• Journal of Hospice and Palliative Care
• /
• v.18 no.4
• /
• pp.267-275
• /
• 2015

Purpose: This study is aimed to investigate the relationship among terminal care stress, job satisfaction and terminal care performance nurses in internal medicine wards and to provide a basis to improve terminal care performance. Methods: This is a descriptive study performed with 201 nurses who have at least one year of experience and are stationed at the internal medicine department of three general hospitals and three university hospitals in P city of a metropolitan city B. The nurses also had an experience with a dying patient. Data were collected from March 1 through March 31, 2014. The study was approved by the Institutional Review Board of Kosin University. Results: Job satisfaction was negatively correlated with stress in end-of-life care (r=-212, P=0.003) and positively correlated with terminal care performance (r=0.383, P<0.001). There was no correlation between terminal care stress and terminal care performance. Conclusion: Appropriate programs are needed to improve job satisfaction for high quality terminal care performance.

• Journal of Hospice and Palliative Care
• /
• v.22 no.4
• /
• pp.145-155
• /
• 2019

Purpose: Amendment to the Act on Decisions on Life-sustaining Treatment was recently enacted to designate long-term care hospitals as providers of hospice and palliative care. Despite its benefit of providing improved accessibility to end-of-life care, the amendment has raised concerns about its effect on quality of service. This study aimed to use information obtained from an expert group interview and previous studies to compare how cancer patients, family caregivers, physicians, and the general Korean population perceive the potential benefits and risks of this amendment. Methods: We conducted a multicenter cross-sectional study from July to October 2016. The included participants answered a structured questionnaire regarding the extent to which they agree or disagree with the questionnaire items indicating the potential benefits and risks of the amendment. Chi-square tests and univariate and multivariate logistic regression analyses were performed. Results: Compared with the general population, physicians agreed more that long-term care hospitals are currently not adequately equipped to provide quality hospice and palliative care. Family caregivers found improved access to long-term care hospitals more favorable but were more likely to agree that these hospitals might prioritize profits, thereby threatening the philosophy of hospice care, and that families might cease to fulfill filial responsibilities. Compared with the general population, cancer patients were more concerned about the potentially decreased service quality in this setting. Conclusion: Although potential service beneficiaries and providers expected improved accessibility of hospice and palliative care services, they were also concerned whether the system can provide adequate quality of end-of-life care.

• Journal of Hospice and Palliative Care
• /
• v.22 no.2
• /
• pp.49-66
• /
• 2019

Along with the advances in medical technology and the economic development, more terminally ill patients are receiving hospice and palliative care services. Moreover, hospice and palliative care clinicians have been showing considerable interest in studies that aim to improve the quality of said care for patients and their families. Meanwhile, after the government has strengthened its policy to protect research participants, the institutional review boards (IRBs) are more closely examining various ethical issues related to patients' vulnerability when reviewing protocols for hospice and palliative care research. However, terminally ill patients should be provided with guaranteed qualities of hospice and palliative care to improve and maintain their quality of life. To that end, support should be provided for efforts to conduct ethical and safe studies with hospice and palliative care patients. Thus, this review paper proposes ethical guidelines for hospice and palliative care research. The guidelines could be appropriately used as a reference for researchers who should prepare for ethically safe and scientifically valued research protocols and the IRBs that will review the protocols.

• Journal of Hospice and Palliative Care
• /
• v.19 no.1
• /
• pp.11-25
• /
• 2016

Purpose: The purpose of this study was to determine the factors that influence healthcare providers' attitude towards end-of-life care (EOLC) in the emergency department (ED) in hospital settings. Methods: From June 1 through June 30, 2014, a descriptive correlational study was performed with 41 doctors and 105 nurses stationed in the ED. Results: According to a regression model on the factors affecting healthcare providers' professional attitude towards EOLC, 28.1% of variance (F=15.185, P=0.000) was explained by awareness of death, gender and personal attitude towards EOLC. And 34.1% of the healthcare providers' personal attitude was related with awareness of death, experience of hospice education, occupations and professional attitude towards EOLC. Conclusion: This study demonstrated that attitude towards EOLC was influenced by awareness of death and personal characteristics. Healthcare providers in the ED should be provided with tailored training to improve their understanding of death. Also an educational program should be developed and provided to ED healthcare providers to improve their awareness of death.

• Asian Pacific Journal of Cancer Prevention
• /
• v.16 no.15
• /
• pp.6331-6334
• /
• 2015

Background: The main purpose of this study was to survey the education and training of certified gynecologic oncologists and fellows in Thailand. A secondary objective was to study the problems in fellowship training regarding palliative care for gynecologic cancer patients. Materials and Methods: A descriptive study was conducted by sending a questionnaire regarding palliative care education to all certified gynecologic oncologists and gynecologic oncology fellows in Thailand. The contents of the survey included fellowship training experience, caring for the dying, patient preparation, attitudes and respondent characteristics. Statistics were analyzed by percentage, mean and standard deviation and chi-square. Results: One hundred seventy completed questionnaires were returned; the response rate was 66%. Most certified gynecologic oncologists and fellows in gynecologic oncology have a positive attitude towards palliative care education, and agree that "psychological distress can result in severe physical suffering". It was found that the curriculum of gynecologic oncology fellowship training equally emphasizes three aspects, namely managing post-operative complications, managing a patient at the end of life and managing a patient with gynecologic oncology. As for experiential training during the fellowship of gynecologic oncology, education regarding breaking bad news, discussion about goals of care and procedures for symptoms control were mostly on-the-job training without explicit teaching. In addition, only 42.9 % of respondents were explicitly taught the coping skill for managing their own stress when caring for palliative patients during fellowship training. Most of respondents rated their clinical competency for palliative care in the "moderately well prepared" level, and the lowest score of the competency was the issue of spiritual care. Conclusions: Almost all certified gynecologic oncologists and fellows in gynecologic oncology have a positive attitude towards learning and teaching in palliative care. In this study, some issues were identified for improving palliative care education such as proper training under the supervision of a mentor, teaching how to deal with work stress, competency in spiritual care and attitudes on responsibility for bereavement care.

• The Korean Journal of Food And Nutrition
• /
• v.22 no.2
• /
• pp.215-222
• /
• 2009

The principal objective of this study was to assess the demands and satisfactions of silver welfare professionals for elderly individuals residing in the Northern Gyeonggi-do area. To this end, a survey was conducted to investigate elderly individuals and employees related with them in terms of their recognition, interest, and involvement in a labor training program. The sources of health information the subjects received included mass media(50%) and health professionals(41%), and they tended to trust the information they received from health professionals(64%) and the mass media(26%). In the case of health professionals working at silver care facilities, the sources of health information to which they had access were: mass media (51%), health professionals(20%), internet(14%), reliable health professionals(56%), mass media(22%), and books related to health(18%). Elderly subjects' reasons for satisfaction with the facilities were as follows: access to meals(32%), elderly communities(24%), and good facilities(22%), whereas the reason subjects reported dissatisfaction with social difficulties(68%), bad facilities(20%), and programs(12%). The degrees of satisfaction of the respondents with the facility's employees were reported as follows: life manager(28%), nurse(16%), and social worker(15%), whereas the subjects reported some degree of dissatisfaction with: nurses(29%), care helpers(17%), and facilities officers(13%). The priorities of the elderly welfare-related information were: disease and health(49%), daily life support(17%), nursing(11%), welfare facilities(8%), and the principal issues they reported as being relevant to elderly individuals were: palsy(16%), arthritis(14%), diabetes (12%), hypertension(10%), dementia(6%). They reported that the most important personnel for elderly in the future would be care managers(44%) and care helpers(21%). Via this developmental program of silver health care professionals, a variety of new job opportunities may be provided in the future, and a program related to the silver service industry must be established as soon as possible.

• Journal of Hospice and Palliative Care
• /
• v.25 no.2
• /
• pp.85-97
• /
• 2022

Purpose: This study aimed to describe nurses' perceived needs and barriers to pediatric palliative care (PPC). Methods: Mixed methods with an embedded design were applied. An online survey was conducted for nurses who participated in the End-of-Life Nursing Education Consortium- Pediatric Palliative Care (ELNEC-PPC) train-the-trainer program, of whom 63 responded. Quantitative data were collected with a survey questionnaire developed through the Delphi method. The 47 items for needs and 15 items for barriers to PPC were analyzed with descriptive statistics. Qualitative data were collected through open-ended questions and analyzed with topic modeling techniques. Results: The mean scores of most subdomains of the PPC needs were 3.5 or higher out of 4, and those of PPC barriers ranged from 3.22 to 3.56, indicating the items in the questionnaire developed in this study properly reflect each factor. The needs for PPC were divided into 4 categories: "children and adolescents," "families," "PPC management system," and "community-based PPC." Meanwhile, PPC barriers were divided into 3 categories: "healthcare delivery system," "healthcare provider," and "client." The keywords derived from the topic modeling were perception, palliative, children, and education for necessities and lack, perception, medical care, professional care providers, service, and system for barriers to PPC. Conclusion: In this study, by using mixed-methods, items of nurses' perceived needs and barriers to PPC were identified, categorized, and weighted, and their meanings were explored. For the stable establishment of PPC, the priority should be given to improving perceptions of PPC, establishing an appropriate system, and training professional care providers.

• Journal of Korean Academy of Nursing
• /
• v.10 no.2
• /
• pp.21-40
• /
• 1980

In order to take cue of the dying persons and their survivors in a more positive and affirmative atti-tube. and to understand the valuable meaning of and dying. a survey was performed to 550 cases of health care personnels including 116 nursing students. 238 medical students. 137 nurses. and 59 doctors. Samplings were made through census Procedure from the entire group of medical and nursing students in College of Medicine. Chung-Ang University. and of licenced nurses and doctors in Chung-Ang University Hospital. and in Han-Gang Sacred Heart Hospital from the first to the end of march. 1980. These collected data were computerized at KIST by SPSS programming and were statistically analyzed by chi-square test. Through content analysis of the word associated with death and descriptive analysis of the death-re-lated variables. the following conclusion in is reached. First. Total numbers of death-word percieved by health care personnels were 198 kinds. Among them, 40 kinds of words associated with death were responded from than 1% of the total. As to the 10 death related word responded by free word association method. it was revealed that individual average number of death related word was 7.70 word. which came from higher number of words in the senior students (8.96 word) or the graduates (8.10 word) compared with the freshman (6.84 word). Second. In Content specific analysis of the death related word. more frequently perceived types summarized as the following order; the affective context of death. the diseases. the disasters. the religion, the funeral ceremonies. the separation, the drakness. and the life. Third. The most prevalent 10 words associated with death which the the respondents gave response to the the first recalling word. were as following o order； the dieases. the sadness, the vanity. the darkness, the frustration. the suicide. the incurable dieases, the graves. the dead. and the catastrophes. By sex, the diease is outstanding in females, but the vanity is in males. By occupation. the vanity and the dead was frequently observed in student group including senior students. while the incurable dieases presented by doctors. Fourth. In health care personnels. the first perceived ages of death were 11.47 $\pm$3.33 years (8.14- 15.80 years). Among them. senior students were inclined to percept death at the earliest age of life (11.28years). while doctors and nurses perceived death later in their life (12.98 years). Fifth, It is revealed in this survey that the most frequently responded death perceiving motives by health care personnels ar“psychological conflict”and“death of those around them”. Death perceiving motives can be classified in two factors; personality and life circumstances. Sixth It is of interest that only 11.3% health care personnels was found to feel death as inevitable or acceptable event. whereas 58.3% deny or reject it.

• Journal of Hospice and Palliative Care
• /
• v.20 no.3
• /
• pp.159-166
• /
• 2017

According to the advance of antiretroviral regimen and the early treatment strategy, people living with human immunodeficiency virus (PLWH) are achieving the goal of virologic suppression and immune restoration. Most of them no more die of acquired immunodeficiency syndrome (AIDS) defining illnesses, and become older with chronic comorbidities such as cardiovascular, metabolic, hepatic, renal and neurological diseases. However some PLWH still visit hospitals as late presenters with very low CD4+ T cell counts, so that they suffer AIDS defining illnesses to die or experience severe neurological complications resulting in disabilities. Early palliative interventions are needed on the various symptoms of PLWH. Thus far chronic pains such as distal symmetric sensory polyneuropathies have been underevaluated. Active pain-relieving interventions are important to them. Recently we define end of life condition of human immunodeficiency virus (HIV) or eligibility to hospice care after adjusting current status of HIV treatment. Hospice teams should pay attention to the specific medical conditions, psychological needs, and social circumstances of PLWH. With just standard precautions as common infection control measures, general hospice cares can be provided to them like to other hospices subjects. For giving PLWH opportunities to have the end of life with value and dignity, hospice multidisciplinary team should intervene them early and aggressively. Now we need more clinical experiences and institutional improvements.

• Journal of Hospice and Palliative Care
• /
• v.16 no.3
• /
• pp.155-165
• /
• 2013

Koreans' traditional view on death has been much influenced by Confucianism, Taoism, Buddhism, and shamanism since ancient times. Confucianism emphasizes the importance of the real life in this world and highly praises doing good deeds for the family and the community. It also praises people who are enlightened by education and self-discipline. Confucian scholars admit that death cannot be understood by rational thinking although it is unavoidable as a cosmic order. Taoism sees life as the same entity as death; Both are two different aspects of the same cosmos or the wholeness. However, the disciples of Taoism became much interested in a long life and well being that may be achieved by harmonizing with the cosmic order. Buddhism thinks that death and life are an "illusion". It says that people can be enlightened by recognizing the fact that "Nothing is born and nothing is dying in this world. Everything is the product of your mind occupied with false belief." However, secular Buddhists believe in the afterlife and metempsychosis of the soul. This belief is sometimes connected with the view of the traditional shamanism. Shamanism dichotomizes the world between "this world" and "that world". After death, the person's soul travels to "that world", where it may influence life of people who reside in "this world". And shamans who are spiritual beings living in "this world" mediate souls and living people. In conclusion, there are various views and beliefs regarding death, which are influenced by a number of religions and philosophies. They should be seriously considered when making a medical decision regarding the end of patients' life.