• 간호행정학회지
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• 제14권2호
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• pp.182-195
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• 2008

Purpose: Hospice care represents all meaningful aspects of physical, mental and economical status of the end stage patients. The purpose of this study was to estimate the cost of home-based hospice care. Method: Fifteen nurses participated in counting an hour for requirement and home visit data of 50 end stage patients were analyzed. The method of to estimate the cost of home-based hospice care was three ways. Result: In case, including traffic expense, Singles fixed fee per visit via direct inquiry was 112,970 won but in case, excluding traffic expenses, was 86,036 won and traffic expenses per visit was 26,934 won. Final cost of home-based hospice care integrated the fixed fee per the needed time for visit and fee-for services. The fixed fee per 30 minutes was 35,251 won and 60 minutes was 46,595 won and 90 minutes was 57,939 won. We included pain management and the management of emergency and bereavement care among fee-for services. Conclusion: The cost of hospice care should be establish for not only patient but the living spouse, families, and children of the dying and for anyone else affected by any patient's death.

• Journal of Hospice and Palliative Care
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• 제17권4호
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• pp.223-231
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• 2014

목적: 본 연구의 목적은 말기암환자로서 가정호스피스 돌봄을 받고 있는 대상자의 삶의 경험에서 얻어지는 현상을 이해하고 경험의 본질을 이해하고자 함이다. 방법: 가정호스피스 돌봄을 받고 있는 말기암환자 10명으로부터 심층면담을 통해 자료를 수집하였고 Colaizzi의 현상학적 방법을 사용하여 분석하였다. 결과: 의미 있는 진술에서 구성된 의미가 도출되고, 구성된 의미에서 주제 및 주제모음을 확인하여 범주화 한 결과, '삶의 질 저하', '남은 삶의 수용', '신앙으로 준비된 죽음', '고마움', '부정적 대처'의 범주가 도출되었다. 결론: 가정호스피스 돌봄을 받고 있는 말기암환자들의 삶의 경험을 이해하고, 호스피스 간호를 통해 대상자가 부정적인 삶의 경험을 극복하고, 긍정적인 삶의 경험을 할 수 있도록 체계화된 호스피스 간호의 제공이 필요하다.

• 지역사회간호학회지
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• 제24권3호
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• pp.292-301
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• 2013

Purpose: The purpose of this study was to compare the spiritual well-being and quality of life between hospital and home hospice patients. Methods: A total of 116 patients from 4 hospice hospitals in D city and P city participated in this study from January to April 2012. To measure spiritual well-being, an instrument developed by Paloutzian and Ellison (1982) and revised by Park (2005) was used. To measure quality of life, an instrument developed by Cho (1993) and revised by Sun (2003) was used. The data were analyzed by using descriptive statistics, t-test, $x^2$-test, and ANCOVA. Results: Spiritual well-being and quality of life were higher in home hospice patients than in hospital hospice patients, but they were not statistically significant. Higher education and having religion were significantly related to higher spiritual well-being in both groups. Having religion and pain history for the past one week were significantly related to higher quality of life in both groups. Conclusion: For hospice patients, participation in religious activities needs to be encouraged to improve their spiritual well-being and quality of life. Assessing the hospice patients' pain history with close observation and managing the pain are suggested.

• Journal of Hospice and Palliative Care
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• 제13권2호
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• pp.76-80
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• 2010

목적: 본 연구에서는 제주지역내의 보건소, 지역 암센터와 말기암환자 전문의료기관 등에서 실시하고 있는 재가암환자 관리 사업의 객관적 현황을 파악하여 각 기관별의 재가암 관리를 위한 역할을 정립하고자 한다. 방법: 제주지역에서 재가암환자 관리를 실시하고 있는 각 기관을 대상으로 재가암환자 관리 사업의 시작연도와 현재 실시하고 있는 사업과 부족한 부분 등을 알아보고, 각 기관과의 연관사업 등을 파악하였다. 결과: 제주지역내의 재가암환자 관리는 6개의 보건소와 1개의 지역 암센터, 1개의 말기암환자 전문의료기관이 활동 중에 있으며, 제공되는 서비스는 약간의 차이는 있으나, 신체적, 정서적, 영적, 교육 정보적 서비스를 실시하고 있으나 보건소의 경우, 통증완화를 위한 마약성 진통제의 사용이 부족한 실정이었다. 결론: 본 연구는 재가암환자 관리 사업에서 말기암환자 전문의료기관과 보건소에서 급성기의 경우와 재가암환자 관리를 위한 인력의 교육을 위한 교육은 지역 암센터와 연계하여 재가암환자에 대한 체계적인 관리와 역할 분담을 정립시켜야 할 것으로 생각된다.

• 호스피스학술지
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• 제1권1호
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• pp.46-69
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• 2001

Hospice Care is the best way to care for terminally ill patients and their family members. However most of them can not receive the appropriate hospice service because the Korean health delivery system is mainly be focussed on acutly ill patients. This study was carried out to clarify the situation of hospice in Korea and to develop a hospice care delivery system model which is appropriate in the Korean context. The theoretical framework of this study that hospice care delivery system is composed of hospice resources with personnel, facilities, etc., government and non-government hospice organization, hospice finances, hospice management and hospice delivery, was taken from the Health Delivery System of WHO(1984). Data was obtained through data analysis of litreature, interview, questionairs, visiting and Delphi Technique, from October 1998 to April 1999 involving 56 hospices, 1 hospice research center, 3 non-government hospice organizations, 20 experts who have had hospice experience for more than 3 years(mean is 9 years and 5 months) and officials or members of 3 non-government hospice organizations. There are 61 hospices in Korea. Even though hospice personnel have tried to study and to provide qualified hospice serices, there is nor any formal hospice linkage or network in Korea. This is the result of this survey made to clarify the situation of Korean hospice. Results of the study by Delphi Technique were as follows: 1.Hospice Resources: Key hospice personnel were found to be hospice coordinator, doctor, nurse, clergy, social worker, volunteers. Necessary qualifications for all personnel was that they conditions were resulted as have good health, receive hospice education and have communication skills. Education for hospice personnel is divided into (i)basic training and (ii)special education, e.g. palliative medicine course for hospice specialist or palliative care course in master degree for hospice nurse specialist. Hospice facilities could be developed by adding a living room, a space for family members, a prayer room, a church, an interview room, a kitchen, a dining room, a bath facility, a hall for music, art or work therapy, volunteers' room, garden, etc. to hospital facilities. 2.Hospice Organization: Whilst there are three non-government hospice organizations active at present, in the near future an hospice officer in the Health&Welfare Ministry plus a government Hospice body are necessary. However a non-government council to further integrate hospice development is also strongly recommended. 3.Hospice Finances: A New insurance standards, I.e. the charge for hospice care services, public information and tax reduction for donations were found suggested as methods to rise the hospice budget. 4.Hospice Management: Two divisions of hospice management/care were considered to be necessary in future. The role of the hospice officer in the Health & Welfare Ministry would be quality control of hospice teams and facilities involved/associated with hospice insurance standards. New non-government integrating councils role supporting the development of hospice care, not insurance covered. 5.Hospice delivery: Linkage&networking between hospice facilities and first, second, third level medical institutions are needed in order to provide varied and continous hospice care. Hospice Acts need to be established within the limits of medical law with regards to standards for professional staff members, educational programs, etc. The results of this study could be utilizes towards the development to two hospice care delivery system models, A and B. Model A is based on the hospital, especially the hospice unit, because in this setting is more easily available the new medical insurance for hospice care. Therefore a hospice team is organized in the hospital and may operate in the hospice unit and in the home hospice care service. After Model A is set up and operating, Model B will be the next stage, in which medical insurance cover will be extended to home hospice care service. This model(B) is also based on the hospital, but the focus of the hospital hospice unit will be moved to home hospice care which is connected by local physicians, national public health centers, community parties as like churches or volunteer groups. Model B will contribute to the care of terminally ill patients and their family members and also assist hospital administrators in cost-effectiveness.

• 성인간호학회지
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• 제20권6호
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• pp.960-972
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• 2008

Purpose: The purpose of this study was to validate the nursing intervention standards of home care to home care setting for a guide in giving quality care to home hospice patients. Methods: The developed nursing standards were applied to 79 home hospice patients at K hospital, C university. Data were collected through the developed nursing intervention standards of home care with 19 selected nursing interventions and 418 associated nursing activities from January to June in 2006. Results: The performance frequency was 509 times for total nursing interventions and 7,815 times for total associated nursing activities. The most frequently used nursing activity was 722 times(9.24%) on teaching prescribed medication, followed by surveillance(718 times, 9.18%), and vital signs & neurologic monitoring nursing intervention(701 times, 8.97%). The highest mean nursing activity performance rate showed on Intravenous therapy(82%), followed by dying care(81%), and vital signs & neurologic monitoring (80%). Among 418 nursing activities, there were three classifications: 168 as core activities, 165 as major, and 85 as accessory activities. Conclusion: The final validated nursing intervention standards can guide home care nurses to perform quality care and contribute to computerized nursing services and request of nursing fees.

• 가정간호학회지
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• 제23권1호
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• pp.90-99
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• 2016

Purpose: The purpose of this study was to examine the influences of emotional intelligence and attitudes about death on hospice volunteers' perception of life as meaningful. Methods: In this study, 232 hospice volunteers who were serving at 3 university hospitals and 7 general hospitals for 6 months or longer. Data were collected using self-report questionnaires from January 20 to February 15, 2016. Data were analyzed using descriptive statistics, independent-tests, one way ANOVAs, Pearson's correlation coefficients, and multiple regression analyses with SPSS 21.0. Results: Hospice volunteers' perception of life as meaningful was positively correlated with their attitudes toward death and emotional intelligence. The significant predictors of perception of meaning were emotional intelligence, attitudes toward death, religion and perceived health status. These variables explained 41.0% of the variance in hospice volunteers' perception of life as meaningful. Conclusion: These results suggest that hospice volunteers perceptions of life as meaningful can be changed positively by increasing emotional intelligence and positive attitudes about death.

• 가정간호학회지
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• 제28권3호
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• pp.256-265
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• 2021

Purpose: This study examined the effects of nurses' attitude toward death and their perception of hospice and palliative care on their terminal care stress in long-term care hospitals (LCHs). Methods: Participants included 127 nurses from 6 Incheon LCHs. Data were collected between July and August, 2020. Self-report questionnaires were administered to collect data on their general characteristics, terminal care stress, attitude toward death, and perception of hospice and palliative care. Data analysis included descriptive statistics, independent t-test, one-way ANOVA, Pearson's correlation coefficient, and stepwise multiple linear regression using the SPSS 23.0 statistical program. Results: Nurses' terminal care stress was affected by their attitude toward death (𝛽=.30, p<.001) and perception of hospice and palliative care (𝛽=.28, p=.002) with an explanatory power of 21.6%. Conclusion: Terminal care stress was significantly associated with their attitude toward death and perception of hospice and palliative care. Therefore, educating nurses in LCHs about death and hospice and palliative care is essential to manage their terminal care stress effectively.

• Journal of Hospice and Palliative Care
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• 제26권1호
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• pp.22-25
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• 2023

Although most patients prefer dying at home, patients whose condition rapidly becomes critical need care in the intensive care unit (ICU), and it is rare for them to die at home with their families. Therefore, interest in hospice and palliative care for patients in the ICU is increasing. Hospice and palliative care (PC) is necessary for all patients with life-threatening diseases. The following patients need palliative care in the ICU: patients with chronic critical illnesses who need tracheostomy, percutaneous gastrostomy tube, and extracorporeal life support; patients aged 80 years or older; stage 4 cancer patients; patients with specific acute diseases with a poor prognosis (e.g., anoxic brain injury and intracerebral hemorrhage requiring mechanical ventilation); and patients for whom the attending physician expects a poor prognosis. There are two PC models-a consultative model and an integrative model-in the ICU setting. Since these two models have advantages and disadvantages, it is necessary to apply the model that best fits each hospital's circumstances. Furthermore, interdisciplinary decision-making between the ICU care team and PC specialists should be strengthened to increase the provision of hospice and palliative care services for patients expected to have poor outcomes and their families.

• 호스피스학술지
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• 제2권1호
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• pp.41-57
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• 2002

This study was done to examine spiritual well-being of hospice care service volunteers for the purpose of providing them with programs promoting coping skills in response to the wholistic needs of patient effectively, also providing data for professional or nonprofessional hospice training program. Subjects were 123 volunteers serving in 6 hospice centers in Jeonbuk province at present. Data collection were done from 16 Oct. 2000 to 17 Nov. 2000. questionnairs were consisted of activities of hospice care service volunteer and spiritual well-being. The study results were as follows 1.Mean of activities of hospice care service volunteers were 2.433, those activities were divided into 5 categories such as spiritual, activities of volunteer for themselves, psychosocial, physical area and bereavement. The highest mean score was spiritual area 2.578, activities of volunteers for themselves 2.525, psychosocial area 2.456, physical area was 2.359 and the lowest mean score was bereavement area 2.130. 2.Spiritual well-being of hospice care service volunteers was 5.25, the highest mean. In subcategories of spiritual well-being, religious spiritual well-being was higher than existential spiritual well-being, mean score for each one was 5.41, 5.10. 3.Statistically significant relations among demographic characteristics such as gender(t=2.72, P=.008), status of marriage(t=6.067, P=.003), occupation(F=3.795, P=.025), frequency of visiting for volunteered hospice care(F=3.833, P=.024) were noted. 4.Statistically significant demographic characteristics of hospice service volunteers was religion(t=-4.38, p=0.000), status of marriage(F=3.505, p=0.033), frequency of visiting for volunteered hospice care(F=3.107, p=0.048), level of satisfaction from hospice care volunteer service(F=3.610, p=0.030), hospice service volunteers doing more home visiting(5-9times/month) had higher status of spiritual well being than volunteer with less home visiting(1-4times/month) 5.A significant relationship between activities of hospice service volunteers and status of spiritual well-being was noted(r=.236, p=.004), activities of hospice service volunteers was related to both subcategories of spiritual well-being such as religious well-being(r=.210, p=.010) and existential well-being(r=.208, p=.011). From the results of the study It is noted that status of spiritual well-being for hospice volunteers influences on service activities. It means spiritual well-being should be considered as a essential character for hospice service volunteers, it also means that managing and maintaining of status of spiritual well-being for hospice service volunteers is important. On the base of the study recommendation are made as follows: 1.Considering status of spiritual well-being for hospice care service volunteers is needed to promote hospice care activities. 2.It is necessary to develope spiritual well-being programs for hospice care service volunteers and further study for effect validation of them is needed. 3.Further study to sort out effecting variables for hospice care service volunteer activities is needed. 4.It will be desirable to have spiritual well-being information included in the hospice education program.