• Title/Summary/Keyword: Life sustaining care

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Illness Experiences and Palliative Care Needs in Community Dwelling Persons with Cardiometabolic Diseases (심혈관대사질환이 있는 지역사회 거주 환자의 질환경험 및 완화의료 요구)

  • Cha, EunSeok;Lee, JaeHwan;Lee, KangWook;Hwang, Yujin
    • Journal of Hospice and Palliative Care
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    • v.22 no.1
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    • pp.8-18
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    • 2019
  • Purpose: This study was conducted to better understand the illness experiences and palliative care needs in community-dwelling persons with cardiometabolic diseases. Methods: This qualitative descriptive study was conducted with 11 patients (and three family members) among 28 patients contacted. Interviews were led by the principal investigator in her office or at participants' home depending on their preference. All interviews were digitally recorded and transcribed by a research assistant. The interviews were analyzed by two independent researchers using a conventional method. Results: Participants' ages ranged from 42 to 82 years (nine men and two women). Three themes were identified: (1) same disease, but different illness experiences; (2) I am in charge of my disease(s); (3) preparation for disease progression. Participants were informed of the name of their disease when they were diagnosed, but not provided with explanation of the diagnosis or meant or how to do self-care to delay the disease progression, which increased the feelings of uncertainty, hopelessness and anxiety. Taking medication was considered to be the primary treatment option and self-care a supplemental one. Advanced care plans were considered when they felt the progression of their disease(s) while refraining from sharing it with their family or health care professionals to save their concerns. All participants were willing to withhold life-sustaining treatment without making any preparation in writing. Conclusion: Education on self-care and advanced care planning should be provided to community-dwelling persons with cardiometabolic diseases. A patient-centered education program needs to be developed for this population.

The Reason to Select Complementary and Alternative Therapy for Terminally Ill Cancer Patients (말기암환자가 보완대체요법을 선택한 이유)

  • Kim, Kyeong-Uoon;Park, Jean-No;Lee, Soo-Han
    • Journal of Hospice and Palliative Care
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    • v.14 no.1
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    • pp.34-41
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    • 2011
  • Purpose: The purpose of this study was to analyze the reason to select complementary and alternative therapy for terminally ill cancer patients. Methods: The data were collected from 21 terminal cancer patients and families through the in-depth interview. Data analysis were performed by the Colaizzi's phenomenological method (1976). Results: The reason to select complementary and alternative therapy for terminal cancer patients and families was then categorized with 4 elements; Awareness of limitations in contemporary medical treatments, Belief in effectiveness of the CAM, Satisfaction with emotional needs of family members, and Disbelief due to negative attitudes of physicians. The result indicated the following 9 themes expectation for a complete cure, uncertainty in hospital treatments, complementary method for management of side effect of chemotherapy, alleviation of symptoms and life-sustaining, fear for side effects of cancer treatments, belief in earned information, referrals by other, responsibility of family, and dissatisfaction with negatine attitudes of physicians. Conclusion: Physicians should provide a sufficient explanation and try to effectively communicate with clients about hospice and palliative service and the CAM. We strongly realized that concerns about patients' best care and satisfactions with family's needs should be understood.

Nursing Students' Awareness of Biomedical Ethics and Attitudes toward Death of Terminal Patients (간호대학생의 말기환자에 대한 생명의료윤리 인식과 죽음에 대한 태도)

  • Kim, Young-Hee;Yoo, Yang-Sook;Cho, Ok-Hee
    • Journal of Hospice and Palliative Care
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    • v.16 no.1
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    • pp.1-9
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    • 2013
  • Purpose: The aim of this study was to investigate nursing students' awareness of biomedical ethics and attitudes toward death of terminal patients. Methods: A structured questionnaire was developed to examine nursing students' biomedical ethics. Their attitudes toward terminal patients' death were measured by using the Collett-Lester Fear of Death Scale. Surveys were conducted with 660 nursing students enrolled at a three-year college located in Daejeon, Korea. Data were analyzed using descriptive statistics, Wilcoxon rank sum test and Kruskall Waills test. Results: Students who have experienced biomedical ethics conflicts, agreed to prohibition of cardiopulmonary resuscitation (CPR) and have no religion exhibited more negative attitudes toward death compared to students without the above characteristics. Of the participants, 81.2% answered that life sustaining treatment for terminal patients should be discontinued and 76.4% replied that CPR on terminal patients should be prohibited. The majority of the correspondents stated that the two measures above are necessary "for patients' peaceful and dignified death". Conclusion: Study results indicate the need to establish a firm biomedical ethics value to help nursing students form a positive attitude toward death. It also seems necessary to offer students related training before going into clinical practice, if possible. The training program should be developed by considering students' religion, school year, experience with biomedical ethics conflicts and opinion about CPR on terminal patients. The program should also include an opportunity for students to experience terminal patient care in advance via simulation practice on standardized patients.

Public Attitudes Toward Dying with Dignity and Hospice.Palliative Care (품위 있는 죽음과 호스피스.완화의료에 대한 일반 국민들의 태도)

  • Yun, Young-Ho;Rhee, Young-Sun;Nm, So-Young;Chae, Yu-Mie;Heo, Dae-Seuk;Lee, So-Woo;Hong, Young-Seon;Kim, Si-Young;Lee, Kyung-Sik
    • Journal of Hospice and Palliative Care
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    • v.7 no.1
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    • pp.17-28
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    • 2004
  • Purpose: Even though there have been various efforts for the dying with dignity of terminal patients, no researches focused on the public attitudes. Methods: In February 2004, we sampled 1,055 persons over 20 years of age from the sixteen cities and local districts of Korea through the quota sampling method according to their gender, age, and location. We conducted a telephone survey with a structured questionnaire on the attitudes toward dying with dignity and hospice palliative care. Results: The most important conditions for the dying with dignity on the patients' views were 'removing burdens for other people' (27.8%). Over the half of the samples chose their home as a preference for place of death (54.8%). 82.3% of the respondents agreed to the idea of withdrawing the medically futile life-sustaining treatment. Fifty seven percents of the answered public said that they intended to use the hospice service in case of terminal illness. Eighty percents thought that health care insurance should cover hospice service, and 80.9% gave positive response to the necessity of advance directives. Respondents emphasized 'the financial support for the terminal patients' (29.8%), 'covering hospice service with health insurance' (16.5%), and 'the education and public relation for settlement of desirable dying culture and hospice service' (15.9%) as the roles and responsibilities of the government for the dying with dignity. Conclusion: This study shows that there is a possibility of significant consensus on hospice and palliative care system for the dying with dignity of patients and reduction of the suffering for their families among the general public.

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A Study on How Elderly People are Preparing for Dying Well (웰다잉을 어떻게 준비하고 있는가: 노인을 대상으로)

  • Lim, HyoNam;Kim, Kwang-Hwan
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.9
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    • pp.432-439
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    • 2019
  • This study was a qualitative study that attempted to find out the meaning of preparation for dying well that the elderly think through a question of how to prepare for dying well. The focus group interview was conducted on 10 elderly people aged 65 or older who visited the elderly welfare center in B city, Gyeonggi-do, and a total of two groups were interviewed with five subjects as one group. As a result, eight themes were drawn from four dimensions of physical, psychological, social, and spiritual aspects. In physical preparation, 'health management' and 'doing what you want to do' were derived. In psychological preparation, 'not regretting' and 'giving to others' were derived, and in social preparation, 'organizing property', 'determining a place of death you wish', and 'writing a letter of advance life sustaining care directives' were derived. In spiritual preparation, 'relying on religion' was derived. The elderly were preparing for well-being in various aspects, and when developing a program for well-being, the program should be planned to prepare for actual death in various aspects.

A study on the expansion of culture industry and establishment of industrialization of well-dying education (웰다잉 교육의 문화산업 확산과 산업화 구축에 관한 연구)

  • Chang, Kyung-Hee;Kim, Moon-Joon;Kim, Seol-Hee;Park, Arma;Ahn, Sang-Yoon;Kim, Kwang-Hwan
    • Journal of Digital Convergence
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    • v.19 no.5
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    • pp.321-331
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    • 2021
  • The purpose of this study is to establish well-dying education, well-dying culture, and industrialization for well-aging. For this, data was collected through Gallup Korea from February 1, 2021 to February 22, 2021. As a result of the study, well-dying education experience was 4.7%, and education satisfaction was surveyed with 2.88 points out of 5. As a result of analyzing the needs of well-dying education according to the age groups, the educational demands of youth and middle-aged were in the order of hospice education and information, life-sustaining medical information, and funeral information. In the case of the young old, it was in the order of hospice education and information, funeral information, and psychological overcoming related to death. In the case of the elderly, the survey was conducted in the order of hospice education and information, funeral information, and life-care related information. The perception of industrialization related to the well-dying culture was inspected in the order of the well-dying café where you can talk about life and death, the well-dying experience such as the entrance experience, and the development of travel products related to culture and art (p<0.05). Such results can be usefully utilized in the development of well-dying education programs for well aging, cultural spreading, and industrialization.

Subjective Attitudes towards Terminal Patients of Nursing Students with Clinical Practice Experience: Application of Q Methodology (임상실습을 경험한 간호대학생의 말기환자에 대한 주관적 태도: Q방법론 적용)

  • Lee, Eun Ju;Hwang, Kyung-Hye;Cho, Ok-Hee
    • Journal of Hospice and Palliative Care
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    • v.22 no.4
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    • pp.156-165
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    • 2019
  • Purpose: This study was conducted to identify subjective attitudes towards terminal patients in nursing students who had clinical practice. The types of subjective attitude were classified by applying Q methodology. According to those types, basic reference data for the development of educational programs were provided. Methods: Thirty-four final Q samples were selected, and Q classification with a nine-point scale was performed with P samples of 43 nursing students. A key factor analysis was conducted with the collected data using the PC QUANAL program. Results: Nursing students' attitudes towards terminal patients were grouped into three types. The total variable was 49.96%. Students with Type 1 ("wish for life-sustaining medical treatment") thought that terminal patients accurately understood their medical condition and wanted to prolong their lives. Others with Type 2 ("need for service and support") believed that a multidisciplinary nursing system needs to be established to help terminal patients prepare for death. Students with Type 3 ("awareness and acceptance of death") thought that terminal patients wanted to die with dignity at a hospice unit. Conclusion: This study analyzed various types of attitude towards terminal patients, as perceived by nursing students with clinical training experience. Development of educational programs for each attitude type analyzed in this study could contribute to systematic training programs for nursing students caring for terminal patients.

A Study on the Interest in Hospice According to the Perception of Happiness (행복 인식에 따른 호스피스 준비의 관심에 관한 연구)

  • Chang, Kyung-Hee;Lee, Seo-Hui;Kim, Kwang-Hwan
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.5
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    • pp.489-498
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    • 2018
  • The purpose of this study is to examine whether there is a difference in the awareness of death based on happiness (since attitude or way of life differs among the general public, depending on the perception of death), and to investigate whether there is a difference in the interest in hospices between a group with a high happiness index and a group with a low happiness index. A survey was conducted on 200 men and women aged over 20 who participated in a walking event held in a metropolitan city on April 22, 2017. The survey consisted of eight demographic items: gender, age, education, occupation, marital status, family cohabitation, religion, and health status. It included 29 questions regarding happiness and nine questions regarding the perception of death. For the statistical tests, a chi-square test, an independent sample t-test, correlation analysis, and canonical correlation analysis were performed on the items of the survey based on a happiness index. The results of the study showed that, for a suitable place for death, medical institutions was the highest score (46.3%) for the group with a low happiness index, and own house was highest (59.4%) for the group with a high happiness index. This was a significant difference. It is thought that management systems should be supplemented by professional manpower, educating people so as to increase the utilization rates of home-based hospice as a way for patients to die in a comfortable and familiar place because, for Korea, death is much more common in hospitals. It is also necessary to increase the awareness of death and to make effective use of hospices through individual and various other approaches, considering the demographics of the subjects.

Study of Efficiency of the East-west Medical Combined Treatment of Advanced Gastric Cancer in Patients Case (진행성 위암 환자 증례를 통한 한양방 병용치료의 효용성 연구)

  • Lee Nam-Heon;Shim Jae-Chul;Chae Eun-Yeong;Yoo Hwa-Seung;Cho Jung-Hyo;Lee Yeon-Weol;Son Chang-Kyu;Cho Chong-Kwan;Yun Dam-Hee
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.19 no.6
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    • pp.1681-1684
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    • 2005
  • Gastric cancer is the most common disease which is the highest genetic rate, chemotherapy is the only known way to treat, especially advanced gastric cancer. Although, it is the remedy, the harmful side-effects are an obstacle of the sustaining treatment and negative effect on immunologic ability of patients prologed. Consequently, it is surely necessary that effective control for sequele of anti-cancer treatment, and remedy which can improve the quality of patients life. 1, the writer, medicate patients, diagnose as gastric cancer in 4th stage, with Sohap-hyangwon and Chungwoolhyadamjen who complained of pain in sequele of anti-cancer treatment. The size of the metastastic liver tumor is decreasing in patients and the immunologic abilities are maintaining stable. This clinical cases are shown that the oriental medical care in long-term can improve the quality of life of the patients who has sequele of anti-cancer treatment.

Factors Associated with Willingness to Volunteer for End-Stage AIDS Patients among Hospice Volunteers (호스피스 자원봉사자들의 말기 AIDS 환자들에게 자원봉사를 제공할 의향에 영향을 미치는 요인)

  • Yoon, SeokJoon;Choi, YoungSim;Jung, Jin Gyu;Kim, Jong-Sung;Ryu, Hyewon
    • Journal of Hospice and Palliative Care
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    • v.20 no.4
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    • pp.226-234
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    • 2017
  • Purpose: With the implementation of the Act on Life Sustaining Treatment, hospice-palliative care will be extended to non-cancer diseases including the acquired immunodeficiency syndrome (AIDS). However, there are concerns about negative perceptions and prejudice toward AIDS patients. The purpose of this study was to investigate factors related with willingness to volunteer (WV) for patients with end-stage AIDS among hospice volunteers. Methods: Participants were 326 hospice volunteers from 19 institutions. A self-administered questionnaire was employed to investigate the participants' WV for end-stage AIDS patients, and the questions were answered using an 11-point rating scale. Demographics, volunteer activity, satisfaction with hospice volunteering, knowledge of AIDS, and attitudes towards AIDS patients (i.e., fear AIDS patients, negative attitude towards AIDS patients, personal stigmatization and stigmatizing attitude) were also investigated. A multiple regression analysis was performed to examine factors associated with WV for patients with end-stage AIDS. Results: WV for patients with end-stage AIDS was 2.82 points lower than that for cancer patients (P<0.001). The multiple regression analysis showed that the higher the level of satisfaction with hospice volunteering (P=0.002) and the lower the level of "personal stigmatization" (P<0.001), participants showed greater WV for end-stage AIDS patients. Conclusion: The level of satisfaction with hospice volunteering and "personal stigmatization" were factors associated with participants' WV for patients with end-stage AIDS.