• Journal of Hospice and Palliative Care
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• v.11 no.4
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• pp.196-205
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• 2008

Purpose: The purpose of this study was to evaluate the current status of hospice palliative care facilities, and to identify problems and improve hospice palliative care in Korea. Methods: The questionnaire survey was implemented from October to December, 2007. It was consisted of general characteristics of organization, health manpower, facilities & equipments, service programs, and so on. Sixty two (79.5%) out of 78 hospice palliative care facilities returned the questionnaires. Results: They were 42 hospital-based hospice palliative care hospitals and 9 clinics, and most of them are located at central metropolitan areas (Seoul and Gyeonggi Province). more than 80% of hospitals met with the requirements (one doctor per 10 patients and one nurse per 1.5 patients), whereas 42.9% of clinics met the requirements. Approximately 22% of them met the requirement of sick room (4 patients for 1 room). Most of them provided various hospice palliative care programs. The proportion of giving regular education programs to hospice palliative care personnels were about half (41.9%). Thirty two (51.6%) facilities provided home visiting hospice palliative care service. Conclusion: There were lack of enough health manpower, rooms, and programmes and they varied among facilities. It is necessary to increase the number of hospice palliative care facilities with consideration of regional fair distribution and standardization of programmes.

• Journal of Hospice and Palliative Care
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• v.12 no.1
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• pp.5-13
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• 2009

Purpose: This exploratory study was undertaken to analyze the information needs of family members of terminal cancer patients, collected through the telephone counselling service by National Cancer Information Center. Methods: The study included 113 family members of terminal cancer patients who had enrolled at the National Cancer Information Center for the period from June, 2007 through March, 2008 and had agreed to the survey. Results: The subjects (n=113) consisted of grown-up children (n=82) and spouses (n=8) of patients'. Those in their 40's (n=40) and 30's (n=36) accounted for the majority of the sample. The questions raised most were about the information on treatment methods (n=117), management of terminal cancer patients (n=46), terminal cancer patients' life (n=27), deathbed and prediction of remaining life (n=18), hospitalization (n=16), and financial support (n=15). Most of the subjects were satisfied with the telephone counseling services, and 69% of the subjects had come to know about the telephone counseling service via Internet, and 10.6% of them stated that the PR for the service was poor. Conclusion: It is deemed essential for the government to use the mass media for PR of the hospice services, since family members of terminal cancer patients' are less aware of the hospice conducive to enhancement of patients' remaining quality of life, being involued too deeply in their treatment.

• Journal of the Korean Applied Science and Technology
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• v.37 no.4
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• pp.794-806
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• 2020

This study was conducted in order to attain an in-depth understanding of and describe the Ego-Integrity Phenomenon of the elderly of age 65 and older. The data was collected from June 2020 to July 2020 as an in-depth interview consisting of semi-structured questions. The data was analyzed using the Colaizzi's method, one of the phenomenology methods. All interviews were recorded and transcribed for analysis. Through analysis, 309 significant statements were extracted, and 88 formulations of meaning, 53 themes, 16 theme clusters, and 5 categories were derived. The categories and the theme clusters are as such : 'reflecting on the past life with delight' ('fruitfulness over the lifetime', 'achieving through fulfilling responsibilities', 'achieved specially and gratefully'), 'Currently lonely and distressed due to the bitter old days' ('Physical health needs and psychosocial needs are not met', 'Wasn't able to make good choices for parents and children', 'Elderly life is not easy'), 'Satisfaction from enduring tough and difficult journeys in life' ('Compensated for hard work at workplace and home', 'Problem solved through endurance and overcoming', 'Living a healthy elderly life by escaping from the habits of the past'), 'Realizing the way of life as an elderly' ('Now is the best and most satisfying moment', 'Managing self in old age', 'Living passionately, though it may be late', 'Retiring from the forefront of life with an abundant heart'), 'Passing on beautifully' ('Desires toward the later years', 'Hope during the last moments', 'Appearance and emotions when death approaches'). It was observed that during the Ego-Integrity Phenomenon of the elderly, they have come to discern the meaning of life by reminiscing the regrets and difficulties of the past, and through this reminiscence, they have come to attain a positive and transcendental hope for the rest of their lives. The Ego-Integrity of the elderly appeared to be subjective, dynamic, and occurring simultaneously rather than continuously. It is recommended to develop a variety of nursing interventions while taking into consideration the age and the type of experience of the elderly.

• Journal of Hospice and Palliative Care
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• v.20 no.2
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• pp.100-110
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• 2017

Purpose: We explored Koreans' perception of the meaning of death with dignity that Korean people. Methods: A phenomenological research methodology was applied. A total of 13 participants were sampled based on their age and gender. Participants were interviewed in depth from September 2015 through February 2016. Colaizzi's phenomenological analysis method was used for data analysis. To establish the validity of the study, we evaluated its realistic value, applicability, consistency and neutrality of the qualitative evaluation criteria of Lincoln and Guba. Results: Koreans' perception of death with dignity was structured as 19 themes, nine theme clusters and four categories. The four categories were "comfortable death", "good death", "resolving problems before death", and "death with good reputation". The theme clusters were "death without pain", "death submitting to one's fate", "death that is not ugly", "leaving good memories to others", "dying in a way we want", "death after proper settling of things", "dealing with chronic resentment before death", "death after living a good life", and "death with recognition". Conclusion: For Koreans, death with dignity meant not burdening others, settling things right and leaving good memories to their families and friends. Such perceptions can be applied to hospice care for terminally ill patients.

• Journal of Hospice and Palliative Care
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• v.16 no.2
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• pp.80-89
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• 2013

Purpose: We investigated how intensive care unit (ICU) nurses understand the meaning of death, death anxiety, death concern and respect for life. Methods: From November 2009 through February 2010, a survey was conducted on 230 nurses working at the ICU of 10 general hospitals located in Seoul and Gyeonggi province. Participants were asked to answer a questionnaire consisted of 67 questions under four categories of the meaning of death, death anxiety, death concern and respect for life. Results: Participants scored 4.27 points on their understanding of the meaning of death, 4.43 on death anxiety, 4.12 on death concern and 4.18 on respect for life. Participants' meaning of death was negatively correlated with death anxiety and death concern and positively with respect for life. Participants' positive meaning of death was negatively correlated with death anxiety and death concern and positively with respect for life. Participants' negative meaning of death was negatively correlated with death anxiety and death concern and positively with respect for life. Participants' death anxiety was positively correlated with death concern and negatively with respect for life. Participants' death concern was negatively correlated with respect for life. Conclusion: Compared with nurses who served at ICU for a long time, nurses with less ICU experience scored lower on the meaning of death and respect for life, while they presented high anxiety and concern about death. A training course may help nurses develop their view on the meaning of death, which in turn would enhance their performance in caring dying patients.

• Journal of Hospice and Palliative Care
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• v.4 no.1
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• pp.57-67
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• 2001

Purpose : The purpose of this study was to identify attitudes of hospice volunteers toward care of for terminally ill patients. Method : This was a descriptive study with a sample of 84 adults who were registered for a hospice volunteer education program at Severence Hospice Center. The Frommelt (FATCOD) scale on attitudes toward the care of the dying (Cronbach alpha=.778) and an open ended questions on "what if you only have 6 months to live" were used to collect the data. The data was analyzed using SPSS/W and content analysis. Results : 1) The hospice volunteers were mostly female, with an average age of 45 years, half of them were college graduates and their religious preference was Protestant. 2) The participants of this study demonstrated positive attitudes to care for the dying which is in coherence with hospice philosophy and principles. However they indicated difficulties in maintaining close relationships with people who are dying, and in communicating and sharing, and encouraging those who are dying to express their feelings. In the open ended questions, they identified that their most important issues would be guilt feelings toward their children, family concerns, and the burden of unfinished business in their lives. They also identified the fear of pain in the dying process and fear of the afterlife. The care they would like to receive was to have peace of mind, have a good listener, spiritual counselling, and pain relief and to be respected as a human being. The source of strength would be faith in God and they would like to overcome their of dying. The FATCOD scale has limitation in describing and identifying the need and attitude toward the care of the dying revisions were made. Conclusion : We all are the potential clients for the hospice rare. In a hospice volunteer education program, communication and interpersonal skill are essential. The fear of dying, afterlife, concerns about family with children, and human dignity are major concerns in hospice and palliative care.

• Journal of Korean Academy of Nursing
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• v.22 no.4
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• pp.506-525
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• 1992

Older people, because of the psychological and physiological changes related to the aging process are more vulnerable to experiencing powerlessness than any other age group. This self destructive cycle of depression in older people related to the experience of continued and long term powerlessness can lead even to death. The purpose of this study was to measure powerlessness and resources to increase power in older people, and to measure the effectiveness of a psychological rehabilitation program for reducing powerlessness. The research methodology used was a two step process. In the first step, a survey was done of perceived powerlessness and power resources comparing four groups of elderly people ; those living at home, those in hospital, those living in nursing homes and those attending educational programs for the elderly. The total sample size was 236. In the second step, a psychological rehabilitation program was carried out, pre and post measurements were taken related to this program. The sample consisted of 29 residents in a nursing home. The results of the study are as follows : 1. Powerlessness was classified as cognitive, emotional, activity and learning. The lowest score for powerlessness was in the area of activity, that is the people in the sample felt more power concerning their activities. The highest score was in the area of cognition where they felt they had less power. 2. When the different groups of elderly were compared, it was found that the residents of the nursing home had the highest score on perceived powerlessness and the group who were living at home had the lowest score. 3. Among the general characteristics, the factors influencing the powerlessness score were age, sex, level of education, financial resources and health status. In the interaction effects among these factors, it was found that level of education and health status were factors influencing perceived powerlessness. The elderly with lower education and poorer health status had the higher scores for perceived powerlessness. 4. The power resources could be classified into the following areas : physical strength, emotional strength, positive self-image, energy, knowledge, motivation and belief system. Belief system was given the highest score among the power resources and energy, knowledge and motivation were given low scores. 5. The group participating in an educational program for the elderly had the highest score for power resources while the group made up of residents of a nursing home had the lowest score as well as the highest score for perceived powerlessness. 6. The factors influencing the power resource scores were sex, level of education, financial resources and health status. In the analysis of the interaction effect among the factors, it was found that sex, level of education and financial resources were the factors that influenced the power resource score, that is, women, those with a low level of education and those with poor financial resources reported a lower level of power resources. 7. There was a negative correlation between perceived powerlessness and power resources in the elderly in this study. Since power resources explainded 49% of the variance for powerlessness, it can be concluded that the power resources can be used to reduce powerlessness. 8. The psychological rehabilitation program was carried out with the nursing home residents over a period of five weeks. No statistically significant difference was found in the scores on powerlessness between the pre and post tests, but there was a slight decrease in the raw scores on the post test for emotional, activity and learning powerlessness. There was a statistically significant increase in the power resource scores for emotional strength, positive self-image, energy, knowledge and motivation in the post test as compared to the pre test. In conclusion, the study indicates that a psychological rehabilitation program for the elderly could be effective in increasing power resources and this in turn could lead to a decrease in perceived powerlessness.

• Journal of Hospice and Palliative Care
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• v.9 no.2
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• pp.77-85
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• 2006

Purpose: The purpose of this study is to develop the basic curriculum for the nurses who work at hospice and palliative care settings. Methods: Seven curricula of hospice and palliative care for the nurses in Korea and other countries were reviewed, and Education Need for hospice and palliative care was surveyed from 162 nurses by mailing the questionnaires to hospice palliative care settings. Results: 1. The curricula of hospice and palliative care for the nurses in Korea and other countries in common include 'understanding of hospice and palliative care', 'understanding of lift and death', 'pain and symptom management for person with terminal disease', 'on-the-spot study and practical training', 'management of hospice and palliative ward', 'hospice and palliative care at home', 'physical assessment', 'therapeutic communication skills', 'children's hospice', 'administration and management of hospice and palliative care', 'interdisciplinary team of hospice and palliative care', 'ethics and laws in hospice and palliative care', 'psychological, social and spiritual care', 'care of the dying', 'bereavement care', etc. 2. The scores above 3.3 were marked for 34 items in education Need Survey. The highest scores were given in the order for the items 'understanding of death and dying', 'attitude and response to death and dying', 'understanding and assessment of pain' etc. respondents marked that they have been trained for 'pain and symptom management', 'ethics and laws in hospice and palliative care', 'building the system for cooperation and publicity activities in hospice' etc. 3. The basic curriculum of hospice and palliative care for the nurses requires 78 studying hours for 17 subjects, comprising 48 hours of theory education and 30 hours of practical training. The education methods are lectures, discussions, and case studies. Conclusion: The efforts of developed basic curriculum should be evaluated after educating nurses. It is necessary to develop the standard curriculum and regularly update it based on the result of education Need Survey for actively working nurses in hospice and palliative care settings.

• Journal of Hospice and Palliative Care
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• v.8 no.1
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• pp.8-17
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• 2005

Purpose: This study was performed to investigate burden, job satisfaction and quality of life of nurses who take care of cancer patients. Methods: The subjects were 237 nurses working at the oncology unit of hospitals with over 500 beds in Seoul and Gyeonggi-do. Data were collected using questionnaire from the February to March, 2005. Data were analyzed through t-test, ANOVA, Pearson's correlation coefficient and stepwise multiple regression using SAS. Results: 1. The item that showed the highest level of burden was 'I feel limited even if I make efforts to reduce patients' pain. 'Burden was high in those group both who were younger than 35 years old and who had clinical experiences caring cancer patients for $3{\sim}4$ years. 2. The item that showed the lowest level of job satisfaction was 'the possibility of promotion'. Job satisfaction was high in those group both who had a spouse and were head nurses or incharge nurses. 3. The item that showed the lowest level of quality of life was 'I am physically exhausted'. Over 35 years old who had a spouse, and over 2,000,000 won monthly income made a high score in the quality of life. 4. There were negative correlations among burden, iob satisfaction and the quality of life. 5. The major factor affecting the quality of life was burden. Conclusion: The results of this study are expected to be utilized as basic data for developing support system to improve nurses' work conditions and quality of life.

• Journal of Hospice and Palliative Care
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• v.19 no.2
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• pp.119-126
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• 2016

Purpose: This study analyzed the difference in survival time of patients with delirium according to sedative medication. Methods: From January 2012 through December 2013, a retrospective cohort study was performed using the electronic medical records (EMR) of Pusan National University Hospital. Among 900 patients who died from cancer, we selected 240 who suffered delirium based on the EMR. The Nu-DESC delirium screening test was used to diagnose delirium. Results: The median length of delirium period was five days. Delirium characteristics were dominated by inappropriate behaviors (35.0%). Sedatives were administered in 72.1% of the cases. The most frequently used sedative was haloperidol which was used in 59.6% of cases. The delirium period significantly differed by patients' age (F=3.96, P=0.021), cancer type (F=3.31, P=0.010), chemotherapy (t=-3.44 P=0.001). The average survival time was 16.85 days for the sedative medication group and 9.37 days for the non-medication group, which, however, was not significant (t=1.766, P=0.079). Conclusion: In this study, the use of sedatives did not affect patients' survival time. Thus, appropriate sedative medication can be positively recommended to comfort terminal cancer patients and their families.