• Journal of Hospice and Palliative Care
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• 제10권3호
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• pp.137-144
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• 2007

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.

• Journal of Hospice and Palliative Care
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• 제20권4호
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• pp.215-220
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• 2017

Spiritual care is at the center of hospice and palliative care. Patients facing serious and life-threatening illness have important needs in regard to faith, hope, and existential concerns. The purpose of this article is to review the key aspects of this care, including the definitions of spirituality, spiritual assessment, and spiritual care interventions. A review of the current literature was conducted to identify content related to spiritual care in hospice and palliative care. A growing body of evidence supports the importance of spiritual care as a key domain of quality palliative care. The literature supports the importance of spiritual assessment as a key aspect of comprehensive patient and family assessment. Spirituality encompasses religious concerns as well as other existential issues. Future research and clinical practice should test models of best support to provide spiritual care.

• Journal of Korean Academy of Nursing
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• 제29권3호
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• pp.576-584
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• 1999

The purpose of this study was to develop an education program for hospice care and to examine the effect of the program. The education program for hospice care was developed based on the philosophy and principle of Hospice and integrated with various professional areas related to the problems with which terminal patients and their family might be associated. The program was continued for 16 weeks and consisted of lectures and practices. The courses of this program were The Concept and Principle of Hospice, The Role of the Hospice Nurse, The Characteristics of Terminal Disease, Physical Care in Terminal Patients, Death Orientation, Psychological care for Terminal Patients, Spiritual care for Terminal Patients, and Care for the Family. To identify the effect of the education program for hospice care, the difference in death orientation of subjects between the pre and post performance of the education program was examined using the t-test. The finding of this statistic indicated that this education program for hospice care was effective in terms of changing the death orientation of subjects with positive direction. The education program for hospice care was performed several times at Kwangrim Hospice Missionary, Chungbuk University Hospital, and Wooam Church. Case studies were reported for a description of content of hospice care experienced by subjects after the performance of education, put this at the beginning 8 the sentence. In conclusion, the education program for hospice care was developed effectively. Therefore, this program should be used to educate and activate the subjects in community to be participants in hospice care.

• Journal of Hospice and Palliative Care
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• 제7권2호
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• pp.232-237
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• 2004

Purpose: DNR order is generally accepted for cancer patients near the end of life at Hospice Ward. It means not only no CPR when cardiopulmonary arrest develops but no aggressive meaningless medical interventions. Usually on admission, we discuss with the patients' family about DNR order at the Hospice Ward. Recently, we experienced a terminal lung cancer patient who had been on the ventilator for two months after pulmonary arrest. CPR and artificial ventilation were performed because patient's family refused DNR order. There is no consensus when, who, and how DNR order could be written for terminal cancer patients in Korea, yet. Methods: Hospice charts of 60 patients who admitted between Jan and Jun 2003 to Hospice Ward were reviewed retrospectively. Results: The median age was 66(range $31{\sim}93$) and there were 31 males and 29 females. Their underlying cancers were lung (12), stomach (12), biliary tract (7), colon (6), pancreas (4) and others (19). The persons who signed DNR order were son (22), spouse(19), daughter (16) and others (3). But, there was no patients who signed DNR order by oneself. Thirty families of 60 patients signed on day of admission and 30 signed during hospitalization when there were symptom aggravation (19), vital sign change (4), organ failure (3) and others (4). There were 13 patients who died within 5 days after DNR order. Most of patients died at our hospice ward, except in 1 patient. The level of care was mostly 1, except in 2 patients. (We set level of care as 3 categories. Level 1 is general medical care: 2 is general nursing care: 3 is terminal care.) Conclusion: We have to consider carefully discussing DNR order with terminal cancer patients in the future & values on withholding futile intervention.

• Journal of Hospice and Palliative Care
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• 제13권4호
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• pp.232-242
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• 2010

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.

• Journal of Hospice and Palliative Care
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• 제18권1호
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• pp.25-34
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• 2015

Purpose: This study is to find relationship between cancer patient's spiritual health and the level of their anxiety and pain. Methods: From April 27 through May 11, 2012, a survey was conducted with 167 cancer patients hospitalized at a university hospital in Busan. Spiritual health was measured by the Spiritual Health Inventory developed by Highfield (1992). The instrument for anxiety measurement was the State-Trait Anxiety Inventory by Spielberger (1975) and that for pain was the Visual Analogue Scale (2009). The association between patients' characteristics and spiritual health, anxiety or pain degree were analyzed using the ANOVA test. The interrelationship between spiritual health, anxiety and pain was analyzed using Pearson's correlation coefficients. Results: The patients exhibited a moderate degree of spiritual health and anxiety and a mild level of pain. Patients' spiritual health significantly differed by their religion, education, monthly income of the family, illness conditions, physical conditions, metastasis, daily living and support. Their anxiety level was significantly different according to age, religion, education, illness conditions, physical conditions, metastasis, daily living, family/friends' support and use of analgesics. Significant differences were also found in the level of pain according to illness conditions, physical conditions, metastasis, daily living, family/friends' support and use of analgesics. We found a moderately negative correlation between spiritual health and anxiety. Anxiety and pain showed a positive correlation, and spiritual health and pain exhibited a negative correlation. Conclusion: To help cancer patients to manage their spiritual health, anxiety and pain, a program should be developed considering the primary factors discussed in this study.

• Journal of Korean Academy of Nursing
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• 제30권4호
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• pp.1006-1017
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• 2000

The purpose of this study was to provide basic information for developing a nursing intervention that helps patients learn how to acquire coping to reduce post operation uncertainty and anxiety by investigating the level of uncertainty and anxiety experienced by mastectomy patients. The subjects were 134 patients selected from St. Mary's Kangnam and St. Mary's hospital, and the data collection period was from October to December of 1998. Uncertainty was measured by using Mishel Uncertainty in Illness Scale (MUIS), anxiety measured by using State-Trait Anxiety Inventory(STAI), and coping by using a questionnaire developed by Kim & Yoo (1996). Data were analyzed with SAS program by t-test, ANOVA, Duncan's multiple range test, Pearson correlation coefficients, and stepwise multiple regression. The results were as follows : 1. The mean uncertainty score was 57.6. The results of the correlation between the compliance of medical regimen and demographic characteristics were as follows ; Those who monthly income over 2,010,000 won had lower than above 1,000,000 won, and those with the experience of chemotherapy had higher than those without, and the patient who has 7∼12 months(1 yr.) post operation period had higher than the one below 6months, 25∼36 months(3 yrs.), 37∼60 months(5 yrs.), and over 61 months. 2. The mean anxiety score was 45.9. Anxiety tended to be increased slightly in subjects with low educational background, poor monthly income, experience of chemotherapy, and 7∼12 months(1 yr.) post operation period, but there was no significant difference by general characteristics 3. The mean value of the coping score was 100.7. The study revealed higher score in problem-focused coping than emotion-focused coping. In regard to coping by demographic characteristics were as follows ; those who had monthly income over 2,010,000 won had higher level of coping than those whose monthly income was between 1,010,000 and 2,000,000 won. In terms of problem- focused coping, those who had 25∼36 months of post operation period showed significantly lower level of coping than those below 6 months or 37∼60 months(5 yrs.) or over 61 months of post operation period. Regarding the emotion-focused coping, those with the christianity had significantly lower level of coping than those without it. Also, those whose monthly income over 2,010,000 won had significantly higher coping level than those with income of between 1,010,000 and 2,000,000 won. 4. A positive relationship was found between uncertainty and anxiety. Patients who experienced more uncertainty also showed more anxiety. Problem-focused coping was inversely related to uncertainty and anxiety. 5. The major variable that affected uncertainty was anxiety, explaining 63.3% of the uncertainty. In addition to this, it would explain 66.4% in total when experience of chemotherapy was added.

• Journal of Korean Public Health Nursing
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• 제13권2호
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• pp.101-114
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• 1999

This study was designed to investigate the effects of an aquatic exercise program on the shoulder joint function. physical symptom. quality of life and stress among the patients who received modified radical mastectomy between 6 to 12 months prior to their visits. The subjects were 31 women aged between 40 and 60 who visited the out-patient department at Kang Nam St. Mary's Hospital for follow-up care. and were not under the treatment of intravenous cancer chemotherapy or radiation therapy. and had no complications. Twelve of them were assigned to the control group. while nineteen subjects to the experimental group. The aquatic exercise program was developed by the author with the assistance of exercise specialists. The program includes warming uP. aerobic and cooling down exercises in water. The aquatic exercise program for the experimental group was carried out 3 times a week with 60 minutes in each time for 8 weeks from September 20th to November 15th. 1995 in a regular swimming pool in Seoul. Changes in the range of motion of the shoulder joint. muscle strength. physical symptom. quality of life. and stress were examined after the completion of treatment. The data were collected through isokinetic muscle strength evaluation and questionnaire survey before and after the treatment. Paired and unpaired t-test were adopted to analyze the data. The results were as follows ; 1. The increment in the range of motion of the shoulder joint in the experimental group after the exercise was significantly greater than those in the control group. 2. The peak torque of shoulder girdle muscles increased significantly after the exercise in the experimental group only. 3. The physical symptom score decreased significantly after the exercise in the experimental group only. 4. The experimental group revealed significantly higher level of quality of life and lower level of stress after the exercise compared with those before the exercise. whereas the control group showed no significant changes in those levels. These findings may indicate that the aquatic exercise program is effective in increasing the range of motion of the shoulder joint and muscle strength and quality of life. and also effective in decreasing physical symptoms. and the level of stress in postmastectomy patients. Accordingly. the acquatic exercise program' can be adopted as an effective nursing intervention for postmastectomy rehabilitation.

• Korean Journal of Adult Nursing
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• 제13권1호
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• pp.15-28
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• 2001

The purpose of this study was to identify the trends of resourcefulness researche studies for suggesting the future direction of study. Study design, types of subjects, measurement tools, study concept, and outcome were examined by reviewing 61 research studies published from 1980 to 1999. The results were as follows: 1. There were 24 works in the 1980s and 37 works in 1990, according to the published year of resourcefulness study. Nonexperimental studies like descriptive study, correlational study and comparative study were more frequent than experimental studies. 2. Research studies that consisted of 30- 100 subjects were the most numerous with 27 studies in all. The majority of study subjects was shown as healthy students and depressive patients. 3. Most studies used Rosenbaum's Self Control Schedule(SCS) for assessing resourcefulness. Reliabilities of resourcefulness researches were cronbach ${\alpha}=.70$ or more. According to statisitical tests done for internal validity, SCS was negatively correlated to maladaptation. Factor analysis revealed that the most parsimonious structure was 3 to 6 factors. The total communality variance in the SCS was about 40 %. Other tools used with the SCS were about coping, depression, satisfaction of life and symptoms, self management and health promotion. 4. In correlational studies, concepts like depression, anxiety, and psychological symptoms were related to resourcefulness negatively. Adaptive functioning, life satisfaction and self achievement had positive correlations to resourcefulness. 5. Studies on comparison between a healthy person and depressive patient or smoker and non-smoker were done. There were coping, depression, symptom, self efficacy, health problem and self-control as comparative concepts. 6. Study subjects consisted of depressive patients in 9 of 18 experimental studies. The majority of studies were done with cognitive-behavioral therapy as an experimental intervention. The most effective treatment was revealed in high resourcefulness group. Since the above findings, resourcefulness research increased since 1980 and mostly non-experimental design for quantitative study were done. In the field of nursing, research about resourcefulness was in an initial stage. It is expected that further research needed to be done. Recommendations on the basis of the present research suggest that it is necessary to replicate studies, develop nursing intervention enhancing resourcefulness and apply it to patients with chronic diseases including cancer.

• Journal of Hospice and Palliative Care
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• 제6권1호
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• pp.22-33
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• 2003

Purpose : The purpose of this study was to evaluate the present status of patients' satisfaction and the reasons for any satisfaction or dissatisfaction in cancer pain management Methods : A cross-sectional survey was used to obtain the feedback about pain management. The results of the survey were collected from 59 in- or out-patient who had cancer treatment at two of the teaching hospitals in Seoul from July, 2002 to November, 2002. The data was obtained by a structured questionnaire based on the American Cancer Society Patient Outcome Questionnaire(APS-POQ) and other previous research. The clinical information for all patients were compiled by reviewing their medical records. Resuts : 1) The subjects' mean score of the worst pain was 6.77, the average pain score was 3.80, and the pain score after management was 2.93 for the past 24 hours. The mean score of total pain interference was $25.03{\pm}12.82$. Many of the subjects had false beliefs about pain such as 'the experience of pain is a sign that the illness has gotten worse', 'pain medicine should be 'saved' in case the pain gets worse' and 'people get addicted to pain medicine easily'. 2) 66.1% of the subjects were properly medicated with analgesics. 33.9% of the subjects reported use of various methods in controlling pain other than the prescribed medication. Only 33.9% of the subjects had a chance to be educated about pain management by doctors or nurses. 3) The mean score of patients' satisfaction with pain management was $4.19{\pm}1.14$. 72.9% of the subjects answered 'satisfied' with pain management. The reasons for dissatisfaction were 'the pain was not relieved even after the pain management', 'I was not quickly and promptly treated when I complained of pain', 'doctors and nurses didn't pay much attention to my complaints of pain.', and 'there was no appropriate information given on the methods of administration, effect duration and side effects of pain medicine.' The reasons for satisfaction were: 'the pain was relieved after the pain management.', 'doctors and nurses quickly and promptly controlled my pain.', 'doctors and nurses paid enough attention to my complaints of pain.' and 'trust in my physician'. 4) In pain severity or pain interference, no significant difference was found between the satisfied group and dissatisfied group. On the belief 'good patients avoid talking about pain', a significant difference was found between the satisfied group and dissatisfied group. Conclusions : The patients' satisfaction with cancer pain management has increased over the years but still about 30% of patients reported to be 'not satisfied' for various reasons. The results of this study suggest that patients' education should be done to improve satisfaction in the pain management program.