• Journal of Hospice and Palliative Care
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• v.25 no.2
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• pp.85-97
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• 2022

Purpose: This study aimed to describe nurses' perceived needs and barriers to pediatric palliative care (PPC). Methods: Mixed methods with an embedded design were applied. An online survey was conducted for nurses who participated in the End-of-Life Nursing Education Consortium- Pediatric Palliative Care (ELNEC-PPC) train-the-trainer program, of whom 63 responded. Quantitative data were collected with a survey questionnaire developed through the Delphi method. The 47 items for needs and 15 items for barriers to PPC were analyzed with descriptive statistics. Qualitative data were collected through open-ended questions and analyzed with topic modeling techniques. Results: The mean scores of most subdomains of the PPC needs were 3.5 or higher out of 4, and those of PPC barriers ranged from 3.22 to 3.56, indicating the items in the questionnaire developed in this study properly reflect each factor. The needs for PPC were divided into 4 categories: "children and adolescents," "families," "PPC management system," and "community-based PPC." Meanwhile, PPC barriers were divided into 3 categories: "healthcare delivery system," "healthcare provider," and "client." The keywords derived from the topic modeling were perception, palliative, children, and education for necessities and lack, perception, medical care, professional care providers, service, and system for barriers to PPC. Conclusion: In this study, by using mixed-methods, items of nurses' perceived needs and barriers to PPC were identified, categorized, and weighted, and their meanings were explored. For the stable establishment of PPC, the priority should be given to improving perceptions of PPC, establishing an appropriate system, and training professional care providers.

• Journal of Hospice and Palliative Care
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• v.19 no.3
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• pp.240-248
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• 2016

Purpose: Patients and their caretakers need to understand various problems and requirements in the dying process so that they may prepare for death for the rest of their remaining life. Accordingly, a systematic audio-visual resource was developed to educate hospice patients and their families at the palliative care ward about the process of dying. Methods: For the development of an audio-visual resource, a initial education material was produced in the form of simple and accessible Power Point handouts based on literature study. Then, the program was completed through five rounds of a process, including expert advice, revision, update and evaluation. Results: The final version of the program was filmed with cooperation of the medical literature information division. Using the program, patients and families were educated through five phases over three sessions for a total 26 minutes and 34 seconds. Conclusion: The significance of this study lies in the fact that it was conducted after the establishment of the palliative care ward, which made it easier for nurses provide the education. It is expected that the program may be used by hospice specialists as well as nurses as an education resource for hospice patients and their families.

• Korean Journal of Hospice Care
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• v.7 no.1
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• pp.15-28
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• 2007

This study was focused on figure out what kinds of elements are influencing on job satisfaction with approach of the educational system. It was also to figure out how work characteristics and role conflicts of employees influence on job satisfaction. Objects of study were employeeswho had been working in Hospice and Palliative medical center at least for 6 months, and they were doctors, nurses, ministers, and welfare workers. Collected materials were analyzed by Frequency Analysis, One-way ANOVA, Correlation Analysis, and SimpleRegression Analysis. Results from study can be summarized like below. The first, job satisfaction of workers in Hospice and Palliative medical center were 3.36, and this numerical value is pretty high over all. For saying from the higher to the lower satisfaction level, there were satisfaction with job itself, satisfaction with co-workers, satisfaction with seniors (superiors), and satisfaction with organizations, on the other hands, satisfaction with salaries was turned out as the lowest level among those. The second, role conflict was 2.63, and it is considered as the medium level. after inquiring into it by elements of role conflict, they felt many environmental difficulties compared to other workers in different fields such as environmental difficulty, role ambiguity, insufficient ability, process obscurity, etc. The third, work environment influencing on job satisfaction are as follows. Professional environment among characteristics of work environment was significant statistically. Job satisfaction of ministers was the highest; others were in the order of doctors, welfare workers, and nurses. For employment history, job satisfaction was higher as they have more and longer job experience including whole professional experience both in hospice and palliative medical center. In addition, participating in hospice and palliative programs, intensive training regularly was significantly. Job Motivation was also significant statistically. Especially, job satisfaction was higher when people decided to work in hospice and palliative medical center because of individual desire (self-realization). Lastly, influence of role conflict on job satisfaction is as follows. Environmental difficulty, role ambiguity, insufficient ability, process obscurity, etc showed the significant meaning statistically, and the lower role conflict was related with the higher job satisfaction. Suggestions for next study based on such results are as follows in order to improve or increase job satisfaction of employees in hospice/palliative medical centers. The first, to expand education opportunity of employees is needed to increase job satisfactionof hospice/palliatives medical centers. Participating in intensive programs and seminars by types of occupation and acquiring professional knowledge are very important since employees are motivated by those activities. For that, developing and activating intensive education/programs by professional occupations are suggested. The second, dividing roles of employees and determining each job's limit clearly in hospice/palliative medical centers are required. For that, study developing standard job regulations is suggested for each professional job. Lastly, developing and providing reasonable salaries is needed because low salaries of hospice/palliative medical centers are the absolute reason lowering job satisfaction. Therefore, this paper suggests improving the salary level of employees of hospice/palliative medical centers and developing practical plan for it.

• 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.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.2
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• pp.695-701
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• 2014

The main objective of palliative treatment for cancer patients has been to maintain, if not improve, the quality of life (QoL). There is a lack of local data on satisfaction and QoL among cancer patients receiving palliative treatment in Malaysia. This study covers patients with incurable, progressive cancer disease receiving palliative treatment in a teaching hospital in Kuala Lumpur, comparing the different components of QoL and correlations with patient satisfaction. A cross-sectional survey using Malay validated SF36 QoL and PSQ-18 (Short Form) tools was carried out between July 2012 -January 2013 with 120 cancer patients receiving palliative treatment, recruited into the study after informed consent using convenient sampling. Results showed that highest satisfaction were observed in Communication Aspect ($50.6{\pm}9.07$) and the least in General Satisfaction ($26.4{\pm}5.90$). The Mental Component Summary ($44.9{\pm}6.84$) scored higher when compared with the Physical Component Summary ($42.2{\pm}7.91$). In this study, we found that patient satisfaction was strongly associated with good quality of life among cancer patients from a general satisfaction aspect (r=0.232). A poor significant negative correlation was found in Physical Component (technical quality, r=-0.312). The Mental Component showed there was a poor negative correlation between time spent with doctor (r=-0.192) and accessibility, (r=-0.279). We found that feeling at peace and having a sense of meaning in life were more important to patients than being active or achieving good physical comfort. More studyis needed to investigate patients who score poorly on physical and mental component aspects to understand their needs in order to achieve better cancer care.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.10
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• pp.4637-4642
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• 2016

Purpose: To evaluate palliative care for patients with gynecologic cancer in Japan. Materials and Method: A questionnaire asking facility characteristics, systems to coordinate palliative care, current status of end-of-life care, provision of symptom relief, palliative radiation therapy and chemotherapy, and cases of death from gynecological cancer, was mailed to facilities treating gynecologic cancer. Results: A total of 115 facilities (29.3% of the total) responded to the questionnaire. Of these, 33.0 (29.0%) had a palliative care ward. End-of-life care was managed by obstetricians and gynecologists in 72.0% of the facilities. The site where end-of-life care was provided was most often a ward in the department where the respondent worked. The waiting period for transfer to a hospice was 2 weeks or more in 52% of facilities. Before the start of primary treatment, pain control was managed by obstetrians and gynecologists in 98.0% of facilities. Palliative radiation therapy or chemotherapy was administered at 93.9% and 92.0% of facilities, respectively. Of the 115 facilities, 34.0 (29.6%) reported cases of death from gynecological cancer. There were 1,134 cases of death. The median time between the last cycle of chemotherapy and death was 85 days for all gynecological cancers. The proportion of patients receiving chemotherapy in the last 30 and 14 days of life were 17.4% and 7.1%, respectively. Conclusions: This large-scale survey showed characteristics of palliative care given to patients with gynecologic cancer in Japan. Assessment of death cases showed that the median time between the last cycle of chemotherapy and death was relatively short.

• Journal of Hospice and Palliative Care
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• v.24 no.2
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• pp.85-96
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• 2021

Purpose: The aim of this study was to investigatecomplementary therapiesprovided at hospice palliative care facilities in South Koreaas designated by the Ministry of Health and Welfare. Methods: The survey was conducted via e-mail from September 2 to September 23, 2020, with responsesfrom 109 therapists and 59 managers from 55 different hospice care facilities. Results: Hospices provided an average of 3.67 different types of therapies, ranging from 1 to 7 different types. The most common types of therapies were horticultural therapy (81.4%), music therapy (79.7%), art therapy (76.3%), and aromatherapy (57.6%). The average frequency of sessions was once a week, the median duration was 60 minutes. Most therapists (96.3%) had qualifications, but the certification-issuing organizations and training intensiveness varied greatly. None of the therapists were employed on a full-time basis, and their average monthly income was KRW 270,000. Therapists and managers gave average scores of 8.90 and 8.38 out of 10, respectively, regarding the positive impact of complementary therapies on patients. Conclusion: In order for patients and their families to benefit from complementary therapiesat hospice care facilities, in addition tobetter terms of employment for therapists, evidence-based guidelines for different types of therapies are needed so that therapy sessions can be conducted according to the theoretical underpinnings and characteristics of the type of therapy. It is expected that the results of this study will be used for policy-making in support of therapy as an essential hospice service.

• Journal of Hospice and Palliative Care
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• v.25 no.1
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• pp.42-49
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• 2022

As population aging increases the burden of cancer, the quality of death of patients with cancer is emerging as an important issue alongside their quality of life. To improve the quality of death, it is necessary to prepare for death, allowing patients to die comfortably and with dignity at the end. Considering these issues, I aim to discuss the practical aspects of notifying the patient of the terminal phase of cancer and planning for end-of-life care (i.e., advance care planning). When cancer treatment that can extend the patent's lifespan becomes difficult, the patient enters a treatment transition period. Treatment is shifted from life-prolonging care to life-enhancing care, and end-of-life care must be well planned. Medical providers often worry too much about whether the patient will be disappointed or psychologically traumatized when notified of the terminal phase of their cancer, thus delaying plans for end-of-life care. In fact, patients can accept their condition and prepare for end-of-life care better than we expect. During the treatment transition period, notification of terminal status should be given, and a well-prepared advance care plan should be established early when the patient has decision-making ability. In addition to conveying information, it is always necessary to be sensitive to whether the patient and caregiver understand the information and respond to their emotions.

• 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.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.