• Title/Summary/Keyword: Patients with terminal cancer

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Analysis of Survival in 273 Terminally Ill Cancer Patients Treated with Traditional Oriental Therapies

  • Cho Jung-Hyo;Kang Wee-Chang;Son Chang-Gue;Lee Yeon-Weol;Yoo Hwa-Seung;Lee Nam-Heon;Yun Dam-Hee;Cho Chong-Kwan
    • The Journal of Korean Medicine
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    • v.25 no.4
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    • pp.152-160
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    • 2004
  • Objective : Recently, an increasing portion of cancer patients use various therapies of complementary and alternative medicine (CAM) including traditional oriental medicine, which is believed to improve the consequence of cancer according to clinical experience and laboratory data. But the clinical-based systemic statistic validity of these therapies is lacking, so this study was aimed to validate the traditional oriental therapies (TOT) for terminally ill cancer patients. Patients and methods : This retrospective study was performed on 273 patients who were diagnosed with terminally ill cancer in Korea and treated with TOT in the oriental hospital of Daejeon University, from March 1997 to June 2003. We examined the median duration of the terminal period and the correlations between 9 factors and survival of terminally ill cancer patients. Results : During the study period, we could confirm 142 patients' death (52.01%) in 273 subjects. The median length of survival in terminally ill cancer patients was 16 weeks (95%CI 14.0∼20.0) and 40.15% (95%CI 40.07∼40.22) of patients had survived more than 24 weeks. According to Cox's proportional hazard model including gender, age, conventional therapies (chemotherapy, radiotherapy and surgery), performance status and clinical symptoms as independent variables, history of conventional therapies (RR 0.581, 95%CI 0.381∼0.885), higher performance status (RR 1,855, 95%CI 1.454∼2.366) and absence of ascites and pleural effusion (RR 1.631, 95%CI 1.047∼2.538) showed independent prognostic value of survival. Conclusion : Our findings suggest that TOT offer potential benefits for cancer patients at the terminal stage.

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Association between D-Dimer Levels and the Prognosis of Terminal Cancer Patients in the Last Hours of Life

  • Lee, Hwan Hee;Hwang, In Cheol;Shin, Jinyoung
    • Journal of Hospice and Palliative Care
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    • v.23 no.1
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    • pp.11-16
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    • 2020
  • Purpose: D-dimer levels are known to be associated with poor outcomes in patients with various cancers, but their significance at the end of life remains unclear. This study investigated D-dimer levels as a prognostic indicator for terminal cancer patients in the last hours of life. Methods: The retrospective study was conducted at a palliative care unit of a tertiary cancer center, using a database to analyze the records of patients treated from January 1, 2010 to December 31, 2018. In total, 67 terminal cancer patients with available data on D-dimer levels were included. Patients' demographic data, clinical information, and laboratory values, including D-dimer levels, were collected. Survival was analyzed using the Kaplan-Meier method and the log-rank test. A Cox proportional-hazards model was used to identify prognostic factors of poor survival. Results: The most common site of cancer was the lung (32.8%) and the median survival time was 5 days. Most laboratory results, particularly D-dimer levels, deviated from the normal range. Patients with high D-dimer levels had a significantly shorter survival time than those with low D-dimer levels (4 days vs. 7 days; P=0.012). In the Cox regression analysis, only a high D-dimer level was identified as a predictor of a poor prognosis (hazard ratio, 1.83; 95% confidence interval, 1.09~3.07). Conclusion: Our results suggest that at the very end of life, D-dimer levels may serve as a prognostic factor for survival in cancer patients.

A study of external applications for cancer treatment (외부법의 종양치료활용에 대한 고찰)

  • Lee, Yong-Yeon;Song, Kee-Cheol;Choi, Byung-Lyul;Seo, Sang-Hoon;Choi, Woo-Jin;Cho, Jung-Hyo;Lee, Yeon-Weol;Son, Chang-Gue;Cho, Chong-Kwan;Yoo, Hwa-Seung
    • The Journal of Internal Korean Medicine
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    • v.22 no.4
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    • pp.659-667
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    • 2001
  • Objectives: The purpose of this study was to explore some new therapies to control clinical symptoms of patients with terminal cancer by using external applications. Methods: We investigated some literatures on the external applications for cancer patients and made diagrams. Results: The results are summarized as follows. External applications are one of the traditional oriental medical methods and these are effective for pain control, ascites & pleural effusion and palpitable mass. It has some characteristics which are simple, safe and popular, but we must pay attention carefully to allergic reaction and toxicity in using external applications. The therapeutic portion of external applications are decided by discipline of syndrome and disease differentiation, and the prescriptions are composed of antitumor herb medicines. Conclusions: From the above results, it is expected that external applications are useful to improve clinical symptoms and quality of life(QOL) for patients with terminal cancer who cannot intake foods or medicines.

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암환자 인식에 관한 연구 - 간호사ㆍ의사를 중심으로

  • Jo, In-Hyang
    • Korean Journal of Hospice Care
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    • v.2 no.1
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    • pp.58-74
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    • 2002
  • This paper constitutes a descriptive investigation and used a structured questionnaire to investigate nurses' and doctors' recognition of cancer patients. The subjects were extracted from the medical personnel working at the internal medicine, the surgery ward, the obstetrics and gynecology department, the pediatrics department, the cancer ward, and the emergency room of five general hospitals located in Seoul and Gyeonggi Province. The research lasted from August, 2001 to September 2001. Total 137 nurses and 65 doctors were included and made out the questionnaires directly distributed by the investigator. The study tool was also developed by the investigator and consisted of such items as the demographic and social characteristics, the medical personnel's recognition degree of cancer and cancer patients, their recognition of the management of cancer patients, and their participation in a hospice. The results were analyzed using the SPSS Window program in terms of technological statistics, ranks, t-test, and ANOVA. The reliability was represented in Cronbach' α=.75. The nurses' and doctors' recognition degree of cancer and cancer patients had an overall average of 3.86 at the 5 point-scale. The items that received an average of 4.0 or more included 'Medical personnel should explain about the cancer cure plans to the cancer patient and his or her family', 'A patient whose case has been diagnosed as a terminal cancer should be notified of it, 'If I were a cancer patient, I would want to get informed of it,' and 'Cancer shall be conquered whenever it is'. In the meantime, the items that received an average of 3.0 or less was 'My relationship with the cancer patient's family has gotten worse since I announced his or her impending death.' And according to the general characteristics and the difference test, the recognition degree of cancer and cancer patient was high among the subgroups of nurses, females, married persons, who were in their 30s, who had a family member that was a cancer patient, and who received a hospice education. The biggest number of the nurses and doctors saw 'a gradual approach over several days'(68.8%) as a method to tell a cancer patient about his or her cancer diagnosis or impending death. Those who usually tell tragic news were the physician in charge(62.8%), the family members or relatives(32.1%) and the clergymen(3.8%) in the order. The greatest number of them recommended a cancer patient's home as the place where he or she should face death because they thought 'it would stabilize his or her mentality'(91.9%) while a number of them recommended the hospital because they 'should give the psychological satisfaction to the patient'(40%) or 'should try their best until the last moment of the patient's death'(30%). A majority of the medical personnel regarded 'smoking or drinking' and 'diet' as the causes of cancer. The biggest symptom of a cancer patient was 'pain' and the pain management of a cancer patient was mostly impeded by the 'excessive fear of drug addiction, tolerance to drugs and side effects of drugs' by medical personnel, the patient, and his or her family. The most frequently adopted treatment plan of a terminal cancer patient was 'to do whatever the patient or his or her family wants' to resort to a hospice' and 'to continue active treatment efforts' in the order. The biggest reasons why a terminal cancer patient went to see a doctor were 'pain alleviation' 'control of symptoms other than pain(intravenous supply)' and 'incapability of the patient's family' in the order. Terminal cancer patients placed their major concern in 'spiritual(religious) matter' 'emotional matters' their family' 'existence' and 'physical matters' in the order. 113(58.5%) of the whole medical personnel answered they 'would recommend' an alternative treatment to a terminal cancer patient mostly because they assumed it would 'stabilize the patient's mentality.' Meanwhile, 80(41.5%) of them chose 'not to recommend it mostly due to the unverified effects and high cost of it(78.7%). A majority of them, I. e. 190(94.1%) subjects said they 'would recommend' a hospice to a terminal cancer patient mostly because they thought it would help the patient to 'mentally prepare'(66.6%) Only 17.3% of them, however, had received a hospice education, most of which was done through the hospital duty education(41.4%) and volunteer training(34.5%). The follows are results of this study: 1. The nurses and the doctors turned out to be still passive and experience confusion in dealing with a cancer patient despite their great sense of responsibility for him or her. 2.Nurses and Doctors realize the need of a hospice, but an extremely small number of them participate in a hospice education or performance. Thus, a whole recognition of a hospice should be changed, for which purpose a hospice education for nurses and doctors should be provided. 3.Terminal cancer patients preferred their home to a hospital as the place to face their impending death because they felt it would bring 'mental stability.' And most of nurses and doctors think it would be unnecessary for them to be hospitalized just for control of their symptoms. Accordingly a terminal cancer patient can be cared at home, and a home hospice care needs to be activated.

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The Effects of Foot Reflexology on Pain and Quality of Sleep in Patients with Terminal Cancer (말기 암 환자에게 적용한 발 반사 마사지의 통증경감 및 수면증진 효과)

  • Kim, Eun Joo;Kyong, Boo Soon
    • Journal of Korean Clinical Nursing Research
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    • v.14 no.1
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    • pp.33-44
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    • 2008
  • Purpose: This study was performed to determine the effects of foot reflexology on pain and quality of sleep in patients with terminal cancer. Method: Quai-experimental research design was used. The subjects of this study were consisted of 19 for experimental group and 18 for control group. Visualue Scale(VAS) was used as the measurement tool of pain in this study, Verra & Snyder-Halpern Sleep Scale(VSH) and Visual Analogue Scale(VAS) were used as the measurement tool of perceived quality of sleep. Data were analyzed using statistical methods such as frequency, percent, $x^2$-test, t-test using SPSS WIN 12.0 program. Results: The hypothesis 1 that the experimental group with reflexology has less degree of pain than the control group without reflexology was supported (t=5.41, p<.001). The hypothesis 2 that the experimental group with reflexology has higher degree of VSH Scale than the control group without reflexology was supported(t=2.37, p=.02). The hypothesis 3 that the experimental group with reflexology has the difference among the mean of sleep VAS Scale during the 12 measurement periods was not supported(F=1.63, p=.08), and no significant interactions between group and time. Conclusion: It is considered that reflexology is effective for reducing cancer pain and improving quality of sleep in patients with terminal cancer.

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The Group Counseling Program for Terminal Cancer Patients and their Family Members in the Seoul National University Hospital (말기 암환자와 가족을 위한 집단상담 프로그램 - 서울대학교병원 경험의 분석-)

  • Lee, Young-Sook;Heo, Dae-Seog;Yun, Young-Ho;Kim, Hyun-Sook;Choi, Kyung-Sook;Yun, Yeo-Jung
    • Journal of Hospice and Palliative Care
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    • v.1 no.1
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    • pp.56-64
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    • 1998
  • Purpose : Seoul National University Hospital developed a group counseling program for the terminal cancer patients and their family members. This program consists of each of doctor, nutritionist, nurse, pharmacist, and social worker to provide them with the information and to enhance their ability to cope with terminal cancer. This research aims to introduce this new program per se, and to appreciate its validity and applicability to the terminal cancer patients and their family members by analyzing the concerns and specific questions of the participants. Methods : The methodological approach employed in this research is 1996 content analysis of the group counseling reports, and interview of the 312 participants. The analysis includes the general characteristics of the subjects, family relationship to the patients, times of attendance to the group session, source of information to the program. Results : The participants consist of 261 family members(84%) and 51 patients(16%). Majority responded to the program with a single-attendance. Diagnosis are mainly lung cancer, stomach cancer, liver cancer. The ratio of participants by family members is decreased in the order of spouse, children, daughter-in-law, brothers and sisters, and parents. The source of information to the program is largely through medical staff(69%) as compared with posters in the hospital (26%). The participants are interested primarily in the medical information. Their interests are various, such as pain control, patient care, nutrition, psychosocial problem and etc. Conclusion : This program is characterized largely as a family-supporting program which primarily offers information for terminal cancer. This program is a sort of a hospice program, which maximizes the present quality of living of the terminal cancer patients as long as life continues by encouraging them to live with terminal cancer. Thus, this group program can be employed as an active support network for the patients and their family. In order to develop comprehensive care-giving services, it is required to have 24-hour telephone service, hospice facilities, home care service, and communication between the referral hospitals and the primary care physicians, in particular. Such a development of services is the ultimate goal for improving care. But the immediate goal of the program is to make possible better education for the patients and their family to live with terminal cancer.

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Pilocarpine Mouth Care for Patients with Terminal Cancer (필로카르핀을 이용한 구강간호가 말기 암환자의 구강 상태와 불편감에 미치는 효과)

  • Park, Myung-Hee;Yoo, Yang-Sook
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.13 no.2
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    • pp.217-224
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    • 2006
  • Purpose: This study was done to investigate the effects of pilocarpine mouth care on the condition and discomfort of the oral cavity in patients with terminal cancer. Method: A quasi-experimental design with a non-equivalent control group, pre- and post-test was used. The participants were 30 patients admitted to the hospice care unit of C university hospital. Fourteen patients received pilocarpine mouth care for 5 days. The other sixteen received general mouth care. Results: Improvement in the condition of the oral cavity was significantly higher in the experimental group compared to the control group. Decrease in oral discomfort scores was significantly higher in the experimental group compared to the control group. The incidence of oral candidiasis was significantly higher in the control group compared to the experimental group. Conclusion: These findings indicate that pilocarpine mouth care could be an effective intervention for relieving oral discomfort, improving the condition of the oral cavity, and decreasing the incidence of oral candidiasis in patients with terminal cancer.

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Effects of Oral Care with Essential Oil on Improvement in Oral Health Status of Hospice Patients (정유를 이용한 구강간호가 호스피스 대상자의 구강상태에 미치는 효과)

  • Kang, Hee-Young;Na, Song-Sook;Kim, Yun-Kyung
    • Journal of Korean Academy of Nursing
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    • v.40 no.4
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    • pp.473-481
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    • 2010
  • Purpose: This study was done to examine the effects of oral care with essential oil in improving the oral health status of hospice patients with terminal cancer. Methods: The participants were 43 patients with terminal cancer admitted to K hospital in G city, Korea. Twenty-two patients were assigned to the experimental group and 21 to the control group. Participants in the experimental group received special mouth care with essential oil (application of essential oil mixture consisting of geranium, lavender, tea tree, and peppermint). The control group received special mouth care with 0.9% saline. The special mouth care was performed twice daily for one week in both groups. The scores for subjective oral comfortness, objective oral state, and numbers of colonizing Candida albicans were measured before and after the treatment. Results: The score for subjective oral comfortness and objective oral state were significantly higher in the experimental group compared to the control group. The numbers of colonizing Candida albicans significantly decreased in the experimental group compared to the control group. Conclusion: Oral care with essential oil could be an effective oral health nursing intervention for hospice patients with terminal cancer.

Continuous Intraventricular Morphine Infusion for Control of Pain in Terminal Cancer Patients (말기 암성통증 환자의 통증제거를 위한 지속적 뇌실내 몰핀 주입)

  • Kim, Chul-Ho
    • The Korean Journal of Pain
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    • v.5 no.1
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    • pp.69-75
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    • 1992
  • The author experienced of four patients with intractable pain who were treated by continuous intraventricular infusion of morphine through an implanted port system. One suffered from tongue cancer and the others from bone metastasis or distant metatasis of abdominal cancer which were ineffectively to managed through an epidural route. Our experience is that this is a safe and effective method of pain management in patients with head and neck cancer. It is useful as well in patients who have intractable pain that cannot be managed through an intrathecal or epidural route.

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A Time Study of Nursing Activities by Home Care Nurses for Non-Cancer Terminal Patients (가정전문간호사의 비암성 말기환자 간호행위 시간 분석)

  • Lee, Hanul;Lee, Jong-Eun
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.26 no.2
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    • pp.180-188
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    • 2019
  • Purpose: To investigate the duration of each nursing activity performed by home care nurses for non-cancer patients and the relationship between patients' palliative prognostic index (PPI) and duration of each nursing activity. Methods: Nursing activities performed for six non-cancer terminal patients were timed using a stopwatch, and 18 parameters were measured by visiting each patient thrice. The mean and standard deviations of duration for each category of nursing activities were computed. The relationship between category-specific duration of nursing activities and PPI was analyzed with Spearman's correlation and multiple regression analysis. Results: Among nursing activities, the highest greatest duration of time was spent on traffic time (11.91 min), followed by urinary catheter management (10.65 min) and insertion and management of nasogastric tube (9.03 min). In terms of nursing categories, after excluding movement time, the greatest duration of time was spent on excretion care (5.48 min), nutrition care (5.40 min), and medication (3.82 min). PPI correlated with hygiene care, excretion care, and patient and information management. Multiple regression analysis revealed that PPI increased with increasing duration of hygiene care. Conclusion: These study findings provide grounds for the increased nursing time of hygiene care for people reaching the end of life.