일부 지역주민들의 호스피스에 대한 인지와 태도 및 간호요구 조사

노유자,한성숙,안성희,용진선,Ro, You-Ja,Han, Sung-Suk,Ahn, Sung-Hee,Yong, Jin-Sun 한국호스피스완화의료학회 1999 한국호스피스.완화의료학회지 Vol.2 No.1

목적 : 본 연구는 일부 지역 주민들의 호스피스에 대한 인지와 태도 및 호스피스 간호 요구를 조사하고, 호스피스에 대한 인지와 태도에 따른 호스피스 간호요구를 파악하기 위함이다. 방법 : 1998년 9월부터 10월까지 서초구에 거주하는 $20{\sim}60$세의 성인 남녀 924명을 대상으로 하였으며, 자료는 자기보고식 설문지를 통하여 수집되었고, t-test와 ANOVA를 사용하여 분석하였고 Scheffe test로 다중비교를 하였다. 결과 : 1) 연구대상자의 평균연령은 38세였고, 대부분이 고학력자였다. 2) 호스피스에 대한 인지에서, 호스피스에 대해 들어 본 경험이 있다고 한 경우가 54.1%(501명)였으며, 그 중에서 64%가 여성이었고, 고졸 이상 학력자가 90.7%이었다. 죽음을 미리 준비해야 한다고 생각하는가에 대하여는 약 74%가 긍정적 대답을 하였다. 암과 같은 불치병에 걸린다면 의료인이 그 사실을 말해주기를 원하는가에 대해서는 약 83%가 원한다고 답하였다. 불치병에 걸린 사람에 대한 간호에 대해서는 63.1%가 고통을 최소로 줄이고 편안한 죽음을 맞이할 수 있도록 신체적, 정신적, 영적인 간호를 제공해야한다고 응답하였다. 3) 호스피스에 대한 태도에서, 필요시 호스피스 간호를 받겠다고 한 경우가 약 73.8% 이었고, 말기환자를 돌보는 방법으로는 기정에서 호스피스 팀의 방문을 받으며 돌보는 것이 33.5%로 가장 높았다. 4) 호스피스 간호요구를 영역별로 보면, 신체적 요구(M=4.37)가 가장 높았고 사회적 요구(M=3.96), 정서적 요구(M=3.87), 영적 요구(M=3.79)순이었으며, 전체 요구도는 평균 약 4.00점으로 호스피스에 대한 높은 요구를 보였다. 인구학적 특성별로는, 50세 이상의 연령층과 기혼자들에서 요구도가 가장 높았고, 남성보다 여성이 높았으며, 종교별로는 가톨릭의 경우 요구도가 가장 높았다. 호스피스 간호 요구도는 호스피스에 대해 들어본 경험, 죽음에 대한 준비, 불치병에 대한 통고 및 호스피스의 필요성 인식에 따라 유의한 차이를 보였다. 즉, 호스피스에 대해 들어본 군, 죽음을 미리 준비해야 된다고 전적으로 긍정한 군, 불치병에 대한 통고를 원하는 군, 그리고 필요시에 호스피스 간호를 받겠다는 군에서 호스피스 간호 요구도가 유의하게 높았다. 결론 : 본 연구의 결과는 호스피스에 대한 인지정도를 높일 수 있는 홍보와 교육이 필요함을 시사하며, 지역사회 주민들의 요구를 충족시켜 삶의 질을 향상시키기 위한 가정 호스피스를 발전시키고 나아가서는 전반적인 호스피스 발전을 위한 유용한 자료가 될 것으로 기대된다. Purpose : The hospice movement began about 30 years ago in Korea. However, basic studies have seldom been conducted about the general public's knowledge concerning hospice care and their needs for it. The purpose of this study was to investigate the general public's knowledge of and attitude toward hospice, and their needs for hospice care, and to analyze the needs for hospice care in relation to their knowledge and attitude in residents from a specific community. Methods : The survey was conducted with 924 people randomly selected from a district in Seoul. The data were collected through a self-reporting questionnaire constructed by the authors. With 30 items given in the questionnaire, the level of hospice needs showed Cronbach's alpha .89 in a pilot study and .92 in this study and the items were classified into four areas by a factor analysis. The data collected were analyzed by means of t-test and ANOVA. Results : 1) The average age of the respondents was 38. The majority of the respondents were well-educated. 2) Regarding awareness of hospice care, 54%(501 people) indicated they have heard of hospice. About 74% thought that people should be able to prepare for death in advance. About 83% wanted to be informed when they have life threatening illnesses such as terminal cancer. Also, about 63% responded that patients with terminal diseases should be provided with physical, spiritual, and psychological care for minimizing pain and peaceful death. Regarding the attitude toward hospice care, 74% responded that they would use hospice care if needed. The number of the respondents who preferred home visitation by the hospice team to care for the terminally ill ranked first with 34%. Concerning needs for hospice care : 1) By needs area, physical need showed highest mean(M=4.37), followed by social need(M=3.96), emotional need(M=3.87), and the spiritual need(M=3.79). The overall need level showed the mean value of 4.00 which reflects a considerable need for hospice care. 2) By demographic characteristics, people age over 50, the married, and the unemployed indicated higher level of needs for hospice care. Women showed higher level of needs than did men, and Catholics demonstrated higher level of needs than believers of other religion(P<0.0001). 3) As for the knowledge of and attitude toward hospice rare, the level of hospice care needs was significantly higher in the following groups: those who have heard of hospice, those who are aware of death preparation, those who want information on terminal diseases, those who want to use every method to sustain life, and those who are aware of hospice needs(P<0.001). Conclusion : It is assumed that the findings of this study on the knowledge, attitude, and needs for hospice care in the public can contribute to planning a successful hospice care program. Furthermore, the findings of this study will serve as useful data for the promotion of home hospice care to improve the quality of life of community residents, and contribute to the development of hospice care as a whole.

의료인의 호스피스가정간호에 대한 지식과 태도 조사연구

김옥겸,Kim, Ok-Gyeom 한국호스피스협회 2002 호스피스 학술지 Vol.2 No.2

The advances of medical technologies have not only prolonged human life span, but also extended suffering period for the patients with incurable medical diseases. Hospice movement was developed to help these patients keep dignity and lives peaceful at the end of their life. Since many patients prefer to spend the last moment of life at home with their family, hospice home care has become very popular worldwide. The purpose of this study for a promotion and development of hospice home care in Korea, and features basic research on medical profession's knowledge and attitudes to hospice home care. This study which was used for the research questionnaires developed by the researcher that were answered by 100 physicians and 127 nurses in a general hospital. Data were collected from April 22, 2002 to May 10, 2002. The SPSS was used to make a comparative analysis of the frequency, percentile, ANOVA, and x2-test. The results of the study were as follows; 1.The medical profession showed high level of knowledge of the definition and philosophy of hospice. However, the physician group of the examinees showed insufficient knowledge of the fact that hospice care includes bereavement care, while the nurse group's response to the same question showed a significant difference(x2=10.752, p=.001). 2.For whom the hospice home care is provided, 95.6% of the respondents showed very high level of knowledge as answering that the incurable terminal illness patients and their families are the beneficiaries of hospice care. The respondents counted nurses, volunteers, pastors, physicians and social workers, consecutively, as hospice care providers. More nurse were positive toward pastors than physicians in regarding as a hospice care provider by a significant difference(x2=11.634, p=.001). 3.For when to referral hospice home care to the patients, only 34.2% answered that patients with less than 6 months of survival time are advised to receive hospice care, reflecting very low level of knowledge. 23.0% of the physicians and 48.0% of the nurses answered that hospice care should be provided when death is imminent, making a significant difference between the two groups(x2=6.413, p=.000). 4.To promote hospice activities, 87.2% pointed out that it is crucial to make general people, including those engaging in the medical field, more aware of hospice. 79.7% answered that a national hospice management should be developed, marking a significant difference between the physician group and nurse group(x2=10.485, p=.001). 5.Advantages of hospice home care are 87.2% responded that patients can have better rest at home receiving hospice home care. Economical merit was brought forward as one of the advantages also, where there was a significant difference between the physicians group and nurse group(x2=7.009, p=.008). 6.The medical professions' attitude to hospice home care are 92.8% of the physicians answered that they would advise incurable terminally ill patients to be discharged from hospital, with 44.3% of them advising the patients to receive hospice home care after leaving the hospital. From the nurses' point of view, 20.9% of the terminally ill patients are being referred to hospice home care after discharge, which makes a significant difference from the physicians' response(x2=19.121, p=.001). 7. 30.6% of physicians have referred terminally ill patients to hospice home care, 75.9% of whom were satisfied with their decision. Those physicians who have never referred their patients to hospice home care either did not know how to do it(66.7%) or were afraid of losing trust by giving the patients an impression of giving up(27.3%). 94.9% of the physicians responded that they would refer their last stage patients to a doctor who is involving palliative care. 8.Only 36.2% of nurses have suggested to physicians that refer the terminally ill patients discharged from the hospital to hospice home care. Once suggested, 95.8% of the physicians have accepted the suggestion.

한국 호스피스.완화의료기관 실태 조사

윤영호,최은숙,이인정,이영선,이정석,유창훈,김현숙,백유진,Yun, Young-Ho,Choi, Eun-Sook,Lee, In-Jeong,Rhee, Young-Sun,Lee, Jung-Suk,You, Chang-Hoon,Kim, Hyun-Sook,Paek, Yu-Jin 한국호스피스완화의료학회 2002 한국호스피스.완화의료학회지 Vol.5 No.1

목적 : 연구의 목적은 호스피스 완화의료의 표준화를 위한 기초자료로서 국내 호스피스 완화의료 서비스를 제공하는 의료기관 및 비의료기관의 서비스 대상자, 시설 인력구성, 서비스 내용 및 재정적 문제 등 실태를 파악하는 것이다. 방법 : 설문조사는 2001년 7월부터 10월까지 이루어졌으며, 연구자들이 기존 연구를 참조하여 개발한 총 39항목의 설문지를 반송봉투를 넣어 우편으로 발송하여 조사하였다. 회신이 되었지만 내용을 재확인할 필요가 있는 부분과 회신이 안된 기관은 전화를 통해 설문을 완성하였다. 64개 기관이 설문에 응답하였다. 결과 : 국내에는 호스피스 완화의료 서비스를 제공하는 의료기관이 40개, 비의료기관이 24개 있었다. 의료기관 중 11개 기관은 병원연계 및 독립 또는 별도병동이 었고, 비의료기관 중 6개는 입원이 가능한 독립시설에서 호스피스 완화의료서비스를 제공하고 있었다. 호스피스 완화의료 서비스를 받는 대상자 대부분은 암환자였지만 일부는 말기 질환이 아닌 경우도 포함되어 있었다. 전체 64개 호스피스 완화의료 서비스 기관 중 24개만이 의사, 간호사, 사회복지사 및 성직자가 있었다. 가정호스피스 기관으로서 의뢰체계가 있는 경우는 의료기관 89.7%, 비의료기관 73.7% 였다. 24시간 서비스를 제공하는 기관은 의료기관 65.0%, 비의료기관 37.5%였다. 가족을 위한 휴식공간은 병원중심 호스피스완화의료 프로그램의 50%에서 있었다. 전체 호스피스 완화의료기관의 73.9%는 재정적인 문제가 있었으며, 610%는 정부로부터의 재정적인 지원이 필요하다고 응답하였다. 결론 : 64개 호스피스완화의료 프로그램에서 서비스를 제공하고 있지만 아직도 인력, 서비스의 질 및 시설 측면에서는 문제점이 있었다. 말기환자를 위한 서비스의 질을 향상시키고 의료자원의 효율적인 이용을 촉진하기 위해 호스피스 완화의료 서비스의 표준화와 제도화가 필요하다. Purpose : The purpose of this study was to evaluate the present status of hospice palliative care programs in Korea as a basic database for standardization of hospice palliative care. Method : The data was collected from July to October, 2001. The instrument used for this study was the questionnaires which was consisted of the general characteristics of organization, recipient of service, manpower, contents of service, financial conditions and facilities. Sixty-four hospice palliative care programs answered the questionnaires, confirmed by telephone. Results : They were 40 hospital-based hospice palliative care programs and 24 nonmedical hospice palliative care programs. 11 Hospital-based hospice palliative programs have isolated unit or hospital affiliated free standing hospice. 6 Non-hospital hospice palliative programs have a free standing hospice. Major subjects of hospice palliative program were terminal cancer patients but patients with non-terminal illness were also included. Only 24 of 64 hospice palliative programs had all of the essential professionals : physicians, nurses, social workers, and clergies. Home hospice palliative care programs have a referral system in hospital based (89.7%) and nonmedical programs (73.7%). 24hr hospice are were provided in 26 hospital-based (65.0%) and 9nonmedical programs (37.5%). There were rooms for family in half of hospital-based programs. 73.9% of hospice palliative care programs have financial problems. 62.0% of Hospice palliative care programs need financial support from government. Conclusion : 64 Hospice palliative care programs provided hospice palliative services but had many problems in manpower, quality of care and facility. For improving the quality of terminal patients' life and promoting the cost effectiveness of health care resources, it is necessary to consider the standardization and institutionalization of hospice palliative care.

호스피스 프로그램 운영 현황 조사

장현숙,박실비아,유선주,Chang, Hyun-Sook,Park, Sylvia,You, Sun-Ju 한국호스피스완화의료학회 2000 한국호스피스.완화의료학회지 Vol.3 No.1

목적 : 본 연구는 우리나라의 호스피스 프로그램 현황을 조사하여 향후 호스피스관련 정책 수립을 위한 참고자료를 제시하고, 궁극적으로 말기환자의 삶의 질을 향상하고 보건의료자원의 효율적 이용을 도모하는 것을 목적으로 수행되었다. 방법 : 전국의 59개 호스피스 프로그램을 대상으로 기관 일반현황과 활동 인력 현황, 환자 현황, 케어 현황, 재정 현황, 시설 현황 등을 우편설문 조사하였다. 조사에 응답한 기관은 38개(64.4%)기관을 분석하였다. 결과 : 조사에 응답한 기관은 3차진료기관이 11개소, 3차 진료기관을 제외한 병원급 이상 의료기관이 11개소, 의원이 3개소, 가정방문팀이 12개소, 독립시설이 1개소였다. 38개 기관을 중심으로 운영현황을 조사한 결과, 호스피스 기관마다 활동 내용 및 구조에서 큰 차이가 있었고, 일부 기관은 호스피스 기관임을 지향함에도 불구하고 엄밀한 의미에서의 호스피스의 요건을 충족시키지 못하고 있었다. 38개 기관중 호스피스 활동의 기본 인력을 모두 갖춘 곳은 9개소에 그쳤고, 호스피스 교육을 받지 않은 자원봉사자가 활동하는 기관도 있었다. 절반 이상의 기관이 '의식이 분명하고 의사소통이 되는 환자만을 대상으로 한다'는 호스피스 케어의 일반 원칙을 준수하지 않고 있었고, 환자의 의무기록을 보관하지 않는 기관도 16%나 되었다. 3차 진료기관을 비롯한 병원의 호스피스에서는 상대적으로 강도 높은 의료서비스가 제공되고 있는 것을 확인할 수 있었다. 호스피스 프로그램이 기관마다 큰 편차를 보이고, 일반적인 호스피스 기준에 미치지 못하는 기관이 많음에도 불구하고 본 조사의 응답기관 중 11개 기관에서 대기중인 호스피스 환자가 있다고 답하여 호스피스에 대한 수요는 제공기관의 공급을 초과하는 것으로 나타났다. 결론 ; 말기환자는 지속적으로 발생하며 말기환자에 의한 의료자원 소모가 점차 중요한 문제로 부각되고 있다. 그러한 고비용의 서비스보다 증상조절을 중심으로 한 호스피스 케어가 말기환자의 삶의 질 향상에 유용하다는 보고가 증가하고 있으므로, 장차 우리나라에서도 말기환자를 위한 호스피스의 제도화가 고려되어야 할 것이다. 호스피스의 제도화를 앞당기기 위해서는 호스피스 프로그램의 표준화와 함께 호스피스 프로그램 신임(Accreditation)제도 도입 등을 적극적으로 검토하여 질적 수준을 높혀 나아가야 할 것이다. Purpose : This study aimed to investigate and to evaluate the present conditions of hospice programs in Korea for supplying data useful in making policy in hospice, which is not institutionalized yet. Method : For this purpose we surveyed 59 hospice programs regarding the general characteristics, manpower, patients, services, financial conditions, and facilities. Thirty-seven hospice programs answered the questionnaires. Result : They were 11 tertiary hospitals, 11 other hospitals, 3 clinics, 12 home care hospice, and 1 freestanding hospice. Only 9 hospice programs have all of the essential professionals: physicians, nurses, social workers, clergies, and volunteers. In some hospice programs, volunteers who had not been trained for hospice provided services to terminal patients. More than half of the hospice said they provided services to the patients who lost their consciousness and were not suitable for hospice care. 16% of the hospice said they did not keep the patients' record. Some hospitals including tertiary hospitals provided such intensive care as radiotherapy, TPN, injections to hospice patients. Many hospice programs other than hospitals didn't charge patients for hospice care. 60% of the hospice said they suffered from financial problems. Most of the hospice wards were not built for hospice use at first. So they did not have such supplementary facilities as dayroom, waiting room, special bathing facilities etc. Conclusion : For improving the quality of terminal patients and promoting the cost effective use of health care resources, it is necessary to consider the institutionalization of hospice. The institutionalization of hospice programs can improve the quality of hospice care and the standardization of the hospice program can hasten its institutionalization.

Terminal cancer patients’ and their primary caregivers’ attitudes toward hospice/palliative care and their effects on actual utilization: A prospective cohort study

An, Ah Reum,Lee, June-Koo,Yun, Young Ho,Heo, Dae Seog SAGE Publications 2014 Palliative medicine Vol.28 No.7

<P><B>Background:</B></P><P>Previous studies on hospice/palliative care indicated that patients’ socio-demographic factors, disease status, and availability of health-care resources were associated with hospice/palliative care utilization. However, the impact of family caregivers on hospice/palliative care utilization has not been thoroughly investigated.</P><P><B>Aim:</B></P><P>To evaluate the association between attitudes toward hospice/palliative care of both patients with terminal cancer (defined as progressive, advanced cancer in which the patient will die within months) and their family caregivers and utilization of inpatient hospice/palliative care facilities.</P><P><B>Design:</B></P><P>A prospective observational cohort study was performed in 12 hospitals in South Korea. Attitude toward hospice/palliative care was assessed immediately after terminal cancer diagnosis. After the patient’s death, caregivers were interviewed whether they utilized hospice/palliative care facilities.</P><P><B>Participants:</B></P><P>A total of 359 patient–caregiver dyads completed baseline questionnaires. After the patients’ death, 257 caregivers were interviewed.</P><P><B>Results:</B></P><P>At the baseline questionnaire, 137/359 (38.2%) patients and 185/359 (51.5%) of caregivers preferred hospice/palliative care. Preference for hospice/palliative care was associated with awareness of terminal status among both patients (adjusted odds ratio: 1.87, 95% confidence interval: 1.16–3.03) and caregivers (adjusted odds ratio: 2.14, 95% confidence interval: 1.20–3.81). Religion, metastasis, and poor performance status were also independently associated with patient preference for hospice/palliative care. At the post-bereavement interview, 104/257 (40.5%) caregivers responded that they utilized hospice/palliative care facilities. Caregiver’s preferences for hospice/palliative care were significantly associated with actual utilization (adjusted odds ratio: 2.67, 95% confidence interval: 1.53–4.67). No patient-related factors were associated with hospice/palliative care utilization.</P><P><B>Conclusion:</B></P><P>Promoting awareness of prognosis and to improve communication between doctors and families is important for facilitating the use of hospice/palliative care.</P>

한국 시설호스피스의 원리와 실제

강승계,김수호,김신수,박희명,송근옥,원주희,이명숙,이성옥,이옥제,이은의,이채영,이현미,허필석,Gang Seung-Gye,Kim Su-Ho,Kim Sin-Su,Park Hui-Myeong,Song Geun-Ok,Won Ju-Hui,Lee Myeong-Suk,Lee Seong-Ok,Lee Ok-Je,Lee Eun-Ui,Lee Chae-Yeong,Lee Hyeo 한국호스피스협회 2002 호스피스 학술지 Vol.2 No.1

The hospice activities in Korea have still stood in the premature stage, although the contemporary hospice program, which professionally accommodates terminally ill patients, appeared in the history 35 years ago. Especially, the availability of the facility hospice is not only poor in number, but also lack of a guideline for the conduct of the facility. Saemmul Hospice has keenly felt the necessity of more facility hospices and has interchanged experiences and informations with people interested in hospice. However, the number of facilities has fallen short of one's expectations, and many problems have been revealed in order to maintain the operation. This paper was written in order to improve these atmospheres and to help more terminally ill cancer patients properly. This paper clarifies in detail the principle of management, the method of practice in each departments of Saemmul Hospice, expected effects and supplemental items. We try to provide concrete and practical informations and to help extensively for all peoples who are to begin or currently working. 1.Facility: It secures, maintain, and manage the hospice environment for all around care of patients effectively. 2.Education and Volunteer: It trains and manages hospice volunteers devoted to hospice. 3.Financial: It manages donation by healthy soul with an effective method. 4.Administration and Organization: It executes the administration efficiently and constitutes the organization to operate. 5.Medical and Nursing: It offers the maximum professional supports to a hospital. 6.Medicine and alternative medicine: It improves the quality of life of patients by medical and pharmaceutical approach and by other possible methods available. 7.Nutrition: It helps patients to have diets in accord with the order of the creation. 8.Belief: It offers spiritual care which allows the profound relationship with God. 9. Funeral ceremonies: Funeral ceremonies may heal grieves of families faced with their deaths. 10. Bereaved families: It supports the families after the deaths of patients. 11.Reception and consultation: It seeks to help the patients who meet the purposes for which Saemmul Hospice is established. 12.Publication: It allows publicity activities for Saemmul Hospice. Facility hospice programs are able to overcome the disadvantages that the other type of the hospice possess, like as the economic burdens of the families, and the patients' losses of comforts of home after being transferred to a hospital. Facility hospice can provide home atmosphere with professional manpower and facilities like hospital to the patients. Therefore, it can also improve patients' qualities of life and make them comfortable death. We anticipate that the hospice program in Korea would be more active to let more people be indebted to maintain the nobel human dignity and to cross beautifully in the most painful process of dying in the journey of their lives.

초기경전에 나타난 불교호스피스(비하라) 서비스 원형 연구

김응철 한국불교학회 2010 韓國佛敎學 Vol.56 No.-

The people who, not only the cancer because of inveterate disease,dies today increased rapidly. Reason because like this the hospice service is introduced, the recently many research is advanced. The hospice services are one from in terminal care service. It is one of the social welfare service for the dying hour people and those families Hospice services developed in religious base of the Western society. On the other hand, from teacher’s platform founding early stage to Buddhism vihara was operated. And hospice services of the form which is similar were provided from that place. Accidentally hospice and vihara is meaning which is similar. Vihara service activities were advocated from the Buddhism, the interest increased about Buddhism hospice service development. If compares from the side which is a service method, Vihara and hospice services are similar. But in case sees from the different side,there is a big difference to between two terminologies. Namely the dead and the world of dead after that, abode of the blessed and Heaven, dying hour world-wide, spirit of service etc. Vihara is one of Buddhism social welfare service, to provide hospice services from Buddhism viewpoint. From this research used Vihara with the word which substitutes Buddhism hospice. Also from while Buddha’s preaching the contents which relates with vihara services sought, and re-interpreted. And for the development of vihara services from, presented the founding of vihara professional academic society, magnification of international interchange and the operation of vihara hospitals. 현대사회에서 암과 같은 난치병으로 사망하는 사람들이 늘어나고 있다. 이로 인하여 호스피스 서비스가 도입되었고 최근 들어 많은 연구가 진행되고 있다. 호스피스는 터미널 케어의 한 방법으로 임종자와 그 가족들을위한 복지서비스의 하나이다. 호스피스 서비스는 서양 사회의 종교적 기반을 가지고 발전하였다. 반면에 불교는 교단설립 초기부터 비하라가 운영되었고 그곳에서 유사한 서비스가 제공되고 있었다. 공교롭게도 호스피스와 비하라는 유사한 의미를지니고 있다. 불교계 일각에서는 비하라 운동을 제창하면서 불교 호스피스 서비스 개발에 대한 관심이 커지게 되었다. 비하라는 호스피스와 서비스 방법이라는측면에서 큰 차이는 없지만 서비스의 정신과 임종과정에 대한 인식, 사생관 등에서 차이가 있다. 비하라는 불교적 관점에서 호스피스를 제공하려는불교사회복지 서비스의 하나이다. 본고에서는 비하라 서비스를 불교 호스피스를 대체하는 용어로 사용하고자 하였다. 또한 부처님의 설법 중에서 비하라 서비스와 관련된 내용을찾아서 이를 재해석하고자 하였다. 또한 비하라 서비스의 발전을 위해서이와 관련된 전문 연구학회를 만들고 국제교류 확대 및 비하라 병동을 운영하는 안을 제시하였다.

국내 호스피스 현실에 적합한 불교적 호스피스 모델 연구

문진건 동방문화대학원대학교 자연치유연구소 2023 자연치유연구 Vol.7 No.3

The purpose of this study is to examine the reality of the domestic hospice systems and hospice programs for Buddhists, and to derive a conceptual model of the Buddhist hospice necessary to make a hospice program for the terminally ill Buddhist patients. In fact, in the Buddhist community in Korea, the Korean Buddhist Hospice Association carried out practical activities based on the Buddhist ideology, but showed limitations in its spread and practice. In this reality, rather than seeking to train Buddhist hospice specialists, I think it is more practical to create and distribute a 'hospice program for Buddhists' suitable for nurses to use in domestic hospice hospitals. In order to provide hospice services suitable for Buddhists to the medical field of domestic hospitals, it is necessary to develop and disseminate a Buddhist hospice service model that nurses and hospice volunteers at hospitals can receive and use in the field. With this in mind, this study derived a conceptual model of Buddhist hospice suitable for the Buddhist point of view based on the 'peaceful end of life theory' of nursing. First, the peaceful end of life theory was reviewed and important sub-concepts were extracted, and then it was explained how it should be modified in relation to the Buddhist doctrine. The Buddhist hospice model can be seen as a hospice model that focuses on the Buddhist view of life and death, which is a fusion of the nursing theory of death with dignity and the Buddhist theory of karma and the Four Noble Truths. If this Buddhist hospice model is distributed to existing hospitals and used to educate nurses and hospice caregivers, it can be expected to revitalize Buddhist hospice.

감각자극요소를 적용한 독립형 호스피스 치유환경에 관한 연구

김성배 ( Seongbae Kim ),이종세 ( Jongse Yi ),김주연 ( Jooyun Kim ) 한국공간디자인학회 2017 한국공간디자인학회논문집 Vol.12 No.3

(Background and Purpose) The number of diagnosed patients and deaths caused by all kinds of cancer has significantly grown, due to rapid changes in personal lifestyles and the natural environment. Conversely, however, the use of hospice services has reached an all-time low. The central government has also been providing moderate support in numerous ways, including asking legislators to add more hospice facilities, yet challenges face the future of hospice planning, as practical changes have been limited to merely renovating a hospital ward into a hospice ward. This study aims to propose a new model for hospice care, as a freestanding hospice incorporating natural healing elements from sensory stimuli in the environment. To terminal cancer patients and their families, such a space is both necessary and sufficient for patients to live in comfort the remainder of their lives. (Method) This research focuses on the freestanding hospice. The research method is to identify the sensory stimuli needed for healing conditions and use the Evidence Based Design method to classify whichever elements may be applied to the planning of hospice facilities. What follows thereafter are the analysis and verification steps taken to study the freestanding hospice case, based on the details of the classified sensory stimuli. Finally, this research proposes a specific direction for the design of hospice facilities. (Results) In this study, investigations were conducted to determine the healing characteristics of different sensory stimuli, while analyses of the cases of domestic and foreign freestanding hospice facilities were performed and based on the details of sensory stimuli. Consequently, the elements of visual stimuli of the Saemmul Hospice were good overall. The Sungmo Kotmaeul Hospice`s elements of the visual and olfactory stimuli were good overall. Whereas, the Mohyeon Hospice`s elements of the visual, auditory, and olfactory stimuli were good overall. Hospice Djursland of Denmark rated well across all elements of the sensory stimuli. Houston Hospice`s elements of the visual, auditory, and olfactory stimuli were good overall. (Conclusions) Free standing hospice facilities employing detailed elements of sensory stimuli for healing can offer a healthy environment that may positively change negative thoughts of patients and their families. Details of the sensory stimuli extracted from the concept and elements of healing environments maintain such a critical relationship with hospice facilities in that the very physical transmission of parasympathetic nerves and the experience of sentimental space yielded by positive stimuli on each sensation provide a physically and mentally healing environment for the patients and their families.

국내 호스피스 현실에 적합한 불교적 호스피스 모델 연구

문진건 동방문화대학원대학교 자연치유연구소 2023 자연치유연구 Vol.8 No.1

본 연구는 국내의 호스피스 제도와 불교인을 위한 호스피스 프로그램의 현실을 살펴보고, 불교인 말기 환자를 위한 호스피스 프로그램을 만들기 위해 필요한 불 교적 호스피스의 개념적 모델을 도출하는 데에 목적을 두고 있다. 실제로 국내의 불교계는 한국불교 호스피스협회가 불교 이념에 바탕을 둔 실천 활동을 전개하였 으나 보급과 실천에 한계를 보였고, 최근에는 국내의 호스피스 분야는 병원의 의 료현장 위주의 호스피스가 주류를 이루고 있다. 이와 같은 현실에서 불교 호스피 스 전문가의 양성을 모색하는 것보다는 국내의 호스피스 병원에서 간호사가 직접 쓰기에 적합한 ‘불교인을 위한 호스피스 프로그램’을 만들어 보급하는 것이 더 실 용적이라고 본다. 국내 의료현장에 불교인에 적합한 호스피스 서비스가 보급되기 위해서는 병원의 간호사와 호스피스 봉사자들이 배워서 현장에서 활용할 수 있는 불교적 호스피스 서비스 모델이 개발·보급되어야 한다. 이와 같은 취지로 본 연구 는 간호학의 ‘평화로운 생의 임종 이론’을 기반으로 불교적 관점에 적합한 불교적 호스피스의 개념 모델을 도출하였다. 이러한 불교적 호스피스 모델을 기존의 병원 에 보급하여 간호사 및 호스피스 교육에 사용된다면 불교 호스피스 활성화를 기 대해 볼 수 있다. The purpose of this study is to examine the reality of the domestic hospice systems and hospice programs for Buddhists, and to derive a conceptual model of the Buddhist hospice necessary to make a hospice program for the terminally ill Buddhist patients. In fact, in the Buddhist community in Korea, the Korean Buddhist Hospice Association carried out practical activities based on the Buddhist ideology, but showed limitations in its spread and practice. In this reality, rather than seeking to train Buddhist hospice specialists, I think it is more practical to create and distribute a 'hospice program for Buddhists' suitable for nurses to use in domestic hospice hospitals. In order to provide hospice services suitable for Buddhists to the medical field of domestic hospitals, it is necessary to develop and disseminate a Buddhist hospice service model that nurses and hospice volunteers at hospitals can receive and use in the field. With this in mind, this study derived a conceptual model of Buddhist hospice suitable for the Buddhist point of view based on the 'peaceful end of life theory' of nursing. First, the peaceful end of life theory was reviewed and important sub-concepts were extracted, and then it was explained how it should be modified in relation to the Buddhist doctrine. The Buddhist hospice model can be seen as a hospice model that focuses on the Buddhist view of life and death, which is a fusion of the nursing theory of death with dignity and the Buddhist theory of karma and the Four Noble Truths. If this Buddhist hospice model is distributed to existing hospitals and used to educate nurses and hospice caregivers, it can be expected to revitalize Buddhist hospice.