• Title/Summary/Keyword: End-of-life care performance

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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.

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.

Prediction of Survival in Patients with Advanced Cancer: A Narrative Review and Future Research Priorities

  • Yusuke Hiratsuka;Jun Hamano;Masanori Mori;Isseki Maeda;Tatsuya Morita;Sang-Yeon Suh
    • Journal of Hospice and Palliative Care
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    • v.26 no.1
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    • pp.1-6
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    • 2023
  • This paper aimed to summarize the current situation of prognostication for patients with an expected survival of weeks or months, and to clarify future research priorities. Prognostic information is essential for patients, their families, and medical professionals to make end-of-life decisions. The clinician's prediction of survival is often used, but this may be inaccurate and optimistic. Many prognostic tools, such as the Palliative Performance Scale, Palliative Prognostic Index, Palliative Prognostic Score, and Prognosis in Palliative Care Study, have been developed and validated to reduce the inaccuracy of the clinician's prediction of survival. To date, there is no consensus on the most appropriate method of comparing tools that use different formats to predict survival. Therefore, the feasibility of using prognostic scales in clinical practice and the information wanted by the end users can determine the appropriate prognostic tool to use. We propose four major themes for further prognostication research: (1) functional prognosis, (2) outcomes of prognostic communication, (3) artificial intelligence, and (4) education for clinicians.

Terminal Care Stress, Job Satisfaction and Terminal Care Performance for Nurses in Internal Medicine Wards (내과병동 간호사의 임종간호 스트레스, 직무만족도 및 임종간호수행)

  • Baek, Eu Kyoung;Choi, Eun Joung
    • Journal of Hospice and Palliative Care
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    • v.18 no.4
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    • pp.267-275
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    • 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.

The Meaning of Dignified Dying Perceived by Nursing Students (간호대학생이 인식하는 품위 있는 죽음)

  • Jo, Kae-Hwa
    • The Journal of Korean Academic Society of Nursing Education
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    • v.16 no.1
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    • pp.72-82
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    • 2010
  • Purpose: The purpose of this study is to understand the meaning of dignified dying expressed by undergraduate nursing students. Method: Data were collected by in-depth interviews with fifteen nursing students. Conventional qualitative content analysis was used to analyze the data. Result: There were six major themes and eleven sub-categories from the analysis. Six major themes include death with no artificial life support, obedient death as a human nature, death with family members, meaningful death, no self destructive death, and sympathized death receiving from health care providers. Conclusion: The result of this study suggests that the nursing curriculum related to dignified dying can be developed and may affect the teaching and learning settings to improve end-of-life care performance among undergraduate nursing students, as well as, students in human service areas and health care providers.

Effect of Debriefing Based on the Clinical Judgment Model on Simulation Based Learning Outcomes of End-of-Life Care for Nursing Students: A Non-Randomized Controlled Trial (임상판단모델에 근거한 디브리핑 적용이 임종간호 학습성과에 미치는 효과: 비무작위 대조시험설계)

  • Jeong, Kyung In;Choi, Ja Yun
    • Journal of Korean Academy of Nursing
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    • v.47 no.6
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    • pp.842-853
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    • 2017
  • Purpose: This study was conducted to identify effects of debriefing based on the clinical judgment model for nursing students on their knowledge, skill performance, clinical judgment, self-confidence and learner satisfaction during simulation based end-of-life care (ELC) education. Methods: Simulation based ELC education was developed in six steps as follows: selection of learning subjects and objects, development of learning tools, a trial run of simulation-based education, students' skill training, and evaluators' training. Forty-eight senior nursing students (25 in the experimental group and 23 in the control group) participated in the simulation-based ELC education using a high-fidelity simulator. Debriefing based on the clinical judgment was compared with the usual debriefing. Results: ANCOVA showed that there were differences in knowledge (F=4.81, p=.034), skill performance (F=68.33, p<.001), clinical judgment (F=18.33, p<.001) and self-confidence (F=4.85, p=.033), but no difference in satisfaction (t=-0.38, p=.704) between the experimental and control groups. Conclusion: This study found that debriefing based on the clinical judgement model is effective for supporting nursing students for reflecting on clinical judgment and improving their diverse competencies in complex clinical settings such as ELC.

Investigation of the Relationships Between Death Recognition, Terminal Care Stress, and Terminal Care Performance in Terminal Hospital Nurses (요양병원간호사의 죽음인식, 임종간호스트레스와 임종간호수행간의 관계 조사)

  • Jung, Ji Soo;Lee, Kyung-Sun
    • Science of Emotion and Sensibility
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    • v.23 no.1
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    • pp.79-88
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    • 2020
  • The purpose of this study is to investigate the relationships between death recognition, terminal care stress, terminal care performance, and other influencing factors of terminal care performance in terminal care hospital nurses. Two hundred forty nurses working in 11 hospitals for the elderly located in G, N, C city were surveyed. They were asked to complete three questionnaires: one on death recognition, one on terminal care stress, and a final one on terminal care performance. The data collected were analyzed using descriptive statistics, Pearson's correlation, and stepwise regression using SAS 9.1. The findings suggest that the nurses' own mental and occupational stress was the cause of many difficulties in the practice of end-of-life care, where the nurse will often experience the death patients, which results in increased dysentery stress. There was a negative correlation between species stress and terminal care performance. Death recognition and terminal care stress were correlated with terminal care performance. The results suggest that the longer the clinical experience, the higher the quality of terminal care performance. Therefore, it is suggested that terminal care should be performed considering the longevity of the careers career and their death tendency. Further to this study, it is necessary to find out how to reduce stress and to evaluate other variables affecting the care of the patient.

Nurses Attitudes toward Death, Coping with Death and Understanding and Performance Regarding EOL Care: Focus on Nurses at ED, ICU and Oncology Department (임종 다빈도 부서 간호사의 죽음에 대한 태도 및 대처정도와 생애 말기환자 간호와의 관계 - 응급실, 중환자실, 종양내과 병동 간호사를 중심으로)

  • Seo, Min-Jeong;Kim, Jung Yeon;Kim, Sanghee;Lee, Tae Wha
    • Journal of Hospice and Palliative Care
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    • v.16 no.2
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    • pp.108-117
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    • 2013
  • Purpose: The objectives of this study were to 1) explore nurses' attitudes toward death, coping with death, understanding and performance regarding end-of-life (EOL) care, 2) describe correlations among the above factors, and 3) determine the factors affecting nurses' EOL care performance. Methods: Study participants were 187 nurses stationed at departments that post higher mortality than others such as the oncology department, intensive care unit (ICU) and emergency department (ED). Data were collected from three urban university-affiliated hospitals. Multi-dimensional measure was performed for study instruments such as "attitude toward death", "coping with death" and "understanding and performance regarding EOL care". Data were analyzed by using descriptive statistics, correlation, and multiple regressions. Results: First, nurses showed significantly different attitudes toward death by age, religion, work unit and EOL care education. Younger nurses tend to score low on the understanding of EOL care, and ED nurses' score was lower than their peers at the oncology department and ICU. Second, EOL care performance was positively correlated with attitude toward death (P<0.001), coping with death (P=0.003) and understanding of EOL care (P<0.001). Third, nurses' EOL care performance was affected by work unit (P<0.001) and understanding of EOL care (P<0.001). Conclusion: Because nurses' performance was influenced by their work unit and understanding of EOL care, they should be provided with appropriate training to improve their understanding of death and EOL care according to work unit.

Effects of Dietary Supplementation of Shrimp Soluble Extract on Growth Performance, Innate Immunity and Digestibility of Pacific White Shrimp Litopenaeus vannamei (사료 내 새우가용성추출물(shrimp soluble extract) 첨가가 흰다리새우(Litopenaeus vannamei)의 성장, 면역력 및 소화율에 미치는 영향)

  • Ko, Daehyun;Shin, Jaehyeong;Kim, Min-Gi;Lee, Chorong;Kim, Sung-Sam;Park, Gunhyun;Lee, Kyeong-Jun
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.54 no.3
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    • pp.287-292
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    • 2021
  • This study was conducted to evaluate the effects of dietary supplementation with shrimp soluble extract (SSE) on growth performance, feed utilization, innate immunity and digestibility of Pacific white shrimp Litopenaeus vannamei. A basal diet (Con) was formulated and three other diets were prepared with SSE supplementation at different levels of 1, 2 and 4% (designated as SSE1, SSE2 and SSE4, respectively). Triplicate groups of shrimp (1.20±0.01 g) were fed one of the experimental diets for 6 weeks. At the end of the feeding trial, growth performance and feed utilization of the shrimp were significantly improved by dietary supplementation of SSE4 compared to those of shrimp fed the Con diet. Shrimp fed SSE4 diet had significantly higher phagocytic activity than shrimp fed the Con diet. Dietary supplementation of SSE improved the protein and dry matter digestibility of shrimp. These results indicate that SSE can be used as a functional additive in the diets for Pacific white shrimp.

Use of Blood Transfusion at the End of Life: Does it Have Any Effects on Survival of Cancer Patients?

  • Goksu, Sema Sezgin;Gunduz, Seyda;Unal, Dilek;Uysal, Mukremin;Arslan, Deniz;Tatli, Ali Murat;Bozcuk, Hakan;Ozdogan, Mustafa;Coskun, Hasan Senol
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.10
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    • pp.4251-4254
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    • 2014
  • Background: Treatment of anemia is an important issue in the palliative care setting. Blood transfusion is generally used for this purpose in supportive care. However the place of blood transfusion in terminally ill cancer cases is less far established. Objective: We aimed to outline the use of transfusions and to find the impact of blood transfusion on survival in patients with advanced cancer and very near to death. Design: Patients dying in 2010-2011 with advanced cancer were included in the study. We retrospectively collected the data including age, type of cancer, the duration of last hospitalisation, ECOG performance status, Hb levels, transfusion history of erythrocytes and platelets, cause and the amount of transfusion. The anaemic patients who had transfusion at admission were compared with the group who were not transfused. Survival was defined as the time between the admission of last hospitalisation period and death. Results: Three hundred and ninety eight people with solid tumours died in 2010-2011 in our clinic. Ninety percent of the patients had anemia at the time of last hospitalisation. One hundred fifty three patients had erythrocyte transfusion at admission during the last hospitalisation period (38.4%). In the anaemic population the duration of last hospitalisation was longer in patients who had erythrocyte transfusion (15 days vs 8 days, p<0.001). Conclusions: Patients who had blood transfusion at the end of life lived significantly longer than the anaemic patients who were not transfused. This study remarks that blood transfusions should not be withheld from terminal cancer patients in palliative care.