A Comparison of Nursing Interventions with Terminal Cancer Patients in a Hospice Unit and General Units / 성인간호학회지

PURPOSE: The purpose of the study was to compare symptoms, medical therapies, and nursing interventions with terminal cancer patients during the last four weeks of their lives in a hospice unit and general units. METHOD: For the descriptive survey study, data were collected by reviewing the medical records of 243 patients who died of terminal cancer at K hospital in Seoul. The data was analyzed by using Chi-square test and t-test. RESULT: The study findings are summarized as follows: There were higher frequencies in physical symptoms of constipation, itching sensation, pain, sleeping disturbance, soreness and dysuria for those patients in the hospice unit than those patient in general units. All emotional symptoms were recorded significantly higher for those patients in the hospice unit than those in general units. Regarding the major medical interventions, pain management was used more significantly for those patients in the hospice unit, but antibiotic therapy and resuscitation were used more significantly for those patients in general units. CONCLUSION: The hospice unit provided more comprehensive nursing interventions including psychological, spiritual, and family cares as well as physiological care for terminal cancer patients. The facts showed that those patients who would need hospice care in general units should be referred to the hospice unit at an appropriate time.

Factors Influencing Pain with Terminally Ill Cancer Patients in Hospice Units / 간호학회지

The purpose of this study was to investigate the impact of depression, discomfort, spirituality, physical care, and opioid use on pain with terminally ill cancer patients residing in hospice units. The convenient sample of this study consisted of 41 terminally ill cancer patients at three hospice units in university affiliated hospitals. Patients were interviewed with structured questionnaires three times at predetermined intervals: admission to the hospice unit (Time 1), one week later (Time 2), and two weeks later (Time 3). The data was collected from January 1998 to January 1999 and was analyzed using ANOVA, Pearson correlation coefficient, and multivariate multiple regression. The results of this study were as follows: 1. The mean age of the participants was approximately 55 years old. In terms of diagnosis, lung cancer showed the highest frequency (19.5%), followed by stomach cancer and rectal cancer (17.1%). The motive of seeking hospice unit admission was control (72. 2%), followed by spiritual care (50%), and symptom relief (38.9%). 2. Regarding the type of pain felt, the highest pain frequency the participants experienced was deep pain (55%), followed by multiple pain (25%), intestinal pain (10%), then superficial (5%) and neurogenic pain (5%). For the level of pain measured by VAS, there was no significant difference among the three time points; Time 1 (5.04 +/-2.21), Time 2 (4.82+/-2.58) and Time 3(4.73+/-2.51). 3. There was significant change seen in spirituality and physical care in each time interval. Namely, the longer the length of admission at the hospice unit, the higher the importance of spirituality (p=0.0001) and the more the physical care the participants received (p=0.01). The opioid use at the three time points showed the following frequencies : Time 1 (75.6%), Time 2 (85.4%) and Time 3 (75.6%). 4. Regarding factors influencing pain, the pain level was significantly affected by the depression level (p <0.01) and the opioid use (p <0.1). These results were the most significant at the two time points (Time 1 and Time 2). At Time 3 (two weeks later), the pain level was significantly affected by the depression level (p <0.05) and the amount of physical care the participants received (p <0.1). In conclusion, the terminally ill cancer patients had moderate pain, were generally depressed, and were treated with opioid analgesics. As approaching death, the patients received more physical care due to increased physical symptoms experienced and they had a higher perception of the importance of spirituality. Thus, health care professionals need to provide continuous care for each of them to die comfortably physically, psycho- logically, and spiritually.

Effects of Motivation-Enhancing Program on Health Behaviors, Cardiovascular Risk factors, and Functional status for Institutionalized Elderly Women / 간호학회지

This study was to compare changes in health behaviors, motivational factors, cardiovascular risk factors, and functional status (SIP) after implementing the 6-month motivation-enhancing program to institutionalized elderly women. METHODS: Sixty-four elderly women participated. Face to face interviews with blood sampling and anthropometric assessment were conducted at the pretest, 10 weeks and 6 months during the program. RESULTS: 1. The program participants showed significantly better health behaviors over 6 months. The mean motivational level was also significantly improved, especially for perceived benefits, perceived barriers, and emotional salience. 2. The mean of cardiovascular risk factors for the participants was 21.8 at the level of low to moderate risk. After completing the program, total risk score was significantly decreased to 18.7 at 10 weeks, and further to 17.7 at 6 months. A significant reduction was also found in HDL and LDL-cholesterol levels, blood pressure, obesity, inactivity, and stress. 3. The functional status (SIP) was 11% at the baseline and significantly changed in positive direction at 10 weeks (M=9.3) and at 6 month (M=6.3). The significant improvement was also found in physical and psychosocial dimensions and sleep/rest dimension. CONCLUSION: The motivation enhancing program was effective to reduce cardiovascular risks and to improve the functional status of institutionalized elderly women by motivating them to perform better health behaviors.

A Comparison between Home Care Nursing Interventions for Hospice and General Patients / 간호학회지

PURPOSE: The purpose of the study was to compare home care nursing intervention activities analyzed by the Nursing Intervention Classification (NIC) system for hospice and general patients. METHOD: For the descriptive survey study, data was collected by reviewing charts of 151 hospice patients and 421 general patients who registered in the department of home health care nursing at K Hospital. RESULTS: According to the NIC system application, there were 2380 total nursing interventions used for the hospice patients and 8725 for the general home care patients. For both sets of patients (hospice vs. general), the most frequently used nursing intervention in level 1 was the Physiological: Complex domain (40.13 vs. 31.06 percent), followed by the Safety domain; in level 2, the Risk Management class (28.4 vs. 27.70 percent), followed by Tissue Perfusion Management; and in level 3, Vital Sign Monitoring (6.18 vs. 4.84 percent), followed by Health Screening. CONCLUSION: The study showed that there was a lack of specialized hospice nursing interventions such as emotional, family and spiritual support, and care for dying hospice patients.

Effects of Aromatherapy on Menstrual Cramps and Dysmenorrhea in College Student Woman: A Blind Randomized Clinical Trial / 성인간호학회지

This study was designed to verify the effect of aromatherapy on menstrual cramps and dysmenorrhea by a quasi experiment (nonequivalent control group pretest-posttest design), from March to October, 2000. The subjects of this experiment consisted of 45 college women with menstrual cramps and dysmenorrhea. They were randomized by 25 for the experimental group and 20 for the control group. Their mean age was 20.6 years, mean menstrual period 28.7 days, mean menstrual cramps(VAS) 7.25, mean dysmenorrhea (Dysmenorrhea Scale) was 27.34. As treatment, aromatherapy was to give effleurrage of the abdomen with lavender, clary sage and rose as aroma oil, almond oil as carrier oil. For the control group, abdominal massage was given with only almond oil. Data collection included menstrual cramps, dysmenorrhea, the change of symptoms(low abdominal pain, lumbago, headache, nausea, fatigue, edema). Menstrual cramps, dysmenorrhea and general, menstrual characteristics of subjects were measured the first day of the pre menstrual period before treatment (pre-test), menstrual cramps, dysmenorrhea, the change of symptoms were measured the first and second day of post menstrual period after treatment (posttest). Data were analyzed by t-test, X2-test, repeated measures ANOVA, Cronbach's alpha with SAS Program. The results of this study was as follows; 1. Menstrual cramps was significantly lower in the experimental group(p = .001). 2. Dysmenorrhea was significantly lower in the experimental group(p = .027). 3.Less women in the experimental group complained about the six symptoms than women in the control group after treatment on the first day of the menstrual period(p <0.05, p <0.01) In conclusion, these findings indicate that aromatherapy with lavender, clary sage, and rose could be effective to decrease menstrual cramps, and dysmenorrhea. So, aromatherapy could be applied to women suffering with menstrual cramps, dysmenorrhea periodically as an nursing intervention.

Prevalence and Risk Factors for Diabetes Mellitus and Impaired Fasting Glucose of Adults / 간호학회지

This study was conducted to draw out prevalence and the risk factors of diabetes mellitus and impaired fasting glucose for adults,(age 30-69). The subjects were 2096 adults, who had regular health examinations between January and December of 1999 at K Hospital in Seoul. The data was analyzed using chi-square test, unpaired t-test and logistic regression. Diabetes Mellitus and impaired fasting glucose were diagnosed by ADA (American Diabetes Association, 1997) criteria. The results were as follows: 1. Mens' prevalence of Diabetes Mellitus was 7.9% and womens' prevalence of Diabetes Mellitus was 3.8%. Mens' prevalence of impaired fasting glucose was 10.4% and womens' prevalence of impaired fasting glucose was 6.5%. Prevalences of Diabetes Mellitus and impaired fasting glucose increased with age. 2. Prevalence of Diabetes Mellitus and impaired fasting glucose of obese subjects (relative body weight>=162) was higher than that of overweight subjects (110<=relative body weight<=119) in men and women. 3. The diagnoses of Diabetes Mellitus and impaired fasting glucose increased with systolic blood pressure and triglyceride. 4. Significant factors associated with diabetes in the logistic regression best gut model were age, relative body weight, systolic blood pressure, triglyceride in men, and systolic blood pressure in women. In conclusion, as age, weight, systolic blood pressure and triglyceride get higher, Diabetes Mellitus and impaired fasting glucose prevalence also increases, porportionally.

A Study on the Development of an Independent Hospice Center Model / 간호학회지

The study was aimed at developing an independent hospice center model that would be best suited for Korea based on a literature review and the current status of local and international hospices. For the study, five local and six international hospice organizations were surveyed. Components of the hospice center model include philosophy, purpose, resources (workers, facilities, and equipment), allocation of resources, management, financial support and hospice team service. The following is a summary of the developed model: Philosophies for the hospice center were set as follows: based on the dignity of human life and humanism, help patients spend the rest of their days in a meaningful way and accept life positively. On the staff side, to pursue a team-oriented holistic approach to improve comfort and quality of life for terminally ill persons and their families. The hospice center should have 20 beds with single, two, and four bed rooms. The center should employ, either on a part-time or full-time basis, a center director, nurses, doctors, chaplains, social workers, pharmacists, dieticians, therapists, and volunteers. In addition, it will need an administrative staff, facility managers and nurses aides. The hospice should also be equipped with facilities for patients, their families, and team members, furnished with equipment and goods at the same level of a hospital. For the organizational structure, the center is represented by a center director who reports to a board and an advisory committee. Also, the center director administers a steering committee and five departments, namely, Administration, Nursing Service, Social Welfare, Religious Services, and Medical Service. Furthermore, the center should be able to utilize a direct and support delivery systems. The direct delivery system allows the hospice center to receive requests from, or transfer patients to, hospitals, clinics, other hospice organizations (by type), public health centers, religious organizations, social welfare organizations, patients, and their guardians. On the other hand, the support delivery system provides a link to outside facilities of various medical suppliers. In terms of management, details were made with regards to personnel management, records, infection control, safety, supplies and quality management. For financial support, some form of medical insurance coverage for hospice services, ways to promote a donation system and fund raising were examined. Hospice team service to be provided by the hospice center was categorized into assessment, physical care, emotional care, spiritual care, bereavement service, medication, education and demonstrations, medical supplies rental, request service, volunteer service, and respite service. Based on the results, the study has drawn up the following suggestions: 1. The proposed model for a hospice center as presented in the study needs to be tested with a pilot project. 2. Studies on criteria for legal approval and license for a hospice center need to be conducted to develop policies. 3. Studies on developing a hospice charge system and hospice standards that meet local conditions in Korea need to be conducted.

An Analysis of Nursing Research Related to Quality of Life Reported in Korea from 1987 to 1996 / 성인간호학회지

This study was done to analyze research trends and to suggest future directions for nursing research on the quality of life (QL) in Korea. The purposes of this study were to describe systematically 10 years of QL nursing, and to identify patterns of tools and significant variables on studies of QL. This article reviewed 71 nursing researches on QL between 1987 and 1996, by examining them according to the period of publication, research for a degree or not, research design, type of subjects, data collection methods, measurement instruments and range of reliabilities, type of nursing intervention, and association of QL and related variables. The findings of the analysis can be summarized as follows: 1. The number of studies related to QL increased from 1987 to 1994. But they have decreased since 1995. 48 of them(67.6%) identified surveys and correlational studies. 2. In all the titles of the studies, there were 7 types of concepts, including QL, quality satisfaction, life satisfaction, and well-being. Among them, QL was the most often used. 3. The subjects of 21 studies were healthy people. In 49 studies, patients had various illnesses. The majority of the patients were hemodialysis patients and cancer patients. Questionnaires were used for data collection in 58 studies. 56 studies were done for the thesis of a degree, while those in the remaining studies were not for degrees. 4. The research designs were various, except in the thesis for a doctorate. There were many more experimental studies(57.1%) done in the thesis for a doctorate. 5. The types of intervention were categorized as exercise(6), supportive care(3), reminiscence (2), relaxation(1), music(1), and hospice care(1). 6. As measurement tools, 14 types of tools relating to QL were used. 11 of them were composed of multiple dimensions. Among them, the QL Scale by You-Ja Ro(1988) was the most widely used in the studies. In the following, the Life Satisfaction Index by Jin Yun(1982), the Quality of life Scale of National Conference of Cancer nursing (1983), and the Life Satisfaction Index by Wood, Wylie and Sheafor(1969) were used. The reliabilities of the QL Scale were reported in 63 studies, and the Cronbach's alpha coefficients were over 0.7 in 60 cases. The quality of life scales included five dimensions; such as physical, psychological, social, economical, and spiritual dimensions. 7. There were two categories of factors influencing the quality of life: First, factors that cannot be changed by nursing intervention were; age, educational level, gender, marital status, income, employment status, occupation, number of family members, religion, and illness history. Second, factors that can be changed by nursing intervention were; physical activity, health status, the presence of complications, support, self-esteem, stress, self-efficacy, activities of daily life, physical strength, satifaction with life, and anxiety. Types of nursing intervention used to improve quality of life were; therapies in relaxation, exericse, reminiscence, and family support, social support, and hospice care. On the basis of the above findings, the following recommendations were made: 1. Further studies on the quality of life instruments of analysis are needed to provide an understanding of dimensions of life in detail. 2. A Meta-analysis needs to be conducted to identify intervention effects on the quality of life. 3. A tool development study is needed to measure the quality of life appropriately in different illnesses 4. More replicated analysis studies of QL are needed to prove the effect of variables on the QL.

Model Development of Korean Professional Hospice Care Education / 간호학회지

This study was conducted to develop an education program of hospice care for the professional in order to care for nurses for terminally ill patients facing death and their families. The Modified Tyler-Type Ends-Means model was used to guide the curriculum development of the study. The curriculum include a philosophical conception of hospice education, fundamental concepts, purpose, objective and the educational contents. The content was developed based upon a 70% or more demand in educational demand analysis. The education program has a total of 360 hours consisting of 172 hours of theoretical study and 188 hours of practice including fundamental nursing care for hospice.

A Study on the Curriculum Development for the Professional Hospice Nurse in Korea / 간호학회지

The purpose of this study is to develop the first domestic professional hospice educational program. We investigated the present condition of Korean hospice education and analyzed the prerequisite need for a dedicated hospice course in the professional education process. Research was conducted between June and November 1996 for nursing professors teaching at each nursing education institute to find out how much hospice is being discussed and by whom, in which course it is being discussed, and also to find out the contents that needed to be include in the professional education process. From a total of 49 colleges(29 three year colleges, 20 four year colleges) out of 99, 162 nursing professors replied, the collection rate was 49.5%. The conclusions are as follows: 1. The present condition of the hospice nursing education. 1) Whether hospice is included in the education program. (1) 89-65% of 3 year colleges and 90% of 4year colleges included hospice education in their education program. (2) In graduate studies three schools included hospice their program and three schools expressed their plans to include hospice education. 2) Hospice related education were commonly discussed in adult nursing(26.3%), fundamental nursing(22.8%), and psychiatric nursing(20.2%). In 3 year colleges its commonly discussed in the first and second year and in 4 year colleges it is taught in the second and third year. 3) Hospice related theory/practical education hours were averages of 6.5/7.0 hrs in 3 year colleges and 14.2/11.3 hrs in 4 year colleges. 4) The majority of professors in charge of hospice education were in the following order adult nursing, psychiatric nursing, and fundamental nursing. 5) The courses that are thought to be adequate to manage hospice related education were adult nursing(29.3%), community health nursing(21.7%) and the described method education was the method currently being used(36.5%). 2. The demand for hospice nursing education. 1) Over 70% demanded professional hospice education program, the highest demand was for the value and meaning of life followed by the role and qualification of the hospice team and the mental maintenance of a dying patient. 25 categories showed over 90% demand. 2) The highest demand was for the value and meaning of life(98.2%) and the lowest demand were for danjeon breathing(71.0%) and acupuncture(71.0%). 3) Other contents that need to be discussed in the professional hospice education program were hospice nursing, the attitude and reaction of death, bereavement care, and the prospect of hospice.

The trend and Issues of the Gerontological Nursing Study in Korea / 간호학회지

Issues related to the elderly have been recognized in Korea and nursing scholars have tried to study there issues. It is hard to say which the direction we, are going or have to go, since there has been little systemic effort to establish gerontological nursing field yet. Therefore, it is necessary to find out the trend and the guidelines of gerontolotical nursing studies for the future. Dissertation and published articles related to the elderly in the nursing field from 1991 to the February of 1997 were are reviewed. Total 127 studies were analysed in terms of concept, design/methodology, and results, and the nature and issues of the geronotologic nursing studies in Korea were explored. The results are as follows: 1. There was no clear chronological definition of the elderly. 2. The most popular research design was an exploratory/descriptive study. 3. The major concepts studies were physical and mental health. 4. Among those studies using instrument which were developed and modified and /or translated by researchers, the reliability and validity were rarely reported. 5. Theory based studies were rare. We suggest the following issues for future studies : 1. The chronological and other criteria related to the definition of elderly is needed. 2. Physiopsychosocial characteristics of Korean elderly and their managements in terms of intervention studies need to be conducted more synthetically. 3. Social issues from the change of types and function of family such as single elderly family need to be studied. 4. Participation in and collaborate with other disciplines are needed. 5 Development and test of instruments to measure phenomena or concepts is needed. 6. Macroscopic approach such as policy also needed. 7. Theory based studies are needed.

A Comparison of Quality of Life between the Families of Hospital Hospice Patients and Those of Home: Based Hospice Patients / 간호학회지

This study aims at providing more qualitative care in family nursing practice. It is designed to analyze the degree of quality of life(QL) among families of the patients. The subjects consisted of 79 families of hospital hospice patients and 74 families of home-based hospice patients. The ages of the subjects were 17-74 years, at five university hospitals in Seoul, Inchon, and Kyung Gi Province, and one clinic in Chunchon. The data were collected from September, 1996 to August, 1997. The instrument used for the study was the Quality of Life Scale(QLS), which was composed of six factors, developed by Ro. You Ja, The analysis was done using t-test, ANOVA, Scheffe test, and Stepwise multiple regression. The results were as follows : 1. There were no statistically significant differences between the families of hospital hospice patients and the families of home-based hospice patients ; however, the mean score of the families of hospital hospice patients was higher than that of the families of home-based hospice patients. The scores on QLS ranged from 75 to 224 with a mean score of 140.58 in the families of hospital hospice patients. In the families of home-based hospice patients, the scores ranged from 79 to 214, showing a mean score of 135.25. Among six factors of QLS, family relationships showed the highest score in the families of hospital patients. Self-esteem and relationship with the neighborhood were significantly higher in the families of hospital hospice patients than the families of home-based hospice patients(t= 2.69, P= 0.008 ; t= 2.04, p= 0.043). 2. In the families of hospital hospice patients, QL had significant relationship with family member's age (F= 2.52, P=0.029), marital status (F= 3.57, P = 0.018), economic state(F= 6.07, P= 0.004), and education level(F =3.77, P=0.014), In the families of home based hospice patients, QL had significant relationship with marital status(F=2.53, P=0.049), education level(F= 4.35, P=0.007), occupation(F=3.93, P=0.002), and patient's age(F=2.73, P=0.020). 3. Economic status accounted for 17% of QL, and diagnosis accounted for an additional 7% of QL in the families of hospital hospice patients by means of stepwise multiple regression analysis, In the families of home-based hospice patients, relationships with patient accounted for 12% of QL. The findings showed that self-esteem and relationship with the neighborhood were significantly higher in the families of hospital hospice patients than the families of homed-based hospice patients and family relationships showed the highest value in QL. These finding should be considered in nursing practice.

Quality of life among renal transplantation recipients / 성인간호학회지

No abstract available.

The effect of thermal biofeedback and progressive muscle relaxation training in reducing blood pressure,plasma cortisol and aldostrone level of patients with essential hypertension / 성인간호학회지

No abstract available.