• Journal of Hospice and Palliative Care
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• v.12 no.1
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• pp.20-26
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• 2009

Purpose: We undertook this study to find out the recognitions of terminal cancer patients and doctors about advance directives (ADs), of how they would do in non-response medical conditions and whether ADs could be one of medical options for their dying with dignity. Methods: One hundred thirty four cancer patients in the Hospice Unit, St. Vincent's Hospital, and 97 medical doctors in the Department of Internal Medicine, Catholic Medical Center, were asked about ADs, including Do-Not-Resuscitate (DNR), medical power of attorney, living will and medical options. Results: One hundred thirty patients (97%) and 38 doctors (39.2%) were unfamiliar with ADs, however, 128 patients (95.5%), 95 doctors (97.9%) agreed with it. Seventy nine patients (59.0%) and 96 doctors (99.0%) wanted DNR rather then intensive treatments if they were in non-response medical conditions. Eighty four patients (62.7%) and 75 doctors (77.3%) were agreeable to medical power of attorney. One hundred Thirty four patients (100.0%) and 94 doctors (96.9%) did not want medical options to be in terminal conditions, and hoped to die in peace. Conclusion: Most of patients did not know about ADs and how to make it. However, they showed positive attitudes about it. If we advertise it properly, it is highly likely that a large number of cancer patients would make their living wills easily by ADs. Nevertheless, many legal and ethical problems have to be solved. Doctors should engage their patients in an ongoing communication about the end-of-life. Therefore, let the patients have opportunities to plan their own deaths.

• The Korean Chronic Disease News
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• no.303
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• pp.1-18
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• 2006

한국만성질환관리협회 신준식 부회장/국가 심.뇌혈관 질환 예방위 설치/약제비 절감‘포지티브’제도 강행/6월부터 환자 식대 보험 적용 확정/말기암 환자 호스피스기관 선정/“농촌지역 암.만성질환 관리 시급”/의료법인, 세제개선 헌법소원 추진/‘신약인프라 구축’5개년 계획 추진/화장품에 인태반 원료 사용 금지/약국 간판.광고 규제 대폭 완화/‘한방의학으로 수술 않고, 척추질환 치료’/“건강의 비결은 걷는데 있다”/식이섬유 1일 평균 19.8g 섭취/식도암, 내시경 수술 효과 좋았다/만성질환 관리의 현황과 발전방향/“40~50대 파킨슨병 발생 많다”/전립선비대증 치료‘시알리스’효과 있다/위암 수술 후‘젤로다+ 엘록사틴’투여 평가/

• Journal of Hospice and Palliative Care
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• v.20 no.3
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• pp.188-193
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• 2017

Purpose: There has been very little study on the associations between patient's symptoms themselves and family caregiver (FC)'s depression in the palliative phase. This cross-sectional study was to investigate the relationship between symptom features of terminally ill cancer patients and their FC's depression. Methods: We performed a multicenter survey using the MD Anderson symptom inventory and the Hospital Anxiety and Depression Scale. A total of 293 patient-FC pairs were recruited from seven tertiary medical centers. A multivariate regression analysis was applied for identifying the relevant factors associated with FC depression and for estimating adjusted depression score of FCs. Results: Among various psychosocial factors, low FC quality of life, low social support, spouse, and more caregiving time were significantly associated with FCs' depression. According to the presence of FCs' depression, there were significant differences in some symptom characteristics of patients. Even after adjusting for the relevant confounders, depression scores were lower in FCs caring for patients who had negative symptoms (loss of appetite, P=0.005; drowsiness, P=0.024; and dry mouth, P=0.043) than in FCs caring for patients who had not. FCs caring for patients with severe appetite loss had lower depression scores than those with not severe one (P=0.039). Conclusion: Our result suggests that patient's symptom characteristics might be helpful when evaluating a FC's depression.

• Journal of Hospice and Palliative Care
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• v.3 no.1
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• pp.60-73
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• 2000

Purpose : The purpose of this study was to describe a total pain model in patients with terminal cancer and to identify factors relating to total pain using the Twycross Pain Management Model, which included physical, psycho-social and spiritual pain. Method : The study was a retrospective descriptive study. The first stage included 87 patients who received hospice service at Y hospital in 1997. The second stage included five model patients who suffer severe pain as selected by the four hospice nurses. Data collection was from 1) chart analysis and 2) in-depth interviews with the hospice nurses about their selected patients. Data analysis was performed using SPSS-WIN and content analysis. Result : 1) The main problems of 3 patient with terminal cancer were pain(77%), constipation (25.3%), family coping(35.6%), psycho-spiritual distress(17.2%)and other symptoms. 2. The Twycross model was a useful model. However, new items were added; loneliness, depression, and no improvement in condition as depression factors. In anger, new items were anger due to family neglect, at God and in relationships. The case studies identified the followsing; 1) Patient suffer from physical pain as well as multiple other symptoms when cancer is advanced. 2) Body concept, role change, threat to self concept, fear of pain, fear of death, anxiety, family conflict, financial burden, spiritual distress, hope for a cure, are all affected. Conclusion : 1) It is believed that the Twycross model is useful but further tests and revisions are necessary for deciding priorities in the care plan. 2) Pain management must improve culturally appropriate and family support, psychological, spiritual care are imperative for patient with terminal cancer. 3) Further study is recommended to test correlations of depression, anxiety, spiritual distress and family coping using valid instruments. A qualitative study on the spiritual journey of the patient with terminal cancer is also recommended.

• Journal of Hospice and Palliative Care
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• v.1 no.1
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• pp.23-29
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• 1998

Purpose : Validity of WHO guideline of cancer pain management has been proven and many trials were done for resolution of inadequate management of cancer pain. We assessed the severity of pain in terminal cancer patients and patient's characteristics influencing inadequate pain management. Methods : This study was done on 100 patients who was confirmed as terminal in Seoul National University Hospital from lune 1997 to November. For getting the informations about dermographic and medical characteristics such as performance and metastasis, and drug-adjusted pain severity the patients, we reviewed the medical records and interview the patients. we assessed the adequacy of prescribed analgesics with WHO guidelines of pain management, and patient's characteristics influencing on adequacy of pain management. Results : 85.0 percent of cancer patient had pain when diagnosed as terminal cancer and 68% of patient had pain above moderate severity. 38.0 percent of those were given inadequate pain management and the greater pain severity, the less adequate(P<0.001). Sex, age, primary site of cancer, metastasis, symptoms such as depression and anxiety, and performance were not significant. Conclusion : Despite guidelines for pain management, many patients with terminal cancer received inadequate pan management. Their is a need for education about evaluation of pain and guidelines of pain management.

• Journal of Hospice and Palliative Care
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• v.9 no.2
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• pp.59-66
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• 2006

• 대한두경부종양학회:학술대회논문집
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• 1997.05a
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• pp.127-132
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• 1997

• 한국호스피스완화의료학회:학술대회논문집
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• 2000.06a
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• pp.84-85
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• 2000

• 한국호스피스완화의료학회:학술대회논문집
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• 2000.06a
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• pp.93-95
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• 2000

• Journal of Hospice and Palliative Care
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• v.6 no.2
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• pp.180-185
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• 2003