Journal of Korean Academy of Nursing Administration
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v.7
no.2
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pp.237-251
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2001
It is important for nursing managers to understand the lived experience of nursing care for dying patients in clinical nurses for the effective management of them. The purpose of this Phenomenological study was to explore the lived experience of nursing care for the dying patients in clinical nurses and identify the meaning and structure of their lived experience. This study was conducted from 1 of June, 2000 to 1 of November, 2000. Data were collected with several in-depth interviews until data were fully saturated, from 1 of June, 2000 to 10 of September, 2000. The Subjects were five nurses who had more than three-year job experience in caring for dying patients, three protestant christians and two atheists, one married and four unmarried persons. The range of their age was from 28 to 36. Data were analysed by the Colaizzi's methodology. Ten themes were extracted from fifty-one fomulated-meanings. Fomulated-meanings were extracted from the restatements and the significant-statements which were deriven from the raw data. Finally ten themes took form of five structures. Five structures of 'The lived experience of nursing care for the dying patients in clinical nurses' were : 1. Experiencing guilty feeling and anger due to their and other's manneristic and ignored attitude toward dying patients 2. Feeling heartily the necessity of the education of hospice care because of their incompetence due to lack of knowledge of hospice care 3. Recognizing the human rights of dying patient's thinking themselves and their families 4. Felling satisfaction with their nursing accomplishments and reflecting their life through nursing care of the dying patients 5. Experiencing low self-respect due to the other's negative perspective toward their job The results of the study would give useful information to nursing managers to understand the lived experience of nursing care for dying patients in clinical nurses and establish adequate strategies to support them.
Purpose: This study aimed to identify the confidence and educational needs of clinical nurses in care for the family of dying patients. Methods: The subjects of this study were 218 clinical nurses working at two tertiary general hospitals located in D city, Korea, and the data were collected through online questionnaires. The collected data were analyzed using descriptive statistics, t-test, analysis of variance (ANOVA), Scheffe test and 𝝌2 test using the SPSS WIN 20.0 program. Results: 97.6% of clinical nurses recognized the need for family care for dying patients, but 76.7% had never received any education on family care for dying patients. The average score of dying patients' confidence in family care was 3.09. About 90% of clinical nurses were willing to participate in family nursing education for dying patients. The group with more than 5 years of clinical experience was significantly higher than the group with less than 5 years of clinical experience. Conclusion: This study recognized the necessity of family nursing for dying patients highly. It is necessary to develop and apply an educational program based on the education topic that recognizes the need highly.
In order to care the persons who are dying a nurse should first solve her / his own conflicts about death. and be aware of their own concepts of death and dying. In order to find out patient's spiritual needs and to give better spiritual nursing care. a nurse should know her / his own spiritual needs and be aware of their own concepts of spiritual nursing problems. To improve nurse's understanding towards death and dying and nurse's knowledge towards spiritual needs and spiritual nursing care. 14 weeks(two hours a week) spiritual nursing care education was given to 3th grade baccalaureate nursing college student. Before and after spiritual nursing care education. 30 items of prepared questionare focused on the attitudes toward death and dying was asked. Pre and post results are as follow ; 1. The dying patient's emotional and physical needs. There was no significant difference between pre and post educated groups. Both of the situations. they agreed upon$(69.64\%)$ that the dying patients have high emotional and physical needs to solve. 2. Telling the truth of dying process. There was no significant difference between pre educated group$(53.33\%)$ and post educated group$(55.95\%)$. 3. Attitudes of medical personnels. There was no significant difference between pre$(51.49\%)$ and post educated groups $(53.87\%)$. These responses indicate that nursing college student didn't have enough experiences on dying patients care. 4. General attitudes on death and dying. Number of nursing students who were thinking positively toward death and dying were Increased (pre $39.68\%$. post $45.44\%$) and who were thinking negatively toward death and dying were also decreased (pre $37.30\%$. post $33.93\%$). 5. Attitudes toward mechanical assistance for life-expanding of helpless patient. There was a significant difference between pre and post educated groups. About $34.13\%$ of them approved upon mechanical assistance for life and about $33.14\%$ of them disapproved. 6. Attitudes of family members of dying patient. There was no significant difference between pre and post educated groups. About $45.24\%$ of both groups, agreed upon that the family members feel annoyed with dying patients and about $22.42\%$ of both groups disagreed. Whether they received the spiritual nursing education or not, they were aware of that the family members feel annoyed with dying patients. 7. Special facility and educational preparation for dying patient. There was a significant difference between pre$(82.14\%)$ and post$(90.87\%)$ educated groups. These responses indicated that after they received the education, they felt more about the necessity of special facility and educational preparation for the death and dying patients. 8. Special facility and welfare system for the old. There was a significant difference between pre$(58.33\%)$ and post$70.64\%$ educated groups. There responses indicated that after they received the education, they felt more about the necessity of special facility and welfare systems for the old.
The purpose of this hermeneutic study was to investigate the meaning of "good dying" of Chinese terminally ill cancer patients in Taiwan; the factors related to this morning; and the strategies cancer patients used to ensure "good dying". Indepth unstructured interviews, prolonged participant observations, and review of clinical records were selected as the methods for data collection. In the four and one-half month period of data collection, the researcher was in the role of a full time clinical nurse specialist who directly took care of the subject patients in 4 hospitals and in patients' homes. The 20 subject were selected purposively according to selection criteria and various demographic backgrounds. Interview transcripts and field notes comprised the data for analysis. The results were composed by 3 constitutive patterns and 12 themes. Achieving inner peace appeared to herald the good dying state. The "good dying" for Chinese terminally ill cancer patients in Taiwan meant peace of body, peace of mind, and peace of thought. The constitutive pattern of peace of body included 4 themes: (1)minimizing the agony of physical symptoms; (2)short period of dying process without lingering death; (3) cleanliness, neatness, and integrity of the body; and (4) mobility. The constitutive pattern of peace of mind included 5 themes: (1) yielding; (2) non-attachment; (3) not to be lonely; (4) settle down all affairs; and (5) being in a preferred environment and enjoying nature. The third constitutive pattern of peace of thought included 3 themes: (1) getting through day by day without thinking; (2) meaningful life; and (3) expectation that the suffering would be ending. Through understanding of the terminally ill cancer patient' needs in their meanings of "good dying", recommendations can be made for humanistic care. The findings of this study have recommendations for care givers daily contact with dying patients and for medical and nursing education.
Purpose: The purpose of this study was to identify the mediating effect of compassionate competence on the relationship between nurses' spirituality and attitude toward care of dying patients. Methods: A cross-sectional correlational research design was conducted. The total subjects were 172 nurses at one general hospital in Gangwon-do. Data were collected using self-report questionnaires and analyzed using t-test, one-way ANOVA, Scheffe's test, Pearson's correlation coefficients, and multiple regression analysis. Results: Compassionate competence showed the mediating effect (${\beta}=.19$, p=.025) on the relationship between nurses' vertical spirituality and attitudes toward care of dying patients. However, no mediating effect of compassionate competence on the relationship between nurses' horizontal spirituality and attitudes toward care of dying patients was found. Conclusions: Based on the findings of this study, development of training programs with a focus on spirituality and compassionate competence was highly recommended to improve and maintain nurses' positive attitudes toward caring of the dying patients.
Objectives : This study aims to examine the effects of death education program on meaning in life, death anxiety and attitude toward nursing care of the dying patients among nursing students. Methods : Subjects were 155 nursing students of the K college. Before and after the intervention, students responded a questionnaire developed to measure meaning in life, death anxiety and attitude toward nursing care of the dying patients. To analyse the data, Cronbach's ${\alpha}$, t-test, and paired t-test were used with an SPSS 12.0 program. Results : 1. Meaning in life and attitude toward nursing care of the dying patients levels significantly increased, death anxiety levels significantly decreased. 2. Meaning in life levels increased significantly in the 20-24 age group, female, first grade, no religion, no death experience of relatives. 3. Death anxiety levels decreased significantly in the 20-24 age group, female, no religion, no death experience of relatives, but increased significantly in a buddhist group. 4. Attitude toward nursing care of the dying patients levels increased significantly in the 20-24 age group, female, first grade, won buddhist, no death experience of relatives. Conclusions : This study, through the above result, shows that the death education program can be an effective nursing education to improve meaning in life and attitude toward nursing care of the dying patients and to decrease death anxiety. These results suggest that the death education program will be helpful for recognizing the values of themselves and their current lives and improving their nursing intervention care of the dying patients.
Purpose : This study aimed to develop an in-depth and comprehensive understanding of the experiences of critical care nurses caring for dying patients. Method : Eleven critical care nurses with experience in caring for dying patients were recruited from four tertiary hospitals. Semi-structured face-to-face interviews were conducted between November 2016 and March 2017. The transcribed data were analyzed using qualitative content analysis to identify major themes and sub-themes that represented the experiences of critical care nurses. Results : The following six themes, and twelve sub-themes, were identified: (1) the gap between expectation and reality, (2) a distorted meaning of death, (3) repeated emotional pain and stress, (4) finding a solution alone, (5) sublimation into mission and calling, and (6) integration into one's own life. Conclusion : This study found that critical care nurses experience various psychological difficulties while caring for dying patients, and they made efforts on their own to overcome them. These findings are expected to inform the development of specialized programs to support critical care nurses to tackle these challenges, create guidelines on caring for dying patients, and help promote death education.
Prupose: The purpose of this study was to identify signs and symptoms of hospice patients during their dying processes. Method: The subjects of this study were 76 patients who received hospice care services in 2 different hospice care programs in Seoul area. Data was obtained from January, 1999 to June, 2001 by hospice nurse's observation, interviews with patient's primary caregiver and hospice volunteers, patient's self report, nursing records and questionnaires which had been developed by selecting from various references and refining them based on the result of preliminay studies. The collected data were analyzed with the SPSS PC+ program and content analysis. Results: Mean lengths of hospice patient's dying process were 3.6 days. Physical signs and symptoms of hospice patients during their dying processes were 'increased sleep'(89.5%), 'decreased oral intake of food'(88.2%) and 'liquids'(86.8%), 'change of respiration'(82.9%), 'decreased urine output'(80.3%), 'cold extremities'(69.7%), 'death rattle'(67.1%), 'cyanosis'(57.9%), 'restlessness'(55.3%), etc. And psychological, spiritual and social signs and symptoms were 'decreased interpersonal relationships'(61.8%), 'panorama of memories from childhood'(60.5%), 'experiences as like hallucination'(56.5%), 'saying bye with family'(69.7%), 'forgiveness', 'make a will', etc. Experiences as like hallucination were seemed not as dream but reality were shown by 43 dying patients. They had experienced to see and to talk with their deceased mother(18.6%) and/or relatives(30.2%), angels(20.9%), heaven(11.6%), old house in which they had lived, someone from the world beyond with black clothes, etc. Conclusion: The above results indicate that death of hospice patients is ongoing process with dying signs and symptoms during several days contains not only in physical aspects but also among psychological, spiritual and social aspects including family dynamics.
The purpose of this study is to find out most wanted nursing contents (behavior) of the dying patient and his family and to discover the obstacles to helping the dying as analysis of 53 factual reports on the care of dying patients on American Journal of
This study is a phenomenological study done to promote understanding of the dying process in patients with terminal cancer who were in an independent hospice center. The purpose of study was to explore and understand indepth information on the dying process in order to provide data for holistic hospice care in nursing and to give insights in to practical applications in the nursing care In-depth interviewing was done from may, through November, 1995 with 11 patient with cancer who were being cared for at K Hospice Care Center. Experiences in the dying process were discussed as they expressed feelings about death including (a) feeling of isolation because family members try to hide the diagnosis of cancer. (b) hopelessness, (c) guilt, anger, and hostility, (d) suffering from pain, (e) fear of death. However, subjects did not deny death itself and were developing peace of mind and acceptance of death through religion.
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