• Title/Summary/Keyword: 완화의료

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Usage of Statistics in Clinical Trials (임상시험에서의 통계 활용)

  • Ahn, Hong-Yup
    • Journal of Hospice and Palliative Care
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    • v.13 no.1
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    • pp.1-6
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    • 2010
  • The purpose of clinical trials is to find evidences for the effects of experimental new drugs or treatments on human. For the successful clinical trials, it is not sufficient to use statistics only for the analyses of collected data, but it is necessary to extend the usage of statistics in various ways. At the beginning of the study, one needs to use statistics for systematically and concretly planning the study. For this, we discussed the usage of statistics in defining the effect, determining the sample size, statistical analyses, and so on.

A Case Showing the Effect of Partial Decompression Therapy on Patient with Lymphedema (임파부종 환자에서 부분 감압술을 통해 효과를 본 사례)

  • Yeom, Chang-Hwan;Jung, Gyou-Chol
    • Journal of Hospice and Palliative Care
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    • v.6 no.2
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    • pp.177-179
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    • 2003
  • Lymphedema is the most common of complications after surgery and radiotherapy in patients with breast cancer or cervical cancer. The cancer itself is a worry, but the lymphedema ia an additional handicap for the patients, both physical and psychosoical. Recently the best treatment of lymphedema is complete lymphedema therapy, and Dr. Foldi developed in 1980s. But this treatment has not always given satisfactory and permanent results. We report a case of the lymphedema patient who was treated by partial decompression therapy.

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The Management of Malignant Ascites in Terminal Cancer Patients (말기 암환자에서 악성 복수의 치료)

  • Kim, Sun-Hyun;Yeom, Chang-Hwan
    • Journal of Hospice and Palliative Care
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    • v.11 no.3
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    • pp.131-135
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    • 2008
  • The management of malignant ascites can be problematic for physicians and patients. The mass effect of ascites can cause symptoms of painful abdominal distention, nausea, vomiting, and bowel obstruction. Also patients often complain of shortness of breath and lower extremity edema. These symptoms not only are distressing, but also adversely affect quality of life in terminal cancer patients. We will introduce you how to treat ascites based on our cases.

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One Case of Effect of Complex Lymphedema Therapy(CLT) on Elephantiasis of the Leg (상피증 환자에서 복합적인 림프부종 치료법을 통해 효과를 본 1예)

  • Yeom, Chang-Hwan;Hong, Young-Sun
    • Journal of Hospice and Palliative Care
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    • v.4 no.2
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    • pp.161-164
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    • 2001
  • Elephantiasis, which is the final stage of lymphedema, has swelling, papillomas and discharges in the skin. Although this disease is recorded in literature since 50 AD, the treatment is not yet. After all this time, complex lymphedema therapy (CLT) involving lymphatic massaging, bandaging, exercise, and skin care is becoming recognized as the best approach to care for people who develop lymphedema. The patient was a 30-year-old male who complained of swelling, papillomas, and discharges on left leg. He was received with CLT for 2 months, and the symptoms of him were improved.

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Analytical Study on Medical Expenses of Hospice Service for Terminal Patients

  • Cho, Hyun;Kim, Won-Joong;Heo, Jeung-Gue;Jin, Eun-Hee
    • Journal of Hospice and Palliative Care
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    • v.8 no.2
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    • pp.234-244
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    • 2005
  • As Korea has just turned into an aging society with the increase of average life expectancy, and the main causes of deaths is cancer and other chronic diseases. And this corresponds to a dramatic increase in medical expenses for the aged. To curve this problem, the hospice care can be an effective alternative, which can provide patients with both quality service and intensive care to help ensure high quality life for the patients. To demonstrate the economical effect of hospice services, a comparative study on the media expenses of geriatric hospitals and general hospitals, which bear similarities in common regarding the characteristics of their patients, is performed. Thus the results of the study can serve as a quantitative indication for the management of hospice services.

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Hospice Medical Guideline, Non-Cancer Diseases (비암성 질환들의 호스피스 의뢰 기준)

  • Choi, Youn-Seon;Kim, Hyun-Sook
    • Journal of Hospice and Palliative Care
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    • v.13 no.2
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    • pp.69-75
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    • 2010
  • Hospice is defined by the National Hospice and Palliative Care Organization (NHPCO, USA) and WHO, as a program of care that provides comprehensive medical, nursing and support services to dying patients and their family. Despite its broad definition, however, hospice care in Korea has been focused mostly on terminal cancer patients. Thus hospice eligibility for patients with advanced cancer is relatively easier to predict than those with other fatal chronic illnesses such as heart, lung, renal or liver diseases, and dementia. This makes it more difficult for patients and families to prepare for death and gain full benefits of hospice care. This article introduces the medical guidelines for selected non-cancer patients who are expected to live for only six months, this making it possible for patients, who are nearing the end of life, to avoid unwarranted suffering.

A Case of a Huge Mass Due to Pleural Metastasis and Management of Dyspnea in a Patient with Terminal Breast Cancer (말기 유방암 환자에서 발생한 흉막 전이에 의한 거대 종양 1예와 호흡곤란의 치료)

  • Lee, Na Ri
    • Journal of Hospice and Palliative Care
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    • v.17 no.2
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    • pp.85-89
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    • 2014
  • Pleural metastasis from breast cancer is a common manifestation. While pleural effusion is the most frequent finding, it is relatively rare for pleural nodularity and plaque that do not accompany pleural effusion. We report a patient with a rapidly growing huge pleural mass without pleural effusion caused by breast cancer. The patient was treated for severe dyspnea caused by the pleural mass. Along with the case report, we performed a systematic review of management of dyspnea in terminal cancer patients.

Models of Care for Frail Older Adults

  • Ersek, Mary;Byun, Eee-Seung
    • Journal of Hospice and Palliative Care
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    • v.14 no.2
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    • pp.71-80
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    • 2011
  • The growth of the aging population in Korea will challenge health and social services. As Korean society changes, the U.S. models of end-of-life care and geriatric care for frail older adults may have increasing relevance for the Korean healthcare system. This article reviews three U.S. models of care for frail older adults: hospice and palliative care, the Program for All-Inclusive Care for the Elderly (PACE), and the transitional care model. We describe the strengths and limitations of each model and discuss ways in which these models could be adapted for the Korean healthcare system.

Initial Spiritual Screening and Assessment: Five Things to Remember

  • Taylor, Elizabeth Johnston
    • Journal of Hospice and Palliative Care
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    • v.23 no.1
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    • pp.1-4
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    • 2020
  • To deliver holistic and person-centered palliative care (PC), the spiritual dimension must also be assessed. However, many nurses do not screen for or assess patient spirituality. This article presents five things that PC nurses can consider in order to improve their spiritual screening and assessment practices. These points are as follows: (1) Understand that spirituality is manifest in a myriad of ways and is not the same thing as religiosity. (2) Screen for spiritual distress, and then later conduct a spiritual history or assessment. (3) Remember that spirituality is not just something to assess upon admission. (4) Know that there are many ways to assess spirituality (it is not merely how a patient verbally responds to a question about spirituality or religiosity). (5) Remember that assessment can also be therapeutic.

The Effects of Advance Care Planning on Decision Conflict and Psychological Distress: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

  • Yeun, Young-Ran
    • Journal of Hospice and Palliative Care
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    • v.24 no.3
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    • pp.144-153
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    • 2021
  • Purpose: Advance care planning (ACP) is widely understood to improve end-of-life care. This systematic review and meta-analysis aimed to examine the effects of ACP interventions on decision conflict and psychological distress. Methods: A search of PubMed, CINAHL, CENTRAL, EMBASE, KISS, KoreaMed, and RISS was conducted in November 2020. The study included randomized controlled trials. Data were pooled using fixed- and random-effects models. Results: Fourteen studies were identified that cumulatively included 1,548 participants. ACP interventions were effective in alleviating decision conflict (d=-0.53; 95% CI: -0.83 to -0.23), depression (d=-1.22; 95% CI: -1.71 to -0.74) and anxiety (d=-0.76; 95% CI: -1.12 to -0.39). Conclusion: ACP interventions have significant positive effects on reducing decision conflict and psychological distress. A high level of bias was shown related to allocation concealment and blinding. The results of this study are expected to be useful for end-of-life care providers to improve the effectiveness of ACP interventions.