• Journal of Hospice and Palliative Care
• /
• v.24 no.1
• /
• pp.26-35
• /
• 2021

Purpose: The purpose of this study was to determine the effects of awareness of good death and end-of-life care attitudes on end-of-life care performance in long-term care hospital nurses. Methods: This study used a cross-sectional study design. The participants were 147 nurses working at six long-term care hospitals with more than 200 beds in B city, South Korea. Data were collected using self-reported questionnaires, and analyzed with descriptive statistics, the t-test, analysis of variance, Pearson correlation coefficients, and multiple stepwise regression analysis using IBM/SPSS 26.0 for Windows. Results: The participants' awareness of good death, end-of-life care attitudes, and end-of-life care performance were positively correlated. The factors affecting end-of-life care performance were age, education level, awareness of good death, and end-of-life care attitudes; these variables explained 19.0% of end-of-life care performance. Conclusion: In order to improve long term care hospital nurses' end-of-life care performance, continuing education and training should be provided regarding awareness of good death and end-of-life care attitudes.

• Journal of Korean Academy of Fundamentals of Nursing
• /
• v.17 no.2
• /
• pp.209-219
• /
• 2010

Introduction: The phenomenon related to sign & symptom management for end of life of the patients is of interest to researchers in nursing society today. This study was conducted to clarify and to conceptualize the factors of sign & symptom management in end of life care though nurses' perceptions on this phenomena. Methods: The qualitative study method was used to explore the experienced nurses' perceptions related to sign & symptom management in end of life care. It included a field study carried out in South Korea using in-depth interviews with 30 experienced nurses from three nursing home facilities. Results: This study identified the following categories related to end of life care with sub-categories for each category: (1) nurses' modes in identifying the signs related to patients' end of life, (2) nurses' perceived directions on patients' end of life care, (3) nurses' perceived strategies in end of life care and (4) nurses' perceived barriers in end of life care Conclusion: Through this study, characteristics of the way nurses' provide for patients' end of life care are identified, along with how nursing decisions are made to manage the sign & symptom indicating patients' end of life.

• Journal of Korean Academic Society of Home Health Care Nursing
• /
• v.29 no.2
• /
• pp.143-152
• /
• 2022

Purpose: This study aims to describe and explore the experiences of visiting nurses so as to providing high-quality end-of-life care at home. Methods: Data was collected and recorded through in-depth interviews with 11 visiting nurses and transcribed verbatim. The data were analyzed with qualitative contents analysis. Data were collected from April 8 to July 30, 2021. Results: The results revealed the following four themes and ten sub-themes: The main themes were 'Dignified end-of-life caring practice at home', 'Providing integrated support of end-of-life family caregivers', 'Confronting the limits of visiting nursing at the end of life' and 'Reflection on life and feeling rewarded'. Visiting nurses have performed dignified end-of-life care at home and integrated support for family caregivers. Although the visiting nurse sometimes faced the limits of visiting nursing during end-of-life care, it was surveyed that they rewarded on their lives and felt rewarding through the end-of-life nursing experience. Conclusion: Practical and systematic training is needed to positively change the end-of-life care of visiting nurses. We propose programs, such as expert counseling, to improve coping skills in end-of-life care practice at home. Additionally, we propose various institutional supports which can support the limitations of end-of-life care provision.

• Journal of The Korean Society of Integrative Medicine
• /
• v.5 no.4
• /
• pp.57-66
• /
• 2017

Purpose : The current study objective was to determine the attitudes of nursing students to death, perception of end-of life care, and perceptions of educational training needs in relation to the provision of end-of life care, and to apply the results to the development of an efficient and effective education program in this regard. Method : Data collection was carried out between March and April 2017, and was achieved through the administration of a questionnaire to 124 caregivers working in a nursing home in C. A self-report instrument was used to measure nursing attitudes to death, perceptions of end-of-life care, and perceptions of educational training needs in relation to the provision of end-of-life care. The collected data were analyzed using SPSS(R) Statistics for Windows(R)(version 21.0), and were calculated was whole numbers, percentages, $mean{\pm}standard$ deviation, and Pearson's correlation coefficient. Results : The average scores obtained were 2.85 out of a maximum of 4.00, 2.14 out of 4.00, and 2.42 out of 4.00, for attitudes to death, perceptions of end-of-life, and perceptions of educational training needs in relation to the provision of end-of-life care, respectively. A positive correlation was found between attitudes to death and perceptions of end-of-life care, and a negative correlation was found between perceptions of end-of-life care and educational training needs in relation to the provision of end-of-life care. Conclusion : The development and implementation of an educational program is necessary to ensure positive attitudes to death in nursing students and improve their perceptions about end-of-life care. Further research is also warranted to determine the impact of such a program in this regard.

• Journal of Hospice and Palliative Care
• /
• v.23 no.3
• /
• pp.139-150
• /
• 2020

Purpose: The purpose of this study was to investigate the levels of end-of-life care competency; knowledge, attitudes, and experiences regarding advance directives; perceptions of good death; and end-of-life care obstacles and supportive behaviors among tertiary care nurses. Methods: The participants were 150 nurses at a tertiary hospital in Jinju, Korea. The data collected using a questionnaire were analyzed using descriptive statistics, the t-test, analysis of variance, Pearson correlation coefficients, and stepwise multiple regression in SPSS for Windows version 24.0. Results: The mean (±SD) score of end-of-life care competency was 3.63 (±0.53) on a 5-point scale. A significant difference in end-of-life care competency was found according to whether nurses had experienced the death of a family member or acquaintance (P=0.029). According to stepwise multiple regression analysis, the factors affecting end-of-life care competency were the frequency of end-of-life care supportive behaviors (β=0.38, P<0.001), experience with advance directives (β=0.29, P<0.001), and marriage (β=0.15, P=0.039). This model had an explanatory power of 27.9% (F=18.87, P<0.001). Conclusion: In order to improve nurses' end-of-life care competency, it is important to strengthen end-of-life care supportive behaviors by exposing nurses to those behaviors and providing frequent experience with advance directives.

• Journal of Hospice and Palliative Care
• /
• v.26 no.4
• /
• pp.160-170
• /
• 2023

Purpose: The aim of this study was to examine the effects of death anxiety and perceived end-of-life care competencies on the fear of terminal care among clinical nurses. Methods: This correlational study was conducted from June to July 2021. The study included 149 clinical nurses employed at a tertiary hospital and seven other hospitals. The measurement tools used in this study were the Thanatophobia Scale (Cronbach's α=0.87), the Death Anxiety Scale (Cronbach's α=0.80), and the Scale of End-of-life Care Competencies (Cronbach's α=0.94). These instruments were chosen to assess the levels of fear of terminal care, death-related anxiety, and competencies in end-of-life care. Results: The mean score for fear of terminal care was 3.32±1.32. Differences in fear of terminal care were observed based on the working unit, position, number of patients requiring terminal care, and experience with end-of-life care education. Fear of terminal care was significantly positively correlated with death anxiety and significantly negatively correlated with end-of-life care competencies. In multiple regression analysis, the factors influencing fear of terminal care were attitudes toward end-of-life care competencies (𝛽=-0.39, P<0.001), death anxiety (𝛽=0.24, P<0.001), knowledge of end-of-life care competencies (𝛽=-0.22, P=0.005), and behaviors related to end-of-life care competencies (𝛽=-0.16, P=0.021). These factors explained 64.6% of the total variance (F=25.54, P<0.001). Conclusion: This study suggests that developing nurses' end-of-life care competencies and reducing death anxiety are crucial for managing the fear of terminal care. Therefore, providing end-of-life care education and psychological support programs is important.

• Journal of Hospice and Palliative Care
• /
• v.24 no.4
• /
• pp.235-244
• /
• 2021

Purpose: This study aimed to provide basic data for developing interventions to relieve the end-of-life care stress experienced by pediatric nurses by examining the relationships of end-of-life care stress with compassionate competence and attitudes toward end-of-life care. Methods: Data were collected via a survey that was conducted from September 10 to September 30, 2018 and administered to 113 nurses who had worked for more than 6 months in a pediatric unit at a tertiary hospital in Seoul, South Korea. The data were analyzed for frequency, percentage, mean, and standard deviation, and the independent t-test, one-way analysis of variance, and Pearson correlation analysis were conducted using SPSS version 25.0. Results: End-of-life care stress among pediatric nurses had a weak positive correlation (r=0.216, P<0.05) with compassionate competence and had no significant correlation with attitudes toward end-of-life care. Among the sub-factors of end-of-life care stress, psychological difficulties had a weak positive correlation with sensitivity (r=0.309, P<0.01) and communication (r=0.230, P<0.05), which are aspects of compassionate competence. Lack of knowledge about end-of-life care had a weak positive correlation with communication (r=0.209, P<0.05) as an aspect of compassionate competence. Conclusion: To improve the quality of end-of-life care provided by pediatric nurses, it is necessary to improve their compassionate competence and reduce their end-of-life care stress by developing education and support programs tailored to the characteristics of children and specific communication methods.

• Journal of Hospice and Palliative Care
• /
• v.26 no.3
• /
• pp.101-111
• /
• 2023

Purpose: This study aimed to identify levels of perception and performance of end-oflife care among nurses and to investigate correlations between perception and performance. Methods: This cross-sectional descriptive survey included 321 nurses from a tertiary hospital in Seoul, Korea. The participants had at least 6 months of work experience and had been involved in end-of-life care at least once, in either ward or intensive care unit settings. A structured questionnaire was utilized to assess their perception and performance of endof-life care. Results: The mean score for perception of end-of-life care was 3.23±0.34, while the score for performance of end-of-life care was 3.08±0.34. There was a significant positive correlation between nurses' perception of end-of-life care and their performance in this area (r=0.78, P<0.001). Conclusion: It is necessary to change perceptions regarding end-of-life care and to develop systematic and standardized education programs including content such as assessing the hydration status of dying patients, evaluating mental aspects such as suicidal ideation, and providing spiritual care for nurses working in end-of-life departments.

• Journal of Korean Institute of Industrial Engineers
• /
• v.34 no.1
• /
• pp.79-89
• /
• 2008

An end-of-life strategy is concerned with how to disassemble a product and what to do with each of the resultingdisassembled parts. A sound understanding of the end-of-life strategy at the early design stage could improve theease of disassembly and recycling in an efficient and effective manner. Therefore, the end-of-life decisionmaking for environmental conscious design has become a great concern to product manufacturers.We introduce a novel concept ofeco-architecture which represents a scheme by which the physical componentsare allocated to end-of-life modules. An end-of-life module is a physical chunk of connected components or afeasible subassembly which can be simultaneously processed by the same end-of-life option without furtherdisassembly. In this paper, a method for analyzing the eco-architecture of a product at the configuration designstage is proposed. It produces an optimal eco-architecture under the given environmental regulations. To dealwith the case ofa complex product, the method is extended for analyzing hierarchical eco-architecture.

• Child Health Nursing Research
• /
• v.24 no.4
• /
• pp.353-363
• /
• 2018

Purpose: The purpose of this study was to investigate pediatric nurses' perceptions regarding in end-of-life care and turnover intention. Methods: A cross-sectional descriptive study was performed among 111 hospital nurses. Pediatric nurses' perceptions of obstacles and supportive behaviors were measured using the Pediatric Nurses' Perceptions of End of Life Care Questionnaire which was translated into Korean and turnover intention was measured using the Korean Nurse Turnover Intention Scale (K-NTIS). Results: The supportive behavior with the highest perceived magnitude was 'Physicians who are compassionate, but very clear about prognosis.' The obstacle with the highest perceived magnitude was 'Instigating painful treatments when there is no hope of recovery.' Pediatric nurses' perceptions of obstacles in end-of-life care showed statistically significant differences depending on whether nurses received end-of-life care education (t=2.02, p=.046). The perception of obstacles in end-of-life care was positively correlated with turnover intention (intensity r=.28, p=.002) (frequency r=.20, p=.027). Conclusion: These results suggest that pediatric nurses' perception of obstacles and supportive behaviors in end-of-life care need to be assessed when considering turnover intention. Furthermore, psychological counseling should be offered to nurses to prevent burnout and reduce moral distress which is correlated with the turnover rate.