• Child Health Nursing Research
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• v.24 no.4
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• pp.475-483
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• 2018

Purpose: This study aimed to identify stress levels due to end-of-life care, coping strategies, and psychological well-being among nurses in neonatal intensive care unit, and to investigate the effect of stress levels and coping strategies on their well-being. Methods: A total of 128 nurses in the neonatal intensive care units of general hospitals in B city participated. The data were collected using a self-report questionnaire. The collected data were analyzed using descriptive statistics, the t-test, ANOVA, the Pearson correlation coefficient, and hierarchical regression with SPSS version 22.0. Results: The coping strategy that nurses most often used was seeking social support. The factors affecting the well-being of the participants were wishful thinking, problem-focused coping and seeking social support, in order. Those 3 variables explained 21 % of the total variance in psychological well-being. Problem-focused coping and seeking social support were positively associated with psychological well-being, while wishful thinking showed a negative association. Conclusion: In order to improve the psychological well-being of nurses in neonatal intensive care units, it is necessary to provide nurses with a program to build a social support system and to improve their problem-based coping skills.

• The Journal of the Korea Contents Association
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• v.22 no.10
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• pp.374-382
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• 2022

This study aims to explore the research trends of hospice that were published in KCI from July 2003 to 2022. Using Korea Citation Index, a total of 115 papers were selected for data analysis. According to the analysis, research on terminal care were conducted mostly from 2017 to 2019. A total of 26 papers were published on Journal of Hospice and Palliative Care. 115 papers were mostly conducted with nurses and nursing students. It was found that those nurses were working in tertiary hospitals, long-term care hospitasl, and general hospitals. The research topics of the published papers are mainly related to end-of-life care attitude, end-of-life care performance, experiences of end-of-life care, and end-of-life care stress. Among them, 78.3% of the papers adopted quantitative research method. Concerning the IRB, 64.3% of the papers got an approval. It is expected that the present study can shed some lights on hospice care field by analyzing the trends of terminal care studies.

• Journal of Hospice and Palliative Care
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• v.15 no.4
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• pp.205-211
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• 2012

Purpose: This study was performed to identify the level of stress perceived by nurses who attend dying patients in the cancer care unit; their understanding regarding end-of-life care and related training needs. Methods: A cross-sectional descriptive study was conducted with 151 nurses stationed at the cancer care units of four general hospitals located in Seoul and Gyeonggi province in Korea. Data were collected using self-reported questionnaires and the response rate was 96%. The data were analyzed using t-test, ANOVA and Pearson's correlation analysis. SPSS 12.0 was used for data analysis. Results: Nurses experienced a high level of stress in the end-of-life care settings. Their understanding of end-of-life care was above the mid-point of the scale while their training needs for end-of-life care was relatively high. The more experienced the nurses were, the more stressed they were, particularly due to excessive workload. Nurses who served longer in the cancer unit tended to show greater needs for end-of-life care training. Conclusion: This study found nurses perform end-of-life care with a high level of stress but with insufficient understanding, and thus, showed great needs for related training. Such findings can be useful to develop an end-of-life care training program for nurses.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.1
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• pp.209-215
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• 2013

Objectives: Terminal cancer patients and their caregivers often experience traumatic stress and need many types of assistance. In the present study we interviewed terminally ill cancer patients and caregivers to determine how much burden they experienced and to find out what factors are most important for satisfaction. Design: We constructed a questionnaire including overall care burden and needs experienced, and administered it to 659 terminal cancer patients and 659 important caregivers at 11 university hospitals and 1 national cancer center in Korea. Results: Finally, 481 terminal cancer patients and 381 caregivers completed the questionnaire. Care burden was not insubstantial in both and the caregiver group felt more burden than the patient group (P<0.001). While the patient group needed financial support most (39.0%), the caregiver group placed greatest emphasis on discussion about further treatment plans (44.8%). Stepwise multiple logistic regression analyses showed that in the patient group, patient's health status (OR, 2.03; 95%CI, 1.16-3.56) and burden (OR, 2.82; 95%CI, 1.76-4.50) influenced satisfaction about overall care, while in the caregiver group, high education level (OR, 1.84; 95%CI, 1.76-4.50), burden (OR, 2.94; 95%CI, 1.75-4.93) and good family function (OR, 1.94; 95%CI, 1.24-3.04) were important. Conclusions: Our study showed that burden was great in both terminal cancer patients and their caregivers and was perceived to be more severe by caregivers. Our study also showed that burden was the factor most predicting satisfaction about overall care in both groups.

• Journal of Korean Critical Care Nursing
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• v.13 no.1
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• pp.27-43
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• 2020

Purpose : This integrative review aimed to synthesize studies on intensive care unit (ICU) nurses' attitude, perceptions, and experiences toward end-of-life care decision-making. Methods : Using Whittermore and Knafl (2005)'s methods, we identified and synthesized research articles published in domestic journals between the years 2003 and 2019 and evaluated the quality of selected articles using the Mixed Methods Appraisal Tool. Results : In the 13 studies reviewed, 12 were published prior to enactment of the "The Act for Hospice and Palliative Care and Decision-Making about Life-Sustaining Treatment (2018)." All nine quantitative studies identified were based on cross-sectional descriptive survey. In four qualitative studies, content analysis (n=2) and phenomenology (n=2) were used. Overall, ICU nurses were well-aware of the necessity of communicating and limiting life-sustaining treatments. Many ICU nurses had positive attitude towards limiting life-sustaining treatments to promote patients' comfort and dignity. Although nurses were willing to take active roles, they also reported having experienced high stress in the process of decision-making and implementation. Conclusions : It is important to prepare ICU nurses with proper knowledge and attitude regarding the topic area. It is also equally important to develop systems to support nurses' emotional stress and moral distress during communication, decision-making, and implementation.

• Asian Oncology Nursing
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• v.11 no.1
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• pp.49-57
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• 2011

Purpose: The purpose of this study was to test the reliability and validity of an instrument to measure suffering of family of patients with terminal cancer. Methods: This research was a methodological study processed as follows: 1) The preliminary 32 items were developed based a conceptual framework of suffering for patients with cancer. 2) The content was validated by an expert panel (n=24) and the family of patients with terminal cancers (n=33). 3) The instrument was validated by survey (n=92). Finally, 29 items were selected in developing final version of the scale. Results: Seven factors were extracted through factor analysis: 'economical distress', 'loss of meaning in life', 'feeling of social isolation', 'emotional distress', 'burnout', 'guilty feeling', and 'physical discomfort'. These factors explained 66.94% of the total variance. Cronbach's alpha and Guttman Split-half coefficient of the 29 items were .93 and .92. respectively. Conclusion: This scale identified as a valid and reliable tool with a high degree of reliability and validity. It can be effectively utilized to assess the degree of suffering of family in palliative care settings.

• 한국호스피스완화의료학회:학술대회논문집
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• 2004.07a
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• pp.100-102
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• 2004

Under the current medical system, a terminal patient and his/her family who are neglected inevitably face various aspects of crises including not only physical, but also psychological, social, economic, spiritual and legal problems. Nurses often look after many terminal patents with these types of complicated problems. Therefore, educating the nurses who will take care of such patents would greatly reduce stress so the patents end could their lives in peace and without losing their dignity. This research is a quasi experimental study of nonequivalent control group. A pretest-posttest design where a basic education program is developed for nurses, who frequently treat terminal patents, to understand the importance of the role of hospice and to apply their understandings to treat terminal lancer patents. A sample of the nurses were taken from those who were working in general wards at two general hospitals in Seoul during October, 2003${\sim}$December 2003. The study was composed of 46 experimental group and 43 control group. A basic hospice education program was developed by taking emphasized and overlapping parts from advanced practice hospice nurses education course, short-term education course, an extensive literature survey and by consulting three professionals as well. With the group of 5 professors with vast experiences in oncolgy, 5 nursing administrator, 3 nursing practitioner, the tentative first version of the program was developed and reviewed. Afterwards, by utilizing person to person interviews with 2 head nurses experienced with terminal patients, 1 nurse in charge of hospice, 1 nurse on the contents of the program, and a person to person rating on the educating medium by a nurse were performed. The final version of a basic education program was developed after the second revision. The hospice basic education program consists of introduction to hospice, hospice and commucation, management of pain for terminal cancer patients, physical management for terminal cancer patients, socio-psycological caring of terminal cancer patients and management of death and separation. Total education time was four hours organized into 50 minutes of instruction and 10 minutes of break. $Powerpoint^{(R)}$ software was used as the education medium. As research tools, "Knowledge on Hospice" was developed by the author after receiving a review from one expert. "Attitude of Hospice Nursing" was revised Kim(2001)'s attitude measuring tool which was based on Wang(1998), Kwon(1989), Park and Sung(1991)'s tool. "Liability on nursing terminal patients" was used as developed by Zarits(1980) and Mongomory(1985) translated by Lee(1985). For collecting data, preliminary investigation prior to 1 week of the hospice basic education program and post-investigations after 1 week and 4 weeks of the education were carried out for the nurses at a general ward who understood and agreed on the purpose of the program. Collected data were analyzed throughout t-test, $x^2-test$, Manova test and Bonferroni correction in $SAS^{(R)}$ program. The summary of the investigation is as follows: Hypothesis 1: "Educated experimental group would possess more knowledge on hospice compared to the un-educated control group" was supported after 1 (F=12.14, p=.00) and 4 (F=5.3, p=.02) weeks of education. Hypothesis 2: "Educated experimental group would take a positive attitude toward hospice nursing compared to the un-educated control group" was supported after 1(F=3.92, p=.05) and 4(F=5.05, p=.02) weeks of education. Hypothesis 3: "Educated experimental poop would feel less liability compared to the un-educated control group in nursing terminal cancer patients' was rejected. In this study, it was found that knowledge on hospice was significantly important. By applying hospice basic education programs to nurses, the education program helped nurses to take a positive attitude toward terminal patients. It was, however, seen that the education program had no effect on alleviating liability in nursing terminal patients. Therefore, it is expected that this educational program would help hospices and nurses at general wards to understand the concept and the role of hospice so that terminal patents, now neglected under current medical system, would be able to end their lives in peace.

• The Journal of Korean Academic Society of Nursing Education
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• v.26 no.1
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• pp.56-66
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• 2020

Purpose: The purpose of this study was to explore nursing students' experiences with patient deaths during clinical practice. Methods: The participants were ten nursing students who had experienced patient deaths during clinical nursing practice at a university hospital in Korea. Individual in-depth interviews were conducted, and the data were analyzed using the content analysis method suggested by Graneheim and Lundman (2004). Results: The participants' experience was structured into six categories: experiencing various emotions in facing patient deaths, viewing oneself as a nursing student at the scene of a patient's death, thinking about death again, finding a pathway of understanding and support for patient death experiences, impressions and regret felt while actually observing terminal care, and picturing oneself as a future nurse dealing with a patient's death. Conclusion: Based on this study, stress management and self-reflection programs are suggested for nursing students who have experienced patient deaths. Practical nursing education for patient death and end of life care is also needed.

• Journal of Korean Traditional Oncology
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• v.13 no.1
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• pp.1-11
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• 2008

Objectives: To grasp the traditional stream of cancer treatment inherited from the previous doctors. Methods: The author's research has been performed cancer treatment based on JIJU(積聚) taking the original text as a reference. Results & Conclusion: The general three outlines and five detailed rules of cancer treatment have been obtained as follows. The first outline of cancer treatment is that reinforced vital function makes cancer reduce naturally. the second is that Harmless cancer can coexist in human beings and aging with them. and the third is that Elimination and reinforcing therapies should be executed in appropriate era and those therapies should utilize appropriate methods. The first detailed rule of cancer treatment is when using reinforcing therapy, it must applicate mildly and when using elimination therapy, it must applicate calmly. The second detailed rule is that the methods of cancer treatment are different from each cancer stage. The concentration should be made on reinforcing therapy at early stage while reinforcing and elimination therapies must be conducted together at middle stage. At terminal stage reinforcing therapy is the sole method to be taken. The third detailed rule is that the basis property of cancer drug is warm nature and extremely biased property should be avoided and when complication arises (eg. inflamatory disease, cancer fever, etc), cold or cool nature can be applied. The fourth detailed rule is that Cancer drug must have the effect eliminating the blood stasis, phlegm and excessive fluid, all together. The fifth detailed rule is that Physicians have to control patient's stress or stress related symptom and teach patients about right way of taking care of themselves and patients should take hygienic rules with their free will by themselves (eg diet, exercise, stress, etc)

• Asian-Australasian Journal of Animal Sciences
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• v.12 no.2
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• pp.244-252
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• 1999

Intensive selection for muscle development and against fat deposition in pigs during the last 50 years has contributed to the increased incidence of porcine stress syndrome (PSS) and pale soft exudative pork (PSE). Genetics, nutrition and management, preslaughter animal handling, stunning, dehairing and carcass chilling influence the incidence and magnitude of the PSE condition. The normal incidence of PSE has been reported to range from 10 to 30%, but in some isolated instances is up to 60%. The elimination of halothane-positive pigs in breeding programs has reduced PSS and PSE. Further improvements in meat quality by terminal sire evaluation and selection can be achieved within halothane-negative populations because around 20% of the variation in meat color and water binding capacity seems to be genetically related. Pre-slaughter handling on the farm, during transit to the packing plant and at the packing plant can greatly influence the meat quality, contributing 10 to 25% of the variation. An effective stunning method, skinning instead of scalding/dehairing and rapid post-slaughter chilling further reduce the incidence of PSE pork. In addition to proper care and handling a carcass-merit based marketing system, that reflected the value differential between desirable and undesirable meat quality in the pricing system for pigs, would provide a great incentive to change pork production systems in order to improve meat quality, thus improving the image and usefulness of pork as food.