간호사가 인식·경험하는 말기암 환자 간호의 장애요인과 지지요인

허경숙(Heo, Kyung Suk),박은준(Park, Eun-Jun) 대한종양간호학회 2016 Asian Oncology Nursing Vol.16 No.3

Purpose: The purpose of this study was to examine obstacles and supportive behaviors perceived or experienced by clinical nurses providing care for terminally ill cancer patients. Methods: Beckstrand’s survey questionnaire was translated into Korean and verified by an expert committee and through a preliminary study. A survey that used 26 questionnaire items on obstacles and 24 on supportive behaviors, was conducted among 228 registered nurses with more than one year of experience at medical-surgical general wards in a hospital. Results: The highly-perceived and frequently-experienced obstacles in providing care for terminally-ill cancer patients were related to patients’ uncontrollable pain or psychologically unstable family members. The highly-perceived and frequently-experienced supportive behaviors were related to caring family members or having supportive family members. However, nurses’ perceptions or experiences of multiple obstacles and supportive behaviors differed by hospital type, career length, and department. Conclusion: Nurses seem to be in need of training for pain management for terminal cancer patients and of family care in general. Highlyperceived and highly-experienced obstacles or highly-perceived but rarely-experienced supportive behaviors should be intervened without delay considering a hospital type or nurses’ career length.

가족 구성에 따른 호스피스 완화의료 말기암환자의 특성

박상미,황선욱,한경도 한국호스피스완화의료학회 2018 한국호스피스.완화의료학회지 Vol.21 No.4

Purpose: The purpose of this study was to investigate the family composition of terminally ill cancer patients admitted to the hospice unit and how it affects their hospice care. Methods: We retrospectively analyzed the medical records of terminal cancer patients who died in one hospice unit between January 2009 and March 2014. The demographic and clinical characteristics of the patients were examined, and any different made by their marital status was evaluated. We calculated the time interval between cancer diagnosis and hospice admission and the survival period from hospice admission to death and analyzed their association with family composition. Results: When divided by the median time of 13 months between diagnosis and admission, Group B (>13 months) had a significantly higher proportion of patients living with their spouses; (P<0.01). The main decision maker was a spouse (52.9%) in Group B; (P=0.04). Conclusion: Among the characteristics of the family composition, the presence of spouse was an important factor associated with admission to a hospice unit. Clinicians need to be aware of the impact of marital status on end-of-life care. This study indicates that it is helpful to understand family composition of terminally-ill cancer patients for an effective palliative and hospice care. 목적: 가족구성의 특성이 건강에 미치는 영향에 관한 다양한 실증 연구들이 꾸준히 보고되어 왔다. 우리나라에 말기암환자의 가족구성의특성에 대한 연구가 부족하여 이에 본 연구에서는 호스피스 병동에입원하고, 사망한 말기암환자의 가족구성의 특징을 파악하고 호스피스 완화의료 이용과의 연관성에 대해 알아보고자 하였다. 방법: 2009년 1월부터 2014년 3월까지 일개 호스피스 병동에 입원후 48시간 후 사망한 말기암환자의 134명의 의무기록을 후향적으로분석하였다. 환자들의 인구사회학적 및 임상적인 특성을 확인하여동거배우자 유무에 따른 차이를 살펴보았으며, 암 진단 후 호스피스입원까지 기간(개월) 및 입원 후 사망까지의 생존기간(일)을 산출하여 가족구성과의 연관성을 알아보았다. 결과: 암 진단 후 호스피스 입원까지 기간의 중앙값 13개월을 기준으로 나눈 Group B(13개월 이후)에서 배우자 동거군의 비율이 통계적으로 유의하게 높았다(P<0.01). 주의사결정권자는 Group A 에서는 자녀인 경우가 59.0%, B에서는 배우자가 52.9%로 많았다(P=0.04). 호스피스 입원 후 사망까지 기간의 중앙값 20일을 기준으로 Group 1(20일 미만)과 Group 2(20일 이상)로 나누어 살펴보았을 때 두 군 간의 가족구성의 특징은 통계적으로 유의한 차이가 없었다. 결론: 가족구성의 특성 중 배우자의 유무가 말기암환자의 호스피스완화의료 이용 시기에 영향을 미치는 요인으로 나타났으며, 말기암환자와 가족의 보다 더 효율적이고 적절한 호스피스 완화의료 이용을 위해 가족 구성의 특성을 파악하는 것이 도움이 될 수 있다.

교정시설 중증질환 수용자의 인권적 의료처우

허경미(Huh Koung Mi) 한국공안행정학회 2018 한국공안행정학회보 Vol.27 No.1

이 연구는 중증질환 수용자의 인권적 의료처우와 관련한 유엔피구금자최저기준규칙을 포함한 국제규범을 살펴보고 형의 집행 및 수용자 처우에 관한 법령, 법무부의 수용자의료관리지침 등을 비교분석하여 국제적 인권규범 수준에 준하는 정도의 국내법의 정비방향을 제시하고자 하였다. 교정시설의 중증질환 수용자의 의료환경은 매우 열악하여 2016년을 기준으로 의사는 정원의 79%에 그치며, 안양교도소 등 14개소는 전문의가 한 명도 없었다. 2013년 이후 4년 동안 교정시설에서 매년 질병으로 22명이 사망하였고, 형집행정지거부로 외부진료를 받지 못하고 사망한 경우는 66명으로 나타났다. 또한 2016년을 기준으로 교정시설 수용자 중 34.2%가 질병관리본부가 정한 4대중증질환을 앓고 있는 것으로 나타났다. 그런데 현행 형의 집행 및 수용자 처우에 관한 법령은 국제규범의 중증질환 수용자에 대한 인권적 의료처우의 가이드라인에 미치지 못하는 것으로 분석되었다. 유엔피구금자최저기준규칙, 유엔수용자처우기본원칙, 유엔경제사회이사회결의안 2004/35, 유럽평의회 각료위원회 권고 No.R (93) 6, 유럽평의회 각료위원회 권고, No. R (98) 7, 말기질환에 대한 세계의료협의회 선언 등은 중증질환 수용자에 대하여 외부의료시설로의 이송원칙, 조기석방, 차별 없는 진료기회, 임종호스피스, 에이즈보균 수용자의 조기석방 등 구체적인 가이드라인을 제시하고 있다. 이를 바탕으로 중증질환 수용자의 인권적 의료처우를 위한 국내법의 정비방향을 다음과 같이 제시하였다. 첫째, 교정시설 중증질환 수용자 의료처우 규정의 명문화가 필요하다. 둘째, 중증질환 수용자의 범주 및 처우규정의 명문화가 필요하다. 셋째, 임종 호스피스의 제공과 지역의료사회체계와의 연계규정 명문화가 필요하다. 넷째, 중증질환 수용자에 대한 최우선적 형집행정지제도의 명문화가 필요하다. 다섯째, 교정시설 의료인프라 수준의 명문화 규정이 필요하다. The purpose of this study is to compare the international norms on humanitarian medical treatment for prisoners with serious illnesses, the administration and treatment of correctional institution inmates act. Based on this, I tried to suggest the improvement direction of the administration and treatment of correctional institution inmates act based on the international human rights norm. The medical environment for the patients with serious diseases of the correctional facilities is very poor, and as of 2016, there are only 79% of doctors in total, and 14 hospitals, including Anyang Prison, have no specialists. From 2013 to 2016, 22 people died of the disease each year at the correctional institution, and 66 prisoners were found to have died without receiving external medical treatment because of the reject of the sentence execution suspension permission by the prison government. As of 2016, 34.2% of the patients in the correctional institution have suffered from the four serious diseases prescribed by the KCDC. However, it is analyzed that the current laws do not conform to the human rights medical treatment standard for the severe disease prisoner prescribed by international norms. International norms such as the United Nations Guidelines for the Minimum Standards for Detained Persons provide specific guidelines for the transfer of illness prisoners to external medical facilities, early release, equitable access to medical care, terminal illness hospice and early release of AIDS prisoners. Therefore, the direction of the improvement of the administration and treatment of correctional institution inmates act for the human rights medical treatment of the severe disease prisoner is as follows. First, it is necessary to label the medical treatment provisions of the correctional institution’s serious illness prisoners. Second, it is necessary to clarify the category of serious illnesses and treatment regulations. Third, the provision of terminal illnesses hospice and the stipulation of linkage with local medical social system are necessary. Fourth, it is necessary to stipulate the top priority for the sentence execution suspension permission of serious illnesses. Fifth, regulations on the level of medical infrastructure of correctional facilities are necessary.

Nurses’ Roles in the Spiritual Care of Patients with Terminal Illness

( Foluso Oladayo Ojewole ),( Afolarin Olutunde Ojewole ) 삼육대학교 선교와사회문제연구소 2017 Asia-Africa Journal of Mission and Ministry(AAMM) Vol.16 No.-

Traditionally, issues of religion or spiritual care are left to hospital chaplains in missionary hospitals and some first-world hospitals where chaplains are a part of holistic multi-disciplinary hospital care. In other instances, the patients are merely left on their own to call in their spiritual or religious leaders to attend to them during visiting hours. This paper posits that spiritual care of patients, especially terminally-ill ones, belongs to nurses too. Unfortunately, many nurses working with patients approaching the end of their lives might feel illequipped to recognize and respond to such spiritual needs. This paper seeks to equip front-line health care providers, especially nurses, with an actionable and practical guide to assist in identifying spiritual need in their patients and to feel confident in their ability to provide it. It focuses on terminally-ill patients who are expected to die in the near future, however much of the content is relevant to other situations such as sudden death.

소아 청소년 완화의료에서 놀이의 역할에 관한 연구동향: 주제범위고찰

전주영,하성규 한국엔터테인먼트산업학회 2023 한국엔터테인먼트산업학회논문지 Vol.17 No.4

Although play is a highly significant activity for children, those receiving palliative care face various restrictions that prevent them from participating in play, resulting in their unequal rights compared to other children. In this study, we aim to find out how play affects children with terminal illness by examining the subject range of studies that apply play for children with terminal illness, and analyze the factors surrounding children with terminal illness to find out the impact on play. We conducted a search on foreign databases such as CINAHL, MEDLINE, and Web of Science from 2000 to 2022, using a subject range review methodology, including setting research questions, searching for related studies, selecting literature, data entry, and collecting, summarizing, and recording result data. We analyzed the final 12 studies that met our research questions, which included a total of 226 children, adolescents, and families, with ages ranging from 0 to 18 years. Qualitative research was the most common research design, with eight studies, and measurement tools included child observation in ten cases and quantitative assessment tools and child and family interviews in six cases. Children and their families recognize play as the most critical activity for children and hope that play activities will continue to be provided in hospitals. Our analysis revealed that play has a positive effect on children's diseases and treatment processes, and we suggest that all palliative care experts, including therapists, should ensure children's right to play.

말기질환에 있어서 영성:이론의 다른견해

Hall, beverly A,용진선 가톨릭대학교 가톨릭대학교 간호대학 호스피스 교육연구소 1998 호스피스논집 Vol.3 No.-

말기 암 환자에서 임상변수를 이용한 생존 기간 예측

염창환,최윤선,홍영선,박용규,이혜리,Yeom, Chang-Hwan,Choi, Youn-Seon,Hong, Young-Seon,Park, Yong-Gyu,Lee, Hye-Ree 한국호스피스완화의료학회 2002 한국호스피스.완화의료학회지 Vol.5 No.2

목적 : 의학의 발달로 인간의 생존 기간이 길어졌지만, 암 발생율과 사망율은 오히려 증가하고 있어 그로 인해 말기 암 환자는 계속 늘어나고 있는 실정이다. 말기 암 환자를 진료하는 데 있어서 환자의 생존 기간을 예측하는 것은 중요한 문제로 만약 환자의 생존 기간을 예측할 수 있다면 남은 시간에 따라 환자, 가족, 의료진은 치료의 선택에 큰 차이를 보일 것이다. 이에 저자 등은 말기 암 환자에서 사망 위험도를 높이는 예후 인자를 알아내고 이들 예후 인자의 개수에 따른 생존 기간을 예측하여 말기 암 환자의 진료에 도움이 되고자 하였다. 방법 : 2000년 7월 1일부터 2001년 8월 31일 사이에 국민건강보험공단 일산병원 가정의학과에 말기 암으로 입원한 환자 157명을 대상으로 입원당시 환자의 임상변수 31가지를 조사하였다. 그리고 환자의 의무기록과 조사된 환자의 신상기록을 가지고 2001년 10월 31일까지의 환자의 생존 여부를 확인하였다. Kaplan-Meier 방법과 로그순위 검정(log-rank test)을 이용하여 임상변수에 따른 생존 기간에 차이가 있는지를 알아보았다. Cox의 비례위험함수 모형(Cox's proportional hazard model)을 이용하여 임상변수 중 사망 위험도를 높이는 유의한 변수를 얻은 후 이를 예후 인자로 삼고, 이것을 와이블 비례위험함수 모형(Weibull proportional hazard function model)을 이용하여 예후 인자들의 유무에 따른 생존 기간의 평균, 중앙값 제 1사분위수 그리고 제 3사분위수를 계산하여 생존기간을 예측하였다. 결과 : 말기 암 환자 157명 중 성별은 남자가 79명(50.3%), 여자가 78명(49.7%)이었고, 평균 연령은 남자가 $65.1{\pm}13.0$세, 여자는 $64.3{\pm}13.7$세였다. 암의 종류를 보면 위암이 36명(22.9%)으로 제일 많았고, 폐암이 27명(17.2%), 대장암이 20명(12.7%) 순이었다. 의식변화, 식욕부진, 저혈압, 수행능력 저하, 백혈구 증가증, 중성구 증가증, 크레아티닌 증가, 저알부민혈증, 고빌리루빈혈증, 간효소(SGPT)치 증가, 프로트롬빈 시간(PT) 연장, 활성부분 트롬보플라스틴 시간(aPTT) 연장, 저나트륨혈증, 고칼륨혈증 등을 보이는 환자는 통계학적으로 유의하게 생존 기간이 짧았다. 이중 Cox의 비례위험함수 모형을 통해 수행능력 저하, 중성구 증가증, PT 연장, aPTT 연장인 경우가 환자의 사망위험도를 높이는 유의한 예후 인자로 나왔다. 생존 기간의 중앙값은 4가지 인자가 모두 있는 경우는 3.0일, 3가지만 있는 경우는 $5.7{\sim}8.2$일, 2가지만 있는 경우는 $11.4{\sim}20.0$일, 1가지만 있는 경우는 $27.9{\sim}40.0$일, 4가지 모두 없는 경우는 77일로 나왔다. 결론 : 말기 암 환자에서 수행능력 저하, 중성구 증가증, PT 연장, aPTT 연장이 사망위험도를 높이는 예후 인자임을 알 수 있었다. 이들 4개 인자를 통해 말기 암 환자에서 생존 기간을 예측할 수 있을 것으로 사료된다. Purpose : Although the average life expectancy has increased due to advances in medicine, mortality due to cancer is on an increasing trend. Consequently, the number of terminally ill cancer patients is also on the rise. Predicting the survival period is an important issue in the treatment of terminally ill cancer patients since the choice of treatment would vary significantly by the patents, their families, and physicians according to the expected survival. Therefore, we investigated the prognostic factors for increased mortality risk in terminally ill cancer patients to help treat these patients by predicting the survival period. Methods : We investigated 31 clinical parameters in 157 terminally ill cancer patients admitted to in the Department of Family Medicine, National Health Insurance Corporation Ilsan Hospital between July 1, 2000 and August 31, 2001. We confirmed the patients' survival as of October 31, 2001 based on medical records and personal data. The survival rates and median survival times were estimated by the Kaplan-Meier method and Log-rank test was used to compare the differences between the survival rates according to each clinical parameter. Cox's proportional hazard model was used to determine the most predictive subset from the prognostic factors among many clinical parameters which affect the risk of death. We predicted the mean, median, the first quartile value and third quartile value of the expected lifetimes by Weibull proportional hazard regression model. Results : Out of 157 patients, 79 were male (50.3%). The mean age was $65.1{\pm}13.0$ years in males and was $64.3{\pm}13.7$ years in females. The most prevalent cancer was gastric cancer (36 patients, 22.9%), followed by lung cancer (27, 17.2%), and cervical cancer (20, 12.7%). The survival time decreased with to the following factors; mental change, anorexia, hypotension, poor performance status, leukocytosis, neutrophilia, elevated serum creatinine level, hypoalbuminemia, hyperbilirubinemia, elevated SGPT, prolonged prothrombin time (PT), prolonged activated partial thromboplastin time (aPTT), hyponatremia, and hyperkalemia. Among these factors, poor performance status, neutrophilia, prolonged PT and aPTT were significant prognostic factors of death risk in these patients according to the results of Cox's proportional hazard model. We predicted that the median life expectancy was 3.0 days when all of the above 4 factors were present, $5.7{\sim}8.2$ days when 3 of these 4 factors were present, $11.4{\sim}20.0$ days when 2 of the 4 were present, and $27.9{\sim}40.0$ when 1 of the 4 was present, and 77 days when none of these 4 factors were present. Conclusions : In terminally ill cancer patients, we found that the prognostic factors related to reduced survival time were poor performance status, neutrophilia, prolonged PT and prolonged am. The four prognostic factors enabled the prediction of life expectancy in terminally ill cancer patients.

Analysis of Survival in 273 Terminally Ill Cancer Patients Treated with Traditional Oriental Therapies

Cho Jung-Hyo,Kang Wee-Chang,Son Chang-Gue,Lee Yeon-Weol,Yoo Hwa-Seung,Lee Nam-Heon,Yun Dam-Hee,Cho Chong-Kwan The Society of Korean Medicine 2004 대한한의학회지 Vol.25 No.4

Objective : Recently, an increasing portion of cancer patients use various therapies of complementary and alternative medicine (CAM) including traditional oriental medicine, which is believed to improve the consequence of cancer according to clinical experience and laboratory data. But the clinical-based systemic statistic validity of these therapies is lacking, so this study was aimed to validate the traditional oriental therapies (TOT) for terminally ill cancer patients. Patients and methods : This retrospective study was performed on 273 patients who were diagnosed with terminally ill cancer in Korea and treated with TOT in the oriental hospital of Daejeon University, from March 1997 to June 2003. We examined the median duration of the terminal period and the correlations between 9 factors and survival of terminally ill cancer patients. Results : During the study period, we could confirm 142 patients' death (52.01%) in 273 subjects. The median length of survival in terminally ill cancer patients was 16 weeks (95%CI 14.0∼20.0) and 40.15% (95%CI 40.07∼40.22) of patients had survived more than 24 weeks. According to Cox's proportional hazard model including gender, age, conventional therapies (chemotherapy, radiotherapy and surgery), performance status and clinical symptoms as independent variables, history of conventional therapies (RR 0.581, 95%CI 0.381∼0.885), higher performance status (RR 1,855, 95%CI 1.454∼2.366) and absence of ascites and pleural effusion (RR 1.631, 95%CI 1.047∼2.538) showed independent prognostic value of survival. Conclusion : Our findings suggest that TOT offer potential benefits for cancer patients at the terminal stage.

연명중단에 관한 관련법 제정에서의 주요 내용과 방향성을 위한 소고 - 네덜란드「연명중단 및 자살방조를 위한 심사법」의 내용을 중심으로 -

문성제 법조협회 2010 法曹 Vol.59 No.2

On May 21, 2009, all medical instruments for sustaining the life of an old woman patient were legitimately removed in accordance with final judgment of the Supreme Court by her will and the consent of her family, but she has still survived with stable breathing. As a result, this case has involved social controversies about termination of meaningless life-sustaining medical treatment. In Korea, it is not so many years that there have been social interests and discussions formed concerning the termination of meaningless life-sustaining medical treatment. In terms of terminal care, however, some advanced foreign countries have even limitedly approved the right to refuse any medical treatment only for sustaining the life of patients in accordance with relevant judicial precedents since 1970's. Furthermore, there have been many discussions about certain hot issues such as physician-assisted suicide, death with dignity and natural death. As an example of actual disputes concerning the termination of life-sustaining medical treatment, the Right of Terminally Ill Act (a law regarding the rights of terminal patient) was enacted by the Legislative Assembly of Northern Territory in 1995 with a view to legalizing active euthanasia even under social controversies. Ultimately, the said Act was rejected by the Senate of Australian Parliament. In particular, the Netherlands already enacted Review Procedures for Termination of Life on Request and Assisted Suicide and Amendment to the Penal Code and the Burial and Cremation Act (hereinafter called ‘Euthanasia Act’) in 2001. This Act concludes that attending physician may disclaim any responsibility or liability for death with dignity which complies with certain requirements and procedures. Some foreign countries have already proceeded with a series of active discussions on death with dignity, and have enacted laws concerning the termination of life-sustaining medical treatment or have still addressed active discussions on enactment of such laws. On the contrary, Korea has just begun to discuss this issue with interests in recent years. The purpose of this study is to investigate what is covered by overseas laws regarding termination of life on request as well as details behind the enactment of such laws, so that it can examine what is discussed concerning this issue in Korea, major considerations of legal provisions required for future enactment of relevant laws, and possible orientation of such enactment in the future. Starting from such a critical mind, this study focused on discussing the ‘Euthanasia Act’ in the Netherlands, because Netherlands contemporary social and medical settings at the enactment of the Euthanasia Act were more or less similar to those of Korea, so the said Act may be a good reference for Korea to enact the law on death with dignity. Notably, the Netherlands had limitedly approved the euthanasia in accordance with judicial precedents before the enactment of Euthanasia Act. In this respect, it is inevitably consequential to review social environment and major judicial precedents before the enactment of said Act. Hence, this study deals with major considerations about Netherlands Euthanasia Act, major considerations for Korea to enact laws concerning the termination of life on request in near future, and also gives suggestions for possible orientation of such enactment. 2009년 5월 21일 대법원 판결에 의하여 환자의 연명을 위한 의료장치 등을 제거하였으나 환자가 스스로 안정적인 호흡으로 연명을 함으로서 충분한 논의과정 없이 판결을 내린 법원은 물론 병원의 환자에 대한 과잉진료 등을 둘러싸고 사회적 논란을 야기하게 되었다. 그러나 제 외국에서는 이미 활발한 논의 과정을 거쳐 연명중단을 위한 관련법을 제정하였거나 제정을 위한 논의가 활발하게 진행되고 있는데 반하여 우리의 경우 최근에 들어 관심을 가지고 논의가 시작되었다는 점을 고려할 때 관련법을 제정하여 시행하고 있는 국가들의 관계법의 내용과 법 제정 과정에서 나타난 제 문제 기타 사회 환경 등을 살펴봄으로서 향후 우리나라에서 논의될 경우를 대비하여 사전적으로 제 외국의 입법을 연구하는 것은 매우 의미 있는 일이라고 생각한다. 이 같은 문제의식을 가지고 본고에서는 그 논의의 범위를 한정하여 네덜란드의 ‘연명중단 및 자살방조를 위한 심사법’의 내용을 중심으로 살펴보았다. 논의의 범위를 네덜란드의 관련법으로 한정한 것은 본 법을 제정할 당시 네덜란드의 사회 및 의료 환경이 오늘 우리나라의 상황과 다소 유사하다는 점에서 향후 법 제정을 위한 논의과정에서 참고가 될 수 있다고 판단했기 때문이다. 그러나 우리나라의 경우 충분한 논의가 이루어지지 않은 상태에서 관련법의 제정은 예상하지 못한 위험에 처할 수 있다는 점에서, 법제정 이전에 충분한 논의와 연구를 통하여 법제화로 이어져야 할 것이다. 이를 위해서 우선 의사의 치료의무 및 범위 나아가 말기환자에 대한 치료의무와 그 한계에 대한 개념에 대한 정립이 필요하다고 보며, 의학적 적응이 없는 무의미한 치료라 하더라도 말기 환자들을 위한 통증완화 등을 목적으로 하는 호스피스의료 등과 같은 대체시설과 환경도 필요하다. 인간의 존엄을 강조하면서 무의미한 치료로 간주하여 생명을 중단하려는 그 자체는 이미 인간의 존엄을 해치는 것이다. 결국 연명중단을 위한 법제화의 노력보다 현대 의학으로 치유 불가능한 말기환자들의 마지막 삶을 영위할 수 있는 사회적 관심과 보장이 우선되어야 하며, 이 같은 보장이 없는 상태에서의 법제화는 인간의 존엄을 유지하기 위한 법제화가 아니라 인간의 존엄을 말살하고 생명을 경시하기 위한 법제라는 점에서 반대한다.

간호사를 위한 말기 환자 존엄간호 측정도구 개발

안윤실,오복자 한국간호과학회 2023 Journal of Korean Academy of Nursing Vol.53 No.3

Purpose: This study aimed to develop an instrument to showcase Dignity in Care of Terminally Ill Patients for Nurses and to examine its validity and reliability. Methods: A total of 58 preliminary items on dignity in care of terminally ill patients for nurses were selected using content validity analysis and expert opinions on 97 candidate items derived through a literature review and qualitative focus group interviews. Questionnaires were administered to 502 nurses caring for terminally ill cancer patients at hospice and palliative care institutions. The data were analyzed using item analysis, exploratory and confirmatory factor analysis, convergent and discriminant validity, and Pearson correlation for criterion validity, reliability was tested using Cronbach’s alpha. Results: The final instrument consisted of 25 items, with four factors identified through confirmatory factor analysis. Four factors-ethical values and moral attitudes, interaction-based communication, maintaining comfort, professional insight and competence–accounted for 61.8% of the total variance. Cronbach’s ⍺ for total items was .96, and test-retest reliability of intraclass correlation coefficient was .90. Conclusion: Since its validity and reliability have been verified through various methods, the Dignity in Care Scale of Terminally Ill Patients for Nurses can be used for develop nursing interventions and improve dignity in care of terminally ill patients. .