Kim, Sera;No, Mi Jin;Moon, Kyung Eun;Cho, Hee Ju;Park, Young;Lee, Nam Joo;Lee, Soon Haeng;Shim, Mi Young
Journal of Korean Clinical Nursing Research
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v.24
no.2
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pp.255-262
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2018
Purpose: This study aimed to identify the view of life and death among ICU nurses and to analyze the problems related to end-of-life care in the current ICUs. Methods: A descriptive study design was used. The participants were 975 nurses working in the intensive care units of 16 general hospitals. Using a descriptive survey design, data were collected from August to December in 2016 and were analyzed using descriptive statistics, t-test, ANOVA, correlation analysis, and multiple regression analysis. Results: As a result of a correlation analysis of the data, Death perception had a significant positive correlation with EOL of nursing attitudes(r=.100, p=.002), and negative correlation with EOL stress care(r=-.221, p=<.001). The regression model explained for individual characteristics in the model, age(${\beta}=.126$, p<.001) and death perception(${\beta}=.182$, p<.001), Satisfaction of the EOL care(${\beta}=.173$, p<.001), Healing training needs on the EOL(${\beta}=-.144$, p<.001) were the most influential factors for EOL stress. Conclusion: Results reveal that ICU nurses have a moderate level of EOL stress, and that individual, age, death perception, Satisfaction of the EOL care, Healing traning needs on the EOL relevant in ICU nurses' EOL stress. Programs or interventions to reduce EOL stress and to should be developed taking into account these multidimensional factors.
Purpose: The purpose of this study was to investigate the influence of perceptions of death, end-of-life (EOL) care stress, and emotional intelligence on attitudes toward EOL care among nurses in the neonatal intensive care unit (NICU). Methods: The participants were 111 nurses working in a NICU who had experienced EOL care at least once. Data were analyzed using the t-test, Pearson correlation coefficient, and stepwise multiple regression analysis in SPSS for Windows. Results: The mean score for perceptions of death was 3.16 out of 5, the mean score for EOL care stress was 3.61 out of 5, the mean emotional intelligence score was 4.66 out of 7, and the average score for EOL care attitudes was 2.77 out of 4. The factors affecting attitudes towards EOL care were academic degree, anxiety regarding death, negativity towards death, experiences of patient death, and emotional intelligence. The explanatory power of these variables for attitudes towards EOL care was 24.7%. Conclusion: The results of this study are expected to serve as a basic reference for the development of nursing education programs and EOL care protocols to improve attitudes toward EOL care among NICU nurses.
Purpose: The purpose of this systematic review is to explore end-of-life (EOL) care planning and the impact of socioeconomic status (SES) among people who identify as Black or African American. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) were used to guide and inform this systematic review process. The following academic electronic databases with publications that reflected the interdisciplinary fields related to the research objective were searched: APA PsycINFO, CINHAL, PubMed, Scopus, and Social Work Abstracts. Results: After the authors conducted the search, 14 articles (from 13 studies) ultimately met the criteria for inclusion. The results substantiated significant concerns highlighted in previous literature regarding SES and its relation to EOL planning, but also revealed an absence of original work and interventions to increase engagement in EOL planning among Black and African American populations. Conclusion: Black individuals deserve an equitable EOL experience. Researchers, practitioners, and policymakers need to move towards advocacy and action to meet this important need.
Kim, Kyong-Jee;Kim, Do Yeun;Shin, Sung Joon;Heo, Dae Seog;Nam, Eun Mi
Journal of Hospice and Palliative Care
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v.22
no.4
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pp.207-218
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2019
Purpose: Physician competency in end-of-life (EOL) care is becoming increasingly important. This study investigated the EOL care curricula in Korean medical schools. Methods: Questionnaires were issued to the faculty members responsible for the EOL care curricula at each of the medical schools. These included questions on the structure and content of the curricula, teaching methods, and faculty members' attitudes to the curricula. Results: Characteristics of the EOL care curricula were compiled from 27 (66%) of the 41 medical schools. All of the medical schools taught essential aspects of the EOL care curriculum either as a separate course or embedded within other medical education courses. The mean time spent on EOL care teaching was 10 hrs (range, 2~32 hrs). The most frequently taught topics were delivering bad news (100%) and symptom management (74%). When the palliative care education assessment tool (PEAT) was used to evaluate the curricula, a median of 11 PEAT objectives was met (range, 2~26; maximum, 83). More than two teaching methods were used in most of the curricula. However, lectures were the only teaching method used by three medical schools. 78% of faculty members who were responsible for curriculum reported dissatisfaction with it, whereas 18% believed that the time allotted to it was adequate. Only 7% of these faculty members believed that their students were adequately prepared to practice EOL care. Conclusion: There is a need to improve EOL care education in basic medical curricula and to take a more systematic approach to achieving learning outcomes.
Purpose: This study reviewed what the location of death (LOD) means as an outcome and how to use LOD to assess end-of-life (EOL) care. This study also examined the reason why LOD is significant for the quality of EOL care. Methods: A literature review was performed, using LODs and home deaths as outcomes in the field of EOL care, and analyzed the findings associated with key fields in regards to LOD. Results: Palliative care research used LOD, in particular, hospital death (versus home death) as a significant outcome when examining cost savings, quality of life care, and patient and family preferences. Based on substantial evidence from previous research, home hospice or continuous palliative care in non-hospital settings (i.e. homes, nursing homes) have been designed and available for dying patients in developed countries. Conclusion: The LOD delivers practical significance as an outcome for diverse reasons. In-depth examination on LOD in South Korea is needed despite limitations to interpretation of its meaning in the country.
Recovery of end-of-life (EOL) products is an environmentally and economically sound way to achieve many of the goals of sustainable development. Many product recovery systems are dependent upon destructive disassembly such as shredding, which undesirably causes a large volume of shredder dust and makes parts reuse impossible. Although non-destructive disassembly has been considered as an alternative for solving the problems, the classification of disassembled items has not been sufficiently investigated. In this paper, we propose a model that mathematically optimizes the disassembly and classification of EOL products. Based on the AND/OR graph that illustrates all possible disassembly sequences of a given product, we identify the physical properties that are considered as constraints in the model. As a result of the solution procedure, the recovery problem can be transformed into a mixed integer linear programming (MILP) model. We show an example that illustrates the concept of our model.
The Journal of Korean Academic Society of Nursing Education
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v.19
no.3
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pp.330-340
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2013
Purpose: This study was performed to identify the level of Korean elderly's knowledge regarding concepts of end-of-life (EOL), Life-sustaining-treatment (LST), and advance directives (AD) which are critical aspects for establishing AD in Korean society. Methods: A questionnaire survey was done between October 2011 and February 2012. Knowledge of AD was evaluated with 3 aspects including EOL, LST, and AD utilizing a questionnaire that was developed by authors for the study. Data were collected from 268 community dwelling elderly from three cities and analyzed using descriptive statistics, t-tests, one-way analysis of variance, and a Scheffe post hoc test with SAS Ver. 9.1 program. Results: Overall, Korean elderly were poorly acquainted with AD related concepts. Significant differences in awareness of AD including understanding of EOL, the level of comprehension of LST, and knowledge about AD were revealed by gender, education level, economic state, and acquaintance with terms of AD or LST. Conclusion: To acknowledge autonomy and support quality of life for elderly and to meet the purpose of AD, attention should be given to target populations including elderly in terms of knowledge level related to AD, social marketing, and infra structure relevant to practice AD in our society.
Nayssem Khessairi;Dhouha Bacha;Rania Aouadi;Rym Ennaifer;Ahlem Lahmar;Sana Ben Slama
Journal of Hospice and Palliative Care
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v.27
no.2
/
pp.64-76
/
2024
Purpose: End-of-life (EOL) care is a vulnerable period in an individual's life. Healthcare professionals (HPs) strive to balance the preservation of human life with respect for the patient's wishes. The aims of our study were to assess HPs' knowledge and perceptions of EOL care and to propose areas of improvement to improve the quality of care. Methods: We conducted a single-center, cross-sectional study involving HPs from a university hospital who encountered EOL care situations. We used a questionnaire divided into four sections: knowledge, practice, perception, and training. We calculated the rate of correct answers and the collective competence index. Results: Eighty-six questionnaires were analyzed, with 82.5% (71/86) completed by medical respondents and 17.5% (15/86) by paramedical respondents. Most of the respondents, 71.8% (51/71), were interns and residents. The study focused on palliative care, medical assistance in dying, aggressive medical treatment, and euthanasia, finding adequate knowledge in the first three areas. Respondents assigned to the intensive care unit and those with more than 8 years of experience had significantly higher correct answer rates than their counterparts. Seventy-five percent of respondents (65/86) reported feeling that they had little or no mastery of EOL care, primarily attributing this to insufficient training and the unavailability of trainers. Conclusion: Based on the findings of our study, which we believe to be the first of its kind in Tunisia, we can conclude that HPs possess an acceptable level of knowledge regarding EOL care. However, they require more exposure and training to develop expertise in this area.
Journal of the Korea institute for structural maintenance and inspection
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v.27
no.2
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pp.77-84
/
2023
As the installation of solar panel accelerates, so does the number of solar panels reaching their end-of-life (EOL). However, the EOL solar panels is becoming a concern, as they contain potentially hazardous materials and are not easily recycled. Coping strategies such as effective collection, disposal, and recycling methods will be important to manage the growing number of EOL solar panels in the coming years.Therefore, many studies have focused on the development of EOL solar panel recycling technology. One recycling technology for EOL solar panels applicable to the construction field is the application of extracted tempered glass from EOL solar panels as construction materials. This study summarized the EOL solar panel disassembly technology and evaluated the mechanical properties of mortar using extracted tempered glass as fine aggregate. The results showed that when tempered glass was used as a fine aggregate in mortar, the compressive strength, flexural strength, and macro pores in the 1-3 ㎛ with 200-300 ㎛ range were affected, regardless of the disassembly technology of EOL solar panels. Especially, we found that the mechanical performance of mortar using chemically treated tempered glass was noticeably decreased due to changes in the chemical composition of the extracted tempered glass resulting from the removal of K2O and CuO due to chemical reactions. Meanwhile, it was found that when fly ash was used as a binder, the reduction of mechanical performance could be alleviated.
According to one Medicare report, in the US, total federal spending on health care expends almost 18 percent of the nation's GDP, about double what most industrialized nations spend on health care. And in 2011, Medicare spending reached close to $554 billion, which amounted to 21 percent of the total spent on U.S. health care in that year. Of that $554 billion, Medicare spent 28 percent, or about $170 billion, on patients' last six months of life. So what are the reasons of this high cost in EOL care and its possible solutions? Much spendings of Medicare on End-of-Life care for the terminally ill/chronically ill in the US has led health economics experts to assess the characteristics of the care. Decades of study shows that EOL care is usually supply-sensitive and poor in cost-effectiveness. The volume of care is sensitively depending on the supply of resources, rather than the severity of illness or preferences of patients. This means at the End-of-Life care, the medical resources are being overused. On the other hand, opposed to the common assumption, "The more care the better utility", the study shows that the outcome is very poor. Actually the patient preference and concerns are quite the opposite from what intense EOL care would bring about. This study analyzes the reasons for the supply-sensitiveness of EOL care. It can be resulted from the common misconception about the intense care and the outcome, physicians' mission for patients, lack of End-of-Life Care Decision which helps the patients choose their own preferred treatment intensity. It also could be resulted from physicians' fear of legal liabilities, and the management strategy since the hospitals are also seeking for financial benefits. This study suggests the possible solutions for over-treatment at the End-of-Life resulting from supply-sensitiveness. Solutions can be sought in two aspects, legal implementation and management strategy. In order to implement advance directive properly, active ethics education for physicians to change their attitude toward EOL care and more conversations about end-of-life care between physicians and patients is crucial, and incentive system for the physicians who actively have the conversations with patients will also help. Also, the general education towards the public is also important in the long run, and easy and official advance directive registry system-such as online registry-has to be built and utilized more widely. Alternative strategies in management are also needed. For example, the new strategic cost management and management education, such as cutting unnecessary costs and resetting values as medical providers have to be considered. In order to effectively resolve the problem in EOL care for the terminally ill/chronically ill and provide better experience to the patients, first of all, the misconception and the wrong conventional wisdom among doctors, patients, and the government have to be overcome. And then there should be improvements in systems and cultures of the EOL care.
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