This study was conducted to be helpful to the expansion and development of hospice and to provide the basic data for Hospice palliative care by identifying the general characteristics of curriculum of hospice perception, level of perception, practice experiences, routes, times, meanings, needs, targets, supply, types, organizations, experiences, use of hospice and physical, emotional, social and spiritual aspects of hospice services. Study tools which were used in this study were composed of three sections. Survey paper is 3-point Likert scale which is composed of 6 questions of general characteristics, nominal scale of 24 questions about hospice perception and hospice service contents. Respondents can reply with 3 answers of Necessary (1), Mediocre (2), and Not necessary (3), in physical, emotional, social and spiritual aspects. Score ranges of this tool are from minimum of 24 points to maximum of 72 points and higher scores mean higher perception of Hospice. Hospice is a behavior to take care of terminal patients who are waiting for death and their family and it should be conducted physically, emotionally, socially and spiritually in order that the patients could meet their last moments of life by maintaining a high quality of life, human dignity and peace for the rest of their lives. Hospice could be mentioned to be a comprehensive care to relieve the pains and grieves of bereaved family.
Purpose: The purpose of this study was to examine the relationships of knowledge, attitudes, and self-efficacy related to palliative care among health care providers (doctors and nurses) in order to provide a basis to develop a training program for health care providers. Methods: A correlational and descriptive study design was used. Participants were recruited from a university-affiliated hospital located in Daejeon and an e-nurse community. After IRB approval, data were collected from July 12, 2018, to September 30, 2018. A total of 169 responses were finally analyzed using version SPSS 24. The data were analyzed in terms of descriptive statistics (frequency and percentage or mean and standard deviation, as appropriate), the t-test, analysis of variance (with the Duncan post hoc test), and Pearson correlation coefficients. Results: Knowledge, attitudes, and self-efficacy were significantly higher in those who had received palliative care training or had been exposed to awareness-raising initiatives. There were positive relationships among knowledge, attitudes, and self-efficacy, with small to moderate effect sizes. Conclusion: Palliative care training for health care professionals is necessary to meet patients' needs. Such programs should take into account not only knowledge about palliative care, but also ways to improve empathy and resolve ethical dilemmas. Interprofessional training would be an excellent option to share therapeutic goals and develop communication skills among multidisciplinary team members.
Kim, Boon-Han;Choe, Sang-Ok;Chung, Bok-Yae;Yoo, Yang-Sook;Kim, Hyun-Sook;Kang, Kyung-Ah;Yu, Su-Jeong;Jung, Yun
Journal of Hospice and Palliative Care
/
v.13
no.1
/
pp.13-23
/
2010
Purpose: This study was to identify the role of general hospice palliative nurse through job analysis (duties, task, and task elements). Methods: The sample consisted of 136 nurses or professors who were performing duties related to hospice care areas in Korea. A survey method was used, and the questionnaire included frequencies, criticality, and difficulties of task elements in job description by the DACUM method. Descriptive statistics were performed by using SPSS WIN 17.0. Results: The job description of general hospice palliative nurse was identified 8 duties, 36 tasks, and 137 task elements. As for the 8 duties, the average scores of frequency, criticality, and difficulty were 2.94, 3.66, and 2.80, respectively. The role of ‘pain assessment’ was the most important task element among frequency and criticality. The lowest score at the frequency and criticality were ‘manage public finance’ and ‘collect datum through diagnostic test & lab', respectively. Furthermore, the role of 'identify spiritual needs of patients and family' was the most difficult task, whereas the role of 'manage documents and information' was the least. Conclusion: In this study, we could recognize the reality of general hospice palliative nurse's performances. For general hospice palliative nurse, therefore, concrete practice guide lines of psychosocial and spiritual care, communication skills, and bereavement care with qualifying system are critically needed.
Purpose: Focusing manner is very powerful mind-body self-help and self-awareness competence. So focusing manner may affect nurses' emotional labor and nursing performance, but few are known about it to date. The purpose of this study was to identify the degree of focusing manner, emotional labor, nursing performance of clinical nurses, and the factors that affect nursing performance. Methods: In order to collect data, structured questionnaires were administered to 212 nurses who worked at 2 university hospitals located in D city. Data were analyzed by t-test, ANOVA, correlation and multiple regression using SPSS/WIN 20.0. Results: Nursing performance had positive relationship with focusing manner (r=.45, p<.001), and negative relationship with emotional labor (r=-.25, p<.001). And the most prediction factor influencing nursing performance was focusing manner (${\beta}=.41$, p<.001) and the other factors were age (${\beta}=.30$, p=.002), and emotional labor (${\beta}=.14$, p=.012). The total variance was 37.1% by those predictors (F=25.87, p<.001). Conclusion: Based on the results of this study, it is necessary to develop and educational program on focusing manner-oriented psychotherapy in order to improve the nursing performance. Also, the management system for controlling emotional labor needs to be set up for nurses in clinical settings.
This paper provides practical suggestions for how palliative care clinicians can address the expressions of spiritual struggle voiced by patients and their loved ones. In addition to practical tips for listening and responding, ethical guidance and opportunities for self-reflection related to spiritual care are briefly discussed. Principles to guide practice when the clinician is listening and responding to a patient expressing spiritual struggle include being non-directive, honoring (vs. judging) the patient's spiritual or religious experience, keeping the conversation patient-centered, focusing on the core theme of what the patient is expressing presently, using the patient's terminology and framing, and responding "heart to heart" or "head to head" to align with the patient. Ultimately, the goal of a healing response from a spiritual care generalist is to allow the patient to "hear" or "see" themselves, to gain self-awareness. To converse with patients about spirituality in an ethical manner, the clinician must first assess the patient's spiritual needs and preferences and then honor these.
Kim, Gi-Yon;Choi, Sang-Soon;Pak, So-Mi;Song, Hee-Young;Hur, Hea-Kung
Journal of Hospice and Palliative Care
/
v.5
no.2
/
pp.136-145
/
2002
Purpose : This study was designed to develop an instrument that could be used for comprehensive and effective need assessment for patients with cancer. Methods : In the first phase, a conceptual framework for the instrument was established by Wingate & Lackey (1989). In the second phase, the preliminary instrument was drawn up through a review of the literature and in consultation with three professors in Nursing. In the third phase validity and reliability of the preliminary instrument were tested as follows; 1) an expert validity test of the preliminary instrument was done by nine head nurses and charge nurses who had over ten years experience caring for patients with cancer at Wonju Christian Hospital. 2) A construct validity test and reliability test was done for the instrument by 116 staff nurses selected by convience sampling from hospitals located in Kang-Won, Kyoung-Ki, and Choong-Chung Provinces. The collected data were analyzed using SPSS 10.0 WIN program. For the factors of the instrument, factor analysis was used. The reliability of the scale was analyzed by Cronbach's alpha. Results : The results of the experts' test of validity, showed that, of 32 items, only one item had less than 55.4%. It was then deleted and a total of 31 items was selected. On the basis of the results of the factor analysis, the following six components were identified: physiological, informational, spiritual, and emotional needs, available resources, and legal/financial needs. These factors explained 61.8% of the variance. In the factor analysis, the first factor (physiological needs) and the second factor (informational needs) explained 25.4% and 10.9% of the variance respectively, which were major factors for the needs of patients with cancer in Korea. Cronbach' alpha for the scale was .90 indicating internal reliability. Conclusion : This instrument can be effectively utilized for assessment of needs of patients with cancer in Korea. Use of the needs assessment instrument developed in this study will allow nurses to develop nursing interventions that provide comprehensiveness and continuity in meeting the needs of patients with cancer.
Purpose: This study was conducted to identify subjective attitudes towards terminal patients in nursing students who had clinical practice. The types of subjective attitude were classified by applying Q methodology. According to those types, basic reference data for the development of educational programs were provided. Methods: Thirty-four final Q samples were selected, and Q classification with a nine-point scale was performed with P samples of 43 nursing students. A key factor analysis was conducted with the collected data using the PC QUANAL program. Results: Nursing students' attitudes towards terminal patients were grouped into three types. The total variable was 49.96%. Students with Type 1 ("wish for life-sustaining medical treatment") thought that terminal patients accurately understood their medical condition and wanted to prolong their lives. Others with Type 2 ("need for service and support") believed that a multidisciplinary nursing system needs to be established to help terminal patients prepare for death. Students with Type 3 ("awareness and acceptance of death") thought that terminal patients wanted to die with dignity at a hospice unit. Conclusion: This study analyzed various types of attitude towards terminal patients, as perceived by nursing students with clinical training experience. Development of educational programs for each attitude type analyzed in this study could contribute to systematic training programs for nursing students caring for terminal patients.
Spirituality is an essential part of human beings. Spiritual care, designed to meet the spiritual needs of terminally ill patients and their families, is one of the most important aspects of hospice and palliative care (HPC). This study reviewed and analyzed literature utilizing the most commonly used Korean and international healthcare databases to identify care models that adequately address the spiritual needs of terminally ill patients and their families in practice. The results of this study show that spirituality is an intrinsic part of humans, meaning that people are holistic beings. The literature has provided ten evidence-based theories that can be used as models in HPC. Three of the models focus on how the spiritual care outcomes of viewing spiritual health, quality of life, and coping, are important outcomes. The remaining seven models focus on implementation of spiritual care. The "whole-person care model" addresses the multidisciplinary collaboration within HPC. The "existential functioning model" emphasizes the existential needs of human beings. The "open pluralism view" considers the cultural diversity and other types of diversity of care recipients. The "spiritual-relational view" and "framework of systemic organization" models focus on the relationship between hospital palliative care teams and terminally ill patients. The "principal components model" and "actioning spirituality and spiritual care in education and training model" explain the overall dynamics of the spiritual care process. Based on these models, continuous clinical research efforts are needed to establish an optimal spiritual care model for HPC.
Purpose: This study was conducted to explore the effects of attitude to death in hospice and palliative professionals on their terminal care stress, and to analyze relationships among variables related to the two aforementioned parameters, such as depression and coping strategies. Methods: Participants were 131 hospice and palliative professionals from the cancer units of two tertiary hospitals and two general hospitals, two hospice facilities, two geriatric hospitals, and two convalescent hospitals in J province. Data were collected from April through June 2015 and analyzed using t-test, factor analysis, ANOVA ($Scheff{\acute{e}}$ test), ANCOVA, and Pearson's correlation and a path analysis using the SPSS/WIN 21.0 and AMOS 18.0 programs. Results: The score for attitude to death was low (2.63), and that for depression was 0.45. Among all, 16.0% of the participants showed need for depression management. They scored 3.82 on terminal care stress. The subcategory with the highest mark was inner conflicts on limitation given availability of medical services (4.04). The score on coping strategy was low (3.13). They used passive coping strategies such as interpersonal avoidance (4.03), fulfilling basic needs (3.65) such as sleeping or eating. Attitudes to death had a direct negative effect on the terminal care stress level and indirectly affected through depression and fulfilling basic needs (CS2). Conclusion: It is necessary to provide hospice and palliative professionals with education on death and dying, as well as access to programs that provide emotional support and promote positive cognition of death and dying.
Purpose: The purpose of this study was to compare the need for hospice care between families of children and adults with cancer. Methods: The data was collected from 190 families of children and adult with cancer using self-rating questionnaires from December, 2004 to February, 2005. Data was analyzed using SPSS/Win program by Mean, SD and t-test. Results: The mean score of the need for hospice care in families of children with cancer was greater significantly than in families of adults with cancer (t=-2.126, P=.035). The scores of two factors among the five factors evaluated for the need for hospice care were different significantly. The mean score of control of major terminal physical symptoms' in families of children with cancer was greater significantly than the mean score of adults with cancer (t=-2.165, P=.032). The mean score of 'spiritual care to prepare for death' in families of adults with cancer was greater significantly than the mean score of children with cancer (t=-2.380, P=.018). Conclusion: For improving the quality of life for both patients and families, the hospice service program needs to consider the life cycle of patients.
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