• 제목/요약/키워드: Hospice palliative care

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재가 호스피스완화 대상자의 증상 및 돌봄 요구도 분석 -부산광역시 보건소 중심 재가 호스피스사업을 중심으로- (Analysis of Symptom and Care Needs of Home-Based Hospice Palliative Patients - Home-Based Hospice Business Centered on Community Health Centers in Busan-)

  • 김정림;최순옥;김숙남
    • 보건의료산업학회지
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    • 제12권4호
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    • pp.173-190
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    • 2018
  • 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.

Advances in Hospice and Palliative Care in Japan: A Review Paper

  • Mori, Masanori;Morita, Tatsuya
    • Journal of Hospice and Palliative Care
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    • 제19권4호
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    • pp.283-291
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    • 2016
  • 지난 10년 동안 암 관리법에 의한 국가 정책에 따라 일본에서는 호스피스 및 완화의료가 급속히 발전해왔다. 완화의료 시설 및 입원 환자의 호스피스, 병원의 완화 의료팀, 가정 호스피스 기능을 갖춘 진료소의 수는 꾸준히 증가하고 있으며 국가 협회로부터 완화의료 전문가로 공인된 의사, 간호사, 약사의 수도 증가하고 있다. 학부, 대학원 및 계속적인 의학 교육을 통해서 교육프로그램 및 교육의 기회를 표준화하고 보급하기 위한 공동 노력이 이루어졌다. 일본의 연구 활동은 말기 섬망, 말기 탈수증, 완화적 진정, 임종 환자의 의료, 예후, 의사 소통, 정신 종양학, 지역적인 완화의료 프로그램의 분야에서 현저하게 기여하였다. 이 보고서에서는 일본에서의 주요 완화의료 환경, 특성, 국가 협회, 교육, 완화의료 연구에 초점을 맞추었다.

Spiritual Care in Hospice and Palliative Care

  • Ferrell, Betty R.
    • Journal of Hospice and Palliative Care
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    • 제20권4호
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    • pp.215-220
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    • 2017
  • 영적간호는 호스피스 완화의료의 중심에 있다. 심각하고 생명을 위협하는 질병에 직면한 환자는 신앙, 희망 및 실존적 관심과 관련하여 중요한 요구를 가지고 있다. 이 논문의 목적은 영성, 영적 평가 및 영적간호 중재의 정의를 포함하여 이러한 간호의 핵심 측면들을 검토하는 것이다. 호스피스 완화의료에서 영적간호와 관련된 내용을 파악하기 위해 현재의 문헌 자료들을 조사했다. 점점 더 많은 증거들이 양질의 완화의료의 핵심 영역으로서 영적간호의 중요성을 뒷받침하고 있다. 문헌은 포괄적인 환자 및 가족 평가의 핵심 측면으로서 영적 평가의 중요성을 뒷받침한다. 영성은 다른 실존적 문제들뿐만 아니라 종교적인 관심도 포함한다. 향후 연구 및 임상시험은 영적간호를 제공하기 위한 최선의 지원 모델을 검증해야 한다.

Screening and Assessment Tools for Measuring Delirium in Patients with Cancer in Hospice and Palliative Care: A Systematic Review

  • Yang, Eun Jung;Hahm, Bong-Jin;Shim, Eun-Jung
    • Journal of Hospice and Palliative Care
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    • 제24권4호
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    • pp.214-225
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    • 2021
  • Purpose: This study reviewed screening and assessment tools that are used to measure delirium in patients with cancer in hospice and palliative care settings and examined their psychometric properties. Methods: Four databases were searched for studies using related search terms (delirium, tools, palliative care, cancer, and others). The inclusion criteria were a) studies that included screening/assessment tools for measuring delirium in cancer patients receiving hospice/palliative care, and b) studies published in English or Korean. The exclusion criteria were a) studies that were conducted in an intensive care setting, and b) case studies, qualitative studies, systematic reviews, or meta-analyses. Results: Out of the 81 studies identified, only 10 examined the psychometric properties of tools for measuring delirium, and 8 tools were ultimately identified. The psychometric properties of the Memorial Delirium Assessment Scale (MDAS) were the most frequently examined (n=5), and the MDAS showed good reliability, concurrent validity, and diagnostic accuracy. The Delirium Rating Scale had good reliability and diagnostic accuracy. The Delirium Rating Scale-Revised 98 also showed good reliability and structural validity, but its diagnostic performance was not examined in hospice/palliative care settings. The Nursing Delirium Screening Scale showed relatively low diagnostic accuracy. Conclusion: The MDAS showed evidence of being a valid assessment tool for assessing delirium in patients with cancer in palliative care. Few studies examined the diagnostic performance of delirium tools. Therefore, further studies are needed to examine the diagnostic performance of screening/assessment tools for the optimal detection of delirium in patients with cancer in hospice/palliative care.

병동형 호스피스 대상자를 위한 전인적 호스피스 간호중재 프로그램의 개발 (Development of Wholistic Hospice Nursing Intervention Program for In-patient of Hospice Palliative Care Unit)

  • 강은실;최성은;강성년
    • 호스피스학술지
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    • 제7권1호
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    • pp.29-45
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    • 2007
  • People in the end of life and their families suffer in their physical disease and other aspects as a whole person. They need hospice care to palliate their total suffering in physical, emotional, social and also spiritual aspect through professional hospice team. To care their whole personal needs, hospice team must be a multi-discipline team which consists of medical doctors, nurses, social workers, pastors and volunteers. Recently those who die in hospice palliative care unit have trend to increase more than in home year by year. So it is necessary to develop the nursing intervention program to be performed by multi-discipline team approach for in-patient of hospice palliative care unit. The purposes of this study were to develop of wholistic hospice nursing intervention program for inpatient of hospice palliative care unit. The subjects of study were collected from 30 patients those who were over 18 years old and admitted in hospice palliative care unit of S hospital in P city with agreement in hospice palliative care in their terminal disease. The period of data collection was from December 15, 2003 to March 15, 2004. The result were as follows : 1. The result of Wholistic Hospice Nursing Program's development was as follow : A Wholistic Hospice Nursing Program was developed by me in this study is one of the service program for hospice palliative care unit. It was named as ‘Rainbow Program’ to be approached easily by hospice patients. The purposes of it are to improve the quality of life of the terminal patients with their dignity, to help them live in abundant and meaningful in their lives, to care them in peaceful in dying process with understanding them in whole personal, and also to palliate the grief and suffering of the bereaved. It was provided by hospice professionals(nurses, medical doctors, social worker, pastors, art therapists) and volunteers those who were educated in hospice for multi-diciplinary team approach to collaborate with each role play I 20-30 minuters of each through visiting their rooms individually and a place of hospice palliative care unit of S hospital in P city. The subjects of it were the terminal patients those who admitted hospice palliative care unit and their familes. with agreement in hospice palliative care in their terminal disease. The characteristics of it were multi-disciplinary team approach, whole personal care, individual care and total care according to their needs in their condition. The contents of it were pain control, symptom control, counseling patient, counseling family, hair cutting, hair shampooing, bed bath, recreation, taking a walk, event of culture(screen, recital, festival of praises, exhibition and so on), pastoral counseling, ritual service in bed, praying, service in bed, sing a worship praise, listening to the music, sharing remembrance of life, individual visiting music service(sing and praying), meditation Bible, art therapies(dance and drawing), social worker's counselling, confessing and sharing love and thanksgiving. The experimental group subjects participated in Wholistic Hospice Nursing Program which takes 120 minutes per session, total 10 sessions(total 1,200 minutes) altogether. In conclusion, this Wholistic Hospice Nursing Intervention can be used actively for whole personal well-being of the patients in hospice palliative in hospice palliative care unit and also applied in hospice practice as an useful model of multi-disciplinary team approach by hospice professionals.

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Current Status of Complementary Therapies Provided by Hospice Palliative Care in South Korea

  • Kwon, Sinyoung;Bak, Jihye;Kwon, So-Hi
    • Journal of Hospice and Palliative Care
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    • 제24권2호
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    • pp.85-96
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    • 2021
  • Purpose: The aim of this study was to investigatecomplementary therapiesprovided at hospice palliative care facilities in South Koreaas designated by the Ministry of Health and Welfare. Methods: The survey was conducted via e-mail from September 2 to September 23, 2020, with responsesfrom 109 therapists and 59 managers from 55 different hospice care facilities. Results: Hospices provided an average of 3.67 different types of therapies, ranging from 1 to 7 different types. The most common types of therapies were horticultural therapy (81.4%), music therapy (79.7%), art therapy (76.3%), and aromatherapy (57.6%). The average frequency of sessions was once a week, the median duration was 60 minutes. Most therapists (96.3%) had qualifications, but the certification-issuing organizations and training intensiveness varied greatly. None of the therapists were employed on a full-time basis, and their average monthly income was KRW 270,000. Therapists and managers gave average scores of 8.90 and 8.38 out of 10, respectively, regarding the positive impact of complementary therapies on patients. Conclusion: In order for patients and their families to benefit from complementary therapiesat hospice care facilities, in addition tobetter terms of employment for therapists, evidence-based guidelines for different types of therapies are needed so that therapy sessions can be conducted according to the theoretical underpinnings and characteristics of the type of therapy. It is expected that the results of this study will be used for policy-making in support of therapy as an essential hospice service.

Changes in Perceptions and Attitudes of Medical Students toward End-of-Life Care after Hospice and Palliative Medicine Education

  • Cha, Jeehyun;Lihm, Hoseob;Kim, Yoonyoung;Kang, Jihun
    • Journal of Hospice and Palliative Care
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    • 제22권4호
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    • pp.166-173
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    • 2019
  • 목적: 높은 수준의 호스피스 및 완화의료 교육은 한국 의과대학 교육과정에 필요하다. 하지만 이와 연관된 연구는 많지 않은 실정이며 이에 본 연구는 호스피스와 완화의료 교육 과정을 마친 의과 대학생의 호스피스와 완화의료에 대한 인지 및 태도 변화를 연구하기 위해 수행 되었다. 또한 의과대학의 기본 교육 과정 안에서 호스피스 교육과정의 역할에 대해서도 탐구하고자 한다. 방법: 호스피스와 완화의학에 대한 통합적인 교육과정을 마친 총 76명의 의학과 4학년 학생이 자기 기입 형태의 설문조사에 참여 하였다. 교육 과정을 마친 후 수업 전과 비교하여 수업 후의 후의 호스피스 및 완화의료에 대한 지식과 태도를 조사하였다. 결과: 교육 과정을 이수한 이후 가장 큰 변화는 호스피스 및 완화의료 세팅에서 적절한 마약성 진통제를 사용할 수 있는가 하는 부분에서 나타났다(3.50점 vs 5.32 점; P≤0.001). 수업 전과 비교하여 수업 이후 호스피스와 완화의료에 대한 태도를 나타내는 질문인 "나는 호스피스와 완화의료의 목표와 역할을 바르게 알고 있다"고 답한 학생은 17명(22.4%)에서 65명(85.6%)으로 증가하였다. 또한 "예비의사로서 나는 호스피스와 완화의료의 바른 적용 시점을 알고 있다"고 답한 학생은 수업 전의 22명(28.9%)과 비교하여 65명(85.6%)으로 증가하였다. 결론: 통합적인 호스피스 완화의료 교육과정은 의과 대학생의 호스피스 및 완화의료에 대한 인식과 태도를 긍정적인 방향으로 변화시킬 수 있다.