Journal of Hospice and Palliative Care

Korean Society for Hospice and Palliative Care (한국호스피스완화의료학회)
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The Characteristics of Terminally Ill Cancer Patients in Hospice and Palliative Care according to Family Composition

가족 구성에 따른 호스피스 완화의료 말기암환자의 특성

  • Park, Sang Mi (Department of Family Medicine, St. Paul Hospital, The Catholic University of Korea) ;
  • Hwang, Sun Wook (Department of Family Medicine, St. Paul Hospital, The Catholic University of Korea) ;
  • Han, Kyung Do (Department of Biostatistics, College of Medicine, The Catholic University of Korea)
  • 박상미 (가톨릭대학교 성바오로병원 가정의학과) ;
  • 황선욱 (가톨릭대학교 성바오로병원 가정의학과) ;
  • 한경도 (가톨릭대학교 의과대학 의학통계학교실)
  • Received : 2018.08.24
  • Accepted : 2018.11.09
  • Published : 2018.12.01
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Abstract

Purpose: The purpose of this study was to investigate the family composition of terminally ill cancer patients admitted to the hospice unit and how it affects their hospice care. Methods: We retrospectively analyzed the medical records of terminal cancer patients who died in one hospice unit between January 2009 and March 2014. The demographic and clinical characteristics of the patients were examined, and any different made by their marital status was evaluated. We calculated the time interval between cancer diagnosis and hospice admission and the survival period from hospice admission to death and analyzed their association with family composition. Results: When divided by the median time of 13 months between diagnosis and admission, Group B (>13 months) had a significantly higher proportion of patients living with their spouses; (P<0.01). The main decision maker was a spouse (52.9%) in Group B; (P=0.04). Conclusion: Among the characteristics of the family composition, the presence of spouse was an important factor associated with admission to a hospice unit. Clinicians need to be aware of the impact of marital status on end-of-life care. This study indicates that it is helpful to understand family composition of terminallyill cancer patients for an effective palliative and hospice care.

목적: 가족구성의 특성이 건강에 미치는 영향에 관한 다양한 실증 연구들이 꾸준히 보고되어 왔다. 우리나라에 말기암환자의 가족구성의 특성에 대한 연구가 부족하여 이에 본 연구에서는 호스피스 병동에 입원하고, 사망한 말기암환자의 가족구성의 특징을 파악하고 호스피스 완화의료 이용과의 연관성에 대해 알아보고자 하였다. 방법: 2009년 1월부터 2014년 3월까지 일개 호스피스 병동에 입원 후 48시간 후 사망한 말기암환자의 134명의 의무기록을 후향적으로 분석하였다. 환자들의 인구사회학적 및 임상적인 특성을 확인하여 동거배우자 유무에 따른 차이를 살펴보았으며, 암 진단 후 호스피스 입원까지 기간(개월) 및 입원 후 사망까지의 생존기간(일)을 산출하여 가족구성과의 연관성을 알아보았다. 결과: 암 진단 후 호스피스 입원까지 기간의 중앙값 13개월을 기준으로 나눈 Group B(13개월 이후)에서 배우자 동거군의 비율이 통계적으로 유의하게 높았다(P<0.01). 주의사결정권자는 Group A에서는 자녀인 경우가 59.0%, B에서는 배우자가 52.9%로 많았다(P=0.04). 호스피스 입원 후 사망까지 기간의 중앙값 20일을 기준으로 Group 1(20일 미만)과 Group 2(20일 이상)로 나누어 살펴보았을 때 두 군 간의 가족구성의 특징은 통계적으로 유의한 차이가 없었다. 결론: 가족구성의 특성 중 배우자의 유무가 말기암환자의 호스피스 완화의료 이용 시기에 영향을 미치는 요인으로 나타났으며, 말기암 환자와 가족의 보다 더 효율적이고 적절한 호스피스 완화의료 이용을 위해 가족 구성의 특성을 파악하는 것이 도움이 될 수 있다.

Keywords

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