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Kyungeun Son,Sanghee Kim,Sue Kim,Hei-cheul Jeung 한국간호과학회 2021 한국간호과학회 학술대회 Vol.2021 No.10
Aim(s): For the quality of care for cancer patients at the end of their lives, the healthcare professional’s competency regarding the end of life care is crucial. By measuring the competency of healthcare providers, an education program relating to a quality end-of-life care should be established. The purpose of this study was to develop instruments for identifying the knowledge, practice, and perceived barriers to end-of-life care among healthcare professionals caring for terminal cancer patients. Method(s): This study was designed to use methodological research. To measure the knowledge and practice of medical staff in end-of-life care, the first draft of the instrument was developed based on three national and international clinical practice guidelines, including “The end-of-life care clinical practice guidelines”(2020) by the Korean Society of Hospice and Palliative Medicine, the National Cancer Center, and the Ministry of Health and Welfare; “Care of dying adults in the last days of life” (2016) by the National Institute for Excellence in Health and Care; and “Palliative care Version Ⅱ” (2021) by the National Comprehensive Cancer Network. The first draft of the instrument consists of core items that were suggested for at least two of the guidelines. There were 20 initial items of knowledge, 16 items of practice, and 8 items of perceived barriers to end-of-life Care. To validate the developed instrument, 2 oncologists and 4 nurses with master"s degrees or higher and caring for cancer patients were evaluated for validity of content. In addition, the items related to perceived barriers were corrected and supplemented after receiving comments from them. Result(s): After expert validation, all items met the criteria except 1 with a CVI of less than 0.8. That item was deleted. Finally, 19 items of knowledge, 16 items of practice, and 12 items of perceived barriers regarding end-of-life care were established. The items consist of questions about imminent death, interventions in physical and psychological symptoms, and communication. Conclusion(s): This survey instrument was reported as applicable to both doctors and nurses, and as relevant to measuring health care providers’ knowledge, practice, and perceived barriers to end-of-life care. This instrument would be helpful in identifying and reducing the gap between the two groups in team nursing that require cooperation for end-of-life care. Ultimately, it provides basic data for research to provide high-quality end-of-life care to terminal cancer patients.
Laryngeal involvement in Non-Langerhans cell histiocytosis: a case of Erdheim-Chester disease
( Yoon Jeong Son ),( Dong-hoe Koo ),( Hyo Sun Lee ),( Min Chul Kim ),( Sukjoong Oh ),( Yong-kyun Cho ),( Sang-hyuk Lee ),( Ji-hye Park ),( Kyungeun Kim ),( Hyun-joo Lee ),( In-gu Do ),( Su-young Jung 대한내과학회 2015 대한내과학회 추계학술대회 Vol.2015 No.1
Erdheim-Chester disease (ECD) is a rare form of non-Langerhans cell histiocytosis characterized by infiltrates of lipid laden CD68(+)/CD1a(-) histiocytes, which involves multiple organ system. Currently, interferon-α is the mostly studied agent in the treatment of ECD and serves as the first line of treatment. We report a case of ECD patient who presented with dyspnea, dysphagia, and dysphonia. He had multiple erythematous papules and plaques on peri-orbital, perioral, neck, axilla, inguinal area, and anus.On endoscopic examination, multiple nodular lesions were observed in larynx and stomach. Biopsy specimens from skin and stomach showed dense, nodular infiltrates of histiocytes, which were positive for CD68, and negative for CD1a and S100 on immunohistochemical staining. To relieve his symptoms, laryngeal mass excision was performed, and the excised specimen also showed similar findings with CD68(+)/CD1a(-) histiocytes compatible with ECD. After mass excision, his symptoms improved dramatically; therefore, the systemic therapy with interferon-αis delayed and will be considered later. Since the aim of ECD treatment is to relieve symptoms besides to suppress the disease progression, the local surgical approach should be considered in some patients with aggressive diagnostic evaluation.