• Journal of Hospice and Palliative Care
• /
• v.18 no.4
• /
• pp.322-328
• /
• 2015

Purpose: The aging of society has rapidly progressed, especially in Korea. Therefore, the necessity of research on end-of-life (EOL) care in elderly patients has increased. However, there are few studies on EOL care intensity for non-cancer patients. This study was designed to compare the EOL care intensity between cancer and non-cancer patients. Methods: We retrospectively analyzed the EOL care intensity based on medical records of decedents of Kyung Hee University Medical Center, a tertiary referral hospital from December 2014 through March 2015. And we compared EOL care intensity between cancer patients and non-cancer patients using statistical analysis of the frequency of invasive procedures and logistic regression analysis for factors that affect the EOL care intensity. Results: Statistical analysis showed invasive procedures, such as intensive care unit admission, endotracheal intubation followed by mechanical ventilation and emergency dialysis, were performed more frequently in non-cancer patients than cancer patients (29.3% vs. 72.4%, P<0.001). And age (P=0.038) and morbidity of cancer (P<0.001) influenced the invasive procedural decision when analyzed by logistic regression analysis. Conclusion: The EOL care was more intensive in non-cancer patients, and age and morbidity of cancer were major factors for the treatment intensity.

• Journal of Hospice and Palliative Care
• /
• v.13 no.1
• /
• pp.41-49
• /
• 2010

Purpose: This study was performed to explore the preference for care near the end-of-life of nurses who had been working in an acute hospital. Methods: Data were collected by using PCEOL-K which was originally developed in U.S. and standardized into Korean version. Two hundred nurses from one acute hospital who agreed to participate in the study filled out questionnaires and 177 questionnaires were analyzed for the study results. Results: Relatively positive preference toward spirituality and pain control and negative preference toward decision making by health care professional were uncovered. Conclusion: Nurses consider patient's autonomy, pain control and spirituality as important factors at the end-of-life care. Further studies regarding the preference for the care near the end-of-life of diverse groups such as patients, doctors, and family members are called for.

• Journal of Internet of Things and Convergence
• /
• v.6 no.1
• /
• pp.45-53
• /
• 2020

This study aimed to examine the relationship of the knowledge of end-of-life(EOL) care, life-sustaining treatment(LST), and advance directive(AD) with the educational needs regarding AD writing among nurses in convergence era. For this cross-sectional study, participants were 169 nurses at a general hospital in South Korea. Data were collected from July 19 to 26 in 2018 using structured questionnaires. Knowledge on EOL care scored 8.56 out of 11 points, knowledge on LST scored 5.11 out of 6 points, and knowledge on AD scored 8.02 out of 9 points. Educational needs regarding AD writing scored 4.31 out of 5 points. There were statistically correlations between knowledge on LST and educational needs regarding AD writing (r=.182, p=.018), and between knowledge on AD and educational needs regarding advance AD writing (r=.234, p=.002). The findings can be used to develop the educational program regarding AD.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.17 no.9
• /
• pp.212-220
• /
• 2016

Purpose: The purpose of this study was to examine self-transcendence, life satisfaction, and preference for end-of-life care in elderly patients. Method: This was a descriptive survey study. The study period was between August 2013 and October 2013 and included 208 elderly patients. Results: The average scores for self-transcendence, life satisfaction, and preference for end-of-life care were 2.79, 9.97, and 3.24, respectively. Statistically significant positive correlations were observed between self-transcendence and life satisfaction, decision making by health care professionals, spiritual area, family area. A positive correlation was observed between: (1) life satisfaction and spiritual area, (2) decision making by health care professionals and family area, and (3) decision making by health care professionals and pain area. Self-transcendence was a significant predictor of PCEOL. Conclusion: This study will provide basic information for use in the development of a program to encourage self- transcendence and life satisfaction, as well as to consider the elder's autonomy, pain control, and spirituality as important factors at the end-of-life care.

• The Journal of Korean Academic Society of Nursing Education
• /
• v.19 no.3
• /
• pp.330-340
• /
• 2013

Purpose: This study was performed to identify the level of Korean elderly's knowledge regarding concepts of end-of-life (EOL), Life-sustaining-treatment (LST), and advance directives (AD) which are critical aspects for establishing AD in Korean society. Methods: A questionnaire survey was done between October 2011 and February 2012. Knowledge of AD was evaluated with 3 aspects including EOL, LST, and AD utilizing a questionnaire that was developed by authors for the study. Data were collected from 268 community dwelling elderly from three cities and analyzed using descriptive statistics, t-tests, one-way analysis of variance, and a Scheffe post hoc test with SAS Ver. 9.1 program. Results: Overall, Korean elderly were poorly acquainted with AD related concepts. Significant differences in awareness of AD including understanding of EOL, the level of comprehension of LST, and knowledge about AD were revealed by gender, education level, economic state, and acquaintance with terms of AD or LST. Conclusion: To acknowledge autonomy and support quality of life for elderly and to meet the purpose of AD, attention should be given to target populations including elderly in terms of knowledge level related to AD, social marketing, and infra structure relevant to practice AD in our society.

• Journal of East-West Nursing Research
• /
• v.20 no.2
• /
• pp.103-111
• /
• 2014

Purpose: The purpose of this study was to identify the characteristics of life-sustaining treatment and attitudes towards advance directives among geriatric patients. Methods: The elderly participants (N=146) were recruited from a university hospital from October 30, 2012 to March 31, 2013. A questionnaire for collecting data of participants' characteristics, their experiences related to life-sustaining treatment, and attitudes towards advance directives was used. The data were analyzed using SPSS WIN 17. Results: Most participants (84.9%) were in favor of advance directives. Although most of participants wanted to receive CPR for sudden cardiac arrest (78.8%) and pain control medication (74.0%), most preferred to refuse life-sustaining treatments such as tracheostomy (96.6%) or ventilator (87.0%). Participants who had a family or acquaintances with CPR experiences (U=852.00 p=.038), had discussed with their family and acquaintances regarding end-of-life sustaining treatment (t=2.91, p=.004), or made decisions about refusing the life sustaining treatments (t=3.19, p=.002) preferred to have advance directives than those who did not. Conclusion: The findings of this study suggested the potential benefits of educational programs about advance directives for the end-of-life for geriatric patients to make decisions for life-sustaining treatments in advance.

• Journal of Hospice and Palliative Care
• /
• v.5 no.1
• /
• pp.17-23
• /
• 2002

Purpose : The prevalence of symptoms in patients with terminal cancer varies considerably and these symptoms are very difficult to control. However, patients can spend their last days or hours of life without suffering pain with appropriate care. One of the major concerns during last days of life is to predict the time of death. We would like to investigate symptom prevalence during terminal cancer patients' last 48 hours in Korea, and therefore contribute to predict the time of death and to help to determine appropriate treatments. Methods : The data for this study was recorded from 92 of 132 patients who died with terminal cancer at the hospital between February 1 and October 31, 2000. We investigated the symptom prevalence during the last 48 hours through medical obligation record and analyzed the changes of symptom prevalence at the admission, $48{\sim}24$ hours and $24{\sim}0$ hours before death. Results : The predominant symptom prevalence was pain (57.6%), followed by confusion (55.4%), dyspnea (48.9%), voiding difficulty (42.4%) in the last 48 hours before death. From the statistical analysis for the changes of symptom prevalence in time, pain, nausea and vomiting were decreased but noisy and moist breathing, sweating, groan, restlessness and agitation, and loss of consciousness were increased (P<0.05). Conclusion : The results from this study show the tendency to increase of prevalence of noisy and moist breathing, sweating, groan, restlessness and agitation as well as loss of consciousness in 48 hours before death. Therefore the symptoms above can be used for the important indicators to predict the imminent death.

• Journal of Hospice and Palliative Care
• /
• v.19 no.3
• /
• pp.201-210
• /
• 2016

Delirium is a common symptom in patients with terminal cancer. The prevalence increases in the dying phase. Delirium causes negative effects on quality of life for both patients and their families, and is associated with higher mortality. However, some studies reported that it tends to remain unrecognized in palliative care setting. That may be related with difficulties to distinguish the symptom from others with overlapping characteristics such as depression and dementia, and a lack of knowledge regarding assessment and diagnostic tools. We suggest that accurate recognition with validated tools and early diagnosis of the symptom should be highly prioritized in delirium management in palliative care setting. After diagnosing delirium, it is important to identify and address reversible precipitants such as medication, dehydration, and infection. Non-pharmacological interventions including comfortable environment for the patient and family education are also essential in the management strategy. If such interventions prove ineffective or insufficient to control hyperactive symptoms, pharmacologic interventions with antipsychotics and benzodiazepine can be considered. Until now, low levels of haloperidol remains the standard treatment despite a lack of evidence. Atypical antipsychotics such as olanzapine, quetiapine and risperidone reportedly have similar efficacy with a stronger sedating property and less adverse effect compared to haloperidol. Currently, delirium medications that can be used in palliative care setting require more clinical trials, and thus, clinical guidelines are not sufficiently available. We suggest that it is warranted to develop clinical guidelines based on well-designed clinical studies for palliative care patients.

• Journal of muscle and joint health
• /
• v.20 no.3
• /
• pp.214-224
• /
• 2013

Purpose: The purpose of this study was to identify the differences in preference for terminal care between hospitalized patients and nurses. Methods: A cross-sectional descriptive design was used in 79 patients and 107 nurses. The data were collected from August to October 2011, using the Preference for Care near the End of life Scale - Korean Version (PCEOL-K) with 5-point scale of 26 items. The reliability of the tool was Cronbach's ${\alpha}=.74$. Results: The mean score (SD) of PCEOL-K's sub-dimensions in nurses' priority was: (a) pain $3.70{\pm}0.63$, (b) spirituality $3.63{\pm}0.61$, (c) family $3.40{\pm}0.70$, (d) autonomous decision making $2.30{\pm}0.66$, and (e) decision making by healthcare professionals $2.14{\pm}0.64$. In patients' priority, the $M{\pm}SD$ score of each sub-dimension was: (a) pain $3.86{\pm}0.65$, (b) family $3.83{\pm}0.57$, (c) decision making by healthcare professionals $3.37{\pm}0.85$, (d) spirituality $3.01{\pm}0.80$, and (e) autonomous decision making $2.43{\pm}0.63$. Results indicated significant differences between nurses and patients regarding decision making by healthcare professionals (t=-11.28, p<.001), family (t=-4.66, p<.001), and spirituality (t=5.71, p<.001). Conclusion: The PCEOL-K of patients was higher than nurses'. A terminal care program for hospitalized patients at the end of life should be planned according to the results of PCEOL-K in nurses and patients.

• 한국노년학
• /
• v.30 no.4
• /
• pp.1197-1211
• /
• 2010

This research was concucted to present a model of advance directives(AD) when a patient, who is in consciousness, shows a preference for an end of life care as an act of preparing for an uncertain situation that may arise in the forseeable future. The subjects of the research are 383 doctors/nurese and adults, who live in six cities and provinces, to investigate the status of AD, attitude regarding a meaningless life-prolonging treatment, and moreover, an understanding of and a preference for AD. The research was done by the well-structured questionnaire. Also, SPSS 14.0 is used to analyse the collected data, focused on frequency analysis, avearage and standard deviation, X2 test. As the results of the study, the most of the surveyed doctors/nurese knew DNR orders and AD and a few of them used DNR orders and AD practically. Also, the result shows that there is a negative conception of meaningless life-prolonging treatment among the responents, in addition, most of them agreed upon the idea of introducing AD to Korea, filling it out and making it legally effective. As a method of making AD out, the respondents wanted to use a form that mixed living will with an Power of Attorney in a document. Also, considering the appropriate time, respondents prefered when they are diagnosed with terminal illness. At the moment, the introductory model for AD, which is suitable for the Korean culture and current situation is presented based on the result of this research. In the future, other researches should deal with specific measures that can lead to a social consensus to adopt AD in Korea.