DOI QR코드

DOI QR Code

End-of-life Care, Comfort Care, and Hospice: Terms and Concepts

  • Hyeon Ju Kim (Department of Family Medicine, Jeju National University Hospital, College of Medicine Jeju National University) ;
  • Jung-Sik Huh (Department of Urology, Jeju National University Hospital, College of Medicine Jeju National University)
  • Received : 2024.08.30
  • Accepted : 2024.11.18
  • Published : 2024.12.01

Abstract

Purpose: This study aims to clarify and standardize the terms and concepts associated with end-of-life care, specifically within the contexts of hospice and palliative care. Methods: We reviewed references pertaining to hospice and palliative care, including definitions of end-of-life care and comfort care. Two meetings were held with members of the medical terminology committee of the Korean Society for Hospice and Palliative Care, along with experts in the field, to establish a consensus on the terms used. In the first round, six experts participated, and in the second round, eight experts engaged in online meetings to brainstorm, exchange opinions, and review and discuss reference materials concerning terms related to hospice and palliative care. Results: Legal definitions do not always align with those used in clinical medical settings. Although it is challenging to define the period precisely, end-of-life care encompasses all diseases, including age-related infirmities, typically spanning 6 months to 1 year. Hospice care, in contrast, includes certain non-cancerous terminal diseases as well as terminal cancer, covering a period of 3 to 6 months. Comfort care generally refers to the care provided approximately 7 days before death. Conclusion: A conceptual understanding of terms related to end-of-life care must be reached through cultural and social consensus. Furthermore, end-of-life care should not be limited to cancer but extended to all diseases. In the future, the scope of end-of-life care should expand to encompass care for bereaved families, evolving into a more comprehensive concept of comfort care.

Keywords

References

  1. Kim CG. The history of hospice and palliative care in Korea. Korean J Hosp Palliat Care 2019;22:1-7. https://doi.org/10.14475/kjhpc.2019.22.1.1
  2. OECD. End-of-life care. In: OECD. Health at a Glance 2021: OECD Indicators. Paris:OECD Publishing;2021.
  3. Huh JS, Kim HJ. The problems of implementation of the life-sustaining treatment decision act in the medical field. Korean Journal of Medicine and Law 2024;32:27-40. https://doi.org/10.17215/kaml.2024.06.32.1.27
  4. Korean Society for Hospice and Palliative Care. Textbook of hospice & palliative care. Paju:Koonja;2023.
  5. Kwon SH, Kwak SY, Kwon SY, Kim MJ, Kim SJ, Park JH, et al. Hospice and palliative nursing. Seoul:Hakjisa;2023.
  6. Park SS, Han SH, Lee YC, Jang YH. Hospice practice for well-dying. Seoul:Hakjisa;2023.
  7. Lee SM, Kim SJ, Choi YS, Heo DS, Baik S, Choi BM, et al. Consensus guidelines for the definition of the end stage of disease and last days of life and criteria for medical judgment. J Korean Medi Ass 2018;61:509-21. https://doi.org/10.5124/jkma.2018.61.8.509
  8. Taum PE, Mills SS. Hospice and palliative care: an overview. Med Clin Noth Am 2020;104:359-73. https://doi.org/10.1016/j.mcna.2020.01.001
  9. MacPherson N, Montaque T, Aylen J, Martin L, Gogovor A, Baxter S, et al. Canada’s evolving medicare: End-of life care. J Palliat Care 2021;36:157-61. https://doi.org/10.1177/0825859720924169
  10. Ko MJ, Moon SH. Factors influencing performance of end-of-life care by ICU nurses. J Korean Acad Psych Mental Health Nurs 2016;25:327-37. https://doi.org/10.12934/jkpmhn.2016.25.4.327
  11. Park M, Je NJ. The impact of nursing hospital workers’ hospice and palliative care knowledge and awareness, end-of-life care attitude and death awareness on their end-of-life care performance. Korean J Hosp Palliat Care 2018;21:124-36. https://doi.org/10.14475/kjhpc.2018.21.4.124
  12. Lynn J, Adamson DM. Redefining and reforming health care for the last years of life. Santa Monica (CA):RAND Corporation;2006.
  13. Mariana CSS, Rosangela GJ, Borges Mda S. Comfort of patients in palliative care: an integrative review. Enfermeria Global 2021;20:451-65.
  14. National Hospice Center; Korean Society for Hospice and Palliative Care. Clinical practice guideline care for last days of life. Goyang:National Hospice Center; Seoul:Korean Society for Hospice and Palliative Care;2018. p. 7-11.
  15. Korean Society of Critical Care Medicine. Korean professional consensus for comfort care and withdrawing/withholding in the intensive care unit; by the Task force of Korean Society of Critical Care Medicine. Seoul:Korean Society of Critical Care Medicine;2018.
  16. Shin YJ. End of life care system in England. HIRA Policy Brief 2020:14:63-78.
  17. Breyre AM, Bauns G, Moore J, Siegel L, Sporer KA. Hospice and comfort care patient utilization of emergency medical services. J Palliat Med 2022;25:259-64. https://doi.org/10.1089/jpm.2021.0143
  18. Olausson S, Fridh I, Kindahl B, Torkildsby AB. The Meaning of Comfort in the Intensive Care Unit. Crit Care Nurs Q 2019;42:329-41. https://doi.org/10.1097/CNQ.0000000000000268