• Journal of Hospice and Palliative Care
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• v.5 no.2
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• pp.163-171
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• 2002

Purpose : The purpose of this study was to analyze activities and satisfaction of volunteers for hospice care. Methods : We used 271 reports of hospice care and 20 questionnaire of activities and satisfaction of volunteers for hospice care from volunteers of in a community. Window SPSS-PC was used for the data analysis and the statistical method used were the descriptive statistics, t-test, ANOVA and Pearson's correlation coefficient. Results : 1) The highest score of activity was emotional area and the next activities was physical area. 2) The degree of emotional area (t=4.94, P<.05) and spiritual area (t=3.80, P<.05) was influence by religion of volunteers. 3) The mean score of satisfaction was 3.61. 4) There was correlation between duration of activity and death experience (r=.558, P<.05), emotional care (r=.698, P<.01), spiritual care (r=.474, P<.05), satisfaction (r=.651, P<.01), and the between physical care and family care (r=.559, P<.05), and the between spiritual cue and family care (r=.512, P<.05), and between emotional care and satisfaction (r=.536, P<.05). Conclution : The above result indicated that we must develope the management and education of volunteer of hospice care for various hospice care. Also, We should to encouraged the continuous education and efficient management.

• Journal of Hospice and Palliative Care
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• v.19 no.2
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• pp.109-118
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• 2016

The purpose of this study was to evaluate Korean advance directives (K-AD) by examining the degree of adults' acceptance and reliability of the directive itself. Methods: Survey was performed with 181 adults aged 20 or older who were recruited from three regions. A questionnaire used to examine the participants' acceptance of their K-AD in terms of visual analogue scale score of complexity, difficulty, necessity, satisfaction, recommendation. Then, a retest was carried out by asking participants to write up a K-AD again to confirm the reliability of the directives. Results: On a scale of 100, the average acceptance score was 70 or above, which represents rather high level of acceptance in all five categories. The test-retest reliability kappa values ranged from 0.592 to 0.950, and the conformity degree was moderate or high. Regarding K-AD components such as values, treatment preference, proxy appointment, differences among age groups were observed in each component. Conclusion: The results of this study suggest that K-AD is a feasible instrument to analyze its acceptability and reliability for adult population. K-AD could be utilized to help people make their own decision on their end-of-life care. Further studies are needed to confirm this study results and promote widespread use of K-AD.

• Journal of Hospice and Palliative Care
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• v.21 no.2
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• pp.51-57
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• 2018

Purpose: End-of-life (EoL) decisions are challenging and multifaceted for patients and physicians. This study was aimed to explore how EoL care is practiced for patients with a do-not-resuscitate (DNR) order. Methods: We retrospectively analyzed medical records of patients who died after agreeing to a DNR order in 2016 at a university hospital. Characteristics including cause of death, intensity of EoL care, and other factors were reviewed and statistically analyzed. Results: Of total 375 patients, 170 patients (45.3%) died with malignancies, and 205 patients (54.6%) with other causes involving the central nervous system (19.2%), pulmonary (14.7%), cardiologic (6.7%) and infectious (6.4%) conditions. Both the cancer and non-cancer patient groups showed a short duration from DNR to death (median 3 days vs 2 days, P=0.629). An intensive care group comprising patients who received one or more intensive treatments such as ventilator (n=205) showed a higher number of non-cancer patients and a shorter duration from DNR to death than a group that withheld treatment before DNR (P<0.05). Conclusion: EoL decisions were made very late by both cancer and non-cancer patients. About half of the patients did not have cancer, and two-thirds of them decided DNR during intensive treatment. To make a good EoL decision, a shared decision making with patients should be done at an earlier stage.

• Journal of Hospice and Palliative Care
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• v.19 no.3
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• pp.201-210
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• 2016

Delirium is a common symptom in patients with terminal cancer. The prevalence increases in the dying phase. Delirium causes negative effects on quality of life for both patients and their families, and is associated with higher mortality. However, some studies reported that it tends to remain unrecognized in palliative care setting. That may be related with difficulties to distinguish the symptom from others with overlapping characteristics such as depression and dementia, and a lack of knowledge regarding assessment and diagnostic tools. We suggest that accurate recognition with validated tools and early diagnosis of the symptom should be highly prioritized in delirium management in palliative care setting. After diagnosing delirium, it is important to identify and address reversible precipitants such as medication, dehydration, and infection. Non-pharmacological interventions including comfortable environment for the patient and family education are also essential in the management strategy. If such interventions prove ineffective or insufficient to control hyperactive symptoms, pharmacologic interventions with antipsychotics and benzodiazepine can be considered. Until now, low levels of haloperidol remains the standard treatment despite a lack of evidence. Atypical antipsychotics such as olanzapine, quetiapine and risperidone reportedly have similar efficacy with a stronger sedating property and less adverse effect compared to haloperidol. Currently, delirium medications that can be used in palliative care setting require more clinical trials, and thus, clinical guidelines are not sufficiently available. We suggest that it is warranted to develop clinical guidelines based on well-designed clinical studies for palliative care patients.

• The Journal of the Korea Contents Association
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• v.16 no.8
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• pp.257-267
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• 2016

The research subject is 8 mothers who put their physical/mentally impaired children in a group home, as the research method, this study conducted an in-depth interview survey. The participants of this study collected data from the in-depth interview on 8 mothers who put their disabled children to the group home. In the result of open coding, total 34 concepts, 28 subcategories and 13 categories were derived. The core category in the selective coding was 'establishing restorative relationship through entering a group home after encountering the limit of nurture.' Practical Strategies include the following; first, it's necessary to provide psychology counselling consequent on a mother's nurturing phase, and this study proposes a program for a father having a child with disability; in addition, there is the necessity of having to arrange the differentiated facility for physically/mentally impaired people, which meets the needs of the relevant people. At a level of policy, this study suggested the necessity of having to take into account the minimization of poverty problem facing a family having a disable child through the caring card, necessity of the use of good-natured card, and medical-social-welfare-based intervention, expansion of facility-touring class installation, and use of adult guardianship system, and differential payment of disabled child nurturing allowance consequent on income quantile, etc.