Beliefs and Attitudes toward Physician-assisted Suicide among Korean Adults

황인철,강정훈,Won-chul Kim,Jeanno Park,김현숙,DaeKyun Kim,Kyung Hee Lee 한국호스피스완화의료학회 2022 한국호스피스.완화의료학회지 Vol.25 No.4

Purpose: To grasp public opinion accurately, we conducted an opinion poll on beliefs and attitudes toward physician-assisted suicide (PAS). Methods: A randomized telephone survey ensuring a representative sample was conducted, 1,007 participants aged 18 years or older (response rate, 9.5%). Results: The main results are as follows: i) 61.1% of participants thought that the current social support system for terminally ill patients and their families is insufficient; ii) 60% of participants did not recognize the term “hospice and palliative care”; iii) 81.7% of participants would not like to receive life-sustaining treatment if there is no possibility of recovery; iv) 58.4% of participants would like to receive hospice and palliative care if they are diagnosed with a terminal illness; v) the priorities for dignified dying were preparing a support system to reduce the burden of care (28.6%), economic support including reduction of medical expenses (26.7%), expansion of hospice and palliative care services (25.4%), and legalization of PAS (13.6%); and vi) 58.3% of participants agreed that the expansion of hospice and palliative care should precede the legalization of PAS. Conclusion: Koreans currently want other efforts, including expansion of hospice and palliative care services, instead of the legalization of PAS.

Use of a decision aid to help caregivers discuss terminal disease status with a family member with cancer: a randomized controlled trial.

Yun, Young Ho,Lee, Myung Kyung,Park, Sohee,Lee, Jung Lim,Park, Jeanno,Choi, Youn Seon,Lim, Yeun Keun,Kim, Sam Yong,Jeong, Hyun Sik,Kang, Jung Hun,Oh, Ho-Suk,Park, Ji Chan,Kim, Si-Young,Song, Hong Suk Grune Stratton ; American Society of Clinical Onco 2011 Journal of clinical oncology Vol.29 No.36

<P>We tested whether a decision aid explaining how to discuss the approach of death with a family member with cancer would help family caregivers decide to discuss a terminal prognosis.</P>

When is similar different? When is different similar? A review of language assessment foci of selected Philippine English language textbooks

Allan B. de Guzman,Rowena Marie R. Chua,Geline R. Cruz,Jeanno Lorenz G. Dinglasan,Mary Noll P. Giliberte,Mary Anne G. Martin 한국교육개발원 2012 KEDI Journal of Educational Policy Vol.9 No.2

The centrality of textbooks in basic education calls for periodic assessment of their pedagogical, substantial and assessment features, thus ensuring optimum development of students—the end-users of all educational efforts. Cognizant of the fact that textbooks define the backbone of “micro” organizations for classroom activities (Schmidt, McKnight, & Raizen, 1997), this exploratory undertaking is aimed at identifying the dominant emphasis of a select group of Philippine textbooks in English with regards to macro skills, facets of understanding, and learning strategies. A total of 12 textbooks across four curriculum levels published from 2004 to 2006were subjected to content analysis. Results indicate that Philippine English language textbooks put a premium on the writing and reading skills of students. There is continuing emphasis on the knowledge aspect of language assessment strategies,leaning toward behaviorism. Cognitive strategies are extensively employed along with memory strategies. Policy implications of the study are also discussed in this paper.

Reliability and Validity of the Korean Cancer Pain Assessment Tool (KCPAT)

Jeong A Kim,Youn Seon Choi,Juneyoung Lee,Jeanno Park,Myung Ah Lee,Chang Hwan Yeom,Se Kwon Jang,윤덕미,Jun Suk Kim 대한의학회 2005 Journal of Korean medical science Vol.20 No.5

The Korean Cancer Pain Assessment Tool (KCPAT), which was developed in 2003, consists of questions concerning the location of pain, the nature of pain, the present pain intensity, the symptoms associated with the pain, and psychosocial/spiritual pain assessments. This study was carried out to evaluate the reliability and validity of the KCPAT. A stratified, proportional-quota, clustered, systematic sampling procedure was used. The study population (903 cancer patients) was 1% of the target popu-lation (90,252 cancer patients). A total of 314 (34.8%) questionnaires were collected. The results showed that the average pain score (5 point on Likert scale) according to the cancer type and the at-present average pain score (VAS, 0-10) were corre-lated (r=0.56, p<0.0001), and showed moderate agreement (kappa=0.364). The mean satisfaction score was 3.8 (1-5). The average time to complete the question-naire was 8.9 min. In conclusion, the KCPAT is a reliable and valid instrument for assessing cancer pain in Koreans.

The impact of caregiver’s role preference on decisional conflicts and psychiatric distresses in decision making to help caregiver’s disclosure of terminal disease status.

Yoo, Shin Hye,Yun, Young Ho,Kim, Kyoung-Nam,Lee, Jung Lim,PARK, Jeanno,Choi, Youn Seon,Lim, Yeun Keun,Kim, Samyong,Jeong, Hyun Sik,Kang, Jung Hun,Oh, Ho-Suk,Park, Jichan,Kim, Si-Young,Song, Hong-Suk,L American Society of Clinical Oncology 2017 Journal of clinical oncology Vol.35 No._suppl15

<P> 10106 </P><P> Background: A decision aid (DA) increases knowledge, decreases decisional conflicts and regrets and improves post-decision satisfaction, emotional distress. However, few DA trials have revealed whether decisional role preferences have an impact on patient-reported outcomes by decision making. The objective of this study was to investigate the impact of caregiver’s decisional role preference on decisional conflicts and psychiatric distresses in decision making. Methods: 406 of 444 caregivers of terminally ill cancer patients enrolled onto a previous trial determining the efficacy of the decision aid about disclosure of terminal disease status were included in this analysis. The analysis outcomes were change score of decisional conflicts using the Decision Conflict Scale (DCS) and depression and anxiety using the Hospital Anxiety and Depression Scale (HADS) at 1 and 3 months from baseline. Participants were divided into 4 groups: active caregiver who received DA (active-DA), active caregiver in control group (active-control), passive caregiver who received DA (passive-DA), and passive caregiver in control group (passive-control). Linear mixed model was conducted to find out the impact of caregiver’s decisional role preference on the DCS and the HADS. Results: Among 406 caregivers, 137 (33.7%) showed active role preference, and 269 (66.3%) showed passive role preference. In post-hoc analysis of adjusted differences of change scores between passive-DA and active-DA groups, non-significant differences were observed in DCS. However, at 3 months, change scores of HADS depression subscale increased as 4.43 (95% confidence interval (CI), 0.78-8.07; P< 0.007; effect size (ES) 0.71) and those of HADS anxiety subscales increased as 4.14 (95% CI, 0.37-7.91; P= 0.021; ES 0.61) in passive-DA group than in active-DA group, showing moderate to large difference. Conclusions: These findings suggest that information about decision making might be provided with tailored format for how much individual wish to involve in decision making. </P>

Multicenter, cross-sectional observational study of the impact of neuropathic pain on quality of life in cancer patients

Oh, So Yeon,Shin, Sang Won,Koh, Su-Jin,Bae, Sang Byung,Chang, Hyun,Kim, Jung Han,Kim, Hyo Jung,Hong, Young Seon,Park, Keon Uk,Park, Jeanno,Lee, Kyung Hee,Lee, Na Ri,Lee, Jung Lim,Jang, Joung Soon,Hong Springer Berlin Heidelberg 2017 SUPPORTIVE CARE IN CANCER Vol.25 No.12

<P><B>Purpose</B></P><P>Neuropathic cancer pain (NCP) is a common and potentially debilitating symptom in cancer patients. We investigated the prevalence of NCP, as well as its management and association with QOL.</P><P><B>Methods</B></P><P>Cancer patients with pain ≥1 on the visual analogue scale (VAS) were surveyed with the Douleur Neuropathique (DN4) questionnaire, the Brief Pain Inventory-Short Form (BPI-SF), and the EuroQOL five dimensions (EQ-5D) questionnaire. The associations between NCP and pain severity or NCP and QOL, while controlling for variables relevant to QOL, were then analyzed.</P><P><B>Results</B></P><P>A total of 2003 patients were enrolled in this survey; the prevalence of NCP was 36.0% (<I>n</I> = 722, 95% CI, 32.5–39.5). We found that NCP in cancer patients was closely correlated to a higher pain severity (BPI-SF; 4.96 ± 1.94 versus 4.24 ± 2.02, <I>p</I> < 0.001), and in patients with NCP, pain more severely interfered with daily living, as compared to those without NCP (BPI-SF; 4.86 ± 2.71 versus 4.41 ± 2.87, <I>p</I> < 0.001). Patients with NCP also had worse QOL than those without NCP, as measured by EQ-5D index score (0.47 ± 0.30 vs. 0.51 ± 0.30, <I>p</I> = 0.005), and this was confirmed using multivariate analysis (<I>p</I> < 0.001), even after controlling for other variables such as age, sex, disease stage, cancer duration, radiotherapy, chemotherapy, and comorbidities. Importantly, adjuvant analgesics were used in less than half of patients with NCP (<I>n</I> = 358, 46.4%).</P><P><B>Conclusions</B></P><P>We found that NCP in cancer patients was significantly associated with a worsened QOL, and current management is inadequate. Therefore, future research aimed at developing improved strategies for management of NCP is required.</P><P><B>Electronic supplementary material</B></P><P>The online version of this article (doi:10.1007/s00520-017-3806-5) contains supplementary material, which is available to authorized users.</P>

Developing competencies for multidisciplinary hospice and palliative care professionals in Korea

Kang, Jina,Kim, Yeol,Yoo, Yang Suk,Choi, Jin Young,Koh, Su Jin,Jho, Hyun Jung,Choi, Youn Seon,Park, Jeanno,Moon, Do Ho,Kim, Do Yeun,Jung, Yun,Kim, Won Chul,Lim, Seung Hee,Hwang, Seung Joo,Choe, Sang O Springer-Verlag 2013 Supportive care in cancer Vol.21 No.10

국내의 비암성 질환의 호스피스 완화의료 적용에 대한 전문가의 인식에 관한 질적 연구: 후천성 면역결핍 증후군, 만성 폐쇄성 폐질환, 간경화를 중심으로

신진영,윤석준,김선현,이언숙,고수진,박진노,Shin, Jinyoung,Yoon, Seok-Joon,Kim, Sun-Hyun,Lee, Eon Sook,Koh, Su-Jin,Park, Jeanno 한국호스피스완화의료학회 2017 한국호스피스.완화의료학회지 Vol.20 No.3

목적: 2017년 8월부터 말기 암 이외에도 후천성 면역결핍 증후군, 만성 폐쇄성 폐질환, 간경화 환자들에게도 호스피스 완화의료가 적용될 예정이다. 이에 본 연구에서는 비암성 질환 전문가들을 대상으로 세 가지 질환에서의 호스피스 완화의료의 목표, 내용 및 적용 방법에 대한 심층 면담을 통해, 호스피스 완화의료에 대한 생각, 인식, 태도에 대해 살펴보아, 국내 실정에 맞는 비암성 호스피스 완화의료 진료 모델 마련에 기여하고자 하였다. 방법: 본 연구는 반구조적 심층 면담조사를 통한 질적 연구이다. 암환자의 호스피스 완화의료를 담당하는 네 명의 임상 의사가 85편의 문헌 검색을 통해 핵심 질문을 선정하여 총 11명의 비암성 질환 전문가들에게 면담을 하고 질적 연구 방법에 따라 분석되었다. 결과: 전문가들은 비암성 질환의 말기환자를 정의하기 어렵다고 하였고, 호스피스 완화의료의 목표와 내용은 암환자들을 대상으로 한 것과 다르지 않다고 하였지만, 통증보다는 다른 신체 증상과 정서적 문제에 중점을 두어야 한다고 하였다. 또한, 말기라고 진단할 수 있는 시점에 호스피스 완화의료를 적용해야 한다고 하였다. 질환 별로 특수한 점들(AIDS 환자들의 항바이러스제 사용, COPD 환자들의 호흡곤란, LC 환자들의 간이식)과 의료진들에 대한 교육의 필요성에 대해 언급하였다. 호스피스 완화의료 적용 시 환자들이 자신을 포기한다는 느낌을 받을 수 있다고 하였고 정부의 재정 지원 문제에 대해서도 언급하였다. 결론: 비암성 질환에 대한 호스피스 완화의료 도입의 문제점을 최소화하기 위해서는 심도 있는 논의를 통해 비암성 질환의 말기환자에 대한 정의를 마련해야 할 필요가 있다. 또한, 비암성 말기환자들을 돌보는 의료진과 현재 말기 암환자의 호스피스 완화의료를 담당하고 있는 인력의 협력이 필요하다. Purpose: From August 2017, hospice-palliative care (HPC) will be provided to patients with acquired immunodeficiency syndrome (AIDS), chronic obstructive pulmonary disease (COPD), and liver cirrhosis in Korea. To contribute to building a non-cancer (NC) hospice-palliative care model, NC specialists were interviewed regarding the goals, details, and provision methods of the model. Methods: Four physicians specializing in HPC of cancer patients formulated a semi-structured interview with questions extracted from literature review of 85 articles on NC HPC. Eleven NC disease specialists were interviewed, and their answers were analyzed according to the qualitative content analysis process. Results: The interviewees said as follows: It is difficult to define end-stage NC patients. HPC for cancer patients and that for NC patients share similar goals and content. However, emphasis should be placed on alleviating other physical symptoms and emotional care rather than pain control. Timing of the care provision should be when patients are diagnosed as "end stage". Special issues should be considered for each NC disease (e.g., use of anti-retroviral drugs for AIDS patients, oxygen supply for COPD patients suffering from dyspnea, liver transplantation for patients with liver cirrhosis) and education should be provided to healthcare professionals. NC patients tend to negatively perceive HPC, and the government's financial assistance is insufficient. Conclusion: It is necessary to define end-stage NC patients through in-depth discussion to minimize issues that will likely accompany the expansion of care recipients. This requires cooperation between medical staff caring for NC patients and HPC givers for cancer patients.