• Journal of Hospice and Palliative Care
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• v.8 no.1
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• pp.57-64
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• 2005

Cyclooxygenase-2 (COX-2) selective inhibitors were specifically developed to reduce the risks of gastrointestinal bleeding associated with other NSAID drugs. However, the APPROVe (Adenomatous Polyp Prevention on VIOXX) trials revealed that rofecoxib sometimes exerts prothrombotic effects. Meanwhile, cancer patients, who also carry a risk of thrombosis due to a variety of mechanisms, are often treated with COX-2 selective inhibitors, due to their relative gastrointestinal safety. This report concerns the case of a 46-year old woman with advanced cervical cancer, who had been treated with opioids and a COX-2 selective inhibitor (celecoxib) for 2 months, for the relief of pain associated with her cancer. The patient was admitted due to swelling of the left leg, which was also accompanied by pain. A computerized tomography scan revealed deep vein thrombosis occurring in multiple veins of both legs. After the administration of low-molecular weight heparin and oral warfarin, the patient's symptoms were relieved initially. However, her prothrombin time was found to be prolonged, necessitating the discontinuation of anticoagulation therapy. The patient's dyspnea worsened, ultimately resulting in her death. In conclusion, the administration of cox-2 selective inhibitors should be carefully considered in patients with a number of different risk factors, and assessed on a case-by-case basis.

• Journal of Hospice and Palliative Care
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• v.4 no.2
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• pp.130-136
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• 2001

Purpose : It is very important to endow the cancer patients underwent chemotherapy with satisfactory quality of life (QOL). However, little is known about the factors influencing QOL during chemotherapy. Therefore, we designed this study to find out the factors influencing QOL in the cancer patients who underwent chemotherapy. Methods : Ninety-seven cancer patients were studied, prospectively. The patients' characteristics were as follows; median age(range): 48(19{\sim}83) years, male:female; 57:40, PS:0,1/2,3;55/42 patients, diagnosis(number): lymphoma (28), lung cancer (22), gastrointestinal cancer (18), sarcoma (12), breast cancer (12), gynecological cancer (5), Stage: I,II/III.IV;37/60 patients. We used EORTC QLQ-C30 questionnaires to evaluate QOL. EORTC QLQ-C30 scores were performed before the onset of chemotherapy and after the end of 3 cycles of chemotherapy. The correlation of these scores with performance status (PS), diagnosis, disease stage, response to chemotherapy, and regimen related toxicity was evaluated. Results : The responder group (CR, PR) demonstrated marked improvement of social functional and emotional scales to non-responder group (SD,PD) (P=0.024, 0.045). Non-hematologic regimen related toxicity such as mucositis, nausea and vomiting was significantly correlated with pain scale change (P=0.043). Other factors had no notable correlation with QOL changes. Conclusion : Our preliminary study results may suggest as follows. The response to chemotherapy is associated with the change of social functional and emotional scales and the severity of non-hematologic regimen related toxicity is associated with pain scale change.

• Journal of Hospice and Palliative Care
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• v.4 no.2
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• pp.154-160
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• 2001

Purpose : This study, as the first year project of setting up a community based management system, was attempted for the cancer patients and their family to improve their quality of life; investigating and managing the cancer patients, educating volunteers and connecting the patients with the volunteers were performed. Method and result : The education of managing cancer patients for the volunteers was done once in lune for 2 days to the 80 volunteers. Questions about education effect, volunteer motivation and so on were made up. The survey showed, generally, education satisfaction level was high and a longer education and an intensive course were needed and was suggested that organizing a volunteer community be needed for the continuous further education and systematic management. As the result, after the public health center and volunteers deliberated, a volunteer community consisting of 4 teams, 28 members was organized, launched in Oct. and operated for the cancer patients and their family. For investigating and enrolling the patients, advertising on a local information paper, recommending of local doctors, publicizing by educating the heads of a subdivision of the city, the heads of a neighborhood association and the people in charge of the related local communities such as women's society, and surveying the community by volunteers were performed and the total, 41 patients were registered. Management of cancer patients was carried out by volunteers in a community and in a nursing school. A regional volunteers' community is composed of 23 members and they have worked 87 times, that is 3.8 times per capita on an average. The content of duties is attending the education (41.1%) the most. A volunteers' community of nursing students composed of 12 members have worked 135 times, that is 11.3 times per capita on an average. The content of duties - consulting with patients and home visiting (37.8 %) were the most and survey for investigating the cancer patients was the second. Conclusion : This study has the meaning that this is the guiding attempt in building a community based management system, and especially the achievement of this study is that a regional society organized a volunteer community for the cancer patients by itself and went into action for the cancer patients and their family. Furthermore, to activate this volunteering, it is necessary to keep managing volunteers and running continuing education or the intensive course of the volunteers. Indeed we should let the patients have good impression on this program through publicity and education for the residents to keep track of more cancer patients. For that, systematic and powerful cooperation of a self-administrative organization is required.

• Journal of Hospice and Palliative Care
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• v.12 no.1
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• pp.14-19
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• 2009

Purpose: The purpose of this study was to provide basic data to assess spiritual health of HIV/AIDS patients and devise spiritual nursing mediation plans in practical nursing work by examining the levels of spiritual wellbeing (SWB) and spiritual needs of HIV/AIDS patients'. Methods: A correlation survey study was conducted on HIV/AIDS patients age ranging from 20 to 70 years to investigate the relationship between their SWB and spiritual needs. Results: 1. Average scores of HIV/AIDS patients' related to SWB were found to be higher than the intermediate level: 54.59 in SWB; more specifically, 27.78 in existential well-being and 26.80 in religious well-being. 2. Average score of for HIV/AIDS patients' spiritual needs was 108.67: More specifically, 37.80 in the needs of love and interest, 42.35 in the needs of seeking meanings and purposes, and 28.51 in the needs of wanting to be forgiven. 3. Concerning the correlation between SWB and spiritual needs, the total SWB and total spiritual needs of HIV/AIDS patients' showed a weak positive correlation (r=0.344, P=0.013). Conclusion: The result of the study showed that SWB and spiritual needs of HIV/AIDS patients' are higher than the average scores, and these two parameters have a weak positive correlation, indicating that HIV/AIDS patients have strong spiritual needs of seeking meanings and purposes. Therefore, more studies on the spiritual nursing mediation plans are needed in order to raise their spiritual well-being levels and meet their spiritual needs through precise assessment.

• Journal of Hospice and Palliative Care
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• v.8 no.2
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• pp.156-162
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• 2005

Purpose: Lymphedema is edema developing mainly in the arms and legs due to an abnormal lymphatic system, over one hundred millions of patient worldwide suffer from it. At present, prevention is the best treatment. Thus, It is important to know which patient are more pone to develop it in order to prevent it. By evaluating the risk factor for lymphedema, we intended to find the effective prevention. Methods: We have investigated that outpatients who chiefly complained of lymphedema visited the lymphedema clinic at one university hospital from September 1 in 2003 to August 31 in 2005. We evaluated the risk factor for lymphedema by questionnaires. Questionnaire consists of demographic data, disease factor, treatment factor, posttreatment factor. We evaluated the correlation between lymphedema with each factor. Results: The total number of patients was 50, 19 patients with breast cancer and 31 patients with cervical cancer. In terms of stages of edema, 12 patients were below stage 1 and 38 patients were above stage 2. The incidence of lymphangitis was more frequent, more obese and the impairment of the site of edema site more severe, the stage of cancer was higher in the patients higher than stage 2 than in the patients below stage 1 (P>0.05). Conclusion: Lymphedema is more severe when the cancer stage in higher, accompanying more frequent infections, more obesity and more impairment at the site of edema site. Above all, cancer stage and the impairment of edema site are impossible to correct but obesity and infection may be corrected. Therefore we speculate that we are able to protect the aggravation of edema by weight reduction and infection control.

• Journal of Hospice and Palliative Care
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• v.18 no.2
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• pp.148-155
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• 2015

Purpose: The purpose of this study is to examine how wish granting influences children with life-threatening medical conditions when it comes to their adaptation to disease with a focus on the mediating effect of resilience and stress caused by disease. Methods: From January 2, 2015 through January 12, 2015, a survey was conducted on 292 children with life-threatening diseases whose wishes were granted through Make-A-Wish Korea. The data were collected using the impact of a wish scale, the Children's Adjustment to Cancer Inventory, the Childhood Cancer Stressor Inventory, and the resilience scale in children with chronic illness. The data were analyzed using SPSS/WIN 20.0 and Amos 21.0. Results: Satisfaction with the wish granting program enhances resilience, and resilience affects stress caused by medical conditions as well as adaptation to disease. Also, stress caused by medical conditions influences adaptation to disease. Conclusion: Wish granting is effective in both facilitating chronically ill children to adjust to disease and reduce their stress from disease. Thus, children with life-threatening medical conditions could be assisted or motivated to adjust to disease by improving satisfaction achieved by wish granting.

• Journal of Hospice and Palliative Care
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• v.14 no.1
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• pp.20-27
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• 2011

Purpose: The purpose of this study was to investigate the effects of Death Education Program which had been provided to family caregivers of disabled individuals. A single group pretest-posttest design was employed for this study, which was conducted at a community rehabilitation center located in Ulsan, South Korea. Methods: Death Education Program was conducted for 16 family caregivers of disabled individuals who agreed to participate in this study. A 2.5-hour session was conducted once a week for 10 weeks. To investigate the effects of the education program, structured questionnaires, which assessed the patients and their family member's conceptions on the meaning of life, and their resilience, burden, and attitude towards death, were administered before and after the program. Results: The subjects' conception of the meaning of life and resilience did not significantly change. The median scores for the burden of family caregivers declined, while those for the subjects' attitude towards death increased, after attending the education program. Conclusion: The findings showed that Death Education Program has an affirmative effect on the burden of family caregivers of disabled individuals and their attitude towards death.

• Journal of Hospice and Palliative Care
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• v.13 no.2
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• pp.81-88
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• 2010

Purpose: This study was conducted to study the attitude of Korean lawyers toward withdrawal of life sustaining treatment, and compare and analyze different types of their attitudes. Methods: Research design of this project was Q methodology approach. The study population was 24 lawyers, aged from 32 to 69 years. Q sample to investigate the attitude of the lawyers toward withdrawal of life sustaining treatment included 34 statements obtained from literatures, TV debate, and depth interviews of 5 lawyers among the lawyers included. After listening to the purpose and method of the study, the 24 lawyers agreed to fill out a survey asking sociodemographic information, and the information was distributed in 9 scale Q-sample. Results: The collected data were processed through QUANL PC program and sorted into 5 types as follows: The first type was 'Choosing to withdraw life sustaining treatment', the second 'Withholding life sustaining treatment' regardless of the cost, the third is neutral type that claims that humans have the right to decide the death and life, and demands the proper legalization to protect such rights, the fourth type agrees to withdrawal of life sustaining treatment, nevertheless, admits that one has a rigt to withhold one's own life treatment, categorized as self contradiction type. The fifth type believed that 'Life and death are providential' with the faith, therefore, such authority to decide life and death belongs to God, but not human beings. Conclusion: In conclusion, the lawyer's attitudes toward withdrawal of life sustaining treatment were grouped into five different types as follows: 'Choosing to withdraw life sustaining treatment', 'Withholding life sustaining treatment', 'Demanding legalization', 'Self contradiction type', and 'Life and death are providential'.

• Journal of Hospice and Palliative Care
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• v.11 no.2
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• pp.91-98
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• 2008

Purpose: This study was undertaken to compare perceived stress and coping patterns, and their effects on depression between cancer patients and healthy adults. Methods: A descriptive design was used with 278 subjects, consisting of 139 cancer patients and 139 health adults, living in an urban area. All participants completed the following prerequisites; Stress Visual Analog Scale, Ways of Coping Checklist (W.C.C.L), Depression Index (CES-D), and Demography and Disease Data Questionnaire. Results: Perceived stress and depression were significantly higher, while wishful thinking was lower among cancer patients than healthy adults, after adjusting for education and family income which were not homogeneous between the groups. Among cancer patients, 20.2% of depression was mainly due to seeking support (10.7%), perceived stress and education, while 30.7% of depression in healthy adults was due to perceived stress, problem solving, and seeking support. Conclusion: These findings suggest that interventions to manage depression in cancer patients should include strategies to best foster positive coping patterns and reduce perceived stress.

• Journal of Hospice and Palliative Care
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• v.17 no.4
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• pp.270-277
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• 2014

Purpose: This is a retrospective study that investigated cancer patients' complaints of moderate or severe pain to analyze pain characteristics, pain relief interventions and their effects. Methods: The participants of this study were 363 patients who were hospitalized in the cancer ward for three to 30 days and scored 4 points or higher on the pain severity assessment. Results: The most frequent region of pain was the abdomen. The most frequent factor that exacerbated pain was movement. The most frequent pain alleviating factor was administration of analgesics. The most frequent pain type was breakthrough pain, and the most frequent non-pharmaceutical intervention for pain control was heat therapy. Among all, analgesics were routinely prescribed for 52.2% of the participants. Morphine sulfate was the most frequently used analgesic while Gabapentin was the most frequently used non-narcotic analgesic. At the time of discharge, 82.5% of the participants marked their pain intensity as 3 points or lower. Conclusion: For cancer patients complaining of moderate or severe pain, it is important to actively control pain from the beginning of admission. Thus, it is necessary to educate not only cancer patients using narcotic analgesic for pain control and their families but nurses about the effects and side-effects of drugs. Moreover, patients and their families need to learn how to assess and record pain at home to collect data that can be referred for future treatment.