• 가정간호학회지
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• 제11권1호
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• pp.57-70
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• 2004

Purpose: This study was to develop a cost-effective and efficient curriculum for advanced practice nurse (APN) programs in home health care and hospice. Method: The process was to: (1) compare and analyze the present curriculum in home health care and hospice programs, (2) identify the needs of 7 expert nurses in home health care and hospice, and (3) develop a common curriculum structure and contents between home health care and hospice specialty courses. Result: Out of the 10 credits constituting the home health care and hospice specialty courses respectively, 6 credits were identified the common courses, Common content areas included introduction to hospice, communication skills, pain control. symptom control. teaching methods, and agency management. Conclusion: These results can be utilized in the development of APN programs for home health care and hospice in terms of qualified and cost-effective aspects of education.

• 호스피스학술지
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• 제3권2호
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• pp.1-11
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• 2003

Purpose: The purpose of this study was to find out the effect of hospice home care on the pain relief and quality of life of terminal cancer patients. Method: Experimental pre and post tests were provided to a single group to see the changes of quality of life of patients who were referred to a hospice home care department after having cancer treatment. They were visited at least 8 times for the duration of 4~6 weeks and were provided a 24 hour phone call service. 41 subjects were transferred to a hospice home care department after being discharged from hospital were selected. Result: 1)The first hypothesis that "the pain score of the subjects after receiving hospice home care would be different from before receiving hospice home care would be different from before receiving hospice home care" which scored 4.06 point at the first test and 3.41 at the second did not statistically show a significant difference(t=1.421 p=1.66), even though the pain score is decreased. 2)The 2nd hypotheses that "the quality of life score of the subjects after receiving hospice home care would be different from before receiving hospice home care" which scored 2.88 point at the first test and 3.39 at the second showed a significant difference(t=-6.759, p=.000) and was supported. Regarding the changes of quality of life score, social aspect(t=-5.745, p=.000), emotional aspect(t=-5.684, p=.000), and spiritual aspect(t=-6.889, p=.000) has significantly been increased, while physical aspect has been more decreased significantly than before the hospice home care is provided(t=4.282, p=.000). Conclusion: It was effective to provide hospice home care in relieving the terminal cancer patients' pain and in improving their quality of life, even though a short term hospice home care for 4-6 weeks was provided.

• 호스피스학술지
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• 제2권2호
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• pp.28-48
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• 2002

The advances of medical technologies have not only prolonged human life span, but also extended suffering period for the patients with incurable medical diseases. Hospice movement was developed to help these patients keep dignity and lives peaceful at the end of their life. Since many patients prefer to spend the last moment of life at home with their family, hospice home care has become very popular worldwide. The purpose of this study for a promotion and development of hospice home care in Korea, and features basic research on medical profession's knowledge and attitudes to hospice home care. This study which was used for the research questionnaires developed by the researcher that were answered by 100 physicians and 127 nurses in a general hospital. Data were collected from April 22, 2002 to May 10, 2002. The SPSS was used to make a comparative analysis of the frequency, percentile, ANOVA, and x2-test. The results of the study were as follows; 1.The medical profession showed high level of knowledge of the definition and philosophy of hospice. However, the physician group of the examinees showed insufficient knowledge of the fact that hospice care includes bereavement care, while the nurse group's response to the same question showed a significant difference(x2=10.752, p=.001). 2.For whom the hospice home care is provided, 95.6% of the respondents showed very high level of knowledge as answering that the incurable terminal illness patients and their families are the beneficiaries of hospice care. The respondents counted nurses, volunteers, pastors, physicians and social workers, consecutively, as hospice care providers. More nurse were positive toward pastors than physicians in regarding as a hospice care provider by a significant difference(x2=11.634, p=.001). 3.For when to referral hospice home care to the patients, only 34.2% answered that patients with less than 6 months of survival time are advised to receive hospice care, reflecting very low level of knowledge. 23.0% of the physicians and 48.0% of the nurses answered that hospice care should be provided when death is imminent, making a significant difference between the two groups(x2=6.413, p=.000). 4.To promote hospice activities, 87.2% pointed out that it is crucial to make general people, including those engaging in the medical field, more aware of hospice. 79.7% answered that a national hospice management should be developed, marking a significant difference between the physician group and nurse group(x2=10.485, p=.001). 5.Advantages of hospice home care are 87.2% responded that patients can have better rest at home receiving hospice home care. Economical merit was brought forward as one of the advantages also, where there was a significant difference between the physicians group and nurse group(x2=7.009, p=.008). 6.The medical professions' attitude to hospice home care are 92.8% of the physicians answered that they would advise incurable terminally ill patients to be discharged from hospital, with 44.3% of them advising the patients to receive hospice home care after leaving the hospital. From the nurses' point of view, 20.9% of the terminally ill patients are being referred to hospice home care after discharge, which makes a significant difference from the physicians' response(x2=19.121, p=.001). 7. 30.6% of physicians have referred terminally ill patients to hospice home care, 75.9% of whom were satisfied with their decision. Those physicians who have never referred their patients to hospice home care either did not know how to do it(66.7%) or were afraid of losing trust by giving the patients an impression of giving up(27.3%). 94.9% of the physicians responded that they would refer their last stage patients to a doctor who is involving palliative care. 8.Only 36.2% of nurses have suggested to physicians that refer the terminally ill patients discharged from the hospital to hospice home care. Once suggested, 95.8% of the physicians have accepted the suggestion. Nurses were reluctant to suggest hospice home care to the physicians, as 48.8% of the nurses said they did not want to. From the result of this study the following conclusion can be drawn, the medical profession's awareness of general hospice care has been increased greatly compared to the results of the previously performed studies. However, this study result also shows that their knowledge of hospice home care is not good enough yet. There is a need for high recommended that medical education institute and develop regular courses on various types of hospice care. Medical field training courses for physicians and nurses will be very helpful as well. It is also important to train hospice experts such as palliative physicians and develop a national hospice management urgently in order to improve the hospice care in Korea.

• 호스피스학술지
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• 제2권1호
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• pp.1-20
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• 2002

The purpose of this study is to develop a management model to effectively provide hospice service of nursing home. In a method of study to achieve this purpose, a positive research and literature study have been performed at the same time. Concerning contents to be examined as a definition of notions and patterns about hospice for the aged, foreign hospice and structural elements of hospice management, a literature study to support a theoretical background has presented leading studies as an analysis form of this study through analyzing domestic and foreign literature, thesis, journal and so on. In order to attain the purpose of this study, the positive research is to carry out a survey of demand and desire of people who have already got hospice service in the first place as a fact-finding survey related to the subject of hospice service, investigate organizations to operate nursing home and hospice and relevant experts in the second place as a survey of supply system to provide hospice service, and develop an appropriate management model to connect the demand and supply of nursing home through it. Therefore, this study has developed a delivery system and a chart of the practical trend to be done minutely, presenting a model to manage a hospice of nursing home based on the above results. The management model externally has connected medical team of hospital with hospice team of home based on a community, and internally is composed centering on five elements such as administrative organization, manpower, program and contents of service, finances. In practical model of hospice management of nursing home, in order to plan a program, provide service and give a high-quality service to the aged, this study has presented a trend chart of service management on the basis of five structural elements, an analysis form of this study. In conclusion, this study could present data to develop a hospice in the field of nursing home for the aged by showing a model concerning a hospice management of nursing home, but in my opinion, a following study to be detailed and developed even more than this study should be continued.

• Journal of Hospice and Palliative Care
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• 제25권2호
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• pp.76-84
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• 2022

Purpose: We compared cost-effectiveness parameters between inpatient and home-based hospice-palliative care services for terminal cancer patients in Korea. Methods: A decision-analytic Markov model was used to compare the cost-effectiveness of hospice-palliative care in an inpatient unit (inpatient-start group) and at home (home-start group). The model adopted a healthcare system perspective, with a 9-week horizon and a 1-week cycle length. The transition probabilities were calculated based on the reports from the Korean National Cancer Center in 2017 and Health Insurance Review & Assessment Service in 2020. Quality of life (QOL) was converted to the quality-adjusted life week (QALW). Modeling and cost-effectiveness analysis were performed with TreeAge software. The weekly medical cost was estimated to be 2,481,479 Korean won (KRW) for inpatient hospice-palliative care and 225,688 KRW for home-based hospice-palliative care. One-way sensitivity analysis was used to assess the impact of different scenarios and assumptions on the model results. Results: Compared with the inpatient-start group, the incremental cost of the home-start group was 697,657 KRW, and the incremental effectiveness based on QOL was 0.88 QALW. The incremental cost-effectiveness ratio (ICER) of the home-start group was 796,476 KRW/QALW. Based on one-way sensitivity analyses, the ICER was predicted to increase to 1,626,988 KRW/QALW if the weekly cost of home-based hospice doubled, but it was estimated to decrease to -2,898,361 KRW/QALW if death rates at home doubled. Conclusion: Home-based hospice-palliative care may be more cost-effective than inpatient hospice-palliative care. Home-based hospice appears to be affordable even if the associated medical expenditures double.

• 대한간호학회지
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• 제28권3호
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• pp.773-785
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• 1998

This study aims at providing more qualitative care in family nursing practice. It is designed to analyze the degree of quality of life(QL) among families of the patients. The subjects consisted of 79 families of hospital hospice patients and 74 families of home-based hospice patients. The ages of the subjects were 17-74 years, at five university hospitals in Seoul, Inchon, and Kyung Gi Province, and one clinic in Chunchon. The data were collected from September, 1996 to August, 1997. The instrument used for the study was the Quality of Life Scale (QLS), which was composed of six factors, developed by Ro, You Ja. The analysis was done using t-test, ANOVA Scheff test, and Stepwise multiple regression. The results were as follows : 1. There were no statistically significant differences between the families of hospital hospice patients and the families of home-based hospice patients ; however, the mean score of the families of hospital hospice patients was higher than that of the families of home-based hospice patients. The scores on QLS ranged from 75 to 224 with a mean score of 140.58 in the families of hospital hospice patients. In the families of home-based hospice patients, the scores ranged from 79 to 214, showing a mean score of 135.25. Among six factors of QLS, family relationships showed the highest score in both groups, but economic life showed the lowest score in the families of hospital hospice patients, and emotional state showed the lowest score in those of home-based hospital patients. Self-esteem and relationship with the neighborhood were significantly higher in the families of hospital hospice patients than the families of home-based hospice patients (t=2.69, P= 0.008 ; 1=2.04, p=0.043). 2. In the families of hospital hospice patients, QL had significant relationship with family member's age(F=2.52, p =0.029), marital status (F=3.57, P=0.018), economic state(F=6.07, P=0.004), and education level(F=3.77, P=0.014). In the families of home-based hospice patients, QL had significant relationship with marital status (F=2.53, P=0.049), education level(F=4.35, P=0.007), occupation(F=3.93, P=0.002), and patient's age(F=2.73, P=0.020) 3. Economic status accounted for 17% of QL, and diagnosis accounted for an additional 7% of QL in the families of hospital hospice patients by means of stepwise multiple regression analysis. In the families of home-based hospice patients, relationships with patient accounted for 12% of QL. The findings showed that self-esteem and relationship with the neighborhood were significantly higher in the families of hospital hospice patients than the families of homed-based hospice patients and family relationships showed the highest value in QL. These findings should be considered in nursing practice.

• 성인간호학회지
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• 제18권1호
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• pp.102-114
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• 2006

Purpose: The purpose of this study is to develop a set of standardized nursing interventions and their associated nursing activities according to the NIC system to guide home care nurses in performing nursing intervention activities for hospice patients. Method: This study was a descriptive survey that first identified frequently used & specialized hospice nursing interventions based on the NIC systems and next validated a set of standardized nursing interventions and their associated nursing activities. One hundred chart records of home hospice patients were used to identify nursing interventions. Also, thirty-nine hospice specialized nurses participated twice using the Delphi technique to test the content validity of the standards. Results: Among the nursing interventions, 19 important nursing interventions and 418 associated nursing activities were selected after two rounds of Delphi technique by hospice specialized nurses. The mean content validity of the final nursing activities was 0.82. In this paper, only the 3 most frequently used nursing interventions and 3 hospice specialized nursing interventions with their associated nursing activities are presented since space is limited. Conclusion: The nursing intervention standards will be a basis for home hospice nurses to improve quality of hospice care for hospice patients.

• 호스피스학술지
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• 제4권2호
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• pp.1-8
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• 2004

Purpose: This research aims to assess the effect of group education of hospice and palliative care program on recognition of home hospice care for terminal cancer patients and their family members. Methods: The terminal cancer patients or their family members who have visited Sam Anyang Hospital from January to September in 2004 participated in group education of hospice and palliative care program on one time a week. Of those, 32 patients or family members who were called education group has participated in group education more than 4 times and responded to a questionnaire. Sixty three patients or family members who were called non-education group have never participated in group education of hospice and palliative care program during the same period. Data were collected and done comparative analysis about both group. Results: A knowledge difference on definition of hospice and palliative care come out 29 people(91%) in education group and 26 people(41%) in non-education group. The recognition of home hospice care in education group(32 people, 100%) was significantly higher than non-education group(15 people,24%). A intention to home hospice care in education group(23 people, 72%) was significantly higher than non-education group(10 people,16%) and practically number of home hospice care was 15 people(50%) in education group and 8(13%) in non-education group. The recognition about cancer of patients was not significant differences in both group. People that the response to the question about 'Did you let your patient know to be the terminal cancer patient?' is 'yes' was 12 people(38%) in education group and 13(21%) in non-education group. Patients in education group had insight about terminal cancer significantly higher than non-education group. Conclusion: If we educated effective hospice and palliative care program in terminal cancer patients or their family members, we think the recognition of cancer and hospice and palliative care improve, and the home hospice care be activated more and more.

• 가정간호학회지
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• 제28권3호
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• pp.307-316
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• 2021

Purpose: This study aimed to examine the influence of family support and death preparation on the quality of life in home care hospice patients. Methods: The study recruited 117 patients in home care hospice in four general tertiary hospitals and three general hospitals in three cities. Data were collected using self-reported questionnaires from September 1, 2019 to March 31, 2020 and analyzed using the statistical package IBM SPSS software version 22.0. Results: The quality of life according to the participants' general characteristics of the subjects shows a statistically significant difference between patients who live with supporters and those who do not(Z=2.96, p=.003). A statistically significant correlation was found between predictors such as family support, death preparation, and quality of life. Family support and death preparation affect the quality of life in home care hospice patients and these variables could explain 33.7% of it. Conclusion: To improve the quality of life in home care hospice patients, we should develop an intervention to enhance family support and death preparation.

• Journal of the Korean Data and Information Science Society
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• 제25권1호
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• pp.37-52
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• 2014

본 연구는 가정 호스피스완화의료 제도도입방안 연구의 일부로 가정호스피스 기관들의 실태를 파악하여 가정 호스피스완화의료 표준지침 개발을 위한 기초자료로서 활용하기 위해 시행되었다. 별도의 인력을 배정하고 지속적으로 가정호스피스를 운영하고 있는 7개 기관의 실무자들을 대상으로 개방식 서면조사와 포커스그룹 인터뷰를 실시하였다. 인터뷰에 참여한 기관들은 24시간 on call 서비스, 의사와 간호사, 사회복지사, 사목자를 포함한 호스피스팀 구성, 정기적 팀회의, 사별가족관리 등을 가정 호스피스완화의료의 필수사항으로 여기고 있었고, 필수 시설은 방문간호사 사무실 및 물품준비 공간, 필수 장비는 방문용 가방으로 파악되었다. 방문을 가장 많이 하는 인력은 간호사였고, 가정방문서비스를 위한 전담인력을 두어야 한다는 데에 합의하였다. 가정호스피스 활성화의 장애요인으로 가정 호스피스에 대한 보험수가보상이 없어 팀원의 방문이 제한적이고, 집에서 처방변경이 어려우며, 24시간 주 7일 입원연계가 어려운 점, 가정 내 돌봄제공자가 없는 경우가 늘어나고 있는 점 등이 제시되었다. 가정호스피스 제도화를 위해 가정호스피스 서비스의 표준 개발은 매우 시급하고도 중요하며, 이에 본 연구의 결과는 서비스 표준안의 초안 마련에 근거자료로 활용될 것이다.