• Journal of Hospice and Palliative Care
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• v.10 no.1
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• pp.29-34
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• 2007

Purpose: The purpose of this study was to show the differences of medical cost between hospice and non-hospice care for terminally ill patients. This information provides basic data to nationally institutionalize hospice care for decreasing costs and enhancing quality of life for terminally ill patients. Methods: Participants of this study were 114 terminally ill cancer patients who were diagnosed and died with stomach cancer and lung cancer at the K hospital of the C university. The study was a retrospective survey design that analyzed the medical costs for two weeks before they died. The cost analysis was done according to 11 items form the medical cost bill. Results: Patients enrolled in hospice care had significantly lower medical costs (53%) than did non-hospice patients especially in use of TPN, narcotic analgesics, nursing care, radiology tests, and blood tests. Among patients enrolled/admitted in the hospice unit, there was a significant cost difference only in use of analgesics whether the hospice specialized doctor was in charge of care or not. The cost was significantly lower when a hospice specialized doctor was in charge of care although the total medical cost was the same. Conclusion: This study identified lower medical costs for patients cared for in the hospice unit. Thus, we urge institutionalizing hospice care without delay to insure cost benefits as well as quality care.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.2 no.2
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• pp.115-130
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• 1995

The incidence of oral complications among adult cancer patients undergoing chemotherapy varies from 12 to 80%. Adequate oral hygiene has been shown to be important in prevention of oral complication and an essential role is reserved for the nursing staff. These considerations prompted the decision to survey by means of a questionaire, the nurses who give care to cancer patients. The Questions were included multidisciplinary treatment, inspection skill, nursing intervention, nursing education, problem in mouth care, solution for problem solving. - Results are fellow : 1. A total of 116 of the nurses returned the questionaire 2. According to 88.2% of the respondents, the policy with regard to oral-hygine is determined by the physician and the nurse. 62.1% of nurses do not consult the dentist When oral complication is occured. 3. In only 34.5% of case was a penight used to provide the necessary extra illumination nursing Inspection of oral cavity. 4. Frequency of oral complications observed by the respondents is that they observed complications in < 25% of patients. The nature of the complication varied from ulcer, stomatitis, infection, dry mouth, candidiasis, herpes simplix, bleeding. 5. Percentages of respondents who use the intervention indicated 1) to prevent oral complication : 0.9% normal saline gargling(44%), 0.02% chlorhexidine gargling, oral dressing(38.8%), observation, nutrition, restriction of alcohol and tabaco(23.2%) 2) to deal with the early symptoms 0.9% normal saline gargling (47.4%), cryotherapy(37.9%), 0.02% chlorhexidine gargling(20.7%) 3) to help alleviate severe complications : dental consult, holding the chemotherapy(34.5%), 0.9% normal saline gargling(31.1%), cryotherapy(18.0%) 6. According to 70% of the respondents, insufficient attention is given to oral complication during nursing education classes only 8.6% said that both the theory and the practical aspects had been deal with in sufficient detail during their training. The results of the survey indicate thatoral care in cancer patients undergoing chemothrapy has a number of problem. There are not enough dentist to provide the necessary care for patients undergoing chemotherapy. The expertise of the nurses with respect to the pathogenesis of the complication is limited. In the training of nurses, additional attention to oral examinations and oral hygine is warranted. The care of patients should be the responsibility of a multidisciplinary team approach. The nurse occupies a key position with in this team, which includes the medical oncologist, a dentist.

• Journal of the Korean Society of Fisheries and Ocean Technology
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• v.33 no.3
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• pp.159-165
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• 1997

This paper presents the optimum dimension of 89 ton class stow-net vessel with stern-fishing. The model of basic design is developed by using the optimization techniques referring to objective function and numerous constraints as follows; speed, fishing quantity, fishing days, catch per unit effort(CPUE), and weight/ratio of main dimensions, etc. Thus, the basic design of stow-net fishing vessel is built up by using the optimization of the design variables called the economic optimization criteria, and the objective function represents the criterion which is cost benefit ratio(CBR). The main conclusions are as follows. 1. S/W for decision of optimum hull size is developed in 89 ton class stow-net fishing vessel which is constructed with optimization of the design variables called the economic optimization criteria. 2. For optimum ship dimensions in 89 ton class stow-net fishing vessel, the hull dimensions can be obtained in the range of L= 27.3m, B = 6.6m, D = 2.80m, Cb = 0.695, T/D = 0.80, $\Delta$(displacement)=281.7ton with 10 knots.

• Asian Oncology Nursing
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• v.3 no.2
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• pp.145-154
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• 2003

Purpose: The study was to furnish basic raw materials that evaluate the efficacy of meatal care according to the form and the relative importance of symptom distress which most of cancer sufferers have been experienced. For that, an investigation of five diverse major cancer symptom distress made a comparison between symptom distress and degree of suffering. Method: Study subjects were 138 inpatients with stomach cancer, lung cancer, hepatocellular carcinoma(HCC), large intestine cancer and breast cancer, except those in the terminal-stage, in 'H' university hospital in Seoul and 'K' center in Ilsan gathered from November 20, 2002 to February 20, 2003. To measure the correlation between feeling of discomfort and agony caused by cancer, 5 point scale (from zero to four), stood on the basis of Symptom Distress Scale (SDS, Rodes & Watson, 1987), was used for this study and the Cronbach's coefficient alpha was 0.95. Accumulated data was analyzed with SPSS 10.0 for window, also used by ANOVA and Duncan's Multiple Range Test. Pearson's Correlation Analysis. Results: 1. Symptom distress of cancer patients was noted and defined in their severity-fatigue, anorexia, pain, depression, dyspepsia, changing appearance and nausea. The degree of symptom distress was fatigue, dyspepsia, depression, anorexia, pain, changing appearance and the degree of suffering was nausea, pain, anorexia, dyspepsia, vomiting, breathing difficulty, changing appearance and fatigue. 2. Examining the difference of degree of symptom distress in each cancer cases, it takes the precedence of them. First, in case of stomach cancer, depression, pain, vomiting and nausea were shown in sequence. In case of lung cancer depression, pain, sleeping problem, anxiety, changing appearance, inattentiveness and vomiting were showed in sequence, depression, changing appearance, sleeping problem, pain in case of HCC, depression, pain in case of large intestine cancer and lastly in case of breast cancer changing appearance, depression, pain and anxiety were shown in sequence. The category of the degree of symptom distress that has a signifiant difference was anorexia, activity discomfort, fatigue, constipation or diarrhea, breathing difficulty, dyspepsia, caughing, fever or chillness, scotoma and urinary disorder. Verifying the highest degree of symptom distress in each cancer cases, anorexia was 1.94(F=4.00, p<.01) in stomach cancer, activity discomfort was 0.97(F=3.08, p<.01) in lung cancer and HCC, fatigue was 2.32(F=4.64, p<.01) in HCC, constipation or diarrhea was 1.83(F=22.31, p<.001) in large intestine cancer, breathing difficulty was 1.83(F=4.00, p<.01) in lung cancer, dyspepsia was 2.69(F=9.98, p<.001) in stomach cancer, coughing was 1.53(F=20.49, p<.001) in lung cancer, fever or chillness was 1.23(F=6.88, p<.001) in lung cancer, scotoma was 1.20(F=3.02, p<.05) in lung cancer and urinary disorder was 1.54(F=11.56, p<.001) in HCC. 3. Examining the difference degree of suffering on cancer cases, the result was as follows; depression of lung cancer was 1.17(F=3.76, p<.01), anorexia of stomach cancer was 1.61(F=3.89, p<.01), constipation or diarrhea of large intestine cancer was 1.42(F=10.43, p<.001), changing appearance of breast cancer was 1.65(F=5.43, p<.001), breathing difficulty of lung cancer was 2.27(F=18.57, p<.001), dyspepsia of stomach cancer was 1.97(F=13.56, p<.001), coughing of lung cancer was 1.70(F=22.07, p<.001), fever or chillness of lung cancer was 1.13(F=4.41, p<.01), scotoma of lung cancer was 0.87(F=3.34, p<.05), anxiety of lung cancer was 0.87(F=4.50, p<.001) and urinary disorder of HCC was 1.43(F=16.71, p<.001). 4. In consequence, comparing between symptom distress and degree of suffering on cancer patients undergoing chemotherapy, lung cancer patients showed the highest feeling of discomfort following stomach cancer, HCC, breast cancer and large intestine cancer(F=2.88, p<.05). On those undergoing radiotherapy, lung cancer, HCC, breast cancer, large intestine cancer was in sequence(F=3.78, p<.05) and those resisting radiotherapy, lung cancer, HCC, stomach cancer, large intestine cancer and breast cancer was in sequence(F=2.72, p<.05). 5. Correlation between symptom distress and degree of suffering on cancer patients was generally significant. Conclusion: this study not only defines a significant correlation between symptom distress and degree of suffering but also proffers basic data to evaluate the efficient meatal care depending upon diverse spectrums of symptom distress and degree of suffering.

• Korean Journal of Adult Nursing
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• v.12 no.2
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• pp.184-195
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• 2000

It has been believed that cancer is an omnious factor threatening the future and life itself. Patients having the disease experience anxiety, fear, feeling of weakness, depression and feelings of uncertainty and hopelessness. Most cancer patients, however, have expectations of possible recovery and a better future, very different from the patients who feel hopeless. Therefore. hope allows people to respond effectively to the fatal disease they have and prevents them from detoriorating physically and spiritually, positively influencing their survival, response to treatment and sense of security. Studies previously performed showed that hope is positively correlated with social and family supports, self-esteem, spiritual well-being, responsive action, health promotion behavior and quality of life. Thus, the study attempted to provide basic information on nursing cancer patients by investigating their levels of hope and determining predictive factors which influence hope. For the study 200 cancer patients in two university hospitals located in Pusan were sampled as subjects. Data were collected for twenty nine days from Feburary 1, 1999 to March 1. Instrumets for the study included 10 items from the self-esteem scale by Rosenberg (1965), 39 hope measurements by Kim and Lee(1965), 16 of the social support scale by Tae(1986) and 16 of the general characteristics scale, all of which totaled 81 items. The data were analyzed using the SPSS program. General characteristics of the investigated based on numbers and percentage. Hope, self-esteem and social support were analyzed using means, minimum, maximum and standard deviation. Relations among the foregoing three factors were analyzed using Pearson' correlation coefficient. Levels of hope in cancer patients were determined using t-test, ANOVA and Scheffe test. Predictive factors influencing hope were investigated using multiple stepwise regression analysis. Results of the study are summarized as follows: 1. An average level of hope was $185.55{\pm}23.39$ points(96 min. and 234 max.) 2. Levels of hope showed a significant difference among them according to sex (t=-3.69, P=.000), age(F=4.714, P=.000), job(F=3.247, P=.008), monthly income (F=6.113, P=.003), treatment charge (F=3.796, P=.011), supportive resources (F=10.554, P=.000), diagnosis(F=2.287, P=.029), perceived health status(F=22.184, P=.000), level of pain(F=3.334, P=.021), religion (F=4.911, P=.001) and religion's effect in life (F=11.706, P=.000), 3. For the subjects, self-esteem and social support were $38.32{\pm}7.21$(13 min, and 50 max.) and $52.97{\pm}8.49$points(28 min, 80 max.). Concerning social support, average levels of family support and medical support were found $35.95{\pm}6.05$(18 min, and 40 max) and $27.02{\pm}4.99$ points(20 min and 40 max). The hope the cancer patients showed significant correlations with self-esteem (r=.588, P=.000), family support(r=.224, p=.001) and medical support(r=.221, P=.002). 4. The five variables related to hope (self-esteem, religion's effect in life, perceived health status, social support and age) accounted for 54.2 percent of the hope level; especially, self-esteem was the highest at 34.6%. As shown in the above results, predictive factors which most influence hope in cancer patients were self-esteem and religion's effect of life. Therefore, nursing interventions to increase self-esteem should be developed. Regarding religion's effects, studies on spiritual aspects should be carried out in a way that contributes to promotion of hope.

• Journal of Korean Academy of Nursing
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• v.25 no.3
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• pp.510-537
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• 1995

Human health is an integral part of experience in the process of Human Becoming. Through continual interaction with the environment human beings freely choose experience and develop as responsible beings. The process of the health experience of patient with terminal cancer is a unique. he objective of this study is to understand the lived experience of patients with terminal cancer in order to provide basic information for nursing care in the clinical setting and to develop a theoretical background for clinical practice. This study is to de-scribe and define the lived experience of patients with terminal cancer in order to provide a foundation for nursing research and education. Data collection has been done between December 1993 and November 1994. The subjects included five persons -four females and one male : one who was in her sixties, one in his fifties, two in their forties, and one who was in her thirties. The researcher has met with these patients 35 times, but at eight times the patient was in a stuporous condition and not able to participate, so these were not included in the data analysis. Parse's "Human Becoming Methodology", an existential phenomenological research methodology is used for this study. Data has been collected using he dialogical engagement process of "I and You", the participant researcher and the participant subject. Dialogical engagement was discontinued when the data was theoretically saturated. Data was analyzed using the extraction - synthesis and heuristic interpretation. The criteria of Guba and Lincoln(1985). and Sandelo wski(1986) : credibility, auditability, fitness and objectivity were used to test the validity and reliability of the data. The following is a description of the structure of the lived experience of patients with terminal cancer as defined by this study : 1. Structure : 1) Suffering through the reminiscence of past experience 2) The appearance of complex emotions related to life and connectedness 3) The increasing importance of significant people and of the Absolute Being 4) The increasing realization of the importance of health and belief 5) Desire for a return to health and a peaceful life or for acceptance of dying and a comfortable death In summary the structure of the lived experience of these patients can be said to be : suffering comes through reminiscence of past experience, and there are complex emotions related to life and connectedness. Significant people and the Absolute Being become increasingly important along with a realization of the importance of health and faith. And finally there is a desire for either a return to health and a peaceful life or for the acceptance of dying and a comfortable death. 2. Heuristic Interpretation : Using Parse's Human Becoming Methodology, the structure of the lived experience of patients with terminal cancer identified in this research is interpreted as. The lived experience of patients with terminal cancer involves the solving of past conflicts, and the experience of the healing and valuing of sorrow and pain. Through the relation of life and health, and the complex emotions that arise, the lived experience of revealing - concealing is of paradoxical emotions. The increasing importance of significant others and of the Absolute Being shows Connecting and Separating an on- going process of nearness and farness. Revision of thoughts about health and faith is interpreted as transforming and desire for restoration to health and a peaceful life or acceptance of dying and a cowfortable death, as powering. In summary, it is possible to see, in the lived experience of patients with terminal cancer, the relationship of the five concepts of Parse's theory : valuing, revealing -concealing, connecting-separating, transforming, and powering. From Parse's theory, the results of this study show that meaning is related to valuing, rhythmicity to revealing-concealing and connect-ing-separating, and cotranscendence to transforming and powering.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.7
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• pp.645-655
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• 2020

This is a descriptive study investigating the relationships between sexual function, depression, and sleep quality in male hemodialysis patients. The participants of this study consisted of 134 outpatients who were diagnosed with end stage chronic kidney disease and who had undergone hemodialysis. The data were collected from June 10, 2019, to October 30, 2019. The collected data were then analyzed using descriptive statistics, the mean from independent sample t-tests, one-way analysis of variance (ANOVA), the Scheffe test, and Pearson's correlation coefficient using SPSS version 21.0. The lower the overall satisfaction, the lower the sexual function and the higher the degree of depression (r=.-19, p=.028). The greater the depression, the lower the quality of sleep (r=.60, p<.001). This study shows it is necessary to develop a program including symptom management to reduce depression in male hemodialysis patients. When developing nursing interventions to improve sexual function and quality of sleep, it will be necessary to develop a program that includes people who help the subjects.

• Journal of Korean Academy of Nursing
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• v.21 no.3
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• pp.418-435
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• 1991

The purposes of this study were to find out the effects of hospice care for the quality of life of the terminally - ill patients and to analyze the relationship between the effect of hospice care and the general characteristics of subjects. The subjects of the study were 32 terminally - ill patients hospitalized in the two general hospitals in Seoul, which have the hospice care unit. The data were collected using the questionnaire with interviews. They were done from Sept.28, 1989 to March 20, 1991. The tools used for the research were 17-item questionnaire regarding general characteristics, 42-item questionnaire about the quality of life (11- item for physical, 16 for psychosocial, and 15 for spiritual). The questionnaires were to measure the duality of life by means of the measure instruments of Betty R. Farewell(1989), Stein Kaasa(1988), Palm Pamela(1987), and Hwa-sook Choi(1987). 42 items were used after pre-test. In accordance with each purpose in this study, frequency and percentage were used on the general characteristics of subjects. ANOVA, t-test, and Pearson correlation were employed to evaluate the general characteristics of subjects and different level of quality of life before-and-after hospice care. The results of the study may be summarized as follws : 1. The effects of hospice care. Main Hypothesis : “The quality of life of the terminally - ill patients will be different from before-and-after hospice care” was supported(t＝6.82, df＝31, p＝ .000). Sub Hypothesis 1 : “The quality of life of the terminally - ill patients in the physical aspects will be different from before - and -after hospice care” was not supported(t＝0.07, df＝31, p＝ .946). Sub Hypothesis 2 : “The quality of life of the terminally - ill patients in the psychosocial aspects will be different from before-and-after hospice care” was supported (t＝4.69, df＝31, p＝ .000). Sub Hypothesis 3 : “The quality of life of the terminally - ill patients in the spiritual aspects will be different from before-and-after hospice care” was supported(t＝6.64, df＝31, p＝ .000). 2. Relationship between the general characteristics of subjects and the effects of hospice care. (1) The more the number of family, the higher the quality of life in the psychosocial aspects. (2) The higher the age of the patient, the lower the quality of life in the psychosocial aspects. (3) The high educational level of patients enjoy the high quality of life in general. (4) The high religious level of petients enjoy the higy Quality of life in the spiritual aspects. As a results of analysis above : 1. The most effective aspects of the hospice care to the terminally- ill patients was spiritual aspects. The next effective aspects was psychosocial area. 2. The least effective aspcets of the hospice care to the terminally- ill patients was physical aspects. Further study is needed to improve the quality of life in the physical aspects.

• Journal of Hospice and Palliative Care
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• v.16 no.3
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• pp.175-182
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• 2013

Purpose: Spirituality is an important domain and is related with physical and psychological symptoms in terminal cancer patient. The aim of this study is to examine how patients' spirituality is associated with their physical and psychological symptoms as it has been explored by few studies. Methods: In this cross sectional study, 50 patients in the palliative ward of a tertiary hospital were interviewed. Spiritual well-being, depression, anxiety and pain is measured by Functional Assessment of Chronic-Illness Therapy-Spirituality (FACIT-Sp), hospital anxiety and depression scale (HADS) and the Korean version of the Brief Pain Inventory (BPI-K). The correlations between patients' spiritual well-being and anxiety, depression and pain were analysed. The association between spiritual well-being and age, gender, palliative performance scale (PPS), religion, mean pain intensity, anxiety, depression were assessed by univariate and multivariate regression analyses. Results: Spiritual well-being was negatively correlated with the mean pain intensity (r=-0.283, P<0.05), anxiety (r=-0.613, P<0.05) and depression (r=-0.526, P<0.05). In multivariate regression analysis, spiritual well-being showed negative association with anxiety (OR=-1.03, 95% CI=-1.657~-0.403, P=0.002) and positive association with the existence of religion (OR=9.193, 95% CI=4.158~14.229, P<0.001). Conclusion: In this study, patients' anxiety and existence of religion were significantly associated with spiritual well-being after adjusting age, gender, PPS, mean pain intensity, depression. Prospective studies are warranted.

• Journal of Hospice and Palliative Care
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• v.11 no.4
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• pp.196-205
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• 2008

Purpose: The purpose of this study was to evaluate the current status of hospice palliative care facilities, and to identify problems and improve hospice palliative care in Korea. Methods: The questionnaire survey was implemented from October to December, 2007. It was consisted of general characteristics of organization, health manpower, facilities & equipments, service programs, and so on. Sixty two (79.5%) out of 78 hospice palliative care facilities returned the questionnaires. Results: They were 42 hospital-based hospice palliative care hospitals and 9 clinics, and most of them are located at central metropolitan areas (Seoul and Gyeonggi Province). more than 80% of hospitals met with the requirements (one doctor per 10 patients and one nurse per 1.5 patients), whereas 42.9% of clinics met the requirements. Approximately 22% of them met the requirement of sick room (4 patients for 1 room). Most of them provided various hospice palliative care programs. The proportion of giving regular education programs to hospice palliative care personnels were about half (41.9%). Thirty two (51.6%) facilities provided home visiting hospice palliative care service. Conclusion: There were lack of enough health manpower, rooms, and programmes and they varied among facilities. It is necessary to increase the number of hospice palliative care facilities with consideration of regional fair distribution and standardization of programmes.