Purpose: The purpose of this study was to find out the effect of hospice home care on the pain relief and quality of life of terminal cancer patients. Method: Experimental pre and post tests were provided to a single group to see the changes of quality of life of patients who were referred to a hospice home care department after having cancer treatment. They were visited at least 8 times for the duration of 4~6 weeks and were provided a 24 hour phone call service. 41 subjects were transferred to a hospice home care department after being discharged from hospital were selected. Result: 1)The first hypothesis that "the pain score of the subjects after receiving hospice home care would be different from before receiving hospice home care would be different from before receiving hospice home care" which scored 4.06 point at the first test and 3.41 at the second did not statistically show a significant difference(t=1.421 p=1.66), even though the pain score is decreased. 2)The 2nd hypotheses that "the quality of life score of the subjects after receiving hospice home care would be different from before receiving hospice home care" which scored 2.88 point at the first test and 3.39 at the second showed a significant difference(t=-6.759, p=.000) and was supported. Regarding the changes of quality of life score, social aspect(t=-5.745, p=.000), emotional aspect(t=-5.684, p=.000), and spiritual aspect(t=-6.889, p=.000) has significantly been increased, while physical aspect has been more decreased significantly than before the hospice home care is provided(t=4.282, p=.000). Conclusion: It was effective to provide hospice home care in relieving the terminal cancer patients' pain and in improving their quality of life, even though a short term hospice home care for 4-6 weeks was provided.
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.
The goal of medicine is to contribute to promoting national health by preventing diseases and providing treatment. The scope of modern medicine isn't merely confined to disease testing, treatment and prevention in accordance to that, and making experiments by using the human body is widespread. The advance in modern medicine has made a great contribution to valuing human dignity and actualizing a manly life, but there is a problem that has still nagged modern medicine: treatment and healing for terminal patients including cancer patients. In advanced countries, pain care and hospice medicine are already universal. Offering a helping hand for terminal patients to lead a less painful and more manly life from diverse angles instead of merely focusing on treatment is called the very hospice medicine. That is a comprehensive package of medical services to take care of death-facing terminal patients and their families with affection. That is providing physical, mental and social support for the patients to pass away in peace after living a dignified and decent life, and that is comforting their bereaved families. The National Hospice Organization of the United States provides terminal patients and their families with sustained hospital care and home care in a move to lend assistance to them. In our country, however, tertiary medical institutions simply provide medical care for terminal patients to extend their lives, and there are few institutional efforts to help them. Hospice medicine is offered mostly in our country by non- professionals including doctors, nurses, social workers, pastors or physical therapists. Terminal patients' needs cannot be satisfied in the same manner as those of other patients, and it's needed to take a different approach to their treatment as well. Nevertheless, the focus of medical care is still placed on treatment only, which should be taken seriously. Ministry for Health, Welfare & Family Affairs and Health Insurance Review & Assessment Service held a public hearing on May 21, 2008, on the cost of hospice care, quality control and demonstration project to gather extensive opinions from the academic community, experts and consumer groups to draw up plans about manpower supply, facilities and demonstration project, but the institutions are not going to work on hospice education, securement of facilities and relevant legislation. In 2002, Ministry for Health, Welfare & Family Affairs made an official announcement to introduce a hospice nurse system to nurture nurse specialists in this area. That ministry legislated for the qualifications of advanced nurse practitioner and a hospice nurse system(Article 24 and 2 in Enforcement Regulations for the Medical Law), but few specific plans are under way to carry out the regulations. It's well known that the medical law defines a nurse as a professional health care worker, and there is a move to draw a line between the responsibilities of doctors and those of nurses in association with medical errors. Specifically, the roles of professional hospice are increasingly expected to be accentuated in conjunction with treatment for terminal patients, and it seems that delving into possible problems with the job performance of nurses and coming up with workable countermeasures are what scholars of conscience should do in an effort to contribute to the development of medicine and the realization of a dignified and manly life.
Purpose: The purpose of this study was to analyze the need for hospice care programs in families of patients with cancer. Method: The study surveyed 98 families who were taking care of patients with cancer. This survey was conducted from August 2004 to October 2004 at two general hospitals in Seoul. The data were collected through a self-reporting questionnaire of 22 items. The items were classified into five areas by factor analysis to identify the construct validity. The reliability of the tool was established by Cronbach's alpha as .93 and the data collected were analyzed by descriptive statistics, t-test and ANOVA. Results: 1) The degree of need for hospice care of the subjects showed a high average of $3.26({\pm}3.7$). The need for 'emotional care of patients showed the highest mean' (M=3.47), 'management of terminal physical symptoms' (M=3.34), 'control of secondary physical problems' (M =3.26), 'acceptance of the family's difficulty' (M=3.12), 'spiritual care for preparing for death' (M=2.96), respectively. 2) With respect to the demographic characteristics of the subjects, there were statistically significant differences in hospice care needs, according to the onset of diagnosis (F=3.110, p=.030). Conclusion: Hospice care must be provided considering the needs of families of patients with cancer. In this sense, this country's needs as well as hospice nurses' higher concern and support for hospice care of patients require further education and program development to meet the current demands.
Many terminally ill cancer patients grapple with a range of physical, psychological, and social challenges. Therefore, it is critical to offer effective psychological interventions to assist them in managing these issues and enhancing their quality of life. This brief communication provides a concise overview of acceptance and commitment therapy (ACT), along with empirical evidence of its application for patients, caregivers, and healthcare professionals in hospice and palliative care settings and an overview of future directions of ACT interventions in South Korea. ACT, a third-wave type of cognitive behavioral therapy, is a model of psychological flexibility that promotes personal growth and empowerment across all life areas. Currently, there is substantial evidence from overseas supporting the effectiveness of ACT on health-related outcomes among patients with various diseases, caregivers, and healthcare professionals. The necessity and significance of conducting ACT-based empirical research in hospice and palliative care settings in South Korea are discussed.
Purpose: Hepatocellular carcinoma is the 3rd leading cause of cancer death in Korea and its prognosis is very poor. We aimed to investigate the clinical characteristics of terminal patients with hepatocellular carcinoma on admission into a hospice unit, and to know if they had received appropriate hospice and palliative care. Methods: We retrospectively reviewed the medical records in 62 patients with hepatocellular carcinoma who had admitted, received palliative care, and died in a hospice unit between January 2003 and December 2005. Results: The median age of patients was 56.5 years with 50 men(80.65%) and 12 women(19.35%) and gender ratio(male to female) was 417. Child-Pugh class A, B, and C were 6(9.68%), 22(35.38%), and 34(58.84%) respectively. We divided the patients into two groups and compared, the terminal HCC patients with class C as group I and those with class A & B as group 2. The median time from hospice referral to death was significantly short in group 1 with 15.5 days compared to group 2 with 53 days. Statistically more prevalent symptoms in group I were ascites, dyspnea, peripheral edema, and hepatic encephalopathy with abnormal laboratory findings (jaundice, hypoalbuminemia, or renal insufficiency). There, however, was no significant difference in complications and managements during admission between group 1 and 2. Conclusion: Most terminal HCC patients were often accompanied with chronic liver disease. The length of hospice and palliative care for above patients was not enough to attend them. Therefore, we suggest that proper education and information should be provided to physicians, patients, and their family members for effective hospice and palliative care.
We all human beings, should be reached the terminal of life in the world. There is the only difference between that comes suddenly or slowly. Persons who should be come the terminal stage suddenly due to disease, especially, malignancy, are Hospice patients. Hospice work is the work of all of us because anyone, anywhere, whenever can be suffered in terminal stage. The characters of Hospice-care are total care of wholistic human beings, comprehensive total assessment of the life and the team work composed of diverse team-members, for example, doctors, nurses, social workers, physical therapists, psychologists, ministers & volunteers. The care manager of the total care(the coordinator of Hospice care), should be worked systemically and, rationally. The comprehensive assessment concept should be entered to the infra-consultant of terminal care-program. The care manager should be have the ability of comprehensive assessment for terminal patients. It will also help standardization of Hospice, and application of medical insurance and social security.
The Spiritual Care Guide in HospiceㆍPalliative Care is evidence-based and focuses on the universal and integral aspects of human spirituality-such as meaning and purpose, interconnectedness, and transcendence-which go beyond any specific religion. This guide was crafted to improve the spiritual well-being of adult patients aged 19 and older, as well as their families, who are receiving end-of-life care. The provision of spiritual care in hospice and palliative settings aims to assist patients and their families in finding life's meaning and purpose, restoring love and relationships, and helping them come to terms with death while maintaining hope. It is recommended that spiritual needs and the interventions provided are periodically reassessed and evaluated, with the findings recorded. Additionally, hospice and palliative care teams are encouraged to pursue ongoing education and training in spiritual care. Although challenges exist in universally applying this guide across all hospice and palliative care organizations in Korea-due to varying resources and the specific environments of medical institutions-it is significant that the Korean Society for Hospice and Palliative Care has introduced a spiritual care guide poised to enhance the spiritual well-being and quality of care for hospice and palliative care patients.
Purpose: The purpose of the study was to identify types of care needs for hospice patients through Q- methodology. Method: Twenty three Q-statements were selected through in-depth interviews of hospice patients. Data were collected from 20 hospice patients by sorting 23 Q-statements into 9 points standard and then analyzed using PC QUANL program. Result: Type 1 was named 'the need for pain control type' and patients of this type had the greatest need of physical care to be free of pain and be comfortable. Type 2 was named 'the need for love and intimacy type' and patients of this type would like to share love and intimacy with their family members. Type 3 was named 'the needs for reliance on an Absolute Being type' and patients of this type would like to receive forgiveness from their God and prayers. Type 4 was named 'the need for accomplishment and service type' and patients of this type would like to complete their on going work and to give service to others. Conclusion: The study result could be basic data to perform effective nursing interventions for satisfying the care needs of hospice patients.
Objectives: This study was conducted to analyze the symptoms and care needs of home-based hospice palliative patients in Busan and to provide a basic reference for developing practical guidelines for their care. Methods: By examining the registration cards of 409 hospice palliative patients, who were registered in community health centers in Busan as of 2016, this study retrospectively analyzed their characteristics, symptoms and care needs. Results: The average age was 70.6 years, 59.4% were receiving medical benefits, and 48.4% lived alone. As per the data obtained from the Palliative Performance Scale, many were able to mobile. Fatigue was the most severe and depression and anxiety were reported together, and their care needs were also high. Most subjects reported mild or low pain, but care needs were high. Furthermore, the medical benefits group showed a high level of symptoms and care needs across areas. Conclusions: To help subjects to live in their homes for as long as possible, it is necessary to identify symptoms and care needs and provide services in accordance with their severity and situation. Thus, it is necessary to develop practical guidelines for standardized community hospice palliative care services.
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