Journal of Hospice and Palliative Care

Korean Society for Hospice and Palliative Care (한국호스피스완화의료학회)
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Physical Symptoms and Psychiatric, Social, Spiritual and Economical Care Needs of Patients under Home-based Cancer Service

재가암환자의 신체 증상들과 정신적, 사회적, 영적, 그리고 경제적 돌봄 요구도

  • Kang, Myung Hee (Department of Internal Medicine, School of Medicine, Gyeongsang National University) ;
  • Moon, Young Sil (Jinju Public Health Center) ;
  • Lee, Young Joon (Department of Surgery, School of Medicine, Gyeongsang National University) ;
  • Kang, Yoon Sik (Department of Preventive Medicine, School of Medicine, Gyeongsang National University) ;
  • Kim, Hoon Gu (Department of Internal Medicine, School of Medicine, Gyeongsang National University) ;
  • Lee, Gyeong Won (Department of Internal Medicine, School of Medicine, Gyeongsang National University) ;
  • Lee, Won Sup (Department of Internal Medicine, School of Medicine, Gyeongsang National University) ;
  • Kang, Jung Hun (Department of Internal Medicine, School of Medicine, Gyeongsang National University)
  • 강명희 (경상대학교병원 혈액종양내과) ;
  • 문영실 (진주시보건소) ;
  • 이영준 (경상대학교병원 외과) ;
  • 강윤식 (경상대학교병원 예방의학과) ;
  • 김훈구 (경상대학교병원 혈액종양내과) ;
  • 이경원 (경상대학교병원 혈액종양내과) ;
  • 이원섭 (경상대학교병원 혈액종양내과) ;
  • 강정훈 (경상대학교병원 혈액종양내과)
  • Received : 2014.05.27
  • Accepted : 2014.10.28
  • Published : 2014.12.01
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Abstract

Purpose: This study was performed to identify the symptoms and care needs of home-based cancer patients in Korea and to add to the scarce literature on this topic. Methods: Data were collected from patients who subscribed to home-based cancer care services in Jinju. Assessments were performed by nurses at the local public health center. The Edmonton Symptom Assessment System with a numeric rating scale (NRS) was used to identify symptoms, and a four-point Likert scale was used to assess psychological, social, and spiritual needs. Results: Cross-sectional data were collected in October 2013. A total of 209 patients participated and their median age was 65 years (range, 17~89 years). Most patients were diagnosed in the early stage of cancer (n=188); only 19 patients were diagnosed in the advanced stage. More than half the patients lived alone (n=115, 55.0%) and took care of themselves (n=128, 61.2%). Anorexia and fatigue were the most common symptoms (median NRS, 5 and 4, respectively). Patients needed economic support the most, whereas spiritual care was least needed (n=138 [67.3%] vs. n=128 [62.1%], respectively). Conclusion: Patients who signed up for home-based cancer care services in Jinju are struggling with a financial issue and physical symptoms. A customized approach is needed to improve the quality of the home-based care services.

목적: 국내에서 재가암환자를 대상으로 시행된 연구는 많지 않다. 이 연구의 목적은 재가암환자들의 증상정도와 돌봄 요구도를 확인하기 위함이다. 방법: 진주시 재가암 서비스에 등록된 환자를 대상으로 자료를 수집하였다. 측정은 보건소에 소속된 간호사들이 시행하였다. 증상의 평가를 위해 Edmontone Symptome Assessment System (ESAS)와 Numeric Rating Scale (NRS)가 사용되었으며 정신적, 사회적 영적 요구도의 평가를 위해 4점 Likert scale이 사용되었다. 결과: 2013년 10월에 단면조사 방식으로 자료를 수집하였다. 총 209명이 등록되었으며 평균 나이는 65세였다(범위 17~89세). 대다수의 환자들이 초기에 진단 받았으며(n=188), 19명만이 진행된 병기였다. 절반 이상의 환자들이 혼자 거주하고 있었으며(n=115, 55%), 다른 보호자가 없이 스스로 돌보고 있었다(n=128, 61.2%). 식욕부진과 피로가 가장 흔한 증상이었다(NRS 중앙값 각각 5, 4). 환자들은 경제적 문제에 대한 지원이 가장 필요한 반면 영적인 돌봄이 가장 적게 필요하다고 대답하였다(n=138 [67.3%] vs. n=128 [62.1%]). 결론: 이 자료는 진주시 재가암환자들이 신체적 증상과 경제적 문제로 고통 받고 있다는 결과를 보여주었다. 서비스의 질을 향상시키기 위하여 맞춤형 접근이 필요할 것으로 사료된다.

Keywords

References

  1. Ministry of Health and Welfare. 2011 Guidlines for home-based cancer patient management projects. Seoul;Ministry of Health and Welfare:2011. p. 6-13.
  2. Huh JS, Kim HJ. Current status of home-based cancer patients management in Jeju. Korean J Hosp Palliat Care 2010;13:76-80.
  3. Cho H, Son JY, Heo JD, Jin EH. A study on demand and the supply for home-based cancer patient management projects of public health centers. Korean J Hosp Palliat Care 2007;10:195-201.
  4. Cella D, Davis K, Breitbart W, Curt G; Fatigue Coalition. Cancer-related fatigue: prevalence of proposed diagnostic criteria in a United States sample of cancer survivors. J Clin Oncol 2001; 19:3385-91. https://doi.org/10.1200/JCO.2001.19.14.3385
  5. Kim TS, Yang BG, Jeong EK, Park NR, Lee YS, Lee YS, et al. Need assessment of home-based cancer patients. Korean J Hosp Palliat Care 1999;2:36-45.
  6. Park CH, Shin DW, Choi JY, Kang J, Baek YJ, Mo HN, et al. Determinants of the burden and positivity of family caregivers of terminally ill cancer patients in Korea. Psychooncology 2012;21: 282-90. https://doi.org/10.1002/pon.1893
  7. Park JS, Oh YJ. The effects of psychosocial intervention on depression, hope and quality of life of home-based cancer patients. J Korean Acad Adult Nurs 2010;22:594-605.
  8. Lee Hs, Park SH, Chung YS, Lee B, Kown SH. Evaluation of community-based cancer patient management program: collaboration between a hospice center and public health centers. Korean J Hosp Palliat care 2010;13:216-24.
  9. Bruera E, Kuehn N, Miller MJ, Selmser P, Macmillan K. The Edmonton Symptom Assessment System (ESAS): a simple method for the assessment of palliative care patients. J Palliat Care 1991; 7:6-9.
  10. Kwon JH, Nam SH, Koh S, Hong YS, Lee KH, Shin SW, et al. Validation of the Edmonton Symptom Assessment System in Korean patients with cancer. J Pain Symptom Manage 2013;46:947-56. https://doi.org/10.1016/j.jpainsymman.2013.01.012
  11. Carvajal A, Hribernik N, Duarte E, Sanz-Rubiales A, Centeno C. The Spanish version of the Edmonton Symptom Assessment System-revised (ESAS-r): first psychometric analysis involving patients with advanced cancer. J Pain Symptom Manage 2013;45: 129-36. https://doi.org/10.1016/j.jpainsymman.2012.01.014
  12. Monteiro Dda R, Almeida Mde A, Kruse MH. Translation and cross-cultural adaptation of the Edmonton Symptom Assessment System for use in Palliative Care. Rev Gaucha Enferm 2013;34: 163-71.
  13. Richardson LA, Jones GW. A review of the reliability and validity of the Edmonton Symptom Assessment System. Curr Oncol 2009; 16:55.
  14. Jacobsen PB, Donovan KA, Small BJ, Jim HS, Munster PN, Andrykowski MA. Fatigue after treatment for early stage breast cancer: a controlled comparison. Cancer 2007;110:1851-9. https://doi.org/10.1002/cncr.22993
  15. Choi J, Kong K, Mozaffar T, Holcombe RF. Delayed oxaliplatinassociated neurotoxicity following adjuvant chemotherapy for stage III colon cancer. Anticancer Drugs 2006;17:103-5. https://doi.org/10.1097/01.cad.0000185185.64980.70
  16. Heedman PA, Strang P. Symptom assessment in advanced palliative home care for cancer patients using the ESAS: clinical aspects. Anticancer Res 2001;21(6A):4077-82.
  17. Tsai JS, Wu CH, Chiu TY, Chen CY. Significance of symptom clustering in palliative care of advanced cancer patients. J Pain Symptom Manage 2010;39:655-62. https://doi.org/10.1016/j.jpainsymman.2009.09.005

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