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RISS 인기검색어
- 검색키워드
- 저자 : 한성숙(Han Sung-Suk) (검색결과 44 건)
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한성숙,노유자,양수,유양숙,김석일,황희경,Han, Sung-Suk,Ro, You-Ja,Yang, Soo,Yoo, Yang-Sook,Kim, Sek-Il,Hwang, Hee-Hyung 한국가정간호학회 2003 가정간호학회지 Vol.10 No.1
The purpose of this study was to describe the perceived burden of the terminally III patients's caregiver and to analyze relationship between the perceived burden and the various demographics, illness characteristics, family relationships, and economic factor of the family & patients. The sample of 132 caregivers who care for the terminally III patients Kyung-Gi province, Seoul, Korea. The period of this study was from August to September, 2002. The perceived burden of the family caregiver was measured by the burden scale(20 items, 4 point scale) developed by Montgomery et al. (1985). The Data was analyzed using SAS-program by t-test and ANOVA. The results were as follows; 1. The mean of the family caregiver's burden score was 3.02. The score showed that caregivers perceive severe the level of burden. The hight items of the family caregiver's burden were' I feel it is painful to watch patient's diseases'(3.77). 'I feel afraid for what the future holds for my patients'(3.66), 'I feel it reduced to amount of privacy time'(3.64). 2. The caregiver's burden was significantly related to patient's gender(F=3.17, p= 0.0020), patient's job(F=2.49, p=0.0476), caregiver's age(F=4.29, p=0.0030), and caregiver's job(F=2.49, p=0.0476). 3. The caregiver's burden according to illness characteristics showed no significant difference. 4. The caregiver's burden was significantly associated with patient's family relationship (F=4.05, p=0.0041), patient's care mean period in a day(F=47.18, <p=.000l), patient's care period after diagnosis (F=5.18, p=<.0001), and economic status of family(F=3.58, p=0.0088). The highest caregiver's burden related to family was 'parents caregivers'(3.27), the lowest was 'patient's son & daughter caregivers'(2.88). In case of prolonged care period in a day, the caregiver's burden was significantly high. In case of prolonged care period after diagnosis, the caregiver's burden was significantly high. In case of no monthly family income. the caregiver's burden was significantly increased (3,24). The need for health care has expanded from curative therapy to health promotion and rehabilitation also. finally the need for hospice care has demanded in order to improve the quality of life of the terminally ill patients and their families. Because physical, emotional, social and spiritual approaches are required to meet their needs, the integration of various resources is very important. This study is carried out to build a community-based integrated model that is good for improving the patients and familiy's quality of life and to minimize the cost from tertiary hospitals. There were several subjects in this study such, analyses as traditional home care, utilization review of terminally ill patients, measurement of burden of family members and provided practice guidelines for the home cancer patient management. We suggest three strategies for the development of a new model. The firstly the change of the role of the healthcare center from a direct service provider to a management-oriented organization. The secondly the induction of a team-based approach by preserving the proper role of each organization. The thirdly the reenforcement of this team-based approach with the sharing of information on the patients and community-based resources. These suggests are based on the Partnership Collaboration Model and the strategies stated as in the above. In this model, the health care center could playa managerial role and all of the community's resources and the patient's information could hold in common. It is indicated that the information of the patients might be safely used by a semi-open system and an open-system for sharing of the information of the community-based resources.
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간호사들이 임상에서 경험하는 도덕적 고뇌(distress)
한성숙(Sung-Suk Han) 한국생명윤리학회 2005 생명윤리 Vol.6 No.2
The sample population for this research is based on 300 employees ranging from general nurses to unit managers at the University Hospital. The survey was conducted to measure moral distress in descriptive way that nurses experience at clinical practice. Myung-Sook Yu(2003) developed the tool used for this moral distress research and there were total number of 66 questions on the survey. In terms of the reliability rate, the circumstances aspect was at .93(Cronbach's a score), cognition aspect at .90, behavior aspect at .60, and emotional aspect was at .91. The results were as follows: 1. As we look at the scores on each aspects of moral distress, the average score of circumstances was 2.89, cognition average at 3.06, behavior at 2.69, and emotion average was at 3.80. 2. In circumstances aspect, a significant difference was found only in nursing practice area(F=3.94, p=0.00). 3. There was no significant difference in cognition aspect. However, a marginal difference was found between age and nursing practice area by Duncan Test. 4. In behavior aspect, length of practice was the only difference shown(F=4.49, p=0.01) 5. Emotion aspect resulted in no sufficient difference. 6. As we looked at the circumstance aspect, depending on practice type, a significant difference was found in two categories, general ward and special ward.(t=3.94, p=0.00). 7. As we looked at the behavior aspect, depending on practice type, a significant difference was found in two categories, general ward and special ward.(t= -2.40, p=0.02). 8. There was significant positive correlation among all aspects of moral distress As a result, we can conclude that there were differences in each aspects of moral distress and the scores were above average. However, since the sample population was collected from one specific hospital setting, the reliability issue is certainly a concern. Thus, similar researches need to be conducted repeatedly, and use of larger sample population is particularly recommended to represent various regional areas.
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한성숙 ( Sung Suk Han ),김중호 ( Joong Ho Kim ),구인회 ( In Hoe Ku ),홍석영 ( Suk Young Hong ),이경상 ( Kyung Sang Lee ) 한국의료윤리학회 2005 한국의료윤리학회지 Vol.8 No.2
In Korea, the existence of clear guidelines on DNR(Do Not Resuscitate) has been insufficient. Generally, the procedure is done after assigned doctors and family members subjectively make decisions on DNR. Also, because patients who need DNR have been receiving the procedure inconsistently, the need for clear DNR guidelines is increasing. Through the research, the main purpose is to develop the guidelines. As the first step of the research procedure, various documentary records and DNR related database were used as references. Secondly, based on the reference, the first draft of DNR guidelines that can be applied to hospital settings was created by our researchers. On the next step, a group of professional experts was invited to review the first draft and rectify any controversial contents. To be specific, the guideline proposal was reviewed and corrected by professionals (doctors, philosophers, lawyers, etc) through 2 meetings by Delphi method. Finally, the draft was sent to Hospital Ethics Committee for a delicate examination. As a result, our guideline draft was ethically and legally acceptable according to the committee. Moreover, ethical issues were examined and discussed to provide deep understanding on the guideline draft.
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DNR(Do-Not-Resuscitate)에 대한 의사와 간호사의 경험 및 인지도
한성숙(Sung Suk Han) 한국간호행정학회 2005 간호행정학회지 Vol.11 No.3
This study is a descriptive research in investigating the perception of doctors and nurses with regard to DNR, and data were collected through survey questionnaires. The period of collecting data was between July 15 and October 30, 2004, distributing 128 questionnaires to 128 participants, and a total of 110 questionnaires from 55 doctors and 55 nurses were collected (86%) among 70 different hospitals. The collected data were analyzed using SAS program to get real number and percentage, and were also analyzed with X2-test. The Study Results are as follows: 1. Respondents who agreed with the necessity of DNR was 97.27%, the reasons of DNR necessity were 59.20% of ``impossibility of recovery in spite of lots of efforts,`` and 35.20% of ``for the purpose of choosing a comfortable and dignified death,`` and 97.2% of respondents answered that it was necessary to give explanation of DNR to serious case patients, terminal patients and their family. 2. Problems derived from DNR decisions were 44.44% of ``lack of treatment and nursing,`` 21.11% of ``guilty conscience about failing to do best efforts,`` and 71.57% of CPR implementation right after DNR decision. 3. Reasons of implementing CRP for patients with DNR decision were 50.94% of ``for the presence of family and relatives at the point of patient`s death,`` 20.76% of ``guardian`s change of DNR decision,`` and 16.98% of ``no communication for the consent after DNR decision.`` 4. With regard to who was to make DNR decision? there was a difference in the opinion between doctors`` and nurses`` group while the group of doctors chose ``by the consent of the family and the doctor in charge,`` and the group of nurses chose ``patient``s intension,`` and with regard to Have you received DNR related education? And will people who want DNR increase if there is explanation given? There was a difference between the two groups. 5. In the catholic institutions, respondents of 71.7% said that it was necessary to take DNR depending upon the situation, and 73% said that they had performed DNR before. 6. In the institutions with over 500 beds, 91.92% of respondents said that there should be an establishment of guideline book as a written format to implement DNR. From the results of this study, it was found that DNR was implemented and executed broadly in clinical fields in the absence of necessary instructions and/or guideline, and that DNR order was placed to the group of doctors who got less opportunity for proper education than did that of nurses.
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"실폐소생술포기(DNR)"에 대한 요청서 및 지시서 개발
한성숙(Han Sung Suk),김중호(Kim Joong Ho),문인성(Moon In Sung),용진선(Yong Jin Sun) 한국생명윤리학회 2005 생명윤리 Vol.6 No.1
The subjects of the study are First, to accumulate DNR related guideline and DNR request and order, questionnaires were sent to 70 randomly selected university hospitals and general hospitals, and the data were collected between July and September 2004. Second, after the draft of DNR request and order was developed, the first professional group (total 12 people) to seek advise regarding the draft was formed including four doctors, three head nurses, two ministers, two philosophers, and one legal professional. The second professional group (5 people) included four doctors and a legal professional who presented significant opinions in the first advisory meeting, and they discussed the revised draft during the second advice. In this study, Delphi technique was used to develop DNR requests and order. The instrument was the draft of DNR request and order form developed by researchers for our hospital based on DNR request and order collected from 9 institutions at home and materials from abroad for the development of DNR instructions and requests. For the final revision of DNR request and order form, we've decided to prepare some space to write down the diagnosis, the progress of treatment, and the prognosis of patients on the back of the form, and us e it for explaining and seeking the consent in compliance with the regulation of the hospital ethics committee. Also we've decided to call the form "DNR request and order form". Regarding the suggestion from the hospital ethics committee, the legal interpretation is needed advised; the second suggestion from a legal professional could be an alternative. This "DNR request form" will be evaluated after one year of trial in our hospital from March 1 2005. Furthermore, for the proper use of this form, we are planning to publicize to develop and use "DNR guides". I suggest developing the forms of living wills or advance directives, for they are of use in case that patient can't make his own decision due to any abrupt accident.
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