• Journal of Hospice and Palliative Care
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• v.16 no.1
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• pp.20-32
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• 2013

Purpose: The purpose of the study was to develop a feasible form of a Korean version of advance directives (K-AD). Methods: Sixteen adults participated in this study: 10 aged 20~50 years and nine aged 65 years or older. Using a draft version of the K-AD, cognitive interview was conducted on the participants to establish a culturally acceptable form of advance directives whose directions can be understood and responded accordingly by the general population. Results: Cognitive interviews revealed areas of concerns for the draft version of K-AD: lack of instructions or clarity for technical and medical terms, context complexity and inadequate response categories. The draft version was revised by rewording, offering examples and rearranging the context. Editorial style was added with appropriate uses of bold fonts, bullet-points and underlines to facilitate interviewees' cognitive responses. Conclusion: Study results feasibility of the revised version of the K-AD. Further study should be performed with a larger number of participants to develop a K-AD with an acceptable level of reliability and validity.

• Korean Journal of Culture and Social Issue
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• v.23 no.2
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• pp.215-237
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• 2017

Most research on medical accidents is related to medical disputes and malpractice of relief system. Therefore, there is a lack of research which explores the psychological experiences of patients injured by medical accidents. The purpose of this study was to investigate Post Traumatic Stress Disorder (PTSD) of patients harmed by medical accidents and to examine the moderating role of social support on the relationship between clinicians' explanation and attitude and PTSD symptoms. A total of 180 patients were drawn from a medical accident organization and online communities related to medical accidents. Results showed that 171 (95%) of the subjects experienced full PTSD symptoms and their severity of the PTSD Symptoms was as high as those who experienced other severe traumatic events. Though the main effect of clinician's explanation and attitude on PTSD symptoms was not significant, the moderating effect of social support was significant in the relationship between clinicians' explanation and attitude and PTSD symptoms. In other words, when the level of social support was low, the poorer the explanation and attitude of clinicians, the more severe the symptoms of PTSD. Drawing from these results, psychological, social, and institutional strategies were suggested to alleviate and prevent PTSD symptoms of patients injured by medical accidents. Finally, limitations of this study and suggestions for future research were discussed.

• Journal of Hospice and Palliative Care
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• v.12 no.4
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• pp.177-193
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• 2009

The assessment of patient status in palliative medicine is essential for determining treatments and for clinical outcomes. The objective of assessment tools is to raise the quality of care for individual patients and their families. There are a number of tools available to assess pain, non-pain symptoms and quality of life. The tools are either uni-dimensional or multi-dimensional measures. Unfortunately, however, no single tool is recommended to be a superior to others in symptoms or quality of life assessment. Therefore, to select an appropriate assessment tool, one should consider the time frame and unique characteristics of tools depending on purpose and setting. The combination of prognostic index is highly recommended in prognostication, and web-based prognostic tools are available. Recently, a new objective prognostic score has been constructed through multicenter study in Korea. It does not include clinicalestimates of survival, but includes new objective prognostic factors, therefore, anyone can easily use it. For beginners in palliative medicine, relatively easy-to-use tools would be convenient. We recommend Eastern Cooperative Oncology Group performance status to assess functional status, numeric rating scale for pain assessment and the Korean version of brief pain inventory for initial pain assessment. Asking directly with numeric rating scale or the Korean version of MD Anderson Symptom Inventory would be desirable to assess various symptoms together. We think that European Organization Research and Treatment Quality of Life Questionnaire Core 15 for Palliative Care is good to assess the quality of life, while Objective Prognostic Score is convenient as prognostic index for beginners.

• Journal of Hospice and Palliative Care
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• v.18 no.4
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• pp.329-334
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• 2015

Purpose: This study was aimed at analyzing the characteristics and symptoms in home-based hospice-palliative care (HBHPC) patients registered at local public health centers. Methods: A retrospective study was performed; Data of 144 HBHPC patients registered at six public health centers in Pusan City were analyzed, including their initial visit records (registration cards, initial pain evaluation and symptom evaluation). Results: The average age of the patients was 67.7 years old. Among all, 46.2% of the patient lived alone, and 65% had middle school education or lower. The most popular (36.3%) religion was Buddhism, and 47.5% received medical assistance from the government. The most frequent diagnosis was lung cancer followed by stomach cancer and liver cancer in that order. Of all, 48.9% were functionally too weak to lead a daily life, 39.6% were under cancer treatment when registered at the public health center, and 84.5% were aware of the fact that they have reached the terminal phase. Moreover, 83.6% complained about pain, and the pain level was moderate or severe in 36.5% of them. Besides pain, fatigue was the most complained symptom (84.7%), and 49.3% of them rated their fatigue as moderate or severe. Conclusion: Most of the HBHPC patients were socio-economically underprivileged and complained about moderate or worse pain and symptoms. Therefore, it appears necessary to develop an integrated strategy that is tailored for each patient reflecting their characteristics.

• Journal of Hospice and Palliative Care
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• v.2 no.2
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• pp.109-113
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• 1999

Purpose : Because we don't have inappropriate health care system for the terminal cancer patients, there were abnormal behavior patterns of health care utilization. So, There were needs to develop the comprehensive care for terminal cancer patients. Increased attention is being paid to the futility of life-sustaining treatment and high cost of management of terminal cancer patients Materials and Methods : This study was performed on cancer patients, registered in 1996 Central Cancer Registry, who were as insured person of Korea Medical Insurance and died from January 1997 to June 1998. We studied the day of medical care and medical expenses of 151 cancer patients evaluable. Results : The mean day of inpatient care was 39 days, and the mean days of outpatient care was 14 days in study subjects. Mean expenses per day of medical care, day of inpatient, and day of outpatients care were 85,392 won, 105,908 won, and 40,173 won. 95% of medical expenses is paid to the general hospital, and 85% of medical expenses was paid for inpatient care. About half of all medical expenses in th last 6 months were incurred in the last 60 days of life, and about 30 percent were incurred in the last 30 days. Expenses of outpatients care increased between 6 month and 3 months, after which they decreased. Expenses of inpatients care increased during all last 6months Conclusion : The distribution or medical expenses during the last 6 months in our study is similar to the distribution of American Medicare costs. We need to study medical expenses during the last year of life with large scale and details in order to develop the plan about the management of terminal cancer patient.

• Journal of Hospice and Palliative Care
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• v.11 no.1
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• pp.51-54
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• 2008

Qualify of life is the main consideration in pain management and palliative care for patients with advanced cancer. Cancer pain is primarily relieved with pharmacological therapy including aretaminophen, nonsteroidal anti-inflammatory drugs, adjuvant analgesics, and opioids. In addition to pharmacological therapy, the neurolytic celiac plexus block is claimed to be an effective approach in management of advanced pancreatic cancer pain. We report our patient who has been treated for advanced cancer pain with multiple neurolytic blocks. The clinical result suggests that combined neurolytic blocks improved the quality of life of patient who had advanced ranter pain by reducing both the intensity of pain and opioid consumption, without serious complications.

• Journal of Hospice and Palliative Care
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• v.19 no.3
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• pp.256-261
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• 2016

Radiation therapy is an effective modality to alleviate cancer-related symptoms. To deliver radiation accurately, it is essential to secure stability of the treatment position in patients during each treatment time. However, some patients could be less cooperative due to their psychoemotional issues. We present two cases of terminal-stage cancer patients who were initially unable to lie still on the treatment table before simulation. A relaxation technique was taught to them on the bed, and they could relax and undergo radiation therapy with effective symptom relief.

• Journal of Hospice and Palliative Care
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• v.10 no.2
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• pp.67-73
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• 2007

To make ones life meaningful is one of human's most valuable goal. Nevertheless, for cancer patients who are in the last phase of their lives obtaining this goal may be threatened by physical, psychological, and social difficulties. Music therapy ran be utilized to effectively fill in these physical, psychological, and social needs. In the form of a creative art, music therapy can be effective in easing the pain and tension as well as assisting the patient to discover meanings of life through psychological comfort. Further, music is itself a verbal/non-verbal communication tool and thus connects the patients with their families with understanding and sympathy. This study aims to examine the need and role of music therapy in hospice.

• Journal of Hospice and Palliative Care
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• v.12 no.2
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• pp.49-55
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• 2009

Self expandable metal stent (stent) implantation of upper gastrointestinal (UGI) tract is now widely accepted for the palliation of obstructive symptoms caused by inoperable malignant UGI obstruction. With the technical progress and accumulation of clinical experiences, it became possible to perform the procedure easily, safely and effectively. However, clinicians should pay attention to the post-procedural care, because early or late complications such as ulceration, pain, bleeding, food impaction, perforation, migration or in-stent tumor growth could occur. In this review, several topics about stent placement in the UGI tract are discussed, such as major indications for stenting, kinds of stents, and post-procedural management.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.28 no.3
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• pp.256-265
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• 2021

Purpose: This study examined the effects of nurses' attitude toward death and their perception of hospice and palliative care on their terminal care stress in long-term care hospitals (LCHs). Methods: Participants included 127 nurses from 6 Incheon LCHs. Data were collected between July and August, 2020. Self-report questionnaires were administered to collect data on their general characteristics, terminal care stress, attitude toward death, and perception of hospice and palliative care. Data analysis included descriptive statistics, independent t-test, one-way ANOVA, Pearson's correlation coefficient, and stepwise multiple linear regression using the SPSS 23.0 statistical program. Results: Nurses' terminal care stress was affected by their attitude toward death (𝛽=.30, p<.001) and perception of hospice and palliative care (𝛽=.28, p=.002) with an explanatory power of 21.6%. Conclusion: Terminal care stress was significantly associated with their attitude toward death and perception of hospice and palliative care. Therefore, educating nurses in LCHs about death and hospice and palliative care is essential to manage their terminal care stress effectively.