상단 PDF The Need for Hospice Care in Families of Patients with Cancer

Cancer patients' need for financial assistance and its related factors

Cancer patients' need for financial assistance and its related factors

Conclusion : In spite of the current policy to increase health insurance coverage, the majority of cancer patients and their families in Korea still need financi[r]

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The financial burden associated with medical costs among childhood cancer patients and their families related to their socioeconomic status: the perspective of National Health Insurance Service

The financial burden associated with medical costs among childhood cancer patients and their families related to their socioeconomic status: the perspective of National Health Insurance Service

In addition to the special system described above, the government also provides financial support to low-income patients who pay health insurance premiums below KRW 100,000 [40]. However, our study found that the medical costs of the low status group and the mid-low status group showed not much of a difference on average. The mid-low status group had decreased cumulative medical costs at 1-year post-diagnosis. Patients did not have different medical accessibility or service based on their socioeconomic status. However, due to the uncovered items and 20% of OOP cost, patients could have received different services. Thus, it could cause difference in medical services. Currently, most supportive programs target patients in low socioeconomic status based on the household income. Yet, people in the mid-low group have limited support programs towards medical treatment. Therefore, we suggest expanding financial support for families who are in need.
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Hepatic resection after neoadjuvant chemotherapy for patients with liver metastases from colorectal cancer: need for cautious planning

Hepatic resection after neoadjuvant chemotherapy for patients with liver metastases from colorectal cancer: need for cautious planning

Although most studies report consistent findings of early recurrence but a relatively favorable OS in CLM patients after resection, the factors associated with RFS or OS have differed. Factors are assessed either independently or in a scoring system for their relation to oncologic outcomes. Clinical risk scores (CRS) are used to determine the prognosis of patients with CLM after resection; widely used scoring systems have been developed by Fong et al. [15] Nordlinger et al. [2], Nagashima et al. [16], and Konopke et al. [17]. The different CRS consist of common factors such as pathologic T stage, pathologic lymph node stage, number of liver metastases, and size of the largest CLM, with slight variations. However, despite their wide used, the CRS may be outdated, as the scoring systems were established over a decade ago and most CRS excluded patients with R1 resections. CLM patients who have undergone resection may present with R1 margins even though they were assessed as curatively resectable prior to surgery; thus, determining patient prognosis without accounting for potential R1 resections can be challenging.
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The perceived care needs of breast cancer patients in Korea

The perceived care needs of breast cancer patients in Korea

Patients who had surgery less than 1 year ago were more likely to report some needs in the physical and daily living domain and patients who were in-between 1 to 3 years after surgery were more likely to report some needs in the health system and information domain. This finding may reflect the treatment process that breast cancer patients normally go through; diag- nosis, surgery, adjuvant therapy (chemotherapy, radiation therapy, endocrine therapy) and re- covery or survivorship. While or until patients have postoperative adjuvant therapy after sur- gery, they might experience many physical side effects related to the treatments and be more likely to report some needs both in the physical and daily living domain and the information domain. After the treatment is over, patients do not see their physicians as often as they were receiving treatment and also the side effects are alleviated. Therefore, patients who are in-between 1 to 3 years since surgery might need information to manage their illness by themselves and also need professionals or groups of patients to talk with not as patients but more as survivors.
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A qualitative inquiry of the lived experiences of music therapists who have survived cancer who are working with medical and hospice patients

A qualitative inquiry of the lived experiences of music therapists who have survived cancer who are working with medical and hospice patients

them... and have extra ways to connect with them because you’ve been where they are to a degree.” DISCUSSION Five music therapists have shared their experiences of surviving cancer and returning to work as therapists. As survivors, cancer had a significant impact on their personal, relational and musical dimensions of self. The personal self was touched by powerful intrapersonal journeys through denial, acceptance, optimism, self-awareness, spiritual faith, and/or discovery of multiple meanings in cancer, in addition to their own self- care and therapeutic experiences. The relational self as patients, was affected by the incredible love from family, unexpected and humbling support from friends, deeply-felt connections with other patients and survivors, and/or compassionate and trustworthy medical care staff. As a professional, they learned to value healthy boundaries, self-disclosure, and mentorship. The cancer experience brought changes in their relationship with music as well. As patients, they witnessed the therapeutic effect of music to provide deep relaxation, powerful imagery, creative outlets, therapeutic self-expression, and effective procedural support. As music therapists, they gained even higher levels of trust and respect for music, which fostered more direct and intentional use of music.
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Hospice care compliance of nurses working at a hospice ward in Korea

Hospice care compliance of nurses working at a hospice ward in Korea

In the emotional area, the level of respecting client’s privacy with sincere attitude in hospice nurses was high, but the communication level such as talking to a client about his/her health status or talking to express his/her feelings was low. In Anthony and Scarcelli’s study, one of the important cost-effective approaches to corporate compliance for hospice and home health providers is communication. Communicating compliance standards, policies, and procedures among organization, employees, agents, and clients is emphasized in the study. Based on the findings, nurses working at hospice ward need to have more time to communicate clients and families but also understand clients’ feelings and families’ exhaus- tions.
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Attitudes toward early palliative care in cancer patients and caregivers: a Korean nationwide survey.

Attitudes toward early palliative care in cancer patients and caregivers: a Korean nationwide survey.

Factors related to the negative attitudes toward EPC varied between the groups. This suggests that the perceived potential benefits of EPC might be different between patients and caregivers. Our findings showed that male and younger patients showed more negative attitudes for EPC than female and older patients. This may reflect the known tendency that male [29] and younger [30] patients prefer aggressive care to PC. However, according to a study of the efficacy of EPC intervention [31], these groups appeared to experience more improvement of quality of life and depression with EPC than other patients did, suggesting that they should be involved in EPC. Interestingly, patients who experienced ICU admission showed more negative attitudes toward EPC than those who did not. We speculate that after ICU care, survivors might consider aggressive care as more beneficial than PC. The correlations between attitudes toward death and attitudes toward EPC reported in our study imply that beliefs about death and dying may differently influence the perception of EPC. Groups that did not agree with EPC also showed negative thoughts on charity upon death or being remembered. Patients not afraid of death were also less likely to be interested in
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Synchronous and metachronous malignancy in endometrial cancer patients treated in a tertiary care center of Thailand

Synchronous and metachronous malignancy in endometrial cancer patients treated in a tertiary care center of Thailand

We obtained approval from the Ethics Committee for Research involving human subjects of Vajira Hospital prior to commen- cing our study. The Archives of the Gynecologic Oncology Unit, Department of Obstetrics and Gynecology were searched to identify EC patients treated between January 1995 and Decem- ber 2012. We included patients with EC or carcino sarcoma who had treatment and follow-up visits at our institution. Ex clusion criteria were patients who had uterine sarcoma or no avail able medical records.

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Quality indicators for cervical cancer care in Japan

Quality indicators for cervical cancer care in Japan

Japanese population, making further studies necessary for solidifying the optimal choice of treatment for this population. Although the trend was most clearly elucidated for the QI referring to radiation therapy, reasons for non-adherence implicated comorbidities as the major reason for choosing alternatives for most of the QIs. Although the comorbidities were varied, a substantial number of patients were treated with alternative treatment due to age-related issues such as impairment of the liver and/or the kidney. Overall, except for QI8, which showed heavy use of CT and MRI as diagnostic tools, ‘insufficient reasons’ for non-adherence were observed in as low as 10% to 20% of the cases. We conclude from our results that though there is room for improvement, efforts were made by the participating hospitals to provide care in accordance with the guidelines.
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Do we need a better marker for successful ovarian cancer surgery?

Do we need a better marker for successful ovarian cancer surgery?

In the recent issue of the Journal of Gynecologic Oncology, Zwakman and his colleagues boldly proposed that the perioperative decline in serum CA125 can be a better marker for residual tumor volume after ovarian cancer surgery than the surgeons' estimation of residual tumor [2]. In the retrospective study including 123 ovarian cancer patients, the authors compared perioperative decline of CA125 levels with residual tumor categories which is subjectively reported by surgeons. In agreement with a few similar studies [3-5], the authors concluded that the patients who have less than 50% decrease of CA125 levels showed higher disease specific mortality and the perioperative change of CA125 was a better predictor than residual tumor volume.
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Knowledge, attitude, confidence, and educational needs of palliative care in nurses caring for non-cancer patients: a cross-sectional, descriptive study

Knowledge, attitude, confidence, and educational needs of palliative care in nurses caring for non-cancer patients: a cross-sectional, descriptive study

Conclusion Despite these limitations, this study provided solid in- formation that can be utilised to develop palliative care educational programs. In this study, nurses who cared for patients with CHF, stroke, ESRD, and ESLD had lower palliative care knowledge and were less confident about palliative care management, programs, and counselling than they were about pain and symp- tom management. In addition, this study revealed that a significant factor affecting nurses’ palliative care confidence was a previous education course in hospice, palliative, or EOL care. In conclusion, to provide high- quality palliative care for non-cancer patients and their families, continuous and integrated palliative care edu- cation programs should be developed based on the nurses’ palliative care knowledge, attitude, confidence, and educational needs. Furthermore, palliative care should be specialised based on disease characteristics and coordinated professional disciplines. Future stud- ies should be considered to explore palliative care experiences in different types of health care profes- sionals and different types of non-cancer patients, and to develop effective training programs for palliative care specialists caring for non-cancer patients.
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The effects of aroma hand massage on fatigue and sleeping among hospice patients

The effects of aroma hand massage on fatigue and sleeping among hospice patients

We used lavender and bergamot essential oils because they were reported to help clients relax in previous studies [15] [21]. One study subject expressed displeasure with the smell of the oil in the early days of this study and wanted to drop from the study. Also, a few subjects in the experimental group wanted sometimes only mas- sage without aroma oil to be applied a couple of times, but they did not want to drop from the group. Based on the findings, even though lavender and bergamot oils have been reported as 2 of the best oils for inducing relax- ation, the client’s preferences for the type of oil needs to be taken into consideration. In addition, comparisons of the effects of different types of oils need to be conducted to determine the best oil for alleviating fatigue and im- proving sleep in hospice clients in further studies.
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Multivariate survival analysis of the patients with recurrent endometrial cancer

Multivariate survival analysis of the patients with recurrent endometrial cancer

Although the exact reason why two factors are indepen- dently related to survival after relapse remains to be deter- mined, it is easy to speculate the possible reasons. Time to relapse within one year after primary surgery may largely depend on the aggressive phenotype and resistance to adjuvant chemotherapy of endometrial cancer cells, and multiple sites of recurrence may be related to the metastatic potential of endometrial cancer cells. Therefore, we need to establish a new treatment strategy to efficiently treat patients with recurrent endometrial cancer in addition to currently available treatment modalities including debulking surgery, chemotherapy, and radiotherapy. One of the promising molecular targeting agents is the vascular endothelial growth factor inhibitor, bevacizumab, which has been recently shown to improve progression-free survival of the patients with ovarian cancer [13]. To search for new molecular markers to predict survival after relapse and/or new molecular targets to improve survival, we need to further investigate the molecular mechanism of chemoresistance and radioresistance in endometrial cancer cells. Cyr61, a member of CCN family, may be a good target because Cyr61 predicts survival of patients Fig. 1. Stratificatiion of survival of patients with recurrent endometrial
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Study on relationship of patients' information need, e-Health system use and outcomes: CHIS system in patients with breast cancer center

Study on relationship of patients' information need, e-Health system use and outcomes: CHIS system in patients with breast cancer center

수집된 데이터 원본은 다양한 시점에서의 환자의 정보 요구와 관련된 데이터가 기록되어 있으나 본 연구에서 는 유방암 환자들의 정보 요구의 정도에 따라 시스템 사용과 환자 성과가 어떠한 영향을 받는 지 알아보기 위하여 환자들의 정보 요구 수준은.. 수요자의료정보시스템의 사용 이전에 기록된 데이터를 기준으로 분석에 사용하였다.[r]

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The clinical study of oral care for early radiation therapy in the head and neck cancer patients

The clinical study of oral care for early radiation therapy in the head and neck cancer patients

이에 착안하여 저자 등은 두경부 악성 종양으로 방사선 치료가 내정된 상태에서 조기 방사선치료를 위한 치과적 관리문제로 대진의뢰된 환자들에서 치성 염증이 존재하는 경우에 관련 문헌의 고찰과 방사선치료의 원리와 위해효 과에 대한 이해를 바탕으로, 발치의 적응증이 되는 치아들 은 발치를 시행하고 문헌에서 가장 단축된 1주일 경과 후 에 방사선치료를 시작하고, 무증상의 만성 치근단염증 상 태처럼 발치를 연기할 수 있는 상태의 염증치아들은 가능 한 한 근관치료와 같은 보존적인 방법으로 관리하여 모든 경우들에서 1주일 이내에 조기 방사선치료에 임하게 하는 방법을 선택해서 임상에 적용했다. 또한 방사선치료 도중 과 치료 후 과정에서 계속적인 치성 염증의 관리를 시도했 는데, 최근 10년간 특기할 치성 염증의 합병증(방사선성 골 괴사증 등) 발생이 없음을 관찰했다. 이런 방법을 선택할 수 있는 이유는 문헌에서 언급도 있지만 과학적 근거로 방 사선치료의 조사량이 통상적으로 매일 180-200 cGy씩 1주 일에 900-1,000 cGy 조사되어 최초 2-3주일은 조사량이 많 지 않아 초기에는 방사선의 위해효과가 적고, 발치를 시행 하는 경우에도 창상감염을 유발시키는 요소들(국소, 전신, Table 12. The distribution of chronic long sustained oral complications over one year after radiotherapy
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The experimental study of oral care for early radiation therapy in the head and neck cancer patients

The experimental study of oral care for early radiation therapy in the head and neck cancer patients

이상의 동물실험을 통한 통계학적 유의성을 감안할 때, 두경부 악성종양으로 방사선치료를 시행받게 되는 환자들 이 가능한 한 조기에 방사선치료가 진행되어야 되는 상황 이라면 방사선치료 시행 전에 발치의 적응증이 되는 치아 는 발치를 시행하고 1주일 경과 후에 방사선치료를 시작하 고, 무증상의 만성 치근단 염증치아는 근관치료 등 보존적 [r]

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The clinical study of oral care for early radiation therapy in the head and neck cancer patients

The clinical study of oral care for early radiation therapy in the head and neck cancer patients

이에 착안하여 저자 등은 두경부 악성 종양으로 방사선 치료가 내정된 상태에서 조기 방사선치료를 위한 치과적 관리문제로 대진의뢰된 환자들에서 치성 염증이 존재하는 경우에 관련 문헌의 고찰과 방사선치료의 원리와 위해효 과에 대한 이해를 바탕으로, 발치의 적응증이 되는 치아들 은 발치를 시행하고 문헌에서 가장 단축된 1주일 경과 후 에 방사선치료를 시작하고, 무증상의 만성 치근단염증 상 태처럼 발치를 연기할 수 있는 상태의 염증치아들은 가능 한 한 근관치료와 같은 보존적인 방법으로 관리하여 모든 경우들에서 1주일 이내에 조기 방사선치료에 임하게 하는 방법을 선택해서 임상에 적용했다. 또한 방사선치료 도중 과 치료 후 과정에서 계속적인 치성 염증의 관리를 시도했 는데, 최근 10년간 특기할 치성 염증의 합병증(방사선성 골 괴사증 등) 발생이 없음을 관찰했다. 이런 방법을 선택할 수 있는 이유는 문헌에서 언급도 있지만 과학적 근거로 방 사선치료의 조사량이 통상적으로 매일 180-200 cGy씩 1주 일에 900-1,000 cGy 조사되어 최초 2-3주일은 조사량이 많 지 않아 초기에는 방사선의 위해효과가 적고, 발치를 시행 하는 경우에도 창상감염을 유발시키는 요소들(국소, 전신, Table 12. The distribution of chronic long sustained oral complications over one year after radiotherapy
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Home hospice palliative care service in Korea: Based on focus group interview

Home hospice palliative care service in Korea: Based on focus group interview

> PCU=Palliative care unit, PCT=Palliative care team 3.4. 대상자 선별과 등록 절차 포커스 그룹에 참여한 기관의 대상자 선별과 등록절차는 Table 3.4로 정리하였다. 가정호스피스 대상 자 선별과정에서 말기판단은 독립형 가정호스피스기관을 제외한 모든 기관에서 호스피스완화의료 표준 에 따라 의사 2인에 의해 이루어지고 있었다. 본원의 입원형이나 외래를 통해 의뢰된 경우에는 암 진료 를 맡았던 주치의와 완화의료 주치의, 2인이 진단검사 결과나 의무기록에 근거하여 말기상황을 판단할 수 있었다. 그러나 타병원에서 의뢰되어 올 때 말기상태이므로 호스피스의뢰를 한다는 내용이 진단서에 기재되지 않는 경우가 많을 뿐 아니라 말기진단을 위해 모든 진단검사를 다시 실시하는 것 또한 부적절 한 경우가 많아 내원한 상담자의 진술과 완화의료병동에 근무하는 의사 2인의 임상적 판단에 따르는 경 우가 일반적이었다. 말기판단이 확정된 다음, 가정호스피스에 대한 동의 취득과정은 주로 호스피스팀장 이나 사례관리자를 맡고 있는 호스피스전문간호사에 의해 이루어지고 있었으며, 서면동의 대신 구두동 의를 받는 경우도 있었고, 환자의 병식이 불명확하더라도 가족이 동의하면 호스피스완화의료를 개시하 고 있었으며, 실제 환자의 서면동의를 받는 경우는 드물었다. 다시 말해, 각 기관에서는 서비스 개시 시 점에서 가족의 말기인식은 요구하고 있었으나, 환자에게는 가족과 상의하여 점진적으로 알리는 것이 일 반적인 것으로 파악되었다. 인터뷰에 응한 실무자들은 환자의 병식이 서비스 개시의 선행조건이 되지 않으며, 원칙적으로 모두 알려야 하나, 서비스를 개시하고 점진적으로 환자의 요구에 맞게 정보를 공유 하는 것이 우리문화에 적합하다는 판단을 공유하였다. 또한 초기면담이 입원형에서 이루어지는 경우 가 정호스피스에 대한 별도의 동의서 없이 가정간호 동의서만 받는 경우가 많았으며 호스피스 동의서에 입 원형/가정형에 대한 설명을 추가하고 원하는 서비스에 체크하는 방식이 추천되었다.
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A survey on the current status and the opinion of professional oral health care for oral cancer patients

A survey on the current status and the opinion of professional oral health care for oral cancer patients

2. 연구대상자의 전문가 구강건강관리교육 현황 및 참여의사 구강암 환자의 구강건강관리를 수행하는 담당인력의 전문가 구강건강관리교육 현황을 확인한 결과, 치과 의사 7명, 치과위생사 5명, 간호사 2명, 총 14명(29.8%)이 전문가 구강건강관리교육을 받은 것으로 나타났다 . 교육받은 내용은 구강암 환자의 구강건강관리방법이 85.7%로 가장 높았고, 전문가 구강건강관리 를 위해 추가적으로 필요한 교육내용은 ‘구강암 환자의 구강위생관리’, ‘항암치료 중인 환자의 구강건강관리 시, 주의사항’, ‘구강암 환자의 식이요법’을 제안하였다. 구강암 환자의 전문가 구강건강관리교육에 대한 참여 Table 1. Relations between general characteristics and status of receiving professional oral health care education for oral cancer patient, conducting education for oral cancer patient and protector, recognizing importance of professional oral health care더 보기

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Factors predicting the need for hemorrhage control intervention in patients with blunt pelvic trauma: a retrospective study

Factors predicting the need for hemorrhage control intervention in patients with blunt pelvic trauma: a retrospective study

Conclusion OTA/AO type B and C fractures, hypothermia, and in- creased lactate level are independent factors predicting the need for hemorrhage control intervention in patients with blunt pelvic traumas. Type B and C fractures are more likely to be associated with vascular injuries than are type A fractures. Hypothermia is well known to worsen coagulopathy. Lactate is a marker of systemic tis- sue perfusion and is elevated in cases of hypoperfusion of the tissues, such as hemorrhagic shock. These three factors may reflect the severity and occurrence of pelvic bleeding in patients with blunt pelvic trauma. Therefore, the predictors can be helpful in making decisions about management of pelvic bone fractures with hemorrhage.
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