• Journal of Korean Critical Care Nursing
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• v.12 no.2
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• pp.39-49
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• 2019

Purpose : The purpose of this study was to identify the extent to which intensive care unit (ICU) nurses' perceptions of life-sustaining treatment decisions and "a good death" affect attitudes toward terminal care. Method : Participants included 109 ICU nurses from three university hospitals. Data were collected using structured questionnaires, and collected data were analyzed using a t-test, ANOVA, the $Scheff{\acute{e}}$ test, Pearson correlation coefficients, and a multiple regression analysis (SPSS 24.0 program). Results : Perceptions of life-sustaining treatment decisions and a sense of closeness (a constituent for the awareness of "a good death") were positively correlated with terminal care attitudes. The factors affecting terminal care attitudes were a clinical career in ICU (${\beta}=.20$, p =.035), a sense of closeness(${\beta}=.19$, p =.041), and the perception of a life-sustaining treatment decision (${\beta}=.22$, p =.017). This finding indicates that more than 10 years of experience in ICU, a greater sense of closeness, and a higher view of life-sustaining treatment decisions results in more positive attitudes toward terminal care. The explanatory power of these variables on terminal care attitudes was 14% (F=6.84, p < .001, Adj $R^2=.140$). Conclusion : A sense of closeness and the perception of life-sustaining treatment decisions were identified as the factors affecting terminal care attitudes. Thus, various programs must be developed to raise awareness among ICU nurses of "a good death" and perceptions of life-sustaining treatment decisions.

• Perspectives in Nursing Science
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• v.16 no.2
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• pp.55-64
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• 2019

Purpose: This study examined the knowledge and perception of hospice-palliative care and terminal care stress among pediatric nurses, and the relationships among these variables. Methods: In this descriptive research study, 154 pediatric nurses who experienced terminal care at least once were surveyed. This study used three scales, including the Palliative Care Quiz for Nursing (PCQN), Perception of Hospice-Palliative Care, and Terminal care stress. Data analyses using SPSS 22.0 included descriptive statistics, independent t-test, one-way ANOVA, Mann-Whitney U test, Pearson's correlation coefficient, and stepwise multiple linear regression. Results: Terminal care stress experienced by the pediatric nurses was significantly related to the perception of hospice-palliative care; the hospice-palliative care education program enhanced the knowledge and perception of hospice-palliative care. Conclusion: Hospice-palliative care education programs should be developed and provided for pediatric nurses to improve pediatric hospice-palliative care. Additionally, further research on this topic is required because the present results are inconsistent with previous and current researches.

• Journal of Hospice and Palliative Care
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• v.25 no.1
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• pp.42-49
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• 2022

As population aging increases the burden of cancer, the quality of death of patients with cancer is emerging as an important issue alongside their quality of life. To improve the quality of death, it is necessary to prepare for death, allowing patients to die comfortably and with dignity at the end. Considering these issues, I aim to discuss the practical aspects of notifying the patient of the terminal phase of cancer and planning for end-of-life care (i.e., advance care planning). When cancer treatment that can extend the patent's lifespan becomes difficult, the patient enters a treatment transition period. Treatment is shifted from life-prolonging care to life-enhancing care, and end-of-life care must be well planned. Medical providers often worry too much about whether the patient will be disappointed or psychologically traumatized when notified of the terminal phase of their cancer, thus delaying plans for end-of-life care. In fact, patients can accept their condition and prepare for end-of-life care better than we expect. During the treatment transition period, notification of terminal status should be given, and a well-prepared advance care plan should be established early when the patient has decision-making ability. In addition to conveying information, it is always necessary to be sensitive to whether the patient and caregiver understand the information and respond to their emotions.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.3 no.2
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• pp.285-297
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• 1996

This study has been done for the purpose of investigating the degrees of death orientation and terminal care performance. The factors related to these two variables, and the relationship between death orientation and terminal care performance. The subjects of study were 128 nurses who implemented nursing care for terminally ill patients at C University Hospital in Kwang Ju city. The data were collected from March 13 to 19, 1996, by means of Death Orientation by Thorson Powell(1988) and Terminal Care Performance Scale by researcher. The data were analysed by t-test, ANOVA, Duncan test and Pearson's correlation coefficient. The Results of this study were summarized as follows : 1. The mean score of death orientation was 61.4. The degree of death orientation showed no significant difference depending on the general characteristics of nurses. 2. The mean score of terminal care performance was 45.5. In comparison of the degree of terminal care performance among three domains, the mean score of each item tended to show higher degrees in order of 'Psychological domain(2.4)', 'Physical domain(2.2)', 'Spiritual domain(1.9)'. 3. The degree of terminal care performance showed significant differences in age(F=11.48 p=.0001), marital status(t=10.49 p=.0015), religion(t=5.01 p=.0270), period of clinical experience(F=10.30 p=.0001) and ward unit(F=3.73 p=.0036). The degree of terminal care performance in physical domain showed significant differences in age(F=7.26 p=.0010), marital status(t=9.72 p=.0023), period of clinical experience(F=7.03 p=.0013), ward unit(F=6.23 p=.0001). The degree of terminal care performance in psychological domain showed significant differences in age(F=8.73 p=.0003), marital status(t=4.22 p=.0419), religion(t=5.59 p=.0196), period of clinical experience(F=6.36 p=.0023), ward unit(F=3.33 p=.0075). The degree of terminal care performance in spiritual domain showed significant differences in age(F=8.30 p=.0004), marital status(t=10.45 p=.0016), religion(F=5.41 p=.0216), period of clinical experience(F=8.80 p=.0003). 4. The relationship between the degrees of death orientation and terminal care performance showed no correlation(r=-.026 p=.7746).

• Journal of Hospice and Palliative Care
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• v.25 no.4
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• pp.159-168
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• 2022

Purpose: This study aimed to investigate the impacts of end-of-life care competency and ethical dilemmas on psychological burnout in nurses who care for terminal cancer patients. Methods: A cross-sectional study of 160 nurses who cared for terminal cancer patients was conducted. The participants were recruited from the hospice-palliative care wards, hematology or oncology wards, or intensive care units of three general hospitals in a single metropolitan area. Data were collected using a self-administered survey to assess end-oflife care competency, ethical dilemmas, psychological burnout, and general sociodemographic characteristics. Data were analyzed using descriptive statistics, the independent ttest, analysis of variance, Pearson correlation coefficients, and hierarchical linear regression analysis using SPSS for Windows (version 26.0). Results: Psychological burnout was significantly correlated with end-of-life care competency (r=-0.23, P=0.003) but not with ethical dilemmas. The results of the hierarchical linear regression analysis indicated that endof-life care competency (β=-0.280, P=0.010) and ethical dilemmas (β=0.275, P=0.037) were significant predictors of psychological burnout, after adjusting for age, religious status, clinical experience, and unit type. Conclusion: The current study's findings demonstrate that end-of-life care competency and ethical dilemmas are crucial factors that affect psychological burnout in nurses who care for terminal cancer patients. Substantive education programs must be developed to improve nurses' competencies in end-of-life care and ethical dilemmas to decrease psychological burnout.

• The Journal of Korean Academic Society of Nursing Education
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• v.23 no.1
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• pp.37-47
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• 2017

Purpose: This study aimed to explore the influences of attitude to death and resilience on terminal care attitude among Korean nursing students. Methods: Participants were 230 nursing undergraduates from two nursing schools in Korea. The students responded to a self-report questionnaire that included demographics, attitude to death, resilience, and terminal care attitude. Results: The majority of the participants who had undertaken a clinical practicum had experienced the death of a patient during their clinical placements but had not yet received any support from their instructors or professionals, but also academic training on patients' death or terminal care. The mean score of terminal care of the students who had death-related education was significantly higher than among those who had not. Regression analysis indicated that attitude to death, grade, and resilience were the most significant predictors of terminal care attitude. These explained 30.3% of their terminal care attitude. Conclusion: Death-related education is needed throughout the curriculum including not only death but also resilience to develop emotional competences. In this way, nursing undergraduates will be better prepared to cope positively and constructively with the suffering and death they encounter, and thus may minimize the distress they experience in the patients' dying process. It may also create a significant positive increase in their terminal care attitude.

• The Korean Journal of Pain
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• v.12 no.1
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• pp.101-107
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• 1999

Background : In order to improve the quality of life of dying patients, they need to receive not only the physical, psychological, social, and spiritual care, but also systematic and continuous care to die with dignity. However, no adequate medical services are available for these terminal cancer patients. We studied their behavior patterns of health care utilization to understand more of their medical and social needs. Methods : We investigated 108 bereaved families through the telephone interview with structured questionnaires. They were randomly selected through the retrospective chart review of the terminal patients who passed away due to cancer. Results : Most of the terminal cancer patients received their care from proper medical services including admission to hospital (45.4%), outpatient clinic (22.2%), emergency room (16.7%), and oriental medicine (12.0%). But during the terminal phase of their illness, 32.4% of patients never received medical care including oriental medicine, and 28.7% received alterative natural care. 26 bereaved families (24.1%) pointed out the indifference of medical staff as a problem receiving proper hospital care, and 22 (20.4%) emphasized emotional strain of their helplessness with the patients' suffering as a problem of caring at home. Over 90% suggested availability of continuous care, hospice care, home care, and 24 hour telephone service to be improved. Conclusions : Due to various reasons, adequate medical care is not delivered to the terminal cancer patients in our present medical system. These problems can be approached with the establishment of proper education and medical delivery system. The role of comprehensive medical specialty cannot be overly emphasized to accomplish this most effectively.

• 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 Korean Academic Society of Home Health Care Nursing
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• v.16 no.2
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• pp.135-144
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• 2009

Purpose: This study was to analysis the effect of spiritual nursing care on meaning of life and spiritual well-being of terminal cancer older adult patients. Method: The study was a one group pre-posttest design. Data collection and intervention were performed from May 10 to December 20, 2007. The participants were 28 older adults in Jeonju city. Data was analyzed with paired t-test and Pearson correlation coefficient using the SPSS/WIN 12.0 program. Result: Meaning of life, spiritual well-being, religious well-being and existential well-being scores were significantly higher than before spiritual nursing care (all p<.001). Meaning of life and the spiritual well-being were significantly correlated before and after spiritual nursing care, but it was not highly correlated after than before the spiritual nursing care. Conclusion: The study verified spiritual nursing care the improvement of the meaning of life and spiritual well-being for the terminal cancer older adult patients.

• Journal of Hospice and Palliative Care
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• v.18 no.4
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• pp.276-284
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• 2015

Purpose: This study was performed to identify factors affecting terminal care performance of clinical nurses. Methods: The participants in this study were 175 nurses working in hospitals in Daegu and North Gyeongsang Province. Data were collected using a self-reported questionnaire and were analyzed with the IBM SPSS WIN 19.0 program. Results: Nurses' terminal care performance was significantly related with suffering experience, empathy ability and caring behaviors. Significant predictors for terminal care performance were their department, empathy ability and caring behaviors. These factors explained 43.52% of the variance in terminal care performance of clinical nurses. Conclusion: Our study results suggest that terminal care performance of clinical nurses can be strengthened by improving empathy ability and caring behaviors.