• Journal of Hospice and Palliative Care
• /
• v.15 no.1
• /
• pp.18-29
• /
• 2012

Purpose: We analyzed how clinical nurses in Korea perceive terminally ill patients' medical decision-making. Methods: The Q-methodology which analyzes the subjectivity of each item was used. We selected 34 Q-statements among those provided by each of 37 subjects and grouped them into a shape of normal distribution using a 9 point scale. The collected data were analyzed using a QUANL PC program. Results: Four types of perception toward medical decision-making were identified. Type I focuses on patient participation, and Type II emphasizes the role of health professionals. Type III is characterized by an open-minded culture toward death, and Type IV values the role of family members. Conclusion: The results of this study indicate the need for development of a multi-disciplinary curriculum medical decision-making and death for medical and nursing students.

• Journal of Hospice and Palliative Care
• /
• v.22 no.4
• /
• pp.174-184
• /
• 2019

Purpose: The aim of this study was to analyze the current status of end-of-life (EoL) care education of the undergraduate nursing curriculum and senior students' EoL care experience and competency. Methods: A survey was conducted with 41 nursing schools and 622 senior nursing students on June 2018. The questionnaire consisted of 38 items on teaching regarding EoL care and 17 items on EoL care competencies based on the suggestions made by the American Nurses Association. Results: Only 20% among 41 nursing schools opened an EoL care course as an elective, and the course was taken by 5.1% students. Of 622 students, 70.7% witnessed death of patients during their clinical training, but 74.8% received no or little education on EoL care from their clinical training instructors. Two of 38 education contents on EoL care were taught in class for over 80% of the students. All students scored below 3 points (2.31±0.66) for all 17 competencies, which means that they cannot perform EoL care. Conclusion: This study showed that there was a serious deficiency in undergraduate nursing education on EoL care. Accordingly, most nursing students who would graduate soon considered themselves incapable of performing EoL care. Nurses experience death and dying as a part of their practice and should be prepared to provide adequate EoL care. Therefore, it is urgent to improve EoL care training in the undergraduate nursing education.

• Journal of Hospice and Palliative Care
• /
• v.12 no.2
• /
• pp.61-71
• /
• 2009

Purpose: The purpose of this study was to develop a CD program of applied logotherapy for psycho spiritual care of late adolescents with terminal cancer. Methods: Keller & Song's ARCS theory and a model for developing learning materials was applied to develop this program composed four distinct phases: planning, designing, developing, and evaluation stages. Results: This program was entitled 'Finding meaning in my life' and consisted of 5 sessions and its educational contents were made up as follows: "First Secret" is 'learning three natures of the human mind', "Second Secret" is 'learning creative values first method to find meaning of life', "Third Secret" is 'learning experiential value as second method to find meaning of life', "Fourth Secret" is 'learning attitudinal value as third method to find meaning of life', and "Fifth Secret" is 'Becoming the master of my life'. The sub-menu was made up of 'Beginning', 'Opening mind', 'Learning'. 'Laughing Song', 'Experiencing'. Conclusion: This CD program applied logotherapy with flash animation technique as an emotional and spiritual nursing intervention program for easier and more scientific application in pediatric oncology and hospice care area.

• Journal of Hospice and Palliative Care
• /
• v.12 no.4
• /
• pp.199-208
• /
• 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
• /
• v.18 no.3
• /
• pp.196-207
• /
• 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
• /
• v.18 no.3
• /
• pp.208-218
• /
• 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
• /
• v.14 no.1
• /
• pp.20-27
• /
• 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
• /
• v.22 no.2
• /
• pp.87-99
• /
• 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
• /
• v.19 no.1
• /
• pp.11-25
• /
• 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
• /
• v.18 no.3
• /
• pp.188-195
• /
• 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.