Purpose : Hospice Care is considered as one of the most perfect solutions for the problems brought up as the number of chronically ill patients are increasing rapidly and most of social welfare oriented countries are seeking the quality of life. Our former studies(1996, 1997) were to find out the current status of the hospice care in Korea by surveying terminally ill patients and their family members as well as medical professionals. The former study was also to conduct the operation research by developing an information service system for training of hospice care teams and volunteers, and hospice patients management. The purpose of this study was that hospice information service system was tested by home visiting hospice care through visiting nurses. Methods : From October 1, 1997 to March 31, 1998, Twenty six terminal cancer patients were included in this study from Seoul National University Hospital and other hospital. Databases and homepage, hospice information service system were designed and developed for the information needed for the hospice care before this study by our research team and this services were available through the internet. Visiting nurses were trained about this system and they visited the patients with PC notebook and provided them hospice care with hospice information system. They collected physical, psychiatric, social data of the subjects at the first visit and during hospice care at home. Results : Sixteen subjects(61.5%) died during the study and the mean survival was 20.7 days. Anorexia(96.2%), immobility(88.5%) and pain(84.6%) were the major symptom in the 26 subjects, Altered nutrition(26.1%) and pain(12.4%) were the most frequent diagnoses in 226 nursing diagnoses of the subjects. Families understood and demanded the hospice care more than patients. And most patients and families didn't demand spiritual or social care. Conclusion : Through this demonstration study, it was found that we have to provide the information of pain management and nutritional support for patients by the nurses and visiting hospice nurse. The information service system needs to be upgraded with information and manpower of spiritual and social care according to the findings.
Purpose: This study was to investigate the satisfaction for voluntary activity and the meaning of life in hospice volunteers. Method: Data were obtained by self-reported questionnaire from 102 volunteers and were analyzed using a t-test, ANOVA and Pearson's correlation. Result: The mean score of the satisfaction for hospice volunteer activity was $2.48{\pm}0.38$. Of the domains of the satisfaction, the experience domain had the highest mean score $(2.93{\pm}0.53)$, and the social exchange domain had the lowest mean score $(1.65{\pm}0.63)$. The mean score of the meaning of life was $3.20{\pm}0.33$. The score of satisfaction was significantly different by economic status, and volunteering time per week. The score of meaning of life was statically different by financial status. There was a positive correlation between satisfaction for voluntary activity and the meaning of life. Conclusion: Satisfaction for hospice volunteer activity was significantly related to their meaning of life. In order to increase the satisfaction of volunteers, it is important to consider their financial aspect and the volunteering time.
Purpose : To clarify the relation between psychosocial variables and cancer in Korea. Methods : Case-control study. Participants: 239 subjects in 2 university hospitals in Seoul completed a series of psychometric instruments(the Olson's FACES III and the Lee's 98-items life event scale). Results : In bivariable analysis, there were statistically significant difference in age and economic status(income): marginal significance in education status and marital status between the cases and controls. The family function type and stress score were not significantly different. The result of multivariable logistic regression, analysis showed that the risk of cancer was associated with economic status and marital status, but neither the family function nor the life event stress. Conclusion : In this study, we cannot prove the statistical association between the family function, life event stress and cancer. It is necessary to persevere in our efforts to clarify the relation between stress and disease and to develop the useful tools to measure the Korean family function and life event stress.
The purpose of this case study is to explore the difference of hospice care and the efficiency of hospice education, by comparing the care of the nurse, the volunteer and the minister who have been trained by the Hospice Education Program. The index of common hospice care delivered by cases is that 1) the physical problems (pain, physical discomfort, incontinece, nausea, vomiting etc.) 2) the family problems(family support, change of family function, inefficiency, preparing the death of family) 3) the psychiatric problems(grief and sadness of death, anxiety, fear, helplessness). The case of volunteer and minister is different with the hospice care by nurse, because it is some what related to Christian's base. The index of care by the volunteer and minister is pertaining to social support and spiritual support for family and dying patient. In conclusion, for the wholistic hospice care, we need the hospice caregiver who have diverse background and expert in knowledge of various dimension. For that, it is necessary to build and develop hospice education program as a team apprach, which indudes a systematic expertizing items for care in consideration of caregiver's background.
Purpose: This study was conducted to develop a measuring tool for spiritual care performance of hospice team members. The tool may be utilized for providing hospice patients with more systematic and standardized spiritual tares. Methods: The concept and questions of the tool were developed, and then its validity and reliability were tested. For the validity and reliability tests, a self-reported questionnaire comprising 33 questions with 4 point scale ($1{\sim}4$), was developed, and the data were collected from 192 hospice team members from December 2005 to February 2006. Results: Thirty three questions, drafted through literature review and professional consultation, were reviewed by 20 professionals for their validity, were revised and supplemented resulted in the final 33 questions. The questions with a correlation coefficient grater than .30 were selected: all the 33 questions were selected based on this criterion. The reliability coefficient, Cronbarh's ${\alpha}$, was 0.95. The 33 questions were analyzed for factors, and six factors were extracted: relationship formation and communication, encouragement and promotion of spiritual growth, linking with spiritual resources, preparation of death, evaluation and quality control for spiritual intervention, Intervention, and spiritual assessment for intervention. Conclusion: The tool developed in this study includes six factors and has high level of reliability. This tool Will greatly contribute to assess and improve hospice care services, providing systematic and standardized spiritual cares for terminally ill patients and their families.
The purpose of this study was to promote the popularization of hospice services by providing the information about the influences of hospice training on participants. We compared differences of attitudes toward death between those of pre-training and post-training by use of questionnaire. This study involved 137 volunteers participating in the hospice training held by one hospice center located in K-city. The questionnaire was composed of 46 items, 21 items of general information and 25 items of information about attitudes toward death. We applied Park's translated version(1992), originally distributed by Thorson and Powell(1988), in the assessment of participants' changed attitudes toward death. Participants were asked to fill out the questionnaire before and after the hospice training. The data were analged by frequency. ANOVA t-test, paired t-test. The results were as follows, 1.Pre-training items holding a high rank were 'The subject about the future life after death is distressing'(F=5.20), 'No worry about any occurrences around the body after a funeral'(F=4.75), 'Having little interest in being laid in a coffin after death'(F=4.56); items holding a low rank were 'Having little interest in any occurrences around the body after death'(F=2.22), 'Willing to deal with the aftermath of the death in detail'(F=1.94), 'No fear to have an idea to be cancerous'(F=1.72). 2.Post-training items holding a high rank were 'No fear to be dead as a result of sufferings from long-lasting illness'(F=3.18), 'No fear to have an idea to be cancerous'(F=3.16)', Having little interest in the future life after death'(F=3.09); items holding a low rank were 'Unpleasant to be not able to move after death(F=1.74), 'Distressing not to know about the future life after death'(F=1.61), 'The subject about the future life after death is distressing'(F=1.60). 3.There were significant difference in participants' attitudes toward death. Compared with pretraining(F=3.97), more positive were developed in post training(F=2.30). The results of this study indicate that hospice training renders positive regards toward death to the participants. Therefore every human being, who is able to speculate about the meaning of death, has to be exposed to the hospice training. In conclusion, hospice training should be popularized in the near future.
Purpose: This study was done to investigate effects of foot massage and supportive communication provided by hospice volunteers on depression, anxiety, and mood of cancer patients who are going under intravenous chemotherapy at out patient department (OPD). Methods: A non-equivalent control group non-synchronized design was used. Sixty-four participants were recruited from out-patients setting in a university hospital by a convenient sampling. Two trained- hospice volunteers first provided regular hospice volunteer service to 34 patients in the control group. Subsequently, foot massage and supportive communication were provided to 30 participants in the experimental group. After the intervention, all participants answered the structured questionnaire with visual analog scales on depression, anxiety, and mood including general characteristics. Data were analyzed using descriptive statistics, two sample t-test, and paired t-test by PASW 17. Results: After the intervention, changes in negative moods, i.e. strain and powerlessness in the experimental group were significantly different from those in control group; strain and powerlessness in the experimental group were significantly decreased by foot massage and supportive communication provided by hospice volunteers. Conclusion: The current findings provide an empirical evidence of a brief and efficacious intervention for cancer patients. Further studies are warranted with larger sample size to validate the effectiveness of foot massage and supportive communication as a solid intervention for cancer patients who are undergoing intravenous chemotherapy at OPD.
Purpose: The purpose of this study is to identify and assess the needs of the cancer patients and their families and provide basic data to meet with their needs. Methods: This is a descriptive study using questionnaire method. Questionnaire were collected by mail from 76 discharged patients from a hospice ward from May until the end of October, 2004, and data were analyzed by SPSS 10.0. Results: Admitted patients had needs of pain control (85.5%), non-pain symptoms (63.2%) such as vomiting, dyspnea, ascites, etc, and emotional and spiritual problem solving (28.9%, 14.5%). Interests of patients were health care of himself/herself (65.8%), concern for their spouses left alone (32.9%), and future of their children (15.8%). In families' needs of care of 5 areas, "information on patient's status and treatment/nursing care" was shown most high score ($3.48{\pm}0.62$). In detailed questions, they request most 'to inform the prognosis of patients' and the next is 'to inform the reasons that nursing care was required'. The next highest score was to 'inform family roles' ($3.39{\pm}0.64$), and next was spiritual support ($3.11{\pm}0.79$), and emotional support ($3.08{\pm}0.72$). Expectations of family on the treatment were comfortable dying (73.4%) scored the highest. Patients' families were satisfied with volunteer service most in service area (97.4%). The next was pain control (89.5%) and nursing service (77.6%). Conclusion: Health care staff should identify the actual needs of families caring cancer patients and they should operate realistic programme which can give continuous and assistance by reflecting individual needs and characteristics. With these srategies, the quality of life of patients and families can be improved. And then the intervention programme should be developed to measure subjective nursing care needs of terminally ill cancer patients and their families.
Objectives: This study was to develop and evaluate a web-based multimedia content for the education of hospice volunteers. Methods: The multimedia content was developed based on Baik's teaching and learning structure plan model. The developed program was evaluated by 24 hospice volunteer university students. Results: On main page, there were 4 menu bars that consisted of a lecture guide, cyber lecture, pause and quiz. In the operation of the web based multimedia content, HTML, Java Script, Photoshop and multimedia technology were utilized. There were significant differences in the test scores, before and after using this web-based learning program. After using a web-based learning program, scores of students were much higher. Conclusion: The developed web based program is based on systematic structure and it can provide hospice volunteers with the educational flexibilities and will be help for them to perform the more efficient hospice care.
The purpose of this study was analyzed the factors of influencing toward attitude to death with dignity to hospice volunteers. The data was collected for 21 days from 14 March to 3 April 2010. Among a total of 220 cases of the questionaries, only 195 cases were used. To data were analyzed by factor analysis, independent t-test, one-way anova and logistic regression using PASW statistics 18.0. The results were as follows; The attitudes towards death with dignity according to general characteristics was high in those with will to agreed to the passive euthanasia than those opposite to the attitude factors, namely, acceptive, the right to decide, negative, and dereliction of duty attitude factors. Significant variables for effects of death with dignity were gender, acceptive attitude factor and dereliction of duty attitude factors. Given that main provider of human organs is the brain-dead and we don't have enough organ donation, death with dignity should be linked with activating policy of organ donation, while solving donation shortage problem. This way, constructing social implementation and sharing consciousness on organ donation, would be diluting the bio-ethic controversies.
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