• Journal of Hospice and Palliative Care
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• v.25 no.1
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• pp.50-54
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• 2022

Antibiotics are commonly prescribed medications in the hospice and palliative care setting, as well as in many other healthcare settings. The overuse or negligent use of antibiotics is associated with the harmful consequence of fostering the development of antibiotic-resistant pathogens. Thus, there is an urgent need to critically examine and audit antibiotic use in all aspects of healthcare. In the status quo, there is a lack of consistent standards and guidelines surrounding the use of antibiotics in hospice and palliative care settings, leading to significant variations in how antibiotics are prescribed and administered in end-of-life care. It is apparent that greater thought needs to go into antibiotic decisions for patients receiving hospice or palliative care, especially considering the harmful consequences of the overprescription of antibiotics. The literature suggests that many clinicians prescribe antibiotics inappropriately for patients who would not benefit from their use or prescribe them without adequate documentation. Clinicians should be deliberate about when they prescribe antibiotics and adhere to the appropriate documentation standards and procedures within their institution or community. Future research should seek to generate generalizable knowledge about which patients will benefit most from antibiotic therapy during end-of-life care.

• Journal of Hospice and Palliative Care
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• v.24 no.3
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• pp.184-193
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• 2021

Purpose: This study attempted to develop clinical guidelines to help patients use hospice and palliative care (HPC) at an appropriate time after writing physician orders for life-sustaining treatment (POLST) by identifying the characteristics of HPC use of patients with terminal cancer. Methods: This retrospective study was conducted to understand the characteristics of HPC use of patients with terminal cancer through decision tree analysis. The participants were 394 terminal cancer patients who were hospitalized at a cancer-specialized hospital in Seoul, South Korea and wrote POLST from January 1, 2019 to March 31, 2021. Results: The predictive model for the characteristics of HPC use showed three main nodes (living together, pain control, and period to death after writing POLST). The decision tree analysis of HPC use by terminal cancer patients showed that the most likely group to use HPC use was terminal cancer patients who had a cohabitant, received pain control, and died 2 months or more after writing a POLST. The probability of HPC usage rate in this group was 87.5%. The next most likely group to use HPC had a cohabitant and received pain control; 64.8% of this group used HPC. Finally, 55.1% of participants who had a cohabitant used HPC, which was a significantly higher proportion than that of participants who did not have a cohabitant (1.7%). Conclusion: This study provides meaningful clinical evidence to help make decisions on HPC use more easily at an appropriate time.

• Health Policy and Management
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• v.10 no.3
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• pp.68-87
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• 2000

This study aims at the operation of the hospice in the virtual space by the use of telecommunication technology. The hospice can be an efficient alternative for the elderly and terminal patients. It can achieve both the quality of life of patients and the conservations of medical resources. The virtualization creates new norms and values which are different from the conventional environments. The concepts and limitations which are crucial to the projection of the existing hospice into the virtual space are discussed. The items ranging from the hospice need to the design criteria of the modules are investigated. The most important point in constructing the virtual hospice center is the human factor, which characterizes the hospice. In addition, the real-world circumstances of the hospice should be considered in the realization of the VHC.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.15 no.12
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• pp.7148-7159
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• 2014

This study examined the relationship between the death perceptions and attitudes of the severely diseased persons in hospice facilities based on their general characteristics. The surveys were conducted from March 10 to July 31, 2013 on 149 patients at hospice facilities in ${\bigcirc}$ city, Gyeonggi-do. The data was analyzed by the SPSS WIN 18.0. First, positive death attitudes showed significant differences according to the patients' general characteristics (F=6.218, p<.001). Second, the patients' death attitudes by their death perceptions showed meaningful results (F=6.634, p<.001). Third, the death attitudes revealed a positive relation with hospice use (r=.496, p<.001). Overall, patients, who have positive death perceptions and attitudes, have high expectations for hospice use and these results support for welfare policies to encourage hospice use of severely diseased persons.

• Korean Journal of Hospice Care
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• v.2 no.2
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• pp.17-27
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• 2002

Purpose: The purpose of this study was to elucidate the effects of spiritual nursing intervention on anxiety and depression of the hospice patients. This study was devised one group pretest-posttest design. The data was collected during the period from July 10 to September 25 in 2000 at the general hospital in cheonju city. The subjects were thirty-seven patients who referred the hospice service. Method: The tools were used Spielberger's State Anxiety Scale and Zung's Depression Inventory. The spiritual nursing intervention was carried out through Hymn, Scripture, Prayer, the therapeutic use of self over a period of three weeks. Data were analyzed by frequency, percentage, mean, standard deviation, paired t-test. Results: 1.After the spiritual nursing intervention, state anxiety of hospice patients was reduced(t=6.237, p=0.000). 2.After the spiritual nursing intervention, depression of hospice patients was reduced(t=18.58, p=0.000). Conclusion: The hospice patients who were offered spiritual nursing intervention had lower anxiety & depression than those who were not offered spiritual nursing intervention. According to these results, spiritual nursing intervention can be regarded as an effective nursing intervention that relieved anxiety and depression of the hospice patients.

• Journal of Hospice and Palliative Care
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• v.21 no.4
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• pp.109-114
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• 2018

The objective of this paper is to suggest plans to properly establish and promote the use of hospice music therapy by examining its necessity and how it is being used in Korea. Hospice music therapy is a clinical and evidence-based use of music interventions administered by a professional to alleviate total pains suffered by hospice patients and their families. While the effects of hospice music therapy have been reported by many studies, its meaning and value are still poorly understood in Korea, which explains the lack of related institutions in the nation. Recently policy-wise and legislative efforts have been made to promote hospice and palliative care, which in turn will likely fuel demand for hospice music therapy. Therefore, the meaning and role of hospice music therapy should be defined by major hospice and palliative care institutions and societies, followed by institutional and academic efforts as follows. First, a set of qualification criteria for hospice music therapists should be established to provide proven music therapy interventions to patients and their families. Second, a systematic program offering both theoretical and practical trainings needs to be developed to foster hospice music therapists. Last but not least, clinical studies should be promoted with development of a research road map for hospice music therapy and a standard protocol.

• Korean Journal of Hospice Care
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• v.3 no.2
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• pp.12-18
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• 2003

The purpose of this study was to promote the popularization of hospice services by providing the information about the influences of hospice training on participants. We compared differences of pre-training and post-training by use of questionnaire. This study involved 59 volunteers participating in the hospice training held by one hospice center located in K-city. The questionnaire was composed of 41 items, 21 items of general information and 20 items of information about spiritual welling-being. We applied Choi's translated version(1990), originally distributed by Paloutzion and Ellison(1982), in the assessment of participants' changed spiritual welling-being score. Participants were asked to fill out the questionnaire before and after the hospice training. The data were analyzed by frequency, paired t-test. The results were as follows, There were significant differences in participants' spiritual welling-being score. Compared with pretraining(3.51), more spiritual well-being score were improved in post-training(3.69)(t=-2.45, p<.05). The results of this study indicate that hospice training improve spiritual well-being score to the participants. In conclusion, hospice training should be popularized in the near future.

• Journal of Hospice and Palliative Care
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• v.10 no.1
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• pp.29-34
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• 2007

Purpose: The purpose of this study was to show the differences of medical cost between hospice and non-hospice care for terminally ill patients. This information provides basic data to nationally institutionalize hospice care for decreasing costs and enhancing quality of life for terminally ill patients. Methods: Participants of this study were 114 terminally ill cancer patients who were diagnosed and died with stomach cancer and lung cancer at the K hospital of the C university. The study was a retrospective survey design that analyzed the medical costs for two weeks before they died. The cost analysis was done according to 11 items form the medical cost bill. Results: Patients enrolled in hospice care had significantly lower medical costs (53%) than did non-hospice patients especially in use of TPN, narcotic analgesics, nursing care, radiology tests, and blood tests. Among patients enrolled/admitted in the hospice unit, there was a significant cost difference only in use of analgesics whether the hospice specialized doctor was in charge of care or not. The cost was significantly lower when a hospice specialized doctor was in charge of care although the total medical cost was the same. Conclusion: This study identified lower medical costs for patients cared for in the hospice unit. Thus, we urge institutionalizing hospice care without delay to insure cost benefits as well as quality care.

• Journal of Hospice and Palliative Care
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• v.3 no.1
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• pp.4-17
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• 2000

Purpose : This study aimed to investigate and to evaluate the present conditions of hospice programs in Korea for supplying data useful in making policy in hospice, which is not institutionalized yet. Method : For this purpose we surveyed 59 hospice programs regarding the general characteristics, manpower, patients, services, financial conditions, and facilities. Thirty-seven hospice programs answered the questionnaires. Result : They were 11 tertiary hospitals, 11 other hospitals, 3 clinics, 12 home care hospice, and 1 freestanding hospice. Only 9 hospice programs have all of the essential professionals: physicians, nurses, social workers, clergies, and volunteers. In some hospice programs, volunteers who had not been trained for hospice provided services to terminal patients. More than half of the hospice said they provided services to the patients who lost their consciousness and were not suitable for hospice care. 16% of the hospice said they did not keep the patients' record. Some hospitals including tertiary hospitals provided such intensive care as radiotherapy, TPN, injections to hospice patients. Many hospice programs other than hospitals didn't charge patients for hospice care. 60% of the hospice said they suffered from financial problems. Most of the hospice wards were not built for hospice use at first. So they did not have such supplementary facilities as dayroom, waiting room, special bathing facilities etc. Conclusion : For improving the quality of terminal patients and promoting the cost effective use of health care resources, it is necessary to consider the institutionalization of hospice. The institutionalization of hospice programs can improve the quality of hospice care and the standardization of the hospice program can hasten its institutionalization.

• Korean Journal of Hospice Care
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• v.5 no.2
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• pp.1-14
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• 2005

The purpose of this study was to promote the popularization of hospice services by providing the information about the influences of hospice training on participants. We compared differences of attitudes toward death between those of pre-training and post-training by use of questionnaire. This study involved 137 volunteers participating in the hospice training held by one hospice center located in K-city. The questionnaire was composed of 46 items, 21 items of general information and 25 items of information about attitudes toward death. We applied Park's translated version(1992), originally distributed by Thorson and Powell(1988), in the assessment of participants' changed attitudes toward death. Participants were asked to fill out the questionnaire before and after the hospice training. The data were analged by frequency. ANOVA t-test, paired t-test. The results were as follows, 1.Pre-training items holding a high rank were 'The subject about the future life after death is distressing'(F=5.20), 'No worry about any occurrences around the body after a funeral'(F=4.75), 'Having little interest in being laid in a coffin after death'(F=4.56); items holding a low rank were 'Having little interest in any occurrences around the body after death'(F=2.22), 'Willing to deal with the aftermath of the death in detail'(F=1.94), 'No fear to have an idea to be cancerous'(F=1.72). 2.Post-training items holding a high rank were 'No fear to be dead as a result of sufferings from long-lasting illness'(F=3.18), 'No fear to have an idea to be cancerous'(F=3.16)', Having little interest in the future life after death'(F=3.09); items holding a low rank were 'Unpleasant to be not able to move after death(F=1.74), 'Distressing not to know about the future life after death'(F=1.61), 'The subject about the future life after death is distressing'(F=1.60). 3.There were significant difference in participants' attitudes toward death. Compared with pretraining(F=3.97), more positive were developed in post training(F=2.30). The results of this study indicate that hospice training renders positive regards toward death to the participants. Therefore every human being, who is able to speculate about the meaning of death, has to be exposed to the hospice training. In conclusion, hospice training should be popularized in the near future.