• Journal of Digital Convergence
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• v.17 no.9
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• pp.301-310
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• 2019

This study aims to examine eligibilities, services and delivery of services for the current end-of-life care and analyze the quality control of services for end-of-life care. We analyzed the literature and laws on end-of-life systems in Korean and the United States. Current end-of-life care, hospice and palliative care in Korea is being provided mainly in hospital setting. Quality control for the services focuses on setting the criteria for structures in hospitals (i.e. staffing, facilities and equipment). Whereas American end-of-life care system has much broader eligibility for service beneficiaries and provides care mostly at home. Also quality control for services includes process (delivering service) and outcomes, such as monitoring performance indicators and consumer's satisfaction. This is linked to annual payment. The comparative analysis findings contributed to give the next direction of current Korean end-of-life care system. It is nessary to establish the better and extensive end-of-life care system in Korea in considering other countries' end-of-life care systems based on more future research.

• Journal of Korean Critical Care Nursing
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• v.16 no.3
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• pp.109-122
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• 2023

Purpose : This study aims to explore nursing activities after the decision to discontinue life-sustaining treatment, awareness of a good death, and perception of life-sustaining treatment decisions among nurses in intensive care units (ICUs) at tertiary general hospitals. Methods : Participants were 173 nurses working in two tertiary general hospitals. The data were collected using structured questionnaires and analyzed using an independent t-test, paired t-test, one-way ANOVA, Scheffé's test, and Pearson's correlation coefficient. Results : Participants were 173 nurses working in two tertiary hospitals. The nursing activity increase was the greatest in the spiritual domain, and the physical domain was where the activities decreased the most. There were significant associations between Awareness of good death (Clinical) and Perception of life-sustaining treatment decision(r=.26, p <.001), Awareness of good death (Closure) and Perception of life-sustaining treatment decision(r=.36, p <.001), and Awareness of good death (Personal control) and Perception of life-sustaining treatment decision(r=.49, p <.001). Conclusion : Based on the results, systematic education programs and job training are required to improve the awareness regarding good death and perception of life-sustaining treatment decision for nurses in ICUs where discontinuing life-sustaining treatment decisions are made.

• Child Health Nursing Research
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• v.25 no.1
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• pp.38-47
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• 2019

Purpose: The purpose of this study was to investigate the influence of perceptions of death, end-of-life (EOL) care stress, and emotional intelligence on attitudes toward EOL care among nurses in the neonatal intensive care unit (NICU). Methods: The participants were 111 nurses working in a NICU who had experienced EOL care at least once. Data were analyzed using the t-test, Pearson correlation coefficient, and stepwise multiple regression analysis in SPSS for Windows. Results: The mean score for perceptions of death was 3.16 out of 5, the mean score for EOL care stress was 3.61 out of 5, the mean emotional intelligence score was 4.66 out of 7, and the average score for EOL care attitudes was 2.77 out of 4. The factors affecting attitudes towards EOL care were academic degree, anxiety regarding death, negativity towards death, experiences of patient death, and emotional intelligence. The explanatory power of these variables for attitudes towards EOL care was 24.7%. Conclusion: The results of this study are expected to serve as a basic reference for the development of nursing education programs and EOL care protocols to improve attitudes toward EOL care among NICU nurses.

• Journal of Hospice and Palliative Care
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• v.22 no.3
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• pp.125-133
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• 2019

Purpose: The purpose of this study was to investigate the relationship between end of life care competencies and terminal care stress of nurses in long term care hospitals. Methods: For this study, 140 nurses were sampled among those that have over 6-month end of life care experience and were working at long term care hospitals located in A city and C city of Chungcheongnam-do. Using a questionnaire, data were collected from January 2018 through March 2018. Data were analyzed using the SPSS, Windows version 21.0, according to the purpose of the study and analyzed by descriptive statistics, t-test, one way ANOVA, $Sch\acute{e}ffe^{\prime}s$ test, and Pearson's correlation coefficient. Results: The mean score on terminal care stress of nurses was above the normal level. The scores on end of life care competencies significantly varied by age, total career at hospitals, death/hospice and palliative care education, and bereavement experience. The mean score of end of life care competencies was negatively correlated with the mean score of lack of knowledge and skills among the subitems of the terminal care stress category (r=-0.260, P=0.002). Conclusion: To decrease the terminal care stress of long term care hospital nurses, it is suggested to carry out end of life care education tailored to nurses characteristics.

• Journal of Hospice and Palliative Care
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• v.26 no.1
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• pp.7-17
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• 2023

Purpose: The purpose of this study was to analyze end-of-life care practices in lung disease patients with physician orders for life-sustaining treatment (POLSTs). Methods: We retrospectively analyzed data from medical records regarding the end-of-life care practices of POLST decisions for patients with lung disease hospitalized at a tertiary hospital in Seoul, South Korea. Data were collected from January 1 to June 30, 2021. Results: Of 300 total patients, 198 had lung cancer (66.0%) and 102 had non-malignant lung diseases (34.0%). A POLST was written for 187 patients (62.3%), and an advance directive was written for 20 patients (6.7%). Subsequent treatments were hemodialysis in 13 patients (4.3%), surgery in 3 patients (1.0%), and cardiopulmonary cerebral resuscitation in 1 patient (0.3%). Among cancer patients, chemotherapy was performed in 11 patients (3.7%), targeted therapy in 11 patients (3.7%), immunotherapy in 6 patients (2.0%), and radiation therapy in 13 patients (4.3%). Depending on the type of lung disease, types of treatment differed, including hemodialysis, ventilators, bilevel positive airway pressure, high-flow nasal cannulas, nebulizers, enteral nutrition, central line, inotropic agents, and opioids. Conclusion: Although the goals of hospice care are the same whether a patient has lung cancer or a non-malignant lung disease, because the characteristics of the respective diseases differ, end-of-life care practices and hospice approaches must be considered differently.

• The Journal of the Korea Contents Association
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• v.22 no.5
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• pp.503-517
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• 2022

This study was to investigate the social workers' psycho·social experiences and roles during the end-of-life care process in elderly long-term care facilities. As a result of data analysis through in-depth interviews, social workers experienced great exhaustion and burnout due to frequent death experiences during the end-of-life care process, and expressed regret for not being able to provide better service for the deceased and longing for loved ones. And in the event of a sudden death, social workers would undergo criticism and complaints. The main roles of social workers during end-of-life care were to contact and communicate with family members when signs of death appeared and support them after the death. The necessity of standardized manuals and education for end-of-life care, a recharging program and support group to prevent burnout of social workers, and a legal safety net for emergency preparedness and emergency measures were suggested. The necessity of death preparation education, hospice care, and advance medical directive was also emphasized for the dignified death of the elderly.

• Journal of muscle and joint health
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• v.7 no.2
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• pp.281-293
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• 2000

This study was conducted to identify the relationships among self-care agency, family support, qualify of life in patients with rheumatoid arthritis. The subjects were 120 rheumatoid arthritis patients who attended RA O.P.D. at a university hospital, located in Daegu city, from 10th of May in 1998 to 30th of July in 1998. Three structure questionnaires were administered for explore three main research variables; 소향숙's self-care agency scale, 강현숙's family support scale, and 김종임's quality of life scale of RA patien. Data analysis was conducted with SPSS program including percentage, mean, standard deviation, mean score, Pearson Correlation Coefficient, multiple regression, and Cronbach's Alpha. Results are summarized as follows; 1. The mean of RA patient's self-care agency was 136.62, the mean of family support 37.38, and the mean of qualify of life 134.41. 2. Subject's self-care agency was positively correlated with family support(r=.2446) and with quality of life(r=.4341). Subject's family support was positively correlated with quality of life(r=.2630). 3. Stepwise multiple regression was used to determine the predictors of subject's quality of life. Significant predictors for subject's quality of life were self-care agency(t=4.873 p=0.0000), family support(t=4.480 p=0.0000) and the severity of arthralgia(t=-3.838, p=0.0002). The number of joints involved and the periods of illness did not show significant contribution to subject's quality of life. Self-care agency, family support, and family support explained 40. 39% of the variance in RA patient's quality of life. Given this results, it is suggested that a repeated study to measure RA patient's self-care practice in their own life may be needed to develope and validate an optimum level of nursing intervention for RA patient with which family support will be encouraged and patient's self-care agency will be facilitated.

• Journal of muscle and joint health
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• v.30 no.2
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• pp.111-119
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• 2023

Purpose: The purpose of this study was to describe end-of-life care stress, compassionate competence, and job satisfaction among nurses caring for cancer patients and to identify the relationship between variables. Methods: The participants comprised 141 nurses at the D cancer center in Busan metropolitan city. Data were collected from October 14 to the 31, 2022. The data were analyzed using the SPSS/WIN 29.0 program. Results: There was a significantly positive correlation between a participnat's job satisfaction and compassionate competence (r=.45, p<.001), and end-of-life care stress (r=.42, p<.001). Conclusion: Compassionate competence and end-of-life care experience among nurses caring for cancer patients are factors that influence job satisfaction. A program that can improve compassionate competence should be developed to improve job satisfaction.

• Journal of Korean Academy of Nursing
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• v.34 no.8
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• pp.1402-1408
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• 2004

Purpose: The purpose of this study was to analyze the concept of self-care in elders with dementia through a review of nursing literature and to provide more understanding of the definition and perspectives of the concept of self-care notion in elders with dementia. Methods: The technique developed by Walker and Avant was used as a guide in analyzing the concept of self-care. Results: Attributes of self-care in dementia may include a single or group of actions needed for sustaining life, a personal effort to maintain functional independence while minimizing other's assistance, an outcome behavior from the person's interaction with inter-personal and/or contextual environment, and a functional ability that may decline in parallel to cognitive impairment. Antecedents of self-care in dementia may include at least presence of a certain degree of cognitive appraisal for the self-care needs, self-willingness for the self-care action, spatial and visual orientation, cultural pre-conception of the self-care behavior, presence of environmental context/equipment available for self-care, and sufficient time available. The consequences may include sustaining of life, feel of satisfaction, achieving independence, extended life expectancy, increased self-confidence, decreased caregiver distress and/or burden, savings in health care costs. Discussion: Defining attributes and antecedents and consequences of self-care in dementia identified in this study provided empirical ground of a middle-range theory of self-care for a clinical population with dementia and generated possible hypotheses to be tested in future studies.

• 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.