• Journal of Hospice and Palliative Care
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• 제24권4호
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• pp.245-253
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• 2021

Purpose: This study aimed to explore the experiences of hospice and palliative care (HPC) nurses at inpatient hospice centers in South Korea during the coronavirus disease 2019 pandemic. Methods: Data collection was conducted through individual interviews with 15 HPC nurses using face-to-face interviews, telephone calls, or Zoom videoconferencing. Data were analyzed using the thematic analysis method. Results: This study found that HPC nurses experienced practical and ethical dilemmas that reinforced the essential meaning and value of hospice and palliative care. The participants emphasized their practical roles related to compliance with infection prevention measures and their roles as rebuilders of hospice and palliative care. Conclusion: The findings of this study indicate that inpatient hospice centers must mitigate the practical and ethical dilemmas experienced by nurses, consider establishing explanation nursing units, and provide education to support nurses' highlighted roles during the pandemic. This study can be used to prepare inpatient hospice centers and the nurses that work there for future infectious disease outbreaks.

• Journal of Hospice and Palliative Care
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• 제25권1호
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• pp.50-54
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• 2022

Antibiotics are commonly prescribed medications in the hospice and palliative care setting, as well as in many other healthcare settings. The overuse or negligent use of antibiotics is associated with the harmful consequence of fostering the development of antibiotic-resistant pathogens. Thus, there is an urgent need to critically examine and audit antibiotic use in all aspects of healthcare. In the status quo, there is a lack of consistent standards and guidelines surrounding the use of antibiotics in hospice and palliative care settings, leading to significant variations in how antibiotics are prescribed and administered in end-of-life care. It is apparent that greater thought needs to go into antibiotic decisions for patients receiving hospice or palliative care, especially considering the harmful consequences of the overprescription of antibiotics. The literature suggests that many clinicians prescribe antibiotics inappropriately for patients who would not benefit from their use or prescribe them without adequate documentation. Clinicians should be deliberate about when they prescribe antibiotics and adhere to the appropriate documentation standards and procedures within their institution or community. Future research should seek to generate generalizable knowledge about which patients will benefit most from antibiotic therapy during end-of-life care.

• Journal of Hospice and Palliative Care
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• 제10권1호
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• pp.1-20
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• 2007

• 대한간호학회지
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• 제41권3호
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• pp.374-381
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• 2011

Purpose: The purpose of this study was to develop and validate a hospice palliative care performance measure which would cover more than just physical symptoms or quality of life. Methods: Through an intensive literature review, the author chose questions that measured aspects of physical, emotional, spiritual, social, or practical domains pertinent to hospice palliative care for inclusion in the scale. Content validation of the questions was established by 15 hospice palliative care professionals. A preliminary Hospice Palliative Care Performance Scale (HPCPS) of 20 questions was administered to 134 pairs of terminal cancer patients from 5 hospice palliative care units and their main family caregiver. A validation study was conducted to evaluate construct validity and internal consistency. Results: Factor analysis showed 14 significant questions in five subscales; Physical, Emotional, Spiritual, Social, and Patient' rights. There were no significant differences between the ratings by patients and family members except for three out of the 14 questions. The measure demonstrated construct validity, and Cronbach's ${\alpha}$ of the subscales ranged from .73 to .79. Conclusion: The HPCOS demonstrated acceptable validity and reliability. It can be used to assess effectiveness of hospice palliative care for terminal cancer patients in practice and research.

• 호스피스학술지
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• 제4권2호
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• pp.1-8
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• 2004

Purpose: This research aims to assess the effect of group education of hospice and palliative care program on recognition of home hospice care for terminal cancer patients and their family members. Methods: The terminal cancer patients or their family members who have visited Sam Anyang Hospital from January to September in 2004 participated in group education of hospice and palliative care program on one time a week. Of those, 32 patients or family members who were called education group has participated in group education more than 4 times and responded to a questionnaire. Sixty three patients or family members who were called non-education group have never participated in group education of hospice and palliative care program during the same period. Data were collected and done comparative analysis about both group. Results: A knowledge difference on definition of hospice and palliative care come out 29 people(91%) in education group and 26 people(41%) in non-education group. The recognition of home hospice care in education group(32 people, 100%) was significantly higher than non-education group(15 people,24%). A intention to home hospice care in education group(23 people, 72%) was significantly higher than non-education group(10 people,16%) and practically number of home hospice care was 15 people(50%) in education group and 8(13%) in non-education group. The recognition about cancer of patients was not significant differences in both group. People that the response to the question about 'Did you let your patient know to be the terminal cancer patient?' is 'yes' was 12 people(38%) in education group and 13(21%) in non-education group. Patients in education group had insight about terminal cancer significantly higher than non-education group. Conclusion: If we educated effective hospice and palliative care program in terminal cancer patients or their family members, we think the recognition of cancer and hospice and palliative care improve, and the home hospice care be activated more and more.

• Journal of Hospice and Palliative Care
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• 제26권1호
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• pp.22-25
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• 2023

Although most patients prefer dying at home, patients whose condition rapidly becomes critical need care in the intensive care unit (ICU), and it is rare for them to die at home with their families. Therefore, interest in hospice and palliative care for patients in the ICU is increasing. Hospice and palliative care (PC) is necessary for all patients with life-threatening diseases. The following patients need palliative care in the ICU: patients with chronic critical illnesses who need tracheostomy, percutaneous gastrostomy tube, and extracorporeal life support; patients aged 80 years or older; stage 4 cancer patients; patients with specific acute diseases with a poor prognosis (e.g., anoxic brain injury and intracerebral hemorrhage requiring mechanical ventilation); and patients for whom the attending physician expects a poor prognosis. There are two PC models-a consultative model and an integrative model-in the ICU setting. Since these two models have advantages and disadvantages, it is necessary to apply the model that best fits each hospital's circumstances. Furthermore, interdisciplinary decision-making between the ICU care team and PC specialists should be strengthened to increase the provision of hospice and palliative care services for patients expected to have poor outcomes and their families.

• Journal of Hospice and Palliative Care
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• 제24권4호
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• pp.214-225
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• 2021

Purpose: This study reviewed screening and assessment tools that are used to measure delirium in patients with cancer in hospice and palliative care settings and examined their psychometric properties. Methods: Four databases were searched for studies using related search terms (delirium, tools, palliative care, cancer, and others). The inclusion criteria were a) studies that included screening/assessment tools for measuring delirium in cancer patients receiving hospice/palliative care, and b) studies published in English or Korean. The exclusion criteria were a) studies that were conducted in an intensive care setting, and b) case studies, qualitative studies, systematic reviews, or meta-analyses. Results: Out of the 81 studies identified, only 10 examined the psychometric properties of tools for measuring delirium, and 8 tools were ultimately identified. The psychometric properties of the Memorial Delirium Assessment Scale (MDAS) were the most frequently examined (n=5), and the MDAS showed good reliability, concurrent validity, and diagnostic accuracy. The Delirium Rating Scale had good reliability and diagnostic accuracy. The Delirium Rating Scale-Revised 98 also showed good reliability and structural validity, but its diagnostic performance was not examined in hospice/palliative care settings. The Nursing Delirium Screening Scale showed relatively low diagnostic accuracy. Conclusion: The MDAS showed evidence of being a valid assessment tool for assessing delirium in patients with cancer in palliative care. Few studies examined the diagnostic performance of delirium tools. Therefore, further studies are needed to examine the diagnostic performance of screening/assessment tools for the optimal detection of delirium in patients with cancer in hospice/palliative care.

• 보건의료산업학회지
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• 제12권4호
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• pp.173-190
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• 2018

Objectives: This study was conducted to analyze the symptoms and care needs of home-based hospice palliative patients in Busan and to provide a basic reference for developing practical guidelines for their care. Methods: By examining the registration cards of 409 hospice palliative patients, who were registered in community health centers in Busan as of 2016, this study retrospectively analyzed their characteristics, symptoms and care needs. Results: The average age was 70.6 years, 59.4% were receiving medical benefits, and 48.4% lived alone. As per the data obtained from the Palliative Performance Scale, many were able to mobile. Fatigue was the most severe and depression and anxiety were reported together, and their care needs were also high. Most subjects reported mild or low pain, but care needs were high. Furthermore, the medical benefits group showed a high level of symptoms and care needs across areas. Conclusions: To help subjects to live in their homes for as long as possible, it is necessary to identify symptoms and care needs and provide services in accordance with their severity and situation. Thus, it is necessary to develop practical guidelines for standardized community hospice palliative care services.

• Journal of Hospice and Palliative Care
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• 제22권1호
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• pp.1-7
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• 2019

한국에서 호스피스의 기원은 11세기 초, 고려시대의 동서대비원(東西大悲院)에서 그 유래를 찾을 수 있다. 한국에 호스피스가 도입된 이후, 50여년이 흘렀고, 초기에는 종교적 배경과 민간차원의 활동이 더디게 발전해왔으나, 1990년대에 각 종교단체가 구성되고 학회가 출범한 이후, 2000년대 초기부터 정부의 개입으로 제도화가 진행되면서 본격적인 성장기를 맞게 되었다. 비록 말기암환자와 그 가족들의 고통이 경감되고 삶의 질과 서비스의 질은 향상되었으나, 안정적인 재정기반을 보장할 수 있는 현실적인 보상체계는 마련되지 못했었다. 그러나, 2015년에 호스피스 완화의료 서비스에 대한 국민건강보험 급여수가가 인정되었고, 2016년에 "호스피스 완화의료 및 임종과정에 있는 환자의 연명의료결정에 관한 법률"이 제정되어 말기환자의 무의미한 연명치료를 거부할 수 있게 되었으며, 호스피스 완화의료 서비스의 대상 질환이 확대되면서 서비스제공자들에게는 더 많은 도전과 과제들이 남아있다.

• Journal of Hospice and Palliative Care
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• 제5권1호
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• pp.31-42
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• 2002

목적 : 연구의 목적은 호스피스 완화의료의 표준화를 위한 기초자료로서 국내 호스피스 완화의료 서비스를 제공하는 의료기관 및 비의료기관의 서비스 대상자, 시설 인력구성, 서비스 내용 및 재정적 문제 등 실태를 파악하는 것이다. 방법 : 설문조사는 2001년 7월부터 10월까지 이루어졌으며, 연구자들이 기존 연구를 참조하여 개발한 총 39항목의 설문지를 반송봉투를 넣어 우편으로 발송하여 조사하였다. 회신이 되었지만 내용을 재확인할 필요가 있는 부분과 회신이 안된 기관은 전화를 통해 설문을 완성하였다. 64개 기관이 설문에 응답하였다. 결과 : 국내에는 호스피스 완화의료 서비스를 제공하는 의료기관이 40개, 비의료기관이 24개 있었다. 의료기관 중 11개 기관은 병원연계 및 독립 또는 별도병동이 었고, 비의료기관 중 6개는 입원이 가능한 독립시설에서 호스피스 완화의료서비스를 제공하고 있었다. 호스피스 완화의료 서비스를 받는 대상자 대부분은 암환자였지만 일부는 말기 질환이 아닌 경우도 포함되어 있었다. 전체 64개 호스피스 완화의료 서비스 기관 중 24개만이 의사, 간호사, 사회복지사 및 성직자가 있었다. 가정호스피스 기관으로서 의뢰체계가 있는 경우는 의료기관 89.7%, 비의료기관 73.7% 였다. 24시간 서비스를 제공하는 기관은 의료기관 65.0%, 비의료기관 37.5%였다. 가족을 위한 휴식공간은 병원중심 호스피스완화의료 프로그램의 50%에서 있었다. 전체 호스피스 완화의료기관의 73.9%는 재정적인 문제가 있었으며, 610%는 정부로부터의 재정적인 지원이 필요하다고 응답하였다. 결론 : 64개 호스피스완화의료 프로그램에서 서비스를 제공하고 있지만 아직도 인력, 서비스의 질 및 시설 측면에서는 문제점이 있었다. 말기환자를 위한 서비스의 질을 향상시키고 의료자원의 효율적인 이용을 촉진하기 위해 호스피스 완화의료 서비스의 표준화와 제도화가 필요하다.