• Health Policy and Management
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• v.26 no.4
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• pp.305-314
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• 2016

Background: The purpose of this study is to examine the characteristics of and factors associated with long-term care (LTC) utilization under public long-term care insurance (LTCI) among end-of-life older adults in Korea. Methods: Using a 5% sample of older people aged 65 or older and their health and LTC insurance data, two-part model analyses were conducted. We compared LTC uses and their determinants during the last year of life among decedents in the year 2010 with those of survivors. We also compared the medical uses of the same sample with their LTC uses. Results: The end-of-life elderly were more likely to use LTC, and their expenditure on LTC was higher than their counterparts. Whether or not older people used LTC during their last year of life was significantly affected by age, sex, health insurance, household income, and living alone; however, LTC costs of the decedents were only affected by functional status, which may have been due to the reimbursement scheme of the current LTCI, which is mainly based on functional dependency level. For the survivors, having chronic diseases significantly increased the likelihood of LTC use, which was not the case for the decedents. End-of-life elderly with relatively low social economic status were more likely to use the LTC other than medical services, while the health conditions affected their medical uses most significantly. Conclusion: The study findings provide key information for predicting demand related to the increasing LTC needs of Korean older people at the end of life.

• Journal of Hospice and Palliative Care
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• v.25 no.1
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• pp.1-11
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• 2022

The Act on Decisions on Life-Sustaining Treatment has been in effect since 2018 for end-of-life patients. However, only 20~25% of deaths of terminally ill patients comply with the law, while the remaining 75~80% do not. There is significant confusion in how the law distinguishes between those in the terminal stage and those in the dying process. These 2 stages can be hard to distinguish, and they should be understood as a single unified "terminal stage." The number of medical institutions eligible for life-sustaining treatment decisions should be legally expanded to properly reflect patients' wishes. To prevent unnecessary suffering resulting from futile life-sustaining treatment, life-sustaining treatment decisions for terminal patients without the needed familial relationships should be permitted and made by hospital ethics committees. Adult patients should be permitted to assign a legal representative appointed in advance to represent them. Medical records can be substituted for a patient's judgment letter (No. 9) and an implementation letter (No. 13) for the decision to suspend life-sustaining treatment. Forms 1, 10, 11, and 12 should be combined into a single form. The purpose of the Life-sustaining Medical Decisions Act is to respect patients' right to self-determination and protect their best interests. Issues related to the act that have emerged in the 3 years since its implementation must be analyzed, and a plan should be devised to improve upon its shortcomings.

• Women's Health Nursing
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• v.28 no.4
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• pp.296-306
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• 2022

Purpose: This study investigated the effects of peripheral neuropathy symptoms, self-care ability, and disturbances to daily life on quality of life (QoL) among gynecological cancer patients undergoing chemotherapy. Methods: The participants included 144 patients with gynecological cancer undergoing anticancer chemotherapy at a tertiary hospital in Seoul, South Korea, from December 1, 2021 to January 28, 2022. Convenience sampling was used to recruit patients who had received 4 or more cycles of chemotherapy using a paclitaxel-platinum regimen, and a self-reported questionnaire was used to collect data. Descriptive statistics, the t-test, analysis of variance, Scheffé test, Pearson correlation coefficients, and multiple regression analysis were performed. Results: Most of the participants had ovarian cancer (70.1%) or endometrial cancer (14.6%), and the most common number of treatment cycles was 6 to 10 (29.2%). The mean QoL (60.83±19.89) was greater than the midpoint. The regression model analyzing the patients' QoL was statistically significant (F=15.38, p<.001) with an explanatory power of 56.7%. Self-care ability (β=.39, p<.001), disturbances to daily life (β=-.38, p<.001), the duration of peripheral neuropathy symptoms (β=2.14, p=.034), and regular exercise (β=-2.12, p=.036) were found to significantly affect QoL. Conclusion: Efforts to improve the self-care ability of gynecological cancer patients who have experienced peripheral neuropathy after receiving chemotherapy and mitigate disturbances to their daily life can improve their QoL. Healthcare professionals should identify peripheral neuropathy symptoms and examine the effects of the symptoms on patients' daily lives. Improving the self-care ability of patients and alleviating their limitations in daily life may improve QoL.

• Journal of Korean Critical Care Nursing
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• v.9 no.1
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• pp.1-14
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• 2016

Purpose: To investigate the post-intensive care syndrome (PICS) and to analyze the factors affecting the quality of life (QoL) of survivors of critical illness. Methods: Subjects were 114 outpatients who had been discharged from intensive care units of a university hospital in B city, Korea. From July 30 through September 30, 2015, PICS was assessed using the Korean Montreal Cognitive Assessment, Hospital Anxiety-Depression Scale, Korean Instrumental/Activities of Daily Living (K-I/ADL) index, and handwriting transformation, while physical and mental health-related QoL was measured using the SF-12. Results: Of the subjects, 39.5% were screened for mild cognitive disorder and 23.7% experienced handwriting transformation after discharge. Multiple regression analysis revealed that restraint application, current job, time of ${\geq}36$ months after discharge, depression, anxiety, and handwriting transformation accounted for 40.9% of the physical health-related QoL, and depression, anxiety and experience of delirium accounted for 62.4% of the mental health-related QoL. Conclusions: It is necessary to make efforts to reduce restraint application in intensive care units and prevent the occurrence of delirium, with the objective of reducing PICS and improving the QoL of critical illness survivors.

• Journal of Hospice and Palliative Care
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• v.13 no.2
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• pp.89-97
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• 2010

Purpose: This study investigated the relationship between the needs for hospice care and quality of life in cancer patients. Methods: Data were collected from 127 cancer patients hospitalized at a university hospital in Chonbuk between October, 2006 to March, 2007. Two instruments were used: cancer patients' need for hospice care, developed by Kang and Kim and quality of life developed by Tae et al. Results: The mean scores were 3.11 out of 4 for hospice care needs, and 5.25 out of 10 for quality of life. The correlation between needs for hospice care and quality of life was moderate and negative (r=-0.395, P<0.01). Among the four groups of needs, physical need was the most strongly correlated with quality of lifer (r=-0.388, P<0.01). The need for hospice care was significantly different according to participants' religion (t=6.02, P<0.05), and duration of disease (F=3.45, P< 0.05). Quality of life was significantly different according to participants' monthly income (F=3.38, P<0.05). cancer stage (F=8.10, P<0.01) and chemotherapy (t=6.09, P=0.015). Conclusion: The results suggested that the cancer patients' hospice care needs should be answered in order to improve their quality of life. While doing so, participants' characteristic need should also be considered.

• The Journal of the Korea Contents Association
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• v.17 no.6
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• pp.591-599
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• 2017

With the introduction of long-term care insurance, the number of long-term care facilities and the elderly using it is increasing. Nevertheless, there was a lack of concern and research on elderly abuse and how to affect the life of the elderly in long-term care facilities. The study analyzed the data collected from 278 senior citizens of 44 long-term care facilities in two regions. The analysis was conducted to analyze the relationship among elderly abuse, service quality, service satisfaction and life satisfaction. An analysis showed that some of the elderly experienced elderly abuse, especially sexual abuse. The experience of abuse affect the perception of the service quality, service satisfaction and life satisfaction of the elderly. The elderly experienced abuse was undervalued in service quality, service satisfaction and life satisfaction. Based on these findings, the implications to prevent elderly abuse of long-term care facilities are suggested.

• Journal of Korean Academy of Nursing
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• v.37 no.5
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• pp.744-753
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• 2007

Purpose: The effects of telephone intervention on self-care practices and quality of life for gynecological cancer patients under chemotherapy was investigated. Methods: A non-equivalent control group pre-test post-test quasi-experimental design was used. The subjects were women cancer patients who had received less than two chemotherapy sessions at C university hospital of Chonnam province(26 in the experimental group: 25 in the control group). The patient's self-care practices(Na & Lee, 1999; Jang, 2004) and quality of life(Lee & Jo, 1997) were measured three times. using a questionnaire. The data was analyzed by Repeated Measures ANOVA, the Friedman test, and the Mann-Whitney test using the SPSS window version 12.0 program. Results: This study showed that the score of self-care practices and quality of life for the experimental group under telephone counseling were higher than those of the control group. Conclusion: This study revealed that a telephone intervention as supportive nursing care for women cancer patients under going chemotherapy was effective for self-care practices and qualify of life during the recovery period. Futhermore, this study also suggests that telephone counseling can serve as a continuing nursing supportive intervention for women cancer patients for the upcoming stages of further chemotherapy.

• Korea Journal of Hospital Management
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• v.25 no.4
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• pp.29-37
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• 2020

Purposes: This study purposed to identify influence of postpartum care services on health-related quality of life in women after birth. Methodology: Korea Health Panel Survey 2009-2015 provided by the Korea Institute for Health and Social Affairs and National Health Insurance Service was used for the analysis. The health-related quality of life evaluate as a EuroQoL-5D(EQ-5D-3L, used the weight of the CDC) was used as dependent variables. Postpartum care services was used as independent variable. Demographic factors(education, economic activity, region, house income), health related variable(presence of chronic disease, self-rated health), birth related variable(birth-related problem, childbirth, pregnancy of advanced maternal age) used as covariates. Regression analysis was used. Findings: The rate of use of postpartum care services is increasing year by year. Postpartum care services and self-rated health positively influence on the health-related quality of life in women after birth and chronic disease and birth-related problem negatively influence on. Practical Implications: Therefore, it is necessary that the government's policy of the postpartum care service be expanded and systematized to increase accessibility on. There are rare studies on the health-related quality of life of women after childbirth, adjusted for birth-related variables. So this study has significance.

• Journal of Hospice and Palliative Care
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• v.16 no.4
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• pp.223-231
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• 2013

Purpose: This study was conducted to explore how nurses' attitude toward dignified death and moral sensitivity affect their end-of-life care performance. Methods: Study participants were 172 nurses who work at university hospitals in a metropolitan city in Korea. Data were collected from June 20 through August 13, 2012 using the Dignified Death Scale, Moral Sensitivity Scale, and End-of-Life Care Performance Scale. Data were analyzed using the SPSS/WIN 19.0 program. Results: Factors affecting nurses' end-of-life care performance included moral sensitivity, dignified death and education level. Conclusion: Moral sensitivity, dignified death and education level should be considered when developing an educational program for nurses' end-of-life care performance.

• Journal of Hospice and Palliative Care
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• v.20 no.4
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• pp.221-225
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• 2017

Care for the human spirit is a core component of quality end-of-life care. Logotherapy, based on the premise that the primary motivation of human beings is to find meaning and purpose in life, can be helpful in providing care for patients, families, and loved ones in hospice care. The use of Socratic dialog in posing questions about one's life experiences, values, and attitudes is a useful method of evoking reflection. Guidance for finding meaning, even until one's last moments, can be found in the three categories: (a) tasks or deeds, (b) experiences of love and beauty, and (c) attitudes chosen in spite of a fate that cannot be changed. Self-transcendence, defined as getting outside the self for the good of others, can add meaning to life. A growing body of research concerning meaning-centered therapy is promising for improving spiritual well-being and a sense of meaning and purpose in life.