• The Journal of Internal Korean Medicine
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• v.43 no.4
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• pp.779-793
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• 2022

Objectives: The purpose of this study was to report on the cases and prescriptions of non-face-to-face care performed to alleviate COVID-19 symptoms and to present their results. Methods: This study was conducted on 63 COVID-19 patients who visited the Ilsan Hamsoa Korean Medicine Clinic from January 24 to June 11, 2022. We retrospectively analyzed all 63 patient charts and amassed COVID-19-related symptoms and their changes according to clinical characteristics and outcomes. Results: All 63 COVID-19 patients complained of symptoms, such as coughing, sore throat, sputum, fever, headache, myalgia, rhinorrhea, nasal obstruction, postnasal drip, and voice change. In total, 30 patients were administered Eunma-san, 6 patients were administered Eungyo-san plus Mahaenggamseok-tang, 10 patients were administered Galgeunhaegi-tang, 7 patients were administered Eungyo-san, 6 patients were administered Maekmundong-tang, and 4 patients were administered Jugyeopseoggo-tang. Improvements in symptoms due to herbal medicine included the disappearance of COVID-19 fever (22 cases) within 3.59±4.2 days, sore throat (32 cases) within 4.37±2.98 days, and cough (36 cases) within 4.86±3.1 days. Conclusion: Various herbal medicine prescriptions were effective COVID-19 treatments, indicating that herbal medicines may be alternative treatment options for COVID-19. However, the evidence should be supplemented with better designed prospective research on individual prescriptions.

• Journal of the Korea Convergence Society
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• v.13 no.5
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• pp.365-372
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• 2022

South Korea is entering an aging society, and since the musculoskeletal system directly affects elders' daily life, muscle exercise and flexibility are required. In particular, yoga relaxes the mind and the body and heightens stress coping ability. To investigate keywords about yoga, news articles provided by BIGKinds, a news analysis system, was applied to collect articles from January 1, 2019, to December 31, 2021, and an analysis was conducted about the monthly keywords and the relationship followed by the weighted degree. Based on the research findings, first, it showed that there is high interest in yoga during the spring and autumn seasons. Second, yoga is offered in non-contact methods nowadays, and various social network services are applied for the operation. Third, there was high public attention to articles on yoga instructors and trainers, and this revealed the importance and interest in online coaching. It is anticipated to apply it for the development of yoga workout programs and base data to develop sports for all.

• Journal of Hospice and Palliative Care
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• v.25 no.1
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• pp.1-11
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• 2022

The Act on Decisions on Life-Sustaining Treatment has been in effect since 2018 for end-of-life patients. However, only 20~25% of deaths of terminally ill patients comply with the law, while the remaining 75~80% do not. There is significant confusion in how the law distinguishes between those in the terminal stage and those in the dying process. These 2 stages can be hard to distinguish, and they should be understood as a single unified "terminal stage." The number of medical institutions eligible for life-sustaining treatment decisions should be legally expanded to properly reflect patients' wishes. To prevent unnecessary suffering resulting from futile life-sustaining treatment, life-sustaining treatment decisions for terminal patients without the needed familial relationships should be permitted and made by hospital ethics committees. Adult patients should be permitted to assign a legal representative appointed in advance to represent them. Medical records can be substituted for a patient's judgment letter (No. 9) and an implementation letter (No. 13) for the decision to suspend life-sustaining treatment. Forms 1, 10, 11, and 12 should be combined into a single form. The purpose of the Life-sustaining Medical Decisions Act is to respect patients' right to self-determination and protect their best interests. Issues related to the act that have emerged in the 3 years since its implementation must be analyzed, and a plan should be devised to improve upon its shortcomings.

• Journal of Hospice and Palliative Care
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• v.24 no.4
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• pp.226-234
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• 2021

Purpose: The accessibility of medical facilities for cancer patients affects both their comfort and survival. Patients in rural areas have a higher socioeconomic burden and are more vulnerable to emergency situations than urban dwellers. This study examined the feasibility and effectiveness of a cancer care model integrating a regional cancer center (RCC) and public health center (PHC). Methods: This study analyzed the construction of a safety care network for cancer patients that integrated an RCC and PHC. Two public health institutions (an RCC in Gyeongnam and a PHC in Geochang County) collaborated on the development of the community care model. The study lasted 13 months beginning in February 2019 to February 2020. Results: The RCC developed the protocol for evaluating and measuring 27 cancer-related symptoms, conducted education for PHC nurses, and administered case counseling. The staff at the PHC registered, evaluated, and routinely monitored patients through home visits. A smartphone application and regular video conferences were incorporated to facilitate mutual communication. In total, 177 patients (mean age: 70.9 years; men: 59%) were enrolled from February 2019 to February 2020. Patients' greatest unmet need was the presence of a nearby cancer treatment hospital (83%). In total, 28 (33%) and 44 (52%) participants answered that the care model was very helpful or helpful, respectively. Conclusion: We confirmed that a combined RCC-PHC program for cancer patients in rural areas is feasible and can bring satisfaction to patients as a safety care network. This program could mitigate health inequalities caused by accessibility issues.

• Journal of Hospice and Palliative Care
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• v.25 no.3
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• pp.110-120
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• 2022

Purpose: The purpose of this study was to confirm the factor structure of the McGill Quality of Life Questionnaire-Revised (MQOL-R) in the context of Korean culture and to verify its reliability and validity. Methods: The participants comprised terminal cancer patients aged 25 or older, and data from 164 participants were analyzed. The study was conducted in the following order: translation, expert review, reverse translation, preliminary investigation and interviews, and completion of the final version. Confirmatory factor analysis was applied to evaluate the validity of the instrument, and the Beck Depression Inventory, Korean version (K-BDI) was applied to confirm the criterion validity of the MQOL-R Korean version. The Cronbach's alpha coefficient, representing internal consistency, was measured to evaluate reliability. Results: Cronbach's alpha for all 14 questions was 0.862. The model fit indices for confirmatory factor analysis were within the acceptance criteria. The factor loadings of all four factors were over 0.50, and convergent validity and discriminant validity were confirmed. Regarding criterion validity, a negative correlation was found between the four factors of MQOL-R Korean version and the K-BDI. Conclusion: The MQOL-R Korean version, the reliability and validity of which were verified in this study, is a 15-item tool consisting of 14 items dealing with four physical, psychological, existential, and social factors and a single item evaluating the overall quality of life. The MQOL-R Korean version is an instrument that can more concisely and effectively measure the quality of life of patients with life-threatening diseases.

• Journal of Hospice and Palliative Care
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• v.25 no.4
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• pp.198-203
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• 2022

Purpose: To grasp public opinion accurately, we conducted an opinion poll on beliefs and attitudes toward physician-assisted suicide (PAS). Methods: A randomized telephone survey ensuring a representative sample was conducted, 1,007 participants aged 18 years or older (response rate, 9.5%). Results: The main results are as follows: i) 61.1% of participants thought that the current social support system for terminally ill patients and their families is insufficient; ii) 60% of participants did not recognize the term "hospice and palliative care"; iii) 81.7% of participants would not like to receive life-sustaining treatment if there is no possibility of recovery; iv) 58.4% of participants would like to receive hospice and palliative care if they are diagnosed with a terminal illness; v) the priorities for dignified dying were preparing a support system to reduce the burden of care (28.6%), economic support including reduction of medical expenses (26.7%), expansion of hospice and palliative care services (25.4%), and legalization of PAS (13.6%); and vi) 58.3% of participants agreed that the expansion of hospice and palliative care should precede the legalization of PAS. Conclusion: Koreans currently want other efforts, including expansion of hospice and palliative care services, instead of the legalization of PAS.

• Journal of Hospice and Palliative Care
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• v.26 no.1
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• pp.7-17
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• 2023

Purpose: The purpose of this study was to analyze end-of-life care practices in lung disease patients with physician orders for life-sustaining treatment (POLSTs). Methods: We retrospectively analyzed data from medical records regarding the end-of-life care practices of POLST decisions for patients with lung disease hospitalized at a tertiary hospital in Seoul, South Korea. Data were collected from January 1 to June 30, 2021. Results: Of 300 total patients, 198 had lung cancer (66.0%) and 102 had non-malignant lung diseases (34.0%). A POLST was written for 187 patients (62.3%), and an advance directive was written for 20 patients (6.7%). Subsequent treatments were hemodialysis in 13 patients (4.3%), surgery in 3 patients (1.0%), and cardiopulmonary cerebral resuscitation in 1 patient (0.3%). Among cancer patients, chemotherapy was performed in 11 patients (3.7%), targeted therapy in 11 patients (3.7%), immunotherapy in 6 patients (2.0%), and radiation therapy in 13 patients (4.3%). Depending on the type of lung disease, types of treatment differed, including hemodialysis, ventilators, bilevel positive airway pressure, high-flow nasal cannulas, nebulizers, enteral nutrition, central line, inotropic agents, and opioids. Conclusion: Although the goals of hospice care are the same whether a patient has lung cancer or a non-malignant lung disease, because the characteristics of the respective diseases differ, end-of-life care practices and hospice approaches must be considered differently.

• Journal of Hospice and Palliative Care
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• v.26 no.3
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• pp.112-125
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• 2023

Purpose: This study investigated knowledge, attitudes, and nursing stress related to life-sustaining treatment among oncology nurses. Methods: A descriptive study design was used. Data were collected through a survey from April 1 to May 31, 2022. The participants were 132 nurses working in the oncology ward of a tertiary hospital in Seoul. Data were analyzed using the SPSS 25.0 program with descriptive statics, the independent t-test, analysis of variance, and Pearson correlation coefficients. Results: The average scores for knowledge, attitudes, and nursing stress related to life-sustaining treatment were 14.42, 3.29, and 3.96, respectively. Significant differences in knowledge about life-sustaining treatment were observed based on clinical experience (P=0.029) and education about life-sustaining treatment (P=0.044). Attitudes toward life-sustaining treatment varied significantly with education about life-sustaining treatment (P=0.014), while stress levels differed significantly across working units (P=0.004). A positive correlation was found between the dilemma of extending or stopping life-sustaining treatment (a subdomain of nursing stress) and attitudes toward life-sustaining treatment (r=0.260, P=0.003). Conclusion: There was no significant correlation between the nursing stress experienced by oncology nurses and their knowledge and attitudes toward life-sustaining treatment. However, a more positive experience with life-sustaining treatment education was associated with higher stress levels related to the dilemma of extending or stopping life-sustaining treatment. Therefore, it is crucial to develop strategies to manage this dilemma and reduce stress in the field.

• Journal of Hospice and Palliative Care
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• v.26 no.3
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• pp.126-139
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• 2023

Purpose: This study aimed to analyze interventions for bereaved families and evaluate their effectiveness, with the ultimate goal of supporting evidence-based nursing for bereaved families. Methods: Research trends were identified based on a search of domestic databases from January 2000 to December 2022, and a meta-analysis was conducted on interventions for bereaved families. Forty-five papers were selected, and information was extracted on participants, research design, and interventions. A meta-analysis of seven papers was performed, and the effect size was calculated. Results: Fourteen papers dealt with interventions for middle-aged women who had lost their spouses, 20 used qualitative research methods, and 20 were on art therapy programs. Thirty studies had fewer than 10 participants, and most interventions had 60~120 minutes per session and 9~16 sessions in total. There were seven randomized controlled trials, and all studies included in the quality evaluation showed a low risk of bias. Four papers measured grief as an outcome, and the effect size was -1.9577 (95% CI: -2.9206 to -0.9947), indicating that the treatment significantly decreased grief (P<0.001). Six papers measured depression as an outcome, and the effect size was -1.6775 (95% CI: -2.1835 to -1.1716), showing that the treatment significantly decreased depression (P<0.001). Conclusion: Intervention programs for bereaved families were shown to be effective in relieving grief and depression. However, programs should be developed that target middle-aged men who have lost their spouses and children who have lost their parents. Randomized controlled trials should also be conducted on interventions to reduce grief and depression.

• Journal of Hospice and Palliative Care
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• v.26 no.2
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• pp.27-41
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• 2023

Purpose: Pediatric palliative care is a rapidly developing multidisciplinary approach that supports children with life-limiting conditions and their families. However, there is limited evidence on how to effectively support bereaved parents and siblings. The purpose of this study is to explore the therapeutic impact of art therapy for bereaved families, in accordance with John Bowlby's four-stage theory of mourning. Methods: This single-case study employed the consensual qualitative research method. Art therapy records of bereaved families were reviewed individually, and records from one case were selected. Verbal statements made during the art therapy sessions and photocopies of the artworks were analyzed to understand the mourning process of the family. Results: A total of 113 statements and 12 artworks from 19 art therapy sessions were analyzed. As the art therapy progressed, each family member exhibited a pattern of engaging in more positive and healthy conversations in daily life, demonstrating the final stage of mourning: reorganization and recovery. The family dynamics also revealed that they reconstructed their inner world and redefined the meaning of loss, which is the final stage of mourning. The art therapy provided a safe environment for the family, allowing them to fulfill their wishes and regain the strength needed for recovery. Conclusion: This study suggests that art therapy supports bereaved families in alleviating their psychological difficulties, engaging in a healthy mourning process, and functioning as members of society. Further research is needed to better understand the effect of art therapy as a bereavement support tool in pediatric palliative care.