• Title/Summary/Keyword: Hospice.palliative care

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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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    • v.19 no.4
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    • pp.283-291
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    • 2016
  • Over the past decade, hospice and palliative care in Japan have progressed rapidly under the national policies supported by the Cancer Control Act. The numbers of palliative care units/inpatient hospices, hospital palliative care teams, and clinics with a home hospice function have been steadily increasing. The increasing numbers of physicians, nurses, and pharmacists have been certified as specialists in palliative care by national associations. Collaborative efforts have been made to standardize and disseminate educational programs and training opportunities in undergraduate, postgraduate, and continuing medical education. Research activities in Japan have markedly contributed to the growing body of evidence, especially in the fields of terminal delirium, terminal dehydration, palliative sedation, care for dying patients, prognostication, communication, psycho-oncology, and regional palliative care programs. This review focuses on major palliative care settings, specialty, national associations, education, and research in palliative care in Japan.

Spiritual Care in Hospice and Palliative Care

  • Ferrell, Betty R.
    • Journal of Hospice and Palliative Care
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    • v.20 no.4
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    • pp.215-220
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    • 2017
  • Spiritual care is at the center of hospice and palliative care. Patients facing serious and life-threatening illness have important needs in regard to faith, hope, and existential concerns. The purpose of this article is to review the key aspects of this care, including the definitions of spirituality, spiritual assessment, and spiritual care interventions. A review of the current literature was conducted to identify content related to spiritual care in hospice and palliative care. A growing body of evidence supports the importance of spiritual care as a key domain of quality palliative care. The literature supports the importance of spiritual assessment as a key aspect of comprehensive patient and family assessment. Spirituality encompasses religious concerns as well as other existential issues. Future research and clinical practice should test models of best support to provide spiritual care.

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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    • v.24 no.4
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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.

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

  • Kang, Eun-Sil;Choi, Sung-Eun;Kang, Sung-Nyun
    • Korean Journal of Hospice Care
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    • v.7 no.1
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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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    • v.24 no.2
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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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    • 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.