• Journal of Hospice and Palliative Care
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• v.22 no.1
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• pp.19-29
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• 2019

Purpose: In this study, the hospice nursing research trend in 1998~2017 was investigated by analyzing research articles on hospice nursing. Methods: Literature search was performed with keywords of 'nursing' and 'hospice on an academic research information service. Also reviewed were all articles published in the Korean Journal of Nursing Science and its 8 subcategory journals, the Korean Journal of Hospice and Palliative Care and the Korean Hospice Association from 1998 through 2017, except thesis papers. Results: In 2013~2017, 79 articles (31.0%) were relevant, up over 7% from 61 articles (23.9%) in 2008~2012. The most studied field was psychology (92 papers, 36.2%) in the Korean Journal of Hospice and Palliative Care. Enrolled in most papers were patients with end-stage cancer (75, 29.5%), which is overwhelmingly high. Most studies used quantitative methods (183, 72.0%). Recognition was the most studied theme (62, 24.4%), and 16 of them focused on recognition of death (6.3%). Intervention studies totaled 34 (13.4%), and most of them (7, 2.8%) were conducted for palliative education. Conclusion: Most hospice nursing studies were quantitative studies, conducted with patients, and hospice nursing intervention programs were similar to each other. Thus, more studies with hospice patients and their families are needed. And more experimental and qualitative studies are needed to build an evidence-based nursing study environment. Considering how most studies examined psychological factors, physiological factors such as pain, a major issue in hospice care, should be analyzed in experimental studies to construct a pain intervention program for hospice patients.

• Korean Journal of Hospice Care
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• v.8 no.1
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• pp.29-48
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• 2008

Purpose: The purpose of this study was to provide the basic information on the improvement plan by identifying the role accomplishment and job satisfaction of the hospice nurses and analyzing the factors that impact such role accomplishment and job satisfaction. Methods: The data was collected of 189 hospice nurses who have been working more than 6 months in 56 hospice programs registered in Korea Hospice Association and Korean Catholic Hospice Association from October to November, 2007 by structured questionnaire which was developed by Ryu(1979), based on the Riehl's nursing role and the research of Choe(2005) on the role of hospice nurse. Results: The role accomplishment and job satisfaction of the study subject were 3.53 point and 3.39 point, respectively. The roles of hospice nurses were accomplished by the order of advocator, nursing care provider, coordinator (cooperation), educator, quality manager, counsellor, administrator, and researcher. The job satisfaction of the hospice nurses was shown highest in the satisfaction of professional status, followed by the satisfaction of the interaction, satisfaction of the task itself, satisfaction of the administrative aspect, satisfaction of the autonomous, and the lowest in the satisfaction of the pay. The role accomplishment of the subjects according to their socio-demographic and job characteristics was found to have a significant difference by their age, marriage status, academic background, and position. It also has a significant difference by whether they play role of coordinator, whether they took whole responsibility as hospice, working experience as hospice/palliative nurse, and the level of hospice/palliative nursing training(p<.05). In the study of job satisfaction of the subjects according to their socio-demographic and job characteristics, the job satisfaction was found to have a significant difference by the increase of age, the number of duties consisting the hospice team, whether they play role of coordinator, whether they take whole responsibility as hospice, the level of hospice/palliative nursing training, and whether they wish to work for as long as possible(p<.05). The role accomplishment and the job satisfaction of the subjects showed a statistically significant positive correlation. (r=.541, p<.01) Conclusion: Raised saiary will be increased hospice nurse's job satisfaction. And we suggest a repetitive study using the identical tool to the equally extracted subjects with same representativeness of each hospice/palliative institute type. For the expanded role and enhanced professional standard of hospice nurses, we also suggest a study on the improvement plan to enhance the roles of researcher and administrator.

• Journal of Hospice and Palliative Care
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• v.15 no.1
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• pp.1-9
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• 2012

Purpose: The aim of this study was to discuss challenges for hope seeking intervention based on individual experience (HSIBIE) in palliative care, assuming that hope is an individualized unique, subjective, and dynamic experience. Methods: Literature, including analysis and discussion, was reviewed to identify limitations and ways to develop HSIBIE. Results: This study identified following challenges: 1. Hope was often described and utilized as a standardized unified structure with varying attributes or mono-structure emphasizing a realistic hope, or both of them (relativism vs. monism) in one literature. This challenge is represented as a problem in conceptualization. 2. Few studies discussed various patterns of hope or individuals' unique experiences in palliative care. 3. The HSIBIE and the method for the HSIBIE have been rarely discussed. Conclusion: A problem in conceptualization is often related to fixed ideas formed over a long period and used in a closed circle of scholars and professionals. Therefore, such fixed ideas should be openly challenged with fresh perspectives. The second issue requires a cross-cultural studies of various hope experiences in palliative care, which can be used for effective and appropriate HSIBIE.

• Journal of Preventive Medicine and Public Health
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• v.22 no.4 s.28
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• pp.578-590
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• 1989

This study was conducted to assess the equity in the regional insurance scheme through analysis of the computerized data from one regional insurance society and National Federation of Medical Insurance. We analysed the insurance contribution and benefit by the classes based on total and income-related contribution per household. The major findings of this study are as follows : 1. The average proportion of income-related contribution among the total was 39.2% and the upper classes show higher proportion of the income-related contribution. 2. The upper classes show higher health care utilization rate than the lower classes. It suggests that the lower classes have relatively large unmet medical needs. 3. The analysis through the Lorenz curve reveals that there exists transference of contributions from the upper to lower classes. But the cumulative percentage of insurance benefit is smaller than that of the number of the insured. It implies that regional medical insurance scheme in Korea has still some inequity in the context of social security principles.

• Proceedings of the Korea Contents Association Conference
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• 2009.05a
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• pp.1111-1117
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• 2009

Emergency room nurses whom exposed to more confused environment, violence, and medical disputes feel anxiety, due to increasing of demands and needs of emergency room services. Emergency room nurse anxiety needs to intervention in order to relieve emergency room nurses from anxiety, because it is an important factor that decreases job skill and satisfaction. In this paper, we examine whether to improve the effect of music intervention on emergency room nurse anxiety through appreciation of music. We used vocal music and a SAI(State Anxiety Inventory) tool for measuring the effect of music on emergency room nurse anxiety and physiological responses. Experimental results showed that vocal music intervention reduces emergency room nurse anxiety and physiological responses.

• The Korean Journal of Health Service Management
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• v.13 no.4
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• pp.163-177
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• 2019

Objectives: The purpose of this study was to identify the predictors of quality of life (QOL) for terminal cancer patients admitted into the community health center, and to establish a hypothetical model to explain and verify causative relationships among the variables. Methods: Data were collected from January 2015 to June 2016. Participants were 237 registered patients in Busan Metropolitan City hospice & palliative care center. The descriptive and correlation statistics were analyzed using the SPSS/WIN 24.0, and the structural equation modeling procedure was performed using the AMOS 24.0 program. Results: The results of this study showed that the physical symptoms of terminal cancer patients were the most direct factors affecting the QOL, and satisfaction with health care services has a direct effect on the QOL. Conclusions: The study contributes to drawing up measures to improve QOL for terminally ill cancer patients who are living in the end-of-life section of the community by revealing the causal relationship to the QOL for terminal cancer patients.

• Journal of Hospice and Palliative Care
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• v.16 no.1
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• pp.1-9
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• 2013

Purpose: The aim of this study was to investigate nursing students' awareness of biomedical ethics and attitudes toward death of terminal patients. Methods: A structured questionnaire was developed to examine nursing students' biomedical ethics. Their attitudes toward terminal patients' death were measured by using the Collett-Lester Fear of Death Scale. Surveys were conducted with 660 nursing students enrolled at a three-year college located in Daejeon, Korea. Data were analyzed using descriptive statistics, Wilcoxon rank sum test and Kruskall Waills test. Results: Students who have experienced biomedical ethics conflicts, agreed to prohibition of cardiopulmonary resuscitation (CPR) and have no religion exhibited more negative attitudes toward death compared to students without the above characteristics. Of the participants, 81.2% answered that life sustaining treatment for terminal patients should be discontinued and 76.4% replied that CPR on terminal patients should be prohibited. The majority of the correspondents stated that the two measures above are necessary "for patients' peaceful and dignified death". Conclusion: Study results indicate the need to establish a firm biomedical ethics value to help nursing students form a positive attitude toward death. It also seems necessary to offer students related training before going into clinical practice, if possible. The training program should be developed by considering students' religion, school year, experience with biomedical ethics conflicts and opinion about CPR on terminal patients. The program should also include an opportunity for students to experience terminal patient care in advance via simulation practice on standardized patients.

• Journal of Hospice and Palliative Care
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• v.15 no.1
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• pp.18-29
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• 2012

Purpose: We analyzed how clinical nurses in Korea perceive terminally ill patients' medical decision-making. Methods: The Q-methodology which analyzes the subjectivity of each item was used. We selected 34 Q-statements among those provided by each of 37 subjects and grouped them into a shape of normal distribution using a 9 point scale. The collected data were analyzed using a QUANL PC program. Results: Four types of perception toward medical decision-making were identified. Type I focuses on patient participation, and Type II emphasizes the role of health professionals. Type III is characterized by an open-minded culture toward death, and Type IV values the role of family members. Conclusion: The results of this study indicate the need for development of a multi-disciplinary curriculum medical decision-making and death for medical and nursing students.

• 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.

• Fire Science and Engineering
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• v.19 no.2 s.58
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• pp.45-62
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• 2005

This thesis has defined the legal status of 119 rescue who plays a major role in the Korean prehospital emergency medical system and reviewed the various issues that may occur depending on work related legal liabilities. As a result, the purpose of this study was to represent the countermeasures for legal protection of 119 rescue required for the quality improvement of prehospital emergency medical system and as well as the countermeasures for risk management prepared for its related lawsuits. The legal liabilities of 119 rescue officers can be divided largely into public law liabilities and civil and criminal liabilities. In order to decrease the incidences of legal problems and provide the legal protection to rescue officers, the liability of supervising physician should be emphasized when the emergency medical practice is performed by a rescue officer under their supervision by consolidating medical control and the rescue officer should have legal liability on his emergency medical practice. itself Also, the emergency medical service guideline for 119 rescue officers should be prepared and their works should be performed according to such a guideline and procedures. In addition, the accurate legal documentation on emergency medical system from on-site to ER and related mobilization should be framed and preserved. Moreover, it is required to enact a new law such as the Good Samaritan Act or the Rescue Officers Protection Act.