Purpose: This study aimed to describe nurses’ perceived needs and barriers to pediatric palliative care (PPC). Methods: Mixed methods with an embedded design were applied. An online survey was conducted for nurses who participated in the End-of-Life Nursing Education Consortium- Pediatric Palliative Care (ELNEC-PPC) train-the-trainer program, of whom 63 responded. Quantitative data were collected with a survey questionnaire developed through the Delphi method. The 47 items for needs and 15 items for barriers to PPC were analyzed with descriptive statistics. Qualitative data were collected through openended questions and analyzed with topic modeling techniques. Results: The mean scores of most subdomains of the PPC needs were 3.5 or higher out of 4, and those of PPC barriers ranged from 3.22 to 3.56, indicating the items in the questionnaire developed in this study properly reflect each factor. The needs for PPC were divided into 4 categories: “children and adolescents,” “families,” “PPC management system,” and “community-based PPC.” Meanwhile, PPC barriers were divided into 3 categories: “healthcare delivery system,” “healthcare provider,” and “client.” The keywords derived from the topic modeling were perception, palliative, children, and education for necessities and lack, perception, medical care, professional care providers, service, and system for barriers to PPC. Conclusion In this study, by using mixed-methods, items of nurses’ perceived needs and barriers to PPC were identified, categorized, and weighted, and their meanings were explored. For the stable establishment of PPC, the priority should be given to improving perceptions of PPC, establishing an appropriate system, and training professional care providers.

No abstract available.
Immunoassay ; Prostate ; Prostate-Specific Antigen

A resolution adopted by the World Health Assembly in 2014 stated that all nurses should be equipped with palliative care skills in order to integrate palliative care into a day-to-day healthcare system. This article introduces the palliative nursing competency that was developed for the Korean environment by the Korean Hospice Palliative Nursing Research Network based on its study of overseas cases where this competency and competency-based training were developed. This is the first step towards the development of competency-based palliative nursing education, and active efforts should be made to integrate this competency into the undergraduate nursing curriculum.
Clinical Competence ; Curriculum ; Delivery of Health Care ; Education ; Global Health ; Hospice and Palliative Care Nursing ; Hospices ; Humans ; Korea ; Nursing ; Palliative Care ; Students, Nursing

No abstract available.
Disinfectants

OBJECTIVESTo clarify the effects of acupuncture stimulation at Zusanli (ST 36) on the hormonal changes.

METHODSEight-week-old male C57BL/6 mice received acupuncture stimulation at acupoint ST 36 or Quchi (LI 11) once a day for 3 or 5 days in the acupuncture-stimulated groups, but not received in the normal group (n=6 in each group). On day 3 or 5, animals were given 0.1 mL of charcoal orally with a bulbed steel needle, 30 min after the last acupuncture stimulation. Ten minutes later, mice were anesthetized, and the intestinal transit and the concentrations of vasoactive intestinal peptide (VIP), motilin, ghrelin and gastrin in the serum were measured.

RESULTSCompared to no acupuncture stimulation, acupuncture stimulation at ST 36 for 5 days increased the intestinal transit and down-regulated the concentration of VIP and up-regulated the concentrations of motilin, ghrelin and gastrin (P<0.05 or 0.01), whereas acupuncture stimulation at LI 11 did not change them signifificantly (P>0.05).

CONCLUSIONAcupuncture stimulation at ST 36 for 5 days enhances the small intestinal motility and regulates the secretion of hormones related to small intestinal motility.

Acupuncture Points ; Acupuncture Therapy ; Animals ; Gastrointestinal Motility ; physiology ; Hormones ; blood ; Intestine, Small ; physiology ; Male ; Mice, Inbred C57BL

PURPOSE: Up to 90% of pancreatic cancer patients suffer from neuropathic pain. In a palliative care setting, pain control in pancreatic cancer patient is one of the major goals. Ketamine is a N-methyl-D-aspartate (NMDA) receptor antagonist, effective in neuropathic pain. Additionally, there have been studies about the opioid sparing effect of ketamine. This study was held in the palliative care unit among pancreatic cancer patients to determine the factors related to ketamine use and the opioid sparing effect. METHODS: The medical records of pancreatic cancer patients admitted to St. Mary's hospital palliative care unit between January, 2013 and December, 2014 were reviewed. Patients were divided into 2 categories according to ketamine use. Also, opioid use before and after ketamine use was compared in the ketamine group. RESULTS: Compared to the non-ketamine use group, patients in the ketamine group required a higher dose of opioid. The total opioid dose, daily opioid dose, number of daily rescue medications, and daily average rescue dose were statistically significantly higher in the ketamine group. The opioid requirement was increased after ketamine administration. CONCLUSION: In this retrospective study, ketamine was frequently considered in patients with severe pain, requiring higher amount of opioid. Studies about palliative use of ketamine in a larger number of patients with diverse types of cancer pain are required in the future.
Hospices* ; Humans ; Ketamine* ; Medical Records ; Morphine ; N-Methylaspartate ; Neuralgia ; Palliative Care ; Pancreatic Neoplasms* ; Retrospective Studies

BACKGROUND: Prealbumin, a sensitive marker for protein–energy status, is also known as an independent risk factor for mortality in hemodialysis patients. We investigated the impact of prealbumin on survival in incident peritoneal dialysis (PD) patients. METHODS: In total, 136 incident PD patients (mean age, 53.0 ± 15.8 years) between 2002 and 2007 were enrolled in the study. Laboratory data, dialysis adequacy, and nutritional parameters were assessed 3 months after PD initiation. Patients were classified into 2 groups according to prealbumin level: high prealbumin (≥ 40 mg/dL) and low prealbumin (< 40 mg/dL). RESULTS: The patients in the low-prealbumin group were older and had more comorbidities such as diabetes and cardiovascular diseases compared with the patients in the high-prealbumin group. Mean subjective global assessment scores were lower, and the high-sensitivity C-reactive protein levels were higher in the low-prealbumin group. Serum creatinine, albumin, and transferrin levels; percent lean body mass; and normalized protein catabolic rate were positively associated, whereas subjective global assessment scores and high-sensitivity C-reactive protein levels were negatively associated with prealbumin concentration. During the median follow-up of 49 months, patients in the lower prealbumin group had a higher mortality rate. Multivariate analysis revealed that prealbumin < 40 mg/dL (hazard ratio, 2.30; 95% confidence interval, 1.14–4.64) was an independent risk factor for mortality. In receiver operating characteristic curves, the area under the curve of prealbumin for mortality was the largest among the parameters. CONCLUSION: Prealbumin levels were an independent and sensitive predictor for mortality in incident PD patients, showing a good correlation with nutritional and inflammatory markers.
C-Reactive Protein ; Cardiovascular Diseases ; Comorbidity ; Creatinine ; Dialysis ; Follow-Up Studies ; Humans ; Inflammation ; Mortality* ; Multivariate Analysis ; Peritoneal Dialysis* ; Prealbumin* ; Renal Dialysis ; Risk Factors ; ROC Curve ; Transferrin

Although the prognosis of papillary thyroid cancer (PTC) is extremely good, locoregional recurrences after initial treatment occur. Thyroglobulin (Tg) is a reliable tumor marker to detect recurrence or persistence of PTC. However, occasionally serum Tg may miss the detection of a recurrence. We report a 54-year-old female presented with hoarseness due to cervical recurrence without concomitant elevation of serum Tg and anti-Tg antibody, in contrast to extremely increased needle-washout Tg, who had undergone a total thyroidectomy and radioiodine ablation as initial therapies for PTC. Several factors causing such discrepancy between needle-washout Tg and serum Tg can be suggested including site of recurrence, volume of tumor, interference by some kind of plasma antibodies other than anti-Tg antibody, and any conformational defect of Tg protein. Among them, the most convincing explanation is that any conformational defect of Tg may lead to impaired secretion of Tg to blood. We suggest that more studies are needed to find the cause for potential mechanisms involved in PTC recurrences without increased serum Tg.
Antibodies ; Female ; Hoarseness ; Humans ; Middle Aged ; Plasma ; Prognosis ; Recurrence ; Thyroglobulin* ; Thyroid Neoplasms* ; Thyroidectomy

PURPOSE: The aim of this research was to explore nurses' knowledge of and attitudes toward pediatric palliative care (PPC) in Korea. METHODS: A descriptive cross-sectional design was used. A total of 196 participants were recruited from the ELNEC-PPC course held in Seoul, Korea. All participants completed a 20-item survey questionnaire which assessed knowledge of and attitudes toward PPC using a 7-point Likert scale. RESULTS: Nurses' knowledge of PPC correlated with their educational level and work experience in the pediatric unit and hospice care unit. The work experience in the pediatric unit, career length in PPC and completion of palliative education course made differences in the attitudes toward PPC. Married nurses scored significantly higher on the parental rights in determining palliative care service for their child, and nurses with master's degree or higher showed a higher level of understanding of and attitudes toward the differences between PPC and adult palliative care. CONCLUSION: The factors influencing nurses' knowledge of and attitudes toward PPC need be considered to develop a pediatric palliative training program.
Adult ; Child ; Education ; Hospice Care ; Human Rights ; Humans ; Korea ; Palliative Care* ; Parents ; Seoul ; Surveys and Questionnaires

BACKGROUND: Recently, quantitative point-of-care testing (POCT) for cardiac markers using colloidal gold particles was developed in Korea. We evaluated the analytical performance of the HUBI-QUANPRO (Humasis, Korea) assay in comparison with two other assays. METHODS: We evaluated the analytical precision and linearity of HUBI-QUANPRO creatine kinase (CK)-MB, cardiac troponin I (cTnI), and B-type natriuretic peptides (BNP). HUBI-QUANPRO assay was compared with ADVIA Centaur (Siemens, Germany) and Triage (Biosite Diagnostics, USA) assays by using 100 blood samples. In addition, we evaluated the interference of hemoglobin on the HUBI-QUANPRO assay. RESULTS: The coefficients of variation of HUBI-QUANPRO CK-MB, cTnI, and BNP were 7.5-9.7%, 12.0-17.4%, and 14.7-15.7%, respectively. The linearity ranges of HUBI-QUANPRO CK-MB, cTnI, and BNP were 4.7-27.8 ng/mL, 0.76-6.51 ng/mL, and 76.2-762.2 ng/mL, respectively. The comparison study showed no significant difference among them. When 0.5% hemolysis occurred, remarkable hemoglobin interference was found in the three markers resulting in underestimation of the concentrations. CONCLUSIONS: HUBI-QUANPRO CK-MB and BNP showed good analytical performances compared with the other two assays. Hemoglobin interference was noted in the HUBI-QUANPRO assay, especially more in BNP. Although the linearity range of cTnI was narrow, its agreement rate with ADVIA Centaur was good, thus the HUBI-QUANPRO assay could be useful as a quantitative POCT for cardiac markers in the emergency department.
Creatine Kinase ; Emergencies ; Gold Colloid ; Hemoglobins ; Hemolysis ; Korea ; Natriuretic Peptides ; Triage ; Troponin I