• Journal of Hospice and Palliative Care
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• v.14 no.4
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• pp.212-217
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• 2011

Purpose: Since 2005, the Ministry of Health & Welfare has provided financial support to promote palliative care for terminal cancer patients. We analyzed how palliative care facilities used the funding between 2006 and 2010. Methods: Frequency analysis was conducted by the item of expenditure based on fiscal reports of the palliative care facilities. Linear regression analysis was performed to examine a trend over time. Kruskal-Wallis test and Wilcoxon rank-sum test were used to compare expenditure items, the number of provision of financial support and type of palliative care units. Results: About a half of the fund was spent to pay care givers salary, improve facilities and purchase equipment regardless of the year, the number of financial support provided or facility type. By year, the operation cost for palliative care program and the education cost for health care workers have significantly increased in linear regression analysis (P<0.01). However, the amount of financial support for the low income group has decreased over years (P=0.024). This trend was affected by evaluation criteria and weight. Conclusion: The government aid for palliative care units has been used to improve facilities and equipment. Moreover, desirable changes were noted such as a higher portion of expenses for program operation and care giver training to enhance the quality of care. However, the evaluation criteria need to be adjusted to prevent any further decrease in the support provided to the low income group.

• Journal of Hospice and Palliative Care
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• v.19 no.4
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• pp.292-295
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• 2016

Hospice and palliative care in Taiwan has been growing continuously. The 2015 Quality of Death index, as rated by the Economist Intelligence Unit, ranked Taiwan first among Asian countries and sixth in the world. In this review article, we highlight three particular areas that might have contributed to this success; the laws and regulations, spiritual care and research network. Finally, we discuss the future challenges and prospects for Taiwanese encounters. A systemic review was conducted with the keywords "hospice palliative care Taiwan" using PubMed. The passing of the "Natural Death Act" in 2000 set the example and established a landmark for patient autonomy in Asia; it guarantees the patient's right to request that medical staff do not resuscitate (DNR) them and to reject other futile medical treatments at the end of their life, thus reflecting the importance of palliative care from the policy perspective. In 2015, Taiwan passed another pioneering law entitled the "Patient Autonomy Act". This law states that a patient may decline medical treatment according to his/her own will. Taiwanese indigenous spiritual care was launched in 2000. It requires a Buddhist Chaplain to successfully complete a training program consisting of lectures, as well as bedside practicum before applying Buddhist practices to end-of-life care. The Japan-Korea-Taiwan research network was established for the purpose of enabling collaborative research for the East-Asian collaborative cross-cultural Study to Elucidate the Dying process (EASED) cohort. With consensus from the government and society to make it a priority, hospice and palliative medicine in Taiwan has been growing steadily.

• Journal of Hospice and Palliative Care
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• v.8 no.1
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• pp.30-36
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• 2005

Purpose: Regardless of treatment, brain metastases are associated with a poor prognosis. We aimed to investigate the clinical characteristics of cancer patients with brain mestastases they after admission into a hospice unit and knowing they have received appropriate hospice and palliative care. Methods: We retrospectively reviewed the medical records in 40 cancer patients with brain metastases they after admission into a hospice unit from March in 2003 to March in 2005. Results: There were 20 males (50%) and 20 females (50%), and the median age of the patients was 64 years. The most common cause of brain metastases was lung cancer (22 patients, 55%), followed by stomach cancer (5, 13%) and breast cancer (3, 8%). Sixteen patients (40%) have never been teated and 20 patient have received the chemotherapy for the primary cancer. The most common symptom of cancer patients with brain metastases is headache (12 patients, 30%), followed by mental change (10, 25%), focal weakness (9, 23%) and convulsion (4, 10%). The most prevalent cause for admission was mental change (13 patients, 33%), followed by pain (9 patients, 23%). The reasons for hospice and palliative care were through recommendation of physician (1 patient, 3%), patient and family self (14, 35%) and the others (25, 62%). Twenty five of the others has been referred to hospice and palliative care during conservative management after referral and enrolled at hospice unit. The median hospitalization was 19 days and median survival in hospice and palliative care was 41 days. The median survival was 87 days from the day when the cancer patients have been diagnosed as brain metastases to death. Conclusion: The duration of hospice and palliative care was not enough to care the cancer patients with brain metastases. We suggest physicians, patients and family need the education and promotion for effective hospice and palliative care.

• Journal of Home Health Care Nursing
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• v.26 no.3
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• pp.309-318
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• 2019

Purpose: The study aimed to examine the effects of aroma hand massage on state sanxiety, depression, quality of sleep, and blood pressure levels of palliative patients in hospice. Methods: This study was conducted using a nonequivalent control group with a pretest-posttest design. The participants were 48 palliative patients in hospice (experimental group: 24, control group: 24). The aroma hand massage was given to the experimental group once a day for 5 days. Data were collected between December 2017 to February 2018. Data were analyzed using SPSS 20.0 program with the chi-square test, Fisher's exact test, independent t-test, and repeated measurement analysis of variance(ANOVA). Results: There were significant differences in state anxiety levels (t=2.41, p=.020) and quality of sleep (F=14.29, p<.001). However, significant differences in the levels of depression (t=1.59, p=.119), systolic blood pressure (F=0.37, p=.695), and diastolic blood pressure (F=0.37, p=.695) were observed. The aroma hand massage was effective in improving the quality of sleep and state anxiety levels of palliative patients in a hospice. Conclusion: The aroma hand massage was effective in improving the quality of sleep and state anxiety in a hospice.

• Journal of Hospice and Palliative Care
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• v.8 no.2
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• pp.234-244
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• 2005

As Korea has just turned into an aging society with the increase of average life expectancy, and the main causes of deaths is cancer and other chronic diseases. And this corresponds to a dramatic increase in medical expenses for the aged. To curve this problem, the hospice care can be an effective alternative, which can provide patients with both quality service and intensive care to help ensure high quality life for the patients. To demonstrate the economical effect of hospice services, a comparative study on the media expenses of geriatric hospitals and general hospitals, which bear similarities in common regarding the characteristics of their patients, is performed. Thus the results of the study can serve as a quantitative indication for the management of hospice services.

• Journal of Hospice and Palliative Care
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• v.18 no.1
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• pp.9-15
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• 2015

Education is essential for specialists in charge terminal care of cancer patients. In the second 10-year plan to conquer cancer under the Cancer Control Act, the Korean government announced a plan to train more hospice and palliative care (HPC) specialists based on quantitative HPC expansion. Specifically, the government aims to develop e-learning programs to foster social workers in HPC, following those offered to doctors and nurses. In HPC, social workers have served a vital role in helping patients overcome psychological and social issues. As professionals, they have carried out their responsibilities and played their part in the field to help HPC to take root and be institutionalized in Korea. To date, it has been difficult to obtain practical knowledge and skills for social workers due to the lack of systematic training program. Development of an e-learning program for social workers, as proposed in this study, should strengthen social workers in charge of terminally-ill cancer patients in terms of their identity, expertise, and practical skills in clinical setting and improve their access to education. We also hope the program to be further developed by the government by introducing an education system that offers refresher courses to guarantee social workers' continued expertise through.

• The Korean Journal of Health Service Management
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• v.13 no.4
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• pp.163-177
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• 2019

Objectives: The purpose of this study was to identify the predictors of quality of life (QOL) for terminal cancer patients admitted into the community health center, and to establish a hypothetical model to explain and verify causative relationships among the variables. Methods: Data were collected from January 2015 to June 2016. Participants were 237 registered patients in Busan Metropolitan City hospice & palliative care center. The descriptive and correlation statistics were analyzed using the SPSS/WIN 24.0, and the structural equation modeling procedure was performed using the AMOS 24.0 program. Results: The results of this study showed that the physical symptoms of terminal cancer patients were the most direct factors affecting the QOL, and satisfaction with health care services has a direct effect on the QOL. Conclusions: The study contributes to drawing up measures to improve QOL for terminally ill cancer patients who are living in the end-of-life section of the community by revealing the causal relationship to the QOL for terminal cancer patients.

• Journal of Hospice and Palliative Care
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• v.20 no.2
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• pp.81-92
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• 2017

Chronic obstructive pulmonary disease (COPD) is characterized by persistent airflow limitation that is usually progressive. It is a major cause of morbidity and mortality worldwide, leading to substantial and increasing economic and social burden. Palliative care for COPD patients aims to reduce symptoms and exacerbations and improve exercise tolerance and quality of life. It is difficult to make a prognosis for COPD patients due to the variable illness trajectory and advanced care of patients. However, severity of breathlessness, assessment of lung function impairment, and frequency of exacerbations can help to identify palliative care needs and determine effective methods to mitigate symptoms, which is discussed in this paper. In these patients, it is recommended to provide individualized palliative care along with curative/restorative care at the onset of COPD symptoms. Before launching a palliative care system in Korea, it is necessary to prepare pulmonary rehabilitation resources, patient-centered communication, timely palliative responsiveness, and a program for effective advanced care planning. A multidisciplinary approach involving collaboration with not only the respiratory and palliative care teams but also primary care offers a new model of care for these patients and should be considered with a priority.

• Journal of Hospice and Palliative Care
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• v.27 no.2
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• pp.82-86
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• 2024

Purpose: This study examined the quality of life (QoL) and quality of care (QoC) in inpatient hospice settings in Korea before and during the coronavirus disease 2019 (COVID-19) pandemic. Methods: Data were obtained from three institutions that participated in two prospective cohort studies. The primary outcomes measured were the QoL of patients with terminal cancer and their family caregivers (FCs), as well as the QoC as perceived by the FCs. Results: Multivariable regression analysis revealed that during the COVID-19 pandemic, both patients and FCs experienced better QoL than before the pandemic, and FCs reported a higher QoC. Conclusion: Health policymakers should consider our findings when planning for future pandemics.

• Journal of Korean Academy of Nursing
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• v.41 no.1
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• pp.9-17
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• 2011

Purpose: The purpose of this study was to develop and implement the Hospice Smart Patient Program and to evaluate its effectiveness. Methods: It was quasi-experimental non-equivalent pre-post study. Breast cancer patients who underwent surgery, chemotherapy or radiotherapy, or who needed palliative care, participated in the study. Participants were divided into two groups, experimental and control groups based on their preferences. The program was developed after literature review and discussion among experts on hospice and palliative care. Participants who were in the experimental group received either face-to-face or phone "Hospice Smart Patient" Service at least once a week for 5 months. Results: There was a significant difference in quality of life and communication skill between the two groups after the service was provided. In addition, participants in experimental group showed improved decision making skills, mastery sense, and understanding of hospice and palliative care, which would be beneficial in improving their quality of life. Conclusion: We have concluded that the "Hospice Smart Patient" Program is useful for cancer patients in decision making, improving self-control and choosing hospice care to improve their quality of life.