• Journal of Korean Academic Society of Home Health Care Nursing
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• v.30 no.3
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• pp.243-251
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• 2023

Purpose: The aim of this descriptive study was to identify factors influencing quality of life among family caregivers of non-cancer patients at the end-of-life stage. Methods: A cross-sectional survey was conducted using a questionnaire. Participants included 172 family caregivers caring for non-cancer patients. Data were collected from April to May 2016 and analyzed with descriptive statistics, an independent t-test, one-way ANOVA, Pearson's correlation coefficient, and a hierarchical regression analysis using the SPSS/WIN 24.0 program. Results: The mean of the participants' quality of life was 51.70±9.98. Factors influencing quality of life among family caregivers were spiritual care (𝛽=-.45, p=.021), coordination among family members or relatives (𝛽=-.27, p=.029), and psychological support (𝛽=-.04, p=.031). The explanatory power of the model was 21.0%. Conclusion: The findings of this study suggest that care needs; spiritual care, coordination among family members or relatives, and psychological support are important factors for family caregivers' quality of life. To improve quality of life among family caregivers who are taking care of non-cancer patients at the end-of-life stage, national systems establishing comprehensive support considering the respective care needs of patients are crucial.

• 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.21 no.2
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• pp.65-74
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• 2018

Purpose: The aim of this study is to examine the relationships among hospice-palliative care (HPC) nurses' knowledge of delirium, self-efficacy and nursing performance. Methods: This study was participated by 174 nurses working in the HPC unit. The nurses were asked to fill out a questionnaire that was structured to measure their knowledge of delirium, a self-efficacy in clinical performance scale (SECPS) and nursing performance. Results: The mean score for knowledge was 32.83 out of 45, with correction rate of 73%. The mean score for self-efficacy was 7.08 out of 10. The mean score of nursing performance was 2.95 out of 4. Significant correlation was observed among the variables of knowledge (r=0.28, P<0.001), self-efficacy (r=0.51, P<0.001) and nursing performance. Conclusion: Nurses with high level of knowledge of delirium showed high level of self-efficacy, and consequently better HPC nursing performance. It is necessary to develop a training program on delirium considering nurses' needs of knowledge of the condition. The effectiveness of the training program should be also examined in future.

• Journal of Korean Academy of Nursing
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• v.51 no.1
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• pp.15-26
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• 2021

Purpose: This study aimed to distinguish and describe the types of perceptions of do not resuscitate (DNR) proxy decisions among families of elderly patients in a long-term care facility. Methods: This exploratory study applied Q-methodology, which focuses on individual subjectivity. Thirty-four Q-statements were selected from 130 Q-populations formed based on the results of in-depth interviews and literature reviews. The P-samples were 34 families of elderly patients in a long-term care hospital in Busan, Korea. They categorized the Q-statements using a 9-point scale. Using the PC-QUANL program, factor analysis was performed with the P-samples along an axis. Results: The families' perceptions of the DNR proxy decision were categorized into three types. Type I, rational acceptance, valued consensus among family members based on comprehensive support from medical staff. Type II, psychological burden, involved hesitance in making a DNR proxy decision because of negative emotions and psychological conflict. Type III, discreet decisions, valued the patients' right to self-determination and desire for a legitimate proxy decision. Type I included 18 participants, which was the most common type, and types II and III each included eight participants. Conclusion: Families' perceptions of DNR proxy decisions vary, requiring tailored care and intervention. We suggest developing and providing interventions that may psychologically support families.

• 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.22 no.4
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• pp.145-155
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• 2019

Purpose: Amendment to the Act on Decisions on Life-sustaining Treatment was recently enacted to designate long-term care hospitals as providers of hospice and palliative care. Despite its benefit of providing improved accessibility to end-of-life care, the amendment has raised concerns about its effect on quality of service. This study aimed to use information obtained from an expert group interview and previous studies to compare how cancer patients, family caregivers, physicians, and the general Korean population perceive the potential benefits and risks of this amendment. Methods: We conducted a multicenter cross-sectional study from July to October 2016. The included participants answered a structured questionnaire regarding the extent to which they agree or disagree with the questionnaire items indicating the potential benefits and risks of the amendment. Chi-square tests and univariate and multivariate logistic regression analyses were performed. Results: Compared with the general population, physicians agreed more that long-term care hospitals are currently not adequately equipped to provide quality hospice and palliative care. Family caregivers found improved access to long-term care hospitals more favorable but were more likely to agree that these hospitals might prioritize profits, thereby threatening the philosophy of hospice care, and that families might cease to fulfill filial responsibilities. Compared with the general population, cancer patients were more concerned about the potentially decreased service quality in this setting. Conclusion: Although potential service beneficiaries and providers expected improved accessibility of hospice and palliative care services, they were also concerned whether the system can provide adequate quality of end-of-life care.