• Title/Summary/Keyword: hospice patients

Search Result 548, Processing Time 0.025 seconds

Awareness and Attitude Change after End-of-Life Care Education for Medical Students (말기환자 돌봄 교육 후 의과대학생의 인식과 태도 변화)

  • Kim, Hyun-Kyung;Nam, Eun-Mi;Lee, Kyoung-Eun;Lee, Soon-Nam
    • Journal of Hospice and Palliative Care
    • /
    • v.15 no.1
    • /
    • pp.30-35
    • /
    • 2012
  • Purposes: Most medical schools in Korea do not provide adequate education in end-of-life care. This study was designed to illustrate the need to improve end-of-life care education and to assess the effect of the education on fourth-year medical students' awareness and attitude towards hospice and palliative care for terminally ill patients. Methods: One hundred sixty six fourth-year medical students were surveyed with questionnaires on end-of-life care before and after they received the education. Results: Before receiving the education, students most frequently answered "at the end of life" (33.6%) was appropriate time to write an advance medical directive. After the education, the most frequent answer was "in healthy status" (58.7%). More students agreed to withholding or withdrawing futile life-sustaining treatment increased after the education (48.1% vs. 92.5% (P<0.001) for cardiopulmonary resuscitation, 38.3% vs. 92.5% (P<0.001) for intubation and mechanical ventilation, 39.1% vs. 85.8% (P<0.001) for inotropics, 60.9% vs. 94.8% (P<0.001) for dialysis and 27.8% vs. 56.0% (P<0.001) for total parenteral nutrition). Significantly more students opposed euthanasia after the education (46.6% vs. 82.1%, P<0.001). All students agreed to the need for education in end-of-life care. Conclusion: After reflecting on the meaning of death through the end-of-life care education, most students recognized the need for the education. The education brought remarkable changes in students' awareness and attitude towards patients at the end of life. We suggest end-of-life care education should be included in the regular curriculum of all medical schools in Korea.

A study on the attitude toward dying and hospice (임종태도와 HOSPICE에 관한 연구)

  • Kim, Young-Uck;Lee, Jung-Hoon;Lee, Jong-Bum;Park, Byung-Tak;Cheung, Sung-Duk;Kim, Myung-Se;Kim, Hoo-Ja
    • Journal of Yeungnam Medical Science
    • /
    • v.7 no.2
    • /
    • pp.55-66
    • /
    • 1990
  • This research is focused on the attitudes toward dying and hospice. 4subjects groups are Ca. patient, Ca. patien's family, elderly, medical personnel. A 40 questionare was filled out by each participant. For this study chi-square and T-test was done. The result were as follows : 1. Telling the truth 61.2% of all subject groups agreed upon telling the impending death. About 40% of elderly groups and cancer patient group were disagreed which is the highest percentage in all groups. Particularly medical personnel group were remarkably high in telling the truth. 2. Attitudes of medical personnels 43.3% of all groups agreed upon medical personnels prefer to avoid dying patient. In medical personnel group. 44% of respondents disagred comparably higher than other group. But 37.7% of medical personnel agreed. It showed that medical personnels admitted their negative feelings toward dying patient in considerable degree. 3. Attitudes toward mechanical assistance for life-expanding or hopeless patient. 44.8% of all groups disagreed upon mechanical assistance for hopeless case. Elderly (54.9%) and medical personnels (50%) disagreed, which is higher than cancer patient (33.3%) and (22.8%) of cancer patient's family. 4. Special facility and educational preperation for dying patient. 67.4% of all groups agreed upon the needs of special facility for dying, 81.3% of medical personnels agreed which is highest percentage in all group. 5. Attitudes of family members of dying patient. 82.3% of all groups agreed upon the family members feel annoyed at dying patient. 34% of cancer patient's family member and 48% of cancer patients group agreed, but elderly group showed highest percentage(84%). 6. Perception of dying patient about imminent death. 58.3% of all group thought dying patients are aware of their impanding death even though they had not beent told. 77.3% of medical personnel agreed which is highest percentage in all group.

  • PDF

Reliability and Validity of an Instrument Assessing Advance Directives for Nurse (간호사의 사전의사결정 태도측정 도구의 신뢰도 및 타당도 검증)

  • Cheon, Hojung;Kim, Eunha
    • Journal of Hospice and Palliative Care
    • /
    • v.22 no.3
    • /
    • pp.134-143
    • /
    • 2019
  • Purpose: This methodological study was conducted to test the reliability and validity of an instrument that measures attitudes of advance directives (ADs) among nurses. Methods: 1) Sixteen items related to attitudes in the English version of the Knowledge, Attitudinal, and Experiential Survey on Advance Directives (KAESAD) were forward/backward translated into Korean. 2) The content was validated by an expert panel (three nursing professors and eight hospice nursing specialists). 3) The preliminary 12 items were selected as a tool to assess the Korean version of Nurses' Attitudes towards Advance Directives (NAAD-K). 4) The instrument was validated by a survey (n=216). 5) It was confirmed to use the 12 items for the final version of the instrument. Results: NAAD-K was shown to be valid in terms of factors, items and content. The three factors extracted from the factor analysis were named as follows: Caring for patients with an AD (factor 1), nurses' role in informing patients (factor 2) and patient right (factor 3). The three factors explained total variance 57.796%. Factor loadings of the 12 items ranged from 0.47 to 0.93. For the 12 items, Cronbach's alpha was 0.81, and Guttman split-half coefficient was 0.78. Conclusion: This instrument was identified to be applicable with satisfactory reliability and validity for further use in measuring nurses' attitudes towards ADs in hospice and palliative care.

The Effect of Aroma Therapy on Lower Extremity Edema of Terminal Cancer Patients: A Controlled Trial (아로마 요법이 말기 암 환자의 하지부종에 미치는 영향 - 대조군 연구)

  • Kim, Sung-Ah;Kim, Sung-Ju;Chung, Ju-Hye;Lee, Soo-Young;Han, Myung-Suk;Oh, Seon-Hee;Kim, Se-Hong
    • Journal of Hospice and Palliative Care
    • /
    • v.12 no.3
    • /
    • pp.139-146
    • /
    • 2009
  • This study was designed to examine the effect of aroma massage therapy on lower extremity edema of terminal cancer patients. Methods: A total of thirty-six terminal cancer patients with lower extremity edema were divided into two groups: the aroma massage group received massage with blending oil which was applied from toes to 10 cm above the knee of the subject for 15 to 20 minutes in each turn, while the control group received sham aroma massage (applied with carrier oil only). The circumferences of the fore-foot, ankle and calf were measured before massage and 30 minutes, 2 hours, and 12 hours after massage. The blood pressure, pulse and body temperature were also measured to find the change of subject's physiologic conditions. Results: There were no significant differences in blood pressure, heart rate, body temperature and lower extremity circumferences between two groups. However, edema at each site was slightly improved in the treatment group after the aroma massage therapy, compared to baseline data (P<0.05). In addition, the reduction of lower extremity circumference was maximal at 2 hours in foot, 30 min in right ankle and 12 hours in right calf after aroma massage therapy (P<0.05). Conclusion: Our results suggest that aroma massage therapy is not effective on the lower extremity edema of terminal cancer patients.

  • PDF

Intensive Care Nurses' Experiences of Death of Patients with DNR Orders (중환자실 간호사가 경험한 DNR 환자의 임종)

  • Lee, Ji Yun;Lee, Yong Mi;Jang, Jae In
    • Journal of Hospice and Palliative Care
    • /
    • v.20 no.2
    • /
    • pp.122-130
    • /
    • 2017
  • Purpose: The purpose of this study is to describe and understand the meaning and the structure of subjective experiences of intensive care nurses with death of patients with do-not-resuscitate (DNR) orders. Methods: Data were collected from eight intensive care nurses at general hospitals using individual in-depth interviews and analyzed by phenomenological research method. Results: The nurses' experiences were grouped into four theme clusters: 1) ambiguity of death without correct answer, 2) a dilemma experienced at the border between death and work, 3) the weight of death that is difficult to carry and 4) death-triggered reflection of life. Conclusion: It is necessary to develop accurate judgment criteria for DNR, detailed regulations on the DNR decision process, guidelines and education on DNR patient care for nurses. It is also needed to develop an intervention program for DNR patients' families.

A Research of the Spiritual Well-Being and Spiritual Needs of HIV/AIDS Patients (HIV/AIDS 환자의 영적 안녕과 영적 요구도 조사)

  • Gwak, Ji-Hyun
    • Journal of Hospice and Palliative Care
    • /
    • v.12 no.1
    • /
    • pp.14-19
    • /
    • 2009
  • Purpose: The purpose of this study was to provide basic data to assess spiritual health of HIV/AIDS patients and devise spiritual nursing mediation plans in practical nursing work by examining the levels of spiritual wellbeing (SWB) and spiritual needs of HIV/AIDS patients'. Methods: A correlation survey study was conducted on HIV/AIDS patients age ranging from 20 to 70 years to investigate the relationship between their SWB and spiritual needs. Results: 1. Average scores of HIV/AIDS patients' related to SWB were found to be higher than the intermediate level: 54.59 in SWB; more specifically, 27.78 in existential well-being and 26.80 in religious well-being. 2. Average score of for HIV/AIDS patients' spiritual needs was 108.67: More specifically, 37.80 in the needs of love and interest, 42.35 in the needs of seeking meanings and purposes, and 28.51 in the needs of wanting to be forgiven. 3. Concerning the correlation between SWB and spiritual needs, the total SWB and total spiritual needs of HIV/AIDS patients' showed a weak positive correlation (r=0.344, P=0.013). Conclusion: The result of the study showed that SWB and spiritual needs of HIV/AIDS patients' are higher than the average scores, and these two parameters have a weak positive correlation, indicating that HIV/AIDS patients have strong spiritual needs of seeking meanings and purposes. Therefore, more studies on the spiritual nursing mediation plans are needed in order to raise their spiritual well-being levels and meet their spiritual needs through precise assessment.

  • PDF

Symptom Experience in Terminal Cancer Patients during the Last 48 Hours of Life (말기 암환자의 임종 전 48시간 동안의 임상증상)

  • Sim, Yun-Su;Kim, Do-Yeun;Nam, Eun-Mi;Lee, Soon-Nam
    • Journal of Hospice and Palliative Care
    • /
    • v.10 no.4
    • /
    • pp.190-194
    • /
    • 2007
  • Purpose: Individual cancer patients often experience many symptoms that impair their quality of life at the end of life. Identifying symptoms at the terminal stage of cancer patients and possible imminent death prediction by using that assessment can assist physicians and patients in preparing the 'peaceful death'. This study examines symptom experience during the last 48 hours of life of terminal cancer patients, and determines whether symptom experience change with proximal to death. Methods: The medical records of 89 patients who died with terminal cancer at a hospital between July 1, 2003 and March 31, 2006 were reviewed. Symptom prevalence at the last 48 hours was analyzed along with the change of symptom experience at the admission, $48{\sim}24$ hours, and $24{\sim}0$ hours before death. Results: Median age of all patients was 62 years old (range $16{\sim}97$). During the last 48 hours, symptom prevalence was described as follows; unclear consciousness (57%), pain (30%), fever (22%), and dyspnea (19%). According to the primary site, unclear consciousness was notified the most frequent symptom, but fever was relatively high prevalence in patients of biliary origin cancer rather than other site cancer (P=0.012). As death was Impending, the prevalence of poor appetite and general weakness were decreased, while that of unclear consciousness was increased, which were all statistically significant (P < 0.05). Conclusion: The presence of unclear consciousness could be regarded as the symptom indicator as imminent death of terminal canter patients.

  • PDF

Comparison of End-of-Life Care Intensity between Cancer and Non-cancer Patients: a Single Center Experience (암환자와 비-암환자의 임종기 치료 강도 비교: 단일 연구기관 자료)

  • Kim, Jae Min;Baek, Sun Kyung;Kim, Si-Young;Maeng, Chi Hoon;Han, Jae Joon;Park, Soyoung;Park, Jae Hun
    • Journal of Hospice and Palliative Care
    • /
    • v.18 no.4
    • /
    • pp.322-328
    • /
    • 2015
  • Purpose: The aging of society has rapidly progressed, especially in Korea. Therefore, the necessity of research on end-of-life (EOL) care in elderly patients has increased. However, there are few studies on EOL care intensity for non-cancer patients. This study was designed to compare the EOL care intensity between cancer and non-cancer patients. Methods: We retrospectively analyzed the EOL care intensity based on medical records of decedents of Kyung Hee University Medical Center, a tertiary referral hospital from December 2014 through March 2015. And we compared EOL care intensity between cancer patients and non-cancer patients using statistical analysis of the frequency of invasive procedures and logistic regression analysis for factors that affect the EOL care intensity. Results: Statistical analysis showed invasive procedures, such as intensive care unit admission, endotracheal intubation followed by mechanical ventilation and emergency dialysis, were performed more frequently in non-cancer patients than cancer patients (29.3% vs. 72.4%, P<0.001). And age (P=0.038) and morbidity of cancer (P<0.001) influenced the invasive procedural decision when analyzed by logistic regression analysis. Conclusion: The EOL care was more intensive in non-cancer patients, and age and morbidity of cancer were major factors for the treatment intensity.

소설과 말기 암환자를 통해 본 한국인의 죽음의 의미

  • Jeon, Hye-Won;Kim, Bun-Han
    • Korean Journal of Hospice Care
    • /
    • v.3 no.2
    • /
    • pp.34-54
    • /
    • 2003
  • Every one experiences death one day, however no one can knows exactly what it is because people can not experience death until it comes, it is therefore impossible to judge correctly on the phenomenon of the death. On the whole, man experiences indirect death through the mass communications such as TV drama, fiction, magazine etc because those methods can easily access by every one. In addition to this, people usually acquire the negative awareness of death through the dramatic change of story like dying of cancer for dramatic effect by giving scare and fear to the cancers. The purpose of this study is to provide basic information on the spiritual care that enables the facing death patients to accept death as a part of life and divert hope from scare about after death by comparing and analyzing of two aspects of death meaning I.e, Korean fiction and the end stage cancer patients. Additionally, for medical staff to understand the facing death cancer patients by making to aware patients correctly and provide the better quality of care. The study was performed from September 28, 2002 to February, 28 2003. The materials of this study were collected by direct data obtained from observation, interviews, note and diary of end stage of cancer patients and written materials acquired from Korean contemporary fiction. Participants of this study were 4 end stage cancer patients including 2 lung cancer patients, 1 liver cancer patient and 1 esophagus cancer patient. The methodology used in this study was divided into two types; Huberman & Miles methodology was used for fiction to find and categorize subject, and Colaizzi, one of phenomenological methodology was used for end stage cancer patients to find the major meaning, subject and categorization. 1.The death investigated in the fiction, was found as a progress of negative emotion, acceptance and sublimation, life related subjects in the negative emotion were tenacity for life, anxiety, lingering attachment, responsibility, abandonment and death related subjects were shock, isolation, fear, scare and rejection. Acceptance related subjects were acceptance, destiny, secularism, preparation and arrangement, and sublimation related subjects were sublimation through Christian and Buddhism. 2.The death showed in the participants was negative emotion, acceptance and sublimation, life related subjects were repentance, anxiety, responsibility and hopelessness, and death related subjects were dejection, solitude, anger, fear and scare. The acceptance was a type of religious acceptance that admitted instantly by reaching an understanding with the God, and death was accepted as a progress of preparation, arrangement, acceptance and hope. Sublimation related subjects were Christian sublimation and relief or destiny incurred from self-reflective sublimation through communications and thoughts. 3.The death in view of fiction and participants were positively accepted both death and negative emotion, and the study disclosed the fact that death was sublimated dependent on religion. 4.The progress of negative emotion, acceptance and sublimation was disclosed more complicated and various in the real end stage cancer patients and acceptance only found in the patients on the form of religious acceptance, according to the results compared with fiction and real end stage cancer patients. The death showed in the fiction was standardized, gradated and similar progress with psychological status of Kubler-Ross. However, death in the participants was showed complex and various feelings simultaneously, and sometimes they accepted death positively. The sublimation through religion was found in Buddhism and Christian in the fiction and mostly Christian in the participants due to a number of Hospice patients. It was found that negative emotion various types of death was more found in the participants than fiction. It is therefore necessary to study on the response of death in various types. In the participants death was incurred more systematic and variously, we knew that nursing practice focused on experience of participants is required and reality on death is much profound than we analyzed and presented, lots of situations and reactions should be premised because we can not completely rule out the negligence possibility of care mediation of participants. In caring for the facing death patients, we discovered and confirmed again through this study that the spiritual care should be needed as a mediation method.

  • PDF

Prognostic Value of Serum Ferritin in Terminally Ill Cancer Patients (말기암환자에서 예후인자로서 혈청 Ferritin의 유용성)

  • Lee, Soo Hee;Choi, Youn Seon;Hwang, In Cheol;Yeom, Chang Hwan;Lee, June Yeong
    • Journal of Hospice and Palliative Care
    • /
    • v.18 no.1
    • /
    • pp.51-59
    • /
    • 2015
  • Purpose: Predicting life expectancy of terminally ill cancer patients is very important. In many studies, ferritin is detected at higher levels in the sera of cancer patients, and higher ferritin level correlates with aggressiveness of disease and poor outcomes of patients. This study evaluated a prognostic role of serum ferritin levels in terminally ill cancer patients. Methods: This study enrolled 65 terminally ill cancer patients from March through June 2012. We assessed routine laboratory findings including serum ferritin levels as well as demographic and clinical characteristics of the patients. To examine the association between serum ferritin levels and patient's characteristics, we used Spearman's correlation analysis, Wilcoxon's rank sum test or Kruskal-Wallis test, as appropriately. For multivariate analysis, Cox's proportional hazard regression model was used to evaluate significance of serum ferritin levels as a prognostic factor. Results: A negative correlation between serum ferritin levels and survival time was found. After adjusting for sex, age, performance status, creatinine levels and white blood cell counts, serum ferritin levels were significantly associated with survival time. Conclusion: Even at the very end of life of terminal cancer patients, serum ferritin levels were an independent prognostic factor for survival.