• Journal of Korean Academy of Nursing
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• v.30 no.6
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• pp.1488-1502
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• 2000

This study, based on current home nursing services, aims at promoting measures for establishing a community-based home nursing system derived from the pilot home nursing demonstration project conducted by the Seoul Nurses Association. The study was based on an analysis of home nursing records from march 1993 to December 1999. The following is a summary analysis, based on individual characteristics of the patients, the organization, which recommended the service for their patients and personnel services. 1. The service has been used by many elderly people 60years of age or older(66.4%). and married people(60.9%). The average number of visits by service personnel for patients of city government was 23.5. This is 2.5 times as many visits by general patients. General patients(20.2%) had only one visit from service personnel, while 65.5% of patients of city government had 10 or more visits. Particularly, for government recommended patients, 72.7% of the patients were recommended by nurses, while only 21.9% where referred to the services by doctors. The main focus of a home nursing service was to maintain present health status (53.4%), and hospice(11.6%). Also to increase hospital-based home nursing services focused on recovery(55.9%) and maintain present health conditions (19.0%). 2. For general patients, 42.0% of patients were suffering from problems related to CVA, 11.3% from high blood pressure, and for patients referred from city, 21.2% from skeletal muscular disease. Results of home nursing services 29.4% of patients were able to recover or maintain their health status, but 48.9% of the patients died. Another main point of community-based home nursing services is medication(6.7%), other basic nursing services(6.1%), special treatment, instructions on how to use medical devices(5.9%), change of physical posture(4.6%), and training on changing physical positions(4.7%). As mentioned above there were some differences between the characteristics of patients who used the pilot home nursing service conducted by the Seoul Nurses Association and those hospital-based service users. The results are believed to be useful to support a community-based home nursing service model. Particularly, patients under medical supervision and patients recommended by government-run health clinics show a higher frequency and longer use of home nursing services compared to general patients or hospital-based home nursing service users. According to the study, nurses accounted for a large number of recommendations for home nursing services. Many patients with CVA, high blood pressure, skeletal muscular disease and bedsores used community-based home nursing services, while others used the service for minor treatments or maintaining their current health status. Based on the study, the researchers make several suggestions to establish a community- based home nursing service system. First, different ways of setting up a community-based home nursing system have to be mapped out based on the evaluation of the pilot home nursing service conducted by the Seoul Nurses Association. Secondly, a new, community-based, home health care nursing service model, and reimbursement payment system have to be developed. This is based on the outcome of the analysis, and implemented policy. Accordingly, efforts are needed to develop a community- based home nursing system with an intermediary role to promote the visiting nursing services of government-run health centers.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.17
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• pp.7911-7916
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• 2015

Serum anti-Helicobacter pylori antibodies and pepsinogens (PGs) have been used as gastric cancer screening and gastric mucosal status markers. Nepal is a low risk country for gastric cancer. However, the mountainous populace in the northern region culturally linked to Tibet as well as Bhutan, a neighboring country, have a high risk of GC. We collected gastric biopsy specimens and sera from 146 dyspeptic patients living in Kathmandu, Nepal. We also examined the sera of 80 volunteers living in the mountainous regions of the Himalayas. The optimal cut-off was calculated for serum biomarkers against the histology. Kathmandu patients (43.8%) were serologically positive for H. pylori infection, which was significantly lower than that for the mountainous (61.3%, P = 0.01). The same results also found in the prevalence of PG-positivity, PG I levels and PG I/II ratios (P = 0.001, P<0.0001 and P = 0.03, respectively). Moreover, the PG I/II ratios were significantly, and inversely correlated with the OLGA score (r = -0.33, P<0.009). The low incidence of gastric cancer in Nepal can be attributed to low gastric mucosal atrophy. However, the mountainous subjects have high-risk gastric mucosal status, which could be considered a high-risk population in Nepal.

• Korean Medical Education Review
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• v.24 no.2
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• pp.113-127
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• 2022

Considering the recent medicalization of death, the importance of preparing both laypersons and medical students to have meaningful end-of-life conversations, which is among the objectives of death education, will grow. The Act of Hospice and Palliative Care and Decisions on Life-Sustaining Treatment for Patients at the End of Life provided a new source of momentum to death education for both laypersons and medical professionals, as the importance of education on death is widely recognized. However, problems remain regarding how to prepare people for productive conversations at the end-of-life and how to secure the continuity of care. Different focuses and deficiencies are observed in death education programs for each category of learner. In education for laypeople, tangible information on how to actualize one's existential and personal understanding of death through real-life options is lacking, except for presenting the "protocol" of the Act. Conversely, basic medical education lacks an understanding of or confrontation with death on the existential and personal levels. Death education should aim to build a shared understanding that can facilitate communication between the two groups. The scant overlap between layperson education and basic medical education even after the Act's enactment is worrisome. Further fundamental changes in death education are required regarding its content. Topics that patients and doctors can share and discuss regarding death and end-of-life care should be discovered and provided as educational content both to laypeople and future medical professionals.

• Journal of Hospice and Palliative Care
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• v.19 no.1
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• pp.61-69
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• 2016

Purpose: It is important to alleviate care burden for terminal cancer patients and their families. This study investigated the factors associated with care burden among family caregivers (FCs) of terminally ill cancer patients. Methods: We analyzed data from 289 FCs of terminal cancer patients who were admitted to palliative care units of seven medical centers in Korea. Care burden was assessed using the Korean version of Caregiver Reaction Assessment (CRA) scale which comprises five domains. A multivariate logistic regression model with stepwise variable selection was used to identify factors associated with care burden. Results: Diverse associating factors were identified in each CRA domain. Emotional factors had broad influence on care burden. FCs with emotional distress were more likely to experience changes to their daily routine (adjusted odds ratio (aOR), 2.54; 95% confidence interval (CI), 1.29~5.02), lack of family support (aOR, 2.27; 95% CI, 1.04~4.97) and health issues (aOR, 5.44; 2.50~11.88). Family functionality clearly reflected a lack of support, and severe family dysfunction was linked to financial issues as well. FCs without religion or comorbid conditions felt more burdened. The caregiving duration and daily caregiving hours significantly predicted FCs' lifestyle changes and physical burden. FCs who were employed, had weak social support or could not visit frequently, had a low self-esteem. Conclusion: This study indicates that it is helpful to understand FCs' emotional status and family functions to assess their care burden. Thus, efforts are needed to lessen their financial burden through social support systems.

• Journal of Hospice and Palliative Care
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• v.8 no.1
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• pp.8-17
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• 2005

Purpose: This study was performed to investigate burden, job satisfaction and quality of life of nurses who take care of cancer patients. Methods: The subjects were 237 nurses working at the oncology unit of hospitals with over 500 beds in Seoul and Gyeonggi-do. Data were collected using questionnaire from the February to March, 2005. Data were analyzed through t-test, ANOVA, Pearson's correlation coefficient and stepwise multiple regression using SAS. Results: 1. The item that showed the highest level of burden was 'I feel limited even if I make efforts to reduce patients' pain. 'Burden was high in those group both who were younger than 35 years old and who had clinical experiences caring cancer patients for $3{\sim}4$ years. 2. The item that showed the lowest level of job satisfaction was 'the possibility of promotion'. Job satisfaction was high in those group both who had a spouse and were head nurses or incharge nurses. 3. The item that showed the lowest level of quality of life was 'I am physically exhausted'. Over 35 years old who had a spouse, and over 2,000,000 won monthly income made a high score in the quality of life. 4. There were negative correlations among burden, iob satisfaction and the quality of life. 5. The major factor affecting the quality of life was burden. Conclusion: The results of this study are expected to be utilized as basic data for developing support system to improve nurses' work conditions and quality of life.

• Journal of Hospice and Palliative Care
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• v.8 no.1
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• pp.37-44
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• 2005

Purpose: To provide the basic data in developing the nursing intervention for patients who have symptoms of insomnia after undergoing hemopoietic stem cell transplantation (HSCT). This was achieved through investigating sleep quality and sleep patterns according to admission time, and discharge time. Methods: Data was put together by studying 52 HSCT patients who have been admitted to the department of HSCT from August 2002 to August 2003, in a university hospital. Research instruments used were, PSQI for sleep quality and a specified questionnaire for sleep patterns. Results: The PSQI regarding the past mono which was measured at the last day of hospitalization, was 11.8. This was significantly higher than 5.3, which was a measurement for the past month before the hospitalization (t=11.41, P=0.000). Looking at it with 7 categories-quality of sleep, consistency of sleep, sleep period, effectiveness of sleep, sleeping disorder, usage of sleeping pills, impediment of daily life- the PSQI for a month after admission increased significantly compared to the rate measured for a month before admission. Comparing the subjects sleep pattern before and after admission, it showed a significant difference regarding time attending sleep, time it takes to sleep, wake-up time, total time of sleep, day time sleep, number of times waking up during sleep, number of usage of sleeping pills, actions that are taken during sleep disorder, reasons for insomnia. Conclusion: The PSQI score of patients who undergo hemopoietic stem cell transplantation have increased significantly after hospitalization. Compared to the change of sleep patterns when hospitalized, significant changes were observed. Therefore nursing interventions addressing sleep are needed.

• Journal of Hospice and Palliative Care
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• v.9 no.1
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• pp.1-10
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• 2006

Purpose: Terminal cancer influences on patients as well as their family members. This research was performed to evaluate the quality of lift of primary family caregivers and to investigate the influencing factors. Methods: The results of survey were collected from 81 family caregivers who were taking care of hospitalized terminal cancer patients at an oncology department of university hospital in Daejeon from March 2005 to January 2006 with questionnaires. The questionnaires were consisted of the general characteristics of the subjects, and 36-items short-form Health Survey (SE-36) Korean version to evaluate the quality of life of family caregivers, the characteristics of patients and family caregivers' caring trait. Results: Family caregivers' mean (${\pm}SD$) SF-36 score was 47.9 (${\pm}20.7$). Influential factors on family caregivers' life quality were daily raring hours, economic burden, type of treatment; only supportive care, caring duration, sex, the numbers of ADLs (activity of daily livings) items that patients needed help in order by stepwised multiple logistic regression analysis (overall $R^2=0.639$, P=0.044). Conclusion: Daily raring hours and economic burden were two influential modifiable factors on family caregivers' quality of life. Therefore, social supportive systems are required to reduce family caregivers' daily caring hour and economic burden.

• Journal of Hospice and Palliative Care
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• v.16 no.1
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• pp.10-19
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• 2013

Purpose: Home-based care providers were surveyed to assess the effect of collaborative service between Gyeongnam Regional Cancer Center (GRCC) and public health centers (PHCs) in Gyeongnam province. Methods: Twenty home-based care providers who had previously participated in the GRCC-PHC care project were recruited from nine PHCs and were surveyed using a questionnaire developed by specialists. Questions were rated using the 5-point Likert scale ranging from "strongly disagree (-2)" to "strongly agree (+2)" and each score was multiplied by the corresponding number of respondents (n=20) with the maximum score of 40. Results: Between January 2008 and December 2011, 73 patients were registered to the collaborative service: 72 by GRCC and one by PHC. Home-based care providers marked the highest score (23 points) to "The collaborative service contributed to patients and their family's psychological stability" and the lowest score (11 points) to "The collaborative service was generally helpful for home-based cancer management." For possible suggestions to improve the service, the highest score (35 points) was given to "Simplification of the hospitalization process" followed by "Substantial benefits for patients at their visit to the hospital" (34 points). Conclusion: The results revealed several limitations of the GRCC-PHC collaborative care service for terminal cancer patients. The service could be further improved by developing measures to address the limitations and a service model tailored to region-specific needs.

• Journal of Hospice and Palliative Care
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• v.7 no.2
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• pp.248-257
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• 2004

Purpose: To evaluate the efficacy of dolasetron mesylate in controlling nausea and vomiting in the first 24 hours and to extend these comparisons over the next 4 days in patients receiving moderately emetogenic chemotherapy. Methods: This was a single center, open-labeled study with single arm. Dolasetron (1.8 mg/kg) was given intravenously (I.V.) prechemotherapy with 10 mg of dexamethasone IV, followed 24 hours later by oral dolasetron (200 mg once daily) for the subsequent 4 days. The frequency of vomiting, severity of nausea and the presence of rescue antiemetics were assessed daily. Results: Of 30 patients enrolled, 28 were eligible and evaluable for the efficacy. Four out of 28 patients had complete control of nausea and vomiting without any rescue antiemetics through 5 days. The complete control got better as time went by with the rates of 17.9/46.4/42.9/53.6/60.7% on days 1 to 5. Vomiting was better controlled than nausea in both cisplatin-containing and non-containing chemotherapy. The adverse events were mild to moderate degrees of headache, diarrhea and fever, but were recovered spontaneously. Conclusion: Dolasetron was effective and safe for the control of nausea and vomiting in the patients with moderately emetogenic chemotherapeutic agents.

• Journal of Hospice and Palliative Care
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• v.12 no.2
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• pp.72-79
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• 2009

Purpose: The purpose of this study was to test the correlation between the levels of spiritual well-being and spiritual nursing care of nurses for cancer patients and to provide baseline data for spiritual nursing care. Methods: In the study, there were 209 nurses involved who cared for cancer patients, and they were from Christian General Hospital in a city, Jeonju. Data were collected from September 17 to 30 in 2008 using structured questionnaires. The data were analyzed using research methods, including descriptive statistics, t-test, ANOVA, Duncan test, and Pearson correlation coefficients. Results: The mean score of spiritual well-being of nurses was $63.41{\pm}10.32$ (range $20{\sim}80$) and that of spiritual nursing care was $26.96{\pm}7.05$ (range $15{\sim}60$). There was a significant positive correlation between the spiritual well-being of nurses and their spiritual nursing care (r=.353, P=.000). Conclusion: The spiritual well-being and spiritual nursing care have a positive correlation. The level of spiritual well-being of nurses was relatively significant, whereas that of spiritual nursing care was relatively low. Therefore, it is recommended, for spiritual nursing care that nurses responsible for cancer patients should pursue more spiritual growth, attend church services regularly, and should further be educated in their care and responsibility.