• Journal of Hospice and Palliative Care
• /
• 제26권2호
• /
• pp.60-68
• /
• 2023

Purpose: For the dignity of patients nearing the end of their lives, it is essential to provide end-of-life (EoL) care in a separate, dedicated space. This study investigated the utilization of specialized rooms for dying patients within a hospice unit. Methods: This retrospective study examined patients who died in a single hospice unit between January 1, 2017, and December 31, 2021. Utilizing medical records, we analyzed the circumstances surrounding death, the employment of specialized rooms for terminally ill patients, and the characteristics of those who received EoL care in a shared room. Results: During the 1,825-day survey period, deaths occurred on 632 days, and 799 patients died. Of these patients, 496 (62.1%) received EoL care in a dedicated room. The average duration of using this dedicated space was 1.08 days. Meanwhile, 188 patients (23.5%) died in a shared room. Logistic regression analysis revealed that a longer stay in the hospice unit was associated with a lower risk of receiving EoL care in a shared room (odds ratio [OR]=0.98, 95% confidence interval [CI] 0.97~0.99; P=0.002). Furthermore, a higher number of deaths on the day a patient died was associated with a greater risk of receiving EoL care in a shared room (OR=1.66, 95% CI 1.33~2.08; P<0.001). Conclusion: To ensure that more patients receive EoL care for an adequate duration in a private setting, additional research is necessary to increase the number of dedicated rooms and incorporate them into the hospice unit at an early stage.

• 호스피스학술지
• /
• 제6권2호
• /
• pp.1-9
• /
• 2006

In this thesis, Chapter I Introduction suggested the necessity of this research and defined related terms, and Chapter II defined hospice for children and examined the symptoms of pediatric cancers as well as the general characteristics of pediatric cancer patients. In particular, we surveyed the physical condition, psychological and emotional condition, financial condition, environmental aspect, educational aspect and spiritual aspect of pediatric cancer patients’ families, investigated pediatric cancer patients’ parents and siblings with regard to their understanding of the pediatric cancer patients’ death, and lastly considered spiritual care. Chapter III presented summaries and conclusions. In their developmental stage, pediatric cancer patients lack abilities to express themselves and are highly dependent on their parents, so parents who take care of cancer children have to make hard decisions and cancer children’s families are heavily burdened by the situation of preparing their children’s death and sending them away while denying their death, and for this reason they need help from specialists. That is, for pediatric cancer patients, we need highly experienced pediatricians or nurses skilful in managing young terminal patients as well as hospice counseling and family counselors for consulting on family crises. In particular, there is a keen need of child life support specialists. In addition, clergymen’s help is critical for spiritual care to ease the fear and terror of the unknown world, fear of death, etc. Moreover, in order to prevent cancer children from failing to adjust themselves to school life or peer relation after recovery, hospice service should provide cancer children with opportunities to learn school curriculums and associate with friends.

• Journal of Hospice and Palliative Care
• /
• 제9권2호
• /
• pp.93-100
• /
• 2006

목적: 본 연구는 말기 암 환자의 호스피스 완화의료에 대한 의사들의 태도에 대하여 알아보고자 하였다. 방법: 서울과 경지지역의 종합병원에 근무하는 전문의를 대상으로 호스피스 완화의학 연구회에서 자체 개발한 설문지를 이용하여 말기 암 환자에서 호스피스 완화의료에 대한 태도를 조사하였다. 설문지는 총 17문항으로 구성되었다. 수집된 자료는 실수, 중앙값과 백분율로 분석되었다. 결과: 총 81명(남자 46명, 여자 35명)이 설문지에 응답하였으며 나이의 중앙값은 35세였다. 내과가 36명(44.4%)으로 가장 많았다. 전문의 경력의 중앙값은 4년이었다. 1주일에 진료를 하는 환자 수는 거의 환자를 보지 않는 경우가 43명(53.2%)으로 가장 많았다. 호스피스 완화의료의 정확한 정의를 알고 있는 의사수는 37명(45.6%)이었다. 호스피스 완화의료의 필요성에 대하여 80명(98.8%)이 필요하다고 응답하였고 이 중에 73명(91.2%)이 완화의학 전문의가 필요하다고 응답하였다. 말기 암 환자에 대하여 적극적으로 호스피스 완화의료에 의뢰하겠는가에 대한 질문에 55명(67.9%)이 그렇게 하겠다고 응답하였으며 이 중 17명(30.9%)은 주저한 경험이 있는데 이유로 가족의 반대가 6명(35.3%)으로 가장 많았으며 다음으로 '환자를 포기하는 것 같아서'로 응답한 의사가 4명(23.5%)이었다. 적극적으로 호스피스 완화의료에 의뢰하지 않은 22명(27.2%)에 대하여 이유로 '환자를 포기하는 느낌'과 기타 사항으로 '절차를 모른다'가 각각 6명(27.2%)으로 가장 많았다. 37명(45.7%)의 의사가 임종 전 3개월에 호스피스 완화의료를 받는 것이 가장 좋다고 응답하였으며 가장 도움을 받는 것은 정신적, 심리적 조절이라고 응답한 의사가 58명(71.6%)으로 가장 많았다. 결론: 대부분의 의사들이 호스피스 완화의료의 필요성은 인식하고 있으나 말기 암 환자에 대한 호스피스 완화의료에 의뢰하는 적극적인 자세는 부족하였다. 의사들에게 지속적인 호스피스 완화의료에 대한 교육과 정보, 홍보가 필요하리라고 생각된다.

• Journal of Hospice and Palliative Care
• /
• 제24권1호
• /
• pp.1-12
• /
• 2021

Hospice palliative care refers to holistic care provided by an interdisciplinary team aimed at improving the quality of life of patients suffering from life-threatening diseases and their families. Among interdisciplinary team members, hospice advanced practice nurses (APNs) trained as master's-level advanced nursing professionals are leaders who play an important role in providing patient-centered care and improving the quality of services. The Medical Service Act revised in 2018 requires the scope of practice of APNs in each field to be specified in the Ordinance of the Ministry of Health and Welfare. Accordingly, discussions on the role and scope of practice of hospice APNs are actively underway. In this review, the curriculum of hospice APNs, their work responsibilities and roles, and their current status are reviewed, and the future direction of the hospice APN system is also discussed.

• Journal of Hospice and Palliative Care
• /
• 제26권4호
• /
• pp.171-184
• /
• 2023

Purpose: The study explored the meaning of experiences within a family art therapy process among terminal cancer patients and their families. Methods: Ten participants, including four terminal cancer patients currently admitted to the hospice ward at an inpatient hospice facility in S City and four caregiving family members, engaged in four cycles of family art therapy sessions. The sessions were conducted weekly or bi-weekly, and each lasted approximately 50 minutes. Results: Nine cross-case themes emerged: "feeling unfamiliar and intimidated by the idea of expressing my thoughts through art," "trying to accept the present and positively overcome sadness," "expressing hope through emotional bonds during the process of parting," "conveying and preserving personal and family beliefs," "feeling upset about family imbalances caused by deteriorating health," "valuing togetherness and striving for stability amidst the current challenges," "art as a medium of empowerment for patients and facilitator of family conversations, even amidst difficulties," "sharing a range of emotions-not just joy, but concerns and sorrow-through art," and "gratitude for art' s role in improving family communication and connection through artwork. Conclusion: The findings of this study lead to several conclusions. First, patients and their families faced psychological challenges when confronted with impending death, yet they strove to remain optimistic by seeking meaning in their struggles. Second, families practiced open and expressive communication, sharing a spectrum of complex emotions with one another. Third, even as the patient's condition worsened, resulting in family fatigue, their support and cohesion strengthened.

• Journal of Hospice and Palliative Care
• /
• 제26권3호
• /
• pp.145-148
• /
• 2023

Preserving dignity is a significant concern for individuals approaching the end of their lives, as they face an increasing number of conditions that can potentially compromise their dignity. This article discusses dignity therapy as one intervention method aimed at enhancing the psychological and spiritual well-being of patients with terminal illnesses. Dignity therapy is an empirically supported therapeutic intervention that interviews patients with nine questions about what is important to them and what they want to remember, culminating in the production of a document based on these conversations. This intervention serves as a valuable tool and framework, enabling clinical professionals to reflect on dignity. It also provides clinicians with a medium to connect with patients on a deeply human level.

• Journal of Hospice and Palliative Care
• /
• 제13권2호
• /
• pp.89-97
• /
• 2010

목적: 본 연구는 호스피스 간호 요구도와 삶의 질을 파악하여 호스피스 간호 중재 방안을 모색하고자 시도 되었다. 방법: 자료수집기간은 2006년 10월부터 2007년 3월까지이며 전라북도 소재 1개 대학 병원에 입원한 암환자 127명을 대상으로 하였다. 연구도구는 Kang과 Kim이 개발한 암환자의 호스피스 간호 요구도 측정도구와 Tae 등이 개발한 삶의 질 측정도구를 이용하였다. 수집된 자료는 SPSS Win 12.0을 이용하였으며, 실수와 백분율, 평균, 표준편차 t-test, ANOVA, Pearson correlation을 이용하여 분석하였다. 결과: 대상자의 호스피스 간호 요구도는 4점 만점에 평점 3.11점이었으며 가족지지 영역이 3.15점으로 가장 높게 나타났으며 다음이 심리적 영역이 3.12점, 신체적 영역이 3.10점, 영적 영역이 3.05점의 순으로 나타났다. 대상자의 삶의 질은 10점 만점에 평점 5.25점이었으며 영적 영역이 5.84점으로 가장 높았고 다음 심리적 영역이 5.18점, 신체적 영역이 5.06점, 사회적 영역이 5.01점의 순이었다. 대상자의 호스피스 간호 요구도와 삶의 질은 호스피스 간호 요구도가 높을수록 삶의 질이 낮게 나타나는 역 상관관계를 보였으며(r=-0.395, P=0.000), 호스피스 간호 요구도 4개 영역 중 신체적 요구가 삶의 질과 가장 강한 역 상관관계를 보였다(r=-0.388, P= 0.000). 대상자의 특성별 호스피스 간호 요구도는 종교(t=6.02, P=0.016), 암 투병기간(F=3.45, P=0.019)에 따라 차이가 있었으며, 삶의 질은 월수입(F=3.38, P=0.021), 암 병기(F=8.10, P=0.000), 항암화학요법(t=6.09, P=0.015)에서 통계적으로 유의한 차이가 있었다. 결론: 결론적으로 암환자의 삶의 질을 향상시키기 위해서는 호스피스 간호 요구를 파악하여야 하며, 동시에 종교, 암 투병기간, 월수입, 암 병기 등과 같은 대상자의 특성을 고려하여야 함을 제안하다.

• 호스피스학술지
• /
• 제3권1호
• /
• pp.31-41
• /
• 2003

Background: The purpose of this study is to assess the effectiveness of family support on the quality of life in patients admitted to the hospice facility at Saemmul Hospice. Method: The subjects of this study were 152 terminal cancer patients that were admitted to the hospice facility at Saemmul hospice between January 2002 and February 2003. Their each quality of life were assessed at admission, one, three, five and seven weeks at Saemmul Hospice using a questionnaire prepared by the Saemmul hospice and were anlalyzed by means of T-test. Result: There was no difference in the quality of life score between patients with family support and patients without family support in terms of physical, psychosocial, and spiritual aspects in the admission. There was no difference in the quality of life score between the patients with frequent family member's visit(>=8) and less frequent family visit(<=7), and between the patients whose family members stayed at the facility for 24hrs and the patients without staying family members. There was no difference in the quality of life score between the patients in low-middle and low-high class among 9 classes of familial economic status(high-high, high-middle, high-low, middle-high, middle-middle, middle-low, low-high, low-middle, low-low). There was no difference in the quality of life score between the patients whose familial religion were Christianity and the patients with other religions. After 1, 3, 5, 7 weeks assessment, the scores in the physical, psychosocial, spiritual aspect of quality of life were increased. Conclusion: The results suggest that family support is important to improve the quality of life in hospice patients and hospice care team is needed to replace 24 hours of family care. There is a urgent need of trained hospice care teams, so training programs for physicians, nurses, clergies, social workers, and volunteers are necessary.

• 호스피스학술지
• /
• 제5권2호
• /
• pp.75-85
• /
• 2005

The objective of this research is to provide the basic material for effective hospice care by analyzing the recognition of families who have terminally ill patients over death. To do so, this research is designed to investigate the general tendency toward death and changes after hospice care. To analyse the initial status of the recognition about the death, questionnaires were provided to the families of the terminally ill patients who were taken hospice care from June 1st, 2005 to September 10th, 2005 at Saemmul Hospice. The same questionnaires were distributed to research some changes of the recognition of the death after 3 weeks. As the Data Analysis Methodology, SPSS v.10.0 statistics program were utilized. The summary of this research is as follows. First, by gender, it is analyzed that women have more fear than men in terms of incompetence sense after death. By religion, Christians have less fear than other religious people in terms of fear toward after death and general sense of death. Second, those who experienced deaths of close family members, relatives, friends for the past 3 years have more fear toward the moment of death than those who did not experience it. Third, statistically valid difference was found in terms of fear toward the moment of death, fear toward incompetence, fear toward after death, and fear toward death before and after the hospice care was taken. Based on the result of this research, terminally ill patients' families facing death have shown significant differences on fear and incompetence before and after hospice care was offered. It is necessary that the hospice care should be settled more professionally by expanding the opportunities of hospice care and institutionalizing the system. In addition, hospice activities which are focused on providing hope after death and facing death with dignity and peace should be expanded increasingly as the family members who experienced deaths showed higher degree of fear and powerlessness and Christians have less fear toward death with the help of biblical influence. It is also required that hospice care specialized in recognizing the importance of terminal cancer patients and their families at the same time.

• 재활간호학회지
• /
• 제8권1호
• /
• pp.50-58
• /
• 2005

Purpose: The purpose of this study was to increase our understanding of the terminal cancer patients and their families concerns. I analyzed the counseling contents of terminal cancer patients and their relatives who referred to hospice office. Method: Data was collected from January 2004 to November 2004. During the counseling, I took notes the key points and contents. 109 patients and/or their families's counseling records were analyzed with the descriptive statistics and content analysis. Result: 73.4% of patients knew their current terminally ill status. The mobility of 86.2% of the patients was worse than ECOG 3 level. Patients have uncontrolled pain(28.4%), emotional distress(55.0%), and physical distress(49.5%). Caregivers of the patients were spouse(46.8%), sons and daughters(24.8%). Family members had problems to tell the bad news to their family cancer patient. 95.4% of the patient and family members was informed about the hospice and palliative care services, and 35.8% of them was referred to the hospice and palliative organizations. Frequently asked questions were 'what is hospice?', 'how much is the cost of hospice services?' etc. Conclusion: Care planning for terminal cancer patients must include patient. Also, professionals should consider and offer accessible, effective and empathetic counseling services to patients and families.