• Journal of Hospice and Palliative Care
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• v.5 no.2
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• pp.136-145
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• 2002

Purpose : This study was designed to develop an instrument that could be used for comprehensive and effective need assessment for patients with cancer. Methods : In the first phase, a conceptual framework for the instrument was established by Wingate & Lackey (1989). In the second phase, the preliminary instrument was drawn up through a review of the literature and in consultation with three professors in Nursing. In the third phase validity and reliability of the preliminary instrument were tested as follows; 1) an expert validity test of the preliminary instrument was done by nine head nurses and charge nurses who had over ten years experience caring for patients with cancer at Wonju Christian Hospital. 2) A construct validity test and reliability test was done for the instrument by 116 staff nurses selected by convience sampling from hospitals located in Kang-Won, Kyoung-Ki, and Choong-Chung Provinces. The collected data were analyzed using SPSS 10.0 WIN program. For the factors of the instrument, factor analysis was used. The reliability of the scale was analyzed by Cronbach's alpha. Results : The results of the experts' test of validity, showed that, of 32 items, only one item had less than 55.4%. It was then deleted and a total of 31 items was selected. On the basis of the results of the factor analysis, the following six components were identified: physiological, informational, spiritual, and emotional needs, available resources, and legal/financial needs. These factors explained 61.8% of the variance. In the factor analysis, the first factor (physiological needs) and the second factor (informational needs) explained 25.4% and 10.9% of the variance respectively, which were major factors for the needs of patients with cancer in Korea. Cronbach' alpha for the scale was .90 indicating internal reliability. Conclusion : This instrument can be effectively utilized for assessment of needs of patients with cancer in Korea. Use of the needs assessment instrument developed in this study will allow nurses to develop nursing interventions that provide comprehensiveness and continuity in meeting the needs of patients with cancer.

• Journal of Hospice and Palliative Care
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• v.18 no.2
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• pp.128-135
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• 2015

Purpose: As the National Health Insurance Service (NHIS) began to cover home oxygen therapy (HOT) services from 2006, it is expected that the new services have contributed to overall positive outcome of patients with chronic obstructive pulmonary disease (COPD). We examined whether the usage of HOT has helped slow down the progression of COPD. Methods: We examined hospital claim data (N=10,798) of COPD inpatients who were treated in 2007~2012. We performed ${\chi}^2$ tests to analyze the differences in the changes to respiratory impairment grades. Multiple logistic regression analysis was used to identify factors that are associated with the use of HOT. Finally, a generalized linear mixed model was used to examine association between the HOT treatment and changes to respiratory impairment grades. Results: A total of 2,490 patients had grade 1 respiratory impairment, and patients with grades 2 or 3 totaled 8,308. The OR for use of HOT was lower in grade 3 patients than others (OR: 0.33, 95% CI: 0.30~0.37). The maintenance/mitigation in all grades, those who used HOT had a higher OR than non-users (OR: 1.41, 95% CI: 1.23~1.61). Conclusion: HOT was effective in maintaining or mitigating the respiratory impairment in COPD patients.

• Journal of Hospice and Palliative Care
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• v.18 no.2
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• pp.105-111
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• 2015

Purpose: Fatigue, energy loss, feeling of helplessness, poor appetite, pain besides general weakness are major symptoms presented to terminally ill cancer patients. These symptoms are similar to those that appeared with adrenal insufficiency. Also, for terminally ill cancer patients who are hospitalized for palliative care, opioid agents are prescribed to control moderate to severe pain. We studied the relationship of opioid agents and adrenal insufficiency. Methods: From November 2013 through June 2014, we monitored the serum level of cortisol and dehydroepiandrosterone sulfate (DHEAS, serum) in 55 cancer patients who were over 18 years old and were treated at a hospice center. We also checked the treatment period and dosage of opioid agents. Results: The DHEAS level, treatment period and dosage of opioid agents did not have significant correlation. Correlation between the serum cortisol level and the opioid agent treatment period was not significant either, but the serum cortisol level was positively correlated with the dosage of opioid agents (P value 0.0322). Conclusion: This study did not identify a novel link between treatment period, dosage of opioid agents and adrenal insufficiency. But, the DHEAS level was mostly below the normal level in patients who were treated with opioid agents.

• Journal of Hospice and Palliative Care
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• v.14 no.1
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• pp.8-19
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• 2011

Purpose: This study identifies research trends and provides fundamental data related to curative power of aromatherapy to relieve pain in Korea. Methods: The study analyzed 44 experimental studies on humans that were published in Korea before the end of December, 2009. The key words used for searching were: aroma, aromatherapy, hyang-yobeob, hyanggi-yobeob, hyanggichilyo, aromatherapy and pain, headache, scapulodynia, omodynia, feeling uncomfortable in the perineal region, sense of pain, labor pains, arm pain, menstrual pain, aches, and dysmenorrheal. Those words were found on websites, including those for Korea Education & Research Information Service, the National Assembly Library, KISS, KoreaMed, and NDSL. Collected data were analyzed using descriptive statistics. Results: The results showed that most of essential oils to relieve pain is composed of three to four kinds of oils, including Lavender, Roman chamomile, Rosemary, and Clarysage. Aromatherapy is applied usually by means of massage (50%), inhalation (13.6%), or a combination of the above two (13.6%). Measuring instruments as a dependent variable include VAS, questionnaire, GRS, blood pressure, pulse, and Algometer. Aromatherapy plays an important role in soothing headaches and arthralgia. However, when it comes to labor and menstrual pain, it doesn't seem to be effective. Conclusion: The study found that different kinds of oil, frequencies, and periods of time are used for the same symptoms. Further research should employ standardized oil blending, application, duration, and measuring instruments, and more systematically analyze the effects of aromatherapy to establish the effects on relieving pain.

• Journal of Hospice and Palliative Care
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• v.13 no.2
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• pp.98-108
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• 2010

Purpose: The purpose of this study was to identify the relationship between fatigue and quality of life (QOL) of Korean cancer inpatients. Methods: The data were collected from May to August 2007. Study subjects were recruited at D, Y and A university hospitals in Daegu and Kyungpook, Korea. The research instruments utilized in this study were fatigue (FACT-F) and quality of life (FACT-G) in Korean version 4. Data were analyzed with descriptive statistics, t-test, ANOVA, and Pearson correlation using SPSS Win 12.0 program. Results: Fatigue of subjects showed a significant difference according to the type of treatment, change in weight, performance status, exercise, and sleep. The QOL of subjects showed a significant difference according to the purpose of treatment, change in weight, performance status, exercise, and sleep. The mean score of fatigue was 22.48 and the mean score of QOL was 55.52. The fatigue was negatively related to QOL, physical well-being, emotional well-being, and functional well-being. Conclusion: The results suggest the needs for intervention in order to reduce fatigue and to improve QOL of cancer inpatients.

• Journal of Hospice and Palliative Care
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• v.17 no.4
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• pp.216-222
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• 2014

Purpose: This study was performed to identify the symptoms and care needs of home-based cancer patients in Korea and to add to the scarce literature on this topic. Methods: Data were collected from patients who subscribed to home-based cancer care services in Jinju. Assessments were performed by nurses at the local public health center. The Edmonton Symptom Assessment System with a numeric rating scale (NRS) was used to identify symptoms, and a four-point Likert scale was used to assess psychological, social, and spiritual needs. Results: Cross-sectional data were collected in October 2013. A total of 209 patients participated and their median age was 65 years (range, 17~89 years). Most patients were diagnosed in the early stage of cancer (n=188); only 19 patients were diagnosed in the advanced stage. More than half the patients lived alone (n=115, 55.0%) and took care of themselves (n=128, 61.2%). Anorexia and fatigue were the most common symptoms (median NRS, 5 and 4, respectively). Patients needed economic support the most, whereas spiritual care was least needed (n=138 [67.3%] vs. n=128 [62.1%], respectively). Conclusion: Patients who signed up for home-based cancer care services in Jinju are struggling with a financial issue and physical symptoms. A customized approach is needed to improve the quality of the home-based care services.

• Journal of Hospice and Palliative Care
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• v.9 no.1
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• pp.11-16
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• 2006

Purpose: This study is aimed to confirm nurse's attitudes and to investigate the factor analysis on organ donation in brain dead donors. Methods: This survey were collected from 198 nurses in three university hospitals and four general hospitals in B city with questionnaires developed by the author. The consent for this research was obtained from nursing managers, head nurses, and staff nurses after explaining the purpose of this research. Results: In questionnaires, 45 items about attitudes were included and positive and negative attitude were analyzed. The contents of factors are 'legal permission of brain death', 'one's will of organ donation at the brain death', 'need for educational program about brain dead during college curriculum', 'organ donation is good presents for others', 'connection with professional institutes', 'necessity of brain death', 'convenient to control of brain death' and 'the goods for organ transplantation in brain dead donors' as positive attitudes. Meanwhile, 'contrast to certain religion and dignity to life', 'negative dangers on brain dead permission', 'unbelief to the medical teams', 'burdens to ask organ donation to brain deads/families' and 'economical compensation' are factors as negative attitudes about organ donation in brain dead. The total mean point score of positive attitudes about organ donation in brain dead donors was $3.753{\pm}3.398$. The total mean point score of negative attitudes about organ donation in brain dead donors was $2.915{\pm}0.472$. Conclusion: The results of this study may be of help for the nurses who concern organ sharing and make effective interventions and educations to facilitate the decision making process for organ donation in brain dead donors or families.

• Journal of Hospice and Palliative Care
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• v.19 no.2
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• pp.170-179
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• 2016

Purpose: This study examined self-efficacy, self-care behavior, posttraumatic growth, and quality of life in cancer patients and their levels by disease characteristics groups to identify patient groups that require psychosocial intervention. Methods: We surveyed 107 patients using a structured questionnaire about the four factors and analyzed the factors by stratifying the patients by the period after the cancer diagnosis, by stage and by current treatment status. Results: The mean score for self-efficacy was 37.78, and that for self-care behavior 49.96. Patients who were diagnosed less than one year ago scored higher on medication, a sub-category of self-care behavior, than the post-diagnosis period of 1~2 year group. The score was higher in the currently-treated group than the follow-up and distant metastasis groups. For posttraumatic growth, the mean was 56.17, and the factor was higher in the 1~2 year post-diagnosis group after than the less than one year group. The score was higher in the follow-up group than the currently-treated group. With regard to quality of life, the mean score was 25.79, and no significant correlation was found with disease characteristics. Conclusion: A shorter post-diagnosis period increased self-care behavior, and the greatest posttraumatic growth was reported by the 1~2 year post-diagnosis group. It may be necessary to provide cancer patients with an education program and other strategies less than one year after the diagnosis to improve self-efficacy and self-care behavior. To promote post-traumatic growth, it may be helpful to provide patients with psychosocial intervention within two years after the diagnosis.

• Journal of Hospice and Palliative Care
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• v.19 no.2
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• pp.119-126
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• 2016

Purpose: This study analyzed the difference in survival time of patients with delirium according to sedative medication. Methods: From January 2012 through December 2013, a retrospective cohort study was performed using the electronic medical records (EMR) of Pusan National University Hospital. Among 900 patients who died from cancer, we selected 240 who suffered delirium based on the EMR. The Nu-DESC delirium screening test was used to diagnose delirium. Results: The median length of delirium period was five days. Delirium characteristics were dominated by inappropriate behaviors (35.0%). Sedatives were administered in 72.1% of the cases. The most frequently used sedative was haloperidol which was used in 59.6% of cases. The delirium period significantly differed by patients' age (F=3.96, P=0.021), cancer type (F=3.31, P=0.010), chemotherapy (t=-3.44 P=0.001). The average survival time was 16.85 days for the sedative medication group and 9.37 days for the non-medication group, which, however, was not significant (t=1.766, P=0.079). Conclusion: In this study, the use of sedatives did not affect patients' survival time. Thus, appropriate sedative medication can be positively recommended to comfort terminal cancer patients and their families.

• Journal of Hospice and Palliative Care
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• v.10 no.4
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• pp.195-201
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• 2007

Purpose: As a part of the analysis of home-based cancer patients management of public health renters in cities, counties and districts across the nation, this study is to understand the degree of patient demands for that management and the degree and scope of the supply for the patient's demand. Methods: Developed the questionnaire which was constituted of degree of demand and supply for home-based cancer patient management and analyzed data centering on the frequencies and percentages by utilizing SPSS WIN 12.0. Results: The services provided through the home-based cancer patients management project include physical, emotional, spiritual and education/informative services. A survey was conducted for home-based cancer patients about these services, and its result showed that the degree of demand and supply was highest for emotional service, followed by education/informative service, spiritual service and physical service in the order of the demand-supply degree. When main items for each service were examined, it was found that: in the case of physical service, pain control was provided murk lower than its demand, while excretion disorder control and individual hygiene is provided murk more than its demand. In the case of emotional service, the degree of demand was overall higher than that of supply; spiritual service was provided appropriately to the degree of demand. Conclusion: This study examines the home-based canter patients management project of public health centers and compares and analyzes the degree of demand for patient services and the degree of services that are actually provided. The findings could be used as based data for the development of effective programs in future on the basis of actual demands of home-based cancer patients.