Purpose: This phenomenological analysis was conducted to explore the experiences of college student volunteers in the field of pediatric palliative care. Methods: In-depth interviews were conducted with nine study participants who had experience volunteering with children receiving pediatric palliative care. The study analysis was conducted using the Colaizzi method, a rigorous qualitative research method, to develop “intra-group” comparisons among the study participants. Results: Through an analysis of the data, 51 themes, 18 theme clusters, and five main categories were derived. The results confirmed that the experience of university student volunteers in pediatric palliative care can be summarized as “awareness of the role of a volunteer,” “difficulties encountered while volunteering,” “efforts to overcome the difficulties of volunteer work,” “personal reflection,” and “awareness of life and death.” Conclusion The results of this study can be used as a practical guide for the effective management of volunteers in the pediatric palliative care setting.

PURPOSE: Despite recent advances in the surgical and postoperative management of infants with congenital heart disease, nutritional support for this population is often suboptimal. The purpose of this study was to develop a nutritional program for the postoperative period for infants who have had cardiac surgery and to evaluate effects of the program. METHODS: A quasi-experimental design with pretest and posttest measures was used. A newly developed nutritional program including a feeding protocol and feeding flow was provided to the study group (n=19) and usual feeding care to the control group (n=19). The effects of the feeding program were analyzed in terms of total feed intake, total calorie intake, gastric residual volume, and frequency of diarrhea. RESULTS: Calorie intake and feeding amount in the study group were significantly increased compared to the control group. However, the two groups showed no significant differences in gastric residual volume and frequency of diarrhea. CONCLUSION: The results indicate that the nutritional program used in the study is an effective nursing intervention program in increasing feeding amount and calorie intake in infants postoperative to cardiac surgery and does not cause feeding-related complications.
Diarrhea/complications/etiology ; Enteral Nutrition/*methods/standards ; Female ; Heart Diseases/*surgery ; Humans ; Infant ; Infant, Newborn ; Male ; Nutritional Requirements ; *Postoperative Care/methods ; Postoperative Complications ; Program Development ; Program Evaluation

BACKGROUND: Metastatic skin cancers are relatively uncommon, however, may forcast the diagnosis of internal malignancy. Therefore, early recognition can contribute to proper management. OBJECTIVE: We studied patients with metastatic skin cancer to find out average age, gender distribution, frequency of primary tumor, time interval between manifestation and primary cancer, and their clinical appearance, location, other metastatic sites and survival time. METHODS: We reviewed the medical records, clinical photographs and histopathologic records of 80 patients who had been diagnosed with metastatic skin cancer at the department of dermatology and pathology in Chonbuk National University Hospital during the last 19 years from January 1986 to December 2004. RESULTS: The mean age at the time of diagnosis was 58.8 years. The ratio of men to women was 1.05:1. The most frequent primary tumors were breast cancer (20.0%), lung cancer (15.0%), colorectal cancer (8.8%), head and neck cancer (8.8%), and gastric cancer (8.8%). Lung cancer in men and breast cancer in women were the most common primary cancers. The sites of metastatic skin cancer were widespread over the whole body. However, the abdomen and chest were the most common sites for metastases, because most cutaneous metastases occur at body regions near the primary tumor. Metastatic skin cancers usually presented as discrete, painless, hard nodules, with sudden onset. However, we also found ulcers, inflammatory patches, plaques and cystic masses as clinical manifestations of metastatic skin cancer. The mean interval time between manifestation and primary tumor was 23.5 months. Histopathological findings indicated that adenocarcinoma was the most common pathologic type, followed by squamous carcinoma, melanoma and small cell carcinoma. Metastatic skin cancers revealed grave prognosis. The mean survival time after diagnosis of metastatic skin cancer was 9.9 months. CONCLUSION: The incidence of metastatic skin cancer was much lower than in western countries, maybe because of genetic and racial differences. Overall incidence of common metastatic skin cancer was similar to that found in the literature, but our results showed a periodic difference according to primary cancer type, other organs metastasized, plus mean survival rate was 9.9 months, thereby confirming a poor prognosis of metastatic skin cancer.
Abdomen ; Adenocarcinoma ; Body Regions ; Breast Neoplasms ; Carcinoma, Small Cell ; Carcinoma, Squamous Cell ; Colorectal Neoplasms ; Dermatology ; Diagnosis ; Female ; Head and Neck Neoplasms ; Humans ; Incidence ; Jeollabuk-do ; Lung Neoplasms ; Male ; Medical Records ; Melanoma ; Neoplasm Metastasis ; Pathology ; Prognosis ; Skin Neoplasms* ; Skin* ; Stomach Neoplasms ; Survival Rate ; Thorax ; Ulcer

PURPOSE: Pediatric palliative care (PPC) is emphasized as standard care for children with life-limiting conditions to improve the quality of life. In Korea, a government-funded pilot program was launched only in July 2018. Given that, this study examined various PPC delivery models in other countries to refine the PPC model in Korea. METHODS: Target countries were selected based on the level of PPC provided there: the United Kingdom, the United States, Japan, and Singapore. Relevant literature, websites, and consultations from specialists were analyzed by the integrative review method. Literature search was conducted in PubMed, Google, and Google Scholar, focusing publications since 1990, and on-site visits were conducted to ensure reliability. Analysis was performed on each country's process to develop its PPC scheme, policy, funding model, target population, delivery system, and quality assurance. RESULTS: In the United Kingdom, community-based free-standing facilities work closely with primary care and exchange advice and referrals with specialized PPC consult teams of children's hospitals. In the United States, hospital-based specialized PPC consult teams set up networks with hospice agencies and home healthcare agencies and provide PPC by designating care coordinators. In Japan, palliative care is provided through several services such as palliative care for cancer patients, home care for technology-dependent patients, other support services for children with disabilities and/or chronic conditions. In Singapore, a home-based PPC association plays a pivotal role in providing PPC by taking advantage of geographic accessibility and cooperating with tertiary hospitals. CONCLUSION: It is warranted to identify unmet needs and establish an appropriate PPD model to provide need-based individualized care and optimize PPC in South Korea.
Adolescent ; Child ; Delivery of Health Care ; Disabled Children ; Financial Management ; Great Britain ; Health Services Needs and Demand ; Home Care Services ; Hospice Care ; Hospices ; Humans ; Japan ; Korea ; Methods ; Palliative Care ; Pediatrics ; Primary Health Care ; Quality of Life ; Referral and Consultation ; Singapore ; Specialization ; Tertiary Care Centers ; United States

PURPOSE: This study was performed to investigate the current status of pediatric palliative care provision and how it is perceived by the palliative care experts. METHODS: A descriptive study was conducted with 61 hospice institutions. From September through October 2017, a questionnaire was completed by experts from the participating institutions. Data were analyzed using SPSS 21.0. RESULTS: Among 61 institutions, palliative care is currently provided for pediatric cancer patients by 11 institutions (18.0%), all of which are concentrated in Seoul, Incheon and Gyeonggi and Gyengsang provinces; 85.2% of all do not plan to provide specialized pediatric palliative care in the future. According to the experts, the main barriers in providing pediatric palliative care were the insufficient number of trained specialists regardless of the delivery type. Experts said that it was appropriate to intervene when children were diagnosed with cancer that was less likely to be cured (33.7%) and to move to palliative care institutions when their conditions worsened (38.2%); and it was necessary to establish a specialized pediatric palliative care system, independent from the existing institutions for adult patients (73.8%). CONCLUSION: It is necessary to develop an education program to establish a nationwide pediatric palliative care centers. Pediatric palliative care intervention should be provided upon diagnosis rather than at the point of death. Patients should be transferred to palliative care institutions after intervention by their existing pediatric palliative care team at the hospital is started.
Adult ; Child ; Diagnosis ; Education ; Gyeonggi-do ; Hospices ; Humans ; Incheon ; Palliative Care ; Republic of Korea ; Seoul ; Specialization ; Terminal Care

Purpose: This study presents the process of designing workbooks for advance care planning appropriate for the Korean cultural setting and describes actual case studies. Methods: This study focused on single inductive case studies of the utilization of an advance care planning workbook and recruited individual participants. Results The workbook for adolescents contained six sessions and the workbook for children contained seven sessions. The workbook sessions led to four major discoveries: 1) considering the Korean cultural context, discussions on life and death must be held indirectly; 2) the role of the counselor as a supporter is crucial for the workbook to be effective; 3) the workbook must be accessible regardless of the seriousness of the illness; and 4) patients must be able to make their own choice between the workbook versions for children and adolescents. Six facilitating factors improved engagement: 1) the role of the counselor as a supporter; 2) building trust with the patient; 3) affirming freedom of expression on topics the patient wished to avoid talking about; 4) having discussions on what private information to keep secret and to whom the information can be disclosed; 5) discovering and regularly discussing relevant topics; and 6) regular communication and information-sharing with the patient’s medical service providers. Conclusion: It is necessary to build on actual case studies regarding workbooks for children and adolescents in order to expand the usage of these workbooks to all relevant medical institutions in Korea.

Purpose: This study presents the process of designing workbooks for advance care planning appropriate for the Korean cultural setting and describes actual case studies. Methods: This study focused on single inductive case studies of the utilization of an advance care planning workbook and recruited individual participants. Results The workbook for adolescents contained six sessions and the workbook for children contained seven sessions. The workbook sessions led to four major discoveries: 1) considering the Korean cultural context, discussions on life and death must be held indirectly; 2) the role of the counselor as a supporter is crucial for the workbook to be effective; 3) the workbook must be accessible regardless of the seriousness of the illness; and 4) patients must be able to make their own choice between the workbook versions for children and adolescents. Six facilitating factors improved engagement: 1) the role of the counselor as a supporter; 2) building trust with the patient; 3) affirming freedom of expression on topics the patient wished to avoid talking about; 4) having discussions on what private information to keep secret and to whom the information can be disclosed; 5) discovering and regularly discussing relevant topics; and 6) regular communication and information-sharing with the patient’s medical service providers. Conclusion: It is necessary to build on actual case studies regarding workbooks for children and adolescents in order to expand the usage of these workbooks to all relevant medical institutions in Korea.

Background: The rapid rise in coronavirus disease worldwide has drastically limited the availability of hospital facilities for patients. Residential treatment centers were opened in South Korea for the admission of asymptomatic or patients with mild symptoms. This study discusses the appropriateness of the admission criteria set by the centers in a pandemic situation, the prioritization of patients for admission, and ways to minimize the risk of self-isolation. Methods: A total of 217 low-risk patients (n=217) were admitted to the Nowon Residential Treatment Center between August 22 and October 14, 2020. The following criteria were met at the time of admission: patients (1) were asymptomatic or had mild symptoms, (2) had either a controlled or no underlying chronic disease, and (3) did not need oxygen treatment. Among them, 202 patients who were eligible for inclusion in the study were retrospectively investigated through periodic interviews. Results: Of the 202 patients, 153 satisfied the criteria for symptomatic isolation standards, and 25 for asymptomatic isolation standards. The clinical conditions of 24 patients were aggravated, and these patients were transferred to other hospitals, among which 12 had persistent fever and 13 were suffering dyspnea with oxygen saturation (SpO2) <95%. Conclusion In the event of another large-scale epidemic, it would be appropriate to prioritize accommodating patients who are elderly or have underlying diseases and self-isolate young patients with no underlying diseases and provide them with SpO2 meters and thermometers to self-measure SpO2 and body temperature.

The purposes of this study were to analyze the quality attributes, quality factors and customer satisfaction in school foodservice and to provide suggestions for improving school foodservice environments. The survey was distributed to different respondents (5,771 students, 2,045 parents, and 1,981 faculty members) at different types of schools (elementary school, middle school, and high school) on September 2010 in 16 cities and provinces. The data were analyzed using SPSS for descriptive analysis, one-way ANOVA, t-test and multiple linear regression analysis. First, all foodservice quality attributes were significant different by respondents and the faculty had higher scores than parents and students. A comparison of scores by respondents and distribution place demonstrated that classroom of student and parents had a higher score for quality attributes. The overall satisfaction with school foodservice was significant different by respondents and higher for classroom than for dining hall for student and parents. In comparison of annual data, there was decreased overall satisfaction and quality attributes in student and parents. Second, in the regression results, which showed the effects of the foodservice quality attributes on overall satisfaction by respondents and distribution place, improvements of 'food taste', 'pleasant foodservice environment', and 'kindness of employee' would increase satisfaction in most of the respondents. Third, the overall satisfaction with school foodservice was higher for nutrition teachers than dietitians for students and faculty. Therefore, the operators will need to make different efforts based on each customer needs to improve the overall satisfaction on school foodservice.
Surveys and Questionnaires ; Humans ; Linear Models ; Parents

Renal involvements of POEMS syndrome are not rare. In some reports, almost 50% of patients show proteinuria. There are some case reports of renal involvement in POEMS syndrome in Korea, but there are no reports about clinical features of renal involvement in POEMS syndrome in Korea and its frequency. We report a case of POEMS syndrome with nephropathy and clinical features of renal involvement in POEMS syndrome in Korea. The most frequent symptoms in POEMS syndrome in Korea were polyneuropathy, edema and ascites. Renal involvement was found in 40% of patients. If there were unknown cause of edema and renal failure when combined with polyneuropathy, considerations should be taken into patients for POEMS syndrome even though POEMS syndrome is very rare.
Ascites ; Edema ; Humans ; Korea* ; POEMS Syndrome* ; Polyneuropathies ; Proteinuria ; Renal Insufficiency