The goal of medicine is to contribute to promoting national health by preventing diseases and providing treatment. The scope of modern medicine isn't merely confined to disease testing, treatment and prevention in accordance to that, and making experiments by using the human body is widespread. The advance in modern medicine has made a great contribution to valuing human dignity and actualizing a manly life, but there is a problem that has still nagged modern medicine: treatment and healing for terminal patients including cancer patients. In advanced countries, pain care and hospice medicine are already universal. Offering a helping hand for terminal patients to lead a less painful and more manly life from diverse angles instead of merely focusing on treatment is called the very hospice medicine. That is a comprehensive package of medical services to take care of death-facing terminal patients and their families with affection. That is providing physical, mental and social support for the patients to pass away in peace after living a dignified and decent life, and that is comforting their bereaved families. The National Hospice Organization of the United States provides terminal patients and their families with sustained hospital care and home care in a move to lend assistance to them. In our country, however, tertiary medical institutions simply provide medical care for terminal patients to extend their lives, and there are few institutional efforts to help them. Hospice medicine is offered mostly in our country by non- professionals including doctors, nurses, social workers, pastors or physical therapists. Terminal patients' needs cannot be satisfied in the same manner as those of other patients, and it's needed to take a different approach to their treatment as well. Nevertheless, the focus of medical care is still placed on treatment only, which should be taken seriously. Ministry for Health, Welfare & Family Affairs and Health Insurance Review & Assessment Service held a public hearing on May 21, 2008, on the cost of hospice care, quality control and demonstration project to gather extensive opinions from the academic community, experts and consumer groups to draw up plans about manpower supply, facilities and demonstration project, but the institutions are not going to work on hospice education, securement of facilities and relevant legislation. In 2002, Ministry for Health, Welfare & Family Affairs made an official announcement to introduce a hospice nurse system to nurture nurse specialists in this area. That ministry legislated for the qualifications of advanced nurse practitioner and a hospice nurse system(Article 24 and 2 in Enforcement Regulations for the Medical Law), but few specific plans are under way to carry out the regulations. It's well known that the medical law defines a nurse as a professional health care worker, and there is a move to draw a line between the responsibilities of doctors and those of nurses in association with medical errors. Specifically, the roles of professional hospice are increasingly expected to be accentuated in conjunction with treatment for terminal patients, and it seems that delving into possible problems with the job performance of nurses and coming up with workable countermeasures are what scholars of conscience should do in an effort to contribute to the development of medicine and the realization of a dignified and manly life.
This study was carried out to identify how a middle-aged woman's consciousness of the death and self-esteem was affected by whether the hospice volunteer's experience exist or not. As a form of descriptive research, this study, which is based on a structured questionnaire intended for the 191 middle aged women doing volunteer work at the non-profit women's organization, had been conducted twice from May 10, 2010, to May 21, 2010. The results of my research work is followed ; First, a middle-aged woman's consciousness of the death and self-esteem showed significant differences depending on whether the hospice volunteer's experience exist or not. Experienced hospice volunteer group showed a lower consciousness of the death and a higher self-esteem compared to non-experienced hospice volunteer group's case. Second, in case that the results show a high self-esteem, the consciousness of death reach at the low stage. Especially, the experienced hospice volunteer group showed an opposite correlation compared to non-experienced group. Third, Anyone's consciousness of death appeared at a low level when she had a religion and higher education background. Anyone's self-esteem oriented sense appeared at low level when she didn't have religion but rather appeared at high level when the health status of the targeted group was in a good shape. As a result, the hospice volunteer activities can be assumed to increase the middle-aged woman's self-esteem, therefore, turn the consciousness of death into a positive attitude.
Over the past decade, hospice and palliative care in Japan have progressed rapidly under the national policies supported by the Cancer Control Act. The numbers of palliative care units/inpatient hospices, hospital palliative care teams, and clinics with a home hospice function have been steadily increasing. The increasing numbers of physicians, nurses, and pharmacists have been certified as specialists in palliative care by national associations. Collaborative efforts have been made to standardize and disseminate educational programs and training opportunities in undergraduate, postgraduate, and continuing medical education. Research activities in Japan have markedly contributed to the growing body of evidence, especially in the fields of terminal delirium, terminal dehydration, palliative sedation, care for dying patients, prognostication, communication, psycho-oncology, and regional palliative care programs. This review focuses on major palliative care settings, specialty, national associations, education, and research in palliative care in Japan.
Purpose : To evaluate the present status of bereavement care in Korean hospice service as a basic database for the effective bereavement care. Method : The data were collected two sets from September to October, 1999 and from November to December, 2000, 55 hospice institutions identified by the Hospice Education Institution, College of Nursing, Catholic University were contacted for a telephone survey. The researchers conducted telephone interviews with hospice administrators for 10 to 30 minutes. Result : 1) Among the 55 Korean Hospice institutions, 38 institutions(69.1%) provided bereavement services. 2) The contents of bereavement services consisted of telephone call 28 institutions(74.5%), bereaved family meeting 26 institutions(69.4%), home visiting 22 institutions(57.9%), mail 16 institutions(42.1%), personal counselling 7 institutions(18.4%). 3) The 26 hospice institutions(68.4%) which provided meetings for bereaved families met with the following frequency : Annually is 11 institutions(42.3%), biannually 6 institutions(23.1%), monthly 6 institutions(23.1%) and bimonthly 3 institutions(11.5%). 4) Only 4 hospice institutions(10.5%) used the assessment tool to screen for high risk of bereaved. 5) The major difficulties of current bereavement services were low attendance for the bereaved family meeting, shortage of professional managers and volunteers, limited accessibility to hospice institutions, little social awareness for the bereaved, and financial difficulties. 6) The hospice administrators expressed the need for the development of bereavement program, the education program for the bereavement services, trained professionals, the sufficient provision of human resource and financial support for more effective bereavement services. Conclusion : Although many hospice institutions(69.1%) provided bereavement services, they generally lacked capable bereavement professionals and various individualized bereavement services. In conclusion, it is required to develop the specified bereavement program and the training program for the staff and volunteers, so as to provide customized bereavement services based on individual needs. Further research will be necessary to evaluate the effects of customized bereavement services in Korea before applying to practice.
Cancer is the second leading cause of the death in Korea. Family caregivers of dying patients manifest many psychological and physical symptoms of stress, and they often seek for informational support from health care providers. Unfortunately, however, few systematic studies identify the actual effect of such support on family caregivers. This study, thus, intends to evaluate the effect of informational support for hospice care. One group pretest-posttest design was used, employing the stress-coping model by Cohen and Wills as a conceptual framework. This research was conducted from July 1 to November 15, 1998, initially with 32 subjects sampled from hemato-oncology department of two general hospitals in Seoul, but reduced to 18 at the end due to the untimely death of patients or caregiver's refusal during the course of study. Informational supports were programmed to provide the family caregivers with 8 times of education and counseling as well as 24-hour hot-line for 4 weeks. A booklet that explains the various problems of hospice care was also prepared and distributed to all subjects. Data were collected by using self-report questionnaires and reviewing medical records. The tools used in this study were based on the Weinert's PRQ-II(scale of perceived social support), Spielberger's state anxiety inventory, and CES-D. Also included in the data collection were the general characteristics of family caregivers and patients, and the pain intensity and the performance status of patients. The data were analyzed with descriptive statistics, Wilcoxon sign rank test and paired t-test using SPSSWIN program. The results of the study were as follows: 1.The perceived social support of family caregivers was not significantly increased with informational support for hospice care(t=1.64, one tailed p=.060). 2.The anxiety of family caregivers was significantly reduced following informational support for hospice care(t=3.48, one tailed p=.002). 3.The depression of family caregivers was significantly reduced following informational support for hospice care(t=-2.18, one tailed=.022). 4.The pain intensity of patients with terminal cancer was significantly reduced following informational support for hospice care(t=-2.41, two tailed p=.027). The results suggest that the informational support provided to family caregivers of patients with terminal cancer reduced not only their anxiety and depression but also the pain intensity of patients. Further study is necessary to consolidate the conceptual framework of this study with expanded number of subjects. Nevertheless, it was certain that the informational support program for hospice care was very helpful to both caregivers and patients. Thus, the informational support program is strongly recommended for the hospitals which have no hospice unit yet.
The purpose of this study was to assess the level of resilience to burnout and work satisfaction of hospice volunteers. Methods: Participants included 235 regular volunteers at hospice facilities of two university hospitals and four general hospitals located in Busan. The study instruments were the scale of resilience to burnout and work satisfaction. The scale of resilience to burnout consisted of six dimensions (professional competency, accomplishment and worthiness, firm belief and value about their profession, good teamwork, support by their agency, and individual resources) and 31 items which were rated on a 5-point Likert scale, whereas the scale of work satisfaction consisted of 6 items which were rated on a 5-point Likert scale. Data were analyzed by descriptive statistics, t-test, ANOVA, Tukey and Pearson's correlation coefficient. Results: The mean score of resilience to burnout and work satisfaction of participants were 3.59 and 3.69, respectively. The highest and lowest scores of resilience to burnout were individual resources (3.81) and accomplishment and worthiness (3.36). There were significant differences in resilience to burnout scores, depending on religion, health status, type of hospice facilities, and period of volunteer experience. There were significant differences in work satisfaction scores, depending on gender, religion, education level, health status, and type of hospice facilities. Conclusions: Continuous education and efficient management need to be developed to improve the level of resilience to burnout and work satisfaction of hospice volunteers.
Purpose: This study was conducted to evaluate the impact of a two-week palliative care education program on Korean Hospice volunteers. Methods: A total of 71 volunteers were assigned to two groups: Group A (intervention, n=34) and Group B (usual care, n=37). Group A received six sessions of palliative care education for two weeks. The level of volunteers' motivation, death anxiety, and communication with the dying were measured at baseline and after the program ended. Results: The palliative care education program had positive influence on the volunteers' motivation (t=2.341, P=0.022), death anxiety (t=-2.166, P=0.034), and communication with the dying (t=-2.808, P=0.006). Conclusion: The findings of this study suggest that a palliative care education program may be an effective way to boost hospice volunteers' motivation, ease their death anxiety and improve their communication with the dying.
The purpose of this study was to provide basic data for developing hospice intervention strategies that can enhance hospice care perception plus attitude toward death of nursing students by grasping the factors affecting the perception of first grade students. Data were collected from 185 nursing students at J university in G-do. Analysis was done using t-test, ANOVA, Pearson correlation coefficient, and Multiple regression with IBM SPSS WIN/25.0. Hospice care perception was correlated to moral behavior (r=.22, p=.002) and biomedical ethics consciousness (r=.29, p<.001). The most influential factor on the subjects' hospice care perception was biomedical ethics consciousness (β=.224, p=.012), followed by high financial competence of parents (β=.187, p=.027). The explanatory power was 11.5%. Therefore, systematic programs that can enhance moral behavior and biomedical ethics consciousness are necessary to promote awareness of hospice care. Also, the following data can be utilized as basic data to help develop hospice education programs.
In Cheol Hwang;Seong Hoon Shin;Youn Seon Choi;Myung Ah Lee;DaeKyun Kim;Kyung Hee Lee
Journal of Hospice and Palliative Care
/
v.27
no.1
/
pp.45-49
/
2024
Purpose: This study investigated palliative care physicians' attitudes regarding social issues related to opioid use. Methods: An email survey was sent to 674 physicians who were members of the Korean Society for Hospice and Palliative Care (KSHPC). Results: Data from 66 physicians were analyzed (response rate, 9.8%). About 70% of participants stated that their prescribing patterns were not influenced by social issues related to opioid use, and 90% of participants thought that additional regulations should be limited to non-cancer pain. Under the current circumstances, pain education for physicians is urgently needed, as well as increased awareness among the public. Half of the respondents identified the KSHPC as the primary organization responsible for providing pain education. Conclusion: Palliative care physicians' prescribing patterns were not influenced by social issues related to opioid use, and these issues also should not affect cancer pain control.
Lee, Young Eun;Kim, Mi Kyung;Choi, Eun Ah;Im, Min Suk
Journal of Hospice and Palliative Care
/
v.19
no.3
/
pp.222-232
/
2016
Purpose: This study was to investigate the relationships between spiritual well-being, attitude towards death and perception of hospice, and the factors influencing hospice perception of high school students. Methods: A survey was conducted with 229 students in four high schools in B city from May 1, 2015 through May 31, 2015. The data were analyzed with descriptive statistics, t-test, ANOVA, Pearson correlation coefficients, stepwise multiple regression using the SPSS 18.0 program. This study was approved by the internal review board. Results: The factors influencing hospice perception of the high school students were previous recognition of hospice (${\beta}=0.412$, P<0.001), attitude towards death preparation among sub-variables of attitude towards death (${\beta}=-0.244$, P<0.001), subjective school life satisfaction (${\beta}=-0.215$, P<0.001), and sex (${\beta}=0.191$, P<0.001). The more positive the attitude towards my body after death and that towards death preparation was, the more positive recognition for hospice was. The total explanatory power of these factors was 34.5%. Conclusion: To improve high school students' perception of hospice, it is necessary to provide them with a hospice education program to help them with their attitudes towards death preparation and their understanding of hospice.
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