• Korean Journal of Hospice Care
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• v.1 no.1
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• pp.46-69
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• 2001

Hospice Care is the best way to care for terminally ill patients and their family members. However most of them can not receive the appropriate hospice service because the Korean health delivery system is mainly be focussed on acutly ill patients. This study was carried out to clarify the situation of hospice in Korea and to develop a hospice care delivery system model which is appropriate in the Korean context. The theoretical framework of this study that hospice care delivery system is composed of hospice resources with personnel, facilities, etc., government and non-government hospice organization, hospice finances, hospice management and hospice delivery, was taken from the Health Delivery System of WHO(1984). Data was obtained through data analysis of litreature, interview, questionairs, visiting and Delphi Technique, from October 1998 to April 1999 involving 56 hospices, 1 hospice research center, 3 non-government hospice organizations, 20 experts who have had hospice experience for more than 3 years(mean is 9 years and 5 months) and officials or members of 3 non-government hospice organizations. There are 61 hospices in Korea. Even though hospice personnel have tried to study and to provide qualified hospice serices, there is nor any formal hospice linkage or network in Korea. This is the result of this survey made to clarify the situation of Korean hospice. Results of the study by Delphi Technique were as follows: 1.Hospice Resources: Key hospice personnel were found to be hospice coordinator, doctor, nurse, clergy, social worker, volunteers. Necessary qualifications for all personnel was that they conditions were resulted as have good health, receive hospice education and have communication skills. Education for hospice personnel is divided into (i)basic training and (ii)special education, e.g. palliative medicine course for hospice specialist or palliative care course in master degree for hospice nurse specialist. Hospice facilities could be developed by adding a living room, a space for family members, a prayer room, a church, an interview room, a kitchen, a dining room, a bath facility, a hall for music, art or work therapy, volunteers' room, garden, etc. to hospital facilities. 2.Hospice Organization: Whilst there are three non-government hospice organizations active at present, in the near future an hospice officer in the Health&Welfare Ministry plus a government Hospice body are necessary. However a non-government council to further integrate hospice development is also strongly recommended. 3.Hospice Finances: A New insurance standards, I.e. the charge for hospice care services, public information and tax reduction for donations were found suggested as methods to rise the hospice budget. 4.Hospice Management: Two divisions of hospice management/care were considered to be necessary in future. The role of the hospice officer in the Health & Welfare Ministry would be quality control of hospice teams and facilities involved/associated with hospice insurance standards. New non-government integrating councils role supporting the development of hospice care, not insurance covered. 5.Hospice delivery: Linkage&networking between hospice facilities and first, second, third level medical institutions are needed in order to provide varied and continous hospice care. Hospice Acts need to be established within the limits of medical law with regards to standards for professional staff members, educational programs, etc. The results of this study could be utilizes towards the development to two hospice care delivery system models, A and B. Model A is based on the hospital, especially the hospice unit, because in this setting is more easily available the new medical insurance for hospice care. Therefore a hospice team is organized in the hospital and may operate in the hospice unit and in the home hospice care service. After Model A is set up and operating, Model B will be the next stage, in which medical insurance cover will be extended to home hospice care service. This model(B) is also based on the hospital, but the focus of the hospital hospice unit will be moved to home hospice care which is connected by local physicians, national public health centers, community parties as like churches or volunteer groups. Model B will contribute to the care of terminally ill patients and their family members and also assist hospital administrators in cost-effectiveness.

• Journal of Hospice and Palliative Care
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• v.19 no.1
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• pp.45-60
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• 2016

Purpose: This study is aimed at understanding the volunteers' experiences and interactions with their corresponding teams during their participation in hospice care. More specifically, the study is to contribute policy-wise to development of hospice care in Korea by helping policy-makers and organizers and managers of hospice care provides better understand the importance of the meaning and roles of volunteers in hospice care. Methods: In-depth interviews and participant observation were performed with study participants who were selected from four different types of hospice agencies. Study analysis was conducted using "case study" as one of the rigorous qualitative research methods to develop "inter-" and "intra-" comparisons among the study participants. Results: Volunteers in hospice care were initially motivated by religion and faith, and the motivation grew stronger through the volunteer experiences. They emphasized that the essence of the hospice volunteering was motivation from religion and faith and something they do for themselves. They characterized their experience as a true service that is offered for free and a job that requires expertise. In addition, they achieved personal (internal) growth by reflecting on the meaning of "good death" and better understood the importance of respecting spiritual diversity. Conclusions: This study could help hospice officials offers better understand hospice volunteers' role and their importance. The study also provide practical implications and policy suggestions.

• Journal of Korean Academy of Nursing
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• v.30 no.5
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• pp.1156-1169
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• 2000

The study was aimed at developing an independent hospice center model that would be best suited for Korea based on a literature review and the current status of local and international hospices. For the study, five local and six international hospice organizations were surveyed. Components of the hospice center model include philosophy, purpose, resources (workers, facilities, and equipment), allocation of resources, management, financial support and hospice team service. The following is a summary of the developed model: Philosophies for the hospice center were set as follows: based on the dignity of human life and humanism, help patients spend the rest of their days in a meaningful way and accept life positively. On the staff side, to pursue a team-oriented holistic approach to improve comfort and quality of life for terminally ill persons and their families. The hospice center should have 20 beds with single, two, and four bed rooms. The center should employ, either on a part-time or full-time basis, a center director, nurses, doctors, chaplains, social workers, pharmacists, dieticians, therapists, and volunteers. In addition, it will need an administrative staff, facility managers and nurses aides. The hospice should also be equipped with facilities for patients, their families, and team members, furnished with equipment and goods at the same level of a hospital. represented by a center director who reports to a board and an advisory committee. Also, the center director administers a steering committee and five departments, namely, Administration, Nursing Service, Social Welfare, Religious Services, and Medical Service. Furthermore, the center should be able to utilize a direct and support delivery systems. The direct delivery system allows the hospice center to receive requests from, or transfer patients to, hospitals, clinics, other hospice organizations (by type), public health centers, religious organizations, social welfare organizations, patients, and their guardians. On the other hand, the support delivery system provides a link to outside facilities of various medical suppliers. In terms of management, details were made with regards to personnel management, records, infection control, safety, supplies and quality management. For financial support, some form of medical insurance coverage for hospice services, ways to promote a donation system and fund raising were examined. Hospice team service to be provided by the hospice center was categorized into assessment, physical care, emotional care, spiritual care, bereavement service, medication, education and demonstrations, medical supplies rental, request service, volunteer service, and respite service. Based on the results, the study has drawn up the following suggestions: 1. The proposed model for a hospice center as presented in the study needs to be tested with a pilot project. 2. Studies on criteria for legal approval and license for a hospice center need to be conducted to develop policies. 3. Studies on developing a hospice charge system and hospice standards that meet local conditions in Korea need to be conducted.

• Health Policy and Management
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• v.27 no.2
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• pp.167-176
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• 2017

Background: This study aimed to analyze the impact of community health care resources on the place of death of older adults with dementia compared to those with cancer in South Korea, using public administrative big data. Methods: Based on a literature review, we selected person- and community-level variables that can affect older people's decisions about where to die. Data on place-of-death and person-level attributes were obtained from the 2013 death certification micro data from Statistics Korea. Data on the population and economic and health care resources in the community where the older deceased resided were obtained from various open public administrative big data including databases on the local tax and resident population statistics, health care resources and infrastructure statistics, and long-term care (LTC) insurance statistics. Community-level data were linked to the death certificate micro data through the town (si-gun-gu) code of the residence of the deceased. Multi-level logistic regression models were used to simultaneously estimate the impacts of community as well as individual-level factors on the place of death. Results: In both the dementia (76.1%) and cancer (87.1%) decedent groups, most older people died in the hospital. Among the older deceased with dementia, hospital death was less likely to occur when the older person resided in a community with a higher supply of LTC facility beds, but hospital death was more likely to occur in communities with a higher supply of LTC hospital beds. Similarly, among the cancer group, the likelihood of a hospital death was significantly lower in communities with a higher supply of LTC facility beds, but was higher in communities with a higher supply of acute care hospital beds. As for individual-level factors, being female and having no spouse were associated with the likelihood of hospital death among older people with dementia. Conclusion: More than three in four older people with dementia die in the hospital, while home is reported to be the place of death preferred by Koreans. To decrease this gap, an increase in the supply of end-of-life (EOL) care at home and in community-based service settings is necessary. EOL care should also be incorporated as an essential part of LTC. Changes in the perception of EOL care by older people and their families are also critical in their decisions about the place of death, and should be supported by public education and other related non-medical, social approaches.

• Journal of Hospice and Palliative Care
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• v.14 no.3
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• pp.152-162
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• 2011

Purpose: This study was conducted to analyze a trend in studies of hospice care in Korea and to suggest future research directions. Methods: This study analyzed a total of 183 studies related to hospice care which were found at http://www.riss.kr. Results: Of the 183 studies, 62 (33.9%) were for thesis studies for a degree, 121 (66.1%) for academic journals. There were 159 (87.8%) quantitative studies, 18 (8.9%) qualitative studies, and 6 (3.3%) Q-Method studies. The most frequently used study design was a descriptive study. The majority of study participants were terminal cancer patients, patients' family members and health care personnel. The thesis articles were searched by using key words as follows: health, nursing, environment, children's hospice, and others. Conclusion: The number of studies of hospice care has increased, and research key words varied. Furthermore, more experimental research is needed on nursing intervention such as pain relief, alternative therapies and hospice care for children.

• Journal of Hospice and Palliative Care
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• v.14 no.3
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• pp.163-171
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• 2011

Purpose: This study tested a model of hospice volunteer's motivations and outcomes to encourage more volunteer workers to participate in hospice care. Methods: This included 200 volunteers who attended the Autumn Conference in 2007 and 132 volunteers from five hospice organizations. Results: Volunteers' existential well-being affected an endogenous variable of volunteers' participation in volunteer activities. The durability of volunteer activity was affected by value motivation, the level of participation in volunteer activities and the level of job satisfaction. For volunteers' job satisfaction level, valid endogenous variables included existential well-being, social motivation, understanding motivation and value motivation. The durability of volunteer activities was indirectly affected through three different paths. Volunteers' existential well-being determined the level of their participation in volunteer activities, which in turn affected the durability of such activities. Social motivation influenced volunteers' job satisfaction, and then the durability of volunteer activities. Volunteers' understanding of motivation also influenced their job satisfaction, and then the durability of volunteer activities. Conclusion: Based on these results, this study proposes that the durability of volunteers activities could be improved by developing a program to improve volunteers' well-being and by providing volunteers with education on altruistic values, encouraging them to seek intellectual growth, and advocating them to continue volunteer activities based on close relationships with other volunteers.

• The Journal of Internal Korean Medicine
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• v.39 no.4
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• pp.662-675
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• 2018

Objective: The aim of this study was to establish the developmental history of hospice palliative care (HPC) with Korean medicine (KM). Methods: We compared the developmental history of HPC in Korea with that of Britain, the United States, Taiwan, Japan, and China. The articles in English or Korean published until Feb. 2017 were searched using 'Hospice' or 'Palliative care' with the name of each nation in the PubMed, MEDLINE, ScienceDirect, and CINAHL (Cumulative Index to Nursing and Allied Health Literature) databases for foreign articles and OASIS (Oriental Medicine Advanced Searching Integrated System) for domestic articles. Books and gray literature were searched on the same databases and websites of the Ministry of Health and Welfare and related organizations in each country. Results: Modern palliative care began with the hospice movement led by Dr. Cicely Saunders. HPC in Korea started earlier than in other countries but it took considerable time for social consensus, so Korean policies have only been published recently. In this process, KM was excluded from HPC. For this reason, western medicine in Korea does not fully accept the spirit of HPC, the government does not take an aggressive stance with KM, and the institutes of KM do not have any interest in HPC. The World Health Organization recommends the establishment of policies and programs connected with a country's own health care system. In 2015, the Korean government made the third comprehensive plan for the development of KM. It included critical pathway guidelines about cancer-related fatigue and anorexia. More effort is required to set up HPC than other care types because Korea has two medical systems. Conclusions: Each nation has been trying to improve systems of HPC. We need to overcome the problems and bring out the best by making our own model of HPC with KM.

• Journal of the Korean Operations Research and Management Science Society
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• v.38 no.1
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• pp.15-27
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• 2013

Because consumers tend to have negative opinion about a company that neglects social issues like poverty or pollution while it focuses on its own profit, a lot of companies have invested their resources in Corporate Social Responsibility(CSR). CSR has merits of image improving and profit gaining, on the other hand, it has also many shortcomings. First, the cost of CSR may become a heavy financial burden. Specifically, CSR tends to be implemented by a company's unilateral backup, and then this may impose a heavy burden on the company. Second, one cannot expect effects of CSR in a short-term. Because of these shortcomings, the unilateral CSR has gone into alteration of the type of CSR since 1980's. Instead of unilaterality, Cause-Related Marketing(CRM) began to be used for mutual profits among company, consumers, and society. That is, CRM has become to be spotlighted as a new type of CSR. It focuses on partnership between a company and consumers based on cause and mutual profit pursuing through this partnership. So, many contemporary companies prefer CRM activities that derive their positive corporate image, that increase their sales, and that reduce their financial cost. The IBM Matching Grants Program, which is the largest of the IBM-Employee partnership programs, is a typical CRM. This program enables employees and retirees to increase the value of their donations to educational institutions, hospitals, hospices, nursing homes, and cultural & environmental organizations with a matching gift from IBM. Hundreds of educational institutions and thousands of nonprofit organizations have benefited from the contributions by IBM. There might be various types of matching grants. For example, an employee might choose a lump-sum expense or partitioning a lump-sum into a series of small ongoing expenses for his (or her) donation, and a firm might match the employee's total contribution with a lump-sum expense or might match the employee's total contribution with a series of small ongoing expenses. However, it is not easy to find an academic research on which type of matching grant is preferred by employees. This paper shows that an employee prefers the type of matching grants that consists of a lump-sum expense for his (or her) contribution and a series of small ongoing expenses for a firm's contribution [or the type of matching grants that consists of a series of small ongoing expenses for an employee's contribution and a lump-sum expense for a firm's contribution] to the other types of matching grants.

• Korean Journal of Hospice Care
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• v.2 no.1
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• pp.87-111
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• 2002

The hospice activities in Korea have still stood in the premature stage, although the contemporary hospice program, which professionally accommodates terminally ill patients, appeared in the history 35 years ago. Especially, the availability of the facility hospice is not only poor in number, but also lack of a guideline for the conduct of the facility. Saemmul Hospice has keenly felt the necessity of more facility hospices and has interchanged experiences and informations with people interested in hospice. However, the number of facilities has fallen short of one's expectations, and many problems have been revealed in order to maintain the operation. This paper was written in order to improve these atmospheres and to help more terminally ill cancer patients properly. This paper clarifies in detail the principle of management, the method of practice in each departments of Saemmul Hospice, expected effects and supplemental items. We try to provide concrete and practical informations and to help extensively for all peoples who are to begin or currently working. 1.Facility: It secures, maintain, and manage the hospice environment for all around care of patients effectively. 2.Education and Volunteer: It trains and manages hospice volunteers devoted to hospice. 3.Financial: It manages donation by healthy soul with an effective method. 4.Administration and Organization: It executes the administration efficiently and constitutes the organization to operate. 5.Medical and Nursing: It offers the maximum professional supports to a hospital. 6.Medicine and alternative medicine: It improves the quality of life of patients by medical and pharmaceutical approach and by other possible methods available. 7.Nutrition: It helps patients to have diets in accord with the order of the creation. 8.Belief: It offers spiritual care which allows the profound relationship with God. 9. Funeral ceremonies: Funeral ceremonies may heal grieves of families faced with their deaths. 10. Bereaved families: It supports the families after the deaths of patients. 11.Reception and consultation: It seeks to help the patients who meet the purposes for which Saemmul Hospice is established. 12.Publication: It allows publicity activities for Saemmul Hospice. Facility hospice programs are able to overcome the disadvantages that the other type of the hospice possess, like as the economic burdens of the families, and the patients' losses of comforts of home after being transferred to a hospital. Facility hospice can provide home atmosphere with professional manpower and facilities like hospital to the patients. Therefore, it can also improve patients' qualities of life and make them comfortable death. We anticipate that the hospice program in Korea would be more active to let more people be indebted to maintain the nobel human dignity and to cross beautifully in the most painful process of dying in the journey of their lives.

• Journal of Hospice and Palliative Care
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• v.19 no.3
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• pp.211-221
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• 2016

Purpose: Dignity therapy is a very effective intervention to improve the dignity of end-stage patients. A concept analysis by Walker and Avant (2005) was adopted to define, describe, and delimitate the concept of dignity therapy. Methods: Nursing literature in the National Digital Science Links (NDSL) and Medline database were searched for the definitions of "dignity" and "dignity therapy". Definitions, uses, and defining attributes of dignity therapy were identified; model and contrary cases were developed; and antecedents, consequences, and empirical references were determined. Results: Through dignity therapy patients and their families share their stories, and that in turn improves the quality of life and death. Five attributes were identified: higher quality of life and death, therapeutic conversation, respect of human dignity and worth, expressing thoughts about life and death and systematic process. Conclusion: Patients at the end of their lives feel more comfortable about death. Hospice care providers should try to protect dignity of patients in their care. The attributes of the dignity therapy clarified in this study should be applied for terminally ill patients to improve their quality of life and death.