PURPOSE: In this study, the hospice nursing research trend in 1998~2017 was investigated by analyzing research articles on hospice nursing. METHODS: Literature search was performed with keywords of ‘nursing’ and ‘hospice on an academic research information service. Also reviewed were all articles published in the Korean Journal of Nursing Science and its 8 subcategory journals, the Korean Journal of Hospice and Palliative Care and the Korean Hospice Association from 1998 through 2017, except thesis papers. RESULTS: In 2013~2017, 79 articles (31.0%) were relevant, up over 7% from 61 articles (23.9%) in 2008~2012. The most studied field was psychology (92 papers, 36.2%) in the Korean Journal of Hospice and Palliative Care. Enrolled in most papers were patients with end-stage cancer (75, 29.5%), which is overwhelmingly high. Most studies used quantitative methods (183, 72.0%). Recognition was the most studied theme (62, 24.4%), and 16 of them focused on recognition of death (6.3%). Intervention studies totaled 34 (13.4%), and most of them (7, 2.8%) were conducted for palliative education. CONCLUSION: Most hospice nursing studies were quantitative studies, conducted with patients, and hospice nursing intervention programs were similar to each other. Thus, more studies with hospice patients and their families are needed. And more experimental and qualitative studies are needed to build an evidence-based nursing study environment. Considering how most studies examined psychological factors, physiological factors such as pain, a major issue in hospice care, should be analyzed in experimental studies to construct a pain intervention program for hospice patients.
Education ; Evidence-Based Nursing ; Hospice and Palliative Care Nursing ; Hospice Care ; Hospices ; Humans ; Information Services ; Nursing Research ; Nursing ; Palliative Care ; Psychology

PURPOSE: It is necessary to develop a proper payment system for more health care facilities to provide hospice and palliative cares. In deciding the proper level of payment for hospice per diem fee, willingness to pay (WTP) may provide one of the critical information. This study was conducted to determine WTP for hospice care and to analyze those factors affecting WTP. MATERIALS AND METHODS: A contingent valuation method with a double-bounded dichotomous-choice model was used. Interview survey was organized and conducted by a survey company from April 4 to 18, 2008. The mean WTP was calculated through an infinite integration of survival functions. RESULTS: The average willingness to pay was found to be 42,240 Korean won (KRW) (USD 35), with the amount becoming higher as hospice services were deemed more necessary or where average monthly household income was higher. The amount was also higher among male respondents than females. CONCLUSION: To compare this WTP with actual cost (32,500 KRW) (USD 27) for hospice care. To facilitate hospice service, hospice specific payment system should be developed. This study provides information regarding the general public's preference of hospice service and their WTP for hospice care, and it may be useful in the decision-making process.
Fees and Charges ; Female ; Health Care Costs ; Hospice Care/*economics/psychology ; Humans ; Male ; *Public Opinion ; Socioeconomic Factors

PURPOSE: Physician Orders for Life-Sustaining Treatment (POLST) form is a legal document for terminally ill patients to make medical decisions with physicians near the end-of-life. A multicenter prospective study was conducted to evaluate the feasibility of POLST administration in actual oncological practice. MATERIALS AND METHODS: Patients with terminal cancer, age ≥ 20 years, and capable of communicating were eligible. The primary endpoint was the completion rate of POLST. Data about physicians' or patients' barriers were also collected. RESULTS: From June to December 2017, 336 patients from seven hospitals were eligible. Median patient age was 66 years (range, 20 to 94 years); 52.7% were male; and 60.4% had poor performance status. Primary cancer sites were hepato-pancreato-biliary (26.2%), lung (23.2%), and gastrointestinal (19.9%). Expected survival duration was 10.6±7.3 weeks, with 41.2% receiving hospice care, 37.9% showing progression after cancer treatment, and the remaining patients were under active treatment (15.8%) or initially diagnosed with terminal cancer (5.1%). POLST forms were introduced to 60.1% of patients, and 31.3% signed the form. Physicians' barriers were reluctance of family (49.7%), lack of rapport (44.8%), patients' denial of prognosis (34.3%), lack of time (22.7%), guilty feelings (21.5%), and uncertainty about either prognosis (21.0%) or the right time to discuss POLST (16.6%). The patients' barriers were the lack of knowledge/understanding of POLST (65.1%), emotional discomfort (63.5%), difficulty in decision-making (66.7%), or denial of prognosis (14.3%). CONCLUSION: One-third of patients completed POLST forms, and various barriers were identified. To overcome such barriers, social engagement, education, and systematic support might be necessary.
Denial (Psychology) ; Education ; Feasibility Studies ; Hospice Care ; Humans ; Lung ; Male ; Prognosis ; Prospective Studies ; Terminally Ill ; Uncertainty

PURPOSE: The purpose of this study was to identify and understand nurses' experiences of the death of patients in geriatric hospitals. METHODS: Van Manen's hermeneutic phenomenological analysis was applied in the interpretation of experiential descriptions of seven nurses who had experienced the death of patients in a geriatric hospital. RESULTS: The essential subjects derived from the experience of the nurses on the death of patients in a geriatric hospital are covered in the following 7 themes. 'Placed in death site', 'Difficult repetition of death and farewell', 'Emotional waves that rushes in after farewell', 'Dilemmas in a place with no preparation to greet expected death', 'Getting dull from continually being struck with sorrow', 'Being together with living death', and 'Showing courtesy for a good farewell and living well'. CONCLUSION: The results of this research will contribute to the development of policy on all the deaths of patients in geriatric hospitals and suggest basic data that need to be applied in real practice and directions to introduce plans for realistic improvements in nursing care of deathbed patients in geriatric hospitals.
Adult ; Attitude to Death ; Emotions ; Female ; Hospice Care/*psychology ; Hospices ; Humans ; Interviews as Topic ; Male ; Middle Aged ; Nurses/*psychology

OBJECTIVE: To investigate the influence of hospice care on the life quality and psychological state of aged mortal inpatients. METHODS: Seventy-six aged patients were randomly divided into 2 groups (n=38). The research group was treated with hospice care, while the control group was treated with conventional nursing. Before and after more than one month of the interference, the quality of life, social support, satisfied degree, anxiety, and depression mood were investigated. RESULTS: All the indexes, such as total scale of life quality, appetite, spirit, sleep, family comprehension and coordination, recognition of cancer, attitude to therapy, and facial expression of the mortal inpatients after the interference, were raised and higher than those of the controls (P<0.05 or P<0.01). Life satisfaction index and the total scale of social support and subjective support, utilization ratio of support were raised and higher than those of the controls (P<0.05 or P<0.01). The level of anxiety and depression was decreased and lower than the control (P<0.05 or P<0.01). CONCLUSION Hospice care can raise the life quality, subjective support, utilization ratio of support and life satisfaction of aged mortal inpatients. It could decrease the negative mood, such as anxiety and depression and improve the psychological state.
Aged ; Anxiety ; nursing ; Hospice Care ; psychology ; Humans ; Inpatients ; Neoplasms ; nursing ; psychology ; Personal Satisfaction ; Quality of Life ; Surveys and Questionnaires

PURPOSE: The purpose of this study was to develop and validate a hospice / palliative care performance measure which would cover more than just physical symptoms or quality of life. METHODS: Through an intensive literature review, the author chose questions that measured aspects of physical, emotional, spiritual, social, or practical domains pertinent to hospice / palliative care for inclusion in the scale. Content validation of the questions was established by 15 hospice / palliative care professionals. A preliminary Hospice Palliative Care Performance Scale (HPCPS) of 20 questions was administered to 134 pairs of terminal cancer patients from 5 hospice palliative care units and their main family caregiver. A validation study was conducted to evaluate construct validity and internal consistency. RESULTS: Factor analysis showed 14 significant questions in five subscales; Physical, Emotional, Spiritual, Social, and Patient' rights. There were no significant differences between the ratings by patients and family members except for three out of the 14 questions. The measure demonstrated construct validity, and Cronbach's alpha of the subscales ranged from .73 to .79. CONCLUSION: The HPCOS demonstrated acceptable validity and reliability. It can be used to assess effectiveness of hospice / palliative care for terminal cancer patients in practice and research.
Aged ; Caregivers/psychology ; Factor Analysis, Statistical ; Female ; Hospice Care/*standards ; Humans ; Male ; Middle Aged ; Outcome Assessment (Health Care)/standards ; Palliative Care/*standards ; Program Development ; Questionnaires

PURPOSE: The purpose of this study was to further understanding of the experience in acceptance of hospice by patients with terminal cancer and to explore the structure of this experience. METHODS: A phenomenological methodology was used for the study. Participants were nine patients who were admitted to the hospice unit of a university hospital. In-depth interviews were done for data collection and the data were analyzed using Colaizzi's method. RESULTS: Four categories, eight theme clusters and 18 themes were identified for the experience in acceptance of hospice by patients with terminal cancer. The three categories were 'Hope for a comfortable death', 'Overcoming barrier of prejudice about hospice', 'Incessant craving for life', 'The last consideration for self and family'. CONCLUSION: While accepting the hospice care, participants experienced inner conflict between giving up medical treatments that prolong life and choosing a comfortable death, and also experienced an incessant craving for life. By accepting hospice care, they showed a human dignity that entails careful concerns for both self and family members.
Adaptation, Psychological ; Adult ; Aged ; Caregivers/psychology ; Female ; *Hospice Care ; Hospitals, University ; Humans ; Interviews as Topic ; Male ; Middle Aged ; Neoplasms/*psychology ; *Qualitative Research ; Terminally Ill

BACKGROUND: Few studies have specifically addressed quality of life issues for elderly hospice patients. The purpose of this study is to explore various factors and service patterns of the quality of life of end-of-life care for the elderly. METHODS: We collect the data and make small-scale exploratory study via semi-structured individual interviews. Data were collected from the family of 2 elderly cancer patients receiving hospice services, and the data were analyzed qualitatively. RESULTS: After investigation, we found that elderly people in hospice care, regardless of age, are suffering from physical and psychological pain and do not want to spend the rest of their lives in the hospital, but want to die in their own homes. CONCLUSIONS Both hospitalization and in-home care can improve resource utilization, and the key is to find various factors affecting the quality of life. Improving the quality of life is what patients and their families need most.
Adult ; Aged ; Aged, 80 and over ; China ; Female ; Health Personnel ; psychology ; statistics & numerical data ; Hospice Care ; psychology ; statistics & numerical data ; Humans ; Male ; Middle Aged ; Neoplasms ; therapy ; Patients ; psychology ; statistics & numerical data ; Quality of Health Care ; statistics & numerical data ; Social Work

PURPOSE: This preliminary study is aimed at developing standardized tools for psycho-social assessment of patients in needs for hospice/palliative care. To accomplish the purpose, investigators examined effects of perceptions of social workers on the importance of psycho-social domains of assessment in hospice/palliative care settings. Moreover, investigators paid attention to variances of perceptions of social workers' along with types of institution and credentials of those family settings. METHODS: A form of questionnaire was first explored from an initial interview assessment of 10 government-certified hospice care providers and a literature review, second constructed with eight domains and 80 items, and sent by e-mail to 55 institutions and hospitals providing hospice/palliative cares in Korea. Lastly, a total of 31 agencies returned with a completed responses and consent form (56% response rate). SPSS program (version 18.0) was used for data analysis. RESULTS: Study found that social workers perceived patients' family background (m=4.53, 5-point scale) as the most important assessment domain, whereas economic conditions (4.06 point) the least important. Social workers' perception varied by credentials (i.e., license types, training, full-time position, types of care facility). CONCLUSION: Based upon study findings, investigators can conclude strong needs for developing a assessment tool that measures multiple domains (i.e., psychological, social and ecological aspects) of patients. A standardized assessment tool should be structured with 2 axis (center/core and expanded/peripheral) and tailored for institution type. Second, professional trainings must be provided by strengthening legal institutionalization and fostering qualified social workers with full responsibilities of hospice and palliative care patients.
Axis, Cervical Vertebra ; Consent Forms ; Electronic Mail ; Foster Home Care ; Hospice Care ; Hospices* ; Humans ; Institutionalization ; Korea ; Licensure ; Palliative Care* ; Psychology ; Research Personnel ; Self-Assessment ; Social Workers* ; Statistics as Topic ; Surveys and Questionnaires

PURPOSE: The purpose of this study was to examine the effects of aroma hand massage on pain, state anxiety and depression in hospice patients with terminal cancer. METHODS: This study was a nonequivalent control group pretest-posttest design. The subjects were 58 hospice patients with terminal cancer who were hospitalized. Twenty eight hospice patients with terminal cancer were assigned to the experimental group (aroma hand massage), and 30 hospice patients with terminal cancer were assigned to the control group (general oil hand massage). As for the experimental treatment, the experimental group went through aroma hand massage on each hand for 5 min for 7 days with blended oil-a mixture of Bergamot, Lavender, and Frankincense in the ratio of 1:1:1, which was diluted 1.5% with sweet almond carrier oil 50 ml. The control group went through general oil hand massage by only sweet almond carrier oil-on each hand for 5 min for 7 days. RESULTS: The aroma hand massage experimental group showed more significant differences in the changes of pain score (t=-3.52, p=.001) and depression (t=-8.99, p=.000) than the control group. CONCLUSION: Aroma hand massage had a positive effect on pain and depression in hospice patients with terminal cancer.
Aged ; Anxiety/*therapy ; Aromatherapy ; Boswellia/drug effects ; Data Interpretation, Statistical ; Depression/*therapy ; Female ; *Hospice Care ; Humans ; Male ; Massage ; Middle Aged ; Neoplasms/*psychology/therapy ; Oils, Volatile/therapeutic use ; Pain/*therapy ; Pain Measurement ; Plant Oils/therapeutic use ; Stress, Psychological