PURPOSE: The purpose of this study was to develop Nurse's Suffering Experience Scale and to test the reliability and validity of the instrument. METHOD: The subjects used to verify the scale's reliability and validity were 220 nurses who were taking care of the end stage cancer patients, while working at university and general hospitals in Daegu and Kyungbuk province from April 20. to July 10, 2001. The data was analyzed by the SPSS/WIN 8.0 program. RESULTS: A factor analysis was conducted, and items that had a factor loading more than .40, and an eigen value more than 1.0. were selected. The factor analysis classified a total of seven factors statistically, and it's communality was 44%. The explanation of factors based on the conceptual framework and item content are as follows: The first factor was expanding self consciousness, the second factor was forming empathy with family, the third factor was professional challenge, the fourth factor was change of values, the fifth factor was spiritual sublimation, the sixth factor was helplessness, and finally the seventh factor was rejection to death. Cronbach's coefficient to test reliability of the scale was .8665 for total of 44 items. The Scale for Nurse's Suffering Experience developed in the study was identified as a tool with a high degree of reliability and validity. Therefore this scale can be effectively utilized for the evaluation of the degree of nurse's suffering experience in clinical settings.
Consciousness ; Daegu ; Empathy ; Factor Analysis, Statistical ; Hospitals, General ; Humans ; Reproducibility of Results ; Sublimation

PURPOSE: The purpose of this study was to evaluate changes regarding knowledge, attitude and practice toward end-of-life care in nursing university students. METHOD: This study adopted nonequivalent control group pretest-posttest design. The subjects consisted of 35 in the experimental group and 35 in the control group. The education was performed for 2 hours a session, once a week for 16 weeks. Data was analyzed by the SPSS/WIN 14 computer program, and included chi2 test, independent t-test, and repeated measure ANOVA. RESULTS: There were statistically significant differences in knowledge toward end-of-life care between the experimental group and the control group. CONCLUSION: Findings suggested that holistic education on end-of-life care was effective to change students' knowledge toward end-of-life care. Therefore, holistic education is recommended as nursing education for nursing university students.
Education* ; Education, Nursing ; Humans ; Nursing

PURPOSE: The purpose of this study was to analyze attitude toward dignified dying of Korean students majoring in human service area. METHODS: The Q-methodology which provides a method of analyzing the subjectivity of each item was used. The 34 selected Q-statements from each of 38 subjects were classified into a shape of normal distribution using a 9 point scale. The collected data was analyzed using a QUANL PC program. RESULTS: Four types of attitude toward dignified dying from the subjects were identified. Type I is an expression type for happy emotion, Type II is a dislike type for life prolongation, Type III is a pursuit type for relationship improvement, and Type IV is a perception type for family presence. CONCLUSION: The results of the study indicate that integrating multi-disciplinary curriculum development related to dignified dying and death education for students majoring in human service area are needed.
Curriculum ; Humans ; Life Support Care

This study is a methodical research to develop a health behavior assessment scale for patients with rheumatoid arthritis, and to test the validity and reliability of the instrument. The research procedure was as follows; 1) The first step was to develop conceptual framework based on a comprehensive review of the literature, in-depth interviews patients with rheumatoid arthritis. This conceptual framework was organized in eight dimensions; pain management, exercise, rest, diet control, active committment, self-management, positive thinking, interpersonal maintenance. Initially 56 items were selected from 164 statement. 2) These items were reviewed by panel of eight specialists and the Index of Content validity (CVI) was calculated, and forty six items were selected which met more than 70% on the CVI. 3) 174 rheumatoid arthritis pateints were interviewed, and data was gathered from Jan. 25 to Feb. 18, 1999 for test reliabilities and validities of the scale. The item analysis was carried out and 40 items were selected. Factor analysis by varimax rotation was carried out to test construct validity. The internal consistency by chronbach's alpha was calculated. The findings were as follows; 1) Item analysis and factor analysis were carried out to test the validity of the health behavior assessment scale. The item analysis was based on the corrected item`s to total correlation coefficient (.30 or more), and information about the alpha estimate. However, this was only if this item was deleted from the scale. As a result of the item analysis, forty items were selected. Thirty items were selected by a initial factor analysis by varimax rotation, and ten items were deleted because of factor complexity. In the secondary factor analysis, eight factors were labled as 'positive thinking', 'exercise', 'rest', 'pain management', 'active committment', 'self-management', 'diet control', and 'interpersonal maintenance', each similar with the conceptual framework. 2) Chronbach's alpha coefficient to test reliability of the scale was. 903 for total the thirty items. The Scale for assessing health behavior developed in this study was identified to be a tool with a high degree of reliability and validity. Therefore this scale can be effectively utilized for assessment in the health behaviors of the patients with rheumatoid arthritis.
Arthritis, Rheumatoid* ; Diet ; Health Behavior* ; Humans ; Pain Management ; Reproducibility of Results ; Self Care ; Specialization ; Thinking

PURPOSE: The Purpose of this study is to understand the meaning and the essence of suffering as viewpoint and to find the meaning and structure of the experience from encounters with patients in their terminal stages of illness. METHOD: A descriptive design based on the phenomenological approach model developed by Collaizzi was used. The period of data collection was from August to November of 2000. Data collection was conducted by open-ended and audio-taped interviews. The participants were nine female nurses who were willing to take part in this study. RESULTS: Results of this study were classified into five main categories. The main category clusters were "difficulty in experiencing suffering," "professional challenges to expert nurses," "formation of empathic relationships," "expanding consciousness through suffering," and "alleviation of the patient's suffering." CONCLUSION: In conclusion, the implications for providing nursing care to end-stage patients in the throes of suffering is both rewarding and stressful. However, sharing these research results may help other nurses discover and experience deeper meanings in their own practice and careers.
Consciousness ; Surveys and Questionnaires ; Female ; Humans ; Nursing Care ; Reward

PURPOSE: The purpose of this study was to explore clinical nurse's reported conflict experience toward end-of-life medical decision making. METHODS: Data were collected by in-depth interviews with eight nurses from three different wards of university hospital in D city of Korea. Conventional qualitative analysis was used to analyze the data. RESULTS: Results were three major themes and twelve categories from the analysis. The three major themes were prioritization of treatment, non-disclosure of diagnosis, and hierarchical and power relations. CONCLUSION: The results of this study suggest that shared decision making in end of life among patient, family members, physician, and nurse may contribute to improve end-of-life care performance as well as dignified dying of patient in end of life.
Decision Making ; Humans ; Korea

PURPOSE: The purpose of this study was to identify the effects of a nurse presence program on suicide prevention for elders with chronic disease. METHOD: The subjects were recruited from two different elderly institutions located in D city and K province, Korea. Twenty subjects in the control group received no intervention and nineteen subjects in the experimental group received a nurse presence program. RESULT: There were more significant decreases in suicide ideation, and the cortisol level and increases in life satisfaction in the experimental group compared to the control group. CONCLUSION: According to the above results, a nurse presence program for elders with a chronic disease decreased stressful events like suicide ideation and increased self esteem through therapeutic interaction. These findings suggest that this program can be used as an efficient independent nursing intervention for elders in a critical situation.
Aged ; *Chronic Disease ; Female ; Frail Elderly ; Geriatric Assessment ; Geriatric Nursing ; Health Services ; Humans ; Interpersonal Relations ; Nursing Methodology Research/*methods ; Personal Satisfaction ; Self Concept ; Social Support ; Suicide/*prevention & control

PURPOSE: This study was conducted to explore how nurses' attitude toward dignified death and moral sensitivity affect their end-of-life care performance. METHODS: Study participants were 172 nurses who work at university hospitals in a metropolitan city in Korea. Data were collected from June 20 through August 13, 2012 using the Dignified Death Scale, Moral Sensitivity Scale, and End-of-Life Care Performance Scale. Data were analyzed using the SPSS/WIN 19.0 program. RESULTS: Factors affecting nurses' end-of-life care performance included moral sensitivity, dignified death and education level. CONCLUSION: Moral sensitivity, dignified death and education level should be considered when developing an educational program for nurses' end-of-life care performance.
Education ; Hospitals, University ; Korea ; Terminal Care

PURPOSE: This study was conducted to evaluate the effects of integrated palliative care intervention on quality of life in terminally ill patients. METHODS: A comprehensive literature search was performed via PubMed, Cochrane Library CENTRAL, LWW (Ovid), CINAHL and several Korean databases. The main search strategy was to combine terms indicating palliative care intervention, presence of terminal illness and study design. Methodological quality was assessed using Cochrane's Risk of Bias for randomized studies and Risk of Bias Assessment tool for non-randomized studies. Data were analyzed by the Stata 10 program. RESULTS: Eight clinical trials met the inclusion criteria with a total of 356 participants. Integrated palliative care interventions were administered for a mean of 6.5 weeks, 5.6 sessions and an average of 47.8 minutes per session. Effect sizes were heterogeneous, and subgroup analysis was done. Integrated palliative care interventions had a significant effect on quality of life (ES=1.83, P=0.018, l2=92%), spiritual well-being (ES=0.78, P=0.040, l2=0), depression (ES=0.86, P<0.001, l2=32) and anxiety (ES=0.69, P=0.041, l2=71.1). But integrated palliative care interventions had no significant effect on pain (ES=0.365, P=0.230, l2=69.8). CONCLUSION: Results support findings that integrated palliative care interventions were helpful in lessening depression and anxiety and improving quality of life and spiritual well-being, however, the interventions did not assist pain management in terminal cancer patients. These findings suggest that various integrated palliative care interventions can assist terminal cancer patients with better quality of life in the socio-psycho-spiritual dimension.
Anxiety ; Bias (Epidemiology) ; Depression ; Humans ; Pain Management ; Palliative Care* ; Quality of Life* ; Terminally Ill

This study is a research of conceptual development to find the factors of presence. The concept and the definition of presence received from literary review. On the basis of these findings, we formulate the contents of presence through structured interview guide composed of open-ended questionnaire which included the frequency, attitude, and posture. We selected 104 samples who are the patients, doctors, nurses, and other health providers. And then the contents of presence were established after integrating the formulated contents and putting them in order. The categorizing of the presence was made after discussing with specialist in this field. By using the selected contents, we made 25 statements of presence which were categorized into three factors. The results were as follows: 1. The definition of presence is being with at the same time and space, making attention with openness, and the therapeutic interaction with empathy. 2. The contents of presence through personal interviews are (1) The time required is 5 minutes(46.15%), 2-3 minutes(34.61%), and 10 minutes (15.38%) respectively. The frequency of visiting is 3 times(39.20%), every time(23.07%), and more than 5 times(20.19%) respectively. (2) In case of being with nurse is having pain(39.42%), suffering trouble or severe fear(9.61%), feeling discomfort(8.65%), taking care of wound(7.69%), and other unfavorable symptoms(6.73%) respectively. (3) The posture being with nurse is depends on the situations(63.46%), sitting(26.92%), and standing(9.61%) respectively. Eye contact with nurse is face to face(78.84%), depends on the situations(20.19%), and not face to face(0.96%) respectively. (4) The attitudes of comfort are explaining about disease(23.07%), holding on hands (14.42%), touching on the suffering parts (11.53%), and unconditionally being with(7.69%) respectively. (5) Nurses' caring actions are kindness (27.88%), replying to the question (12.50%), smiling(10.57%), bright appearances (8.65%), and right and quick treatment(8.65%) respectively. (6) The effects of being with are peaceful mind(58.65%), quick recovery(13.46%), and decrease in fear(12.50%) respectively. (7) The attitudes of being with are listening (11.53%), recognition(8.65%), talking about discomfort(8.65%), and answering kindly (7.69%) respectively. 3. From the analysis of presence factors, 25 statements and 3 categorized factors are presented.
Empathy ; Factor Analysis, Statistical* ; Hand ; Humans ; Posture ; Surveys and Questionnaires ; Specialization