• The Journal of the Korea Contents Association
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• v.22 no.8
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• pp.628-639
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• 2022

The purpose of this study was to investigate the relationship between the optimal end-of-life care and well-dying perceived by nurses to provide the optimal end-of-life care for patients and their families. This subjects of the study were 121 nurses working in the ward or intensive care unit of a general hospital in Seoul, and the data collected from April 28 to May 12, 2021 were analyzed. Data were analyzed using t-test, ANOVA, and Pearson correlation coefficients with the SPSS/WIN 27.0 program. The total average of the subjects' perceptions of the optimal end-of-life care was 4.04±0.82 on a five-point scale, indicating the overall level of 'agree' with the optimal end-of-life care. The total average of well dying perceived by the subjects was 3.63±1.14 on a five-point scale, and the most important recognized questions was to die peacefully. Of general characteristics, there was a significant differences on optimal end-of-life care according to age (t=-.97, p=.013). The nurse group in their 30s showed higher consent for end-of-life care than those in their 20s. An analysis of the correlation between the optimal end-of-life care and well-dying showed that there was no significant correlation. This study suggest that education should be provided to raise awareness of end-of-life care for young nurses with low experience.

• Journal of Hospice and Palliative Care
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• v.20 no.3
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• pp.167-172
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• 2017

End-stage liver disease (ESLD) is a terminal condition of cirrhosis which cannot be treated without liver transplantation. Thus, it is natural for patients to consider hospice/palliative care (HPC). Since the recent legislation of the Act on Decisions on Life-Sustaining Treatment for Patients in Hospice and Palliative Care or at the End of Life (Act No. 14013) in Korea, the practicality of this law has become an issue. The criteria for HPC should be defined with consideration to how the severity of each ESLD complication may vary by individual patients. Generally, patients qualify if they have an intractable condition despite aggressive treatment such as the hepatorenal syndrome, hepatic encephalopathy or variceal hemorrhage. However, the option of liver transplantation should be sufficiently discussed with patients and their families before making a decision on HPC. The evaluation of which ESLD patients should receive HPC should be based on a long-term doctor-patient relationship and sufficient objective data. Therefore, a multidisciplinary approach and mutual consultation among cirrhosis specialists and doctors with other expertise are essential to offer optimal and balanced treatments between liver-specific treatment and HPC. Discussed in this review are adequate criteria for HPC and special considerations for ESLD at the point of HPC.

• Journal of Chest Surgery
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• v.56 no.1
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• pp.6-13
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• 2023

Background: Coronavirus disease 2019 (COVID-19) has been found to cause life-threatening respiratory failure, which can progress to irreversible lung damage. Lung transplantation can be a life-saving treatment in patients with terminal lung disease (e.g., acute respiratory distress syndrome caused by infection). This study aimed to present the clinical course and results after initial lung transplantation in patients with severe COVID-19 who did not recover even with optimal medical care. Methods: From August 2019 to February 2022, this study enrolled 10 patients with COVID-19 (5 men; median age, 55.7 years) who underwent lung transplantation at a single center in Korea. All patients' characteristics, clinical pathway, overall survival, complications, and operative data were collected and analyzed. Results: Veno-venous extracorporeal membrane oxygenation or an oxygenator in a right ventricular assist device circuit was applied to 90% of the patients, and the median length of extracorporeal life support before operation was 48.5 days. There were no cases of mortality after a median follow-up of 372.8 days (interquartile range, 262.25-489 days). The major complications included the requirement for postoperative extracorporeal membrane oxygenation support in 2 cases (20%), re-transplantation in 1 case (10%), and re-exploration due to bleeding in 2 cases (20%). During the follow-up period, 3 out of 10 patients died. Conclusion: Excellent early outcomes were observed for patients who underwent lung transplantation. Thus, lung transplantation can be an effective and feasible treatment for patients with end-stage lung disease caused by COVID-19.