• Title/Summary/Keyword: adolescents in palliative care

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Development and Application of Advance Care Planning Workbooks to Facilitate Communication with Children and Adolescent Patients: A Pilot Test

  • Moon, Yi Ji;Lee, Jung;Choo, In Sil;Kang, Sung Han;Kim, Cho Hee;Song, In Gyu;Kim, Min Sun
    • Journal of Hospice and Palliative Care
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    • v.23 no.4
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    • pp.212-227
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    • 2020
  • Purpose: This study presents the process of designing workbooks for advance care planning appropriate for the Korean cultural setting and describes actual case studies. Methods: This study focused on single inductive case studies of the utilization of an advance care planning workbook and recruited individual participants. Results: The workbook for adolescents contained six sessions and the workbook for children contained seven sessions. The workbook sessions led to four major discoveries: 1) considering the Korean cultural context, discussions on life and death must be held indirectly; 2) the role of the counselor as a supporter is crucial for the workbook to be effective; 3) the workbook must be accessible regardless of the seriousness of the illness; and 4) patients must be able to make their own choice between the workbook versions for children and adolescents. Six facilitating factors improved engagement: 1) the role of the counselor as a supporter; 2) building trust with the patient; 3) affirming freedom of expression on topics the patient wished to avoid talking about; 4) having discussions on what private information to keep secret and to whom the information can be disclosed; 5) discovering and regularly discussing relevant topics; and 6) regular communication and information-sharing with the patient's medical service providers. Conclusion: It is necessary to build on actual case studies regarding workbooks for children and adolescents in order to expand the usage of these workbooks to all relevant medical institutions in Korea.

Nurses' Perceived Needs and Barriers Regarding Pediatric Palliative Care: A Mixed-Methods Study

  • Kang, Kyung-Ah;Yu, SuJeong;Kim, Cho Hee;Lee, Myung-Nam;Kim, Sujeong;Kwon, So-Hi;Kim, Sanghee;Kim, Hyun Sook;Park, Myung-Hee;Choi, Sung Eun
    • Journal of Hospice and Palliative Care
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    • v.25 no.2
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    • pp.85-97
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    • 2022
  • Purpose: This study aimed to describe nurses' perceived needs and barriers to pediatric palliative care (PPC). Methods: Mixed methods with an embedded design were applied. An online survey was conducted for nurses who participated in the End-of-Life Nursing Education Consortium- Pediatric Palliative Care (ELNEC-PPC) train-the-trainer program, of whom 63 responded. Quantitative data were collected with a survey questionnaire developed through the Delphi method. The 47 items for needs and 15 items for barriers to PPC were analyzed with descriptive statistics. Qualitative data were collected through open-ended questions and analyzed with topic modeling techniques. Results: The mean scores of most subdomains of the PPC needs were 3.5 or higher out of 4, and those of PPC barriers ranged from 3.22 to 3.56, indicating the items in the questionnaire developed in this study properly reflect each factor. The needs for PPC were divided into 4 categories: "children and adolescents," "families," "PPC management system," and "community-based PPC." Meanwhile, PPC barriers were divided into 3 categories: "healthcare delivery system," "healthcare provider," and "client." The keywords derived from the topic modeling were perception, palliative, children, and education for necessities and lack, perception, medical care, professional care providers, service, and system for barriers to PPC. Conclusion: In this study, by using mixed-methods, items of nurses' perceived needs and barriers to PPC were identified, categorized, and weighted, and their meanings were explored. For the stable establishment of PPC, the priority should be given to improving perceptions of PPC, establishing an appropriate system, and training professional care providers.

Case Study on the Use of Songwriting to Promote Self-Acceptance in Adolescents in Palliative Care (노래 만들기를 통한 완화의료 청소년의 자기수용 증진 사례 연구)

  • Youn, Ha Jeong
    • Journal of Music and Human Behavior
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    • v.19 no.2
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    • pp.55-80
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    • 2022
  • This study aimed to examine the effects of songwriting on the self-acceptance of adolescent in palliative care. Three participants were recruited from a university hospital in an urban area in South Korea. The songwriting intervention was conducted in six sessions, and each session was composed of an introduction, song writing and wrap-up. Participants were asked to complete the Unconditional Self-Acceptance Questionnaire (USAQ) before and after the intervention. Their verbal expressions and written song lyrics observed during the intervention were also measured. The results showed that the USAQ scores increased after the intervention, indicating the improvement in their acceptance of the self without judgement or high reactivity to feedback. In addition, the participants exhibited greater recognition of their emotions and acceptance of themselves as they are. They were also better able to discover internal resources and psychological competence. The participants reported that they could more freely express their emotions through song writing and that recording the songs they created was a means of communicating their feelings to others. Based on this study, it is expected that adolescents in palliative care will be able to experience self-acceptance through such brief song writing interventions.

The Effects of Logotherapy on Meaning in Life and Quality of Life of Late Adolescents with Terminal Cancer (의미요법이 청소년 후기 말기 암환자의 생의 의미와 삶의 질에 미치는 효과)

  • Kang, Kyung-Ah;Shim, Jeoung-Sook;Jeon, Dae-Geun;Koh, Myung-Suk
    • Journal of Korean Academy of Nursing
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    • v.39 no.6
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    • pp.759-768
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    • 2009
  • Purpose: To evaluate the effects of a logotherapy program entitled 'Finding meaning in my life' for adolescents with terminal cancer. Methods: A nonequivalent control group, non-synchronized design was conducted with a convenience sample of 44 late adolescents with terminal cancer. The experimental group (n=22) participated in the 'Finding meaning in my life' program which consisted of five-day sessions for one week. The control group (n=22) received the usual nursing care. The effects were measured using adolescent meaning in life (AMIL), and quality of life (QOL) scales. The collected data were analyzed by descriptive statistics, Chi-square, and t-test using SPSS/PC 17.0 program. Results: There were significant differences in AMIL (t=3.36, p<.05) and QOL (t=2.67, p<.05) between the experimental and control groups. Conclusion: Logotherapy is effective in improving the meaning in life and quality of life of late adolescents with terminal cancer, and can be used to prevent existential distress.

The Effect of Logotherapy on the Suffering, Finding Meaning, and Suffering, Well-being of Adolescents with Terminal Cancer

  • Kang, Kyung-Ah;Im, Jae-Im;Kim, Hee-Su;Kim, Shin-Jeong;Song, Mi-Kyung;Sim, Song-Yong
    • Child Health Nursing Research
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    • v.15 no.2
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    • pp.136-144
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    • 2009
  • Purpose: To evaluate the effects of a logotherapy education program. Methods: A nonequivalent control group, non-synchronized design was conducted with a convenience sample of 29 children with cancer. The experimental group (n=17) participated in the logotherapy education program which consisted of 5 daily sessions for one week. The control group (n=12) received the usual nursing care. The effects were measured using suffering, adolescent meaning in life (AMIL), and spiritual well-being (SWBS) scales. Results: There were significant differences in suffering (W=153.00, p<.05) and meaning in life (W=78.00, p<.05) between the experimental and control groups. However, there was no significant difference in spiritual well-being (W=136.50, p>.05). Conclusions: Logotherapy was effective in reducing suffering and improving the meaning in life. Logotherapy can be utilized for adolescents with terminal cancer to prevent existential distress and improve their quality of life.

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Development of a CD Program Applied Logotherapy for Psycho.Spiritual Care of Late Adolescents with Terminal Cancer (청소년 후기 말기 암 환자의 정서적.영적 돌봄을 위한 의미요법 CD 프로그램 개발)

  • Kang, Kyung-Ah;Kim, Shin-Jeong;Song, Mi-Kyung
    • Journal of Hospice and Palliative Care
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    • v.12 no.2
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    • pp.61-71
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    • 2009
  • Purpose: The purpose of this study was to develop a CD program of applied logotherapy for psycho spiritual care of late adolescents with terminal cancer. Methods: Keller & Song's ARCS theory and a model for developing learning materials was applied to develop this program composed four distinct phases: planning, designing, developing, and evaluation stages. Results: This program was entitled 'Finding meaning in my life' and consisted of 5 sessions and its educational contents were made up as follows: "First Secret" is 'learning three natures of the human mind', "Second Secret" is 'learning creative values first method to find meaning of life', "Third Secret" is 'learning experiential value as second method to find meaning of life', "Fourth Secret" is 'learning attitudinal value as third method to find meaning of life', and "Fifth Secret" is 'Becoming the master of my life'. The sub-menu was made up of 'Beginning', 'Opening mind', 'Learning'. 'Laughing Song', 'Experiencing'. Conclusion: This CD program applied logotherapy with flash animation technique as an emotional and spiritual nursing intervention program for easier and more scientific application in pediatric oncology and hospice care area.

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Supportive Songwriting to Improve Resilience of Adolescents With School Maladjustment (학교 부적응 청소년의 적응유연성 향상을 위한 지지적 노래만들기)

  • Kim, Ji Won
    • Journal of Music and Human Behavior
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    • v.15 no.2
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    • pp.41-67
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    • 2018
  • The purpose of this case study was to examine how a supportive songwriting program could facilitate resilience for adolescents with school maladjustment. Participants included four middle school students with adaptive difficulties. The participants received eight 50-minute sessions of a supportive songwriting program. The program consisted of singing and discussing selected songs, followed by the participants creating their own lyrics about their current adaptation issues. The Resilience Scale for Adolescents was completed by each participant before and after the intervention, and the participants' lyrics were analyzed for how the factors of resilience were reflected in their lyrics. The results showed that all participants' scores on the resilience scale increased. It was also found that the factor on the resilience scale that increased the most for each participant was related to the issues expressed in their lyrics. The results suggest that the process of writing songs can be effective in eliciting adolescents' school related issues and accessing their positive resources, which can lead to behavioral and psychological improvements.

The Development of Hospice and Space Configuration Characteristics of Hospice Facilities Established Between 1980-2009 (호스피스의 전개과정과 1980-2009년대 호스피스 시설의 공간구성 특징에 관한 사례연구)

  • Chung, Miryum
    • Journal of the Architectural Institute of Korea Planning & Design
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    • v.34 no.11
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    • pp.3-12
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    • 2018
  • Hospice is the wholistic caring service for terminally ill patient and his family so that he can live in dignity and maintain the quality of life until he passes away peacefully. The purpose of this study is to compare the development of hospice movement in UK, USA, Japan and Korea, to analyze space configuration characteristics of facilities built between 1980-2009 through case study. The result is as follows. First, The modern hospice started in England and it has spread around the world rapidly. In Korea, hospice service was introduced even prior to US and Japan and developed in spite of poor medical environment. The application of health insurance subsidies were late compared to other countries, but the hospice and palliative care system was quickly set on the basis of precedent cases. Second, the number of hospital beds per facility is decreasing, and it has been divided into smaller clusters for the residential atmosphere. The controversy between private rooms and multi-patient room is still ongoing, and increasing facilities without in-patient service. Rather than establishing uniform and absolute regulations, it is necessary to design a flexible space which can cope with various situations such as patients' needs, service changes, and manpower status. Third, the spaces for family members and friends to stay in both private rooms and communal spaces are increasing. Forth, Facilities for patients with different needs, such as children and adolescents and AIDS patients, have been developed in UK and USA. Further research on of patients' diverse needs and customized environmental support is necessary.

Identification of Knowledge Structure of Pain Management Nursing Research Applying Text Network Analysis (텍스트네트워크분석을 적용한 통증관리 간호연구의 지식구조)

  • Park, Chan Sook;Park, Eun-Jun
    • Journal of Korean Academy of Nursing
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    • v.49 no.5
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    • pp.538-549
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    • 2019
  • Purpose: This study aimed to explore and compare the knowledge structure of pain management nursing research, between Korea and other countries, applying a text network analysis. Methods: 321 Korean and 6,685 international study abstracts of pain management, published from 2004 to 2017, were collected. Keywords and meaningful morphemes from the abstracts were analyzed and refined, and their co-occurrence matrix was generated. Two networks of 140 and 424 keywords, respectively, of domestic and international studies were analyzed using NetMiner 4.3 software for degree centrality, closeness centrality, betweenness centrality, and eigenvector community analysis. Results: In both Korean and international studies, the most important, core-keywords were "pain," "patient," "pain management," "registered nurses," "care," "cancer," "need," "analgesia," "assessment," and "surgery." While some keywords like "education," "knowledge," and "patient-controlled analgesia" found to be important in Korean studies; "treatment," "hospice palliative care," and "children" were critical keywords in international studies. Three common sub-topic groups found in Korean and international studies were "pain and accompanying symptoms," "target groups of pain management," and "RNs' performance of pain management." It is only in recent years (2016~17), that keywords such as "performance," "attitude," "depression," and "sleep" have become more important in Korean studies than, while keywords such as "assessment," "intervention," "analgesia," and "chronic pain" have become important in international studies. Conclusion: It is suggested that Korean pain-management researchers should expand their concerns to children and adolescents, the elderly, patients with chronic pain, patients in diverse healthcare settings, and patients' use of opioid analgesia. Moreover, researchers need to approach pain-management with a quality of life perspective rather than a mere focus on individual symptoms.