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: This methodological study was conducted to test the reliability and validity of an instrument that measures attitudes of advance directives (ADs) among nurses. METHODS: 1) Sixteen items related to attitudes in the English version of the Knowledge, Attitudinal, and Experiential Survey on Advance Directives (KAESAD) were forward/backward translated into Korean. 2) The content was validated by an expert panel (three nursing professors and eight hospice nursing specialists). 3) The preliminary 12 items were selected as a tool to assess the Korean version of Nurses' Attitudes towards Advance Directives (NAAD-K). 4) The instrument was validated by a survey (n=216). 5) It was confirmed to use the 12 items for the final version of the instrument. RESULTS: NAAD-K was shown to be valid in terms of factors, items and content. The three factors extracted from the factor analysis were named as follows: Caring for patients with an AD (factor 1), nurses' role in informing patients (factor 2) and patient right (factor 3). The three factors explained total variance 57.796%. Factor loadings of the 12 items ranged from 0.47 to 0.93. For the 12 items, Cronbach's alpha was 0.81, and Guttman split-half coefficient was 0.78. CONCLUSION: This instrument was identified to be applicable with satisfactory reliability and validity for further use in measuring nurses' attitudes towards ADs in hospice and palliative care.
Advance Directives ; Hospice and Palliative Care Nursing ; Hospices ; Humans ; Methods ; Nursing ; Palliative Care ; Patient Rights ; Reproducibility of Results

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

PURPOSE: The aim of this study is to examine the relationships among hospice-palliative care (HPC) nurses' knowledge of delirium, self-efficacy and nursing performance. METHODS: This study was participated by 174 nurses working in the HPC unit. The nurses were asked to fill out a questionnaire that was structured to measure their knowledge of delirium, a self-efficacy in clinical performance scale (SECPS) and nursing performance. RESULTS: The mean score for knowledge was 32.83 out of 45, with correction rate of 73%. The mean score for self-efficacy was 7.08 out of 10. The mean score of nursing performance was 2.95 out of 4. Significant correlation was observed among the variables of knowledge (r=0.28, P < 0.001), self-efficacy (r=0.51, P < 0.001) and nursing performance. CONCLUSION: Nurses with high level of knowledge of delirium showed high level of self-efficacy, and consequently better HPC nursing performance. It is necessary to develop a training program on delirium considering nurses' needs of knowledge of the condition. The effectiveness of the training program should be also examined in future.
Delirium* ; Education ; Hospice and Palliative Care Nursing ; Nursing* ; Self Efficacy

PURPOSE: This study tried to understand discourses of life-sustaining treatments in general daily and healthcare newspapers. METHODS: A text-network analysis was conducted using the NetMiner program. Firstly, 572 articles from 11 daily newspapers and 258 articles from 8 healthcare newspapers were collected, which were published from August 2013 to October 2016. Secondly, keywords (semantic morphemes) were extracted from the articles and rearranged by removing stop-words, refining similar words, excluding non-relevant words, and defining meaningful phrases. Finally, co-occurrence matrices of the keywords with a frequency of 30 times or higher were developed and statistical measures—indices of degree and betweenness centrality, ego-networks, and clustering—were obtained. RESULTS: In the general daily and healthcare newspapers, the top eight core keywords were common: “patients,” “death,” “LST (life-sustaining treatments),” “hospice palliative care,” “hospitals,” “family,” “opinion,” and “withdrawal.” There were also common subtopics shared by the general daily and healthcare newspapers: withdrawal of LST, hospice palliative care, National Bioethics Review Committee, and self-determination and proxy decision of patients and family. Additionally, the general daily newspapers included diverse social interest or events like well-dying, euthanasia, and the death of farmer Baek Nam-ki, whereas the healthcare newspapers discussed problems of the relevant laws, and insufficient infrastructure and low reimbursement for hospice-palliative care. CONCLUSION: The discourse that withdrawal of futile LST should be allowed according to the patient's will was consistent in the newspapers. Given that newspaper articles influence knowledge and attitudes of the public, RNs are recommended to participate actively in public communication on LST.
Advisory Committees ; Bioethics ; Delivery of Health Care ; Euthanasia ; Farmers ; Hospice and Palliative Care Nursing ; Hospice Care ; Hospices ; Humans ; Jurisprudence ; Life Support Care ; Palliative Care ; Periodicals ; Proxy ; Semantics

PURPOSE: This study aimed to identify how an education program on palliative care affects nursing home caregivers' perception of hospice care and attitude towards terminally ill patient care. METHODS: This study was conducted using a nonequivalent control group with a pretest-posttest design. The participants were 101 certified care workers: 58 in the experimental group and 43 in the control. The experimental group completed the palliative care education program consisted of 20 hours of classroom training and 20 hours of clinical practicum. An ANCOVA was performed to compare the score changes to outcome variables. RESULTS: Compared with the control group, the experimental group showed significant pretest-posttest differences in both the perception of hospice care (F=21.09, P < 0.001) and attitude towards caring for terminally ill patients (F=13.28, P < 0.001). CONCLUSION: These results indicate that the palliative care education program for caregivers is effective in preparing participants to provide hospice/palliative care service. Further study is warranted to explore the effects of this program on palliative caregivers' performance.
Attitude to Death ; Caregivers* ; Education* ; Hospice Care ; Hospices* ; Humans ; Nurses' Aides ; Nursing Homes ; Palliative Care* ; Patient Care ; Preceptorship ; Terminally Ill

PURPOSE: This study examined the effects of a hospice palliative education program for adults on their perception of hospice, attitude towards death, and meaning of life. METHODS: This study was a quasi-experimental study with a non-equivalent control group design. Among 43 participants, 22 were assigned to the non-equivalent experimental group and 21 to the control group. The hospice palliative education program comprised 10 three-hour sessions, each given once a week. Data were analyzed by descriptive statistics, t-test and χ2-test using SPSS version 20.0. RESULTS: Significant differences between the experimental and control groups were observed in their perception of hospice (t=6.63, P < 0.001), attitude towards death (t=2.36, P=0.023), and meaning of life (t=5.06, P < 0.001). CONCLUSION: The results indicate that this education program could positively affect the perception of hospice, attitude toward death, and meaning of life in adults. More studies are warranted to explore the effects of this education program for various age groups so that it may help more people get positive understanding of hospice palliative care. The results suggest this program could help improve the negative perception of hospice, negative attitude towards death and meaning of life that are generally held by the public.
Adult* ; Attitude to Death* ; Education* ; Hospice and Palliative Care Nursing ; Hospices* ; Humans ; Non-Randomized Controlled Trials as Topic ; Palliative Care ; Program Development

PURPOSE: The purpose of this study was to test the reliability and validity of an instrument that measures spiritual needs of families of terminal cancer patients. METHODS: This methodological study was processed as follows: 1) The preliminary 26 items were developed based a conceptual framework of spiritual needs of families of patients with cancer. 2) The content was validated by an expert panel (Three nursing professors and five hospice nursing specialists). 3) The instrument was validated by a survey (n=111). 4) Twenty-six items were selected and used for the final version of the scale. RESULTS: Three factors were extracted through factor analysis: ‘relationship with God/Acceptance of dying’, ‘recovery of relationship/hope and peace’, and ‘meaning and purpose of life’. These factors explained 61.088% of the total variance. Cronbach's alpha and Guttman split-half coefficient of the 26 items were 0.944 and 0.826 respectively. CONCLUSION: This scale was identified as a valid and reliable tool. Therefore, the scale is useful in assessing spiritual needs of families of terminal cancer patients in the field of hospice and palliative care.
Hospice and Palliative Care Nursing ; Hospices ; Humans ; Methods ; Nursing ; Palliative Care ; Reproducibility of Results* ; Spirituality ; Surveys and Questionnaires

PURPOSE: Given the emergence of a new profession called a palliative care aide, this study aims to develop the scope of its practice using the Delphi consensus method. METHODS: This study was participated by a panel of experts comprising 36 members who were involved in either hospice palliative care practice or making relevant policies. Through a four-step Delphi study, the feasibility of the duty, task and task element was examined. Among the results, items that scored over 4.0 out of 5.0 were selected. RESULTS: The analysis of the Delphi study suggested four job duties, 15 tasks and 46 task elements to be included in the practice scope for palliative care aides. CONCLUSION: This study defined the scope of practice for palliative care aides, which is expected to prevent any conflict or confusion regarding their job and to promote the quality of their service.
Consensus ; Delphi Technique ; Hospice and Palliative Care Nursing ; Hospices ; Job Description ; Methods* ; Palliative Care*

PURPOSE: This study aimed to identify and compare hospice care research topics between Korean and international nursing studies using text network analysis. METHODS: The study was conducted in four steps: 1) collecting abstracts of relevant journal articles, 2) extracting and cleaning keywords (semantic morphemes) from the abstracts, 3) developing co-occurrence matrices and text-networks of keywords, and 4) analyzing network-related measures including degree centrality, closeness centrality, betweenness centrality, and clustering using the NetMiner program. Abstracts from 347 Korean and 1,926 international studies for the period of 1998–2016 were analyzed. RESULTS: Between Korean and international studies, six of the most important core keywords-“hospice,”“patient,”“death,”“RNs,”“care,” and “family”-were common, whereas “cancer” from Korean studies and “palliative care” from international studies ranked more highly. Keywords such as “attitude,”“spirituality,”“life,”“effect,” and “meaning” for Korean studies and “communication,”“treatment,”“USA,” and “doctor” for international studies uniquely emerged as core keywords in recent studies (2011~2016). Five subtopic groups each were identified from Korean and international studies. Two common subtopics were “hospice palliative care and volunteers” and “cancer patients.” CONCLUSION: For a better quality of hospice care in Korea, it is recommended that nursing researchers focus on study topics of patients with non-cancer disease, children and family, communication, and pain and symptom management.
Child ; Hospice Care* ; Hospices* ; Humans ; Korea* ; Nursing ; Nursing Research ; Palliative Care ; Semantics