• Journal of Hospice and Palliative Care
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• v.14 no.2
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• pp.71-80
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• 2011

The growth of the aging population in Korea will challenge health and social services. As Korean society changes, the U.S. models of end-of-life care and geriatric care for frail older adults may have increasing relevance for the Korean healthcare system. This article reviews three U.S. models of care for frail older adults: hospice and palliative care, the Program for All-Inclusive Care for the Elderly (PACE), and the transitional care model. We describe the strengths and limitations of each model and discuss ways in which these models could be adapted for the Korean healthcare system.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.3
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• pp.428-436
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• 2017

The purpose of this study is to investigate the study subjects' awareness on hospice & palliative care service; and explore its activation methods of Long-term care hospitals located in the metropolitan cities B and K. The total of returned survey was answered from 183 employees on Long-term care hospitals which it was selected 13 institutions. One month to study during from July 1 to July 30, 2016 the researchers visited to investigate relevant data and surveyed to examine their awareness and activation methods. The returned survey questionnaires were processed with SPSS 21.0 for basic data analysis. The results of the 13 institutions under this research, 9 institutions provided hospice & palliative care education once a year. Most of the staff members were found to be aware of the idea of hospice & palliative care, think of it as a good program, and wish it to be implemented(81.9%). They answered that the reason of not implementing the hospice&palliative care was the 'lack of personnel(50.8%)', 'lack of knowledge on hospice&palliative care program; and presented activation method was 'insurance fee introduction(15.8%)' followed by 'service education(15%)' and 'governmental financial support(14%)'.

• Journal of Hospice and Palliative Care
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• v.25 no.2
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• pp.66-75
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• 2022

Purpose: The purpose of this study was to examine person-centered care, nursing professionalism, the nursing work environment, and empathy capacity among hospice ward nurses and to identify the factors affecting person-centered care. Methods: Data were collected using a self-report questionnaire completed by 120 nurses at 30 inpatient hospice institutions in South Korea from August 24, 2020 to September 8, 2020. The independent t-test, one-way analysis of variance, and Pearson correlation analysis were conducted using SPSS version 26.0. Results: The scores were 3.76±0.45 for person-centered care, 3.58±0.47 for nursing professionalism, 3.24±0.57 for the nursing work environment, and 4.00±0.46 for empathy capacity. There were positive correlations between the variables. Factors that influenced the person-centered care of hospice nurses were being a manager (β=0.20, P=0.002), high nursing professionalism (β=0.20, P=0.012), a better nursing work environment (β=0.15, P=0.033), and high empathy capacity (β=0.51, P<0.001). The explanatory power was 65.3%. Conclusion: To reinforce the person-centered care competency of hospice nurses, it is necessary to improve nursing professionalism, the nursing work environment, and empathy competency. Opportunities for nurses to practice independently must be expanded for nurses to develop nursing professionalism. Sufficient nursing personnel and material resources must be provided to nurses to cultivate a positive work environment. Empathy should be improved by implementing integrated education programs that include nursing practice situations.

• Journal of Hospice and Palliative Care
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• v.17 no.4
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• pp.259-269
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• 2014

Purpose: This preliminary study is aimed at developing standardized tools for psycho-social assessment of patients in needs for hospice/palliative care. To accomplish the purpose, investigators examined effects of perceptions of social workers on the importance of psycho-social domains of assessment in hospice/palliative care settings. Moreover, investigators paid attention to variances of perceptions of social workers' along with types of institution and credentials of those family settings. Methods: A form of questionnaire was first explored from an initial interview assessment of 10 government-certified hospice care providers and a literature review, second constructed with eight domains and 80 items, and sent by e-mail to 55 institutions and hospitals providing hospice/palliative cares in Korea. Lastly, a total of 31 agencies returned with a completed responses and consent form (56% response rate). SPSS program (version 18.0) was used for data analysis. Results: Study found that social workers perceived patients' family background (m=4.53, 5-point scale) as the most important assessment domain, whereas economic conditions (4.06 point) the least important. Social workers' perception varied by credentials (i.e., license types, training, full-time position, types of care facility). Conclusion: Based upon study findings, investigators can conclude strong needs for developing a assessment tool that measures multiple domains (i.e., psychological, social and ecological aspects) of patients. A standardized assessment tool should be structured with 2 axis (center/core and expanded/peripheral) and tailored for institution type. Second, professional trainings must be provided by strengthening legal institutionalization and fostering qualified social workers with full responsibilities of hospice and palliative care patients.

• Journal of Hospice and Palliative Care
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• v.24 no.4
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• pp.254-260
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• 2021

Continuous deep sedation (CDS) is an extreme form of palliative sedation to relieve refractory symptoms at the end of life. In this study, we shared our experiences with CDS and examined the clinical characteristics associated with survival in patients with terminal cancer who received CDS. We conducted a chart audit of 106 consecutive patients with terminal cancer who received CDS at a single hospice care unit between January 2014 and December 2016. Survival was defined as the first day of admission to the date of death. The associations between clinical characteristics and survival were presented as hazard ratios and 95% confidence intervals using a Cox proportional hazard model. The mean age of participants was 65.2 years, and 33.0% (n=35) were women. Diazepam was the most commonly administered drug, and haloperidol or lorazepam were also used if needed. One sedative was enough for a majority of the patients. Stepwise multivariate analysis identified poor functioning, a high Palliative Prognostic Index score, hyperbilirubinemia, high serum ferritin levels, and a low number of sedatives as independent poor prognostic factors. Our experiences and findings are expected to be helpful for shared decision-making and further research on palliative sedation.

• Korean Journal of Hospice Care
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• v.7 no.2
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• pp.6-14
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• 2007

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.

• Journal of Hospice and Palliative Care
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• v.25 no.4
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• pp.139-197
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• 2022

Patients with terminal cancer experience very severe symptoms during the end of life, and palliative sedation (PS) may be considered if those symptoms are refractory to any other treatment. This brief report presents ethical considerations, practices, and recent concerns on PS. PS is quite different from euthanasia. There is a lack of consensus and standards on protocols, but its notable effects have been reported in hospice care settings. Most studies to date have reported no difference in survival between patients receiving PS and those not, and PS must be conducted proportionally with the lightest level of sedation. The most common indication for PS is delirium, and midazolam is the main sedative used. It is recommended that information regarding PS should be provided to patients and their caregivers repeatedly as early as possible. Existential suffering alone is not an indication for PS, and there is a lack of evidence on bispectral analysis. Additional research on PS is needed in Korea.

• Journal of Hospice and Palliative Care
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• v.26 no.2
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• pp.95-100
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• 2023

With the implementation of Act on Hospice and Palliative Care and Decisions on Life-Sustaining Treatment for Patients at the End of Life, interests of the general public on self-determination right and dignified death of patients have increased markedly in Korea. However, "self-determination" on medical care is misunderstood as decision not to sustain life, and "dignified death" as terminating life before suffering from disease in terminal stage. This belief leads that physician-assisted suicide should be accommodated is being proliferated widely in the society even without accepting euthanasia. Artificially terminating the life of a human is an unethical act even though there is any rational or motivation by the person requesting euthanasia, and there is agreement thereof has been reached while there are overseas countries that allow euthanasia. Given the fact that the essence of medical care is to enable the human to live their lives in greater comfort by enhancing their health throughout their lives, physician-assisted suicide should be deemed as one of the means of euthanasia, not as a means of dignified death. Accordingly, institutional organization and improvement of the quality of hospice palliative care to assist the patients suffering from terminal stage or intractable diseases in putting their lives in order and to more comfortably accept the end of life physically, mentally, socially, psychologically and spiritually need to be implemented first to ensure their dignified death.

• Journal of Hospice and Palliative Care
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• v.27 no.1
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• pp.45-49
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• 2024

Purpose: This study investigated palliative care physicians' attitudes regarding social issues related to opioid use. Methods: An email survey was sent to 674 physicians who were members of the Korean Society for Hospice and Palliative Care (KSHPC). Results: Data from 66 physicians were analyzed (response rate, 9.8%). About 70% of participants stated that their prescribing patterns were not influenced by social issues related to opioid use, and 90% of participants thought that additional regulations should be limited to non-cancer pain. Under the current circumstances, pain education for physicians is urgently needed, as well as increased awareness among the public. Half of the respondents identified the KSHPC as the primary organization responsible for providing pain education. Conclusion: Palliative care physicians' prescribing patterns were not influenced by social issues related to opioid use, and these issues also should not affect cancer pain control.

• Journal of Hospice and Palliative Care
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• v.21 no.4
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• pp.109-114
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• 2018

The objective of this paper is to suggest plans to properly establish and promote the use of hospice music therapy by examining its necessity and how it is being used in Korea. Hospice music therapy is a clinical and evidence-based use of music interventions administered by a professional to alleviate total pains suffered by hospice patients and their families. While the effects of hospice music therapy have been reported by many studies, its meaning and value are still poorly understood in Korea, which explains the lack of related institutions in the nation. Recently policy-wise and legislative efforts have been made to promote hospice and palliative care, which in turn will likely fuel demand for hospice music therapy. Therefore, the meaning and role of hospice music therapy should be defined by major hospice and palliative care institutions and societies, followed by institutional and academic efforts as follows. First, a set of qualification criteria for hospice music therapists should be established to provide proven music therapy interventions to patients and their families. Second, a systematic program offering both theoretical and practical trainings needs to be developed to foster hospice music therapists. Last but not least, clinical studies should be promoted with development of a research road map for hospice music therapy and a standard protocol.