• Journal of Hospice and Palliative Care
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• v.7 no.1
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• pp.8-16
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• 2004

Purpose: The porpose of this descriptive study was grasp the QOL (Quality of Life) of cervix cancer patient and to analysis QOL (Quality of Life) by stage of disease, type of treatment and de me graphic characteristics Methods: Data were collected from 67 patients with cervical cancer from 3 General Hospitals from March 15 to June 4 using The "QOL (Quality of Life)-Cancer Version" inventory made by Ferrell et al (1995). The data were analysed by using SPSS $PC^+$ program including t-test, ANOVA, and Scheffe test. Results: Progressing stage of disease and QOL, the significant between the progressing stage of disease and QOL was significant (F=5.06, P=.003). The degree of difference between the progresstion of the stage of the disease and each item in the test was physical well-being (F=3.97 P=.012), the items of psychological well-being (F=3.91, P=.013), the items of social well-being (F=4.96, P=.004). It show a significant difference, but the item of spiritual well-being (F=1.36, P=.262) was not significant difference. The significance between the type of treatment and QOL was insignificant. The degree of difference between each area of life was the psychological well-being (t=-2.14, P=.037), the social well-being (t=-2.15, P=.036). But the physical well-being (t=-.93, P=.356), the spiritual well-being (t=.73, P=.469) was insignificant. Conclusion: As a result, The QOL of patients with cervical cancer is differentiated by the stage of disease, the type of treatment, and the demographic data. Therefore, there is a need to apply nursing intervention to patients with cervical cancer by considering the stage of disease, the type of treatment, and the demographic data.

• Journal of Hospice and Palliative Care
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• v.7 no.1
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• pp.37-48
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• 2004

Purpose: Population using complementary and alternative medicine (CAM) and the cost or it are increasing all over the world. In this study, we investigated the utilization state of CAM in the elderly people during the last 6 months of life. Methods: We found 4,210 persons in Seoul, older than 65 years who received a funeral subsidy from health insurance after death during the latter half of the year, 2001. We stratified them by age and gender and selected 301 persons and surveyed them by questionnaire. Results: 247 persons (83.1%) used at least one of CAM during their last 6 months of life. Diet and Nutrition remedy showed the highest utilatization rate (65.5%), and drug therapies also were much used (29.9%). Utilization rate was higher in female (60%) and according to the cause of death, the highest in a geriatric disease groups, and the lowest in the cancer group. Whole satisfaction to CAM was high with average 4.25 points out of total 6, and adverse effects were almost free with average 5.55 points out of total 6. Satisfaction was the highest in Diet and Nutrition remedy but the lowest in Manipulative and Body-Based methods. Adverse-effect score was best in Manipulative and Body-Based methods. According to age and the causative disease of death, there were significant differences in satisfaction and adverse effect levels. Conclusion: Majority of old people used at least one of CAM during their last 6months of life. Whole satisfaction and adverse-effect level were very excellent.

• Journal of Hospice and Palliative Care
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• v.19 no.1
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• pp.26-33
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• 2016

Purpose: This study was conducted to identify clinical characteristics of oncologic patients at a point when they signed their do-not-resuscitate (DNR) orders. Methods: From January through December 2014, we retrospectively analyzed the records of 197 patients who passed away after agreeing to a DNR order in the hemato-oncology department of a tertiary hospital. Results: Of all, 121 patients (61.4%) were male and 76 (38.6%) were female, and their average age was 58.7 years. Ninety-four patients (47.7%) had gastrointestinal cancer. The ECOG performance status at admission was grade 3 in 76 patients (36.5%) and grade 4 in 11 (5.6%). The patients' mean hospital stay was 20 days. The mean duration from the admission to DNR decision was 13 days, and the mean duration from DNR decision to death was seven days. Conclusion: Study results indicate that a decision on signing or refusing a DNR order was made by medical staff mostly based on the opinions of patients' guardians rather than the patients themselves. This suggests that patients' own wishes are not well respected. Thus, it is urgent to establish institutional devices to enhance cancer patients' autonomy regarding DNR and to define an adequate timing for withdrawal of treatments.

• Journal of Hospice and Palliative Care
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• v.16 no.3
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• pp.139-144
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• 2013

Advanced cancer patients tend to present multiple concurrent symptoms which are often moderate or severe in intensity. To date, the majority of studies have focused on either a single symptom, such as pain, fatigue, or depression or associated symptoms. While this approach has advanced understanding of some symptoms, it has offered clinicians not much guidance for treating several multiple concurrent symptoms in cancer patients. So in recent years, a few symptom management studies attempted a new approach of focusing on symptom clusters instead of individual symptoms. A symptom cluster is defined as two or more concurrent symptoms that are related to each other. If we better understand symptom clusters, interrelations of symptoms, and their common mechanisms in advanced cancer patients, clinicians can more effectively control multiple, concurrent symptoms and reduce drug side effects. And clinicians can also predict any other symptoms, functional performance, and the relationship between symptom clusters and survival in advanced cancer patients. At present, there is inconsistency in symptom clusters due to many unexplained mechanisms and various means to assess and analyze symptoms. Still, with further study, the approach to symptom clusters rather than individual symptoms could more effectively control symptoms and improve patients' quality of life.

• Journal of Hospice and Palliative Care
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• v.18 no.1
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• pp.35-41
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• 2015

Purpose: This study was conducted to examine how patients' coping style and social support affect post-traumatic stress disorder (PTSD) in breast cancer patients who are treated with chemotherapy. Methods: The sample consisted of 134 outpatients who received breast cancer treatments at the cancer clinic of a university hospital. The collected data were analyzed by frequency, percentage, t-test, ANOVA, ${\chi}^2$-test, Pearson correlation coefficients using SPSS for Windows, version 18.0. Results: Among total, 26.9% of patients were classified into a high-risk PTSD group. In the high-risk group, a positive correlation was found between active and passive coping styles and between social support and active coping styles. Conclusion: In this study, the stronger the social support was, the more active the coping style was for high-risk PTSD patients with breast cancer. Considering the fact that cancer requires life-long self-management, strong social support could improve patients' healthcare capability. Furthermore, solid social support could effectively reduce the stress level and improve the quality of life for breast cancer patients in the high-risk PTSD group.

• Journal of Hospice and Palliative Care
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• v.8 no.1
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• pp.1-7
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• 2005

Purpose: The purpose of this study was to identify the quality of sleep in hospitalized patients with lung cancer. Methods: The data were collected from January to April 2001. Study subjects were 50 lung cancer patients hospitalized at K University and G hospital in Busan, Korea. Quality of sleep was measured using the Quality of Sleep Scale (range $15{\sim}60$) developed by Oh et al (1999). The data were analyzed with the SPSS 10.0 program using frequency and percentage, mean, standard deviation, t-test, ANOV4 and Post-hoc test (Scheffe's test). Results: The results of this study were as follow; 1) The mean quality of sleep score was $35.64{\pm}7.59$ (range: $21{\sim}52$). 2) There was 3 Significant difference in 'ongoing pain' (t=-1.943, P=.046), 'major caregiver' (F=B863, P=.047), 'change of weight' (F=5.906, P=.019), according to general characteristics in the quality of sleep in hospitalized patients with lung cancer. Conclusion: As a results, the level of the quality of sleep in hospitalized patients with lung cancer was moderate. And, the study results indicate that ongoing pain, major caregiver, change of weight impact the quality of sleep of lung cancer patients. Therefore, nurses should consider those factors in providing nursing care for hospitalized patient with lung cancer.

• Journal of Hospice and Palliative Care
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• v.8 no.2
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• pp.200-208
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• 2005

Purpose: Palliative procedures or surgical interventions not only manage various symptoms of malignant gastrointestinal obstruction, but also improve the quality of life. We investigated the clinical characteristics and prognostic factors of terminal cancer patients with palliative procedures for malignant gastrointestinal obstruction. Methods: We retrospectively reviewed the medical records of 48 terminal cancer patients with palliative procedures for malignant gastrointestinal obstruction at Sam Anyang hospital from May in 2002 to May in 2005. We excluded patients with palliative tumor resection. We analyzed prognostic factors in symtom-free survival and overall survival using Kaplan-Meier method, univariate and multivariate analysis. Results: There were 25 males (52%) and 23 females (48%), and median age of 48 patients was 65 years. The most common cause of malignant gastrointestinal obstruction was colorectal (26 patients, 55%), followed by stomach (10, 21%). Twenty patients (42%) received previous treatment (chemotherapy, surgery, and radiotherapy) and 28 (58%) never received any. Eighteen of 20 had received chemotherapy. The most common symptom was pain (15 patients, 31%). Twenty three patients (48%) had Eastern Cooperative Oncology Group(ECOG) performance status of 1 or 2 score and 25 patients (52%) 3 or 4 score. The most common palliative procedure was colostomy and there was no mortality concerning the palliative procedures. By univariate and multivariate analysis, performance status was the only independent prognostic factor in overall survival and symptom-free survival. Overall survival was 150 days and symptom-free survival was 90 days. Conclusion:. We confirmed that perftatdormance status is significant independent prognostic factor in terminal cancer patients with palliative procedures for malignant gastrointestinal obstruction.

• Journal of Hospice and Palliative Care
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• v.11 no.2
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• pp.91-98
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• 2008

Purpose: This study was undertaken to compare perceived stress and coping patterns, and their effects on depression between cancer patients and healthy adults. Methods: A descriptive design was used with 278 subjects, consisting of 139 cancer patients and 139 health adults, living in an urban area. All participants completed the following prerequisites; Stress Visual Analog Scale, Ways of Coping Checklist (W.C.C.L), Depression Index (CES-D), and Demography and Disease Data Questionnaire. Results: Perceived stress and depression were significantly higher, while wishful thinking was lower among cancer patients than healthy adults, after adjusting for education and family income which were not homogeneous between the groups. Among cancer patients, 20.2% of depression was mainly due to seeking support (10.7%), perceived stress and education, while 30.7% of depression in healthy adults was due to perceived stress, problem solving, and seeking support. Conclusion: These findings suggest that interventions to manage depression in cancer patients should include strategies to best foster positive coping patterns and reduce perceived stress.

• Journal of Hospice and Palliative Care
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• v.9 no.1
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• pp.35-39
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• 2006

A 77-year-old female presented panperitonitis due to advanced gastric ranter during palliative care. In the case of panperitonitis following obstruction or perforation, surgical treatment is vital to avoid fatal sepsis and dehydration. However, the risk of surgery and the residual life of a patient must be carefully considered because of high mortality and complication rate in those patients with advanced disease due to the poor condition. The therapeutic value of aggressive hydration, nasogastric tube insertion, and the use of antibiotics is also questionable. Palliative surgery was not performed on this case, and she passed away peacefully in the presence of family after 4 days of palliative medical care. Here is the appropriate management for this kind of patients we would like to recommend through review of relevant references and long discussions. Firstly, we need to predict survival time using clinical variables. Secondly, considering patient status and risk of surgery, non surgical palliative care such as pain control, transient nasogastric tube insertion, and parenteral hydration is recommended. Minimal use of fluid is desirable to minimize complications such as edema and dyspnea if massive hydration in the beginning of treatment is not proved to be effective. Even though started earlier in the course of disease, discontinuation of antibiotics could be discussed with patients and their caregiver if patient status is not improved.

• Journal of Hospice and Palliative Care
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• v.6 no.1
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• pp.45-50
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• 2003

Purpose : This study was conducted to develop primary assessment tools to evaluate the relationship between symptom prevalence and symptom distress in cancer patients of Korea. Methods : A total of 196 patients diagnosed with cancer admitted in 5 general hospitals from January, 6 to January, 20 in 2003, were entered into the study. These patients were asked to complete the MSAS (Memorial symptom assessment scale). We classified these answers into prevalence and distress and then scored them according to grade and frequency. Results : The five most prevalent symptoms were lack of energy (82.1%), dry mouth (73.5%), pain (73.5%), itching (72.4%), and feeling drowsy (68.9%). Among 24 common prevalent symptoms, the ten most distress the symptoms were dry mouth (2.11), itching (2.07), pain (2.03), lack of energy (1.98), difficulty sleeping (1.96), worrying (1.94), "I don't look like myself" (1.91), constipation (1.88), and difficulty concentration (1.76). Conclusion : These 10 symptoms had high prevalence and distress in cancer patients of Korea. We suggest these symptoms to be applied in developing the primary assessment tool in cancer patients.