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NTIS 바로가기한국호스피스·완화의료학회지 = Korean journal of hospice and palliative care, v.21 no.3, 2018년, pp.75 - 83
정성인 (부산대학교병원 가정의학과) , 이승훈 (부산대학교병원 가정의학과) , 김윤진 (부산대학교병원 가정의학과) , 이상엽 (부산대학교 의과대학 의학 교육실) , 이정규 (부산대학교병원 가정의학과) , 이유현 (부산대학교병원 가정의학과) , 조영혜 (부산대학교 의과대학 가정의학교실) , 탁영진 (부산대학교병원 가정의학과) , 황혜림 (부산대학교병원 가정의학과) , 박은주 (양산부산대학교병원 가정의학과) , 김경미 (부산대학교병원 가정의학과)
Purpose: To provide effective palliative care, it is important to predict not only patients' life expectancy but their discharge status at a time of inpatient admission to a hospice care facility. This study was aimed to identify meaningful life expectancy indicators that can be used to predict pati...
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핵심어 | 질문 | 논문에서 추출한 답변 |
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암 진단 초기에 여명 예측에 사용되는 것은? | 암 진단 초기에는 암의 종류, 암세포 종류와 분화도, 진단 시점 에서의 병기 등이 여명 예측에 이용되는 반면 말기암환자에서는 환자의 수행지수(performance status), 환자의 증상과 징후 그리고 검사결과 등을 이용하여 여명을 예측하게 된다(3). 잘 알려져 있는 있는 말기암환자의 여명 예측 도구 중 완화의료 예후지 수(Palliative Prognostic Index, PPI)는 경구 섭취량, 휴식 시 호흡곤란, 섬망, 부종과 같은 임상적 증상을 이용하여 여명을 예측할 수 있게 고안되었으며, 완화의료 수행지수(Palliative Perfor-mance Scale, PPS)는 보행상태(ambulation), 활동수준(activity level), 질병 정도(evidence of disease), 자가 돌봄(self-care), 경구 섭취 및 의식상태의 5가지 면을 통해 예측을 한다(4,5). | |
국내 호스피스 지정기관과 병상수가 증가 추세인 이유는? | 국내 호스피스의 상황을 살펴보면 1965년 국내 호스피스에 대한 개념이 도입된 이후 호스피스 지정기관은 2018년 현재 82개소 병상수 1,351개로 점차 증가 추세에 있다(1). 이것은 의학 기술의 발달과 질병구조의 변화 등으로 말기암환자가 증가하고 있고 가족 구성원의 사회진출이 늘어나면서 말기암환자를 돌보는 문제가 사회적 차원으로 확대되었으며, 또한, 인간다운 죽음 즉, 죽음의 질에 대한 관심이 높아지면서 품위 있는 죽음을 보장하기 위해 호스피스에 대한 관심이 높아졌기 때문인 것으로 보인다. 이러한 변화와 함께 호스피스에서 가족 및 환자가 의료진과 치료의 방향을 결정하고 임종을 단계적으로 준비하기 위해 기대여명등 생존기간 예측이 중요하게 인식되고 있다(2). | |
국내 호스피스의 상황은? | 국내 호스피스의 상황을 살펴보면 1965년 국내 호스피스에 대한 개념이 도입된 이후 호스피스 지정기관은 2018년 현재 82개소 병상수 1,351개로 점차 증가 추세에 있다(1). 이것은 의학 기술의 발달과 질병구조의 변화 등으로 말기암환자가 증가하고 있고 가족 구성원의 사회진출이 늘어나면서 말기암환자를 돌보는 문제가 사회적 차원으로 확대되었으며, 또한, 인간다운 죽음 즉, 죽음의 질에 대한 관심이 높아지면서 품위 있는 죽음을 보장하기 위해 호스피스에 대한 관심이 높아졌기 때문인 것으로 보인다. |
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