• The Journal of the Korea Contents Association
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• v.15 no.12
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• pp.355-369
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• 2015

Purpose: This study aimed to identify on the attitudes toward the life support care among elderly people using Q methodology. Methods: Thirty-nine elderly people classified 34 selected Q statements into a shape of normal distribution using a 9 point scale. The obtained data were analyzed by using a PQ Method PC program. Results: Principal component analysis identified 4 types of the attitudes toward the life support care among elderly people. Type I is "Situational & Self-determination linear type", type II is "Destiny & Life support care denied type", type III is "Avoidant & Family decision emphasis type" and type IV is "Respect for life & life support care approved type". Most of elderly people have been attitude that wish to receive honor their own decisions toward the prolongation treatment. Conclusion: The findings indicate a need to policy guidelines and public information that express self-determination of elderly people.

• Journal of The Korea Institute of Healthcare Architecture
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• v.29 no.4
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• pp.7-20
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• 2023

Purpose: The main purpose of this paper is to assess a body of research evidence that articulates the impact of physical and environmental factors on behavioral·psychological health and quality of life for the elderly people with dementia who reside in long-term care facilities. This follow-up study of the previous literature review aims to further identify physical and environmental factors, that improve health and quality of life for the elderly people with dementia, published in recent five years and to expand the understanding of clinical outcomes as mechanism that mediate the effect of physical environmental factors on improving behavioral·psychological health and quality of life for the elderly people with dementia. Methods: Comprehensive literature review has been conducted to identify empirical studies that link the design of dementia care facilities to health- and quality of care(QOL)-related outcomes and this follow-up review scrutinized peer-reviewed articles published in recent five years (from January 2018 to December 2022), filling the gap between the previous literature review and the current state of research. Results: The review identified a growing body of literature that articulates environment-related factors that improve behavioral·psychological health and quality of life for the elderly people with dementia living long-term care facilities. Implications: The findings of the review can be translated to design implications and design decisions to promote psychological and behavioral health and quality of life of people with dementia in long-term care facilities.

• Journal of Families and Better Life
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• v.34 no.4
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• pp.1-19
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• 2016

The present study aimed at investigating the relations between the amount of child care experienced in the first three years of life and socioemotional development of children at age 4 indicated by problem behaviors and peer competence. Using the longitudinal data of the Panel Study of Korean Children(PSKC), the information of 1,699 children were analyzed. The results indicated that any child care experience, hours in child care, full-time child care and early entry to child care were significantly related to children's externalizing behavior problem and play disruption at age 4. Some significant relations were detected between child care experience and better peer competence as well. Interestingly, the patterns of relations were different for boys and girls. Being in child care, a greater amount of child care and early entry to child care tended to be related to externalizing problem behaviors of boys and whereas they were more related to peer competence of girls indicated by play interaction, play disruption and play disconnection. Child care hours at age 3 were relative stronger predictors of children's development compared to those at age 1 or at age 2. The findings imply that the amount of child care during the first 3 years of life does not have strong harmful effects on preschoolers' socioemotional development and that there are differences in the effects of child care on boys and girls.

• Health Policy and Management
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• v.15 no.2
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• pp.1-15
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• 2005

The aim of this study was to compare medical cost of hospice care and that of conventional care during the last year of life, and identify factors that influenced the cost. From January to August 2003 592 terminal cancer patients receiving care from 5 hospice care units and 2 hospice care teams in general hospitals were enrolled to case group. Two hundreds and seventy two terminal cancer patients receiving conventional care from 7 general hospitals were enrolled to hospital-based control group, and 1,636 terminal cancer patients from 122 general hospitals located in same regions with the 7 hospitals were enrolled to community-based control. We used characteristics and medical cost from data of National Health Insurance Cooperation. Total medical cost per beneficiary in cases was about 10 millions won, 14.5 millions in hospital-based controls and 11.1 millions in community-based controls. The hospice care saved $45\%$ over the last year of life compared with hospital-based controls (p<0.0001). Saving of inpatient cost account for approximately $80\%$ of saving per beneficiary. Hospice care saved $29\%$ of medical cost per hospitalization day compared with hospital­based controls and $17\%$ compared with community-based controls (p<0.0001). Multiple regression analyses showed that hospice care significantly saved the medical cost. This study suggest that hospice care save medical cost compared with hospital-based control and community-based control. Most of saving of inpatient cost account for approximately $80\%$ of saving of medical cost.

• Journal of Hospice and Palliative Care
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• v.16 no.4
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• pp.232-241
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• 2013

Purpose: This study was conducted to do preliminary report of differences and similarities between Koreans residing in Korea and Korean Americans residing in America regarding their awareness of end-of-life care, attitudes toward advance care planning, truth telling, and preferred decision-making model. Methods: Two participating groups were selected: a) Koreans residing in Korea, and b) Koreans Americans who had resided in the United States for at least 20 years. 25 Koreans and 23 Korean Americans who were older than 65 years old participated in this study. They were asked via a self-administered questionnaire that contained demographic questions and questions about end-of-life decision making regarding awareness of end-of-life care, attitudes toward advance care planning, truth telling, and preferred decision-making model. A Chi-square was used to measure differences between Koreans' and Korean Americans planning. A P value of less than 0.5 was considered significant. Data analysis was performed using SPSS 18.0. Results: In some aspects of awareness of end of life care, attitudes toward advance care planning, and truth telling, both groups had similar opinions. However, there were significant differences between groups in the necessity of end of life documentation, preferential informing the truth, and preferred decision making model. Conclusion: There were similarities and differences regarding some end of life issues between the Koreans and the Korean Americans.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.27 no.3
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• pp.241-249
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• 2020

Purpose: This study aimed to investigate possible ways to expand the services of home-visit nursing through a review of the progress, achievements, and obstacles of home-visit nursing; a pilot project of an integrated home-service; the application of the Omaha System; as well as a case analysis of providing home-visit nursing services. Method: An integrated review was conducted using various source materials, including laws, previous studies, and a case analysis. Results: In case analysis of providing visiting nursing service, rehabilitation nursing, end-of-life nursing, and dementia care showed high nursing needs. It was necessary that the various home visit nursing services in the intervention area of the Omaha System, administrative services, case management, and center operation activities were all included in the payment systems of long-term care insurance. Conclusion: In the future, home visit nursing services of long-term care insurance should be reborn in the form of a center for integrated case management in the community, which would set long-term goals until the time of a client's death and encompass the realm of human rights for health, quality of daily life, and a dignity of life.

• Korean Journal of Adult Nursing
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• v.25 no.2
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• pp.207-218
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• 2013

Purpose: The purpose of this study was to explore the chronic patients' preferences for care near the end of life. Methods: This is a descriptive survey research, with subjects of 161 outpatients with hypertension, diabetes mellitus or chronic renal failure. Results: The majority of the subjects do not want meaningless life sustaining treatment and they report thinking positively about family or health care professional to participate in their end of life decision making process. Subjects reported preferring adequate pain management and spiritual support at the end of life. In regard to advance directives (ADs), those subjects with chronic disease report thinking positively about the necessity of ADs and its institutionalization. However, the subjects report not having the detailed information on the proper time and method of writing their ADs. Conclusion: Based on these results, educational programs on end of life decision making for chronic patients need to be developed. Also, the nurse should try to reflect the opinion of chronic patients as much as possible when make an end-of-life decision.

• Journal of Korean Academy of Nursing
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• v.27 no.3
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• pp.627-638
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• 1997

Most patients having leukemia suffer severely from emotional turmoil due to the generalized perception that cancer will be fatal. The conventional chemotherapy results in side effects such as severe bone marrow depression which interfere with self-care management, vital for improvement in their condition. Bandura's theory of the self-efficacy suggests that self- efficacy can be enforced by performance attainments, vicarious experiences, verbal per-suasion and the release of emotional arousal. Self-efficacy can be enforced by a program of vicarious experiences and verbal persuasion, while the emotional arousal can be relieved through a hope promotion program, If once self-efficacy increases, the patient's self-care behaviors and the quality of life will also increase. The purpose of this study was to empirically test the effects of a program, to promote self-efficacy and hope, on self-care behaviors and quality of life in patients having leukemia. In this study, three types of approaches to enhance self-efficacy and hope were used : 1) a 20-minute long slide /tape for vacarious experiences : 2) a 10-minute long telephone call coaching for verbal persuasion ; and 3) two booklets for information about the symptoms of leukemia and treatment modalities and hope promotion. Thirty one patients were recruited in the experimental group and 29 in the control group with a nonequivalent pretest-posttest design. The subjects were patients with leukemia undergoing chemotherapy. Sherer and Maddux's self-efficacy scale, Nowotny's hope scale, and Padilla's quality of life scale were employed with some modifications. A self-care behavior scale was developed by the researchers. Statistical analyses including paired t-test, Chi-square, ANCOVA and ANOVA, were used. The results are as follows : The levels of self-efficacy, self-care behavior and quality of life were higher in the experimental group than in the control group after four weeks of intervention(F=28.71, P=.0001 ; F=63.35, P=.0001 F=16.57, P=.0001). After ten weeks of intervention, all of the dependent variables(self-efficacy, self-care behavior, hope & quality of life) in the experimental group were higher than in the control group (F=74.12, P=.0001 ; F=108.34, P=.0001 ; F=13,11, P=.001 : F=43.52, P=.0001). In conclusion, self-care behavior and quality of life increased mainly through an increase in self-efficacy, while increases in hope took more time and effort.

• Journal of Digital Convergence
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• v.15 no.8
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• pp.257-265
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• 2017

The purpose of this study was to investigate the degree of awareness of the concept of 'hospice palliative medical care' and decision of 'life-prolonging medical care' by the general public subjects. A survey was conducted on 346 participants and officials who participated in an event held in September 2016. As a result of the research, the subjects' responses results to the life-prolonging medical care decision showed that people with religion wanted natural death compared to people without religion, and had more active attitude toward decisions related to dignity death. Religion is an important factor that can influence perceptions of life and death, believing that afterlife is after death, so it is possible to take a more firm stance on the extension of meaningless life at the last minute. Therefore, in order to stabilize the hospice care and prescription medical decision law to the general public and to improve the quality of the death and the dignity of life, it is necessary to develop awareness through various educational programs in consideration of age, education level. In addition, education and promotion should be strengthened so that the general public can fully understand the knowledge of hospice palliative care and health care and government standardization and policies for hospice personnel and breeding programs will be urgent.

• Asian Oncology Nursing
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• v.10 no.1
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• pp.19-29
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• 2010

Purpose: The purpose of this article was to review and discuss the current status, issues, and nursing perspectives of cancer survivorship. Methods: A comprehensive literature review was conducted. Results: The major areas of concern for the survivors included recurrence, secondary malignancies, and long-term treatment sequalae which affect their quality of life. The four essential components of survivorship are prevention, surveillance, intervention, and coordination. Cancer survivorship care plan should address survivor's long-term care, such as types of cancer, treatment modalities, potential side effects, and recommendations for follow-up. It also needs to include preventive practices, health maintenance and well-being, information on legal protections regarding employment and health insurance, as well as psychosocial services in the community. Survivorship care for cancer patients requires multidisciplinary efforts and team approach. Conclusion: Nurses are uniquely positioned to play a key role in ensuring quality services for cancer survivors and family members. Nurses should review the care plans for cancer survivorship with patients and families by instructing them when to seek medical treatment, promoting any recommended surveillance protocols, and encouraging healthy life styles for health promotion and quality of life.