• Title/Summary/Keyword: terminal cancer patient

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A case report of monitoring PSA level changes in two prostate cancer patients treated with Mountain Ginseng Pharmacopuncture and Sweet Bee Venom along with western anticancer therapy (양방 항암치료와 병행하여 산삼약침과 봉약침 치료를 받은 전립선암 환자들의 PSA 수치 변화 관찰 보고)

  • Lee, Yeon-Hee;Kim, Chae-Won;Lee, Kwang-Ho
    • Journal of Pharmacopuncture
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    • v.14 no.4
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    • pp.81-88
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    • 2011
  • Objectives: The purpose of this report is to find out how Mountain Ginseng Pharmacopuncture(MGP) and Sweet Bee Venom(SBV) treatments are effective on prostate cancer patients by monitoring Prostate specific antigen(PSA) values. Methods: We treated two prostate cancer patients with MGP and SBV from October 2008 to April 2011. One patient had localized prostate cancer, the other was in the terminal stage of prostate cancer with lung and bone metastasis and both had been receiving western anticancer therapy. We had monitored the changes of PSA value. Results: In case 1, MGP and SBV treatments seemed to be helpful in preventing the recurrence of localized prostate cancer. In case 2, PSA value was decreased by MGP treatment. Conclusions: It is conceivable that MGP and SBV are effective treatments for patients with prostate cancer.

Delirium-Related Knowledge, Caregiving Performance, Stress Levels, and Mental Health of Family Caregivers of Terminal Cancer Patients with Delirium in a Hospice Care Unit

  • Jung, Mi Hyun;Park, Myung-Hee;Kim, Su-Jeong;Ra, Jeong Ran
    • Journal of Hospice and Palliative Care
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    • v.24 no.2
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    • pp.116-129
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    • 2021
  • Purpose: The purpose of this study was to examine the knowledge, caregiving performance, stress levels, and mental health of family caregivers of terminal cancer patients with delirium, insofar as these characteristics are relevant for delirium. Methods: Between May 1, 2019, and June 1, 2020, 96 family caregivers of terminal cancer patients with delirium completed a structured survey, the results of which were analyzed. Results: The average correct answer rate for delirium-related knowledge was 53.2% across all subcategories, which included knowledge of causes (41.5%), symptoms (65.4%), and caregiving (51.7%). The average score for family caregivers' performance of caregiving for delirium was 2.60±0.5, with subcategories including caregiving for patients without delirium (2.16±0.95), caregiving for patients with delirium (2.84±1.01), and stress related to caregiving for delirium (39.88±16.55), as well as categories such as patient-related caregiving (44.32±28.98), duty-related caregiving (44.21±30.15), and interpersonal relationship-related caregiving (22.35±25.03). For mental health, the average score among family caregivers was 1.96±0.70, with the highest score being for the category of additional items (2.28±0.84). Family caregivers of patients with hyperactive delirium as the delirium subtype had higher scores for caregiving performance than caregivers of patients with mixed delirium. Conclusion: Scores for the delirium-related knowledge and caregiving performance of family caregivers were low, while their caregiving stress levels were high due to their lack of knowledge and experience. This indicates the importance of delirium-related education for family members of patients with delirium and the necessity of developing nursing intervention programs to help manage stress and promote mental health among family caregivers.

Doctor's Attitudes toward Hospice and Palliative Care for Terminal Cancer Patients (말기 암 환자의 호스피스 완화의료에 대한 의사들의 태도)

  • Moon, Do-Ho;Lee, Myung-Ah;Koh, Su-Jin;Choi, Youn-Seon;Kim, Su-Hyun;Yeom, Chang-Hwan
    • Journal of Hospice and Palliative Care
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    • v.9 no.2
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    • pp.93-100
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    • 2006
  • Purpose: This study was designed to understand the doctor's attitude toward hospice and palliative care for terminal cancer patients. Methods: Specialists who work at general hospital were surveyed with questionnaires about hospice and palliative care for terminal cancer patients. The questionnaires comprise 17 items. The data were statistically analyzed. Results: Eighty one doctors responded. Their median age was 35 years old. Thirty six doctors (44.4%) were from internal medicine. The median of specialist's experience was 4 years. Forty three respondents (53.2%) have rarely examined and treated cancer patients even a week. Thirty seven respondents (45.6%) knew the exact definition of hospice and palliative care. Eighty respondents (98.8%) felt that hospice and palliative care is necessary, and 91.2% of them responded the necessity of palliative medicine specialist. As to the question 'Do you positively referred terminal cancer patient to hospice and palliative care?', 55 respondents (67.9%) responded 'Yes' and 22 (27.2%) 'No'. Among the 'Yes' respondents 17 (30.9%) had an experience of hesitation for referring patients to hospice and palliative care; the most common reason was the disagreement of family members (6, 35.3%). As for the reasons of responding 'No', 6 doctors (27.2%) did so because of their 'feeling of abandoning the patients' and the other f for the 'lack of information on the referral procedure for hospice and palliative care'. Thirty seven specialists (45.7%) thought it is most desirable for the patients to have hospice and palliative care for 3 months before death. Fifty eight specialists (71.6%) responded that hospice and palliative care help controlling the patient's psychological symptoms before all. Conclusion: While most doctors recognize the need of hospice and palliative care for patients with terminal ranter, their attitude toward hospice and palliative care was rather reserved. We suggest that continuing education, information and promotion for hospice and palliative care should be provided for doctors.

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Comparison of Spiritual Needs between Patients with Progressive Terminal Kidney Disease and Their Family Caregivers

  • Kim, Ye-Jean;Choi, Oknan;Kim, Biro;Chun, Jiyoung;Kang, Kyung-Ah
    • Journal of Hospice and Palliative Care
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    • v.23 no.1
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    • pp.27-38
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    • 2020
  • Purpose: The purpose of this study was to compare differences in spiritual needs (SNs) and factors influencing SNs between patients with progressive terminal kidney disease and their family caregivers. Methods: An explorative comparative survey was used to identify the SNs of patients (N=102) with progressive terminal kidney disease undergoing hemodialysis and their family caregivers (N=88) at a general hospital located in Seoul, South Korea. The data were analyzed using descriptive statistics, the chi-square test, the independent t-test, one way analysis of variance, the Scheffe test, and multiple regression with dummy variables. Results: The SNs among family caregivers were higher than in the patient group. SNs were higher among those who were religious in both groups. Loving others was the highest-ranked subdimension in the patient group, followed in descending order by maintaining positive perspective, finding meaning, Reevaluating beliefs and life, asking "why?", receiving love and spiritual support, preparing for death, and relating to God. In the family group, the corresponding order was maintaining positive perspective, loving others, finding meaning, receiving love and spiritual support, preparing for death, relating to God, and asking "why?". The factors that had a negative influence on the level of SNs were not being religious in the patient group and having only a middle school level of education in the family group. Conclusion: The results of this study may serve as evidence that spiritual care for non-cancer patients' family caregivers should be considered as an important part of hospice and palliative care.

Korean Medicine Treatment for Pressure Injury in Terminal Stage Cancer Patients with Debridement and Local Flap: A Case Report (변연절제 및 국소 피판술을 시행한 말기 암환자의 욕창에 대한 한의학적 치료 1례)

  • Song, Juyeon;Moon, Jiseong;Min, Seonwoo;Kim, Hakkyeom;Kim, Youngji;Ahn, Lib
    • The Journal of Internal Korean Medicine
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    • v.41 no.3
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    • pp.478-486
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    • 2020
  • Objectives: Pressure injury is a common symptom of end-stage cancer, which impact quality of life. This case study reports on use of traditional Korean medicine in an end-stage cancer patient with pressure injury after debridement and local flap. Methods: A pressure injury with debridement and a local flap was treated using herbal medicine, a carbon arc, acupuncture, dressing, and cooperation in plastic surgery. Pressure injury was followed up with photographs. Results: On the 22nd day of treatment (26 days after the debridement and local flap), redness, swelling, and the condition of pressure injury were all improved. Moreover, the condition of the pressure injury was good without dressing. Conclusions: These results show that traditional Korean medicine may have a positive effect on a pressure injury and improve the quality of life of cancer patients. However, further study is needed to confirm these findings.

DNR (Do-Not-Resuscitate) Order for Terminal Cancer Patients at Hospice Ward (호스피스 병동에서 시행되는 말기 암 환자의 DNR (Do-Not-Resuscitate) 동의)

  • Shim, Byoung-Yong;Hong, Seok-In;Park, Jin-Min;Cho, Hong-Joo;Ok, Jong-Sun;Kim, Seon-Young;Han, Sun-Ae;Lee, Ok-Kyung;Kim, Hoon-Kyo
    • Journal of Hospice and Palliative Care
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    • v.7 no.2
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    • pp.232-237
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    • 2004
  • Purpose: DNR order is generally accepted for cancer patients near the end of life at Hospice Ward. It means not only no CPR when cardiopulmonary arrest develops but no aggressive meaningless medical interventions. Usually on admission, we discuss with the patients' family about DNR order at the Hospice Ward. Recently, we experienced a terminal lung cancer patient who had been on the ventilator for two months after pulmonary arrest. CPR and artificial ventilation were performed because patient's family refused DNR order. There is no consensus when, who, and how DNR order could be written for terminal cancer patients in Korea, yet. Methods: Hospice charts of 60 patients who admitted between Jan and Jun 2003 to Hospice Ward were reviewed retrospectively. Results: The median age was 66(range $31{\sim}93$) and there were 31 males and 29 females. Their underlying cancers were lung (12), stomach (12), biliary tract (7), colon (6), pancreas (4) and others (19). The persons who signed DNR order were son (22), spouse(19), daughter (16) and others (3). But, there was no patients who signed DNR order by oneself. Thirty families of 60 patients signed on day of admission and 30 signed during hospitalization when there were symptom aggravation (19), vital sign change (4), organ failure (3) and others (4). There were 13 patients who died within 5 days after DNR order. Most of patients died at our hospice ward, except in 1 patient. The level of care was mostly 1, except in 2 patients. (We set level of care as 3 categories. Level 1 is general medical care: 2 is general nursing care: 3 is terminal care.) Conclusion: We have to consider carefully discussing DNR order with terminal cancer patients in the future & values on withholding futile intervention.

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Malignant Bowel Obstruction in Terminal Cancer Patients (말기암 환자의 악성 장 폐색)

  • Moon, Do-Ho;Choe, Wha-Sook
    • Journal of Hospice and Palliative Care
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    • v.7 no.2
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    • pp.214-220
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    • 2004
  • Purpose: As for the malignant bowel obstruction of terminal cancer patient, a prognosis is relatively bad. Physicians consider palliative procedures or surgery for the quality of life, but sometimes it is hard to decide. After diagnosis of a malignant bowel obstruction in terminal cancer patients, we investigated the clinical characteristics, the prognostic factors and the survival of patients with palliative procedures or surgery. Methods: we retrospectively reviewed the medical records in 40 malignant bowel obstruction patients who had been diagnosed as terminal cancer from May in 2002 to May in 2004. Results: There were 21 males (53%) and 19 females (47%), and median age of patients was $64.1{\pm}1.58$ years. The most common cause of malignant bowel obstruction was colorectal cancer (18 patients, 45%), followed by stomach cancer (11, 28%), pancreatic cancer (4, 10%), others (7, 19%). Metastases were carcinomatosis peritonei (14 patients, 35%), liver (13, 33%). During a bowel obstruction, symptoms were vomiting (15 patients, 38%), abdominal pain (10, 25%), constipation (6, 15%), abdominal distension (5, 13%). Performance status (ECOG) was 2 score (16 patients, 40%), 3 score (20, 50%), 4 score (4, 10%). Palliative procedure group were 30 patients, the others 10. Median survival in palliative procedure group was 142 days, that of no palliation group 30. Median survival time of palliative procedure group from palliative procedures or surgery were significantly higher than that of no palliation group from diagnosis of malignant bowel obstruction. Prognostic factors of palliative procedure group were PS, site of obstruction and primary cancer. Median survival in PS 2, lower GI obstruction and colorectal cancer was higher than PS 3, upper GI obstruction and others, respectively. Conclusion: we recommend aggressively palliative procedures or surgery in malignant bowel obstruction patients diagnosed with terminal cancer if palliative procedures or surgery could be performed effectively.

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The Single-Session Group Education for Advanced & Terminal Cancer Patients and their Family Members (진행암 및 말기암 환자와 가족을 위한 집단 교육 프로그램)

  • Lee, Young-Sook;Heo, Dae-Seuk;Kim, Mi-Ra;Kim, Won-Gyung;Choi, Jeong-Yun
    • Journal of Hospice and Palliative Care
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    • v.7 no.1
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    • pp.64-72
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    • 2004
  • Purpose: This research aims to assess the effect of a single session of group education of hospice program at Seoul National University Hospital for the advanced and terminal cancer patients and their family members. Methods: Response to questionnaires from 89 participants were evaluated using SAS and CHISQ analysis. The questionnaires included the following items: 1) the characteristics of participants; 2) the characteristics of patients; 3) the difficulties of patient care; 4) the satisfaction with the program Results: The participants consist of 33 patients (37.5%) and 56 family members (56.2%). Diagnosis included mainly stomach, lung, breast, and colon cancer. Participants of family members consisted of spouse, parent, children, daughter-in-law, and siblings (in decreasing order). The participants were interested in the medical information, nutrition, pain and symptom management, and psychosocial adaptation. They had difficulties in emotional problem, nutrition and symptom management. Even though it was a single session of group education, the level of satisfaction was high (95%). Conclusion: This research shows that even the single session of the group education for the advanced and terminal cancer patients and their family members is very helpful by giving them the necessary information. In order to develop comprehensive care-giving services, more specific informations, more opportunities to participate in such sessions and longer question-answer time is required.

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Development and Validation of the Hospice Palliative Care Performance Scale (호스피스완화의료서비스 성과평가 도구개발)

  • Kwon, So-Hi
    • Journal of Korean Academy of Nursing
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    • v.41 no.3
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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.

A Study on the Architectural Characteristics of the German Stationary Hospice Facility (독일 입원형 호스피스 시설의 건축 계획적 특성에 관한 연구)

  • Kim, Cheol-Hwan
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.14 no.1
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    • pp.39-48
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    • 2008
  • Well-dying is as important as Well-Being because dying is also a natural part of life. Recently, due to the change of lifestyles, cancer, AIDS and other chronic diseases cause drastic increase of mortality rate. Needs for hospice services are growing as many terminal patients interested in quality of life during their end of life period. They want calm and dignity in case process as well as pain-relieving. However, there is not many researches on the architectural planning of hospice facilities and their service system as well as government regulations. This study focuses on the German hospice facilities which have developed advanced models through researches on service contents and architectural planning. The purpose of this study is to provide fundamental data for designing hospice facilities through analyzing 7 cases of German hospice facilities with different characteristics.

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