Hospice Care is the best way to care for terminally ill patients and their family members. However most of them can not receive the appropriate hospice service because the Korean health delivery system is mainly be focussed on acutly ill patients. This study was carried out to clarify the situation of hospice in Korea and to develop a hospice care delivery system model which is appropriate in the Korean context. The theoretical framework of this study that hospice care delivery system is composed of hospice resources with personnel, facilities, etc., government and non-government hospice organization, hospice finances, hospice management and hospice delivery, was taken from the Health Delivery System of WHO(1984). Data was obtained through data analysis of litreature, interview, questionairs, visiting and Delphi Technique, from October 1998 to April 1999 involving 56 hospices, 1 hospice research center, 3 non-government hospice organizations, 20 experts who have had hospice experience for more than 3 years(mean is 9 years and 5 months) and officials or members of 3 non-government hospice organizations. There are 61 hospices in Korea. Even though hospice personnel have tried to study and to provide qualified hospice serices, there is nor any formal hospice linkage or network in Korea. This is the result of this survey made to clarify the situation of Korean hospice. Results of the study by Delphi Technique were as follows: 1.Hospice Resources: Key hospice personnel were found to be hospice coordinator, doctor, nurse, clergy, social worker, volunteers. Necessary qualifications for all personnel was that they conditions were resulted as have good health, receive hospice education and have communication skills. Education for hospice personnel is divided into (i)basic training and (ii)special education, e.g. palliative medicine course for hospice specialist or palliative care course in master degree for hospice nurse specialist. Hospice facilities could be developed by adding a living room, a space for family members, a prayer room, a church, an interview room, a kitchen, a dining room, a bath facility, a hall for music, art or work therapy, volunteers' room, garden, etc. to hospital facilities. 2.Hospice Organization: Whilst there are three non-government hospice organizations active at present, in the near future an hospice officer in the Health&Welfare Ministry plus a government Hospice body are necessary. However a non-government council to further integrate hospice development is also strongly recommended. 3.Hospice Finances: A New insurance standards, I.e. the charge for hospice care services, public information and tax reduction for donations were found suggested as methods to rise the hospice budget. 4.Hospice Management: Two divisions of hospice management/care were considered to be necessary in future. The role of the hospice officer in the Health & Welfare Ministry would be quality control of hospice teams and facilities involved/associated with hospice insurance standards. New non-government integrating councils role supporting the development of hospice care, not insurance covered. 5.Hospice delivery: Linkage&networking between hospice facilities and first, second, third level medical institutions are needed in order to provide varied and continous hospice care. Hospice Acts need to be established within the limits of medical law with regards to standards for professional staff members, educational programs, etc. The results of this study could be utilizes towards the development to two hospice care delivery system models, A and B. Model A is based on the hospital, especially the hospice unit, because in this setting is more easily available the new medical insurance for hospice care. Therefore a hospice team is organized in the hospital and may operate in the hospice unit and in the home hospice care service. After Model A is set up and operating, Model B will be the next stage, in which medical insurance cover will be extended to home hospice care service. This model(B) is also based on the hospital, but the focus of the hospital hospice unit will be moved to home hospice care which is connected by local physicians, national public health centers, community parties as like churches or volunteer groups. Model B will contribute to the care of terminally ill patients and their family members and also assist hospital administrators in cost-effectiveness.
Purpose: The appropriate duration for effective hospice care is estimated about 3 months. However, the length of hospice care of many hospice patients is mostly less than 1 months. This is too short for effective hospice care. Therefore we investigated the reason by clinical considuations include the length of hospie care, duration from diagnosed as terminatlly ill to refer to hospice, the recogntion of hospice of doctors, patients and familis. Methods: This study was designed to retrospective cohot study. The data was obtaind from 50 hospice patients those who died in hospital from July to September in 2003. Results: Out of 50 patient, 30 were male(60%). The median age wes 60years in males and was 61 years in femailes. The most prevalant cancer was colorectal cancer(9 patients, 18%), followed by hepatoma(8 patients, 16%), and stomach cancer(7 patients, 14%). The most prevalent symptom was pain(37 patients 74%) and most prevalant reason of admission was also pain(30 patients, 60%). The most prevalent physician specialty was general internal medicine(21 doctors, 42%), followed by oncology(19 doctors, 38%). The median days form diagnosed terminally ill to refere to hospice was 47 days. The median lengths of hospice care was 23 days and the median admission days was 17. Conclusion: We found that lack of recognition of hospice of doctors, patients and families made the lengths of hospice care too short. If the patient and family go to hospice just after diagnosed as terminally ill, they could get more effective hospice care. To resolve these problems, it is needed education for them constantly.
Hospice can not only help the dying persons to maintain the high quality of life and facing the death in comfortable and peaceful state, but also the bereaved family to relieve the grief and sufferings. We investigated the work of hospice performed by church base from March 2000 until recently and reported the results dividing them into three parts. 1)The application of resources in church to administration, education, nursing delivery of hospice in the aspects of management. 2)Spiritual and postmortal management relating hospice nursing and funeral in hospice practice. 3)Case report of hospice and the patients situation(5 in average a month). The expected effects of hospice practice using the resources in church are as follows. 1)Hospice practice can provide the highly qualified persons with the opportunities to do voluntary services and find their lives worth living. Consequently hospice contributes to the spreading of the volunteering culture. 2)The volunteers in hospice can grow mature spiritually and get interpersonal relationships among the volunteers. Doyle. D., Geoflrey.W.C., & Macdonald. N.(1988). Oxford Textbook of Palliative Medicine(2nd ed). New York :Oxford University Press. Woodruff. R.(1996). Palliative Medicine(2nd ed). Melburn: Asperula Pty Ltd. 3)Through the hospice activity, church can practice and show the moral. 4)The volunteers in hospice can make a organization with a hope to be a beautiful community in church. 5)The patients and their families can enjoy the high quality of life through the holistic care provided by 33 nursing practical items of hospice. 6)'Hospice newsletter' can be a useful vehicle to provide readers with hope and encouragement through the stories of the patient and the volunteers. The persons unaware of the hospice can be contacted with hospice by this 'Hospice newsletter'. 7)Irrespective of the economic status, all patients are served equally that hospice can contribute to dying with dignity and the equality of human being.
Journal of Korean Academy of Fundamentals of Nursing
Purpose: The purpose of study was to identify the death orientation and cognition, attitude and nursing needs in hospice care according to training of volunteers. Method: Data were collected using a structured questionnaire which included characteristics, death orientation and cognition, attitude and nursing needs in hospice care. Data collection was done between June 1st and 20th, 2003. The participants in the study were the 86 trained hospice volunteers and 76 non-trained hospice volunteers. The data were analyzed using the SPSS/PC+ program. Result: The results are as follows: There was a significant difference in the average for the death orientation scores between non-trained hospice volunteers and trained hospice volunteers. There was a significant difference for the cognition of hospice and attitude, with higher responses being given by the hospice trained group. For the domains of nursing needs in hospice care, the highest response was to emotional needs. Conclusion: This study showed that training in hospice care was effective in changing the death orientation, cognition, attitude and nursing needs in hospice care.
Purpose: This study was to find out hospice nurses and other health professionals' perception on the system of hospice and palliative nurse specialist. Methods: Using questionnaire, 63 nurses and 22 other health professionals answered about the benefit required qualification, workforce standard, and the extent of autonomy needed for hospice and palliative nurse specialist. Data was collected from August, 2002 to November, 2002. and analyzed by using SPSS 10 program. Results: 1) 96.4% of the subjects perceived that hospice nurse specialist will improve the quality of care and patient satisfaction. 2) The most frequent response for the type of education required for hospice nurse specialist was one year post RN program. 3) The most frequent response for the required clinical experience of hospice nurse specialists was minimum of four to five years. 4) The most important qualification for the hospice nurse specialists was an "good relationship with others", and "clinical experience". 5) One to two hospice nurse specialist per hospice facility was viewed as a sufficient number. 6. Autonomy was viewed as the most important characteristic which should be granted to hospice nurse specialist. Conclusion: The results of this study can be used as a basic information in establishing hospice nurse specialist program.
The conecpt of hospice care for the terminally ill is a development of relatively modern times, although it has its origins in antiquity. The hospice will be able to handle progressively more and more patient, to the limit of its resources. The purposes of this study were to review of demand and issues of the hospice care programes and to recommand the hospice care approaches in south Korea that using the book-review method. At this point, although at present there is a general unawareness of hospice throughout Korean society, the public will become gradually aware of hospice. This will thus aid the development of hospices. Awareness will come about because of the educational efforts of medical schools, nursing schools, allied health training programs, practicing hospice care giver, universities, and others interested in hospice education. At present, there are many issues of the hospice care program that are hospice resources problems of manpower, facilities, finances, and cost of hospice services, quality of care, and ethics. Additional studies are needed to determine the most efficacious organizational hospice models for varying conditions. They will insist upon reasonable regulatory agency regulations that will promote the hospice idea and. permit adequate remuneration for services provided. More research is needed on health professionals', patients', and others' attitudes towards death.
Purpose: This study aimed to identify the relationships among attitudes towards death, perceptions of hospice care, and hospice care needs as perceived by family members of patients in the intensive care unit (ICU). Methods: This study used a descriptive correlational method. A structured questionnaire was used to collect data from 114 participating families in the ICU at Dong-A University Hospital, from October 10 to November 1, 2019. The data were analyzed in terms of frequency, percentage, and mean and standard deviation. The t-test, one-way analysis of variance, and Pearson correlation coefficients were also conducted. Results: Perceptions of hospice care showed significant differences according to age (F=3.06, P=0.031) and marital status (t=3.55, P=0.001). However, no significant differences in attitudes towards death or hospice care needs were found. A significant positive correlation was found between perceptions of hospice care and hospice care needs (r=0.49, P<0.001). Conclusion: In order for families to recognize the need for hospice care and to receive high-quality palliative care at the appropriate time, it is necessary to increase public awareness of hospice care through various educational and awareness-raising efforts, thereby providing opportunities for families of terminally ill patients to request hospice care.
Journal of The Korea Institute of Healthcare Architecture
The hospice movement evolved as an alternative to hospitals as places to die. Recently, the palliative care for dying and hospice has been developed rapidly and placed itself as one of the medical systems. But the studies on hospice program and establishment method in Korea are few or no in comparison with developed countries. Hospice unit within a general hospital is more efficient hospice type than other terminal care establishments, therefor it will be developed rapidly. With this in mind, this study puts elements of architectural planning on the hospice unit for the space requirements. Also, It is investigated the architectural conditions of hospice unit within a general hospital, analyzed the unit space and spatial composition in hospice unit. The purpose of this study is to propose the fundamental data and unit space for architectural plan and design.
This study was done to examine spiritual well-being of hospice care service volunteers for the purpose of providing them with programs promoting coping skills in response to the wholistic needs of patient effectively, also providing data for professional or nonprofessional hospice training program. Subjects were 123 volunteers serving in 6 hospice centers in Jeonbuk province at present. Data collection were done from 16 Oct. 2000 to 17 Nov. 2000. questionnairs were consisted of activities of hospice care service volunteer and spiritual well-being. The study results were as follows 1.Mean of activities of hospice care service volunteers were 2.433, those activities were divided into 5 categories such as spiritual, activities of volunteer for themselves, psychosocial, physical area and bereavement. The highest mean score was spiritual area 2.578, activities of volunteers for themselves 2.525, psychosocial area 2.456, physical area was 2.359 and the lowest mean score was bereavement area 2.130. 2.Spiritual well-being of hospice care service volunteers was 5.25, the highest mean. In subcategories of spiritual well-being, religious spiritual well-being was higher than existential spiritual well-being, mean score for each one was 5.41, 5.10. 3.Statistically significant relations among demographic characteristics such as gender(t=2.72, P=.008), status of marriage(t=6.067, P=.003), occupation(F=3.795, P=.025), frequency of visiting for volunteered hospice care(F=3.833, P=.024) were noted. 4.Statistically significant demographic characteristics of hospice service volunteers was religion(t=-4.38, p=0.000), status of marriage(F=3.505, p=0.033), frequency of visiting for volunteered hospice care(F=3.107, p=0.048), level of satisfaction from hospice care volunteer service(F=3.610, p=0.030), hospice service volunteers doing more home visiting(5-9times/month) had higher status of spiritual well being than volunteer with less home visiting(1-4times/month) 5.A significant relationship between activities of hospice service volunteers and status of spiritual well-being was noted(r=.236, p=.004), activities of hospice service volunteers was related to both subcategories of spiritual well-being such as religious well-being(r=.210, p=.010) and existential well-being(r=.208, p=.011). From the results of the study It is noted that status of spiritual well-being for hospice volunteers influences on service activities. It means spiritual well-being should be considered as a essential character for hospice service volunteers, it also means that managing and maintaining of status of spiritual well-being for hospice service volunteers is important. On the base of the study recommendation are made as follows: 1.Considering status of spiritual well-being for hospice care service volunteers is needed to promote hospice care activities. 2.It is necessary to develope spiritual well-being programs for hospice care service volunteers and further study for effect validation of them is needed. 3.Further study to sort out effecting variables for hospice care service volunteer activities is needed. 4.It will be desirable to have spiritual well-being information included in the hospice education program.
The advances of medical technologies have not only prolonged human life span, but also extended suffering period for the patients with incurable medical diseases. Hospice movement was developed to help these patients keep dignity and lives peaceful at the end of their life. Since many patients prefer to spend the last moment of life at home with their family, hospice home care has become very popular worldwide. The purpose of this study for a promotion and development of hospice home care in Korea, and features basic research on medical profession's knowledge and attitudes to hospice home care. This study which was used for the research questionnaires developed by the researcher that were answered by 100 physicians and 127 nurses in a general hospital. Data were collected from April 22, 2002 to May 10, 2002. The SPSS was used to make a comparative analysis of the frequency, percentile, ANOVA, and x2-test. The results of the study were as follows; 1.The medical profession showed high level of knowledge of the definition and philosophy of hospice. However, the physician group of the examinees showed insufficient knowledge of the fact that hospice care includes bereavement care, while the nurse group's response to the same question showed a significant difference(x2=10.752, p=.001). 2.For whom the hospice home care is provided, 95.6% of the respondents showed very high level of knowledge as answering that the incurable terminal illness patients and their families are the beneficiaries of hospice care. The respondents counted nurses, volunteers, pastors, physicians and social workers, consecutively, as hospice care providers. More nurse were positive toward pastors than physicians in regarding as a hospice care provider by a significant difference(x2=11.634, p=.001). 3.For when to referral hospice home care to the patients, only 34.2% answered that patients with less than 6 months of survival time are advised to receive hospice care, reflecting very low level of knowledge. 23.0% of the physicians and 48.0% of the nurses answered that hospice care should be provided when death is imminent, making a significant difference between the two groups(x2=6.413, p=.000). 4.To promote hospice activities, 87.2% pointed out that it is crucial to make general people, including those engaging in the medical field, more aware of hospice. 79.7% answered that a national hospice management should be developed, marking a significant difference between the physician group and nurse group(x2=10.485, p=.001). 5.Advantages of hospice home care are 87.2% responded that patients can have better rest at home receiving hospice home care. Economical merit was brought forward as one of the advantages also, where there was a significant difference between the physicians group and nurse group(x2=7.009, p=.008). 6.The medical professions' attitude to hospice home care are 92.8% of the physicians answered that they would advise incurable terminally ill patients to be discharged from hospital, with 44.3% of them advising the patients to receive hospice home care after leaving the hospital. From the nurses' point of view, 20.9% of the terminally ill patients are being referred to hospice home care after discharge, which makes a significant difference from the physicians' response(x2=19.121, p=.001). 7. 30.6% of physicians have referred terminally ill patients to hospice home care, 75.9% of whom were satisfied with their decision. Those physicians who have never referred their patients to hospice home care either did not know how to do it(66.7%) or were afraid of losing trust by giving the patients an impression of giving up(27.3%). 94.9% of the physicians responded that they would refer their last stage patients to a doctor who is involving palliative care. 8.Only 36.2% of nurses have suggested to physicians that refer the terminally ill patients discharged from the hospital to hospice home care. Once suggested, 95.8% of the physicians have accepted the suggestion. Nurses were reluctant to suggest hospice home care to the physicians, as 48.8% of the nurses said they did not want to. From the result of this study the following conclusion can be drawn, the medical profession's awareness of general hospice care has been increased greatly compared to the results of the previously performed studies. However, this study result also shows that their knowledge of hospice home care is not good enough yet. There is a need for high recommended that medical education institute and develop regular courses on various types of hospice care. Medical field training courses for physicians and nurses will be very helpful as well. It is also important to train hospice experts such as palliative physicians and develop a national hospice management urgently in order to improve the hospice care in Korea.
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