• 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.

• Journal of Dental Anesthesia and Pain Medicine
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• v.24 no.1
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• pp.67-73
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• 2024

Background: Nitrous oxide has been an integral part of surgical anesthesia for many years in the developed world and is still used in developing countries such as India. The other main concerns in low-resource countries are the lack of an advanced anesthesia gas-scavenging system and modular surgical theatres. As a greenhouse gas that has been present in the atmosphere for more than 100 years and damages the ozone layer, nitrous oxide is three times worse than sevoflurane. Here, we conducted an observational study to quantify the annual nitrous oxide consumption and its environmental impact in terms of carbon dioxide equivalence in one of busiest tertiary health care and research centers in Northern India. Methods: Data related to nitrous oxide expenditure' from the operation theatre and manifold complex of our tertiary care hospital and research center from 2018 to 2021 were collected monthly and analyzed. The outcomes were extracted from our observational study, which was approved by our institutional ethics board (INT/IEC/2017/1372 Dated 25.11.2017) and registered prospectively under the Central Registry (CTRI/2018/07/014745 Dated 05.07.2018). Results: The annual nitrous oxide consumption in our tertiary care hospital was 22,081.00, 22,904.00, 17,456.00, and 18,392.00 m³ (cubic meters) in 2018, 2019, 2020, and 2021, respectively. This indicates that the environmental impact of nitrous oxide (in terms of CO₂ equivalents) from our hospital in 2018, 2019, 2020, and 2021 was 13,016.64, 13,287.82, 10,289.94, and 10,841.24 tons, respectively. Conclusion: This huge amount of nitrous oxide splurge is no longer a matter of laughter, and serious efforts should be made at every central and peripheral health center level to reduce it.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.22 no.3
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• pp.277-286
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• 2015

Purpose: This study was done to develop a death education program for nursing students and evaluate the effects of the program. Methods: The education program was developed based on ADDIE model. The death education program was developed on the base of educational needs, a comprehensive review of the literature and focus group interviews and then evaluated with 53 nursing students, 27 in the experimental and 26 in the control group. Measurement was done for the meaning of life using the tool by Choi et al (2005) for attitudes concerning death, the tool Thorson and Powell (1998) revised by Kim (2006) and for attitude to end-of-life patient care, the Attitudes toward Nursing Care of the Dying Scale by Frommelt (1991) translated by Cho and Kim (2005). Results: The program consisted of five sessions: Understanding of death, Family bereavement care, Communication and End-of-life patient care, Professional role, and Ethics and legal issues There was a statistically significant difference between pretest and posttest for the meaning of life in the experimental group compared to the control group. About 82% of students in the experimental group were satisfied with the program. Conclusion: The results indicate that this program can be used to educate nursing students.

• Journal of Hospice and Palliative Care
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• v.9 no.2
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• pp.77-85
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• 2006

Purpose: The purpose of this study is to develop the basic curriculum for the nurses who work at hospice and palliative care settings. Methods: Seven curricula of hospice and palliative care for the nurses in Korea and other countries were reviewed, and Education Need for hospice and palliative care was surveyed from 162 nurses by mailing the questionnaires to hospice palliative care settings. Results: 1. The curricula of hospice and palliative care for the nurses in Korea and other countries in common include 'understanding of hospice and palliative care', 'understanding of lift and death', 'pain and symptom management for person with terminal disease', 'on-the-spot study and practical training', 'management of hospice and palliative ward', 'hospice and palliative care at home', 'physical assessment', 'therapeutic communication skills', 'children's hospice', 'administration and management of hospice and palliative care', 'interdisciplinary team of hospice and palliative care', 'ethics and laws in hospice and palliative care', 'psychological, social and spiritual care', 'care of the dying', 'bereavement care', etc. 2. The scores above 3.3 were marked for 34 items in education Need Survey. The highest scores were given in the order for the items 'understanding of death and dying', 'attitude and response to death and dying', 'understanding and assessment of pain' etc. respondents marked that they have been trained for 'pain and symptom management', 'ethics and laws in hospice and palliative care', 'building the system for cooperation and publicity activities in hospice' etc. 3. The basic curriculum of hospice and palliative care for the nurses requires 78 studying hours for 17 subjects, comprising 48 hours of theory education and 30 hours of practical training. The education methods are lectures, discussions, and case studies. Conclusion: The efforts of developed basic curriculum should be evaluated after educating nurses. It is necessary to develop the standard curriculum and regularly update it based on the result of education Need Survey for actively working nurses in hospice and palliative care settings.

• The Korean Journal of Applied Statistics
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• v.24 no.1
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• pp.145-159
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• 2011

National long-term care insurance started in July, 2008. We try to make up for weak points and develop a long-term care insurance system. Especially, it is important to upgrade the rating model of the category of need for long-term care continually. We improve the rating model using the data after enforcement of the system to reflect the rapidly changing long-term care marketplace. A decision tree model was adpoted to upgrade the rating model that makes it easy to compare with the current system. This model is based on the first assumption that, a person with worse functional conditions needs more long-term care services than others. Second, the volume of long-term care services are de ned as a service time. This study was conducted to reflect the changing circumstances. Rating models have to be continually improved to reflect changing circumstances, like the infrastructure of the system or the characteristics of the insurance beneficiary.

• Journal of Korean Public Health Nursing
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• v.34 no.3
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• pp.473-489
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• 2020

Purpose: This study investigated the patient safety culture (PSC), the perception of importance on patient safety management (PIPSM) and the patient safety management activities (PSMA) of care workers in nursing homes. This was a descriptive study that attempted to provide basic data for the patient safety education program of care workers. Methods: Data were collected using questionnaires and interviews from July 1 to 31 in 2020. One hundred and seventy-four care workers participated in quantitative research. The collected data were analyzed by the SPSS/WIN 25.0 program using descriptive statistics, t-test, ANOVA, Bonferroni, and Pearson's correlation. The qualitative data were collected through semi-structured, audio-recorded interviews with six representatives and six care workers from six nursing homes. Content analysis was performed to analyze the data. Results: Positive correlations were observed between PSC and PIPSM, and between PIPSM and PIPSM. Care workers' experience in patient safety management was in the following six categories: "Safety accident risk factors", "Type of safety accidents", "How to prevent safety accidents", "Effective safety management education", "Emphasis on occupational ethics of care workers", and "Needs for standard protocol" Conclusion: These findings indicate that considering the care workers' age and facility size, nurses should enhance patient safety education for care workers and establish a management activity system.

• Journal of Korean Academy of Nursing
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• v.50 no.4
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• pp.583-598
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• 2020

Purpose: This study was to investigate the operational status of the midwifery birthing centers (MBCs) and midwives' job status (Phase 1) and to develop midwifery practice guidelines (MPG) (Phase 2) in Korea. Methods: In the first phase, the subjects were 15 midwives who operated 11 of 14 MBCs that were opened as of August 2018. The questionnaire consisted of items to measure the operational status of the MBC and midwives' job status. In the second phase, the MPG was developed from literature review, interviews with five midwives opening their MBCs, surveys with 74 midwives, and a validity evaluation conducted by seven experts. Results: The distribution of operating MBCs was five in Gyunggi-do, two each in Seoul and Incheon, one each in Busan, Chungcheongbuk-do, Gyeongsangbuk-do, Gyeongsangnam-do and Jeju-do. The mean age of midwives was 54.3 and all were female. In 2017, a total of 762 births including 81 homebirths were performed by midwives. The job performance was highest in the order of neonatal care 3.81, childbirth care 3.56, and postpartal care 3.53, respectively. The MPG included seven areas of prenatal care, childbirth care, postpartal care, neonatal care, primary health care, law/ethics, and administration, with 56 tasks and 166 task elements. Conclusion: This study provides the valid basic data for the operational status of the MBC and the midwives' job status. The MPG describes the midwife's job and may be used as basic data for preparing policies for the development of midwifery practice in Korea.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.2
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• pp.725-729
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• 2014

Background: Having been known as a virulent disease in 1970s, cancer is now onsidered a chronic disease and 64% of cancer patients live for five years after diagnosis. Home care has gradually gained more importance and it is a great burden on the shoulders of caregivers. Caregivers have to undertake the responsibility of the cancer patient's home management, and organize care and arrange health care services according to the ever-changing condition of patients. Caregivers should be prepared for home care so they can provide accurate and complete care to patients. This descriptive study aims to investigate challenges that caregivers encounter in the home care of patients and the reasons for these challenges. Materials and Methods: The research group consisted of caregivers of outpatients in a daily treatment center in a university hospital. The research sampling consisted of 137 voluntary caregivers of patients who attended the Daily Treatment Center for control, chemotherapy or other supportive cares services between January-June, 2011. Data were collected with face-to-face interviews in the Daily Treatment Center. Ethics Committee approval was taken university hospital; caregivers and their patients were informed about the research and their approval was taken as well. Results: It was found that 54.01% of caregivers help patient's nutrition, 50.36% help medicine use, 26.28% help oral hygiene, 26.28% help to meet urinary needs and 51.82% help to change clothes, 69.34% of caregivers help to change bed sheets, 38.69% help the patient to communicate with their environment and 71.53% help to bring the patient to hospital or outside. Conclusions: This study, it was found that caregivers experience challenges due to following factors: patient nutrition, medicine use, oral and body hygiene, colostomy maintenance and stomach tube feeding, concern of dropping the patient, feeling incompetency in body temperature and fever control, fatigue, and lack of personal time.

• The Journal of the Korea Contents Association
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• v.22 no.3
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• pp.43-53
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• 2022

The purpose of this study was to derive ethical life skills in the era of the COVID-19 pandemic from the 'care of self' that Foucault highlighted in . Care of self extends to the relationship one has with oneself and one with others. care of self is a practical ethic that realigns relationships with others and changes society through self-transformation. This study tried to derive specific practices for a life of care of self that individuals can realize against another rule of neoliberalism. Its specific practice style is keeping one's distance from dominant thoughts, forming oneself through practice and writing of subjective thinking, practicing knowing in everyday life, and practicing 'looking down'. These modes of self-care include the other and the world into consciousness in self-examination and transformation. Therefore, through care of self, individuals in the pandemic era can be reborn as members of society who change their lives while building a self-centered life that is faithful to themselves.

• The Journal of Korean Physical Therapy
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• v.3 no.1
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• pp.189-201
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• 1991

Hospice, a concept of care for dying patients, focuses on providing comfort measures rather than aggressively searching for a cure. Hospice addresses symptom control from a wholistic view under the direction of an interdisciplinary team. Physical therapy fits with many of the tenets of hospice, such as the interdisciplinary team, inclusion of the patient and family as the care unit, provision of treatment in various in and out patient settings, and attention to the comfort of the patient. Physical therapy educators must recognize the need for medical ethics, psychosocial and medicolegal issues to be incorporated throughout the curriculum.