관련 논문 - 호스피스 서비스의 활성화 방안 연구 / 임봉자

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호스피스 서비스의 활성화 방안 연구 / 임봉자

20 죽음과 죽어감 조회 수 5258 추천 수 0 2017.08.09 11:08:41

nibp *.223.3.98 https://www.nibp.kr/xe/info4_3/87898

발행년 :	2008
구분 :	학위논문
학술지명 :
관련링크 :	http://www.riss.kr/link?id=T11686203

호스피스 서비스의 활성화 방안 연구

저자
임봉자
형태사항
; 26cm
학위논문사항
학위논문(석사)-- 조선대학교 정책대학원 : 사회복지학과 2008. 2
발행국
광주
언어
한국어
출판년
2007
소장기관
- 조선대학교 도서관
초록 (Abstract)
- The investigator investigated the origin and history of hospice systems and the status of Korea through the related data, and analyzed the cases of hospice patients who visited the social service center of A Hospital in Chonnam province. The aim of th...
The investigator investigated the origin and history of hospice systems and the status of Korea through the related data, and analyzed the cases of hospice patients who visited the social service center of A Hospital in Chonnam province. The aim of this study deduces the problem of Korean hospice system and suggests how to activate the hospice system in Korea.
The estimation of the hospice patients in advanced countries reaches about 0.015% of the whole population. In Korea, various indices of the diseases are being shown similarly with the advanced ones, and the aging process is rather faster than other countries, so the patients of hospice in Korea will reach 750,000 by the above estimated ratio to the whole population.
The hospice facilities in Korea were 64 in 2002 and the employees are about 11,000 in number, so those are markedly insufficient when compared with the advanced countries. Also, the hospice supporting budget of our country in 2008 is about 1.3 billion won, and it is so insufficient in number not reaching the extent of 1/1000 to the total medical budget.
Considering the analysis of the references above, the investigator suggests that our country need to propel specialized spaces for hospice, to expand supporting the budget, and to train professional staffs for hospice.
In this study, the investigator compared and analyzed 3 cases of hospice and then was to propose the plan to activate the hospice system of Korea based on this.
First case was a patient of gastric cancer/B-type hepatitis. He and his family had positive perception toward the hospice, and wanted to enter the hospice facility, but did not enter the facility by insufficiency.
The second case was an AIDS/hepatoma patient. He was an existing hospice patient, but faced difficulty because of social prejudice and indifference. He was denied to enter to hospice facilities because of the possibility of secondary infection. Especially, even exclusive hospice refused his admission for the risk of secondary infection of AIDS, so he lived the rest of his life in a general hospital.
The third case was a terminal esophageal cancer patient. He couldn't accept his severe disease. He had a seriously negative and exclusive personality, so his family was in a very difficult situation. When entering the hospital, he couldn't expect the effect of anti-cancer treatment any more, and the status of the patient required a special palliative medicine. However, he perceived that the transfer to another facility was regarded as death, so he opposed to transfer to another.

Summary of the problems shown at the above hospice case analysis is as follows.
First, it is the problem of perception. The problem results from the error of perception for the patient himself. The biggest problem is the wrong understanding toward the hospice that the transfer to another hospice directly mean his death.
Second, it is the problem of qualitatively and quantitatively insufficient facilities of hospice. The patient himself wanted to spend the rest of his life at the hospice by understanding it well, but due to the lack of hospice facility, he couldn't even be hospitalized. Although hospice must have special facilities such as aseptic room that can accept strongly infectible patient such as AIDS as well as no infectious patient, the present status in our country does not even have the special rooms for them.
Third, there is the problem of insufficient staffs to support the hospice system. In case of the terminal patients, the doctors and nurses that take charge of diagnosis and treatment play important role in elongating the life-span of the patient, but it doesn't suggest reasonable solution about the economic and mental problems of the patient's family and the psychological insecurity of the patient facing death.

Hereafter, for activation of hospice system to support comfortable death and right perception of death in the patients with terminal disease, the investigator infers the improvement plans such as followings are needed.
First, it is the education and public relations(PR) for hospice. The education and PR for the conception of hospice targeting all people as well as the medical staffs and terminal patients must be performed actively. Ministry of Health and Welfare prepares appropriate education programs that fit to the hospice, and large hospitals and related departments educating and training staffs related to hospice, patients and the people through lecture and practice and also promotes the necessity and achievement of hospice.
Second, there is the expansion in quantity for specialized facilities. For solving this problem, the government promotes active investment by the nation, and activates private capital investment by securing appropriate profits, just as the medical protection system. Especially, the local hospice that has special facilities which can prevent secondary infection must be established under the leading of the government.
Third, it is the training of supporting staffs in hospice system. Especially, the training of the social workers must be rapidly and actively performed by nation, because it is more easier and more rapid than the training of other supporting staffs such as medical staffs.

In conclusion, to activate hospice system in Korea, the investigator inferred that followings are the necessary factors: ① to preestimate correctively the degree of hospice demand through accurate basic investigation on hospice system, ② to expand the both of quantity and quality of hospice facilities, ③ to train rapidly supportive staffs, especially social workers, ④ to educate a right perception toward the hospice to all people as well as the patients and their family.
목차 (Table of Contents)
목 차
Abstract ‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥Ⅴ
제1장 서 론 ‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥1
제1절 연구목적‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥1
제2절 연구방법 및 범위 ‥‥‥‥‥‥‥‥‥‥‥‥2
제2장 이론적 고찰‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥4
제1절 죽음의 이해‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥4
1. 죽음의 정의‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥4
2. 죽음의 유형‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥5
3. 죽음의 수용과정‥‥‥‥‥‥‥‥‥‥‥‥‥‥9
제 2 절 호스피스의 의의‥‥‥‥‥‥‥‥‥‥‥‥10
1. 호스피스의 정의‥‥‥‥‥‥‥‥‥‥‥‥‥10
2. 호스피스 활동의 역사‥‥‥‥‥‥‥‥‥‥‥12
3. 호스피스의 목적‥‥‥‥‥‥‥‥‥‥‥‥‥20
제 3 절 호스피스 서비스‥‥‥‥‥‥‥‥‥‥‥‥22
1. 호스피스의 유형‥‥‥‥‥‥‥‥‥‥‥‥‥‥22
2. 호스피스 대상자 선정‥‥‥‥‥‥‥‥‥‥‥26
3. 호스피스 팀 구성 ‥‥‥‥‥‥‥‥‥‥‥‥‥27
제3장 호스피스 제도의 현황 및 문제점‥‥‥‥‥‥‥33
제1절 한국 호스피스 운영 현황‥‥‥‥‥‥‥‥‥33
1. 호스피스 현황‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥33
2. 호스피스 기관 분류 및 활동 인력‥‥‥‥‥‥‥35
3. 환자 현황‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥37
4. 재정 현황‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥37
5. 시설 현황 ‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥38
6. 프로 그램‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥40
7. 모델‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥41
8. 대상자‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥43
제2절 호스피스 서비스 사례분석‥‥‥‥‥‥‥‥44
1. 사례 Ⅰ‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥44
2. 사례 Ⅱ‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥55
3. 사례 Ⅲ‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥64
4. 사례의 비교분석‥‥‥‥‥‥‥‥‥‥‥‥‥74
제3절 한국 호스피스 서비스의 문제점‥‥‥‥‥‥76
1. 호스피스에 대한 인식 부족‥‥‥‥‥‥‥‥76
2. 호스피스 제도의 문제점‥‥‥‥‥‥‥‥‥‥77
3. 호스피스 전문 인력 및 시설 부족‥‥‥‥‥‥78
제4장 호스피스 서비스의 활성화 방안‥‥‥‥‥‥‥80
1. 호스피스에 대한 인식 제고 및 홍보‥‥‥‥‥80
2. 호스피스의 제도적 보완‥‥‥‥‥‥‥‥‥‥81
3. 인력양성과 시설확충 및 지원시스템 구축‥‥84
제5장 결 론‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥86
참고문헌‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥94