Survey of the Circumstances of Cancer Patients Treated at Home and the Presence of Doctors and Nurses at the Time of Death

In recent years, the system for providing home medical care and palliative care has been improved, and the number of cancer patients who are treated at home until the end is increasing. The aim of this study was to investigate the circumstances of cancer patients who died at home and the presence of doctors and nurses at the moment of death. We conducted a prospective survey of end-oflife cancer patients receiving home visits from home care and palliative care clinics in Japan from 1st July to 31st December 2017. During the study period, we analyzed the mortality status of 676 patients who died in their homes, serviced by 45 clinics. Of these patients, 91% were living with families, 49% died on holidays or at night, and the doctor and nurse was present at the time of death in only 5.6% and 9.9% of cases, respectively. Most of the patients who died at home lived with their families, with few doctors and nurses present at the time of their patients’ death.

Octreotide acetate use for patient with cancerous peritonitis and postoperative gastric cancer in home hospice care setting

The patient, a woman in her 60's with gastric cancer, was diagnosed post-operatively with Schnitzler metastasis, and an artificial anus constructed for her. After receiving chemotherapy, she was admitted to the hospital with both increased lower abdominal pain and nausea. The exacerbation of cancerous peritonitis was suspected and confirmed at the start of continuous subcutaneous administration of octreotide acetate. One week after octreotide administration, the anorexia STAS improved from a score of 4 to a score of 1. Based on the desires of the patient and her household, she transferred to home hospice care, where she maintained good Quality of Life (QOL), again by octreotide acetate administration. Although octreotide acetate is effective in treating nausea, the emesis accompanying cancerous peritonitis, or for the relief of abdominal distension symptoms, there are restrictions associated with inpatient care. In home hospice care, octreotide acetate administration is useful for the maintenance and improvement of a patient's QOL. Therefore, we suggest that octreotide acetate could serve as an important tool for home hospice care. Palliat Care Res 2009; 4(2): 321-329

Development of Home Hospice Information SystemUsing Personal Digital Assistants: In Association with the Goryeong Health Center / 대한의료정보학회지

OBJECTIVE: This study focuses on the development of a systematic and efficient information system for effective management of patient data in home hospice care. It is easily implemented in the hospice environment and is based on wired and wireless communications along with mobile computing technology. METHODS: The design of this portable home hospice information system was based on an analysis of the services provided by visiting nurses and on the opinions of users, in accordance with the Ministry of Health and Welfare's Guidelines for Cancer Patient Management Program 2005. The system has eight main menus, each of which performs a different function. The system includes the home hospice information system (HHIS), a compact .NET framework, and the health center information system (HCIS). RESULTS: A trial was conducted with three experienced visiting nurses, who each used a personal digital assistant (PDA) loaded with the new system to add patient information. The functions include registering a new patient, performing appropriate nursing service according to established guidelines, based on the patient's condition, and searching data records. The system resulted in a saving of 8.5 minutes in nursing data recording time. CONCLUSION: The findings of this study are expected to help field workers in community nursing to decrease the nursing data recording time by using PDAs.

Development of Nursing Intervention Standards for Home Hospice Patients / 성인간호학회지

PURPOSE: The purpose of this study is to develop a set of standardized nursing interventions and their associated nursing activities according to the NIC system to guide home care nurses in performing nursing intervention activities for hospice patients. METHOD: This study was a descriptive survey that first identified frequently used & specialized hospice nursing interventions based on the NIC systems and next validated a set of standardized nursing interventions and their associated nursing activities. One hundred chart records of home hospice patients were used to identify nursing interventions. Also, thirty-nine hospice specialized nurses participated twice using the Delphi technique to test the content validity of the standards. RESULTS: Among the nursing interventions, 19 important nursing interventions and 418 associated nursing activities were selected after two rounds of Delphi technique by hospice specialized nurses. The mean content validity of the final nursing activities was 0.82. In this paper, only the 3 most frequently used nursing interventions and 3 hospice specialized nursing interventions with their associated nursing activities are presented since space is limited. CONCLUSION: The nursing intervention standards will be a basis for home hospice nurses to improve quality of hospice care for hospice patients.