Purpose: Nurses’ acceptance of patient deaths enables them to practice holistic end-of-life care and pursue positive living. The place where most deaths occur in Korea has changed from home to medical institutions, making it necessary to understand the process through which nurses who practice end-of-life care accept patient deaths. This study aimed to obtain insight into nurses’ experiences of accepting patient deaths and to develop a practical theory regarding the context of this process. Methods: This qualitative study investigated nurses’ process of acceptance of patient deaths based on grounded theory. Results: A core category of this process was found to be “grieving over dying”, which consisted of the following steps: “being close by”, “being attentive”, “acknowledging together”, and “accompanying.” Conclusion This study established that nurses’ attentiveness toward dying people is due to their grief over patient deaths, and clarified Korean nurses’ process of accepting patient deaths and its related factors.

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

PURPOSE: The purpose of this paper is to identify a theoretical basis of end-of-life care by examining attributes of the concept of the nurses' acceptance of patient deaths. METHODS: Walker and Avant's approach to concept analysis was used. A literature study was performed to check the usage of the concept. To identify the attributes of the concept and come up with an operational definition, we analyzed 16 qualitative studies on nurses' experiences of death of patients, published in a national science magazine from 1999 to 2015. RESULTS: The nurses' acceptance of death of patients was identified as having four attributes: acceptance through mourning, attaining insight on life and death while ruminating life, facing with fortitude and practicing human dignity. Antecedents of the concept were experiences of patient's death, confusion and conflict, negative emotions, passive responses, denial of patients' death. The consequences of the concept were found as the holistic end-of-life care and active pursuit of life. CONCLUSION: This study on the attributes of the concept of the nurses' acceptance of death of patients and it's operational definition will likely lay the foundation for applicable end-of-life care mediations and theoretical development.
Denial (Psychology) ; Grief ; Humans ; Periodicals as Topic ; Personhood ; Walkers

BACKGROUND: The combination chemotherapy of gemcitabine and cisplatin has been proven effective in the treatment of advanced non-small cell lung cancer (NSCLC). However, the optimal schedule for administration of the two drugs has not yet been determined. We therefore started a phase II trial to evaluate efficacy, toxicity and dose intensity (DI) as three-week scheduled chemotherapy of gemcitabine and cisplatin. METHODS: Between October 2000 and March 2003, a total of 56 patients with stage IIIB and IV NSCLC were enrolled in this study. Treatment schedule consisted of gemcitabine 1200 mg/m2 i.v. on days 1 and 8, and cisplatin 80 mg/m2 i.v. on day 1 of each chemotherapy cycle followed by two weeks of rest. RESULTS: Forty-eight patients were evaluable in response and adverse effects in this study. The median DI was 529 mg/m2/week for gemcitabine (66%) and 22 mg/m2/week for cisplatin (83%). Partial response was observed in 23 patients. The overall response rate was 47.8% (95% confidence interval [CI], range from 33.6% to 61.9%). Anemia and thrombocytopenia were the main hematologic adverse effects, with 8.3% and 8.3% of patients experiencing grade III to IV toxicity, respectively. The median survival time was 11.78 months (95% CI, range from 8.59 to 14.97months). No significant differences in response rate were observed according to sex, age, histology and DI of gemcitabine and cisplatin. CONCLUSION: The 3-week-scheduled combination chemotherapy of gemcitabine and cisplatin has feasibility to treat advanced stage IIIB and IV NSCLC with modest adverse effects. The regimen deserves further evaluaton in a phase III prospective randomized trial.
Anemia ; Appointments and Schedules ; Carcinoma, Non-Small-Cell Lung ; Cisplatin* ; Drug Therapy ; Drug Therapy, Combination* ; Humans ; Thrombocytopenia

BACKGROUND: Measurement of the maximum oxygen uptake in patients with chronic obstructive pulmonary disease (COPD) has been used to determine the intensity of exercise and to estimate the patient's response to treatment during pulmonary rehabilitation. However, cardiopulmonary exercise testing is not widely available in Korea. The 6-minute walk test (6MWT) is a simple method of measuring the exercise capacity of a patient. It also provides high reliability data and it reflects the fluctuation in one's exercise capacity relatively well with using the standardized protocol. The prime objective of the present study is to develop a regression equation for estimating the peak oxygen uptake (VO2) for men with moderate to very severe COPD from the results of a 6MWT. METHODS: A total of 33 male patients with moderate to very severe COPD agreed to participate in this study. Pulmonary function testing, cardiopulmonary exercise testing and a 6MWT were performed on their first visits. The index of work (6Mwork, 6-minute walk distance [6MWD]xbody weight) was calculated for each patient. Those variables that were closely related to the peak VO2 were identified through correlation analysis. With including such variables, the equation to predict the peak VO2 was generated by the multiple linear regression method. RESULTS: The peak VO2 averaged 1,015+/-392 ml/min, and the mean 6MWD was 516+/-195 meters. The 6Mwork (r=.597) was better correlated to the peak VO2 than the 6MWD (r=.415). The other variables highly correlated with the peak VO2 were the FEV1 (r=.742), DLco (r=.734) and FVC (r=.679). The derived prediction equation was VO2 (ml/min)=(274.306xFEV1)+(36.242xDLco)+(0.007x6Mwork)-84.867. CONCLUSION: Under the circumstances when measurement of the peak VO2 is not possible, we consider the 6MWT to be a simple alternative to measuring the peak VO2. Of course, it is necessary to perform a trial on much larger scale to validate our prediction equation.
Exercise Test ; Humans ; Korea ; Linear Models ; Male ; Oxygen ; Pulmonary Disease, Chronic Obstructive ; Respiratory Function Tests