were nausea/vomiting (31.8%) and urinary retention (38.9%), which were managed with conservative therapies. Conclusions: Intrathecal morphine administration using ICSP provided immediate and beneficial effects on pain scores with tolerable side effects in terminal cancer patients.

• 대한한의학회지
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• 제25권4호
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• pp.152-160
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• 2004

Objective : Recently, an increasing portion of cancer patients use various therapies of complementary and alternative medicine (CAM) including traditional oriental medicine, which is believed to improve the consequence of cancer according to clinical experience and laboratory data. But the clinical-based systemic statistic validity of these therapies is lacking, so this study was aimed to validate the traditional oriental therapies (TOT) for terminally ill cancer patients. Patients and methods : This retrospective study was performed on 273 patients who were diagnosed with terminally ill cancer in Korea and treated with TOT in the oriental hospital of Daejeon University, from March 1997 to June 2003. We examined the median duration of the terminal period and the correlations between 9 factors and survival of terminally ill cancer patients. Results : During the study period, we could confirm 142 patients' death (52.01%) in 273 subjects. The median length of survival in terminally ill cancer patients was 16 weeks (95%CI 14.0∼20.0) and 40.15% (95%CI 40.07∼40.22) of patients had survived more than 24 weeks. According to Cox's proportional hazard model including gender, age, conventional therapies (chemotherapy, radiotherapy and surgery), performance status and clinical symptoms as independent variables, history of conventional therapies (RR 0.581, 95%CI 0.381∼0.885), higher performance status (RR 1,855, 95%CI 1.454∼2.366) and absence of ascites and pleural effusion (RR 1.631, 95%CI 1.047∼2.538) showed independent prognostic value of survival. Conclusion : Our findings suggest that TOT offer potential benefits for cancer patients at the terminal stage.

• 대한간호학회지
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• 제25권3호
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• pp.510-537
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• 1995

Human health is an integral part of experience in the process of Human Becoming. Through continual interaction with the environment human beings freely choose experience and develop as responsible beings. The process of the health experience of patient with terminal cancer is a unique. he objective of this study is to understand the lived experience of patients with terminal cancer in order to provide basic information for nursing care in the clinical setting and to develop a theoretical background for clinical practice. This study is to de-scribe and define the lived experience of patients with terminal cancer in order to provide a foundation for nursing research and education. Data collection has been done between December 1993 and November 1994. The subjects included five persons -four females and one male : one who was in her sixties, one in his fifties, two in their forties, and one who was in her thirties. The researcher has met with these patients 35 times, but at eight times the patient was in a stuporous condition and not able to participate, so these were not included in the data analysis. Parse's "Human Becoming Methodology", an existential phenomenological research methodology is used for this study. Data has been collected using he dialogical engagement process of "I and You", the participant researcher and the participant subject. Dialogical engagement was discontinued when the data was theoretically saturated. Data was analyzed using the extraction - synthesis and heuristic interpretation. The criteria of Guba and Lincoln(1985). and Sandelo wski(1986) : credibility, auditability, fitness and objectivity were used to test the validity and reliability of the data. The following is a description of the structure of the lived experience of patients with terminal cancer as defined by this study : 1. Structure : 1) Suffering through the reminiscence of past experience 2) The appearance of complex emotions related to life and connectedness 3) The increasing importance of significant people and of the Absolute Being 4) The increasing realization of the importance of health and belief 5) Desire for a return to health and a peaceful life or for acceptance of dying and a comfortable death In summary the structure of the lived experience of these patients can be said to be : suffering comes through reminiscence of past experience, and there are complex emotions related to life and connectedness. Significant people and the Absolute Being become increasingly important along with a realization of the importance of health and faith. And finally there is a desire for either a return to health and a peaceful life or for the acceptance of dying and a comfortable death. 2. Heuristic Interpretation : Using Parse's Human Becoming Methodology, the structure of the lived experience of patients with terminal cancer identified in this research is interpreted as. The lived experience of patients with terminal cancer involves the solving of past conflicts, and the experience of the healing and valuing of sorrow and pain. Through the relation of life and health, and the complex emotions that arise, the lived experience of revealing - concealing is of paradoxical emotions. The increasing importance of significant others and of the Absolute Being shows Connecting and Separating an on- going process of nearness and farness. Revision of thoughts about health and faith is interpreted as transforming and desire for restoration to health and a peaceful life or acceptance of dying and a cowfortable death, as powering. In summary, it is possible to see, in the lived experience of patients with terminal cancer, the relationship of the five concepts of Parse's theory : valuing, revealing -concealing, connecting-separating, transforming, and powering. From Parse's theory, the results of this study show that meaning is related to valuing, rhythmicity to revealing-concealing and connect-ing-separating, and cotranscendence to transforming and powering.

• Asian Pacific Journal of Cancer Prevention
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• 제15권2호
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• pp.1041-1046
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• 2014

Evidence is growing that the $GABA_B$ receptor, which belongs to the G protein-coupled receptor (GPCR) superfamily, is involved in tumorigenesis. Recent studies have shown that ${\beta}$-arrestin can serve as a scaffold to recruit signaling protein c-Jun N-terminal knase (JNK) to GPCR. Here we investigated whether ${\beta}$-arrestin recruits JNK to the $GABA_B$ receptor and facilitates its activation to affect the growth of cancer cells. Our results showed that ${\beta}$-arrestin expression is decreased in breast cancer cells in comparison with controls. ${\beta}$-arrestin could enhance interactions of the $GABA_BR{\cdot}{\beta}-arrestin{\cdot}JNK$ signaling module in MCF-7 and T-47D cells. Further studies revealed that increased expression of ${\beta}$-arrestin enhances the phosphorylation of JNK and induces cancer cells apoptosis. Collectively, these results indicate that ${\beta}$-arrestin promotes JNK mediated apoptosis via a $GABA_BR{\cdot}{\beta}-arrestin{\cdot}JNK$ signaling module.