• Research in Community and Public Health Nursing
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• v.12 no.1
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• pp.175-186
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• 2001

To evaluate the effect of informational support by hospice team on family caregivers of terminally ill cancer patients. 22 family caregivers of D University Hospital in Daegu city were participated. The research was conducted from Aug. 16th to Oct. 28th 2000 by using self-reported questionnaires. The instruments used in this study were the Weinert's scale of perceived social support. Spielberger's state anxiety inventory. CES-D. and Ellison and Paloutzian's spiritual well-being scale. The intervention was designed to give educational and counselling program up to 7 times within 4 weeks. Educational and counselling booklets which made by the researcher were used step by step by hospice team, he data were analysed frequency. percentage. Wilcoxon Singed Ranks Test with SPSS Win l0.0/PC. The results obtained from this study were as follows; 1. The perceived social support of family caregivers was significantly increased after ready planned informational support was applied by hospice team(z=-3.045. p=0.002). 2. The anxiety of family caregivers was significantly reduced after ready planned informational support was applied by hospice team(z =-3:348. p=0.001). 3. The depression of family caregivers was significantly reduced after ready planned informational support was applied by hospice team(z=-3.641. p=0.000). 4. The spiritual well-being score of family caregivers was not significantly improved after ready planned informational support was applied by hospice team(z=-0.422. p=0.673). In conclusion. the results of this study clearly suggests that the informational support provided by hospice team not only increased the family caregivers' who are caring for terminally ill cancer patients. Therefor the informational support program designed by researcher for family caregivers who are caring for terminally ill cancer patients should be utilized and expended.

• Journal of Hospice and Palliative Care
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• v.12 no.3
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• pp.132-138
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• 2009

Proper education of hospice professionals is essential for ensuring quality of end-of-life care. In 2005, 'End-of-life Care Task Force Team' by Ministry of Health and Welfare established '60 hours of hospice education' as basic requirement for hospice professionals. This study is aimed to determine how many of the hospice professionals meet with the criteria and whether there are significant regional variations. Methods: We analyzed the data from 46 hospice organizations, which submitted the application to the 2008 designation program of Ministry of Health, Welfare, and Family Affairs. Data included details of the educational records of each hospice professionals. Results: Total 673 hospice professionals were included in the analysis. Overall, only 41.5% (279/673) met the requirement. Nurses (46.8%; 177/378) were more likely to meet the requirement than doctors (35.8%; 38/106), social workers (32.0%; 24/75) and clergies (35.1%; 40/114). Hospice professionals of the organizations in metropolitan area received more education than those in small cities or rural area (52.4% vs. 25.0% for doctors, 50.6% vs. 43.9% for nurses, 42.9% vs. 25.5% for social workers). By geographic areas, hospice professionals in southeast regions received less education than other part of Korea (28.1% vs. 43.0${\sim}$48.8%, respectively). Conclusion: Less than half of the Korean hospice professionals has received proper amount of hospice education, and significant regional variations existed. National programs to promote the education of hospice professionals and eliminate its disparities are greatly warranted. Implementation of the 60-hour currirulum for hospice professionals, based on the train-the-trainer model, would be regarded as one potential solution.

• Journal of Korean Traditional Oncology
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• v.16 no.2
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• pp.43-51
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• 2011

Objectives : This study reports one case of a patient diagnosed with non-small cell lung cancer with brain metastasis. Methods : A 79 year-old male patient diagnosed with non-small cell lung cancer with brain metastasis was treated chemotherapy for 3 months and quitted it due to poor general condition. He transferred to Korean medicine hospital and was treated herbal medicine(Saengmaek-san plus Baekhapgogeum-tang gagam), acupuncture, moxibustion, interferential current therapy. To evaluate the patient, we measured of Visual Analogue Scale (VAS), Functional Assessment of Cancer Therapy-Lung (FACT-L), Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue). Results : Patient's outcomes were improved during the 1st week regarding VAS (41${\rightarrow}$25), FACT-L (81.2${\rightarrow}$90), FACIT-fatigue (25${\rightarrow}$10). However, dyspnea and cough were was aggravated in the 2nd week. Conclusions : Treatment with Korean medicine therapy may have substantial benefit for patients with end-stage lung cancer. But, Integrated medicine therapy is necessary for proper management of end-stage cancer patients.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.16 no.1
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• pp.31-39
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• 2009

Purpose: This study utilized a non-equivalent control group pre-post design to assess the effects of spiritual nursing care on loneliness and spiritual well-being of terminal cancer patients. Method: Forty-one terminal cancer patients in a general hospital, were divided into an experimental group of 20 patients and a control group of 21 patients. Those in the experimental group received four weeks of treatment three times a week for about 45 minutes each session. The treatment included nurses' spiritual care involving five instruments of spiritual nursing intervention, each of which was used according to the six types of spiritual need assessment. Data was analyzed with descriptive statistics including real number, percentage, $X^2$-test, t-test, and ANCOVA. Result: There were significant differences between the experimental and control groups in the level of loneliness and spiritual well-being. Conclusion: Spiritual nursing care was verified as an effective program that can lessen the loneliness and improve the spiritual well-being of patients with terminal cancer.

• Research in Community and Public Health Nursing
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• v.16 no.3
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• pp.270-281
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• 2005

Purpose: The objective of this study was to understand the caring experience of families with terminal cancer patients. Method: This was designed to be an inductive and descriptive study. Forty-seven families with terminal cancer patients were interviewed in depth and collected data were examined through content analysis. Result: The main categories of difficulties found in this study were 'suffering of patient', 'emotional suffering of family', 'bereavement of patient', 'difficulties in coping', 'problems in treatment', 'incurable situation', 'family problems', 'relationship with other people', 'economic problems', 'spiritual problems', 'problems in the future', 'informing patients of their condition', 'preparing death', 'emotional unstability', 'meaninglessness', 'unkindness of medical teams', 'poor environment for treatment', 'difficulties in hospital environment' and 'economic burden'. Conclusion: The main point found from this result was that families taking care of terminal cancer patients are suffering emotionally from watching the patients' pains and had difficulties in coping with the patients' situation and treatment. In addition, they had negative experiences in medical teams' attitude and hospital environment. This result can be used as an important guide for nurses to assess families' needs in the terminal care setting.

• Korean Journal of Psychosomatic Medicine
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• v.16 no.2
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• pp.81-86
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• 2008

Delirium is not developed naturally and is not an endogenous disease. However, delirium has occurred in some specific populations, such as the elderly or medically compromised patients. These become limitations on the systematic study of the epidemiology of delirium. Many epidemiologic studies of delirium have been focused on the elderly due to the fact there are relatively few in the general population. In addition, assessment tools with various sensitivity and specificity have been used. Advanced age, male, poorer cognitive and functional status, and alcohol abuse are well known risk factors of delirium. the epidemiological data will be reviewed in the elderly, patients with dementia, hip fractures, patients hospitalized in intensive care units, terminal cancer and patients with stroke.

• Journal of Hospice and Palliative Care
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• v.14 no.4
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• pp.197-203
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• 2011

Purpose: Pain is the most common and influential symptom in cancer patients. Few studies concerning pain intensity in the terminally ill cancer patients have been done. This study aimed to identify factors related with more than moderate pain. Methods: This study used secondary data of 162 terminal cancer inpatients at the palliative ward of six training hospitals in Korea. Physician-assessed pain assessment was by 10 point numeric rating scale. Substantial pain was defined more than moderate intensity by the Korean National Guideline for cancer pain. The Korean version of the MD Anderson Symptom Inventory was self-administered to assess symptoms. Survival prediction was estimated by the attending physicians at the time of admission. Results: Less than six weeks of predicted survival and more than numeric rating of six for worst drowsiness in the previous 24 h were significantly related to substantial pain (P=0.012 and P=0.046, respectively). The dose of opioid analgesics was positively related to substantial pain (P=0.004). Conclusion: Factors positively related to substantial pain were less than six weeks of predicted survival and considerable drowsiness. Careful monitoring and active preparation for pain are required in terminal cancer patients having those factors.

• The Korean Journal of Nuclear Medicine
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• v.36 no.3
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• pp.185-194
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• 2002

Purpose: We studied clinical aspects and courses of patients with pulmonary radioactivity on liver scintigraphy and speculated the mechanism of pulmonary uptake of radiocolloids. Materials and Methods: Forty-nine patients with pulmonary radioactivity were classified into 5 disease groups-liver disease, infection, cancer, ischemic necrosis of liver, etc.- and their presence or absence of chronic liver disease (CLD), Child-Pugh class, serum levels of AST and ALT, results of follow-up liver scintigraphy and clinical course were checked. Results: Of total 49 patients 25 had CLD; there were 23 liver disease patients, 16 infection patients, 7 advanced cancer patients, 2 ischemic necrosis of liver patients, and 1 hemolytic anemia patient. Reversible rise of serum levels of AST and ALT was observed in all patients with liver disease and ischemic necrosis of liver; on one-way ANOVA, these rise were statistically significant (p<0.01). Serum level of ALT of liver disease group patients without CLD was significantly higher than that of infection group patients without CLD (p<0.05). Among 17 patients who underwent follow-up liver scintigraphy, 13 showed no pulmonary radioactivity. Total 12 patients died during follow-up and most of them were terminal cancer patients or CLD patients of Child-Pugh class C. Conclusion: Pulmonary radioactivity of radiocolloid liver scintigraphy could be attributed to the mobilization of reticuloendothelial system (RES) cells by the activation of RES cells in severe infection and terminal cancer, and also by the extensive liver destruction in liver diseases.

• Journal of Hospice and Palliative Care
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• v.19 no.1
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• pp.26-33
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• 2016

Purpose: This study was conducted to identify clinical characteristics of oncologic patients at a point when they signed their do-not-resuscitate (DNR) orders. Methods: From January through December 2014, we retrospectively analyzed the records of 197 patients who passed away after agreeing to a DNR order in the hemato-oncology department of a tertiary hospital. Results: Of all, 121 patients (61.4%) were male and 76 (38.6%) were female, and their average age was 58.7 years. Ninety-four patients (47.7%) had gastrointestinal cancer. The ECOG performance status at admission was grade 3 in 76 patients (36.5%) and grade 4 in 11 (5.6%). The patients' mean hospital stay was 20 days. The mean duration from the admission to DNR decision was 13 days, and the mean duration from DNR decision to death was seven days. Conclusion: Study results indicate that a decision on signing or refusing a DNR order was made by medical staff mostly based on the opinions of patients' guardians rather than the patients themselves. This suggests that patients' own wishes are not well respected. Thus, it is urgent to establish institutional devices to enhance cancer patients' autonomy regarding DNR and to define an adequate timing for withdrawal of treatments.

• Journal of Hospice and Palliative Care
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• v.8 no.2
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• pp.183-189
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• 2005

Purpose: Despite the advance of medical science, the number of cancer patient have increased and the mortality rate is also on the rise. Therefore, a perfect cure for cancer is crucial, but the value and meaning of the remaining life for the patient are also becoming more and more important. The principal aim of this study is to examine the differences in the quality of life, physical and psychosocial symptoms according to the performance status of terminal cancer patients. Methods: We evaluated the performance status, demographical data, blood analysis and quality of life of cancer patients who visited the Department of family Medicine at Myoung-ji Hospital in Korea between September 1, 2003 and August 31, 2005. Their performance status (ECOG) was divided into two groups ($ECOG\;0{\sim}1/ECOG\;2{\sim}4$) and analyzed by ANOVA to see if there was a difference in their blood analysis and quality of life. A P value of less than 0.05 was considered to be significant. Results: A total of 104 patients were evaluated, among which 71 patients (23 male and 48 female) scored $0{\sim}1$, and 33 patients (8 males and 25 females) scored $2{\sim}4$ in the ECOG. The blood analysis showed that patients whose performance status was $2{\sim}4$ had lower levels of lymphocytes, hemoglobin, protein, albumin and sodium. The evaluation on their quality of life showed that the overall health status of patients with $2{\sim}3$ functional ability were poor (P=0.02). Also, from a functional perspective, these patients had poor physical (P=0.05) and role (P=0.01) scores, and in terms of symptoms, they showed a significant loss of appetite. Conclusion: If a patient's performance status was poor, levels related to certain nutritions were also found to fall in blood tests, thereby leading to an overall weakened state of health. However, there was no difference in symptoms except for a loss of appetite. In conclusion, it is most important to increase the appetite in patients with poor performance status.