• Journal of Korean Academy of Nursing
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• v.28 no.3
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• pp.773-785
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• 1998

This study aims at providing more qualitative care in family nursing practice. It is designed to analyze the degree of quality of life(QL) among families of the patients. The subjects consisted of 79 families of hospital hospice patients and 74 families of home-based hospice patients. The ages of the subjects were 17-74 years, at five university hospitals in Seoul, Inchon, and Kyung Gi Province, and one clinic in Chunchon. The data were collected from September, 1996 to August, 1997. The instrument used for the study was the Quality of Life Scale (QLS), which was composed of six factors, developed by Ro, You Ja. The analysis was done using t-test, ANOVA Scheff test, and Stepwise multiple regression. The results were as follows : 1. There were no statistically significant differences between the families of hospital hospice patients and the families of home-based hospice patients ; however, the mean score of the families of hospital hospice patients was higher than that of the families of home-based hospice patients. The scores on QLS ranged from 75 to 224 with a mean score of 140.58 in the families of hospital hospice patients. In the families of home-based hospice patients, the scores ranged from 79 to 214, showing a mean score of 135.25. Among six factors of QLS, family relationships showed the highest score in both groups, but economic life showed the lowest score in the families of hospital hospice patients, and emotional state showed the lowest score in those of home-based hospital patients. Self-esteem and relationship with the neighborhood were significantly higher in the families of hospital hospice patients than the families of home-based hospice patients (t=2.69, P= 0.008 ; 1=2.04, p=0.043). 2. In the families of hospital hospice patients, QL had significant relationship with family member's age(F=2.52, p =0.029), marital status (F=3.57, P=0.018), economic state(F=6.07, P=0.004), and education level(F=3.77, P=0.014). In the families of home-based hospice patients, QL had significant relationship with marital status (F=2.53, P=0.049), education level(F=4.35, P=0.007), occupation(F=3.93, P=0.002), and patient's age(F=2.73, P=0.020) 3. Economic status accounted for 17% of QL, and diagnosis accounted for an additional 7% of QL in the families of hospital hospice patients by means of stepwise multiple regression analysis. In the families of home-based hospice patients, relationships with patient accounted for 12% of QL. The findings showed that self-esteem and relationship with the neighborhood were significantly higher in the families of hospital hospice patients than the families of homed-based hospice patients and family relationships showed the highest value in QL. These findings should be considered in nursing practice.

• Journal of Korean Academy of Nursing
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• v.31 no.2
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• pp.206-220
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• 2001

The purpose of this study was to investigate the impact of depression, discomfort, spirituality, physical care, and opioid use on pain with terminally ill cancer patients residing in hospice units. The convenient sample of this study consisted of 41 terminally ill cancer patients at three hospice units in university affiliated hospitals. Patients were interviewed with structured questionnaires three times at predetermined intervals: admission to the hospice unit (Time 1), one week later (Time 2), and two weeks later (Time 3). The data was collected from January 1998 to January 1999 and was analyzed using ANOVA, Pearson correlation coefficient, and multivariate multiple regression. 1. The mean age of the participants was approximately 55 years old. In terms of diagnosis, lung cancer showed the highest frequency (19.5%), followed by stomach cancer and rectal cancer (17.1%). The motive of seeking hospice unit admission was control (72. 2%), followed by spiritual care (50%), and symptom relief (38.9%). 2. Regarding the type of pain felt, the highest pain frequency the participants experienced was deep pain (55%), followed by multiple pain (25%), intestinal pain (10%), then superficial (5%) and neurogenic pain (5%). For the level of pain measured by VAS, there was no significant difference among the three time points; Time 1 (5.04$\pm$2.21), Time 2 (4.82$\pm$2.58) and Time 3(4.73$\pm$2.51). 3. There was significant change seen in spirituality and physical care in each time interval. Namely, the longer the length of admission at the hospice unit, the higher the importance of spirituality (p=0.0001) and the more the physical care the participants received (p=0.01). The opioid use at the three time points showed the following frequencies : Time 1 (75.6%), Time 2 (85.4%) and Time 3 (75.6%). 4. Regarding factors influencing pain, the pain level was significantly affected by the depression level (p〈0.01) and the opioid use (p〈0.1). These results were the most significant at the two time points (Time 1 and Time 2). At Time 3 (two weeks later), the pain level was significantly affected by the depression level (p〈0.05) and the amount of physical care the participants received (p〈0.1). In conclusion, the terminally ill cancer patients had moderate pain, were generally depressed, and were treated with opioid analgesics. As approaching death, the patients received more physical care due to increased physical symptoms experienced and they had a higher perception of the importance of spirituality. Thus, health care professionals need to provide continuous care for each of them to die comfortably physically, psycho- logically, and spiritually.

• The Korean Nurse
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• v.37 no.1
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• pp.98-106
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• 1998

The purpose of this study was to investigate what effect providing the hospice care team with hospice education programs had on the death orientation. The subjects of study were 28 volunteers. 14 nurses. 30 clergies who registered on hospice education programs from Aug. 6th. 1996 to May 20th. 1997. The data were analysed by descriptive analysis. ANOVA. Duncan test. paired t-test. The results of the study can be summarized as follows ; 1. The degrees of death orientation were 85.70 in volunteers group. 84.31 in nurses group. and 73.00 in clergies group. So. clergies group has more positive death orientation than others(F=6.33. p=. 000). The degree of death orientation showed significant differences between age groups(F=5.78. p =.002). and religiosity(t=3.92. p=.000). There were no significant differences between the degree of death orientation and the others general characteristics of subjects. 2. The mean of death orientation was 80.04 before hospice education programs. but was 75.56 after hospice education programs(t= 3.92. p= .000). In conclusion. the subjects who received the hospice education programs showed the positive change in the degree of the death orientation. Therefore. it has been judged that education programs has been prerequisite in positive death orientation for hospice care. Furthermore. all of the hospice care members those who complete the hospice education program. will be performed efficient hospice care intervention for dying patients and their families.

• Journal of Hospice and Palliative Care
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• v.19 no.2
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• pp.154-162
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• 2016

Purpose: This descriptive study was aimed at identifying the relations among geriatric nurses' terminal care performance, death anxiety and self-esteem and the factors that affect nurses' terminal care stress. Methods: Data were collected using a self-reported questionnaire completed by 212 geriatric hospital nurses working in 10 hospitals in K city and B metropolitan city. Results: The survey results showed that the stress factors were terminal care performance and death anxiety. Significant predictors for terminal care stress were death anxiety and terminal care performance. (And the higher the level of death anxiety and terminal care performance were, the heavier the stress was.) These factors explained 32.5% of the variance in terminal care stress. Conclusion: The results of the study suggested that terminal care performance was an important factor of terminal care stress for geriatric nurses. Therefore, it seems that it is necessary to develop an educational intervention program to improve nurses' terminal care performance to reduce their terminal care stress.

• Korean Journal of Hospice Care
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• v.5 no.2
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• pp.64-74
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• 2005

Purpose : This study is non-equivalent control group pre-post design attempted to see 'The effect of spiritual nursing intervention on the meaning of life and spiritual distress of the terminal cancer patients.' Method : The data collection was performed from June to October, 2004. The subjects were 41 terminal cancer patients of one general hospital in Jeon Ju city. They are formed two groups, 20 experimental group and 21 control group. Experimental treatment provided spiritual nursing intervention 3 times per a week, the mean 45 minutes each, for 4 weeks for experimental group with the contents of therapeutical use of oneself, use of bible, use of hymn, use of prayer, depend on the priest in the spiritual need assessment of 6 kinds. Study tools was used the thing which Kim(1990) developed about purpose inspection of life which Crumbaugh(1968) developed to measure the meaning of life. The measure of spiritual distress was used the tool which Kim(1990) developed, spiritual nursing intervention was developed by researcher of this thesis. Data was analyzed by descriptive statistics of real number, percentage, the mean etc. and x2-test, t-test, ANCOVA. Result: The 1st hypothesis, 'spiritual the meaning of life score in the experimental group, who received the spiritual nursing intervention, will be higher than the control group who did not receive it' was supported(F=157.09, P=0.000) The 2nd hypothesis, 'spiritual distress score in the experimental group, who received the spiritual nursing intervention, will be lower than the control group who did not receive it' was supported(F=36.48, P=0.000) Conclusion: Spiritual nursing intervention was verified as an effective program to improve the meaning of life and decrease spiritual distress for the terminal cancer patients. Thus, it was confirmed with an effective nursing intervention which helps them in order to spend the rest time of life meaningfully and meet the peaceful death.

• Journal of Hospice and Palliative Care
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• v.18 no.4
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• pp.306-313
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• 2015

Purpose: This study was performed to explore factors that influence attitudes toward terminal care in nursing students. Methods: Data were collected using a self-reported questionnaire filled by 175 nursing students at a university in a metropolitan city B. Data were analyzed using descriptive analysis, t-test, ANOVA, Pearson correlation coefficients and stepwise multiple regression with the SPSS/WIN 22.0 program. Results: Attitudes toward terminal care in nursing students was significantly correlated with communication competence (r=0.438, P<0.001), spirituality (r=0.374, P<0.001), and gratitude (r=0.318, P<0.001). Communication competence explained 18.7% of the variance in attitudes toward terminal care. Conclusion: The study shows communication competence is an important factor for attitudes toward terminal care in nursing students. Therefore, it is necessary to develop a communication competence enhancement program to foster nursing students with appropriate attitudes toward terminal care.

• Korean Journal of Hospice Care
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• v.7 no.1
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• pp.29-45
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• 2007

People in the end of life and their families suffer in their physical disease and other aspects as a whole person. They need hospice care to palliate their total suffering in physical, emotional, social and also spiritual aspect through professional hospice team. To care their whole personal needs, hospice team must be a multi-discipline team which consists of medical doctors, nurses, social workers, pastors and volunteers. Recently those who die in hospice palliative care unit have trend to increase more than in home year by year. So it is necessary to develop the nursing intervention program to be performed by multi-discipline team approach for in-patient of hospice palliative care unit. The purposes of this study were to develop of wholistic hospice nursing intervention program for inpatient of hospice palliative care unit. The subjects of study were collected from 30 patients those who were over 18 years old and admitted in hospice palliative care unit of S hospital in P city with agreement in hospice palliative care in their terminal disease. The period of data collection was from December 15, 2003 to March 15, 2004. The result were as follows : 1. The result of Wholistic Hospice Nursing Program's development was as follow : A Wholistic Hospice Nursing Program was developed by me in this study is one of the service program for hospice palliative care unit. It was named as ‘Rainbow Program’ to be approached easily by hospice patients. The purposes of it are to improve the quality of life of the terminal patients with their dignity, to help them live in abundant and meaningful in their lives, to care them in peaceful in dying process with understanding them in whole personal, and also to palliate the grief and suffering of the bereaved. It was provided by hospice professionals(nurses, medical doctors, social worker, pastors, art therapists) and volunteers those who were educated in hospice for multi-diciplinary team approach to collaborate with each role play I 20-30 minuters of each through visiting their rooms individually and a place of hospice palliative care unit of S hospital in P city. The subjects of it were the terminal patients those who admitted hospice palliative care unit and their familes. with agreement in hospice palliative care in their terminal disease. The characteristics of it were multi-disciplinary team approach, whole personal care, individual care and total care according to their needs in their condition. The contents of it were pain control, symptom control, counseling patient, counseling family, hair cutting, hair shampooing, bed bath, recreation, taking a walk, event of culture(screen, recital, festival of praises, exhibition and so on), pastoral counseling, ritual service in bed, praying, service in bed, sing a worship praise, listening to the music, sharing remembrance of life, individual visiting music service(sing and praying), meditation Bible, art therapies(dance and drawing), social worker's counselling, confessing and sharing love and thanksgiving. The experimental group subjects participated in Wholistic Hospice Nursing Program which takes 120 minutes per session, total 10 sessions(total 1,200 minutes) altogether. In conclusion, this Wholistic Hospice Nursing Intervention can be used actively for whole personal well-being of the patients in hospice palliative in hospice palliative care unit and also applied in hospice practice as an useful model of multi-disciplinary team approach by hospice professionals.

• The Korean Journal of Health Service Management
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• v.8 no.3
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• pp.219-228
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• 2014

The purpose of this study was to provide a basic data for the establishment of attitude on death, perception on hospice and attitude of DNR by nursing students. The survey was performed with 214 nursing students in Busan. The data was collected by questionnaires and were analyzed using SPSS/win 21.0 program. The period of data collection was from June 1, 2013 to June 15, 2013. The mean scores of attitude on death, perception on hospice and attitude of DNR were 2.63, 3.30 and 3.83 point. The attitude of DNR of the nursing students was significantly different according to the grade and satisfaction of major. The attitude of DNR showed the significant positive relationship with attitude on death and perception on hospice. Attitude on death and perception on hospice accounted for 16.8% of variance in attitude of DNR. Finding of this study is necessary to develop nursing understanding for the attitude of DNR by considering attitude on death and perception on hospice.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.3
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• pp.63-71
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• 2017

In today's society interest in beautiful death is rising. This study investigated the perception of death and well-dying-terminal care attitude-of nursing students and determined the factors that influence their attitude on terminal care and beautiful death. Data was collected from 319 baccalaureate nursing students in S-City, Kyunggido, in Korea using a self-reported questionnaire. The collected data was analyzed by t-test, ANOVA, Person's correlation coefficients, and multiple stepwise regression, using WIN SPSS 18.0 program. There were significant differences in terminal care attitude of subjects in accordance with the experience of hospice education (F=2.53, p=.012), experience with the death of close acquaintances (F=3.37, p=.001), and perceived health status (F=5.37 p=.005). There was a positive correlation between perception of death and well-dying (r=.23, p<.001), and the relationship between well-dying and terminal care attitudes was also statistically significant (r=.22, p<.001). Factors that influence the attitude on terminal care were well-dying (${\beta}=.19$) and experience with the death of close acquaintances (${\beta}=.16$). It is necessary to develop an education program for nursing students to promote positive attitudes toward the perception of death and well-dying, as well as toward terminal care.

• Journal of Hospice and Palliative Care
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• v.18 no.4
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• pp.267-275
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• 2015

Purpose: This study is aimed to investigate the relationship among terminal care stress, job satisfaction and terminal care performance nurses in internal medicine wards and to provide a basis to improve terminal care performance. Methods: This is a descriptive study performed with 201 nurses who have at least one year of experience and are stationed at the internal medicine department of three general hospitals and three university hospitals in P city of a metropolitan city B. The nurses also had an experience with a dying patient. Data were collected from March 1 through March 31, 2014. The study was approved by the Institutional Review Board of Kosin University. Results: Job satisfaction was negatively correlated with stress in end-of-life care (r=-212, P=0.003) and positively correlated with terminal care performance (r=0.383, P<0.001). There was no correlation between terminal care stress and terminal care performance. Conclusion: Appropriate programs are needed to improve job satisfaction for high quality terminal care performance.