PURPOSE: The purpose of this study is to examine how wish granting influences children with life-threatening medical conditions when it comes to their adaptation to disease with a focus on the mediating effect of resilience and stress caused by disease. METHODS: From January 2, 2015 through January 12, 2015, a survey was conducted on 292 children with life-threatening diseases whose wishes were granted through Make-A-Wish Korea. The data were collected using the impact of a wish scale, the Children's Adjustment to Cancer Inventory, the Childhood Cancer Stressor Inventory, and the resilience scale in children with chronic illness. The data were analyzed using SPSS/WIN 20.0 and Amos 21.0. RESULTS: Satisfaction with the wish granting program enhances resilience, and resilience affects stress caused by medical conditions as well as adaptation to disease. Also, stress caused by medical conditions influences adaptation to disease. CONCLUSION: Wish granting is effective in both facilitating chronically ill children to adjust to disease and reduce their stress from disease. Thus, children with life-threatening medical conditions could be assisted or motivated to adjust to disease by improving satisfaction achieved by wish granting.
Adaptation, Psychological ; Child Welfare ; Child* ; Chronic Disease ; Financing, Organized* ; Humans ; Korea ; Negotiating* ; Resilience, Psychological ; Social Adjustment ; Stress, Physiological ; Stress, Psychological

PURPOSE: This study was conducted to evaluate the effects of integrated palliative care intervention on quality of life in terminally ill patients. METHODS: A comprehensive literature search was performed via PubMed, Cochrane Library CENTRAL, LWW (Ovid), CINAHL and several Korean databases. The main search strategy was to combine terms indicating palliative care intervention, presence of terminal illness and study design. Methodological quality was assessed using Cochrane's Risk of Bias for randomized studies and Risk of Bias Assessment tool for non-randomized studies. Data were analyzed by the Stata 10 program. RESULTS: Eight clinical trials met the inclusion criteria with a total of 356 participants. Integrated palliative care interventions were administered for a mean of 6.5 weeks, 5.6 sessions and an average of 47.8 minutes per session. Effect sizes were heterogeneous, and subgroup analysis was done. Integrated palliative care interventions had a significant effect on quality of life (ES=1.83, P=0.018, l2=92%), spiritual well-being (ES=0.78, P=0.040, l2=0), depression (ES=0.86, P<0.001, l2=32) and anxiety (ES=0.69, P=0.041, l2=71.1). But integrated palliative care interventions had no significant effect on pain (ES=0.365, P=0.230, l2=69.8). CONCLUSION: Results support findings that integrated palliative care interventions were helpful in lessening depression and anxiety and improving quality of life and spiritual well-being, however, the interventions did not assist pain management in terminal cancer patients. These findings suggest that various integrated palliative care interventions can assist terminal cancer patients with better quality of life in the socio-psycho-spiritual dimension.
Anxiety ; Bias (Epidemiology) ; Depression ; Humans ; Pain Management ; Palliative Care* ; Quality of Life* ; Terminally Ill

PURPOSE: As the National Health Insurance Service (NHIS) began to cover home oxygen therapy (HOT) services from 2006, it is expected that the new services have contributed to overall positive outcome of patients with chronic obstructive pulmonary disease (COPD). We examined whether the usage of HOT has helped slow down the progression of COPD. METHODS: We examined hospital claim data (N=10,798) of COPD inpatients who were treated in 2007~2012. We performed chi2 tests to analyze the differences in the changes to respiratory impairment grades. Multiple logistic regression analysis was used to identify factors that are associated with the use of HOT. Finally, a generalized linear mixed model was used to examine association between the HOT treatment and changes to respiratory impairment grades. RESULTS: A total of 2,490 patients had grade 1 respiratory impairment, and patients with grades 2 or 3 totaled 8,308. The OR for use of HOT was lower in grade 3 patients than others (OR: 0.33, 95% CI: 0.30~0.37). The maintenance/mitigation in all grades, those who used HOT had a higher OR than non-users (OR: 1.41, 95% CI: 1.23~1.61). CONCLUSION: HOT was effective in maintaining or mitigating the respiratory impairment in COPD patients.
Home Care Services ; Humans ; Inpatients ; Logistic Models ; Lung Diseases, Obstructive* ; National Health Programs ; Oxygen Inhalation Therapy ; Oxygen* ; Pulmonary Disease, Chronic Obstructive ; Respiratory Mechanics

PURPOSE: We aimed to investigate how serum vitamin D levels are related to survival of terminally ill cancer patients. METHODS: From May 2012 through June 2013, a retrospective chart review was performed on 96 hospice patients. Univariate and multivariate logistic regression analyses were conducted to identify factors associated with severe vitamin D deficiency and Coxcy and Coxional hazard analyses were used to evaluate effects on survival. RESULTS: The mean vitamin D level in patients was 8.60+/-7.16 ng/ml. Vitamin D was severely deficient (<10 ng/ml) in 75 patients (78.2%), deficient (10~20 ng/ml) in 13 patients (13.5%), relatively insufficient (21~29 ng/ml) in five patients (8.3%) and sufficient ((t ng/ml) in three patients (3.1%). Hyperbilirubinemia (> or =1.2 g/dl) was the only factor associated with severe vitamin D deficiency according to the multiple logistic regression analysis (Odds ratio, OR=18.48, P<0.05). Although hyperbilirubinemia showed a strong association with survival (Hazard ratio, HR=2.25, P<0.01), no association was found between severe vitamin D deficiency and survival (HR=1.15, P>0.05) in Cox's proportional hazard analysis. CONCLUSION: Although serum vitamin D levels were severely low in terminally ill cancer patients, we found no association between severe vitamin D deficiency and patient survival.
Hospices ; Humans ; Hyperbilirubinemia ; Logistic Models ; Retrospective Studies ; Survival Analysis ; Terminal Care ; Terminally Ill* ; Vitamin D Deficiency ; Vitamin D*

PURPOSE: The purpose of this study was to explore the level of occupational stress and emotional intelligence in hospice volunteers. METHODS: Participants were 158 hospice volunteers at hospitals in B city. Occupational stress, emotional intelligence, and general characteristics of hospice volunteers were measured. The data were analyzed with descriptive statistics, t-tests, ANOVA, and Pearson's correlation coefficients. RESULTS: The mean score for occupational stress was 2.16 points out of 4 and 4.65 out of 7 for emotional intelligence. The scores for occupational stress and emotional intelligence were significantly different by educational level and monthly income in hospice volunteers. Occupational stress was negatively correlated with emotional intelligence (r=-0.196, P=0.013). CONCLUSION: A continuous educational program is needed to offer volunteers with new hospice-related trends. To ensure quality care for patients and their families, it should be helpful to encourage hospice volunteers to build a social network to enhance their emotional intelligence.
Emotional Intelligence* ; Hospice Care ; Hospices* ; Humans ; Intelligence ; Stress, Psychological ; Volunteers*

PURPOSE: Fatigue, energy loss, feeling of helplessness, poor appetite, pain besides general weakness are major symptoms presented to terminally ill cancer patients. These symptoms are similar to those that appeared with adrenal insufficiency. Also, for terminally ill cancer patients who are hospitalized for palliative care, opioid agents are prescribed to control moderate to severe pain. We studied the relationship of opioid agents and adrenal insufficiency. METHODS: From November 2013 through June 2014, we monitored the serum level of cortisol and dehydroepiandrosterone sulfate (DHEAS, serum) in 55 cancer patients who were over 18 years old and were treated at a hospice center. We also checked the treatment period and dosage of opioid agents. RESULTS: The DHEAS level, treatment period and dosage of opioid agents did not have significant correlation. Correlation between the serum cortisol level and the opioid agent treatment period was not significant either, but the serum cortisol level was positively correlated with the dosage of opioid agents (P value 0.0322). CONCLUSION: This study did not identify a novel link between treatment period, dosage of opioid agents and adrenal insufficiency. But, the DHEAS level was mostly below the normal level in patients who were treated with opioid agents.
Adrenal Insufficiency ; Analgesics, Opioid* ; Appetite ; Dehydroepiandrosterone Sulfate ; Dehydroepiandrosterone* ; Fatigue ; Hospices ; Humans ; Hydrocortisone* ; Palliative Care ; Terminally Ill

PURPOSE: The aim of this study was to investigate attitudes toward death according to personality types and to suggest the need to develop related hospice programs. METHODS: Personality types were identified by the Korean version of the Myers-Briggs Type Indicator (MBTI) Form G. A questionnaire with 26 five-point Likert items was used to survey participants' attitudes toward death. RESULTS: The ESFP personality type was most common (20%) among available 100 participants. Significant differences were observed in the attitudes towards death preparation according to personality type s. Participants with personality preference types E, T and J showed positive attitudes (P<0.05) toward death, but no significant differences were shown based on the SN index. CONCLUSION: The attitudes toward death differed by personality types. Therefore, this study points to the need to develop diverse hospice programs based on the personality types.
Hospice Care ; Personality Inventory ; Surveys and Questionnaires

In Korea, modern art therapy was developed in the 1960s and 1970s in the form of supplementary activities for patients in psychiatry. Along with the foundation of the Korean Association for Clinical Art in 1982 by psychiatric doctors, the therapy involved more various arts forms such as music, art, dance, poetry therapy, and psychodrama. More organizations with specific expertise opened such as the Korean Art Therapy Association, Korean Art Therapy Association, etc. in the 1990s and the Korea Arts Therapy Institute in 2001. As of April 2015, the members of the Korean Art Therapy Association total 15,000, including 6,200 regular members. The arts in integrative arts therapy (IAT) is an individual's creative activity which is related to his inner world, and the forms of IAT include music, drawing, dance and poetry therapy. From the aspect of phenomenology, IAT is psychophysical therapy involving the arts that helps patients recognize and perceive their experiences with an aim of at a recovery of the body and creativity from the phenomenological aspect. It is also a therapeutic activity that targets growth and development of the body and mind. Meta-analysis of the effects of art therapy with a focus on that involving music, drawing, dance movement and IAT in recent years in Korea, significant effects were observed in all factors but physical function. The biggest effect was mentality adaptation followed by activity adaptation and physiology. In the run up to the implementation of the daily flat-rate system for the health insurance reimbursement for palliative care in July 2015, the Ministry of Health and Welfare is reviewing the coverage of music therapy, drawing therapy and flower therapy, which are currently practiced by 56 hospice institutes in Korea. This is a meaningful step because the coverage of hospice and palliative care came after that of art therapy for psychiatric patients was approved in 1977. Still, there is a need clarify the therapeutic mechanism by exploring causality among the treatment media, mediation type and treatment effects. To address the issue of indiscriminately issued licenses, more efforts are needed to ensure expertise and identity of the licensed therapists through education, training and supervision.
Academies and Institutes ; Art Therapy* ; Creativity ; Education ; Flowers ; Growth and Development ; Hospices* ; Humans ; Insurance, Health, Reimbursement ; Korea ; Licensure ; Music ; Music Therapy ; Negotiating ; Organization and Administration ; Palliative Care* ; Physiology ; Psychodrama

PURPOSE: Recently, health policy making is increasingly based on evidence. Therefore, Korean Terminal Cancer Patient Information System (KTCPIS) was developed to meet such need. We aimed to report its developmental process and statistics from 6 months data. METHODS: Items for KTCPIS were developed through the consultation with practitioners. E-Velos web-based clinical trial management system was used as a technical platform. Data were collected for patients who were registered to 34 inpatient palliative care services, designated by Ministry of Health, Welfare, and Family Affairs, from 1st of January to 30th of June in 2009. Descriptive statistics were used for the analysis. RESULTS: From the nationally representative set of 2,940 patients, we obtained the following results. Mean age was 64.8+/-12.9 years, and 56.6% were male. Lung cancer (18.0%) was most common diagnosis. Only 50.3% of patients received the confirmation of terminal diagnosis by two or more physicians, and 69.7% had an insight of terminal diagnosis at the time of admission. About half of patients were admitted to the units on their own without any formal referral. Average and worst pain scores were significantly reduced after 1 week when compared to those at the time of admission. 73.4% faced death in the units, and home-discharge comprised only 13.3%. Mean length of stay per admission was 20.2+/-21.2 days, with median value of 13. CONCLUSION: Nationally representative data on the characteristics of patients and their caregiver, and current practice of service delivery in palliative care units were obtained through the operation of KTCPIS.
Caregivers ; Evidence-Based Practice ; Health Policy ; Humans ; Information Systems ; Inpatients ; Korea ; Length of Stay ; Lung Neoplasms ; Male ; Palliative Care ; Quality of Health Care ; Referral and Consultation

PURPOSE: This study was to identify the death recognition, meaning in life, and death attitude of participants in the death education program. METHODS: A survey was conducted, and 205 data were collected. Descriptive statistics, chi-square-test, ANOVA, and Duncan test were used. RESULTS: 1) The followings were the characteristics of death recognition shown by the participants. Over half of the participants said that they had given some thoughts on their deaths, that they had agreeable view on death acceptance, and that diseases and volunteer works made them think about their deaths. Moreover, suffering, parting with family and concerns for them, etc. were the most common reasons for the difficulty of accepting death. As for 'the person whom I discuss my death with', spouse, friend, and son/daughter were the most chosen in this order. Lastly, the funeral type that most of the participants desired was cremation. 2) The means of meaning in life and death attitude were 2.92+/-0.29 and 2.47+/-0.25, respectively. There were significant differences between health status, meaning in life and death attitude. 3) A significant positive corelationship was found between meaning in life and death attitude (r=0.190, P=0.001). CONCLUSION: For an effective death education program that would fit each individual's situation, an educational content that can make a person understand the meaning of his or her life and death, includes knowledge to lessen the fear and anxiety of death, and helps a person heal from the loss of a family member is absolutely necessary.
Anxiety ; Cremation ; Friends ; Humans ; Quality of Life ; Spouses ; Stress, Psychological