• Journal of Hospice and Palliative Care
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• v.15 no.1
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• pp.30-35
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• 2012

Purposes: Most medical schools in Korea do not provide adequate education in end-of-life care. This study was designed to illustrate the need to improve end-of-life care education and to assess the effect of the education on fourth-year medical students' awareness and attitude towards hospice and palliative care for terminally ill patients. Methods: One hundred sixty six fourth-year medical students were surveyed with questionnaires on end-of-life care before and after they received the education. Results: Before receiving the education, students most frequently answered "at the end of life" (33.6%) was appropriate time to write an advance medical directive. After the education, the most frequent answer was "in healthy status" (58.7%). More students agreed to withholding or withdrawing futile life-sustaining treatment increased after the education (48.1% vs. 92.5% (P<0.001) for cardiopulmonary resuscitation, 38.3% vs. 92.5% (P<0.001) for intubation and mechanical ventilation, 39.1% vs. 85.8% (P<0.001) for inotropics, 60.9% vs. 94.8% (P<0.001) for dialysis and 27.8% vs. 56.0% (P<0.001) for total parenteral nutrition). Significantly more students opposed euthanasia after the education (46.6% vs. 82.1%, P<0.001). All students agreed to the need for education in end-of-life care. Conclusion: After reflecting on the meaning of death through the end-of-life care education, most students recognized the need for the education. The education brought remarkable changes in students' awareness and attitude towards patients at the end of life. We suggest end-of-life care education should be included in the regular curriculum of all medical schools in Korea.

• Clean Technology
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• v.4 no.1
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• pp.1-5
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• 1998

• Journal of Korean Critical Care Nursing
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• v.10 no.1
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• pp.41-50
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• 2017

Purpose: The purpose of this study was to describe what critical care nurses perceived about life-sustaining treatment at end of life. Methods: A qualitative content analysis method was utilized. The unit of analysis was interview text obtained from fifty critical care nurses of a general hospital. Results: Seven categories in two content areas were abstracted. In the negative perception area, the following five categories were abstracted: patients' suffering, dying with damaged dignity, patients' isolation from family members, regret about choosing life-sustaining treatment, and family members' burden. In the positive perception area, the following two categories were abstracted: willingness to sustain life and duty as family members. Conclusions: Nurses have better competencies pertaining to understanding patients' responses and suffering than any other health care professions do. Nurses should play an important role in advocating for patients and their family in the process of end-of-life care decision making.

• Korean Journal of Computational Design and Engineering
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• v.17 no.1
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• pp.1-6
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• 2012

The End Coupling is main component of the aluminum hot roll process. The End Coupling is used for transmission of rotational power with heavy-duty load. Fracture of the End Coupling cause serious economic losses because an End Coupling is a very expensive component and it takes a long time to repair it. Therefore, preventing the destruction of the End Coupling is essential for ensuring a long mechanical life cycle. In this paper, the parametric study on the End Coupling was performed in order to minimize maximum stress under operation loads. To verify the interference of spindle assembly with modified End Coupling, kinematics simulation was performed by applying the various combination type and dynamic boundary condition of the spindle assembly. The interference of optimized model was not occurred during combination process and driving process. As a result of an optimum design for life extension on End Coupling, the maximum stress of modified End Coupling was lower than that of the initial model by 26%.

• Health Policy and Management
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• v.26 no.4
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• pp.305-314
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• 2016

Background: The purpose of this study is to examine the characteristics of and factors associated with long-term care (LTC) utilization under public long-term care insurance (LTCI) among end-of-life older adults in Korea. Methods: Using a 5% sample of older people aged 65 or older and their health and LTC insurance data, two-part model analyses were conducted. We compared LTC uses and their determinants during the last year of life among decedents in the year 2010 with those of survivors. We also compared the medical uses of the same sample with their LTC uses. Results: The end-of-life elderly were more likely to use LTC, and their expenditure on LTC was higher than their counterparts. Whether or not older people used LTC during their last year of life was significantly affected by age, sex, health insurance, household income, and living alone; however, LTC costs of the decedents were only affected by functional status, which may have been due to the reimbursement scheme of the current LTCI, which is mainly based on functional dependency level. For the survivors, having chronic diseases significantly increased the likelihood of LTC use, which was not the case for the decedents. End-of-life elderly with relatively low social economic status were more likely to use the LTC other than medical services, while the health conditions affected their medical uses most significantly. Conclusion: The study findings provide key information for predicting demand related to the increasing LTC needs of Korean older people at the end of life.

• Journal of the Korea Convergence Society
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• v.12 no.9
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• pp.273-283
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• 2021

The purpose of this study is to identify factors affecting the stress of End-of-life care in long-term care hospitals and to identify perception and education requirement of End-of-life care. The subjects of this study were 163 nurses who had worked at seven long-term care hospitals in Gyeongsangnam-do for more than six months and had more than one end-of-life care experience. They agreed to participate in the study using structured questionnaires from May 27 to June 7, 2021. As a result of this study, the most influential factor for the terminal care stress of the nurses in the long-term care hospitals is the education needs of End-of-life care(β=.25, p=.001). The following factors have been identified death anxiety (β=.21, p=.005), satisfaction with the End-of-life care environment (β=.17, p=.017), and End-of-life care perception(β=-.15, p=.040). Based on the results of this study, it is necessary to meet the educational needs of the End-of-life care for the nurses in the long-term care hospitals in order to relieve their stress. For this, it is necessary to develop and apply educational programs for End-of-life care.

• Korean Journal of Adult Nursing
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• v.29 no.2
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• pp.119-130
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• 2017

Purpose: The purpose of this study was to understand the nurses' experiences of end of life care of older adults with dementia living in long-term care hospitals and geriatric care facilities. Methods: The participants were nine nurses. Open in-depth interviews were used to collect data from June, 2016 to November, 2016. Colaizzi's phenomenological approach was used to analyze the data. Results: Three categories were identified. The nurses' reported experiences of end of life care of older adults with dementia were 'warm care with living together', 'care for family', and the 'self-reflection and responsibility as a nurse'. There were ten clusters of themes and 24 themes. The participants stated that the end of life care of older adults with dementia were individualized holistic care with dignity, being in older adults with dementia and family, and responsibility as a professional. Nurses reported the need for dementia hospice care. Conclusion: These results could be considered in planning nursing intervention for hospice care. The findings support the need for educational strategies and programs to improve end of life care among older adults with dementia.

• Research in Community and Public Health Nursing
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• v.19 no.4
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• pp.684-695
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• 2008

Purpose: The purpose of this study was to evaluate changes regarding knowledge. attitude and practice toward end-of-life care in nursing university students. Method: This study adopted nonequivalent control group pretest-posttest design. The subjects consisted of 35 in the experimental group and 35 in the control group. The education was performed for 2 hours a session, once a week for 16 weeks. Data was analyzed by the SPSS/WIN 14 computer program, and included $X^2$ test. independent t-test. and repeated measure ANOVA. Results: There were statistically significant differences in knowledge toward end-of-life care between the experimental group and the control group. Conclusion: Findings suggested that holistic education on end-of-life care was effective to change students' knowledge toward end-of-life care. Therefore. holistic education is recommended as nursing education for nursing university students.

• Korean Circulation Journal
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• v.52 no.9
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• pp.659-679
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• 2022

Efforts to improve end-of-life (EOL) care have generally been focused on cancer patients, but high-quality EOL care is also important for patients with other serious medical illnesses including heart failure (HF). Recent HF guidelines offer more clinical considerations for palliative care including EOL care than ever before. Because HF patients can experience rapid, unexpected clinical deterioration or sudden death throughout the disease trajectory, choosing an appropriate time to discuss issues such as advance directives or hospice can be challenging in real clinical situations. Therefore, EOL issues should be discussed early. Conversations are important for understanding patient and family expectations and developing mutually agreed goals of care. In particular, high-quality communication with patient and family through a multidisciplinary team is necessary to define patient-centered goals of care and establish treatment based on goals. Control of symptoms such as dyspnea, pain, anxiety/depression, fatigue, nausea, anorexia, and altered mental status throughout the dying process is an important issue that is often overlooked. When quality-of-life outweighs expanding quantity-of-life, the transition to EOL care should be considered. Advanced care planning including resuscitation (i.e., do-not resuscitate order), device deactivation, site for last days and bereavement support for the family should focus on ensuring a good death and be reviewed regularly. It is essential to ensure that treatment for all HF patients incorporates discussions about the overall goals of care and individual patient preferences at both the EOL and sudden changes in health status. In this review, we focus on EOL care for end-stage HF patients.

• 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.