일 지역 요양시설의 임종돌봄서비스 = Terminal Care in Nursing Homes

다국어 초록 (Multilingual Abstract)

Purpose: This study aimed at understanding terminal care provided in nursing homes. Method: An interview survey with staff in charge of terminal care was conducted in 97 nursing homes using questionnaires. The questionnaire was reviewed by 3 experts and pretested at 5 facilities. Data were analyzed using descriptive statistics, chi-square test, and Fisher's exact test. Result: Dyspnea was the most prevalent symptom predicting death. The most prevalent services were vital sign check for physical care, providing services by talking despite an unconscious state for psychosocial care, and respecting the faith of the elder for spiritual care. Employment of a registered nurse showed a significant difference in tube feeding (p=.035), analgesic administration (p=.022), informing the elder of end-of-life state (p=.020), helping an elderly person say good-byes through a visit with friends and acquaintances (p=.023), and helping express feelings related to death (p=.002). Lack of service was noticed for elderly resident, family, and staff after death of an elder. Problems related to terminal care were indifference of family members, difficulty in obtaining medical prescription, difficulty in predicting death, and so forth. Conclusion: Terminal care must be improved by making specific guidelines and it must become a part of nursing home evaluation.

참고문헌 (Reference)

1 김분한, "한국 호스피스 완화 돌봄의 현재와 나아갈 방향" 한국호스피스완화의료학회 14 (14): 191-196, 2011

2 지순일, "임상간호사의 임종간호태도와 영적건강이 임종간호스트레스에 미치는 영향" 한국호스피스완화의료학회 17 (17): 232-240, 2014

3 윤매옥, "암 환자를 돌보는 간호사의 영적안녕과 영적간호수행" 한국호스피스완화의료학회 12 (12): 72-79, 2009

4 임세현, "노인요양시설 간호사의 임종 징후 관리에 대한 인식" 기본간호학회 17 (17): 209-219, 2010

5 서영숙, "노인요양시설 간호사의 영성이 호스피스 간호수행에 미치는 영향" 노인간호학회 14 (14): 11-19, 2012

6 안미숙, "노인요양병원 간호사의 좋은 죽음인식과 임종간호태도" 한국호스피스완화의료학회 17 (17): 122-133, 2014

7 임세현, "노인요양 시설에서 거주노인의 이상징후 확인과 관리에 대한 간호사의 인식" 노인간호학회 12 (12): 81-94, 2010

8 이미정, "노인병원 환자 죽음에 대한 간호사의 경험" 한국간호과학회 45 (45): 513-522, 2015

9 우영화, "간호사의 죽음불안과 임종간호스트레스 및 임종간호수행" 한국호스피스완화의료학회 16 (16): 33-41, 2013

10 안수연, "간호사의 노인임종 경험" 노인간호학회 16 (16): 118-129, 2014

11 English, D, "Why hospice care belongs in nursing homes, Part 1" 50 (50): 46-50, 2001

12 Maitland, J, "They don’t just disappear : acknowledging death in the long-term care setting" 10 (10): 241-247, 2012

13 Lee, M, "The present and the improving way of the senior recuperation facility in service field" Ulsan University 2009

14 Hall, P, "The last 48 hours of life in long-term care : a focused chart audit" 50 (50): 501-506, 2002

15 Welch, L. C, "Referral and timing of referral to hospice care in nursing homes : the significant role of staff members" 48 (48): 477-484, 2008

16 Brazil, K, "Quality of care for residents dying in Ontario long-term care facilities : findings from a survey of directors of care" 22 (22): 18-25, 2006

17 Brazil, K, "Quality end-of-life care in long-term care facilities : service providers’ perspective" 20 (20): 85-92, 2004

18 Catholic University Hospice Education Research Institute, "Hospice and palliative care" Koonja Publishing Company 2006

19 Goodridge, D, "End-of-life care in a nursing home : a study of family, nurse and healthcare aide perspectives" 11 (11): 226-232, 2005

20 Katz, J. S, "Dying in long-term care facilities : Support needs of other residents, relatives, and staff" 18 (18): 321-326, 2001

21 Yong J. J, "Development and validation of a scale assessing spiritual needs for Korean patients with cancer" 24 (24): 240-246, 2008

22 Israel, G. D, "Determining sample size"

23 Hanson, L, "Care of the dying in long-term care settings" 16 (16): 225-237, 2000

24 Kim, H, "Attitudes toward death and end-of-life care among nurses in nursing homes" Seoul National University 2013

25 Yoo, H. S, "A study on the hospice service in the elderly welfare facilities" Sahmyook University 2008

26 Yoon, E, "A study on the actual condition of hospice service in nursing home" 15 (15): 91-120, 2002

27 Statistics Korea, "2015 Statistics on the Aged"

28 Ministry of Health & Welfare, "2012 Welfare Facilities for the Aged"