• Journal of Hospice and Palliative Care
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• v.24 no.3
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• pp.165-173
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• 2021

Purpose: This study aimed to compare the attitudes of nurses and physicians toward neonatal palliative care and identify the barriers to and facilitators of neonatal palliative care, with the goal of improving palliative care for infants in neonatal intensive care units (NICUs). Methods: This cross-sectional study analyzed data from the NICUs of seven general hospitals with 112 nurses and 52 physicians participating. Data were collected using the Neonatal Palliative Care Attitude Scale questionnaire. Results: Only 12.5% of nurses and 11.5% of physicians reported that they had sufficient education in neonatal palliative care. In contrast, 89.3% of the nurses and 84.6% of the physicians reported that they needed further education. The common facilitators for both nurses and physicians were: 1) agreement by all members of the department regarding the provision of palliative care and 2) informing parents about palliative care options. The common barriers for both nurses and physicians were: 1) policies or guidelines supporting palliative care were not available, 2) counseling was not available, 3) technological imperatives, and 4) parental demands for continuing life support. Insufficient resources, staff, and time were also identified as barriers for nurses, whereas these were not identified as barriers for physicians. Conclusion: It is necessary to develop hospital or national guidelines and educational programs on neonatal palliative care, and it is equally necessary to spread social awareness of the importance of neonatal palliative care.

• Journal of Hospice and Palliative Care
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• v.17 no.3
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• pp.122-133
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• 2014

Purpose: We conducted a descriptive correlational study to determine a relationship between nurses' awareness of good death and attitudes toward terminal care, which in turn could be used as basic data for improvement of the quality of terminal care at geriatric hospitals. Methods: From April 3, 2013 through April 22, 2013, data were collected from 230 nurses working at geriatric hospitals. Results: Nurses' attitudes toward terminal care showed no significant correlation with awareness of good death, but it was positively correlated with a sense of closeness, a subfactor of awareness of good death. There was negative correlation between emotions regarding a deathbed, a subfactor of attitudes of nurses in charge of terminal patients, and awareness of good death. We found positive correlation between terminal care performance and awareness of good death. Conclusion: This study warrants the need for nursing education catered to characteristics of geriatric hospitals and development of diverse intervention strategies to help them to attain a positive attitude toward death by familiarizing themselves with the concept of good death and enhancing job satisfaction.

• Journal of Hospice and Palliative Care
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• v.23 no.4
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• pp.198-211
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• 2020

Purpose: The purpose of this study was to examine the relationships of knowledge, attitudes, and self-efficacy related to palliative care among health care providers (doctors and nurses) in order to provide a basis to develop a training program for health care providers. Methods: A correlational and descriptive study design was used. Participants were recruited from a university-affiliated hospital located in Daejeon and an e-nurse community. After IRB approval, data were collected from July 12, 2018, to September 30, 2018. A total of 169 responses were finally analyzed using version SPSS 24. The data were analyzed in terms of descriptive statistics (frequency and percentage or mean and standard deviation, as appropriate), the t-test, analysis of variance (with the Duncan post hoc test), and Pearson correlation coefficients. Results: Knowledge, attitudes, and self-efficacy were significantly higher in those who had received palliative care training or had been exposed to awareness-raising initiatives. There were positive relationships among knowledge, attitudes, and self-efficacy, with small to moderate effect sizes. Conclusion: Palliative care training for health care professionals is necessary to meet patients' needs. Such programs should take into account not only knowledge about palliative care, but also ways to improve empathy and resolve ethical dilemmas. Interprofessional training would be an excellent option to share therapeutic goals and develop communication skills among multidisciplinary team members.

• Journal of Hospice and Palliative Care
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• v.23 no.3
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• pp.162-165
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• 2020

Purpose: The coronavirus disease 2019 (COVID-19) pandemic has brought the world to a standstill and has exposed the lack of preparedness of most nations' health care systems. Even in usual times, palliative care has not received its fair share of recognition as an important component of patient care; instead, the emphasis is often placed on aggressive patient management. Now, with the entire medical community and decision-making committees focussed on intensive patient care, end-of-life care has taken a backseat. Methods: This article is a brief communication. Results: COVID 19 infection has been shown to lead to greater mortality and morbidity in patients with pre-existing illnesses such as hypertension, diabetes, renal failure, and cancer. Patients typically in need of end-of-life care, such as those with late-stage cancer or heart failure, are therefore at a higher risk of both contracting COVID-19 and suffering a more severe disease course. The strict nationwide lockdowns being imposed in most countries have deterred patients from seeking medical attention or hospice care. Every day new research is coming to light regarding COVID 19. This has helped significantly in creating awareness and limiting the spread of disease. However, misinformation is also rampant, leading to discrimination and mistreatment of infected patients. Conclusion: This pandemic has been a terrifying ordeal for all and has exposed our entire population physically, psychologically, emotionally, and financially to unimaginable stresses. In the present scenario, EOL care is as much a necessity as intensive care and should be given at least a fraction of its importance.

• Journal of Hospice and Palliative Care
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• v.21 no.4
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• pp.115-123
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• 2018

Purpose: The purpose of this study was to identify how nursing students' awareness of biomedical ethics and ethical values affect their attitudes towards a do-not-resuscitate (DNR) order. Methods: This cross-sectional correlation study was conducted with 275 nursing students enrolled at two universities in North Chungcheong Province and North Gyeongsang Province of South Korea. Data were collected in April 2017 using a self-reported questionnaire. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation coefficient and stepwise multiple regression with the SPSS/WIN 23.0 program. Results: The students' attitudes towards DNR were positively correlated with attitudes that seek ethical values but negatively correlated with their biomedical ethics awareness. The explained variance for attitudes towards DNR was 20%, which was significant (F=13.01, P<0.001). Conclusion: These findings suggest that nursing students' biomedical ethics awareness and ethical values were associated with their attitudes towards DNR. Curriculum organization and various educational programs should be developed and applied to help nursing students develop ethical values and awareness of biomedical ethics.

• Journal of Hospice and Palliative Care
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• v.22 no.2
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• pp.67-76
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• 2019

For hospice palliative care that provides comprehensive and general care, it is necessary to use assessment tools to objectively list issues and detail care plans. The initial assessment is a process of establishing an overall direction of care by identifying the patient's symptoms, social and spiritual issues and palliative care needs on the admission day or within one day of admission. This process is also used to identify the patients' and families' awareness of the illness, prognosis, treatment options and if the Physician Orders for Life-Sustaining Treatment (POLST) has been drafted. Consisting of 13 simple questions regarding the physical, mental, social, and spiritual domains, the Needs at the End-of-Life Screening Tool (NEST) is recommended as an initial assessment tool. Using specific assessment tools, a care plan is established for the issues identified in the initial assessment within three days of admission. A multidisciplinary assessment tool can be helpful in the physical domain. The psychosocial domain evaluates psychological distress, anxiety and depression. The social domain examines an ability to make decisions, understanding of the socioeconomic circumstance, family relationship, and death preparedness. A spiritual evaluation is also important, for which the Functional Assessment of Chronic Illness Therapy-Spiritual WellBeing Scale (FACIT-Sp) or the Spiritual Health Inventory (SHI) can be used. The use of an assessment tool could not only contribute to pain mitigation a better quality of life for patients, but also provide systematic training for a multidisciplinary team; And the process itself could be a stepping stone for the better care provision.

• Journal of Hospice and Palliative Care
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• v.25 no.4
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• pp.139-149
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• 2022

Purpose: The purpose of this study was to promote awareness of the need for advance directives (ADs) and to provide baseline data for the development of a nurse training program about ADs. Methods: Nurses at eight long-term care hospitals in Busan and South Gyeongsang Province (N=143) were recruited using the random sampling method from December 2018 to January 2019. Data were obtained using a structured self-reported questionnaire to assess their knowledge, experience, and attitudes regarding ADs. Data were analyzed in SPSS 22.0 using descriptive statistics, the t-test, analysis of variance, the Scheffé test, Pearson's correlation coefficient, and stepwise multiple regression analysis. Results: The mean scores were 7.79±1.39 points for knowledge, 1.92±2.00 points for experience, and 2.80±0.24 points for attitudes regarding ADs. Knowledge and experience (r=0.32, P<0.001) had a positive correlation with knowledge and attitudes (r=0.17, P=0.39). Conclusion: According to the results, nurses generally had a high level of knowledge regarding ADs, which resulted in a positive attitude toward ADs. However, they had little experience with ADs. Therefore, nurses' must develop both direct and indirect experience with ADs using a practical training program to strengthen their clinical competency regarding ADs.

• Journal of Hospice and Palliative Care
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• v.26 no.2
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• pp.42-50
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• 2023

Purpose: The purpose of this study was to identify barriers to effective conversations about advance care planning (ACP) and palliative care reported by health care and community-based service providers in Massachusetts, USA. Methods: This qualitative research analyzed open-ended responses to two survey questions, inquiring about perceived barriers to having conversations about ACP and palliative care with patients and consumers. Data were collected between November 2017 and June 2019 from nine organizations in Massachusetts, including health care provider organizations, health insurers, community-based organizations, and a nursing education institution. Two researchers reviewed and coded the responses and identified common themes inductively. Results: Across 142 responses, primary barriers to ACP included hesitation and lack of understanding and knowledge, discomfort and resistance among service providers, lack of staff knowledge, difficulties with followup, and differences in ACP policies across regions. Common barriers to palliative care were misconceptions about palliative care and lack of knowledge, service providers' lack of preparedness, and limited policy support and availability. Challenges relevant to both ACP and palliative care were fear and discomfort around serious illness discussions, lack of knowledge and awareness, discussions that occur too late, and cultural and language barriers. Conclusion: Health care practitioners and community-based professionals reported consumer-, service provider-, and system-level barriers to facilitating conversations about ACP and palliative care with patients experiencing serious illness. There is a need for more tools and support to strengthen service providers' ACP and palliative care competencies and to promote a structured approach to health care planning conversations.

• Journal of Hospice and Palliative Care
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• v.3 no.2
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• pp.126-135
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• 2000

Purpose : To evaluate the present status of bereavement care in Korean hospice service as a basic database for the effective bereavement care. Method : The data were collected two sets from September to October, 1999 and from November to December, 2000, 55 hospice institutions identified by the Hospice Education Institution, College of Nursing, Catholic University were contacted for a telephone survey. The researchers conducted telephone interviews with hospice administrators for 10 to 30 minutes. Result : 1) Among the 55 Korean Hospice institutions, 38 institutions(69.1%) provided bereavement services. 2) The contents of bereavement services consisted of telephone call 28 institutions(74.5%), bereaved family meeting 26 institutions(69.4%), home visiting 22 institutions(57.9%), mail 16 institutions(42.1%), personal counselling 7 institutions(18.4%). 3) The 26 hospice institutions(68.4%) which provided meetings for bereaved families met with the following frequency : Annually is 11 institutions(42.3%), biannually 6 institutions(23.1%), monthly 6 institutions(23.1%) and bimonthly 3 institutions(11.5%). 4) Only 4 hospice institutions(10.5%) used the assessment tool to screen for high risk of bereaved. 5) The major difficulties of current bereavement services were low attendance for the bereaved family meeting, shortage of professional managers and volunteers, limited accessibility to hospice institutions, little social awareness for the bereaved, and financial difficulties. 6) The hospice administrators expressed the need for the development of bereavement program, the education program for the bereavement services, trained professionals, the sufficient provision of human resource and financial support for more effective bereavement services. Conclusion : Although many hospice institutions(69.1%) provided bereavement services, they generally lacked capable bereavement professionals and various individualized bereavement services. In conclusion, it is required to develop the specified bereavement program and the training program for the staff and volunteers, so as to provide customized bereavement services based on individual needs. Further research will be necessary to evaluate the effects of customized bereavement services in Korea before applying to practice.

• Journal of Hospice and Palliative Care
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• v.27 no.1
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• pp.11-20
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• 2024

Purpose: Advance directives (ADs) are legal documents that outline a person's preferences or decisions regarding end-of-life care ahead of time. In Korea, there is insufficient awareness and knowledge about ADs among patients undergoing hemodialysis. This study explored the relationship between perceptions of a good death, knowledge about ADs, and attitudes toward ADs in this patient population. Methods: This cross-sectional survey enrolled 119 hemodialysis patients from a secondary hospital in 2021. The participants completed a self-administered questionnaire, and the data were analyzed using the t-test, analysis of variance, Pearson correlation coefficients, Spearman rank correlation coefficients, and multiple regression analysis. Results: The average score for perceptions of a good death among hemodialysis patients was 2.80 out of 4, with clinical symptoms identified as the most critical factor. The average scores for knowledge about ADs and attitudes toward ADs were 5.69 out of 9 and 2.79 out of 4, respectively. There was a positive correlation between perceptions of a good death and attitudes toward ADs (r=0.34, P<0.001), as well as between knowledge about Ads and attitudes toward ADs (r=0.19, P=0.037). Factors influencing attitudes toward Ads included employment status (β=0.22, P=0.011), education level (β=0.22, P=0.013), and perceptions of a good death (β=0.29, P=0.001), which accounted for 24.8% of the variance in attitudes toward ADs. Conclusion: A positive perception of a good death among patients undergoing hemodialysis was associated with a positive attitude toward ADs. Educational programs are needed to improve individuals' understanding of a good death and encourage the development of end-of-life care plans.