• Journal of Hospice and Palliative Care
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• v.22 no.1
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• pp.8-18
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• 2019

Purpose: This study was conducted to better understand the illness experiences and palliative care needs in community-dwelling persons with cardiometabolic diseases. Methods: This qualitative descriptive study was conducted with 11 patients (and three family members) among 28 patients contacted. Interviews were led by the principal investigator in her office or at participants' home depending on their preference. All interviews were digitally recorded and transcribed by a research assistant. The interviews were analyzed by two independent researchers using a conventional method. Results: Participants' ages ranged from 42 to 82 years (nine men and two women). Three themes were identified: (1) same disease, but different illness experiences; (2) I am in charge of my disease(s); (3) preparation for disease progression. Participants were informed of the name of their disease when they were diagnosed, but not provided with explanation of the diagnosis or meant or how to do self-care to delay the disease progression, which increased the feelings of uncertainty, hopelessness and anxiety. Taking medication was considered to be the primary treatment option and self-care a supplemental one. Advanced care plans were considered when they felt the progression of their disease(s) while refraining from sharing it with their family or health care professionals to save their concerns. All participants were willing to withhold life-sustaining treatment without making any preparation in writing. Conclusion: Education on self-care and advanced care planning should be provided to community-dwelling persons with cardiometabolic diseases. A patient-centered education program needs to be developed for this population.

• Journal of Hospice and Palliative Care
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• v.11 no.3
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• pp.147-155
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• 2008

Purpose: This study aimed to assess the educational needs for nurses who care for terminal cancer patients and their families. To identify top needs along with key issues in consideration to develope hospice training program and provide specific recommendations. Methods: A cross-sectional design with nurses from nine universities' hospice specialist courses and seven cancer centers was used. Data were collected via e-mail or mail service from March to April in 2008. One hundred seventy three questionnaires were returned (return rate: 73.6%), and 156 questionnaires were eventually analyzed. The questionnaire consisted of Mason and Ellershaw's The Self-efficacy in Palliative Care (SEPC) and self-reporting confidence and educational needs in hospice care. Results: The mean age of the participants was 37.94 years, 82.1% were staff nurses, and 44.9% completed over six months hospice education. Mean$\pm$standard deviation score for total SEPC was $2.67{\pm}.62$, which was lower than average (score 3), with communication score being the lowest ($2.49{\pm}.69$). The lowest self-reporting confidence score was $2.03{\pm}.77$ in hospice administration and management, followed by providing complement therapy ($2.34{\pm}.77$), bereavement care ($2.34{\pm}.71$), lymph edema management ($2.35{\pm}.79$), and care planning ($2.36{\pm}.81$). The participants reported that additional education is needed in all topics, with pain management score being the highest ($3.71{\pm}.50$), followed by pain and symptom evaluation ($3.67{\pm}.52$), care for dying ($3.67{\pm}.52$), and communication and counseling ($3.63{\pm}.53$). There were significant subgroup differences in SEPC and self-reporting confidence between groups who completed 6 months hospice education or not, however, no significant difference in educational need between the groups. Conclusion: This study showed the need for developing hospice training program to improve compentency of nurses in hospice palliative care.

• Korean Security Journal
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• no.43
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• pp.67-97
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• 2015

In Korea, a single emergency number, such as 911 of the USA and 999 of the UK, does not exist. This issue became highly controversial, when the Sewol Ferry Sinking disaster occurred last year. So, the Korean government has planned to adopt a single emergency number, integrating 112 of the Police, 119 of the Fire and Ambulance, 122 of the Korean Coast Guard, and many other emergency numbers. However, the integration plan recently proposed by the Ministry of Public Safety Security seems to be, what is called, a "partial integration model" which repeals the 122 number, but still maintains 112, 119, and 110 respectively. In this context, the study looks into USA's (diverse) 911 operating system, and subsequently tries to draw general features or characteristics. Further, the research attempts to derive policy implication from the general features. If the proposed partial integration model reflects the policy implications, the model can virtually operate like the 911 system -i.e. a single emergency number system - creating inter-operability between responding agencies such as police, fire, and ambulance, even though it is not a perfect integration model. The features drawn are (1) integration of emergency call-taking, (2) functional separation of call-taking and dispatching, (3) integration of physical facilities for call-taking and dispatching, and (4) professional call-takers and dispatchers. Moreover, the policy implications derived from the characteristics are (1) a user-friendly system - fast but accurate responses, (2) integrated responses to accidents, (3) professional call-taking and dispatching & objective and comprehensive risk assessment, and finally (4) active organizational learning in emergency call centers. Considering the policy implications, the following suggestions need to be applied to the current proposed plan: 1. Emergency services' systems should be tightly linked and connected in a systemic way so that they can communicate and exchange intelligence with one another. 2. Public safety answering points (call centers) of each emergency service should share their education and training modules, manuals, etc. Common training and manuals are also needed for inter-operability. 3. Personal management to enable-long term service in public safety answering points (call centers) should be established as one of the ways to promote professionalism.