• Journal of Hospice and Palliative Care
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• v.12 no.4
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• pp.199-208
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• 2009

Purpose: The purpose of this study was to analyze the effect of death preparing education on death anxiety and meaning of life for volunteers. Methods: Data collection and intervention were carried out from January 11 to 25, 2009. The subjects included 60 volunteers in Jeonju city, and they were divided into two groups; 30 each of experimental group and control group. Death preparing education program contained 5 steps. Data were analyzed with t-test, $x^2$-test, and ANCOVA test with SPSS version 12.0. Results: The death anxiety scores in the experimental group were significantly lower than in the control group (F=4.01, P=0.046). The meaning of life scores in the experimental group were significantly higher than in the control group (F=6.32, P=0.015). Conclusion: The death preparing education program for volunteers was confirmed to be an effective intervention to lessen death anxiety and to improve the meaning of life. Therefore, I strongly recommend that this program should generously be applied to volunteers.

• Journal of Hospice and Palliative Care
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• v.18 no.3
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• pp.196-207
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• 2015

Purpose: We comprehensively analyzed domestic studies on the effects of death preparation education in order to present objective data. Methods: Meta-analysis was conducted with a total of 22 master's and doctoral theses published between 2004 and 2014. Results: According to our analysis, the death preparation education had a mid-size effect. The effect size of a moderator variable was the greatest in infants and children, and the effect size was bigger in younger ages. The effect size was the greatest when education was given through a total of 10~15 sessions, twice a week, and less than 60 minutes per session. The effect variable and death-related variable showed a significant effect size, and sub-variables were equivalent to the death-related variable with a biggest effect size. Non-death related variables had a mid-level effect size and sub-variables were found to have the highest ego integrity. Conclusion: The significance of this study lies its systematic integration of advanced research on the effects of death preparation education through meta-analysis. By suggesting guidelines for the design of a death preparation education program, evidence-based basic data were proposed which will more likely strengthen intervention effects. Based on these results, more studies are needed to develop and extensively carry out a death preparation program which can meet needs of specific age groups from children to seniors.

• Journal of Hospice and Palliative Care
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• v.18 no.3
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• pp.208-218
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• 2015

Purpose: Although a Do-Not-Resuscitate (DNR) order is widely in use, it is one of the challenging issues in end-of-life care. This study was conducted to investigate attitudes toward DNR according to education and clinical experience. Methods: Data were collected using a structured questionnaire comprising 30 items in a tertiary hospital in Seoul, Korea. Results: Participants were 238 nurses and 72 physicians. Most participants (99%) agreed to the necessity of DNR for reasons such as dignified death (52%), irreversible medical condition (23%) and patients' autonomy in decision making (19%). Among all, 33% participants had received education about DNR and 87% had DNR experience. According to participants' clinical DNR experience, their attitudes toward DNR significantly differed in terms of the necessity of DNR, timing of the DNR consent and post-DNR treatments including antibiotics. However, when participants were grouped by the level of DNR education, no significant difference was observed except in the timing of the DNR consent. Conclusion: This study suggests that the attitudes toward DNR were more affected by clinical experience of DNR rather than education. Therefore, DNR education programs should involve clinical settings.

• Journal of Hospice and Palliative Care
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• v.14 no.1
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• pp.20-27
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• 2011

Purpose: The purpose of this study was to investigate the effects of Death Education Program which had been provided to family caregivers of disabled individuals. A single group pretest-posttest design was employed for this study, which was conducted at a community rehabilitation center located in Ulsan, South Korea. Methods: Death Education Program was conducted for 16 family caregivers of disabled individuals who agreed to participate in this study. A 2.5-hour session was conducted once a week for 10 weeks. To investigate the effects of the education program, structured questionnaires, which assessed the patients and their family member's conceptions on the meaning of life, and their resilience, burden, and attitude towards death, were administered before and after the program. Results: The subjects' conception of the meaning of life and resilience did not significantly change. The median scores for the burden of family caregivers declined, while those for the subjects' attitude towards death increased, after attending the education program. Conclusion: The findings showed that Death Education Program has an affirmative effect on the burden of family caregivers of disabled individuals and their attitude towards death.

• Journal of Hospice and Palliative Care
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• v.22 no.2
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• pp.87-99
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• 2019

Purpose: This study aimed to identify the difficulties with end-of-life care (EOLC) experienced by intensive care unit (ICU) nurses and to investigate their educational needs for EOLC. Methods: Mixed methods were used to survey ICU nurses at a university hospital. Quantitative data (N=106) were collected through a questionnaire and analyzed using an independent samples t-test, ANOVA, Mann-Whitney U test and $Scheff{\acute{e}}$ test. Qualitative data (N=19) were collected through focus group interviews and analyzed through qualitative content analysis. Results: The mean score on the difficulty of EOLC was 3.41 out of 5. The education needs derived from the qualitative analysis was categorized into four themes: 1) guidelines on professional EOLC, 2) spiritual care, 3) a program to take care of feelings of patients, families and nurses, and 4) activities to think about death. Conclusion: This study confirmed that ICU nurses were experiencing an extreme difficulty in providing EOLC. In addition, a qualitative analysis confirmed that they needed an EOL nursing program. To mitigate the difficulties experienced by nurses involved in EOLC, there is an urgent need to develop an education program for EOLC tailored to nurses' needs.

• 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.7 no.1
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• pp.37-48
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• 2004

Purpose: Population using complementary and alternative medicine (CAM) and the cost or it are increasing all over the world. In this study, we investigated the utilization state of CAM in the elderly people during the last 6 months of life. Methods: We found 4,210 persons in Seoul, older than 65 years who received a funeral subsidy from health insurance after death during the latter half of the year, 2001. We stratified them by age and gender and selected 301 persons and surveyed them by questionnaire. Results: 247 persons (83.1%) used at least one of CAM during their last 6 months of life. Diet and Nutrition remedy showed the highest utilatization rate (65.5%), and drug therapies also were much used (29.9%). Utilization rate was higher in female (60%) and according to the cause of death, the highest in a geriatric disease groups, and the lowest in the cancer group. Whole satisfaction to CAM was high with average 4.25 points out of total 6, and adverse effects were almost free with average 5.55 points out of total 6. Satisfaction was the highest in Diet and Nutrition remedy but the lowest in Manipulative and Body-Based methods. Adverse-effect score was best in Manipulative and Body-Based methods. According to age and the causative disease of death, there were significant differences in satisfaction and adverse effect levels. Conclusion: Majority of old people used at least one of CAM during their last 6months of life. Whole satisfaction and adverse-effect level were very excellent.

• Journal of Hospice and Palliative Care
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• v.18 no.3
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• pp.188-195
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• 2015

Purpose: We examined the effects of a well-dying program on nursing students in terms of death preparation, death recognition and perception of well-dying perception. Methods: The design of this study was quasi-experimental and non-synchronized with a non-equivalent control group. The study was conducted with nursing students: 32 in the experimental group and 36 in the control group. The well-dying program was consisted of five sessions: introduction, thinking about meaning of death, organizing things to do before dying, looking back on my life, and leaving a trail of my life. Descriptive analysis, t-test, ${\chi}^2$ test and ANCOVA were used with SPSS 18.0 program to analyze the data. Results: After attending the program, a difference was observed in death preparation of the experimental group (t=2.61, P=0.014). The death recognition (F=154.15, P<0.001) score of the experimental group was significantly higher than the control group. There was no significant difference between the groups in perception of well-dying (F=0.11, P=0.747). Conclusions: The well-dying program helped nursing students build positive death recognition. Therefore, this study is expected to contribute to development of a death education program for nursing students.

• Journal of Hospice and Palliative Care
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• v.17 no.3
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• pp.142-150
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• 2014

Purpose: This study was to identify the attitude of Korean HIV (Human Immunodeficiency Virus)-positive men toward death. Methods: A Q-methodology was performed with 20 HIV-positive male individuals. Participants were asked to select and answer questions among a set of 40 Q-statements using a 9-point scale. The collected data were analyzed using the PC QUANL program. Results: Participants' attitudes toward death were categorized into four types. Type I was characterized by respect for life, type II by reality orientation, type III by pain evasion and type IV religious beliefs. Conclusion: It is necessary to develop an assessment tool and an intervention program for HIV-positive individuals.

• Journal of Hospice and Palliative Care
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• v.17 no.4
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• pp.278-288
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• 2014

Purpose: The purpose of this study is to analyze types of shared medical decision making by health professionals in a decision making position. Methods: The Q-methodology was used. Q sample was constructed with a total of 35 Q-statements that were offered with a 9-point rating scale. The statements were structured to generate answers that would form a shape of a normal distribution. Answers to Q sample were analyzed using a QUANL PC program. Results: Four types of shared medical decision making were identified. Type I is patient-centered decision making, Type II is physician-centered, Type III is health professional-centered and Type IV is patient-family-centered. Conclusion: Study results indicate that it is recommended to develop an education program based on the four types of shared medical decision making so that health professionals can be provided with different approaches according to their decision making style.