• Journal of Hospice and Palliative Care
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• v.19 no.1
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• pp.11-25
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• 2016

Purpose: The purpose of this study was to determine the factors that influence healthcare providers' attitude towards end-of-life care (EOLC) in the emergency department (ED) in hospital settings. Methods: From June 1 through June 30, 2014, a descriptive correlational study was performed with 41 doctors and 105 nurses stationed in the ED. Results: According to a regression model on the factors affecting healthcare providers' professional attitude towards EOLC, 28.1% of variance (F=15.185, P=0.000) was explained by awareness of death, gender and personal attitude towards EOLC. And 34.1% of the healthcare providers' personal attitude was related with awareness of death, experience of hospice education, occupations and professional attitude towards EOLC. Conclusion: This study demonstrated that attitude towards EOLC was influenced by awareness of death and personal characteristics. Healthcare providers in the ED should be provided with tailored training to improve their understanding of death. Also an educational program should be developed and provided to ED healthcare providers to improve their awareness of death.

• Journal of Hospice and Palliative Care
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• v.21 no.4
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• pp.124-136
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• 2018

Purpose: This descriptive study is aimed at identifying how nursing hospital workers' performance of end-of-life care is influenced by their knowledge and awareness of hospice palliative care, attitude towards end-of-life care, performance, importance, awareness of death and the factors. Methods: A self-reported questionnaire was used to collect data from 113 workers at an accredited nursing hospital in K province. Variables were their knowledge and awareness of hospice palliative care, attitude towards end-of-life care, end-of-life care performance and importance and awareness of death. An analysis was performed with the frequency, percentage, mean, standard deviation, t-test, ANOVA, Scheffe's test, Pearson's correlation coefficient and multiple regression using IBM SPSS 21.0. Results: The factors affecting the nursing hospital workers' end-of-life care performance were the importance of end-of-life care and their marital status, which showed an explanatory power of 38.2%. Conclusion: In order to improve the nursing hospital workers' end-of-life care performance, a training on the importance of end-of-life care should be provided. Therefore, we would like to propose establishing administrative measures such as 1) efficient staffing to help the caregivers better perform what they think is important, 2) development of a training program that can improve their performance of end-of-life nursing care and 3) a study to verify the effectiveness of the program.

• Journal of Hospice and Palliative Care
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• v.20 no.2
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• pp.111-121
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• 2017

Purpose: This study was performed to explore the current state of end-of-life (EoL) care education provided to new interns at two university hospitals. Methods: A questionnaire was given to incoming interns (N=64). The levels of acquired knowledge and experience of clinical observation were measured. Seven areas for self-assessment questions were identified and used to analyze the interns' attitudes towards EoL-related education and practice. Results: On average, participants learned five elements (nine in total) from EoL-related classes and two (seven in total) from clinical observation. The most frequently educated element was how to deliver bad news (96.9%) in the classroom setting and how to control physical symptoms (56.5%) in clinical observation. Less than 20% received training on EoL care communication, including discussion of advanced directives. Compared with participants who had no EoL training, those who had EoL training showed positive attitudes in all seven categories regarding overall satisfaction, interest and preparedness in relation to EoL-care classes and practice. Conclusion: Although interns are responsible for caring of dying patients, their EoL training in classroom and clinical settings was very insufficient. Further research should be conducted to establish an education system that provides sufficient knowledge and training on EoL care.

• Journal of Convergence for Information Technology
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• v.11 no.7
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• pp.288-297
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• 2021

The purpose of this study was to provide basic data for the development of end-of-life care program by analyzing the importance and performance of end-of-life care. Data were collected from 127 hospice team members currently working in hospice and palliative care units from six different university hospitals, general hospitals and hospice clinics. The data was collected throughout the time span of Dec. 1, 2020 to Feb. 15, 2021. Data were analyzed using descriptive statistics, t-tests, ANOVA, & IPA matrix. As a result of this study, 'physical care' and 'psychological care' were part of the first quadrant that requires maintenance and continuous enhancement. The 'spiritual care' appeared to be in the third quadrant area which entails long-term improvement. Based on the outcome of the study, it is evident that strategies are needed to continuously maintain and enhance physical and psychological care as well establish long-term plans for spiritual care when organizing the hospice team's end-of-life care performance training program.

• Journal of Hospice and Palliative Care
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• v.22 no.4
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• pp.207-218
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• 2019

Purpose: Physician competency in end-of-life (EOL) care is becoming increasingly important. This study investigated the EOL care curricula in Korean medical schools. Methods: Questionnaires were issued to the faculty members responsible for the EOL care curricula at each of the medical schools. These included questions on the structure and content of the curricula, teaching methods, and faculty members' attitudes to the curricula. Results: Characteristics of the EOL care curricula were compiled from 27 (66%) of the 41 medical schools. All of the medical schools taught essential aspects of the EOL care curriculum either as a separate course or embedded within other medical education courses. The mean time spent on EOL care teaching was 10 hrs (range, 2~32 hrs). The most frequently taught topics were delivering bad news (100%) and symptom management (74%). When the palliative care education assessment tool (PEAT) was used to evaluate the curricula, a median of 11 PEAT objectives was met (range, 2~26; maximum, 83). More than two teaching methods were used in most of the curricula. However, lectures were the only teaching method used by three medical schools. 78% of faculty members who were responsible for curriculum reported dissatisfaction with it, whereas 18% believed that the time allotted to it was adequate. Only 7% of these faculty members believed that their students were adequately prepared to practice EOL care. Conclusion: There is a need to improve EOL care education in basic medical curricula and to take a more systematic approach to achieving learning outcomes.

• Journal of Hospice and Palliative Care
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• v.18 no.4
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• pp.276-284
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• 2015

Purpose: This study was performed to identify factors affecting terminal care performance of clinical nurses. Methods: The participants in this study were 175 nurses working in hospitals in Daegu and North Gyeongsang Province. Data were collected using a self-reported questionnaire and were analyzed with the IBM SPSS WIN 19.0 program. Results: Nurses' terminal care performance was significantly related with suffering experience, empathy ability and caring behaviors. Significant predictors for terminal care performance were their department, empathy ability and caring behaviors. These factors explained 43.52% of the variance in terminal care performance of clinical nurses. Conclusion: Our study results suggest that terminal care performance of clinical nurses can be strengthened by improving empathy ability and caring behaviors.

• Child Health Nursing Research
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• v.19 no.4
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• pp.252-261
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• 2013

Purpose: The purpose of this phenomenological study was to explore neonatal intensive care unit (NICU) nurses' experience in caring for infants who are approaching death and to identity the meaning and structure of their experiences. Methods: The participants were eight nurses who had experience in caring for these infants. In-depth interviews were performed from December, 2012 to February, 2013 until data were fully saturated. Collected data were analyzed using Colaizzi's method. Results: Four theme clusters were extracted from fifteen themes. The four theme clusters of the NICU nurses' experience in caring for infants who are dying were: 1) Crossroads between life and comfort of infants approaching death, 2) emotional suffering at the death of the infant, 3) adapting and coping with the death of the infant, 4) new expectations for caring for infants who are dying. Conclusion: The results of the study provide useful information in understanding NICU nurses' experience in caring for infants who are dying and establishing effective strategies to support these nurses.

• Journal of Hospice and Palliative Care
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• v.18 no.4
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• pp.285-293
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• 2015

Purpose: This study was conducted to explore the effects of attitude to death in hospice and palliative professionals on their terminal care stress, and to analyze relationships among variables related to the two aforementioned parameters, such as depression and coping strategies. Methods: Participants were 131 hospice and palliative professionals from the cancer units of two tertiary hospitals and two general hospitals, two hospice facilities, two geriatric hospitals, and two convalescent hospitals in J province. Data were collected from April through June 2015 and analyzed using t-test, factor analysis, ANOVA ($Scheff{\acute{e}}$ test), ANCOVA, and Pearson's correlation and a path analysis using the SPSS/WIN 21.0 and AMOS 18.0 programs. Results: The score for attitude to death was low (2.63), and that for depression was 0.45. Among all, 16.0% of the participants showed need for depression management. They scored 3.82 on terminal care stress. The subcategory with the highest mark was inner conflicts on limitation given availability of medical services (4.04). The score on coping strategy was low (3.13). They used passive coping strategies such as interpersonal avoidance (4.03), fulfilling basic needs (3.65) such as sleeping or eating. Attitudes to death had a direct negative effect on the terminal care stress level and indirectly affected through depression and fulfilling basic needs (CS2). Conclusion: It is necessary to provide hospice and palliative professionals with education on death and dying, as well as access to programs that provide emotional support and promote positive cognition of death and dying.

• Journal of Hospice and Palliative Care
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• v.13 no.1
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• pp.7-12
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• 2010

Purpose: To evaluate medications at the end of life care for terminal cancer patients during their last admission. Methods: Medical records of terminal cancer patients during their last admission from July 2003 to April 2008 at a district academic hospital were evaluated. Patient's characteristics, therapeutic drug classification during their last admission and on the patient's day of death, and the administrated route and number of medications on the patient's day of death were analyzed. Results: Total 81 patients were included. The median patient age was 63 years. The median length of admission was 18 days (range: 1~101). 54% of the patients had more than one comorbidities. The most frequently prescribed drugs during the last admission were opioid analgesics (63%), followed by antibiotics (58%) and antacids (53%). On the day of death, common medications were antibiotics (59%), antacids (58%), and opioid analgesics (46%). Intravenous injection was given to 81% of the patients and intramuscular injection was given to 16% of the patients on the day of patient's death. Number of medications prescribed to patients was between 0 and 11 (median: 3) and 12% (10/81) of the patients took over 8 medications including intravenous and oral drugs on the day of death. 6% (5/81) of the patients took potentially futile medications, like multivitamin or statin until the day of death. Conclusion: This study suggests that potentially futile medications and uncomfortable care were given to terminal cancer patients. Multicenter-based studies are necessary to diminish futile medications by essential medication at the end of life care for terminal cancer patients.

• Journal of Home Health Care Nursing
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• v.22 no.2
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• pp.216-227
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• 2015

Purpose: This study aimed at understanding terminal care provided in nursing homes. Method: An interview survey with staff in charge of terminal care was conducted in 97 nursing homes using questionnaires. The questionnaire was reviewed by 3 experts and pretested at 5 facilities. Data were analyzed using descriptive statistics, chi-square test, and Fisher's exact test. Result: Dyspnea was the most prevalent symptom predicting death. The most prevalent services were vital sign check for physical care, providing services by talking despite an unconscious state for psychosocial care, and respecting the faith of the elder for spiritual care. Employment of a registered nurse showed a significant difference in tube feeding (p=.035), analgesic administration (p=.022), informing the elder of end-of-life state (p=.020), helping an elderly person say good-byes through a visit with friends and acquaintances (p=.023), and helping express feelings related to death (p=.002). Lack of service was noticed for elderly resident, family, and staff after death of an elder. Problems related to terminal care were indifference of family members, difficulty in obtaining medical prescription, difficulty in predicting death, and so forth. Conclusion: Terminal care must be improved by making specific guidelines and it must become a part of nursing home evaluation.