호스피스/완화치료가 일부말기암환자의 불안과 우울, 통증에 미치는 효과

Abstract

In the patients with terminal cancers, it is necessary to provide proper supportive cares to them and, eventually, to let them spend rest of their life meaningful. And then the purpose of this study was to compare the anxiety, depression and pain relief between terminal cancer patients with or without hospice care as the supportive cares. The study was performed for 32 hospice patients selected as experimental group, hospitalized patients in J hospital in Gwangju city from Oct. 1st 2006 to Jul. 27th 2007. Assessment Evaluation was performed based on the information at initial admission date and after 1 week from admission. Control group included 32 terminal cancer patients who were being treated in B, C, or J. general hospitals in Gwangju City either by out-patient or inpatient based service and provided with home care nursing service at the same time, without any kind of hospice care. Evaluation was performed with preliminary assessment, followed by subsequent reassessment after 1 week. Collected data was statistically analyzed by SPSS version 12.0, with descriptive analysis, x²-test and t-test, paired t-test, and ANCOVA. The major study findings were as follows:

1. On anxiety parameter, significant difference(-5.09±11.02, p<0.05)was found pre-intervention and post-intervention. result in experiment while no significant change in control group. 2. On depression parameter was found in experiment group while no significant change in control group.(-3.34±8.62, p<0.05). 3. Severity of pain was significantly decreased (-1.19±2.71, p<0.05) between pre-intervention and post-intervention value in experiment group, while no significant change in control group. 4. Social support indicator was significantly increased (-1.66±4.34, p<0.05) between initial value and one week later value in control group while no significant change in experiment group. 5. The difference of post-intervention value from pre-intervention value between experiment group and post experiment group did not show any significant change in anxiety, depression, and pain severity by ANCOVA analysis with adjusting covariates In conclusion, significants decreases of anxiety, depression and pain severity between before hospice/palliative care and after the intervention were found, although the difference of change in post-intervention from pre-intervention was not statistically significant. So more well-designed with adequate sample are necessary to prove the value of hospice/palliative care.