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NTIS 바로가기Journal of Korean academy of nursing = 대한간호학회지, v.48 no.1, 2018년, pp.59 - 69
김소명 (대구과학대학교 간호대학) , 권소희 (경북대학교 간호대학.간호과학연구소)
Purpose: The purpose of this study was to investigate variables and construct paths that affect complicated grief. Methods: Participants in this cross-sectional, descriptive study were 164 bereaved spouses of cancer patients at least 12 months before the death. Data were collected from October 2016 ...
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핵심어 | 질문 | 논문에서 추출한 답변 |
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사별 후 대처가 좋지 않으면 어떻게 되는가? | 사회적지지가 낮을수록 사별준비가 부족하고[12], 복합적 슬픔의 유병률과 관련이 있으며[13], 사별 후 대처수준이 낮은 것으로 보고되었다[14]. 또한 사별 후 대처가 부정적이면 복합적 슬픔을 악화시키는 것으로 알려져 있다[15]. 그 외에 암환자의 말기치료의 질, 즉 말기상황에서 환자에게 제공된 의료서비스의 질은 임종의 질[16]과 사별준비[17] 뿐 아니라 사별 후 적응에도 영향을 미치는 것으로 보고되고 있다[18]. | |
암환자의 가족은 무엇을 경험하는가? | 암환자의 가족은 환자의 투병과정을 함께 경험하기 때문에 가족 스스로도 정신건강의 악화와 심리적 고통을 겪고, 사별 후에는 복합적 슬픔을 경험하기도 한다. 슬픔은 사별에 따른 정상적인 반응이고 대부분의 경우 시간이 경과됨에 따라 자연스럽게 해소된다. | |
임종의 질과 복합적 슬픔은 예상과 어떤 차이를 보였는가? | 또한 본 연구에서 말기치료의 질은 임종의 질에 직·간접적인 정적 영향을 미치는 것으로 나타났으나, 임종의 질은 복합적 슬픔에 대해 영향을 미치지 않는 것으로 나타났다. 이러한 결과는 Miyajima 등[7]의 연구에서 6개월에서 10년 사이에 사별을 경험한 641명의 시민을 대상으로 조사한 결과 말기치료의 질이 낮은 경우, 즉 환자의 상태와 병의 진행에 대한 의료진의 설명이 부족하거나, 의료비용이 비합리적으로 높거나, 고인이 삶을 완성했다는 느낌을 가지지 못했었다면 복합적 슬픔의 가능성이 높아졌다고 한 것과 달랐다. 또한 호스피스완화의료 분야에서 보편적으로 수용되고 있는 양질의 말기치료와 임종의 질이 사별가족의 슬픔과 고통을 덜어주는데 도움이 될 것이라는 가정[31]을 뒤엎는 결과이다. |
Statistics Korea. Cancer death statistics outcome [Internet]. Seoul: Statistics Korea; c2016 [cited 2018 Jan 12]. Available from: http://www.index.go.kr/potal/main/EachDtlPageDetail.do?idx_cd2770.
Nanni MG, Biancosino B, Grassi L. Pre-loss symptoms related to risk of complicated grief in caregivers of terminally ill cancer patients. Journal of Affective Disorders. 2014;160:87-91. https://doi.org/10.1016/j.jad.2013.12.023
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Newson RS, Boelen PA, Hek K, Hofman A, Tiemeier H. The prevalence and characteristics of complicated grief in older adults. Journal of Affective Disorders. 2011;132(1-2):231-238. https://doi.org/10.1016/j.jad.2011.02.021
Guldin MB, Jensen AB, Zachariae R, Vedsted P. Healthcare utilization of bereaved relatives of patients who died from cancer. A national population-based study. Psychooncology. 2013;22(5):1152-1158. https://doi.org/10.1002/pon.3120
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Miyajima K, Fujisawa D, Yoshimura K, Ito M, Nakajima S, Shirahase J, et al. Association between quality of end-of-life care and possible complicated grief among bereaved family members. Journal of Palliative Medicine. 2014;17(9):1025-1031. https://doi.org/10.1089/jpm.2013.0552
Kim Y, Carver CS, Spiegel D, Mitchell HR, Cannady RS. Role of family caregivers' self-perceived preparedness for the death of the cancer patient in long-term adjustment to bereavement. Psychooncology. 2017;26(4):484-492. https://doi.org/10.1002/pon.4042
Stammel N, Heeke C, Bockers E, Chhim S, Taing S, Wagner B, et al. Prolonged grief disorder three decades post loss in survivors of the Khmer Rouge regime in Cambodia. Journal of Affective Disorders. 2013;144(1-2): 87-93. https://doi.org/10.1016/j.jad.2012.05.063
Li QP, Mak YW, Loke AY. Spouses' experience of caregiving for cancer patients: A literature review. International Nursing Review. 2013;60(2):178-187. https://doi.org/10.1111/inr.12000
Shinjo T, Morita T, Hirai K, Miyashita M, Sato K, Tsuneto S, et al. Care for imminently dying cancer patients: Family members' experiences and recommendations. Journal of Clinical Oncology. 2010;28(1):142-148. https://doi.org/10.1200/JCO.2009.23.2793
Tsai WI, Prigerson HG, Li CY, Chou WC, Kuo SC, Tang ST. Longitudinal changes and predictors of prolonged grief for bereaved family caregivers over the first 2 years after the terminally ill cancer patient's death. Palliative Medicine. 2016;30(5):495-503. https://doi.org/10.1177/0269216315603261
Allen JY, Haley WE, Small BJ, Schonwetter RS, McMillan SC. Bereavement among hospice caregivers of cancer patients one year following loss: Predictors of grief, complicated grief, and symptoms of depression. Journal of Palliative Medicine. 2013;16(7):745-751. https://doi.org/10.1089/jpm.2012.0450
Chang SJ. Psychological well-being of widowed in later life: Based on the dual process model of coping with bereavement. Journal of the Korean Gerontological Society. 2015;35(3):589-608.
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