• Journal of Hospice and Palliative Care
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• v.18 no.2
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• pp.85-96
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• 2015

In Korea, modern art therapy was developed in the 1960s and 1970s in the form of supplementary activities for patients in psychiatry. Along with the foundation of the Korean Association for Clinical Art in 1982 by psychiatric doctors, the therapy involved more various arts forms such as music, art, dance, poetry therapy, and psychodrama. More organizations with specific expertise opened such as the Korean Art Therapy Association, Korean Art Therapy Association, etc. in the 1990s and the Korea Arts Therapy Institute in 2001. As of April 2015, the members of the Korean Art Therapy Association total 15,000, including 6,200 regular members. The arts in integrative arts therapy (IAT) is an individual's creative activity which is related to his inner world, and the forms of IAT include music, drawing, dance and poetry therapy. From the aspect of phenomenology, IAT is psychophysical therapy involving the arts that helps patients recognize and perceive their experiences with an aim of at a recovery of the body and creativity from the phenomenological aspect. It is also a therapeutic activity that targets growth and development of the body and mind. Meta-analysis of the effects of art therapy with a focus on that involving music, drawing, dance movement and IAT in recent years in Korea, significant effects were observed in all factors but physical function. The biggest effect was mentality adaptation followed by activity adaptation and physiology. In the run up to the implementation of the daily flat-rate system for the health insurance reimbursement for palliative care in July 2015, the Ministry of Health and Welfare is reviewing the coverage of music therapy, drawing therapy and flower therapy, which are currently practiced by 56 hospice institutes in Korea. This is a meaningful step because the coverage of hospice and palliative care came after that of art therapy for psychiatric patients was approved in 1977. Still, there is a need clarify the therapeutic mechanism by exploring causality among the treatment media, mediation type and treatment effects. To address the issue of indiscriminately issued licenses, more efforts are needed to ensure expertise and identity of the licensed therapists through education, training and supervision.

• Journal of Hospice and Palliative Care
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• v.22 no.4
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• pp.145-155
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• 2019

Purpose: Amendment to the Act on Decisions on Life-sustaining Treatment was recently enacted to designate long-term care hospitals as providers of hospice and palliative care. Despite its benefit of providing improved accessibility to end-of-life care, the amendment has raised concerns about its effect on quality of service. This study aimed to use information obtained from an expert group interview and previous studies to compare how cancer patients, family caregivers, physicians, and the general Korean population perceive the potential benefits and risks of this amendment. Methods: We conducted a multicenter cross-sectional study from July to October 2016. The included participants answered a structured questionnaire regarding the extent to which they agree or disagree with the questionnaire items indicating the potential benefits and risks of the amendment. Chi-square tests and univariate and multivariate logistic regression analyses were performed. Results: Compared with the general population, physicians agreed more that long-term care hospitals are currently not adequately equipped to provide quality hospice and palliative care. Family caregivers found improved access to long-term care hospitals more favorable but were more likely to agree that these hospitals might prioritize profits, thereby threatening the philosophy of hospice care, and that families might cease to fulfill filial responsibilities. Compared with the general population, cancer patients were more concerned about the potentially decreased service quality in this setting. Conclusion: Although potential service beneficiaries and providers expected improved accessibility of hospice and palliative care services, they were also concerned whether the system can provide adequate quality of end-of-life care.

• Journal of Hospice and Palliative Care
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• v.7 no.1
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• pp.17-28
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• 2004

Purpose: Even though there have been various efforts for the dying with dignity of terminal patients, no researches focused on the public attitudes. Methods: In February 2004, we sampled 1,055 persons over 20 years of age from the sixteen cities and local districts of Korea through the quota sampling method according to their gender, age, and location. We conducted a telephone survey with a structured questionnaire on the attitudes toward dying with dignity and hospice palliative care. Results: The most important conditions for the dying with dignity on the patients' views were 'removing burdens for other people' (27.8%). Over the half of the samples chose their home as a preference for place of death (54.8%). 82.3% of the respondents agreed to the idea of withdrawing the medically futile life-sustaining treatment. Fifty seven percents of the answered public said that they intended to use the hospice service in case of terminal illness. Eighty percents thought that health care insurance should cover hospice service, and 80.9% gave positive response to the necessity of advance directives. Respondents emphasized 'the financial support for the terminal patients' (29.8%), 'covering hospice service with health insurance' (16.5%), and 'the education and public relation for settlement of desirable dying culture and hospice service' (15.9%) as the roles and responsibilities of the government for the dying with dignity. Conclusion: This study shows that there is a possibility of significant consensus on hospice and palliative care system for the dying with dignity of patients and reduction of the suffering for their families among the general public.

• Journal of Hospice and Palliative Care
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• v.22 no.1
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• pp.8-18
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• 2019

Purpose: This study was conducted to better understand the illness experiences and palliative care needs in community-dwelling persons with cardiometabolic diseases. Methods: This qualitative descriptive study was conducted with 11 patients (and three family members) among 28 patients contacted. Interviews were led by the principal investigator in her office or at participants' home depending on their preference. All interviews were digitally recorded and transcribed by a research assistant. The interviews were analyzed by two independent researchers using a conventional method. Results: Participants' ages ranged from 42 to 82 years (nine men and two women). Three themes were identified: (1) same disease, but different illness experiences; (2) I am in charge of my disease(s); (3) preparation for disease progression. Participants were informed of the name of their disease when they were diagnosed, but not provided with explanation of the diagnosis or meant or how to do self-care to delay the disease progression, which increased the feelings of uncertainty, hopelessness and anxiety. Taking medication was considered to be the primary treatment option and self-care a supplemental one. Advanced care plans were considered when they felt the progression of their disease(s) while refraining from sharing it with their family or health care professionals to save their concerns. All participants were willing to withhold life-sustaining treatment without making any preparation in writing. Conclusion: Education on self-care and advanced care planning should be provided to community-dwelling persons with cardiometabolic diseases. A patient-centered education program needs to be developed for this population.

• Journal of Hospice and Palliative Care
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• v.21 no.2
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• pp.65-74
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• 2018

Purpose: The aim of this study is to examine the relationships among hospice-palliative care (HPC) nurses' knowledge of delirium, self-efficacy and nursing performance. Methods: This study was participated by 174 nurses working in the HPC unit. The nurses were asked to fill out a questionnaire that was structured to measure their knowledge of delirium, a self-efficacy in clinical performance scale (SECPS) and nursing performance. Results: The mean score for knowledge was 32.83 out of 45, with correction rate of 73%. The mean score for self-efficacy was 7.08 out of 10. The mean score of nursing performance was 2.95 out of 4. Significant correlation was observed among the variables of knowledge (r=0.28, P<0.001), self-efficacy (r=0.51, P<0.001) and nursing performance. Conclusion: Nurses with high level of knowledge of delirium showed high level of self-efficacy, and consequently better HPC nursing performance. It is necessary to develop a training program on delirium considering nurses' needs of knowledge of the condition. The effectiveness of the training program should be also examined in future.

• Journal of Hospice and Palliative Care
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• v.13 no.3
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• pp.161-168
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• 2010

Purpose: This study investigated the Korean social workers’ burn-out factors and personal traits in hospice and palliative care field, and also examined the effect and correlation between their professionality, social support and supervision. Methods: Data (N=46) from 46 social workers working at hospice and palliative care field were collected, and the data were analyzed for the inferential statistics using t-test, ANOVA, correlation and multiple regression with the SPSS 12.0 program. Results: General factors of the burn-out were age and work experience. The effect of the organization environment is greatly dependant on social support and supervision, and the burn-out were protected when workers got an emotional support from their family. For the workers with supervision, the less negative feeling, the better for the burn-out protection. Furthermore, the low burn-out was thought about when professional organization, self regulation, job vocation and autonomy were utilized. Regression analysis needed that the burn-out were protected well when individual autonomy among expertise was guaranteed. As for social support, vertical support was able to protect physical burn-out. Conclusion: The training program for social workers in hospices and palliative care field is essential to reduce and prevent the burn-out. Hospice should be more activated and a training program with up-to-date knowledge and information should be adopted.

• Journal of Hospice and Palliative Care
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• v.16 no.2
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• pp.74-79
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• 2013

The purpose of this paper is to suggest a direction for future studies based on the analysis of the articles published in the Korean Journal of Hospice and Palliative Care from 1998 to 2012. A total of 240 articles (51 reviews, 189 original) were examined in three five-year groups. Categories of analysis include authors' background (profession, region) and general characteristics and qualitative aspects of the original paper (participants, topic, study design, data analysis, ethical consideration, multidisciplinary approach, research funds and sample size estimation). While the journal publishes more of articles than before, it is mainly due to the increase in the number of review articles, not original articles. As for study topics, healthcare industry and physical symptoms were most frequently studied. The disparity in authors' regional background is fading, and more articles are published by nurses than before. Moreover, more studies are funded while fewer papers tend to adopt a multidisciplinary approach or focus on care givers. Also, in terms of a study design, the number of experimental and methodological studies has slightly increased. In the qualitative aspect, studies considered ethical issues and collected participation consent, and fewer studies reported an estimated sample size. In data analysis, post-adjustment comparison decreased, and new analytical methods are increasingly used. Our results indicate the need to conduct research with more extensive scientific data in various fields of hospice and palliative care.

• Journal of Hospice and Palliative Care
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• v.12 no.3
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• pp.115-121
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• 2009

Despite a recent increased nation's attention given to improving end-life care, we professionals need to be more critical and reflective on our realities surrounding hospice palliative care. The aim of this paper is to suggest that palliative care models can be used for patients/families in the last phase of life and examine whether they are appropriate for caring them in congruence with philosophy of hospice. The hospice experience model (HEM) of Eagan & Labyak and the developmental model of Byock are introduced and examined for their congruence with philosophy of hospice in applying to clinical practice. The HEM as a patient/family value-directed end of life care model emphasizes three principles; unique experience of patient/family, interactions/relationships among multiple dimensions of personhood and between family, and personal growth and development in the face of suffering through a life-completion. The developmental model stipulates dying as the last stage of living, a stage of life cycle in which patients/family may have growth through life-completion in multidimensional relationships of personhood. The model includes the developmental landmarks and tasks for life-completion as the framework to guide a means of professionals' to recognize their opportunity to grow. The landmarks and tasks include worldly and social affair, individual relationships, intrapersonal, and transcendent dimension. The models could work as appropriate palliative care models for patients/families in the last stage of living. The professionals need to be encouraged to apply the models to end of life care setting.

• Journal of Korean Academy of Nursing
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• v.41 no.3
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• pp.374-381
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• 2011

Purpose: The purpose of this study was to develop and validate a hospice palliative care performance measure which would cover more than just physical symptoms or quality of life. Methods: Through an intensive literature review, the author chose questions that measured aspects of physical, emotional, spiritual, social, or practical domains pertinent to hospice palliative care for inclusion in the scale. Content validation of the questions was established by 15 hospice palliative care professionals. A preliminary Hospice Palliative Care Performance Scale (HPCPS) of 20 questions was administered to 134 pairs of terminal cancer patients from 5 hospice palliative care units and their main family caregiver. A validation study was conducted to evaluate construct validity and internal consistency. Results: Factor analysis showed 14 significant questions in five subscales; Physical, Emotional, Spiritual, Social, and Patient' rights. There were no significant differences between the ratings by patients and family members except for three out of the 14 questions. The measure demonstrated construct validity, and Cronbach's ${\alpha}$ of the subscales ranged from .73 to .79. Conclusion: The HPCOS demonstrated acceptable validity and reliability. It can be used to assess effectiveness of hospice palliative care for terminal cancer patients in practice and research.

• Journal of Hospice and Palliative Care
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• v.14 no.3
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• pp.138-143
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• 2011

Korean hospice care has been greatly developed in a short period of time, thanks to help of foreign specialists and aids from developed countries. With enormous growth in economy, Korea which once received foreign aids now give help to other countries. It is the time for the Korean hospice society to consider ways to make an international contribution. That way, Korea could help terminal patients both in Korea and neighboring countries overcome sufferings, maintain their dignity as human beings until the end of their lives and have a comfortable moment of death. Thus, we need to think about ways to contribute to the international hospice society and make related plans.