• Journal of Hospice and Palliative Care
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• 제17권2호
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• pp.66-74
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• 2014

Purpose: This study is aimed to investigate perceptions of caregivers and medical staff toward do not resuscitate (DNR) and advance directives (AD). Methods: Participants were 141 caregivers and 272 medical staff members from five general hospitals. A questionnaire used for the study consisted of 20 items: 14 about DNR perceptions, three about AD, one each for age, gender and employment. Results: Both medical staff and caregivers strongly recognized the need for DNR and AD, and the level of recognition was higher with medical staff than caregivers (DNR ${\chi}^2=44.56$, P=0.001; AD ${\chi}^2=16.23$, P=0.001). The main reason for the recognition was to alleviate sufferings of patients in the terminal phase. In most cases, DNR and AD were filled out when patients with terminal conditions were admitted, and patients made the decisions by consulting with their guardians. Medical staff better recognized the need and for growing demand for guidelines for the DNR and AD decision making process than caregivers (${\chi}^2=7.41$, P=0.0025). Conclusion: This study showed that patients highly rely on their caregivers when making decisions for DNR and AD. Thus, it is important that patients and caregivers are provided with objective information about the decisions. Since participants' strong support for DNR and AD was mainly aimed at alleviating patients' suffering, further study is needed in the association with hospice care. Medical staff also needs to understand the different views held by caregivers and fully consider the disparity when informing patients/caregivers to make the DNR and AD decisions.

• Korean Journal of Hospice Care
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• 제8권1호
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• pp.1-12
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• 2008

Perpose: The purpose of this study was to investigate the perception of death between Korean and Chinese nursing students. And it will help develop curriculum for preparing death, the quality of hospice care, as well as nursing education and practice. Methods: Data was collected from 492 nursing students participated(248 Korean and 244 Chinese) by questionnaire designed for examining Death Orientation (Thorson & Powell, 1988). They were analyzed using Cronbach's Alpha coefficients, factor analysis, t-test, ANOVA and regression analysis (SPSS; win 12.0 version) Results: More than half of the Korean nursing students followed a religion (58.5%) while the majority of Chinese nursing students did not follow a religion (93.9%). In the view of the afterlife, nursing students in China had two views. 'I really don't know what happens after a person dies (30.3%)' and ‘There is no afterlife and death is the end (29.5%)’. On the other hand the Korean nursing students’ answer were, 'After dying, a person goes to heaven or hell (27.3%)' and 'I really don't know what happens after a person dies. (22.9%)' The study also found that the average of 25 items in Death Orientation is 2.36points of nursing students in Korea and 2.50points of nursing students in China. This means that the concern, anxiety and fear were of the middle level for the Chinese Students and were higher than Korean students (t=3.51, p=.000). In the low factor of death orientation, those in Korea had higher 'anxiety of burden to family' than those in China (t=-3.50, p=.001). The nursing students in China had higher 'anxiety of the unknown (t=4.96, p=.000)', 'fear of suffering (t=6.88, p=.000), 'fear of extinction body and life (t=5.20, p=.000), 'fear of lost self-control(t=2.12, p=.034)', and 'anxiety of future existence and nonexistence (t=2.33, p=.020)' than those in Korea. There was no statistically significant difference for the 'concern of body and fear of identity lost' category. The death orientation of Korean nursing students had statistically significant differences according to age (t=3.20, p=.002), religion (t=2.56, p=.011), and afterlife (F=4.64, p=.000). The contribution of Death Orientation had a statistically significant difference, the afterlife variable (0.735, p=0.001). The death orientation of Chinese nursing students did not have any statistically significant differences. Conclusion: In conclusion, there were differences in death orientation between Korean and Chinese nursing students. In particular, those who believed in afterlife showed acceptance of death. The results of this study suggest that nursing curricula should include education program on death and spiritual nursing. Additional studies are needed to establish death education in China with careful considerations on Chinese policies, cultures and social systems.

• Journal of Hospice and Palliative Care
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• 제4권2호
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• pp.137-144
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• 2001

Purpose : Pain is the most serious symptom that cancer patients experience. About $60{\sim}90%$ of advanced cancer patients and four million patients worldwide, according to the WHO statistics, are reported to suffer from cancer pain. Although about $70{\sim}80%$ of the pain could be controlled according to the pain control principles, to our regret, only $30{\sim}40%$ are managed appropriately. This research was aimed to (1) investigates the prevalence of pain among cancer patients, (2) compare patients' perception of pain with physician's recognition and (3) evaluate appropriateness of the doctor's prescription of analgesic. Materials and Methods : Patients with advanced or terminal cancers admitted at department of internal medicine of Seoul National University Hospital for at least 7 days were enrolled. A questionnaire for the patients and the physicians in charge were given and the answers were compared for each other. We also examined their medical records and the physician's orders. Results : Total 59 patients were enrolled. Among them, 43 patients answered the questionnaire, and 27 patients (62.8%) suffered hem cancer pain. The survey also showed that physicians underestimated the severity of pain, overlooked frequently analgesic prescription principle, and that as the patients' pain became severe, the less adequate was pain managements. Conclusion : For cancer patients, pain was frequently overlooked, and treatment still inadequate. Based on this evidence, it seemed that more active practice and education about evaluation and management of cancer pain are needed.

• Journal of Hospice and Palliative Care
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• 제13권3호
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• pp.169-180
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• 2010

Purpose: This study was to identify the death recognition, meaning in life, and death attitude of participants in the death education program. Methods: A survey was conducted, and 205 data were collected. Descriptive statistics, ${\chi}^2$-test, ANOVA, and Duncan test were used. Results: 1) The followings were the characteristics of death recognition shown by the participants. Over half of the participants said that they had given some thoughts on their deaths, that they had agreeable view on death acceptance, and that diseases and volunteer works made them think about their deaths. Moreover, suffering, parting with family and concerns for them, etc. were the most common reasons for the difficulty of accepting death. As for 'the person whom I discuss my death with', spouse, friend, and son/daughter were the most chosen in this order. Lastly, the funeral type that most of the participants desired was cremation. 2) The means of meaning in life and death attitude were $2.92{\pm}0.29$ and $2.47{\pm}0.25$, respectively. There were significant differences between health status, meaning in life and death attitude. 3) A significant positive corelationship was found between meaning in life and death attitude (r=0.190, P=0.001). Conclusion: For an effective death education program that would fit each individual's situation, an educational content that can make a person understand the meaning of his or her life and death, includes knowledge to lessen the fear and anxiety of death, and helps a person heal from the loss of a family member is absolutely necessary.

• Journal of Hospice and Palliative Care
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• 제14권2호
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• pp.81-90
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• 2011

Purpose: This study is to understand how community members perceive past life recollection and preparation for death. Methods: Using a questionnaire, we surveyed 160 adult residents of one of the districts (gu) in Seoul, Korea. Descriptive statistics were used. Results: Participants chose their 30s and 40s as the most difficult time in their lives. The most painful experience was "an illness of a family member", followed by "trouble with a spouse", and "trouble with children". As for the most difficult social experience, "sense of loss in life" was ranked the highest. Personally, the happiest time was "accomplishment of a goal", while it was "happiness through children" in family relationship and "contribution to society through my career" in social life. As for the most regrettable experience, personally "having lived without purpose" was the highest, "not meeting my parents' expectation more" in family relationship; "not providing sufficient education" in relationship with children; "not having an occupation that I wanted" in work life, and "lack of social skills" in social life. More than 87% of the surveyed showed a positive attitude about the system of the do not resuscitate (DNS) order. For a situation where participants were supposed to have an incurable disease, "I want to be notified of the true condition" and "I want to write a will and advanced directives" ranked high, receiving more than 3.1 points out of 4. Conclusion: These results demonstrate the need for death education to provide people with an opportunity to accept their regrettable experiences in the past as part of their life. Also, this study suggests the importance of writing advanced directives for people to prepare for "death with dignity" how it can help their decision to be better respected.

• Research in Community and Public Health Nursing
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• 제13권1호
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• pp.182-196
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• 2002

The purpose of this study was to provide the basic resources for developing a parish nursing program. We did this by investigating what demands were made on the parish nursing service by the parishes or churches under review. The subjects of this study were 96 pastors located throughout the City of Busan. NP (New paragraph) $\gg$ We conducted our research by utilizing a modified version of the study created by Hwang (2000) and by using the help of prior research and professionals gathered from the parish nurse questionnaire by Djupe (1990). The data in this study were collected from July 1 to Oct. 31, 2001, using the questionnaire method. The Data were analyzed by: (a) frequency: (b) percentage: (c) mean: (d) standard deviation, and x^2-test$ with SPSS/PC program. The study has found the follows: 1. For subjects making demands on the parish nursing service, 95.8% were in need of using the services of parish nurses. On the demands of parish nursing service for the subjects, 95.8% the necessity of parish nursing services. And they answered by their intention of asking for parish nursing service practice. 2. Of the subjects under review, 71.9% were part-time workers and 28.1% were full-time employees 71.9% of part time and 28.1% of full times duty. In terms of the method of pay for work, 41.8% were pay free or freelance while 51.2% were on salary. And engagement intention of parish nurse as preacher was 88.5%. 3. The demand for nursing services in various categories were as follows. (a) hospice care: (4.02 1.11), (b) health screening: (3.98 1.09), (c) home visiting: (3.97 1.16), (d) group health education: (3.81 1.12), (e) organization of volunteer groups: (3.75 1.12), (f) individual health education: (3.75 1.14), (g) advice on choosing hospital or hospital consultation: (3.69 1.21) and (h) individual counseling: (3.51 1.31). 4. In terms of the specific services rendered by parish nurses. our study found that services were needed for the following: physical symptom management; preparation before death in spiritual preparation for death, blood pressure check in health examination, home visiting where the patient makes phone call, management of chronic disease in group health education, disease management in individual health education, advice on choosing hospital, or hospital consultation: and physical problems in individual counseling. 5. With respect to whether there was a correlation between what church a pastor came from and the types of demands made, there was NO significant difference found. 6. In relation to the characteristics of the subjects and their church and the hope demands (duty pattern and method of payment and engagement intention of parish nurse as preacher) for parish nurses, these had non significant differences. In conclusion, the perception of parish nursing service is very high. Moreover, we found that there is a great demand for well ordered parish nursing services to promote the health of each congregation. Before doing so, it would be better to make things known and to consider the relevant characteristics shown in the researched results.