• Journal of Digital Convergence
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• v.17 no.9
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• pp.301-310
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• 2019

This study aims to examine eligibilities, services and delivery of services for the current end-of-life care and analyze the quality control of services for end-of-life care. We analyzed the literature and laws on end-of-life systems in Korean and the United States. Current end-of-life care, hospice and palliative care in Korea is being provided mainly in hospital setting. Quality control for the services focuses on setting the criteria for structures in hospitals (i.e. staffing, facilities and equipment). Whereas American end-of-life care system has much broader eligibility for service beneficiaries and provides care mostly at home. Also quality control for services includes process (delivering service) and outcomes, such as monitoring performance indicators and consumer's satisfaction. This is linked to annual payment. The comparative analysis findings contributed to give the next direction of current Korean end-of-life care system. It is nessary to establish the better and extensive end-of-life care system in Korea in considering other countries' end-of-life care systems based on more future research.

• Journal of Hospice and Palliative Care
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• v.16 no.3
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• pp.145-154
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• 2013

This study was performed to evaluate the existing pain assessment methods including the tools developed for use with nonverbal older adults with dementia, and to suggest recommendations to clinicians based on the evaluations. Computerized literature searches published after year 2000 using databases - Google scholar, RISS, KoreaMed, Medline, ScienceDirect, CINAHL - were done. Searching keywords were 'pain', 'pain assessment', and 'cognitive impairment/dementia'. The pain assessments for non-communicative dementia patients who are unable to self-report their pains are often made using the assessment tools relying on the observation of behavioral indicators or alternatively the strategy of surrogate reporting. While several tools in English version and only one in Korean are suggested for the pain assessments based on the observation of behavioral indicators, none are commonly used. In this review, we selectively evaluated those tools known to show relatively higher degree of validity and reliability for nonverbal older adults with dementia, namely, CNPI, DOLOPLUS 2, PACSLAC, PAINAD, and DS-DAT. It is hoped that the present review of selected tools for assessing pain in those vulnerable population and the general recommendations given be useful for clinicians in their palliative care practice. And future studies should focus on enriching the validation of the useful tools used to observe the nonverbal patient's behavioral indicators for pain in Korean.

• Journal of Hospice and Palliative Care
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• v.21 no.3
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• pp.75-83
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• 2018

Purpose: To provide effective palliative care, it is important to predict not only patients' life expectancy but their discharge status at a time of inpatient admission to a hospice care facility. This study was aimed to identify meaningful life expectancy indicators that can be used to predict patients' discharge status on admission to the facility. Methods: Among 568 patients who were admitted to the hospice ward of P hospital from April 1, 2016 through December 31, 2017, 377 terminal cancer patients were selected. This retrospective cohort study was performed by using performance status, symptoms and signs, socioeconomic status, laboratory findings on admission. Results: Alive discharge was associated with a good performance status that was measured with the Karnofsky and Eastern Cooperative Oncology Group (ECOG) scales and the Global health and Mental status. Less anorexia, dyspnea, dysphagia and fatigue were also associated with symptoms and signs. Associated laboratory findings were close to normal Complete Blood Cell (CBC) count, Liver Function Test (LFT) and Blood Urea Nitrogen (BUN). Conclusion: Our findings suggest that Karnofsky Performance Status (KPS), ECOG, Global health, Mental status, anorexia, dyspnea, dysphagia, fatigue, CBC, LFT, BUN are meaningful indicators when predicting discharge status for inpatients. Further investigation is warranted.

• Journal of Hospice and Palliative Care
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• v.15 no.2
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• pp.77-87
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• 2012

Purpose: This study investigated the effects that music therapy by self-selected music listening has on the affect and stress relief in adult patients who have been diagnosed with terminal cancer by pain level. Methods: Participants were 20 terminally ill cancer patients who were over 18 years old and were admitted to the hospice and palliative care unit of a local hospital. At the beginning of each session, participants selected music of their choice. Each participant had a total of six 30-minute music listening sessions. Participants were grouped into two according to their self-rated perceived pain scores on the visual analogue scale and numeric rated score: 5 and above and less than 5. Each participant completed a questionnaire on their affect state before and after each session and a questionnaire on their stress level before the first session and after the last session. Further analysis was performed to compare differences between the two groups according to pain level. Results: There were significant differences in patients' affect before and after each session (P<0.001) and stress level before and after the therapy (P=0.001). Conclusion: In this study, self-selected music listening had positive effects on terminal cancer patients' affect and stress regardless of perceived pain level. Therefore, self-selected music listening can be used as an appropriate intervention to improve affect and reduce stress in terminal cancer patients in the hospice and palliative care unit.

• Journal of Hospice and Palliative Care
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• v.21 no.4
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• pp.109-114
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• 2018

The objective of this paper is to suggest plans to properly establish and promote the use of hospice music therapy by examining its necessity and how it is being used in Korea. Hospice music therapy is a clinical and evidence-based use of music interventions administered by a professional to alleviate total pains suffered by hospice patients and their families. While the effects of hospice music therapy have been reported by many studies, its meaning and value are still poorly understood in Korea, which explains the lack of related institutions in the nation. Recently policy-wise and legislative efforts have been made to promote hospice and palliative care, which in turn will likely fuel demand for hospice music therapy. Therefore, the meaning and role of hospice music therapy should be defined by major hospice and palliative care institutions and societies, followed by institutional and academic efforts as follows. First, a set of qualification criteria for hospice music therapists should be established to provide proven music therapy interventions to patients and their families. Second, a systematic program offering both theoretical and practical trainings needs to be developed to foster hospice music therapists. Last but not least, clinical studies should be promoted with development of a research road map for hospice music therapy and a standard protocol.

• Child Health Nursing Research
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• v.24 no.4
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• pp.527-536
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• 2018

Purpose: The purpose of this study was to investigate the needs for pediatric palliative care (PPC) among parents of children with complex chronic conditions (CCCs) and to investigate differences in the needs for PPC according to their general characteristics. Methods: A cross-sectional survey was conducted between March 28 and May 18, 2018. Parents (N=96) who had a child under 18 years with a CCC were recruited. Data were analyzed using descriptive statistics, independent t-test, and one-way ANOVA. Results: The overall average need for PPC was $3.58{\pm}0.33$ out of 4.00. In terms of care for the subjects' children, the highest need was physical care, followed by psychosocial and spiritual care. In the sub-dimensions, preservation of physical function received the highest score. Of the items, the highest need was for seizure control. In terms of care for the subjects themselves, the highest need was for psychosocial care, followed by bereavement and spiritual care. In the sub-dimensions, communication received the highest score. Of the items, the highest need was for smooth communication with medical staff. Differences in needs for PPC according to participants' general characteristics were not statistically significant. Conclusion: Medical staff should provide PPC according to the priorities of parents' perceived needs.

• Information and Communications Magazine
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• v.28 no.5
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• pp.21-27
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• 2011

본고에서는 IT 기술의 급속한 발전과 보급에 힘입어 최근 많은 관심을 끌고 있는 미래의 의료형태인 유헬스케어에 필요한 IT융합 헬스케어기술을 소개하였다. IT융합 헬스케어기술이 성공적으로 실시되면 맞춤형 헬스케어 서비스와 웰빙을 필요로 하는 많은 이용자의 요구에 의해서 헬스케어는 환자 중심의 질병 및 증상을 완화하고, 치료하는 개념에서 점차 일반인의 건강을 증진하고 질병을 예방하는 개념으로 변화 되고 있다. 이를 위해서는 IT 기술과 의료서비스를 융합하여 언제 어디서나 예방, 진료, 치료 그리고 사후관리를 받을 수 있는 유헬스케어 서비스가 제공될 수 있을 것이다.

• Journal of Hospice and Palliative Care
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• v.13 no.3
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• pp.181-189
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• 2010

Purpose: Recently, health policy making is increasingly based on evidence. Therefore, Korean Terminal Cancer Patient Information System (KTCPIS) was developed to meet such need. We aimed to report its developmental process and statistics from 6 months data. Methods: Items for KTCPIS were developed through the consultation with practitioners. E-Velos web-based clinical trial management system was used as a technical platform. Data were collected for patients who were registered to 34 inpatient palliative care services, designated by Ministry of Health, Welfare, and Family Affairs, from $1^{st}$ of January to $30^{th}$ of June in 2009. Descriptive statistics were used for the analysis. Results: From the nationally representative set of 2,940 patients, we obtained the following results. Mean age was $64.8{\pm}12.9$ years, and 56.6% were male. Lung cancer (18.0%) was most common diagnosis. Only 50.3% of patients received the confirmation of terminal diagnosis by two or more physicians, and 69.7% had an insight of terminal diagnosis at the time of admission. About half of patients were admitted to the units on their own without any formal referral. Average and worst pain scores were significantly reduced after 1 week when compared to those at the time of admission. 73.4% faced death in the units, and home-discharge comprised only 13.3%. Mean length of stay per admission was $20.2{\pm}21.2$ days, with median value of 13. Conclusion: Nationally representative data on the characteristics of patients and their caregiver, and current practice of service delivery in palliative care units were obtained through the operation of KTCPIS.

• Journal of Hospice and Palliative Care
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• v.10 no.4
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• pp.178-183
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• 2007

Purpose: The prevalence and mortality of gastric lancer is high. We studied clinical characteristics and prognostic factors of the advanced gastric canter patients who had died in the hospice care unit. and our study is the basic report for efficient hospice and palliative care for the terminally ill patients with gastric cancer. Methods: We retrospectively reviewed the medical records of 99 advanced gastric cancer patients who had died in a hospice rare unit from May 2004 to August 2007. The survival days during the hospice and palliative care were analyzed using Kaplan-Meier method of SPSS version 13.0. Results: There were 62 males (63%) and 37 females (37%). Median age of patients was 60.9 years and liver metastasis was as high as 38 patients (38%) of all. The most prevalent symptom of admission was general weakness (97%) and poor or intake (86%). There were also bypoalbuminemia (88%), anemia (73%), and hyponatremia (61%). Palliative procedure was performed on 17 (63%) out of 27 patients with intestinal obstruction. Of these stents were inserted to 11 patients. The stores of ECOGPS and dyspnea were significantly correlated with the length of survival. The duration of median survival and hospitalization in the hospice and palliative care was 22 days and was 20 days respectively. Conclusion: We need to study more about clinical characteristics of advanced gastric rancor patients to predict the length of survival for an effective hospice and palliative care.

• Journal of Hospice and Palliative Care
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• v.13 no.4
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• pp.252-256
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• 2010

Breathlessness is a frequent and distressing symptom in terminal cancer patients. Refractory breathlessness is defined as a state that does not respond to conventional disease-specific therapy with an exclusion of reversible underlying causes, and the main classes of symptomatic drug treatments include opioids and benzodiazepines. Korean Family Medicine Palliative Medicine Research Group discussed two terminal cancer patients in whom severe breathlessness with different causes were treated with inhalation of nebulized furosemide, which is an emerging option of palliative treatment. It still remains unclear how it becomes effective or how much it is effective, therefore, its routine use seems to be somewhat early. Nevertherless, if a patient with intractable breathlessness does not have a marked obstructive airway lesion, its use should be considered. Based on the discussion in the seminar, we want to share our experience of the application of inhaled furosemide with other palliative care practitioners and strongly recommend further research on this topic in the future.