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

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The Importance and Performance Analysis for the Development of Endurance Nursing Education Program : Focusing on Hospice Teams (임종돌봄 수행 프로그램 개발을 위한 교육요구도 분석 : 호스피스팀원을 중심으로)

  • Jang, Sun-Hee;Jang, Eun-Sil
    • Journal of Convergence for Information Technology
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    • v.11 no.7
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    • pp.288-297
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    • 2021
  • The purpose of this study was to provide basic data for the development of end-of-life care program by analyzing the importance and performance of end-of-life care. Data were collected from 127 hospice team members currently working in hospice and palliative care units from six different university hospitals, general hospitals and hospice clinics. The data was collected throughout the time span of Dec. 1, 2020 to Feb. 15, 2021. Data were analyzed using descriptive statistics, t-tests, ANOVA, & IPA matrix. As a result of this study, 'physical care' and 'psychological care' were part of the first quadrant that requires maintenance and continuous enhancement. The 'spiritual care' appeared to be in the third quadrant area which entails long-term improvement. Based on the outcome of the study, it is evident that strategies are needed to continuously maintain and enhance physical and psychological care as well establish long-term plans for spiritual care when organizing the hospice team's end-of-life care performance training program.

Dignity and Dignity Therapy in End-of-Life Care

  • Yoojin Lim
    • Journal of Hospice and Palliative Care
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    • v.26 no.3
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    • pp.145-148
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    • 2023
  • Preserving dignity is a significant concern for individuals approaching the end of their lives, as they face an increasing number of conditions that can potentially compromise their dignity. This article discusses dignity therapy as one intervention method aimed at enhancing the psychological and spiritual well-being of patients with terminal illnesses. Dignity therapy is an empirically supported therapeutic intervention that interviews patients with nine questions about what is important to them and what they want to remember, culminating in the production of a document based on these conversations. This intervention serves as a valuable tool and framework, enabling clinical professionals to reflect on dignity. It also provides clinicians with a medium to connect with patients on a deeply human level.

Palliative Care Provided for Older Patients with Terminal Stage of Cardiopulmonary Disease Before and After Life-Sustaining Treatment Decisions (만성 심폐질환을 가진 말기 노인환자의 연명의료결정 전후 완화간호의 제공)

  • Choi, Jung-Ja;Kim, Su Hyun
    • Journal of Convergence for Information Technology
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    • v.11 no.1
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    • pp.45-53
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    • 2021
  • This study was a retrospective descriptive study to identify frequency and change of palliative care provided for older patients with terminal stage of cardiopulmonary disease before and after life-sustaining treatment (LST) decision making. As a result of chart review of 124 older patients in a university hospital, oral analgesics medication, cold and hot therapy for pain management, antibiotics medication and urine culture for urinary infection, oral care, hair wash, and partial bath were provided significantly less after LST decision making. Provision of praying and relaxation therapy for pain control, oral and nasal care, and emotional care were not changed before and after LST decision making. Spiritual care was the least provided care. Therefore, non-pharmacological pain management, emotional care, and spiritual care need to be improved for older patients with terminal cardiopulmonary disease at the end of life.

Nurse's Conflict Experience toward End-of-life Medical Decision-making (말기의 의료적 의사결정에 관한 임상간호사의 갈등경험)

  • Jo, Kae-Hwa
    • Korean Journal of Adult Nursing
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    • v.22 no.5
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    • pp.488-498
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    • 2010
  • Purpose: The purpose of this study was to explore clinical nurse's reported conflict experience toward end-of-life medical decision making. Methods: Data were collected by in-depth interviews with eight nurses from three different wards of university hospital in D city of Korea. Conventional qualitative analysis was used to analyze the data. Results: Results were three major themes and twelve categories from the analysis. The three major themes were prioritization of treatment, non-disclosure of diagnosis, and hierarchical and power relations. Conclusion: The results of this study suggest that shared decision making in end of life among patient, family members, physician, and nurse may contribute to improve end-of-life care performance as well as dignified dying of patient in end of life.

The Use of Antibiotics in Hospice and Palliative Care Settings

  • Shekhar, Aditya C.
    • Journal of Hospice and Palliative Care
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    • v.25 no.1
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    • pp.50-54
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    • 2022
  • Antibiotics are commonly prescribed medications in the hospice and palliative care setting, as well as in many other healthcare settings. The overuse or negligent use of antibiotics is associated with the harmful consequence of fostering the development of antibiotic-resistant pathogens. Thus, there is an urgent need to critically examine and audit antibiotic use in all aspects of healthcare. In the status quo, there is a lack of consistent standards and guidelines surrounding the use of antibiotics in hospice and palliative care settings, leading to significant variations in how antibiotics are prescribed and administered in end-of-life care. It is apparent that greater thought needs to go into antibiotic decisions for patients receiving hospice or palliative care, especially considering the harmful consequences of the overprescription of antibiotics. The literature suggests that many clinicians prescribe antibiotics inappropriately for patients who would not benefit from their use or prescribe them without adequate documentation. Clinicians should be deliberate about when they prescribe antibiotics and adhere to the appropriate documentation standards and procedures within their institution or community. Future research should seek to generate generalizable knowledge about which patients will benefit most from antibiotic therapy during end-of-life care.

Knowledge and Perceptions of the End of Life among Tunisian Medical and Paramedical Staff

  • 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
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    • pp.64-76
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    • 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.

Good Death Awareness, Attitudes toward Advance Directives and Preferences for Care Near the End of Life among Hospitalized Elders in Long-term Care Hospitals (요양병원 입원 노인의 좋은 죽음 인식, 사전의료의향서에 대한 태도 및 임종치료선호도)

  • Kim, Eunju;Lee, Yoonju
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.26 no.3
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    • pp.197-209
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    • 2019
  • Purpose: This study was done to examine good death awareness, attitudes toward advance directives (ADs), and preference for care near the end-of-life (PCEOL) of hospitalized elders in long-term care hospitals. Relevant characteristics were investigated as well as correlation of the variables. Methods: This descriptive research study involved 161 hospitalized elderly patients in long-term care hospitals. A self-report questionnaire was used to measure Good Death Scale, ADs Survey, PCEOL Scale, and general characteristics. Collected data were analyzed using descriptive statistics, t-test, ANOVA, and Pearson correlation with SPSS/WIN 23.0. Results: In terms of good death awareness, a significant difference was observed; in according to age (F=3.35, p=.037), payer of treatment costs (F=3.98, p=.021), mobility (F=3.97, p=.021), heard discussion about ADs (t=-3.89, p<.001), and willing to complete ADs (t=2.12, p=.036). As far as attitudes toward ADs, the participants presented significant difference depending on religion (t=2.38, p=.018), average monthly income (F=3.91, p=.022), duration of hospital admission (F=5.33, p=.006), person to discuss ADs (t=-2.76, p=.006). On PCEOL, there was a significant difference, depending on religion (t=-3.59, p<.001) and perceived health status (F=3.93, p=.022). Finally, as for how the variables were related to each other, good death awareness and attitudes toward ADs had a weak positive correlation with PCEOL. Conclusion: To help seniors staying in nursing homes face a good death and enjoy autonomy, there should be educational and support systems that reflect each individual's sociodemographic characteristics so that the seniors can choose what kind of care they want to receive near the end-of-life.

Comparison of Education Programs for Hospice Volunteer Workers (호스피스 자원봉사자교육의 비교)

  • Huh, Jung-Sik;Kim, Hyeon-Ju
    • Journal of Hospice and Palliative Care
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    • v.11 no.2
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    • pp.78-81
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    • 2008
  • Purpose: The end of one's life can be one of the most important times in human life. However, physicians, nurses and volunteer workers are not sufficiently trained to understand the end-life care with competence and confidence. The purpose of this study was to compare various education programs currently carried out for volunteer workers. Methods: Nine curricula of hospice and palliative cares for volunteer workers at hospital and palliative care settings. Results: The mean time duration of theory education at nine institutes was 21.56 hours (range; 14-30). The common curricula of hospice and palliative cares for volunteer workers included 'Understanding of hospice and palliative care', 'Understanding of life and death', and 'Understanding of psychologic problem of end-of-life'. The education method comprised lectures, off-line 8 institutes and on-line 1 instiutute. Conclusion: It is necessary to develop the standard curriculum as well as regularly updated education program for volunteer workers.

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Attitudes, Perceptions, and Experiences toward End-of-Life Care Decision-Making among Intensive Care Unit Nurses in Korea: An Integrative Review (생애말 치료결정 과정에 대한 중환자실 간호사의 인식, 태도, 경험: 국내 연구논문의 통합적 고찰)

  • Choi, JiYeon;Son, Youn-Jung;Lee, Kyounghoon
    • Journal of Korean Critical Care Nursing
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    • v.13 no.1
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    • pp.27-43
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    • 2020
  • Purpose : This integrative review aimed to synthesize studies on intensive care unit (ICU) nurses' attitude, perceptions, and experiences toward end-of-life care decision-making. Methods : Using Whittermore and Knafl (2005)'s methods, we identified and synthesized research articles published in domestic journals between the years 2003 and 2019 and evaluated the quality of selected articles using the Mixed Methods Appraisal Tool. Results : In the 13 studies reviewed, 12 were published prior to enactment of the "The Act for Hospice and Palliative Care and Decision-Making about Life-Sustaining Treatment (2018)." All nine quantitative studies identified were based on cross-sectional descriptive survey. In four qualitative studies, content analysis (n=2) and phenomenology (n=2) were used. Overall, ICU nurses were well-aware of the necessity of communicating and limiting life-sustaining treatments. Many ICU nurses had positive attitude towards limiting life-sustaining treatments to promote patients' comfort and dignity. Although nurses were willing to take active roles, they also reported having experienced high stress in the process of decision-making and implementation. Conclusions : It is important to prepare ICU nurses with proper knowledge and attitude regarding the topic area. It is also equally important to develop systems to support nurses' emotional stress and moral distress during communication, decision-making, and implementation.