• Title/Summary/Keyword: Hospice and Palliative Care

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Education, Role, and Prospects of Advanced Practice Nurses in Hospice and Palliative Care in South Korea

  • Kwon, So-Hi;Park, Myung-Hee;Kim, Hyun Sook
    • Journal of Hospice and Palliative Care
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    • v.24 no.1
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    • pp.1-12
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    • 2021
  • Hospice palliative care refers to holistic care provided by an interdisciplinary team aimed at improving the quality of life of patients suffering from life-threatening diseases and their families. Among interdisciplinary team members, hospice advanced practice nurses (APNs) trained as master's-level advanced nursing professionals are leaders who play an important role in providing patient-centered care and improving the quality of services. The Medical Service Act revised in 2018 requires the scope of practice of APNs in each field to be specified in the Ordinance of the Ministry of Health and Welfare. Accordingly, discussions on the role and scope of practice of hospice APNs are actively underway. In this review, the curriculum of hospice APNs, their work responsibilities and roles, and their current status are reviewed, and the future direction of the hospice APN system is also discussed.

Ethical Considerations in Hospice and Palliative Care Research (호스피스 완화의료 연구에서의 윤리적 고려사항)

  • Youn, Gahyun
    • Journal of Hospice and Palliative Care
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    • v.22 no.2
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    • pp.49-66
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    • 2019
  • Along with the advances in medical technology and the economic development, more terminally ill patients are receiving hospice and palliative care services. Moreover, hospice and palliative care clinicians have been showing considerable interest in studies that aim to improve the quality of said care for patients and their families. Meanwhile, after the government has strengthened its policy to protect research participants, the institutional review boards (IRBs) are more closely examining various ethical issues related to patients' vulnerability when reviewing protocols for hospice and palliative care research. However, terminally ill patients should be provided with guaranteed qualities of hospice and palliative care to improve and maintain their quality of life. To that end, support should be provided for efforts to conduct ethical and safe studies with hospice and palliative care patients. Thus, this review paper proposes ethical guidelines for hospice and palliative care research. The guidelines could be appropriately used as a reference for researchers who should prepare for ethically safe and scientifically valued research protocols and the IRBs that will review the protocols.

Spiritual Care Guide in HospiceㆍPalliative Care

  • Kyung-Ah Kang;Do-Bong Kim;Su-Jin Koh;Myung-Hee Park;Hye Yoon Park;Deuk Hyoung Yoon;Soo-Jin Yoon;Su-Jeong Lee;JI-Eun Choi;Hyoung-Suk Han;Jiyoung Chun
    • Journal of Hospice and Palliative Care
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    • v.26 no.4
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    • pp.149-159
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    • 2023
  • The Spiritual Care Guide in HospiceㆍPalliative Care is evidence-based and focuses on the universal and integral aspects of human spirituality-such as meaning and purpose, interconnectedness, and transcendence-which go beyond any specific religion. This guide was crafted to improve the spiritual well-being of adult patients aged 19 and older, as well as their families, who are receiving end-of-life care. The provision of spiritual care in hospice and palliative settings aims to assist patients and their families in finding life's meaning and purpose, restoring love and relationships, and helping them come to terms with death while maintaining hope. It is recommended that spiritual needs and the interventions provided are periodically reassessed and evaluated, with the findings recorded. Additionally, hospice and palliative care teams are encouraged to pursue ongoing education and training in spiritual care. Although challenges exist in universally applying this guide across all hospice and palliative care organizations in Korea-due to varying resources and the specific environments of medical institutions-it is significant that the Korean Society for Hospice and Palliative Care has introduced a spiritual care guide poised to enhance the spiritual well-being and quality of care for hospice and palliative care patients.

Critical Care Nurses' Attitudes toward Hospice and Palliative Care and their Related Factors (중환자 간호사의 호스피스·완화의료에 대한 태도와 이에 영향을 미치는 요인)

  • Seol, Eun Mi;Koh, Chin Kang
    • Perspectives in Nursing Science
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    • v.12 no.2
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    • pp.94-105
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    • 2015
  • Purpose: The study purpose was to describe critical care nurses' attitudes toward hospice and palliative care and their related factors. Methods: In this cross-sectional descriptive study, 175 critical care nurses who worked at a general hospital in Seoul participated via self-report survey. The Frommelt Attitude Toward Care of the Dying Scale was used to measure their attitudes, and a palliative care quiz for nursing was used to measure their knowledge about hospice and palliative care. Results: Education level, duration of nursing employment, duration of critical care nursing employment, and knowledge about hospice and palliative care were significantly associated with nurses' attitudes. In the multiple regression analysis, education level, and duration of nursing employment were significant predictors of nurses' attitudes. Conclusion: These findings suggest that education programs to improve nurses' knowledge about hospice and palliative care should be developed. These will help critical care nurses obtain a positive attitude toward hospice and palliative care.

Hospice and Palliative Care for Patients in the Intensive Care Unit: Current Status in Countries Other than Korea

  • Minkyu Jung
    • Journal of Hospice and Palliative Care
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    • v.26 no.1
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    • pp.22-25
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    • 2023
  • Although most patients prefer dying at home, patients whose condition rapidly becomes critical need care in the intensive care unit (ICU), and it is rare for them to die at home with their families. Therefore, interest in hospice and palliative care for patients in the ICU is increasing. Hospice and palliative care (PC) is necessary for all patients with life-threatening diseases. The following patients need palliative care in the ICU: patients with chronic critical illnesses who need tracheostomy, percutaneous gastrostomy tube, and extracorporeal life support; patients aged 80 years or older; stage 4 cancer patients; patients with specific acute diseases with a poor prognosis (e.g., anoxic brain injury and intracerebral hemorrhage requiring mechanical ventilation); and patients for whom the attending physician expects a poor prognosis. There are two PC models-a consultative model and an integrative model-in the ICU setting. Since these two models have advantages and disadvantages, it is necessary to apply the model that best fits each hospital's circumstances. Furthermore, interdisciplinary decision-making between the ICU care team and PC specialists should be strengthened to increase the provision of hospice and palliative care services for patients expected to have poor outcomes and their families.

Influence of Nurses' Attitude toward Death and Perception of Hospice and Palliative Care on their Terminal Care Stress in Long-term Care Hospitals (요양병원 간호사의 죽음에 대한 태도, 호스피스완화의료인식이 임종간호 스트레스에 미치는 영향)

  • Song, Yeon Ju;Kim, Kyung Ah
    • Journal of Home Health Care Nursing
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    • v.28 no.3
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    • pp.256-265
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    • 2021
  • Purpose: This study examined the effects of nurses' attitude toward death and their perception of hospice and palliative care on their terminal care stress in long-term care hospitals (LCHs). Methods: Participants included 127 nurses from 6 Incheon LCHs. Data were collected between July and August, 2020. Self-report questionnaires were administered to collect data on their general characteristics, terminal care stress, attitude toward death, and perception of hospice and palliative care. Data analysis included descriptive statistics, independent t-test, one-way ANOVA, Pearson's correlation coefficient, and stepwise multiple linear regression using the SPSS 23.0 statistical program. Results: Nurses' terminal care stress was affected by their attitude toward death (𝛽=.30, p<.001) and perception of hospice and palliative care (𝛽=.28, p=.002) with an explanatory power of 21.6%. Conclusion: Terminal care stress was significantly associated with their attitude toward death and perception of hospice and palliative care. Therefore, educating nurses in LCHs about death and hospice and palliative care is essential to manage their terminal care stress effectively.

Cost-Effectiveness Analysis of Home-Based Hospice-Palliative Care for Terminal Cancer Patients

  • Kim, Ye-seul;Han, Euna;Lee, Jae-woo;Kang, Hee-Taik
    • Journal of Hospice and Palliative Care
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    • v.25 no.2
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    • pp.76-84
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    • 2022
  • Purpose: We compared cost-effectiveness parameters between inpatient and home-based hospice-palliative care services for terminal cancer patients in Korea. Methods: A decision-analytic Markov model was used to compare the cost-effectiveness of hospice-palliative care in an inpatient unit (inpatient-start group) and at home (home-start group). The model adopted a healthcare system perspective, with a 9-week horizon and a 1-week cycle length. The transition probabilities were calculated based on the reports from the Korean National Cancer Center in 2017 and Health Insurance Review & Assessment Service in 2020. Quality of life (QOL) was converted to the quality-adjusted life week (QALW). Modeling and cost-effectiveness analysis were performed with TreeAge software. The weekly medical cost was estimated to be 2,481,479 Korean won (KRW) for inpatient hospice-palliative care and 225,688 KRW for home-based hospice-palliative care. One-way sensitivity analysis was used to assess the impact of different scenarios and assumptions on the model results. Results: Compared with the inpatient-start group, the incremental cost of the home-start group was 697,657 KRW, and the incremental effectiveness based on QOL was 0.88 QALW. The incremental cost-effectiveness ratio (ICER) of the home-start group was 796,476 KRW/QALW. Based on one-way sensitivity analyses, the ICER was predicted to increase to 1,626,988 KRW/QALW if the weekly cost of home-based hospice doubled, but it was estimated to decrease to -2,898,361 KRW/QALW if death rates at home doubled. Conclusion: Home-based hospice-palliative care may be more cost-effective than inpatient hospice-palliative care. Home-based hospice appears to be affordable even if the associated medical expenditures double.

A Study on the Projected Manpower of Hospice and Palliative Care Nurses & APNs in Korea (호스피스 간호사 및 호스피스 전문간호사 수요추계에 관한 연구)

  • Lee, Hee-Jung;Oh, Pok-Ja
    • 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.

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