• Journal of Hospice and Palliative Care
• /
• v.21 no.4
• /
• pp.109-114
• /
• 2018

The objective of this paper is to suggest plans to properly establish and promote the use of hospice music therapy by examining its necessity and how it is being used in Korea. Hospice music therapy is a clinical and evidence-based use of music interventions administered by a professional to alleviate total pains suffered by hospice patients and their families. While the effects of hospice music therapy have been reported by many studies, its meaning and value are still poorly understood in Korea, which explains the lack of related institutions in the nation. Recently policy-wise and legislative efforts have been made to promote hospice and palliative care, which in turn will likely fuel demand for hospice music therapy. Therefore, the meaning and role of hospice music therapy should be defined by major hospice and palliative care institutions and societies, followed by institutional and academic efforts as follows. First, a set of qualification criteria for hospice music therapists should be established to provide proven music therapy interventions to patients and their families. Second, a systematic program offering both theoretical and practical trainings needs to be developed to foster hospice music therapists. Last but not least, clinical studies should be promoted with development of a research road map for hospice music therapy and a standard protocol.

• Physical Therapy Korea
• /
• v.30 no.1
• /
• pp.32-40
• /
• 2023

Background: Equating is a statistical procedure used to create a common measurement scale across two instruments. Item-level information should be taken into consideration so that scores can communicate interchangeably across the instruments. Objects: To investigate a common measurement scale across two health-related quality of life questionnaires (HRQOL) applied to various cancer survivors who underwent palliative care in healthcare institutions. Methods: A total of 139 cancer survivors who underwent palliative care were recruited from two rehabilitation hospitals and an oriental medicine hospital. Participants consisted of various cancer survivors who presented to the sites for palliative care. They were asked to fill out Korean versions of the World Health Organization Quality of Life (WHOQOL-BREF) and EuroQOL-5 dimension (EQ-5D) questionnaires following the palliative care. For the item level comparison, the Rasch rating scale model was used to investigate how participants regarded individual test items of two instruments in relation to item difficulty calibrations. Results: All items except the three items fit the Rasch model. One item (anxiety/depression) of the EQ-5D and two items (dependence on medical aids and negative feelings) of the WHOQOL-BREF are misfit. The WHOQOL-BREF targets the survivors well, while the EQ-5D is able to target the survivors with lower HRQOL levels with some ceiling effects. By inspecting the item difficulty calibrations of the two instruments, five items of the WHOQOL-BREF are selected as common items in relation to the EQ-5D. These five items are considered compatible with each other. Differential item functioning (DIF) analysis reveals that the healthcare item of the WHOQOL-BREF vs the self-care item of the EQ-5D exhibits significant DIF. Conclusion: Findings suggest that one paired item should be taken into consideration when equating the WHOQOL-BREF and the EQ-5D applied to cancer survivors who underwent palliative care.

• Clinical and Experimental Pediatrics
• /
• v.51 no.2
• /
• pp.214-218
• /
• 2008

Neuroblastoma is one of the most common extracranial solid tumor of childhood, and treatment of refractory neuroblastoma remains a significant clinical problem. Iodine-131-metaiodobenzylguanidine ($^{131}I-MIBG$) therapy is an alternative approach to treat stage IV neuroblastoma. We report the palliative effect of $^{131}I-MIBG$ in three cases of relapsed neuroblastoma after autologous peripheral blood stem cell transplantation. $^{131}I-MIBG$ is an effective and relatively nontoxic palliative therapy resulting in reduction of pain and prolongation of survival.

• Korean Journal of Head & Neck Oncology
• /
• v.40 no.1
• /
• pp.7-13
• /
• 2024

The current standard of treatment for differentiated thyroid cancer is surgical resection followed by radioactive iodine therapy according to the recurrence risk. However, external beam radiotherapy may be recommended in limited cases where surgical resection is impossible or residual gross lesion remains or the aforementioned standard therapy is deemed insufficient in achieving local control. We report a case of 59 year old patient who presented with advanced papillary thyroid carcinoma of right neck but was unable to receive surgical resection due to underlying Eisenmenger syndrome. He received radiation therapy of 67.5 Gy in 30 fractions with palliative aim with no further treatment and has been maintaining long-term stable disease state for 38 months. Herein, we report a rare case of palliative aim radiation therapy alone for advanced papillary thyroid carcinoma with literature review.

• Journal of Hospice and Palliative Care
• /
• v.18 no.2
• /
• pp.85-96
• /
• 2015

In Korea, modern art therapy was developed in the 1960s and 1970s in the form of supplementary activities for patients in psychiatry. Along with the foundation of the Korean Association for Clinical Art in 1982 by psychiatric doctors, the therapy involved more various arts forms such as music, art, dance, poetry therapy, and psychodrama. More organizations with specific expertise opened such as the Korean Art Therapy Association, Korean Art Therapy Association, etc. in the 1990s and the Korea Arts Therapy Institute in 2001. As of April 2015, the members of the Korean Art Therapy Association total 15,000, including 6,200 regular members. The arts in integrative arts therapy (IAT) is an individual's creative activity which is related to his inner world, and the forms of IAT include music, drawing, dance and poetry therapy. From the aspect of phenomenology, IAT is psychophysical therapy involving the arts that helps patients recognize and perceive their experiences with an aim of at a recovery of the body and creativity from the phenomenological aspect. It is also a therapeutic activity that targets growth and development of the body and mind. Meta-analysis of the effects of art therapy with a focus on that involving music, drawing, dance movement and IAT in recent years in Korea, significant effects were observed in all factors but physical function. The biggest effect was mentality adaptation followed by activity adaptation and physiology. In the run up to the implementation of the daily flat-rate system for the health insurance reimbursement for palliative care in July 2015, the Ministry of Health and Welfare is reviewing the coverage of music therapy, drawing therapy and flower therapy, which are currently practiced by 56 hospice institutes in Korea. This is a meaningful step because the coverage of hospice and palliative care came after that of art therapy for psychiatric patients was approved in 1977. Still, there is a need clarify the therapeutic mechanism by exploring causality among the treatment media, mediation type and treatment effects. To address the issue of indiscriminately issued licenses, more efforts are needed to ensure expertise and identity of the licensed therapists through education, training and supervision.

• Journal of Hospice and Palliative Care
• /
• v.26 no.4
• /
• pp.171-184
• /
• 2023

Purpose: The study explored the meaning of experiences within a family art therapy process among terminal cancer patients and their families. Methods: Ten participants, including four terminal cancer patients currently admitted to the hospice ward at an inpatient hospice facility in S City and four caregiving family members, engaged in four cycles of family art therapy sessions. The sessions were conducted weekly or bi-weekly, and each lasted approximately 50 minutes. Results: Nine cross-case themes emerged: "feeling unfamiliar and intimidated by the idea of expressing my thoughts through art," "trying to accept the present and positively overcome sadness," "expressing hope through emotional bonds during the process of parting," "conveying and preserving personal and family beliefs," "feeling upset about family imbalances caused by deteriorating health," "valuing togetherness and striving for stability amidst the current challenges," "art as a medium of empowerment for patients and facilitator of family conversations, even amidst difficulties," "sharing a range of emotions-not just joy, but concerns and sorrow-through art," and "gratitude for art' s role in improving family communication and connection through artwork. Conclusion: The findings of this study lead to several conclusions. First, patients and their families faced psychological challenges when confronted with impending death, yet they strove to remain optimistic by seeking meaning in their struggles. Second, families practiced open and expressive communication, sharing a spectrum of complex emotions with one another. Third, even as the patient's condition worsened, resulting in family fatigue, their support and cohesion strengthened.

• Journal of Hospice and Palliative Care
• /
• v.10 no.2
• /
• pp.74-77
• /
• 2007

Purpose: We evaluated how many patients received radiotherapy and how many those of them could not complete radiation therapy in Hospice Ward. Methods: We retrospectively reviewed the general characteristics in 33 patients who began to receive palliative radiation therapy, and radiation dose and reasons of not-completing radiation therapy in Hospice Ward of St. Vincent's Hospital. Results: Thirty three (8.2%) among 404 patients who had been admitted from November 2003 and October 2005 received palliative radiation therapy. The main indications of radiation therapy included brain metastasis, painful bone metastasis, painful tumor mass, and obstructive shortness of breath. Forty five percent of these patients could not complete. And 20% could receive less than 1/3 of planned radiation dose. They failed to complete the treatment often due to poor general rendition. Conclusion: Although palliative radiation therapy had been used frequently for patients with advanced cancer in Hospice Ward of St. Vincent's Hospital, but it was often not completed. With appropriate selection criteria of patients and shorter modification of radiation treatment period, more patients would be benefited with palliative radiation therapy in Hospice Ward.

• Journal of Digestive Cancer Research
• /
• v.2 no.1
• /
• pp.1-4
• /
• 2014

Palliative care for cancer aims to relieve the discomfort and pain from the cancer itself and associated conditions. Gastrointestinal cancers originate from the tube like structure of gastrointestinal tract and cause complications such as obstruction, bleeding, adhesion, invasion, and perforation to adjacent organ. Recent advances in interventional endoscopy enables endoscopy physicians to do safe and effective care for gastrointestinal cancer patients. Endoscopic palliation includes stent, hemostasis, nutritional support and targeted drug delivery. Self expandable metallic stent is one of the most important modalities in gastrointestinal palliation. Through the endoscopy or over the wire pre-placed by endoscopy, stents restore the gastrointestinal luminal patency and relieve the obstructive condition. Endoscopic hemostasis is another important palliation in gastrointestinal cancer patients. Epinephrine injection, argon plasma coagulation and thermal cauterization are usual modalities for hemostasis. Histoacryl glue and fibrin glue are also available. Hemostatic nanopowder spray is newly reported effective in benign disease and is supposed to be effective also in cancer bleeding. Enteral feeding tubes including gastro- or jejunostomy and nosoduodenal tubes are placed by using endoscopic guidance. Enteral feeding tubes role as the route of easily absorbable or semi-digested nutrients and effectively maintain both patients calorie requirements and gut microenvironment. Photodynamic therapy is the one of the outstanding medical employments of photo-physics. Especially for superficial cancers in esophagus, photodynamic therapy is very useful in cancer removal and maintaining organ structure. In biliary neoplasm, photodynamic therapy is well known to be effective in cancer ablation and biliary ductal patency restoration. Targeted drug delivery is the lastest issue in palliative endoscopy. Debates and questions are still on the table. In this article, the role of endoscopic interventions in palliative care for the gastrointestinal tumors will be thoroughly reviewed.

• Journal of Hospice and Palliative Care
• /
• v.25 no.1
• /
• pp.50-54
• /
• 2022

Antibiotics are commonly prescribed medications in the hospice and palliative care setting, as well as in many other healthcare settings. The overuse or negligent use of antibiotics is associated with the harmful consequence of fostering the development of antibiotic-resistant pathogens. Thus, there is an urgent need to critically examine and audit antibiotic use in all aspects of healthcare. In the status quo, there is a lack of consistent standards and guidelines surrounding the use of antibiotics in hospice and palliative care settings, leading to significant variations in how antibiotics are prescribed and administered in end-of-life care. It is apparent that greater thought needs to go into antibiotic decisions for patients receiving hospice or palliative care, especially considering the harmful consequences of the overprescription of antibiotics. The literature suggests that many clinicians prescribe antibiotics inappropriately for patients who would not benefit from their use or prescribe them without adequate documentation. Clinicians should be deliberate about when they prescribe antibiotics and adhere to the appropriate documentation standards and procedures within their institution or community. Future research should seek to generate generalizable knowledge about which patients will benefit most from antibiotic therapy during end-of-life care.

• Journal of Music and Human Behavior
• /
• v.20 no.2
• /
• pp.1-32
• /
• 2023

The purpose of this study was to analyze the rationale and format of music therapy interventions with patients receiving hospice or palliative care in Korea. Through this analysis, I examined whether the music intervention used was based on a valid rationale and represented the professionalism expected of today's music therapy interventions. A total of 12 studies that met the selection criteria were identified, and the overall characteristics of each study and its format were analyzed. As a result of the analysis, it was confirmed that the rationale for each study and its format were influenced by the author's research field. The analysis also showed that the research on music-based interventions in hospice or palliative care settings was insufficient and involved a mix of professional and nonprofessional interventions. The results of this study suggest that importance of researchers possessing professional competence which requires offering a clear justification for their choice of interventions, music, and instruments. Additionally, these results emphasize the need for further development of evidence-based music therapy approaches in hospice and palliative care settings as the role of music in supporting patients in these environments has gained increasing recognition and validation.