• Journal of Hospice and Palliative Care
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• v.24 no.1
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• pp.26-35
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• 2021

Purpose: The purpose of this study was to determine the effects of awareness of good death and end-of-life care attitudes on end-of-life care performance in long-term care hospital nurses. Methods: This study used a cross-sectional study design. The participants were 147 nurses working at six long-term care hospitals with more than 200 beds in B city, South Korea. Data were collected using self-reported questionnaires, and analyzed with descriptive statistics, the t-test, analysis of variance, Pearson correlation coefficients, and multiple stepwise regression analysis using IBM/SPSS 26.0 for Windows. Results: The participants' awareness of good death, end-of-life care attitudes, and end-of-life care performance were positively correlated. The factors affecting end-of-life care performance were age, education level, awareness of good death, and end-of-life care attitudes; these variables explained 19.0% of end-of-life care performance. Conclusion: In order to improve long term care hospital nurses' end-of-life care performance, continuing education and training should be provided regarding awareness of good death and end-of-life care attitudes.

• Korean Journal of Social Welfare
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• v.66 no.1
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• pp.221-249
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• 2014

This paper has the objectives to define the concept of 'Good Care' which is the service goal we are aiming essentially for the improvement of long-term care service quality, to find out the components for 'Good Care', and to explore the conditions that create a good care. In addition, we tried to find the answer about what is the best way to measure the service quality. For this, I referred the advanced researches which explored the fundamental properties of care and tried to find the answer from the accumulated wisdom of service field through the 5-year long term care service experience. As a result of research, the good care can be defined as helping someone to be able to maintain his own life as maximum as possible with the goal to assure total quality life. The most important condition for good care is making 'a good care relationship'. Without damaging the relationship between care provider and care receiver, the individualized service focusing on the demand of care receiver based on mutual reliability, mutual respect and smooth communication should be provided. For the evaluation system, it is reasonable to set the standard according to the size of each institution for the core quality of facility service and establish the certification system of absolute standard to carry out the quantitative evaluation rather than the relative evaluation in the whole. For the part over the absolute certification standard, it is reasonable for each institution to characterize its own characteristics autonomously and carry out the qualitative evaluation for this. For the evaluation of home visit care service, it is recommended to contain the evaluation contents such as user satisfaction, satisfaction of care worker, how well the case management system of home care service center is operated etc.

• Health Policy and Management
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• v.17 no.3
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• pp.106-128
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• 2007

The Korean health care system is under great controversy. Over the last 30 years, main goal of health policies was to pursue equal access of health care services. However, another goal of health policies laid on efficiency and Quality of care, it had lower priorities. Superficially, controversy stems from priority setting among goals of health care system, equity, efficiency and quality. At a deeper level, arguments arise from disagreement and confusion about the values of Korean health care system. One of the value spectrums believes that health care is the basic right of human beings, therefore it should be produced and distributed on need approach, and needs are known to be decided by professionals. If we accept need approach, health care is a pubic good. Another value of spectrums considers that health care should be distributed on demand approach. Demand approach means that health care is a consumption good on the positive economics, while normative judgement believes that health care is a public good. In equity aspect, health care is considered as a public good. Over the last several years, some of scholars proposed health care reform based on the principle of competition which is based on demand approach. Others argue that the competition principle based on demand approach is not appropriate for the reform proposal, because health care has to be approached on need base. If we do not make explicit values we should adopt, consensus building for reform is nearly impossible. From this perspective, this article will review an ideology and reality in health policies in Korea.

• Korean Journal of Social Welfare
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• v.67 no.3
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• pp.203-225
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• 2015

Social care service has grown much with the introduction of Long-Term Care Insurance, but it remains difficult to answer in the affirmative to the question: are we providing sufficiently good care? This study has its purpose in figuring out what conditions are necessary to realize good care in our society. The study has used focus group interview (FGI) as a way to acquire realistic knowledge on the conditions that create good care and its deterring factors. The focus group interview, which targeted long-term care workers and facility heads, was conducted three times from January through March 2014, with each session taking about 3 hours. The analysis showed that the components of good care were mutual understanding and recognition through active interaction, making a good relationship based on mutual trust and respect, professionalism of care worker with flexible judgment that provides customized services, professionalism of center manager with appropriate intermediation, and the tripartite partnership among family, elderly, and care worker. Meanwhile, the deterring factors of good care were identified as devaluation of care labor, ambiguous job description and abuse, unprofessionalism of care worker and manager, inappropriate interference and indifference of family, and the structural constraints on long-term care environment.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.26 no.3
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• pp.197-209
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• 2019

Purpose: This study was done to examine good death awareness, attitudes toward advance directives (ADs), and preference for care near the end-of-life (PCEOL) of hospitalized elders in long-term care hospitals. Relevant characteristics were investigated as well as correlation of the variables. Methods: This descriptive research study involved 161 hospitalized elderly patients in long-term care hospitals. A self-report questionnaire was used to measure Good Death Scale, ADs Survey, PCEOL Scale, and general characteristics. Collected data were analyzed using descriptive statistics, t-test, ANOVA, and Pearson correlation with SPSS/WIN 23.0. Results: In terms of good death awareness, a significant difference was observed; in according to age (F=3.35, p=.037), payer of treatment costs (F=3.98, p=.021), mobility (F=3.97, p=.021), heard discussion about ADs (t=-3.89, p<.001), and willing to complete ADs (t=2.12, p=.036). As far as attitudes toward ADs, the participants presented significant difference depending on religion (t=2.38, p=.018), average monthly income (F=3.91, p=.022), duration of hospital admission (F=5.33, p=.006), person to discuss ADs (t=-2.76, p=.006). On PCEOL, there was a significant difference, depending on religion (t=-3.59, p<.001) and perceived health status (F=3.93, p=.022). Finally, as for how the variables were related to each other, good death awareness and attitudes toward ADs had a weak positive correlation with PCEOL. Conclusion: To help seniors staying in nursing homes face a good death and enjoy autonomy, there should be educational and support systems that reflect each individual's sociodemographic characteristics so that the seniors can choose what kind of care they want to receive near the end-of-life.

• Journal of Korean Critical Care Nursing
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• v.12 no.2
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• pp.39-49
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• 2019

Purpose : The purpose of this study was to identify the extent to which intensive care unit (ICU) nurses' perceptions of life-sustaining treatment decisions and "a good death" affect attitudes toward terminal care. Method : Participants included 109 ICU nurses from three university hospitals. Data were collected using structured questionnaires, and collected data were analyzed using a t-test, ANOVA, the $Scheff{\acute{e}}$ test, Pearson correlation coefficients, and a multiple regression analysis (SPSS 24.0 program). Results : Perceptions of life-sustaining treatment decisions and a sense of closeness (a constituent for the awareness of "a good death") were positively correlated with terminal care attitudes. The factors affecting terminal care attitudes were a clinical career in ICU (${\beta}=.20$, p =.035), a sense of closeness(${\beta}=.19$, p =.041), and the perception of a life-sustaining treatment decision (${\beta}=.22$, p =.017). This finding indicates that more than 10 years of experience in ICU, a greater sense of closeness, and a higher view of life-sustaining treatment decisions results in more positive attitudes toward terminal care. The explanatory power of these variables on terminal care attitudes was 14% (F=6.84, p < .001, Adj $R^2=.140$). Conclusion : A sense of closeness and the perception of life-sustaining treatment decisions were identified as the factors affecting terminal care attitudes. Thus, various programs must be developed to raise awareness among ICU nurses of "a good death" and perceptions of life-sustaining treatment decisions.

• Korean Journal of Adult Nursing
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• v.28 no.6
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• pp.669-679
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• 2016

Purpose: The purpose of this study was to explore the reported good service experiences from the perspective of elderly residents of long-term care facilities. Methods: Of those residents who are 65 years old or older, 14 residents whose length of stay were one month or longer and scores of the K-Mini Mental State Examination were 15 or higher were interviewed. The interview data formed the basis for the empirical statements about the reported nature of patients' experiences as residents of long-term care facilities. These data were used in concept mapping. Results: Through multidimensional scaling analysis and hierarchical cluster analysis, 62 core statements, two dimensions, and six clusters of good service experiences were derived. The two dimensions were classified as 'care centered-participation centered services' and as 'physical-emotional services.' Six cluster themes emerged as good service experiences: 'safety of care and treatment', 'responsible and supportive staff', 'comfort of living environment', 'mental well-being', and 'respect and communication'. Conclusion: The result of the study provides information about what experiences are important to older adults with cognitive impairment. The concept map can be used to develop a patient experience index for the elderly residents of long-term care facilities.

• The Journal of the Korea Contents Association
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• v.18 no.12
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• pp.624-638
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• 2018

The purpose of this study was to determine the perception of good death, knowledge and perception hospice palliative care among the nursing graduates. The subjects of this study were 241 nursing students in 4th grade in 8 universities nationwide. The results showed that the perception of good death was positively correlated with perception of hospice palliative care and knowledge of hospice palliative care with perception of hospice palliative care. The perception of good death was 3.28 points. Knowledge of hospice palliative care was 9.24 points. Perception of hospice palliative care was 4.07 points. Based on the results of this study, it is necessary to improve the curriculum to improve knowledge and perception of good death and hospice palliative care, and to develop various teaching methods and programs such as role play, simulation, and discussion.

• Journal of Korean Critical Care Nursing
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• v.13 no.3
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• pp.51-61
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• 2020

Purpose : This study aimed to explore and describe good nursing experiences of patients with cancer. Methods : Data were collected using individual in-depth interviews with 15 males and 8 females who were hospitalized in a Korean cancer hospital. The transcribed script was analyzed using Colaizzi's phenomenological method. Results : As a result, three theme clusters and nine themes were identified. The three theme clusters were as follows: "being kind and expert in every step along the cancer care trajectory," "taking an omnipotent mediator role supporting patients' well-being," and "providing professional care touching patients' mind and body." Three themes were assigned to each cluster to illustrate the given phenomena. Conclusion : Cancer patients wanted considerate understanding and sincere care from nurses while they experienced physical and emotional suffering owing to the cancer, treatment trajectory, and hospital system. To improve the quality of nursing care for cancer patients, patient-centered care combined with nurses' expertise in oncology care must be provided based on the insights from our study's findings.

• The Korean Journal of Health Service Management
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• v.10 no.3
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• pp.85-97
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• 2016

Objectives : In this study, the awareness of hospice and the perceptions on the need for visiting palliative care and what constitutes a good death of the citizens of Busan were investigated. The purpose of this study was to develop a hospice system based on the needs of the citizenry of Busan by seeking solutions for current hospice strategies. Methods : One thousand Busan citizens from 20 to 80 years of age were surveyed in this study. Results : Busan citizens defined a good death as spending less than one month of time in the actual process of dying at home between the ages of 80-89 years. They knew about hospice a little and were aware of its necessity. They also knew about the necessity of visiting palliative care and were interested in receiving it when appropriate but did not know much about it. Conclusions : First, there is a large difference between Busan citizens' expectations on what constitutes a good death and what a good death really is. Second, Hospice palliative care should be provided to the community. Third, the older the patient is, the more palliative care visits are necessary. Fourth, 40s and 50s must make preparations for hospice palliative care in their future.