• Journal of Hospice and Palliative Care
• /
• v.19 no.4
• /
• pp.303-309
• /
• 2016

Purpose: Malignant ascites is a common complication in terminal cancer patients. Less-invasive pigtail catheter insertion is the most frequent procedure in patients who need repeated ascites drainage. This study investigated effects and adverse events associated with catheter insertion for ascites drainage and evaluated prognostic outcomes. Methods: We reviewed medical records between 2010 and 2013 of hospice and palliative care institutions in Seoul, South Korea. Among 2,608 inpatients, 67 patients received ascites pigtail catheter drainage. We reviewed demographic data, palliative performance scale, laboratory data, duration of catheter insertion, prevalence and type of complications, use and duration of antibiotics, and survival time. Univariate and multivariate Cox regression models were used to evaluate prognostic outcomes related with catheter insertion. Results: Ascites drainage was performed most commonly in hepatobiliary and gastric cancer patients. Ascites symptoms improved in 55 patients after the catheter drainage. Adverse events included pain (19.4%), leakage (14.9%), disconnection (7.5%), catheter occlusion (6%) and fever (4.5%). In Cox regression analysis, survival time from the catheter insertion was significantly associated with Palliative Performance Scale (PPS) (HR 0.73; P value 0.045) and serum sodium level (HR 2.77; P value 0.003) in a multivariate model. Conclusion: Patients' PPS and serum sodium level should be considered before making a decision of pigtail catheter insertion.

• Journal of Hospice and Palliative Care
• /
• v.11 no.2
• /
• pp.78-81
• /
• 2008

Purpose: The end of one's life can be one of the most important times in human life. However, physicians, nurses and volunteer workers are not sufficiently trained to understand the end-life care with competence and confidence. The purpose of this study was to compare various education programs currently carried out for volunteer workers. Methods: Nine curricula of hospice and palliative cares for volunteer workers at hospital and palliative care settings. Results: The mean time duration of theory education at nine institutes was 21.56 hours (range; 14-30). The common curricula of hospice and palliative cares for volunteer workers included 'Understanding of hospice and palliative care', 'Understanding of life and death', and 'Understanding of psychologic problem of end-of-life'. The education method comprised lectures, off-line 8 institutes and on-line 1 instiutute. Conclusion: It is necessary to develop the standard curriculum as well as regularly updated education program for volunteer workers.

• Journal of Home Health Care Nursing
• /
• v.26 no.2
• /
• pp.180-188
• /
• 2019

Purpose: To investigate the duration of each nursing activity performed by home care nurses for non-cancer patients and the relationship between patients' palliative prognostic index (PPI) and duration of each nursing activity. Methods: Nursing activities performed for six non-cancer terminal patients were timed using a stopwatch, and 18 parameters were measured by visiting each patient thrice. The mean and standard deviations of duration for each category of nursing activities were computed. The relationship between category-specific duration of nursing activities and PPI was analyzed with Spearman's correlation and multiple regression analysis. Results: Among nursing activities, the highest greatest duration of time was spent on traffic time (11.91 min), followed by urinary catheter management (10.65 min) and insertion and management of nasogastric tube (9.03 min). In terms of nursing categories, after excluding movement time, the greatest duration of time was spent on excretion care (5.48 min), nutrition care (5.40 min), and medication (3.82 min). PPI correlated with hygiene care, excretion care, and patient and information management. Multiple regression analysis revealed that PPI increased with increasing duration of hygiene care. Conclusion: These study findings provide grounds for the increased nursing time of hygiene care for people reaching the end of life.

• Journal of Hospice and Palliative Care
• /
• v.18 no.3
• /
• pp.179-187
• /
• 2015

For patients who are near the end of life, an inevitable step is discussion of a do-not-resuscitate (DNR) order, which involves patients, their family members and physicians. To discuss DNR orders, patients and family members should know the meaning of the order and cardiopulmonary resuscitation (CPR) which includes chest compression, defibrillation, medication to restart the heart, artificial ventilation, and tube insertion in the respiratory tract. And the following issues should be considered as well: patients' and their families' autonomy, futility of treatment, and the right for death with dignity. Terminal cancer patients should be informed of what futility of treatment is, such as a low survival rate of CPR, unacceptable quality of life after CPR, and an irremediable disease status. In Korea, two different law suits related to life supporting treatments had been filed, which in turn raised public interest in death with dignity. Since the 1980s, knowledge of and attitude toward DNR among physicians and the public have been improved. However, most patients are still alienated from the decision making process, and the decision is often made less than a week before death. Thus, the DNR discussion process should be improved. Early palliative care should be adopted more widely.

• Journal of Korean Clinical Nursing Research
• /
• v.14 no.2
• /
• pp.103-114
• /
• 2008

Purpose: The purpose of this study was to investigate the level of QoL of the terminal cancer patients at home and to identify any influencing factors on QoL. Method: Subjects of this study consisted of 72 terminal cancer patients who were receiving home care nursing for more than 2 weeks in 6 general hospitals. Data were collected by a self-reporting questionnaire on QoL, pain, physical functioning, and symptom experience from Feb, 2006 to Dec, 2006. Data were analyzed by t-test, one way ANOVA, Pearson correlation coefficients, and multiple regression using SPSS Win 14.0. Results: Mean score of QoL was 98.6(230 in total). Except the level of family coping, general characteristics and disease related variables did not show significant difference in QoL. QoL was higher in the family with better coping, and QoL showed negative correlation with three types of pain, physical functioning, and symptom experiences. Least pain, physical functioning, and level of family coping explained QoL up to 26.7%. Conclusion: The QoL was closely related with pain, physical functioning, symptom experience, and family coping. And the least pain, physical functioning and level of family coping were important factors influencing on QoL of terminal cancer patients. However, some other variables influencing the QoL need to be investigated in the future.

• Journal of Korean Academy of Nursing
• /
• v.35 no.3
• /
• pp.441-450
• /
• 2005

Purpose: The purposes of this study were to determine the core nursing interventions in nursing notes and the practice which was perceived by nurses of an oncology unit with patients with terminal cancer. Also, comparing interventions in nursing notes with interventions in perceived practice was done. Method: Subjects were 44 nursing records of patients with terminal cancer who had died from Jan. to Dec. 2002 at C University Hospital and 83 nurses who were working on an oncology unit for more than one year. Data was collected using a Nursing Interventions Classification and analyzed by means of mean and t-test. Results: The most frequent nursing intervention was 'nausea management' in the nursing note and was 'medication administration: oral' in perceived practice. The frequency of nursing interventions in the nursing record was lower than in perceived practice. Conclusion: This study finds that nurses actually practice nursing care, but they may omit records. To correct for omitted nursing records, development of a systematic nursing record system, continuous education and feedback is recommended.

• Journal of Korean Academy of Nursing
• /
• v.32 no.2
• /
• pp.243-253
• /
• 2002

The purpose of this study was to develop Nurse's Suffering Experience Scale and to test the reliability and validity of the instrument. Method: The subjects used to verify the scale's reliability and validity were 220 nurses who were taking care of the end stage cancer patients, while working at university and general hospitals in Daegu and Kyungbuk province from April 20. to July 10, 2001. The data was analyzed by the SPSS/WIN 8.0 program. Results: A factor analysis was conducted, and items that had a factor loading more than .40, and an eigen value more than 1.0. were selected. The factor analysis classified a total of seven factors statistically, and it's communality was 44%. The explanation of factors based on the conceptual framework and item content are as follows: The first factor was expanding self consciousness, the second factor was forming empathy with family, the third factor was professional challenge, the fourth factor was change of values, the fifth factor was spiritual sublimation, the sixth factor was helplessness, and finally the seventh factor was rejection to death. Cronbach's coefficient to test reliability of the scale was .8665 for total of 44 items. The Scale for Nurse's Suffering Experience developed in the study was identified as a tool with a high degree of reliability and validity. Therefore this scale can be effectively utilized for the evaluation of the degree of nurse's suffering experience in clinical settings.

• Research in Community and Public Health Nursing
• /
• v.23 no.2
• /
• pp.127-133
• /
• 2012

Purpose: This study was conducted to assess needs at each end-of-life care stage and to analyze importance and difficulty of care needs for home care nursing among non-cancer patients. Methods: We used a retrospective design. Total eligible patients were 117 at the ages of 40 and over, who continuously received home care nursing throughout beginning, stable, and near death stages, and finally died at home from January 1, 2006 to December 31, 2006. Descriptive statistics, Cochran's Q test, Friedman's test were used for data analysis. Results: In the area of physical care, the care need for 'assistance for activities in daily life' was significantly highest in the beginning stage. The care need for 'aggravation or adverse changes in physical symptoms' was significantly increased in the near death stage. In the area of psychospiritual care, 'family's psychological burden' was revealed as having the highest rate of care needs in the every stage. Conclusion: Future intervention should consider assessing care needs in end-of-life care for non-cancer patients who are provided with home care nursing.

• Asian Oncology Nursing
• /
• v.8 no.1
• /
• pp.32-39
• /
• 2008

Purpose: This study was to identify the relationship between perceived family support and quality of life in hospitalized patient with terminal cancer. Method: Study subjects were 104 patients with terminal cancer who were hospitalized and treated at K university hospital, in Busan. Perceived family support and quality of life were measured using the Kang's Revised Family Support Scale and Youn's Quality of Life scale for terminal patients. Results: 1) The mean score of perceived family support was $4.23{\pm}0.61$. The mean score of quality of life was $5.83{\pm}1.37$. 2) The perceived family support was significantly different with primary care giver, food type, medical period after diagnosis. 3) The levels of quality of life was significantly different by number of children, effect of religion on the one' life, perceived state of disease and pain. 4) There was moderate positive correlation between perceived family support and quality of life. Conclusions: Increase in perceived family support was associated with increase in quality of life in hospitalized patients with terminal cancer. It is necessary that the development of nursing education program for family which help to support the patient with terminal cancer for increasing the quality of life of patient with terminal cancer.

• Journal of Korean Academy of Nursing
• /
• v.36 no.2
• /
• pp.299-309
• /
• 2006

Purpose: The main purpose of this study was to develop a substantive theory on the process of the spiritual experience in Christian terminal cancer patients in the context of Korean society and culture. The question for the study was 'What is the spiritual process in Christian terminal cancer patients?'. Method: The research method used was the Grounded Theory Method developed by Strauss & Corbin(1998). Participants for this study in total were 9 Christian terminal cancer patients. Data was collected using in-depth interviews during April 2003 to March. 2004. Data collection and analysis were carried out at the same time. Result: From the analysis 58 concepts and 20 categories emerged. The categories were presented into a paradigm, which consisted of condition-actions/interactions-consequences. The theoretical scheme was described by organizing categories. In total, 4 stages were developed from the condition-actions/ interactions-consequences. Throughout these stages, the 'overcoming process of unbalanced interconnectedness' was the core category discovered. Conclusion: This study provides a framework for the development of individualized care interventions in the 'overcoming process of unbalanced interconnectedness' for Christian terminal cancer patients.