Journal of hospice and palliative care最新文献

{"title":"Medication Prescriptions for Chronic Diseases in Terminal Cancer Patients in Korea: A Real-World Study.","authors":"Mina Kim, Yonghwan Kim, Jae-Min Park","doi":"10.14475/jhpc.2025.28.1.18","DOIUrl":"10.14475/jhpc.2025.28.1.18","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to investigate the prescribing patterns of medications for chronic diseases in patients with terminal cancer in South Korea as their life expectancy declined.</p><p><strong>Methods: </strong>This study analyzed data on cancer patients from the National Health Insurance Service (NHIS) database in South Korea. It included a total of 89,606 patients who died of cancer in 2021. We evaluated prescriptions for dyslipidemia, hypertension, diabetes, and osteoporosis at 52, 12, 4, and 1 week prior to death.</p><p><strong>Results: </strong>A significant proportion of patients nearing death continued to receive prescriptions for chronic disease medications, despite guidelines suggesting that these medications can be discontinued when life expectancy is limited. For instance, 2.6% of patients were prescribed medications for dyslipidemia just 1 week before death, highlighting a discrepancy between clinical practice and recommended guidelines.</p><p><strong>Conclusion: </strong>These findings underscore the need to reevaluate prescription practices for terminal cancer patients. Optimizing medication use can decrease polypharmacy, reduce adverse drug reactions, and increase the quality of life (QOL) for these individuals.</p>","PeriodicalId":73780,"journal":{"name":"Journal of hospice and palliative care","volume":"28 1","pages":"18-24"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11891024/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sarcopenia in Terminally Ill Patients with Cancer: Clinical Implications, Diagnostic Challenges, and Management Strategies.","authors":"Se-Il Go, Myoung Hee Kang, Hoon-Gu Kim","doi":"10.14475/jhpc.2025.28.1.10","DOIUrl":"10.14475/jhpc.2025.28.1.10","url":null,"abstract":"<p><p>Sarcopenia, characterized by progressive loss of skeletal muscle mass and strength, is a prevalent but often overlooked condition in patients with cancer who are terminally ill. It contributes to functional decline, increased symptom burden, and reduced quality of life, yet remains underrecognized in palliative care. Diagnosing sarcopenia in this population is challenging because conventional imaging techniques are often impractical. Instead, alternative assessments, such as the Strength, Assistance with walking, Rise from a chair, Climb stairs, and Falls questionnaire (SARC-F), anthropometric measurements, and bioelectrical impedance analysis offer feasible options. Management should focus on symptom relief, functional preservation, and patient comfort, rather than on muscle mass restoration. Nutritional support must be tailored to prognosis, with aggressive interventions generally avoided during end-of-life care. Although exercise may help to maintain mobility and alleviate symptoms, its feasibility is often limited. Pharmacological interventions, including appetite stimulants and anti-cachexia agents, remain largely investigational, with insufficient evidence for routine use in palliative care. Future research should refine sarcopenia assessment methods and develop patient-centered interventions that align with palliative care principles, emphasizing quality of life and individualized needs.</p>","PeriodicalId":73780,"journal":{"name":"Journal of hospice and palliative care","volume":"28 1","pages":"10-17"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11891026/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tasks to Establish the Role of Hospice and Palliative Care Social Workers in Community Care.","authors":"Wonchul Kim, Sungkyu Lee, Junhee Jeon, Msw","doi":"10.14475/jhpc.2025.28.1.1","DOIUrl":"10.14475/jhpc.2025.28.1.1","url":null,"abstract":"<p><p>In 2018, the South Korean government launched a community care policy aimed at providing more extensive social services for older adults, the disabled, and mental health patients. This policy also included an expansion of home-based hospice services in response to the growing demand for hospice and palliative care. Despite these initiatives, social workers play a limited role in home-based hospice care, and those specializing in hospice and palliative care are not yet fully equipped to provide effective community care services. This study investigated both domestic and international research trends to identify key tasks for defining the roles of hospice and palliative care social workers within community care. It also examined how these social workers perceive community care. The findings suggest that previous research has called for a more precise definition of the roles of hospice and palliative care social workers. It is particularly critical to address the underutilization of social workers in home-based hospice care, which is essential for effective community care. The study also revealed that while hospice and palliative care workers recognize the necessity of community care, their understanding of the community resources needed for its implementation and their actual performance in delivering such care are lacking. Additionally, their appreciation of the importance of establishing discharge plans, which include home visits, assessments and improvements of the residential environment, and transportation arrangements, was found to be limited. They acknowledged the need to establish a community linkage system and develop an information system to effectively implement community care. To clearly establish the role of hospice and palliative care social workers in community care, several measures should be taken: First, the role and function of home-based hospice and palliative care workers need to be institutionally strengthened. Second, training focused on developing discharge plans for these social workers should be improved. Concurrently, priority in this training should be given to those workers who are at a higher risk of burnout. Third, the activation of regional hospice centers should be pursued to ensure a robust community linkage system and the implementation of a community information system.</p>","PeriodicalId":73780,"journal":{"name":"Journal of hospice and palliative care","volume":"28 1","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11891023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Palliative Care in End-Stage Lung Disease.","authors":"So Young Park","doi":"10.14475/jhpc.2025.28.1.25","DOIUrl":"10.14475/jhpc.2025.28.1.25","url":null,"abstract":"<p><p>The prevalence of chronic obstructive pulmonary disease (COPD) is increasing, and the condition is associated with a high mortality rate. For patients with COPD, the reality of a life-limiting illness causing severe breathlessness is often daunting. Unlike cancer, the progression of COPD is less predictable, making its prognosis challenging for clinicians. Patients with COPD in the intensive care unit (ICU) present a unique set of challenges characterized by persistent respiratory distress, dependence on ventilator support, and complex medical needs. Therefore, palliative care is vital for ICU patients with COPD, as it offers a compassionate, patient-centered approach that emphasizes symptom relief, quality of life, and alignment of care with patient values. However, palliative care for these patients is extremely difficult in Korea. Discussion of end-of-life care for non-cancer patients is particularly difficult in Korean society. One reason for this is that hospice palliative care is perceived as termination of treatment by the public. Additionally, because Korean society has a Confucian cultural background, people are usually reluctant to discuss death. Moreover, lack of attention among medical professionals is another key factor that makes implementing palliative care difficult for patients with end-stage COPD. This review aimed to explore ways to provide a meaningful and dignified life for patients with COPD in the ICU by administering palliative care.</p>","PeriodicalId":73780,"journal":{"name":"Journal of hospice and palliative care","volume":"28 1","pages":"25-29"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11891025/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nurses' Experience of Good Nursing Care for Terminally Ill and End-of-life Patients: The Client-Nurse, Practice, and Environment Domains.","authors":"Myung-Nam Lee, Ye-Jean Kim, Jung Won Suk, Hee-Jung Wang, Hyunsook Zin Lee","doi":"10.14475/jhpc.2024.27.4.120","DOIUrl":"10.14475/jhpc.2024.27.4.120","url":null,"abstract":"<p><strong>Purpose: </strong>This study explored nurses' experience of \"good nursing care\" in the context of caring for terminally ill and end-of-life patients, providing a foundation for improving patient care.</p><p><strong>Methods: </strong>We employed a qualitative research approach, integrating both inductive and deductive analysis methods. Data collection occurred from May 1 to August 1, 2023, involving nine nurses from intensive care units, hospice and palliative care wards, and nursing homes. All participants had at least two years of experience in caring for terminally ill and end-of-life patients. Data were collected through individual in-depth interviews and analyzed using Colaizzi's six-stage phenomenological method for inductive analysis, and a deductive method based on four taxonomies client domain, client-nurse domain, practice domain, and environment domain.</p><p><strong>Results: </strong>A total of 172 meaningful statements were derived, with five themes and 57 (33.14%) statements in the client-nurse domain, including three phenomena (contact, communication, and interaction); eight themes and 91 (52.91%) statements in the practice domain, including three phenomena (mentalistic, enactment, and role related phenomenon); and five themes and 24 (13.95%) statements in the environmental domain, including three phenomena (physical, social, and symbolic).</p><p><strong>Conclusion: </strong>The 18 themes of good nursing care, as conceived and experienced by nurses who cared for terminally ill and end-of-life patients, underscore the importance of attentive nursing care.</p>","PeriodicalId":73780,"journal":{"name":"Journal of hospice and palliative care","volume":"27 4","pages":"120-130"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11646822/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Attitudes toward Death, Perceptions of Hospice Care and Needs for Hospice Care among the LGBT Population.","authors":"Sook Jung Kang, Hae In Jang","doi":"10.14475/jhpc.2024.27.4.149","DOIUrl":"10.14475/jhpc.2024.27.4.149","url":null,"abstract":"<p><strong>Purpose: </strong>This study explored the attitudes of lesbian, gay, bisexual, and transgender (LGBT) individuals toward death and their perceptions of hospice and palliative care, as well as their care needs. It also investigated their preferences for alternative decision-making and advance care planning options at the end of life.</p><p><strong>Methods: </strong>A descriptive survey study was conducted with LGBT adults aged 18 and older. Participants were recruited through LGBT organizations and online communities, and data from 207 respondents were analyzed. Questionnaires were utilized to assess attitudes toward death, perceptions of hospice care, and care needs. Statistical analysis was performed using SPSS 20.0, employing the t-test, ANOVA, and Pearson correlation coefficients.</p><p><strong>Results: </strong>LGBT individuals generally had low attitudes toward death and negative perceptions of hospice care. Attitudes toward death varied significantly by sex, age, and education, while perceptions of hospice care differed significantly by sexual orientation and education. Care needs in hospice settings also varied significantly by age, gender identity, and education. Most LGBT participants preferred their biological family members (52%) and partners (39%) as surrogate decision-makers. A significant positive correlation was found between perceptions of hospice care and overall care needs.</p><p><strong>Conclusion: </strong>The findings highlight the need for healthcare services tailored to LGBT individuals' specific needs. It is necessary to promote social understanding, awareness, and policy support to improve the quality of life for LGBT individuals through more inclusive and responsive healthcare services. It also points to the need for healthcare professionals to increase their awareness and understanding of these issues.</p>","PeriodicalId":73780,"journal":{"name":"Journal of hospice and palliative care","volume":"27 4","pages":"149-161"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11646823/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Achievements and Barriers in Hospice and Palliative Social Work Practice: A Qualitative Study.","authors":"Soo Mi Jang, Jung-Won Lim, Ji Eun Choi","doi":"10.14475/jhpc.2024.27.4.131","DOIUrl":"10.14475/jhpc.2024.27.4.131","url":null,"abstract":"<p><strong>Purpose: </strong>Hospice and palliative care is a multidisciplinary approach to treatment and care designed to meet the needs of patients and their families at the end of life. Social workers are essential members of the hospice team, but their role is not well understood. The purpose of this study was to explore achievements and barriers in hospice social work practice and to suggest strategies for enhancing the role of social workers.</p><p><strong>Methods: </strong>The participants were 10 social workers who had worked in hospice institutions for over 5 years and were recruited based on reputational case sampling. Data were collected through two focus group interviews, and were qualitatively analyzed using thematic analysis.</p><p><strong>Results: </strong>Through the data analysis, two topics (achievements in hospice social work practice, barriers to achievements in hospice social work practice), five categories, 17 subcategories, and 182 concepts were derived.</p><p><strong>Conclusion: </strong>Based on an in-depth discussion of our key findings, we propose several types of institutional support, including expanding the hospice social work workforce, improving competence through education and supervision, developing professional programs and community resources, and refining methods for measuring achievements.</p>","PeriodicalId":73780,"journal":{"name":"Journal of hospice and palliative care","volume":"27 4","pages":"131-148"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11646818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reorganization of Long-Term Care Insurance for End-of-Life Care.","authors":"Hyunjong Song","doi":"10.14475/jhpc.2024.27.4.167","DOIUrl":"10.14475/jhpc.2024.27.4.167","url":null,"abstract":"<p><p>Korea introduced long-term care insurance on July 1, 2008, to alleviate the burden on families caring for older adults amidst rapid aging and societal changes. Since then, the system has expanded significantly. However, there remains a shortfall in services adequately addressing the nursing, care, health, and medical needs of older adults at the end of life. Therefore, it is essential to reform the long-term care insurance system to enhance service coverage and improve the quality of care for older adults, thereby supporting dignified end-of-life experiences. A phased approach is necessary to integrate end-of-life care into the existing long-term care insurance framework. Several strategies could be considered. First, end-of-life care could be included as a home-based benefit within the long-term care insurance system. Second, introducing an additional fee could be a practical method to incorporate these services into the premiums for long-term care insurance. This approach would make it feasible to extend these benefits to nursing homes. Third, recognizing the significance of end-of-life services and promoting quality improvement could be achieved by incorporating end-of-life needs assessments and related services into the regular evaluations of long-term care facilities.</p>","PeriodicalId":73780,"journal":{"name":"Journal of hospice and palliative care","volume":"27 4","pages":"167-171"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11646820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Presentation of Two Patients Compassionately Discharged, from Hospital to Home, Who Did Not Achieve Their Desired Home Death.","authors":"Anne Tan, Zhi Zheng Yeo","doi":"10.14475/jhpc.2024.27.4.172","DOIUrl":"10.14475/jhpc.2024.27.4.172","url":null,"abstract":"<p><p>The objective of this case presentation is to identify factors that hinder home deaths after patients have been compassionately discharged from the hospital. It aims to shed light on modifiable factors that could facilitate a home death. Compassionate discharges differ from routine discharges as they are done to support the wishes of terminally ill patients to pass on at home. The two cases selected for detailed analysis were unique in our cohort; they were the only patients admitted to an inpatient hospice after being compassionately discharged to their homes. This study excluded patients who were readmitted to an acute hospital setting for further treatment trials, as their care objectives had changed. A retrospective analysis of medical notes identified several factors associated with the patient's inability to achieve a desired home death. These included a significant increase in nursing needs compared to the pre-admission status, the substantial psychological burden on families caring for a dying relative at home, and the absence of adaptable and sustainable care plans. Therefore, a successful compassionate discharge requires the provision of caregiver training and psychological support to families both before and after discharge. Moreover, healthcare providers must collaborate with families to develop flexible care plans that are sufficiently robust to manage the unpredictable prognoses of patients.</p>","PeriodicalId":73780,"journal":{"name":"Journal of hospice and palliative care","volume":"27 4","pages":"172-176"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11646821/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advance Care Planning in Palliative Care in Asia: Barriers and Implications.","authors":"Yoo Jeong Lee, Sun-Hyun Kim, Shin Hye Yoo, A-Sol Kim, Cheng-Pei Lin, Fhea, Sup, Sup, Diah Martina, Masanori Mori, Sang-Yeon Suh","doi":"10.14475/jhpc.2024.27.4.107","DOIUrl":"10.14475/jhpc.2024.27.4.107","url":null,"abstract":"<p><p>Advance care planning (ACP) in palliative care is essential for patient autonomy and quality of dying. This review explores ACP practices in South Korea, Japan, and Taiwan, highlighting how legislation and cultural values shape those practices. In these three sectors, which are influenced by Confucian values, family involvement plays a significant role in decision-making. In South Korea, the Life-Sustaining Treatment Decisions Act made ACP processes mandatory at all healthcare institutions and rapidly created advance directive registration agencies nationwide, with a national web-based system for legal documentation. The Act's narrow focus on terminal illness and dying phase may inadvertently delay end-of-life discussions. A broader social consensus is needed to allocate end-of-life care resources in a way that reflects patients' and families' wishes. Japan's family-based approach highlights relational autonomy, with ACP timing varying and no formal legal frameworks for advance directives. Expanded palliative care, ACP guidelines, systemic support, and public awareness drive progress in Japan. Taiwan's two relevant legislative frameworks-the Hospice Palliative Care Act and Patient Right to Autonomy Act-expand palliative care services for terminal illnesses and non-cancer diseases such as severe dementia, irreversible coma, and a persistent vegetative state. Misunderstandings of ACP and family-led decision-making may hinder ACP uptake. ACP referral based on patient care needs rather than terminal diagnoses is suggested. Overcoming common barriers in Asia necessitates open dialogues about death and public education. A standardized legal framework and comprehensive training for healthcare providers are equally important. Further international collaboration will suggest culturally sensitive ACP conversations across Asia.</p>","PeriodicalId":73780,"journal":{"name":"Journal of hospice and palliative care","volume":"27 4","pages":"107-119"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11646817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}