• The Korean Journal of Pain
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• 제13권1호
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• pp.60-66
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• 2000

Background: For terminal cancer pain management, controlled-release oral morphine (morphine sulfate tablet, MST) is a simple and convenient regimen. Recently, fentanyl transdermal therapeutic system (F-TTS, transdermal fentanyl) has been developed and became one of the alternative ways of providing adequate pain relief. This open prospective study was designed to compare the analgesic efficacy and safety of MST and transdermal fentanyl in the management of terminal cancer pain. Methods: In this open comparative and randomized study, 64 terminal cancer patients received one treatment for 15 days, controlled-release oral morphine (MST group) or fentanyl transdermal therapeutic system (F-TTS group). Daily diaries about the vital sign, visual analogue scale (VAS) for pain, opioids requirement, co-anagesics, adjuvant drugs and adverse effects were completed with 24 patients in MST group, 18 patients in F-TTS group. Results: The majority of patients in both treatment groups were late-stage cancer and their distribution was not different in both groups. Daily opioids requirement was 126.4 mg in MST uced in F-TTS group (P<0.05). The incidence of nausea, vomiting and constipation was lower in F-TTS group (P<0.05). Patients satisfaction was similar, but F-TTS patient group favored continous use of same treatment compared with MST group after the study was finished. Conclusions: Transdermal fentanyl seems to be safe and similar analgesic effect to controlled-release oral morphine for the control of the terminal cancer patients. However, transdermal fentanyl provides a simpler and more convenient especially in respect to constipation, nausea & vomiting. To determine the exact analgesic effect, cost-effectiveness and complications, controlled trials should be followed.

• 종양간호연구
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• 제9권1호
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• pp.1-6
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• 2009

Purpose: The purpose of this study was to identify the needs of hospice care in families of the hospitalized patients with terminal cancer. Method: The data were collected from April to July, 2008. The participants were 100 family caregivers of hospitalized terminal patients with cancer recruited from two general hospitals in 2 cities in Korea. Needs of hospice care were measured using the 'Needs Assessment Instrument for Hospice Care in Families of the Patients with Cancer'. Results: The mean of needs score was 76.6, which meant degree of the needs was very high. Among the categories of the needs, the mean of category 'emotional care' was the highest. There were significant differences in the needs of hospice care according to sex and type of present therapy. Conclusion: Health care providers in hospital and hospice facilities must assess the needs of families as well as the patients in order to meet their specific needs. Additionally, they need to have deeper understanding of the need of emotional care and to apply emotional care to hopice patients and their families.

• 보건의료산업학회지
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• 제13권4호
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• pp.163-177
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• 2019

Objectives: The purpose of this study was to identify the predictors of quality of life (QOL) for terminal cancer patients admitted into the community health center, and to establish a hypothetical model to explain and verify causative relationships among the variables. Methods: Data were collected from January 2015 to June 2016. Participants were 237 registered patients in Busan Metropolitan City hospice & palliative care center. The descriptive and correlation statistics were analyzed using the SPSS/WIN 24.0, and the structural equation modeling procedure was performed using the AMOS 24.0 program. Results: The results of this study showed that the physical symptoms of terminal cancer patients were the most direct factors affecting the QOL, and satisfaction with health care services has a direct effect on the QOL. Conclusions: The study contributes to drawing up measures to improve QOL for terminally ill cancer patients who are living in the end-of-life section of the community by revealing the causal relationship to the QOL for terminal cancer patients.

• 대한간호학회지
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• 제49권3호
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• pp.329-339
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• 2019

Purpose: The purpose of this study was to investigate the frequency, patterns, and factors of reversals in decisions about life-sustaining treatment (LST) among older patients with terminal-stage chronic cardiopulmonary disease. Methods: This was a retrospective correlational descriptive study based on medical chart review. De-identified patient electronic medical record data were collected from 124 deceased older patients with terminal-stage cardiopulmonary disease who had made reversals of LST decisions in an academic tertiary hospital in 2015. Data were extracted about the reversed LST decisions, LST treatments applied before death, and patients' demographic and clinical factors. Multivariate logistic regression analysis was used to identify the factors associated with the reversal to higher intensity of LST treatment. Results: The use of inotropic agents was the most frequently reversed LST treatment, followed by cardiopulmonary resuscitation, intubation, ventilator therapy, and hemodialysis. Inconsistency between the last LST decisions and actual treatments occurred most often in hemodialysis. One-third of the reversals in LST decisions were made toward higher intensity of LST treatment. Patients who had lung diseases (vs. heart diseases); were single, divorced, or bereaved (vs. married); and had an acquaintance as a primary decision maker (vs. the patients themselves) were significantly more likely to reverse the LST decisions to higher intensity of LST treatment. Conclusion: This study demonstrated the complex and turmoil situation of the LST decision-making process among older patients with terminal-stage cardiopulmonary disease and suggests the importance of support for patients and families in their LST decision-making process.

• 임상간호연구
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• 제14권2호
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• pp.103-114
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• 2008

Purpose: The purpose of this study was to investigate the level of QoL of the terminal cancer patients at home and to identify any influencing factors on QoL. Method: Subjects of this study consisted of 72 terminal cancer patients who were receiving home care nursing for more than 2 weeks in 6 general hospitals. Data were collected by a self-reporting questionnaire on QoL, pain, physical functioning, and symptom experience from Feb, 2006 to Dec, 2006. Data were analyzed by t-test, one way ANOVA, Pearson correlation coefficients, and multiple regression using SPSS Win 14.0. Results: Mean score of QoL was 98.6(230 in total). Except the level of family coping, general characteristics and disease related variables did not show significant difference in QoL. QoL was higher in the family with better coping, and QoL showed negative correlation with three types of pain, physical functioning, and symptom experiences. Least pain, physical functioning, and level of family coping explained QoL up to 26.7%. Conclusion: The QoL was closely related with pain, physical functioning, symptom experience, and family coping. And the least pain, physical functioning and level of family coping were important factors influencing on QoL of terminal cancer patients. However, some other variables influencing the QoL need to be investigated in the future.

• Journal of Hospice and Palliative Care
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• 제25권1호
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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 Hospice and Palliative Care
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• 제25권4호
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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.

• 가정간호학회지
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• 제16권2호
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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.

• 재활간호학회지
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• 제8권1호
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• pp.50-58
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• 2005

Purpose: The purpose of this study was to increase our understanding of the terminal cancer patients and their families concerns. I analyzed the counseling contents of terminal cancer patients and their relatives who referred to hospice office. Method: Data was collected from January 2004 to November 2004. During the counseling, I took notes the key points and contents. 109 patients and/or their families's counseling records were analyzed with the descriptive statistics and content analysis. Result: 73.4% of patients knew their current terminally ill status. The mobility of 86.2% of the patients was worse than ECOG 3 level. Patients have uncontrolled pain(28.4%), emotional distress(55.0%), and physical distress(49.5%). Caregivers of the patients were spouse(46.8%), sons and daughters(24.8%). Family members had problems to tell the bad news to their family cancer patient. 95.4% of the patient and family members was informed about the hospice and palliative care services, and 35.8% of them was referred to the hospice and palliative organizations. Frequently asked questions were 'what is hospice?', 'how much is the cost of hospice services?' etc. Conclusion: Care planning for terminal cancer patients must include patient. Also, professionals should consider and offer accessible, effective and empathetic counseling services to patients and families.

• Journal of Hospice and Palliative Care
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• 제12권1호
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• pp.5-13
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• 2009

목적: 본 연구는 국가암정보센터의 전화상담을 통해 말기 암 환자가족의 정보요구와 만족도 조사를 통해 말기 암 환자 간호의 질을 향상하고자 시도되었다. 방법: 2007년 6월부터 2008년 3월까지 국가암정보센터를 통해 문의한 말기 암 환자 가족 중 만족도 조사에 동의하고 실제 통화된 113명을 대상하였다. 결과: 1. 정보를 요구한 말기 암 환자 가족은 113명으로 가족 중 자녀(82명)와 배우자(8명)가 주로 이용하였고, 연령은 40대(40명)와 30대(36명)의 이용이 많았다. 가장 많은 질문은 치료방법 117건, 말기 암 환자의 관리 46건, 말기 암 환자의 생활은 27건, 임종과 수명예측 18건, 입원기관에 관한 정보 16건, 경제적 지원은 15건 으로 나타났다. 전화상담 서비스에 대해 전반적으로 높은 만족을 보였다. 전화상담 서비스를 알게 된 경위는 인터넷이 69%로 가장 많았고 상담 후 개선사항을 묻는 질문에 홍보가 부족하다는 대답이 10.6%로 가장 많았다. 결론: 이 연구의 결과를 통해 말기 암 환자 가족은 치료방법에 매여 있어 남은 삶의 질을 높일 수 있는 호스피스에 대한 인식이 적은 만큼 국가적 차원에서 매스미디어를 활용한 호스피스 홍보방안을 모색해야 한다.