• Journal of Hospice and Palliative Care
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• 제10권1호
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• pp.35-42
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• 2007

Purpose: Colorectal ranter is the 4th leading cause of cancer death in Korea and the prevalence is increasing continuously. This study was aimed to figure out the problems through the clinical consideration about terminal colorectal ranter patients who had died in hospice unit. Methods: We retrospectively reviewed the medical records in 78 patients with colorectal ranter who had admitted, received palliative care, and died in a hospice unit between April 2003 and November 2006. Results: The median age of patients was 59.6 years with 45 men (58%) and 24 women (42%). The median survival in hospice and palliative care was 36 days. The median hospitalization was 22 days. The most prevalent reason for admission was pain (38 patients, 49%), and the most common symptom was also pain (70 patients, 90%). Forty eight patients (62%) took analgesics before hospice referral. Twenty seven patients (65%) of 45 patients with intestinal obstruction have been performed palliative procedures. Median survival of patients with palliative procedure was higher than that of no palliative procedure group (47 days vs 19 days, P-value=0.005). Conclusion: The duration of hospice and palliative care was not enough to care the terminal colorectal cancer. Therefore, we suggest that proper education and information should be provided to physician, patients and their family members for effective hospice and palliative care.

• Journal of Hospice and Palliative Care
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• 제19권1호
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• pp.45-60
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• 2016

Purpose: This study is aimed at understanding the volunteers' experiences and interactions with their corresponding teams during their participation in hospice care. More specifically, the study is to contribute policy-wise to development of hospice care in Korea by helping policy-makers and organizers and managers of hospice care provides better understand the importance of the meaning and roles of volunteers in hospice care. Methods: In-depth interviews and participant observation were performed with study participants who were selected from four different types of hospice agencies. Study analysis was conducted using "case study" as one of the rigorous qualitative research methods to develop "inter-" and "intra-" comparisons among the study participants. Results: Volunteers in hospice care were initially motivated by religion and faith, and the motivation grew stronger through the volunteer experiences. They emphasized that the essence of the hospice volunteering was motivation from religion and faith and something they do for themselves. They characterized their experience as a true service that is offered for free and a job that requires expertise. In addition, they achieved personal (internal) growth by reflecting on the meaning of "good death" and better understood the importance of respecting spiritual diversity. Conclusions: This study could help hospice officials offers better understand hospice volunteers' role and their importance. The study also provide practical implications and policy suggestions.

• Journal of Hospice and Palliative Care
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• 제21권3호
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• pp.92-103
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• 2018

Purpose: This descriptive study was conducted to examine factors that affect hospital workers in their decision to withdraw from life-sustaining treatment, such as knowledge, attitude, and perception of organ donation, transplantation, death and hospice palliative care. Methods: A questionnaire was completed by 228 workers of a tertiary general hospital, and data were analyzed using t-test, ANOVA, and Pearson's correlation by using SPSS 21.0. Results: The subjects' knowledge of biomedical ethics awareness differed by age, education level, occupation, affiliated department, and biomedical ethics education. Their knowledge of brain death, organ donation and transplantation was positively correlated with attitudes toward tissue donation and transplantation, knowledge of hospice palliative care, and perception of hospice palliative care. Their attitudes toward tissue donation and transplantation were significantly correlated with knowledge of hospice palliative care, perception of hospice palliative care, and withdrawal of life-sustaining treatment. Their awareness of death was significantly correlated with knowledge of hospice palliative care, perception of hospice palliative care and withdrawal of life-sustaining treatment. The perception of hospice palliative care was significantly correlated with withdrawal of life-sustaining treatment. Factors associated with their withdrawal of life-sustaining treatment were work at the hospice ward (32.5%), attitudes toward tissue donation and transplantation and perception of hospice palliative care. Conclusion: This study has shown that work at the hospice ward, attitudes toward tissue donation and transplantation and perception of hospice palliative care were related to attitudes toward withdrawal of life-sustaining treatment. More research is needed to further develop various curriculums based on biomedical methods.

• Journal of Hospice and Palliative Care
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• 제19권2호
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• pp.145-153
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• 2016

Purpose: This study was conducted to investigate patients' characteristics and actual conditions of home-based services offered by a free-standing hospice center. Methods: A retrospective review was performed with the medical records of 75 patients who received home-based hospice care from a free-standing hospice center from January 2014 through December 2014. Results: Most patients (54.7%) were enrolled via self-directed referral. The reason for the service termination was death at home 25.3%, admission to a hospice ward 50.7%, hospitalization 22.6% and patients' refusal 2.7%. Seventy three patients had cancer, and two patients had ALS. Among all, 58.7% were in a dying phase, and 34.7% were almost completely bedfast at the time of their enrollment in this study. When they enrolled, the patients' physical symptoms were characterized as pain (89.4%), sleep disturbance (71.2%), urinary difficulties (35.8%) and defecation difficulties (47.8%). Among all, 77.4% terminated the home visit service within one month. The mean frequency of the home visits was 3.25 (${\pm}3.98$), and less than five in 82.7% of patients. The mean frequency of the phone service was 3.40 (${\pm}3.12$). The frequency of doctor's home visits was $1.21{\pm}0.79$ on average, and the figure increased when patients' conditions turned unstable. Conclusion: It is necessary to develop a home-based hospice care model with consideration of patients' characteristics and the actual service conditions delivered by free-standing hospice facilities.

• Journal of Hospice and Palliative Care
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• 제8권2호
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• pp.131-142
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• 2005

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.

• Journal of Hospice and Palliative Care
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• 제10권2호
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• pp.74-77
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• 2007

Purpose: We evaluated how many patients received radiotherapy and how many those of them could not complete radiation therapy in Hospice Ward. Methods: We retrospectively reviewed the general characteristics in 33 patients who began to receive palliative radiation therapy, and radiation dose and reasons of not-completing radiation therapy in Hospice Ward of St. Vincent's Hospital. Results: Thirty three (8.2%) among 404 patients who had been admitted from November 2003 and October 2005 received palliative radiation therapy. The main indications of radiation therapy included brain metastasis, painful bone metastasis, painful tumor mass, and obstructive shortness of breath. Forty five percent of these patients could not complete. And 20% could receive less than 1/3 of planned radiation dose. They failed to complete the treatment often due to poor general rendition. Conclusion: Although palliative radiation therapy had been used frequently for patients with advanced cancer in Hospice Ward of St. Vincent's Hospital, but it was often not completed. With appropriate selection criteria of patients and shorter modification of radiation treatment period, more patients would be benefited with palliative radiation therapy in Hospice Ward.

• Journal of Hospice and Palliative Care
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• 제17권3호
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• pp.170-178
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• 2014

Purpose: Delirium is a common and serious neuropsychiatric complication among terminally ill cancer patients. We investigated risk factors related to the development of delirium among hospice care patients. Methods: Between May 2011 and September 2012, we included patients who were mentally alert and had no psychiatric disease or drug addiction at the hospice ward of two local hospitals. Among them, participants who had been diagnosed with delirium by two doctors according to the DSM-IV (Diagnostic and Statistical Manual of Mental Disorders-4th edition) criteria were grouped as Delirium Group. We analyzed results of psychometric and other laboratory tests performed at the time of patient's admission - psychometric tests included cognitive function (mini-mental status examination, MMSE), depression (Beck Depression Inventory, BDI), anxiety, and insomnia (Insomnia Severity Index, ISI). Logistic regression analysis was used to compare delirium and the related factors. Cox's proportional hazard model was performed using significant factors of logistic regression analysis. Results: Of the 96 patients who met the inclusion criteria, 41 (42.7%) developed delirium. According to the logistic regression analysis, primary cancer site, cognitive impairment (MMSE < 24), depression ($BDI{\geq}16$), and insomnia ($ISI{\geq}15$) were significant factors related to delirium. Among the four factors, depression (OR 5.130; 95% CI, 2.009~13.097) and cognitive impairment (OR 5.130; 95% CI, 2.009~13.097) were found significant using Cox's proportional hazard model. Conclusion: The development of delirium was significantly related to depression and cognitive impairment among patients receiving hospice care. It is necessary to carefully monitor depression and cognitive function in hospice care.

• Journal of the Korea Academia-Industrial cooperation Society
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• 제12권10호
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• pp.4394-4402
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• 2011

The study was done to examine the effects of horticulture therapy on depression and stress in patient of hospice unit. The subjects of this study were hospice patient in D hospital in D city, thirty hospice patient were assigned to experimental group, thirty hospice patient were assigned to control group. Data were collected from April 29, 2009 to July 26, 2009. Horticulture therapy program consisted of indoor and outdoor horticultural activities. The horticulture therapy was conducted 30 minutes, 6 times a week for 3 weeks (a total 18 times). Measures were depression, and stress by serum cortisol count. Data were analyzed using descriptive statistics, chi-square test and t-test with SPSS/WIN 17.0 version. The results of this study was patients in the experimental group receiving Horticulture therapy had a significant difference in changes of depression between the experimental group and control group. The study results indicate that horticulture therapy is an effective, palliative intervention program to improve the depression and stress of hospice patients.

• Journal of Hospice and Palliative Care
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• 제12권3호
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• pp.122-131
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• 2009

This study was performed to identify the importance and performance of hospice volunteer's activities perceived by hospice volunteers. Methods: The subjects were 259 hospice volunteers from six hospitals in Daegu and Gyeongsangbukdo areas. A list of hospice volunteer's activities was developed by authors, based on literature, and interviews with the hospice volunteers were used to measure the perception on the importance and performance of their activities. Data were analyzed by using Descriptive statistics, t-test, One-way ANOVA with Scheffe test, and Pearson's product-moment correlation in SPSS Win 12.0. Results: The average of the importance of hospice volunteer's activities was 3.09 and the performance was 2.31, which was lower than the importance. There was a significant correlation between the importance and the performance (r=.487, P=.000). There were significant differences in total score of the importance, depending on religion, education, and period of hospice volunteer activity of subjects. There were significant differences in total score of the performance, depending on age, religion, and period of hospice volunteer activity of subjects. Conclusion: The importance of hospice volunteer's activities, perceived by hospice volunteers, was relatively high, however their performance didn't reach the level of the importance. Some characteristics of the volunteers influenced the perception of the importance and performance of the hospice volunteer's activities. The findings of this study are expected to provide useful information for the development of educational and management programs the hospice volunteers.

• Journal of Hospice and Palliative Care
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• 제7권2호
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• pp.153-168
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• 2004

Purpose: The purpose of tile study was to identify types of care needs of hospice patients and those from the family caregivers' perspective and to compare these two groups in reporting patients' care needs through Q-methodology. Methods: Twenty three Q-statements concerning care needs were selected through in-depth interviews of hospice patients. Data were collected from 20 hospice patients as well as 20 family caregivers respectively by sorting 23 Q-statements into 9 points standard. Data analysis was performed by using PC QUANL program. Results: Principal component analysis identified four types of care needs of the hospice patients. Overall, the accuracy of family caregiver reports was 48% in all types of care needs. Type 1 was named 'physical care needs type' for those whose greatest need was physical care to be free of pain and comfortable. The accuracy in Type 1 was 62.5%. Type 2 was named 'emotional care needs type' for those who would like to share love and intimacy with their family members. The accuracy in Type 2 was 20%. Type 3 was named 'spiritual care needs type' for those who would like to receive forgiveness from their God and prayers and visitation of clergy. The accuracy in Type 3 was 60%. Type 4 was named 'social care needs type' for those who would like to complete their ongoing work and to give service to others. The accuracy in Type 4 was 50%. Conclusion: There was a great difference between hospice patients and the family caregivers in reporting patients' care needs. Thus, hospice nurses need to educate family caregivers to more accurately assess patients' care needs.