• Title/Summary/Keyword: End of life care

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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.

End-of-Life Assessments and Communication for Dying Patients and Their Families

  • Lee, Eun Kyung;Jeong, Hyae Yeong;Kim, Kyung Won
    • Journal of Hospice and Palliative Care
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    • v.24 no.3
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    • pp.194-197
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    • 2021
  • End-of-life assessments aim to help dying patients and their families plan clinical interventions in advance and prepare them for a peaceful end of life, in which the patient accepts life and death, and the family accepts the patient's departure. It is important to assess whether death is imminent within a few days, because critical hospice care is provided intensively during that period. The following five changes constitute objective evidence of the end of life: diminished daily living performance, decreased food intake, changes in consciousness and increased sleep quantity, worsening of respiratory distress, and end-stage delirium. As subjective evidence, it is suggested that sensitive perceptions of experienced nurses and the feelings of family members caring for patients should also be considered. When notifying a patient or family members that the end of life is approaching, the members of the multidisciplinary hospice team must communicate with each other, share accurate information, and provide consistent explanations. They must also listen to non-verbal communication in an empathic and supportive manner.

The Relationship between Optimal End-of-Life Care and Well Dying of Nurses (간호사의 최상의 임종간호 및 웰다잉 관계 연구)

  • Hyun, Woo-In;Kim, Miyoung
    • The Journal of the Korea Contents Association
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    • v.22 no.8
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    • pp.628-639
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    • 2022
  • The purpose of this study was to investigate the relationship between the optimal end-of-life care and well-dying perceived by nurses to provide the optimal end-of-life care for patients and their families. This subjects of the study were 121 nurses working in the ward or intensive care unit of a general hospital in Seoul, and the data collected from April 28 to May 12, 2021 were analyzed. Data were analyzed using t-test, ANOVA, and Pearson correlation coefficients with the SPSS/WIN 27.0 program. The total average of the subjects' perceptions of the optimal end-of-life care was 4.04±0.82 on a five-point scale, indicating the overall level of 'agree' with the optimal end-of-life care. The total average of well dying perceived by the subjects was 3.63±1.14 on a five-point scale, and the most important recognized questions was to die peacefully. Of general characteristics, there was a significant differences on optimal end-of-life care according to age (t=-.97, p=.013). The nurse group in their 30s showed higher consent for end-of-life care than those in their 20s. An analysis of the correlation between the optimal end-of-life care and well-dying showed that there was no significant correlation. This study suggest that education should be provided to raise awareness of end-of-life care for young nurses with low experience.

Awareness and Attitude of Nurses in Regard to Providing Hospice Care

  • Aghdam, Alireza Mohajjel;Aghaei, Mir Hossein;Hassankhani, Hadi;Rahmani, Azad
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.16
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    • pp.6941-6945
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    • 2015
  • Background: Awareness and attitudes of nurses regarding end of life care are important factors in providing hospice care. In an extensive literature review, we found no related articles investigating Iranian nurses awareness and attitudes about providing such care. Objectives: The aims of this study were to investigate the awareness and attitudes of Iranian nurses in providing hospice care. Materials and Methods: In this descriptive-correlational study, 240 nurses employed in six educational centers were selected by non-randomized stratified sampling. The data collection instruments included an awareness test and attitudes regarding providing end of life care in hospice questionnaire. The data were analyzed using descriptive statistics and independent sample t-tests, one-way ANOVA, and Pearson correlation tests. Results: The nurses' awareness score was 14.3 out of 29 and 55.7% of them stated that they had not received any education in providing end of life care. Also, by obtaining the score of 91.7 out of 120 the attitudes of participants in providing end of life care in hospices were positive. In addition, the highest attitudes score of nurses were in the dimensions of benefits of implementation and health care team. Conclusions: Considering low awareness of nurses about end of life care in hospices, continuing education should be provided for them in this regard. Especially, by considering the positive attitude of nurses, providing such programs could help develop hospice care in Iran.

Preferences for Care Near the End of Life among Hospital Employees (일 대학병원종사자의 생애말기 치료 선호도)

  • Kang, Jiyeon;Yun, Seonyoung;Kim, Soo Jeong;An, So Ra;Lee, Myeong Hee;Kim, Shinmi
    • Journal of muscle and joint health
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    • v.20 no.3
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    • pp.197-206
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    • 2013
  • Purpose: The purpose of this study was to investigate end-of-life care preferences of employees working in a university hospital. Methods: Of 650 eligible employees that were approached, 607 employees (386 nurses, 93 physicians, and 128 general staff) completed the Korean version of Preferences for Care Near the End of Life (PCEOL-K). Results: Among 5 dimensions of the PECOL-K, "Pain" was the most preferred care dimension and "Decision making by health care professional" was the least preferred care dimension. The item that received the highest mean score was "I want to let nature guide my dying and I do not want my life to be artificially prolonged in any way", and the lowest item was "I want health care providers to make all decisions about my care". As preferred care near the end of life, nurses gave lower scores to the life sustaining treatment and decision making by health care profession than physicians and general staff. Compared to physicians and nurses, general staff preferred the decision making by health care professional and by family. Conclusion: The results show that adequate pain relief is the most preferred care at the end of life among hospital employees and non-medical personnel preferred decision making by others.

Convergence Analysis of Factors Influencing the End-of-life Care Attitude in Undergraduate Nursing Students (간호대학생의 임종간호 태도에 영향을 미치는 융합적인 요인분석)

  • Yang, Seung Ae
    • Journal of the Korea Convergence Society
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    • v.7 no.4
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    • pp.141-154
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    • 2016
  • Objectives: The purpose of the study was to identify factors influencing on nursing students' end-of-life care attitude. Methods: A sample of convenience of 147 nursing students, Instrument included death anxiety, death attitude, Self-esteem, Life satisfaction, end-of-life care attitude. Results: A significant negative correlation was found among end-of-life care attitude, death anxiety, death attitude. Death anxiety(${\beta}$=-.392), self-esteem(${\beta}$=.179) & experience of learning(${\beta}$=-.227) about death were significant predictive variables. This variables accounted for 18.7% of the variance in end-of-life care attitude. Conclusions: Based on the Findings of this study, it can be used to develop educational programs for end-of-life care.

Life-Sustaining Treatment in End-Stage Liver Disease Patients: Patients' Decisions and Results

  • Jung, Hyun Jung;Park, Jeong Yun
    • Journal of Hospice and Palliative Care
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    • v.23 no.2
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    • pp.85-92
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    • 2020
  • Purpose: In 2018, the Act on Decisions on Life-Sustaining Treatment for Patients in Hospice and Palliative Care or at the End of Life was implemented and the scope of official recognition for terminally ill patients was expanded. The purpose of this study was to investigate the decisions made by patients with end-stage liver disease about their life-sustaining treatment in a clinical setting. Methods: The subjects of this study were patients with end-stage liver disease hospitalized at a tertiary hospital in Seoul, Korea who wrote physician orders for life-sustaining treatment (POLST). Data collection was done using patients' electronic medical records, and a retrospective analysis of POLST was conducted. Results: Among 101 patients, 18.8% were female and 81.2% were male, and their mean age was 61.8 (±10.61) years. Sixty-three patients (62.4%) wrote their POLST by themselves. Three patients withdrew the POLST, of whom two did so for liver transplantation, and one did so for chemotherapy. Conclusion: This study shows that sufficient consideration of liver transplantation is needed for end-stage liver disease patients before making decisions on life-sustaining treatment. The self-determination of patients must be respected and effective guidelines are urgently needed.

A Study on the Research Trend of the End-of-Life Care in Korea (임종간호에 관한 국내 연구동향 분석)

  • Byun, Jinyee;Kwon, Sinyoung
    • The Journal of the Korea Contents Association
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    • v.22 no.10
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    • pp.374-382
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    • 2022
  • This study aims to explore the research trends of hospice that were published in KCI from July 2003 to 2022. Using Korea Citation Index, a total of 115 papers were selected for data analysis. According to the analysis, research on terminal care were conducted mostly from 2017 to 2019. A total of 26 papers were published on Journal of Hospice and Palliative Care. 115 papers were mostly conducted with nurses and nursing students. It was found that those nurses were working in tertiary hospitals, long-term care hospitasl, and general hospitals. The research topics of the published papers are mainly related to end-of-life care attitude, end-of-life care performance, experiences of end-of-life care, and end-of-life care stress. Among them, 78.3% of the papers adopted quantitative research method. Concerning the IRB, 64.3% of the papers got an approval. It is expected that the present study can shed some lights on hospice care field by analyzing the trends of terminal care studies.

Factors Influencing Compassion Fatigue among Hospice and Palliative Care Unit Nurses

  • Cho, Eun-Ju;Cho, Hun Ha
    • Journal of Hospice and Palliative Care
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    • v.24 no.1
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    • pp.13-25
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    • 2021
  • Purpose: This descriptive study aimed to explore nursing workplace spirituality, end-of-life care stress, and resilience as factors influencing compassion fatigue among nurses working in hospice and palliative care units. Methods: Data were collected using a self-report questionnaire completed by 146 nurses at 14 hospice and palliative care institutions across South Korea who had worked in a hospice and palliative care institution for at least 6 months and had experience providing end-of-life care. Data were collected from February 25, 2019 to April 12, 2019, and analyzed using SPSS for Windows version 18.0. As appropriate, descriptive statistics, the t-test, analysis of variance, the Scheffé test, Pearson correlation coefficients, and stepwise multiple regression were used. Results: The survey results showed that factors influencing compassion fatigue were resilience, subjective health status, current satisfaction with the hospice ward, and end-of-life care stress. Higher levels of resilience, a subjective health status of "healthy", high levels of current satisfaction with the hospice ward, and lower levels of end-of-life care stress were associated with lower levels of compassion fatigue, explaining 42.9% of the total variance. Conclusion: The results of this study suggest that resilience is an important factor mitigating compassion fatigue among nurses at hospice and palliative care institutions. Therefore, intervention programs should be developed to reduce compassion fatigue.

Qualitative Study on Social Workers' Experiences and Roles during End-of-Life Care in Elderly Long-Term Care Facilities (노인 장기요양기관에 종사하는 사회복지사의 임종 케어 경험과 역할에 관한 질적 연구)

  • Kim, Eun-Kyung
    • The Journal of the Korea Contents Association
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    • v.22 no.5
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    • pp.503-517
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    • 2022
  • This study was to investigate the social workers' psycho·social experiences and roles during the end-of-life care process in elderly long-term care facilities. As a result of data analysis through in-depth interviews, social workers experienced great exhaustion and burnout due to frequent death experiences during the end-of-life care process, and expressed regret for not being able to provide better service for the deceased and longing for loved ones. And in the event of a sudden death, social workers would undergo criticism and complaints. The main roles of social workers during end-of-life care were to contact and communicate with family members when signs of death appeared and support them after the death. The necessity of standardized manuals and education for end-of-life care, a recharging program and support group to prevent burnout of social workers, and a legal safety net for emergency preparedness and emergency measures were suggested. The necessity of death preparation education, hospice care, and advance medical directive was also emphasized for the dignified death of the elderly.