• 대한간호학회지
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• 제39권4호
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• pp.528-538
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• 2009

Purpose: This study was done to develop and test a palliative care program based on home care nursing. Methods: A quasi-experimental design was employed. Changes in the variables were evaluated to test effects of the developed program. Participants were patients with terminal cancer and their families receiving home care nursing from six hospitals (experimental group: 24 and control group: 22). Data collection was conducted from February to October, 2006. Chi-square test, Fisher's exact test, t-test, Mann-Whitney U test and repeated measures ANOVA were used to analyse the data. Results: Hypothesis 1, the experimental group receiving this program will experience less pain (severe, average, weak pain) than the control group, was supported. Hypothesis 2, the experimental group will have less symptom experience than the control group, was supported. Hypothesis 3, the experimental group will have higher QOL than the control group, was supported and the last hypothesis 4, family burden in the experimental group will be less than the control group, was supported. Conclusion: The home care nursing based palliative program developed in this study was found to be an effective program to reduce patient pain and symptom experience, to improve patient QOL and to decrease family burden.

• 호스피스학술지
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• 제8권1호
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• pp.153-171
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• 2008

• 호스피스학술지
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• 제8권1호
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• pp.89-122
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• 2008

• Journal of Hospice and Palliative Care
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• 제5권2호
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• pp.101-110
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• 2002

Purpose : With the elongation of the average life span, the main causes of death are chronicle illness including cancers resulting in a large amount of medical resources. And there are still many patients to whom a sufficient medical care is not given. All these bring on the uneven distribution of medical resources together with the increase of medical cost. Hence, an efficient system should be set up to solve these problems. Methods : The hospice draws a great attention as a resolution of high medical cost and uneven medical resource distribution, and has been proved to be an alternative to the existing medical system. So, the characteristics of the hospice has been reviewed, particularly with respect to its scopes and related resources. And by tracking the actual cases, the necessary services and supports are investigated. Results : The intrinsic characteristics of hospice is that it executes not only the medical exercise but also all the subjects related with patients and their families. And the hospice is performed not only by the medical experts but also by all the disciplines including social and spiritual affairs. This indicates that the hospice requires the integrated system comprised of medical, social and other welfare entities. Conclusion : To establish the actual hospice, an efficient and systematic integration of all the existing medical and other welfare resources in the local society is necessary. The most practical way is the networking of resources, which practices the hospice more efficiently without additional investment.

• 호스피스학술지
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• 제7권1호
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• pp.29-45
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• 2007

People in the end of life and their families suffer in their physical disease and other aspects as a whole person. They need hospice care to palliate their total suffering in physical, emotional, social and also spiritual aspect through professional hospice team. To care their whole personal needs, hospice team must be a multi-discipline team which consists of medical doctors, nurses, social workers, pastors and volunteers. Recently those who die in hospice palliative care unit have trend to increase more than in home year by year. So it is necessary to develop the nursing intervention program to be performed by multi-discipline team approach for in-patient of hospice palliative care unit. The purposes of this study were to develop of wholistic hospice nursing intervention program for inpatient of hospice palliative care unit. The subjects of study were collected from 30 patients those who were over 18 years old and admitted in hospice palliative care unit of S hospital in P city with agreement in hospice palliative care in their terminal disease. The period of data collection was from December 15, 2003 to March 15, 2004. The result were as follows : 1. The result of Wholistic Hospice Nursing Program's development was as follow : A Wholistic Hospice Nursing Program was developed by me in this study is one of the service program for hospice palliative care unit. It was named as ‘Rainbow Program’ to be approached easily by hospice patients. The purposes of it are to improve the quality of life of the terminal patients with their dignity, to help them live in abundant and meaningful in their lives, to care them in peaceful in dying process with understanding them in whole personal, and also to palliate the grief and suffering of the bereaved. It was provided by hospice professionals(nurses, medical doctors, social worker, pastors, art therapists) and volunteers those who were educated in hospice for multi-diciplinary team approach to collaborate with each role play I 20-30 minuters of each through visiting their rooms individually and a place of hospice palliative care unit of S hospital in P city. The subjects of it were the terminal patients those who admitted hospice palliative care unit and their familes. with agreement in hospice palliative care in their terminal disease. The characteristics of it were multi-disciplinary team approach, whole personal care, individual care and total care according to their needs in their condition. The contents of it were pain control, symptom control, counseling patient, counseling family, hair cutting, hair shampooing, bed bath, recreation, taking a walk, event of culture(screen, recital, festival of praises, exhibition and so on), pastoral counseling, ritual service in bed, praying, service in bed, sing a worship praise, listening to the music, sharing remembrance of life, individual visiting music service(sing and praying), meditation Bible, art therapies(dance and drawing), social worker's counselling, confessing and sharing love and thanksgiving. The experimental group subjects participated in Wholistic Hospice Nursing Program which takes 120 minutes per session, total 10 sessions(total 1,200 minutes) altogether. In conclusion, this Wholistic Hospice Nursing Intervention can be used actively for whole personal well-being of the patients in hospice palliative in hospice palliative care unit and also applied in hospice practice as an useful model of multi-disciplinary team approach by hospice professionals.

• Asian Pacific Journal of Cancer Prevention
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• 제17권8호
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• pp.3887-3895
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• 2016

Background: In order to increase breast and cervical cancer screening uptake in Singapore, women's perceived barriers to screening need to be identified and overcome. Using data from both focus groups and surveys, we aimed to assess perceived barriers and motivations for breast and cervical cancer screening. Materials and Methods: We conducted 8 focus groups with 64 women, using thematic analysis to identify overarching themes related to women's attitudes towards screening. Based on recurring themes from focus groups, several hypotheses regarding potential barriers and motivations to screen were generated and tested through a national survey of 801 women aged 25-64. Results: Focus group participants had misconceptions related to screening, believing that the procedures were painful. Cost was an issue, as well as efficacy and fatalism. Conclusions: By identifying barriers to and motivators for screening through a mixed-method design that has both nuance and external validity, this study offers valuable suggestions to policymakers to improve breast and cervical cancer screening uptake in Singapore.

• Journal of Hospice and Palliative Care
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• 제22권2호
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• pp.67-76
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• 2019

포괄적이고 총체적 돌봄을 제공하는 호스피스 완화의료의 경우 평가도구를 사용하여 문제목록의 객관화하고 돌봄 계획의 구체화하는 것이 필요하다. 초기평가는 입원 당일 혹은 1일 이내에 환자의 증상과 사회적, 영적 문제, 완화의료에 대한 요구가 무엇인지 파악하며 개괄적인 돌봄의 방향을 설정하는 과정이다. 현재 병에 대한 인식과 예후를 파악하는 것부터 연명의료계획서 작성까지 함께 검토한다. 초기평가도구로는 간단하지만 포괄적으로 신체적, 정신적, 사회적, 영적 영역을 아우르는 13개의 간단한 질문으로 구성된 NEST를 추천한다. 초기평가에서 파악된 문제에 대하여 구체적인 평가도구들을 활용하여 돌봄 계획을 수립하며 입원 후 3일이내 시행하는 것이 좋다. 신체적 영역의 경우 기능상태를 포함하여 통증과 비 통증 증상, 삶의 질을 함께 파악할 수 있는 다증상 평가도구가 도움이 될 수 있다. 환자의 증상은 단독으로 의미를 가지는 것이 아니라 복합적인 상호작용으로 발생하며, 그에 따라 포괄적으로 접근해야 하기 때문이다. 정신심리적 영역은 심리적 고통과 불안, 우울을 평가한다. 사회적 영역의 평가는 의사결정, 사회경제적 환경 파악, 가족 평가 및 임종 준비의 단계로 이루어진다. 영적 평가 역시 중요한데 FACIT-Sp나 SHI를 사용할 수 있다. 평가도구를 활용하는 것은 환자의 고통을 경감시키고 삶의 질을 향상시킬 뿐 아니라 의료진이 체계적으로 훈련되는 방안이 될 수 있으며 그 과정 자체가 더 나은 돌봄 제공을 위한 발판이 될 수 있다.

• Journal of Hospice and Palliative Care
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• 제23권2호
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• pp.85-92
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• 2020

Purpose: In 2018, the Act on Decisions on Life-Sustaining Treatment for Patients in Hospice and Palliative Care or at the End of Life was implemented and the scope of official recognition for terminally ill patients was expanded. The purpose of this study was to investigate the decisions made by patients with end-stage liver disease about their life-sustaining treatment in a clinical setting. Methods: The subjects of this study were patients with end-stage liver disease hospitalized at a tertiary hospital in Seoul, Korea who wrote physician orders for life-sustaining treatment (POLST). Data collection was done using patients' electronic medical records, and a retrospective analysis of POLST was conducted. Results: Among 101 patients, 18.8% were female and 81.2% were male, and their mean age was 61.8 (±10.61) years. Sixty-three patients (62.4%) wrote their POLST by themselves. Three patients withdrew the POLST, of whom two did so for liver transplantation, and one did so for chemotherapy. Conclusion: This study shows that sufficient consideration of liver transplantation is needed for end-stage liver disease patients before making decisions on life-sustaining treatment. The self-determination of patients must be respected and effective guidelines are urgently needed.

• Journal of Hospice and Palliative Care
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• 제23권4호
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• pp.212-227
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• 2020

Purpose: This study presents the process of designing workbooks for advance care planning appropriate for the Korean cultural setting and describes actual case studies. Methods: This study focused on single inductive case studies of the utilization of an advance care planning workbook and recruited individual participants. Results: The workbook for adolescents contained six sessions and the workbook for children contained seven sessions. The workbook sessions led to four major discoveries: 1) considering the Korean cultural context, discussions on life and death must be held indirectly; 2) the role of the counselor as a supporter is crucial for the workbook to be effective; 3) the workbook must be accessible regardless of the seriousness of the illness; and 4) patients must be able to make their own choice between the workbook versions for children and adolescents. Six facilitating factors improved engagement: 1) the role of the counselor as a supporter; 2) building trust with the patient; 3) affirming freedom of expression on topics the patient wished to avoid talking about; 4) having discussions on what private information to keep secret and to whom the information can be disclosed; 5) discovering and regularly discussing relevant topics; and 6) regular communication and information-sharing with the patient's medical service providers. Conclusion: It is necessary to build on actual case studies regarding workbooks for children and adolescents in order to expand the usage of these workbooks to all relevant medical institutions in Korea.

• Journal of Hospice and Palliative Care
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• 제25권4호
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• pp.159-168
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• 2022

Purpose: This study aimed to investigate the impacts of end-of-life care competency and ethical dilemmas on psychological burnout in nurses who care for terminal cancer patients. Methods: A cross-sectional study of 160 nurses who cared for terminal cancer patients was conducted. The participants were recruited from the hospice-palliative care wards, hematology or oncology wards, or intensive care units of three general hospitals in a single metropolitan area. Data were collected using a self-administered survey to assess end-oflife care competency, ethical dilemmas, psychological burnout, and general sociodemographic characteristics. Data were analyzed using descriptive statistics, the independent ttest, analysis of variance, Pearson correlation coefficients, and hierarchical linear regression analysis using SPSS for Windows (version 26.0). Results: Psychological burnout was significantly correlated with end-of-life care competency (r=-0.23, P=0.003) but not with ethical dilemmas. The results of the hierarchical linear regression analysis indicated that endof-life care competency (β=-0.280, P=0.010) and ethical dilemmas (β=0.275, P=0.037) were significant predictors of psychological burnout, after adjusting for age, religious status, clinical experience, and unit type. Conclusion: The current study's findings demonstrate that end-of-life care competency and ethical dilemmas are crucial factors that affect psychological burnout in nurses who care for terminal cancer patients. Substantive education programs must be developed to improve nurses' competencies in end-of-life care and ethical dilemmas to decrease psychological burnout.