• Korean Journal of Hospice Care
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• v.2 no.1
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• pp.58-74
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• 2002

This paper constitutes a descriptive investigation and used a structured questionnaire to investigate nurses' and doctors' recognition of cancer patients. The subjects were extracted from the medical personnel working at the internal medicine, the surgery ward, the obstetrics and gynecology department, the pediatrics department, the cancer ward, and the emergency room of five general hospitals located in Seoul and Gyeonggi Province. The research lasted from August, 2001 to September 2001. Total 137 nurses and 65 doctors were included and made out the questionnaires directly distributed by the investigator. The study tool was also developed by the investigator and consisted of such items as the demographic and social characteristics, the medical personnel's recognition degree of cancer and cancer patients, their recognition of the management of cancer patients, and their participation in a hospice. The results were analyzed using the SPSS Window program in terms of technological statistics, ranks, t-test, and ANOVA. The reliability was represented in Cronbach' α=.75. The nurses' and doctors' recognition degree of cancer and cancer patients had an overall average of 3.86 at the 5 point-scale. The items that received an average of 4.0 or more included 'Medical personnel should explain about the cancer cure plans to the cancer patient and his or her family', 'A patient whose case has been diagnosed as a terminal cancer should be notified of it, 'If I were a cancer patient, I would want to get informed of it,' and 'Cancer shall be conquered whenever it is'. In the meantime, the items that received an average of 3.0 or less was 'My relationship with the cancer patient's family has gotten worse since I announced his or her impending death.' And according to the general characteristics and the difference test, the recognition degree of cancer and cancer patient was high among the subgroups of nurses, females, married persons, who were in their 30s, who had a family member that was a cancer patient, and who received a hospice education. The biggest number of the nurses and doctors saw 'a gradual approach over several days'(68.8%) as a method to tell a cancer patient about his or her cancer diagnosis or impending death. Those who usually tell tragic news were the physician in charge(62.8%), the family members or relatives(32.1%) and the clergymen(3.8%) in the order. The greatest number of them recommended a cancer patient's home as the place where he or she should face death because they thought 'it would stabilize his or her mentality'(91.9%) while a number of them recommended the hospital because they 'should give the psychological satisfaction to the patient'(40%) or 'should try their best until the last moment of the patient's death'(30%). A majority of the medical personnel regarded 'smoking or drinking' and 'diet' as the causes of cancer. The biggest symptom of a cancer patient was 'pain' and the pain management of a cancer patient was mostly impeded by the 'excessive fear of drug addiction, tolerance to drugs and side effects of drugs' by medical personnel, the patient, and his or her family. The most frequently adopted treatment plan of a terminal cancer patient was 'to do whatever the patient or his or her family wants' to resort to a hospice' and 'to continue active treatment efforts' in the order. The biggest reasons why a terminal cancer patient went to see a doctor were 'pain alleviation' 'control of symptoms other than pain(intravenous supply)' and 'incapability of the patient's family' in the order. Terminal cancer patients placed their major concern in 'spiritual(religious) matter' 'emotional matters' their family' 'existence' and 'physical matters' in the order. 113(58.5%) of the whole medical personnel answered they 'would recommend' an alternative treatment to a terminal cancer patient mostly because they assumed it would 'stabilize the patient's mentality.' Meanwhile, 80(41.5%) of them chose 'not to recommend it mostly due to the unverified effects and high cost of it(78.7%). A majority of them, I. e. 190(94.1%) subjects said they 'would recommend' a hospice to a terminal cancer patient mostly because they thought it would help the patient to 'mentally prepare'(66.6%) Only 17.3% of them, however, had received a hospice education, most of which was done through the hospital duty education(41.4%) and volunteer training(34.5%). The follows are results of this study: 1. The nurses and the doctors turned out to be still passive and experience confusion in dealing with a cancer patient despite their great sense of responsibility for him or her. 2.Nurses and Doctors realize the need of a hospice, but an extremely small number of them participate in a hospice education or performance. Thus, a whole recognition of a hospice should be changed, for which purpose a hospice education for nurses and doctors should be provided. 3.Terminal cancer patients preferred their home to a hospital as the place to face their impending death because they felt it would bring 'mental stability.' And most of nurses and doctors think it would be unnecessary for them to be hospitalized just for control of their symptoms. Accordingly a terminal cancer patient can be cared at home, and a home hospice care needs to be activated.

• Journal of The Korea Institute of Healthcare Architecture
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• v.14 no.1
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• pp.39-48
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• 2008

Well-dying is as important as Well-Being because dying is also a natural part of life. Recently, due to the change of lifestyles, cancer, AIDS and other chronic diseases cause drastic increase of mortality rate. Needs for hospice services are growing as many terminal patients interested in quality of life during their end of life period. They want calm and dignity in case process as well as pain-relieving. However, there is not many researches on the architectural planning of hospice facilities and their service system as well as government regulations. This study focuses on the German hospice facilities which have developed advanced models through researches on service contents and architectural planning. The purpose of this study is to provide fundamental data for designing hospice facilities through analyzing 7 cases of German hospice facilities with different characteristics.

• 한국호스피스완화의료학회:학술대회논문집
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• 2008.07a
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• pp.19-21
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• 2008

Hospice movement in Taiwan emerged early in 1983. There was a nurse visiting terminal cancer patients by herself in Taipei city. It was ceased after one year. This stage of hospice movement might be called as "compassionate era". In early 1990, the first in-patient hospice ward was set up in north Taiwan. She demonstrated high touch in the high technology medical atmosphere. There was a great echo in Taiwan society to this action. In the following years, quite a few new hospice settings were founded. Medical professionals were aroused again to talk and think about life and death, dignity of dying and holistic care. This stage of hospice movement might be called as "ethical stage". Around 2000, obstructions were discovered in our development. We do need system and rules. Standard of setting and care, Curriculum of education and training, Accreditation system and specialist system and Nature Death Act are some of the systems we approached. This stage of hospice movement might be called as "Act stage". Among the "Act stage", the Nature Death Act is actually the mile stone in our history. What listed below are the translated one for the reference:

• Journal of Hospice and Palliative Care
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• v.10 no.1
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• pp.35-42
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• 2007

Purpose: Colorectal ranter is the 4th leading cause of cancer death in Korea and the prevalence is increasing continuously. This study was aimed to figure out the problems through the clinical consideration about terminal colorectal ranter patients who had died in hospice unit. Methods: We retrospectively reviewed the medical records in 78 patients with colorectal ranter who had admitted, received palliative care, and died in a hospice unit between April 2003 and November 2006. Results: The median age of patients was 59.6 years with 45 men (58%) and 24 women (42%). The median survival in hospice and palliative care was 36 days. The median hospitalization was 22 days. The most prevalent reason for admission was pain (38 patients, 49%), and the most common symptom was also pain (70 patients, 90%). Forty eight patients (62%) took analgesics before hospice referral. Twenty seven patients (65%) of 45 patients with intestinal obstruction have been performed palliative procedures. Median survival of patients with palliative procedure was higher than that of no palliative procedure group (47 days vs 19 days, P-value=0.005). Conclusion: The duration of hospice and palliative care was not enough to care the terminal colorectal cancer. Therefore, we suggest that proper education and information should be provided to physician, patients and their family members for effective hospice and palliative care.

• Journal of Hospice and Palliative Care
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• v.3 no.1
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• pp.39-48
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• 2000

Purpose : The purpose of the study is to disclose the spiritual needs of hospice patients. Method : The questionaire survey was carried out on 49 hospice patients and 40 caregivers who were in the 9 hospice institutions from lune to August in 1999. Results : In the patients, mean scores of the spiritual needs were significantly higher in the group with stomach cancer, college education, christians, $8{\sim}14$ days of hospice care and the group thinking that religion was important, and in the caregivers in the group of religions besides christianity and lives under $3{\sim}5$ years of medical treatment. In the total average of the spiritual needs, the patients's average was significantly lower than the caregiver's. Among the different categories, the patient's needs were highest in the area of meaning of life and the hope, the caregiver's needs in the love and the concern. However, both groups were low in the religion area. In the items of the love and the concern, the patient was highly responding to the 'wanting someone to give warm concern in conversation' and the caregiver was highly responding to the 'giving a warm response to questions on the sad and hard time'. And also, the patient was lowly responding to the 'wanting more concerns to him than other patients', and the caregiver was low responding to the 'patients wanting warm response in conversation'. In the categories of religious area both group were highly responding to the 'wanting to be helped to relax out of all'. And they gave lowest response to the 'wanting to introduce a book to know God'. In the area of meaning of life and hope, the both groups gave highest response to the 'wanting to be guided to have the hope' and lowest to the 'wanting to have opportunity to reconcile the person with bad relationship'. Conclusion : Summing up the above results, personal in-depth conversation is necessary to understand more deeply the spiritual needs of hospice patient. Moreover the hospice team needs to have more systematic approach to find out the spiritual needs of hospice patients.

• Journal of Hospice and Palliative Care
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• v.4 no.1
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• pp.47-56
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• 2001

Purpose : Surveying the effects on drop the anxiety of the hospice patients in spiritual nursing intervention with a quasi-experimental design using non-equivalent contrast group non-synchronized design to try in order to give the support which provide a holistic and individualizational nursing to comfort of hospice patients. Method : The results of survey were collected from 67 patients(67 subjects comprised 37 hospice patients of the experimental group and 30s of contrast) who were given hospice care from July to September of 2000 at the General Hospital in Cheon Ju city. The tool was used Spielberger's State Anxiety Scale, and the difference in the level of dropping anxiety among patient groups was analyzed with the mean, standard deviation, $x^2-test$. t-test and paired t-test. The spiritual nursing intervention was carried out through Hymn, Scripture, prayer, the therapeutic use of self over a period of three weeks. Results : 1) In general characters, men were a many more of the objects and the average age of the experimental and contrast group was 59.6, 55.9 respectively. The family of living together was $2{\sim}3$ members of most part. 2) There were not significant differences in the general, disease and therapeutic, religional characters between the experimental and contrast group. 3) The majority of the objects were cancer patients in disease and therapeutic characters(Experimental : 92%, Contrast : 95%). 4) After the spiritual nursing intervention state anxiety of the experimental group were remarkably lower than those of the contrast (t=-5.987, P=0.000). 5) Decreasing rate in the anxiety scores of before and post facto of the experimental group were remarkably lower than those of the contrast (t=6.237, P=0.000). Conclusion : The hospice patients who were offered spiritual nursing intervention became much lower than those who were not offered it in anxiety. Spiritual nursing intervention can be suited to field with one program of an effective that that relieved their anxieties. It is not only a very short time but has quite a little findings in part of spiritual nursing intervention. Therefore, further study in this field is necessary to concrete and substantial investigate in order to more and more increasing hospice patients in 21st century.

• Korean Journal of Adult Nursing
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• v.15 no.4
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• pp.585-595
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• 2003

Purpose: The purpose of this study was to suggest the projected manpower of hospice and palliative care nurses & APNs(advanced practice nurses)needed in the future. Method: Need model, ratio model and expert opinion were used for projecting the number of hospice and palliative care nurses & APNs. Result: 1. The number of Korean hospice facilities was 64 in 2002. The number of hospice nurses in 2001 was 194 and that of beds was 407. 2. The number of hospice target patients was estimated at a minimum of 16,415 to a maximum of 25,254 in 2002, 12,366 to 26,389 in 2005, and 14,057 to 30,000 in 2020. 3. The number of hospice and palliative nurses needed to meet the demands in 2002, 2005 and 2020 was estimated at a minimum of 1,136 to maximum of 1,748, 1,187 to 1,826, and 1,349 to 2,076, respectively. 4. The number of hospice & palliative care APNs needed to meet the demands in 2002, 2005 and 2020 was estimated at 232, 242, and 274, respectively. Conclusion: The legalization of hospice is expected to increase demands for hospice nurses and advanced practice hospice and palliative care nurses in the future.

• Journal of East-West Nursing Research
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• v.19 no.1
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• pp.7-14
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• 2013

Purpose: The purpose of this study is to compare the effect of aroma hand massage with hand massage without aroma on well-being of hospice patients. Methods: The design of this study is a quasi-experimental design. Data collection was conducted from May to December, 2012. Sixteen subjects were participated in the experimental group (aroma hand massage) and thirteen were paticipated in the control group (hand massage without aroma). The essential oil for aroma therapy was composed with 1% of Lavender and Bergamot. The aroma hand massage for the experimental group and hand massage for the control group were provided at 9 pm once a day for five days in a row. Subjects' characteristics and well-being were measured. To test the effect of aroma therapy a t-test was used with SPSS WIN 18.0. Results: There was no difference on well-being between aroma hand massage only group and hand massage group (t=1.90, p=.068). Conclusion: To develop aroma therapy to improve well-being for hospice patients, does not show that hand massage with aroma oil is superior them hand massage only for hospice patients. we recommend further studies to consider patients' preferences to aroma essential oil, aroma concentration and the time to provide aroma therapy need to be assessed.

• Journal of Hospice and Palliative Care
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• v.17 no.4
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• pp.259-269
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• 2014

Purpose: This preliminary study is aimed at developing standardized tools for psycho-social assessment of patients in needs for hospice/palliative care. To accomplish the purpose, investigators examined effects of perceptions of social workers on the importance of psycho-social domains of assessment in hospice/palliative care settings. Moreover, investigators paid attention to variances of perceptions of social workers' along with types of institution and credentials of those family settings. Methods: A form of questionnaire was first explored from an initial interview assessment of 10 government-certified hospice care providers and a literature review, second constructed with eight domains and 80 items, and sent by e-mail to 55 institutions and hospitals providing hospice/palliative cares in Korea. Lastly, a total of 31 agencies returned with a completed responses and consent form (56% response rate). SPSS program (version 18.0) was used for data analysis. Results: Study found that social workers perceived patients' family background (m=4.53, 5-point scale) as the most important assessment domain, whereas economic conditions (4.06 point) the least important. Social workers' perception varied by credentials (i.e., license types, training, full-time position, types of care facility). Conclusion: Based upon study findings, investigators can conclude strong needs for developing a assessment tool that measures multiple domains (i.e., psychological, social and ecological aspects) of patients. A standardized assessment tool should be structured with 2 axis (center/core and expanded/peripheral) and tailored for institution type. Second, professional trainings must be provided by strengthening legal institutionalization and fostering qualified social workers with full responsibilities of hospice and palliative care patients.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.6
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• pp.2861-2866
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• 2012

Background: The aim of our study was to assess the practical utility of the palliative prognostic index (PPI) as a prognostic tool used by nurse specialists in a hospice consultation setting in Taiwan. Methods: In total, 623 terminal cancer patients under hospice consultation care from one medical center in northern Taiwan were enrolled between January 1 and June 30, 2011. PPI was assessed by a nurse specialist at first hospice consultation and patients categorized into groups by prognosis (good, intermediate, poor). Patient survival was analyzed retrospectively to determine significance of between-group differences. Results: By PPI sum score, 37.2% of patients were in the good prognosis group, 18% in the intermediate prognosis group and 44.8% in the poor prognosis group. The death rates were 56%, 81.2% and 89.6% and median survivals were 76, 18 and 7 days, respectively. The hazard ratio was 0.19 (95% confidence interval [CI] 0.10-0.24, p<0.001) for the poor versus good prognosis group and 0.54 (95% CI 0.43-0.69, p<0.001) for the poor versus intermediate prognosis group. The sensitivity and specificity for the poor prognosis group was 66% and 71%; the positive predictive value and negative predictive value were 81% and 52%, respectively, to predict patient death within 21 days (area under the curve of the receiver operating characteristic was 0.68). Conclusions: Assessment by PPI can accurately predict survival of terminal cancer patients receiving hospice consultation care. PPI is a simple tool and can be administered by nurse members of hospice consultation teams.