• Journal of Hospice and Palliative Care
• /
• v.12 no.2
• /
• pp.61-71
• /
• 2009

Purpose: The purpose of this study was to develop a CD program of applied logotherapy for psycho spiritual care of late adolescents with terminal cancer. Methods: Keller & Song's ARCS theory and a model for developing learning materials was applied to develop this program composed four distinct phases: planning, designing, developing, and evaluation stages. Results: This program was entitled 'Finding meaning in my life' and consisted of 5 sessions and its educational contents were made up as follows: "First Secret" is 'learning three natures of the human mind', "Second Secret" is 'learning creative values first method to find meaning of life', "Third Secret" is 'learning experiential value as second method to find meaning of life', "Fourth Secret" is 'learning attitudinal value as third method to find meaning of life', and "Fifth Secret" is 'Becoming the master of my life'. The sub-menu was made up of 'Beginning', 'Opening mind', 'Learning'. 'Laughing Song', 'Experiencing'. Conclusion: This CD program applied logotherapy with flash animation technique as an emotional and spiritual nursing intervention program for easier and more scientific application in pediatric oncology and hospice care area.

• Journal of Hospice and Palliative Care
• /
• v.17 no.4
• /
• pp.216-222
• /
• 2014

Purpose: This study was performed to identify the symptoms and care needs of home-based cancer patients in Korea and to add to the scarce literature on this topic. Methods: Data were collected from patients who subscribed to home-based cancer care services in Jinju. Assessments were performed by nurses at the local public health center. The Edmonton Symptom Assessment System with a numeric rating scale (NRS) was used to identify symptoms, and a four-point Likert scale was used to assess psychological, social, and spiritual needs. Results: Cross-sectional data were collected in October 2013. A total of 209 patients participated and their median age was 65 years (range, 17~89 years). Most patients were diagnosed in the early stage of cancer (n=188); only 19 patients were diagnosed in the advanced stage. More than half the patients lived alone (n=115, 55.0%) and took care of themselves (n=128, 61.2%). Anorexia and fatigue were the most common symptoms (median NRS, 5 and 4, respectively). Patients needed economic support the most, whereas spiritual care was least needed (n=138 [67.3%] vs. n=128 [62.1%], respectively). Conclusion: Patients who signed up for home-based cancer care services in Jinju are struggling with a financial issue and physical symptoms. A customized approach is needed to improve the quality of the home-based care services.

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

• Korean Journal of Occupational Health Nursing
• /
• v.28 no.2
• /
• pp.114-123
• /
• 2019

Purpose: The aims of this study were to identify the effects of caring burden and the way of coping on burnout in caregivers of cancer patients. Methods: One-hundred and forty family caregivers of cancer patients who visited the cancer center at one tertiary hospital in metropolitan city B were included. The data collection was conducted from August 1st to October 1st, 2018, using a structured, self-reported questionnaire. The collected data were analyzed using descriptive statistics, t-test, one-way ANOVA, Pearson correlation coefficients, and multiple regression. Results: In the multiple regression analysis, the subject's gender (${\beta}=.12$, p=.028) and caring burden (${\beta}=.74$, p<.001) had a significant effect on burnout. The explanatory power of the subject's gender, education level, religion, caring time, number of family caregivers, monthly income, economic burden, expectation for treatment, caring burden, the way of aggressive coping, and the way of passive coping with burnout was 63.8% (F=23.28, p<.001). Conclusion: Reducing the caring burden in family caregivers of cancer patients will ultimately contribute to reducing burnout, thereby contributing to an improvement in the psychological well-being and quality of life of family members, as well as positively contributing to the recovery of patients.

• Journal of Hospice and Palliative Care
• /
• v.2 no.2
• /
• pp.91-100
• /
• 1999

Purpose : This study was performed to investigate the satisfaction in the hospice services provided for inpatient families and bereaved families whose members had been admitted to the hospice unit at Kangnam St. Mary's Hospital to improve the quality of care for the terminally ill patients and their families. Methods : This sample consisted of 33 families of hospice patients during the period of April to lune, 1998 and 30 bereaved families whose patients had died from March, 1993 to March, 1998. The data were collected through a self-report questionnaire and analyzed using t-test and ANOVA. Results : 1) The satisfaction level of inpatient families and bereaved families showed the mean value of 3.5 where the highest value is 5.0. 2) According to age, the level of satisfaction of inpatient families had significant differences in the fields of hospice philosophy, support for the family, medical management and nursing management(P=0.0001). The level of satisfaction of bereaved families showed significant differences in the field of support for the family, medical management, nursing management, and facilities of the hospice unit(P=0.0001). 3) By family relationship, the level of satisfaction of inpatient families had significant differences in the fields of hospice philosophy, support for the family, medical management and nursing management (P=0.0001). 4) According to religion, the level of satisfaction of inpatient families had significant differences in the fields of hospice philosophy, support for the family and nursing management (P=0.0001), but there was no significant difference for the bereaved families. Conclusions : The findings of this study showed that hospice services had positive influence on families with terminal disease such as cancer. To improve the level of satisfaction in the hospice services for families with hospice patients, we need to provide care by an interdisciplinary hospice team approach, and to assess needs of the families according to their socio-psychological characteristics. Further studies need to be conducted with large samples.

• Journal of Hospice and Palliative Care
• /
• v.18 no.3
• /
• pp.179-187
• /
• 2015

For patients who are near the end of life, an inevitable step is discussion of a do-not-resuscitate (DNR) order, which involves patients, their family members and physicians. To discuss DNR orders, patients and family members should know the meaning of the order and cardiopulmonary resuscitation (CPR) which includes chest compression, defibrillation, medication to restart the heart, artificial ventilation, and tube insertion in the respiratory tract. And the following issues should be considered as well: patients' and their families' autonomy, futility of treatment, and the right for death with dignity. Terminal cancer patients should be informed of what futility of treatment is, such as a low survival rate of CPR, unacceptable quality of life after CPR, and an irremediable disease status. In Korea, two different law suits related to life supporting treatments had been filed, which in turn raised public interest in death with dignity. Since the 1980s, knowledge of and attitude toward DNR among physicians and the public have been improved. However, most patients are still alienated from the decision making process, and the decision is often made less than a week before death. Thus, the DNR discussion process should be improved. Early palliative care should be adopted more widely.

• Asian Oncology Nursing
• /
• v.5 no.2
• /
• pp.79-86
• /
• 2005

Purpose: This study was explored the meaning of hospice volunteer's experience in caring for cancer patients and tried to understand their experiences. Method: The data was collected from 7 participants living in Seoul and Gyeonggi province from Jan. to Apr. 2005. Collection of data was by means of in-depth interviews. The analysis of the data was made the phenomenological analytic method suggested by Colaizzi(1978). Result: The result is consisted of nine theme-cluster; experienced a fear, limitation of activity, experienced social care, experienced physical care, good death, experienced necessity of recharging, experienced bereavement care. Conclusion: The result above indicated that health professionals must develop the management and education of volunteer of hospice care for various hospice care. Also, We should to encouraged the continuous education and efficient management. And support system should be developed.

• Asian Oncology Nursing
• /
• v.8 no.1
• /
• pp.17-23
• /
• 2008

This study was conducted to examine the effect of an individualized educational program by multidisciplinary staffs on the need for caring among patients with radiotherapy. Methods: A quasi experimental study with one group was designed to examine the effect. A total of 48 adult patients were recruited from a university hospital in G-city, Korea from July, 2006 to June, 2007. The level of patients' need for caring during radiotherapy was assessed at the pre- and post-education by a trained research assistant. The level of patients' need for caring on radiotherapy was measured with a 20-item questionnaire. Results: Paired t-test showed that the level of patients' need was reduced at the post-test compared to pre-test (t=3.40, p=0.002). The level of need was higher among the older than 65 yr (F=4.82, p=0.034), and patients who had education years less than 10 yr (F=4.40, p=0.042) and not a spouse (F=5.97, p=0.019) at the pre-test, while there were no difference according to participants' characteristics at the post-test. Conclusions: This multidisciplinary and individualized education program was effective on reducing the level of need for caring during radiotherapy. Therefore, for long-term self-management, further educational strategies based on patients' needs through multidisciplinary teamwork need to be developed and applied.

• Journal of Hospice and Palliative Care
• /
• v.5 no.2
• /
• pp.125-135
• /
• 2002

Purpose : The purpose of this study was to investigate the impact of depression, discomfort, spirituality, physical care, and opioid use on pain with terminally ill cancer patients in the hospice units. Method : The convenient sample of this study consisted of 58 terminally ill cancer patients at three hospice units in university-affiliated hospitals. Patients were interviewed with structured questionnaires. The data was analyzed using ANOVA, Pearson correlation coefficient, and multivariate multiple regression. Result : The results of this study were as follows : 1) The mean age of the participants was approximately 57 years. Regarding diagnosis, stomach cancer showed the highest frequency (24.1%), followed by lung cancer (17.2%) and rectal cancer (13.8%). Regarding motivation for admission to the hospice unit, the majority of the participants indicated pain control (67.2%), followed by spiritual care (39.7%), and symptom relief (27.6%). 2) The mean pain level measured by VAS was 5.13 (${\pm}2.61$). Regarding pain type, the highest pain frequency the participants experienced was deep pain (53.4%), followed by multiple pain (20.7%), intestinal pain (17.3%), and neurogenic (5.2%) and superficial pain (3.4%). 3) Regarding the factors influencing pain, the pain level was significantly affected by the depression level (P<0.01) and the opioid use (P<0.01). Conclusion, In summary, the higher the level of pain the terminally ill cancer patents had the higher the depression level as well as the opioid use. Thus, health care professionals need to continuously provide holistic care for them to die comfortably.

• Journal of Hospice and Palliative Care
• /
• v.9 no.2
• /
• pp.86-92
• /
• 2006

Purpose: This study was conducted to develop a measuring tool for spiritual care performance of hospice team members. The tool may be utilized for providing hospice patients with more systematic and standardized spiritual tares. Methods: The concept and questions of the tool were developed, and then its validity and reliability were tested. For the validity and reliability tests, a self-reported questionnaire comprising 33 questions with 4 point scale ($1{\sim}4$), was developed, and the data were collected from 192 hospice team members from December 2005 to February 2006. Results: Thirty three questions, drafted through literature review and professional consultation, were reviewed by 20 professionals for their validity, were revised and supplemented resulted in the final 33 questions. The questions with a correlation coefficient grater than .30 were selected: all the 33 questions were selected based on this criterion. The reliability coefficient, Cronbarh's ${\alpha}$, was 0.95. The 33 questions were analyzed for factors, and six factors were extracted: relationship formation and communication, encouragement and promotion of spiritual growth, linking with spiritual resources, preparation of death, evaluation and quality control for spiritual intervention, Intervention, and spiritual assessment for intervention. Conclusion: The tool developed in this study includes six factors and has high level of reliability. This tool Will greatly contribute to assess and improve hospice care services, providing systematic and standardized spiritual cares for terminally ill patients and their families.