• Journal of Hospice and Palliative Care
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• v.22 no.4
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• pp.166-173
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• 2019

Purpose: High-quality hospice and palliative medicine curricula are necessary in Korean medical schools. This study evaluated changes in students' knowledge and attitudes toward both hospice and palliative care following the completion of a course on these topics, as well as the course's overall role in the basic medical education curriculum. Methods: Questionnaires measuring knowledge and attitudes were collected before and after the course from 76 fourth-year medical students, who had received instructions integrating both hospice and palliative care in 2016. Results: The questionnaire item "Select the correct answer on the use of opioid pain control in hospice and palliative care" changed the most in terms of number of correct answers pre- and post-course (3.50 and 5.32, respectively; P<0.001). Pre- and post-course, the numbers of students who answered "Strongly Agree" and "Agree" to questions concerning their attitudes toward hospice and palliative care ("I know the purposes and roles of hospice and palliative care") were 17 (22.4%) and 65 (85.6%), respectively (P≤0.001). Affirmative responses also increased for "As a pre-physician, I know when to describe and advise hospice and palliative care to patients", from 22 (28.9%) to 65 (85.6%; P≤0.001). Conclusion: This study showed that comprehensive hospice education in the form of an integrated educational course might promote changes in medical students' knowledge and attitudes toward hospice and palliative medicine.

• Journal of Hospice and Palliative Care
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• v.24 no.1
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• pp.1-12
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• 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
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• v.25 no.2
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• pp.76-84
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• 2022

Purpose: We compared cost-effectiveness parameters between inpatient and home-based hospice-palliative care services for terminal cancer patients in Korea. Methods: A decision-analytic Markov model was used to compare the cost-effectiveness of hospice-palliative care in an inpatient unit (inpatient-start group) and at home (home-start group). The model adopted a healthcare system perspective, with a 9-week horizon and a 1-week cycle length. The transition probabilities were calculated based on the reports from the Korean National Cancer Center in 2017 and Health Insurance Review & Assessment Service in 2020. Quality of life (QOL) was converted to the quality-adjusted life week (QALW). Modeling and cost-effectiveness analysis were performed with TreeAge software. The weekly medical cost was estimated to be 2,481,479 Korean won (KRW) for inpatient hospice-palliative care and 225,688 KRW for home-based hospice-palliative care. One-way sensitivity analysis was used to assess the impact of different scenarios and assumptions on the model results. Results: Compared with the inpatient-start group, the incremental cost of the home-start group was 697,657 KRW, and the incremental effectiveness based on QOL was 0.88 QALW. The incremental cost-effectiveness ratio (ICER) of the home-start group was 796,476 KRW/QALW. Based on one-way sensitivity analyses, the ICER was predicted to increase to 1,626,988 KRW/QALW if the weekly cost of home-based hospice doubled, but it was estimated to decrease to -2,898,361 KRW/QALW if death rates at home doubled. Conclusion: Home-based hospice-palliative care may be more cost-effective than inpatient hospice-palliative care. Home-based hospice appears to be affordable even if the associated medical expenditures double.

• Journal of Hospice and Palliative Care
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• v.13 no.2
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• pp.69-75
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• 2010

Hospice is defined by the National Hospice and Palliative Care Organization (NHPCO, USA) and WHO, as a program of care that provides comprehensive medical, nursing and support services to dying patients and their family. Despite its broad definition, however, hospice care in Korea has been focused mostly on terminal cancer patients. Thus hospice eligibility for patients with advanced cancer is relatively easier to predict than those with other fatal chronic illnesses such as heart, lung, renal or liver diseases, and dementia. This makes it more difficult for patients and families to prepare for death and gain full benefits of hospice care. This article introduces the medical guidelines for selected non-cancer patients who are expected to live for only six months, this making it possible for patients, who are nearing the end of life, to avoid unwarranted suffering.

• The Korean Journal of Health Service Management
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• v.12 no.4
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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.

• Journal of Hospice and Palliative Care
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• v.26 no.1
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• pp.22-25
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• 2023

Although most patients prefer dying at home, patients whose condition rapidly becomes critical need care in the intensive care unit (ICU), and it is rare for them to die at home with their families. Therefore, interest in hospice and palliative care for patients in the ICU is increasing. Hospice and palliative care (PC) is necessary for all patients with life-threatening diseases. The following patients need palliative care in the ICU: patients with chronic critical illnesses who need tracheostomy, percutaneous gastrostomy tube, and extracorporeal life support; patients aged 80 years or older; stage 4 cancer patients; patients with specific acute diseases with a poor prognosis (e.g., anoxic brain injury and intracerebral hemorrhage requiring mechanical ventilation); and patients for whom the attending physician expects a poor prognosis. There are two PC models-a consultative model and an integrative model-in the ICU setting. Since these two models have advantages and disadvantages, it is necessary to apply the model that best fits each hospital's circumstances. Furthermore, interdisciplinary decision-making between the ICU care team and PC specialists should be strengthened to increase the provision of hospice and palliative care services for patients expected to have poor outcomes and their families.

• Journal of Hospice and Palliative Care
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• v.22 no.2
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• pp.49-66
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• 2019

Along with the advances in medical technology and the economic development, more terminally ill patients are receiving hospice and palliative care services. Moreover, hospice and palliative care clinicians have been showing considerable interest in studies that aim to improve the quality of said care for patients and their families. Meanwhile, after the government has strengthened its policy to protect research participants, the institutional review boards (IRBs) are more closely examining various ethical issues related to patients' vulnerability when reviewing protocols for hospice and palliative care research. However, terminally ill patients should be provided with guaranteed qualities of hospice and palliative care to improve and maintain their quality of life. To that end, support should be provided for efforts to conduct ethical and safe studies with hospice and palliative care patients. Thus, this review paper proposes ethical guidelines for hospice and palliative care research. The guidelines could be appropriately used as a reference for researchers who should prepare for ethically safe and scientifically valued research protocols and the IRBs that will review the protocols.

• Journal of Hospice and Palliative Care
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• v.26 no.4
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• pp.149-159
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• 2023

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.

• Korean Journal of Adult Nursing
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• v.15 no.4
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• pp.585-595
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• 2003

Purpose: The purpose of this study was to suggest the projected manpower of hospice and palliative care nurses & APNs(advanced practice nurses)needed in the future. Method: Need model, ratio model and expert opinion were used for projecting the number of hospice and palliative care nurses & APNs. Result: 1. The number of Korean hospice facilities was 64 in 2002. The number of hospice nurses in 2001 was 194 and that of beds was 407. 2. The number of hospice target patients was estimated at a minimum of 16,415 to a maximum of 25,254 in 2002, 12,366 to 26,389 in 2005, and 14,057 to 30,000 in 2020. 3. The number of hospice and palliative nurses needed to meet the demands in 2002, 2005 and 2020 was estimated at a minimum of 1,136 to maximum of 1,748, 1,187 to 1,826, and 1,349 to 2,076, respectively. 4. The number of hospice & palliative care APNs needed to meet the demands in 2002, 2005 and 2020 was estimated at 232, 242, and 274, respectively. Conclusion: The legalization of hospice is expected to increase demands for hospice nurses and advanced practice hospice and palliative care nurses in the future.

• Journal of Hospice and Palliative Care
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• v.26 no.2
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• pp.51-59
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• 2023

Purpose: We evaluated the status of patients enrolled in South Korea's pediatric palliative care pilot project based on the experience of a single center. This study examined factors related to end-of-life services and differences in medical costs. Methods: The medical records of 120 patients referred by a pediatric palliative care team were analyzed retrospectively. Data from July 1 to February 28, 2022 were collected and analyzed using the chi-square test and the Mann-Whitney U test. Results: Volunteer programs and psychological support (100%), family support and education (99.2%), and financial support through institutional linkage (62.5%) were provided to the participants. In the deceased group, there were no significant differences in general characteristics, which included age, gender, primary disease, religion, duration of hospitalization in an intensive care unit (ICU) and non-intensive care unit (non-ICU). However, the ICU group had fewer opportunities to access individual pain and physical symptom management than the non-ICU group and there were limitations in linking with external resources. Medical expenses were significantly different for the ICU group, with a 3-times higher average cost than the non-ICU group. Conclusion: Although an individualized approach is needed for each patient in pediatric palliative care, psychosocial care is essential. In addition, if early intervention for end-of-life pediatric patients is available from a palliative care team, the cost burden of medical care for patients and their families should be minimal.