• Asian Oncology Nursing
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• v.3 no.1
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• pp.15-23
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• 2003

Purpose: This study was to find out hospice nurses and other health professionals' perception on the system of hospice and palliative nurse specialist. Methods: Using questionnaire, 63 nurses and 22 other health professionals answered about the benefit required qualification, workforce standard, and the extent of autonomy needed for hospice and palliative nurse specialist. Data was collected from August, 2002 to November, 2002. and analyzed by using SPSS 10 program. Results: 1) 96.4% of the subjects perceived that hospice nurse specialist will improve the quality of care and patient satisfaction. 2) The most frequent response for the type of education required for hospice nurse specialist was one year post RN program. 3) The most frequent response for the required clinical experience of hospice nurse specialists was minimum of four to five years. 4) The most important qualification for the hospice nurse specialists was an "good relationship with others", and "clinical experience". 5) One to two hospice nurse specialist per hospice facility was viewed as a sufficient number. 6. Autonomy was viewed as the most important characteristic which should be granted to hospice nurse specialist. Conclusion: The results of this study can be used as a basic information in establishing hospice nurse specialist program.

• Journal of Hospice and Palliative Care
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• v.2 no.1
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• pp.46-53
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• 1999

The purpose of this case study is to explore the difference of hospice care and the efficiency of hospice education, by comparing the care of the nurse, the volunteer and the minister who have been trained by the Hospice Education Program. The index of common hospice care delivered by cases is that 1) the physical problems (pain, physical discomfort, incontinece, nausea, vomiting etc.) 2) the family problems(family support, change of family function, inefficiency, preparing the death of family) 3) the psychiatric problems(grief and sadness of death, anxiety, fear, helplessness). The case of volunteer and minister is different with the hospice care by nurse, because it is some what related to Christian's base. The index of care by the volunteer and minister is pertaining to social support and spiritual support for family and dying patient. In conclusion, for the wholistic hospice care, we need the hospice caregiver who have diverse background and expert in knowledge of various dimension. For that, it is necessary to build and develop hospice education program as a team apprach, which indudes a systematic expertizing items for care in consideration of caregiver's background.

• The Journal of Korean Academic Society of Nursing Education
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• v.9 no.2
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• pp.329-339
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• 2003

The purpose of this study is to consider of meaning in life based on Frankl's theory and to propose of hospice nursing according to conceptual framework of meaning in life. The conceptual framework of meaning in life is composed of 4 phases. According to the first phase, acceptance & awareness of self and life, hospice nurse should helps dying patient to accept limitedness of human existence and death. and according to the second phase, actualization of creative value, hospice nurse can helps dying patient to discover meaning in life through doing a deed for last time before his death. According to the third phase, actualization of experiential value, hospice nurse can helps them to discovery of meaning by experiencing of love through meetings with other people, nature, and god. According to the forth phase, actualization of attitudinal value, hospice nurse can helps them to discovery of meaning by realizing meaning in suffering and death through exercising of the inner freedom to choose bravery and acceptance in the face of death and misfortune. As mentioned above, the Frankl's theory accords with the core of hospice nursing that helps people to accomplish human essence in suffering and death. therefore we accepted Frankl's point of view, asserted that one of the most important roles of a hospice nurse as a supporter and sustainer for dying patients is to help patients to find meaning in life even in the course of death. To achieve the goal, hospice nurses should try to have a firm faith through philosophical introspection about life, death, human existence and meaning in life what the most important goal of life is to discover meaning in life and human have the duty and responsibility of recognizing and pursuing meaning up to the last moment of life.

• The Korean Society of Law and Medicine
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• v.9 no.1
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• pp.385-411
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• 2008

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.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.8 no.1
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• pp.35-50
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• 2001

The purpose of this study was to identify the perception of hospice nurses on suffering, the type of stracture and characteristics of suffering. The research process is followed : First, the researcher selected 35 statements on suffering using content analysis of in-depth interviews and a literature search Second, the researcher asked 38 hospice nurses to classify the statement cards. The result of the research showed that the hospice nurse's perception of suffering can be divided into 4 types (Self-recognition, Suffering-elimination, Relation-restoration, and Meaning-endowment). The total explained variance was 46 percent. In relation to this, nursing intervention skills could be presence, listening touch, hope, reassurance, and comforting which result in positive effects between nurse and hospice client.

• Korean Journal of Hospice Care
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• v.2 no.2
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• pp.28-48
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• 2002

The advances of medical technologies have not only prolonged human life span, but also extended suffering period for the patients with incurable medical diseases. Hospice movement was developed to help these patients keep dignity and lives peaceful at the end of their life. Since many patients prefer to spend the last moment of life at home with their family, hospice home care has become very popular worldwide. The purpose of this study for a promotion and development of hospice home care in Korea, and features basic research on medical profession's knowledge and attitudes to hospice home care. This study which was used for the research questionnaires developed by the researcher that were answered by 100 physicians and 127 nurses in a general hospital. Data were collected from April 22, 2002 to May 10, 2002. The SPSS was used to make a comparative analysis of the frequency, percentile, ANOVA, and x2-test. The results of the study were as follows; 1.The medical profession showed high level of knowledge of the definition and philosophy of hospice. However, the physician group of the examinees showed insufficient knowledge of the fact that hospice care includes bereavement care, while the nurse group's response to the same question showed a significant difference(x2=10.752, p=.001). 2.For whom the hospice home care is provided, 95.6% of the respondents showed very high level of knowledge as answering that the incurable terminal illness patients and their families are the beneficiaries of hospice care. The respondents counted nurses, volunteers, pastors, physicians and social workers, consecutively, as hospice care providers. More nurse were positive toward pastors than physicians in regarding as a hospice care provider by a significant difference(x2=11.634, p=.001). 3.For when to referral hospice home care to the patients, only 34.2% answered that patients with less than 6 months of survival time are advised to receive hospice care, reflecting very low level of knowledge. 23.0% of the physicians and 48.0% of the nurses answered that hospice care should be provided when death is imminent, making a significant difference between the two groups(x2=6.413, p=.000). 4.To promote hospice activities, 87.2% pointed out that it is crucial to make general people, including those engaging in the medical field, more aware of hospice. 79.7% answered that a national hospice management should be developed, marking a significant difference between the physician group and nurse group(x2=10.485, p=.001). 5.Advantages of hospice home care are 87.2% responded that patients can have better rest at home receiving hospice home care. Economical merit was brought forward as one of the advantages also, where there was a significant difference between the physicians group and nurse group(x2=7.009, p=.008). 6.The medical professions' attitude to hospice home care are 92.8% of the physicians answered that they would advise incurable terminally ill patients to be discharged from hospital, with 44.3% of them advising the patients to receive hospice home care after leaving the hospital. From the nurses' point of view, 20.9% of the terminally ill patients are being referred to hospice home care after discharge, which makes a significant difference from the physicians' response(x2=19.121, p=.001). 7. 30.6% of physicians have referred terminally ill patients to hospice home care, 75.9% of whom were satisfied with their decision. Those physicians who have never referred their patients to hospice home care either did not know how to do it(66.7%) or were afraid of losing trust by giving the patients an impression of giving up(27.3%). 94.9% of the physicians responded that they would refer their last stage patients to a doctor who is involving palliative care. 8.Only 36.2% of nurses have suggested to physicians that refer the terminally ill patients discharged from the hospital to hospice home care. Once suggested, 95.8% of the physicians have accepted the suggestion. Nurses were reluctant to suggest hospice home care to the physicians, as 48.8% of the nurses said they did not want to. From the result of this study the following conclusion can be drawn, the medical profession's awareness of general hospice care has been increased greatly compared to the results of the previously performed studies. However, this study result also shows that their knowledge of hospice home care is not good enough yet. There is a need for high recommended that medical education institute and develop regular courses on various types of hospice care. Medical field training courses for physicians and nurses will be very helpful as well. It is also important to train hospice experts such as palliative physicians and develop a national hospice management urgently in order to improve the hospice care in Korea.

• Korean Journal of Hospice Care
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• v.8 no.1
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• pp.29-48
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• 2008

Purpose: The purpose of this study was to provide the basic information on the improvement plan by identifying the role accomplishment and job satisfaction of the hospice nurses and analyzing the factors that impact such role accomplishment and job satisfaction. Methods: The data was collected of 189 hospice nurses who have been working more than 6 months in 56 hospice programs registered in Korea Hospice Association and Korean Catholic Hospice Association from October to November, 2007 by structured questionnaire which was developed by Ryu(1979), based on the Riehl's nursing role and the research of Choe(2005) on the role of hospice nurse. Results: The role accomplishment and job satisfaction of the study subject were 3.53 point and 3.39 point, respectively. The roles of hospice nurses were accomplished by the order of advocator, nursing care provider, coordinator (cooperation), educator, quality manager, counsellor, administrator, and researcher. The job satisfaction of the hospice nurses was shown highest in the satisfaction of professional status, followed by the satisfaction of the interaction, satisfaction of the task itself, satisfaction of the administrative aspect, satisfaction of the autonomous, and the lowest in the satisfaction of the pay. The role accomplishment of the subjects according to their socio-demographic and job characteristics was found to have a significant difference by their age, marriage status, academic background, and position. It also has a significant difference by whether they play role of coordinator, whether they took whole responsibility as hospice, working experience as hospice/palliative nurse, and the level of hospice/palliative nursing training(p<.05). In the study of job satisfaction of the subjects according to their socio-demographic and job characteristics, the job satisfaction was found to have a significant difference by the increase of age, the number of duties consisting the hospice team, whether they play role of coordinator, whether they take whole responsibility as hospice, the level of hospice/palliative nursing training, and whether they wish to work for as long as possible(p<.05). The role accomplishment and the job satisfaction of the subjects showed a statistically significant positive correlation. (r=.541, p<.01) Conclusion: Raised saiary will be increased hospice nurse's job satisfaction. And we suggest a repetitive study using the identical tool to the equally extracted subjects with same representativeness of each hospice/palliative institute type. For the expanded role and enhanced professional standard of hospice nurses, we also suggest a study on the improvement plan to enhance the roles of researcher and administrator.

• The Korean Nurse
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• v.28 no.3
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• pp.52-67
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• 1989

True nursing care means total nursing care which includes physical, emotional and spiritual care. The modern nursing care has tendency to focus toward physical care and needs attention toward emotional and spiritual care. The total nursing care is mandatory for patients with terminal cancer and for this purpose, hospice care became emerged. Hospice case originated from the place or shelter for the travellers to Jerusalem in medieval stage. However, the meaning of modem hospice care became changed to total nursing care for dying patients. Modern hospice care has been developed in England, and spreaded to U.S.A. and Canada for the patients with terminal cancer. Nowaday, it became a part of nursing care and the concept of hospice care extended to the palliative care of the cancer patients. Recently, it was introduced to Korea and received attention as model of total nursing care. This study was attempted to assess the efficacy of hospice care. The purpose of this study was to prove a difference in terms of physical, emotional a d spiritual aspect between the group who received hospice care and who didn't receive hospice care. The subject for this study were 113 patients with advanced cancer who were hospitalized in the S different hospitals. 67 patients received hospice care in 4 different hospitals, and 46 patients didn't receive hospice care in another 4 different hospitals. The method of this study was the questionaire which was made through the descriptive study. The descriptive study was made by individual contact with 102 patients cf advanced cancer for 9 months period. The measurement tool for questionaire was made by author through the descriptive study, and included the personal religious orientation obtained from chung(originated R. Fleck) and 5 emotional stages before dying from Kubler Ross. The content ol questionaire consisted in 67 items which included 11 for general characteristics, 10 for related condition with cancer, 13 for wishes far physical therapy, 13 for emotional reactions and 20 for personal religious orientation. Data for this study was collected from Aug. 25 to Oct. 6 by author and 4 other nurse's who received education and training by author for the collection of data. The collected data were ana lysed using descriptive statistics, $X^2-test$, t-test and pearson correlation coefficient. Results of the study were as follows: "H.C Group" means the group of patient with cancer who received hospice care. "Non H.C Group" means the group of patient with cancer who did not receive hospice care. 1. There is a difference between H.C Group and Non H.C Group in term of the number of physical symptoms, subjective degree of pain sensation and pain control, subjective beliefs in physical cure, emotional reaction, help of present emotional and spiritual care from other personal, needs of emotional and spiritual care in future, selection of treatment method by patients and personal religious orientation. 2. The comparison of H.C Group and Non H.C Group 1) There is no difference in wishes for physical therapy between two groups(p=.522). Among Non H.C Group, a group, who didn't receive traditional therapy and herb medicine was higher than a group who received these in degree of belief that the traditional therapy and herb medicine can cure their disease, and this result was higher in comparison to H.C Group(p=.025, p=.050). 2) Non H.C Group was higher than H.C Group in degree of emotional reaction(p=.050). H.C Group was higher than Non H.C Group in denial and acceptant stage among 5 different emotional stages before dying described by Kubler Ross, especially among the patient who had disease more than 13 months(p=.0069, p=.0198). 3) Non H.C Group was higher than H. C Group in demanding more emotional and spiritual care to doctor, nurse, family and pastor(p=. 010). 4) Non H.C Group was higher than H.C Group in demanding more emotional and spiritual care to each individual of doctor, nurse and family (p=.0110, p=.0029, P=. 0053). 5) H.C Group was higher th2.n Non H.C Group in degree of intrinsic behavior orientation and intrinsic belief orientation of personal religious orientation(p=.034, p=.026). 6) In H.C Group and Non H.C Group, the degree of emotional demanding of christians was significantly higher than non christians to doctor, nurse, family and pastor(p=. 000, p=.035). 7) In H.C Group there were significant positive correlations as following; (1) Between the degree of emotional demandings to doctor, nurse, family & pastor and: the degree of intrinsic behavior orientation in personal religious orientation(r=. 5512, p=.000). (2) Between the degree of emotional demandings to doctor, nurse. family & pastor and the degree of intrinsic belief orientation in personal religious orientation(r=.4795, p=.000). (3) Between the degree of intrinsic behavior orientation and the degree of intrinsic: belief orientation in personal religious orientation(r=.8986, p=.000). (4) Between the degree of extrinsic religious orientation and the degree of consensus religious orientation in personal religious orientation (r=. 2640, p=.015). In H.C. Group there were significant negative correlations as following; (1) Between the degree of intrinsic behavior orientation and extrinsic religious orientation in personal religious orientation (r=-.4218, p=.000). (2) Between the degree or intrinsic behavior orientation and consensus religious orientation in personal religious orientation(r=-. 4597, p=.000). (3) Between the degree of intrinsic belief orientations and the degree of extrinsic religious orientation in personal religious orientation(r=-.4388, p=.000). (4) Between the degree of intrinsic belief orientation and the degree of consensus religious orientation in personal religious orientation(r=-. 5424, p=.000). 8) In Non H.C Group there were significant positive correlation as following; (1) Between the degree of emotional demandings to doctor, nurse, family & pastor and the degree of intrinsic behavior orientation in personal religious orientation(r= .3566, p=.007). (2) Between the degree of emotional demandings to doctor, nurse, family & pastor and the degree of intrinsic belief orientation in personal religious orientation(r=.3430, p=.010). (3) Between the degree of intrinsic behavior orientation and the degree of intrinsic belief orientation in personal religious orientation(r=.9723, p=.000). In Non H.C Group there were significant negative correlation as following; (1) Between the degree of emotional demandings to doctor, nurse, family & pastor and the degree of extrinsic religious orientation in personal religious orientation(r= -.2862, p=.027). (2) Between the degree of intrinsic behavior orientation and the degree of extrinsic religious orientation in personal religious orientation(r=-. 5083, p=.000). (3) Between the degree of intrinsic belief orientation and the degree of extrinsic religious orientation in personal religious orientation(r=-. 5013, p=.000). In conclusion above datas suggest that hospice care provide effective total nursing care for the patients with terminal cancer, and hospice care is mandatory in all medical institutions.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.11 no.1
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• pp.57-70
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• 2004

Purpose: This study was to develop a cost-effective and efficient curriculum for advanced practice nurse (APN) programs in home health care and hospice. Method: The process was to: (1) compare and analyze the present curriculum in home health care and hospice programs, (2) identify the needs of 7 expert nurses in home health care and hospice, and (3) develop a common curriculum structure and contents between home health care and hospice specialty courses. Result: Out of the 10 credits constituting the home health care and hospice specialty courses respectively, 6 credits were identified the common courses, Common content areas included introduction to hospice, communication skills, pain control. symptom control. teaching methods, and agency management. Conclusion: These results can be utilized in the development of APN programs for home health care and hospice in terms of qualified and cost-effective aspects of education.

• The Korean Nurse
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• v.23 no.3 s.126
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• pp.62-67
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• 1984