• 임상간호연구
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• 제19권3호
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• pp.407-418
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• 2013

Purpose: The purpose of this study is to examine the nurse's role performance and the perception of the importance of role among nurses practicing in a cancer care facility. Methods: A descriptive study design was applied with convenient sampling of 175 nurses working at a cancer care facility in Daegu, Korea. Data was collected using a structured questionnaire from July 1, 2013 to July 5, 2013. Results: Cancer care facility nurse's role performance score was measured on average $3.23{\pm}0.64.$ Oral medication was the most frequently performed role, followed by encouragement, care related to medication, and pain management. The perception of the importance of nurse's role was measured on average $3.31{\pm}0.35$. Care related to medication was regarded as the most important, followed by transfusion, oral medication, and intravenous & intramuscular medication. Nurse's role performance was different according to nurse's age (F=3.21, p=.024) and current practice area (F=3.73, p=.012). The perception of the importance of nurse's role was different only in relation to current practice area (F=6.82, p<.001). Conclusion: Nurses practicing in oncology setting frequently involve encouraging patients and pain management. Training programs designed to facilitate frequently performed and highly regarded nurse's roles are required for nurses practicing in oncology setting.

• 한국의료질향상학회지
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• 제26권2호
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• pp.86-94
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• 2020

Purpose: This study aimed to identify current quality control (QC) practices of primary care clinics participating in the National Cancer Screening Program (NCSP) in Korea. Methods: A nationwide survey using a structured questionnaire was conducted among the primary care clinics participating in the NCSP, which were selected by a proportionate stratified sampling. The questionnaire consisted of general information about the responding clinics and the scope of QC activities undertaken. A total of 360 clinics responded and the set of data was then analyzed with Chi-square test and multivariable logistic regression analysis. Results: Among 360 respondents, 332 (92%) reported that they were involved in the QC activities. Most frequently performed QC activities were 'maintenance of facility and instruments' (89%) and 'staff training' (85%). The analysis revealed, with statistical significance (p<.05), that there was an association between certain characteristics of the clinics and the scope of QC activities. These findings also indicated that the diversity of QC practices varies according to the size of the clinics. The clinics screening more types of cancer, those with more screenees, and those with more employees were more likely to implement various QC activities including 'maintenance of facility and instruments', 'external quality control', and 'management of screening data'. Conclusion: To our knowledge, this is the first study to investigate the current status of QC activities conducted among primary care clinics participating in the NCSP. The results of this survey can be used as a basis for further development of policies on quality management of small- and medium-sized primary care clinics in Korea. However, further studies encompassing various aspects of QC activities and management of primary care clinics are needed to assess the current situation in a concise manner.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제8권1호
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• pp.45-52
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• 2002

Recently cancer, AIDS, chronic sickness have increased according to the elevation of socioeconomic level and fast change of lifestyle. The number of patients receiving terminal care increased fairly because the span of life is extended by development of medicinal technology. Also necessity of hospice and palliative care was risen according to the request of terminal patients that remove pain and keep calm life by interest about quality of life. However architectural plan and type specialization of facility which can correspond team's composition and supplied nursing program are not consisting. This study researches about care environment of hospice facility plan through investigation into terminal patient's special quality. The purpose of this study is to propose fundamental datas of hospice facility for architectural plan through comparative analysis of cases of domestic and outside facilities.

• 농업과학연구
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• 제50권4호
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• pp.735-747
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• 2023

This study was conducted to identify the appropriate space requirements for forest healing program for physical and mental health care of female cancer survivors in their 40s and 60s. From September to November 2023, 12 cancer survivors were surveyed at Chungnam National University Forest and Daejeon Healing Forest. One Forest Therapy instructor and two researchers conducted a forest healing program once a week for eight sessions of two hours each, Perceptions and satisfaction with the program and space were assessed using pre and post program questionnaires, and the effect of participation in the forest healing program on mood status was evaluated. The satisfaction survey results were supplemented by qualitative studies conducted through post-interviews. Result of the analysis showed that the satisfaction of the participants was very high (4.8/5.0). There was a notable increase in vigor and a decrease in total mood disturbance after participation in the program. Toilets and water facilities (11), tool boxes (9), pest control facilities (3), deck facilities (3), forest hut (3), electrical outlets (2), shade shelters (2), and shoe hairy (1) were proposed as required facilities for cancer survivors. This study demonstrated that the forest healing program is effective in reducing distress in female cancer survivors in their 40s and 60s and appropriate facility standards for the forest healing space are needed to increase the satisfaction of cancer survivors.

• Journal of Hospice and Palliative Care
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• 제26권4호
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• pp.171-184
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• 2023

Purpose: The study explored the meaning of experiences within a family art therapy process among terminal cancer patients and their families. Methods: Ten participants, including four terminal cancer patients currently admitted to the hospice ward at an inpatient hospice facility in S City and four caregiving family members, engaged in four cycles of family art therapy sessions. The sessions were conducted weekly or bi-weekly, and each lasted approximately 50 minutes. Results: Nine cross-case themes emerged: "feeling unfamiliar and intimidated by the idea of expressing my thoughts through art," "trying to accept the present and positively overcome sadness," "expressing hope through emotional bonds during the process of parting," "conveying and preserving personal and family beliefs," "feeling upset about family imbalances caused by deteriorating health," "valuing togetherness and striving for stability amidst the current challenges," "art as a medium of empowerment for patients and facilitator of family conversations, even amidst difficulties," "sharing a range of emotions-not just joy, but concerns and sorrow-through art," and "gratitude for art' s role in improving family communication and connection through artwork. Conclusion: The findings of this study lead to several conclusions. First, patients and their families faced psychological challenges when confronted with impending death, yet they strove to remain optimistic by seeking meaning in their struggles. Second, families practiced open and expressive communication, sharing a spectrum of complex emotions with one another. Third, even as the patient's condition worsened, resulting in family fatigue, their support and cohesion strengthened.

• Journal of Gynecologic Oncology
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• 제29권6호
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• pp.83.1-83.10
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• 2018

Objective: We aimed to propose a set of quality indicators (QIs) based on the clinical guidelines for cervical cancer treatment published by The Japan Society of Gynecologic Oncology, and to assess adherence to standard-of-care as an index of the quality of care for cervical cancer in Japan. Methods: A panel of clinical experts devised the QIs using a modified Delphi method. Adherence to each QI was evaluated using data from a hospital-based cancer registry of patients diagnosed in 2013, and linked with insurance claims data, between October 1, 2012, and December 31, 2014. All patients who received first-line treatment at the participating facility were included. The QI scores were communicated to participating hospitals, and additional data about the reasons for non-adherence were collected. Results: In total, 297 hospitals participated, and the care provided to 15,163 cervical cancer patients was examined using 10 measurable QIs. The adherence rate ranged from 50.0% for 'cystoscope or proctoscope for stage IVA' to 98.8% for 'chemotherapy using platinum for stage IVB'. Despite the variation in care, hospitals reported clinically valid reasons for more than half of the non-adherent cases. Clinically valid reasons accounted for 75%, 90.9%, 73.4%, 44.5%, and 88.1% of presented non-adherent cases respectively. Conclusion: Our study revealed variations in pattern of care as well as an adherence to standards-of-care across Japan. Further assessment of the causes of variation and non-adherence can help identify areas where improvements are needed in patient care.

• Asian Pacific Journal of Cancer Prevention
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• 제17권10호
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• pp.4637-4642
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• 2016

Purpose: To evaluate palliative care for patients with gynecologic cancer in Japan. Materials and Method: A questionnaire asking facility characteristics, systems to coordinate palliative care, current status of end-of-life care, provision of symptom relief, palliative radiation therapy and chemotherapy, and cases of death from gynecological cancer, was mailed to facilities treating gynecologic cancer. Results: A total of 115 facilities (29.3% of the total) responded to the questionnaire. Of these, 33.0 (29.0%) had a palliative care ward. End-of-life care was managed by obstetricians and gynecologists in 72.0% of the facilities. The site where end-of-life care was provided was most often a ward in the department where the respondent worked. The waiting period for transfer to a hospice was 2 weeks or more in 52% of facilities. Before the start of primary treatment, pain control was managed by obstetrians and gynecologists in 98.0% of facilities. Palliative radiation therapy or chemotherapy was administered at 93.9% and 92.0% of facilities, respectively. Of the 115 facilities, 34.0 (29.6%) reported cases of death from gynecological cancer. There were 1,134 cases of death. The median time between the last cycle of chemotherapy and death was 85 days for all gynecological cancers. The proportion of patients receiving chemotherapy in the last 30 and 14 days of life were 17.4% and 7.1%, respectively. Conclusions: This large-scale survey showed characteristics of palliative care given to patients with gynecologic cancer in Japan. Assessment of death cases showed that the median time between the last cycle of chemotherapy and death was relatively short.

• 보건행정학회지
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• 제27권2호
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• pp.167-176
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• 2017

Background: This study aimed to analyze the impact of community health care resources on the place of death of older adults with dementia compared to those with cancer in South Korea, using public administrative big data. Methods: Based on a literature review, we selected person- and community-level variables that can affect older people's decisions about where to die. Data on place-of-death and person-level attributes were obtained from the 2013 death certification micro data from Statistics Korea. Data on the population and economic and health care resources in the community where the older deceased resided were obtained from various open public administrative big data including databases on the local tax and resident population statistics, health care resources and infrastructure statistics, and long-term care (LTC) insurance statistics. Community-level data were linked to the death certificate micro data through the town (si-gun-gu) code of the residence of the deceased. Multi-level logistic regression models were used to simultaneously estimate the impacts of community as well as individual-level factors on the place of death. Results: In both the dementia (76.1%) and cancer (87.1%) decedent groups, most older people died in the hospital. Among the older deceased with dementia, hospital death was less likely to occur when the older person resided in a community with a higher supply of LTC facility beds, but hospital death was more likely to occur in communities with a higher supply of LTC hospital beds. Similarly, among the cancer group, the likelihood of a hospital death was significantly lower in communities with a higher supply of LTC facility beds, but was higher in communities with a higher supply of acute care hospital beds. As for individual-level factors, being female and having no spouse were associated with the likelihood of hospital death among older people with dementia. Conclusion: More than three in four older people with dementia die in the hospital, while home is reported to be the place of death preferred by Koreans. To decrease this gap, an increase in the supply of end-of-life (EOL) care at home and in community-based service settings is necessary. EOL care should also be incorporated as an essential part of LTC. Changes in the perception of EOL care by older people and their families are also critical in their decisions about the place of death, and should be supported by public education and other related non-medical, social approaches.

• Asian Pacific Journal of Cancer Prevention
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• 제14권6호
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• pp.3541-3547
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• 2013

Background: This cross-sectional observational study was undertaken to establish clinico-pathological characteristics of patients with gynecological malignancies, focusing mainly on symptoms, histological type and stage of the disease at presentation, in a tertiary care setting in Eastern India. Materials and Methods: In the gynecology out-patient clinic of a tertiary care hospital in Kolkata, India, the patients with suggestive symptoms of gynecological malignancies were screened. Their diagnoses were confirmed by histopathology. One hundred thirteen patients with histopathologically confirmed gynecological malignancies were interviewed. Results: The most frequently reported symptoms by the patients with histopathologically confirmed gynecological malignancies were excessive, offensive with or without blood stained vaginal discharge (69.0%), irregular, heavy or prolonged vaginal bleeding (36.3%) and postmenopausal bleeding (31.9%). The majority of the patients (61.0%) had squamous cell carcinoma on histopathological examination, followed by adenocarcinoma (30.1%). Nearly half of the patients (48.7%) were suffering from the Federation Internationale des Gynaecologistes et Obstetristes (FIGO) stage III, followed by stage II (40.7%) malignancy. Conclusions: This study highlights that most of the patients with gynecological malignancies present late at an appropriate health care facility. Ovarian cancer may often have non-specific or misleading symptomatic presentation, whereas cervical cancer often presents with some specific symptoms. These observations point to the need for increasing awareness about gynecological malignancies in the community and providing easily accessible adequate facilities for early detection and treatment of the disease by optimal use of available resources, i.e. strengthening the primary health care system.

• Journal of Hospice and Palliative Care
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• 제5권1호
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• pp.31-42
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• 2002

목적 : 연구의 목적은 호스피스 완화의료의 표준화를 위한 기초자료로서 국내 호스피스 완화의료 서비스를 제공하는 의료기관 및 비의료기관의 서비스 대상자, 시설 인력구성, 서비스 내용 및 재정적 문제 등 실태를 파악하는 것이다. 방법 : 설문조사는 2001년 7월부터 10월까지 이루어졌으며, 연구자들이 기존 연구를 참조하여 개발한 총 39항목의 설문지를 반송봉투를 넣어 우편으로 발송하여 조사하였다. 회신이 되었지만 내용을 재확인할 필요가 있는 부분과 회신이 안된 기관은 전화를 통해 설문을 완성하였다. 64개 기관이 설문에 응답하였다. 결과 : 국내에는 호스피스 완화의료 서비스를 제공하는 의료기관이 40개, 비의료기관이 24개 있었다. 의료기관 중 11개 기관은 병원연계 및 독립 또는 별도병동이 었고, 비의료기관 중 6개는 입원이 가능한 독립시설에서 호스피스 완화의료서비스를 제공하고 있었다. 호스피스 완화의료 서비스를 받는 대상자 대부분은 암환자였지만 일부는 말기 질환이 아닌 경우도 포함되어 있었다. 전체 64개 호스피스 완화의료 서비스 기관 중 24개만이 의사, 간호사, 사회복지사 및 성직자가 있었다. 가정호스피스 기관으로서 의뢰체계가 있는 경우는 의료기관 89.7%, 비의료기관 73.7% 였다. 24시간 서비스를 제공하는 기관은 의료기관 65.0%, 비의료기관 37.5%였다. 가족을 위한 휴식공간은 병원중심 호스피스완화의료 프로그램의 50%에서 있었다. 전체 호스피스 완화의료기관의 73.9%는 재정적인 문제가 있었으며, 610%는 정부로부터의 재정적인 지원이 필요하다고 응답하였다. 결론 : 64개 호스피스완화의료 프로그램에서 서비스를 제공하고 있지만 아직도 인력, 서비스의 질 및 시설 측면에서는 문제점이 있었다. 말기환자를 위한 서비스의 질을 향상시키고 의료자원의 효율적인 이용을 촉진하기 위해 호스피스 완화의료 서비스의 표준화와 제도화가 필요하다.