임종환자에 대한 태도조사

A Study on the Attitudes Toward Dying Patients

This study examines the attitude toward dying patients among the families of dying patients, the families of patients who are not terminally ill, psychiatrists, non-psychiatric physicians, nurses and a control group. A 19-item questionnaire was filled out by each participant. 1) 69% of all that responded thought dying patients were aware of their situation even though they had not been told. 2) 83 깠 of the respondents agreed to informing the dying patient of his prognosis. But 28% of the families of dying patients, which was the highest percentage in any group, did not want to inform the patient. Frequently given rationales for informing the patient were that the patient should prepare for death psychologically, that he must be given the opportunity to put remaining affairs in order, and that he has the right to know. Psychological preparation for death was the most frequent answer. The families of dying patients more frequently chose the opportunity to put remaining affairs in order as a rationale. 3) The most frequently considered pre-requisite for disclosure was emotional stability. And items such as religion, age, level of education, remaining affairs, expectation of life followed. All respondents except physicians regarded a year or more before death was the best time to inform the patinet upon death. Physicians thought one to three months before death was the best timing. Almost all respodents thought it was most proper to tell the patient when he vaguely knew about his prognosis. 4) Medical personnels chose the physician-in-charge as the most appropriate person to inform the patient. Families of patients and control group chose a family member as the most appropriate person. Speaking frankly without discouragement was thought to be the best way to inform the patient by all groups. 5) As to what a dying patient needed most, various items were selected evenly. More frequently chosen items were care of family members, relief of physical discomfort, religious help, and psychiatric treatment. Families of pateints thought a dying patient suffered from feeling of isolation and physical pain. The medical personnel, however, thought a dying patient suffered from more abstract items such as fear of unknown, or fear of identity loss. 6) All groups agreed that psychiatric treatment for a dying patient was a good idea when death was near. 7) Families of dying patients and non-psychiatric physicians wanted to send the patient home to die ; many psychiatrists thought Hospice care was preferable. Non-psychiatric physicians and nurses thought only the immediate family members should be present on death bed i other groups preferred as many family members and relatives as possible to be on death bed.