• Journal of Hospice and Palliative Care
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• v.17 no.1
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• pp.10-17
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• 2014

Purpose: This study was conducted to examine understanding of the meaning of well-dying and types of such views held by medical practitioners and nursing students. Methods: The Q-methodology was used to analyze the subjectivity of each item. The P-sample was made up of 22 medical practitioners or nursing students. The P-sample was instructed to rate 33 statements using a 7-point scale to obtain forced normal distribution. They were asked to make extra comments on the statements that were placed on both ends of the distribution curve. The PC-QUANL Program was used for the factor analysis of the collected data. Results: The participants had three types of meaning of well-dying. Total variance explained by these types was 57.97%" where type 1 was "reality-oriented", type 2 "relationship-oriented" and type 3 "obeying-the-nature". Conclusion: The participants' subjective views on well-dying influences their medical practice on patients who are facing death. Therefore, medical practitioners should have profound insights concerning life and death. To that end, a training program is needed to help medical practitioners develop a proper view on well-dying by subjectivity type.

• Journal of Hospice and Palliative Care
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• v.19 no.1
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• pp.5-10
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• 2016

Purpose: This study reviewed what the location of death (LOD) means as an outcome and how to use LOD to assess end-of-life (EOL) care. This study also examined the reason why LOD is significant for the quality of EOL care. Methods: A literature review was performed, using LODs and home deaths as outcomes in the field of EOL care, and analyzed the findings associated with key fields in regards to LOD. Results: Palliative care research used LOD, in particular, hospital death (versus home death) as a significant outcome when examining cost savings, quality of life care, and patient and family preferences. Based on substantial evidence from previous research, home hospice or continuous palliative care in non-hospital settings (i.e. homes, nursing homes) have been designed and available for dying patients in developed countries. Conclusion: The LOD delivers practical significance as an outcome for diverse reasons. In-depth examination on LOD in South Korea is needed despite limitations to interpretation of its meaning in the country.

• Journal of Hospice and Palliative Care
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• v.20 no.3
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• pp.173-176
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• 2017

On Aug 4, 2017, the new legislation of 'Act on Hospice & Palliative Care and Patient Determination of Life Sustaining Treatments' was enforced. Compared with articles about the hospice & palliative care of 'National Cancer Act', it should be helpful to update the change points.

• Journal of Korean Medical classics
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• v.3
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• pp.1-150
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• 1989

Oriental medicine thinks life and death as the following. 1. The universe seems to be a kind of organism which is divided into 3 branches, as Heaven, Earth and Man. Man is not created from nihil by the Creator. Heaven and Earth by their interaction operate to produce man. This is similiar that zygote is not created from nihil, and that sperm and ovum are transformed into zygote by their interaction. The symbolic meaning of sperm is Heaven, and that of ovum is Earth. Mind and body, as well as spirit and body, are not the real, but artificial words for the purpose of observing and expressing one man. So there is not spiritual substance as distinct from body. The expected life span of man is subjected to change, and is always becoming through life. Fate, the Creator and the world to come cannot be said to be. 2. After one's death, man is transformend into Heaven and Earth. Dying is this process of transformation. Although man comes into existence and closes one's life, the total life of the universe does not change. The criteria of determination of death is not in cell death, but in somatic death. Somatic death divided into 2 branches, one is heart-lung death, the other is brain death. For the standard of health changes ceaselessly as time goes by, aging and dying is not the process of losing health. Because of mind cannot be seperated from body, we'll feel at ease bodily and mentally in healthy dying. The completion of lifetimes is the value of healthy dying. 3. From the viewpoint of these, we must think to let a person die healthily is the right medical ethics. The way to let a person die healthily is divided into 3 branches, one is treatment, another is prevention and the other is promotion of health. We should treat and prevent death of sickness, but take care of healthy dying.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.20 no.9
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• pp.432-439
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• 2019

This study was a qualitative study that attempted to find out the meaning of preparation for dying well that the elderly think through a question of how to prepare for dying well. The focus group interview was conducted on 10 elderly people aged 65 or older who visited the elderly welfare center in B city, Gyeonggi-do, and a total of two groups were interviewed with five subjects as one group. As a result, eight themes were drawn from four dimensions of physical, psychological, social, and spiritual aspects. In physical preparation, 'health management' and 'doing what you want to do' were derived. In psychological preparation, 'not regretting' and 'giving to others' were derived, and in social preparation, 'organizing property', 'determining a place of death you wish', and 'writing a letter of advance life sustaining care directives' were derived. In spiritual preparation, 'relying on religion' was derived. The elderly were preparing for well-being in various aspects, and when developing a program for well-being, the program should be planned to prepare for actual death in various aspects.

• Journal of Hospice and Palliative Care
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• v.13 no.2
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• pp.69-75
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• 2010

Hospice is defined by the National Hospice and Palliative Care Organization (NHPCO, USA) and WHO, as a program of care that provides comprehensive medical, nursing and support services to dying patients and their family. Despite its broad definition, however, hospice care in Korea has been focused mostly on terminal cancer patients. Thus hospice eligibility for patients with advanced cancer is relatively easier to predict than those with other fatal chronic illnesses such as heart, lung, renal or liver diseases, and dementia. This makes it more difficult for patients and families to prepare for death and gain full benefits of hospice care. This article introduces the medical guidelines for selected non-cancer patients who are expected to live for only six months, this making it possible for patients, who are nearing the end of life, to avoid unwarranted suffering.

• Journal of Korean Academy of Nursing
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• v.30 no.4
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• pp.1045-1054
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• 2000

As cost pressures have escalated, policy makers, politicians, health care providers and families have tried to devise ways to reduce health care costs. While originally developed to enhance patient control and to provide better care at the end of life, hospice care has recently received significant attention as a mean of reducing health care costs. As a program providing care for patients who are dying at their homes, hospice has expanded slowly since the opening of the first hospice in Korea in 1963. Therefore, a variety of services that responds to the needs and concerns of many dying people and their families is limited The purpose of this study was to determine the potential cost savings at the end of life among patients who used home hospice compared with the patients who received institutional care in Korea. This study used a retrospective, descriptive design. The sample for this study included 46 patients who died of lung cancer: 25 patients who received home hospice care and 21 patients who received institutional care. Data on patient characteristics, kinds and frequencies of provided treatment and nursing services, and hospice and hospital charges during the last month before death were collected. Cost of care was measured by the average cost per patient per day in the last month of life. The results of the study indicated that there were significant differences in average cost of care between home hospice sample and institutional care sample (t=9.956, p<.001; home hospice sample: M=18,102 won, institutional care sample: M=317,578 won). The cost of the home hospice sample was approximately 6% of the cost of institutional care. The majority of the home hospice nursing services were education (35.7%) and supportive counseling (25.2%), followed by medication management (13.6%), assessment (12.1%), basic nursing (7.2%), treatment (5.5%) and others. In institutional care sample, basic nursing and treatment were more emphasized than education or supportive counseling among the nursing services provided. The results of this study showed the potential for hospice to reduce costs and implications for policymakers and clinicians to incorporate hospice program into the formal health care delivery system in Korea.

• Journal of the Korea Convergence Society
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• v.10 no.8
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• pp.37-44
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• 2019

The purpose of this study is to determine the inhibiting factors of dying well for people who want to have a good death. The final respondents in this study were sampled using stratified proportional allocation using a stratified random sampling method, and 1,000 adults aged between 19 and 75 years were selected. The questionnaire used consisted of four items on general characteristics and 20 items related to the inhibiting factors of dying well scored on a 7-point Likert scale. Analysis was conducted using descriptive statistics, correlation analysis, and decision tree analysis. Results showed that, among the inhibiting factors of dying well, "degenerative diseases (such as dementia)" and "loss of control (mental / physical)" scored 5.502 and 5.268 points, respectively; the highest significant positive correlation was found between "bad marital relationship" and "bad relationship with children," followed by "did not receive death education" and "lack of medical policy promotion (dying well)" and "bad relationship with children" and "indifference of others." Considering these findings, it appears that the whole society will make efforts to improve the perception and practice of good death, and life and death education will be expanded if death education for dying well is organized and implemented.

• Journal of Hospice and Palliative Care
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• v.19 no.3
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• pp.240-248
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• 2016

Purpose: Patients and their caretakers need to understand various problems and requirements in the dying process so that they may prepare for death for the rest of their remaining life. Accordingly, a systematic audio-visual resource was developed to educate hospice patients and their families at the palliative care ward about the process of dying. Methods: For the development of an audio-visual resource, a initial education material was produced in the form of simple and accessible Power Point handouts based on literature study. Then, the program was completed through five rounds of a process, including expert advice, revision, update and evaluation. Results: The final version of the program was filmed with cooperation of the medical literature information division. Using the program, patients and families were educated through five phases over three sessions for a total 26 minutes and 34 seconds. Conclusion: The significance of this study lies in the fact that it was conducted after the establishment of the palliative care ward, which made it easier for nurses provide the education. It is expected that the program may be used by hospice specialists as well as nurses as an education resource for hospice patients and their families.

• Journal of Hospice and Palliative Care
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• v.9 no.2
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• pp.77-85
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• 2006

Purpose: The purpose of this study is to develop the basic curriculum for the nurses who work at hospice and palliative care settings. Methods: Seven curricula of hospice and palliative care for the nurses in Korea and other countries were reviewed, and Education Need for hospice and palliative care was surveyed from 162 nurses by mailing the questionnaires to hospice palliative care settings. Results: 1. The curricula of hospice and palliative care for the nurses in Korea and other countries in common include 'understanding of hospice and palliative care', 'understanding of lift and death', 'pain and symptom management for person with terminal disease', 'on-the-spot study and practical training', 'management of hospice and palliative ward', 'hospice and palliative care at home', 'physical assessment', 'therapeutic communication skills', 'children's hospice', 'administration and management of hospice and palliative care', 'interdisciplinary team of hospice and palliative care', 'ethics and laws in hospice and palliative care', 'psychological, social and spiritual care', 'care of the dying', 'bereavement care', etc. 2. The scores above 3.3 were marked for 34 items in education Need Survey. The highest scores were given in the order for the items 'understanding of death and dying', 'attitude and response to death and dying', 'understanding and assessment of pain' etc. respondents marked that they have been trained for 'pain and symptom management', 'ethics and laws in hospice and palliative care', 'building the system for cooperation and publicity activities in hospice' etc. 3. The basic curriculum of hospice and palliative care for the nurses requires 78 studying hours for 17 subjects, comprising 48 hours of theory education and 30 hours of practical training. The education methods are lectures, discussions, and case studies. Conclusion: The efforts of developed basic curriculum should be evaluated after educating nurses. It is necessary to develop the standard curriculum and regularly update it based on the result of education Need Survey for actively working nurses in hospice and palliative care settings.