Purpose : To evaluate the present status of bereavement care in Korean hospice service as a basic database for the effective bereavement care. Method : The data were collected two sets from September to October, 1999 and from November to December, 2000, 55 hospice institutions identified by the Hospice Education Institution, College of Nursing, Catholic University were contacted for a telephone survey. The researchers conducted telephone interviews with hospice administrators for 10 to 30 minutes. Result : 1) Among the 55 Korean Hospice institutions, 38 institutions(69.1%) provided bereavement services. 2) The contents of bereavement services consisted of telephone call 28 institutions(74.5%), bereaved family meeting 26 institutions(69.4%), home visiting 22 institutions(57.9%), mail 16 institutions(42.1%), personal counselling 7 institutions(18.4%). 3) The 26 hospice institutions(68.4%) which provided meetings for bereaved families met with the following frequency : Annually is 11 institutions(42.3%), biannually 6 institutions(23.1%), monthly 6 institutions(23.1%) and bimonthly 3 institutions(11.5%). 4) Only 4 hospice institutions(10.5%) used the assessment tool to screen for high risk of bereaved. 5) The major difficulties of current bereavement services were low attendance for the bereaved family meeting, shortage of professional managers and volunteers, limited accessibility to hospice institutions, little social awareness for the bereaved, and financial difficulties. 6) The hospice administrators expressed the need for the development of bereavement program, the education program for the bereavement services, trained professionals, the sufficient provision of human resource and financial support for more effective bereavement services. Conclusion : Although many hospice institutions(69.1%) provided bereavement services, they generally lacked capable bereavement professionals and various individualized bereavement services. In conclusion, it is required to develop the specified bereavement program and the training program for the staff and volunteers, so as to provide customized bereavement services based on individual needs. Further research will be necessary to evaluate the effects of customized bereavement services in Korea before applying to practice.
Kim, Young-Soon;Lee, Chang-Geol;Lee, Kyoung-Ok;Kim, Ok-Kyum;Kim, In-Hye;Kim, Mi-Jeong;Hwang, Ae-Ran;Lee, Won-Hee
Journal of Hospice and Palliative Care
/
v.7
no.2
/
pp.200-213
/
2004
Purpose: The purpose of this study was to create an electronic nursing record form to build a hospice nursing process database to be used in the u-hospital EMR system. Specific aims of the study were: 1. To generate a complete, accurate, and simple electronic nursing record form. 2. To verify its appropriateness following documentation with the standardized hospice protocol. 3. To verify its validity and finalize the hospice nursing process database through discussion among hospice professionals. Methods: Nursing records from three independent hospice organizations were collected and analyzed by five expert hospice nurses with more than 10 years of experience, and a nursing record database was developed. This database was applied to 81 hospice patients at three hospice organizations to verify its completeness. Results: 1. An electronic nursing record form with completeness, accuracy, and simplicity was developed. 2. The completeness of the standardized home hospice service protocol was 95.86 percent. 3. The hospice nursing process database contains 18 items on health problems, 79 items on related causes and major symptoms, and 229 items on nursing interventions. Conclusion: The new nursing record form and database will reduce documentation time and articulate and streamline the working process among team members. They can also improve the quality of hospice services, and ultimately enable us to estimate hospice service costs.
Purpose: This preliminary study is aimed at developing standardized tools for psycho-social assessment of patients in needs for hospice/palliative care. To accomplish the purpose, investigators examined effects of perceptions of social workers on the importance of psycho-social domains of assessment in hospice/palliative care settings. Moreover, investigators paid attention to variances of perceptions of social workers' along with types of institution and credentials of those family settings. Methods: A form of questionnaire was first explored from an initial interview assessment of 10 government-certified hospice care providers and a literature review, second constructed with eight domains and 80 items, and sent by e-mail to 55 institutions and hospitals providing hospice/palliative cares in Korea. Lastly, a total of 31 agencies returned with a completed responses and consent form (56% response rate). SPSS program (version 18.0) was used for data analysis. Results: Study found that social workers perceived patients' family background (m=4.53, 5-point scale) as the most important assessment domain, whereas economic conditions (4.06 point) the least important. Social workers' perception varied by credentials (i.e., license types, training, full-time position, types of care facility). Conclusion: Based upon study findings, investigators can conclude strong needs for developing a assessment tool that measures multiple domains (i.e., psychological, social and ecological aspects) of patients. A standardized assessment tool should be structured with 2 axis (center/core and expanded/peripheral) and tailored for institution type. Second, professional trainings must be provided by strengthening legal institutionalization and fostering qualified social workers with full responsibilities of hospice and palliative care patients.
Purpose: The purpose of this study is to examine the level of understanding of hospice palliative care (HPC) and shared decision making (SDM) among middle-aged adults. Methods: Data were collected from 90 middle-aged adults living in D city using a self-reported questionnaire. The SPSS program was used to analyze the data. Results: Among the participants, 76.7% were aware of the HPC while 82.2% of the participants were not aware of SDM. Among all, 85.6% responded positively for needs of HPC, and 77.8% of participants for SDM. Participants with Christian faith (Protestants and Catholics), high income level and present illness were better aware of HPC than others. The most needed services were nursing care and treatment along with systematic counseling and explanation provided by the medical staff. There was also a significant relationship between the HPC factors, gender, income, current health status and current illness status. Participants with high income level were well aware of SDM. Stronger SDM needs were observed among participants with professional jobs or current illness. Conclusion: For continued discussion on HPC and SDM, it is necessary to implement and promote various education programs for medical staff and the public.
Purpose: The Hospice Oriented Medical Record (HOMR) was developed for assessing the pain and symptoms of terminal cancer patients. Methods and Results: The HOMR consists of an instruction for users and 2 assessment pages which include the graph showing vital signs (temperature, blood pressure, pulse, respiration rate and pain score), current problem lists, performance status, laboratory data, pain characteristics and management, sedation score, associated symptoms and drug side effects, etc. Pilot study was performed in the inpatient Hospice Care Unit in Guro Hospital, Korea University Medical Center. Because an one-week progress data was recorded in HOMR as a flow sheet, the patient's condition and pain control status could be seen at a glance. Conclusion: The HOMR is useful for assessing the terminal cancer patients because it is simple and convenient to use. Further research is needed before it can be universally used in the clinical settings.
The purpose of this study was to examine relationships among perception on hospice, self-esteem, knowledge on advance directives and attitudes toward advance directives and identify the factors that affect attitudes toward advance directives in nursing students. The data were collected from 216 nursing students in the two colleges located Jeonnam and December 03 2018 to December 07 2018. The data were analyzed by descriptive statistics, t-test, ANOVA, Scheffe, Pearson's correlation coefficient, and multiple regression with SPSS 20.0 program. The result of the multiple regression indicates the perception on hospice, gender, intention to execute advance directives and influence of religion on one's life predict 29.7% (F=12.566, P=.000) of attitudes toward advance directives. Therefore, it is necessary to develop a program to establish attitudes toward advance directives by providing professional education on perception on hospice of nursing students.
Purpose: This study was aimed at analyzing the characteristics and symptoms in home-based hospice-palliative care (HBHPC) patients registered at local public health centers. Methods: A retrospective study was performed; Data of 144 HBHPC patients registered at six public health centers in Pusan City were analyzed, including their initial visit records (registration cards, initial pain evaluation and symptom evaluation). Results: The average age of the patients was 67.7 years old. Among all, 46.2% of the patient lived alone, and 65% had middle school education or lower. The most popular (36.3%) religion was Buddhism, and 47.5% received medical assistance from the government. The most frequent diagnosis was lung cancer followed by stomach cancer and liver cancer in that order. Of all, 48.9% were functionally too weak to lead a daily life, 39.6% were under cancer treatment when registered at the public health center, and 84.5% were aware of the fact that they have reached the terminal phase. Moreover, 83.6% complained about pain, and the pain level was moderate or severe in 36.5% of them. Besides pain, fatigue was the most complained symptom (84.7%), and 49.3% of them rated their fatigue as moderate or severe. Conclusion: Most of the HBHPC patients were socio-economically underprivileged and complained about moderate or worse pain and symptoms. Therefore, it appears necessary to develop an integrated strategy that is tailored for each patient reflecting their characteristics.
Purpose: From August 2017, hospice-palliative care (HPC) will be provided to patients with acquired immunodeficiency syndrome (AIDS), chronic obstructive pulmonary disease (COPD), and liver cirrhosis in Korea. To contribute to building a non-cancer (NC) hospice-palliative care model, NC specialists were interviewed regarding the goals, details, and provision methods of the model. Methods: Four physicians specializing in HPC of cancer patients formulated a semi-structured interview with questions extracted from literature review of 85 articles on NC HPC. Eleven NC disease specialists were interviewed, and their answers were analyzed according to the qualitative content analysis process. Results: The interviewees said as follows: It is difficult to define end-stage NC patients. HPC for cancer patients and that for NC patients share similar goals and content. However, emphasis should be placed on alleviating other physical symptoms and emotional care rather than pain control. Timing of the care provision should be when patients are diagnosed as "end stage". Special issues should be considered for each NC disease (e.g., use of anti-retroviral drugs for AIDS patients, oxygen supply for COPD patients suffering from dyspnea, liver transplantation for patients with liver cirrhosis) and education should be provided to healthcare professionals. NC patients tend to negatively perceive HPC, and the government's financial assistance is insufficient. Conclusion: It is necessary to define end-stage NC patients through in-depth discussion to minimize issues that will likely accompany the expansion of care recipients. This requires cooperation between medical staff caring for NC patients and HPC givers for cancer patients.
Purpose: Regardless of treatment, brain metastases are associated with a poor prognosis. We aimed to investigate the clinical characteristics of cancer patients with brain mestastases they after admission into a hospice unit and knowing they have received appropriate hospice and palliative care. Methods: We retrospectively reviewed the medical records in 40 cancer patients with brain metastases they after admission into a hospice unit from March in 2003 to March in 2005. Results: There were 20 males (50%) and 20 females (50%), and the median age of the patients was 64 years. The most common cause of brain metastases was lung cancer (22 patients, 55%), followed by stomach cancer (5, 13%) and breast cancer (3, 8%). Sixteen patients (40%) have never been teated and 20 patient have received the chemotherapy for the primary cancer. The most common symptom of cancer patients with brain metastases is headache (12 patients, 30%), followed by mental change (10, 25%), focal weakness (9, 23%) and convulsion (4, 10%). The most prevalent cause for admission was mental change (13 patients, 33%), followed by pain (9 patients, 23%). The reasons for hospice and palliative care were through recommendation of physician (1 patient, 3%), patient and family self (14, 35%) and the others (25, 62%). Twenty five of the others has been referred to hospice and palliative care during conservative management after referral and enrolled at hospice unit. The median hospitalization was 19 days and median survival in hospice and palliative care was 41 days. The median survival was 87 days from the day when the cancer patients have been diagnosed as brain metastases to death. Conclusion: The duration of hospice and palliative care was not enough to care the cancer patients with brain metastases. We suggest physicians, patients and family need the education and promotion for effective hospice and palliative care.
Purpose: The purpose of this study was to survey the knowledge and needs of hospice for inpatients' family. Methods: This study was carried out with 277 inpatients' families at J General Hospital located in J city, Korea during the period from March to May, 2004. The data were collected through a self-reporting questionnaire constructed by the authors. The data were analyzed by descriptive statistics and $x^2-test$ with SPSSWIN 10.0. Results: 83.8% of the respondents heard about hospice mostly through mass communication. 76.9% of the respondents recognized hospice to be helpful and to provide comfort during the remainder of life and to confront the moment of death. Most of the respondents responded positively to the necessity of hospice service, and would receive hospice if necessary. 76.5% of them would consider arranging preparation for death if he/she were to be diagnosed with a terminal illness. 63.9% of the respondents wanted only to be with their family members, 31.4% wanted both the family and hospice members at the moment of death. They named the best helper among the hospice members to be the nurse. 81.6% of the respondents wanted a hospice institution to be established, 23.8% of them report that the most adequate hospice management institution would be the hospice ward in hospital. Conclusion: Consequently, most respondents wanted hospice services. So Korean society is in need of developing adequate teaching and care programs for hospice according to local needs.
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