Purpose:The purpose of this study was to find the ways to improve a quality of life of cancer patients through the family support by analyzing the correlation between quality of life and family support that cancer patients perceived. Methods: The questionnaires for this study were collected from 43 cancer patients who were admitted in general hospitals at Gyounggido from July 2004 to August 2004. The questionnaire was composed of total 60 items, which were general characteristics of 18 items, family support of 11 items and quality of life of 31 items. Kang's(1984) scale of family support and Tae's(2000) scale of quality of life were used. The data were analyzed with SPSS WIN 10.0 program using frequency, mean±SD, t-test, ANOVA and Pearson's correlation analysis. Results: Forty three cancer patients answered the questionnaire. Twenty three patients was a male and 20 a female. Mean scale of family support according to general characteristics was 3.87±0.71. Mean scale of quality of life according to general characteristics was 5.89±1.08 and relatively high. The better degree of education, the higher quality of life significantly and the less physical discomfort, the higher quality of life significantly. The quality of life when the patient burdens the spouse with treatment cost was significantly higher. A correlation between degree of family support and quality of life was r=0.488 and the higher family support that cancer patients perceived, the higher quality of life significantly(p<0.001). Conclusion: The higher family support that cancer patients perceived, the higer quality of life significantly. We suggest concrete and systemic program for family support.

This study was conducted to examine the present state, types of services, difficulties, education programs, motivation, satisfaction and attitude of hospice volunteers and also to suggest supporting programs for the volunteer. For these purposes, a questionnaire was distributed among the 200 hospice volunteers in ten hospice organizations in Daejeon and Chungcheong province. In this research, 85.5% of the respondents were women and most of them were housewives in their forties and fifties. The majority of hospice volunteers had an education background of more than high school. Christianity (94%) was the dominant religion of volunteers. Among the service area of the hospice, emotional caring, such as listening closely and establishing empathy were the most frequently done by the respondents and the next one was spiritual care. Hospice volunteers who had started with altruistic motivation show more dynamic activities in emotional, spiritual, physical caring and so on, than those with non-altruistic motivation. Most of the respondents expressed that they felt a hospice volunteer was valuable. However they had a hard time to overcome the sorrow coming from sharing empathy with the dying patients. Those who had started with altruistic motivation usually took part in two times per a week and had more positive attitude. Volunteers who had been working more than five years showed better attitude than those who had been working less than three years. The longer the voluntary services, the more positive attitude experienced by volunteers. Hospice volunteers encountered the most considerable difficulty with lack of background knowledge and their actual capability. Insufficiency of time was the next reason for the considerable difficulty of the hospice volunteer. On the other hand, those who served more than twice per week replied that lack of background knowledge and their capability were the least considerable difficulty. Insufficiency of time was the reason of difficulty for male volunteers, as well as for females under thirty and those in their forties and fifties respectively. Generally most of the hospice volunteers (70%) were satisfied with their services and they usually satisfied with physical caring, spiritual caring, hospice's family caring. The less difficulty in voluntary services, more satisfaction for the volunteers in the end. There is a positive correlation between a attitude of the hospice volunteer and frequency of voluntary services while the volunteers' difficulty affect negatively their attitude as well as the frequency of voluntary services. Most of the hospice volunteers want to have more education about basic skills, volunteer's attitude and role, spirituality, the way of attending on the hospice and so on. Most of them considered discussion and sharing different cases as the most effective method. They also wish to had more supporting programs for the hospice volunteers(in the order of their needs) such as regular events, newsletters, personal concern, social meetings among the volunteers, insurance and minimum expenses. Based on the study results, more programs should be run in order to activate the voluntary services regardless of their gender and education background. A continuous practical supporting policy and education programs are required in order to provide special education and training courses considering every field of voluntary services. Expanding the role of the volunteers allows them more opportunities to take part in voluntary services and th activate participation. It is necessary to establish a new hospice system as a part public medical system, which can not only facilitate the voluntary services for a hospice but also enhance professional hospice volunteers. Finally, experts are needed to operate the voluntary services effectively.

Purpose: To know for what the medical expenditure had been used and to seek the way how it can be efficiently redistributed, I investigated total medical expenditure according to the time period to death in the expired patients for recent 2 years. Methods: 21patients were enrolled in this study. Total medical expenditure including benefit charge and non-benefit charge charged to patients in in-patient department(IPD) and out-patient department(OPD) was counted according to the period for one year by death. Results: 94.7% of the total medical expenditure had been payed for admission-related expenditure and 89% during period 3 and 4 for 6months before death, which may be due to the more days of admission during those periods. 70.1% of the total expenditure had been charged on the admission-fee, room charge, diet, and administration of the fluid, medicines, and blood etc. Conclusion: Majority of medical expenditure has been used in the affairs being unable to improve the survival or quality of life of patients and during the periods closer to death. Here, it would be needed heartily to look for the best ways in detail how the idea of hospice can come true through nation-wide and social consensus.

Purpose: The purpose of this study was to identify the effects of education of hospice for nurses on concern and coping about death and dying. Methods: The subjects of this study were 33 Korean nurses who participated in the education of hospice which consisted of lectures and practices for 5 months. Data were collected using questionnaire of concern and coping about Death and Dying. Data were analyzed with the mean, SDs and Wilcoxen test. Results: The mean score of concern about death and dying was 7.03. The highest items of concern about death and dying were 'thoughts of physical pain and being, 'thoughts of suffocating and choking, 'fear of darkness', The lowest items of concern about death and dying were. 'thoughts of burglars invading my possessions', 'rejection by God', thoughts of no one attending funeral', 'thoughts of no one paying respect or tribute', The mean score of coping about death and dying was 11.37. The highest items of coping about death and dying were 'call family member(s) into room and ask them ti sit close by, reminisce on happy events of the past, tell myself that there is nothing to be afraid of, look at family picture albums'. The lowest items of coping about death and dying were 'stay up stay up late till ready to fall asleep', 'look at family heirlooms', 'phone a prayer line', 'ask for a snack or something to drink'. In concern and coping about death and dying, significant differences were not found between pre and post test. But there was a tendency to decrease concern and increase coping about death and dying after education of hospice. Conclusion: According to these results, it is needed for nurses not only to do research for concern and coping about death and dying but also to develop an education program.

To determine which are the culturally specific factors of Korean bereavement, this chapter focuses on the view of death and the traditional mourning process which reflect Korean values and norms. The formation of the Korean view and understanding of death has been strongly influenced by three of its major traditional religions: Shamanism, Buddhism, and Confucianism (Park:1994: Hao:1999) and Christianity more recently. Each religion has a different view of death and the appropriate expression of mourning. Korea accommodates funeral customs and rules strictly as a cultural system and has retained these traditions over a long period; hence, some of the traditional funeral rituals still remain in modern Korean life, although some of the rites have been simplified. We have looked at the various ways in which grief and mourning is displayed and shared in a collective manner over a long period of time. This fits in well within the other Eastern cultures that are collectively organized, and contrary to the Eurocentric models do not hastily seek to detach the living from the dead and recognize that grief is a long process, and different individuals may take different amounts of time to recover from the grief. The view of death and bereavement in Korea has sprung from the roots of three Korean religions, together with the recent addition of Christianity, although they mainly result from the three earlier religions. The beliefs of these religions are still closely linked together in the rituals of Korean bereavement on both conscious and unconscious levels. The influence of these religions is evident in practice through the bereaved family's mourning reactions, funeral rites and customs and its views about death. Korea used to have a period of mourning for three years, following traditional mourning rites; then the chief mourner and the bereaved families could return to their normal life. In spite of this long mourning process for the bereaved family, once the funeral ceremony is finished, people expect the bereaved family not to express their grief in public; even the bereaved family does not like to talk about death. The process for bereaved people is related to mourning processes in terms of detachment from the deceased in order to start a new life. Relatives and the community recommend the performance of the kut ceremony for relieving the grief of the bereaved. When one family member dies in an unlucky way, the bereaved family may have some fear or other psychological reactions of grief such as pain, depression, insomnia and nightmares, hallucinations or other physical reactions. Unlucky deaths give the bereaved a very painful time and these types of reactions are often more serious than reactions to natural death. But through the kut ceremony, the bereaved family can start to make a new relationship with the deceased. The taboo of this type of death and death generally remains a crucial aspect of the isolation that bereaved people might face and the collective nature of mourning(even where it is still present) is unable to address this aspect of the privatization of grief.

The elderly people was over 8.3% in 2003. This seament is projected to grow to 14.4% by 2019(Aged society) and over 20% by 2026(Super aged society). As the elderly population is increasing and young population is declined social issues around elderly care are emerged in Korea. As a result of that, they are in the condition of poor system of the welfare of the old and it is the worst one in Korea. And because of the worst financial independence and difficulty in Korea, welfare facilities and medical instruments are so insufficient and deteriorated, so the quality of service is getting low. Furthermore the mortality of cancer is rapidely increased in recent years. So it is expected that the number of families who are caring for terminal cancer patient will be increased. We can not solve those problems only with government's policy such as to secure ample budget and to enlarge the aged welfare institutions. Definitely, to acheve the suggetions persistence concern about old people is most important, and family, community and national government should be linked to accomplish to goal. Accordingly, for this study attempts to provide conceptual framework of the respite care, spiritual care and home hospice, nursing home for the elderly. And this study is to discuss the necessity and effect about the construction of housing welfare infrastructure and to make a cooperation and linkage system among the aged welfare institutions, government and the aged welfare programs. As is well known, the issue of the increasing aged people is neither a matter of individuals nor of the family, but rather a complex matter of whol society. Therefore it can be resolved by the active participation of government. Conclusively this study tries to provide an direction of the improvement with regard to the welfare policy for the elderly. The study is as follwos: Chapters 1: The theological base, conception, essentiality, respite care, spiritual care and home hospice, nursing home for the elderly. Chapters 2: Definitions of respite care, spiritual care, hospice, patient of termina cancer and quality of life. And relations between respite care and nursing home. Chapters 3: The necessity of long-term care insurance and the perspectives of spiritual care. Chapters 4: Conclusions and summarizing(The directions of improvement of welfare policy for the elderly). To sum up, the problems of the aged people has not effects only to the aged people. This means that the problems of aged is the problems of the young generation today. Because young generation will be the old generation in the near future.

Purpose: The purpose of this study is to help apply spiritual care in clinics by testing whether spiritual support like prayer and praise, which is appled on a patient who has been cared for by Facility Hospice can have an effect on their physical pain, emotional anxietv, loneliness and well being. Method: This research was done on a subject patient who had been hospitalized in Saemmul from Jan, 2002 to June, 2003, and who could easily communicate. Questionnaire of quality of life, they had this test from the date of admission into the hospital 1week, 3week, 5week later. The Target was 182 people for the hospital data, 124 people after one week, 84 people after 3 weeks and 54 people after for 5 weeks later. For statistics, SPSS for Window(SPSS inc. ver.10), student T-test and one way ANOVA were used. The interrelation between pray and pain was analyzed by the "Pearson correlation". In case where the P-value was below 0.05, we concluded it had statistical-value. Results: When we compared both the party which had a low degree of peace by prayer and praise and the B party which had the highest degree, B party had an increasing tendency for less anxiety and loneliness and more well-being. Each of the data 0, 1, 3 and 5 week showed visible difference between both parties. Conclusion: First, in case that a late cancer patient is hospitalized, the difference for tranquility and pain control by prayer and praise is not noticeable. While, 1 and 3 weeks later, the difference is visible, so we concluded the relationship between the cancer patient's spiritual tranquility and physical pain are closely related with each other. Also the patients who are in spiritual peace by prayer and praise can control the pain better than the other patients. Second, because the patient who can feel calm from the data of being admitted into the hospital is mentally calm, both party's difference is noticeable in each period of the 1, 3 and 5th week. Compared with other patients, the object patients who have spiritual tranquility will have less anxiety and loneliness and more tranquility.