• 제목/요약/키워드: family members

검색결과 2,357건 처리시간 0.028초

말기 암 환자의 완화 의료 연계 시스템의 문제점과 개선 방안 (Problems of the Current Referral System of the Terminal Cancer Patients in Korea)

  • 윤초희;이주영;김미라;허대석
    • Journal of Hospice and Palliative Care
    • /
    • 제5권2호
    • /
    • pp.94-100
    • /
    • 2002
  • 목적 : 말기 암 환자가 삶의 마지막 시간 동안 정서적, 사회적으로 안정을 취할 수 있는 곳은 대형화된 3차 의료기관이 아니라, 거주지에서 가까운 1, 2차 의료기관이나 호스피스 기관, 혹은 가정일 것이다. 그러나 현재 우리 나라는 말기 암 환자들을 3차 의료기관에서 1, 2차 의료기관, 호스피스 시설 등으로 연계(referral)하여 주는 시스템이 매우 미약한 상태이다. 본 연구는 현재 연계 상황의 문제점을 파악하여 이에 대한 개선점을 제시해 보고자 한다. 방법 : 2001년 4월부터 2002년 3월까지 서울대학교 병원으로부터 각 기관으로 연계된 말기 암 환자 76명의 보호자와 이 환자들을 연계 받은 35개의 의료기관을 대상으로 하여 설문 조사를 실시하였다. 환자의 보호자에게는 직접 전화를 하여 조사하였고, 의료기관에 대해서는 우편으로 설문지를 발송하였다. 결과 : 환자 보호자를 대상으로 한 47부의 설문지 분석 결과는 다음과 같다. 연계를 결정하는 데 있어서 의료진의 권유가 44%로 가장 큰 영향을 미쳤으며, 32%가 환자의 편의, 24%가 가족의 편의를 주로 고려하여 결정하였다. 연계 결정 과정에서는 가족의 생활권, 연계 기관의 인지도, 환자가 마지막으로 지내고 싶어하는 곳, 가족의 경제 상황, 장례 장소가 순서대로 영향을 많이 미치는 것으로 나타났다. 연계 과정에서는 47명 중 38명이 어려움을 겪었다고 응답했으며, 이들은 원하지 않는 퇴원의 종용을 가장 큰 어려움으로 꼽았다. 이 외에도 연계 기관에 대한 정보 부족, 환자의 고통에 대한 염려, 환자 및 가족의 거부 등으로 인해서도 어려움을 겪은 것으로 나타났다. 이와 같이 연계 과정에서는 어려움을 표현하였지만, 실제로 연계된 기관에서는 47명 중 35명이 완화 의료에 대해 대체로 만족스러웠다고 응답하였다. 그 이유로 환자가 안정과 평안함을 찾았고, 가족들도 편안하였으며 경제적 부담이 감소하였다는 점을 꼽았다. 그러나 15명은 연계 전후에 별 차이가 없다고 응답하였다. 연계된 기관을 대상으로 한 24부의 설문지 분석 결과는 다음과 같다. 24명의 응답자 중 1명을 제외한 23명이 완화 의료 연계 시스템에 대해 찬성하였고, 좀더 활발한 연계가 이루어질 수 있는 제도적 뒷받침의 필요성을 절실히 표현하였다. 의뢰된 환자를 돌보는 데 있어서 경험하는 어려움으로는 가장 큰 것으로 환자에 대한 정보 부족을 꼽았고, 그 외에도 환자의 경제적인 어려움이나 완화 의료 연계 기관에 대한 이해 부족, 통증 조절의 어려움 등을 호소하였다. 대부분(96%)의 기관 종사자들은 환자들이 연계된 이후의 보살핌에 만족하고 있다고 생각하는 것으로 나타났다. 결론 : 3차 기관으로부터 1, 2차 의료기관 및 호스피스로 말기 암 환자들이 연계되는 과정에서 환자, 보호자 뿐만 아니라 연계 기관도 많은 어려움을 겪고 있다. 향후 완화 의료의 연계 시스템 개발과 제도적 뒷받침이 절실히 필요하다.

  • PDF

한국 내 조선족 여성의 분거가족 관계에 대한 탐색적 연구 (An Exploratory Study on Korean-Chinese Women's Experiences about Family Separation)

  • 이율이;양성은
    • 가정과삶의질연구
    • /
    • 제28권4호
    • /
    • pp.77-87
    • /
    • 2010
  • The purpose of this research was to explore Korean-Chinese women's experiences of family separation. A qualitative approach was used to analyze the in-depth interviews with 14 Korean-Chinese women who lived away from their families in China. Korean-Chinese women showed the child-centered family values. The main reason of family separation was to provide children of better educational opportunities. Korean-Chinese women, their husbands, and their extended family members worked as a team to support children. Their cohesive family relationships reflected the unique sociocultural context of Korean-Chinese society. Family separation seems to be normalized for the purpose of child education. The research would contribute to understand how family values affect family life style.

여성가족간호자의 치매노인 돌봄경험: 여성주의적 접근 (Women Caregivers′ Experiences in Caring at Home for a Family Member with Dementia: A Feminist Approach)

  • 이봉숙;김춘미;이명선
    • 대한간호학회지
    • /
    • 제34권5호
    • /
    • pp.881-890
    • /
    • 2004
  • Purpose: The purpose of this study was to explore women caregivers' lived experiences in caring at home for a family member with dementia and to identify conditions that oppress women in the context of family caregiving. Method: This study was conducted within the feminist perspectives using qualitative secondary data. Ten secondary data conveying self reflective contents were selected from the 25 original data obtained in 1999 to 2000. Result: Six themes that emerged from the qualitative thematic content analysis were; androcentric view of family caregiving, undervalued family caregiving by the family members, Self rationalization in the context of family caregiving, family-centric care mechanism, exemplary caring within the family context, and inter-familial relationships among women. Conclusion: The main focus of feminist research is to provide empowerment for the women, research participants and to bring about social change of oppressive constraint through some actions. On the basis of the research findings, therefore, action strategies from feminist perspectives were suggested in some aspects of health care delivery sectors, nursing education and research sectors, and administrative sectors.

가족 구성원의 변화에 따른 라이프스타일의 변천 (Change of Lifestyle by Changing Member of Family)

  • 이남식;서귀숙
    • 한국실내디자인학회:학술대회논문집
    • /
    • 한국실내디자인학회 2007년도 추계학술발표대회 논문집
    • /
    • pp.54-58
    • /
    • 2007
  • The part of women was limited in a large family of the past and the benefit of a family was more valuable than the advantage of an individual. But social activity of the individual who is a member of the family is increased by the industrialization and rapid changes of society. As a result importance of the family is on the decrease in a society. All such phenomenons make new family types that we could not imagine at past and various life-style. This research proposes life-style of the near future and investigated by life-style stream process according to change members of the family with various documentary record. In conclusion, life-style of the near future is changed individualistic, rationalistic and material.

  • PDF

두부 손상환자 가족의 간호요구에 대한 연구 (A Study on Needs of the Families of Head Injury Patients)

  • 조규영;박형숙
    • 기본간호학회지
    • /
    • 제6권3호
    • /
    • pp.414-433
    • /
    • 1999
  • The purpose of this study is to identify the needs which are perceived by one of the familiy members who have head injury parients by traffic accidents in the intensive care units. Subjects were 70 families members of head injury patients admitted to 2 general hospitals NICU located Pusan city, 1 general hospital NICU located Ulsan city from December 1. 1998 to February 28. 1999. For this study, 70 family members were interviewed with aid of a Likert scale which was developed by researcher for this study. For development of the survey instrument, literature review and open questionnaire technique with family members and the nurses working in NICU. The 50needs-items were classified into 7 groups according to the homogeneity of the items with the support of literature review. For the content validity, the instrument was reviewed by 1 nursing professor and the internal reliability of this instrument was Cronbach alpha=0.94 which is highly accepted. Data was analyzed by a SPSS computer program. Data analysis included frequency. percentage, mean, standard variance and t-test or ANOVA. The results were as followings : 1. The general characteristics of head injury patients shows that the male was 74.3%, the female was 25.7% and age distribution shows that the fifty-fifty nine years was 30%, the highest. Of religion the buddhism was the most, The diagnosis distribution shows that epidural hematoma was 32.9% and subdural hematoma was 24.3%. The mentalility distribution shows that semicoma was 31.4% and stupor was 31.4%. Hemiplegia was 42.9% 2. The general charaterisrics of the family needs of head injury patients shows that thirty-thirty nine years was 31.4%, the highest. sex distribution shows that the male was 20%, the female was 80%. Of religion the buddism was the most. 3. The family needs of head injury patients was $3.03{\pm}0.42$, needs for the information of a patient's condition was $3.65{\pm}0.48$, the highest. And needs for the information of care and treatment was $3.48{\pm}0.48$, needs to be supplied with comfortable facilities for family was $3.04{\pm}0.66$, needs to be participate in a patient's care was $2.90{\pm}0.55$, needs to be informed about the available resources was $2.83{\pm}0.59$, needs to be supported emotionally for family was $2.79{\pm}0.55$, needs for religious assistance was $2.51{\pm}0.85$. 4. Examining the family needs of head injury patients according to patient's characteristics, mentality, plegia degree and operation were shown be variables to make an effect on the needs for the head injury patients family. At all, according to severity of head. injury, the family needs of head injury patients was high. 5. Examining the family needs of head injury patients according to their general characteristics, we could know that religion, job. income were shown to be variables to make an effect on the family needs. Through the examination it can be seen that the characteristics of head injury patients and the family needs of head injury patients. In conclusion, the family needs of head injury patients was almost same the family needs of ICU patients. Therefore we must involve the family's care of head injury patients and we must provide exact and repeated explanation, education and support the family of head injury patients. As this study was resulted in selecting the families admitted to NICU of some general hospital, we couldn't stretch the result in our favor. Therefore, continuous studies are suggested.

  • PDF

재미 한국 간호사들이 경험한 한국과 미국 병원의 간호실무의 차이 (A Comparison of Hospital Nursing Practice in Korea and the U.S. as Experienced by Korean Nurses)

  • 이명선
    • 대한간호학회지
    • /
    • 제28권1호
    • /
    • pp.60-69
    • /
    • 1998
  • Since the introduction of Western concept of nursing to Korea in late 1880s, Korean nursing practice has evolved into Korean culture. The purpose of this study was to explore and identify similarities and differences in hospital nursing practice between Korea and the United States using the grounded theory method. The data were gathered from 15 Korean nurses working in U.S. hospitals using semi-structured, in-depth interview method. Major similarities in nursing practice between Korea and U.S. existed in the 7 domains that Benner indicated in 1984. The nursing administration system was also similar in both countries. On the other hand, differences existed in how nurses execute these domains of nursing practice. These are the roles of nurses. nurse aides and family members. and the interpersonal relationships, and problem presentation and problem-solving strategies. American family members rarely participated in the patient's bedside nursing care, while Korean family members actively participated. American nurse aide participated in direct patient care, while Korean nurse aides did not. Also Korean nurses were participated more in administering and managiang the patient's diagnostic and treatment modalities, while American nurses foucused on the needs and demands of the patient. In terms of interpersonal relationships, American patients were more self-centered and demanding than Korean. American nurses focused more on the right of individuals while Korean nurses were more oriented to harmony with the coworkers. With inferiors and superiors, American members were more egalitarian, while Koreans tended to be hierachical. In ways of suggesting problems, American nurses tended to pick out the problems more frequently than Korean nurses did.. As to ways to solve the problems, American nurses relied heavily on explicit verbal explanations, while Korean nurses relied more on bodily action and behaviors. The results of this comparative study contribute to nursing by adding knowledge on the theory of culture care by describing the similarities and differences in nursing practice between Korea and the United States.

  • PDF

탁구 동호인의 스포츠 재미요인이 운동지속의지 및 심리적 행복감에 미치는 영향 (The Effects of Sports Fun Factors on Willingness to Continue Exercise and Psychological Happiness of Table Tennis Club Members)

  • 김점순;홍상욱
    • 산업진흥연구
    • /
    • 제8권2호
    • /
    • pp.149-156
    • /
    • 2023
  • 본 연구는 생활체육 탁구 동호인의 스포츠 재미요인이 운동지속의지 및 심리적 행복감에 미치는 영향에 알아보고 분석하고자 한다. 본 연구의 참여자는 탁구 동호인 293명을 대상으로 스포츠 재미요인, 운동지속의지, 심리적 행복감 설문지를 활용하여 자료를 수집하였다. 운동지속의지에 영향력을 주는 요인은 승리/경쟁, 대인관계, 연습/혜택, 가족지원으로 파악되었으며 운동지속의지는 자아실현과 쾌락적 즐거움에 모두 유의미한 정적인 영향력을 주는 것으로 나타났다. 재미요인인 유능성/지각, 승리/경쟁, 대인관계, 연습/혜택, 가족의 지원이 심리적 행복감인 자아실현, 쾌락적 즐거움에 미치는 영향에서 운동지속의지의 매개 효과분석 결과 유능성/지각만을 제외한 모든 요인의 매개 효과를 확인하였다. 특히, 대인관계(팀 분위기) 요인이 타 요인보다 자아실현과 쾌락적 즐거움에 높은 매개효과를 주는 것을 확인할 수 있었다.

건강가정지원센터의 장애아가족 통합지원서비스 사업을 위한 프로그램 개발 기초연구 (A Preliminary Study of Developing Integrated Supportive Service Works for the Families of Disabled Children Focus on the Healthy Family Support Center)

  • 오윤자
    • 가정과삶의질연구
    • /
    • 제26권6호
    • /
    • pp.209-225
    • /
    • 2008
  • This study has been designed to develop integrated supportive service works for the families of disabled children registered in the D-Healthy Family Support Center. The service works are intended to improve family members' health and their growth potentials, and cover service programs of family education, counselling, culture solidarity, and information networks. There are two topics covered in this study; first, this study is to develop integrated supportive service programs for the families of disabled children, and second, the study is also to construct comprehensive strategies and plans for effective services after evaluating practical service programs. In this study, 31 families with one or more disabled children have been selected through stratified random sampling, and all the family members were observed for program effects of integrated service items developed from previously validated indices. For analysis, eight question items were made for interview and each item denotes satisfaction score ranging from 1(very dissatisfied) to 5(very satisfied) on the Likert's five point scale. Mean value of each item was counted after the program, and satisfaction scores were compared over the programs implementation. Overall, the satisfaction scores range 4.1 to 4.6, indicating relatively high satisfaction over most service program. Therefore, it is finally proposed that a longitudinal strategy model offer high quality service programs consistently for the target families, as a goal of achieving comprehensive cooperation and support exchanges between community and healthy family support center be schematized.

아동양육시설 퇴소 성인들의 원가족 재회 경험 연구: 근거이론(Grounded Theory) 연구 접근 (A Study on the Family Reunion Experience of Adults Discharged from Childcare Welfare Facilities - Grounded Theory Approach -)

  • 황수연
    • 한국가족복지학
    • /
    • 제60호
    • /
    • pp.31-71
    • /
    • 2018
  • 본 연구는 아동양육시설 퇴소 성인이 경험한 원가족과의 재회에 대한 연구로서 아동청소년기시절 시설에서 성장한 후 성인이 되어 원가족을 다시 만난 개인들의 경험을 분석했다. 본 연구는 근거이론 연구방법으로 접근했으며 원가족과 재회한 후 10년이상 교류를 가졌던 19명의연구 참여자가 참여했다. 분석결과는 패러다임에 의한 범주분석에서 인과적 조건은 '다시 만남의 후회', '소속감 없음', '버림받은 상처의 재현'으로 나타났고, 맥락적 조건은 '상처받은 존재로서의 예민성', '보상심리의 좌절'로 나타났다. 중심현상은 '감정의 소용돌이'로 나타났다. 중재적 조건은 '천륜의 인식', '부모부양 지지체계', '부모의 상처 씻어주기'로 나타났고, 작용/상호작용은 '선으로 복수하기', '자기 구속의 끈 풀기', '자신의 푯대 세우기', '가족화해'로 나타났다. 결과는 '가족의승화', '생애과업 완수', '삶의 터전 확보'로 나타났다. 이상과 같은 분석결과를 토대로 논의를 거쳐 제언을 하였다.