• Title/Summary/Keyword: End of Life

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A Review on End-of-life Care System between South Korea and the United States (한국과 미국의 생애말기케어 시스템 비교 연구)

  • Choi, Ji-Won;Rhee, YongJoo
    • Journal of Digital Convergence
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    • v.17 no.9
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    • pp.301-310
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    • 2019
  • This study aims to examine eligibilities, services and delivery of services for the current end-of-life care and analyze the quality control of services for end-of-life care. We analyzed the literature and laws on end-of-life systems in Korean and the United States. Current end-of-life care, hospice and palliative care in Korea is being provided mainly in hospital setting. Quality control for the services focuses on setting the criteria for structures in hospitals (i.e. staffing, facilities and equipment). Whereas American end-of-life care system has much broader eligibility for service beneficiaries and provides care mostly at home. Also quality control for services includes process (delivering service) and outcomes, such as monitoring performance indicators and consumer's satisfaction. This is linked to annual payment. The comparative analysis findings contributed to give the next direction of current Korean end-of-life care system. It is nessary to establish the better and extensive end-of-life care system in Korea in considering other countries' end-of-life care systems based on more future research.

Effects of a Hospice and Palliative Care Education Program Including Meaning in Life on Attitudes Toward End-of-Life Care and Meaning in Life Among Nursing College Students (의미요법이 포함된 호스피스·완화 간호교육이 간호대학생의 임종간호태도와 생의 의미에 미치는 효과)

  • Kim, Sook-Nam;Kim, Hyun-Ju;Choi, Soon-Ock
    • The Journal of Korean Academic Society of Nursing Education
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    • v.17 no.3
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    • pp.454-463
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    • 2011
  • Purpose: The purpose of this study was to examine the effects of a hospice and palliative care education program including meaning in life on attitudes to end-of-life care and meaning in life for nursing students. Methods: This study used a quasi-experimental and non- synchronized with a non-equivalent control group design. The experimental group (n=28) participated in a hospice and palliative care education program including meaning in life. The control group (n=28) participated only in a hospice and palliative care education program. The 30-hour course examined hospice and palliative nursing care and logotherapy. Data were collected using a structured questionnaire consisting of general characteristics, attitudes to end-of-life care, and meaning in life. Collected data were analyzed for frequency, percentage, ${\chi}^2$-test, and t-test using SPSS 19.0 WIN Program. Results: Scores for the attitude towards end-of-life care in the experimental group were significantly higher than in the control group. The meaning in life scores in the experimental group were significantly higher than in the control group. Conclusion: These findings suggest that the hospice and palliative care education program, including meaning in life, was effective in enhancing the attitude to end-of-life care and meaning in life among nursing students.

Clinical approach to quality of life in children with end-stage renal disease

  • Cho, Min Hyun
    • Clinical and Experimental Pediatrics
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    • v.56 no.8
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    • pp.323-326
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    • 2013
  • Quality of life in addition to various medical problems in children with end-stage renal disease (ESRD) should be objectively assessed to accomplish normal growth and development during childhood. However, unfortunately, studies of quality of life (QoL) in children with ESRD have been not popular yet and there are only fewer suitable assessment tools compared with adults. Recently, disease-specific modules to evaluate QoL in children with chronic disease such as ESRD have been developed. This review was made to introduce these QoL instruments for children and help the clinical application of them.

A New End of Lamp Life Detection Method for Fluorescent Lamps (새로운 형광램프 수명말기 현상 검출 방법)

  • Cho, Gye-Hyun
    • Journal of the Korean Institute of Illuminating and Electrical Installation Engineers
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    • v.21 no.7
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    • pp.1-5
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    • 2007
  • This paper presents the new detection method for the end of life on fluorescent lamps. At the end of lamp life, the lamp voltage and current asymmetrically increase and decrease more than normal state. If the ballast system does not have the protection function especially for T4 and T5 lamps, we may see the melting socket which is connected to the end of the lamp. To protect from this kind of abnormal status is the most important thing in the ballast system that has very old lamps.

A Structural Equation Model of Clinical Nurses' End-of-life Care Performance (임상간호사의 임종간호수행 구조모형)

  • Park, Hyo jin;Lee, Yun Mi;Kim, Min Hye
    • Journal of Korean Critical Care Nursing
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    • v.14 no.1
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    • pp.1-13
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    • 2021
  • Purpose : Based on Quint's theory and the relevant literature, this study constructed a structural equation model for explaining and predicting end-of-life care performance in clinical nurses. Methods : A self-administered questionnaire was used to collect data from 265 nurses between September 1 and September 30, 2016. The data were analyzed using SPSS ver. 21 and AMOS ver. 21. Results : The goodness of fit of the modified model was found to be relatively satisfactory (χ2=114.82, Nomed χ2(χ2/df)=2.44, SRMR=.06, GFI=.94, AGFI=.89, CFI=.95, TLI=.91, RMSEA=.07). End-of-life care performance was affected by the attitudes toward nursing care of the dying, working unit, and death anxiety. The attitudes toward such care had the highest effect on end-of-life care performance. Conclusion : The results suggest that end-of-life care performance is directly and indirectly affected by attitudes toward nursing care of the dying, participation in end-of-life care education, working unit, death perception, and death anxiety. To improve clinical nurses' end-of-life care performance, effective programs to promote death anxiety and attitudes toward nursing care of the dying need to be developed. In addition, hospital nursing organizations should attempt to produce concrete measures for death anxiety and terminal care attitudes in clinical nurses.

End-of-Life Care Practice in Dying Patients after Enforcement of Act on Decisions on Life-Sustaining Treatment For Patients in Hospice and Palliative Care or at the End of Life : A Single Center Experience

  • Jin, Sol;Kim, Jehun;Lee, Jin Young;Ko, Taek Yong;Oh, Gyu Man
    • Journal of Hospice and Palliative Care
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    • v.23 no.2
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    • pp.93-102
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    • 2020
  • Purpose: The Act on Hospice and Palliative Care and Decisions on Life-Sustaining Treatment for Patients at the End of Life came into force in February 2018 in Korea. This study reviews the practices of end-of-life care for patients who withdrew or withheld life-sustaining treatment at a tertiary care hospital, addresses the limitations of the law, and discusses necessary steps to promote patient-centered self-determination. Methods: We retrospectively analyzed the medical records of patients who died after agreeing to withhold life-sustaining treatment in 2018 at our university hospital. The cause of death, the intensity of end-of-life care, and other characteristics were reviewed and statistically analyzed. Results: Of a total of 334 patients, 231 (69%) died from cancer. The decision to stop life-sustaining treatment was made by family members for 178 patients overall (53.3%) and for 101 (43.7%) cancer patients, regardless of the patient's wishes. When the patient decided to stop life-sustaining treatment, the time from the authorization to withhold life-sustaining treatment to death was longer than when the decision was made by family members (28.7±41.3 vs 10.5±23.2 days, P<0.001). Conclusion: In many cases, the decision to discontinue life-sustaining treatment was made by the family, not by the patient. In order to protect human dignity based on the patients' self-determination, it is necessary for patients to understand their disease based on careful explanations from physicians. Ongoing survey-based research will be necessary in the future.

End of Life Issues in Cancer Cases: Ethical Aspects

  • Taghavi, Afsoon;Hashemi-Bahremani, Mohammad;Hosseini, Leili;Bazmi, Shabnam
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.sup3
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    • pp.239-243
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    • 2016
  • This article investigates ethical challenges cancer patients face in the end stages of life including doctors' responsibilities, patients' rights, unexpected desires of patients and their relatives, futile treatments, and communication with patients in end stages of life. These patients are taken care of through palliative rather than curative measures. In many cases, patients in the last days of life ask their physician to terminate their illness via euthanasia which has many ethical considerations. Proponents of such mercy killing (euthanasia) believe that if the patient desires, the physician must end the life, while opponents of this issue, consider it as an act of murder incompatible with the spirit of medical sciences. The related arguments presented in this paper and other ethical issues these patients face and possible solutions for dealing with them have been proposed. It should be mentioned that this paper is more human rational and empirical and the views of the legislator are not included, though in many cases human intellectual and empirical comments are compatible with those of the legislator.

Awareness and Attitude Change after End-of-Life Care Education for Medical Students (말기환자 돌봄 교육 후 의과대학생의 인식과 태도 변화)

  • Kim, Hyun-Kyung;Nam, Eun-Mi;Lee, Kyoung-Eun;Lee, Soon-Nam
    • Journal of Hospice and Palliative Care
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    • v.15 no.1
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    • pp.30-35
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    • 2012
  • Purposes: Most medical schools in Korea do not provide adequate education in end-of-life care. This study was designed to illustrate the need to improve end-of-life care education and to assess the effect of the education on fourth-year medical students' awareness and attitude towards hospice and palliative care for terminally ill patients. Methods: One hundred sixty six fourth-year medical students were surveyed with questionnaires on end-of-life care before and after they received the education. Results: Before receiving the education, students most frequently answered "at the end of life" (33.6%) was appropriate time to write an advance medical directive. After the education, the most frequent answer was "in healthy status" (58.7%). More students agreed to withholding or withdrawing futile life-sustaining treatment increased after the education (48.1% vs. 92.5% (P<0.001) for cardiopulmonary resuscitation, 38.3% vs. 92.5% (P<0.001) for intubation and mechanical ventilation, 39.1% vs. 85.8% (P<0.001) for inotropics, 60.9% vs. 94.8% (P<0.001) for dialysis and 27.8% vs. 56.0% (P<0.001) for total parenteral nutrition). Significantly more students opposed euthanasia after the education (46.6% vs. 82.1%, P<0.001). All students agreed to the need for education in end-of-life care. Conclusion: After reflecting on the meaning of death through the end-of-life care education, most students recognized the need for the education. The education brought remarkable changes in students' awareness and attitude towards patients at the end of life. We suggest end-of-life care education should be included in the regular curriculum of all medical schools in Korea.

Critical Care Nurses' Perception of Life-sustaining Treatment at End of Life: A Content Analysis (생애 말 연명의료에 대한 중환자실 간호사의 인식: 내용 분석 연구)

  • Koh, Chin-Kang;Ko, Chung Mee;Park, Hyeyoung
    • Journal of Korean Critical Care Nursing
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    • v.10 no.1
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    • pp.41-50
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    • 2017
  • Purpose: The purpose of this study was to describe what critical care nurses perceived about life-sustaining treatment at end of life. Methods: A qualitative content analysis method was utilized. The unit of analysis was interview text obtained from fifty critical care nurses of a general hospital. Results: Seven categories in two content areas were abstracted. In the negative perception area, the following five categories were abstracted: patients' suffering, dying with damaged dignity, patients' isolation from family members, regret about choosing life-sustaining treatment, and family members' burden. In the positive perception area, the following two categories were abstracted: willingness to sustain life and duty as family members. Conclusions: Nurses have better competencies pertaining to understanding patients' responses and suffering than any other health care professions do. Nurses should play an important role in advocating for patients and their family in the process of end-of-life care decision making.

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