Purpose : The hospice movement began about 30 years ago in Korea. However, basic studies have seldom been conducted about the general public's knowledge concerning hospice care and their needs for it. The purpose of this study was to investigate the general public's knowledge of and attitude toward hospice, and their needs for hospice care, and to analyze the needs for hospice care in relation to their knowledge and attitude in residents from a specific community. Methods : The survey was conducted with 924 people randomly selected from a district in Seoul. The data were collected through a self-reporting questionnaire constructed by the authors. With 30 items given in the questionnaire, the level of hospice needs showed Cronbach's alpha .89 in a pilot study and .92 in this study and the items were classified into four areas by a factor analysis. The data collected were analyzed by means of t-test and ANOVA. Results : 1) The average age of the respondents was 38. The majority of the respondents were well-educated. 2) Regarding awareness of hospice care, 54%(501 people) indicated they have heard of hospice. About 74% thought that people should be able to prepare for death in advance. About 83% wanted to be informed when they have life threatening illnesses such as terminal cancer. Also, about 63% responded that patients with terminal diseases should be provided with physical, spiritual, and psychological care for minimizing pain and peaceful death. Regarding the attitude toward hospice care, 74% responded that they would use hospice care if needed. The number of the respondents who preferred home visitation by the hospice team to care for the terminally ill ranked first with 34%. Concerning needs for hospice care : 1) By needs area, physical need showed highest mean(M=4.37), followed by social need(M=3.96), emotional need(M=3.87), and the spiritual need(M=3.79). The overall need level showed the mean value of 4.00 which reflects a considerable need for hospice care. 2) By demographic characteristics, people age over 50, the married, and the unemployed indicated higher level of needs for hospice care. Women showed higher level of needs than did men, and Catholics demonstrated higher level of needs than believers of other religion(P<0.0001). 3) As for the knowledge of and attitude toward hospice rare, the level of hospice care needs was significantly higher in the following groups: those who have heard of hospice, those who are aware of death preparation, those who want information on terminal diseases, those who want to use every method to sustain life, and those who are aware of hospice needs(P<0.001). Conclusion : It is assumed that the findings of this study on the knowledge, attitude, and needs for hospice care in the public can contribute to planning a successful hospice care program. Furthermore, the findings of this study will serve as useful data for the promotion of home hospice care to improve the quality of life of community residents, and contribute to the development of hospice care as a whole.
In Cheol Hwang;Seong Hoon Shin;Youn Seon Choi;Myung Ah Lee;DaeKyun Kim;Kyung Hee Lee
Journal of Hospice and Palliative Care
/
v.27
no.1
/
pp.45-49
/
2024
Purpose: This study investigated palliative care physicians' attitudes regarding social issues related to opioid use. Methods: An email survey was sent to 674 physicians who were members of the Korean Society for Hospice and Palliative Care (KSHPC). Results: Data from 66 physicians were analyzed (response rate, 9.8%). About 70% of participants stated that their prescribing patterns were not influenced by social issues related to opioid use, and 90% of participants thought that additional regulations should be limited to non-cancer pain. Under the current circumstances, pain education for physicians is urgently needed, as well as increased awareness among the public. Half of the respondents identified the KSHPC as the primary organization responsible for providing pain education. Conclusion: Palliative care physicians' prescribing patterns were not influenced by social issues related to opioid use, and these issues also should not affect cancer pain control.
The purpose of this study was to investigate the impact of depression, discomfort, spirituality, physical care, and opioid use on pain with terminally ill cancer patients residing in hospice units. The convenient sample of this study consisted of 41 terminally ill cancer patients at three hospice units in university affiliated hospitals. Patients were interviewed with structured questionnaires three times at predetermined intervals: admission to the hospice unit (Time 1), one week later (Time 2), and two weeks later (Time 3). The data was collected from January 1998 to January 1999 and was analyzed using ANOVA, Pearson correlation coefficient, and multivariate multiple regression. 1. The mean age of the participants was approximately 55 years old. In terms of diagnosis, lung cancer showed the highest frequency (19.5%), followed by stomach cancer and rectal cancer (17.1%). The motive of seeking hospice unit admission was control (72. 2%), followed by spiritual care (50%), and symptom relief (38.9%). 2. Regarding the type of pain felt, the highest pain frequency the participants experienced was deep pain (55%), followed by multiple pain (25%), intestinal pain (10%), then superficial (5%) and neurogenic pain (5%). For the level of pain measured by VAS, there was no significant difference among the three time points; Time 1 (5.04$\pm$2.21), Time 2 (4.82$\pm$2.58) and Time 3(4.73$\pm$2.51). 3. There was significant change seen in spirituality and physical care in each time interval. Namely, the longer the length of admission at the hospice unit, the higher the importance of spirituality (p=0.0001) and the more the physical care the participants received (p=0.01). The opioid use at the three time points showed the following frequencies : Time 1 (75.6%), Time 2 (85.4%) and Time 3 (75.6%). 4. Regarding factors influencing pain, the pain level was significantly affected by the depression level (p〈0.01) and the opioid use (p〈0.1). These results were the most significant at the two time points (Time 1 and Time 2). At Time 3 (two weeks later), the pain level was significantly affected by the depression level (p〈0.05) and the amount of physical care the participants received (p〈0.1). In conclusion, the terminally ill cancer patients had moderate pain, were generally depressed, and were treated with opioid analgesics. As approaching death, the patients received more physical care due to increased physical symptoms experienced and they had a higher perception of the importance of spirituality. Thus, health care professionals need to provide continuous care for each of them to die comfortably physically, psycho- logically, and spiritually.
Purpose: High-quality hospice and palliative medicine curricula are necessary in Korean medical schools. This study evaluated changes in students' knowledge and attitudes toward both hospice and palliative care following the completion of a course on these topics, as well as the course's overall role in the basic medical education curriculum. Methods: Questionnaires measuring knowledge and attitudes were collected before and after the course from 76 fourth-year medical students, who had received instructions integrating both hospice and palliative care in 2016. Results: The questionnaire item "Select the correct answer on the use of opioid pain control in hospice and palliative care" changed the most in terms of number of correct answers pre- and post-course (3.50 and 5.32, respectively; P<0.001). Pre- and post-course, the numbers of students who answered "Strongly Agree" and "Agree" to questions concerning their attitudes toward hospice and palliative care ("I know the purposes and roles of hospice and palliative care") were 17 (22.4%) and 65 (85.6%), respectively (P≤0.001). Affirmative responses also increased for "As a pre-physician, I know when to describe and advise hospice and palliative care to patients", from 22 (28.9%) to 65 (85.6%; P≤0.001). Conclusion: This study showed that comprehensive hospice education in the form of an integrated educational course might promote changes in medical students' knowledge and attitudes toward hospice and palliative medicine.
This study was conducted to be helpful to the expansion and development of hospice and to provide the basic data for Hospice palliative care by identifying the general characteristics of curriculum of hospice perception, level of perception, practice experiences, routes, times, meanings, needs, targets, supply, types, organizations, experiences, use of hospice and physical, emotional, social and spiritual aspects of hospice services. Study tools which were used in this study were composed of three sections. Survey paper is 3-point Likert scale which is composed of 6 questions of general characteristics, nominal scale of 24 questions about hospice perception and hospice service contents. Respondents can reply with 3 answers of Necessary (1), Mediocre (2), and Not necessary (3), in physical, emotional, social and spiritual aspects. Score ranges of this tool are from minimum of 24 points to maximum of 72 points and higher scores mean higher perception of Hospice. Hospice is a behavior to take care of terminal patients who are waiting for death and their family and it should be conducted physically, emotionally, socially and spiritually in order that the patients could meet their last moments of life by maintaining a high quality of life, human dignity and peace for the rest of their lives. Hospice could be mentioned to be a comprehensive care to relieve the pains and grieves of bereaved family.
The purpose of this study was to elucidate the effects of spiritual nursing intervention on pain and anxiety of the hospice patients. This study was devised with a quasi-experimental design using non-equivalent contrast group non-synchronized design. The data were collected during the period from July 10 to September 25 in 2000 at the general hospital in CheonJu city. The subjects were sixty-seven patients who referred the hospice service. They were assigned to two groups, 36 members of the experimental group and 30 members of the contrast group. They also did not any complication, were alert enough tobe interviewed and agree willingly to participate in this study. The tools used were Yoon's Korean Version of Brief Pain Inventory and Spielberger's State Anxiety Scale. The spiritual care intervention was carried out through Hymn, Scripture, Prayer, the therapeutic use of self over a period of three weeks. Data were analyzed by mean, standard deviation, $x^2$-test, t-test, paired t-test and Pearson's Correlation Coefficients. The results of this study were as follows: 1.The examination of the same quality showed that there were not significant differences in the general characters, disease and therapeutic characters, religional characters between the experimental group and the contrast group. 2.After the spiritual nursing intervention pain scores of the experimental group were remarkably lower than those of the contrast group(right now pain: t=-2.634, p=0.012). 3.Decreasing rate in the pain scores of the experimental group were remarkably lower than those of the contrast group(right now pain: t=5.017, p=0.000). 4. After the spiritual nursing intervention state anxiety of the experimental group were remarkably lower than those of the contrast group(t=-5.987, p=0.000). 5. A positive correlation was found between reported pain and depression following the spiritual nursing intervention. In conclusion, the hospice patients who were offered spiritual care became lower than those who were not offered spiritual care and confirmed to decrease pain. According to these results, spiritual nursing intervention can be regarded as an effective nursing intervention that relieved pain and anxiety of the hospice patients.
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.
Purpose : The purpose of this study was to identify hospice volunteers' perception of the death. Methods : This study was conducted with 327 adults who registered for the hospice volunteer education program in Severance Hospice Center from 1996 through 1999. The 4-years data was collected through a self-reporting questionnaire constructed and revised by the authors. The questionnaire was classified into 5 categories. The data collected were analyzed using SPSS/W. Results : 1) Hospice volunteers were mostly female(93.9%) with an average age of 48 years. The majority(82.6%) of the participants were Protestant. 2) From the 4-years data over 90 percent of participants thought of death as a process of life and responded positively to these three items : 'Death is a temporary separation from family', 'I will die in peace', 'Faith in God results in a freedom from fear of death'. 3) Age were statistically relevant to the following items: 'I often read the obituaries in the newspaper', 'Dying is a tragedy', and 6 items were significantly related to religion: 'I rarely think of dying unexpectedly', 'Death is a temporary separation from family'. 'Dying is a tragedy', 'We have to do our best to prolong life by use of modem medical technology', 'I feel comfortable thinking of death and dying, 'Faith in God results in a freedom from fear of death'. The finding that religiosity was related to perception of death is consistent with other reports. And $40{\sim}50$ year old Protestant women had more positive perception of death than $20{\sim}30$ year old women. Conclusion : The findings indicated an importance of considering the age and religiosity when we educate the hospice volunteers. And that will be a important basic-data to develope program for hospice volunteers.
Purpose: This study reviewed what the location of death (LOD) means as an outcome and how to use LOD to assess end-of-life (EOL) care. This study also examined the reason why LOD is significant for the quality of EOL care. Methods: A literature review was performed, using LODs and home deaths as outcomes in the field of EOL care, and analyzed the findings associated with key fields in regards to LOD. Results: Palliative care research used LOD, in particular, hospital death (versus home death) as a significant outcome when examining cost savings, quality of life care, and patient and family preferences. Based on substantial evidence from previous research, home hospice or continuous palliative care in non-hospital settings (i.e. homes, nursing homes) have been designed and available for dying patients in developed countries. Conclusion: The LOD delivers practical significance as an outcome for diverse reasons. In-depth examination on LOD in South Korea is needed despite limitations to interpretation of its meaning in the country.
Dealing with existential concerns experienced by patients is an important part of palliative care. Interventions that use the life review method to encourage patients to reminisce about their lives can help them find new positive meanings, promote ego integrity, and reduce emotional suffering. Not everyone has positive memories when they look back on the past, however. This poses a limit on the effectiveness of the life review method for healthcare providers working in palliative care contexts. In this study, we discuss the limits of life review and suggest imagery rescripting as a new modality constituting a psychotherapeutic approach to deal with negative memories safely and effectively.
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