• Journal of Hospice and Palliative Care
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• v.22 no.3
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• pp.125-133
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• 2019

Purpose: The purpose of this study was to investigate the relationship between end of life care competencies and terminal care stress of nurses in long term care hospitals. Methods: For this study, 140 nurses were sampled among those that have over 6-month end of life care experience and were working at long term care hospitals located in A city and C city of Chungcheongnam-do. Using a questionnaire, data were collected from January 2018 through March 2018. Data were analyzed using the SPSS, Windows version 21.0, according to the purpose of the study and analyzed by descriptive statistics, t-test, one way ANOVA, $Sch\acute{e}ffe^{\prime}s$ test, and Pearson's correlation coefficient. Results: The mean score on terminal care stress of nurses was above the normal level. The scores on end of life care competencies significantly varied by age, total career at hospitals, death/hospice and palliative care education, and bereavement experience. The mean score of end of life care competencies was negatively correlated with the mean score of lack of knowledge and skills among the subitems of the terminal care stress category (r=-0.260, P=0.002). Conclusion: To decrease the terminal care stress of long term care hospital nurses, it is suggested to carry out end of life care education tailored to nurses characteristics.

• Journal of Hospice and Palliative Care
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• v.16 no.2
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• pp.90-97
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• 2013

Purpose: Ten years have passed since the Korean government announced its plan to institutionally support hospice and palliative care in 2002. In line with that, this study aims to suggest future directions for Korea's hospice and palliative care policy. Methods: We conducted a survey on people's perception and acceptance of well-dying. Data were collected from 1,000 participants aged 19~69 years between June 1 and June 11, 2012 via computer-assisted telephone interviews. Results: The most important factor for well-dying was placing no burden of care on others (36.7%) and the second most important factor was staying with their family and loved ones (19.1%). Among nine suggestions of policy support for well-dying, the most popular was the promotion of voluntary care sharing (88.3%), followed by the palliative care training support for healthcare providers (83.7%) and the support for palliative care facilities instead of funeral halls (81.7%). The idea of formulating a five-year national plan for end-of-life care drew strong support (91%). According to the survey, the plan should be implemented by the central government (47.5%), the National Assembly (20.2%) or civic groups (10%). Conclusion: This study demonstrated the public consensus and their consistent direction toward policy support for well-dying. Results of this study may serve as a foundation for the establishment of policy support for people's well-dying and palliative care at the national-level.

• Journal of Hospice and Palliative Care
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• v.5 no.2
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• pp.125-135
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• 2002

Purpose : The purpose of this study was to investigate the impact of depression, discomfort, spirituality, physical care, and opioid use on pain with terminally ill cancer patients in the hospice units. Method : The convenient sample of this study consisted of 58 terminally ill cancer patients at three hospice units in university-affiliated hospitals. Patients were interviewed with structured questionnaires. The data was analyzed using ANOVA, Pearson correlation coefficient, and multivariate multiple regression. Result : The results of this study were as follows : 1) The mean age of the participants was approximately 57 years. Regarding diagnosis, stomach cancer showed the highest frequency (24.1%), followed by lung cancer (17.2%) and rectal cancer (13.8%). Regarding motivation for admission to the hospice unit, the majority of the participants indicated pain control (67.2%), followed by spiritual care (39.7%), and symptom relief (27.6%). 2) The mean pain level measured by VAS was 5.13 (${\pm}2.61$). Regarding pain type, the highest pain frequency the participants experienced was deep pain (53.4%), followed by multiple pain (20.7%), intestinal pain (17.3%), and neurogenic (5.2%) and superficial pain (3.4%). 3) Regarding the factors influencing pain, the pain level was significantly affected by the depression level (P<0.01) and the opioid use (P<0.01). Conclusion, In summary, the higher the level of pain the terminally ill cancer patents had the higher the depression level as well as the opioid use. Thus, health care professionals need to continuously provide holistic care for them to die comfortably.

• Journal of Hospice and Palliative Care
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• v.18 no.1
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• pp.42-50
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• 2015

Purpose: This study was aimed to analyze how social workers understand the rights for elderly patient and family caregiver to make end-of-life (EOL) care decisions and their roles the decision making process. Methods: The study employed a quantitative research method of collecting data from a structured questionnaire that was filled out by 334 social workers at long-term care facilities. Data were analyzed by descriptive statistics, mean differences, correlation between variables, using SPSS 20.0 program. Results: The mean score for the understanding the rights to an EOL care decision was $3.46{\pm}0.69$ and of their own roles $3.48{\pm}0.84$. The level of understanding significantly differed by social workers' experience of assisting a process to make an EOL care decision such as advance directives and life sustaining treatment, work experience, and the number of beds. Positive correlation was observed between the level of understanding of the rights for EOL care decisions and of social workers' roles (Pearson r=0.329, P<0.001). Conclusion: This study proposes development of an education program for social workers and devising standards for the EOL care decision making process to protect elderly patients, family caregivers as well as social workers in a long term care facility.

• Journal of Hospice and Palliative Care
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• v.4 no.1
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• pp.57-67
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• 2001

Purpose : The purpose of this study was to identify attitudes of hospice volunteers toward care of for terminally ill patients. Method : This was a descriptive study with a sample of 84 adults who were registered for a hospice volunteer education program at Severence Hospice Center. The Frommelt (FATCOD) scale on attitudes toward the care of the dying (Cronbach alpha=.778) and an open ended questions on "what if you only have 6 months to live" were used to collect the data. The data was analyzed using SPSS/W and content analysis. Results : 1) The hospice volunteers were mostly female, with an average age of 45 years, half of them were college graduates and their religious preference was Protestant. 2) The participants of this study demonstrated positive attitudes to care for the dying which is in coherence with hospice philosophy and principles. However they indicated difficulties in maintaining close relationships with people who are dying, and in communicating and sharing, and encouraging those who are dying to express their feelings. In the open ended questions, they identified that their most important issues would be guilt feelings toward their children, family concerns, and the burden of unfinished business in their lives. They also identified the fear of pain in the dying process and fear of the afterlife. The care they would like to receive was to have peace of mind, have a good listener, spiritual counselling, and pain relief and to be respected as a human being. The source of strength would be faith in God and they would like to overcome their of dying. The FATCOD scale has limitation in describing and identifying the need and attitude toward the care of the dying revisions were made. Conclusion : We all are the potential clients for the hospice rare. In a hospice volunteer education program, communication and interpersonal skill are essential. The fear of dying, afterlife, concerns about family with children, and human dignity are major concerns in hospice and palliative care.

• Journal of Hospice and Palliative Care
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• v.16 no.4
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• pp.253-263
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• 2013

Purpose: This study was conducted to analyze the association between spirituality and stress of mental health social workers, which could be used in development of a program to help them manage stress and offer spiritual support. Methods: Participants were 154 mental health social workers in Korea. Data were collected from November 1 through November 30, 2011. The study employed the Korean version of the Spirituality Scale and Psychosocial Well-being Index-Short Form (PWI-SF). Data were analyzed using SPSS/Windows 17.0. Results: The mean score for the Spirituality Scale was 3.63 and for PWI-SF 18.78. Spirituality scores showed a significant difference among participants by age, education, religion and marital status. Psychosocial stress scores also significantly differed by marital status. Spirituality scores were negatively correlated with psychosocial stress scores (r=-0.548, P<0.001). Conclusion: In this study, a significant negative association was found between spirituality and stress in mental health social workers in Korea. A follow-up study with a larger sample of participants is needed to confirm these findings.

• Journal of Hospice and Palliative Care
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• v.11 no.4
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• pp.175-180
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• 2008

진행된 암환자에서 피로는 70% 이상이 경험하게 되는 흔한 증상이며 삶의 질을 저하시키는 주된 요인이다. 피로에 대한 선별검사는 "피곤하거나 지친감이 있나요?"라는 단순한 질문으로 가능하며 이미 개발된 평가도구를 사용하여 평가할 수 있다. 동반 질환이나 피로의 원인을 알기 위한 병력청취와 검사실 검사가 필요할 수 있으며 결과에 따라 가역적 인자를 치료하는 과정이 우선되어야 한다. 적절한 약물치료를 시행하여 증상을 호전시킬 수 있으며 이중 methylphenidate는 암 연관 피로를 호전시키고 마약성 진통제에 의한 진정에 효과가 입증되었다. 환자의 여명에 따라 부신 피질 호르몬제도 사용할 수 있고, 운동 및 환자의 교육과 영양관리 또한 중요하다.

• Journal of Hospice and Palliative Care
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• v.11 no.2
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• pp.82-90
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• 2008

Purpose: The purpose of this study was to develop a CD program of applied logotherapy to improve the quality of life of older school-age children with terminal cancer. Methods: Keller's ARCS (Attention, Relevance, Confidence, Satisfaction) theory and a model for developing learning materials (Dick and Cray) were applied to develop this program which comprised four distinct phases: planning, developing, applying, and evaluation stages. Results: This program was entitled 'Finding treasures in my mind' and consisted of 5 sessions, and its educational contents were made up as follows: "Treasure One" is 'learning three natures of the human mind', "Treasure Two" is 'learning creative value as first method to find meaning of life', "Treasure Three" is 'learning experiential value as second method to find meaning of life', "Treasure Four" is 'learning attitudinal value as third method to find meaning of life', and "Treasure Five" is 'Becoming the master of my life'. The sub-menu was made up of 'Beginning', 'What is it?', 'Travelling'. 'Laughing Song', and 'End'. Conclusion: This CD program is an applied logotherapy with flash animation technique as an emotional and spiritual intervention program for easier and more scientific application in pediatric oncology and hospice area.

• Journal of Hospice and Palliative Care
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• v.15 no.4
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• pp.205-211
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• 2012

Purpose: This study was performed to identify the level of stress perceived by nurses who attend dying patients in the cancer care unit; their understanding regarding end-of-life care and related training needs. Methods: A cross-sectional descriptive study was conducted with 151 nurses stationed at the cancer care units of four general hospitals located in Seoul and Gyeonggi province in Korea. Data were collected using self-reported questionnaires and the response rate was 96%. The data were analyzed using t-test, ANOVA and Pearson's correlation analysis. SPSS 12.0 was used for data analysis. Results: Nurses experienced a high level of stress in the end-of-life care settings. Their understanding of end-of-life care was above the mid-point of the scale while their training needs for end-of-life care was relatively high. The more experienced the nurses were, the more stressed they were, particularly due to excessive workload. Nurses who served longer in the cancer unit tended to show greater needs for end-of-life care training. Conclusion: This study found nurses perform end-of-life care with a high level of stress but with insufficient understanding, and thus, showed great needs for related training. Such findings can be useful to develop an end-of-life care training program for nurses.

• Korean Medical Education Review
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• v.22 no.3
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• pp.146-152
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• 2020

Hospice and palliative care (HPC) education is an essential component of undergraduate medical education. Since February 4th, 2018, withholding and withdrawing life-sustaining treatment at the end of life (EOL) has been permitted in Korea as put forth by law, the "Act on Hospice and Palliative Care and Decisions on Life-Sustaining Treatment for Patients at the End of Life." Therefore, Korean medical schools have faced a challenge in providing comprehensive HPC education in order to better prepare medical students to be competent physicians in fulfilling their role in caring for patients at the EOL. There have been considerable variations in the evolution and organization of HPC education across Korean medical schools for the past 20 years. In 2016, all medical schools taught HPC curriculum as a separate course or integrated courses, with the most frequently taught topics including: delivering bad news, pain management, and the concept of palliative medicine. However, the content, time allocation, learning format, and clinical skills practice training of HPC education have been insufficient, inconsistent, and diverse. For this reason, we propose a HPC curriculum containing seven domains with 60 learning objectives in a course duration of over 20 hours based on the Palliative Education Assessment Tool (PEAT) as standard HPC curriculum. Furthermore, we recommend development of a national curriculum for HPC/EOL care education to be organized by the HPC board and managed under the accreditation criteria of the Korea Institute of Medical Education and Evaluation.