Purpose: To provide effective palliative care, it is important to predict not only patients' life expectancy but their discharge status at a time of inpatient admission to a hospice care facility. This study was aimed to identify meaningful life expectancy indicators that can be used to predict patients' discharge status on admission to the facility. Methods: Among 568 patients who were admitted to the hospice ward of P hospital from April 1, 2016 through December 31, 2017, 377 terminal cancer patients were selected. This retrospective cohort study was performed by using performance status, symptoms and signs, socioeconomic status, laboratory findings on admission. Results: Alive discharge was associated with a good performance status that was measured with the Karnofsky and Eastern Cooperative Oncology Group (ECOG) scales and the Global health and Mental status. Less anorexia, dyspnea, dysphagia and fatigue were also associated with symptoms and signs. Associated laboratory findings were close to normal Complete Blood Cell (CBC) count, Liver Function Test (LFT) and Blood Urea Nitrogen (BUN). Conclusion: Our findings suggest that Karnofsky Performance Status (KPS), ECOG, Global health, Mental status, anorexia, dyspnea, dysphagia, fatigue, CBC, LFT, BUN are meaningful indicators when predicting discharge status for inpatients. Further investigation is warranted.
The study attempted to analyze the experiences concerning professional identities of social workers working in hospice palliative care(HPC) multidisciplinary team by adopting ground theory method. The data were drawn from in-depth interviews with 11 social workers working in HPC teams for more than a year. As a result of the study, 166 concepts, 21 themes and 10 categories were presented. The core theme was identified as "growing up as a professional recognized by clients and other team members". The characteristics of social work and those of hospital setting systematic barriers and problems of the governmental support program worked as external conditions. The conflicts and confusions in social workers' professional identities were brought about as results of the conditions while successful team and the characteristics of individual setting promoted to get over the problems. The social workers experienced professional rewards and personal growth from hospice practices by utilizing diverse strategies. It was proposed that social workers should make efforts to be recognized as an essential profession in HPC multidisciplinary teams together with resolving the institutional problems such as regulations on qualifications of HPC social worker, professional education and governmental supports to improve work conditions.
Kim, Sook-Nam;Choi, Soon-Ock;Lee, Jeong-Ji;Shin, Kyung-Il
Korean Journal of Health Education and Promotion
/
v.22
no.2
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pp.141-153
/
2005
Objectives: The purpose of this study was to examine the effects of a death education program on attitude to death and meaning in life for university students. Methods: The design of this study was quasi-experimental and non-synchronized with a non-equivalent control group. The study subjects were 28 students at a college in Busan. The experimental group (n=14) participated in a death education program. While the control group (n=14) didn't. The program consisted of lectures and discussions for 6 hours a day over 5 days. The 30-hr course examined the meaning of death, modern society and death, hospice movements and desirable life and death. Data were collected using a structured questionnaire consisting of general characteristics, attitude to death and meaning in life. Collected data were analyzed as frequency, percentage, $x^2$-test, t-test using SPSS 11.0 WIN Program. Results: The attitude to death scores in the experimental group were significantly lower than in the control group (p=.000). The meaning in life scores in the experimental group were significantly higher than in the control group (p=.039). Conclusions: These findings showed that the death education program was effective to enhance the attitude to death and meaning in life among in college students. Therefore, a continuing death education program can be applied as an effective nursing intervention for other subjects.
The Journal of Korean Academic Society of Nursing Education
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v.12
no.2
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pp.151-161
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2006
Purpose: The purpose of this study was to assess the needs of RN-BSN students concerning the RN-BSN curriculum and make suggestions for improvement in the curriculum based on the needs of the students. Method: A descriptive survey study was used. Data were collected from 707 RN-BSN senior students in 21 universities. The research instrument, which was developed after in-depth interviews with 13 RN-BSN students, consisted of 10 curriculum objectives, 34 cultural courses, 48 major courses, three questions on clinical practicum, and teaching methods for 5 required courses. Result: The curriculum objectives selected by the RN-BSN students were problem solving, clinical applicability, critical thinking, creative thinking, and decision making. They wanted cultural courses such as English, understanding of human behavior, social welfare, women's studies, psychology, nutrition science, leadership, recreation, computer applications, exercise and health. They wanted major courses to include the nursing process, nursing research, health assessment, advanced adult nursing, infection control, spiritual/hospice nursing, and nursing of cancer patients. They responded that a clinical practicum was not necessary. They wanted to experience various teaching methods according to particular characteristics of subject being taught. Conclusion: This study suggests some recommendation for improvement of the curriculum based on the needs of RN-BSN students.
Purpose: From August 2017, hospice-palliative care (HPC) will be provided to patients with acquired immunodeficiency syndrome (AIDS), chronic obstructive pulmonary disease (COPD), and liver cirrhosis in Korea. To contribute to building a non-cancer (NC) hospice-palliative care model, NC specialists were interviewed regarding the goals, details, and provision methods of the model. Methods: Four physicians specializing in HPC of cancer patients formulated a semi-structured interview with questions extracted from literature review of 85 articles on NC HPC. Eleven NC disease specialists were interviewed, and their answers were analyzed according to the qualitative content analysis process. Results: The interviewees said as follows: It is difficult to define end-stage NC patients. HPC for cancer patients and that for NC patients share similar goals and content. However, emphasis should be placed on alleviating other physical symptoms and emotional care rather than pain control. Timing of the care provision should be when patients are diagnosed as "end stage". Special issues should be considered for each NC disease (e.g., use of anti-retroviral drugs for AIDS patients, oxygen supply for COPD patients suffering from dyspnea, liver transplantation for patients with liver cirrhosis) and education should be provided to healthcare professionals. NC patients tend to negatively perceive HPC, and the government's financial assistance is insufficient. Conclusion: It is necessary to define end-stage NC patients through in-depth discussion to minimize issues that will likely accompany the expansion of care recipients. This requires cooperation between medical staff caring for NC patients and HPC givers for cancer patients.
Purpose: The purpose of this study was to determine the factors that influence healthcare providers' attitude towards end-of-life care (EOLC) in the emergency department (ED) in hospital settings. Methods: From June 1 through June 30, 2014, a descriptive correlational study was performed with 41 doctors and 105 nurses stationed in the ED. Results: According to a regression model on the factors affecting healthcare providers' professional attitude towards EOLC, 28.1% of variance (F=15.185, P=0.000) was explained by awareness of death, gender and personal attitude towards EOLC. And 34.1% of the healthcare providers' personal attitude was related with awareness of death, experience of hospice education, occupations and professional attitude towards EOLC. Conclusion: This study demonstrated that attitude towards EOLC was influenced by awareness of death and personal characteristics. Healthcare providers in the ED should be provided with tailored training to improve their understanding of death. Also an educational program should be developed and provided to ED healthcare providers to improve their awareness of death.
Purpose: The purpose of this study is to investigate the current state of the home-based cancer patient management project of public health centers throughout the country. The results of the investigation is employed to identify obstacles to the execution of the program and, finally, to develop an efficient management program of home-based cancer patients. Methods: Data on the home-based cancer patient management project were collected and analyzed through visiting interviews or telephone interviews with 225 public health centers throughout the country for six months from July to December, 2006. Results: Obstacles to the present execution of the home-based cancer patient management project were identified. Some of them are : (1) patients' low trust in cancer patient management by local health centers, (2) absence of programs customized to local communities, (3) lack of personnel and vehicles for home-based cancer patient management, (4) lack of education program for personnel in charge of home-based cancer patient management, (5) problems in public health doctors, weak connection to private medical institutions, (6) absence of medical institutions and hospice facilities for cancer patients, and (7) non-standardized volunteer workers, so on. Considering all these problems, some effective management methods are proposed. The basic concept is to keep the autonomy and variety of the local helath centers. And based on this concept, three models of (1) public health center controlled model, (2) medical institutions and hospice facilities-entrusted model and (3) medical institutions and hospice facilities-cooperative model are developed. Conclusion: By adopting an adequate model among proposed three models, the public health centers are expected to achieve an efficient utilization of material resources and manpower. In addition, by inventing their own programs that are proper for the local societies, they can improve the home-based cancer patient management.
Purpose : Today, people usually die in hospitals and institution-sterile and strange, and equipped with a complex range of technology capable of supporting and prolonging life, frequently only biological one, when a return to health and vitality is no longer possible. Consequently, 'dying with dignity' has become a slogan of opposition to useless and degrading prolongation of life when a patient's organ, though still minimally functional, can no longer support or permit the exercise of self-fulfilling personal control over life's events. Dying with dignity, however, means entirely different things to different people. This study is to investigate the college students' attitude on terminal care and passive euthanasia. Methods : During June 1997, 337 college students participated in this study by responding to the pre-made questionnaire. It deft with the attitude to passive euthanasia, hospice, the most suffering fear facing the death, the preferred place and person to be with if dying. Results : 63.2% of subjects agreed to passive euthanasia. Only 14.2.% of college students can explain the concept of hospice, exactly They got the information about hospice by TV(43%), book(33.5%), religious group(12%) in order. The preferred death place was home(76.6%) and hospital(11.9%) in order. The Most suffering fear facing the death were about unknown(41.5%), loosing colleague(13.6%), pain(11%), isolation(6.5%) in order. Conclusion : About two-thirds of college students agreed to passive euthanasia. But euthanasia is dangerous and unnecessary. We should vigorously promote programmes of education in hospice and palliative medicine and care.
Purpose: The purpose of this study was to analyze the effect of death preparing education on death anxiety and meaning of life for volunteers. Methods: Data collection and intervention were carried out from January 11 to 25, 2009. The subjects included 60 volunteers in Jeonju city, and they were divided into two groups; 30 each of experimental group and control group. Death preparing education program contained 5 steps. Data were analyzed with t-test, $x^2$-test, and ANCOVA test with SPSS version 12.0. Results: The death anxiety scores in the experimental group were significantly lower than in the control group (F=4.01, P=0.046). The meaning of life scores in the experimental group were significantly higher than in the control group (F=6.32, P=0.015). Conclusion: The death preparing education program for volunteers was confirmed to be an effective intervention to lessen death anxiety and to improve the meaning of life. Therefore, I strongly recommend that this program should generously be applied to volunteers.
The Journal of Korean Academic Society of Nursing Education
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v.21
no.3
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pp.361-372
/
2015
Purpose: The purpose of this study is to present a model for R.N. and nursing students. Methods: Main primary sources were certificates, writings, news and articles. On the basis of them, her life was described over time and analyzed on the secondary sources. Results: Park Myungja faced Korean War as a nursing student and became the military officer of nursing. In 1950s and 1960s she worked hard to improve the operation room nursing. And she devoted herself to improve nursing education and help her students. Park Myungja became a military training teacher in 1972 and included first aid with the military training course. As a researcher of Korean National Open University, she tried to develop a course that R.N.s can receive a bachelor's degree in Nursing. Her last formal career was the head of a middle school, and she established the first nursery facility for the teachers. After the retirement, she devoted herself to the volunteer works, especially such as the hospice care, free clothes making, and Taichi teaching to arthritis patients. Conclusion: Park's life has been that of a R.N and volunteer. She has been very creative to find what she could do and pioneering to accomplish them.
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