• Title/Summary/Keyword: 완화의료

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Public Perception and Acceptance of the National Strategy for Well-Dying (웰다잉 국가 전략에 대한 일반 국민들의 인식 및 수용도)

  • Lee, Seo Hyun;Shin, Dong Eun;Sim, Jin Ah;Yun, Young Ho
    • Journal of Hospice and Palliative Care
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    • v.16 no.2
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    • pp.90-97
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    • 2013
  • Purpose: Ten years have passed since the Korean government announced its plan to institutionally support hospice and palliative care in 2002. In line with that, this study aims to suggest future directions for Korea's hospice and palliative care policy. Methods: We conducted a survey on people's perception and acceptance of well-dying. Data were collected from 1,000 participants aged 19~69 years between June 1 and June 11, 2012 via computer-assisted telephone interviews. Results: The most important factor for well-dying was placing no burden of care on others (36.7%) and the second most important factor was staying with their family and loved ones (19.1%). Among nine suggestions of policy support for well-dying, the most popular was the promotion of voluntary care sharing (88.3%), followed by the palliative care training support for healthcare providers (83.7%) and the support for palliative care facilities instead of funeral halls (81.7%). The idea of formulating a five-year national plan for end-of-life care drew strong support (91%). According to the survey, the plan should be implemented by the central government (47.5%), the National Assembly (20.2%) or civic groups (10%). Conclusion: This study demonstrated the public consensus and their consistent direction toward policy support for well-dying. Results of this study may serve as a foundation for the establishment of policy support for people's well-dying and palliative care at the national-level.

Current Situation on Signing Advance Medical Directives and Actual Life-sustaining Treatment Given at a University Hospital (일개 대학병원의 연명치료 선택 및 사전의료의향서 작성 현황)

  • Yoon, Ho-Min;Choi, Youn-Seon;Hyun, Jong-Jin
    • Journal of Hospice and Palliative Care
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    • v.14 no.2
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    • pp.91-100
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    • 2011
  • Purpose: This study was performed to investigate patients' preferences on receiving life-sustaining treatments (LST) and to analyze the relationship between patients' characteristics and LST selection. We also examined any discrepancy between LST patients' choices regarding medical intervention and actual medical intervention given/not given within 48 hours before death. Methods: This cross-sectional study was performed from March 1, 2008 to August 31, 2008 in the Palliative Care Unit of Korea University Hospital. Electric medical records (EMR) of 102 hospice cancer patients were reviewed, and 74 patients with Glasgow coma scale (GCS) ${\geq}$10 at the time of signing the advance medical directives (AMD) were selected for the first analysis. Then, patients alive at the end of this study, transferred to other hospitals or dead within 48 hours were excluded, and the remaining 42 patients were selected for the second analysis. Results: Preferred LST included antibiotics, total parenteral nutrition, tube feeding, transfusion, and laboratory and imaging studies. The relationship between patients' characteristics and LST could not be analyzed due to skewed preferences. LST chosen at the time of signing the AMD and actual medical intervention given/not given in the last 48 hours showed discrepancy in most cases. Conclusion: When making AMD in hospice cancer patients, it is important to consider the time and possibility of changing the choices. Above all, patients must fully understand the AMD. Thus, LST should always be provided with careful consideration of all possibilities, because legal and social aspects of AMD have not been established yet.

Assessment for the Needs to Develop Hospice Training Program for Nurses (간호사를 위한 호스피스 연수교육 요구도 조사)

  • Kwon, So-Hi;Yang, Seong-Kyeong;Park, Myung-Hee;Choe, Sang-Ok
    • Journal of Hospice and Palliative Care
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    • v.11 no.3
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    • pp.147-155
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    • 2008
  • Purpose: This study aimed to assess the educational needs for nurses who care for terminal cancer patients and their families. To identify top needs along with key issues in consideration to develope hospice training program and provide specific recommendations. Methods: A cross-sectional design with nurses from nine universities' hospice specialist courses and seven cancer centers was used. Data were collected via e-mail or mail service from March to April in 2008. One hundred seventy three questionnaires were returned (return rate: 73.6%), and 156 questionnaires were eventually analyzed. The questionnaire consisted of Mason and Ellershaw's The Self-efficacy in Palliative Care (SEPC) and self-reporting confidence and educational needs in hospice care. Results: The mean age of the participants was 37.94 years, 82.1% were staff nurses, and 44.9% completed over six months hospice education. Mean$\pm$standard deviation score for total SEPC was $2.67{\pm}.62$, which was lower than average (score 3), with communication score being the lowest ($2.49{\pm}.69$). The lowest self-reporting confidence score was $2.03{\pm}.77$ in hospice administration and management, followed by providing complement therapy ($2.34{\pm}.77$), bereavement care ($2.34{\pm}.71$), lymph edema management ($2.35{\pm}.79$), and care planning ($2.36{\pm}.81$). The participants reported that additional education is needed in all topics, with pain management score being the highest ($3.71{\pm}.50$), followed by pain and symptom evaluation ($3.67{\pm}.52$), care for dying ($3.67{\pm}.52$), and communication and counseling ($3.63{\pm}.53$). There were significant subgroup differences in SEPC and self-reporting confidence between groups who completed 6 months hospice education or not, however, no significant difference in educational need between the groups. Conclusion: This study showed the need for developing hospice training program to improve compentency of nurses in hospice palliative care.

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A Study on Causality in Medical Civil Liability (의료민사책임에서의 인과관계에 관한 소고)

  • Baek, Kyoung-Hee
    • The Korean Society of Law and Medicine
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    • v.17 no.2
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    • pp.57-81
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    • 2016
  • It can determine the outcome of the lawsuit whether or not there is a causality between the medical malpractice of a physician and the patient's injury when the patient is filing a lawsuit against the physician in order to pursue civil liability for a medical accident. In medical malpractice lawsuits, it is not easy to judge causality between different civil cases because of the special nature of medical care. Also, information such as medical records is concentrated on doctors and the medical knowledge of the patient is relatively insufficient compared with the doctor. Therefore, it is recognized through medical malpractice lawsuits that the burden of proof of the causality burdened by the plaintiff patient is relaxed. In this paper, I examine the legal theory on how to recognize causality in medical civil liability and then concern the attitude of the case in Korea, which is divided into the types of the causality - such as the case of general medical practice, explanation duty, no causality with medical malpractice.

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The Recent Trends in Telemedicine in the era of COVID-19 and Policy Recommendations for the Balanced growth of Healthcare Service Industry in Korea (COVID-19 시대 국내외 원격의료 동향과 의료서비스산업의 균형 성장을 위한 정책 제언)

  • Lee, Jaehee
    • The Journal of the Convergence on Culture Technology
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    • v.6 no.4
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    • pp.591-598
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    • 2020
  • Since COVID-19's 1st pandemic came in February 2020, the demand for telemedicine grew greatly that in most countries the deregulation for telemedicine policy have been implemented in more countries. Also in Korea, with the name of 'Non-face-to-face Treatment' telemedicine began to be approved. Telemedicine having strength in chronic disease management has been effective in more and more specialties along with the recent development of ICT that it is expected to contribute to the improvement of the quality of healthcare service and creation of new treatment model. On the contrary it may also exacerbate the distortion in the hospital healthcare service industry in Korea, which is the excessive tipping toward large hospitals. So the dual promotion policy approach in which the settlement of family doctors system extensively utilizing telemedicine for chronic disease management and the support for tertiary hospitals and hospitals focusing on treating foreign patients to provide quality service using telemedicine technology are pursued simultaneously are recommended.

Beyond Palliative Care (완화치료를 넘어서)

  • Habierei, Rosano Baragan
    • Health and Mission
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    • s.8
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    • pp.16-19
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    • 2007
  • '세계 병자의 날'을 위해 교황특사로 파견된 하비에르 로사노 바라간 추기경이 2007년 2월 9일 오전 11시 명동성당에서 기조연설을 하였다. 바라간 추기경은 난치병 환자들의 육체적, 심리적 그리고 사회적 치료 뿐만 아니라 영성적 치유가 가지는 중요성에 대해 피력하였다.

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The Effect of Private Health Insurance on the Subjective Burden of Medical Expenses (민간의료보험 가입 여부가 본인부담 진료비의 주관적 부담 수준에 미치는 영향)

  • Hong, Jin Hyuk;Noh, Jin-Won;Park, Kisoo;Lee, Yejin;Kwon, Young Dae
    • The Journal of the Korea Contents Association
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    • v.17 no.6
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    • pp.63-70
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    • 2017
  • Although the National Health Insurance, many people sign up for private health insurance to alleviate their financial burden. In this study, we analyzed the relationship between private health insurance and subjective financial burden about cost sharing. To confirm the effect we conducted the binary logistic regression by utilizing the Health Care Policy related to public survey. The private health insurance have a significantly association with the subjective financial burden about cost sharing. People who uninsured to purchase private health insurance were more likely to have the burden. Therefore, given the low participation rate of private medical insurance for high age and low income group, we suggest the need for redefining the role of private insurance to enhance the function and resolve equity issues to prepare for the burden.

The Impact of Nursing Hospital Workers' Hospice·Palliative Care Knowledge and Awareness, End-of-Life Care Attitude and Death Awareness on Their End-of-Life Care Performance (요양병원 근무자의 호스피스 완화돌봄 지식과 인식, 임종돌봄 태도, 죽음에 대한 인식이 임종돌봄 수행에 미치는 영향)

  • Park, Meera;Je, Nam Joo
    • Journal of Hospice and Palliative Care
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    • v.21 no.4
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    • pp.124-136
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    • 2018
  • Purpose: This descriptive study is aimed at identifying how nursing hospital workers' performance of end-of-life care is influenced by their knowledge and awareness of hospice palliative care, attitude towards end-of-life care, performance, importance, awareness of death and the factors. Methods: A self-reported questionnaire was used to collect data from 113 workers at an accredited nursing hospital in K province. Variables were their knowledge and awareness of hospice palliative care, attitude towards end-of-life care, end-of-life care performance and importance and awareness of death. An analysis was performed with the frequency, percentage, mean, standard deviation, t-test, ANOVA, Scheffe's test, Pearson's correlation coefficient and multiple regression using IBM SPSS 21.0. Results: The factors affecting the nursing hospital workers' end-of-life care performance were the importance of end-of-life care and their marital status, which showed an explanatory power of 38.2%. Conclusion: In order to improve the nursing hospital workers' end-of-life care performance, a training on the importance of end-of-life care should be provided. Therefore, we would like to propose establishing administrative measures such as 1) efficient staffing to help the caregivers better perform what they think is important, 2) development of a training program that can improve their performance of end-of-life nursing care and 3) a study to verify the effectiveness of the program.

Effectiveness of Hand Massage Combined with Analgesics on Pain Control in Patients with Terminal Cancer (진통제와 병용한 손 마사지가 말기 암환자의 암성통증 조절에 미치는 효과)

  • Lee, Yunmi;Yoon, Hosoon;Lee, Sungwoon;Kim, Young Mi
    • Journal of Hospice and Palliative Care
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    • v.19 no.4
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    • pp.296-302
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    • 2016
  • Purpose: This study examined the effectiveness of a hand massage combined with analgesics on pain control in hospice patients with terminal cancer. Methods: This study is a quasi-experimental study with a single group time series design. The study included 25 terminal cancer patients who were admitted to a hospice ward. Each patient's pain level was measured after analgesics use only (control group). When patients complained of pain again, the pain level was assessed after administering a combination of hand massage and analgesics (experimental group). As for the experimental treatment, the participants were provided with oil hand massage on each hand for 5 minutes. Results: The experimental group and the control group showed no significant differences in the changes of pain score (F=0.74, P=0.3939). Conclusion: Although the pain level of the experimental group did not significantly improve compared with the control group, their pain levels tended to be low to begin with. Thus, a complementary utility value of hand massage cannot be completely excluded in terminal cancer patients. Since the pain level significantly changed according to the dosage of analgesic, nurses need more education and research on analgesic drug therapy for terminal cancer patients.