• Journal of Hospice and Palliative Care
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• v.8 no.1
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• pp.45-51
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• 2005

Purpose: The purpose of this study is to examine the factors surrounding burnout of nurses caring for cancer patients. Methods: The sample of this study was conveniently selected among nurses who had hospice care experiences working in General Hospitals located in Seoul. This study was conducted by a self-administered questionnaire. Two hundred forty four questionnaires were retrieved and the response rate was 81.3%. The period of data collection was from February 25th to March 5th in 1994. Mean, standard deviation, T-test ANOVA, and multiple regression analysis were performed for statistical analysis. Results: The data showed that respondents reported to have burnout as many as 2.71 out of a 5.0 score. Bivariate analyses indicated that those who had hospice education reported to have a lower burnout than those without hospice education. Multivariate regression analyses revealed factors associated with burnout the nurses have had. They include being a Christian, higher job satisfaction, and experiences of hospice education. Hospice education reducing burnout for the nurses was observed by hierarchial multiple regression analyses, after controlling out the effect of coping methods, sociodemographic characteristics, job satisfaction, and job-related stresses on experience of burnout. This observation was not hue for physical and psychological burnout but for burnout in general and emotional one. But this was not confirmed among the nurses with type A personality. Conclusion: The findings of this study have a weakness in generalizability due to the sampling methodology used in this study. However, for the better hospice care further research with a probability sampling method are necessary.

• Journal of agricultural medicine and community health
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• v.33 no.1
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• pp.59-70
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• 2008

Objectives: This study aimed to find out the effects of hospice care in public health centers by evaluating the quality of life of terminal cancer patients and care-giver burden of their families.Methods: From January to December 2007, 32 terminal cancer patients and their familes were selected as with interviews. Instruments used for this study were C-QOL(Cancer-Quality of Life) that was developed by Le(207) and care-giver burden of families that was developed by Seo et al(193). The data were analyzed using frequency, percentage and paired t-test.

• Journal of Hospice and Palliative Care
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• v.20 no.2
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• pp.93-99
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• 2017

Purpose: This study investigated changes in life-sustaining treatments in terminally ill cancer patients after consenting to a do-not-resuscitate (DNR) order. Methods: Electronic medical records were reviewed to select terminally ill cancer patients who were treated at the oncology unit of the Asan Medical Center, a tertiary hospital in South Korea and died between January 1, 2013 and December 31, 2013. Results: The median (range) age of the 200 patients was 59 (22~89) years, and 62% (124 persons) were male. Among all patients, 83.5% were aware of their medical condition, and 47.0% of the patients had their DNR order signed by their spouses. The median of the patients' hospital stay was 15 days, and time from admission to DNR decision was 10 days. After signing a DNR order, 35.7~100% of the life-sustaining treatments that had been provided at the time of the DNR decision making were administered. The most commonly discontinued interventions were transfusion (13.5%), blood test (11.5%) and parenteral nutrition (8.5%). Conclusion: It is necessary to define the scope of life-sustaining treatments for DNR patients. Treatment guidelines should be established as well to secure terminal patients' death with dignity after their consent to a DNR order, thereby avoiding meaningless life-sustaining treatments and allowing administration of active terminal care interventions.

• Journal of Hospice and Palliative Care
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• v.10 no.3
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• pp.137-144
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• 2007

Purpose: The purpose of this study is to identify and assess the needs of the cancer patients and their families and provide basic data to meet with their needs. Methods: This is a descriptive study using questionnaire method. Questionnaire were collected by mail from 76 discharged patients from a hospice ward from May until the end of October, 2004, and data were analyzed by SPSS 10.0. Results: Admitted patients had needs of pain control (85.5%), non-pain symptoms (63.2%) such as vomiting, dyspnea, ascites, etc, and emotional and spiritual problem solving (28.9%, 14.5%). Interests of patients were health care of himself/herself (65.8%), concern for their spouses left alone (32.9%), and future of their children (15.8%). In families' needs of care of 5 areas, "information on patient's status and treatment/nursing care" was shown most high score ($3.48{\pm}0.62$). In detailed questions, they request most 'to inform the prognosis of patients' and the next is 'to inform the reasons that nursing care was required'. The next highest score was to 'inform family roles' ($3.39{\pm}0.64$), and next was spiritual support ($3.11{\pm}0.79$), and emotional support ($3.08{\pm}0.72$). Expectations of family on the treatment were comfortable dying (73.4%) scored the highest. Patients' families were satisfied with volunteer service most in service area (97.4%). The next was pain control (89.5%) and nursing service (77.6%). Conclusion: Health care staff should identify the actual needs of families caring cancer patients and they should operate realistic programme which can give continuous and assistance by reflecting individual needs and characteristics. With these srategies, the quality of life of patients and families can be improved. And then the intervention programme should be developed to measure subjective nursing care needs of terminally ill cancer patients and their families.

• Journal of Hospice and Palliative Care
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• v.11 no.3
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• pp.136-139
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• 2008

Purpose: Epidural morphine infusion has been used to control pain in cancer patients whose cancer pain can not be controlled high dose intravenous morphine injection. To study the effectiveness and side effects of epidural morphine for the treatment of cancer pain in terminal patients at Hospice Ward, we evaluated the change in morphine equivalent daily dose for effectiveness and complications of epidural morphine infusion. Methods: We retrospectively analyzed 24 terminal cancer patients who were treated with continuous epidural morphine between 2001 and 2004 at Hospice Ward of St. Vincent's Hospital. Results: The median of baseline morphine equivalent daily dose was 615 mg, whereas the median dose of initial epidural morphine was 16 mg. The median of morphine daily equivalent daily dose dropped from 615 mg to 274 mg in one week after epidural morphine infusion therapy (P-value=0.000). The median survival from the time of the first catheter insertion was 35 days. In 6 patients, the catheter was removed due to complications, however the catheter was reinserted in 3 patients. Conclusion: Cancer pain management by epidural morphine infusion is very effective method with low rate of severe complication.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.16 no.4
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• pp.392-401
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• 2009

Purpose: This study was a descriptive survey of nursing needs for post surgical colon cancer patients at discharge. Method: A survey was done utilizing questionnaires about the nursing needs a target sample of 61 patients who had colon cancer surgery during April May 2006 in a general hospital in Seoul. Results: Levels for treatment & prognosis were the highest in all domain, high in order of psychological support & stability, complications & discomfort, diet, daily life style, recovery & health promotion, and support system. Patient factors affecting nursing needs were age, job, duration of colon cancer and handling of stoma. Conclusion: Using discharge education for colon cancer patients based on the results of this study, nurses should focus on the domains of treatment & prognosis, psychological support & stability and complication & discomfort, and should tailor teaching content to be specified for age, job, duration of colon cancer, and handling of stoma.

• Journal of Hospice and Palliative Care
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• v.19 no.3
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• pp.249-255
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• 2016

Purpose: Up to 90% of pancreatic cancer patients suffer from neuropathic pain. In a palliative care setting, pain control in pancreatic cancer patient is one of the major goals. Ketamine is a N-methyl-D-aspartate (NMDA) receptor antagonist, effective in neuropathic pain. Additionally, there have been studies about the opioid sparing effect of ketamine. This study was held in the palliative care unit among pancreatic cancer patients to determine the factors related to ketamine use and the opioid sparing effect. Methods: The medical records of pancreatic cancer patients admitted to St. Mary's hospital palliative care unit between January, 2013 and December, 2014 were reviewed. Patients were divided into 2 categories according to ketamine use. Also, opioid use before and after ketamine use was compared in the ketamine group. Results: Compared to the non-ketamine use group, patients in the ketamine group required a higher dose of opioid. The total opioid dose, daily opioid dose, number of daily rescue medications, and daily average rescue dose were statistically significantly higher in the ketamine group. The opioid requirement was increased after ketamine administration. Conclusion: In this retrospective study, ketamine was frequently considered in patients with severe pain, requiring higher amount of opioid. Studies about palliative use of ketamine in a larger number of patients with diverse types of cancer pain are required in the future.

• Asian Oncology Nursing
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• v.3 no.1
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• pp.5-14
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• 2003

The purpose of this study was to identify key educational and counseling needs of breast cancer patients in Korea. The data were collected from 102 breast cancer survivors. The instrument consisted of 66 items and the items were divided into five treatment stages: pre-admission, admission, discharge, chemotherapy, and radiation therapy. The subjects' mean age was 50 years and most of them were housewives. All had a mastectomy and among them 69 had chemotherapy and 42 had radiation therapy. Average post-surgical period was 47 months. The mean score of the subjects' needs was 2.99 out of 4 points. The highest educational need was to know about the method of recurrence prevention. In terms of the treatment stages, mean score for pre-admission was 3.09, admission 3.06, chemotherapy 3.03, after discharge 2.95, and radiation therapy 2.80. In the pre-admission period, etiology, diagnostic tests, treatment and prevention of the breast cancer were needed the most. During the admission period, symptom management after the operation had the highest score. After discharge, prevention of recurrence had the highest score. The results of this research will help in developing educational and counseling programs by understanding the specific needs of breast cancer patients based on the treatment stages.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.5
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• pp.327-336
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• 2020

This study was undertaken to identify ways that enable a successful comeback to everyday life and improvement in the quality of life, by understanding the experiences of cancer survivors in returning to everyday life. Totally, 19 people diagnosed with complete cure after 5 years of cancer treatment, were recruited for the study. Data was collected through in-depth interviews from January 18 to February 25, 2017. One-time interviews took 90 to 120 minutes, and data analysis was achieved by applying the grounded theory. The central phenomenon of 'reality that cannot be escaped' and 'uncertain reality that cannot know tomorrow' was attributed to the causal conditions 'hard reality', 'physical exhaustion', 'psychological exhaustion' and 'economic exhaustion'. Depending on context conditions such as 'lack of family support', 'shift to a vulnerable working class', 'insufficient support system', 'hope for the societal support system', 'daunted gender', 'prejudice against cancer/cancer patients', 'information on life after rare full healing'. The strategy for a successful return was influenced by intervention conditions such as 'robust family fence' and 'effective cancer insurance', which resulted in 'building a new life' or 'enduring'. We conclude that for a successful return to daily lives, cancer survivors require comprehensive information, health and social-welfare interventions.

• 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.