• Journal of Hospice and Palliative Care
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• v.26 no.3
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• pp.101-111
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• 2023

Purpose: This study aimed to identify levels of perception and performance of end-oflife care among nurses and to investigate correlations between perception and performance. Methods: This cross-sectional descriptive survey included 321 nurses from a tertiary hospital in Seoul, Korea. The participants had at least 6 months of work experience and had been involved in end-of-life care at least once, in either ward or intensive care unit settings. A structured questionnaire was utilized to assess their perception and performance of endof-life care. Results: The mean score for perception of end-of-life care was 3.23±0.34, while the score for performance of end-of-life care was 3.08±0.34. There was a significant positive correlation between nurses' perception of end-of-life care and their performance in this area (r=0.78, P<0.001). Conclusion: It is necessary to change perceptions regarding end-of-life care and to develop systematic and standardized education programs including content such as assessing the hydration status of dying patients, evaluating mental aspects such as suicidal ideation, and providing spiritual care for nurses working in end-of-life departments.

• Journal of Korean Clinical Health Science
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• v.4 no.2
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• pp.593-602
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• 2016

Purpose. The purpose of this study was to investigate knowledge, stress and nursing performance about care for delirium in geriatric hospital nurses. Methods. For this study, data were collected from 242 nurses employed at geriatric hospitals with the capacity of more than 100 beds which were located in A, P and Y cites. Frequency analysis, t-test and one-way ANOVA were utilized to analyze the data and Scheffe test was used to conduct post-hoc tests. Results. Nurses showed significant differences in the level of Knowledge, as well as terminal care performance by marital status, nursing experience. A significant relationship was found between knowledge, stress and Delirium care performance. Conclusion. This study found nurses perform delirium care with a high level of stress but with insuffiecient understanding, and thus, showed great needs for related training. Such findings can be useful to develop educational programs to improve knowledge on delirium and plans to reduce stress from delirium for geriatric hospital nurses.

• Journal of Hospice and Palliative Care
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• v.17 no.3
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• pp.122-133
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• 2014

Purpose: We conducted a descriptive correlational study to determine a relationship between nurses' awareness of good death and attitudes toward terminal care, which in turn could be used as basic data for improvement of the quality of terminal care at geriatric hospitals. Methods: From April 3, 2013 through April 22, 2013, data were collected from 230 nurses working at geriatric hospitals. Results: Nurses' attitudes toward terminal care showed no significant correlation with awareness of good death, but it was positively correlated with a sense of closeness, a subfactor of awareness of good death. There was negative correlation between emotions regarding a deathbed, a subfactor of attitudes of nurses in charge of terminal patients, and awareness of good death. We found positive correlation between terminal care performance and awareness of good death. Conclusion: This study warrants the need for nursing education catered to characteristics of geriatric hospitals and development of diverse intervention strategies to help them to attain a positive attitude toward death by familiarizing themselves with the concept of good death and enhancing job satisfaction.

• 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.16 no.4
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• pp.223-231
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• 2013

Purpose: This study was conducted to explore how nurses' attitude toward dignified death and moral sensitivity affect their end-of-life care performance. Methods: Study participants were 172 nurses who work at university hospitals in a metropolitan city in Korea. Data were collected from June 20 through August 13, 2012 using the Dignified Death Scale, Moral Sensitivity Scale, and End-of-Life Care Performance Scale. Data were analyzed using the SPSS/WIN 19.0 program. Results: Factors affecting nurses' end-of-life care performance included moral sensitivity, dignified death and education level. Conclusion: Moral sensitivity, dignified death and education level should be considered when developing an educational program for nurses' end-of-life care performance.

• Journal of Hospice and Palliative Care
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• v.20 no.4
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• pp.235-241
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• 2017

Purpose: The Palliative Performance Scale (PPS) is a widely used prognostic tool in patients with advanced cancer. This study examines the association between changes in PPS score and survival in patients with advanced cancer. Methods: We identified a cohort of 606 inpatients who died at a Korean university hospital's hospice/palliative care center. For each patient, the PPS score was measured twice according to a standard procedure: 1) upon admission, and 2) three days after admission (D3). "Change on D3" was defined as a difference between initial PPS and PPS on D3. We used a Cox regression modeling approach to explore the association between this score change and survival. Results: The changes in scores were associated with survival. A score change of >30% yielded a hazard ratio for death of 2.66 (95% CI 2.19~3.22), compared to a score change of ${\leq}30%$. PPS of ${\leq}30$ on D3 also independently predicted survival, with a hazard ratio of 1.67 (95% CI 1.38~2.02) compared to PPS of >30. Conclusion: A change of over 30% in PPS appears to predict survival in hospitalized patients with terminal cancer, even after adjustment for confounders. Changes in PPS may be a more sensitive indicator of impending death than a single PPS measured on the day of admission in terminal cancer patients. Further prospective study is needed to examine this important finding in other populations.

• Journal of Hospice and Palliative Care
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• v.16 no.2
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• pp.108-117
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• 2013

Purpose: The objectives of this study were to 1) explore nurses' attitudes toward death, coping with death, understanding and performance regarding end-of-life (EOL) care, 2) describe correlations among the above factors, and 3) determine the factors affecting nurses' EOL care performance. Methods: Study participants were 187 nurses stationed at departments that post higher mortality than others such as the oncology department, intensive care unit (ICU) and emergency department (ED). Data were collected from three urban university-affiliated hospitals. Multi-dimensional measure was performed for study instruments such as "attitude toward death", "coping with death" and "understanding and performance regarding EOL care". Data were analyzed by using descriptive statistics, correlation, and multiple regressions. Results: First, nurses showed significantly different attitudes toward death by age, religion, work unit and EOL care education. Younger nurses tend to score low on the understanding of EOL care, and ED nurses' score was lower than their peers at the oncology department and ICU. Second, EOL care performance was positively correlated with attitude toward death (P<0.001), coping with death (P=0.003) and understanding of EOL care (P<0.001). Third, nurses' EOL care performance was affected by work unit (P<0.001) and understanding of EOL care (P<0.001). Conclusion: Because nurses' performance was influenced by their work unit and understanding of EOL care, they should be provided with appropriate training to improve their understanding of death and EOL care according to work unit.

• Journal of Convergence for Information Technology
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• v.11 no.7
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• pp.288-297
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• 2021

The purpose of this study was to provide basic data for the development of end-of-life care program by analyzing the importance and performance of end-of-life care. Data were collected from 127 hospice team members currently working in hospice and palliative care units from six different university hospitals, general hospitals and hospice clinics. The data was collected throughout the time span of Dec. 1, 2020 to Feb. 15, 2021. Data were analyzed using descriptive statistics, t-tests, ANOVA, & IPA matrix. As a result of this study, 'physical care' and 'psychological care' were part of the first quadrant that requires maintenance and continuous enhancement. The 'spiritual care' appeared to be in the third quadrant area which entails long-term improvement. Based on the outcome of the study, it is evident that strategies are needed to continuously maintain and enhance physical and psychological care as well establish long-term plans for spiritual care when organizing the hospice team's end-of-life care performance training program.

• Korean Journal of Hospice Care
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• v.2 no.1
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• pp.21-40
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• 2002

Cancer is the second leading cause of the death in Korea. Family caregivers of dying patients manifest many psychological and physical symptoms of stress, and they often seek for informational support from health care providers. Unfortunately, however, few systematic studies identify the actual effect of such support on family caregivers. This study, thus, intends to evaluate the effect of informational support for hospice care. One group pretest-posttest design was used, employing the stress-coping model by Cohen and Wills as a conceptual framework. This research was conducted from July 1 to November 15, 1998, initially with 32 subjects sampled from hemato-oncology department of two general hospitals in Seoul, but reduced to 18 at the end due to the untimely death of patients or caregiver's refusal during the course of study. Informational supports were programmed to provide the family caregivers with 8 times of education and counseling as well as 24-hour hot-line for 4 weeks. A booklet that explains the various problems of hospice care was also prepared and distributed to all subjects. Data were collected by using self-report questionnaires and reviewing medical records. The tools used in this study were based on the Weinert's PRQ-II(scale of perceived social support), Spielberger's state anxiety inventory, and CES-D. Also included in the data collection were the general characteristics of family caregivers and patients, and the pain intensity and the performance status of patients. The data were analyzed with descriptive statistics, Wilcoxon sign rank test and paired t-test using SPSSWIN program. The results of the study were as follows: 1.The perceived social support of family caregivers was not significantly increased with informational support for hospice care(t=1.64, one tailed p=.060). 2.The anxiety of family caregivers was significantly reduced following informational support for hospice care(t=3.48, one tailed p=.002). 3.The depression of family caregivers was significantly reduced following informational support for hospice care(t=-2.18, one tailed=.022). 4.The pain intensity of patients with terminal cancer was significantly reduced following informational support for hospice care(t=-2.41, two tailed p=.027). The results suggest that the informational support provided to family caregivers of patients with terminal cancer reduced not only their anxiety and depression but also the pain intensity of patients. Further study is necessary to consolidate the conceptual framework of this study with expanded number of subjects. Nevertheless, it was certain that the informational support program for hospice care was very helpful to both caregivers and patients. Thus, the informational support program is strongly recommended for the hospitals which have no hospice unit yet.

• Journal of Hospice and Palliative Care
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• v.15 no.1
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• pp.10-17
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• 2012

Purpose: This study was conducted to identify the perception regarding palliative care among Korean doctors and referral barriers toward palliative care for terminal cancer patients. Methods: Between May and June 2010, 477 specialists mainly caring cancer patients using a web-based, self-administered questionnaire. Results: A total of 128 doctors (26.8%) responded. All respondents (100%) deemed palliative care a necessary service for terminal cancer patients. More than 80% of the respondents agreed to each of the following statements: all cancer centers should provide palliative care service (80.5%); all terminal cancer patients should receive concurrent palliative care along with anti-cancer therapies (89.1%) and caring for terminal cancer patients requires interdisciplinary approach (96.9). While more than 58% of the respondents were satisfied with their performance of physical and psychological symptoms management and emotional support provided by patient's family members, 64% of the responded answered that their general management of the end-of-life care was less than satisfactory. Doctors without prior experience in referring their patients to palliative care specialists accounted for 26.6% of the respondents. The most common barrier to hospice referral, cited by 47.7% of the respondents, was "refusal of patient or family member", followed by "lack of available palliative care resources" (46.1%). Conclusion: Although most doctors do recognize the importance of palliative care for advanced cancer patients, comprehensive and sufficient palliative medicine, including interdisciplinary cooperation and end-of-life care, has not been put into practice. Thus, more active palliative consultation or referral is needed for effective care of terminal cancer patients.