• Journal of Hospice and Palliative Care
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• v.3 no.1
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• pp.18-27
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• 2000

Purpose : This study aims to find out the quality of life of patients admitted to the hospice unit at Kangnam St. Mary's Hospital, at admission and after weeks hospice service and to assess the effects of hospice service on the quality of life of terminal cancer patients. Methods : This study subjects were 100 patients admitted to the hospice unit at Kangnam St. Mary's Hospital, Catholic University between October 1999 and March 2000, and their primary caregivers. Quality of life data were collected using a questionnaire revised by the authors and were analyzed by means of repeated measures ANOVA. Results : 1) Patient's quality of life as perceived by the primary caregiver was significantly improved and the mean score was 3.31, 3.68, 3.56, 3.73, 3.75 at admission and week 1, 2, 3, 4. With the detailed item analysis, the following items were shown to be significantly improved: "clean bodies"(F=6.50, P=0.0001) "pain control"(F=18.01, P=0.0001) constipate"(F=2.96, P=0.0237) "sleep"(F=3.99, P=0.0048) "nausea/vomiting"(F=4.50, P=0.0022) "medical team's comfortable care" (F=3.95, P=0.0051) "family's care"(F=2.76, P=0.0317) "anxiety" (F=3.14, P=0.0177) "comfort"(F=3.63, P=0.0085) "treat with dignity"(F=3.32, P=0.0136). The item of "death is not the end of life rather the beginning" was significantly decreased(F=2.54, P=0.0450). 2) Patient's quality of life as perceived by the patient showed an improvement but statistically insignificant and the mean score was 3.63 and 3.83 at admission and week 1. With the detailed item analysis, the item of "pain control" was shown to be significantly improved(F=9.19, P=0.0251). 3) The quality of score in the last week of life of patient were 3.48, 3.51, 3.44, 3.46, 3.50, respectively, from 5 week prior to 1 week prior to death and these changes were insignificant. Conclusion : The findings of this study showed a positive effect of hospice service on quality of life of the terminal cancer patients admitted to the hospice unit. To improve the quality of life, we need first of all to develop hospice interventions with a particular emphasis on the spiritual aspect of patient. Secondly, measurement instruments need to be developed to collect the quality of life of the hospice patients who become weakened especially in the last weeks of their life and with this effort more representative data of hospice patients may be collected.

• Journal of Hospice and Palliative Care
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• v.21 no.2
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• pp.51-57
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• 2018

Purpose: End-of-life (EoL) decisions are challenging and multifaceted for patients and physicians. This study was aimed to explore how EoL care is practiced for patients with a do-not-resuscitate (DNR) order. Methods: We retrospectively analyzed medical records of patients who died after agreeing to a DNR order in 2016 at a university hospital. Characteristics including cause of death, intensity of EoL care, and other factors were reviewed and statistically analyzed. Results: Of total 375 patients, 170 patients (45.3%) died with malignancies, and 205 patients (54.6%) with other causes involving the central nervous system (19.2%), pulmonary (14.7%), cardiologic (6.7%) and infectious (6.4%) conditions. Both the cancer and non-cancer patient groups showed a short duration from DNR to death (median 3 days vs 2 days, P=0.629). An intensive care group comprising patients who received one or more intensive treatments such as ventilator (n=205) showed a higher number of non-cancer patients and a shorter duration from DNR to death than a group that withheld treatment before DNR (P<0.05). Conclusion: EoL decisions were made very late by both cancer and non-cancer patients. About half of the patients did not have cancer, and two-thirds of them decided DNR during intensive treatment. To make a good EoL decision, a shared decision making with patients should be done at an earlier stage.

• Journal of Hospice and Palliative Care
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• v.3 no.2
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• pp.136-143
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• 2000

Purpose : The purpose of this study was to identify the characteristics of hospice volunteers and care-takers and analyze activities of volunteers. Methods : First, to identify the characteristics of hospice volunteers and care-takers, 87 records that registered in for the hospice volunteer education program in Wonju C.C.C from 1997 to 2000 were analyzed. Second, to analyze activities of volunteers, 30 volunteers were participated in this study. The data were collected through a self reporting questionnaire developed by research team. Results : 1) Hospice volunteers were mostly female(93.1%) with an average age of 45 years. 32.4% of persons who completed the hospice volunteer education program has been participated hospice care continuously. 2) The care-takers average age was 50 years and mostly with cancer. The majority(13.6%) of cancers was lung cancer. 3) The mean frequency for visiting was 10 and the mean duration for offering hospice care was 49.4 days. 4) The highest score of activity was spiritual area(mean=1.97) and next activity was emotional area(mean=1.49). Conclusion : The findings in this study have an important basic data to develope program for hospice volunteers in W city.

• Journal of Hospice and Palliative Care
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• v.18 no.1
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• pp.42-50
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• 2015

Purpose: This study was aimed to analyze how social workers understand the rights for elderly patient and family caregiver to make end-of-life (EOL) care decisions and their roles the decision making process. Methods: The study employed a quantitative research method of collecting data from a structured questionnaire that was filled out by 334 social workers at long-term care facilities. Data were analyzed by descriptive statistics, mean differences, correlation between variables, using SPSS 20.0 program. Results: The mean score for the understanding the rights to an EOL care decision was $3.46{\pm}0.69$ and of their own roles $3.48{\pm}0.84$. The level of understanding significantly differed by social workers' experience of assisting a process to make an EOL care decision such as advance directives and life sustaining treatment, work experience, and the number of beds. Positive correlation was observed between the level of understanding of the rights for EOL care decisions and of social workers' roles (Pearson r=0.329, P<0.001). Conclusion: This study proposes development of an education program for social workers and devising standards for the EOL care decision making process to protect elderly patients, family caregivers as well as social workers in a long term care facility.

• Journal of Music and Human Behavior
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• v.14 no.1
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• pp.17-39
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• 2017

This study aimed to review Korean-written and English-written studies on music interventions for family caregivers of patients in medical settings. Electronic databases were searched for studies published through 2016, using the keywords of music intervention, family caregivers, and specified settings. A total of 43 studies, five Korean-written and 38 English-written studies, were selected. The results showed that caregivers were the sole participants in five studies (family-only), and caregivers and patients co-participated in 38 studies (family-patient). While diversified types of family participation were included in the English-written studies dating back to the late 1980s, the Korean-written studies were the only ones to include patients as co-participants with their caregivers. Studies with family-only participation tended to be conducted in palliative care units and usually included the spouses of the patients. Meanwhile, studies with family-patient participation tended to be conducted in NICU or cancer units and usually included the parents of the patients. Furthermore, studies with family-only participation tended to apply passive music activities, and those with family-patient participation tended to use active music activities. The results of this study present baseline data on how family-centered care can be included in music interventions in medical settings in Korea, suggesting future studies to systematically analyze music interventions for family caregivers in terms of diversified patient- and caregiver-related factors.

• Journal of Digital Convergence
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• v.12 no.2
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• pp.391-396
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• 2014

This study was conducted to be helpful to the expansion and development of hospice and to provide the basic data for Hospice palliative care by identifying the general characteristics of curriculum of hospice perception, level of perception, practice experiences, routes, times, meanings, needs, targets, supply, types, organizations, experiences, use of hospice and physical, emotional, social and spiritual aspects of hospice services. Study tools which were used in this study were composed of three sections. Survey paper is 3-point Likert scale which is composed of 6 questions of general characteristics, nominal scale of 24 questions about hospice perception and hospice service contents. Respondents can reply with 3 answers of Necessary (1), Mediocre (2), and Not necessary (3), in physical, emotional, social and spiritual aspects. Score ranges of this tool are from minimum of 24 points to maximum of 72 points and higher scores mean higher perception of Hospice. Hospice is a behavior to take care of terminal patients who are waiting for death and their family and it should be conducted physically, emotionally, socially and spiritually in order that the patients could meet their last moments of life by maintaining a high quality of life, human dignity and peace for the rest of their lives. Hospice could be mentioned to be a comprehensive care to relieve the pains and grieves of bereaved family.

• Journal of Hospice and Palliative Care
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• v.11 no.2
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• pp.82-90
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• 2008

Purpose: The purpose of this study was to develop a CD program of applied logotherapy to improve the quality of life of older school-age children with terminal cancer. Methods: Keller's ARCS (Attention, Relevance, Confidence, Satisfaction) theory and a model for developing learning materials (Dick and Cray) were applied to develop this program which comprised four distinct phases: planning, developing, applying, and evaluation stages. Results: This program was entitled 'Finding treasures in my mind' and consisted of 5 sessions, and its educational contents were made up as follows: "Treasure One" is 'learning three natures of the human mind', "Treasure Two" is 'learning creative value as first method to find meaning of life', "Treasure Three" is 'learning experiential value as second method to find meaning of life', "Treasure Four" is 'learning attitudinal value as third method to find meaning of life', and "Treasure Five" is 'Becoming the master of my life'. The sub-menu was made up of 'Beginning', 'What is it?', 'Travelling'. 'Laughing Song', and 'End'. Conclusion: This CD program is an applied logotherapy with flash animation technique as an emotional and spiritual intervention program for easier and more scientific application in pediatric oncology and hospice area.

• Journal of Hospice and Palliative Care
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• v.17 no.2
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• pp.57-65
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• 2014

Purpose: Since most terminally ill cancer patients die of multiple organ failure, plasma endotoxin concentration levels may be used to predict the life expectancy. This study was performed to evaluate the clinical significance of endotoxin level in plasma as a prognostic factor for survival in patients with terminal cancer. Methods: This study was conducted with 56 terminally ill cancer patients, above 20 years old, from April 2009 through October 2009. Demographic characteristics, Karnofsky performance status, and survival time were evaluated. We analyzed blood levels of white blood cell hemoglobin, hematocrit, aspartate aminotransferase, alanine aminotransferase, c-reactive protein, total bilirubin and endotoxin in each patient. Results: We considered following variable for univariate analysis: plasma endotoxin level, sex, age, WBC, hemoglobin, hematocrit, AST, ALT, total bilirubin, CRP and severity of pain. Univariate analysis did not show a significant association between plasma endotoxin level and survival time. However, in a multivariate analysis with factors that were found to be significantly associated with survival sex, WBC count and total bilirubin level in univariate analysis, high levels of plasma endotoxin and short survival time were significantly related. Conclusion: Plasma endotoxin level could be used as a prognostic factor to predict the life expectancy of terminally ill cancer patients.

• Journal of Hospice and Palliative Care
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• v.19 no.2
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• pp.109-118
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• 2016

The purpose of this study was to evaluate Korean advance directives (K-AD) by examining the degree of adults' acceptance and reliability of the directive itself. Methods: Survey was performed with 181 adults aged 20 or older who were recruited from three regions. A questionnaire used to examine the participants' acceptance of their K-AD in terms of visual analogue scale score of complexity, difficulty, necessity, satisfaction, recommendation. Then, a retest was carried out by asking participants to write up a K-AD again to confirm the reliability of the directives. Results: On a scale of 100, the average acceptance score was 70 or above, which represents rather high level of acceptance in all five categories. The test-retest reliability kappa values ranged from 0.592 to 0.950, and the conformity degree was moderate or high. Regarding K-AD components such as values, treatment preference, proxy appointment, differences among age groups were observed in each component. Conclusion: The results of this study suggest that K-AD is a feasible instrument to analyze its acceptability and reliability for adult population. K-AD could be utilized to help people make their own decision on their end-of-life care. Further studies are needed to confirm this study results and promote widespread use of K-AD.

• Journal of Hospice and Palliative Care
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• v.16 no.4
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• pp.232-241
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• 2013

Purpose: This study was conducted to do preliminary report of differences and similarities between Koreans residing in Korea and Korean Americans residing in America regarding their awareness of end-of-life care, attitudes toward advance care planning, truth telling, and preferred decision-making model. Methods: Two participating groups were selected: a) Koreans residing in Korea, and b) Koreans Americans who had resided in the United States for at least 20 years. 25 Koreans and 23 Korean Americans who were older than 65 years old participated in this study. They were asked via a self-administered questionnaire that contained demographic questions and questions about end-of-life decision making regarding awareness of end-of-life care, attitudes toward advance care planning, truth telling, and preferred decision-making model. A Chi-square was used to measure differences between Koreans' and Korean Americans planning. A P value of less than 0.5 was considered significant. Data analysis was performed using SPSS 18.0. Results: In some aspects of awareness of end of life care, attitudes toward advance care planning, and truth telling, both groups had similar opinions. However, there were significant differences between groups in the necessity of end of life documentation, preferential informing the truth, and preferred decision making model. Conclusion: There were similarities and differences regarding some end of life issues between the Koreans and the Korean Americans.