• Title/Summary/Keyword: End-of-life Care

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The Meaning of Death for Korean in View of Novel and End Stage Cancer Patient

  • Jeon, Hye-Won
    • 한국호스피스완화의료학회:학술대회논문집
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    • 2004.07a
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    • pp.103-105
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    • 2004
  • Every one experiences death one day, however no one can hows exactly what it is because people can not experience death until it comes, it is therefore impossible to judge correctly on the phenomenon of the death. On the whole, man experiences indirect death through the mass communications such as TV drama, fiction, magazine etc because those methods can easily access by every one. In addition to this, people usually acquire the negative awareness of death through the dramatic change of story like dying of cancer for dramatic effect by giving scare and fear to the cancers. The purpose of this study is to provide basic information on the spiritual care that enables the facing death patients to accept death as a part of life and divert hope from scare about after death by comparing and analyzing of two aspects of death meaning i.e, Korean fiction and the end stage cancer patients. Additionally, for medical staff to understand the facing death cancer patients by making to aware patients correctly and provide the better quality of care. The study was performed from September 28, 2002 to February, 28, 2003. The materials of this study were collected by direct data obtained from observation, interviews, note and diary of end stage of cancer patients and written materials acquired from Korean contemporary fiction. Participants of this study were 4 end stage cancer patients including 2 lung cancer patients, 1 liver cancer patient and 1 esophagus cancer patient. The methodology used in this study was divided into two types; Huberman & Miles methodology was used for fiction to find and categorize subject, and Colaizzi, one of phenomenological methodology was used for end stage cancer patients to find the major meaning, subject and categorization. Every one experiences death one day, however no one can knows exactly what it is because people ran not experience death until it comes, it is therefore impossible to judge correctly on the phenomenon of the death. On the whole, man experiences indirect death through the mass communications such as TV drama, fiction, magazine etc because those methods can easily access by every one. In addition to this, people usually acquire the negative awareness of death through the dramatic change of story like dying of cancer for dramatic effect by giving scare and fear to the cancers. The purpose of this study is to provide basic information on the spiritual care that enables the facing death patients to accept death as a part of life and divert hope from scare about after death by comparing and analyzing of two aspects of death meaning i.e, Korean fiction and the end stage cancer patients. Additionally, for medical staff to understand the facing death cancer patients by making to aware patients correctly and provide the better quality of care. The study was performed from September 28, 2002 to February, 28 2003. The materials of this study were collected by direct data obtained from observation, interviews, note and diary of end stage of cancer patients and written materials acquired from Korean contemporary fiction. Participants of this study were 4 end stage cancer patients including 2 lung lancer patients, 1 liver cancer patient and 1 esophagus cancer patient. The methodology used in this study was divided into two types; Huberman & Miles methodology was used for fiction to find and categorize subject, and Colaizzi, one of phenomenological methodology was used for end stage cancer patients to find the major meaning, subject and categorization.

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Palliative Care for Patients with Gynecologic Cancer in Japan: A Japan Society of Gynecologic Palliative Medicine (JSGPM) Survey

  • Futagami, Masayuki;Yokoyama, Yoshihito;Sato, Tetsumi;Hirota, Kazuyoshi;Shimada, Muneaki;Miyagi, Etsuko;Suzuki, Nao;Fujimura, Masaki
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.10
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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.

Act on hospice-palliative care and life-sustaining treatment decision-making and institutional measures for its implementation (연명의료결정법의 시행과 제도적 실현을 위한 방안)

  • Huh, Jung-Sik;Kim, Ki-Young
    • Journal of Medicine and Life Science
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    • v.16 no.3
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    • pp.80-83
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    • 2019
  • First of all, this study shows the legal issues of hospice and palliative care, and the legal basis for lifelong medical practice is generally derived from medical, civil and criminal law regulations, and is applied to patients who are severely ill and dying in principle. In addition, those what is particularly meaningful about hospice and palliative care in terms of legal aspects are discussed the determination of the purpose of care and the provision of medical adaptability and adult guardianship, in particular the legal criteria for the work and status of patient representatives. As such, the purpose of care is to form part of the contract of care and to be agreed between the patient and the physician. In addition, the patient may not write to his/her agent in advance, and the patient may admit discretionary powers to his/her agent, but the patient's will is to be considered. In conclusion, the medical institutional ethics committee should play an active role, especially in the case of no-agents/family or no intention of the patient.

Evaluation of End-of-Life Nursing Education Consortium-Geriatric Train-the-Trainer Program in Korea

  • Kim, Boon-Han;Kim, Hyun-Sook;Yu, Su-Jeong;Choi, Sung-Eun;Jung, Yun;Kwon, So-Hi
    • Korean Journal of Adult Nursing
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    • v.24 no.4
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    • pp.390-397
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    • 2012
  • Background: Few nurses are trained in palliative care for long-term care in Korea. The End-of-Life Nursing Education Consortium (ELNEC)-Geriatric training program improves nurses' ability to promote palliative care for the elderly. Purpose: The aim of this study was to evaluate nurses' satisfaction and knowledge following the attendance at the ELNEC-Geriatric curriculum on nurses' knowledge of palliative care. Methods: Nine ELNEC-Geriatric modules were presented to 203 interdisciplinary professionals on July 1 and 3, 2010, in Seoul, South Korea. The Palliative care quiz for nursing (PCQN) was used to evaluate nurses' knowledge. Of all the participants, 128 nurses were completed the questionnaire. Of these nurses, 45.2% were staff nurses and 73.4% were hospital nurses. Results: Approximately eight nine percent of the nurses reported previous experience in caring for dying patients and attending various hospice palliative care training programs. Overall program satisfaction of the participants was 4.03 on a 5-point scale, and their mean of the total PCQN score was 12.75 out of 20 after participating in ELNEC-Geriatric course, which was a significant improvement (p=.022) from the pretest. Conclusion: The results of this study demonstrate that ELNEC-Geriatric curriculum was successfully implemented and significantly contributed to increasing the nurses' knowledge for palliative care in long-term care in Korea.

Perceptions and Attitudes of Nurses toward Euthanasia (임상 간호사의 안락사에 대안 인식과 태도)

  • Son Haeng-Mi
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.11 no.3
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    • pp.309-316
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    • 2004
  • Purpose: The purpose of this study was to identify the perceptions and attitudes of nurses toward euthanasia. Method: In this descriptive study, data were collected from 485 nurses using a self-report questionnaire. The attitudes toward euthanasia scales were composed of four sub dimensions; quality of life, client's right, respect for life and medical ethics. The data were analyzed with descriptive and parametric statistics using SPSS WIN program. Results: Of the nurses, 84.7% were in agreement with constituting a law for euthanasia and 57.6% accepted passive euthanasia. Further, 80.1% would accept euthanasia for their own end-of-life situation. The most frequent reason for pro euthanasia was pain relief, and for con, respect for lift. The mean attitude score was 54.64 and that of sub dimensions, were 2.81 for quality of life, 3.21 for client's right, 2.87 for respect for life, and 2.84 for medical ethics. The nurses who were positive in their thinking about euthanasia had higher attitude scores. Among general characteristics of the nurses, attitudes scores were significantly different according to religion. Conclusion: Although many nurses had a positive concept of euthanasia, they still have ethical dilemmas in lift-sustaining care. Therefore training programs on moral rights are necessary to provide guidelines for end-of-life care.

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Expansion Strategy of Home Visit Nursing Services of Long-Term Care Insurance (노인장기요양보험 재가방문간호 서비스 개발과 확대 방안)

  • Lim, Ji Young;Kim, Juhang
    • Journal of Home Health Care Nursing
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    • v.27 no.3
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    • pp.241-249
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    • 2020
  • Purpose: This study aimed to investigate possible ways to expand the services of home-visit nursing through a review of the progress, achievements, and obstacles of home-visit nursing; a pilot project of an integrated home-service; the application of the Omaha System; as well as a case analysis of providing home-visit nursing services. Method: An integrated review was conducted using various source materials, including laws, previous studies, and a case analysis. Results: In case analysis of providing visiting nursing service, rehabilitation nursing, end-of-life nursing, and dementia care showed high nursing needs. It was necessary that the various home visit nursing services in the intervention area of the Omaha System, administrative services, case management, and center operation activities were all included in the payment systems of long-term care insurance. Conclusion: In the future, home visit nursing services of long-term care insurance should be reborn in the form of a center for integrated case management in the community, which would set long-term goals until the time of a client's death and encompass the realm of human rights for health, quality of daily life, and a dignity of life.

Factors influencing Preferences for Care near the End-of-life among Undergraduate Nursing Students (간호대학생 임종치료선호도에 영향을 미치는 요인)

  • Cheon, Jooyoung
    • Journal of the Korea Convergence Society
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    • v.11 no.12
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    • pp.439-449
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    • 2020
  • This study aimed to identify factors influencing the preferences for end-of-life (EOL) care among undergraduate nursing students. In this cross-sectional study, data were collected from December 2017 to February 2018. This study included 217 undergraduate nursing students. Factors influencing the preference for 'autonomous physiological decision-making' were the following: education level(by grade), having biomedical education, attitude towards death, and attitude towards life-sustaining treatments (LSTs). Preference for 'decision-making by healthcare professionals' was related to having a religion. Factors influencing the preference for 'spirituality' were education level, having a religion, and academic major satisfaction. Preference for 'pain control' was associated with education level, experience with dying patients, bad self-rated health, attitude towards death, and attitude towards LSTs. The study findings suggest that education regarding LSTs, EOL care, and EOL decision-making in nursing curricula is essential.

Comparison of the Casts of Care and Nursing Services for Terminally III Patients Receiving Home Hospice Care in Comparison to Institutional Care (말기 폐암환자를 대상으로 한 가정 호스피스와 병원입원치료의 비교 -서비스 내용과 건강관리비용 중심-)

  • Lee, Tae-Wha;Lee, Won-Hee;Kim, Myung-Sil
    • Journal of Korean Academy of Nursing
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    • v.30 no.4
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    • pp.1045-1054
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    • 2000
  • As cost pressures have escalated, policy makers, politicians, health care providers and families have tried to devise ways to reduce health care costs. While originally developed to enhance patient control and to provide better care at the end of life, hospice care has recently received significant attention as a mean of reducing health care costs. As a program providing care for patients who are dying at their homes, hospice has expanded slowly since the opening of the first hospice in Korea in 1963. Therefore, a variety of services that responds to the needs and concerns of many dying people and their families is limited The purpose of this study was to determine the potential cost savings at the end of life among patients who used home hospice compared with the patients who received institutional care in Korea. This study used a retrospective, descriptive design. The sample for this study included 46 patients who died of lung cancer: 25 patients who received home hospice care and 21 patients who received institutional care. Data on patient characteristics, kinds and frequencies of provided treatment and nursing services, and hospice and hospital charges during the last month before death were collected. Cost of care was measured by the average cost per patient per day in the last month of life. The results of the study indicated that there were significant differences in average cost of care between home hospice sample and institutional care sample (t=9.956, p<.001; home hospice sample: M=18,102 won, institutional care sample: M=317,578 won). The cost of the home hospice sample was approximately 6% of the cost of institutional care. The majority of the home hospice nursing services were education (35.7%) and supportive counseling (25.2%), followed by medication management (13.6%), assessment (12.1%), basic nursing (7.2%), treatment (5.5%) and others. In institutional care sample, basic nursing and treatment were more emphasized than education or supportive counseling among the nursing services provided. The results of this study showed the potential for hospice to reduce costs and implications for policymakers and clinicians to incorporate hospice program into the formal health care delivery system in Korea.

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