• Korean Journal of Adult Nursing
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• 제14권3호
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• pp.368-377
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• 2002

Purpose: The purpose of this study was to analyze the trend of research on the use of home-based pulmonary rehabilitation. Method: Using Medline and CINAHL search engine, experiemental research, titled as 'home-based pulmonary rehabilitation' and 'chronic lung disease', statistics were collected. The total 29 experimental studies published between 1981 to 2000 were selected and analyzed according to the ATS guidelines. Result: 1) The study samples in research were mostly of men, whose lung function was moderate to severe. 2) The total period of the intervention program varied from 5 to 12 week. The program included excercise intervention and educational intervention. Psychosocial intervention was minimal. 3) The outcome of the home-based pulmonary rehabilitation had been measured mostly by physical aspects. Quality of life and cost were less frequently measured. 4) In terms of effectiveness of the home based pulmonary rehabilitation program, physiologic outcome, such as lung function and hematologic markers, there was more 'no effect' than 'positive effect', whereas there was more 'positive effect' in decreasing dyspnea, improving excercise capacity, and improving quality of life. Conclusion: Based on these findings, future research on home-based pulmonary rehabilitation should be emphasized and provide standardized protocol, including psychosocial intervention, and analyses on cost and quality of life.

• Journal of Korean Academy of Nursing
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• 제49권5호
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• pp.538-549
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• 2019

Purpose: This study aimed to explore and compare the knowledge structure of pain management nursing research, between Korea and other countries, applying a text network analysis. Methods: 321 Korean and 6,685 international study abstracts of pain management, published from 2004 to 2017, were collected. Keywords and meaningful morphemes from the abstracts were analyzed and refined, and their co-occurrence matrix was generated. Two networks of 140 and 424 keywords, respectively, of domestic and international studies were analyzed using NetMiner 4.3 software for degree centrality, closeness centrality, betweenness centrality, and eigenvector community analysis. Results: In both Korean and international studies, the most important, core-keywords were "pain," "patient," "pain management," "registered nurses," "care," "cancer," "need," "analgesia," "assessment," and "surgery." While some keywords like "education," "knowledge," and "patient-controlled analgesia" found to be important in Korean studies; "treatment," "hospice palliative care," and "children" were critical keywords in international studies. Three common sub-topic groups found in Korean and international studies were "pain and accompanying symptoms," "target groups of pain management," and "RNs' performance of pain management." It is only in recent years (2016~17), that keywords such as "performance," "attitude," "depression," and "sleep" have become more important in Korean studies than, while keywords such as "assessment," "intervention," "analgesia," and "chronic pain" have become important in international studies. Conclusion: It is suggested that Korean pain-management researchers should expand their concerns to children and adolescents, the elderly, patients with chronic pain, patients in diverse healthcare settings, and patients' use of opioid analgesia. Moreover, researchers need to approach pain-management with a quality of life perspective rather than a mere focus on individual symptoms.

• Journal of Hospice and Palliative Care
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• 제18권2호
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• pp.128-135
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• 2015

Purpose: As the National Health Insurance Service (NHIS) began to cover home oxygen therapy (HOT) services from 2006, it is expected that the new services have contributed to overall positive outcome of patients with chronic obstructive pulmonary disease (COPD). We examined whether the usage of HOT has helped slow down the progression of COPD. Methods: We examined hospital claim data (N=10,798) of COPD inpatients who were treated in 2007~2012. We performed ${\chi}^2$ tests to analyze the differences in the changes to respiratory impairment grades. Multiple logistic regression analysis was used to identify factors that are associated with the use of HOT. Finally, a generalized linear mixed model was used to examine association between the HOT treatment and changes to respiratory impairment grades. Results: A total of 2,490 patients had grade 1 respiratory impairment, and patients with grades 2 or 3 totaled 8,308. The OR for use of HOT was lower in grade 3 patients than others (OR: 0.33, 95% CI: 0.30~0.37). The maintenance/mitigation in all grades, those who used HOT had a higher OR than non-users (OR: 1.41, 95% CI: 1.23~1.61). Conclusion: HOT was effective in maintaining or mitigating the respiratory impairment in COPD patients.

• Journal of Hospice and Palliative Care
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• 제9권1호
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• pp.17-29
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• 2006

Purpose: This research aimed to investigate the actual condition and satisfaction of volunteer activity in Australian hospital. Methods: Data was collected by self reported questionnaire from 101 volunteers and analyzed by frequency and percentage, t-test, ANOVA and Sheffe and Pearson's correlation coefficients using SPSS 12.0. Results: 1. Years involved in volunteer work were $5{\sim}10$ years (32.7%), above 10 years (30.7%), $2{\sim}3$ years (11.9%) and $3{\sim}5$ years (10.9%). Types of volunteer work were physical care (32.7%), physical and emotional care (14.9%), and others (18.8%). Types of allocation of tasks were by volunteer coordination (55.7%), and by volunteer preference and consent between volunteer and coordinator (both respectively, 20.5%). Main reasons for volunteer work were to help sick people (61.4%) and to make good use of leisure time (22.8%). Routes to start volunteer work were from his (her) own inquiries (43.4%), from hearing from other volunteers (30.7%) and from mass media (13.1%). 80.2% of volunteers had received some kinds of training or preparation for volunteer work. Suitability of volunteer's skill and ability to voluntary work were 'very well' (74.0%) and 'mostly well' (18.0%). Reimbursements or benefits received for volunteer work were token or lunch or group outing (31.7%), and token and lunch or group outing (19.8%). Evaluation frequency for volunteer work was occasionally (372%), frequently (30.9%), always (17.0%) and never (14.9%). Relationship with volunteer work coordinator was very good (85.0%). The relationship with other volunteers was very good (81.2%). The relationship with hospital staffs was very good (69.7%) and mostly good (21.2%). Family and friend's support for volunteer work was very good (83.2%). 2 The mean score of satisfaction for the hospital volunteer activity was $3.09{\pm}0.49\;(range:\;1{\sim}4)$. The highest score domain was 'social contact', $3.48{\pm}0.61$, and the lowest was 'social exchange', $1.65{\pm}0.63$. An item of the highest score was 'I have an opportunity to help other people' ($3.83{\pm}0.40$), and the lowest score item was 'I will receive compensation for volunteer work I have done ($1.10{\pm}0.78$).' 3. The satisfaction from hospital volunteer activity was shown by significant difference according to sex (t=2.038, P=0.044), marital status (F=3.806, P=0.013), years involved in volunteer work (F=3.326), nam reason to do volunteer work (F=2.707, P=0.035), receive any training or preparation for volunteer work (t=-1.982, 0=0.050), frequency of evaluation for volunteer work (F=7.877, P=0.000), suitability of volunteer's skill and ability to voluntary work (t=2.712, P=0.049), relationship with volunteer work coordinators (F=-2.517, P=0.013), relation with hospital staffs (F=5.202, P=0.007), and support of their volunteer work by their family and friends (t=-3.394, P=0.001). Conclusion: The satisfaction of hospice volunteer activity was moderate. The satisfaction for hospice volunteer activity was shown by significant difference according to sex (t=2.038, P=0.044), marital status (F=3.806, P=0.013), years involved in volunteer work (F=3.326), main reason to do volunteer work (F=2.707, P=0.035), receive any training or preparation for volunteer work (t=-1.982, 0=0.050), frequency of evaluation for volunteer work (F=7.877, P=0.000), suitability of volunteer's skill and ability to voluntary work (t=2.712, P=0.049), relationship with volunteer work coordinator (F=-2.517, P=0.013), relation with hospital staffs (F=5.202, P=0.007), and family and friend's support for volunteer work (t=-3.394, P=0.001). Therefore, it is necessary to consider various factors to improve the satisfaction of voluntary work.

• Journal of Hospice and Palliative Care
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• 제5권2호
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• pp.136-145
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• 2002

Purpose : This study was designed to develop an instrument that could be used for comprehensive and effective need assessment for patients with cancer. Methods : In the first phase, a conceptual framework for the instrument was established by Wingate & Lackey (1989). In the second phase, the preliminary instrument was drawn up through a review of the literature and in consultation with three professors in Nursing. In the third phase validity and reliability of the preliminary instrument were tested as follows; 1) an expert validity test of the preliminary instrument was done by nine head nurses and charge nurses who had over ten years experience caring for patients with cancer at Wonju Christian Hospital. 2) A construct validity test and reliability test was done for the instrument by 116 staff nurses selected by convience sampling from hospitals located in Kang-Won, Kyoung-Ki, and Choong-Chung Provinces. The collected data were analyzed using SPSS 10.0 WIN program. For the factors of the instrument, factor analysis was used. The reliability of the scale was analyzed by Cronbach's alpha. Results : The results of the experts' test of validity, showed that, of 32 items, only one item had less than 55.4%. It was then deleted and a total of 31 items was selected. On the basis of the results of the factor analysis, the following six components were identified: physiological, informational, spiritual, and emotional needs, available resources, and legal/financial needs. These factors explained 61.8% of the variance. In the factor analysis, the first factor (physiological needs) and the second factor (informational needs) explained 25.4% and 10.9% of the variance respectively, which were major factors for the needs of patients with cancer in Korea. Cronbach' alpha for the scale was .90 indicating internal reliability. Conclusion : This instrument can be effectively utilized for assessment of needs of patients with cancer in Korea. Use of the needs assessment instrument developed in this study will allow nurses to develop nursing interventions that provide comprehensiveness and continuity in meeting the needs of patients with cancer.

• Journal of Hospice and Palliative Care
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• 제19권2호
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• pp.119-126
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• 2016

Purpose: This study analyzed the difference in survival time of patients with delirium according to sedative medication. Methods: From January 2012 through December 2013, a retrospective cohort study was performed using the electronic medical records (EMR) of Pusan National University Hospital. Among 900 patients who died from cancer, we selected 240 who suffered delirium based on the EMR. The Nu-DESC delirium screening test was used to diagnose delirium. Results: The median length of delirium period was five days. Delirium characteristics were dominated by inappropriate behaviors (35.0%). Sedatives were administered in 72.1% of the cases. The most frequently used sedative was haloperidol which was used in 59.6% of cases. The delirium period significantly differed by patients' age (F=3.96, P=0.021), cancer type (F=3.31, P=0.010), chemotherapy (t=-3.44 P=0.001). The average survival time was 16.85 days for the sedative medication group and 9.37 days for the non-medication group, which, however, was not significant (t=1.766, P=0.079). Conclusion: In this study, the use of sedatives did not affect patients' survival time. Thus, appropriate sedative medication can be positively recommended to comfort terminal cancer patients and their families.

• Journal of Hospice and Palliative Care
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• 제21권1호
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• pp.23-32
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• 2018

Purpose: Little is known regarding the extent to which dying patients with chronic obstructive pulmonary disease (COPD) receive life-sustaining procedures and palliative care in U.S. hospitals. We examine hospital cost trends and the impact of palliative care utilization on the use of life-sustaining procedures in this population. Methods: Retrospective nationwide cohort analysis was performed using National Inpatient Sample (NIS) data from 2005 and 2014. We examined the receipt of both palliative care and intensive medical procedures, defined as systemic procedures, pulmonary procedures, or surgeries using the International Classification of Diseases, 9th revision (ICD-9-CM). Results: We used compound annual growth rates (CAGR) to determine temporal trends and multilevel multivariate regressions to identify factors associated with hospital cost. Among 77,394,755 hospitalizations, 79,314 patients were examined. The CAGR of hospital cost was 5.83% (P<0.001). The CAGRs of systemic procedures and palliative care were 5.98% and 19.89% respectively (each P<0.001). Systemic procedures, pulmonary procedures, and surgeries were associated with increased hospital cost by 59.04%, 72.00%, 55.26%, respectively (each P<0.001). Palliative care was associated with decreased hospital cost by 28.71% (P<0.001). Conclusion: The volume of systemic procedures is the biggest driver of cost increase although there is a cost-saving effect from greater palliative care utilization.

• Journal of Korean Academy of Fundamentals of Nursing
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• 제6권2호
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• pp.228-239
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• 1999

In 1990 Home Care Education Programs started when legislation established certification for Home Care Nurses. The Ministry of Health and Welfare proposed a home care education curriculum which has 352 class hours and 248 hours of 'family nursing and practice'. Though Home Care Education Programs have been offered in 11 home care educational institutes, there has been no formal revision for the home care education programs. Also a first and second home care demonstration projects have been carried out, but there has been no research on outcomes for home care education as applied in home care practice. The purposes of this study were to identify the important content areas for home care nursing as perceived by home care nurses, and to identify their clinical competence in each of these areas, and from these to identify the education needs. The sample was 107 home care nurses who were working in home care demonstration hospitals and community-based institutions which have been offering home care services. Responses were received from 88 nurses, comprising a 82.2% return rate, and 86 were included in the final analysis. The instrument used was a modification of the instrument developed by Caie-Lawrence et(1995) and Moon's(1991) instrument on home care knowledge. The instrument's Cronbach's coefficient was 0.982. Among the respondents, 64% were working at home care demonstration hospitals and 36% were working at community-based institutions. Their home care experiences were from one month to six years, with a mean of 20.6 months. The importance rating for home care education content was 3.42 0.325, which means importance was rated relatively high. Technical aspects of home care were identified the most important. Five items 'education skill', 'counseling skill', 'interview skill', 'wound care skill', 'bed sore care skill' received 100% importance ratings. The competency rating was 2.87 0.367 and 'technical aspects of home care' was the highest, and 'application to home care skill' was the lowest. Home care nurses' education needs were identified and compared to the importance ratings and competency ratings. Eleven items were identified as the highest in the importance areas and eleven items were in the lowest competency areas. High importance ratings matched with low competency ratings determined training needs, but there was no matching items in this study. In the lowest competency areas four items were excluded, because of not being applicable in current home care practice. Therefore total eighteen items were identified as home care education needs. These items are 'bed sore care skill', 'malpractice', 'wound care skill', 'general infection control', 'change and management of tracheostomy tubes', 'CVA patient care', 'Hospice care', 'pain management', 'urinary catheterization and management', 'L-tube insertion and managements', 'Respirator use and management skill', 'infant care', 'prevention to burnout', 'child assessment', 'CAPD', 'infant assessment', 'computer literacy', and 'psychiatry patient care'.

• Asian Pacific Journal of Cancer Prevention
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• 제14권12호
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• pp.7309-7314
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• 2013

Aim: To investigate factors that affect the place of death (POD) of terminal cancer patients. Materials and Methods: We recruited 702 consecutive patients (${\geq}18$ years) from 12 centers during July 2005 to October 2006, and 481 completed the questionnaire. In April 2011, we linked the data for 96.0% (n=462) of the deceased patients to the POD using the 2005-2009 death certificate data of Korea's National Statistical Office. The primary outcome variable was POD, and the predictive value of variables pertaining to patients and caregivers was evaluated using univariate and multivariate analyses. Results: Most patients died in a hospital (91.5%, n=441) and age, education, preference for place of terminal care, wish to use hospice/palliative care services, terminal cancer awareness, time between diagnosis and death, and global quality-of-life subscale of the EORTC QLQ-C30 of patients, and education and preference for place of terminal care of caregivers were significant predictors in univariate analyses. On multivariate analysis, patients and caregivers who preferred hospital/palliative care as the terminal care option over home care [adjusted odds ratio (aOR), 2.68; 95% confidential interval (CI), 1.18-7.04 and aOR: 2.65; 95%CI: 1.15-6.09 for patient and caregiver preferences, respectively] and caregivers who were highly educated (aOR, 3.19; 95%CI, 1.44-7.06) were predictors of POD. Conclusions: Most of the terminal cancer patients died in a hospital. Our findings indicate that major predictors of hospital deaths are preference of both the patient and caregiver for hospital/palliative care as the terminal care option and higher education of the caregiver.

• Research in Community and Public Health Nursing
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• 제7권1호
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• pp.154-169
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• 1996

Parish nursing is a community health nursing role developed in 1983 by Lutheran chaplain Granger Westberg. An increasing emphasis on holistic care, personal reseponsibility for a healthy lifestyle, and changes in healthcare delivery systems have undoubtedly facilitated the establishment and nurturance of an innovative nursing role in the community. Parish nurses are functioning in a variety of church congregations of various denominations. The parish nurse is a educator, a personal health counselor, a coordinator of volunteers. The parish nurses helps people relate to the complexed medical care system and assists people to integrate faith and health. The autors conducted a study on pastor's expectations from parish nurses. Results of this study will be useful to those instrumental in planning, initiating, supporting, and evaluating a parish nurses program The research was done on 130 pastors in Taegue and Kyong Sang Buck Do, of various ages ranging from their 20's to 60's: and pastoring churches of various sizes, ranging from under 100 to over 300 members. 94.6% agreed that they needed a parish nurse on their staff; and 86.2% said they wanted to start a parish nurse program in their churches if certain basic conditions were met. The pastors responded that some would hire the nurses on a full-time basis(22.3%), a part -time basis (37.7%) or use volunteer nurses (40%). The pastors said they would expect the following from a parish nurse: health counselling (80.0%) regular health check-ups (78.5%) health care for the elderly (78.5%) health information and education (72.3%) hospice care (72.3%) visiting sick church members at home (69.2%) arranging and training volunteers to help the seek (59.2%) health care for expectant mothers (50.0%) introducing and taking people to health care facilities (46.2%) The pastors were surveyed about specific areas of health education they would want the parish nurse to teach(for example, high blood pressure and heart disease prevention and management(76.2%) ; stress management(74.6%); and diabetes prevention and management(73.8%). The pastors were surveyed about specific areas of health counselling they would expect the parish nurse to do (for example, drug abuse, (73.1), alcohol abuse(64.6%), marriage conflict(60.0%), recovery after the loss of a loved one(56.9%), and women's conflict with parents-in-law(53.8%). The pastors were surveyed about types of things they would want included in regular health check-ups, what they would want a parish nurse to do on home visits, and what they would want included in home care for the elderly. They were also surveyed on what kind of spiritual care they would like parish nurses to give. Most (90.7%) wanted their parish, parishioners to be involved in the parish nurses program as volunteers, and in a variety of ways(such as visiting sick in their homes(68.5%) and helping with housework(63.1%) and taking sick people to health facilities(60%). Parish nurses role, activities, and boundaries of practice should be continuously monitored and refined and a 'case manager' should be conceptualized as an additional or all-encompassing role. An initial parish / community needs and readiness assessment should be done prior to establishing a program to detemine if the congregation is ready, willing, and able to support such a position for at least a 2 to 3 year period.