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Spirituality, Death Anxiety and Burnout Levels among Nurses Working in a Cancer Hospital.

Korean Journal of Hospice and Palliative Care.2013;16(4):264-273. doi:10.14475/kjhpc.2013.16.4.264

PURPOSE: This study is to explore the relationships among spirituality, death anxiety and burnout level of nurses caring for cancer patients. METHODS: Participants were 210 nurses from a cancer hospital in Seoul. Data were collected from April until June 2012 and analyzed using t-test, one-way ANOVA, Scheffe's test, and Pearson's correlation coefficient. RESULTS: The mean score for spirituality was 3.51 out of six. Among sub-categories, the one that scored the highest was the purpose and meaning of life, followed by unifying interconnectedness, inner resources and transcendence. The mean score for death anxiety was 3.22, and the sub-categories in the order of high score were denial of death, awareness of the shortness of time, pure death anxiety and fear of matters related to death. For the burnout, the mean was 4.10. Among sub-categories, highest mark was found with emotional exhaustion, followed by depersonalization and personal accomplishment. The spirituality level was negatively correlated with those of death anxiety and burnout. Death anxiety was positively correlated with burnout levels. Nurses with the higher spirituality level also had a higher level of education and experience of spiritual education, believed in the existence of God. In contrast, death anxiety and burnout levels were higher among those with a lower level of education, atheists, and for those who answered that religion has little influence on life. CONCLUSION: Thus, it is necessary to provide spiritual interventions for nurses who care for cancer patients to develop their spirituality, reduce death anxiety and prevent them from burning out easily.
Anxiety* ; Burnout, Professional ; Burns ; Cancer Care Facilities* ; Denial (Psychology) ; Depersonalization ; Education ; Humans ; Spirituality*

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Spirituality and Stress in Mental Health Social Workers.

Chang Gon KIM

Korean Journal of Hospice and Palliative Care.2013;16(4):253-263. doi:10.14475/kjhpc.2013.16.4.253

PURPOSE: This study was conducted to analyze the association between spirituality and stress of mental health social workers, which could be used in development of a program to help them manage stress and offer spiritual support. METHODS: Participants were 154 mental health social workers in Korea. Data were collected from November 1 through November 30, 2011. The study employed the Korean version of the Spirituality Scale and Psychosocial Well-being Index-Short Form (PWI-SF). Data were analyzed using SPSS/Windows 17.0. RESULTS: The mean score for the Spirituality Scale was 3.63 and for PWI-SF 18.78. Spirituality scores showed a significant difference among participants by age, education, religion and marital status. Psychosocial stress scores also significantly differed by marital status. Spirituality scores were negatively correlated with psychosocial stress scores (r=-0.548, P<0.001). CONCLUSION: In this study, a significant negative association was found between spirituality and stress in mental health social workers in Korea. A follow-up study with a larger sample of participants is needed to confirm these findings.
Education ; Korea ; Marital Status ; Mental Health* ; Social Workers* ; Spirituality* ; Stress, Psychological

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Perception and Knowledge of Hospice Care and Attitude toward Death Held by Medical Professionals from the Same Region in Korea.

Young Eun LEE ; Eun Joung CHOI ; Joung Suk PARK ; Seong Hoon SHIN

Korean Journal of Hospice and Palliative Care.2013;16(4):242-252. doi:10.14475/kjhpc.2013.16.4.242

PURPOSE: The purpose of this study was to examine medical professionals' perception and knowledge of hospice and palliative care (HPC) and attitude toward death. METHODS: The survey was performed on 84 physicians and 172 nurses in Busan, Korea. Data were collected from April 5, 2012 to April 30, 2012. RESULTS: Regarding the purpose of HPC, the most popular perception was "To alleviate pain and accommodate comfort" among both physicians and nurses. For the need for HPC, "Terminal patients need a separate ward for emotional fluctuation" the answer chosen by both groups the most. Both groups scored low on knowledge of HPC. For pain and symptom management, physicians scored higher than nurses (physicians: 6.97+/-1.82, nurses: 5.68+/-1.93, P<0.001). CONCLUSION: Considering the survey results, we suggest development of a program to improve medical professionals' perception and knowledge of HPC and attitude toward death.
Hospice Care* ; Hospices* ; Humans ; Korea* ; Palliative Care

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Advance Care Planning: Preliminary Report of Differences and Similarities between Korean and Korean American.

Jin Hee PARK

Korean Journal of Hospice and Palliative Care.2013;16(4):232-241. doi:10.14475/kjhpc.2013.16.4.232

PURPOSE: This study was conducted to do preliminary report of differences and similarities between Koreans residing in Korea and Korean Americans residing in America regarding their awareness of end-of-life care, attitudes toward advance care planning, truth telling, and preferred decision-making model. METHODS: Two participating groups were selected: a) Koreans residing in Korea, and b) Koreans Americans who had resided in the United States for at least 20 years. 25 Koreans and 23 Korean Americans who were older than 65 years old participated in this study. They were asked via a self-administered questionnaire that contained demographic questions and questions about end-of-life decision making regarding awareness of end-of-life care, attitudes toward advance care planning, truth telling, and preferred decision-making model. A Chi-square was used to measure differences between Koreans' and Korean Americans planning. A P value of less than 0.5 was considered significant. Data analysis was performed using SPSS 18.0. RESULTS: In some aspects of awareness of end of life care, attitudes toward advance care planning, and truth telling, both groups had similar opinions. However, there were significant differences between groups in the necessity of end of life documentation, preferential informing the truth, and preferred decision making model. CONCLUSION: There were similarities and differences regarding some end of life issues between the Koreans and the Korean Americans.
Advance Care Planning* ; Americas ; Asian Americans* ; Decision Making ; Hospice Care ; Humans ; Korea ; Republic of Korea ; Statistics as Topic ; Terminal Care ; United States ; Surveys and Questionnaires

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The Impact of Nurses' Attitude toward Dignified Death and Moral Sensitivity on Their End-of-Life Care Performance.

Kae Hwa JO ; Yeon Ja KIM

Korean Journal of Hospice and Palliative Care.2013;16(4):223-231. doi:10.14475/kjhpc.2013.16.4.223

PURPOSE: This study was conducted to explore how nurses' attitude toward dignified death and moral sensitivity affect their end-of-life care performance. METHODS: Study participants were 172 nurses who work at university hospitals in a metropolitan city in Korea. Data were collected from June 20 through August 13, 2012 using the Dignified Death Scale, Moral Sensitivity Scale, and End-of-Life Care Performance Scale. Data were analyzed using the SPSS/WIN 19.0 program. RESULTS: Factors affecting nurses' end-of-life care performance included moral sensitivity, dignified death and education level. CONCLUSION: Moral sensitivity, dignified death and education level should be considered when developing an educational program for nurses' end-of-life care performance.
Education ; Hospitals, University ; Korea ; Terminal Care

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Nurses' Emotional Responses and Ethical Attitudes towards Elderly Patients' DNR Decision.

Junghee MUN ; Sumi KIM

Korean Journal of Hospice and Palliative Care.2013;16(4):216-222. doi:10.14475/kjhpc.2013.16.4.216

PURPOSE: The purpose of this study was to examine nurses' emotional responses and ethical attitudes towards elderly patients' Do-Not-Resuscitate (DNR) decision. METHODS: Data were collected using a questionnaire which was filled out by 153 nurses who worked in nursing homes and general hospitals. Data were analyzed using real numbers, percentages, means, standard deviations and Pearson's correlation coefficients with SPSS 19.0 program. RESULTS: The average score for ethical attitudes towards the DNR decision was 2.68 out of 4. Under the ethical attitudes category, the highest score was found with a statement that said 'Although they will not perform cardiopulmonary resuscitate (CPR), it is right to do their best with other treatments for DNR Patients'. Items regarding emotional responses to the DNR decision, the average score was 2.36 out of 4. Among them, the highest score was achieved on 'I understand and sympathize'. No significant correlation was found between ethical attitudes and emotional responses in relation to patients' DNR decision (r=-0.12, P=0.13). CONCLUSION: Regarding elderly patients' DNR decision, nurses showed somewhat highly ethical attitudes and slightly positive emotional response. A follow-up study is needed to investigate variables that affect our results.
Aged* ; Ethics ; Hospitals, General ; Humans ; Nursing Homes ; Resuscitation Orders ; Surveys and Questionnaires

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Management of Non-pain Symptoms in Terminally Ill Cancer Patients: Based on National Comprehensive Cancer Network Guidelines.

Hye Ran LEE

Korean Journal of Hospice and Palliative Care.2013;16(4):205-215. doi:10.14475/kjhpc.2013.16.4.205

Most terminally ill cancer patients experience various physical and psychological symptoms during their illness. In addition to pain, they commonly suffer from fatigue, anorexia-cachexia syndrome, nausea, vomiting and dyspnea. In this paper, I reviewed some of the common non-pain symptoms in terminally ill cancer patients, based on the National Comprehensive Cancer Network (NCCN) guidelines to better understand and treat cancer patients. Cancer-related fatigue (CRF) is a common symptom in terminally ill cancer patients. There are reversible causes of fatigue, which include anemia, sleep disturbance, malnutrition, pain, depression and anxiety, medical comorbidities, hyperthyroidism and hypogonadism. Energy conservation and education are recommended as central management for CRF. Corticosteroid and psychostimulants can be used as well. The anorexia and cachexia syndrome has reversible causes and should be managed. It includes stomatitis, constipation and uncontrolled severe symptoms such as pain or dyspnea, delirium, nausea/vomiting, depression and gastroparesis. To manage the syndrome, it is important to provide emotional support and inform the patient and family of the natural history of the disease. Megesteol acetate, dronabinol and corticosteroid can be helpful. Nausea and vomiting will occur by potentially reversible causes including drug consumption, uremia, infection, anxiety, constipation, gastric irritation and proximal gastrointestinal obstruction. Metoclopramide, haloperidol, olanzapine and ondansetron can be used to manage nausea and vomiting. Dyspnea is common even in terminally ill cancer patients without lung disease. Opioids are effective for symptomatic management of dyspnea. To improve the quality of life for terminally ill cancer patients, we should try to ameliorate these symptoms by paying more attention to patients and understanding of management principles.
Analgesics, Opioid ; Anemia ; Anorexia ; Anxiety ; Benzodiazepines ; Cachexia ; Comorbidity ; Constipation ; Delirium ; Depression ; Dyspnea ; Education ; Fatigue ; Gastroparesis ; Haloperidol ; Humans ; Hyperthyroidism ; Hypogonadism ; Lung Diseases ; Malnutrition ; Metoclopramide ; Natural History ; Nausea ; Ondansetron ; Palliative Care ; Quality of Life ; Stomatitis ; Terminal Care ; Terminally Ill* ; Tetrahydrocannabinol ; Uremia ; Vomiting

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Development of Community Health Center-Based Hospice Management Model: Pilot Project at a Community Health Center in Busan.

Sook Nam KIM ; Soon Ock CHOI ; Young Jae KIM ; So Ra LEE

Korean Journal of Hospice and Palliative Care.2010;13(2):109-119.

PURPOSE: This study was a part of a drive to develop a community health center-based hospice management model which is concerned with hospice care at a community health care setting and available resources of the local community. METHODS: Development of a community health center-based hospice management model involved evaluation of existing hospice-related research, including literature review, and research on hospice facilities at the study site, as well as evaluation of model operation. The latter involved community health center-based hospice test operation, and evaluation of test operation by a research team, including of a nursing professor majoring in hospice care and staffs from a community health center in Busan metropolitan city, regional cancer center, and regional terminal cancer patient medical institute. The study was conducted in the 2008 calendar year. RESULTS: The community health center-based hospice management model provides service linked with local community resources, focusing on the local community health center. Financial and administrative assistance is provided by the regional cancer center, with collaboration from academic health care professionals who guide the operation management. The community health center hospice nurse in consultation with a visiting nurse team registers terminally-ill cancer patients and, after assessment, the hospice team prioritize hospice care during team meeting. Care is delivered by staffs and volunteers. CONCLUSION: The developed community health center-based hospice operation management model maximally utilizes available community health resources to produce qualitative improvement of regional health and welfare policy through improving the lives of home-based cancer patients and their family who are in medical blind spot.
Community Health Centers ; Community Health Nursing ; Community Health Services ; Cooperative Behavior ; Delivery of Health Care ; Health Resources ; Hospice Care ; Hospices ; Humans ; Models, Organizational ; Optic Disk ; Organization and Administration ; Pilot Projects

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Fatigue and Quality of Life of Korean Cancer Inpatients.

Hye Sun BYUN ; Gyung Duck KIM ; Bok Yae CHUNG ; Kyung Hye KIM

Korean Journal of Hospice and Palliative Care.2010;13(2):98-108.

PURPOSE: The purpose of this study was to identify the relationship between fatigue and quality of life (QOL) of Korean cancer inpatients. METHODS: The data were collected from May to August 2007. Study subjects were recruited at D, Y and A university hospitals in Daegu and Kyungpook, Korea. The research instruments utilized in this study were fatigue (FACT-F) and quality of life (FACT-G) in Korean version 4. Data were analyzed with descriptive statistics, t-test, ANOVA, and Pearson correlation using SPSS Win 12.0 program. RESULTS: Fatigue of subjects showed a significant difference according to the type of treatment, change in weight, performance status, exercise, and sleep. The QOL of subjects showed a significant difference according to the purpose of treatment, change in weight, performance status, exercise, and sleep. The mean score of fatigue was 22.48 and the mean score of QOL was 55.52. The fatigue was negatively related to QOL, physical well-being, emotional well-being, and functional well-being. CONCLUSION: The results suggest the needs for intervention in order to reduce fatigue and to improve QOL of cancer inpatients.
Fatigue ; Hospitals, University ; Humans ; Inpatients ; Korea ; Quality of Life

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Needs of Hospice Care and Quality of Life for Cancer Patients.

In Sun SUH ; Mi Hwa SHIN ; Se Hwa HONG

Korean Journal of Hospice and Palliative Care.2010;13(2):89-97.

PURPOSE: This study investigated the relationship between the needs for hospice care and quality of life in cancer patients. METHODS: Data were collected from 127 cancer patients hospitalized at a university hospital in Chonbuk between October, 2006 to March, 2007. Two instruments were used: cancer patients' need for hospice care, developed by Kang and Kim and quality of life developed by Tae et al. RESULTS: The mean scores were 3.11 out of 4 for hospice care needs, and 5.25 out of 10 for quality of life. The correlation between needs for hospice care and quality of life was moderate and negative (r=-0.395, P<0.01). Among the four groups of needs, physical need was the most strongly correlated with quality of lifer (r=-0.388, P<0.01). The need for hospice care was significantly different according to participants' religion (t=6.02, P<0.05), and duration of disease (F=3.45, P<0.05). Quality of life was significantly different according to participants' monthly income (F=3.38, P<0.05). cancer stage (F=8.10, P<0.01) and chemotherapy (t=6.09, P=0.015). CONCLUSION: The results suggested that the cancer patients' hospice care needs should be answered in order to improve their quality of life. While doing so, participants' characteristic need should also be considered.
Hospice Care ; Hospices ; Humans ; Quality of Life

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