• Korean Journal of Hospice Care
• /
• v.6 no.2
• /
• pp.69-78
• /
• 2006

Purpose: This study was conducted to analysis relationship about quality of life and family burden of the home-based hospice patient families. Method: The subjects consisted of 94 families with home-based hospice patient. The ages of the subjects were 17-73 years with hospice patient who receivedhome visiting care and registered at 4 hospitals in Daegu and Kyung-Buk. The data was collected from March to November 2004. The instruments used for the study were Quality of Life Scale (GLS) and Family Burden Questionnaire (FBQ). The analysis was done using frequency, mean, standard deviation, correlation and stepwise multiple regression with SPSS WIN 11.0. Results: The results were as follows: 1. The mean score of family burden was 3.36 ($\pm0.55$). The highest mean score of family burden 6 factors were wellness of future 3.85($\pm1.10$), and the second was economic family burden 3.63($\pm0.97$). 2. The mean score of quality of life was 3.09 ($\pm0.48$). The lowest score of quality of life 6 factors were economic status 2.86($\pm0.54$), and the second was physical state and function 3.01($\pm0.62$). 3. In the home-based hospice patient families, family burden had significant negative correlation with quality of life(r=-0.25, p=0.012). 4. Emotional status accounted for 11% of family burden in the home-based hospice patient families by means of stepwise multiple regression. 5. Economical status accounted for 18 and age accounted for an additional 11% of quality of life in the home-based hospice patient families by means of stepwise multiple regression. Conclusion: The finding showed that family burden and quality of life of home-based hospice patient families were significantly negative correlation and the highest factor of family burden was wellness of future and the most important factor of quality of life was economic status.

• Journal of Korean Academy of Nursing
• /
• v.31 no.5
• /
• pp.897-911
• /
• 2001

The purpose of the study was to compare home care nursing intervention activities analyzed by the Nursing Intervention Classification (NIC) system for hospice and general patients. Method: For the descriptive survey study, data was collected by reviewing charts of 151 hospice patients and 421 general patients who registered in the department of home health care nursing at K Hospital. Results: According to the NIC system application, there were 2380 total nursing interventions used for the hospice patients and 8725 for the general home care patients. For both sets of patients (hospice vs. general), the most frequently used nursing intervention in level 1 was the Physiological: Complex domain (40.13 vs. 31.06 percent), followed by the Safety domain; in level 2, the Risk Management class (28.4 vs. 27.70 percent), followed by Tissue Perfusion Management; and in level 3, Vital Sign Monitoring (6.18 vs. 4.84 percent), followed by Health Screening. Conclusion: The study showed that there was a lack of specialized hospice nursing interventions such as emotional, family and spiritual support, and care for dying hospice patients.

• Journal of Hospice and Palliative Care
• /
• v.16 no.2
• /
• pp.98-107
• /
• 2013

Purpose: This study was conducted to investigate how home-based hospice care is provided in Korea. Methods: From July 2011 through August 2011, 29 hospice facilities that provide home-based hospice care were surveyed using a questionnaire. Items included in the questionnaire were general characteristics of the organization, staff members, service programs, difficulties. Results: Among the surveyed, hospice care was hospital-based for 11 (37.9%) facilities, hospital-independent center-based care for four (13.8%) and home-based care only for 10 (34.5%). Near half the participants were located in Seoul and Gyeonggi-do. Caregivers included nurses for 62.1% of the participants, volunteers 62.0%, pastors 44.8%, social workers 37.9%, coordinators 31.0% and doctors 31.0%. The facilities offered service programs such as family counseling (96.6%), transfer to other facilities (93.1%), psychological support (89.7%), bereavement support (86.2%), dying care (79.3%), clinical care (75.9%) and spiritual support (75.9%). The major obstacles were financial issues (24.1%), lack of trained staff (20.7%) and staff members' lack of awareness of home-based hospice care (13.8%). Conclusion: In Korea, home-based hospice care is provided by an insufficient number of facilities. Moreover, the service providers are experiencing difficulties such as lack of trained staff, insufficient financial resource and staff's lack of awareness of home-based hospice care. It is necessary to increase the number of home-based hospice care facilities with consideration of even distribution across regions and standard staffing and service programs and develop related insurance policies.

• Journal of Hospice and Palliative Care
• /
• v.19 no.2
• /
• pp.145-153
• /
• 2016

Purpose: This study was conducted to investigate patients' characteristics and actual conditions of home-based services offered by a free-standing hospice center. Methods: A retrospective review was performed with the medical records of 75 patients who received home-based hospice care from a free-standing hospice center from January 2014 through December 2014. Results: Most patients (54.7%) were enrolled via self-directed referral. The reason for the service termination was death at home 25.3%, admission to a hospice ward 50.7%, hospitalization 22.6% and patients' refusal 2.7%. Seventy three patients had cancer, and two patients had ALS. Among all, 58.7% were in a dying phase, and 34.7% were almost completely bedfast at the time of their enrollment in this study. When they enrolled, the patients' physical symptoms were characterized as pain (89.4%), sleep disturbance (71.2%), urinary difficulties (35.8%) and defecation difficulties (47.8%). Among all, 77.4% terminated the home visit service within one month. The mean frequency of the home visits was 3.25 (${\pm}3.98$), and less than five in 82.7% of patients. The mean frequency of the phone service was 3.40 (${\pm}3.12$). The frequency of doctor's home visits was $1.21{\pm}0.79$ on average, and the figure increased when patients' conditions turned unstable. Conclusion: It is necessary to develop a home-based hospice care model with consideration of patients' characteristics and the actual service conditions delivered by free-standing hospice facilities.

• The Journal of the Korea Contents Association
• /
• v.22 no.6
• /
• pp.567-579
• /
• 2022

The purpose of this study is to find a way to improve the hospice system to increase comfortable home death, which people prefer, by understanding the factors affecting the difference in the rate of home death between South Korea and America within the hospice system. This study employs the Most Similar Systems Design, which is a case study approach. The result of this study is that both countries have public health insurance systems that are identical in terms of the appropriate time for the receipt of hospice services and the application procedure, which requires that two doctors confirm the patient's hospice eligibility. The main difference is that in South Korea, inpatient hospice is prevalent, whereas routine home care is predominant in the United States. Furthermore, in the United States, hospice assistants and housekeepers support at-home daily living care. Additionally, the United States provides inpatient respite care to allow care-giver, such as family to rest and there is no restriction on hospice-eligible diseases. To increase the accessibility of voluntary home death in South Korea, it is necessary to activate and expand the home type hospice service range and provide at-home daily living care, care-giver support services. Furthermore, there should be no restrictions on hospice-eligible diseases.

• Journal of Korean Academy of Nursing
• /
• v.30 no.4
• /
• pp.1045-1054
• /
• 2000

As cost pressures have escalated, policy makers, politicians, health care providers and families have tried to devise ways to reduce health care costs. While originally developed to enhance patient control and to provide better care at the end of life, hospice care has recently received significant attention as a mean of reducing health care costs. As a program providing care for patients who are dying at their homes, hospice has expanded slowly since the opening of the first hospice in Korea in 1963. Therefore, a variety of services that responds to the needs and concerns of many dying people and their families is limited The purpose of this study was to determine the potential cost savings at the end of life among patients who used home hospice compared with the patients who received institutional care in Korea. This study used a retrospective, descriptive design. The sample for this study included 46 patients who died of lung cancer: 25 patients who received home hospice care and 21 patients who received institutional care. Data on patient characteristics, kinds and frequencies of provided treatment and nursing services, and hospice and hospital charges during the last month before death were collected. Cost of care was measured by the average cost per patient per day in the last month of life. The results of the study indicated that there were significant differences in average cost of care between home hospice sample and institutional care sample (t=9.956, p<.001; home hospice sample: M=18,102 won, institutional care sample: M=317,578 won). The cost of the home hospice sample was approximately 6% of the cost of institutional care. The majority of the home hospice nursing services were education (35.7%) and supportive counseling (25.2%), followed by medication management (13.6%), assessment (12.1%), basic nursing (7.2%), treatment (5.5%) and others. In institutional care sample, basic nursing and treatment were more emphasized than education or supportive counseling among the nursing services provided. The results of this study showed the potential for hospice to reduce costs and implications for policymakers and clinicians to incorporate hospice program into the formal health care delivery system in Korea.

• Journal of Hospice and Palliative Care
• /
• v.11 no.1
• /
• pp.12-29
• /
• 2008

Purpose: To develop the standardized record forms for home hospice team members, made up of nurse, doctor, social worker, minister and volunteer, to share information and communicate efficiently in their specialized field. Methods: A methodological study revising and complementing initially developed record forms by obtaining content validity from the experts in each field. Results: Reflecting total 27 experts' opinions, final 11 types of home hospice team documents (registration form, visiting record form for a nurse, initial assessment form for a doctor, progress note for a doctor, initial assessment form for spiritual care, visiting record form for a minister, care note for social worker, visiting record form for a volunteer, final summary note, initial assessment form for bereaved family, and follow-up record form for bereaved family) have been developed. Conclusion: It is believed that this study initiated of effective communication between home hospice team members and enhanced quality of home hospice service and its records.

• Journal of Hospice and Palliative Care
• /
• v.18 no.3
• /
• pp.219-226
• /
• 2015

Purpose: This study was conducted to understand public perception of home-based hospice and identify related factors. Methods: Between August 19, 2014 and August 30, 2014, data were collected using an E-mail questionnaire that was filled by 1,500 adults who were over 20 years of age. Data were analyzed using descriptive statistics, ${\chi}^2$-test and logistic regression. Results: Among the respondents, 15.9% were aware of home-based hospice care, and 61.3% were willing to receive home-based hospice care. The factors that influenced the participants' willingness to use home-based hospice services included residential district, religion and private health insurance. Respondents who lived in Seoul (OR: 1.56, 95% CI: 1.04~2.33), Gwangju/Jeolla province (OR: 2.02, 95% CI: 1.23~3.32), Busan/Ulsan/South Gyeongsang province (OR: 1.81, 95% CI: 1.17~2.82) were more well-aware of home-based hospice care than those who lived in Incheon/Gyeonggi province. The faithful were more informed about the services than those without non-faithful participants (Roman Catholics (OR: 2.03, 95% CI: 1.30~3.17), Protestants (OR: 1.76, 95% CI: 1.22~2.53). Participants who had a private health insurance plan knew more about the services than those without one (OR: 1.45, 95% CI: 1.03~2.04). Conclusion: First, it is necessary to improve perception of the public and healthcare providers regarding home-based hospice care. The government should review a measure to institutionalize operation of a palliative care team at hospitals and community home-based hospice care centers.

• The Korean Journal of Health Service Management
• /
• v.12 no.4
• /
• pp.173-190
• /
• 2018

Objectives: This study was conducted to analyze the symptoms and care needs of home-based hospice palliative patients in Busan and to provide a basic reference for developing practical guidelines for their care. Methods: By examining the registration cards of 409 hospice palliative patients, who were registered in community health centers in Busan as of 2016, this study retrospectively analyzed their characteristics, symptoms and care needs. Results: The average age was 70.6 years, 59.4% were receiving medical benefits, and 48.4% lived alone. As per the data obtained from the Palliative Performance Scale, many were able to mobile. Fatigue was the most severe and depression and anxiety were reported together, and their care needs were also high. Most subjects reported mild or low pain, but care needs were high. Furthermore, the medical benefits group showed a high level of symptoms and care needs across areas. Conclusions: To help subjects to live in their homes for as long as possible, it is necessary to identify symptoms and care needs and provide services in accordance with their severity and situation. Thus, it is necessary to develop practical guidelines for standardized community hospice palliative care services.

• Journal of Hospice and Palliative Care
• /
• v.3 no.1
• /
• pp.28-38
• /
• 2000

Purpose : This study examined characteristics of, problems of and services provided to hospice recipients and their family members at a home hospice organization. Methods : The subjects were 113 people who were discharged from one free-standing home hospice organization between November, 1994 and lune, 1999. Since the opening of the organization in November of 1994, it has provided hospice services at patients' homes with no charge. Data were collected from those subjects' records. Results : The average age of the subjects was 57.1 years; those aged 60 and over were 54%. Spouse was the most frequent(50.9%) primary caregiver followed by daughter-in-law and daughter. All the subjects were diagnosed as having cancer. Of those 41 subjects who did not know their terminal stage in the beginning, 31 subjects came to know their states. Of the subjects, 72.7% were referred from their physicians. On the average, the service duration and the number of home visits were 6.8 weeks and 7.2 times, respectively. Pain was the most prevalent problem of the subjects(89.4%). Medication management was the most frequently provided service followed by psychological supports. The reasons for discharge were death(88.5%) and refusal(8%). Home was the most frequent place of death(60%). Conclusion Home hospice service providers should be trained particularly in working with elders and in managing cancer pain. People need to be referred at an appropriate time for achieving goals of hospice. Community recognition of hospice services needs to be promoted.