• The Journal of Korean Academic Society of Nursing Education
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• v.23 no.2
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• pp.165-174
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• 2017

Purpose: This study was done to develop and to evaluate an integrative palliative care scale for cancer patients. Methods: The process included construction of a conceptual framework, generation of initial items, verification of content validity, selection of secondary items, preliminary study, and extraction of final items. The participants were 173 cancer patients in Daegu and Gyeongbuk. Item analysis, factor analysis, criterion related validity, and internal consistency were used to analyze the data. Results: Eighteen items were selected for the final scale, and categorized into 3 factors explaining 58.3% of total variance. The factors were labeled as social/environmental palliative care (9 items), psychological palliative care (4 items), and physical palliative care (3 items), and spiritually palliative care (2 items). The scores for the scale were significantly correlated with the quality of life of cancer patients. Cronbach's alpha coefficient for the 18 items was .88. Conclusion: The above findings indicate that the integrative palliative care scale has good validity and reliability when used for cancer patients.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.10
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• pp.6173-6180
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• 2013

Background: Our objective was to determine the knowledge and attitudes of Thai generalists (general physicians) toward palliative terminal cancer care (PC) in a primary care setting. Materials and Methods: We performed a cross-sectional descriptive survey using a self-administered questionnaire. The total number of completed and returned questionnaires was 63, giving a 56% response rate. Data analysis was based on these (Cronbach's alpha=0.82) and percentages and mean values were assessed using the Fisher's exact test to determine the correlation of variables. Results: Overall, attitude and knowledge levels were slightly satisfactory. Results indicated that general physicians had moderate scores in both attitudes (84.1%) and knowledge (55.7%) regarding palliative terminal cancer care. However, they had insufficient knowledge regarding truth telling, pain control and management with morphine, emergency management in terminal cancer care and treatment of fluid intake in terminal stages. Attitude and knowledge scores were statistically correlated (p=0.036). Knowledge scores were further positively associated with being taught palliative care in their medical curriculum (p=0.042). Conclusions: Formal education in palliative care and development of palliative care services are very much needed in Thailand to provide holistic care to terminally ill patients.

• Journal of Hospice and Palliative Care
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• v.25 no.2
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• pp.76-84
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• 2022

Purpose: We compared cost-effectiveness parameters between inpatient and home-based hospice-palliative care services for terminal cancer patients in Korea. Methods: A decision-analytic Markov model was used to compare the cost-effectiveness of hospice-palliative care in an inpatient unit (inpatient-start group) and at home (home-start group). The model adopted a healthcare system perspective, with a 9-week horizon and a 1-week cycle length. The transition probabilities were calculated based on the reports from the Korean National Cancer Center in 2017 and Health Insurance Review & Assessment Service in 2020. Quality of life (QOL) was converted to the quality-adjusted life week (QALW). Modeling and cost-effectiveness analysis were performed with TreeAge software. The weekly medical cost was estimated to be 2,481,479 Korean won (KRW) for inpatient hospice-palliative care and 225,688 KRW for home-based hospice-palliative care. One-way sensitivity analysis was used to assess the impact of different scenarios and assumptions on the model results. Results: Compared with the inpatient-start group, the incremental cost of the home-start group was 697,657 KRW, and the incremental effectiveness based on QOL was 0.88 QALW. The incremental cost-effectiveness ratio (ICER) of the home-start group was 796,476 KRW/QALW. Based on one-way sensitivity analyses, the ICER was predicted to increase to 1,626,988 KRW/QALW if the weekly cost of home-based hospice doubled, but it was estimated to decrease to -2,898,361 KRW/QALW if death rates at home doubled. Conclusion: Home-based hospice-palliative care may be more cost-effective than inpatient hospice-palliative care. Home-based hospice appears to be affordable even if the associated medical expenditures double.

• Journal of Hospice and Palliative Care
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• v.19 no.1
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• pp.5-10
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• 2016

Purpose: This study reviewed what the location of death (LOD) means as an outcome and how to use LOD to assess end-of-life (EOL) care. This study also examined the reason why LOD is significant for the quality of EOL care. Methods: A literature review was performed, using LODs and home deaths as outcomes in the field of EOL care, and analyzed the findings associated with key fields in regards to LOD. Results: Palliative care research used LOD, in particular, hospital death (versus home death) as a significant outcome when examining cost savings, quality of life care, and patient and family preferences. Based on substantial evidence from previous research, home hospice or continuous palliative care in non-hospital settings (i.e. homes, nursing homes) have been designed and available for dying patients in developed countries. Conclusion: The LOD delivers practical significance as an outcome for diverse reasons. In-depth examination on LOD in South Korea is needed despite limitations to interpretation of its meaning in the country.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.15
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• pp.6331-6334
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• 2015

Background: The main purpose of this study was to survey the education and training of certified gynecologic oncologists and fellows in Thailand. A secondary objective was to study the problems in fellowship training regarding palliative care for gynecologic cancer patients. Materials and Methods: A descriptive study was conducted by sending a questionnaire regarding palliative care education to all certified gynecologic oncologists and gynecologic oncology fellows in Thailand. The contents of the survey included fellowship training experience, caring for the dying, patient preparation, attitudes and respondent characteristics. Statistics were analyzed by percentage, mean and standard deviation and chi-square. Results: One hundred seventy completed questionnaires were returned; the response rate was 66%. Most certified gynecologic oncologists and fellows in gynecologic oncology have a positive attitude towards palliative care education, and agree that "psychological distress can result in severe physical suffering". It was found that the curriculum of gynecologic oncology fellowship training equally emphasizes three aspects, namely managing post-operative complications, managing a patient at the end of life and managing a patient with gynecologic oncology. As for experiential training during the fellowship of gynecologic oncology, education regarding breaking bad news, discussion about goals of care and procedures for symptoms control were mostly on-the-job training without explicit teaching. In addition, only 42.9 % of respondents were explicitly taught the coping skill for managing their own stress when caring for palliative patients during fellowship training. Most of respondents rated their clinical competency for palliative care in the "moderately well prepared" level, and the lowest score of the competency was the issue of spiritual care. Conclusions: Almost all certified gynecologic oncologists and fellows in gynecologic oncology have a positive attitude towards learning and teaching in palliative care. In this study, some issues were identified for improving palliative care education such as proper training under the supervision of a mentor, teaching how to deal with work stress, competency in spiritual care and attitudes on responsibility for bereavement care.

• Journal of Hospice and Palliative Care
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• v.24 no.2
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• pp.69-73
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• 2021

Dealing with existential concerns experienced by patients is an important part of palliative care. Interventions that use the life review method to encourage patients to reminisce about their lives can help them find new positive meanings, promote ego integrity, and reduce emotional suffering. Not everyone has positive memories when they look back on the past, however. This poses a limit on the effectiveness of the life review method for healthcare providers working in palliative care contexts. In this study, we discuss the limits of life review and suggest imagery rescripting as a new modality constituting a psychotherapeutic approach to deal with negative memories safely and effectively.

• Journal of Hospice and Palliative Care
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• v.24 no.1
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• pp.1-12
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• 2021

Hospice palliative care refers to holistic care provided by an interdisciplinary team aimed at improving the quality of life of patients suffering from life-threatening diseases and their families. Among interdisciplinary team members, hospice advanced practice nurses (APNs) trained as master's-level advanced nursing professionals are leaders who play an important role in providing patient-centered care and improving the quality of services. The Medical Service Act revised in 2018 requires the scope of practice of APNs in each field to be specified in the Ordinance of the Ministry of Health and Welfare. Accordingly, discussions on the role and scope of practice of hospice APNs are actively underway. In this review, the curriculum of hospice APNs, their work responsibilities and roles, and their current status are reviewed, and the future direction of the hospice APN system is also discussed.

• Journal of Hospice and Palliative Care
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• v.26 no.3
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• pp.140-144
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• 2023

Many terminally ill cancer patients grapple with a range of physical, psychological, and social challenges. Therefore, it is critical to offer effective psychological interventions to assist them in managing these issues and enhancing their quality of life. This brief communication provides a concise overview of acceptance and commitment therapy (ACT), along with empirical evidence of its application for patients, caregivers, and healthcare professionals in hospice and palliative care settings and an overview of future directions of ACT interventions in South Korea. ACT, a third-wave type of cognitive behavioral therapy, is a model of psychological flexibility that promotes personal growth and empowerment across all life areas. Currently, there is substantial evidence from overseas supporting the effectiveness of ACT on health-related outcomes among patients with various diseases, caregivers, and healthcare professionals. The necessity and significance of conducting ACT-based empirical research in hospice and palliative care settings in South Korea are discussed.

• Journal of Hospice and Palliative Care
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• v.20 no.4
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• pp.215-220
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• 2017

Spiritual care is at the center of hospice and palliative care. Patients facing serious and life-threatening illness have important needs in regard to faith, hope, and existential concerns. The purpose of this article is to review the key aspects of this care, including the definitions of spirituality, spiritual assessment, and spiritual care interventions. A review of the current literature was conducted to identify content related to spiritual care in hospice and palliative care. A growing body of evidence supports the importance of spiritual care as a key domain of quality palliative care. The literature supports the importance of spiritual assessment as a key aspect of comprehensive patient and family assessment. Spirituality encompasses religious concerns as well as other existential issues. Future research and clinical practice should test models of best support to provide spiritual care.

• Journal of Hospice and Palliative Care
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• v.15 no.3
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• pp.141-146
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• 2012

Over the past several decades, the assessment of quality of life (QoL) has increasingly played a prominent role in both clinical practice and research regardless of the medical field. Palliative care is defined as an approach that improves the QoL of patients and their families and optimizing their QoL is the primary goal of palliative care. However, it is difficult to compare related studies due to several obstacles such as discrepancies in definitions for palliative medicine, lack of consensus on the central domains and diverse instruments. In this paper, we examined the current status of and challenges in QoL studies and discussed possible solutions. We are convinced this review will be helpful for further palliative care studies.