• Title/Summary/Keyword: Home cancer patient

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Respite Care와 영적케어의 고찰

  • Sin, Min-Seon
    • Korean Journal of Hospice Care
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    • v.5 no.1
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    • pp.50-62
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    • 2005
  • The elderly people was over 8.3% in 2003. This seament is projected to grow to 14.4% by 2019(Aged society) and over 20% by 2026(Super aged society). As the elderly population is increasing and young population is declined social issues around elderly care are emerged in Korea. As a result of that, they are in the condition of poor system of the welfare of the old and it is the worst one in Korea. And because of the worst financial independence and difficulty in Korea, welfare facilities and medical instruments are so insufficient and deteriorated, so the quality of service is getting low. Furthermore the mortality of cancer is rapidely increased in recent years. So it is expected that the number of families who are caring for terminal cancer patient will be increased. We can not solve those problems only with government's policy such as to secure ample budget and to enlarge the aged welfare institutions. Definitely, to acheve the suggetions persistence concern about old people is most important, and family, community and national government should be linked to accomplish to goal. Accordingly, for this study attempts to provide conceptual framework of the respite care, spiritual care and home hospice, nursing home for the elderly. And this study is to discuss the necessity and effect about the construction of housing welfare infrastructure and to make a cooperation and linkage system among the aged welfare institutions, government and the aged welfare programs. As is well known, the issue of the increasing aged people is neither a matter of individuals nor of the family, but rather a complex matter of whol society. Therefore it can be resolved by the active participation of government. Conclusively this study tries to provide an direction of the improvement with regard to the welfare policy for the elderly. The study is as follwos: Chapters 1: The theological base, conception, essentiality, respite care, spiritual care and home hospice, nursing home for the elderly. Chapters 2: Definitions of respite care, spiritual care, hospice, patient of termina cancer and quality of life. And relations between respite care and nursing home. Chapters 3: The necessity of long-term care insurance and the perspectives of spiritual care. Chapters 4: Conclusions and summarizing(The directions of improvement of welfare policy for the elderly). To sum up, the problems of the aged people has not effects only to the aged people. This means that the problems of aged is the problems of the young generation today. Because young generation will be the old generation in the near future.

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A Need Analysis for Medical Supporting Service as a Part of Community-based Hospice Palliative Care (지역사회기반 호스피스완화케어에서의 의료지원서비스 요구분석)

  • Kwon, So-Hi;Kim, Sook-Nam;Choi, Soon-Ock;Kim, Jung-Rim;Ryu, Ji-Seon;Baik, Jeong-Won
    • The Korean Journal of Health Service Management
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    • v.10 no.4
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    • pp.109-121
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    • 2016
  • Objectives : This study was conducted to investigate the need of medical supporting service (MSS) as a part of community-based hospice palliative care from the view point of beneficiaries and providers. Methods : This study adopted a methodological triangulation design. A questionnaire regarding intention to use MSS was completed by 175 patients under home-based cancer patient management program. And three focus groups consisted of hospice nurses, public health physicians, and public officials were interviewed to obtain the perceived needs, obstacles, and solutions of MSS. Results : Mean age of home-based cancer patient was 70.18 year old, 48.0% of them were living alone. Only 53.7% of them were treated pain and 93.7% intend to take pain medication prescribed by public health physician. All participants of focus group interviews agreed necessity and importance of MSS. Physicians' lack of confidence and unwillingness to prescribe opioid to terminal patients was the biggest obstacle to provide MSS in the public health center. Conclusions : The necessity and demand of MSS for community-dwelling cancer patients were verified. MSS is urgent issue to meet their needs.

Analysis of Characteristics and Symptoms in Home-Based Hospice-Palliative Care Patients Registered at Local Public Health Centers (일 지역 보건소 등록 호스피스 완화돌봄 대상자의 특성 및 증상 분석)

  • Choi, Soon-Ock;Kim, Sook-Nam
    • Journal of Hospice and Palliative Care
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    • v.18 no.4
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    • pp.329-334
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    • 2015
  • Purpose: This study was aimed at analyzing the characteristics and symptoms in home-based hospice-palliative care (HBHPC) patients registered at local public health centers. Methods: A retrospective study was performed; Data of 144 HBHPC patients registered at six public health centers in Pusan City were analyzed, including their initial visit records (registration cards, initial pain evaluation and symptom evaluation). Results: The average age of the patients was 67.7 years old. Among all, 46.2% of the patient lived alone, and 65% had middle school education or lower. The most popular (36.3%) religion was Buddhism, and 47.5% received medical assistance from the government. The most frequent diagnosis was lung cancer followed by stomach cancer and liver cancer in that order. Of all, 48.9% were functionally too weak to lead a daily life, 39.6% were under cancer treatment when registered at the public health center, and 84.5% were aware of the fact that they have reached the terminal phase. Moreover, 83.6% complained about pain, and the pain level was moderate or severe in 36.5% of them. Besides pain, fatigue was the most complained symptom (84.7%), and 49.3% of them rated their fatigue as moderate or severe. Conclusion: Most of the HBHPC patients were socio-economically underprivileged and complained about moderate or worse pain and symptoms. Therefore, it appears necessary to develop an integrated strategy that is tailored for each patient reflecting their characteristics.

The Relationship between Infection Prevention Behaviors and Barriers among Cancer Patients Undergoing Chemotherapy (항암화학요법을 받는 암환자의 감염예방 행위와 장애요인의 관계)

  • Lee, Young-Ran;Kwon, In-Soo
    • Asian Oncology Nursing
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    • v.7 no.2
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    • pp.150-161
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    • 2007
  • Purpose: This study was to assess the degree of infection prevention behaviors at home, and a relationship between those behaviors and barrier factors among cancer patients undergoing chemotherapy. Method: The data were collected from 92 cancer patients who were undergoing chemotherapy with more than two kinds of immunosuppressive agents at G university hospital in J city from February 17 to April 4, 2003. The instruments were the infection prevention behavior scale developed by researchers and the barrier factor scale by Gu et al. (2003). The data were analysed using mean, standard deviation, t-test, ANOVA, and Pearson's correlation coefficient by SPSS program. Results: The mean score of the behaviors for infection prevention was 2.61 of 4. The highest score was on the subscale 'rest and exercise', and the lowest score was on the subscale 'monitoring sign and symptom of infection'. And a negative correlation(r= -.208, p= .023) was found between infection prevention behaviors and barrier factors. The barriers correlated to infection prevention behaviors were mainly 'no habits' and 'no interest'. Conclusion: It seems that the degree of the behaviors for infection prevention was not performed enough to prevent infection among cancer patients. And there was negative relationship between infection prevention behaviors and barriers. We suggest to develop a nursing intervention program to enhance infection prevention behaviors through reducing the barrier factors.

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Pain Management Knowledge and Attitude of Internal Medicine and Surgery Stream Nurses (내.외과계 간호사의 통증 관리에 대한 지식 및 태도)

  • Song, Seung-Sun;Park, Chai-Soon
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.17 no.1
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    • pp.55-62
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    • 2010
  • Purpose: This study investigated the sought to identify the pain management knowledge and attitude of nurses in internal medicine and surgery stream wards and intensive care units to obtain basic information needed for improved pain control. Method: Data was collected through self-reported questionnaires and analyzed by descriptive statistics, t-test and ANOVA using SPSS Win 12.0. Results: Pain management knowledge score averaged 51.1 out of 100, with significant differences evident depending on age, marital status, educational level, position, total work career, working department and cancer care-giving experience. Pain management attitude score averaged 2.9 out of 4, and significant differences were evident depending on age, marital status, educational level, position, total work career, working department, cancer care-giving experience, education experience and number of patients treated. Conclusion: Further studies are necessary to develop effective nursing knowledge and attitude education programs and evaluation such as discussion by cases, workshops, system of expert help for uncontrollable pain or a multi-disciplinary pain management task force. In addition, patient satisfaction level with pain management should be assessed and the responses reflected practically.

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Evaluation of a Community-Based Cancer Patient Management Program: Collaboration between a Hospice Center and Public Health Centers (병원 호스피스센터-보건소 연계를 통한 지역사회 재가암환자 관리 프로그램 평가)

  • Lee, Hae-Sook;Park, Sun-Hee;Chung, Young-Soon;Lee, Boo-Kyung;Kwon, So-Hi
    • Journal of Hospice and Palliative Care
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    • v.13 no.4
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    • pp.216-224
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    • 2010
  • Purpose: The purpose of this study was to evaluate a community-based cancer patient management program (CBPCMP) which was collaborated between a hospice center and public health centers. Methods: The CBPCMP proceeded on four steps; 1) Signing agreements with three public health centers, 2) Enrolling the domiciliary terminal cancer patients, 3) Providing home hospice service, and 4) Inquiring patient's level of satisfaction. From February 1 to December 31 in 2009, 43 terminal cancer patients were referred and provided with home hospice service. The hospice team made a total of 605 visits. Medical records for each visit and data from satisfaction surveys were analyzed. Results: 76.7% of patients were older than 60 years, and 90.7% of the patients were alert. The level of functional status for 76.7% of patients rated as lower than ECOG grade 1. 62.8% of the patients or their caregivers signed hospice service agreements. On the initial evaluation, the most frequent reasons for referral were general weakness (86.0%), followed by anorexia (72.1%). Nurses visited the patients' most frequently (371 visits), followed by volunteers (216 visits). Nurses provided emotional support and health promotion counseling on 95.1% and 22.9% of visits, respectively. The mean satisfaction score rated by patients and their family was 4.45 out of 5. Conclusion: This study tested CBPCMP in collaboration with hospice centers and public health centers. CBPCMP showed a possibility to improve the quality of end of life care. To insure the quality care, however, the guidelines for home hospice service should be developed.

Effects of a Discharge Education Program using Computerized Animation Video for Post-operative Colon Cancer Patients (대장암 수술 후 퇴원 환자에게 적용한 컴퓨터 기반 애니메이션 동영상 교육의 효과)

  • Kim, Young Mee;Kim, Min Young;Kwon, Won Kyoung;Kim, Ho Sook;Park, Seung Hyun;Chun, Myoung Sook;Han, Hye Jung
    • The Korean Journal of Rehabilitation Nursing
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    • v.16 no.1
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    • pp.37-46
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    • 2013
  • Purpose: This study was to identify the effects of a nurse-led education program using computerized animation video for post-operative colon cancer patients. Methods: a total of 163 patients and 51 nurses were participated in this study. With a non-equivalent control group post-test design, patients were divided into three groups (77 got traditional education, 46 were applying brochure, 40 were watching video). Twelve-item animation video and brochure about the management after discharge for post-operative colon cancer patients were developed based on patient survey and the items of Korea Healthcare Accreditation. Results: The computerized video watching group had better satisfaction than the others, but there was no significant difference about comprehension. When video was applied, satisfaction, usefulness, application, and perceived patients' comprehension of nurses were all increased. Conclusion: This video education program was developed by nurses and it had a special thing for patient to access the same program even after discharge using the authorization system. It would be helpful for nurses to be more concentrated on the direct care for hospitalized patients as well as for patients to provide self-care at home. This program would be adjusted into more various diseases and settings.

The Study on the Medical and Nursing Service Needs of the Terminal Cancer Patients and Their Caregivers (말기암 환자와 가족의 의료 및 간호 서비스 요구)

  • 이소우;이은옥;허대석;노국희;김현숙;김선례;김성자;김정희;이경옥
    • Journal of Korean Academy of Nursing
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    • v.28 no.4
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    • pp.958-969
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    • 1998
  • In this study, we attempted to investigate the needs and problems of the terminal cancer patients and their family caregivers to provide them with nursing information to improve their quality of life and prepare for a peaceful death. Data was collected from August 1, 1995 to July 31, 1996 at the internal medicine unit of S hospital in Seoul area with the two groups of participants who were family members of terminal cancer patients seventy four of them were in-patients and 34 were out-patients who were discharged from the same hospital for home care. The research tool used in this study has been developed by selecting the questionnaires from various references, modifying them for our purpose and refining them based on the results of preliminary study. While general background information about the patients was obtained by reviewing their medical records, all other information was collected by interviewing the primary family caregivers of the patients using the questionnaire. The data collected were analyzed with the SPSS PC/sup +/ program. The results of this study are summarized as follows ; 1) Most frequently complained symptoms of the terminal cancer patients were in the order of pain(87%), weakness(86.1%), anorexia(83.3%) and fatigue (80.6%). 2) Main therapies for the terminal cancer patients were pain control (58.3%), hyperalimentation(47.2%) and antibiotics(21.3%). 3) Special medical devices that terminal cancer patients used most were oxygen device (11.1%), and feeding tube(5.6%). Other devices were used by less than 5% of the patients. 4) The mobility of 70.4% of the patients was worse than ECOG 3 level, they had to stay in bed more than 50% of a day. 5) Patients wanted their medical staffs to help relieve pain(45.4%), various physical symptoms(29.6%), and problems associated with their emotion(11.1%). 6) 16.7% of the family caregivers hoped for full recovery of the patients, refusing to admit the status of the patients. Also, 37% wished for the extension of the patient's life at least for 6 months. 7) Only 38.9% of the family members was preparing for the patient's funeral. 8) 45.4% of family caregivers prefer hospital as the place for the patient's death, 39.8% their own home, and 14.8% undetermined. 9) Caregivers of the patients were mostly close family members, i.e., spouse(62%), and sons and daughters or daughter-in-laws(21.3%). 10) 43.5% of the family caregivers were aware of hospice care. 46.8% of them learned about the hospice care from the mass media, 27.7% from health professionals, and the rest from books and other sources. 11) Caregivers were asked about the most difficult problems they encounter in home care, 41 of them pointed out the lack of health professionals they can contact, counsel and get help from in case of emergency, 17 identified the difficulty of finding appropriate transportation to hospital, and 13 stated the difficulty of admission in hospital as needed. 12) 93.6% of family caregivers demanded 24-hour hot line, 80% the visiting nurses and doctors, and 69.4% the volunteer's help. The above results indicate that terminal patients and their family caregivers demand help from qualified health professionals whenever necessary. Hospice care system led by well-trained medical and nursing staffs is one of the viable answers for such demands.

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Comparison of the Casts of Care and Nursing Services for Terminally III Patients Receiving Home Hospice Care in Comparison to Institutional Care (말기 폐암환자를 대상으로 한 가정 호스피스와 병원입원치료의 비교 -서비스 내용과 건강관리비용 중심-)

  • Lee, Tae-Wha;Lee, Won-Hee;Kim, Myung-Sil
    • 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.

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Needs of Home Care Nursing Services for Hospital Patients (재원환자의 질환군에 따른 가정간호 요구도)

  • Han, Sung-Suk;Kim, Soon-Lae;Lee, So-Young;Kwon, Eun-Ha
    • Research in Community and Public Health Nursing
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    • v.18 no.1
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    • pp.165-176
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    • 2007
  • Purpose: The purpose of this study was to investigate the needs of home care nursing services in relation to the patients in hospital. Method: Subjects were 129 patients who admitted hospital and were selected through convenience sampling. Data were collected using the Home Health Care Need Assessment Questionnaire constructed by the Korea Health Industry Development Institute. Data were analyzed using SAS 8.12 program by applying percentage. Results: 1. According to the diagnosis of the subjects, the majority had cancer (25.0%), followed by musculoskeletal disease (15,6%), neuro/cerebral vascular disease (14.1%), digestive (10.9%) and respiratory disease (10.9%). 2. With regard to fundamental nursing service, subjects wanted to receive home care services for the following reasons: Problem identification and diagnosis (77.5%), vital sign check (49.6%); and intake and output measure (20.9%). 3. With regard to clinical laboratory tests, 62.8% wanted to receive blood tests, and followed by urine tests 26.4%, and wound drainage 26.4%. 4. With regard to medication and treatment service, 40.3% of the subjects wanted to receive intravenous fluid therapy, 26.4% intravenous antibiotics, and 26.4% the monitoring of fluid therapy. 5. With regard to therapeutic nursing service, 33.3% wanted to receive wound care, 26.4% ROM exercise, and 27.9% foley catheter change and care. 6. With regard to educational needs, 42.6% wanted education on infection monitoring, 41.4% on medication, and 34.9% on diet. 7. With regard to counseling needs, 65.9% wanted to receive telephone counseling about patient condition, 52.7% counseling about re-admission and 51.9% direct counseling about patient condition. In the group of injury and toxicity, and cardiovascular/circulatory diseases, 100% wanted telephone and direct counseling about the patient condition. Conclusion: Therefore, in order to improve the quality of hospital based home health care services, various factors that affect to the need of home health care should be analyzed and specified nursing care should be looked into.

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