• 호스피스학술지
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• 제7권2호
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• pp.15-25
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• 2007

The purpose of this study was to survey the hospital staff's perception of hospice and death and thereby, suggest the ways to help them have a mature attitude towards and a better understanding of death through an effective education on hospice. For this purpose, this study was designed to provide some data useful for the hospital staff not experienced in facing the dying patients to handle the desperate situation skillfully and engage themselves more effectively in their hospice services. For this study, the researcher conducted a questionnaire survey for the staff of 'C' hospital in Seoul about their hospice philosophy, attitudes towards hospice and perception of death for the period from February, 2006 to March, 2006. A total of 751 subjects responded effectively to the survey. The data collected were analyzed using the SF55 11.0 for ANOVA and T-test in order to test the relationships among subjects' perception of death, their demographic variables, their health condition, their hospice philosophy formed from their experiences of patients' death and hospice services and their attitudes towards hospice. Besides, the correlations among their hospice philosophy, perception of death and attitudes towards hospice were tested. The results of this study can be summarized as follows; First, as a result of testing the relationships among subjects' experiences of health consulting. their experiences of patients' death and hospice and their hospice philosophy, it was confirmed that their experiences of health and death consulting and their experiences of having been educated were relevant. Second, it was found that such variables as health condition, death, experience of hospice and attitude towards hospice were not significantly correlated with each other. Third, as a consequence of testing the relationships among health condition, death, experience of hospice and perception of death, it was disclosed that only the physical health condition was significant. Fourth, it was confirmed that subjects' hospice philosophy, perception of death and attitudes towards hospice were at the usual level on average. Fifth, hospice philosophy, perception of death and attitudes towards hospice were found correlated significantly with each other. Sixth, as a result of the stepwise variable adjustment for such variables as hospice philosophy, perception of death, attitudes towards hospice, it was found that the adjusted r-square value was 0.347 when departments, experience of having been requested by dying patient for consulting, experience of having been educated on hospice, religion and marital status were set as independent variables. And the estimated value of each variable was found significant. Seventh, as a consequence of conducting the multiple regression analysis by setting 'religion' as significant independent variable, it was found that the estimated value of physical health condition was not significant statistically. This, as a result of the simple regression analysis for 'religion' only, its explanatory power was found .197, while its adjusted r-square value was 0.20. Eight, it was found that subjects' attitude towards hospice was significantly correlated with such variables of experience of patient's or relative's death, experience of having been requested for consulting about death, gender, marital status and departments. As a result of the multiple regression analysis and the subsequent stepwise adjustment for this variable, it was found that only 'experience of having been requested for consulting' had some explanatory power: its adjusted r-square value was 0.089. As discussed above, this study tested the correlations among various variables including hospital staff's attitude towards hospice and perception of death and thereby, provided for the data useful for their education on hospice. This study may be significant in that it proved that it would be essential to educate hospital staff on hospice for more effective care of hospice patients and their family members at hospital.

• Journal of Hospice and Palliative Care
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• 제10권2호
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• pp.78-84
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• 2007

목적: 본 연구는 오늘날 증가추세에 있는 폐암 환자에게 보다 체계적이고 효율적인 호스피스 완화의료를 위한 기초자료를 제공하고자 호스피스 병동에서 임종한 말기 폐암 환자의 임상적 특성을 조사하였다. 방법: 2003년 3월 1일부터 2006년 12월 31일까지 샘 안양병원 호스피스 병동에서 말기 폐암으로 임종한 129명의 환자를 대상으로 하여 이들의 의무기록을 후향적으로 조사하였다. 수집된 자료는 실수와 백분율, 빈도와 중간 값으로 제시하였으며 호스피스 완화의료 동안의 생존기간은 SPSS 13.0의 Kaplan-Meier방법으로 분석하였다. 결과: 129명의 말기 암 환자 중 남자 93명(72%), 여자 36명(28%), 연령의 중간 값은 68세(범위 $37{\sim}93$세)이었다. 진통제를 복용하고 있었던 환자는 82명(64%)이었으며 그렇지 않은 환자는 47명(36%)이었다. 입원 이유는 호흡곤란이 47명(36%)으로 가장 많았고 이는 일반적으로 말기 암환자의 입원이유가 통증인 것과 다르게 나타났다. 호스피스 병동 입원 후 120명(93%)의 환자에게 마약성 진통제를 사용하였고 주사용 모르핀(103명, 80%)이 가장 많이 처방되었다. 진정제를 사용한 환자는 87명(67%)이었으며 미다졸람을 가장 많이 사용하였다(68명, 53%). 호스피스 완화의료 동안의 생존기간의 중간 값은 35일, 입원 일수의 중간 값은 24일이었다. 결론: 말기 폐암환자에서 호흡곤란의 조절은 매우 중요하며 말기 폐암 환자에 대한 호스피스 완화의료의 기간이 짧아서 효과적인 호스피스 완화의료를 위해서는 가족과 환자에게 지속적인 교육과 홍보가 필요하다고 생각된다.

• Journal of Hospice and Palliative Care
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• 제13권2호
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• pp.76-80
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• 2010

목적: 본 연구에서는 제주지역내의 보건소, 지역 암센터와 말기암환자 전문의료기관 등에서 실시하고 있는 재가암환자 관리 사업의 객관적 현황을 파악하여 각 기관별의 재가암 관리를 위한 역할을 정립하고자 한다. 방법: 제주지역에서 재가암환자 관리를 실시하고 있는 각 기관을 대상으로 재가암환자 관리 사업의 시작연도와 현재 실시하고 있는 사업과 부족한 부분 등을 알아보고, 각 기관과의 연관사업 등을 파악하였다. 결과: 제주지역내의 재가암환자 관리는 6개의 보건소와 1개의 지역 암센터, 1개의 말기암환자 전문의료기관이 활동 중에 있으며, 제공되는 서비스는 약간의 차이는 있으나, 신체적, 정서적, 영적, 교육 정보적 서비스를 실시하고 있으나 보건소의 경우, 통증완화를 위한 마약성 진통제의 사용이 부족한 실정이었다. 결론: 본 연구는 재가암환자 관리 사업에서 말기암환자 전문의료기관과 보건소에서 급성기의 경우와 재가암환자 관리를 위한 인력의 교육을 위한 교육은 지역 암센터와 연계하여 재가암환자에 대한 체계적인 관리와 역할 분담을 정립시켜야 할 것으로 생각된다.

• 성인간호학회지
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• 제14권3호
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• pp.337-347
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• 2002

Purpose: The purpose of this study was to elucidate the effects of spiritual nursing intervention on anxiety and depression of the hospice patients. Method: It was devised with a quasiexperimental design using non-equivalent control group pre-post design. The data was from July 10 to September 25 in 2000 at the general hospital in CheonJu city. Subjects were 37 members of the experimental group and 30 members of the control. The tools were used Spielberger's State Anxiety Scale and Zung's Depression Inventory. The spiritual nursing intervention was carried out through Hymn, Scripture, Prayer, the therapeutic ues of self. Data were analyzed by mean, standard deviation, ${\chi}^2-test$, t-test. Result: 1. After the spiritual nursing intervention, state anxiety of the experimental group was lower than those of the control (t=-5.987, p=0.000). 2. After the spiritual nursing intervention, depression of the experimental group were lower than those of the control (t=-9.128, p=0.000). Conclusion: The hospice patients who were offered spiritual nursing intervention had lower anxiety & depression than not offered it. According to these results, it can be regarded as an effective one that relieved anxiety and depression of the hospice patients.

• Journal of Hospice and Palliative Care
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• 제24권4호
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• pp.254-260
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• 2021

Continuous deep sedation (CDS) is an extreme form of palliative sedation to relieve refractory symptoms at the end of life. In this study, we shared our experiences with CDS and examined the clinical characteristics associated with survival in patients with terminal cancer who received CDS. We conducted a chart audit of 106 consecutive patients with terminal cancer who received CDS at a single hospice care unit between January 2014 and December 2016. Survival was defined as the first day of admission to the date of death. The associations between clinical characteristics and survival were presented as hazard ratios and 95% confidence intervals using a Cox proportional hazard model. The mean age of participants was 65.2 years, and 33.0% (n=35) were women. Diazepam was the most commonly administered drug, and haloperidol or lorazepam were also used if needed. One sedative was enough for a majority of the patients. Stepwise multivariate analysis identified poor functioning, a high Palliative Prognostic Index score, hyperbilirubinemia, high serum ferritin levels, and a low number of sedatives as independent poor prognostic factors. Our experiences and findings are expected to be helpful for shared decision-making and further research on palliative sedation.

• 한국컴퓨터정보학회논문지
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• 제29권9호
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• pp.145-158
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• 2024

이 연구의 목적은 간호사 주도의 종교적 및 영적 개입이 완화 돌봄 환자들의 심리적 고통에 미치는 영향을 평가하는 것이다. 2023년 12월까지 Pubmed, CINAHL, Cochrane Library, Embase, RISS, KISS, ScienceOn를 검색하였다. 총 597명의 완화돌봄 환자들을 대상으로 한 10편의 연구에 대해 체계적 문헌고찰과 메타분석이 실시되었다. 전반적으로 간호사 주도의 종교적 및 영적 개입은 불안(SMD = -1.09, 95% CI = -1.67, -0.50)과 우울(SMD = -1.12, 95% CI = -1.83, -0.40)을 감소시키는데 유익한 영향을 미치는 것으로 나타났다. 이러한 결과는 간호사 주도의 종교적 및 영적 개입이 적절히 적용될 경우 완화돌봄 환자의 심리적 고통을 줄이는 방법으로 사용될 수 있음을 보여준다.

• 한국보건간호학회지
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• 제17권2호
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• pp.255-265
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• 2003

This study was conducted to provide a baseline data for hospice nurses to improve their practices for the spiritual wellbeing of their clients. Analysis of the spiritual wellbeing status of hospice patients was conducted from April 20 to June 20, 2002. A total of 59 cancer patients who admitted to hospice care units of one university medical center, and who have alert mental status were recruited for the study. Paloutzian and Ellison (982) spiritual wellbeing scale and Jungho Kang (996) scale, which was modified for the cancer patients, were used as the study instruments, ANOVA and T-test were applied using SPSS win 10.0 for statistical analysis. The results are as follows : 1. The mean spiritual wellbeing score of the hospice patients was $49.76(SD\pm7.95)$. When it was converted into 4 point scale, the mean score for the spiritual wellbeing was 2.49. The mean religious wellbeing score was $24.17 (SD\pm5.56)$ and that of the existential wellbeing was $25.59 (SD\pm3.10)$. 2 The mean score for the total spiritual wellbeing was $52.54 (SD\pm8.12)$ for female, and $47.86 (SD\pm6.95)$ for male and the difference was statistically significant (t=-2.305, p=.025), 3. In testing the spiritual wellbeing, there was significant difference according to the religion (F=28.931, p=.000). 4. In testing the religious wellbeing, the mean score was $22.77 (SD\pm5.35)$ for male, and $26.20 (SD\pm5.32)$ for female and the difference was statistically significant (t=-2.430, p=.019). 5. In testing the religious wellbeing, there was significant difference according to the religion (F=37.522, p=.000). However, the religious wellbeing was not different according to the age, occupation, marital status and education level. 6. In testing the existential wellbeing. there was significant difference according to the religion (F=8.147, p=.000). However, mean score for the existential wellbeing was not significantly different according to sex, age, occupation, marital status and education level. 7. In testing the existential wellbeing, there was significant difference according to the level of vigor (F=3.662, p=.032), while no difference was observed in the existential wellbeing according to the general health status, degree of pain, and diagnosis. From the results described above it can be concluded that : To improve the spiritual wellbeing status of hospice patients, hospice nurses should identify spiritual needs of the patients according to the religion. gender and the level of vigor.

• 호스피스학술지
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• 제1권1호
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• pp.34-45
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• 2001

To evaluate the effect of informational support by hospice team on family caregivers of terminally ill cancer patients, 22 family caregivers of D University Hospital in Daegu city were participated. The research was conducted from Aug. 16th to Oct. 28th 2000 by using self-reported questionnaires. The instruments used in this study were the Weinert's scale of perceived social support, Spielberger's state anxiety inventory, CES-D, and Ellison and Paloutzian's spiritual well-being scale. The intervention was designed to give educational and counselling program up to 7 times within 4 weeks. Educational and counselling booklets which made by the researcher were used step by step by hospice team. The data were analysed frequency, percentage, Wilcoxon Singed Ranks Test Test with SPSS Win 10.0/PC. The results obtained from this study were as follows: 1.The perceived social support of family caregivers was significantly increased after ready planned informational support was applied by hospice team(z=-3.045, p=0.002). 2.The anxiety of family caregivers was significantly reduced after ready planned informational support was applied by hospice team(z=-3.348, p=0.001). 3.The depression of family caregivers was significantly reduced after ready planned informational support was applied by hospice team(z=-3.641, p=0.000). 4.The spiritual well-being score of family caregivers was not significantly improved after ready planned informational support was applied by hospice team(z=-0.422, p=0.673). In conclusion, the results of this study clearly suggests that the informational support provided by hospice team not only increased the family caregivers' who are caring for terminally ill cancer patients. Therefor the informational support program designed by researcher for family caregivers who are caring for terminally ill cancer patients should be utilized and expended.

• 보건행정학회지
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• 제15권2호
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• pp.1-15
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• 2005

The aim of this study was to compare medical cost of hospice care and that of conventional care during the last year of life, and identify factors that influenced the cost. From January to August 2003 592 terminal cancer patients receiving care from 5 hospice care units and 2 hospice care teams in general hospitals were enrolled to case group. Two hundreds and seventy two terminal cancer patients receiving conventional care from 7 general hospitals were enrolled to hospital-based control group, and 1,636 terminal cancer patients from 122 general hospitals located in same regions with the 7 hospitals were enrolled to community-based control. We used characteristics and medical cost from data of National Health Insurance Cooperation. Total medical cost per beneficiary in cases was about 10 millions won, 14.5 millions in hospital-based controls and 11.1 millions in community-based controls. The hospice care saved $45\%$ over the last year of life compared with hospital-based controls (p<0.0001). Saving of inpatient cost account for approximately $80\%$ of saving per beneficiary. Hospice care saved $29\%$ of medical cost per hospitalization day compared with hospital­based controls and $17\%$ compared with community-based controls (p<0.0001). Multiple regression analyses showed that hospice care significantly saved the medical cost. This study suggest that hospice care save medical cost compared with hospital-based control and community-based control. Most of saving of inpatient cost account for approximately $80\%$ of saving of medical cost.

• 지역사회간호학회지
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• 제12권1호
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• pp.175-186
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• 2001

To evaluate the effect of informational support by hospice team on family caregivers of terminally ill cancer patients. 22 family caregivers of D University Hospital in Daegu city were participated. The research was conducted from Aug. 16th to Oct. 28th 2000 by using self-reported questionnaires. The instruments used in this study were the Weinert's scale of perceived social support. Spielberger's state anxiety inventory. CES-D. and Ellison and Paloutzian's spiritual well-being scale. The intervention was designed to give educational and counselling program up to 7 times within 4 weeks. Educational and counselling booklets which made by the researcher were used step by step by hospice team, he data were analysed frequency. percentage. Wilcoxon Singed Ranks Test with SPSS Win l0.0/PC. The results obtained from this study were as follows; 1. The perceived social support of family caregivers was significantly increased after ready planned informational support was applied by hospice team(z=-3.045. p=0.002). 2. The anxiety of family caregivers was significantly reduced after ready planned informational support was applied by hospice team(z =-3:348. p=0.001). 3. The depression of family caregivers was significantly reduced after ready planned informational support was applied by hospice team(z=-3.641. p=0.000). 4. The spiritual well-being score of family caregivers was not significantly improved after ready planned informational support was applied by hospice team(z=-0.422. p=0.673). In conclusion. the results of this study clearly suggests that the informational support provided by hospice team not only increased the family caregivers' who are caring for terminally ill cancer patients. Therefor the informational support program designed by researcher for family caregivers who are caring for terminally ill cancer patients should be utilized and expended.