• Journal of Hospice and Palliative Care
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• v.15 no.1
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• pp.30-35
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• 2012

Purposes: Most medical schools in Korea do not provide adequate education in end-of-life care. This study was designed to illustrate the need to improve end-of-life care education and to assess the effect of the education on fourth-year medical students' awareness and attitude towards hospice and palliative care for terminally ill patients. Methods: One hundred sixty six fourth-year medical students were surveyed with questionnaires on end-of-life care before and after they received the education. Results: Before receiving the education, students most frequently answered "at the end of life" (33.6%) was appropriate time to write an advance medical directive. After the education, the most frequent answer was "in healthy status" (58.7%). More students agreed to withholding or withdrawing futile life-sustaining treatment increased after the education (48.1% vs. 92.5% (P<0.001) for cardiopulmonary resuscitation, 38.3% vs. 92.5% (P<0.001) for intubation and mechanical ventilation, 39.1% vs. 85.8% (P<0.001) for inotropics, 60.9% vs. 94.8% (P<0.001) for dialysis and 27.8% vs. 56.0% (P<0.001) for total parenteral nutrition). Significantly more students opposed euthanasia after the education (46.6% vs. 82.1%, P<0.001). All students agreed to the need for education in end-of-life care. Conclusion: After reflecting on the meaning of death through the end-of-life care education, most students recognized the need for the education. The education brought remarkable changes in students' awareness and attitude towards patients at the end of life. We suggest end-of-life care education should be included in the regular curriculum of all medical schools in Korea.

• The Journal of the Korea Contents Association
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• v.17 no.10
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• pp.667-685
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• 2017

The purpose of this study was to explore the meaning and essence of experience of family members as care-givers of terminally ill cancer patients at hospice wards. This study was based on the Giorgi phenomenological method, which describes the experiences about the family caregivers. We had in-depth interview with spouses and orthogonal families of nine terminally ill cancer patients. Results were drawn into 13 essential themes, 45 sub themes, and 122 main points. The essential themes are as follows: "cling of life", "bed-keeper", "sacrifice of care", "physical and mental exhaustion during care process","feeling of love and hatred", "avenge on a patient", "self-condemnation", "futility after exhaustion", "consolation of other caregivers", "utmost efforts in resignation", "freedom from suffering", "paradoxical blessing of cancer", "introspected revolution", and "preparation of a dignified death". Implications and limitations are discussed based on study results.

• Journal of Hospice and Palliative Care
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• v.21 no.2
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• pp.41-50
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• 2018

Spirituality is an essential part of human beings. Spiritual care, designed to meet the spiritual needs of terminally ill patients and their families, is one of the most important aspects of hospice and palliative care (HPC). This study reviewed and analyzed literature utilizing the most commonly used Korean and international healthcare databases to identify care models that adequately address the spiritual needs of terminally ill patients and their families in practice. The results of this study show that spirituality is an intrinsic part of humans, meaning that people are holistic beings. The literature has provided ten evidence-based theories that can be used as models in HPC. Three of the models focus on how the spiritual care outcomes of viewing spiritual health, quality of life, and coping, are important outcomes. The remaining seven models focus on implementation of spiritual care. The "whole-person care model" addresses the multidisciplinary collaboration within HPC. The "existential functioning model" emphasizes the existential needs of human beings. The "open pluralism view" considers the cultural diversity and other types of diversity of care recipients. The "spiritual-relational view" and "framework of systemic organization" models focus on the relationship between hospital palliative care teams and terminally ill patients. The "principal components model" and "actioning spirituality and spiritual care in education and training model" explain the overall dynamics of the spiritual care process. Based on these models, continuous clinical research efforts are needed to establish an optimal spiritual care model for HPC.

• Journal of Hospice and Palliative Care
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• v.21 no.2
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• pp.58-64
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• 2018

Purpose: This study was conducted to evaluate the impact of a two-week palliative care education program on Korean Hospice volunteers. Methods: A total of 71 volunteers were assigned to two groups: Group A (intervention, n=34) and Group B (usual care, n=37). Group A received six sessions of palliative care education for two weeks. The level of volunteers' motivation, death anxiety, and communication with the dying were measured at baseline and after the program ended. Results: The palliative care education program had positive influence on the volunteers' motivation (t=2.341, P=0.022), death anxiety (t=-2.166, P=0.034), and communication with the dying (t=-2.808, P=0.006). Conclusion: The findings of this study suggest that a palliative care education program may be an effective way to boost hospice volunteers' motivation, ease their death anxiety and improve their communication with the dying.

• Journal of agricultural medicine and community health
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• v.33 no.1
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• pp.59-70
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• 2008

Objectives: This study aimed to find out the effects of hospice care in public health centers by evaluating the quality of life of terminal cancer patients and care-giver burden of their families.Methods: From January to December 2007, 32 terminal cancer patients and their familes were selected as with interviews. Instruments used for this study were C-QOL(Cancer-Quality of Life) that was developed by Le(207) and care-giver burden of families that was developed by Seo et al(193). The data were analyzed using frequency, percentage and paired t-test.

• Health and Mission
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• s.8
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• pp.35-37
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• 2007

• Journal of Hospice and Palliative Care
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• v.19 no.1
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• pp.11-25
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• 2016

Purpose: The purpose of this study was to determine the factors that influence healthcare providers' attitude towards end-of-life care (EOLC) in the emergency department (ED) in hospital settings. Methods: From June 1 through June 30, 2014, a descriptive correlational study was performed with 41 doctors and 105 nurses stationed in the ED. Results: According to a regression model on the factors affecting healthcare providers' professional attitude towards EOLC, 28.1% of variance (F=15.185, P=0.000) was explained by awareness of death, gender and personal attitude towards EOLC. And 34.1% of the healthcare providers' personal attitude was related with awareness of death, experience of hospice education, occupations and professional attitude towards EOLC. Conclusion: This study demonstrated that attitude towards EOLC was influenced by awareness of death and personal characteristics. Healthcare providers in the ED should be provided with tailored training to improve their understanding of death. Also an educational program should be developed and provided to ED healthcare providers to improve their awareness of death.

• Journal of Hospice and Palliative Care
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• v.18 no.2
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• pp.136-147
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• 2015

Purpose: This study was conducted to evaluate the effects of integrated palliative care intervention on quality of life in terminally ill patients. Methods: A comprehensive literature search was performed via PubMed, Cochrane Library CENTRAL, LWW (Ovid), CINAHL and several Korean databases. The main search strategy was to combine terms indicating palliative care intervention, presence of terminal illness and study design. Methodological quality was assessed using Cochrane's Risk of Bias for randomized studies and Risk of Bias Assessment tool for non-randomized studies. Data were analyzed by the Stata 10 program. Results: Eight clinical trials met the inclusion criteria with a total of 356 participants. Integrated palliative care interventions were administered for a mean of 6.5 weeks, 5.6 sessions and an average of 47.8 minutes per session. Effect sizes were heterogeneous, and subgroup analysis was done. Integrated palliative care interventions had a significant effect on quality of life (ES=1.83, P=0.018, $l^2=92%$), spiritual well-being (ES=0.78, P=0.040, $l^2=0$), depression (ES=0.86, P<0.001, $l^2=32$) and anxiety (ES=0.69, P=0.041, $l^2=71.1$). But integrated palliative care interventions had no significant effect on pain (ES=0.365, P=0.230, $l^2=69.8$). Conclusion: Results support findings that integrated palliative care interventions were helpful in lessening depression and anxiety and improving quality of life and spiritual well-being, however, the interventions did not assist pain management in terminal cancer patients. These findings suggest that various integrated palliative care interventions can assist terminal cancer patients with better quality of life in the socio-psycho-spiritual dimension.

• Journal of Hospice and Palliative Care
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• v.13 no.1
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• pp.7-12
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• 2010

Purpose: To evaluate medications at the end of life care for terminal cancer patients during their last admission. Methods: Medical records of terminal cancer patients during their last admission from July 2003 to April 2008 at a district academic hospital were evaluated. Patient's characteristics, therapeutic drug classification during their last admission and on the patient's day of death, and the administrated route and number of medications on the patient's day of death were analyzed. Results: Total 81 patients were included. The median patient age was 63 years. The median length of admission was 18 days (range: 1~101). 54% of the patients had more than one comorbidities. The most frequently prescribed drugs during the last admission were opioid analgesics (63%), followed by antibiotics (58%) and antacids (53%). On the day of death, common medications were antibiotics (59%), antacids (58%), and opioid analgesics (46%). Intravenous injection was given to 81% of the patients and intramuscular injection was given to 16% of the patients on the day of patient's death. Number of medications prescribed to patients was between 0 and 11 (median: 3) and 12% (10/81) of the patients took over 8 medications including intravenous and oral drugs on the day of death. 6% (5/81) of the patients took potentially futile medications, like multivitamin or statin until the day of death. Conclusion: This study suggests that potentially futile medications and uncomfortable care were given to terminal cancer patients. Multicenter-based studies are necessary to diminish futile medications by essential medication at the end of life care for terminal cancer patients.

• Korean Journal of Family Social Work
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• no.57
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• pp.69-98
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• 2017

This study aims to examine the direct effects of two workplace spirituality dimensions, community at work and meaning in work, and burnout on three caring dimensions, emotional, social and spiritual care, for terminally ill people. It also seeks to examine the moderating effect of burnout in the relationship between two workplace spirituality dimensions and three caring dimensions. For these purposes, data were collected from 114 interdisciplinary team members, doctors, nurses, social workers and pastors, working in 68 palliative care in nationwide by questionnaires. The study results indicated that community at work has a positive effect on emotional care, and that meaning in work has a positive effect on social and spiritual care. The results also provided that burnout does not impact on three caring dimensions and has no moderating effect in the relationship between two workplace spirituality dimensions and three caring dimensions. In the findings, managers or leaders from palliative care should consider the potentially positive influence of workplace spirituality on caring for terminally ill people and can improve practitioners' performance with any interventions to increase workplace spirituality. The limitations of this study and recommendations for the future research were discussed.