PURPOSE: This study was done to develop and to evaluate an integrative palliative care scale for cancer patients. METHODS: The process included construction of a conceptual framework, generation of initial items, verification of content validity, selection of secondary items, preliminary study, and extraction of final items. The participants were 173 cancer patients in Daegu and Gyeongbuk. Item analysis, factor analysis, criterion related validity, and internal consistency were used to analyze the data. RESULTS: Eighteen items were selected for the final scale, and categorized into 3 factors explaining 58.3% of total variance. The factors were labeled as social/environmental palliative care (9 items), psychological palliative care (4 items), and physical palliative care (3 items), and spiritually palliative care (2 items). The scores for the scale were significantly correlated with the quality of life of cancer patients. Cronbach's alpha coefficient for the 18 items was .88. CONCLUSION: The above findings indicate that the integrative palliative care scale has good validity and reliability when used for cancer patients.
Daegu ; Gyeongsangbuk-do ; Humans ; Palliative Care* ; Quality of Life ; Reproducibility of Results

PURPOSE: The purpose of this study was to analyze the types of attitudes of nursing students in Korea toward bucket lists. METHODS: The Q-methodology, which provides a method for analyzing the subjectivity of each item was used. From each of the 37 subjects, 34 selected Q-statements were classified into the shape of a normal distribution, using a 9-point scale. The collected data were analyzed using a QUANL PC program. RESULTS: Four types of attitudes toward the bucket list of subjects were identified in Korean nursing students. Typeis a pursuit of money type, Type II is a pursuit of relationship type, Type III is a pursuit of self-centered type, and Type is a pursuit of others-centered type. CONCLUSION: The results of this study indicate that different approaches toward educational programs for students in the human service area are recommended based on the four types of nursing students' attitudes toward the bucket list.
Humans ; Korea ; Nursing ; Students, Nursing*

PURPOSE: This study was performed to identify factors affecting terminal care performance of clinical nurses. METHODS: The participants in this study were 175 nurses working in hospitals in Daegu and North Gyeongsang Province. Data were collected using a self-reported questionnaire and were analyzed with the IBM SPSS WIN 19.0 program. RESULTS: Nurses' terminal care performance was significantly related with suffering experience, empathy ability and caring behaviors. Significant predictors for terminal care performance were their department, empathy ability and caring behaviors. These factors explained 43.52% of the variance in terminal care performance of clinical nurses. CONCLUSION: Our study results suggest that terminal care performance of clinical nurses can be strengthened by improving empathy ability and caring behaviors.
Daegu ; Empathy* ; Nursing Care ; Terminal Care*

PURPOSE: This study was conducted to evaluate the effects of integrated palliative care intervention on quality of life in terminally ill patients. METHODS: A comprehensive literature search was performed via PubMed, Cochrane Library CENTRAL, LWW (Ovid), CINAHL and several Korean databases. The main search strategy was to combine terms indicating palliative care intervention, presence of terminal illness and study design. Methodological quality was assessed using Cochrane's Risk of Bias for randomized studies and Risk of Bias Assessment tool for non-randomized studies. Data were analyzed by the Stata 10 program. RESULTS: Eight clinical trials met the inclusion criteria with a total of 356 participants. Integrated palliative care interventions were administered for a mean of 6.5 weeks, 5.6 sessions and an average of 47.8 minutes per session. Effect sizes were heterogeneous, and subgroup analysis was done. Integrated palliative care interventions had a significant effect on quality of life (ES=1.83, P=0.018, l2=92%), spiritual well-being (ES=0.78, P=0.040, l2=0), depression (ES=0.86, P<0.001, l2=32) and anxiety (ES=0.69, P=0.041, l2=71.1). But integrated palliative care interventions had no significant effect on pain (ES=0.365, P=0.230, l2=69.8). CONCLUSION: Results support findings that integrated palliative care interventions were helpful in lessening depression and anxiety and improving quality of life and spiritual well-being, however, the interventions did not assist pain management in terminal cancer patients. These findings suggest that various integrated palliative care interventions can assist terminal cancer patients with better quality of life in the socio-psycho-spiritual dimension.
Anxiety ; Bias (Epidemiology) ; Depression ; Humans ; Pain Management ; Palliative Care* ; Quality of Life* ; Terminally Ill

PURPOSE: The purpose of this study is to analyze types of shared medical decision making by health professionals in a decision making position. METHODS: The Q-methodology was used. Q sample was constructed with a total of 35 Q-statements that were offered with a 9-point rating scale. The statements were structured to generate answers that would form a shape of a normal distribution. Answers to Q sample were analyzed using a QUANL PC program. RESULTS: Four types of shared medical decision making were identified. Type I is patient-centered decision making, Type II is physician-centered, Type III is health professional-centered and Type IV is patient-family-centered. CONCLUSION: Study results indicate that it is recommended to develop an education program based on the four types of shared medical decision making so that health professionals can be provided with different approaches according to their decision making style.
Decision Making* ; Education ; Health Occupations ; Humans ; Terminally Ill*

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

PURPOSE: We analyzed how clinical nurses in Korea perceive terminally ill patients' medical decision-making. METHODS: The Q-methodology which analyzes the subjectivity of each item was used. We selected 34 Q-statements among those provided by each of 37 subjects and grouped them into a shape of normal distribution using a 9 point scale. The collected data were analyzed using a QUANL PC program. RESULTS: Four types of perception toward medical decision-making were identified. Type I focuses on patient participation, and Type II emphasizes the role of health professionals. Type III is characterized by an open-minded culture toward death, and Type IV values the role of family members. CONCLUSION: The results of this study indicate the need for development of a multi-disciplinary curriculum medical decision-making and death for medical and nursing students.
Curriculum ; Decision Making ; Health Occupations ; Humans ; Korea ; Patient Participation ; Students, Nursing ; Terminally Ill

PURPOSE: This correlation study was performed to examine Korean adults' perceptions and attitudes towards death with dignity and the withdrawal of life sustaining treatment and to identify factors that predict their attitude towards death with dignity. METHODS: The study was conducted using convenience sampling of 291 adults from three towns of a metropolitan city in Korea. Data were collected using structured questionnaires which surveyed people's perception about and attitudes towards withdrawal of life sustaining treatment and scaled their attitude towards death with dignity. Data were analyzed by using descriptive statistics, Pearson correlation coefficients and multiple regression. RESULTS: The attitude towards the withdrawal of life sustaining treatment and death with dignity showed a significant positive correlation (r=0.49, P<0.001). For attitudes towards death with dignity, significant predictors were attitudes towards the withdrawal of life sustaining treatment, age, religion, a proper withdrawal process and advanced medical directives, which explained 49.3% of total variance. CONCLUSION: The results of this study may contribute to development of a new medical decision-making system including nurses' appropriate roles in the process of withdrawing life sustaining treatment and advanced medical directives.
Adult ; Humanism ; Humans ; Korea ; Life Support Care ; Right to Die ; Statistics as Topic

PURPOSE: The purposes of this study were to explore the effects of family cohesion and subjective happiness on death anxiety of Korean elders and to identify other factors contributing to death anxiety. METHODS: The participants were 280 elders who lived in P metropolitan city. Data were collected between November 5, 2011 and January 12, 2012 using the Short Portable Mental Status Questionnaire (SPMSQ), Family Cohesion Evaluation Scale, Subjective Happiness Scale, and Fear of Death Scale (FODS). Data were analyzed using the SPSS/WIN 19.0 program. RESULTS: Family cohesion, marital status, religious activity, perceived health status, and subjective happiness were included in the factors affecting death anxiety of Korean elders. These variables explained 50.1% of death anxiety. CONCLUSION: The results of the study indicate that these variables should be considered in developing nursing intervention programs to decrease death anxiety and increase family cohesion and subjective happiness for life integration in Korean elders.
Aged ; Aged, 80 and over ; *Anxiety ; Asian Continental Ancestry Group ; *Attitude to Death ; *Family Relations ; Female ; *Happiness ; Health Status ; Humans ; Male ; Marriage ; Questionnaires ; Religion ; Republic of Korea

PURPOSE: The study was done to develop a shared decision-making scale for end-of-life patients in Korea. METHODS: The process included construction of a conceptual framework, generation of initial items, verification of content validity, selection of secondary items, preliminary study, and extraction of final items. The participants were 388 adults who lived in one of 3 Korean metropolitan cities: Seoul, Daegu, or Busan. Item analysis, factor analysis, criterion related validity, and internal consistency were used to analyze the data. Data collection was done from July to October 2011. RESULTS: Thirty-four items were selected for the final scale, and categorized into 7 factors explaining 61.9% of the total variance. The factors were labeled as sharing information (9 items), constructing system (7 items), explanation as a duty (5 items), autonomy (4 items), capturing time (3 items), participation of family (3 items), and human respect (3 items). The scores for the scale were significantly correlated among shared decision-making scale, terminating life support scale, and dignified dying scale. Cronbach's alpha coefficient for the 34 items was .94. CONCLUSION: The above findings indicate that the shared decision-making scale has a good validity and reliability when used for end-of-life patients in Korea.
Adult ; Aged ; *Decision Making ; Factor Analysis, Statistical ; Female ; Humans ; Interviews as Topic ; Male ; Middle Aged ; Program Development ; Program Evaluation ; Republic of Korea ; *Terminal Care