• Journal of Hospice and Palliative Care
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• v.13 no.3
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• pp.143-152
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• 2010

Purpose: This study aimed to evaluate the current status of hospice palliative care facilities in Korea. Based on the result, we attempted to suggest activation plans of hospice palliative in Korea. Methods: To conduct a survey, we obtained a list of hospice palliative care facilities from related agencies and academic societies. A survey was conducted from February, 2009 to March, 2009. The survey was consisted of general characteristics of organizations, manpower, facilities & equipments, and so on. In addition, we used data from Statistics Korea to estimate the number of beds required and the bed occupancy rate. Results: Total number of facilities responded to the questionnaire were 53. Forty-two facilities were general hospitals and 6 facilities were clinics among the total 53 facilities, and 18.8% of facilities were located in Seoul, Incheon and Gyeonggido. Overall bed occupancy rate was rather low as 21.9%, and there were 4 provinces where bed occupancy rates were 0%. Deaths in hospice palliative care facilities during 2008 were 6.3% of total deaths from cancers. As for the questions about the financial status of facilities, 86% of facilities were answered financial insufficiency. Also more than half of the facilities gave financial insufficiency as the reason for shortage of human resource supplies and inability to achieve the standard for authorization by the government. Facilities answered in order to activate the hospice palliative care, governmental support is needed, mostly in financial support (71.2%), donation tax deduction (43.1%), and setting up a public utility foundation (23.5%). Conclusion: This study showed low rates of hospice palliative care use and bed occupancy in Korea. Regional variance in bed occupancy rate was significantly high. As a roadblock for these problems, most of the facilities cited financial insufficiency. Therefore, there must be some action plans to boost financial support to activate hospice palliative care in Korea. Finally, efforts to improve these circumstances including lack of understanding about hospice and palliative care, are needed as well.

• Journal of Hospice and Palliative Care
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• v.19 no.2
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• pp.99-108
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• 2016

Hospice palliative care (HPC) in Korea has developed steadily since its introduction in 1965. Currently, HPC in Korea is targeted only towards terminal cancer patients and their families, and the national health insurance scheme covers only inpatient hospice care for said patients. In recent years, healthcare professionals and policy makers began to recognize the need for HPC services in diverse settings including outside hospital boundaries, and for all terminally-ill patients. A law on HPC passed in January 2016 allows terminally-ill patients to refuse life-sustaining treatments, and will likely facilitate further development of HPC services. It is critical for the government and all interested parties in the medical, academic and social sectors to collaborate to ensure its success once it takes effect in 2017. This article will briefly review the half-century history of HPC in Korea, and discuss how to prepare for and cope with death and, thereby, improve the quality of death.

• The Korean Journal of Health Service Management
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• v.10 no.3
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• pp.85-97
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• 2016

Objectives : In this study, the awareness of hospice and the perceptions on the need for visiting palliative care and what constitutes a good death of the citizens of Busan were investigated. The purpose of this study was to develop a hospice system based on the needs of the citizenry of Busan by seeking solutions for current hospice strategies. Methods : One thousand Busan citizens from 20 to 80 years of age were surveyed in this study. Results : Busan citizens defined a good death as spending less than one month of time in the actual process of dying at home between the ages of 80-89 years. They knew about hospice a little and were aware of its necessity. They also knew about the necessity of visiting palliative care and were interested in receiving it when appropriate but did not know much about it. Conclusions : First, there is a large difference between Busan citizens' expectations on what constitutes a good death and what a good death really is. Second, Hospice palliative care should be provided to the community. Third, the older the patient is, the more palliative care visits are necessary. Fourth, 40s and 50s must make preparations for hospice palliative care in their future.

• Journal of Hospice and Palliative Care
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• v.16 no.2
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• pp.65-73
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• 2013

The objective of this paper is to suggest future goals and strategies for social work in hospice and palliative care in Korea by understanding its historical background. Both literature review and participant observation were performed to examine historical data relating to social work in hospice and palliative care in Korea. Also reviewed were the current trends with a focus on the roles of social workers in the said arena, qualifications, education, research and medical insurance policy. First of all, the roles of social workers do not appear to be clearly defined in the field of hospice and palliative care, which seems to lead to the lack of recognition as professional workers. The qualification standard for social workers in hospice and palliative care remains inadequate. Second, there seems to be insufficient professional social worker training resources, in terms of both the number of educators and training programs. Third, social workers in Korea produce significantly less publications than those in other professions. There is also a dearth of qualified evidence-based research that is needed to prove benefits of intervention and ultimately for policy implications. Last, the current medical insurance policy needs to be revised to secure fees for social work services and dedicated full-time social workers in hospice and palliative care. Korea needs to approach social work in hospice and palliative care with specific goals to develop future strategies. Related infrastructure and an executive structure should be established via networking and partnership with academic societies, associations and schools.

• Journal of Hospice and Palliative Care
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• v.24 no.1
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• pp.46-55
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• 2021

Purpose: This pilot study aimed to examine the influence of death counseling on perceptions, preparedness, and anxiety regarding death and dying among family caregivers of hospice patients. Methods: Death counseling developed based on the SPIKES model was provided to 37 family caregivers in a hospice and palliative care unit. Perceptions, preparedness, and anxiety regarding death were assessed with a self-administered structured questionnaire, and participants' scores before and after counseling were compared using the paired t-test. Results: Significant changes were found in perceptions, preparedness, and anxiety regarding death after counseling. Compared to before counseling, the scores for perceptions of death (t=-4.90, P<0.001) and preparedness for death and dying (t=-16.23, P<0.001) improved, while anxiety (t=3.72, P=0.001) decreased after counseling. Some changes were also found in the types of support that family caregivers needed to prepare for the death of their family members in the hospice care unit. Conclusion: The findings demonstrate that death counseling could help family caregivers prepare for the death of their loved ones. Hospice and palliative care providers should play a key role in supporting family caregivers of hospice patients by developing strategies for counseling.

• Journal of Hospice and Palliative Care
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• v.11 no.4
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• pp.206-212
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• 2008

Purpose: To evaluate the effectiveness of pilot program on standard curriculum of hospice palliative care education; a basic training program for physician, nurse, social worker and clergies at hospice institute. Methods: To develop an educational program, we used the Education in Palliative and End-of-life Care (EPEC) program as a paradigm and modified it to be suited in our situation: The standard curriculum consists of 19 modules, and it is designed to be applied to the teaching methods, including lecture, interactive lecture, small group discussions, and role play. To verify its contents and teaching methods, we implemented a pilot program which consisted of 3 modules, using various teaching methods; trigger video tapes, interactive lecture, small group discussions, and role play. Results: Overwhelming majority were satisfied with the teaching methods and learner-centered methods, and agreed that the contents were clinically relevant to the care of dying patients. They also indicated that their attitudes would likely change as a result of the education. Conclusion: The effects of the pilot program on standard curriculum of hospice and palliative care are very positive and has broader implications for improving hospice palliative care education. For successful implementation of the program, trainers must also be prepared to teach effectively. Also it must be accompanied with train-the trainer program.

• Journal of Hospice and Palliative Care
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• v.12 no.4
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• pp.209-219
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• 2009

Purpose: This study was to testify the effects on self esteem and spiritual well-being of holistic hospice nursing intervention program ("Rainbow program") for inpatients of hospice palliative care unit. This was designed as a preliminary experimental study with one-group pre-post test. Methods: A total of 27 patients who were over 18 years old, and admitted in hospice palliative care unit of S hospital in P city, submitted informed consent for this study, participated in holistic hospice nursing intervention program(total 10 sessions and 1,200 minutes for 2 weeks) from April 6, 2004 to April 20, 2005. To test the effects of this intervention, Self Esteem Questionnaire (SEQ) and Spiritual Well-being Questionnaire were used. The collected data were analyzed by Paired t-test with SPSS/WIN 12.0 program. Results: (1) Hypothesis No. 1 "The experimental group which received Rainbow program will have a higher degree of self esteem than before" was supported (t=11.554, P<0.001). (2) Hypothesis No. 2 "The experimental group which received Rainbow program will have a higher degree of spiritual well-being than before" was also supported (t=6.387, P<0.001). Conclusion: This Holistic Hospice Nursing Intervention Program was effective in increasing self-esteem and spiritual well-being of patients in hospice palliative care unit. Therefore, it can actively be used and also applied to hospice palliative care practice, research, and education as a useful model of interdisciplinary team approach by hospice professionals.

• Journal of Hospice and Palliative Care
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• v.27 no.2
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• pp.77-81
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• 2024

This case report explores the challenges and complexities associated with opioid management of cancer pain, emphasizing the importance of early involvement of a hospice consultation team and the adoption of a multidisciplinary approach to care. A 56-year-old man with advanced pancreatic cancer experienced escalating pain and inappropriate opioid prescriptions, highlighting the shortcomings of traditional pain management approaches. Despite procedural intervention by the attending physician and increased opioid dosages, the patient's condition deteriorated. Subsequently, the involvement of a hospice consultation team, in conjunction with collaborative psychiatric care, led to an overall improvement. The case underscores the necessity of early hospice engagement, psychosocial assessments, and collaborative approaches in the optimization of patient-centered palliative care.

• Journal of Hospice and Palliative Care
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• v.23 no.4
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• pp.183-197
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• 2020

Purpose: In this study, the researchers closely investigated the psychosocial problems faced by terminal cancer patients and their family members in hospice palliative care units. Methods: The investigators conducted four sessions of art therapy intervention programs for the terminal cancer patients and their family members, carried out in-depth interviews about the influence of the cancer experience on their family function and quality of life, and analyzed their experiences using grounded theory methodology. Results: After providing autonomous written informed consent, six pairs of terminally ill cancer patients and their family members, accounting for a total of 17 participants with the inclusion of additional family members who took part sporadically, took part in the art therapy intervention and interviews. The raw data, in the form of verbatim records, were analyzed according to the procedures of grounded theory (open, axial, and selective coding). Through these processes, a total of 154 concepts, 56 subcategories, and 13 categories were identified. Families were classified into four types according to their family function, quality of life, and attitude toward death. Though the art therapy intervention, patients and their family members experienced three stages over time. Conclusion: This research focused on essential aspects of the family relationships and the art therapy experiences of terminal cancer patients and their family members through an art therapy intervention in the context of hospice palliative care. Based on these observations, the researchers constructed a theoretical rationale for art therapy interventions delivered to patients and their family members in the process of hospice palliative care.

• Journal of Hospice and Palliative Care
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• v.19 no.1
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• pp.5-10
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• 2016

Purpose: This study reviewed what the location of death (LOD) means as an outcome and how to use LOD to assess end-of-life (EOL) care. This study also examined the reason why LOD is significant for the quality of EOL care. Methods: A literature review was performed, using LODs and home deaths as outcomes in the field of EOL care, and analyzed the findings associated with key fields in regards to LOD. Results: Palliative care research used LOD, in particular, hospital death (versus home death) as a significant outcome when examining cost savings, quality of life care, and patient and family preferences. Based on substantial evidence from previous research, home hospice or continuous palliative care in non-hospital settings (i.e. homes, nursing homes) have been designed and available for dying patients in developed countries. Conclusion: The LOD delivers practical significance as an outcome for diverse reasons. In-depth examination on LOD in South Korea is needed despite limitations to interpretation of its meaning in the country.