CAJ | 학술논문

目的：了解社区临终关怀中家属对癌症晚期患者终末期治疗与抢救决策的现实与意愿，为社区有效开展临终关怀服务提供指引。方法2013年4-9月，采用质性研究中的现象学研究方法，对12名癌症晚期患者的家属进行深入访谈，并用现象学分析法进行资料分析整理，提出主题。结果家属对癌症晚期患者终末期治疗和抢救决策涉及：临终期治疗与抢救方法、救治地点、救治决策意见的形成等。其中方法以姑息治疗为主，终末抢救以无创抢救为主，只有个别家属能做到放弃无效抢救；地点以医院为主，较少能够实施居家关怀；家属对癌症晚期患者临终期治疗与抢救决策占主导作用。结论家属对癌症晚期患者终末期治疗与抢救的决策理念距临终关怀的目标仍有较大差距，我国的临终关怀事业需要社会层面广泛的死亡教育宣传、普及和国家出台相关政策支持、引导，以及从事临终关怀的医务人员的适时引导。
목적：료해사구림종관부중가속대암증만기환자종말기치료여창구결책적현실여의원，위사구유효개전림종관부복무제공지인。방법2013년4-9월，채용질성연구중적현상학연구방법，대12명암증만기환자적가속진행심입방담，병용현상학분석법진행자료분석정리，제출주제。결과가속대암증만기환자종말기치료화창구결책섭급：림종기치료여창구방법、구치지점、구치결책의견적형성등。기중방법이고식치료위주，종말창구이무창창구위주，지유개별가속능주도방기무효창구；지점이의원위주，교소능구실시거가관부；가속대암증만기환자림종기치료여창구결책점주도작용。결론가속대암증만기환자종말기치료여창구적결책이념거림종관부적목표잉유교대차거，아국적림종관부사업수요사회층면엄범적사망교육선전、보급화국가출태상관정책지지、인도，이급종사림종관부적의무인원적괄시인도。
Objective To understand the status of family members' decision making and willingness on treatment and resuscitation of terminal stage advanced cancer patients in community hospice,and provide guidance for effective delivery of hos-pice care in community. Methods Phenomenological methods of qualitative study were applied in the research. Family members of 12 patients with advanced cancer were interviewed in depth during April and September in 2013,data was compiled and ana-lyzed by phenomenological analysis and relevant themes were concluded. Results Family members' decision making on treatment and resuscitation of terminal stage advanced cancer patients involved:methods of treatment and resuscitation in terminal stage, location of treatment,formation of decisions on treatment,etc. Regarding the methods,palliative care was the main approach, non - invasive resuscitation was predominant in terminal stage,only individual family members could give up ineffective resuscita-tion. Hospital was predominant regarding the location,few family members could deliver care at home. Family members played the dominant role in decision making on treatment and resuscitation of terminal stage advanced cancer patients. Conclusion Large gap still exists between family members' philosophy of decision making on treatment and resuscitation of terminal stage advanced cancer patients and the target of end of life care. Universal end of life care education and publicity at the social level,policy sup-port and guidance from the government,proper instructions from hospice health professionals are essential for the development of hospice care.